Table of Content

30 May 2021, Volume 36 Issue 5

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Correlation between serum retinol binding protein 4,homocysteine and blood lipid with atherosclerosis

KONG Fanbin, YUAN Yong, JI Yong, LI Zheng, CHEN Qi, WU Xiaoming, GAO Hui

2021, 36(5):  467-470.  DOI: 10.3969/j.issn.1673-8640.2021.05.001

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Objective To study the relationship of serum retinol binding protein 4（RBP4）,homocysteine（Hcy） and blood lipid with atherosclerosis. Methods According to the carotid intima-medium thickness（IMT）,39 cases were classified into normal carotid IMT group,and 197 cases were classified into increased carotid IMT group. RBP4,Hcy and blood lipids [total cholesterol（TC）,triglyceride（TG）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）,apolipoprotein A1（apo A1） and apolipoprotein B（apo B）] were determined. The correlation between RBP4,Hcy and blood lipids in atherosclerosis group was analyzed. Results The levels of TG,LDL-C,Hcy and RBP4 were higher in increased carotid IMT group than those in normal carotid IMT group（P=0.000）,and HDL-C and apo A1 were lower（P=0.000）. TC and apo B levels had no statistical significance between the 2 groups（P>0.05）. Spearman correlation analysis showed that RBP4 level was positively correlated with TG（r=0.745,P<0.05）,and there were negative correlations with HDL-C（r=-0.727,P<0.05）and apo A1（r=-0.512,P<0.05）. TC was correlated positively with LDL-C（r=0.883,P<0.05） and apo B（r=0.850,P<0.05）,while TG was correlated negatively with HDL-C（r=-0.679,P<0.05） and apo A1（r=-0.336,P<0.05）. The other items had no correlation（P>0.05）. Logistic regression analysis results showed that the regression equations of RBP4 and TG,HDL-C and apoA1 were Y=32.07X-15.30（r=0.745,P<0.05）,Y=-190.84X³+963.61X²-1 493.03X+746.06（r=0.861,P=0.000） and Y=-342.66X³+1 571.76X²-2 372.02X+1 212.93（r=0.670,P=0.000）,respectively. Conclusions RBP4 is associated with blood lipids,while Hcy is not associated with RBP4 and blood lipids. RBP4,Hcy and blood lipids are related to atherosclerosis.

Roles of AST,m-AST and m-AST/AST in preoperative and postoperative evaluation of patients with CHD and AMI

ZHANG Xilin, SHEN Yifeng, ZHU Jing, ZHANG Chunyan, SHAO Wenqi, WANG Beili, GUO Wei

2021, 36(5):  471-476.  DOI: 10.3969/j.issn.1673-8640.2021.05.002

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Objective To evaluate the performance of immunosuppressive assay for mitochondrial aspartate aminotransferase（m-AST）,and to investigate the changes of serum aspartate aminotransferase（AST）,m-AST and m-AST/AST in patients with coronary heart disease（CHD） and acute myocardial infarction（AMI）. Methods The determination performance（precision,accuracy,linear range,reference interval,maximum dilution ratio）of immunosuppressive assay for m-AST was evaluated. Totally,44 patients with CHD undergoing drug-eluting stent implantation and 44 emergency patients with AMI undergoing percutaneous coronary intervention（PCI） were enrolled. Preoperative and postoperative AST and m-AST levels were determined,the ratio of m-AST/AST was calculated,and their correlations with Gensini score were analyzed. Results The precision,accuracy,linear range and reference interval of immunosuppressive assay for m-AST were all verified,which met the clinical requirements,and the maximum dilution ratio was 1∶10. There was no statistical significance in the levels of AST,m-AST and m-AST/AST between CHD patients before and after PCI（P>0.05）. The levels of AST,m-AST,cardiac troponin T（cTnT）,creatine kinase MB isoenzyme mass（CK-MB mass） and N-terminal B-type natriuretic peptide（NT-proBNP） in AMI patients after PCI were higher than those before PCI（P<0.05）,and the m-AST/AST was lower than that before PCI（P<0.05）. There was no statistical significance in the levels of AST,m-AST and m-AST/AST between CHD patients and AMI patients with different Gensini scores before and after operation（P>0.05）,and there was no correlation between AST,m-AST,m-AST/AST and Gensini score before and after operation（P>0.05）. The levels of AST and m-AST before operation,as well as AST,m-AST and m-AST/AST after operation in AMI patients were higher than those in CHD patients（P<0.05）,but there was no statistical significance in m-AST/AST before operation（P>0.05）. Conclusions The changes of serum AST,m-AST and m-AST/AST are related to the degree of myocardial cell injury,but not to the development of atherosclerotic plaque,so they can reflect the myocardial injury and recovery of AMI patients.

