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    30 August 2023, Volume 38 Issue 8
    Establishment of allowable total error,allowable imprecision and allowable bias for 22 endocrine analytes
    WANG Wei, ZHANG Zhixin, ZHANG Chuanbao, ZHOU Weiyan, WANG Zhiguo
    2023, 38(8):  707-712.  DOI: 10.3969/j.issn.1673-8640.2023.08.001
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    Objective To set the allowable total error(TEa),allowable imprecision [coefficient of variation(CV)] and allowable bias(Bias) for 22 endocrine analytes,and to recommend performance specifications for related items. Methods The data,including external quality assessment(EQA) data and internal quality control(IQC) data,of the National Center for Clinical Laboratories from 2020 to 2022 were collected. According to the performance specification setting mode newly determined at the Milan conference in Italy,the performance specification was derived based on biological variation(BV)and current technology level. For the analytes with BV data,the percentage difference of EQA data and the in-control CV of month IQC data were compared with the 3-level evaluation criteria derived based on BV,and the percentage difference passing rate and CV passing rate of all-batch quality control materials were calculated. When the passing rate reached 80%,the performance specifications of this level met the requirements of the recommended performance specifications of the analyte. For the analytes without BV data or the analytes whose performance specifications at 3-level evaluation criteria derived based on BV could not be used as recommended performance specifications,the recommended TEa and allowable CV may be derived based on the current technology level. Based on the current technology level,the recommended TEa and allowable CV were derived,and then the allowable Bias was derived. Results TEa/allowable CV recommended for 22 endocrine analytes were as follows:free triiodothyronine 18.9%/6.5%,triiodothyronine 17.4%/7.1%,free thyroxine 25.0%/6.2%,thyroxine 20.0%/7.0%,thyroid-stimulating hormone 24.6%/8.9%,cortisol 26.3%/8.2%,estradiol 26.0%/7.5%,follicle-stimulating hormone 21.2%/6.2%,luteinizing hormone 25.0%/6.8%,progesterone 26.2%/9.3%,prolactin 18.7%/7.4%,testosterone 16.5%/6.3%,C-peptide 20.8%/8.3%,folate 29.5%/8.9%,insulin 25.0%/6.4%,thyroglobulin 28.2%/8.0%,parathyroid hormone 30.0%/11.8%,aldosterone 21.4%/9.2%,dehydroepiandrosterone sulfate 25.0%/7.5%,vitamin B12 25.0%/7.5%,growth hormone 25.0%/7.0% and adrenocorticotropic hormone 27.4%/9.1%. Conclusions For 22 endocrine analytes,the TEa,allowable CV and allowable Bias that meet the current technology level of Chinese clinical laboratories are recommended.

