Table of Content

30 January 2025, Volume 40 Issue 1

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Research progress on laboratory diagnosis and treatment of ETP-ALL

LIU Mengna, WANG Hongling, BAI Ping, CAI Yu, LI Li

2025, 40(1):  1-7.  DOI: 10.3969/j.issn.1673-8640.2025.01.001

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Early T-cell precursors （ETP） are the earliest progenitors that originate from the bone marrow and reside in the thymus. Early T-cell precursor acute lymphoblastic leukemia （ETP-ALL） is a new subtype of T-cell acute lymphoblastic leukemia （T-ALL） that is discovered with the advancement of research techniques. The traditional view of hematopoiesis is that hematopoietic cells follow a basic process of lineage commitment from multipotent stem cells to lineage-restricted progenitor cells. The first step of hematopoiesis is common myeloid and lymphoid differentiation pathways，and the final step of T lymphocyte lineage restriction occurs in the thymus. However，ETP-ALL has differential potential of T，B and myeloid cells，challenging the traditional hematopoietic lineage development rules. At present，the lineage origin and differential potential of ETP-ALL can not be clearly identified，so its immune phenotype，genetic characteristics and diagnosis and treatment are being investigated，which also increases the difficulty of diagnosis and differential diagnosis. Currently，the flow cytometry immuno-phenotyping scoring system is an important auxiliary diagnostic method of ETP-ALL. ETP-ALL treatment typically includes induction therapy，consolidation therapy after remission and maintenance therapy. Due to poor response to conventional chemotherapy and high relapse rate after remission，patients who achieve complete remission and meet the criteria should perform allogeneic hematopoietic stem cell transplantation as soon as possible. This review provides an overview of the origin and regulation of ETP-ALL，as well as the latest advances in the laboratory diagnosis and clinical treatment of ETP-ALL，which may be useful for its diagnosis and treatment.

Research progress on artificial intelligence in assisting diagnosis of bone marrow cell morphology

WANG Chi, LIU Shaomei, LI Mianyang

2025, 40(1):  8-14.  DOI: 10.3969/j.issn.1673-8640.2025.01.002

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The diagnosis of hematologic neoplasms requires comprehensive consideration of clinical manifestations，bone marrow cell morphology，genetics and immune phenotypes. However，bone marrow cell morphology examination is regarded as the gold standard for morphological diagnosis of most hematologic diseases. With the widespread application of tissue image analysis and artificial intelligence （AI） in clinical practice，the automatic image processing system developed using AI demonstrates significant advantages in the bone marrow cell morphology，which can improve the efficiency and quality of morphological diagnosis，reduce labor costs，and enhance the consistency and comparability of determination results. This review focuses on the latest progress in AI's identification of bone marrow cell morphology and its application in the diagnosis of hematologic neoplasms，as well as discusses the challenges and value that AI faces in the future clinical trials and diagnostics.

Prognostic value of circulating plasma cells determined by morphology in newly diagnosed multiple myeloma

ZHANG Lan, ZHU Jianfeng, PAN Baishen, CHEN Pu, WANG Beili, GUO Wei

2025, 40(1):  15-19.  DOI: 10.3969/j.issn.1673-8640.2025.01.003

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Objective To analyze the clinical characteristics of patients with newly diagnosed multiple myeloma （MM），to investigate the influence of circulating plasma cells （cPC） on the prognosis of these patients，and to provide a reference for personalized diagnosis and treatment. Methods The clinical data and laboratory parameters of 184 newly diagnosed MM patients from January 2016 to July 2020 in Zhongshan Hospital of Fudan University were analyzed retrospectively. Peripheral blood smears of 184 newly diagnosed MM patients were reviewed by conventional morphology，the patients with cPC≥0.5% were enrolled in cPC positive group，and the patients with cPC=0% were enrolled in cPC negative group. The clinical data and laboratory parameters of the 2 groups were compared. Overall survival （OS） and progression free survival（PFS）of the 2 groups were compared. Cox regression analysis was performed to analyze the effect of cPC on the prognosis of newly diagnosed MM patients. Results Among the 184 newly diagnosed MM patients，27（14.7%） cases were in cPC positive group，and 157（85.3%） cases were in cPC negative group. There was statistical significance in the age，hemoglobin，platelet count，albumin，lactic dehydrogenase，β₂-microglobulin，creatinine，percentage of bone marrow plasma cells，high-risk cytogenetic abnormality and the International Staging System（ISS）stage Ⅲ（P<0.05）. The median OS of cPC negative group and cPC positive group were not arrived and 58.7 months，and the median PFS of the 2 groups were not arrived and 47.2 months. The cPC positive group had a shorter OS and PFS than those of cPC negative group（P<0.001）. Cox regression analysis showed cPC≥0.5% was an independent poor prognostic factor for shorten OS[hazard ratio（HR）=13.439，95% confidence interval（CI） 3.051-59.203，P=0.001] and PFS（HR=2.320，95%CI 1.252-4.296，P=0.007） in newly diagnosed MM patients. Conclusions Among the newly diagnosed MM patients，cPC determined by conventional morphology is associated with poor prognosis and aggressive biological characteristics（such as high tumor burden，high incidence of high-risk cytogenetic abnormality，poor clinical stage and so on），and cPC≥0.5% is an adverse independent predictor of shorten OS and PFS.

