Table of Content

30 July 2024, Volume 39 Issue 7

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Correlation between Lp-PLA2 gene polymorphism and histopathological staining of carotid plaque

LIU Yadong, YANG Lei, SONG Shaoting, DU Xiong, LIU Qiang, SUN Jianrong

2024, 39(7):  621-626.  DOI: 10.3969/j.issn.1673-8640.2024.07.001

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Objective To investigate the correlation between the histopolymorphism of lipoprotein-associated phospholipase A2 （Lp-PLA2） gene and the results of histopathological staining of carotid plaque. Methods A total of 135 patients who underwent carotid artery dissection in the Affiliated Hospital of Yan'an University from January 2021 to October 2023 were enrolled. The clinical and drug use data were collected from all the patients. Serum total cholesterol （TC），triglyceride （TG），high-density lipoprotein cholesterol （HDL-C），low-density lipoprotein cholesterol （LDL-C），homocysteine （Hcy），lipoprotein （a） [Lp （a）]，high-sensitivity C-reactive protein （hs-CRP），Lp-PLA2 level and Lp-PLA2 gene R92H，V297F，A379V polymorphisms were determined. Von kossa staining，α-SMA，oil red O staining，EVG staining and CD68+ immunohistochemical staining were performed on the carotid plaque. According to the results of Lp-PLA2 gene polymorphism determination，all the patients were classified into control group （no mutation at R92H，A379V and V297F sites），A379V group （only mutation at A379V site），V297F group （only mutation at V297F site） and R92H group （only mutation at R92H site）. Spearman correlation analysis was used to evaluate the correlation with histopathological staining of carotid plaque. Logistic regression analysis was used to evaluate the effect of Lp-PLA2 gene polymorphism on carotid plaque histopathological staining results. Results There was statistical significance in age and serum levels of HDL-C，LDL-C and Lp-PLA2 among control group，A379V group，V297F group and R92H group （P<0.05），while there was no statistical significance in the other indicators among the 4 groups（P>0.05）. The positive percentages of calcified and necrotic nuclei，fat，elastic fiber，collagen fiber and macrophage in the carotid plaque of control group，A379V group，V297F group and R92H group were statistically significant（P<0.05）. There was no statistical significance in the positive percentage of smooth muscle cells among the 4 groups（P>0.05）. There was a positive correlation between Von kossa staining and CD68+ immunohistochemical staining in R92H group （r=0.819，P=0.025），and there was no correlation between the other histopathological staining results （P>0.05）. There was no correlation among the histopathological staining results in control group，A379V group and V297F group （P>0.05）. After adjusting age and serum HDL-C，LDL-C and Lp-PLA2，Lp-PLA2 gene R92H site mutation was an independent risk factor for increased calcification and necrotic nucleus positive percentage and macrophage positive percentage in carotid plaque [odds ratios （OR） were 1.97 and 1.26，95% confidence intervals（CI）were 1.56- 2.19 and 1.06-1.53，respectively，P<0.05]. Conclusions Lp-PLA2 gene R92H site mutation can affect the stability of carotid plaque and increase the risk of plaque rupture. Clinical attention should be paid to Lp-PLA2 gene R92H site mutation population.

Roles of Notch1 mRNA and Dickkopf-1 in assessing the therapeutic responsiveness of pembrolizumab in non-small cell lung cancer patients

