Table of Content

30 March 2025, Volume 40 Issue 3

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Research progress in laboratory diagnosis and immune regulatory mechanisms of pediatric autoimmune diseases

WENG Wenhao

2025, 40(3):  205-208.  DOI: 10.3969/j.issn.1673-8640.2025.03.001

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Pediatric autoimmune diseases pose challenges in clinical practice due to the complex immune mechanisms，heterogeneous clinical manifestations and distinct differences from adult populations. Recent advancements in molecular diagnostic technologies and immune regulatory mechanisms have improved antibody determination strategies，dynamic analysis of peripheral blood immune indicators and targeted therapies. However，the lack of pediatric-specific data，adult-oriented diagnostic criteria and translational research barriers remain critical limitations. This review synthesizes recent studies from a special issue，high-lighting breakthroughs in laboratory diagnosis，mechanistic insights into immune dysregulation and emerging therapeutic approaches. Future directions emphasize the establishment of pediatric-specific diagnostic frameworks，integration of multi-omics technologies and interdisciplinary collaboration to transition from empirical treatment to precision medicine，ultimately enhancing long-term outcomes for pediatric patients.

Status of laboratory testing for autoimmune encephalitis-related antibodies

LI Hanhua, WU Yazhou, WENG Wenhao

2025, 40(3):  209-217.  DOI: 10.3969/j.issn.1673-8640.2025.03.002

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Autoimmune encephalitis （AE） refers to a group of disorders characterized by inflammation of the central nervous system （CNS）. Due to its diverse clinical manifestations and overlapping features with other neurological disorders，the differential diagnosis of AE presents significant challenges. At present，an increasing number of AE have been identified as distinct subtypes，and different subtypes were associated with specific clinical syndromes and potentially pathogenic antibodies. In clinical laboratory testing，in addition to routine biochemical examinations of blood and cerebrospinal fluid （CSF），the determination of specific autoantibodies in serum or CSF provides critical diagnostic insights. The main determination methods include indirect immunofluorescence assay （IFA），enzyme-linked immunosorbent assay （ELISA） and line immunoassay （LIA）. These autoantibodies typically target neuronal antigens，categorizing AE into paraneoplastic AE and AE mediated by antibodies against neuronal surface or synaptic antigens. This article comprehensively reviews 4 aspects：the pathological mechanisms of AE，the types of associated autoantibodies，advancements in laboratory determination techniques and the application of autoantibodies in the diagnosis of AE. The aim is to enhance clinical understanding of AE and provide references for its clinical diagnosis and treatment.

Autoimmune liver disease in children and progress of laboratory diagnosis

MA Zhan, WENG Wenhao

2025, 40(3):  218-222.  DOI: 10.3969/j.issn.1673-8640.2025.03.003

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Autoimmune liver diseases（ALD） is a group of chronic progressive inflammation of liver caused by immune dysfunction. In the recent years，the incidence of ALD in children has risen significantly. The occurrence，clinical characteristics and laboratory diagnosis of ALD in children differ notably from those in adults. This review focuses on the classification and characteristics of common ALD in children，the status and development in laboratory diagnosis，unresolved challenges and genetic susceptibility. The aim is to provide a reference for clinical research and to improve the diagnosis and treatment of ALD in children.

Roles peripheral blood lymphocyte subsets and cytokines for viral and autoimmune encephalitis in children

