Table of Content

30 August 2025, Volume 40 Issue 8

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Relationship between L-Arg/ADMA and mitochondrial function in patients with asthma

LIU Huifang, LUO Jianjiang

2025, 40(8):  725-730.  DOI: 10.3969/j.issn.1673-8640.2025.08.001

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Objective To investigate the relationship between the levels of L-arginine（L-Arg） and asymmetric dimethylarginine（ADMA） in asthma patients and L-Arg/ADMA ratio，as well as the mitochondrial function indicators [platelet mitochondrial membrane potential（MMP），adenosine triphosphate（ATP） and cytochrome C oxidase（COX）]. Methods Totally，122 patients with acute exacerbation of bronchial asthma（asthma group） and 44 healthy subjects（healthy control group） were enrolled from the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University from November 2016 to May 2017. The activities of MMP，ATP and COX，as well as the levels of plasma L-Arg and ADMA were determined，and the L-Arg/ADMA ratio was calculated. Pearson correlation analysis was used to evaluate the correlations among the various indicators. Results Compared with healthy control group，the levels of MMP，COX and plasma L-Arg，as well as the L-Arg/ADMA ratio in asthma group were decreased（P<0.05），while the ATP level was increased（P<0.05）. There was no statistical significance in plasma ADMA levels between the 2 groups（P>0.05）. Mitochondrial ATP was negatively correlated with plasma ADMA（r=-0.404，P<0.001），and it was positively correlated with the L-Arg/ADMA ratio（r=0.238，P=0.008）. Mitochondrial COX was negatively correlated with plasma ADMA（r=-0.269，P=0.003）. There was no correlation among the other indicators（P>0.05）. Conclusions The L-Arg level in asthma patients is abnormal，indicating a disorder in arginine metabolism，which is related to mitochondrial dysfunction.

Reference range of serum cystatin C in elders in Shanghai

CAO Yue, SUN Qijuan, WANG Su, PAN Yiru, WANG Shiwen

2025, 40(8):  731-734.  DOI: 10.3969/j.issn.1673-8640.2025.08.002

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Objective To establish the reference range of serum cystatin C（Cys C） in elders in Shanghai. Methods A total of 7 277 individuals aged 60 to 89 years who underwent physical examination at Huadong Hospital Affiliated to Fudan University from January 2023 to August 2024 were enrolled. Totally，6 934 individuals aged <50 years who underwent physical examination at Huadong Hospital Affiliated to Fudan University from January to December 2024 were enrolled. Another 741 aged 20 to 89 years individuals who underwent physical examination at Huadong Hospital Affiliated to Fudan University from January to June 2025 were enrolled as the validation set. Serum Cys C levels were compared by gender and age groups. Spearman correlation analysis was used to evaluate the correlation between Cys C levels and age and gender. The 95% reference range of Cys C in elders was established according to the method in the Chinese health industry standard WS/T402—2024. Results There was statistical significance in serum Cys C levels between men and women and among different age groups in both ≥60-year-old and <50-year-old populations（P<0.001）. Cys C levels were positively correlated with age（r=0.206，P<0.001） and negatively correlated with gender（r=-0.322，P<0.001）. The reference range of serum Cys C in healthy elders in Shanghai was as follows：for men aged 60-69 years，0.66-1.16 mg·L^-1；for women aged 60-69 years，0.60-1.03 mg·L^-1；for men aged 70-79 years，0.70-1.23 mg·L^-1；for women aged 70-79 years，0.66-1.15 mg·L^-1；for men aged 80-99 years，0.73-1.30 mg·L^-1；and for women aged 80-99 years，0.64-1.22 mg·L^-1. The percentage of individuals in the validation set below the lower limit or above the upper limit of the reference range was <10%，and the reference range was validated successfully. Conclusions There are gender and age differences in Cys C levels in elders. The reference range of Cys C in healthy elders in Shanghai has been preliminarily established.

