Table of Content

30 September 2025, Volume 40 Issue 9

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Diagnostic roles of transforming growth factor-beta-activated kinase 1 and autophagy-related protein 7 in cerebrospinal fluid of patients with tuberculous meningitis

YAO Yan, GU Juxian, LI Meng, LI Guoce, AI Jingyi, ZHAO Li

2025, 40(9):  829-833.  DOI: 10.3969/j.issn.1673-8640.2025.09.001

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Objective To investigate the diagnostic roles of cerebrospinal fluid transforming growth factor-beta-activated kinase 1（TAK1）and autophagy-related protein 7（ATG7）levels in tuberculous meningitis（TBM）. Methods A total of 80 patients with TBM（TBM group）and 48 patients with bacterial meningitis（control group）were enrolled from the Central Hospital of Cangzhou from March 2019 to June 2022. The levels of cerebrospinal fluid white blood cell count，polymorphonuclear cell proportion，glucose，chloride，procalcitonin（PCT），C-reactive protein（CRP），total protein，TAK1 and ATG7 were determined. Logistic regression analysis was used to evaluate the influencing factors of TBM occurrence. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of cerebrospinal fluid TAK1 and ATG7 levels in diagnosing TBM. Results Compared with control group，the cerebrospinal fluid levels of white blood cell count，total protein，polymorphonuclear cell proportion，PCT，CRP and ATG7 in TBM group were lower（P<0.05），while glucose and TAK1 levels were higher（P<0.05），and the chloride level showed no statistical significance（P>0.05）. Elevated cerebrospinal fluid TAK1 and decreased white blood cell count，total protein and ATG7 were risk factors for TBM occurrence（P<0.05）. The areas under curves（AUC）of single determinations of TAK1，ATG7 and their combined determination were 0.793，0.808 and 0.912，respectively. The AUC of combined determination of TAK1 and ATG7 was higher than those of single determinations（Z values were 2.466 and 2.155，P<0.05）. Conclusions Abnormal levels of cerebrospinal fluid TAK1 and ATG7 are related to TBM and may be used as diagnostic indicators for TBM. The combined determination of TAK1 and ATG7 has a high diagnostic efficacy.

Role of nomogram models based on CAR and NLR in predicting 1-year mortality in elderly patients with hip fractures after surgery

CHU Ye, XIONG Chunxiang, HUANG Yu, ZENG Jiaxing, YI Bode, HUANG Nenggan, YANG Yifeng, YANG Feng

2025, 40(9):  834-840.  DOI: 10.3969/j.issn.1673-8640.2025.09.002

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Objective To investigate the role of nomogram models based on C-reactive protein-to-albumin ratio （CAR） and neutrophil-to-lymphocyte ratio（NLR）in predicting 1-year mortality in elderly patients with hip fractures after surgery. Methods A total of 161 elderly patients with hip fractures who underwent hip replacement surgery at Guangxi Zhuang Autonomous Region People's Hospital from January 2019 to December 2021 were enrolled. The clinical data，surgical-related data and preoperative and postoperative laboratory determination results were collected. Cox regression analysis was used to evaluate the independent risk factors for 1-year mortality in elderly patients with hip fractures after surgery. Cox mortality risk models and nomogram models for predicting 1-year mortality and postoperative 3-month，6-month and 1-year survival rates in elderly patients with hip fractures after surgery were established. Receiver operating characteristic（ROC）curve was used to determine the optimal cut-off value for the total score of the nomogram models to distinguish low-risk，medium-risk and high-risk groups. Kaplan-Meier survival curves were used to analyze the 1-year survival of low-risk，medium-risk and high-risk groups after surgery. Results Age，Charlson comorbidity index（CCI），American Society of Anesthesiologists（ASA）classification，postoperative CAR and postoperative NLR were all independent risk factors for 1-year mortality in elderly patients with hip fractures after surgery [hazard ratios（HR）were 2.745，2.486，3.568，2.597 and 2.518，95% confidence intervals（CI）were 1.377-5.993，1.274-3.738，1.148-6.993，1.126-3.957 and 1.343-3.889，respectively，P<0.01]. Cox mortality risk models and nomogram models for predicting 1-year mortality and 3-month，6-month and 1-year survival in elderly patients with hip fractures after surgery were established based on age，CCI，ASA classification，postoperative CAR and postoperative NLR. Postoperative CAR and postoperative NLR in elderly patients with hip fractures were positively correlated with Cox mortality risk scores. It is negatively correlated with postoperative survival time. The area under curve（AUC）for predicting the mortality of elderly hip fracture patients within 1-year after surgery by the combined determination of the 5 factors was 0.940. The 1-year overall survival rates of low-risk，medium-risk and high-risk groups were decreased successively（P<0.05）. Conclusions The nomogram models based on CAR and NLR for predicting the mortality of elderly hip fracture patients within 1-year after surgery has high clinical application value.