WANG Shuping, ZHANG Wen, WANG Weiya, MA Lijuan

2025, 40(3):  223-229.  DOI: 10.3969/j.issn.1673-8640.2025.03.004

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Objective To investigate the differential diagnosis value for viral encephalitis（VE） and autoimmune encephalitis（AE） in children，by determining 12 cytokines，including interleukin （IL）-1β，IL-2，IL-4，IL-5，IL-6，IL-8，IL-10，IL-12P70，IL-17，interferon-gamma（INF- γ），interferon-alpha（INF- α）and tumor necrosis factor-alpha（TNF- α）in peripheral blood，and lymphocyte subsets natural killer（CD3+T cell，CD3+CD4⁺T cell，CD3+CD8⁺T cell，CD3-CD19+B cell and CD3-CD16+CD56+ natural killer cell） in peripheral blood. Methods Totally，60 pediatric patients with AE（AE group），40 pediatric patients with VE（VE group） and 60 healthy children（control group） were enrolled from May 2020 to May 2024. Using flow cytometry，lymphocyte subsets and 12 cytokines in peripheral blood were determined. Receiver operating characteristic（ROC）was used to estimate the efficiency of differential diagnosis between AE and VE with these various indicators. Results The absolute value of CD3-CD19+B cells in VE group was higher than that in healthy control group（P<0.10），and the absolute value of CD3-CD16+CD56+ natural killer cell cells in VE group was lower than that in healthy control group（P<0.10）. The absolute value of CD3-CD16+CD56+ natural killer cell cells in AE group was lower than that in healthy control group（P<0.10）. The absolute number of CD3+CD8⁺T cells in VE group was lower than that in AE group（P<0.10），and the absolute value of CD3-CD19+B cells was higher than that in AE groups（P<0.10）. Except IL-17，the levels of the other cytokines in VE group were significantly different from those in healthy control group（P<0.10）. There was statistical significance for IL-4，IL-6，IL-8，IL-10 and TNF-α between AE and healthy control group（P<0.10）. The levels of IL-4，IL-6，IL-8，IL-10 and TNF-α in AE group were significantly different from those in healthy control group （P<0.10）. The levels of IL-4，IL-8，IL-10 and INF-γ in VE group were significantly different from those in AE group（P<0.10）. In VE group，IL-8 was positively correlated with IL-10（r=0.588，P<0.05），and INF-γ was positively correlated with IL-4 and IL-8 （r values were 0.322 and 0.426，P<0.05）. In AE group，IL-4 was positively correlated with IL-10（r=0.833，P<0.05），IL-8 was positively correlated with IL-4 and IL-10（r values were 0.437 and 0.460，P<0.05），and TNF-α was positively correlated with IL-10（r=0.420，P<0.05）. There was no correlation between the absolute value of lymphocyte subsets and all cytokines in AE and VE groups（P>0.05）. The areas under curves（AUC）of CD3+CD8⁺T cell absolute value，B cell absolute value，IL-4，IL-8，IL-10 and INF-γ for differentiating AE and VE were 0.599，0.638，0.616，0.603，0.636 and 0.598，respectively. The AUC of the combined cytokine determination model and the combined lymphocyte subset and cytokine determination model were 0.687 and 0.756，respectively. Conclusions Peripheral blood lymphocyte subsets and cytokines may be used as auxiliary indicators in the differential diagnosis of VE and AE in children.

Relationship between serum 25（OH）D3 level and lymphocyte subsets in children with systemic lupus erythematosus

ZHENG Ying, LU Zhe, XUE Jing

2025, 40(3):  230-234.  DOI: 10.3969/j.issn.1673-8640.2025.03.005

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Objective To investigate the relationship between serum 25-hydroxyvitamin D3 [25（OH）D3] level and lymphocyte subsets in children with systemic lupus erythematosus （SLE）. Methods A total of 52 children with SLE （SLE group） and 50 healthy children （healthy control group） were enrolled from Hainan Women and Children's Medical Center from June 2022 to June 2023. Serum 25（OH）D3 level and lymphocyte subsets [CD3+T cells，CD4⁺T cells，CD8⁺T cells，total B cells，natural killer（NK）cell percentage and CD4⁺/CD8⁺ratio] were determined. According to the vitamin D deficiency standard，SLE children were classified into vitamin D deficiency group [20 cases，25（OH）D3<50 nmol·L^-1] and vitamin D normal group [32 cases， 25（OH）D3≥50 nmol·L^-1]. The correlation between serum 25（OH）D3 level and lymphocyte subsets was evaluated by Pearson correlation analysis. Results The serum 25（OH）D3 level，CD4⁺T cell percentage，CD4⁺/CD8⁺ ratio，NK cell percentage and total B cell percentage in SLE group were lower than those in healthy control group（P<0.05），and the percentages of CD3+T cells and CD8⁺T cells were higher（P<0.05）. The percentages of CD4⁺T cells，NK cells，total B cells and CD4⁺/CD8⁺ ratio in vitamin D deficiency group were lower than those in vitamin D normal group（P<0.01），and the percentages of CD3+T cells and CD8⁺T cells were higher（P<0.05）. Serum 25（OH）D3 was positively correlated with CD4⁺T cells，CD4⁺/CD8⁺ ratio，NK cells and total B cells in SLE children（r values were 0.455，0.579，0.574 and 0.448，P<0.001）. It was negatively correlated with CD3+T cells and CD8⁺T cells （r values were -0.574 and -0.466，P<0.001）. Conclusions Serum 25（OH）D3 level is associated to lymphocyte subsets in children with SLE，suggesting that vitamin D levels may have diagnostic and therapeutic value in the diagnosis and treatment of SLE.

