Table of Content

30 October 2024, Volume 39 Issue 10

Previous Issue    Next Issue

Study of latent tuberculosis infection mechanism of DosR antigen Rv2626c inducing macrophage activation through lncRNA MacORIS

WANG Zhaohui, ZHENG Zhenlu, LI Ruina, MA Yuanyuan, XU Hui, WEI Zhenhong, JIA Yanjuan, QI Xiaoming, GAO Xiaoling

2024, 39(10):  923-932.  DOI: 10.3969/j.issn.1673-8640.2024.10.001

Asbtract ( 123 )   HTML ( 34)   PDF (2294KB) ( 47 )  

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the regulation role of dormancy survival regulator（DosR） antigen Rv2626c expressed in latent tuberculosis infection（LTBI） in the activation of macrophage and the regulation influence of long non-coding RNA（lncRNA） MacORIS. Methods Human acute monocytic leukemia cell line THP-1 cells were differentiated into macrophage and categorized into 4 groups based on different transfections：negative control（NC） group [transfected with NC-small interfering RNA（siRNA） for 24 h] and MacORIS-siRNA group [transfected with MacORIS-siRNA for 24 h]，NC-siRNA+recombinant protein Rv2626c（rRv2626c） group [transfected with NC-siRNA for 24 h，then stimulated with 3 μg·mL^-1 rRv2626c for 24 h]，MacORIS-siRNA+rRv2626c group [transfected with MacORIS-siRNA for 24 h，then stimulated with 3 μg·mL^-1 rRv2626c for 24 h]. The expression of lncRNA MacORIS，Toll-like receptor（TLR）2，TLR4，surface co-stimulatory molecules（CD80，CD86，CD163，CD206），indoleamine 2，3-dioxygenase 1（IDO1），tumor necrosis factor-alpha（TNF-α），interleukin（IL）-6，IL-8 and IL-1β were determined. The competitive endogenous RNA（ceRNA） networks of lncRNA MacORIS were predicted and constructed by bioinformatics methods，and the potential target microRNA of lncRNA MacORIS was verified. Results The rRv2626c effectively promoted the upregulation of lncRNA MacORIS and IDO1 in macrophage（P<0.05）. The rRv2626c induced the expression of TLR2 in THP-1 cells，which was dependent on lncRNA MacORIS（P<0.05）. Furthermore，rRv2626c depended on lncRNA MacORIS to upregulate the expressions of CD80，CD86，TNF-α and IL-1β in macrophage（P<0.001）. Compared to the NC group，the relative expression levels of miR-141-3p，miR-150-5p，miR-33-5p，miR-200-3p and miR-203-3p in the MacORIS-siRNA group were increased（P<0.05）. Conclusions The rRv2626c promotes the polarization of macrophage toward M1 phenotype，and it enhances the expression of TLR2 and inflammatory factors，which depends on lncRNA MacORIS. The lncRNA MacORIS could negatively regulate the expression of miR-141-3p，miR-150-5p，miR-33-5p，miR-200-3p and miR-203-3p.

Role of TLR9 of red blood cell membrane surface in sepsis patients with anemia

MENG Qiang, WANG Shuang, BAI Zhou, HUANG Qian, FU Yang

2024, 39(10):  933-938.  DOI: 10.3969/j.issn.1673-8640.2024.10.002

Asbtract ( 130 )   HTML ( 29)   PDF (1007KB) ( 75 )  

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the role of Toll-like receptor（TLR）9 expression on the membrane surface of red blood cell（RBC） in sepsis patients with anemia. Methods A total of 237 sepsis patients（sepsis group），241 patients with local infections（local infection group） and 206 healthy subjects（healthy control group） at West China Hospital of Sichuan University from July 2022 to May 2023 were enrolled. The clinical data and 19 RBC-related parameters within 24 h of sepsis diagnosis were collected. The expressions of TLR9 on peripheral blood RBC membrane surface in 46 sepsis patients，35 common infection patients and 28 healthy subjects were determined simultaneously. The correlation between TLR9 and RBC-related parameters was assessed using Spearman analysis. Results The sepsis group had lower levels of RBC count，hemoglobin（Hb），mean corpuscular hemoglobin concentration（MCHC），the absolute value of reticulocyte（RET#），reticulocyte-hemoblobin（RET-He），red blood cell-O（RBC-O） and reticulocyte-Y（RET-Y） compared to local infection group（P<0.05）. The sepsis group had higher levels of mean corpuscular volume（MCV），red blood cell volume distribution width-standard deviation（RDW-SD），red blood cell volume distribution width-coefficient of variation（RDW-CV） and high fluorescence ratio（HFR） compared to local infection group（P<0.05）. The percentage of TLR9⁺ RBC in peripheral blood of sepsis group was higher than that in local infection group（P<0.01）. The percentage of TLR9⁺ RBC was negatively correlated with RBC count，Hb，RET#，RBC-O，MCHC，RET-He and RET-Y（P<0.01）. The percentage of TLR9⁺ RBC was positively correlated with RDW-SD and RDW-CV（P<0.001）. Conclusions The expression of TLR9 in RBC membrane surface of sepsis patients is increased，and the high expression of TLR9 is related to the degree of severe inflammatory anemia，low RBC hematopoietic ability and greater RBC morphological abnormality.