Establishment of a risk assessment model for predicting the prognosis of patients with anti-MDA5 antibody-positive dermatomyositis complicated with interstitial pneumonia based on inflammatory indicators

YUAN Xiwei, WANG Yiwen, FEI Zhangli, HUANG Wan

2025, 40(9):  841-847.  DOI: 10.3969/j.issn.1673-8640.2025.09.003

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Objective To establish a nomogram model based on inflammatory indicators to predict the risk of poor prognosis in patients with anti-melanoma differentiation-associated gene 5（MDA5）antibody-positive dermatomyositis complicated with interstitial pneumonia，and to evaluate its efficacy. Methods A total of 107 patients with anti-MDA5 antibody-positive dermatomyositis complicated with interstitial pneumonia in the First People's Hospital of Jiaxing from February 2022 to October 2023 were enrolled. These patients were classified into good prognosis group（76 cases）and poor prognosis group（31 cases）based on the prognosis after 6 months of treatment. The clinical data were collected，and erythrocyte sedimentation rate（ESR）and the levels of serum ferritin（FER），C-reactive protein（CRP），interleukin-6（IL-6），albumin，as well as neutrophil-to-lymphocyte ratio（NLR），monocyte-to-lymphocyte ratio（MLR），systemic immune-inflammation index（SII）and C-reactive protein-to-albumin ratio（CAR）were performed and determined. Spearman correlation analysis was used to evaluate the correlation between each indicator and the poor prognosis of patients with anti-MDA5 antibody-positive dermatomyositis complicated with interstitial pneumonia. Multivariate Logistic regression analysis was used to evaluate the influencing factors of poor prognosis in patients with anti-MDA5 antibody-positive dermatomyositis complicated with interstitial pneumonia. A nomogram model was established. The efficiency of nomogram model was evaluated by receiver operating characteristic（ROC）curve，decision curve，calibration curve and Hosmer-Lemeshow goodness-of-fit test. Results The ESR，NLR，SII，FER，CRP and CAR in poor prognosis group were higher than those in good prognosis group（P<0.001），while there was no statistical significance in MLR and IL-6 between the 2 groups（P>0.05）. Anti-MDA5 antibody +++，ESR，NLR，SII，FER，CRP and CAR were all positively correlated with the poor prognosis of patients with anti-MDA5 antibody-positive dermatomyositis complicated with interstitial pneumonia（P<0.05）. SII，FER and CAR were independent risk factors for poor prognosis in patients with anti-MDA5 antibody-positive dermatomyositis complicated with interstitial pneumonia（P<0.05）. Based on SII，FER and CAR，a nomogram model was established to predict the poor prognosis of patients with anti-MDA5 antibody-positive dermatomyositis complicated with interstitial pneumonia. The area under curve（AUC）of the nomogram model was 0.987. The fit of the nomogram model was high（Hosmer-Lemeshow χ²=1.983，p=0.982），and the clinical net benefit was >0 within the threshold probability range of 0 to 0.99，with the maximum net benefit value of 0.27. Conclusions The nomogram model established based on SII，FER and CAR has a high clinical efficacy in evaluating the prognosis of patients with anti-MDA5 antibody-positive dermatomyositis complicated with interstitial pneumonia.