Combined detection of urinary total protein to avoid the hook effect of urinary microalbumin

Danqu, Luosangcizhen, Zerenqucuo, MA Chaochao, LIU Zhijuan

2021, 36(5):  477-479.  DOI: 10.3969/j.issn.1673-8640.2021.05.003

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Objective To analyze the correlation between urinary total protein（TP） and urinary microalbumin（mAlb）,and to find a method for avoiding the false negativity of urinary mAlb caused by hook effect. Methods The results of urinary mAlb and urinary TP of 1 171 patients were collected,and the correlation between them was evaluated by Spearman correlation analysis. Linear regression equation was established. Totally,35 urine samples with hook effect were validated for urinary mAlb. Results Urinary TP was positively correlated with urinary mAlb（r=0.880,P=0.000）. Taking urinary TP as dependent variable（Y）,urinary mAlb as independent variable（X）,the linear regression equation was established,Y=116.361+1.245X（r²=0.921,P=0.000）. By substituting the urinary mAlb determination values of 35 samples with hook effect（recorded as urinary mAlb_hook） into the equation,urinary TP（recorded as urinary TP_hook） was calculated,urine samples were diluted,and urinary mAlb was determined. The results were recorded as urinary mAlb_dilution. After substituting the equation,the urinary TP value（recorded as urinary TP_dilution） was calculated. There was statistical significance between urinary TP_measuredand urinary TP_hook（P<0.001）,and there was no statistical significance with urinary TP_dilution（P>0.05）. Conclusions According to establishing the linear regression equation between urinary TP and urinary mAlb,whether there is a hook effect in urinary mAlb deterimination can be determined simply. This method is simple and not limited by instruments and reagents,which can be popularized in clinic.

Role of bone marrow vascular endothelial growth factor levels in patients with diffuse large B-cell lymphoma after treatment

LI Bin, ZHAO Dong, HUANG Rong, GUO Juansun

2021, 36(5):  480-485.  DOI: 10.3969/j.issn.1673-8640.2021.05.004

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Objective To investigate the role of bone marrow vascular endothelial growth factor（VEGF） levels in monitoring the curative effect of patients with diffuse large B-cell lymphoma（DLBCL）. Methods Totally,40 patients with DLBCL were enrolled. The levels of VEGF,platelet（PLT） count and lactate dehydrogenase（LDH） in bone marrow plasma were determined after treatment,and the ratio of VEGF/PLT was calculated. The clinical data of patients [age,sex,clinical stage,the Eastern Cooperative Oncology Group（ECOG） score,international prognosis index（IPI） score,cancer cell invasion into bone marrow or not,invasion and treatment response（effective or ineffective）] were collected. Spearman correlation analysis was used to evaluate the correlation among the parameters. Cox proportional hazard regression model was used to evaluate the risk factors affecting the overall survival time（OS） and progression free survival（PFS）,and the Kaplan-Meier survival curve was drawn. Results The level of VEGF in bone marrow of DLBCL patients with age≥65 years old,ECOG score≥2,IPI score>3 and ineffective treatment was higher. The PLT count of DLBCL patients whose cancer cells with bone marrow invasion was higher. The VEGF/PLT ratio of patients with age≥65 years old,cancer cells with bone marrow invasion,IPI score>3 and ineffective treatment was higher. There was a positive correlation between VEGF level and PLT count in DLBCL patients（r=0.33,P<0.05）. The ratio of VEGF/PLT in effective group was lower than that in ineffective group（P<0.05）,but there was no statistical significance in VEGF and PLT count between the 2 groups（P>0.05）. Kaplan-Meier survival curve showed that the PFS and OS of VEGF/PLT ratio<3×10^-6 pg group were higher than those of VEGF/PLT ratio≥ 3×10^-6 pg group（P<0.05）. Cox proportional hazard regression model showed that VEGF/PLT ratio was a risk factor for PFS in DLBCL patients [hazard ratio（HR）=3.277,95% confidence interval（CI） 2.276-5.901],and ECOG score,IPI score and bone marrow VEGF level were risk factors of OS in DLBCL patients（HR were 4.26,3.33 and 3.52,95%CI 3.102-5.466,2.257-5.009 and 2.620-4.104,respectively）. Conclusions The level of VEGF in bone marrow is related to the prognosis of DLBCL patients.