Establishment and verification of nomogram diagnostic model of osteoporosis in elders based on laboratory indicators

KE Wencai, LIU Jie, LIN Yong, LU Guangjian, JIAO Luyang

2025, 40(8):  735-741.  DOI: 10.3969/j.issn.1673-8640.2025.08.003

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Objective To investigate the influencing factors of osteoporosis（OP）in elders，and to establish and verify nomogram diagnostic model of OP in elders. Methods A total of 268 elders undergoing physical examination admitted to Shanghai Fifth People's Hospital Affiliated to Fudan University from June 2022 to December 2023 were enrolled as training group （60 cases of OP and 208 cases of non-OP），and 106 elders admitted to Jiading Central Hospital of Shanghai from January to August 2023 were enrolled as validation set. The clinical data and clinical laboratory determination results were collected. LASSO regression analysis was used to screen the influencing factors of OP. The influencing factors were found out by multi-variate Logistic regression analysis，and the nomogram diagnostic model was established based on risk factors. The established nomogram model was verified by receiver operating characteristic （ROC） curve，decision curve，calibration curve and Hosmer-Lemeshow goodness-of-fit test. Results Compared with non-OP group，the proportions of elders and females in OP group were increased （P<0.05），and the levels of serum osteocalcin （OCN），beta-collagen degradation products （β-CTX），alkaline phosphatase （ALP） and parathyroid hormone （PTH） were increased （P<0.05）. The levels of hemoglobin （Hb），free triiodothyronine （FT3），free thyroxine （FT4） and albumin （Alb） were decreased （P<0.05）. Totally，13 variates were screened out. Among them，gender，age，β-CTX and FT4 were independent risk factors for OP in elders [odds ratios （OR） were 12.130，1.050，1.002 and 0.874，95% confidence intervals （CI） were 4.633-31.755，1.005-1.097，1.001-1.003 and 0.765-0.999，respectively，P<0.05]. In the training set and validation set，the areas under curves （AUC） for diagnosing OP by the nomogram model were 0.842 and 0.763，respectively. The nomogram model had good calibration （the P values of Hosmer-Lemeshow goodness-of-fit test were 0.873 and 0.733，respectively） and high clinical utility. Conclusions The nomogram diagnostic model established for OP in elders has good accuracy，and it can provide auxiliary diagnosis for the occurrence of OP in elders.

Correlation between short stature，tic disorders and mineral elements in whole blood

LÜ Na, LI Fangning, BAI Qi, ZHAO Mingliang, LI Youran, CAO Yan, ZHAI Yanhong, LI Na, CAO Zheng

2025, 40(8):  742-750.  DOI: 10.3969/j.issn.1673-8640.2025.08.004

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Objective To establish reference intervals for 10 mineral elements （calcium， magnesium， manganese， iron， copper， selenium， zinc， mercury， lead and cadmium） in capillary whole blood of children aged 0-12 years in Beijing， and to investigate the relationship between these elements and short stature and tic disorders. Methods A total of 1 382 apparently healthy children undergoing physical examinations at Shunyi Maternal and Children's Hospital of Beijing Children's Hospital from July 2023 to April 2024 were enrolled. They were classified by genders and ages [infants/toddlers（≤2 years），preschool（3-5 years） and school-age（6-12 years）]. The levels of the 10 elements were determined using inductively coupled plasma mass spectrometry（ICP-MS），and corresponding reference intervals were established using the percentile method. Additionally，61 children with short stature（short stature group），78 children with tic disorders（tic disorder group） and 152 healthy children undergoing physical examinations during the same period（healthy control group） were enrolled. Venous blood samples from these groups were analyzed for the 10 elements using ICP-MS. Logistic regression analysis was used to assess influencing factors for the occurrence of short stature and tic disorders. Receiver operating characteristic（ROC） curve analysis was performed to evaluate the diagnostic efficacy of each indicator for short stature and tic disorders. Results Statistically significant differences were observed between boys and girls for manganese，copper，lead and cadmium levels（P<0.05），while no statistically significant differences were found for the other elements（P>0.05）. Gender- and age-specific reference intervals were established for manganese，copper，lead and cadmium. Age-specific reference intervals were established for calcium，magnesium，iron，selenium，zinc and mercury. Cadmium，mercury，and lead levels in short stature group were higher than those in healthy control group（P<0.05）. Calcium levels in tic disorder group were lower than those in healthy control group，while zinc，mercury and lead levels were higher（P<0.05）. Elevated mercury and lead levels were identified as independent risk factors for short stature（P<0.05）. The areas under curves（AUC） for diagnosing short stature using mercury，lead and their combined determination were 0.590，0.721 and 0.746，respectively. Elevated cadmium，mercury and lead levels were identified as independent risk factors for tic disorders（P<0.05）. The AUC for diagnosing tic disorders using cadmium，mercury，lead and their combined determination were 0.524，0.585，0.591 and 0.665，respectively. Conclusions The reference intervals for calcium， magnesium， manganese， iron， copper， selenium， zinc， mercury， lead and cadmium have been established in capillary whole blood of children in Beijing， which are stratified by gender and age groups using ICP-MS. Both short stature and tic disorders show carrelations with the levels of certain mineral elements.