Clinical characteristic analysis of ETP-ALL patients with POX positive rate>3%

WANG Hongling, CAI Yu, LIU Mengna, BAI Ping

2025, 40(1):  20-24.  DOI: 10.3969/j.issn.1673-8640.2025.01.004

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Early T-cell precursor acute lymphoblastic leukemia （ETP-ALL） with peroxidase（POX） positive rate>3% is rarely seen. The determination results of ETP-ALL with POX positive rate>3% from a case of Shanghai General Hospital of Shanghai Jiao Tong University School of Medicine were analyzed. The morphological result shows this may be mixed phenotype acute leukemia；the result of flow cytometry indicates ETP-ALL；next generation sequencing results show mutation of FBXW7（6.76%），IKZF1（7.53%），NOTCH1（8.12%），NRAS （8.26%），TCRβDβ-Jβ rearrangements；the analysis of chromosome karyotype is 46，XY，del（2）（p24），t（3；5）（q11；q11）/46，XY[17]. This study aims to improve the diagnostic and therapeutic ability of this disease.

Analysis of laboratory diagnosis and prognostic factors of myeloid neoplasms based on different classification criteria

DING Jing, LI Huidan, ZHANG Chunling, WANG Xiaorui, LIU Weiling, LIN Lihui, QIU Huiying

2025, 40(1):  25-31.  DOI: 10.3969/j.issn.1673-8640.2025.01.005

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Objective To assess the diagnostic role of bone marrow blast percentage in the classification of myeloid neoplasms based on different classification criteria，and to provide a reference for optimizing diagnosis and treatment strategies. Methods A total of 236 patients diagnosed with myeloid neoplasms from 2016 to 2022 at Shanghai General Hospital of Shanghai Jiao Tong University School of Medicine were enrolled，consisting of 56 patients with myelodysplastic syndrome （MDS） and 180 patients with acute myeloid leukemia （AML）. According to the 2022 updated international consensus and classification criteria，the patients were classified into Group A（blast percentage<10%），Group B（10%≤blast percentage<30%）and Group C（blast percentage≥30%）. Group B was further subclassified into Subgroup 1（10%≤blast percentage<20%）and Subgroup 2（20%≤blast percentage<30%）. The clinical and laboratory characteristics between the groups were compared. Cox regression model was used to evaluate the prognostic factors for myeloid neoplasms. Results There was no statistical significance in clinical and laboratory results between Group A and Group B（P>0.05）. However，statistical significance was observed between Group B and Group C. Group C had a younger median age（P=0.007），higher hemoglobin levels（P<0.001），and higher white blood cell counts（P<0.001）. The mutation rates of CEBPA，KIT，NRAS，NPM1 and FLT3-ITD in Group C were higher（P=0.009，P=0.007，P=0.042，P=0.016，P=0.001）. Apart from peripheral white blood cell count（Subgroup 2 higher，P=0.005）and chromosomal karyotype abnormalities（Subgroup 1 having more extra-chromosomal abnormalities，P=0.008），there was no statistical significance in the other laboratory results between Subgroup 1 and Subgroup 2. SF3B1 mutations were associated with a lower blast percentage（P=0.006），while TP53 mutations were correlated with elder age and complex karyotype，which are considered poor prognostic factors（P=0.003，P<0.001）. High blast percentage，low treatment intensity and TP53 gene mutations were identified as adverse prognostic factors for survival in myeloid neoplasm patients. Allogeneic hematopoietic stem cell transplantation（HSCT） improved prognosis（P=0.005，P<0.001，P<0.001，P<0.001）. In Group B，the mortality risk was higher in males than that in females（P=0.009），and the mortality risk was higher in patients with BCOR gene mutations in Group 3（P=0.011）. Conclusions Myeloid neoplasm patients with 10%≤blast percentage≤30% have a better prognosis than those with AML with blast percentage ≥30%. The blast percentage is a prognostic indicator for clinical treatment. The statistical utility of blast percentage as a continuous variable（P=0.005） is much greater than when treated as a categorical variable（P=0.047）. High blast percentage，low treatment intensity and TP53 mutations are associated with poor prognosis，while allogeneic HSCT improves clinical outcomes. Statistical significance in clinical characteristics has been observed in patients with SF3B1 and TP53 mutations.