Change and role of plasma IRF-3 level in patients with chronic hepatitis C

YE Songdao, CHEN Yunguo, YE Xuanmei

2021, 36(5):  486-489.  DOI: 10.3969/j.issn.1673-8640.2021.05.005

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Objective To investigate the changes of interferon regulatory factor（IRF）-3 level in patients with chronic hepatitis C（CHC） and its relationship with hepatitis C virus（HCV） RNA load,the degree of liver injury and antiviral efficacy of interferon. Methods The levels of IRF-3 and beta-interferon（IFN-β） were determined for 26 healthy subjects and 57 patients with CHC. The alanine aminotransferase（ALT） activity,type Ⅳ collagen（CⅣ） level and HCV RNA load in plasma of CHC patients were also determined. According to the ALT activity,CⅣ level ,HCV RNA load and the efficacy of interferon therapy,the patients were classified into 2 groups. Spearman rank correlation analysis was used to evaluate the correlation among these parameters. Results The levels of plasma IRF-3 and IFN-β in CHC group were lower than those in healthy control group（P<0.01）. The levels of plasma IRF-3 had statistical significance between high ALT activity group and normal ALT activity group,high CⅣ level group and normal CⅣ level group,high HCV RNA load group and low HCV RNA load group（P<0.05）. Spearman rank correlation analysis showed that the IRF-3 level was positively correlated with IFN-β in CHC patients（r=0.930,P<0.01）,and showed negative correlations with HCV RNA load,ALT activity and CⅣ level（r values were -0.321,-0.290 and -0.345,respectively,P<0.05）. The IRF-3 level in response group was lower than those in non-response group（P<0.05）,and there was no statistical significance in IFN-β levels between the 2 groups（P>0.05）. Conclusions The level of plasma IRF-3 in CHC patients is related to HCV RNA load,the degree of hepatic cell damage and the degree of hepatic fibrosis,and it is valuable to judge the efficacy of IFN.

Reference interval establishment of serum cytokeratin 19 fragment for healthy adults in Wuhan

JI Zhi, DENG Lingyan, LI Jiaoyuan, WANG Xu, LI Huijun, CHENG Liming

2021, 36(5):  490-494.  DOI: 10.3969/j.issn.1673-8640.2021.05.006

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Objective To establish the reference interval of serum cytokeratin 19 fragment（CYFRA21-1） for local population,and to preliminarily investigate the factors for the level of CYFRA21-1. Methods A total of 8 199 healthy subjects were enrolled. Serum CYFRA21-1 and serum creatinine（SCr） levels were determined,and the estimated glomerular filtration rate（eGFR） was calculated. Non-parametric method was used to determine the upper limit of the reference interval by taking the unilateral 95th percentile（P₉₅）. The influence factors of sex,age and eGFR on CYFRA21-1 were analyzed. Results The Dixon method was used to exclude 7 outliers from the 8 199 subjects,and a total of 8 192 subjects were enrolled. Serum CYFRA21-1 level in males was higher than that in females（P<0.001）. There was statistical significance in CYFRA21-1 levels in different age groups（P<0.001）. The P₉₅ of serum CYFRA21-1 levels in males and females increased with age,especially in ≥60 years old groups. Non-parametric method was used to determine the reference intervals,which were 0-3.37 ng/mL for <60 years old,0-4.17 ng/mL for 60-69 years old,0-5.67 ng/mL for ≥70 years old. Spearman rank correlation analysis showed that serum CYFRA21-1 levels were positively correlated with age（r=0.213,P<0.001）,and they were negatively correlated with eGFR（r=-0.247,P<0.001）. The eGFR was negatively correlated with age（r=-0.612,P<0.001）. Quantile regression analysis showed that age（tau=0.95,β=0.02,P<0.001）,sex（tau=0.95,β=-0.24,P<0.001） and eGFR（tau=0.95,β=-0.01,P<0.001） were influence factors of CYFRA21-1 level. Conclusions The CYFRA21-1 reference interval in Wuhan has been established. Sex,age and eGFR are the influencing factors for serum CYFRA21-1 level.