Early warning value of whole blood cell derived inflammatory markers for delayed graft function of renal transplantation

ZHU Longyin, PAN Qianguang, YANG Sha, ZENG Yuqin, FU Chunxiao, PU Youmin, FANG Jia, YAN Chunyan, ZHAO Hongwen

2024, 39(10):  939-944.  DOI: 10.3969/j.issn.1673-8640.2024.10.003

Asbtract ( 103 )   HTML ( 24)   PDF (1008KB) ( 27 )  

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the early warning value of whole blood cell derived inflammatory markers [neutrophil/lymphocyte ratio（NLR），platelet/lymphocyte ratio（PLR），monocyte/lymphocyte ratio（MLR），systemic immune inflammation index（SII） and systemic inflammation response index（SIRI）] for delayed graft function（DGF）. Methods A total of 191 patients who received allograft renal transplantation in the First Affiliated Hospital of Army Medical University from April 2018 to September 2021 were enrolled. According to whether DGF occurred after operation，the patients were classified into DGF group（33 cases） and immediate graft function（IGF） group（158 cases）. The clinical data of all the patients were collected，blood routine test was performed，and NLR，PLR，MLR，SII and SIRI were calculated. Logistic regression analysis was used to evaluate the influence factors of DGF. Receiver operating characteristic（ROC） curve was used to evaluate the effectiveness of each indicator in determining DGF in renal transplantation patients. Results There was statistical significance on cold ischemia time，hot ischemia time，white blood cell（WBC） count，the absolute value of neutrophils（NEUT#），the absolute value of lymphocytes（LYMPH#） and serum creatinine（SCr） at discharge between DGF group and IGF group（P<0.05）. There was no statistical significance for the other indicators between DGF group and IGF group（P>0.05）. Preoperative NLR，PLR，MLR，SII and SIRI in DGF group were higher than those in IGF group（P<0.01）. The areas under curves（AUC） of preoperative NLR，PLR，MLR，SII and SIRI single and combined determinations to determine DGF in renal transplantation patients were 0.736，0.696，0.672，0.744，0.696 and 0.801，respectively. Multivariate Logistic regression analysis showed that hot ischemia time and preoperative PLR and SII were independent risk factors for DGF in renal transplantation patients [odds ratios（OR） were 1.672，1.035 and 0.994，95% confidence intervals（CI） were 1.104-2.533，1.008-1.063，0.989-1.000，respectively，P<0.05]. Conclusions Preoperative whole blood cell derived inflammatory markers have potential clinical value in determining whether DGF occurs in renal transplantation patients.

Prognostic roles of serum FGF2 and FGFR1 in preeclampsia

ZHANG Caili, LUO Xiaohua, YANG Peifeng, LIU Pengli, REN Fang

2024, 39(10):  945-949.  DOI: 10.3969/j.issn.1673-8640.2024.10.004

Asbtract ( 74 )   HTML ( 15)   PDF (865KB) ( 25 )  