    Role of serum albumin,interleukin-6 and ferritin combined determination in evaluating the functional prognosis of patients with spontaneous intracerebral hemorrhage
    ZHANG Han, LI Jun, LIU Xiaojiang, GUAN Yixiang
    2023, 38(8):  713-718.  DOI: 10.3969/j.issn.1673-8640.2023.08.002
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    Objective To investigate the role of serum albumin,interleukin-6(IL-6) and ferritin combined determination in evaluating the functional prognosis of patients with spontaneous intracerebral hemorrhage(SICH). Methods A total of 148 patients with SICH treated at Hai'an People's Hospital from January 2018 to January 2021 were enrolled. Patients' clinical,laboratory and imaging data were collected,and serum albumin,IL-6 and ferritin were determined before treatment. According modified Rankin scale(mRS) scores,the patients were classified into good prognosis group(mRS<3) and poor prognosis group(mRS≥3),and the patients were followed up for 90 d. Receiver operating characteristic(ROC) curve was used to determine the discriminative capability of various parameters for 90 d functional prognosis and death. Binary Logistic regression analysis was used to determine the factors for 90 d functional prognosis. Results Compared with good prognosis group,poor prognosis group had higher the National Institute of Health Stroke Scale(NIHSS) score,hematoma volume,perihematoma edema volume,white blood cell count,IL-6 and ferritin and lower serum albumin(P<0.05),while the difference for the other parameters were not statistically significant between the 2 groups(P>0.05). The results of Pearson correlation analysis showed serum albumin and perihematoma edema volume was negatively correlated(r=-0.32,P<0.01),and ferritin was positively correlated with hematoma volume(r=0.27,P<0.01). The results of binary Logistic regression analysis showed that hematoma volume,cerebral hemorrhage site,serum albumin,IL-6 and ferritin were prognostic factors for the functional prognosis of SICH patients at 90 d of onset(P<0.05). Binary Logistic regression analysis was used to construct a combined determination model based on the above influencing factors. The results of ROC curve analysis showed that the areas under curves(AUC) of serum albumin,IL-6,ferritin alone and combined determination model for the functional prognosis of SICH patients at 90 d of onset were 0.68,0.65,0.62 and 0.94,respectively. The AUC of serum albumin,IL-6 and ferritin for judging death of SICH patients at 90 d of onset were 0.68,0.68 and 0.51,respectively. The AUC of serum albumin and IL-6 combined determination model and serum albumin,IL-6,hematoma volume and cerebral hemorrhage site combined determination model for judging death of SICH patients at 90 d of onset were 0.76 and 0.90,respectively. Conclusions Serum albumin,IL-6 and ferritin combined determination with cerebral hemorrhage site and hematoma volume help to accurately assess the functional prognosis and death at 90 d of onset in patients with SICH.

    Correlations of serum AChE and IL-17 in patients with herpes simplex encephalitis with cognitive function impairment
    HE Long, WANG Sha, CHENG Liping, LIAO Ziwei, WANG Donghong
    2023, 38(8):  719-724.  DOI: 10.3969/j.issn.1673-8640.2023.08.003
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    Objective To investigate the correlation between serum acetylcholinesterase(AChE) and interleukin(IL)-17 levels and cognitive function impairment in patients with herpes simplex encephalitis(HSE). Methods A total of 159 HSE patients(HSE group) in Handan Central Hospital from March 2019 to March 2021 were enrolled. The patients were classified into cognitive impairment group(69 cases) and cognitive normal group(90 cases) according to whether cognitive function impairment occurred. According to the score of the mini-mental state examination(MMSE),the patients with cognitive function impairment were classified into mild group(23 cases,MMSE score 20-25),moderate group(30 cases,MMSE score 11-19) and severe group(16 cases,MMSE score ≤10). A total of 65 healthy subjects were enrolled as control group. Serum AChE and IL-17 levels were determined. Pearson correlation analysis was used to evaluate the correlation of AChE and IL-17 with Montreal cognitive assessment(MoCA) scores and MMSE scores. Receiver operating characteristic(ROC) curves were used to analyze the efficacy of AChE and IL-17 in diagnosing cognitive function impairment in HSE patients. Results Serum AChE and IL-17 levels in HSE group were higher than those in control group(P<0.05). The levels of serum AChE and IL-17 in cognitive impairment group were higher than those in cognitive normal group(P<0.05). The levels of serum AChE and IL-17 in severe group were higher than those in moderate group and mild group(P<0.05),and the levels of serum AChE and IL-17 in moderate group were higher than those in mild group(P<0.05). The levels of serum AChE and IL-17 were negatively correlated with MoCA score in cognitive impairment group(r values were -0.311 and -0.480,P<0.01),and they were negatively correlated with MMSE score(r values were -0.349 and -0.447,P<0.01). The areas under curves(AUC) of serum AChE and IL-17 single and combined determinations for the diagnosis of cognitive function impairment in HSE patients were 0.689,0.724 and 0.893,respectively. Conclusions Serum AChE and IL-17 levels in HSE patients are correlated with cognitive function impairment and can be used to assess the severity of cognitive function impairment.