Predictive role of serum amyloid A and homocysteine on pregnancy outcome in patients with gestational diabetes mellitus

YAO Yanhong, ZHAI Chunli

2025, 40(8):  751-756.  DOI: 10.3969/j.issn.1673-8640.2025.08.005

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Objective To investigate the predictive role of serum amyloid A（SAA） and homocysteine（Hcy） in adverse pregnancy outcomes of patients with gestational diabetes mellitus（GDM）. Methods A total of 80 GDM patients（GDM group） from Anji County Maternal and Child Health Hospital from January 2022 to January 2023 were enrolled，and 80 pregnant women with normal glucose tolerance were enrolled as control group. The general information was collected，and the levels of glycated hemoglobin A_1c（HbA_1c），blood glucose，blood lipid，SAA and Hcy were determined at 24-28 weeks of pregnancy. The levels of serum nitric oxide（NO），endothelin-1（ET-1），interleukin-6（IL-6） and tumor necrosis factor-alpha（TNF-α） were determined. All the subjects were followed up until the pregnancy outcome. Logistic regression analysis was used to analyze the influencing factors of adverse pregnancy outcomes in GDM patients. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of each indicator in judging the adverse pregnancy outcomes of GDM patients. Results The proportions of history of alcohol consumption，multiparity and family history of diabetes in GDM group were higher than those in control group（P<0.05），and the levels of HbA_1c，fasting blood glucose（FBG），1 h postprandial blood glucose（PG），2 h PG，SAA and Hcy were higher in GDM group（P<0.05）. There was no statistical significance in ages，gestational weeks，pre-pregnancy body mass index（BMI），blood pressure and bood lipid indicators between the 2 groups（P>0.05）. The incidence of adverse pregnancy outcomes in GDM group（23.75%） was higher than that in control group（11.25%）（P=0.038）. The proportions of multiparity and the levels of SAA，Hcy，NO，ET-1，IL-6，TNF-α in adverse pregnancy group among GDM patients were higher than those in non-adverse pregnancy group（P<0.05）. There was no statistical significance in age，gestational week and pre-pregnancy BMI between the 2 groups（P>0.05）. Elevated Hcy and SAA levels were risk factors for adverse pregnancy outcomes in GDM patients [odds ratios（OR） were 1.735 and 1.233，95% confidence intervals（CI） were 1.223-2.462 and 0.972-1.565，P<0.05]. The areas under curves（AUC） of Hcy，SAA，NO，ET-1，IL-6，TNF-α single determinations and SAA+Hcy combined determination in judging the adverse pregnancy outcomes of GDM patients were 0.812，0.746，0.719，0.706，0.746，0.765 and 0.840，respectively. Conclusions Elevated serum SAA and Hcy levels in GDM patients combinedly have certain clinical value in predicting adverse pregnancy outcomes.