Clinical significance of serum lncRNA NEAT1 for multiple myeloma patients with kidney injury

SHEN Ximin, ZHANG Lei, QUAN Heng, NIU Ziguang, XIA Dongge, ZHANG Rulin

2025, 40(1):  32-36.  DOI: 10.3969/j.issn.1673-8640.2025.01.006

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Objective To analyze the clinical application value of serum long non-coding RNA（lncRNA）nuclear paraspeckle assembly transcript 1（NEAT1）for multiple myeloma（MM） patients with kidney injury. Methods A total of 107 newly diagnosed MM patients admitted to Shanghai General Hospital of Shanghai Jiao Tong University School of Medicine from January 2020 to April 2023 were enrolled as MM group，and 60 healthy subjects were enrolled as control group. According to whether MM patients were complicated with kidney injury，they were classified into kidney injury group （36 cases） and non-kidney injury group （71 cases）. The 71 patients with non-kidney injury were followed up for 1 year，19 patients with late kidney injury were enrolled in late kidney injury group，and the remaining 52 patients were enrolled in late non-kidney injury group. The expression of serum lncRNA NEAT1 in each group was determined and compared，and the factors that may affect MM complicated with kidney injury were analyzed by Logistic regression analysis. The predictive value of serum lncRNA NEAT1 for MM complicated with kidney injury was evaluated by receiver operating characteristic （ROC） curve. Results The relative expression level of serum lncRNA NEAT1 in MM group was higher than that in control group （P<0.05）. The proportion of light chain type，Durie-Salmon（DS）stageⅢ，the International Staging System（ISS）stageⅢ and serum creatinine（SCr）level in kidney injury group were higher than those in non-kidney injury group （P<0.05）. The relative expression level of serum lncRNA NEAT1 in kidney injury group was higher than that of non-kidney injury group（P<0.05）. ISS stageⅢ，SCr，DS stageⅢ and lncRNA NEAT1 were the factors affecting the occurrence of kidney injury in patients with MM. The relative expression of serum lncRNA NEAT1 in patients with MM complicated with kidney injury was positively correlated with SCr level（r=0.376，P<0.05）. The relative expression level of lncRNA NEAT1 in late kidney injury group was higher than that in late non-kidney injury group （P<0.05）. Conclusions The relative expression level of serum lncRNA NEAT1 in patients with MM complicated with kidney injury is increased，and serum lncRNA NEAT1 level is related to the severity of kidney injury. Serum lncRNA NEAT1 has a good clinical application value for kidney injury in patients with MM.

Expression of LHPP in patients with gastric adenocarcinoma and its effect on biological function of carcinoma cells

XIANG Min, SHU Yang, SHENG Yucheng, WU Xiaobai, GUO Ruonan, JIANG Yifan

2025, 40(1):  41-48.  DOI: 10.3969/j.issn.1673-8640.2025.01.008

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Objective To investigate the role of phospholysine phosphohistidine inorganic pyrophosphate phosphatase （LHPP ） expression in patients with gastric adenocarcinoma and its effect on the biological function of carcinoma cells. Methods A total of 21 patients with gastric adenocarcinoma from the Affiliated Hospital of Jiangsu University from October 2020 to June 2021 were enrolled to collect gastric cancer tissues and adjacent tissues. The expression of LHPP in gastric cancer and its relationship with prognosis were analyzed by biological database. The expression of LHPP protein and mRNA in cancer tissues and adjacent tissues of patients with gastric cancer and different cell lines （human gastric mucosal epithelial cell line GES-1 and gastric cancer cell line HGC-27，AGS，MKN-45，SGC-7901，MGC-803） were determined. A gastric cancer cell interference model was constructed，and the effects of LHPP on the proliferation and migration of gastric cancer cells were evaluated by cell biology experiments. Gene Ontology （GO） enrichment and Kyoto Encyclopedia of Genes and Genomes（KEGG） signaling pathway analysis were used to evaluate the role of LHPP related genes. Results The analysis results of the Cancer Genome Atlas（TCGA），the Gene Expression Omnibus（GEO）and the Human Protein Atlas（HPA）databases showed that the LHPP mRNA and protein expressions in gastric cancer tissues were lower than those in adjacent tissues（P<0.05）. The analysis results of Kaplan-Meier Plotter database showed that the overall survival，first progression survival and reprogression survival of gastric cancer patients with high LHPP expression were longer than those with low LHPP expression [hazard ratios （HR） were 0.66，0.57 and 0.64，95% confidence intervals （CI） were 0.54-0.81，0.45-0.73 and 0.48-0.85，respectively]. The relative expression levels of LHPP protein and mRNA in all gastric cancer cell lines were statistically significant compared with GES-1 cells （P<0.05），and AGS cells were selected for follow-up tests. The relative expression levels of LHPP protein and mRNA in gastric cancer tissues were lower than those in adjacent tissues （P<0.05）. LHPP can inhibit the proliferation and migration of AGS cells. The main functions of LHPP in gastric cancer were cell cycle regulation in mitosis，positive regulation of DNA metabolism，protein folding，karyoplasmic transport and so on，mainly involved in cell cycle，TPX2 regulated AURKA activation，epigenetic regulation of gene expression and other signaling pathways. Conclusions The expression of LHPP is low in patients with gastric adenocarcinoma，which is related to the prognosis of patients，and LHPP has an inhibitory effect on the proliferation and migration of gastric adenocarcinoma cells.

