Laboratory Medicine

Expert consensus on establishment and validation of review rules for automatic vaginal secretion analysis system

Laboratory Medicine Branch of Chinese Association of Geriatric Health Medicine Research, the Laboratory Medicine Committee of Shanghai Scientific Association of Better Birth and Better Upbringing （Shanghai Maternal and Child Health Association）

2024, 39(5): 415-422. DOI: 10.3969/j.issn.1673-8640.2024.05.001

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Microscopy of vaginal secretions is a routine item of obstetrics and gynecology. With the development of the automation of determination technology，the automatic vaginal secretion analysis systems based on different determination principles have been developed and applied to meet the needs of large clinical sample size，high efficiency and standardization. However，wet smear/Gram staining microscopy is still the gold standard for the diagnosis of common infectious diseases of female genital tract，which is a reference method for assessing the accuracy of automated instrument determination results. As the current quality documents still lack unified requirements and detailed guidance for the review rules of automatic vaginal secretion analysis in body fluid，the Laboratory Medicine Branch of Chinese Association of Geriatric Health Medicine Research and the Laboratory Medicine Committee of Shanghai Scientific Association of Better Birth and Better Upbringing（Shanghai Maternal and Child Health Association） jointly formulated the expert consensus on the establishment and validation of review rules for automatic vaginal secretion analysis system based on national standards，industry standards，quality system requirements and relevant domestic and foreign guidelines，relevant literature reports，which includes the establishment method，verification method and application of the review rules for automatic vaginal secretion analysis system，in order to standardize the establishment of the review rules for automatic vaginal secretion analysis system and ensure the accuracy of the determination results.

Relation of AGGF1 in peripheral blood and coronary artery stenosis

LIU Junfeng, JIA Kegang, CHE Anqi, JING Rui, LI Yongshu, HAN Xuejing, SHI Ping, WU Meng, LIN Wenhua

2024, 39(5): 423-428. DOI: 10.3969/j.issn.1673-8640.2024.05.002

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Objective To investigate the relation of angiogenic factor with G patch and FHA domain 1（AGGF1） in peripheral blood and coronary artery stenosis. Methods A total of 116 patients at TEDA International Cardiovascular Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College from June 2011 to November 2015 were enrolled. According to coronary angiography results，the 116 patients were classified into case group（coronary artery stenosis>50%，82 cases） and control group（coronary artery stenosis≤50%，34 cases）. Non-conditional multifactor stepwise Logistic regression analysis and receiver operating characteristic（ROC） curve were used to evaluate the risk factors for coronary artery stenosis>50% and the diagnostic efficacy in coronary artery stenosis of AGGF1 combined with high-density lipoprotein cholesterol（HDL-C） and low-density lipoprotein cholesterol（LDL-C），respectively. The 34 patients from control group were followed up，and the predictive value of AGGF1 in the occurrence of major adverse cardiovascular events（MACE） was evaluated. Results The level of AGGF1 in case group was lower than that in control group（P<0.001）. Decreased AGGF1 was a risk factor for coronary artery stenosis>50% [odds ratio（OR）=0.536，95% confidence interval（CI） 0.368-0.782]. AGGF1 combined with HDL-C and LDL-C had an area under curve of 0.815 for the diagnosis of coronary artery stenosis. The follow-up of control group showed that there was no MACE in high AGGF1 patients and 6 cases in low AGGF1 patients. Conclusions Decreased AGGF1 in peripheral blood is a risk factor for coronary artery stenosis>50%. AGGF1 combined with HDL-C and LDL-C has a high diagnostic efficacy for the diagnosis of coronary artery stenosis，and decreased AGGF1 may have a certain predictive value for the long-term occurrence of MACE in coronary artery stenosis≤50%.

Serum lncRNA HAND2-AS1 expression in cervical cancer patients and its effect on proliferation，invasion and migration of cervical cancer Caski cells