    Roles of IP-10,SAA,hs-CRP,PCT and CD4+ T cell count determinations in HIV/AIDS patients with opportunistic infection
    ZHAO Jing, LI Yongqin, LI Yan, FAN Weiguang, YANG Xuegang
    2023, 38(8):  725-729.  DOI: 10.3969/j.issn.1673-8640.2023.08.004
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    Objective To investigate the changes and clinical roles of plasma interferon-gamma induced protein 10(IP-10),serum amyloid A(SAA),procalcitonin(PCT) and high-sensitivity C-reactive protein(hs-CRP)in patients with human immunodeficiency virus(HIV) infection and acquired immunodeficiency syndrome(AIDS)(referred to as HIV/AIDS) complicated with opportunistic infection(OI). Methods A total of 187 HIV/AIDS patients were enrolled and classified into OI group(63 cases) and non-OI group(124 cases) according to whether they were combined with OI. According to prognosis,the patients with OI were classified into good prognosis group(45 cases) and poor prognosis group(18 cases). The levels of IP-10,SAA,hs-CRP and PCT and CD4+ T cell count were determined in all the patients before and after 4 weeks of treatment. Logistic regression analysis was used to analyze the risk factors of HIV/AIDS patients with OI. Spearman rank correlation was used to analyze the correlation between the indicators. Results Before treatment,the levels of SAA,PCT,hs-CRP and IP-10 in good prognosis group and poor prognosis group were higher than those in non-OI group(P<0.05),and the level of IP-10 in poor prognosis group was higher than that in good prognosis group(P<0.05). After 4 weeks of treatment,the levels of SAA,PCT,hs-CRP and IP-10 in good prognosis group and non-OI group were lower than those before treatment(P<0.05),while there was no statistical significance before and after treatment in poor prognosis group(P>0.05). Multivariate Logistic regression analysis showed that the decrease of CD4+ T cell count and the increase of SAA,PCT,hs-CRP and IP-10 were risk factors for OI in HIV/AIDS patients [odds ratios(OR) were 0.028,15.606,25.499,9.147 and 10.303,95% confidence intervals(CI) were 0.006-0.128,3.224-75.532,1.544-421.002,1.705-49.071 and 2.582-41.118,P<0.05 ]. Spearman rank correlation analysis showed that IP-10,SAA,hs-CRP and PCT were negatively correlated with CD4+ T cell count(r=-0.297,-0.390,-0.348 and -0.264,P<0.05). Conclusions CD4+ T cell count,SAA,PCT,hs-CRP and IP-10 are related to HIV/AIDS combined with OI,and they may be used as the indicators for prognosis.

    Evaluation of clinical application of expanded non-invasive prenatal testing for chromosome copy number variation
    FENG Xuan, ZHANG Qinghua, WANG Xing, HE Jing, LIANG Jici, JIA Chunyang, LIN Pengwu, ZHU Shaohua, HAO Shengju
    2023, 38(8):  730-737.  DOI: 10.3969/j.issn.1673-8640.2023.08.005
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    Objective To investigate the application role of expanded non-invasive prenatal testing(NIPT-plus) in the determination of chromosome copy number variation(microdeletion or microduplication). Methods A total of 10 187 pregnant women who underwent NIPT-plus were enrolled from the Genetics Center of Gansu Maternal and Child Health Hospital form 2017 to 2018. NIPT-plus was used to determine cell-free fetal DNA(cffDNA) in the plasma of pregnant women. The high-risk pregnant women in NIPT-plus were diagnosed by amniotic fluid karyotyping and copy number variation sequencing(CNV-seq) and were followed up until fetal induction or 3 months after birth. Results Among the 10 187 pregnant women,164 high-risk pregnant women were screened,of which 131 cases were at high risk for chromosome aneuploidy,and 33 cases were at high risk for chromosome microdeletion or microduplication. Totally,131 cases of 164 high-risk pregnant women received CNV-seq,and 59 positive cases were confirmed,including 46 cases of chromosome aneuploidy,13 cases of chromosome microdeletion or microduplication and 72 cases of false positivity. The positive predictive value,sensitivity and specificity of 5-10 Mb deletion or duplication for NIPT-plus were 100.00%. The positive predictive value,sensitivity and specificity of >10 Mb deletion or duplication were 62.50%,100.00% and 99.97%,respectively. The positive predictive value,sensitivity and specificity of <5 Mb deletion or duplication were 42.86%,90.00% and 99.88%,respectively. Conclusions The determination rate of NIPT-plus for chromosome deletion or duplication ≥5 Mb is high,and the positive predictive value for chromosome microdeletion or microduplication <5 Mb is low. The performance of NIPT-plus in chromosome microdeletion or microduplication should be further improved.