WANG Yafei, ZHANG Zhenjun, SONG Changliang, YANG Qiong

2024, 39(7):  627-633.  DOI: 10.3969/j.issn.1673-8640.2024.07.002

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Objective To investigate the roles of Notch1 mRNA and Dickkopf-1 in assessing the therapeutic responsiveness of pembrolizumab in non-small cell lung cancer （NSCLC）patients. Methods Totally，169 patients with NSCLC treated in Handan Central Hospital from July 2020 to September 2022 were enrolled as observation group，and 168 patients with benign lung nodules were enrolled as control group. The clinical data of all the patients were collected，and the relative expression of serum Notch1 mRNA and Dickkopf-1 level in control group before treatment and at 3 and 6 weeks after pembrolizumab treatment were determined. The therapeutic responsiveness [disease progression （PD），disease control （DC）] at 6 weeks after pembrolizumab treatment in NSCLC patients was evaluated. Receiver operating characteristic （ROC） curve was used to evaluate the efficacy of Notch1 mRNA and Dickkopf-1 in judging the therapeutic responsiveness of pembrolizumab before treatment. Logistic regression model was used to analyze the influencing factors of therapeutic responsiveness of pembrolizumab. Results Serum Notch1 mRNA relative expression and Dickkopf-1 level in NSCLC group were higher than those in control group before treatment and at 3 and 6 weeks after treatment（P<0.001）. The relative expression of serum Notch1 mRNA and Dickkopf-1 level in NSCLC group were decreased successively before treatment and at 3 and 6 weeks after treatment （P<0.001）. There was statistical significance in age，the Eastern Cooperative Oncology Group（ECOG） score，clinical stage，lymphatic metastasis，distant metastasis，differentiation degree，programmed cell death-ligand 1（PD-L1）expression and serum Notch1 mRNA relative expression and Dickkopf-1 level before treatment and at 3 and 6 weeks after treatment between PD group and DC group（P<0.05）. The areas under curves （AUC） of serum Notch1 mRNA and Dickkopf-1 in assessing the therapeutic responsiveness of pembrolizumab were 0.791，0.796 and 0.861，respectively. After adjusting for confounding factors，the risk probabilities of PD in high Notch1 mRNA group and high Dickkopf-1 group before treatment were 3.517 times and 3.326 times higher than those in low Notch1 mRNA group and low Dickkopf-1 group [odds ratios （OR） were 3.517 and 3.326，95% confidence intervals （CI） were 2.159-5.728 and 2.211-5.003，respectively]. Conclusions Serum Notch1 mRNA relative expression and Dickkopf-1 level are related to pembrolizumab therapeutic responsiveness，which can be used as effective indicators to evaluate therapeutic responsiveness.

Roles of serum L-Arg and IL-4 levels in predicting recurrent ischemic stroke in patients with symptomatic carotid artery stenosis

LIU Yi, SU Xiaoming, WANG Yuanyuan, JU Tao

2024, 39(7):  634-639.  DOI: 10.3969/j.issn.1673-8640.2024.07.003

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Objective To investigate the roles of serum L-arginine （L-Arg） and interleukin（IL）-4 levels in predicting recurrent ischemic stroke （IS） in patients with symptomatic carotid artery stenosis. Methods Totally，196 patients with symptomatic carotid artery stenosis were enrolled from the First Affiliated Hospital of Xi'an Jiaotong University，the First People's Hospital of Xianyang City and Xianyang Hospital of Yan'an University from July 2018 to July 2021. The clinical data of all the patients were collected，and the parameters related to carotid artery stenosis，carotid plaque traits and plaque neovascularization density [baseline intensity，peak intensity and area under curve of time intensity curves（AUCTC）] were examined by Doppler ultrasound. Serum L-Arg and IL-4 levels were determined. All the patients were followed up for 12 months，which were classified into recurrent IS group（35 cases）and non-recurrent IS group（161 cases）. Logistic regression analysis was used to evaluate the risk factors for recurrent IS in patients with symptomatic carotid artery stenosis. Pearson correlation analysis was used to evaluate the correlation among the indicators. Receiver operating characteristic （ROC） curves were used to evaluate the efficacy of serum L-Arg and IL-4 levels in determining recurrent IS in patients with symptomatic carotid artery stenosis. Results The peak intensity，AUCTC and carotid artery stenosis rate in recurrent IS group were higher than those in non-recurrent IS group （P<0.001），and serum L-Arg and IL-4 levels were lower than those in non-recurrent IS group （P<0.05）. Serum L-Arg and IL-4 levels were negatively correlated with peak intensity，AUCTC and carotid artery stenosis rate （P<0.05）. Decreased L-Arg，decreased IL-4，increased peak intensity，increased AUCTC，severe carotid artery stenosis，history of hyperlipidemia and vulnerable plaque were all independent risk factors for recurrent IS in patients with symptomatic carotid artery stenosis （P<0.05）. The areas under curves （AUC） of serum L-Arg and IL-4 were 0.803，0.760 and 0.845 in patients with symptomatic carotid artery stenosis. All the patients were classified into reduced and non-reduced groups according to the optimal cut-off values of serum L-Arg and IL-4. The proportions of vulnerable plaque in L-Arg decreased group and IL-4 decreased group were higher than those in L-Arg non-decreased group and IL-4 non-decreased group （P<0.001）. Conclusions Low levels of serum L-Arg and IL-4 are associated with recurrent IS in patients with symptomatic carotid artery stenosis，which may be used as the predictors of recurrent IS.