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the relationship between the expression of serum fibroblast growth factor 2（FGF2） and fibroblast growth factor receptor 1（FGFR1） and pregnancy outcome in patients with preeclampsia（PE）. Methods Totally，82 PE patients diagnosed in Maternal and Child Health Hospital of Henan Province from January 2021 to December 2022 were enrolled as study subjects，which included 44 cases of good outcome and 38 cases of adverse outcome，and another 82 pregnant females with successful delivery were enrolled as healthy control group. Serum FGF2 and FGFR1 levels were determined. The correlation of FGF2 and FGFR1 was analyzed by Pearson analysis. The influencing factors of adverse pregnancy outcome in PE patients were analyzed by Logistic regression analysis. The predictive values of serum FGF2 and FGFR1 on adverse pregnancy outcome in PE patients was evaluated by receiver operating characteristic（ROC） curve. Results Serum FGF2 and FGFR1 levels were higher in healthy control group than in PE group（P<0.05），and serum FGF2 and FGFR1 levels in adverse outcome group were lower than those in good outcome group（P<0.05）. The percentages of early PE and severe PE in adverse outcome group were higher than those in good outcome group（P<0.05）. There was no statistical significance for the other clinical data between the 2 groups（P>0.05）. FGF2 was positively correlated with FGFR1 in PE group（r=0.524，P<0.05）. Both early PE [odds ratio（OR）=3.682，95% confidence interval（CI）1.054-12.858] and severe PE（OR=4.029，95%CI 1.086-14.951） were risk factors for adverse pregnancy outcome in PE patients（P<0.05），and increased FGF2（OR=0.491，95%CI 0.293-0.822） and increased FGFR1（OR=0.586，95%CI 0.382-0.898） were protective factors（P<0.05）. The areas under curves（AUC） for the single and combined determinations of serum FGF2 and FGFR1 for adverse pregnancy outcome in patients with PE were 0.81，0.82 and 0.92，respectively. Conclusions The levels of serum FGF2 and FGFR1 of PE patients with adverse outcome are lower than those of patients with good outcome，and the combined determination has good predictive value of adverse pregnancy outcome in PE patients.

Predictive values of serum CTRP3 and DKK-1 levels for the occurrence of fractures in postmenopausal osteoporosis patients

HUANG Qian, SHEN Qin, HU Qiuyun, SUN Jing, WAN Pingyin

2024, 39(10):  950-955.  DOI: 10.3969/j.issn.1673-8640.2024.10.005

Asbtract ( 81 )   HTML ( 17)   PDF (890KB) ( 28 )  

Figures and Tables | References | Related Articles | Metrics

Objective To determine the levels of C1q tumor necrosis factor related protein 3（CTRP3） and Dickkopf related protein 1（DKK-1） in serum，and to investigate their predictive values for the occurrence of fractures in postmenopausal osteoporosis（PMOP） patients. Methods From June 2020 to December 2022，126 PMOP patients from Jiangxi Armed Police Corps Hospital were enrolled as PMOP group. They were classified into fracture group（41 cases） and non-fracture group（85 cases），and another 118 volunteers who underwent physical examination（females without osteoporosis and with a natural menopause of more than 1 year） were enrolled as control group. The levels of serum CTRP3，DKK-1 and lumbar spine（L₁~L₄）bone mineral density（BMD） were determined and compared. Spearman analysis was used to analyze the correlation between serum levels of CTRP3 and DKK-1 and the occurrence of fractures in PMOP patients. Multivariate Logistic regression was used to analyze the influencing factors of fractures in PMOP patients. Receiver operating characteristic（ROC） curve was used to analyze the clinical values of serum CTRP3，DKK-1 levels and BMD in predicting fracture occurrence in PMOP patients. Results Compared with control group，the levels of 25-hydroxyvitamin D [25-（OH）D]，CTRP3 and BMD in PMOP group were decreased（P<0.001），and the level of DKK-1 was increased（P<0.001），and there was no statistical significance in the other indicators between the 2 groups（P>0.05）. Compared with non-fracture group，BMD and serum CTRP3 level in fracture group were decreased（P<0.001），and DKK-1 level was increased（P<0.001）. Serum CTRP3 level was negatively correlated with fracture in PMOP patients（r=-0.574，P<0.05），and serum DKK-1 level was positively correlated with fracture in PMOP patients（r=0.658，P<0.05）. Increased DKK-1，decreased serum CTRP3 and decreased BMD were risk factors for fracture in PMOP patients [odds ratios（OR） were 2.249，0.529，0.424，95% confidence intervals（CI） were 1.199-4.219，0.299-0.936，0.188-0.958，respectively]. The areas under curves（AUC） of serum CTRP3，DKK-1 and BMD single and combined determinations were 0.871，0.904，0.806 and 0.974，respectively. Conclusions Serum CTRP3 is decreased，and DKK-1 is increased in PMOP patients. The combined determination of serum CTRP3，DKK-1 and BMD has a high predictive effect on the occurrence of fractures in PMOP patients，which helps clinic to intervene in high-risk PMOP patients who may experience fractures.