Correlation of serum TET2，ox-LDL，CLU with ventricular remodeling and major adverse cardiovascular events in patients with acute myocardial infarction

WANG Qinglei, HUANG Xiansheng, FU Shan, LI Shucheng, WANG Hong

2025, 40(1):  49-53.  DOI: 10.3969/j.issn.1673-8640.2025.01.009

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Objective To investigate the correlation of serum ten-eleven translocation（TET2），oxidized low-density lipoprotein （ox-LDL），clusterin（CLU）with ventricular remodeling and major adverse cardiovascular events （MACE） in patients with acute myocardial infarction （AMI）after ventricular remodeling and percutaneous coronary intervention （PCI）. Methods A total of 97 patients with AMI （AMI group） and 97 healthy subjects （healthy control group） were enrolled from the Affiliated Hospital of Chengde Medical College from May 2020 to May 2022. The clinical data of all subjects were collected，and serum TET2，ox-LDL，CLU levels and ventricular remodeling indexes [left ventricular ejection fraction （LVEF），left ventricular end-systolic volume （LVESV），left ventricular end-diastolic diameter （LVEDD），left ventricular mass index （LVMI）] were determined before PCI. All the patients underwent PCI and were followed up for 1 year. They were classified into MACE group and non-MACE group. Pearson correlation analysis was used to evaluate the correlation among the indexes. Receiver operating characteristic （ROC） curve was used to evaluate the efficacy of various indexes in determining MACE in AMI patients. Results Compared with healthy control group，serum ox-LDL，CLU，LVEDD，LVESV and LVMI in AMI group were increased （P<0.001），and serum TET2 and LVEF were decreased （P<0.001）. Serum ox-LDL and CLU in AMI group were positively correlated with LVEDD，LVESV and LVMI （P<0.001），and they were negatively correlated with LVEF （P<0.001）. Serum TET2 was negatively correlated with LVEDD，LVESV and LVMI （P<0.001），and it was positively correlated with LVEF （P<0.001）. Compared with non-MACE group，serum ox-LDL and CLU in MACE group were increased （P<0.05），and serum TET2 level was decreased （P<0.001）. The areas under curves（AUC） of serum TET2，ox-LDL and CLU single and combined determinations for MACE in AMI patients were 0.689，0.657，0.664 and 0.839，respectively. Conclusions Serum TET2，ox-LDL and CLU are related to ventricular remodeling and MACE in AMI patients，and the combined determination of TET2，ox-LDL and CLU has a good predictive value for MACE in AMI patients after PCI.

Role of methyltransferase-like protein 14 in patients with coronary heart disease

