Objective To investigate the prognostic value of serum high mobility group box-B1 (HMGB1) in the patients with sepsis. Methods A total of 342 patients with sepsis who were admitted to Renji Hospital (South Campus) Shanghai Jiao Tong University School of Medicine, from January 2018 to December 2021 were enrolled. There were 192 male and 150 female sepsis patients, with an average age of (60.54±17.85) years. The patients were divided into the survival group and the death group based on 28-day outcome. The clinical data were collected and the level of HMGB1 on admission was tested. COX multivariate regression was used to analyze the risk factors for poor prognosis of the sepsis patients. Pearson correlation analysis was performed to analyze the correlation between serum HMGB1, sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score. Receiver operator characteristic (ROC) curves were drawn to analyze the area under the ROC curve (AUC) and cut-off value of serum HMGB1 to evaluate the prognosis of sepsis. According to the cut-off value of serum HMGB1, the patients were divided into high level group and low level group. Kaplan Meier survival curve was drawn to further analyze the relationship between serum HMGB1 and prognosis. Results The mortality rate of sepsis patients was 29.2% (n=100). The indexes which included the level of serum HMGB1, C-reactive protein, procalcitonin, white blood cell count, lactic acid level, SOFA and APACHEⅡ score, the proportion of respiratory tract infection, septic shock, disseminated intravascular coagulation and mechanical ventilation in sepsis death group were significantly higher than those in survival group (all P<0.05), while the proportion of diabetes mellitus and urinary tract infection were significantly lower than those in survival group (all P<0.05). Multiple regression analysis showed that serum HMGB1 level, SOFA score, white blood cell count and respiratory tract infection were the risk factors for 28-day mortality. Pearson correlation analysis presented that serum HMGB1 level was positively correlated with SOFA score and APACHEⅡ score in the sepsis patients (P<0.001). The ROC curve showed that AUC of HMGB1, SOFA score and APACHEⅡ score for predicting 28-day mortality were 0.776, 0.774 and 0.760, respectively. Kaplan Meier survival curve found that 28-day mortality was significantly higher in the patients with higher HMGB1 levels than those with lower HMGB1 levels (P<0.001). Conclusions Serum HMGB1 level increased significantly in the death group, which was one of the risk factors for predicting 28-day mortality, and its predictive efficacy was not inferior to SOFA and APACHEⅡ score.

Objective To investigate the effect of sarcopenia combined with abdominal obesity on muscle strength and somatic function in the elderly. Methods A total of 94 patients who met the admission criteria were enrolled in the ninth ward and comprehensive ward of Shanghai Fourth Rehabilitation Hospital from January to June in 2021. Bioelectrical impedance analysis(BIA) was used to measure the body composition in all subjects, and muscle strength and somatic function were evaluated, and lumbar 3 vertebral CT image analysis was used to assess the fat distribution in all patients with sarcopenia. Stepwise regression was used to analyze the influencing factors of muscle strength and somatic function in them. Results The prevalence of sarcopenia among elderly hospitalized patients was 70.7% in men and 69.8% in women, and the proportion of abdominal obesity was 39.0% in men and 40.0% in women. In patients with sarcopenia and abdominal obesity, the scores of muscle strength and somatic function in men were significantly lower than those in the non-sarcopenia group (P<0.05), and also lower than those in the sarcopeniaonly only group, in which the five-repetition-sit-to-stand test (5STS) time were significantly longer than those in the sarcopeniaonly only group (P<0.05). While the results in women were converse, in which the scores of muscle strength and somatic function significantly were lower than those in the non-sarcopenia group (P<0.05), while higher than or comparable to those in the sarcopeniaonly only group, in which the grip strength was significantly greater than that in the sarcopeniaonly only group(P<0.05). Stepwise regression analysis showed that 5STS time in male patients with sarcopenia was positively correlated with waist circumference, and negatively correlated with appendicular muscle mass index (ASMI) (P<0.05); in female patients: grip strength was negatively correlated with body mass index (BMI), and positively correlated with ASMI and subcutaneous fat area (SFA) (P<0.05). Bone mineral content(BMC) was negatively correlated with 5STS(P<0.05). Conclusions Abdominal obesity aggravated the deterioration of muscle strength and somatic function in male sarcopenia patients, and the protective effect on female sarcopenia patients could be due to a certain amount of subcutaneous fat and higher ASMI and BMC.