Application of nomogram model based on clinical characteristics and serum tumor markers in differential diagnosis of benign and malignant lung lesions

LEI Ming, ZHAI Li, WEI Ying, LIN Yichen, GUO Mengyue

2024, 39(10):  956-962.  DOI: 10.3969/j.issn.1673-8640.2024.10.006

Asbtract ( 136 )   HTML ( 22)   PDF (1148KB) ( 40 )  

Figures and Tables | References | Related Articles | Metrics

Objective Based on clinical characteristics and serum tumor markers，to construct a nomogram model to assist in the differential diagnosis of benign and malignant lung lesions. Methods Totally，1 335 patients with lung cancer（lung cancer group） and 234 patients with benign nodule（benign nodule group） who received surgical treatment in the Third Affiliated Hospital of Kunming Medical University from January 2018 to December 2019 were enrolled and randomly divided into training set and validation set according to 7:3. The clinical data of all patients were collected. Carcinoembryonic antigen（CEA），carbohydrate antigen（CA） 125，CA15-3，CA19-9，CA242，CA72-4，cytokeratin 19 fragment（CYFRA21-1），ferritin（FER），squamous cell carcinoma antigen（SCC-Ag） and neuron-specific enolase（NSE） were determined. Logistic regression analysis was used to screen the indicators with statistical significance，and the nomogram model was constructed. C-index，receiver operating characteristic（ROC） curve，calibration curve and decision curve were used to evaluate the performance of nomogram model. Results In the training set，there was statistical significance in age，CEA，CA125，CA15-3，CA19-9，CYFRA21-1，SCC-Ag and NSE levels between benign nodule group and lung cancer group（P<0.05）. Age，family history of cancer，CEA，CYFRA21-1 and NSE were all independent risk factors for lung cancer [odds ratios（OR） were 1.019，3.243，1.374，1.262 and 1.073，95% confidence intervals（CI） were 1.001-1.037，1.357-7.749，1.225-1.540，1.127-1.412 and 1.024-1.125，respectively，P<0.05]. ROC curve was used to establish the optimal cut-off values of CEA，CYFRA21-1 and NSE for the differential diagnosis of benign nodule and lung cancer. According to the optimal cut-off values，the 3 indicators were transformed into binary categorical variables，and a nomogram model was established combining age and family history of cancer. In the training set and validation set，the C-indexes of nomogram model were 0.816 and 0.843，respectively. The areas under curves（AUC） for differential diagnosis of benign nodule and lung cancer were 0.822 and 0.861，the sensitivities were 67.5% and 65.0%，the specificities were 81.7% and 91.8%，respectively. The nomogram model had a high net benefit rate，and the maximum net benefit rate was 0.78. In the validation set，the AUC of Logistic regression model in the diagnosis of TNM stage Ⅰ，Ⅱ and Ⅲ lung cancer were 0.775，0.843 and 0.911，the sensitivities were 58.2%，78.3% and 83.0%，and the specificities were 87.3%，76.1% and 88.7%，respectively. Conclusions The nomogram model based on clinical characteristics and serum tumor markers has high efficiency in the differential diagnosis of benign and malignant lung lesions.

Correlation between serum METRNL，sTREM-1 levels and carotid atherosclerosis in type 2 diabetes mellitus patients

TIAN Na, CHEN Shihong, YANG Tao

2024, 39(10):  963-968.  DOI: 10.3969/j.issn.1673-8640.2024.10.007

Asbtract ( 75 )   HTML ( 17)   PDF (891KB) ( 8 )  