GUO Fengxia, HU Bing, SHA Yanhua

2025, 40(1):  54-58.  DOI: 10.3969/j.issn.1673-8640.2025.01.010

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Objective To investigate the role of methyltransferase-like protein（METTL）14 in coronary heart disease（CHD）patients. Methods From June 2019 to February 2021，316 patients in Henan Provincial People's Hospital with chest tightness or chest pain as the main complaint were enrolled to undergo coronary angiography to confirm coronary artery stenosis after a series of clinical examinations. According to the results of coronary angiography，they were classified into CHD group（216 cases） and control group（100 cases）. The clinical data were collected. Plasma levels of METTL14，tumor necrosis factor-alpha（TNF-α），monocyte chemotactic protein-1（MCP-1），vascular cell adhesion molecule-1（VCAM-1），intercellular adhesion molecule-1（ICAM-1） and interleukin（IL）-6 were determined by enzyme-linked immunosorbent assay. Correlations were assessed by Pearson or Spearman analysis. The effectiveness of METTL14 in diagnosing CHD was evaluated using receiver operating characteristic （ROC） curves. The risk factors of CHD were evaluated by Logistic regression analysis. Results Compared with control group，the levels of TNF-α，MCP-1，VCAM-1，ICAM-1，IL-6 and METTL14 in CHD group were increased（P<0.001）. There was statistical significance in C-reactive protein（CRP） and METTL14 among all coronary lesion number groups（P<0.05）. METTL14 was positively related with IL-6 and Gensini scores in CHD group（r=0.390 and 0.493，P<0.05）. Increased MCP-1，VCAM-1，IL-6 and METTL14 were risk factors for CHD（P<0.001）. Conclusions METTL14 in peripheral blood is related with CHD，which can be a risk factor for the diagnosis of CHD.

Correlation between glycemic control and T cell memory subsets in type 2 diabetes mellitus patients

GAN Chenxin, CHEN Minghui, WANG Yajie, WU Jiaoxiang, FANG Fengqin, LIN Jinpiao, SHENG Huiming

2025, 40(1):  59-65.  DOI: 10.3969/j.issn.1673-8640.2025.01.011

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Objective To investigate the influence of poor glycemic control in type 2 diabetes mellitus （T2DM） patients on T cell memory subsets and immune marker expression. Methods Peripheral blood samples were collected from 170 T2DM patients（T2DM group）and 85 healthy subjects （healthy control group） in Tongren Hospital of Shanghai Jiao Tong University from January 2022 to January 2024. According to glycated hemoglobin A1c （HbA_1c）levels，T2DM patients were classified into 2 groups，patients with good glycemic control（HbA_1c<7%） and patients with poor glycemic control（HbA_1c≥7%）. Flow cytometry was used to assess the proportion of T cell memory subsets，distinguishing between naive T cell（T_Nai），central memory T cell（T_CM），effector memory T cell（T_EM） and terminally differentiated effector memory T cell（T_EMRA） subgroups. The expressions of T_CM and T_EM membrane molecules （CD38，CD25 and HLA-DR ）were determined. Biochemical indicator determination results were collected，including fasting plasma glucose，HbA_1c，total cholesterol （TC），triglyceride （TG），low-density lipoprotein cholesterol （LDL-C） and high-density lipoprotein cholesterol （HDL-C）. Linear regression was used to assess the correlation between T cell memory subsets and membrane molecules and patients' age and HbA_1c level. Results Compared with healthy control group，T2DM group showed increased levels of fasting plasma glucose，HbA_1c and TG （P<0.05） and a decreased level of HDL-C（P<0.000 1）. There was no statistical significance in TC and LDL-C between the 2 groups （P>0.05）. T2DM patients showed an increased percentage of CD8⁺T_CM cells （P=0.006 7）. There was no statistical significance in the other T cell memory subsets between the 2 groups （P>0.05）. Compared with healthy control group，in T2DM group CD4⁺CD38⁺T_CM%，CD4⁺CD25⁺T_CM%，CD4⁺HLA-DR⁺T_CM%，CD4⁺CD38⁺T_EM%，CD4⁺HLA-DR⁺T_EM%，CD8⁺CD38⁺T_CM%，CD8⁺HLA-DR⁺T_CM% and CD8⁺HLA-DR⁺T_EM% were decreased（P<0.05）. Compared with T2DM patients with good glycemic control，T2DM patients with poor glycemic control showed an increased CD8⁺T_CM%（P<0.05），a decreased CD4⁺CD38⁺T_CM%（P<0.000 1），and a decreased CD4⁺CD38⁺T_EM%（P<0.05）. The CD4⁺CD38⁺T_CM% was negatively related to HbA_1c level and age in T2DM patients（r values were -0.512 6 and -0.234 2，P<0.000 1，P=0.002 1，respectively）. Conclusions Poor glycemic control effects T cell immune function. The CD4⁺CD38⁺T_CM% reduces along with the increase of HbA_1c in T2DM patients.