Immunological indexes in assessing the prognosis of children with autoimmune encephalitis

YANG Hancao, LIANG Keqing, WU Ming, XU Jin

2025, 40(3):  235-240.  DOI: 10.3969/j.issn.1673-8640.2025.03.006

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Objective To evaluate the prognostic value of lymphocyte subsets，immunoglobulins and complements in peripheral blood for children with autoimmune encephalitis （AE）. Methods From January 2015 to April 2024，52 children diagnosed with AE at the Children's Hospital of Fudan University were enrolled. The levels of autoantibodies，lymphocyte subsets，immunoglobulins（IgG，IgM，IgA，total IgE），complements（C3，C4）and 50% complement hemolysis（CH50）in serum and cerebrospinal fluid were determined. According to the modified Rankin Scale （mRS） score at discharge，the children were classified into good prognosis group （29 cases） and poor prognosis group （23 cases）. Spearman correlation analysis was used to assess the relationship between each parameter and mRS score. Logistic regression analysis was used to evaluate the risk factors for poor prognosis. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of each parameter. Results Compared to good prognosis group，the CH50 level，natural killer（NK）cell percentage and NK absolute number of poor prognosis group were decreased （P<0.05）. There was no statistical significance in the other parameters between the 2 groups （P>0.05）. Serum CH50 level，NK cell percentage and NK absolute number were negatively correlated with mRS score（r values were -1.313，-0.276 and -0.379，P<0.05）. The decreased NK absolute number was an independent factor for poor prognosis in children with AE [odds ratio（OR）=0.994，95% confidence interval（CI）0.988-0.999]. The areas under curves of CH50 and NK absolute number were 0.674，0.738 and 0.768，respectively. Conclusions Serum CH50 level and NK absolute number in peripheral blood are associated to the prognosis of children with AE，and may serve as parameters for the prognosis of children with AE.

Relationship between serum miR-370-3p and miR-152-5p expressions and clinical pathological characteristics and prognosis of ovarian cancer patients

JIA Lingyan, XIE Shanli, CHEN Ze

2025, 40(3):  241-246.  DOI: 10.3969/j.issn.1673-8640.2025.03.007

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Objective To investigate the relationship between serum miR-370-3p and miR-152-5p expressions and clinical pathological characteristics and prognosis of ovarian cancer patients. Methods From October 2018 to October 2020，108 patients with ovarian cancer and 108 female healthy subjects in Guangyuan First People's Hospital were enrolled. The clinical data of all the subjects were collected，and the expressions of serum miR-370-3p and miR-152-5p were determined. All the patients with ovarian cancer were followed up for 36 months. According to the prognosis，they were classified into survival group （76 cases） and death group （32 cases）. Receiver operating characteristic （ROC） curve was used to evaluate the efficacy of miR-370-3p and miR-152-5p in judging the death of ovarian cancer patients. Kaplan-Meier survival curve was used to analyze the survival of patients with ovarian cancer. Cox regression analysis was used to evaluate the prognostic factors of ovarian cancer patients. Results The relative expression levels of serum miR-370-3p and miR-152-5p in ovarian cancer group were lower than those in healthy control group （P<0.001）. There was statistical significance in the International Federation of Gynecology and Obstetrics（FIGO）stage，pathological type，degree of differentiation，lymphatic metastasis and ascites between serum miR-370-3p and miR-152-5p high expression groups（≥0.75 and ≥0.76）and low expression groups （<0.75 and <0.76）（P<0.05），and there was no statistical significance for age and tumor diameter（P>0.05）. The relative expression levels of serum miR-370-3p and miR-152-5p in death group were lower than those in survival group （P<0.001）. The areas under curves（AUC）of miR-370-3p，miR-152-5p single determinations and combined determination in judging the death of ovarian cancer patients were 0.780，0.779 and 0.897，respectively. According to the optimal cut-off value obtained by ROC curve，high expression and low expression were distinguished. The survival rates of miR-370-3p and miR-152-5p high expression groups （≥0.73 and ≥0.70）were higher than those of low expression groups（<0.73 and <0.70），respectively（Log-rank χ2=13.149 and 8.554，P=0.001 and 0.003）. Multivariate Cox regression analysis showed that decreased miR-370-3p and miR-152-5p were risk factors for death in patients with ovarian cancer [ hazard ratios （HR） were 0.883 and 0.806，95% confidence intervals （CI）were 0.829-0.940 and 0.714-0.910，respectively，P<0.001]. Conclusions The expressions of serum miR-370-3p and miR-152-5p in patients with ovarian cancer are low，and they are related to the prognosis，which may be used as evaluation indicators for the prognosis of ovarian cancer patients.