ZHANG Xiaoke, CHU Yanrong, WANG Rong, CUI Facai

2024, 39(5): 429-437. DOI: 10.3969/j.issn.1673-8640.2024.05.003

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Objective To investigate the expression of long non-coding RNA（lncRNA）heart and neural crest derivatives expressed 2-antisense RNA 1（HAND2-AS1）in serum of cervical cancer patients and the mechanism of its effect on the proliferation，invasion and migration of cervical cancer Caski cells. Methods The Gene Expression Profiling Interactive Analysis（GEPIA） database was used to analyze the expression of lncRNA HAND2-AS1 in cervical cancer tissues and normal cervical tissues. From January 2019 to December 2021，48 patients with cervical cancer（cervical cancer group），48 patients with cervical intraepithelial neoplasia（CIN）（CIN group） and 48 healthy subjects（healthy control group） were enrolled from Jiaozuo Maternal and Child Health Care Hospital. The samples of postoperative cancer tissue and adjacent tissue（>2 cm from the margin of cancer tissue） were collected from 14 patients with cervical cancer. Serum samples and clinical data of all the subjects were collected to determine the relative expression level of lncRNA HAND2-AS1. Cervical cancer cell line Caski was classified into overexpression group（transfected with pcDNA3.1-HAND2-AS1），negative control group（transfected with pcDNA3.1-NC），interference group（transfected with si-HAND2-AS1） and interference control group（transfected with si-NC） according to different transfected plasmids. The proliferation，invasion and migration were determined by CCK-8 assay，Transwell assay and scratch test. The expressions of phosphatidylinositol 3-kinase（PI3K），phosphorylated phosphatidylinositol 3-kinase（p-PI3K），protein kinase B（Akt） and phosphorylated protein kinase B（p-Akt） were determined by western blot. Results The lncRNA HAND2-AS1 expression in cervical cancer tissues was lower than that in normal cervical epithelial tissues（P<0.05）. The relative expression level of lncRNA HAND2-AS1 in cancer tissues of 14 patients with cervical cancer was lower than that in adjacent tissues（P<0.01）. The relative expression level of serum lncRNA HAND2-AS1 in cervical cancer group was lower than those in CIN group and healthy control group（P<0.01），but there was no statistical significance between CIN group and healthy control group（P>0.05）. The relative expression level of serum lncRNA HAND2-AS1 had statistical significance among cervical cancer patients with different tumor sizes，the International Federation of Gynecology and Obstetrics（FIGO） stages and lymphatic metastasis（P<0.05）. The relative expression level of lncRNA HAND2-AS1 in overexpression group was higher than that in negative control group（P<0.01），while the cell proliferation activity，the number of invasive cells，scratch healing rate and the relative expression levels of p-PI3K and p-Akt protein in overexpression group were lower than those in negative control group（P<0.05）. The relative expression level of lncRNA HAND2-AS1 in interference group was lower than that in interference control group（P<0.01），and the cell proliferation activity，the number of invasive cells，scratch healing rate and the relative expression levels of p-PI3K and p-Akt protein in interference group were higher than those in interference control group（P<0.05）. There was no statistical significance in the relative expression levels of PI3K and Akt between overexpression group and negative control group，or between interference group and interference control group（P>0.05）. Conclusions Serum lncRNA HAND2-AS1 expression is low in patients with cervical cancer，and it is related to disease severity. The lncRNA HAND2-AS1 may affect the proliferation，invasion and migration of cervical cancer cells by regulating the PI3K/Akt signaling pathway.

Relation between Apelin，IRS-2 protein and prognosis of gastric cancer patients

LIU Xuewei, LI Kunpeng, SONG Junyu, ZHAO An

2024, 39(5): 438-442. DOI: 10.3969/j.issn.1673-8640.2024.05.004

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Objective To investigate the relation between the expressions of adipocyte cytokine Apelin and insulin receptor substrate 2（IRS-2） and the prognosis of gastric cancer patients. Methods A total of 87 patients with gastric cancer diagnosed for the first time in Hengshui Hospital of Traditional Chinese Medicine from January 2014 to December 2015 were enrolled. Postoperative cancer tissue samples and adjacent tissue samples（mucosal tissue 3 cm away from tumor margin） of all the patients were collected，and clinical data were collected as well. The expressions of Apelin and IRS-2 in cancer tissues and adjacent tissues of patients with gastric cancer were determined. The correlation between Apelin and IRS-2 was analyzed by column correlation number. Kaplan-Meier survival curve was used to evaluate the survival of patients with gastric cancer，and Cox proportional risk regression analysis was used to evaluate the risk factors for the death of gastric cancer patients. Results The positive expression rates of Apelin were 73.56%（64/87） and 5.75%（5/87） in cancer tissues and adjacent tissues，and the positive expression rates of IRS-2 were 56.32%（49/87） and 6.90%（6/87），respectively. There was statistical significance in the positive expression rates of Apelin and IRS-2 among gastric cancer patients with different tumor differentiation degrees，TNM stages and lymphatic metastasis（P<0.05），while there was no statistical significance in the positive expression rates of Apelin and IRS-2 among gastric cancer patients with different sex，ages and tumor sizes（P>0.05）. Apelin and IRS-2 expressions were weakly correlated in cancer tissues（column correlation number was 0.329，P=0.024）. According to the expressions of Apelin and IRS-2，gastric cancer patients were classified into positive group and negative group. The overall survival times of Apelin positive group and IRS-2 positive group were lower than those of Apelin negative group and IRS-2 negative group，respectively（P<0.05）. Positive Apelin，positive IRS-2，low tumor differentiation，lymphatic metastasis and TNM stage Ⅲ were all risk factors for death in gastric cancer patients [hazard ratios（HR） were 3.015，2.678，2.898，2.745 and 3.266，95% confidence intervals（CI）were 1.077-8.438，1.326-5.408，1.120-7.501，1.081-6.972 and 1.259-8.474，respectively]. Conclusions The high expressions of Apelin and IRS-2 may increase the risk of poor prognosis of gastric cancer patients，and they may be used as prognostic indicators of gastric cancer patients.