    Clinical roles of nuclear matrix protein 22 and Atyp.C parameter in diagnosis of bladder cancer
    WANG Yuemei, LI Lei
    2023, 38(8):  738-741.  DOI: 10.3969/j.issn.1673-8640.2023.08.006
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    Objective To investigate the clinical role of the combined determination of nuclear matrix protein 22(NMP22) and atypical cells(Atyp.C) parameter using urinary sediment analyzer in the diagnosis of bladder cancer. Methods Totally,3 288 patients with NMP22 and urinary sediment determinations in Jing'an District Shibei Hospital were enrolled from October 2021 to September 2022. There were 97 patients with bladder cancer(bladder cancer group,97 males) and 3 191 patients with other urinary system diseases(total control group,1 212 males and 1 979 females). A total of 1 212 male patients with urinary system diseases were used as male control group. Receiver operating characteristic(ROC) curve was used to evaluate the efficiency of each index in the diagnosis of bladder cancer. Results The positive rate of NMP22 and the fluorescence intensity of Atyp.C in bladder cancer group were higher than those in male control group and total control group(P<0.001). ROC curve analysis results showed that the areas under curves(AUC) of NMP22 and Atyp.C fluorescence intensity single and combined determinations in the diagnosis of bladder cancer were 0.794,0.757 and 0.867,respectively,when the male control group was taken as control group. When the total control group was used as control group,the AUC of NMP22 and Atyp.C fluorescence intensity single and combined determinations were 0.787,0.752 and 0.861,respectively. Conclusions In the diagnosis of bladder cancer,NMP22 has a high sensitivity,Atyp.C has a high specificity,and the combined determination can improve the diagnostic efficiency.

    Relationship between KCNH2 and CACNA1C gene polymorphisms and cognitive function in patients with schizophrenia
    PENG Shouning, DENG Weicong, FU Yanbo, WU Yanni
    2023, 38(8):  742-747.  DOI: 10.3969/j.issn.1673-8640.2023.08.007
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    Objective To investigate the relationship between KCNH2 and CACNA1C gene polymorphisms and cognitive function in patients with schizophrenia. Methods Totally,210 patients with schizophrenia in remission in Anning Hospital from June 2017 to June 2021 were enrolled as study group. Totally,210 healthy volunteers in the same period were enrolled as control group. CACNA1C rs1006737 and KCNH2 rs38007792 gene polymorphisms were determined. The Montreal cognitive assessment(MoCA) was used. The event-related potential(ERP),the latency and amplitude of mismatch negativity(MMN)and P300 were evaluated. MoCA score,MMN,P300 latency and amplitude of patients with different genotypes were compared. Results Compared with control group,instudy group,the distribution frequency of TT genotype at KCNH2 rs3800779 locus was decreased(P<0.05),the distribution frequency of TG genotype was increased(P<0.05),the distribution frequency of T allele was decreased(P<0.05),and the distribution frequency of G allele was increased(P<0.05). The distribution frequency of AG genotype at CACNA1C rs1006737 locus was increased(P<0.05),GG genotype distribution frequency was decreased(P<0.05),A allele distribution frequency was increased(P<0.05),and G allele distribution frequency was decreased(P<0.05). Compared with patients with GG genotype at KCNH2 rs3800779 locus,the patients with TT and TG genotypes had decreased MoCA scores(P<0.05),both MMN and P300 latencies were longer(P<0.05),and amplitudes were smaller(P<0.05). Compared with patients with GG genotype at CACNA1C rs1006737 locus,the patients with AA and AG genotypes had decreased MoCA scores(P<0.05),both MMN and P300 latencies were longer(P<0.05),and amplitudes were smaller(P<0.05). Conclusions KCNH2 and CACNA1C gene polymorphisms affect the cognitive function of patients with schizophrenia.