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the correlation between serum meteorin-like protein（METRNL），soluble triggering receptor expression on myeloid cell-1（sTREM-1） levels and the degree of carotid atherosclerosis（CAS） in patients with type 2 diabetes mellitus（T2DM）. Methods A total of 235 T2DM patients from Chengde Central Hospital from December 2021 to December 2023 were enrolled. T2DM patients were classified into CAS group（126 cases） and control group（109 cases） based on whether they had CAS. The clinical data and laboratory determination results were collected，and the levels of serum METRNL and sTREM-1 were determined. Spearman method was used to analyze the correlation between serum METRNL，sTREM-1 levels and the degree of CAS. Multivariate Logistic regression was used to analyze the factors for the degree of CAS. Results Compared with control group，serum METRNL level in CAS group was decreased（P<0.05），while serum sTREM-1 level was increased（P<0.05）. Serum METRNL level in IMT thickening group，plaque formation group and carotid artery stenosis group were decreased in turn（P<0.001），while sTREM-1 level was increased in turn（P<0.001）. There was a negative correlation between serum METRNL and the severity of CAS in CAS patients（r_s=-0.422，P<0.05），and there was a positive correlation between sTREM-1 and the severity of CAS（r_s=0.535，P<0.05）. History of hypertension，sTREM-1，glycated hemoglobin A_1c（HbA_1c） and low-density lipoprotein cholesterol（LDL-C） were risk factors for CAS severity （carotid artery stenosis） [odds ratios（OR） were 3.354，2.165，1.642 and 1.943，95% confidence intervals（CI） were 1.580-7.119，1.296-3.618，1.238-2.177 and 1.188-3.178]，and METRNL was a protective factor（OR=0.768，95%CI 0.640-0.922，P<0.05）. Conclusions Serum METRNL level is decreased and sTREM-1 level is increased in T2DM patients with CAS，which is related to the degree of CAS.

Role of urinary exosome miR-214 expression in diagnosis and prognosis assessment of clear cell renal cell carcinoma

LIU Jianxing, WANG Jinpeng, GENG Xinlong, WANG Shan

2024, 39(10):  969-974.  DOI: 10.3969/j.issn.1673-8640.2024.10.008

Asbtract ( 87 )   HTML ( 22)   PDF (1047KB) ( 20 )  

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the role of urinary exosome miR-214 expression in the diagnosis and prognosis assessment of clear cell renal cell carcinoma（ccRCC）. Methods A total of 124 patients with ccRCC（ccRCC group） and 124 patients with renal benign diseases（nephritis，kidney stones，renal cysts and so on）（control group） were enrolled from Linfen Central Hospital from February 2021 to February 2022. The clinical data of all patients were collected，and the relative expression level of urinary exosome miR-214 in mid-urine in the morning before surgery was determined. Receiver operating characteristic（ROC） curve was used to evaluate the diagnostic efficacy of urinary exosome miR-214 in ccRCC. Kaplan-Meier survival curve was used to evaluate the survival of ccRCC patients. Cox regression analysis was used to evaluate the factors affecting overall survival in ccRCC patients. Results The relative expression of urinary exosome miR-214 in ccRCC group was lower than that in control group（P<0.001）. The area under curve（AUC） of urinary exosome miR-214 for the diagnosis of ccRCC was 0.86，the optimal cut-off value was 0.65，the sensitivity was 86.7%，and the specificity was 82.2%. There was statistical significance in the relative expression of urinary exosome miR-214 among ccRCC patients with different TNM stages，Fuhrman grades，lymphatic metastasis and distant metastasis（P<0.05）. The overall survival rate of low miR-214 expression group was lower than that of high miR-214 expression group（P<0.001）. The relative expression level of urinary exosome miR-214 ≤0.65，TNM stage Ⅲ-Ⅳ，Fuhrman grade Ⅲ-Ⅳ，lymphatic metastasis and distant metastasis were independent risk factors for decreased overall survival in ccRCC patients [hazard ratios（HR） were 1.96，1.55，1.80，1.52 and 1.24，95% confidence intervals（CI） were 1.07-2.83，1.03-2.38，1.06-3.07，1.13-2.68 and 1.09-2.18，respectively，P<0.05]. Conclusions The low expression of urinary exosome miR-214 in patients with ccRCC is related to tumorigenesis，development and metastasis，which can be used as a diagnostic marker and prognostic indicator for ccRCC.

Screening and preliminary verification of differentially expressed genes related to chronic kidney disease based on GEO database

ZHANG Shiqiu, LÜ Jie, YU Rong, WANG Chuanling, LIN Ziyan, ZHU Yongjun

2024, 39(10):  975-984.  DOI: 10.3969/j.issn.1673-8640.2024.10.009

Asbtract ( 91 )   HTML ( 16)   PDF (4826KB) ( 39 )  