Roles of C-reactive protein/albumin ratio and neutrophil/lymphocyte ratio in predicting obstructive sleep apnea hypopnea syndrome with hypertension

YUAN Yongcheng, LIU Shangjun

2024, 39(7):  640-644.  DOI: 10.3969/j.issn.1673-8640.2024.07.004

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Objective To investigate the roles of C-reactive protein/albumin ratio （CAR） and neutrophil/lymphocyte ratio （NLR） in the prediction of obstructive sleep apnea hypopnea syndrome （OSAHS） with hypertension. Methods From October 2019 to October 2022，120 patients with OSAHS in Sanya Central Hospital were enrolled and classified into hypertension group and OSAHS group according to whether they were complicated with hypertension or not during hospitalization and follow-up for 6 months after discharge. The general data were collected，and CAR and NLR were determined and calculated. Bivariate Logistic regression analysis was used to evaluate the risk factors of hypertension in OSAHS patients. Receiver operating characteristic （ROC） curve was used to evaluate the efficacy of single and combined determinations of various indicators in the prediction of OSAHS with hypertension. Results Of 120 OSAHS patients，81 cases （67.5%） were complicated with hypertension. The body mass index （BMI），NLR，CAR，diabetes mellitus history，hyperlipidemia and moderate to severe OSAHS proportion in hypertension group were higher than those in OSAHS group （P<0.05）. NLR and CAR were increased with the increase of hypertension grade of OSAHS patients （P<0.05）. Increased BMI，diabetes mellitus，hyperlipidemia，moderate to severe OSAHS，NLR and CAR were risk factors for hypertension in OSAHS patients （P<0.05）. The areas under curves （AUC） for predicting OSAHS patients with hypertension were 0.696，0.654 and 0.802，respectively，for the single and combined determinations of CAR and NLR （positive for either of the 2 indicators）. The AUC of the prediction model was 0.845. Conclusions CAR and NLR play roles in the prediction of OSAHS with hypertension，and the combined prediction model is effective in the prediction of OSAHS with hypertension.

Correlation between serum ANGPTL7 level and insulin resistance in subjects with different glucose tolerance