Correlation between serum LRG1 level and cognitive impairment and recurrence in patients with acute ischemic stroke

GU Liangliang, WANG Jianfeng, QIAO Xin, ZHANG Baochao, FU Guohui

2024, 39(5): 443-448. DOI: 10.3969/j.issn.1673-8640.2024.05.005

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Objective To investigate the role of leucine-rich alpha-2 glycoprotein-1（LRG1） level in cognitive impairment and its relationship with recurrence in patients with acute ischemic stroke（AIS）. Methods A total of 125 patients with AIS admitted to Nanyang Central Hospital from January 2020 to October 2021 were enrolled，the clinical data and the results of homocysteine（Hcy） and blood lipid determinations for all the patients were collected，and serum LRG1 levels were determined. The research subjects were classified into cognitive impairment group [Montreal Cognitive Assessment（MoCA）<26] and non-cognitive impairment group（MoCA≥26） according to MoCA scale. They were classified into recurrence group and non-recurrence group based on the stroke recurrence situation after 6 months. Pearson or Spearman correlation was performed to analyze the correlation between serum LRG1 level and other indicators. Multivariate Logistic regression was performed to analyze the influencing factors of cognitive impairment in AIS patients. The efficacy of various indicators in predicting cognitive impairment and stroke recurrence in AIS patients was evaluated by receiver operating characteristic（ROC） curve. Results Total cholesterol（TC） level and the proportion of hyperlipidemia in cognitive impairment group were higher than those in non-cognitive impairment group（P<0.05），while the levels of LRG1 and high-density lipoprotein cholesterol（HDL-C） were lower than those in non-cognitive impairment group（P<0.001）. There was no statistical significance in the other clinical data between the 2 groups（P>0.05）. Serum LRG1 levels in AIS patients with cognitive impairment were positively correlated with HDL-C（r=0.497，P<0.05） and were negatively correlated with hyperlipidemia and TC（r values were -0.492 and -0.486，P<0.05）. The decrease in LRG1 and HDL-C levels was a risk factor for cognitive impairment in AIS patients [odds ratios（OR） were 0.845 and 0.876，95% confidence intervals（CI） were 0.748-0.954 and 0.793-0.968，respectively，P<0.05]. The areas under curves（AUC） for single and combined determinations of serum LRG1 and HDL-C to determine cognitive impairment in AIS patients were 0.840，0.670 and 0.851，respectively. Serum LRG1 and HDL-C levels in recurrence group were lower than those in non-recurrence group（P<0.05），and TC levels and the proportion of hyperlipidemia were higher than those in non-recurrence group（P<0.05）. The AUC for single and combined determinations of serum LRG1，HDL-C and TC to determine stroke recurrence in AIS patients were 0.781，0.696，0.806 and 0.899，respectively. Conclusions Serum LRG1 level is related to cognitive impairment and recurrence in patients with AIS，and it may serve as one of the predictive indicators for cognitive impairment and stroke recurrence after AIS.