Correlation between serum sd-LDL-C and AIP and the severity of coronary heart disease

SUN Yang, LI Shouxia, CAI Huixin

2025, 40(8):  757-762.  DOI: 10.3969/j.issn.1673-8640.2025.08.006

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Objective To investigate the correlation between small and dense low-density lipoprotein cholesterol（sd-LDL-C） and atherogenic index of plasma（AIP） and the severity of coronary heart disease（CHD）. Methods Totally，139 patients with CHD from Baoding First Central Hospital from June 1，2023 to January 31，2024 were enrolled as CHD group. According to the severity of coronary artery lesions，they were classified into mild group（Gensini score <31 points，53 cases），moderate group（Gensini score 31-60 points，50 cases） and severe group（Gensini score >60 points，36 cases）. Another 36 patients with chest tightness，chest pain and other discomfort symptoms in the precordial area，but with no obvious abnormalities in coronary angiography（CAG），were enrolled as control group. Serum sd-LDL-C，total cholesterol（TC），triglyceride（TG），high-density lipoprotein cholesterol（HDL-C），low-density lipoprotein cholesterol（LDL-C），apolipoprotein A1（apo A1） and apolipoprotein B（apo B） were determined，and AIP was calculated. Multivariate Logistic regression analysis was used to evaluate the influencing factors of CHD. Spearman rank correlation analysis was used to evaluate the correlation between sd-LDL-C，AIP and the severity of coronary artery lesions in CHD. Receiver operating characteristic（ROC） curve was used to evaluate the diagnostic value of each single and combined determinations for CHD. Results HDL-C and apo A1 in CHD group were lower than those in control group，while TC，TG，LDL-C，apo B，sd-LDL-C and AIP were higher in CHD group than in control group（P<0.05）. TC，TG，HDL-C，LDL-C，apo A1，apo B，sd-LDL-C and AIP were risk factors for CHD（P<0.05）. The sd-LDL-C and AIP were increased successively in the mild group，moderate group and severe group with statistical significance（P<0.05）. The sd-LDL-C was positively correlated with the severity of coronary artery lesions，with a rank correlation coefficient （r_s） of 0.602（P<0.001）. AIP was positively correlated with the severity of coronary artery lesions，with the r_s of 0.261（P=0.012）. The areas under curves（AUC） of AIP and sd-LDL-C for predicting CHD were 0.839 and 0.783，respectively（P<0.05）. The AUC of combined determination of sd-LDL-C and AIP was 0.857，which was higher than those of single determinations（P<0.05）. Conclusions The sd-LDL-C and AIP are elevated in CHD patients，and are positively correlated with the severity of coronary artery lesions in CHD，which have certain value in diagnosing CHD auxiliarily and evaluating the severity of the disease.

Correlation between the expression of serum lncRNA NEAT1，miR-29c-3p and the disease status，clinical prognosis of epilepsy in children

GUO Manman, ZHANG Peng, WANG Runzhi, SHI Long

2025, 40(8):  763-768.  DOI: 10.3969/j.issn.1673-8640.2025.08.007

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Objective To investigate the correlation between serum long non-coding RNA（lncRNA） nuclear-enriched abundant transcript 1（NEAT1）and miR-29c-3p expression and the severity and clinical prognosis of epilepsy in children.Methods Totally，102 children with epilepsy（epilepsy group）and 110 healthy subjects（healthy control group）were enrolled from General Hospital of Pingmei Shenma Group from October 2020 to October 2022. According to the Status Epilepticus in Pediatric Patients Severity Score（STEPSS），all the children were classified into mild group（50 cases），moderate group（24 cases）and severe group（28 cases）. The general data were collected，and the relative expression levels of serum lncRNA NEAT1 and miR-29c-3p were determined. All the chiblren were followed up for 1 year. Based on prognosis，they were classified into poor prognosis group（28 cases，reoccurrence after discharge）and good prognosis group （74 cases，non-occurrence or only precursor occurence）. Pearson correlation analysis was used to evaluate the correlation between lncRNA NEAT1 and miR-29c-3p in children with epilepsy. Using receiver operating characteristic（ROC） curve，the efficacy of serum lncRNA NEAT1 and miR-29c-3p in predicting poor prognosis in children with epilepsy was evaluated. Using multiple Logistic regression analysis，the influencing factors of poor prognosis in epilepsy patients were evaluated. Results Compared with healthy control group，the relative expression level of serum lncRNA NEAT1 in epilepsy group was increased（P<0.001），and the relative expression level of serum miR-29c-3p was decreased（P<0.001）. The relative expression levels of serum lncRNA NEAT1 in the mild，moderate and severe groups were increased sequentially（P<0.001），while the relative expression levels of serum miR-29c-3p were decreased sequentially（P<0.001）. There was a negative correlation between lncRNA NEAT1 and miR-29c-3p（r=-0.414，P<0.05）. Compared with good prognosis group，the relative expression level of serum lncRNA NEAT1 was increased and the relative expression level of serum miR-29c-3p was decreased in poor prognosis group（P<0.001）. There was no statistical significance in the other indicators between the 2 groups（P>0.05）. The areas under curves（AUC） of single and combined determinations of serum lncRNA NEAT1 and miR-29c-3p for predicting poor prognosis in children with epilepsy were 0.849，0.867 and 0.937，respectively. The lncRNA NEAT1>2.52 and miR-29c-3p<0.49 were risk factors for poor prognosis in children with epilepsy [odds ratios（OR）were 1.869 and 0.769，95% confidence intervals（CI） 1.257-2.777 and 0.631-0.937，respectively，P<0.05]. Conclusions The expressions of serum lncRNA NEAT1 and miR-29c-3p in children with epilepsy are related to the severity and prognosis of the disease，and they may serve as biological markers for analyzing the condition and evaluating the prognosis of children with epilepsy.