Correlation between TEG and DIC and its diagnostic value

SUN Yuehong, ZHANG Limin, LI Xiao, WANG Dan, WU Jing, LI Yuwen, ZHANG Guojun

2021, 36(5):  495-499.  DOI: 10.3969/j.issn.1673-8640.2021.05.007

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Objective To investigate the correlation between thrombelastogram（TEG） and disseminated intravascular coagulation（DIC） and its diagnostic value. Methods From March 2017 to November 2018,96 patients with suspected DIC in intensive care unit of Beijing Tiantan Hospital of Capital Medical University were enrolled. Totally,36 patients with DIC were enrolled as study group,and 60 patients without DIC were enrolled as control group. Conventional coagulation indexes and TEG indexes were determined,and TEG indexes of dead patients and non-dead patients were compared. The sensitivities and specificities of conventional coagulation indexes and TEG indexes in the diagnosis of DIC were evaluated by receiver operating characteristic（ROC） curve. The influence of TEG on the diagnosis of DIC was analyzed with single factor Logistic analysis. Results The reaction（R） time and clot formation（K） time of TEG in study group were longer than those in control group（P<0.05）,and the angle alpha（α）,maximum amplitude（MA） and coagulation index（CI） in study group were smaller than those in control group（P<0.05）. In the study group,the R time and K time of dead DIC patients were prolonged（P<0.05）,the α angle,MA and CI were reduced compared with non-dead DIC patients. In the study group,there was statistical significance in the conventional coagulation indexes between dead and non-dead DIC patients（P<0.05）. The sensitivities and specificities of conventional coagulation indexes were lower than those of TEG indexes. In single factor Logistic analysis,R time,K time,α angle,MA,CI,international normalized ratio（INR） and fibrinogen（Fib） were risk factors（P<0.05）. Conclusions TEG indexes and conventional coagulation indexes can be used in predicting the risk of DIC,and TEG indexes have higher diagnostic specificities,which have guiding significance for the early diagnosis and prognosis prevention of DIC.

Changes of coagulation function and influence factors of hypercoagulability in patients with chronic kidney disease

XIE Hui, SHEN Han

2021, 36(5):  500-503.  DOI: 10.3969/j.issn.1673-8640.2021.05.008

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Objective To investigate the changes of coagulation function and the influence factors of hypercoagulability in patients with chronic kidney disease（CKD）. Methods A total of 240 patients with CKD were enrolled from January 2016 to December 2018 in Nanjing Drum Tower Hospital. According to glomerular filtration rate,CKD patients were classified into 5 stages. According to the results of fibrinogen（Fib）,the patients with CKD were classified into non-hypercoagulable group and hypercoagulable group. Totally,45 healthy subjects were enrolled as control group. The general data,coagulation function results and other related laboratory indexes of each group were analyzed. Results Compared with control group,the levels of Fib and D-dimer（DD） of patients with CKD4 and CKD5 were higher（P<0.05）,and the results of antithrombin Ⅲ（ATⅢ） were lower（P<0.05）. The results of Fib,DD and ATⅢ in patients with CKD5 had statistical significance compared with the other 4 groups and control group（P<0.05）. Glomerular filtration rate was negatively correlated with Fib and DD（r=-0.652,P=0.003;r=-0.732,P=0.001,respectively） and positively correlated with ATⅢ（r=0.765,P<0.001）. Binary Logistic regression analysis showed that creatinine（Cr） and C-reactive protein（CRP） were independent risk factors for hypercoagulability in patients with CKD [odds ratio （OR）=1.352 and 1.052,95% confidence intervals（CI）were 1.089-1.664 and 0.989-1.122],while ATⅢ was its protective factor（OR=0.792,95%CI0.771-0.994）. Conclusions There exists coagulation disorder in patients with CKD,and it aggravates with the progression of the disease. Monitoring the coagulation function of patients with CKD plays a role in preventing complications and improving prognosis.