LIU Ying, ZHANG Shitian, LIU Linlin, XIE Xi, WANG Yaru, NIU Wenyan

2024, 39(7):  645-649.  DOI: 10.3969/j.issn.1673-8640.2024.07.005

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Objective To investigate the relationship between serum angiopoietin-like protein 7（ANGPTL7） and insulin resistance in subjects with different glucose tolerance. Methods A total of 159 patients and healthy subjects from Chu Hsien-I Memorial Hospital of Tianjin Medical University from March 2022 to December 2022 were enrolled. According to oral glucose tolerance test （OGTT），159 subjects were classified into 3 groups，normal glucose tolerance group （46 cases），impaired glucose regulation group （53 cases） and type 2 diabetes mellitus （T2DM） group （60 cases）. Blood glucose，glycated hemoglobin A_1c（HbA_1c），insulin，blood lipid，ANGPTL7 and interleukin-1 beta （IL-1β） levels were determined，and homeostasis model assessment of insulin resistance（HOMA-IR） was calculated. Pearson correlation analysis was used to evaluate the correlation among the indicators. Results The level of ANGPTL7 in T2DM group was higher than that in normal glucose tolerance group（P<0.05），but there was no statistical significance between impaired glucose regulation group and normal glucose tolerance group（P>0.05）. The IL-1β level in T2DM group was higher than those in impaired glucose regulation group and normal glucose tolerance group（P<0.05），and the IL-1β level in impaired glucose regulation group was higher than that in normal glucose tolerance group（P<0.05）. Fasting plasma glucose （FPG），fasting insulin （FINS），2 h postprandial blood glucose （2 hPG），HbA_1c，triglyceride （TG），total cholesterol （TC），high-density lipoprotein cholesterol （HDL-C） and low-density lipoprotein cholesterol （LDL-C） had statistical significance in T2DM group，impaired glucose regulation group and normal glucose tolerance group （P<0.001）. ANGPTL7 was positively correlated with FPG，FINS，2 hPG，HbA_lc，TG，IL-1β and HOMA-IR（r=0.316，0.225，0.359，0.296，0.197，0.202 and 0.260，respectively，P<0.05），and it was negatively correlated with HDL-C （r=-0.167，P<0.05）. Conclusions Serum ANGPTL7 level increases gradually with the severity of insulin resistance，and ANGPTL7 is related to the occurrence of T2DM.

Roles of Ang-1，HO-1，NGF and MMSE scores in evaluation of HICH efficacy

ZHANG Chunxiang, JI Mingming, SUN Minling, LI Jianying

2024, 39(7):  650-655.  DOI: 10.3969/j.issn.1673-8640.2024.07.006

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Objective To evaluate the efficacy of angiopoietin-1（Ang-1），heme oxygenase 1（HO-1），nerve growth factor （NGF） and Mini-Mental State Examination（MMSE）score in hypertensive intracerebral hemorrhage （HICH）. Methods Totally，152 patients with HICH（HICH group）and 68 healthy subjects （healthy control group） were enrolled from Zhangjiakou First Hospital from February 2018 to February 2022. All the patients were treated with bone flap hematoma removal，supportive therapy and brain proteolytic hydrolysate. According to the efficacy，they were classified into effective group （105 cases） and ineffective group （47 cases）. Serum Ang-1，HO-1 and NGF levels of HICH and healthy groups before and after treatment were determined，and MMSE scores were used to evaluate the cognitive function of HICH patients. Multivariate Logistic regression analysis was used to evaluate the risk factors of HICH treatment failure. Receiver operating characteristic （ROC） curve was used to evaluate the efficacy of Ang-1，HO-1，NGF and MMSE scores in judging the therapeutic effect of HICH. Results Before treatment，serum Ang-1，NGF and MMSE scores in HICH group were lower than those in healthy control group （P<0.05），and serum HO-1 levels in HICH group were higher than those in healthy control group （P<0.05）. After treatment，serum Ang-1，NGF and MMSE scores in effective group were higher than those before treatment （P<0.05），and serum HO-1 levels were lower（P<0.05）. There was no statistical significance between the 2 groups before and after treatment （P>0.05）. Serum Ang-1，NGF levels and MMSE scores in ineffective group were lower than those in effective group before and after treatment （P<0.05），and serum HO-1 levels were higher than those in effective group （P<0.05）. Grade 3 hypertension and pre-treatment increase of HO-1，decrease of Ang-1，decrease of NGF and decrease of MMSE scores were risk factors for treatment ineffectiveness in patients with HICH [odds ratios （OR） were 2.324，1.442，0.549，0.671 and 0.716，95% confidence intervals （CI） were 1.357-5.468，1.203-4.535，0.211-0.884，0.316-0.854 and 0.461-0.973，respectively，P<0.05]. The areas under curves （AUC） of serum Ang-1，HO-1，NGF levels and MMSE scores and combined determination to judge the treatment efficacy of HICH were 0.859，0.848，0.856，0.820 and 0.958. Conclusions Serum Ang-1，NGF and HO-1 levels are related to the clinical efficacy of patients with HICH，and they may be used as potential indicators for the efficacy evaluation of HICH.