Roles of serum VCAM-1，Gal-3 and Hcy expression levels in evaluating patients with coronary heart disease

SHU Ming

2025, 40(3):  247-252.  DOI: 10.3969/j.issn.1673-8640.2025.03.008

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Objective To investigate the changes and value of vascular cell adhesion molecule-1（VCAM-1），galectin-3（Gal-3）and homocysteine（Hcy）levels in patients with coronary heart disease（CHD）. Methods From February 2023 to July 2024，118 patients diagnosed with CHD by coronary angiography （CHD group）and 120 healthy subjects（healthy control group）were enrolled at Shanghai Electric Power Hospital. The CHD patients were classified based on CHD types，coronary angiography results and New York Heart Association（NYHA） classification criteria. The clinical data were collected，and the levels of VCAM-1，Gal-3，Hcy，glucose（Glu），high-density lipoprotein cholesterol（HDL-C），low-density lipoprotein cholesterol（LDL-C），triglyceride（TG）and total cholesterol（TC）were determined. Spearman correlation analysis was used to assess the relationship between variables. Multivariate Logistic regression analysis was used to evaluate the risk factors for CHD，and receiver operating characteristic（ROC）curve was used to evaluate the efficacy of each indicator in the diagnosis of CHD. Results The smoking history，body mass index（BMI）and serum levels of VCAM-1，Gal-3，Hcy，Glu，LDL-C，TC and TG in CHD group were higher than those in control group（P<0.05），while the serum level of HDL-C was lower（P<0.05）. The serum levels of VCAM-1，Gal-3 and Hcy in stable angina pectoris（SAP）group，unstable angina pectoris（UAP）group and acute myocardial infarction（AMI）group were increased in turn（P<0.001）. The serum levels of VCAM-1，Gal-3 and Hcy in mild stenosis group，moderate stenosis group and severe stenosis group were increased in turn（P<0.01）. The serum levels of VCAM-1，Gal-3 and Hcy in NYHA class Ⅰ+Ⅱ group，NYHA class Ⅲ group and NYHA class Ⅳ group were increased in turn（P<0.001）. Serum VCAM-1，Gal-3 and Hcy levels were positively correlated with the degree of coronary artery stenosis and NYHA classification （P<0.05）. Increased VCAM-1，Gal-3，Hcy，BMI，Glu，smoking history，TC，TG，LDL-C and decreased HDL-C were risk factors for CHD （P<0.05）. The areas under curves （AUC） of single and combined determinations of serum VCAM-1，Gal-3 and Hcy in the diagnosis of CHD were 0.856，0.845，0.873 and 0.952，respectively. Conclusions Serum levels of VCAM-1，Gal-3 and Hcy in patients with CHD are related to the types and severity of CHD，and may be used as biomarkers for CHD assessment.

Predicting early colorectal tumor risk using a deep learning model based on multiple serum tumor markers

YU Jiajie, ZHANG Zhizhi, LUO Qingqiong, KE Xing

2025, 40(3):  253-258.  DOI: 10.3969/j.issn.1673-8640.2025.03.009

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Objective A random forest（RF） algorithm model based on deep learning has been established using multiple serum tumor markers to investigate the role of the model in assessing the risk of early colorectal tumors. Methods A total of 176 patients with colorectal cancer（CRC）（CRC group），110 patients with precancerous lesions（precancerous lesion group） and 72 healthy subjects （healthy control group） from Xinhua Hospital of Shanghai Jiao Tong University School of Medicine from March 2023 to February 2024 were enrolled. The levels of serum tumor markers，including carcinoembryonic antigen（CEA），carbohydrate antigen（CA） 50，CA125，CA15-3，CA19-9，CA 242，CA72-4，cytokeratin 19-fragment（CYFRA 21-1） and alpha-fetoprotein（AFP） were determined. The subjects were randomly divided into a training set and a validation set at a ratio of 7∶3. A model was constructed using the RF algorithm based on deep learning. The performance of the model in screening CRC and precancerous lesions was evaluated by receiver operating characteristic（ROC） curve. Results A cohort of 286 patients，comprising patients diagnosed with CRC and those with precancerous lesions，were collectively categorized as colorectal tumor group. Serum levels of CA50，AFP，CEA，CA19-9，CA125，CA72-4 and CYFRA21-1 in colorectal tumor group were higher than those in healthy control group（P<0.05）. Utilizing feature processing and RF algorithm model，a comprehensive diagnostic model named CR7 was developed，incorporating 7 key features：CEA，CA50，CA15-3，CA242，CYFRA21-1，CA72-4 and gender. In the training set，when using healthy control group as control，the CR7 model achieved an area under curve（AUC） of 0.997 for diagnosing colorectal tumor diseases. In the validation set，the AUC was 0.931. The CR7 model demonstrated an AUC of 0.983 for differentiating early CRC patients from healthy subjects and an AUC of 0.991 for differentiating patients with precancerous lesions from healthy subjects. Conclusions The colorectal tumor disease screening model constructed by the RF algorithm provides a new and effective method for laboratory-assisted diagnosis and can be used to assess the risk of early CRC and precancerous lesions.