Roles of serum copeptin in clinical diagnosis and prognosis evaluation of acute myocardial infarction

XU Yingqian, WANG Jinquan, PENG Huanzi, PENG Jiaqi, HE Kun, XIE Xiaobing

2025, 40(9):  848-855.  DOI: 10.3969/j.issn.1673-8640.2025.09.004

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Objective To investigate the role of serum copeptin in the early diagnosis and prognosis assessment of acute myocardial infarction （AMI）. Methods A total of 102 AMI patients（AMI group）and 55 non-AMI patients（control group）from the First Affiliated Hospital of Hunan University of Chinese Medicine from January 2023 to January 2024 were enrolled. The clinical data were collected，and serum copeptin，creatine kinase MB isoenzyme（CK-MB），cardiac troponin（cTn）I，myoglobin（MYO） and blood lipid levels were determined. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of each index in diagnosing AMI and predicting major adverse cardiovascular events（MACE）within 6 months. Spearman correlation analysis was used to assess the correlation between serum copeptin and CK-MB，cTnI and MYO in AMI patients. Cox proportional hazard regression analysis was used to evaluate the relationship between each indicator and the occurrence of MACE in AMI patients. Results The levels of serum copeptin，CK-MB，MYO and cTnI in AMI group were higher than those in control group（P<0.001）. Serum copeptin was positively correlated with cTnI and MYO levels（r values were 0.578 and 0.624，respectively，P<0.001），but not with CK-MB（r=0.158，p=0.113）. The area under curve（AUC）of serum copeptin for diagnosing AMI was 0.896，and that for predicting MACE within 6 months in AMI patients was 0.810. The AUC of copeptin+cTnI，CK-MB+MYO+cTnI and the combined determination of the 4 indicators for diagnosing AMI were 0.960，0.975 and 0.986，respectively，and those for predicting MACE within 6 months in AMI patients were 0.961，0.958 and 0.949，respectively. Serum copeptin，MYO and cTnI were risk factors for MACE within 6 months in AMI patients [hazard ratios（HR）were 1.005，1.004 and 1.070，95% confidence intervals（CI）were 1.001-1.008，1.000-1.008 and 1.015-1.128，respectively]. Conclusions Serum copeptin has high efficacy in the diagnosis of AMI and the prediction of MACE within 6 months，and it may be used as a biomarker for the early diagnosis and prognosis assessment of AMI.

Diagnostic roles of serum syndecan-1 and eNAMPT levels in patients with severe pneumonia complicated with sepsis

ZHAO Lixiao, YANG Xiaoting, LI Dan, ZHANG Nan, SU Haiyan, WANG Yan

2025, 40(9):  856-861.  DOI: 10.3969/j.issn.1673-8640.2025.09.005

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Objective To investigate the diagnostic roles of serum syndecan-1 and extracellular nicotinamide phosphoribosyltransferase（eNAMPT）levels in patients with severe pneumonia（SP）complicated with sepsis. Methods A total of 168 SP patients admitted to Zhangjiakou First Hospital from June 2019 to October 2023 were enrolled. They were classified into SP with sepsis group（52 cases）and SP without sepsis group（116 cases）based on whether they developed sepsis after admission. The SP with sepsis group was further classified into sepsis group（38 cases）and septic shock group（14 cases）according to the sequential organ failure assessment（SOFA）score. Additionally，they were classified into survival group（35 cases）and death group（17 cases）based on the prognosis. Serum syndecan-1 and eNAMPT levels were determined by enzyme-linked immunosorbent assay（ELISA）. Pearson correlation analysis was used to evaluate the correlation between syndecan-1，eNAMPT levels and inflammatory indicators. Multivariate Logistic regression analysis was used to assess the factors influencing sepsis in SP. Receiver operating characteristic（ROC）curve was used to analyze the diagnostic value of serum syndecan-1 and eNAMPT levels for sepsis in SP. Results The levels of serum C-reactive protein（CRP），interleukin-6（IL-6），cardiac troponin I（cTnI），procalcitonin（PCT），white blood cell（WBC）count，syndecan-1 and eNAMPT in SP with sepsis group were higher than those in SP without sepsis group（P<0.001）. The levels of serum syndecan-1 and eNAMPT in septic shock group were higher than those in sepsis group（P<0.001）. Compared with survival group，the levels of serum syndecan-1 and eNAMPT in death group were increased（P<0.001）. Serum syndecan-1 and eNAMPT levels were positively correlated with CRP，IL-6，cTnI，PCT and WBC count（P<0.001）. Serum syndecan-1，eNAMPT，CRP，IL-6，cTnI，PCT and WBC count were all risk factors for sepsis in SP（P<0.05）. The areas under curves（AUC）of serum syndecan-1，eNAMPT single and combined determinations for diagnosing sepsis in SP were 0.660，0.812 and 0.844，respectively. The AUC of the combined determination determination diapnosis medel for SP with sepsis based on multivariate Logistic regression analysis was 0.981. Conclusions The levels of serum syndecan-1 and eNAMPT in SP patients with sepsis are increased，which are related to the severity and prognosis. The combined determination with conventional inflammatory indicators has a better diagnostic efficiency for sepsis in SP.