Figures and Tables | References | Related Articles | Metrics

Objective Based on the GEO database，to analyze and verify the differentially expressed genes in patients with chronic kidney disease（CKD） by cytological experiments in order to find new potential targets for CKD. Methods The microarray data related to CKD（GSE66494 dataset，GSE15072 dataset and GSE30122 dataset） were downloaded from GEO database. The differentially expressed genes in GSE66494 dataset and GSE15072 dataset were screened by bioinformatics methods. Hub genes were identified by constructing protein-protein interaction（PPI） network. The expression of selected hub genes was analyzed in the GSE30122 dataset. The NetworkAnalyst database was used to construct a microRNA-hub gene regulatory network，and the top 5 miRNA with high association with hub genes were screened. The proximal telomeric renal tubular epithelial cell line HK-2 was used to construct a CKD cell model. According to the different substances added，they were classified into tumor necrosis factor-alpha（TNF-α） group（100 μg·L^-1 TNF-α），TNF-α+infliximab group [10 ng·mL^-1 infliximab（TNF-α specific inhibitor）+100 μg·L^-1 TNF-α] and control group（equal proportion of solvent dimethylsulfoxide）. The expression of hub gene and microRNA in each group was determined. Results A total of 233 differentially expressed genes were screened，which included 20 up-regulated genes and 213 down-regulated genes. Totally，10 hub genes（HSP90AA1，IGF1，REN，MMP2，ACTA2，PXN，COL3A1，CALCA，DMD，LAMA2） and 5 microRNAs（hsa-miR-29b-3p，hsa-miR-421，hsa-miR-29a-3p，hsa-miR-335-5p and hsa-let-7b-5p） were screened out. The analysis results of the GSE30122 dataset showed that the hub gene was more significantly expressed in renal tubular tissue samples. Compared with control group，TNF-α group showed obvious cell necrosis and decreased cell growth density. The relative expression levels of HSP90AA1，IGF1，COL3A1，CALCA and hsa-miR-29b-3p，hsa-miR-421，hsa-miR-29a-3p were increased（P<0.05）. Compared with TNF-α group，the cell necrosis in TNF-α+infliximab group was improved，and the cell growth density was increased. The relative expression levels of HSP90AA1，COL3A1 and hsa-miR-29b-3p，hsa-miR-421，hsa-miR-29a-3p were decreased（P<0.05）. Conclusions There are 10 hub genes and 5 microRNA selected from GEO database. HSP90AA1，IGF1，COL3A1，CALCA and hsa-miR-29a-3p，hsa-miR-29b-3p，hsa-miR-421 may be involved in the process of CKD development，which can be potential targets for CKD.

Epidemiology，drug resistance and virulence gene analysis of Clostridium perfringens in different populations

ZHU Yanyan, YAN Zelin, WU Yuchen, ZHANG Yanyan, ZHANG Rong

2024, 39(10):  985-992.  DOI: 10.3969/j.issn.1673-8640.2024.10.010

Asbtract ( 395 )   HTML ( 17)   PDF (982KB) ( 20 )  

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the carrying status， the virulence and drug resistance characteristics of Clostridium perfringens（Cp） in different populations. Methods Totally，699 fresh fecal samples were collected from the Second Affiliated Hospital of Zhejiang University School of Medicine short-term（stay time≤7 d） hospitalized patients and long-term（stay time>7 d） hospitalized patients. The Cp isolates were isolated by anaerobic culture and identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry（MALDI-TOF MS）. The E test was used to determine the drug susceptibility in vitro. Cp virulence genes（cpa，cpb，iap，cpb2 and cpe） were determined by polymerase chain reaction（PCR），and carbapenem-resistant organism（CRO） in fecal samples were screened by screening plate method. Carbapenases（KPC，NDM，VIM，IMP，OXA） were determined in the Cp isolates. Results Totally，220 isolates of Cp were isolated from 699 fecal samples. The isolation rate of Cp isolates in short-term hospitalized patients was the highest（69.9%，65/93），followed by that in healthy subjects（39.0%，130/333），and that was the lowest in long-term hospitalized patients（12.8%，35/273）. The determination rate of cpa gene was the highest among all Cp isolates（100.0%，220/220）. The determination rates of cpb and cpb2 were higher in short-term hospitalized patients（52.5%，71.2%），cpe gene was only determined in long-term hospitalized patients（1.8%，4/222），and iap gene was only determined in 1 healthy subject and 3 short-term hospitalized patients. The etx gene was not determined in any population. One linezolid-resistant multi-drug resistant isolate was isolated from fecal samples from long-term hospitalized patients. The co-carrying rate of Cp and CRO in long-term hospitalized patients was 25.7% [95% confidence interval（CI） 13.1%-43.6%]. Conclusions Cp isolation rate and virulence gene carrying rate are high in short-term hospitalized patients. The isolation rate of Cp is lower in long-term hospitalized patients，but the co-carrying rate of Cp and CRO is high. The heavy use of antibiotics affects the colonization of Cp in the intestinal tract of the population，and the epidemiological monitoring of Cp in the intestinal tract should be paid attention to.

