Table of Content

30 August 2024, Volume 39 Issue 8

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Determinations of serum interferon regulatory factor 4 and soluble suppression of tumorigenicity 2 in patients with oral periimplantitis

LÜ Minmin, HUANG Ying, YU Lan, CAO Liting, ZENG Cuimin

2024, 39(8):  723-727.  DOI: 10.3969/j.issn.1673-8640.2024.08.001

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Objective To investigate the roles of serum interferon regulatory factor 4（IRF4） and soluble suppression of tumorigenicity 2（sST2） in patients with oral periimplantitis. Methods Totally，30 patients with oral periimplantitis treated in Cangzhou People's Hospital from January 2021 to December 2022（oral periimplantitis group） were enrolled，and another 30 healthy oral implant subjects（healthy oral implant group） and 30 healthy subjects（healthy control group） were enrolled. Serum levels of IRF4 and sST2 were compared among all the groups. The correlations of serum IRF4 and sST2 levels with age，periodontal depth（PD），gingival sulcus fluid volume and sulcus bleeding index（SBI） were analyzed by Pearson correlation analysis. Receiver operating characteristic（ROC） curve was used to analyze the predictive values of serum IRF4 and sST2 levels in oral periimplantitis. Results PD，gingival sulcus fluid volume and SBI in oral periimplantitis group were higher than those in healthy oral implant group and healthy control group（P<0.05）. Serum IRF4 and sST2 levels in healthy control group，healthy oral implant group and oral periimplantitis group were increased successively（P<0.001）. There was no statistical significance in serum IRF4 and sST2 levels between male and female patients with oral periimplantitis（P>0.05）. Serum IRF4 and sST2 levels in patients ≥60 years old were higher than those in patients <60 years old（P<0.001）. Serum IRF4 and sST2 were positively correlated with age，PD，gingival sulcus fluid volume and SBI（P<0.05）. The areas under curves（AUC） of serum IRF4 and sST2 single and combined determinations were 0.919，0.890 and 0.978，respectively. Conclusions Serum IRF4 and sST2 levels are increased in patients with oral periimplantitis，which are related to periodontal indexes，and they may be used in the diagnosis of oral periimplantitis.

Changes of serum FoxO3a and Cav-1 levels in children with craniocerebral trauma and their clinical significance

JI Ran, LI Na, ZHANG Yu, LIU Yiming

2024, 39(8):  728-732.  DOI: 10.3969/j.issn.1673-8640.2024.08.002

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Objective To investigate the changes of serum forkhead box transcription factor O3a（FoxO3a） and caveolin-1（Cav-1） levels in children with craniocerebral trauma and their clinical significance. Methods A total of 107 children with craniocerebral trauma were enrolled from the Children's Hospital of Nanjing Medical University from December 2020 to November 2022，which were classified into mild group（49 cases），moderate group（37 cases） and severe group（21 cases） according to Glasgow coma scale（GCS）. The clinical data of all the children were collected，and serum FoxO3a and Cav-1 levels were determined. All the children were followed up for 60 d after admission，which were classified into poor prognosis group and good prognosis group. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of FoxO3a and Cav-1 in predicting the prognosis of children with craniocerebral trauma. Multivariate Logistic regression analysis was used to evaluate the risk factors of poor prognosis in children with craniocerebral trauma. Results The levels of FoxO3a and Cav-1 in mild group，moderate group and severe group were increased successively（P<0.001）. Serum FoxO3a and Cav-1 levels in poor prognosis group were higher than those in good prognosis group（P<0.001）. The areas under curves（AUC） of serum FoxO3a and Cav-1 single and combined determinations were 0.764，0.843 and 0.908，respectively. In poor prognosis group，the proportions of GCS score ≤8，complicated with other organ injury，time from injury to admission，D-dimer（DD），white blood cell（WBC） count and platelet（PLT） count were all higher than those in good prognosis group（P<0.05）. GCS score ≤8，complicated with other organ injury，FoxO3a≥6.31 ng·mL^-1 and Cav-1≥23.15 ng·mL^-1 were risk factors for poor prognosis in children with craniocerebral trauma [odds ratios（OR） were 1.943，2.061，2.649 and 3.337，95% confidence intervals（CI） were 1.414-2.669，1.474-2.881，1.711-4.100 and 2.076-5.362，respectively，P<0.001]. Conclusions Abnormal levels of serum FoxO3a and Cav-1 are related to the condition and prognosis of children with craniocerebral trauma. High levels of FoxO3a and/or Cav-1 are factors affecting the poor prognosis of children with craniocerebral trauma.