Relationship between serum cell division cyclin 42 and clinicopathological characteristics and prognosis of AFP-negative hepatocellular carcinoma patients

WANG Xiaolong, CHEN Yuanbin

2025, 40(3):  259-263.  DOI: 10.3969/j.issn.1673-8640.2025.03.010

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Objective To investigate the relationship between serum cell division cyclin 42（CDC42）and clinicopathological characteristics and prognosis of alpha-fetoprotein （AFP）-negative hepatocellular carcinoma （HCC） patients. Methods A total of 120 AFP-negative HCC patients （AFP-HCC group） and 40 healthy subjects （healthy control group） were enrolled from Hai'an People's Hospital from January 2015 to December 2020. The clinical data were collected，and serum CDC42 levels were determined. Kaplan-Meier survival curve was used to analyze the survival of AFP-negative HCC patients，and Cox risk proportional regression analysis was used to evaluate the influencing factors of death in AFP-negative HCC patients. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of CDC42 in determining death in AFP-negative HCC patients. Results The serum CDC42 level in AFP-HCC group was higher than that in healthy control group（P<0.001）. There was statistical significance in serum CDC42 levels among AFP-negative HCC patients at different stages，T stages，N stages and M stages（P<0.001）. The overall survival rate of low CDC42 group was higher than that of high CDC42 group（Log-rank χ2=8.71，P<0.001）. CDC42 and Stage stage were independent risk factors for prognosis（death）in AFP-negative HCC patients [hazard ratios（HR）were 1.274 and 3.666，95% confidence intervals（CI）were 1.12-1.47 and 1.70-7.92]. The area under curve of CDC42 to determine the death of AFP-negative HCC patients was 0.723，the optimal cut-off value was 1.092 ng·mL^-1，the sensitivity was 75.0%，and the specificity was 68.3%. Conclusions CDC42 is related to the clinicopathological characteristics of HCC，and may be used as a prognostic indicator for AFP-negative HCC patients.

Application role of an AI-patient based real time quality control intelligent monitoring platform for risk quality management of serum tumor markers

YU Xue, QI Aihong, LI Jinhui, QUAN Zhihui, LI Kui, QIU Yurong

2025, 40(3):  264-270.  DOI: 10.3969/j.issn.1673-8640.2025.03.011

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Objective To investigate the application role of an artificial intelliqence（AI）-patient based real time quality control（PBRTQC） intelligent monitoring platform for risk quality management of 9 serum tumor markers. Methods The AI-PBRTQC intelligent monitoring platform was used to automatically collect the determination results of 106 443 samples of 9 serum tumor markers from Guangzhou Huayin Medical Laboratory Center. from January 1，2023 to December 31，2023. The AI-PBRTQC intelligent software was used for the normal distribution test，parameter setting，program establishment，performance verification，quality control efficiency evaluation and real-time operation of patient big data. According to the intelligent quality control rules based on AI algorithm，the application role of AI-PBRTQC intelligent monitoring platform for serum tumor marker determination quality risk monitoring was evaluated. Results The AI-PBRTQC intelligent monitoring platform selected the optimal program parameters，the patient data exponential weighted moving average（EWMA） quality control chart showed a normal distribution when the performance was stable，and the trend was consistent. In the determination of 9 serum tumor markers，AI-PBRTQC intelligent monitoring platform can sensitively，timely and correctly identify and issue warnings when changing the new batch of detemination products and using new batch of detection reagents cause changes in the accuracy performance of determination system. The optimal weighting coefficient of alpha-fetoprotein（AFP） was 0.03，and the optimal weighting coefficient of the other 8 serum tumor markers was 0.02. The actual cumulative precision（CV） of EWMA for 9 items in 1 year was all lower than the quality target. The AI-PBRTQC intelligent monitoring platform gave 8 warnings in 9 items，all of which were true alarms. Conclusions AI-PBRTQC intelligent monitoring platform can monitor the quality risk of serum tumor marker determinations in real time and accurately identify systemic errors.