Relationship between serum miR-125b and miR-423 expressions in patients with pulmonary tuberculosis and the disease activity and prognosis

FU Ai

2025, 40(9):  862-866.  DOI: 10.3969/j.issn.1673-8640.2025.09.006

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Objective To investigate the relationship between the expressions of serum miR-125b and miR-423 and the activity of pulmonary tuberculosis and the prognosis of patients. Methods A total of 102 patients with active pulmonary tuberculosis（APTB）（APTB group），112 patients with latent tuberculosis infection（LTBI）（LTBI group） and 120 healthy subjects（healthy control group）were enrolled from January 2020 to June 2021 in Changsha Central Hospital Affiliated to South China University. The relative expression levels of serum miR-125b and miR-423 and the levels of serum tumor necrosis factor-alpha（TNF-α）and interleukin-6（IL-6）were determined. According to the therapeutic effect of APTB patients after 6 months of treatment，they were classified into clinical control group（86 cases）and clinical non-control group（16 cases）. Pearson correlation analysis was used to evaluate the correlation between the expressions of serum miR-125b and miR-423 and the levels of TNF-α and IL-6. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of each index in judging the clinical non-control of APTB patients. Results The relative expression levels of serum miR-125b and miR-423 and the levels of serum TNF-α and IL-6 in healthy control group，LTBI group and APTB group were increased successively（P<0.001）. The relative expression levels of serum miR-125b and miR-423 and the levels of serum TNF-α and IL-6 in clinical non-control group were higher than those in clinical control group（P<0.001）. The areas under curves（AUC）of miR-423 and miR-125b single determinations for judging the clinical non-control of APTB patients were 0.830 and 0.852，respectively. The AUC of miR-423+miR-125b and miR-423+miR-125b+TNF-α+IL-6 combined determinations for judging the clinical non-control of APTB patients were 0.910 and 0.942，respectively. The expressions of miR-125b and miR-423 in the serum of APTB patients were positively correlated with the levels of IL-6 and TNF-α（P<0.001）. Conclusions The expressions of miR-125b and miR-423 in the serum of APTB patients are increased，with high clinical value in the judgment of disease activity and therapeutic effect evaluation of APTB.