Correlation between serum Sema4D，fibrinogen-to-albumin ratio and prognosis in patients with acute myeloid leukemia

GUO Yuanyuan, SONG Hui, ZHANG Lin

2025, 40(8):  769-774.  DOI: 10.3969/j.issn.1673-8640.2025.08.008

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Objective To investigate the correlation between serum semaphorin 4D（Sema4D），fibrinogen-to-albumin ratio（FAR） and prognosis in patients with acute myeloid leukemia（AML）. Methods Totally，120 AML patients from Qinhuangdao First Hospital from May 2018 to July 2020 were enrolled as AML group. They were classified into high-risk group，intermediate-risk group and low-risk group according to karyotypes，and into survival group and death group according to 3-year survival status. Another 80 patients with iron deficiency anemia（IDA） and 80 healthy subjects were enrolled as IDA group and healthy control group，respectively. The differences in serum Sema4D levels and FAR were compared among the groups. Spearman correlation analysis was used to evaluate the correlation of serum Sema4D，FAR and the prognosis of AML patients. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of serum Sema4D and FAR in predicting the prognosis of AML patients. The survival status of AML patients was evaluated by Kaplan-Meier survival curve. Results The levels of serum Sema4D and FAR in AML group，IDA group and healthy control group were decreased successively（P<0.05）. The levels of serum Sema4D and FAR in high-risk group，intermediate-risk group and low-risk group were decreased successively（P<0.05）. Serum Sema4D and FAR in AML patients were positively correlated with the risk degree（r=0.452 and 0.577，P<0.001）. The serum Sema4D level and FAR in survival group were lower than those in death group（P<0.05）. The combined determination of serum Sema4D and FAR had a higher area under curve（AUC）（0.824） in predicting the prognosis of AML patients than single determinations（0.649 and 0.724）（P<0.05）. The 3-year survival rate of patients with high expression of serum Sema4D and high FAR was lower than that of patients with low expression of serum Sema4D and low FAR（P<0.05）. Conclusions The levels of Sema4D and FAR in AML patients are increased. Patients with low expression of Sema4D and low FAR have a higher 3-year survival rate. The combined determination of serum Sema4D and FAR has a higher efficacy in predicting the prognosis of AML patients.