Correlation between serum sd-LDL-C，the severity of coronary heart disease and the risk of cardiovascular events in type 2 diabetes mellitus patients

ZHANG Aimin, YIN Yue, QIN Li, ZHANG Na, WANG Chunyan, JIA Mei, PEI Lin

2025, 40(1):  66-72.  DOI: 10.3969/j.issn.1673-8640.2025.01.012

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Objective To investigate the relationship between serum small and dense low-density lipoprotein cholesterol（sd-LDL-C），the severity of coronary vessel lesion and the risk of cardiovascular events in patients with type 2 diabetes mellitus（T2DM）. Methods Totally，3 315 Han T2DM patients from Peking University People's Hospital from January 2016 to March 2019 were enrolled. The general data of all patients were collected，and fasting blood glucose （FBG），homocysteine（Hcy），high-sensitivity C-reactive protein（hs-CRP），total cholesterol（TC），triglyceride（TG），low-density lipoprotein cholesterol（LDL-C），high-density lipoprotein cholesterol（HDL-C），apolipoprotein A1（apo A1）and apolipoprotein B（apo B），lipoprotein（a）[Lp（a）]，sd-LDL-C and glycated hemoglobin A1c（HbA_1c）were determined. According to the results of coronary angiography （CAG），all the patients were classified into coronary heart disease（CHD）group（1 998 cases of T2DM with CHD）and non-CHD group（1 317 cases of T2DM without CHD）. According to the Gensini（GS）scores[≤25（low），26-40（medium），≥41（high）]，T2DM patients with CHD were classified into low GS subgroup，medium GS subgroup and high GS subgroup. T2DM combined with CHD patients were classified into 1 vessel，2 vessel and 3 vessel lesions. All the patients were followed for 5 years，and major adverse cardiovascular events（MACE）were recorded. Binary Logistic regression analysis was used to evaluate the relationship between sd-LDL-C，the severity of coronary vessel lesion and the risk of CHD. Kaplan-Meier survival curve was used to analyze the occurrence of MACE. Results Compared with non-CHD group，the levels of apo B，LDL-C，hs-CRP，Hcy and sd-LDL-C in CHD group were increased（P<0.05），while the levels of apo A1 and HDL-C were decreased（P<0.05）. The LDL-C，apoB and Hcy levels in high GS subgroup were higher than those in low GS subgroup（P<0.05），and the TC and sd-LDL-C levels were higher than those in medium GS subgroup and low GS subgroup（P<0.05）. The sd-LDL-C level in medium GS subgroup was higher than that in low GS subgroup（P<0.05）. After adjusting for age，gender，body mass index，FBG，HbA_1c，apo B，apo A1，TC，TG，HDL-C，LDL-C，Lp（a），hs-CRP and Hcy，sd-LDL-C remained an independent risk factor for CHD and the severity of coronary vessel lesion in T2DM patients. In T2DM patients，the risk of CHD in sd-LDL-C>0.95 mmol·L^-1 group was 2.030 times higher than that in sd-LDL-C<0.57 mmol·L^-1 group[odds ratio（OR）=2.030，95% confidence interval（CI）1.770-4.974，P=0.021]. In patients with T2DM combined with CHD，the risk of 3 vessel lesions and high GS score in sd-LDL-C>1.07 mmol·L^-1 group was 3.168 times and 2.451 times higher than that in sd-LDL-C<0.58 mmol·L^-1 group（OR=3.168 and 2.451，95% CI 1.891-7.305 and 2.032-5.411，respectively，P<0.05）. There was a statistical significance in the incidence of MACE between patients with different levels of sd-LDL-C in non-CHD group and CHD group（P<0.05）. The incidence of MACE in high sd-LDL-C group（>0.74 mmol·L^-1）（15.36%）was higher than that in low sd-LDL-C group（≤0.74 mmol·L^-1）（11.24%）（P=0.001）. Conclusions The serum sd-LDL-C level in T2DM patients is related with the occurrence of CHD and the severity of coronary vessel lesion，and patients with higher serum sd-LDL-C levels also have an increased risk of developing MACE in the future. The sd-LDL-C may serve as a biomarker for assessing the risk of CHD and the severity of coronary vessel lesion in T2DM patients，as well as predicting the occurrence of MACE.

Roles of serum miR-181b and miR-144 expressions in early neurological deterioration in patients with acute ischemic stroke