Expressions and roles of WDR5 and miR-455-5p in cervical cancer patients

LIU Hao, FU Miao, LIU Peng, TIAN Wen, WANG Sha, YIN Xiaomei, WANG Donghai

2025, 40(9):  867-874.  DOI: 10.3969/j.issn.1673-8640.2025.09.007

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Objective To investigate the roles of WD repeat-containing protein 5（WDR5） and miR-455-5p in the diagnosis and prognosis assessment of cervical cancer. Methods A total of 78 patients with cervical cancer（cervical cancer group） and 78 patients with cervical intraepithelial neoplasia（CIN）（grade Ⅱ-Ⅲ）（CIN group） from September 2018 to June 2020 in Baoding Second Central Hospital were enrolled，and 78 healthy females undergoing physical examination were enrolled as healthy control group. The clinical data were collected，and the levels of serum WDR5 protein and the relative expression levels of WDR5 mRNA and miR-455-5p were determined. The expression of WDR5 protein in cancer tissues and adjacent tissues（>5 cm away from the tumor margin） was also determined. The cervical cancer patients were followed up for 3 years. Pearson correlation analysis was used to evaluate the correlation between serum WDR5 mRNA and miR-455-5p expression. Kaplan-Meier survival curve was used to analyze the relationship between the expression of WDR5 mRNA and miR-455-5p and the prognosis（death）of cervical cancer patients. Cox regression analysis was used to evaluate the influencing factors of prognosis in cervical cancer patients. Receiver operating characteristic（ROC）curves were used to evaluate the efficacy of serum WDR5 mRNA and miR-455-5p in diagnosing cervical cancer and predicting the prognosis（death）of cervical cancer patients. Results The relative expression levels of WDR5 mRNA and the levels of WDR5 in serum were successively increased in cervical cancer group，CIN group and healthy control group（P<0.001），while the relative expression levels of miR-455-5p were successively decreased（P<0.001）. The positive rate of WDR5 in cancer tissues of cervical cancer patients（76.92%） was higher than that in adjacent tissues（11.54%）（P<0.001）. There was statistical significance in the relative expression levels of serum WDR5 mRNA and miR-455-5p among cervical cancer patients with different TNM stages，maximum tumor diameters，invasion depths，differentiation degrees and lymphatic metastasis（P<0.05）. Serum WDR5 mRNA was negatively correlated with miR-455-5p in cervical cancer patients（r=-0.405，P<0.001）. The areas under curves（AUC）of single and combined determinations of serum WDR5 mRNA and miR-455-5p for diagnosing cervical cancer were 0.767，0.756 and 0.883，respectively. The AUC for predicting the prognosis（death）of cervical cancer patients were 0.857，0.798 and 0.861. The 3-year overall survival rate of high-expression group of WDR5 was lower than that of low-expression group（Log-rank χ²=5.932，P=0.015），and the 3-year overall survival rate of high-expression group of miR-455-5p was higher than that of low-expression group（Log-rank χ²=4.859，P=0.027）. High expression of WDR5 mRNA，low expression of miR-455-5p，moderate to low differentiation，TNM stage Ⅲ-Ⅳ，invasion depth≥1/2 of the myometrium，maximum tumor diameter≥4 cm and lymphatic metastasis were all risk factors for death in patients with cervical cancer（P<0.05）. Conclusions The levels of WDR5 in serum and the expression of WDR5 mRNA in patients with cervical cancer are increased，while the expression of miR-455-5p is decreased，and these are related to the clinical pathological characteristics. They may serve as biomarkers for the diagnosis，disease monitoring and prognosis assessment of patients with cervical cancer.

Relationship between sd-LDL-C/HDL-C and short-term prognosis of percutaneous coronary intervention in patients with acute myocardial infarction

WANG Chunhong

2025, 40(9):  875-880.  DOI: 10.3969/j.issn.1673-8640.2025.09.008

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Objective To investigate the relationship between the ratio of small and dense low-density lipoprotein cholesterol（sd-LDL-C）to high-density lipoprotein cholesterol（HDL-C）and the short-term prognosis of patients with acute myocardial infarction（AMI）after percutaneous coronary intervention（PCI）. Methods A total of 218 AMI patients who underwent PCI in Hohhot Mongolian Hospital of Traditional Chinese Medicine from January 2020 to December 2023 were enrolled. The clinical data and preoperative laboratory determination results were collected，the levels of sd-LDL-C and HDL-C before PCI were determined，and the sd-LDL-C/HDL-C ratio was calculated. The patients were classified into good prognosis group（153 cases）and poor prognosis group（65 cases）based on the short-term（1 month）prognosis after PCI. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of various indicators in predicting the poor short-term prognosis of AMI patients after PCI. Results There was statistical significance in the proportions of myocardial infarction area，smoking history and hypertension between good prognosis group and poor prognosis group（P<0.05），while there was no statistical significance in the other clinical data between the 2 groups（P>0.05）. There was statistical significance in the levels of low-density lipoprotein cholesterol（LDL-C），sd-LDL-C，HDL-C and sd-LDL-C/HDL-C ratio between poor prognosis group and good prognosis group（P<0.05），while there was no statistical significance in the other indicators between the 2 groups（P>0.05）. Myocardial infarction area≥50%，smoking history，hypertension，elevated LDL-C，elevated sd-LDL-C，decreased HDL-C and elevated sd-LDL-C/HDL-C ratio were risk factors for the poor short-term prognosis of AMI patients after PCI（P<0.05）. The areas under curves（AUC）of single and combined determinations of LDL-C，sd-LDL-C，HDL-C and sd-LDL-C/HDL-C ratio for predicting the prognosis of AMI patients were 0.651，0.868，0.850，0.919 and 0.934，respectively. Conclusions The sd-LDL-C/HDL-C ratio is associated with poor short-term prognosis in AMI patients after PCI，which can be used as one of the indicators for evaluating the short-term prognosis of AMI patients after PCI.