Diagnostic and predictive value of white blood cell population data in patients with sepsis

ZHANG Haoyang, LU Lin, ZONG Ming, HE Long, DING Yuanyuan, FAN Lieying

2025, 40(3):  271-277.  DOI: 10.3969/j.issn.1673-8640.2025.03.012

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Objective To investigate the diagnostic value of white blood cell population data （CPD）in patients with sepsis. Methods Totally，44 sepsis patients admitted to Shanghai East Hospital of Tongji University School of Medicine from January 2022 to May 2022 were enrolled，and 27 patients with pulmonary infection，and 20 healthy subjects were enrolled as well. CPD，C-reactive protein（CRP）and procalcitonin（PCT）were determined and analyzed to establish diagnostic model. Receiver operating characteristic（ROC）curve was used to evaluate the efficiency for the diagnosis of sepsis. A total of 70 sepsis patients from June 2022 to January 2023 at Shanghai East Hospital of Tongji University were enrolled for cross validation. Results In sepsis group，neutrophil fluorescence intensity（NE-SFL），width of dispersion of neutrophil fluorescence（NE-WY） and monocyte complexity（MO-X）were 50.40（46.65，55.20），717.5（642.3，832.5），123.4（120.9，125.7），respectively，which were higher than those in healthy control group [43.60（43.03，46.88），579.0（558.5，595.8），119.7（118.6，121.0）]（P<0.05） and those in pulmonary infection group [46.45（44.73，49.00），616.5（589.8，634.5），120.8（119.3，122.7）]（P<0.05）. The areas under curves of NE-SFL，NE-WY，MO-X，CRP and PCT were 0.734，0.841，0.727，0.817 and 0.862，respectively. The sensitivities of NE-SFL，NE-WY，MO-X，CRP and PCT were 61.9%，77.4%，44.0%，87.8% and 88.6%，respectively. The specificities were 80.0%，84.0%，92.0%，69.4% and 71.4%，respectively. The cross validation results showed that the true positive rates of NE-SFL，NE-WY，MO-X，CRP and PCT were 71.83%，91.55%，47.89%，73.02% and 82.61%，respectively. The false negative rates were 28.17%，8.45%，52.11%，26.98% and 17.39%，respectively. The positive rate of NE-WY before diagnosis for 5 d was higher than those of PCT and CRP，while the positive rates of NE-SFL and MO-X were lower than those of PCT and CRP. The positive time of blood culture was delayed compared to NE-SFL，NE-WY，MO-X，CRP and PCT. Conclusions CPD have certain predictive value in the diagnosis of sepsis. The diagnostic efficacy of NE-WY is superior to that of PCT. The diagnostic efficacy of NE-SFL is similar to that of CRP. The combined diagnosis of sepsis using NE-WY and PCT has better diagnostic efficacy.

Correlation of serum miR-21 and miR-155 levels and vaginal microecological changes in patients with cervical cancer

ZHOU Ying, XU Ying, QIU Jianping

2025, 40(3):  278-282.  DOI: 10.3969/j.issn.1673-8640.2025.03.013

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Objective To investigate the correlation of serum miR-21 and miR-155 levels and vaginal microecological changes in patients with cervical cancer （CC）. Methods From January 2020 to December 2021，68 patients with CC from Suzhou Municipal Hospital（North District）were enrolled as CC group，60 patients with cervical intraepithelial neoplasia （CIN） were enrolled as CIN group，and 60 healthy subjects were enrolled as control group. Quantitative real-time polymerase chain reaction （PCR） was used to determine the levels of serum miR-21 and miR-155. Smear microscopy，Gram staining smears and vaginal microbial functional assay were used to determine vaginal microecological indicators. Pearson correlation was used to analyze the correlation of serum miR-21 and miR-155 in CC group. Spearman correlation was used to analyze the correlation between serum miR-21，miR-155 and vaginal microecological indicators. Results Compared with control group，serum miR-21 and miR-155 levels were higher in CIN and CC groups（P<0.05）. The levels of serum miR-21 and miR-155 and the positive rate of human papillomavirus（HPV）16/18 in CC group were higher than those in CIN group（P<0.05）. The proportions of vaginal flora density（grade 1 or 4），aerobic vaginitis（AV）and bacterial vaginosis（BV）in CC group were higher than those in CIN group（P<0.05），and there was no statistical significance in the proportions of vaginal flora diversity （grade 1 or 4），cleanliness（grade 3-4），pH>4.5，trichomonal vaginitis（TV），positive H₂O₂ and positive leukocyte esterase between CIN and CC groups（P>0.05）. Serum miR-21 and miR-155 levels in CC group were positively correlated（r=0.524，P<0.001）. Serum miR-21 and miR-155 levels were positively correlated with HPV16/18 positive rate，vaginal flora density（grade 1 or 4），AV and BV（P<0.001）. Conclusions The expressions of serum miR-21 and miR-155 in CC patients are up-regulated，and they have a certain correlation with HPV16/18 infection and vaginal microecological changes.