Diagnostic efficacy of different serum IgG4 thresholds for IgG4-related diseases

JI Jinling, JIANG Yuzhang, HAN Chongxu, WANG Li, JIN Defu, YE Yunfeng, LIU Jiaxiu

2024, 39(8):  733-737.  DOI: 10.3969/j.issn.1673-8640.2024.08.003

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Objective To investigate the diagnostic efficacy of different serum IgG4 thresholds for IgG4-related diseases（IgG4-RD）. Methods From January 2013 to July 2021，5 059 patients who received serum IgG4 determination for the first time in the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University，Northern Jiangsu People's Hospital and Xuzhou First People's Hospital were enrolled. There were 38 patients with IgG4-RD（IgG4-RD group） and 5 021 patients without IgG4-RD（non-IgG4-RD group）. Totally，131 healthy subjects from the First Affiliated Hospital of Huaian，Nanjing Medical University were enrolled as healthy control group. Serum IgG4 levels were determined by immunoscattering turbidimetry. Receiver operating characteristic（ROC） curve was used to evaluate the differential diagnosis of IgG4-RD by IgG4. The differential diagnosis of IgG4-RD with different IgG4 thresholds was analyzed. Results Among 38 patients with IgG4-RD，35（92.1%） cases had IgG4>1.35 g·L^-1，and 34（89.5%）cases had IgG4>2.01 g·L^-1. Multiple organs were involved in 23（60.5%） cases. Of the 5 021 non-IgG4-RD patients，430（8.6%） cases had serum IgG4>1.35 g·L^-1，and 203（4.0%） cases had serum IgG4>2.01 g·L^-1. Serum IgG4 levels were increased successively among healthy control group，non-IgG4-RD group and IgG4-RD group（P<0.001）. The area under curve（AUC） for the differential diagnosis of IgG4-RD was 0.971，the optimal threshold was 1.59 g·L^-1，the sensitivity was 92%，and the specificity was 94%. In the differential diagnosis of IgG4-RD，the sensitivity and specificity were 92% and 91% when the threshold of IgG4 was 1.35 g·L^-1，and they were 92% and 92% when the threshold was 1.40 g·L^-1，respectively. When the threshold was 2.01 g·L^-1，the sensitivity and specificity were 89% and 96%，and when the threshold was 2.80 g·L^-1，the sensitivity and specificity were 79% and 97%，respectively. Conclusions Increased levels of IgG4 are seen not only in IgG4-RD patients，but also in non-IgG4-RD patients. Appropriate IgG4 thresholds should be established to assist clinical diagnosis of IgG4-RD.

Expression and clinical significance of serum miR-134 and miR-149 in patients with esophageal cancer

GAO Jinsuo

2024, 39(8):  738-742.  DOI: 10.3969/j.issn.1673-8640.2024.08.004

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Objective To investigate the expression and clinical significance of serum miR-134 and miR-149 in patients with esophageal cancer. Methods From April 2020 to October 2022，132 patients with esophageal cancer（esophageal cancer group），125 patients with benign esophageal diseases（benign control group） and 130 healthy subjects（healthy control group） were enrolled from the Third People's Hospital of Hefei. The general data of all the subjects were collected，and the relative expression levels of miR-134 and miR-149 and the levels of carcinoembryonic antigen（CEA），carbohydrate antigen（CA） 125 and CA72-4 in serum were determined. Pearson correlation analysis was used to evaluate the correlation between serum miR-134，miR-149 and CEA，CA125，CA72-4. The efficacy of serum miR-134 and miR-149 single and combined determination in the diagnosis of esophageal cancer was evaluated by receiver operating characteristic（ROC） curve. Results The relative expression level of miR-134 and the levels of CEA，CA125 and CA72-4 in serum in esophageal cancer group were higher than those in benign control group and healthy control group（P<0.05），and those in benign control group were higher than those in healthy control group（P<0.05）. The relative expression of miR-149 in esophageal cancer group was lower than those in benign control group and healthy control group（P<0.05），and that in benign control group was lower than that in healthy control group（P<0.05）. The positive rates of CEA，CA125 and CA72-4 in esophageal cancer group were higher than those in benign control group（P<0.05）. There was statistical significance in the relative expression levels of serum miR-134 and miR-149 among esophageal cancer patients with different tumor diameters，differentiation degrees and lymphatic metastasis（P<0.05）. Serum miR-134 was positively correlated with CEA，CA125 and CA72-4 in patients with esophageal cancer（r values were 0.425，0.419 and 0.457，P<0.001）. Serum miR-149 was negatively correlated with CEA，CA125 and CA72-4（r values were -0.529，-0.534 and -0.458，P<0.001）. The areas under curves（AUC） of serum miR-134 and miR-149 in the diagnosis of esophageal cancer were 0.768 and 0.773，respectively. The AUC of miR-134+miR-149，CEA+CA125+CA72-4，miR-134+miR-149+CEA+CA125+CA72-4 were 0.910，0.901，0.916，respectively. Conclusions Serum miR-134 and miR-149 are abnormally expressed in patients with esophageal cancer，which are related to the disease，and they may be used as indicators for auxiliary diagnosis and disease monitoring of esophageal cancer.