    Influence of obesity/overweight on inflammatory factors of Th1/Th2 and Th17/Treg in children with asthma attacks
    DING Xiaoyuan, DAI Jinsheng, JIAO Ronghong, MA Suli, ZHU Haifeng, WU Mengya, CHE Yanran, ZHANG Lei
    2023, 38(8):  748-752.  DOI: 10.3969/j.issn.1673-8640.2023.08.008
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    Objective To investigate the influence of obesity/overweight on T helper(Th) 1 cell inflammatory factor [tumor necrosis factor-alpha(TNF-α)],Th2 cell inflammatory factors [interleukin(IL)-10,IL-13],Th17 cell inflammatory factor(IL-17F) and regulatory T cell(Treg) inflammatory factor(IL-35) at attack stage of asthma children in peripheral blood. Methods A total of 112 children with asthma at Shanghai Pudong New Area People's Hospital from January 2020 to December 2021 were enrolled and classified into asthma group(56 cases),obesity/overweight combined asthma group(56 cases) according to body mass index(BMI),and 56 non-asthma children with obesity/overweight(obesity/overweight group) were enrolled. The levels of TNF-α,IL-10,IL-13,IL-17F,IL-35,IL-6 and leptin in peripheral blood were determined. The correlation between BMI and indexes was evaluated by Spearman correlation. Results There was statistical significance in serum levels of IL-6,IL-10,IL-13 and leptin in asthma group,obesity/overweight combined asthma group and obesity/overweight group(P<0.05). The serum TNF-α level in obesity/overweight combined asthma group was higher than that in asthma group(P<0.05). The serum IL-17F level in obesity/overweight group was higher than those in asthma group and obesity/overweight combined asthma group(P<0.05). IL-35 in asthma group was higher than those in obesity/overweight combined asthma group and obesity/overweight group(P<0.05). The obesity/overweight combined asthma group and obesity/overweight group were further classified into overweight combined asthma group,obesity combined asthma group,overweight group and obesity group. BMI was positively correlated with IL-6 in overweight combined asthma group,obesity combined asthma group,overweight group and obesity group by Spearman correlation(r=0.515,0.510,0.515 and 0.432,P<0.05). BMI was positively correlated with leptin(r=0.488,0.578 and 0.546,P<0.05) and negatively correlated with IL-35(r=-0.491,-0.517 and -0.524,P<0.01). Conclusions Obesity/overweight can cause the imbalance of Th1/Th2 expression. Th1 cell inflammatory factors are mainly expressed in children with obesity/ overweight combined asthma.

    Characteristic of blood microbiota of postoperative sepsis based on cfDNA NGS
    LIANG Dong, MEI Yue, WANG Tengjiao, YU Dong
    2023, 38(8):  753-759.  DOI: 10.3969/j.issn.1673-8640.2023.08.009
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    Objective To analyze the characteristic of blood microbiota in patients with sepsis after operation. Methods The sequencing data of microbial cell-free DNA(cfDNA) from plasma of 239 postoperative sepsis patients(SP)(SP group) and 34 postoperative patients without SP [control patients(CP)(CP group)] were downloaded from SRA-NCBI databases and reanalyzed by bioinformatics. Results The blood microbiota in SP group showed a decreased microbial diversity compared with CP group,which mainly enriched in 12 taxa. The most representative taxa which were increased in SP group,with higher relative abundance,included Stenotrophomonas maltophiliaRhodococcus erythropolisAcidovorax sp. KKS102,Ralstonia pickettiiEnterococcus faecium and human beta herpes virus 5. Conclusions The composition of blood microbiota is altered in SP group compared with CP group,and the 6 representative taxa may play roles in the development of SP.