Role of serum exosomal miR-93-5p determination in children with bronchial asthma

LIU Ruishan, LONG Fengming, ZOU Chengli

2024, 39(5): 449-453. DOI: 10.3969/j.issn.1673-8640.2024.05.006

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Objective To investigate the role of serum exosomal microRNA-93-5p（miR-93-5p） determination and its correlation with airway inflammation and lung function in children with bronchial asthma. Methods From April 2020 to April 2022，133 children with bronchial asthma（asthma group） and 133 healthy children（healthy control group） were enrolled from the Second People's Hospital of Neijiang. According to the condition of bronchial asthma，133 children were classified into acute attack group（51 cases） and clinical remission group（82 cases）. The relative expression level of serum exosomal miR-93-5p，airway inflammation indicators [serum IgE，interleukin（IL）-17，the absolute value of eosinophils（EO#），C-reactive protein（CRP），tumor necrosis factor-alpha（TNF-α），IL-8] and lung function [forced vital capacity（FVC%），forced expiratory volume in one second（FEV1%） and the percentage of FEV1 in FVC（FEV1/FVC%）] were determined. Pearson correlation analysis was used to evaluate the correlation of each indicator. Receiver operating characteristic（ROC） curve was used to evaluate the indicators' efficiency for the diagnosis of children with bronchial asthma. Results Compared with healthy control group，serum exosomal miR-93-5p，IgE，IL-17，EO#，CRP，TNF-α and IL-8 in asthma group were increased（P<0.001），while FVC%，FEV1% and FEV1/FVC% were decreased（P<0.001）. Serum exosomal miR-93-5p was positively correlated with IgE，IL-17，EO#，CRP and IL-8 in asthma group（r values were 0.319，0.440，0.535，0.279 and 0.296，P<0.05）. It was negatively correlated with FEV1%，FVC% and FEV1/FVC% （r values were -0.304，-0.295 and -0.327，P<0.05）. Compared with clinical remission group，the relative expression level of serum exosomal miR-93-5p in acute attack group was decreased（P<0.001），and the levels of IgE，IL-17，EO#，CRP and IL-8 were increased（P<0.01）. The areas under curves（AUC） of serum exosomal miR-93-5p，IgE，IL-17，EO#，CRP，TNF-α and IL-8 in the diagnosis of bronchial asthma were 0.88，0.60，0.65，0.64，0.69，0.62 and 0.66，respectively. Conclusions The level of serum exosomal miR-93-5p is increased in children with bronchial asthma，which is related to lung function and airway inflammation in children，and it may be used as an indicator for the diagnosis and disease severity assessment of bronchial asthma.

Roles of IP-10 and MCP-1 in cerebrospinal fluid of children with viral encephalitis

ZHANG Na, LI Jing, YAN Xiaojing, ZHANG Lan, LIU Weixiao

2024, 39(5): 454-457. DOI: 10.3969/j.issn.1673-8640.2024.05.007

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Objective To investigate the roles of interferon-inducible protein-10（IP-10） and monocyte chemotactic protein-1（MCP-1） in the cerebrospinal fluid of children with viral encephalitis. Methods Totally，60 children with viral encephalitis（viral encephalitis group） were enrolled from Xingtai People's Hospital from July 2019 to December 2020，which included 26 mild cases and 34 severe cases，and 40 children with fever excluding intracranial infection were enrolled as control group. The levels of IP-10，MCP-1 and tumor necrosis factor-alpha（TNF-α） in cerebrospinal fluid were determined by enzyme-linked immunosorbent assay. The correlations of IP-10 and MCP-1 with TNF-α levels were evaluated by Pearson correlation analysis. Results The levels of cerebrospinal fluid IP-10，MCP-1 and TNF-α in viral encephalitis group were higher than those in control group（P<0.001）. The levels of cerebrospinal fluid IP-10，MCP-1 and TNF-α in severe group were higher than those in mild group（P<0.05）. The cerebrospinal fluid levels of IP-10 and MCP-1 were positively correlated with TNF-α levels in viral encephalitis group（r values were 0.742 and 0.696，P<0.05）. Conclusions IP-10 and MCP-1 are correlated with the severity of viral encephalitis in children and can be used as one of the indicators of disease surveillance.