Relation between serum osteopontin，fibroblast growth factor 23 levels and vascular calcification in maintenance hemodialysis patients

CHEN Yu, WANG Deqin, MIAO Xianjing, ZHOU Yonghua, LI Xiaofei, GAO Jian

2024, 39(7):  656-660.  DOI: 10.3969/j.issn.1673-8640.2024.07.007

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Objective To investigate the relation between osteopontin （OPN），fibroblast growth factor 23 （FGF23） and vascular calcification in maintenance hemodialysis （MHD） patients. Methods Totally，147 patients with MHD at Hai'an People's Hospital from January 2018 to June 2022 were enrolled. The general data and laboratory routine test results of all the patients were collected，and serum OPN and FGF23 levels were determined. The patients' vascular calcification was scored by X-ray images of abdomen，pelvis and hands，and the total score was 10 points. According to the total score of vascular calcification，the patients were classfied into non-vascular calcification group （total score 0）（49 cases），vascular calcification total score 1 to 5 group （74 cases） and vascular calcification total score 6 to 10 group （24 cases）. Results The dialysis time，the levels of total calcium，phosphorus，intact parathyroid hormone（iPTH），OPN and FGF23 were increased successively in non-vascular calcification group，vascular calcification total score 1 to 5 group and vascular calcification total score 6 to 10 group （P<0.05），and the hemoglobin （Hb） level and Kt/V ratio were decreased successively （P<0.05）. Long dialysis time [odds ratio（OR）=1.070]，high total calcium （OR=2.540），high phosphorus（OR=4.170），high OPN （OR=1.010） and high FGF23 （OR=1.060） were risk factors for vascular calcification in MHD patients. High Kt/V ratio （OR=0.020） was a protective factor for vascular calcification. The consistency （true positive rate+true negative rate） of phosphorus was the highest，but there was no statistical significance between those of phosphorus and OPN （P=0.89），and it was higher than that of FGF23 （P=0.02）. Conclusions The abnormal increase of OPN and FGF23 in MHD patients is related to vascular calcification，and they are potential intervention targets.

Establishment and performance evaluation of candidate reference measurement procedures for serum voriconazole

LIN Jing, PAN Qingqing, SHEN Min, XIE Yangmin, JIN Zhonggan, PAN Jingjue, LIU Jiajuan

2024, 39(7):  661-667.  DOI: 10.3969/j.issn.1673-8640.2024.07.008

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Objective To establish a candidate reference measurement method for serum voriconazole by isotope dilution liquid chromatography-tandem mass spectrometry （ID-LC-MS/MS）. Methods The samples were pretreated by protein precipitation （PPT） with methanol as precipitator. Using voriconazole -2H3 as internal standard，an ID-LC-MS/MS for the determination of voriconazole in serum was established. The linearity，limit of quantification （LOQ），limit of determination （LOD），accuracy，precision，matrix effect and stability were evaluated. Results The linear range of serum voriconazole was 0.2-16.0 μg·mL^-1，the limit of quantification was 0.08 μg·mL^-1，and the limit of determination was 0.016 μg·mL^-1. The recoveries were 97.26%-98.48%. The within-run coefficient of variation （CV） was <1%，and the between-run CV was < 2%. The relative matrix effect ranged from -1.87% to 0.33%. The samples were placed at room temperature [（23±2） ℃] for 4，8 h and repeatedly frozen and thawed for 5 times at -20 ℃，and the samples after pre-treatment were placed at room temperature and automatic injector （8 ℃） for 4，8，12 and 24 h，respectively. The recoveries were 95.63% - 99.50%，and the determination results were stable. The relative extended uncertainty was ≤3.34%. Conclusions A candidate reference method for the determination of serum voriconazole based on ID-LC-MS/MS has been established，which can be used for standardization.