KANG Yi, ZHANG Qiaoling, SHI Yanfang, WANG Yujia, CHEN Xiaodan, PENG Youqun

2025, 40(1):  73-78.  DOI: 10.3969/j.issn.1673-8640.2025.01.013

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Objective To investigate the roles of serum miR-181b and miR-144 expressions in early neurological deterioration （END） in acute ischemic stroke （AIS） patients. Methods A total of 96 AIS patients （AIS group） and 95 healthy subjects （healthy control group） were enrolled from Jiulongpo District Traditional Chinese Medicine Hospital and Chongqing Fifth People's Hospital from May 2020 to May 2022. AIS patients were classified into END group and non-END group. The levels of miR-181b and miR-144 were determined，and the clinical data and laboratory routine determination results of all the patients were collected. Multivariate Logistic regression analysis was used to evaluate the factors affecting the occurrence of END in AIS patients. Receiver operating characteristic （ROC） curve was used to evaluate the efficacy of each index in diagnosing the END of AIS patients. Results The relative expression levels of miR-181b and miR-144 in AIS group were lower than those in healthy control group （P<0.001）. White blood cell （WBC） count，the absolute value of neutrophils （NEUT#），homocysteine （Hcy） level and the National Institute of Health Stroke Scale （NIHSS）baseline score in END group were higher than those in non-END group （P<0.001）. Platelet （PLT） count and relative expression levels of miR-181b and miR-144 were lower than those in non-END group（P<0.05）. There was no statistical significance in the other indexes between the 2 groups （P>0.05）. The increase of WBC count，NEUT# and Hcy and the decrease of miR-181b，miR-144 and PLT count were the risk factors for END in AIS patients（P<0.05）. The areas under curves（AUC）of serum miR-181b，miR-144 and PLT count single and combined determinations in AIS patients were 0.864，0.859，0.870 and 0.968，respectively. Conclusions In AIS patients with END，serum miR-181b and miR-144 are both low in expression，and they have good diagnostic efficacy for END.

Serum suPAR and SDC4 levels in patients with severe bronchial asthma and their relationship with lung function and prognosis

LI Dezhong, WANG Zhiwei, XU Wenjuan, SHU Pinyuan

2025, 40(1):  79-83.  DOI: 10.3969/j.issn.1673-8640.2025.01.014

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Objective To investigate the relationship between serum levels of soluble urokinase plasminogen activator receptor（suPAR），syndecan-4（SDC4） and lung function and prognosis in patients with severe bronchial asthma. Methods A total of 102 patients with bronchial asthma in Xiantao First People's Hospital from October 2018 to March 2021 were enrolled and classified into severe asthma group（46 cases） and mild/moderate asthma group（56 cases），and 60 healthy subjects were enrolled as healthy control group. Serum suPAR，SDC4，tumor necrosis factor-alpha（TNF-α），interleukin-6（IL-6） and lung function indexes [forced expiratory volume in one second（FEV1），forced vital capacity（FVC），maximum mid-expiratory flow（MMEF）] were determined. FEV1/FVC% was calculated. The patients with severe bronchial asthma were followed up for 1 year and classified into good prognosis group（29 cases） and poor prognosis group（17 cases） according to whether they had recurrent asthma. Pearson correlation analysis was used to evaluate the correlation between indexes. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of serum suPAR and SDC4 in predicting the poor prognosis of patients with severe bronchial asthma. Results Serum suPAR，IL-6 and TNF-α levels in healthy control group，mild/moderate asthma group and severe asthma group were increased in turn（P<0.001），while serum SDC4 levels and FEV1，FEV1/FVC% and MMEF were decreased in turn（P<0.001）. Pearson correlation analysis showed that suPAR was positively correlated with IL-6 and TNF-α（P<0.05），it was negatively correlated with FEV1，FEV1/FVC% and MMEF in turn（P<0.001），and it was negatively correlated with SDC4 and IL-6，TNF-α（P<0.05）. It was positively correlated with FEV1，FEV1/FVC% and MMEF（P<0.001）. Compared with good prognosis group，the levels of suPAR，IL-6 and TNF-α in poor prognosis group were increased（P<0.001），and the levels of SDC4 were decreased（P<0.001）. The areas under curves（AUC） of serum suPAR and SDC4 single and combined determinations to determine the poor prognosis of patients with severe bronchial asthma were 0.886，0.875 and 0.949，respectively. Conclusions Serum suPAR and SDC4 levels are related to lung function in patients with severe bronchial asthma，and may be used as biomarkers for prognosis assessment in patients with severe bronchial asthma.

Predictive value of combined determination of serum SFRP5 and KLK1 for myocardial no-reflow after PCI in patients with ST-segment elevation myocardial infarction