Relation between peripheral blood cell score combined with IL-32 and prognosis of patients undergoing surgical treatment for multiple myeloma

MA Liyuan, YU Xiaohui, ZHANG Ningyu

2024, 39(5): 458-463. DOI: 10.3969/j.issn.1673-8640.2024.05.008

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Objective To investigate the relation between peripheral blood cell score combined with interleukin（IL）-32 level and the prognosis of patients with multiple myeloma（MM） after surgical treatment. Methods A total of 102 MM patients who underwent surgical treatment in Dalian Second People's Hospital from January 2019 to January 2021 were enrolled. The absolute value of monocytes（MO#），platelet（PLT） count，mean corpuscular volume（MCV） and IL-32 level were determined at 1 d before operation，and the peripheral blood cell score was calculated. The clinical data and laboratory determination results of all the patients were collected. After 1 year of follow-up，MM patients were classified into survival group（76 cases） and death group（26 cases）. Receiver operating characteristic（ROC） curve was used to analyze the efficacy of each index in predicting postoperative mortality of MM patients. Kaplan-Meier survival curve was used to analyze the prognosis of MM patients，and Cox proportional hazard regression analysis was used to evaluate the risk factors for postoperative death of MM patients. Results The death group had higher percentages of peripheral blood cell score 2-3，MO#>0.6×10⁹·L^-1， MCV>100 fL，cystatin C（Cys C） and IL-32 levels than survival group（P<0.05）. The areas under curves（AUC） of peripheral blood cell score and IL-32 single and combined determinations for predicting postoperative death of MM patients were 0.811，0.837 and 0.905，respectively. The survival rate of peripheral blood cell score 2-3 group was lower than that of 0-1 group（P<0.05），and the survival rate of high IL-32 group （IL-32≥62.38 ng·L^-1） was lower than that of low IL-32 group（IL-32<62.38 ng·L^-1）（P<0.05）. Peripheral blood cell score，IL-32 and Cys C were all risk factors for death of MM patients at 1 year after operation [hazard ratios（HR） were 3.854，3.677 and 3.575， 95% confidence intervals（CI） were 1.394-10.650，1.330-10.161 and 1.294-9.880，respectively]. Conclusions Peripheral blood cell score combined with IL-32 can be used as a sensitive index to predict the death of MM patients at 1 year after operation.

Clinical roles of serum DHEA-S，SHBG and 17α-OHP in patients with polycystic ovary syndrome

DU Jinlong, LU Hong

2024, 39(5): 464-467. DOI: 10.3969/j.issn.1673-8640.2024.05.009

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Objective To investigate the clinical roles of serum dehydroepiandrosterone sulfate（DHEA-S），sex hormone-binding globulin（SHBG） and 17 alpha-hydroxyprogesterone（17α-OHP） levels in patients with polycystic ovary syndrome（PCOS）. Methods A total of 110 PCOS patients（PCOS group） and 550 healthy females（healthy control group） were enrolled from Fengcheng Hospital of Fengxian District from January 1，2020 to March 8，2023. Serum levels of DHEA-S，SHBG and 17α-OHP were determined. Multivariate Logistic regression analysis was used to evaluate the risk factors of PCOS. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of DHEA-S，SHBG and 17α-OHP in the diagnosis of PCOS. Results The serum DHEA-S and 17α-OHP levels in PCOS group were higher than those in healthy control group（P<0.01），and serum SHBG levels were lower than those in healthy control group（P<0.01）. DHEA-S，SHBG and 17α-OHP were all risk factors for PCOS [odds ratios（OR） were 3.546，0.931 and 5.742，95% confidence intervals（CI） were 1.504~8.448，0.882~0.982，1.869~17.648，respectively，P<0.01]. The areas under curves（AUC） of DHEA-S，SHBG and 17α-OHP for the diagnosis of PCOS were 0.823，0.868，0.869 and 0.968，respectively. Conclusions Serum DHEA-S and 17α-OHP levels in PCOS patients are increased，while SHBG levels are decreased. The combined determination of DHEA-S，SHBG and 17α-OHP levels in PCOS patients has high clinical value in the auxiliary diagnosis of PCOS.

Establishment and application of main components of Huang-Lian-Jie-Du decoction based on high performance liquid chromatography