Influence of intestinal flora on serum inflammatory factors in patients with chronic urticaria

REN Yuan, ZHANG Min, YIN Xiang, ZENG Qianwen

2021, 36(5):  504-509.  DOI: 10.3969/j.issn.1673-8640.2021.05.009

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Objective To investigate the influence of intestinal flora on serum inflammatory factors in patients with chronic urticaria. Methods Totally,60 patients with chronic urticaria and 60 healthy subjects were enrolled,and fasting venous blood and stool samples were collected. Gene 16S rDNA real-time fluorescence quantitative polymerase chain reaction（PCR） was used to determine the levels of Faecalibacterium prausnitzii,Clostridium leptum,Bifidobacterium and Lactobacillus. Gas chromatography was used to determine intestinal short chain fatty acid. Serum Toll-like receptor 4（TLR4）,nuclear factor（NF）-κB,tumor necrosis factor-alpha（TNF-α） and interleukin-6（IL-6） were determined by enzyme-linked immunosorbent assay（ELISA）. Spearman correlation analysis was used to analyze the relationship between intestinal flora,short chain fatty acid and serum TLR4,NF-κB,TNF-α and IL-6. Results Compared with the control group,the levels of Faecalibacterium prausnitzii,Clostridium leptum,Lactobacillus and butyric acid in the intestine of patients with chronic urticaria were decreased（P<0.05）. Serum TLR4,NF-κB,TNF-α and IL-6 levels were increased（P<0.05）. Correlation analysis showed that Faecalibacterium prausnitzii,Clostridium leptum,Lactobacillus and butyric acid were negatively correlated with serum TLR4,NF-κB,TNF-α and IL-6（P<0.05）. Conclusions The increase of serum inflammatory factors in patients with chronic urticaria may be related to the decrease of intestinal butyric acid-producing bacteria,leading to a decrease in intestinal butyric acid levels and up-regulation of TLR4/NF-κB signaling pathway.

Evaluation of Middlebrook7H11 slant medium for culturing Mycobacterium from clinical specimens

QIAN Xueqin, LU Hongzhou

2021, 36(5):  519-523.  DOI: 10.3969/j.issn.1673-8640.2021.05.013

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Objective To evaluate Middlebrook7H11 slant medium for culturing Mycobacterium from clinical specimens. Methods Totally,599 clinical specimens of inpatients and outpatients in Shanghai Public Health Clinical Center were cultured by Middlebrook7H11 slant medium and Löwenstein-Jensen medium. The positive rates,positive occurrence times and contamination rates of the 2 media were compared. Results Of the 599 clinical specimens,77（12.9%） cases were positive for Middlebrook7H11 slant medium,and 74（12.4%） cases were positive for Löwenstein-Jensen medium. The combined positive rate was 15.0%（90 cases）. There was no statistical significance in the positive rates between Middlebrook7H11 slant medium and Löwenstein-Jensen medium（χ²=0.07,P>0.05）. The contamination rate of Löwenstein-Jensen medium was higher than that of Middlebrook7H11 slant medium（χ²≤4.67,P<0.05）. The positive occurrence time of Middlebrook7H11 slant medium was 1 week shorter than that of Löwenstein-Jensen medium,and the number of positive clinical specimens appeared earlier than that of Löwenstein-Jensen medium（χ²≤11.62,P<0.01）. Conclusions Middlebrook7H11 slant medium is superior to Löwenstein-Jensen medium in Mycobacteriumculturing. The combined determination of the 2 media can improve the positive rate.