Result analysis of nucleic acid testing in different specimen types for human cytomegalovirus

WANG Chunwei, MA Xiuqing, QI Guochang, CAI Xingyao

2025, 40(9):  881-884.  DOI: 10.3969/j.issn.1673-8640.2025.09.009

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Objective To analyze the roles of different specimen types for human cytomegalovirus（HCMV）nucleic acid testing. Methods Specimens such as breast milk，amniotic fluid，morning urine，sputum，serum and cerebrospinal fluid from suspected HCMV-infected or breast milk HCMV-DNA positive infants at Qinghai Red Cross Hospital from 2022 to 2023 were collected. Fluorescence quantitative polymerase chain reaction（PCR）was used，and the differences in HCMV positive rates among different specimen types were compared. Results Among all the specimen types，the HCMV determination rate in breast milk was the highest（67.93%）. The HCMV positive rates of urine，sputum，serum and cerebrospinal fluid of the corresponding breast milk HCMV-DNA positive infants were 16.92%，12.50%，2.64% and 0.12%，respectively（P<0.001）. There was no statistical significance in HCMV positive rates among infants with different genders and for different specimen types（P>0.05）. There were 115 cases of HCMV-DNA positive in the serum（21 cases），cerebrospinal fluid（1 case），sputum（20 cases）and urine（73 cases）of ≤30 d infants. Conclusions Using qPCR to determine HCMV-DNA amniotic fluid can provide a reference for early diagnosis of intrauterine infection to prevent neonatal infection.

Risk factors，drug resistance and virulence analysis of Klebsiella pneumoniae bloodstream infection

LI Li, DU Jinye, WANG Xinyi, DAI Jing

2025, 40(9):  885-891.  DOI: 10.3969/j.issn.1673-8640.2025.09.010

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Objective To investigate the risk factors，drug resistance and virulence characteristics of bloodstream infection（BSI）caused by Klebsiella pneumoniae（KPN），in order to provide a reference for clinical intervention and treatment. Methods From April 2018 to September 2023，64 KPN patients with BSI（observation group）and 66 KPN patients without BSI（control group）were enrolled from the North Branch of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. The clinical data and pathogenic differences between the 2 groups were compared. The virulence of KPN in blood was determined by mucin filament test and virulence gene determination. Logistic regression analysis was used to evaluate the influencing factors of KPN BSI occurrence. Results The department distribution of 64 KPN BSI patients was mainly in the intensive care unit（ICU）（40.6%），and 59.4% of the patients had primary infection，mainly with respiratory system infection（73.7%）. Deep venous catheterization was an independent risk factor for KPN BSI [odds ratio（OR）=14.708，95% confidence interval（CI）was 4.051-53.401，P<0.001]. The drug resistance rates of BSI KPN to β-lactams，quinolones and compound sulfamethoxazole were 60%-70%，while the drug resistance rate to aminoglycosides was relatively low（<50%）. Totally 39 isolates（60.9%）of carbapenem-resistant Klebsiella pneumoniae（CRKP）were determined. The use of intravenous catheters and respiratory system infection were independent risk factors for CRKP infection in KPN BSI patients. Among the 64 KPN isolates，10 isolates（15.6%）showed positive results in the mucin filament test. There were 3 isolates of CRKP，among which 1 isolate was isolated from a patient with BSI and liver abscess. This isolate carried the rmpA2，magA，iucA，iroN and alls genes simultaneously，and it was a carbapenem-resistant hypervirulent Klebsiella pneumoniae（CR-hvKP）. Conclusions Patients with CRKP infection in the primary lesion and deep venous catheterization are prone to BSI. Clinically，it is necessary to routinely monitor CR-hvKP to take timely prevention and control measures.