Upper respiratory tract bacterial species and Th17/Treg cytokine level changes in patients with neutrophilic asthma

ZHANG Xiaoyi, QU Xiaojie, NIU Sha

2025, 40(3):  283-286.  DOI: 10.3969/j.issn.1673-8640.2025.03.014

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Objective To investigate the upper respiratory tract bacterial species and T helper cell 17（Th17）/regulatory T cell（Treg）cytokine level changes in patients with neutrophilic asthma. Methods A total of 106 patients with neutrophilic asthma admitted to the Second People's Hospital of Jiaozuo City from May 2020 to May 2023 were enrolled as research group，and 106 healthy subjects were enrolled as control group. The subjects in the both groups were determined for upper respiratory tract bacterial species. Flow cytometry was used to determine T lymphocyte populations and Th17/Treg. Enzyme-linked immunosorbent assay （ELISA） was used to determine the levels of interleukin（IL）-6，IL-10 and IL-17. The rate scattering turbidimetry method was applied to determine immunoglobulins（Ig）. Results Totally，169 isolates of bacteria were isolated from research group，of which Neisseria had the highest determination rate，followed by Streptococcus pneumoniae，Staphylococcus epidermidis and Streptococcus A. A total of 56 isolates of bacteria were isolated from control group，with the highest determination rate being Streptococcus A，followed by Streptococcus epidermidis and Neisseria. The CD4⁺T cell percentage and CD4⁺/CD8⁺ ratio in research group were lower than those in control group （P<0.05）. The Th17 percentage，Treg percentage，Th17/Treg ratio，IL-6，IL-10 and IL-17 levels in research group were higher than those in control group （P<0.05）. There was no statistical significance in the levels of IgG，IgA and IgM between research and control groups （P>0.05）. Conclusions The upper respiratory tract bacteria in patients with neutrophilic asthma is dysregulated，mainly Neisseria，and the levels of Th17/Treg are abnormally elevated.

Accuracy analysis of urine protein and urine cast of hospitalized liver cirrhosis patients

LIU Shanfeng, GAO Yun, WANG Limin, WANG Ping

2025, 40(3):  287-293.  DOI: 10.3969/j.issn.1673-8640.2025.03.015

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Objective To analyze the accuracy of urine protein （PRO） by dry chemical method and urine cast （CAST） by flow cytometry. Methods A total of 151 liver cirrhosis patients （liver cirrhosis group） and 50 hepatitis patients （control group） were enrolled from the Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from September to December 2022. The clinical data and liver function and kidney function and urine routine determination results were collected and analyzed. Three microscopy review rules were defined. Rule one：urine PRO by dry chemical method was positive. Rule two：urine CAST by flow cytometry was >2·μL^-1. Rule three：if any results of blood （BLD），leukocyte esterase （LEU）and urine PRO by dry chemical system were different from the results of red blood cell （RBC），white blood cell （WBC）and cast （CAST） by urine sediment analyzer correspondingly，the result of urobilirubin （UBIL） by dry chemical system was positive or abnormal alarms by urine sediment analyzer. The accuracy of urine PRO by dry chemical method and urine CAST by flow cytometry was assessed. Results Serum albumin （Alb） level of liver cirrhosis group was lower than that of control group（P=0.001），the serum creatinine（SCr）level and CAST positive rate in centrifugated urine of liver cirrhosis group were both higher than those of control group. The positive rate of urine PRO by quantitative analysis of liver cirrhosis group was higher than that of urine PRO by qualitative analysis （P<0.001），and the CAST was higher （P<0.05）. CAST [odds ratio（OR）=1.694，95% confidence interval（CI）1.285-2.233，P<0.001]，urine PRO by quantitative analysis（OR=1.002，95%CI 1.001-1.004，P=0.004），urine PRO by qualitative analysis（OR=4.286，95%CI 1.542-11.908，P=0.005）and UBIL（+）（OR=3.345，95%CI 1.687-6.636，P=0.001）were related to positive urine CAST. UBIL（+）（OR=2.473，95%CI 1.143-5.354，P=0.022）and CAST（OR=1.523，95%CI 1.152-2.013，P=0.003）can be used to predict urine CAST. The false negative rates of urine CAST by Rule one，Rule two and Rule three were all > 5%，those of Rule one and Rule two were higher than those of control group（P<0.05），and those of Rule three had no statistical significance with those of control group（P>0.05）. Conclusions For patients with liver cirrhosis，the false negative rates of urine PRO by dry chemical method and urine CAST by flow cytometry are high，and it is recommended that the urinalysis of hospitalized liver cirrhosis patients should be reviewed by microscopy.