Observation of short-term prognosis of patients with ST segment elevation acute coronary syndrome treated with serum ferritin/albumin ratio

ZHANG Shiyue, REN Meng, YIN Changbin

2024, 39(8):  743-748.  DOI: 10.3969/j.issn.1673-8640.2024.08.005

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Objective To evaluate the prognostic value of serum ferritin（SF）/albumin（Alb） ratio in patients with ST segment elevation acute coronary syndrome（STE-ACS） after interventional therapy. Methods A total of 121 STE-ACS patients who underwent percutaneous coronary intervention（PCI） in Tongzhou District Integrated Traditional Chinese and Western Medicine Hospital and Beijing Luhe Hospital of Capital Medical University from June 2020 to June 2022 were enrolled. The general data of all the patients were collected，SF and Alb levels were determined before discharge，and SF/Alb ratio was calculated. All the patients were followed up for 1 year after discharge，and the occurrence of adverse cardiovascular events during the follow-up was recorded. According to the prognosis，they were classified into poor prognosis group and good prognosis group. Logistic regression analysis was used to evaluate the risk factors of poor short-term prognosis in STE-ACS patients after interventional therapy. SF/Alb ratio was analyzed by decision curve to predict the net benefit rate of STE-ACS patients after interventional therapy. Results Of 121 STE-ACS patients，117 completed follow-up，of which 24（20.51%） cases had poor prognosis. The diabetes mellitus history，low-density lipoprotein cholesterol（LDL-C），glycated hemoglobin A_1c（HbA_1c），SF，SF/Alb ratio in poor prognosis group were higher than those in good prognosis group（P<0.05），and high-density lipoprotein cholesterol（HDL-C） and Alb in poor prognosis group were lower than those in good prognosis group（P<0.05）. There was no statistical significance in the other items between the 2 groups（P>0.05）. Diabetes mellitus history，increased LDL-C，increased SF，increased SF/Alb ratio，increased HbA_1c，decreased HDL-C and decreased Alb were risk factors for poor short-term prognosis in STE-ACS patients after interventional therapy（P<0.05）. In the ranges of cut-off value 0.15-0.18，0.25-0.50 and 0.53-0.68，the net benefit rate predicted by SF/Alb ratio of short-term prognosis of STE-ACS patients after interventional therapy was higher than that of single determinations of SF and Alb，and in the range of high-risk cut-off value 0.00-1.00，the net benefit rate was basically >0. The maximum net benefit rate was 0.205. Conclusions SF/Alb ratio is a good predictor of short-term prognosis in STE-ACS patients undergoing PCI.

Influence of hemoglobin，bilirubin，chylomicrons and calcium dobesilate on 3 determination systems