Pulmonary tuberculosis diagnosis model for blood routine test based on machine learning algorithms

HUANG Ying, ZHOU Ying, SONG Yunxiao, MAO Junjie, GUAN Chao, ZHAO Jinyan, NI Peiqing

2024, 39(7):  668-672.  DOI: 10.3969/j.issn.1673-8640.2024.07.009

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Objective To construct a pulmonary tuberculosis diagnosis model based on machine learning algorithms for blood routine test，and to analyze its clinical application value. Methods Totally，469 newly diagnosed patients with pulmonary tuberculosis （pulmonary tuberculosis group） from Shanghai Xuhui Central Hospital from January 2019 to December 2022 were enrolled，and 506 healthy subjects matched by age and sex were enrolled as healthy control group. The data of 22 blood routine test items and demographic parameters of all the subjects were collected. The collinearity was analyzed by LASSO regression analysis. The datum set was randomly divided into 2 parts：75% was used as the training set for the construction of the machine learning model；25% was used as the test set for the performance evaluation of the model. Four machine learning algorithms，distributed random forest （DRF），deep learning，gradient elevator and generalized linear model，were used to test the model，and the diagnostic efficiency of the model was verified by 5-fold crossover method. The diagnostic performance of the model was evaluated by receiver operating characteristic （ROC） curve. Results Based on Logistic regression analysis and LASSO regression analysis，10 non-collinear indicators were selected. DRF was the opitmal machine learning algorithm for the construction of pulmonary tuberculosis diagnosis. In the training set and test set，the areas under curves of the DRF model were 0.992 1 and 0.847 4，the sensitivities were 99.16% and 92.04%，the specificities were 80.91% and 55.22%，and the accuracies were 89.84% and 72.06%，respectively. Conclusions The pulmonary tuberculosis diagnosis model based on machine learning algorithm is an effective diagnostic tool，but its clinical application value needs to be further verified.

Laboratory diagnosis and prognostic factor analysis of core binding factor-related acute myeloid leukemia

DING Jing, ZHANG Chunling, WANG Xiaorui, LI Huidan, WANG Hongling, LIU Weiling, LIN Lihui, LI Li

2024, 39(7):  673-681.  DOI: 10.3969/j.issn.1673-8640.2024.07.010

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Objective To analyze the correlation of general clinical characteristics （age and gender），laboratory determination results with prognosis（efficacy，recurrence and survival time） in patients with core binding factor（CBF）-related acute myeloid leukemia （AML），and to provide a reference for optimizing clinical treatment plans. Methods A total of 116 CBF-AML patients who received standard induction and consolidation chemotherapy at Shanghai General Hospital from January 2014 to December 2021 were enrolled，including 77 cases who received allogeneic hematopoietic stem cell transplantation （allo-HSCT）. According to fusion genes，the subjects were classified into AML RUNX1::RUNX1T1 （Group 1） and AML CBFB::MYH11 （Group 2）. Kaplan-Meier survival analysis and Cox regression analysis were used to evaluate the prognostic factors. Results There was statistical significance in baseline characteristics between Group 1 and Group 2，including age at onset，peripheral blood white blood cell count，hemoglobin level，bone marrow blast percentage，incidence of additional chromosomal abnormalities，sex chromosome deletion，KRAS mutation and NRAS mutation（P<0.05）. The overall survival （OS） of patients with recurrence was lower than that of those without recurrence（P=0.008）. Male，recurrence，TET2 mutation and del（9q） were related with poor OS（P<0.05）. Patients with platelet count <20×10⁹·L^-1 had poor OS and relapse-free survival（RFS）（P<0.05）. The OS of patients who recurred after transplantation was worse than that of patients who did not recurr after transplantation（P=0.001）. Cox regression analysis showed that recurrence，TET2 mutation and chromosome del（9q） were risk factors for OS，and time to remission （days） was an independent influencing factor for OS in AML patients with RUNX1::RUNX1T1 （P=0.038）. The proportion of bone marrow blast percentage was an independent influencing factor for OS in AML patients with CBFB::MYH11（P=0.044）. Conclusions There is heterogeneity in baseline characteristics between the 2 fusion genes of CBF-AML patients. TET2 mutation and del（9q）significantly affect survival time. AML patients with RUNX1::RUNX1T1 should pay attention to the time to remission（days），recurred patients are recommended to undergo salvage transplantation in time，and CBFB::MYH11 patients should pay attention to the bone marrow blast percentage.