ZHOU Fangfang, GU Xuemei, WANG Wei, LIN Ming, WANG Lei

2024, 39(5): 468-473. DOI: 10.3969/j.issn.1673-8640.2024.05.010

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Objective To establish a high performance liquid chromatography（HPLC） for the determination of 6 main components in Huang-Lian-Jie-Du decoction. Methods The chromatography was performed on a Zorbax Eclipse Plus C18 column（250 mm×4.6 mm，5 μm） with 0.03 mg·mL^-1 potassium dihydrogen phosphate acetonitrile（V∶V = 7∶3） as the mobile phase. The flow rate was 1.0 mL·min^-1，and the determination wavelength was 345 nm. The column temperature was 37 ℃，and the sample size was 20 μL. The HPLC was established for the determination of the 6 main components of Huang-Lian-Jie-Du decoction（genipin，berberine，coptisine，jateorhizine，baicalin and palmatine）. The standard curves of 6 components determined by HPLC were drawn，and the methodological evaluation（linear evaluation，recovery rate，accuracy and precision，stability） was carried out. The established HPLC was used to determine the samples of Huang-Lian-Jie-Du decoction. Results The linear ranges of genipin，berberine，coptisine，jateorhizine，baicalin and palmatine were 25.00-800.00，32.00-1 024.00，20.00-640.00，20.30-650.00，13.13-420.00 and 25.00-800.00 μg·mL^-1，respectively. The precision and accuracy were <2%. The recoveries were 105.30%，102.88%，103.51%，107.76%，96.29% and 99.34%，respectively. The stability test results showed that the peak area relative standard derivations（RSD） of genipin，berberine，coptisine，jateorhizine，baicalin and palmatine were all <2% after 24 h at room temperature，3 times frozen and thawing，2-8 ℃ for 1 week，and -80 ℃ for 1 month，and the determination results were all stable. The main components of Huang-Lian-Jie-Du decoction were determined by HPLC. The concentrations from high to low were jateorhizine（2 799.00 μg·mL^-1），berberine（2 358.03 μg·mL^-1），genipin（1 793.34 μg·mL^-1），palmatine（945.30 μg·mL^-1），coptisine （192.00 μg·mL^-1） and baicalin（171.00 μg·mL^-1）. Conclusions The established HPLC for the determination of the main components of Huang-Lian-Jie-Du decoction is rapid，simple，reproducible and accurate，which lays a foundation for the subsequent research and clinical application of Huang-Lian-Jie-Du decoction.

Relationship between uric acid/creatinine ratio and neutrophil/lymphocyte ratio and hypoxemia in patients with acute exacerbation of chronic obstructive pulmonary disease

ZHOU Ruiling, ZHANG Xinyu, REN Xiaoling, ZHANG Wen, FAN Changzheng, ZHANG Qiong

2024, 39(5): 474-479. DOI: 10.3969/j.issn.1673-8640.2024.05.011

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Objective To investigate the clinical roles of uric acid（UA）/creatinine（Cr）ratio and neutrophil/lymphocyte ratio（NLR）in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD） combined with hypoxemia. Methods The clinical data of 126 patients with AECOPD in Xiyuan Hospital of China Academy of Chinese Medical Sciences from January 2019 to December 2021 were analyzed retrospectively，and the 126 patients were classified into hypoxemia group [86 cases，partial pressure of oxygen（PaO₂）<83 mmHg] and non-hypoxemia group（40 cases，PaO₂≥ 83 mmHg） according to the level of PaO₂. The differences of traditional Chinese medicine syndromes，clinical data and related laboratory indexes were compared between the 2 groups. The correlation of UA/Cr ratio，NLR and forced expiratory volume in one second（FEV1）/forced vital capacity（FVC），percentage of forced expiratory volume in one second in predicted value（FEV1pred%），chronic obstructive pulmonary disease assessment test（CAT）score and modified Medical Research Council （mMRC） dyspnea grade of patients with AECOPD combined with hypoxemia was analyzed by Spearman/Pearson correlation analysis. Receiver operating characteristic（ROC） curves were used to analyze the efficacy of UA/Cr ratio and NLR single and combined determinations in predicting hypoxemia in AECOPD patients. Results The UA/Cr ratio and NLR in hypoxemia group were higher than those in non-hypoxemia group（P<0.001）. There was no statistical significance in the proportion of patients with traditional Chinese medicine syndromes between the 2 groups （P>0.05）. UA/Cr ratio and NLR were positively correlated with CAT score and mMRC dyspnea grade（P<0.05） and were negatively correlated with FEV1/FVC and FEV1pred%（P<0.05）. ROC curve analysis showed that the areas under curves of UA/Cr ratio and NLR single and combined determinations of AECOPD patients with hypoxemia were 0.792，0.768 and 0.876，respectively. Conclusions UA/Cr ratio and NLR can be used to predict patients with AECOPD combined with hypoxemia，and the combined determination is effective.