GONG Jingkai, OU Yuanzhu, YU Xiaoxuan, GE Danhong, LIN Feiran

2024, 39(8):  749-758.  DOI: 10.3969/j.issn.1673-8640.2024.08.006

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Objective To investigate the effects of endogenous interfering substances [hemoglobin（Hb），bilirubin，chylomicrons] and exogenous interfering substance（calcium dobesilate） on the routine biochemical tests of 3 determination systems [Vitros 5600 system（dry chemistry），cobas c501 system（liquid chemistry），Maccura-7180 system（liquid chemistry）]. Methods According to the requirements of EP7-A2 document of the Clinical and Laboratory Standards Insititution（CLSI），serum or plasma basic control samples with high and low levels were used to formulate Hb，bilirubin F，chylomicrons and calcium dobesilate interference samples with different concentration gradients to simulate light，moderate and severe interference. Vitros 5600 system，cobas c501 system and Maccura-7180 system were determined，and the relative and absolute deviation of the determination results from the basic control samples were calculated. Results In the Hb interference test，9 of 13 items of Vitros 5600 system were interfered；10 of 13 items of cobas c501 system were interfered；8 of 11 items of Maccura-7180 system were interfered. In the bilirubin interference test，3 of 11 items were interfered in Vitros 5600 system，5 of 11 items in cobas c501 system，and 2 of 9 items in Maccura-7180 system. In the chylomicrons interference test，2 of 12 items were interfered in Vitros 5600 system，4 of 12 items in cobas c501 system，and 4 of 10 items in Maccura-7180 system. Calcium dobesilate interfered with creatinine（Cr） items of the 3 determination systems，but the degree of interference of Vitros 5600 system was less than that of the other 2 systems. Conclusions In the routine biochemical tests，different determination systems are affected by endogenous and exogenous interfering substances. The anti-interference ability of dry chemistry determination system is better than those of liquid chemistry determination systems.

Changes and significance of autophagy in peripheral blood lymphocytes of patients with carbapenem-resistant Enterobacteriaceae-bloodstream infection

HUANG Linling, XU Meirong, SHEN Xiaowen, GU LingLi, SHEN Hongmei

2024, 39(8):  759-763.  DOI: 10.3969/j.issn.1673-8640.2024.08.007

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Objective To analyze the characteristics and clinical significance of autophagy in peripheral blood lymphocytes of patients with carbapenem-resistant Enterobacteriaceae（CRE）-bloodstream infection（BSI）. Methods Totally，125 patients with CRE-BSI（drug-resistant group） and 130 patients with carbapenem-sensitive bacterium-BSI（drug-sensitive group） were enrolled from the Second People's Hospital of Nantong from June 2019 to June 2022，and 105 healthy subjects were enrolled as control group. The mRNA expression levels of autophagy marker genes（Beclin-1，LC3 and Atg5a） in peripheral blood lymphocytes were determined，and the differences were compared. The clinical data of drug-resistant group were collected. The differences of clinical characteristic and Beclin-1，Atg5a，LC3 mRNA levels between death and survival patients were compared. Logistic regression analysis was used to evaluate the prognostic factors in drug-resistant group. Results The Beclin-1，LC3 and Atg5a mRNA levels of peripheral blood lymphocytes in drug-resistant group were lower than those in drug-sensitive group and control group（P<0.05）. Beclin-1，LC3 and Atg5a mRNA levels in peripheral blood lymphocytes in drug-resistant group were negatively correlated with acute physiological and chronic health evaluation Ⅱ（APACHE Ⅱ） score，white blood cell（WBC） count，high-sensitivity C-reactive protein（hs-CRP） and procalcitonin（PCT） levels（P<0.05）. There was statistical significance in Beclin-1，LC3 and Atg5a mRNA levels and age，respiratory tract infection，septic shock，hs-CRP，PCT and APACHE Ⅱ scores between death and survival patients in drug-resistant group（P<0.05）. Beclin-1 and LC3 mRNA levels in peripheral blood lymphocytes，respiratory tract infection，septic shock and APACHE Ⅱ score were the influential factors for death in drug-resistant group（P<0.05）. Conclusions The weakened autophagy of peripheral blood lymphocytes in CRE-BSI patients is related to disease aggravation and poor prognosis.

Predictive value of activated partial thromboplastin time，thromboelastogram and fibrin monomer in patients treated with extracorporeal membrane oxygenation for hemorrhage and thrombosis