Method establishment of spot urine free NMN and MN by HPLC-ED and its clinical application

ZHANG Lei, ZUO Ming, ZOU Wenbi, WANG Haoran, ZHANG Xiaoqing, DING Min

2021, 36(5):  524-529.  DOI: 10.3969/j.issn.1673-8640.2021.05.014

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Objective To establish a method for spot urine free normetanephrine（NMN） and metanephrine（MN） by high performance liquid chromatography-electrochemical detection（HPLC-ED）,and to investigate the clinical application role. Methods Sample processing and chromatographic conditions were improved,and HPLC-ED for spot urine free NMN and MN was established. HPLC-ED was used to determine NMN and MN in 35 patients with pheochromocytoma,70 patients with primary hypertension,78 patients with adrenal mass but without pheochromocytoma and 44 healthy subjects. Creatinine（Cr）was determined as well. NMN/Cr ratio and MN/Cr ratio were calculated. Receiver operating characteristic（ROC） curve was used to evaluate the efficiency for diagnosing pheochromocytoma. Results The linear range of HPLC-ED for the determinations of NMN and MN was 25-2 500 μg/L. The determination limits [signal-to-noise ratio（R_SN）=3] were 5.9 and 11.3 μg/L,respectively. The average recovery was 92.8%-103.4%. The within-run coefficients of variation（CV） of high-concentration and low-concentration NMN were 3.7% and 2.2%,and the between-run CV of high-concentration and low-concentration NMN were 5.6% and 3.3%,respectively. The within-run CV of high-concentration and low-concentration MN were 4.3% and 2.7%,and the between-run CV of high-concentration and low-concentration MN were 5.1% and 3.4%,respectively. The concentrations of NMN and MN,NMN/Cr ratio and MN/Cr ratio in pheochromocytoma group were higher than those in hypertension group,adrenal space-occupying group and healthy control group（P<0.001）,and there was no statistical significance among hypertension group,adrenal space-occupying group and healthy control group（P>0.05）. ROC curve analysis showed that the area under curve（AUC） in diagnosing pheochromocytoma of urine free NMN,urine free MN,NMN/Cr ratio,MN/Cr ratio,plasma free NMN and plasma free NMN were 0.91,0.88,0.96,0.94,0.93 and 0.88,respectively. MN/Cr ratio in urine decreased to normal in 1 week after operation in pheochromocytoma patients,but the concentration of plasma MN in 2 patients was higher than that before operation,and in 1 patient,the plasma NMN concentration was higher than that before operation. Conclusions HPLC-ED has been successfully established to determine the concentrations of urine free NMN and MN. Compared with plasma free NMN and MN,spot urine free NMN and MN show good efficiency for the diagnosis of pheochromocytoma,which perform well to evaluate the prognosis of pheochromocytoma.

Comparison of different nucleic acid extraction methods for the detection of SARS-Cov-2

ZHANG Yunli, WANG Xin, SHAO Ling, QU Bo, ZHAO Hongmei

2021, 36(5):  530-534.  DOI: 10.3969/j.issn.1673-8640.2021.05.015

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Objective To compare the consistency rate,repeatability and detection limit of magnetic bead adsorption method and sample releasing agent method in the nucleic acid extraction of severe acute respiratory syndrome coronavirus 2（SARS-CoV-2）,so as to optimize the extraction method of nucleic acid with high extraction efficiency,short time consuming and low cost. Methods Totally,3 commercial nucleic acid extraction reagents for 2 methods of nucleic acid extraction were used to extract RNA from negative samples,positive samples and SARS-CoV-2 standard samples with different dilution（20-28）,and real-time fluorescence reverse transcription-polymerase chain reaction（RT-PCR） was performed. Ct value was used to evaluate the performance of different nucleic acid extraction methods. Results The consistency rate of negative and positive samples of 3 nucleic acid extraction reagents was 100%. The coefficient of variation（CV） of magnetic bead adsorption method was lower than those of sample releasing agent method（CV 0.89%-1.58%）,sample releasing agent A（CV 1.62%-4.90%） and sample releasing agent B（CV 0.83%-2.73%）. The detection limit of magnetic bead adsorption method and sample releasing agent B was 156.3 copies/mL,and that of sample releasing agent A was 625.0 copies/mL. Conclusions The magnetic bead adsorption method of nucleic acid extraction is efficient and reproducible,which is suitable for the centralized operation of a large number of samples.