Establishment and clinical application evaluation of early warning model for acute pancreatitis complicated with AKI

GAO Xiantong, YAO Qianqian, RU Lijuan

2025, 40(8):  775-781.  DOI: 10.3969/j.issn.1673-8640.2025.08.009

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Objective To establish an early warning model for acute pancreatitis（AP） complicated with acute kidney injury（AKI） based on clinical data and AKI biomarkers，and to validate and evaluate its clinical efficacy. Methods A total of 100 patients with AP in Qingdao Jiaozhou Central Hospital from January 2021 to December 2023 were enrolled as training set and classified into AKI group（41 cases） and non-AKI group（59 cases） based on whether they were complicated with AKI. All the clinical data were collected，and the biomarkers of AKI [urinary cystatin C（Cys C），urinary kidney injury molecule-1（KIM-1），serum creatinine（SCr），serum liver-type fatty acid binding protein（L-FABP） and serum interleukin-18（IL-18）] were determined. Totally，30 patients with AP in Qingdao Jiaozhou Central Hospital from January to December 2024 were enrolled as external training set. Random forest-Logistic regression analysis was used to evaluate the influencing factors of AP complicated with AKI，and an early warning nomogram model was constructed. The clinical application value of the nomogram model was evaluated by receiver operating characteristic（ROC） curve，calibration curve，decision curve analysis and clinical impact curve. Results The proportion of patients using vasoactive drugs and mechanical ventilation，acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ） score，sequential organ failure assessment（SOFA） score，urinary Cys C，urinary KIM-1，serum L-FABP and serum IL-18 in AKI group were all higher than those in non-AKI group（P<0.05）. The top 6 important variables were serum L-FABP，urinary Cys C，urinary KIM-1，serum IL-18，SOFA score and APACHE Ⅱ score. Serum L-FABP，urinary Cys C，urinary KIM-1，serum IL-18，SOFA score and APACHE Ⅱ score were all risk factors for AP complicated with AKI（P<0.05）. A nomogram model for predicting AKI in AP patients was established based on the results of Logistic regression analysis. The area under curve（AUC） of the nomogram model was 0.884，the predicted value was consistent with the actual incidence rate（Brier value was 0.107，calibration was 0.811）. When the threshold probability value was 25% to 75%，the nomogram model had obvious positive net benefit，and the maximum net benefit was 0.4. There was no statistical significance between the model-predicted values and the actual observed values（χ²=2.516，P=0.842）. Conclusions The nomogram model for early warning of AP complicated with AKI established based on serum L-FABP，urinary Cys C，urinary KIM-1，serum IL-18，SOFA score and APACHE Ⅱ score has good clinical applicability and can provide a reference for the risk assessment of AP complicated with AKI.

Characteristics of T-cell subset changes after bronchoscopy in children of different ages with refractory Mycoplasma pneumoniae pneumonia and their relationship with disease outcomes

LIU Mengying, ZHENG Wutian, FANG Hui, WEI Shoujin

2025, 40(8):  782-788.  DOI: 10.3969/j.issn.1673-8640.2025.08.010

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Objective To investigate the characteristics of T-cell subset changes in children with refractory Mycoplasma pneumoniae pneumonia（RMPP） after bronchoscopy and their relationship with disease outcomes. Methods A total of 126 children with RMPP in Hefei Second People's Hospital from July 2021 to April 2023 were enrolled and classified into ≤4-year-old group（63 cases） and >4-year-old group（63 cases） based on the median age（4-year-old）. The general data were collected，and white blood cell（WBC） count，neutrophil percentage（NEUT%），C-reactive protein（CRP），D-dimer（DD），T-cell subsets [percentage of CD3⁺T cells（CD3⁺%），percentage of CD4⁺T cells（CD4⁺%），percentage of CD8⁺T cells（CD8⁺%） and the ratio of CD4⁺-to-CD8⁺（CD4⁺/CD8⁺ ratio）]，lactate dehydrogenase（LDH），IgA，IgG，IgM，interferon-gamma（IFN-γ），interleukin-6（IL-6） and interleukin-10（IL-10） were determined before and 7 d after treatment. Multivariate Logistic regression analysis was used to evaluate the relationship between various indicators and the disease outcomes of RMPP children. Results After treatment，the CD3⁺%，CD4⁺% and CD4⁺/CD8⁺ ratio in >4-year-old group were higher than those in ≤4-year-old group（P<0.05），while the levels of serum IgG，IgM，IFN-γ，IL-6，IL-10 and CD8⁺% were lower than those in ≤4-year-old group（P<0.05）. After adjusting for confounding factors（age，WBC count，NEUT%，CRP，IFN-γ，IL-6，IL-10），the CD4⁺/CD8⁺ ratio for 7 d after treatment was independently associated with the disease outcomes of RMPP children [odds ratio（OR）=0.63，95% confidence interval（CI） 0.45-0.84]. According to the median CD4⁺/CD8⁺ ratio（1.53） of RMPP children，those with a high CD4⁺/CD8⁺ ratio had a 26% lower risk of adverse outcome than those with a low CD4⁺/CD8⁺ ratio（OR=0.74）. When the CD4⁺/CD8⁺ ratio was divided into quintiles，the risk of adverse outcome in the Q2，Q3，Q4 and Q5 groups was reduced by 19%（OR=0.81），27%（OR=0.73），34%（OR=0.66） and 57%（OR=0.43），respectively，compared with the Q1 group. Compared with the NEUT% ≥54.76% group，the correlation between the CD4⁺/CD8⁺ ratio and disease outcomes was stronger in the NEUT% <54.76% group（P_interaction=0.013）. Conclusions Bronchoscopy can improve some cellular and humoral immune indicators in RMPP children. The CD4⁺/CD8⁺ ratio after treatment in RMPP children is related to disease outcomes，and a high CD4⁺/CD8⁺ ratio can reduce the risk of adverse outcome in RMPP children，especially in those with NEUT%≥54.76%.