    CMV and EBV co-infection affecting patient prognosis after hematopoietic stem cell transplantation
    ZHANG Na, NIU Weihua, SUN Yuanyuan, JIA Mei
    2023, 38(8):  760-765.  DOI: 10.3969/j.issn.1673-8640.2023.08.010
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    Objective To investigate the correlation between cytomegalovirus(CMV) and Epstein-Barr virus(EBV) co-infection and the prognosis of patients after hematopoietic stem cell transplantation(HSCT). Methods Totally,327 patients with CMV and EBV co-infection(75 cases),CMV or EBV infection group(165 cases) and no infection group(87 cases) were enrolled in the Hematology Department of Peking University People's Hospital. The clinical data and CMV and EBV infection status were collected. Kaplan-Meier survival curve and Cox proportional regression analysis were used to analyze whether CMV and EBV co-infection was a risk factor for the prognosis of patients after HSCT. Results The patients was mainly ≤40 years old(226 cases,69.1%),and the proportion of patients ≤40 years old in CMV and EBV co-infection group was higher than that in patients >40 years old(P<0.05). In terms of human leukocyte antigen(HLA) matching,the proportion of haploidentical in CMV and EBV co-infection group was higher than that in CMV or EBV infection group and no infection group(P<0.05). The one-year overall survival(OS) rates of CMV and EBV co-infection group,CMV or EBV infection group and no infection group were 86.7%,85.4% and 95.4%(P<0.05). Kaplan-Meier survival curve results showed that CMV and EBV co-infection was a risk factor for one-year OS after HSCT(P<0.05). Cox proportional regression analysis showed that CMV and EBV co-infection and CMV or EBV infection were risk factors for one-year OS after HSCT [hazard ratios(HR) were 12.553 and 13.108,95% confidence interval(CI) 1.456-108.230 and 1.683-102.062,P=0.021 and 0.014,respectively]. Conclusions CMV infection(with or without EBV infection) may reduce one-year OS after HSCT.

    Nested multiple polymerase chain reaction in rapid diagnosis of meningitis/encephalitis in children
    SHI Yingying, PAN Fen, SUN Yan, WANG Chun, JIANG Jie, YU Fangyuan, ZHANG Tiandong, QIN Huihong, ZHANG Hong
    2023, 38(8):  766-770.  DOI: 10.3969/j.issn.1673-8640.2023.08.011
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    Objective To investigate the clinical role of nested multiple polymerase chain reaction(PCR) in the diagnosis of meningitis/encephalitis in children. Methods The cerebrospinal fluid samples of 82 children diagnosed or suspected central nervous system infection in Shanghai Children's Hospital from May 2017 to May 2020 were collected in a retrospective case-control study. The clinical data of children were collected. The use of antibiotics was understanded. The pathogen infection was determined by nested multiple PCR. Bacteria were cultured,and routine test and biochemical determination of cerebrospinal fluid were carried out. Results Totally,31 positive cases were determined,which included 20 cases of viruses and 11 cases of bacteria. The cerebrospinal fluid white blood cell count,protein and lactate dehydrogenase levels,antibiotic use days and hospital stay in bacterial group were higher than those in viral group(P<0.05),while the glucose level was lower than that in viral group(P<0.05),and the cases of using acyclovir were less than those in viral group(P<0.05). Nested multiple PCR with culture method in bacterial meningitis/encephalitis had good consistency(Kappa =0.659,P<0.001),and nested multiple PCR with routine test and biochemical determination in viral meningitis/encephalitis had good consistency as well (Kappa =0.737,P<0.001). Conclusions Nested multiple PCR could be used as a new method to assist in the diagnosis of cerebrospinal fluid pathogen infection and improve the diagnostic efficiency of meningitis/encephalitis.