CHEN Dingzhong, YANG Wen, FENG Yanju, LIANG Xian, ZHANG Xiaozhen

2025, 40(1):  84-89.  DOI: 10.3969/j.issn.1673-8640.2025.01.015

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Objective To analyze the predictive value of combined determination of serum secreted frizzled-related protein-5（SFRP5） and Kallikrein 1（KLK1） for myocardial no-reflow after percutaneous coronary intervention（PCI） in patients with ST-segment elevation myocardial infarction（STEMI）. Methods A total of 156 STEMI patients underwent PCI and 156 healthy subjects in Nanning Eighth People's Hospital from January 2022 to July 2023 were enrolled. The clinical data and laboratory routine determination results of all the patients were collected，and serum SFRP5 and KLK1 levels were determined. STEMI patients were classified into reflow group [132 cases，the Thrombolysis in Myocardial Infarction（TIMI） grade 3] and no-reflow group（24 cases，TIMI grade 0-2） according to TIMI grades 3 months after PCI. Pearson correlation analysis was used to evaluate the correlation among the indicators. Multivariate Logistic regression was used to analyze the influencing factors of no-reflow after PCI in STEMI patients. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of serum SFRP5 and KLK1 in determining no-reflow after PCI in STEMI patients. Results Compared with healthy control group，serum SFRP5 and KLK1 levels in STEMI group were decreased before and after PCI（P<0.05）. Serum levels of SFRP5 and KLK1 in reflow group were higher than those in no-reflow group（P<0.001）. The creatine kinase-MB isoenzyme（CK-MB），cardiac troponin I（cTnI），platelet（PLT）count，Gensini scores and the Global Registry of Acute Coronary Events（GRACE）scores in reflow group were lower than those in no-reflow group（P<0.05）. Serum SFRP5 and KLK1 were negatively correlated with CK-MB，cTnI，PLT count，Gensini score and GRACE score（P<0.05）. Decreased SFRP5 and KLK1 were risk factors for STEMI patients without reflow after PCI [odds ratios（OR） were 0.514 and 0.601，95% confidence intervals（CI） were 0.374-0.707 and 0.435-0.831，respectively，P<0.05]. The areas under curves（AUC） of serum SFRP5 and KLK1 without reflow after PCI in STEMI patients were 0.881，0.885 and 0.949，respectively. Conclusions Serum levels of SFRP5 and KLK1 are lower in STEMI patients with myocardial no-reflow after PCI，and SFRP5 and KLK1 have certain predictive values for myocardial no-reflow in STEMI patients after PCI.

Field application evaluation of intelligent oropharyngeal swab sampling robot

QIN Shuo, WANG Ying, LIU Li, XIONG Yi, TIAN Yong, WANG Xueqing, XIONG Yanwen, LI Shaoqiang, ZHOU Chengzhi, WANG Xiaoling, LIU Zhizhen

2025, 40(1):  90-95.  DOI: 10.3969/j.issn.1673-8640.2025.01.016

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Objective To evaluate the effectiveness and accuracy of intelligent oropharyngeal swab sampling robot for on-site human oropharyngeal swab sampling，and to analyze the related factors that may affect the sampling process of the intelligent oropharyngeal swab sampling robot. Methods Totally，168 teachers and students of Shanxi Medical University were enrolled to participate in on-site intelligent robot sampling. The 52 of them were sampled by both artificial and intelligent robot，and 116 were sampled only by intelligent robot. Questionnaires containing basic information and sampling comfort were collected. Real-time fluorescence quantitation polymerase chain reaction（PCR）was used for nucleic acid determinations of novel coronavirus，influenza A virus，influenza B virus，respiratory syncytial virus，adenovirus，human rhinovirus and mycoplasma pneumoniae，and the difference in determination results of subjects with different basic characteristics of the 2 sampling methods was compared. Results The internal standard cycle threshold（Ct）value of the intelligent robot sampling（29.5±1.8） was lower than that of artificial sampling（30.4±2.0）（P<0.05）. There was statistical significance in Ct values of internal standard between the 2 sampling methods of female subjects and tall subjects（P<0.05）. There was no statistical significance in the nucleic acid determination results of novel coronavirus，influenza A virus，influenza B virus，respiratory syncytial virus，adenovirus，human rhinovirus and mycoplasma pneumoniae between the 2 sampling methods （P>0.05）. The questionnaire showed that 72% of the subjects receiving intelligent robot sampling had no pharyngeal stimulation response，and there was no statistical significance in the overall composition ratio of pharyngeal stimulation response and sampling comfort of subjects with different genders and heights（P>0.05）. The gender and height of the subjects had no correlation with the pharyngeal stimulation response and sampling comfort（P>0.05）. Conclusions The intelligent oropharyngeal swab sampling robot can carry out standardized sampling for different populations. Under the premise of ensuring sample quality，the sampling process can avoid cross infection and reduce the burden of medical personnel.

Human phospholipid scramblase 1 in antiviral infection

MA Xinxin, LU Hongxiang, SHI Qinghai

2025, 40(1):  96-101.  DOI: 10.3969/j.issn.1673-8640.2025.01.017

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Human phospholipid scramblase 1（hPLSCR1）is a member of the transmembrane protein family that mediates the cross-layer movement of membrane phospholipids in a Ca²⁺ dependent manner and plays a role in cell signal transduction，maturation and apoptosis. It has the potential to become a therapeutic target or biomarker for related diseases. This review focuses on the research progress of hPLSCR1 in antiviral infection.