Objective To investigate if the inflammation mediated the association of body mass index(BMI) and the atherosclerosis. Methods A total of 4 508 subjects were randomly recruited from Gaoyou, and the indexes including the demographic characteristics, BMI, blood routine, biochemical test, disease history and brachial-ankle pulse wave velocity (baPWV) were measured. According to BMI, they were divided into low body weight group(BMI<18.5 kg/m²), normal weight group (18.5 kg/m²≤BMI<24 kg/m²), overweight group (24 kg/m²≤BMI<28 kg/m²) and obesity group (BMI≥28 kg/m²). The univariate and multivariate linear regression analysis was used to analyze the correlation between BMI and baPWV. The mediation analysis was used to evaluate whether white blood cell count was involved in the correlation between BMI and baPWV. Results After adjustment of age, gender, systolic blood pressure, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, creatinine, smoking, drinking, diabetes and antihypertensive treatment, compared with normal weight group, the regression coefficient and 95% confidence interval of low body weight group, overweight, obesity group with baPWV were 1.01(0.51-1.51), -0.12(-0.27-0.02) and -0.28(-0.49- -0.08), respectively. The mediation analysis showed that white blood cell count mediated the correlation of BMI and baPWV, the mediation percentage of low body weight, overweight and obesity groups were 3.3%, 11.4% and 9.8%, respectively(all P<0.05). Conclusions The people of low weight could have a higher risk of atherosclerosis, and the inflammation might mediate the correlation between BMI and arterial stiffness.

Objective To investigate the correlations and 5-year changes of metabolic traits in elderly patients with chronic non-communicable diseases. Methods Between January and December 2016, 159 patients with chronic non-infectious diseases were included and followed up until December 2020. Clinical data and biochemical indicators tested in first time (baseline metabolic traits) and every following year were collected. Spearman correlation coefficients were used to analyze correlations among baseline metabolic traits, as well as 5-year changes in metabolic traits. Results Spearman correlation analysis showed that systolic blood pressure in baseline cross-sectional analysis was significantly positively correlated with 2 h blood glucose (r=0.371), fasting insulin (r=0.287), C-reactive protein (r=0.379) and serum uric acid (r=0.268) levels (all P<0.05); while it was negatively correlated with high-density lipoprotein (r=-0.308) and apolipoprotein A (r=-0.311) (both P<0.05). Systolic blood pressure was positively correlated with C-reactive protein level (r=0.305, P<0.05), and negatively correlated with high-density lipoprotein level (r=-0.269, P<0.05). Fasting insulin and 2 h insulin was associated with low density lipoprotein(r=0.349, 0.287), fasting insulin and 2 h insulin were correlated with apolipoprotein B (r=0.290, 0.259), 2 h blood glucose and fasting insulin were positively correlated with serum uric acid (r=0.287 and 0.327, respectively) (all P<0.05). The changes of high-density lipoprotein and apolipoprotein A levels were significantly negatively correlated with the changes of C-reactive protein(r=-0.295, -0.377) and blood uric acid (r=-0.263, -0.262) levels (P<0.05). The changes of low-density lipoprotein and apolipoprotein B levels were significantly positively correlated with the changes of blood uric acid (r=0.258 and 0.257, respectively) (P<0.05). Conclusions The changes of blood pressure, glucose traits, lipids profile and inflammatory traits among the elderly patients with chronic non-infectious diseases showed significantly correlation and a synergistic trend.

Objective To explore the potential pathogenesis-related long non-coding RNA (lncRNA) in gouty arthritis (GA) and the correlation with inflammatory factors. Methods GA microarray data were obtained from the Gene Expression Omnibus(GEO) database, and key lncRNA was identified and intersected by multiple machine learning methods. mRNAs co-expressed with lncRNAs were performed GO enrichment analysis. Kyoto encyclopedia of genes and genomes (KEGG) signaling pathway analysis was accomplished. The expression of key lncRNAs in GA patients was verified using quantitative real-time polymerase chain reaction(qRT-PCR) and the correlation between lncRNA and inflammatory factor levels was analyzed. The diagnostic value of LINC01465 expression levels in GA patients was analyzed by receiver operator characteristic(ROC) curves. Results One key lncRNA(LINC01465) was identified. GO enrichment analysis showed that the genes co-expressed with LINC01465 were enriched in RNA splicing, oxidative phosphorylation, reduced nicotinamide adenine dinucleotide (NADH ) dehydrogenase activity and other functions. KEGG signaling pathway analysis presented that it was mainly enriched in metabolic and inflammatory pathways such as nicotinate and nicotinamide metabolism, phosphoinositide 3-kinase(PI3K)-Akt, tumor necrosis factor signaling pathway. The qRT-PCR results exhibited that LINC01465 expression was upregulated in the patients with GA and was proportional to the expression of hematocrit, C-reactive protein and interleukin-6. The area under the receiver operator characteristic curve(AUC) was 0.86. Conclusions LINC01465 could be a potential diagnostic and therapeutic target for GA.