    Clinical significance of whole blood trace elements and serum vitamin levels in 6 common skin diseases in children
    FU Limei, YANG Dan, XU Jin, ZHU Haiyan, ZHU Fenhua
    2023, 38(8):  771-775.  DOI: 10.3969/j.issn.1673-8640.2023.08.012
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    Objective To investigate the clinical significance of whole blood trace elements and serum vitamin levels in 6 common skin diseases in children. Methods Totally,301 children with skin diseases in the Children's Hospital of Fudan University from January 2018 to December 2021 were enrolled and classified into alopecia areata(50 cases),atopic dermatitis(51 cases),nail disorder(50 cases),exfoliative keratosis(50 cases),pityriasis alba(50 cases) and leukoplakia(50 cases)groups. A total of 52 healthy children were enrolled as control group. The levels of trace elements,copper,zinc,iron,vitamin A(Vit A),vitamin B1(Vit B1),vitamin B2(Vit B2),vitamin B6(Vit B6),vitamin C(Vit C) and 25-hydroxyvitamin D3 [25(OH)D3],were determined. Results Compared with control group,zinc,iron,Vit A,Vit B1,Vit B2,Vit B6,Vit C and 25(OH)D3 levels were decreased in skin disease group(P<0.05),and copper levels had no statistical significance between skin disease and control groups(P>0.05). Zinc,iron,Vit A,Vit B2,Vit B6 and 25(OH)D3 levels were decreased in pityriasis alba group(P<0.05). The levels of zinc,Vit B2,Vit B6,Vit C and 25(OH)D3 were lower in atopic dermatitis group(P<0.05). Zinc,Vit A,Vit B1,Vit B2,Vit B6 and 25(OH)D3 levels were lower in nail disorder group(P<0.05). The exfoliative keratosis group had decreased levels of zinc,Vit B2,Vit B6 and 25(OH)D3P<0.05). Zinc,iron,Vit B1,Vit B2,Vit B6,Vit C and 25(OH)D3 levels were decreased in pityriasis alba group(P<0.05). In leukoplakia group,the levels of zinc,iron,Vit B1,Vit B2 and 25(OH)D3 were lower than those in control group(P<0.05). Conclusions Zinc,iron,Vit A,Vit B1,Vit B2,Vit B6,Vit C and 25(OH)D3 deficiency are known to contribute to the 6 common skin diseases in children.

    Evaluation on the consistency of blind sample test results of 9 SARS-CoV-2 nucleic acid determination kits in Shanghai,China
    YANG Xue, ZHU Jun, JIANG Lingli, WANG Qing, HU Xiaobo
    2023, 38(8):  776-780.  DOI: 10.3969/j.issn.1673-8640.2023.08.013
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    Objective To know the consistency of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) nucleic acid determination results of clinical laboratories in Shanghai,China. Methods The results of 4 SARS-CoV-2 nucleic acid blind sample tests and the cycle threshold(Ct)value of positive results in clinical laboratories were analyzed. Results Totally,249 clinical laboratories participating in the 4 blind sample tests used 9 kinds of determination kits to determine 2 negative blind samples and 3 positive blind samples. The correct rate of negative samples and the determination rate of positive samples were all 100%. The difference ranges of Ct values' x of ORF1ab gene and N gene in 3 positive samples of 9 determination kits were 2.58-2.66 and 2.88-3.06. The difference ranges of range(R) were 7.98-8.15 and 7.71-7.73,respectively. The coefficient of variation(CV) of Ct values of ORF1ab gene and N gene in 5 kit groups were all <5%. Only one kit results showed large variation within and between groups. Conclusions The determination capabilities of SARS-CoV-2 nucleic acid determination among clinical laboratories in Shanghai could all meet the requirements,but the Ct values of different determination kits are different. When interpreting the results based on the Ct value,false negative or positive results might occur,which should be paid attention by clinical laboratories and relevant management institutes.