Application evaluation of 24 h satellite blood culture to improve pathogenic microorganism culture process in emergency

MA Yan, ZHOU Chunmei, HUANG Shenglei, WANG Beili, PAN Baishen, GUO Wei

2024, 39(10):  993-998.  DOI: 10.3969/j.issn.1673-8640.2024.10.011

Asbtract ( 90 )   HTML ( 16)   PDF (860KB) ( 21 )  

Figures and Tables | References | Related Articles | Metrics

Objective To analyze the influence of 24 h satellite blood culture on the blood culture workflow of emergency microbiology laboratory. Methods The relevant laboratory data were collected from June 1，2020 to May 31，2021（the 1st stage） and June 1，2021 to May 31，2022（the 2nd stage） before and after the establishment of satellite blood culture in Zhongshan Hospital of Fudan University（18 208 and 2 810 sets）. The differences of time-to-incubation（TTI），time-to-positivity（TTP），time-to-gram stain（TTG） and final report time [turn-around time（TAT）] were compared before and after satellite blood culture. Results The positive rates before and after satellite blood culture were 6.29%（1 146 /18 208） and 9.57%（269/2 810）（P<0.001）. In the whole time，working time and non-working time，TTI，TTP and TAT after satellite blood culture were shorter than those before satellite blood culture（P<0.05）. In particular，the non-working times were shortened by 3.78，7.76 and 16.18 h，respectively. After satellite blood culture，the TTP of Enterobacteriaceae and Staphylococcus were decreased by 1.93 h（P=0.014） and 6.59 h（P<0.001） compared with that before satellite blood culture，and the TAT of Enterobacteriaceae and Enterococcus were decreased by 8.13 h（P<0.05） and 6.53 h（P<0.05），respectively. Conclusions Setting satellite blood culture can improve the positive rate of blood culture，shorten TTI，TTP and TAT，and realize the optimization of blood culture process.

Construction of prognostic decision tree model of Staphylococcus aureus bloodstream infection in intensive care unit based on MIMIC-Ⅳ database data

QIN Zehui, CHEN Qiuyu, LIANG Fengrui, SONG Yuqi, YE Liping, LIU Xiangtian, TIAN Xinghan

2024, 39(10):  999-1004.  DOI: 10.3969/j.issn.1673-8640.2024.10.012

Asbtract ( 105 )   HTML ( 15)   PDF (1301KB) ( 48 )  

Figures and Tables | References | Related Articles | Metrics

Objective To construct a decision tree model based on MIMIC-Ⅳ database data to evaluate the condition and prognosis of patients with Staphylococcus aureus bloodstream infection（SABI） in intensive care unit（ICU）. Methods The demographic information of 1 030 patients with SABI in ICU and related laboratory indicators were extracted from MIMIC-Ⅳ database. Whether the patient died in hospital was the main outcome. The included patients were classified into training set（773 cases） and validation set（257 cases） in a ratio of 3:1. The random forest model was constructed based on the training set data，and the variables are screened according to the importance score to construct the decision tree model. The model was included in the validation set for validation. Results The importance scores of serum potassium ion（K⁺），serum sodium ion（Na⁺），creatinine（Cr），anion gap（AG），serum calcium ion（Ca²⁺），hematocrit（HCT），hemoglobin（Hb） and international normalized ratio（INR） were high. The decision tree model was constructed based on these 8 indexes. The area under curve（AUC） of receiver operating characteristic（ROC） curve of this model for predicting prognosis of SABI patients （mortality）in ICU was 0.769 4. Conclusions A decision tree model has been constructed to evaluate the condition and prognosis of SABI patients in ICU，which is helpful to rapidly identify the high-risk mortality in this type of patients，which suggests the clinical adjustment of treatment plan in time to improve the prognosis of patients.