Adult reference ranges for platelet count and platelet-related parameters using fluorescence method in Wuhan

ZHANG Hui, YUAN Jingwen, ZHANG Chi

2025, 40(9):  892-896.  DOI: 10.3969/j.issn.1673-8640.2025.09.011

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Objective To establish the reference ranges for fluorescence-based platelet count（PLT-F）and platelet-related parameters for healthy adults in Wuhan. Methods A total of 1 067 healthy subjects aged ≥18 years who underwent physical examinations at Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from November 2021 to August 2023 were enrolled. Venous whole blood samples were collected，and the mean platelet volume（MPV），platelet distribution width（PDW），platelet-larger cell ratio（P-LCR），platelet hematocrit（PCT）and immature platelet fraction（IPF）were determined using automatic hematology analyzer. The data were grouped by gender and age for comparison，and the reference ranges were established. Results There was no statistical significance in IPF and PDW between different genders and ages（P>0.05）. The reference ranges were（0.90-9.86）fL and（9.5-18.1）%，respectively. The reference ranges of MPV and P-LCR% for males were（9.11-12.69）fL and（17.90-46.09）%，while those for females were（9.27-13.00）fL and（18.05-48.87）%. The reference ranges of PLT-F and PCT for males in the young，middle-aged and elderly groups were（161-384）×10⁹L^-1，（147-374）×10⁹L^-1 and（118-366）×10⁹L^-1，respectively. For females，the reference ranges of PLT-F and PCT were（149-404）×10⁹L^-1，（157-375）×10⁹L^-1 and（124-356）×10⁹L^-1，respectively. The reference ranges of PCT for males in the young，middle-aged and elderly groups were（0.19-0.36）%，（0.17-0.37）% and（0.15-0.38）%，respectively. For females，the reference ranges of PCT were（0.17-0.43）%，（0.18-0.40）% and（0.15-0.36）%，respectively. The reference ranges were verified and showed a 100% accuracy rate. Conclusions The reference ranges for PLT-F and PLT-related parameters for adults in Wuhan have preliminarily been established.

Role of MicroR in guiding platelet count re-examination

CHEN Wenli, JIN Cheng, ZHOU Lulu, XU Weiyi

2025, 40(9):  897-900.  DOI: 10.3969/j.issn.1673-8640.2025.09.012

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Objective To analyze the role of the re-examination rule for platelet（PLT）count based on MicroR，mean corpuscular volume（MCV）and red blood cell distribution width（RDW）developed by fully automatic hematology analyzer. Methods Blood samples from 526 outpatients at the First Affiliated Hospital of Zhejiang University School of Medicine（experimental group）and 68 healthy subjects（control group）were collected from June 2023 to March 2024. Additionally，161 samples from patients at the First Affiliated Hospital of Zhejiang University School of Medicine in the same period were collected as re-examination positive verification samples for the rule，and 70 samples from healthy subjects were collected as re-examination negative verification samples. The XN-20 hematology analyzer was used in PLT-F mode to determine various blood routine indicators. The differences in the determination results between the 2 groups were compared. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of MCV，RDW and MicroR in guiding PLT re-examination. The MicroR re-examination rule was verified using the re-examination verification samples. Results There was statistical significance in white blood cell count，hemoglobin（Hb），MCV，RDW，PLT count and MicroR between experimental group and control group（P<0.05），while there was no statistical significance in red blood cell count，mean PLT volume and PLT-larger cell ratio（P>0.05）. The areas under curves for MicroR，MCV and RDW in guiding PLT count re-examination were 0.716，0.720 and 0.474，respectively. The sensitivities were 80.0%，72.9% and 16.0%，respectively，and the specificities were 52.7%，62.1% and 72.4%，respectively. When MicroR≥16.5%，the true positive rate，true negative rate，false positive rate and false negative rate of PLT re-examination were 93%，52%，48% and 7%，respectively. Conclusions The ability of MicroR to guide PLT count re-examination is comparable to that of MCV but significantly better than that of RDW. It is recommended that clinical laboratories set the MicroR≥16.5% re-examination rule in daily work to replace the MCV<75 fL and RDW>22% rules.