Relationship between NLR，TGF-β1 and Cav-1 levels and bleeding risk after mechanical thrombectomy for acute intracranial artery occlusion in elders

LI Kejing, WANG Lin, YANG Ning

2024, 39(5): 480-484. DOI: 10.3969/j.issn.1673-8640.2024.05.012

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Objective To investigate the relationship between neutrophil-to-lymphocyte ratio（NLR），transforming growth factor-beta 1（TGF-β1），caveolin-1（Cav-1） and the risk of bleeding after mechanical thrombectomy for acute intracranial artery occlusion in elders. Methods A total of 120 elderly patients with acute intracranial artery occlusion who were treated in Hebei Petro China Central Hospital from September 2017 to December 2021 were enrolled and classified into bleeding group and non-bleeding group according to whether there was postoperative bleeding. The differences in clinical data，NLR，TGF-β1 and Cav-1 levels between the 2 groups were compared. Multivariate Logistic regression analysis was used to evaluate the influencing factors of postoperative bleeding. The values of NLR，TGF-β1 and Cav-1 in predicting postoperative bleeding were evaluated by receiver operating characteristic（ROC） curve. Results The National Institute of Health Stroke Scale（NIHSS） score in bleeding group was 19.91±2.28，NLR and Cav-1 were 7.20±1.12 and（19.29±5.53） ng·mL^-1，respectively，which were higher than those in non-bleeding group（P<0.05）. The Alberta Stroke Program Early Computed Tomography Score（ASPECTS） was 5.40±0.77，and the TGF-β1 was（20.20±8.28） pg·mg^-1，both of which were lower than those in non-bleeding group（P<0.05）. NIHSS score and NLR were risk factors for postoperative bleeding（P<0.05），and ASPECTS was protective factor for postoperative bleeding（P<0.05）. Based on ASPECTS，NIHSS score and NLR，the area under curve was 0.851，and the sensitivity and specificity were 64.00% and 84.00%，respectively. Conclusions NLR，Cav-1 and TGF-β1 are related to of bleeding after mechanical thrombectomy for acute intracranial artery occlusion in elders，and serum TGF-β1 is the protective factor. They have certain application value in predicting postoperative bleeding.

Correlations between monocyte-to-lymphocyte ratio with coronary heart disease and the extent of coronary atherosclerosis

LIU Lin, WANG Tiankai, QIN Kangchunfeng, DING Ning

2024, 39(5): 485-490. DOI: 10.3969/j.issn.1673-8640.2024.05.013

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Objective To investigate the correlation of monocyte-to-lymphocyte ratio（MLR） with coronary heart disease（CHD） and the extent of coronary atherosclerosis. Methods A total of 200 CHD patients with positive coronary angiography results（major vessel diameter ≥50%） in North Branch of Ruijin Hospital of Shanghai Jiao Tong University School of Medicine from June to December 2022 were enrolled as CHD group，and 131 patients with negative coronary angiography results during the same period were enrolled as control group. The difference of MLR，neutrophil-to-lymphocyte ratio（NLR） and platelet-to-lymphocyte ratio（PLR） was evaluated between CHD and control groups. The correlations between MLR and creatine kinase（CK），lactate dehydrogenase（LDH） and Gensini scores were evaluated by Pearson or Spearman correlation analysis. Logistic regression analysis was used to evaluate the influencing factors of CHD. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of MLR in diagnosing CHD. Results MLR，NLR and PLR in CHD group were higher than those in control group（P<0.001）. There was no statistical significance in MLR between CHD group and control group after therapy（P>0.05）. MLR was positively correlated with CK，LDH and Gensini scores in CHD patients（r values were 0.150 0，0.290 0 and 0.545 1，P<0.05）. CK，MLR，NLR and PLR were all influencing factors of CHD. After adjusting for confounding factors，the risk of CHD was 1.6 times higher when MLR>0.25 than when MLR≤0.17 [odds ratio（OR）=1.609，95% confidence interval（CI） 1.213-2.133]. The area under curve of MLR for diagnosing CHD was 0.674 3，the sensitivity was 62.00%，and the specificity was 62.60%. Conclusions MLR is related with CHD and the extent of coronary atherosclerosis，and it may be an independent predictor of the extent of coronary atherosclerosis in CHD patients，which can help clinical judgement whether to proceed with further invasive treatment.