Analysis of key long noncoding RNA and microRNA in type Ⅰ and type Ⅱ endometrial carcinoma based on endogenous competitive network

YUAN Shuang, WANG Lihua

2021, 36(5):  535-543.  DOI: 10.3969/j.issn.1673-8640.2021.05.016

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Objective To analyze the potential biomarkers involved in the classification,diagnosis and treatment of endometrial carcinoma（EC） based on endogenous competitive network. Methods The differentially expressed genes were summarized from the Cancer Genome Atlas（TCGA） database,and 32 genes were screened to construct endogenous competitive network. In order to further screen key genes,Gene Ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） enrichment analysis,correlation analysis,survival analysis and GEO datum set validation were carried out. Results There were 59 differentially expressed long noncoding RNA（lncRNA）,51 differentially expressed microRNA（miRNA）and 843 differentially expressed messenger RNA between type Ⅰ and type Ⅱ EC. On this basis,an endogenous competitive network was established,and further the key genes related to genotyping and prognosis were screened.LINC00667 and TMCC3 were negatively correlated,while miR-34c,miR-449a,miR-449b were positively correlated with the survival of EC patients in the TCGA database. Pearson correlation analysis showed that LINC00667 was positively correlated with TMCC3（P<0.001）. The high expression of LINC00667 in EC patients was related to the classification of EC,the International Federation of Gynecology and Obstetrics（FIGO） stage and differentiation（P<0.05）,but there was no relation with age（P>0.05）. The high expression of TMCC3 was correlated with the classification of EC,age and differentiation（P<0.05）,but there was no relation with FIGO stage（P>0.05）. The high expression of miR-34c,miR-449a,miR-449b in EC patients was related to the classification of EC,FIGO stage and differentiation（P<0.05）,but there was no relation with age（P>0.05）. Conclusions LINC00667-miR-34c/miR-449a/miR-449b-TMCC3 are identified as key genes in the endogenous competitive network of type Ⅰ and type Ⅱ EC and have good prognostic value.

Internal quality control and evaluation of blood gas analysis based on Westgard sigma rules

ZHAO Ran, LIU Wenbin, LIN Feiran, GONG Jingkai, YU Xiaoxuan, GE Danhong, TANG Liping, OU Yuanzhu

2021, 36(5):  544-548.  DOI: 10.3969/j.issn.1673-8640.2021.05.017

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Objective To evaluate the performance of a blood gas analyzer,to compare the internal quality control（IQC） results from both the automatic quality control（QC） data in the instrument and external manual QC data according to Westgard sigma rules,and to guide the IQC scheme and improve the measurement performance. Methods Parameters,such as coefficient of variation（CV） and bias（Bias）,were used. Allowable total error（TEa） was provided by the Clinical Laboratory Improvement Amendments of 1988（CLIA'88） standard or instruction from the manufacturer. The sigma（σ） values for 16 blood gas items in the automatic and external manual IQC systems were calculated,respectively. Corresponding QC scheme was designed according to Westgard sigma rules,and the consistency rates of the 2 IQC systems were analyzed. Results Among all the 16 blood gas items,the measurement performance of partial pressure of oxygen [p（O₂）] was <3σ,while the other items showed measurement performance >5σ,and 14 items reached 6σ. According to Westgard sigma rules,there were inconsistencies between the automatic and external manual IQC results for items including p（O₂）,pH and partial pressure of carbon dioxide [p（CO₂）]. The consistency rates were 36.11%,94.44% and 93.06% for p（O₂）,pH and p（CO₂）,respectively,while 100% for the others. Conclusions The measurement performance of this blood gas analyzer is good except that the analyzing quality of p（O₂） needs to be improved. Compared with the external manual IQC,the results of automatic QC system in the instrument are relatively stable and easy to operate. However,external manual IQC may include more error causing factors rising from other sources. The automatic QC system in the instrument should adopt reasonable IQC rules and cooperate with external IQC to ensure that the clinical laboratory provides objective and reliable indicators for clinical use.