Analysis of changes in platelet aggregation rate and D-dimer level in recurrent abortion patients with different times

LI Yue, LI Li, YANG Chen

2025, 40(3):  294-298.  DOI: 10.3969/j.issn.1673-8640.2025.03.016

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Objective To analyze the changes in platelet aggregation rate （PAgT） and D-dimer （D-D） level in recurrent abortion patients with different times，and to provide a reference for early prediction and treatment of recurrent abortion. Methods From July 2020 to August 2023，143 patients with recurrent abortion who were treated in Changzhi People's Hospital were enrolled. They were classified into abortion≥3 time group and 2 time group，which were classified into 2 groups based on their final pregnancy outcome，recurrent abortion group and non-abortion group. PAgT，DD and coagulation function indicators such as fibrinogen （Fib），thrombin time （TT），prothrombin time （PT） and activated partial thromboplastin time （APTT） were determined. The correlation between PAgT，DD level and coagulation function indicators in patients with recurrent abortion was analyzed using Pearson method. The influencing factors of recurrent abortion patients with abortion≥3 times were analyzed using Logistic regression analysis. The predictive value of PAgT and DD level for recurrent abortion was analyzed using receiver operating characteristic （ROC） curve. Results Arachidonic acid （AA） induced PAgT，adenosine diphosphate （ADP） induced PAgT，DD，Fib in≥3 time group were higher than those in 2 time group，while TT，PT，APTT were lower than those in 2 time group （P<0.001）. The levels of AA induced PAgT，ADP induced PAgT，DD in patients with recurrent abortion were positively correlated with Fib，and they were negatively correlated with TT，PT and APTT（P<0.001）. AA induced PAgT，ADP induced PAgT，DD were independent risk factors for recurrent abortion patients with abortion≥3 times [odds ratios（OR）were 2.984，2.913 and 2.850，95% confidence intervals（CI） were 1.572-5.614，1.551-5.617 and 1.464-5.550，P<0.05）. The levels of AA induced PAgT，ADP induced PAgT and DD in recurrent abortion group were higher than those in non-abortion group （P<0.05）. The optimal cut-off values of AA induced PAgT，ADP induced PAgT and DD level in predicting recurrent abortion were 87.42%，85.46% and 415.13 μg·L^-1， respectively. Conclusions Patients with recurrent abortion≥3 times have higher AA induced PAgT，ADP induced PAgT and DD level，and the combined determination of various indicators has certain predictive value for recurrent abortion after re-pregnancy in patients with recurrent abortion.

Application of artificial intelligent algorithm for mutual recognition of free thyroxine determination results among different instruments

ZHOU Xin, LIU Zaishuan, WU Yuxiang, LU Xiaoqin, WU Yongkang

2025, 40(3):  299-305.  DOI: 10.3969/j.issn.1673-8640.2025.03.017

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Objective In order to solve the significant difference of free thyroxine （FT4） determination results among different instruments and realize the mutual recognition of determination results among different medical institutions，a result conversion algorithm was designed in this study，and the determination data among different instruments can be converted to each other. Methods Using the algorithm to determine the number of comparison samples among different instruments，the comparison number and concentration of FT4 samples of 2 chemiluminescence instruments were calculated respectively in their determination linear ranges，and then the corresponding conversion interval relationship between the 2 instruments was established. Through the development of mathematical conversion algorithm，the conversion of determination results among different instruments was realized. Totally，20 samples with uniformly distributed concentrations within the linear range were selected on the standard curve of one instrument. The Clinical and Laboratory Standards Institute（CLSI）EP15-A2 document comparison rule and Passing-Bablok regression analysis were used to compare the results of the 2 instruments directly and after conversion. Results The minimum number of samples required for comparison between the 2 instruments was 8 cases，and the average percentage deviation of FT4 determination results directly compared between the 2 instruments was 38.97%. Passing-Bablok regression analysis showed that the slope was 0.491. The average percentage deviation of FT4 after conversion by conversion algorithm was 9.13%，and the slope was 0.955. In clinical diagnosis，after algorithm conversion，the diagnostic accuracy of conversion results was 95%. Conclusions There are differences between the 2 instruments. This problem can be solved by the intelligent algorithm. The algorithm can convert the determination results of the 2 instruments in different reference intervals and different linear ranges，so that the determination results of the 2 instruments are comparable.