DENG Shuang, FANG Jingshu, GAN Fangyan

2024, 39(8):  764-769.  DOI: 10.3969/j.issn.1673-8640.2024.08.008

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Objective To investigate the predictive value of activated partial thromboplastin time（APTT），thromboelastogram（TEG） and fibrin monomer（FM） in patients treated with extracorporeal membrane oxygenation（ECMO）. Methods A total of 26 patients treated with ECMO were enrolled from the People's Hospital of Guangxi Zhuang Autonomous Region from August to December 2023. The patients were classified into hemorrhage group（16 cases），non-hemorrhage group（10 cases），thrombosis group（5 cases） and non-thrombosis group（21 cases） according to the occurrence of hemorrhage and thrombosis. The clinical data of all the patients were collected，and the differences of coagulation parameters were compared. The risk factors of ECMO hemorrhage and thrombosis were evaluated by Cox regression analysis. The roles of APTT，TEG and FM in predicting ECMO hemorrhage and thrombosis were evaluated by receiver operating characteristic（ROC） curve. Results The incidence rates of hemorrhage and thrombosis were 61.5%（16/26） and 19.2%（5/26），respectively. The related event occurrence median days were 3 and 6 d，respectively. The maximum APTT，average APTT，TEG reaction time（R）[citrated kaolin（CK），citrated kaolin heparinase（CKH） and ?R（R_CK-R_CKH）] in hemorrhage group were higher than those in non-hemorrhage group（P<0.05），and FM in thrombosis group was higher than that in non-thrombosis group（P<0.05）. Maximum APTT，TEG R_CK，TEG R_CKH and TEG ?R were risk factors for hemorrhage（P<0.05），and the corrected hazard ratios（HR） were 1.010，1.029，1.216 and 1.018，respectively. FM was a risk factors of thrombosis（P<0.05） and HR was 1.008 after correction. The areas under curves of maximum APTT，TEG R_CK，TEG R_CKH and TEG ?R for predicting ECMO hemorrhage were 0.831，0.800，0.763 and 0.744，respectively，and the area under curve（AUC）of combined determination was 0.869. The area under curve of FM predicted thrombosis was 0.868. Conclusions Maximum APTT，TEG R_CK，TEG R_CKH and TEG ?R can be used to predict ECMO hemorrhage，and the combined determination has optimal predictive value. FM can predict ECMO thrombosis.

Interference and correction of chylemia on blood cell analysis parameters in tumor patients

ZHANG Jialing, QI Jun

2024, 39(8):  770-773.  DOI: 10.3969/j.issn.1673-8640.2024.08.009

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Objective To analyze the influence of chylemia on blood cell analysis parameters in tumor patients，and to investigate the correction effect of plasma exchange on chylemia，so as to provide a reference for laboratory to accurately report the results of blood cell analysis. Methods From January 2022 to August 2023，54 whole blood samples of tumor patients who were confirmed to have chylemia were enrolled from the Department of Clinical Laboratory of Cancer Hospital and Shenzhen Hospital of Chinese Academy of Medical Sciences Peking Union Medical College. cencer of By blood cell analyzer，white blood cell （WBC） count，platelet（PLT） count，red blood cell（RBC） count，hemoglobin（HGB），hematocrit（HCT），mean corpuscular volume（MCV），mean corpuscular hemoglobin（MCH） and mean corpuscular hemoglobin concentration（MCHC） were determined before and after plasma exchange. With the instrument alarm “Turbidity/HGB Interf?” was eliminated，the MCHC returned to normal or stable levels，or it was consistent with historical results，the state of chylemia was corrected. The results were compared before and after correction. The clinical data of patients were collected to understand the source of chylemia samples. Results Chylemia samples were mainly collected from middle-aged and elderly patients with breast cancer，lung cancer，liver cancer and pancreatic cancer（37.04%，20/54）. WBC count，PLT count，HGB，MCH and MCHC before correction were higher than those after correction（P<0.05）. There was no statistical significance in RBC count，HCT and MCV before and after correction（P>0.05）. Conclusions Chylemia mainly affects the results of WBC count，PLT count，HGB，MCH and MCHC，and plasma exchange can eliminate the interference.

Roles of serum CXCL1 and sCD40L in prognosis assessment of patients with subarachnoid hemorrhage