Establishment and preliminary evaluation of HbA_1c determination harmonization plan of Xuhui District of Shanghai

WANG Wei, WANG Lei, WANG Beili, ZHOU Fangfang, HU Jun, WU Pei, YIN Fen, YUAN Kaiying, HOU Yumin, DIAO Duanqin, LI Guoying, CHEN Min, GAO Yuhong

2021, 36(5):  549-553.  DOI: 10.3969/j.issn.1673-8640.2021.05.018

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Objective To establish the harmonization plan of glycated hemoglobin A_1c（HbA_1c） determination in Xuhui District of Shanghai,and to improve the consistency of HbA_1c determination results in Xuhui community healthcare centers. Methods Shanghai Eighth People's Hospital,the leading unit of the HbA_1c determination harmonization plan in Xuhui District,regularly prepared fresh mixed whole blood samples. The target values were determined by the laboratory of Zhongshan Hospital affiliated to Fudan University,which was certified as the second level reference laboratory of the National Glycohemoglobin Standardization Program（NGSP）. The samples were distributed to the 9 laboratories of community healthcare centers participating in the HbA_1c determination harmonization plan in Xuhui District. HbA_1c was determined by high-performance liquid chromatography（HPLC） in each laboratory. The results of 10 laboratories,including the leading unit,were compared,and the pass rate,deviation and coefficient of variation（CV） of HbA_1c determination results were analyzed. Results A total of 5 batches of comparison samples were distributed. The pass rates of 5 comparisons in 10 laboratories were 100%,10%,100%,100% and 50%,respectively. The bias ranges were -4.44%-5.53%,-10.39%-3.39%,-5.00%-7.41%,-4.44%-4.65% and -5.13%-10.91%,and the CV were 1.26%-2.71%,1.20%-4.07%,0.89%-3.36%,0.63%-1.90% and 2.14%-3.62%,respectively. Conclusions By participating in the HbA_1c determination harmonization plan of Xuhui District,the consistency of HbA_1c determination results in the laboratories of community healthcare centers has been improved.

Status and problems of SARS-CoV-2 nucleic acid detection

HUANG Fei, ZHANG Chunyan, GUO Wei, PAN Baishen, WANG Beili

2021, 36(5):  554-559.  DOI: 10.3969/j.issn.1673-8640.2021.05.019

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The ongoing outbreak of corona virus disease 2019（COVID-19） has posed a challenge for worldwide public health. The detection of severe acute respiratory syndrome coronavirus 2（SARS-CoV-2） nucleic acid plays an important role of diagnosis,therapy,prevention and control of COVID-19. In clinical practice,false negative results may mislead clinical decision-making,leading to the spread of the epidemic,while false positive results may cause unnecessary social panic. This review focuses on the interfering factors and the status and problems of SARS-CoV-2 nucleic acid detection,so as to provide a reference for the standardization and accuracy for SARS-CoV-2 nucleic acid detection in clinical laboratory.

Research progress on the mechanism of platelet granule release and its effect on specimen preanalytical variation

ZHANG Shihong, FANG Bangren, YE Manman, DENG Guanhua

2021, 36(5):  560-564.  DOI: 10.3969/j.issn.1673-8640.2021.05.020

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Platelet release refers to the process in which activates platelets release their granules（α granules,compact granules and lysosomal granules） and contents into plasma. Over the past 2 decades,the development of antiplatelet drug has led to advances in the study of platelet release mechanisms and their effects on preanalytical variation of clinical specimens. In vitro,platelet release is closely related to preanalytical variation of the specimen. Factors including the material of the blood storage vessel,internal additives,shear stress and storage temperature may induce platelet morphological changes,activation and dysfunction and consequently affect the release of platelet granules and contents. It will lead to preanalytical variation of specimens,and finally influence the results. Therefore,it is necessary to understand the effect of platelet release on preanalytical variation of specimens to improve the accuracy of results.

Research progress of intestinal microbiota and IL-6/gp130 signaling pathway in acute pancreatitis pathogenesis

XIAO Yingyan, CUI Yan, LI Yan

2021, 36(5):  565-568.  DOI: 10.3969/j.issn.1673-8640.2021.05.021

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Acute pancreatitis is one of the most common acute abdominal diseases. It is characterized by local inflammation of the pancreas with or without changes in the function of other organs. Dysbacteriosis and activation of inflammatory response are risk factors for acute pancreatitis. This review focuses on recent advances in the study of intestinal microbiota and interleukin-6（IL-6）/glycoprotein 130（gp130） inflammatory signaling pathway in the pathogenesis of acute pancreatitis.