Role of peripheral blood lymphocyte morphological classification in curative effect judgment of critical influenza

WANG Qiuju, XIAO Huijian, WU Shuang, ZHAO Wanting, DAI Xubo, ZHUANG Yuepeng

2025, 40(9):  901-906.  DOI: 10.3969/j.issn.1673-8640.2025.09.013

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Objective To analyze the correlation between peripheral blood lymphocyte morphological classification and lymphocyte subsets，and to investigate its role in the curative effect judgment of critical influenza. Methods From June 2018 to May 2024，142 patients with critical influenza and 126 healthy subjects without influenza infection and with nucleic acid testing negative （control group） admitted to the 910th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China were enrolled. Blood smears were prepared. According to lymphocyte characteristics，lymphocytes were classified into ClassⅠ，Ⅱ and Ⅲ. According to B lymphocyte count，ClassⅠlymphocyte count，T lymphocyte count，ClassⅡ lymphocyte count，natural killer（NK）cell count and ClassⅢ lymphocyte count，they were classified into Group A，Group B and Group C. The differences in various indicators among the groups were compared. Pearson correlation analysis was used to evaluate the correlation between the proportion of peripheral blood lymphocyte classification and flow cytometry. Multivariate Logistic regression analysis was used to assess the risk factors for the conversion of critical influenza. Results Compared with control group，ClassⅡ lymphocyte count in critical influenza group was decreased （P<0.05）. ClassⅡand T lymphocyte count in death patients of critical influenza group remained low. The Class Ⅱ and T lymphocyte count in recovered patients of critical influenza group gradually returned to normal. Group A，Group B and Group C showed a positive correlation （r= 0.757，P<0.01）. T lymphocyte，ClassⅡ lymphocyte，B lymphocyte，NK cell，ClassⅠlymphocyte and ClassⅢ lymphocyte counts were all risk factors for critical influenza （P<0.05）. Conclusions The correlation between lymphocyte morphological classification and lymphocyte subsets is good. In patients with critical influenza，the increase of ClassⅡ lymphocyte count in peripheral blood can indicate improvement of the condition，while low values indicate poor prognosis.

Status of clinical research on pancreatic enzyme markers

CHEN Fujun, CHEN Maoming

2025, 40(9):  918-924.  DOI: 10.3969/j.issn.1673-8640.2025.09.016

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The pancreas is one of the important digestive organs in the human body. The enzymes secreted by it can be classified into carbohydrate-degrading enzymes [such as amylase （AMY），maltase]，protein-degrading enzymes （trypsin，elastase，chymotrypsin，carboxypeptidase A，carboxypeptidase B） and fat-degrading enzymes [lipase （LPS），phospholipase A2 （PLA2）]. Currently，pancreatic enzymes like AMY and LPS have been widely used as biomarkers for pancreatic-related diseases in clinical practice. Serum elastase 1 not only has significant reference value for the diagnosis of acute and chronic pancreatitis，but also，when combined with tumor markers，can significantly increase the positive determination rate of early pancreatic cancer （early pancreatic head cancer）. Moreover，elastase 1 in fecal samples can be used as a biomarker for evaluating pancreatic exocrine function. Serum trypsin can be used to predict pancreatitis after endoscopic retrograde cholangiopancreatography （ERCP），and its predictive efficacy is superior to AMY. This review presents the current clinical research status of main pancreatic enzyme markers such as AMY，LPS，trypsin and elastase，and focuses on summarizing the clinical research progress of elastase 1 and trypsin，providing references for clinical diagnosis of pancreatic diseases and assessment of pancreatic exocrine function.