ZHANG Fue, YANG Jing, MA Fuying

2024, 39(8):  774-778.  DOI: 10.3969/j.issn.1673-8640.2024.08.010

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Objective To investigate the role of serum chemokine C-X-C motif ligand 1（CXCL1） and soluble CD40 ligand（sCD40L） in the prognosis of patients with subarachnoid hemorrhage. Methods Totally，218 patients with subarachnoid hemorrhage were enrolled from the Fifth People's Hospital of Qinghai Province from January 2020 to January 2023，which were classified into survival group（153 cases） and death group（65 cases） according to the survival after 90 d of follow-up. The clinical data of all the patients were collected，and serum CXCL1 and sCD40L levels were determined. Logistic regression analysis（stepwise forward method） was used to evaluate the risk factors of death in patients with subarachnoid hemorrhage. The efficacy of serum CXCL1 and sCD40L in determining the death of patients with subarachnoid hemorrhage was analyzed by receiver operating characteristic（ROC） curve. Results There was statistical significance in the time from admission to operation ≥72 h，systolic blood pressure，diastolic blood pressure，Glasgow coma scale（GCS） score，Hunt-Hess grade and modified Fisher score between survival group and death group（P<0.05），while there was no statistical significance in the other items between the 2 groups（P>0.05）. Serum CXCL1 and sCD40L levels in death group were higher than those in survival group（P<0.001）. The time from admission to operation ≥72 h，GCS score，Hunt-Hess grade，modified Fisher score，serum CXCL1 and sCD40L were all risk factors for death in patients with subarachnoid hemorrhage（P<0.05）. The areas under curves（AUC） for death in patients with subarachnoid hemorrhage were 0.845，0.880 and 0.948 by single and combined determinations of serum CXCL1 and sCD40L levels. Conclusions Serum CXCL1 and sCD40L levels are related to the prognosis of patients with subarachnoid hemorrhage，and they may be used as biomarkers for prognosis evaluation of patients with subarachnoid hemorrhage.

Synergistic role of vitamin D and blood glucose in pregnancy outcomes in patients with preeclampsia

ZHANG Jing

2024, 39(8):  779-786.  DOI: 10.3969/j.issn.1673-8640.2024.08.011

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Objective To investigate the synergistic role of vitamin D（VD） deficiency and high blood glucose in pregnancy outcomes in patients with preeclampsia（PE）. Methods Totally，173 PE patients in Bayingol Mongolian Autonomous Prefecture People's Hospital from January 2020 to March 2022 were enrolled. According to the pregnancy outcomes，they were classified into good pregnancy outcome group（118 cases） and poor pregnancy outcome group（55 cases）. The differences of general clinical data，25-hydroxyvitamin D[25（OH）D]，blood glucose and other biochemical indexes were compared between the 2 groups. Multivariate Logistic regression analysis was used to evaluate the independent risk factors for adverse pregnancy outcomes in PE patients，and the interaction of 25（OH）D and blood glucose on adverse pregnancy outcomes was analyzed by additive interaction model. Logistic regression model was used to analyze the relationship between 25（OH）D，blood glucose and the risk of adverse pregnancy outcomes in PE patients. Results VD deficiency and high blood glucose were independent risk factors for adverse pregnancy outcomes in PE patients，and they had interactive effects on the occurrence of adverse pregnancy outcomes in PE patients. With the increase of 25（OH）D level，the probability of adverse pregnancy outcomes decreased gradually. With the increase of blood glucose level，the probability of adverse pregnancy outcomes increased gradually. There was a negative correlation between 25（OH）D and adverse pregnancy outcomes，especially when 25（OH）D<30 ng·mL^-1，and the probability of adverse pregnancy outcomes decreased with the increase of 25（OH）D level. There was a positive correlation between blood glucose and adverse pregnancy outcomes，especially when blood glucose <7.5 mmol·L^-1，the probability of adverse pregnancy outcomes decreased with the decrease of blood glucose level. The synergistic interaction value of 25（OH）D and blood glucose in predicting adverse pregnancy outcomes in PE patients was greater than that of the 2 alone. Conclusions VD deficiency and high blood glucose are independent risk factors for adverse pregnancy outcomes in PE patients and influence each other.

Expression changes of serum miR-21 and miR-146a in children with Mycoplasma pneumoniae pneumonia and their correlation with inflammatory factors