Relationship between FANCF/BRCA1 protein expression and treatment response in patients with acute myeloid leukemia

GUO Yuanyuan, SONG Hui, ZHANG Lin

2024, 39(10):  1005-1009.  DOI: 10.3969/j.issn.1673-8640.2024.10.013

Asbtract ( 68 )   HTML ( 18)   PDF (888KB) ( 6 )  

Figures and Tables | References | Related Articles | Metrics

Objective To analyze the relationship between FANCF/BRCA1 protein expression and treatment response in patients with acute myeloid leukemia（AML）. Methods Totally，120 patients with AML in the First Hospital of Qinhuangdao from February 2018 to January 2022（observation group） were enrolled，and 48 patients with non-malignant blood diseases who underwent bone marrow biopsy were enrolled as control group. The mononuclear cells in the bone marrow fluid of all the subjects were extracted，the FANCF/BRCA1 protein expression was analyzed semi-quantitatively by western blotting，and the difference of FANCF/BRCA1 protein expression between observation group and control group was compared. The patients with AML were treated with induction therapy，the complete remission rate was recorded，and the relationship between FANCF/BRCA1 protein expression and therapeutic response was analyzed. Results The expression of FANCF/BRCA1 protein in observation group was lower than that in control group（P<0.001）. Among the 120 AML patients，62 cases had high expression of FANCF/BRCA1 protein（≥0.79），and 58 cases had low expression（<0.79）. The expression of FANCF/BRCA1 protein was correlated with hemoglobin and platelet count in AML patients（P<0.05）. The expression of FANCF/BRCA1 protein was positively correlated with the therapeutic response of AML patients（r=0.548，P<0.05）. The complete response rate of FANCF/BRCA1 high expression group（82.26%） was higher than that of FANCF/BRCA1 low expression group（56.90%）（P<0.05）. Conclusions The expression of FANCF/BRCA1 protein is positively correlated with the therapeutic response of AML patients，which can be used to evaluate the therapeutic response of patients.

Relation of core-binding factor acute myeloid leukemia associated with KIT mutation in children and clinical characteristics and prognosis

XIE Xin, SHI Lihuan, FAN Pengkai, CHEN Jing

2024, 39(10):  1010-1014.  DOI: 10.3969/j.issn.1673-8640.2024.10.014

Asbtract ( 73 )   HTML ( 18)   PDF (959KB) ( 7 )  

Figures and Tables | References | Related Articles | Metrics

Objective To analyze the expression of core-binding factor acute myeloid leukemia（CBF-AML） associated with KIT mutation in children and its relationship with clinical characteristics and prognosis. Methods Totally，72 newly diagnosed children with CBF-AML were enrolled from the Children's Hospital of Zhengzhou University from February 2014 to August 2022，and the clinical data of 72 children with CBF-AML were collected. According to the results of cytogenetic analysis，they were classified into RUNX1-RUNX1T1 group（60 cases） and CBFβ-MYH11 group（12 cases）. They were classified into KIT positive group（31 cases） and KIT negative group（41 cases） according to the KIT mutation. The clinical characteristics and prognosis of KIT positive group and KIT negative group were compared. Results There was no statistical significance in gender，age，newly diagnosed white blood cell count，proportion of newly diagnosed peripheral blood and bone marrow blast cells，extramedullary leukemia，complete remission（CR） in the first course of treatment，5-year event-free survival and 5-year overall survival between KIT positive and KIT negative groups（P>0.05）. Conclusions KIT mutation has no significant effect on the clinical manifestations and prognosis of children with CBF-AML.

Progress of thrombin-activatable fibrinolysis inhibitor determination in clinical application

CUI Weiqi, OU Xinyang, ZHAO Chunhe, XIA Wei, QU Linlin

2024, 39(10):  1021-1026.  DOI: 10.3969/j.issn.1673-8640.2024.10.016

Asbtract ( 225 )   HTML ( 25)   PDF (861KB) ( 47 )  

Figures and Tables | References | Related Articles | Metrics

Thrombin-activatable fibrinolysis inhibitor（TAFI）is a single chain glycoprotein with plasma carboxypeptidase-like activity，which is synthesized and secreted mainly by the liver，and it exists in plasma in the form of zymogen. The traditional methods of TAFI deterimination include enzyme-linked immunosorbent assay（ELISA），enzymatic assay and functional assay. In the recent years，new determination methods，such as immunoturbidimetry and isotope dilution mass spectrometry，have been developed and popularized，promoting the clinical application of TAFI in deep vein thrombosis，cardiovascular and cerebrovascular diseases，hemorrhagic diseases and inflammatory diseases. This review introduces the physiological function of TAFI，summarizes the determination technologies and determination principles of TAFI，and it reviews the clinical application value of TAFI，aiming to understand the role of TAFI for thrombotic diseases and provide a reference for prevention and treatment.