Roles of thromboelastography and coagulation index in predicting venous thromboembolism in patients with tumors

WANG Xuexing, CHEN Chunmei, HE Yuan, CHU Jie, WEI Chunmei

2024, 39(5): 491-496. DOI: 10.3969/j.issn.1673-8640.2024.05.014

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Objective To analyze the roles of thromboelastography （TEG） and coagulation index in predicting tumor-associated venous thromboembolism （TAVTE）. Methods A case control study was used to enroll 167 patients with malignant solid tumor admitted to the First People's Hospital of Anning from January 2022 to May 2023. They were classified into observation group （31 cases） and control group （136 cases） according to whether TAVTE was confirmed. The differences of general clinical data，blood cell analysis，coagulation test，TEG，blood glucose，blood lipid and other laboratory indexes were compared between the 2 groups. Logistic regression analysis was used to evaluate the influencing factors of TAVTE，and a nomogram prediction model was established. Receiver operating characteristic （ROC） curve and decision curve analysis（DCA） were used to evaluate the efficiency of the nomogram prediction model. Results There was statistical significance in tumor stage，surgical history，Caprini score，red blood cell，hemoglobin，haematocrit，albumin，international standardized ratio，prothrombin time，antithrombin Ⅲ and D-dimer between observation group and control group （P<0.05），while there was no statistical significance in other general clinical data and laboratory indexes （P>0.05）. Tumor stage，diabetes mellitus，D-dimer and maximum amplitude（MA） were independent risk factors for TAVTE in tumor patients（P<0.05）. The sensitivity and specificity of the established nomogram prediction model were 87.1% and 66.2%，respectively，and the area under curve was 0.819. Conclusions TEG parameter MA and coagulation index D-dimer have predictive value for TAVTE. The nomogram prediction model can predict TAVTE well.

Correlation between microbiological characteristics of Helicobacter pylori and chronic atrophic gastritis

LI Yumei, LONG Xiaoping, MAO Xiaoxue, HU Xiaoying, GU Chenghong

2024, 39(5): 497-503. DOI: 10.3969/j.issn.1673-8640.2024.05.015

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Objective To investigate the correlation between the microbiological characteristics of Helicobacter pylori（Hp） and chronic atrophic gastritis（CAG）. Methods The clinical data of 300 patients with chronic gastritis（CG） complicated with Hp infection diagnosed in the Fourth People's Hospital of Zigong City from November 2020 to November 2022 were analyzed retrospectively. The patients were classified into 2 groups according to whether gastric mucosal atrophy occurred，which included non-atrophy group（136 cases） and atrophy group（164 cases）. The clinical characteristics，microbiological characteristics of Hp isolates and drug resistance to common antibiotics were compared between the 2 groups. Logistic regression analysis was used to evaluate the influencing factors of gastric mucosal atrophy. The Bayesian network prediction model was constructed，and the differentiation and accuracy of the prediction model were evaluated by receiver operating characteristic（ROC）curve and calibration curve. Results Irregular diet，family history of gastrointestinal diseases，consumption of pickled products in atrophy group were higher than those in non-atrophy group（P<0.05）. Hp serotype and virulence gene in atrophy group were higher than those in non-atrophy group（P<0.05）. The drug resistance of Hp in atrophy group to amoxicillin，metronidazole and levofloxacin was higher than that in non-atrophy group（P<0.05）. Irregular diet，family history of gastrointestinal diseases，consumption of pickled products，carrying CagA antibody and cagA virulence gene，type Ⅰ isolates and drug resistance to amoxicillin，metronidazole and levofloxacin were risk factors for gastric mucosal atrophy（P<0.05）. The Bayesian network prediction model had good differentiation and accuracy. Conclusions There is a correlation between the microbiological characteristics of Hp isolates and CAG.

Research progress of rivaroxaban causing changes in platelet count and function

XIONG Tianhui, CHAI Kening, XIA Wei, QU Linlin

2024, 39(5): 504-509. DOI: 10.3969/j.issn.1673-8640.2024.05.016

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Thrombotic disease seriously threatens human life and health，especially the normal function of cardiovascular and cerebrovascular diseases. The main strategy of treating thrombotic disease is to inhibit the initiation of coagulation mechanism and block thrombin activation. As a new oral anticoagulant，rivaroxaban can efficiently and accurately block thrombus waterfall formation，with targeting，low side effects and low bleeding risk，and it has been widely used in clinical practice recently. With the widespread clinical use of rivaroxaban，its effects on platelet（PLT） count and function begins to emerge. In this review，the changes in PLT count and function and the mechanism caused by rivaroxaban are summarized to facilitate the rational evaluation on the coagulation function of patients during medication.

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