Clinical value of new neutrophil parameter NEU-X，NEU-Y and NEU-Z in diagnosis of sepsis

WANG Tiankai, LIU Lin, JIN Peipei, WANG Fang, DING Ning

2024, 39(7):  682-686.  DOI: 10.3969/j.issn.1673-8640.2024.07.011

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Objective To evaluate the role of new neutrophil parameters（NEU-X，NEU-Y and NEU-Z）in the auxiliary diagnosis of sepsis. Methods Totally，55 sepsis inpatients，73 non-sepsis inpatients and 175 healthy subjects from the North Branch of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January to December 2021 were enrolled. C-reactive protein （CRP），white blood cell （WBC） count，the absolute value of neutrophils （NEUT#）NEUT count and NEU-X，NEU-Y and NEU-Z were compared among the 3 groups. The correlation between NEU-X，NEU-Y，NEU-Z and procalcitonin （PCT） in sepsis group was analyzed by Pearson analysis. Sepsis group was sub-classified into Gram-negat=ive bacterium infection group，Gram-positive bacterium infection group and fungal infection group，and the differences of NEU-X，NEU-Y and NEU-Z among the 3 groups were compared. Receiver operating characteristic （ROC） curve was used to evaluate the efficacy of NEU-X，NEU-Y and NEU-Z in diagnosing sepsis. Results NEU-X and NEU-Y in sepsis group were higher than those in healthy control group and non-sepsis group（P<0.001），CRP，WBC count and NEUT# were higher than those in healthy control group（P<0.001），but there was no statistical significance between them and non-sepsis group （P>0.05）. NEU-X，NEU-Y and NEU-Z were positively correlated with PCT（r values were 0.392 5，0.532 3，0.416 0，P<0.01）. NEU-Y in fungal infection group was lower than that in Gram-negative bacteria infection group（P<0.05）. The area under curve of NEU-Y for the diagnosis of sepsis was 0.681 8 [95% confidence interval （CI） 0.588 9-0.778 4]. The area under curve of NEU-Y was 0.810 3 （95%CI 0.731 0-0.889 7）. Conclusions NEU-X and NEU-Y can be used in the auxiliary diagnosis of sepsis.

Relationship between serum free light chain and selenium levels and clinicopathological characteristics of B-cell non-Hodgkin lymphoma patients and construction of prognostic risk model