ZHAI Bin, HAN Mei

2024, 39(8):  787-792.  DOI: 10.3969/j.issn.1673-8640.2024.08.012

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Objective To investigate the expression changes of serum miR-21 and miR-146a in children with Mycoplasma pneumoniae pneumonia（MPP） and their correlation with inflammatory factors. Methods From August 2021 to September 2022，62 MPP children（MPP group） and 45 healthy children（healthy control group） were enrolled from Baotou Eighth Hospital. The general data of all the subjects were collected，and the relative expression levels of miR-21 and miR-146a in serum and the levels of inflammatory factors [interleukin（IL）-6，IL-8，IL-1β，tumor necrosis factor-alpha（TNF-α）] were determined. According to the severity of the disease，the MPP children were classified into mild group （38 cases） and severe group （24 cases）. Pearson correlation analysis was used to evaluate the correlation between serum miR-21，miR-146a，IL-6，IL-8，IL-1β and TNF-α. Receiver operating characteristic （ROC） curve was used to evaluate the efficacy of each index in the diagnosis of severe MPP. Results Serum levels of IL-6，IL-8，IL-1β，TNF-α and the relative expression level of miR-21 in MPP group were higher than those in healthy control group（P<0.001），and the relative expression level of miR-146a in serum was lower than that in healthy control group（P<0.001）. The levels of serum IL-6，IL-8，IL-1β，TNF-α and the relative expression of miR-21 in severe group were higher than those in mild group （P<0.001），and the relative expression of serum miR-146a was lower than that in mild group （P<0.001）. The miR-21 was positively correlated with IL-6，IL-8，IL-1β and TNF-α（P<0.05），while miR-146a was negatively correlated with miR-21，IL-6，IL-8，IL-1β and TNF-α（P<0.05）. IL-6，IL-8，IL-1β and TNF-α were positively correlated（P<0.05）. The areas under curves （AUC） of miR-21，miR-146a，IL-6，IL-8，IL-1β and TNF-α in the diagnosis of severe MPP were 0.794，0.770，0.829，0.837，0.866 and 0.865，respectively. The AUC of combined determination was 0.963，and the sensitivity and specificity were 87.5% and 97.4%，respectively. Conclusions Serum miR-21 and miR-146a are abnormally expressed in MPP children，and they are related to inflammatory factors，which may be used as effective indicators for clinical judgment of the severity of MPP children.

Simultaneous identification of 6 diarrhea pathogens based on probe melting curve analysis and multiple PCR

REN Jixuan, HU Zhaohui, CHEN Jiachang, WANG Weishi, LIU Xiangdong, LIU Xinyuan, LI Ying

2024, 39(8):  793-799.  DOI: 10.3969/j.issn.1673-8640.2024.08.013

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Objective To establish a rapid，accurate and highly sensitive diagnostic method for simultaneous identification of 6 common acute infectious diarrhea pathogens based on multiple polymerase chain reaction（PCR） and probe melting curve analysis，and to verify its determination performance. Methods The melting temperature（Tm） values of 6 common acute infectious diarrhea pathogens were analyzed by probe melting curve analysis，and the multiple PCR combined probe melting curve analysis system was established. The sensitivity，specificity and repeatability were evaluated. The method was used to determine fecal samples from 175 patients with suspected infectious diarrhea. The difference between the method results and the results of bacterial culture and fluorescent PCR was compared. The inconsistent results were confirmed by sequencing. Results The established method could determine 6 kinds of pathogens simultaneously by single PCR，the determination limit was 1×10³-1×10⁴ copies/mL，and there was no cross-reaction among different pathogens. The specificity was high. A total of 91（52%） fecal samples from 175 diarrhea patients were positive. The coefficients of variation（CV） within determination for 6 pathogens were <0.1%. The consistency rates of Salmonella，Shigella and Clostridium difficile were 94.85%（kappa=0.894），100.00%（kappa=1.000） and 98.28%（kappa=0.900），respectively. Conclusions The established multiple PCR based on probe melting curve analysis has high sensitivity and specificity for determining 6 kinds of diarrhea pathogens，which can provide a reference for clinical diagnosis of acute infectious diarrhea in time.

Research progress of postprandial lipids and atherosclerosis in patients with type 2 diabetes mellitus

ZHONG Yuhua, LIN Mingxu, SHI Rou, HAO Zirui, LI Guiping

2024, 39(8):  815-819.  DOI: 10.3969/j.issn.1673-8640.2024.08.017

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The pathophysiological mechanism of vascular disease in type 2 diabetes mellitus（T2DM） is complex，and atherosclerosis is prone to occur，leading to vascular stenosis，and eventually leading to coronary atherosclerotic heart disease，ischemic stroke and other serious cardiovascular and cerebrovascular diseases，as well as diabetic foot，amputations and other serious complications. Dyslipidemia is a high risk factor for atherosclerosis. In the past，fasting lipids were used to represent the status of individual lipids. However，postprandial lipids are the dominant lipid state within 1 d and are the most true state throughout the day. Postprandial hyperlipemia is an important characteristic of abnormal lipid metabolism in diabetes mellitus and may promote atherosclerosis. This review focuses on the changes of blood lipids in T2DM patients and the relationship between postprandial blood lipids and atherosclerosis.