    Analysis and progress of peptide and protein biomarker methodology for myocardial injury
    SUN Zepeng, WANG Hongbin, WANG Jiandong, SONG Dewei, XIAO Peng
    2023, 38(8):  784-789.  DOI: 10.3969/j.issn.1673-8640.2023.08.015
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    The prevalence of myocardial injury diseases is increasing rapidly in the world. Monitoring and accurate diagnosis of myocardial injury diseases is essential to reduce disease hazard. Currently,the biomarkers in myocardial injury mainly belong to peptides and proteins,typically expressed lower than 10-8 g/L. Immunoassay-based techniques enable a sensitive determination level for low abundant biomarkers,followed by developed as the dominant method. However,some inherent problems have also existed among current clinical immunoassays regarding testing accuracy. To illustrate testing barriers,this review proposes and summarizes some representative issues that usually interfere with the testing accuracy in B-type natriuretic peptide(BNP) and troponin. Meanwhile,some emerging technologies will be introduced in the context,and then to discuss its application that potential applied in myocardial injury clinical measurement.

    Research progress on formation mechanism and eradication strategy of bacterial persisters
    WANG Chao, ZHAO Yu
    2023, 38(8):  790-795.  DOI: 10.3969/j.issn.1673-8640.2023.08.016
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    Although bacterial persister has been found for a long time,they are rarely mentioned in anti-infective diagnosis and treatment. With the increasingly serious problem of antibiotic resistance and tolerance and the deepening of research,bacterial persistence has been found in most bacteria,and it is considered to be a cause of chronic infection and disease delay. The mechanism of bacterial persister formation involves many cell life processes,but it is still not completely clear. There is a consensus on the treatment strategy for bacterial persisters. This review focuses on the mechanism research of bacterial persisters and the treatment strategies in the recent years,so as to solve the major challenge in the treatment of chronic infectious diseases.

    Analysis on influencing factors of G assay
    FANG Wendong, WANG Youliang, CHEN Shuiping
    2023, 38(8):  796-799.  DOI: 10.3969/j.issn.1673-8640.2023.08.017
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    G assay is one of the most important serological methods for the early diagnosis of invasive fungal disease(IFD). Nowadays it is widely used in clinical practice. However,medical contamination,bacterial infection and intestinal mucosal damage can lead to false positivity of G assay results. The use of antifungal drug and breakthrough Candida infection can lead to false negativity of G assay results. In addition,as the proportion of immunosuppressed and critical patients suffering from IFD continues to increase,early diagnosis of IFD is of importance to reduce mortality and improve the prognosis of those patients. This review focuses on the factors influencing G assay to give proper guidance of the use of G assay both in clinical practice and in laboratory,as well as the corresponding countermeasures.

    Research progress of CRISPR/Cas13 system for pathogen detection
    ZHAO Yanan, CAO Qixin, YAN Yan, LI Xiaocong, ZHAO Jianping, XIAO Weili
    2023, 38(8):  800-804.  DOI: 10.3969/j.issn.1673-8640.2023.08.018
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    Pathogen in environment and food is a serious threat to human life and health. Rapid and accurate detection methods are the keys to the effective prevention and control of the epidemic. At present,clustered regularly interspaced short palindromic repeats(CRISPR)/clustered regularly interspaced short palindromic repeat-associated protein(Cas)13 system has been widely used in the detection of pathogens due to its "attached shear" property. It has been developed as a novel nucleic acid detection tool with high sensitivity,strong specificity,low cost,rapid and convenient,which opens a new era of molecular diagnosis. In this review,the characteristics and molecular mechanism of CRISPR/Cas13 system are introduced,the research progress of CRISPR/Cas13 technology in the detection of pathogens is comprehensively reviewed,and the future development and application prospect of CRISPR/Cas13 system are prospected.