TU Jiaqiang, WEN Xiaoling

2024, 39(7):  687-695.  DOI: 10.3969/j.issn.1673-8640.2024.07.012

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Objective To investigate the relationship between serum free light chain （FLC） and selenium levels in clinicopathological characteristics of B-cell non-Hodgkin lymphoma （B-NHL） patients，and to construct a prognostic risk model. Methods A total of 164 B-NHL patients from Yibin First People's Hospital from June 2014 to June 2021 were enrolled as training set. Another 82 patients with B-NHL were enrolled as validation set. The clinicopathological characteristics of all the patients were collected，and serum FLC and selenium levels and blood routine test were determined and performed. All the patients were followed up for 8 to 108 months until June 2023. Kaplan-Meier survival curve was used to evaluate the survival of patients with different serum FLC and selenium levels. The factors on progress-free survival and overall survival in B-NHL patients were evaluated by Cox proportional hazard regression analysis. R software was used to construct a nomogram risk model for predicting the prognosis of B-NHL patients and evaluating its efficacy. Results B-NHL patients were classified into low FLC level （87 cases） and high FLC level （77 cases） according to whether the FLC level was increased. There was statistical significance in Ann Arbor stage and B symptoms between B-NHL patients with low FLC level and high FLC level （P<0.05）. According to the median of serum selenium level （1.12 μmol/L），all the patients were classified into low selenium level （82 cases） and high selenium level （82 cases），and there was statistical significance in the Eastern Cooperative Oncology Group（ECOG）score between low selenium level and high selenium level B-NHL patients （P<0.05）. The progress-free survival and overall survival of patients with high FLC level and low selenium level were lower than those with low FLC level and high selenium level，respectively （P<0.01）. Multivariate Cox proportional risk regression analysis showed that age>60 years old，international prognostic index （IPI） score of 3-5，lactate dehydrogense（LDH）>250 U·L^-1，beta2-microglobulin （β2-MG）> 3 mg·L^-1 and decreased serum selenium level were risk factors for decreased progress-free survival and overall survival in B-NHL patients （P<0.05）. Increased serum FLC level was a risk factor for decreased progress-free survival in B-NHL patients （P<0.01）. The area under curve of the prognostic risk model was 0.856. The accuracy，sensitivity and specificity were similar in training set and validation set. The prognostic risk model had good stability （Nagelkerke R2=0.602）. Conclusions High FLC level is related to Ann Arbor stage and B symptoms of B-NHL patients，low selenium level is related to ECOG score of B-NHL patients. The nomogram risk model based on clinicopathological characteristics can accurately evaluate the prognosis of B-NHL patients.

Infectious disease screen test project cut-off value verification scheme and its significance

LI Xiaohan, LI Dongdong

2024, 39(7):  700-703.  DOI: 10.3969/j.issn.1673-8640.2024.07.014

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Cut-off value is important for determining the results of qualitative determinations for infectious disease screen. However，there are no recommendations on whether cut-off value verification is necessary and how to verify it. This review comprehensively analyzes the performance verification relevant standards，guidelines and literatures，and discussed the significance of cut-off value verification of infectious disease screen items and the feasibility of verification scheme，in order to provide a reference for clinical laboratories.

Research progress on relationship between histone lactation and disease

KUANG Xiandong, CAI Xin, TANG Dongling, ZHANG Ping'an

2024, 39(7):  704-708.  DOI: 10.3969/j.issn.1673-8640.2024.07.015

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Histones are the main protein components of chromatin and play roles in the regulation of biological genetic information. As a common product of cell metabolism，lactic acid can affect the expression of cell genetic information. Under the action of related enzymes，histones can undergo chemical modifications of various groups，among which lactation is one of the important chemical modifications. This review mainly focuses on the occurrence and influencing factors of histone lactation，the relationship between histone lactation and common diseases and the research progress of treatment.

Progress in application of blood coagulation point-of-care testing

ZHAO Chunhe, SHAO Huihui, CUI Weiqi, XIA Wei, QU Linlin

2024, 39(7):  709-714.  DOI: 10.3969/j.issn.1673-8640.2024.07.016

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Point-of-care testing （POCT） refers to the fact that it can not be limited by places，which has the advantages of easy carrying，simple operation and rapid determination. At present，the methods used in POCT blood coagulation instrument mainly include electrochemical method，biosensor method，immunochemical method and mechanical method and so on，which have their own characteristics and advantages，and they are gradually applied to blood coagulation routine test，coagulation factor determination，platelet function determination and anticoagulation monitoring. This review focuses on the principles，characteristics，application status and prospects of blood coagulation POCT technology at home and abroad.