Correlation between vaginal Candida virulence factors，host immune response and the recurrence of candidal vaginitis

HU Yueli, WU Fenying, TIAN Xuqin, LI Yuan

2025, 40(8):  789-792.  DOI: 10.3969/j.issn.1673-8640.2025.08.011

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Objective To investigate the correlation between vaginal Candida virulence factors，host immune response and the recurrence of candidal vaginitis. Methods The clinical data of 150 patients with candidal vaginitis in Shaoxing Central Hospital from January 2019 to December 2022 were collected. The patients were classified into recurrent vulvovaginal candidiasis（RVVC） group，vulvovaginal candidiasis（VVC） group and asymptomatic vaginal Candida colonization（AC） group based on their conditions. The differences in clinical data，the abilities of biofilm formation，the expression levels of virulence factors in vitro，the immune status of the host's vaginal fluid and the differences in the vaginal inflammatory process among the 3 groups were compared. Results The ability of Candida in RVVC group to form biofilms was higher than those in VVC and AC groups（P<0.05）. The levels of secreted aspartyl proteinase（SAP）-Pz，phospholipase（PL）-Pz and lipase（Lip）-Pz in RVVC group were lower than those in VVC and AC groups（P<0.05），and the in vitro expression level of HWP1 gene in RVVC group was higher than those in VVC and AC groups（P<0.05）. The levels of interferon-gamma（IFN-γ），tumor necrosis factor-alpha（TNF-α） and TNF-α/interleukin（IL）-10 in RVVC group were lower than those in VVC group（P<0.05），and the levels of IL-10 and IL-4 were higher than those in VVC group（P<0.05）. The incidence rate of vaginitis in VVC group（96%）was higher than those in RVVC group（78%）and AC group（82%）（P<0.05）. Conclusions The levels of SAP，PL，Lip and HWP1 are positively correlated with the abilities of biofilm frormation. A weakened inflammatory response will increase the recurrence rate of candidal vaginitis.

Diagnostic value of Xpert MTB/RIF combined with BD-960 rapid culture and Roche culture in BALF for bacteriological negative pulmonary tuberculosis

WU Qi, ZOU Yan, ZHANG Yanxia, CHEN Ligang

2025, 40(8):  793-797.  DOI: 10.3969/j.issn.1673-8640.2025.08.012

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Objective To investigate the diagnostic value of Xpert Mycobacterium tuberculosis/rifampicin（Xpert MTB/RIF） combined with BD-960 rapid culture and Roche culture in bronchoalveolar lavage fluid（BALF） for bacteriological negative pulmonary tuberculosis（BGT）. Methods A total of 210 patients with suspected BGT treated at former Jingzhou Chest Hospital were enrolled between January 2019 and August 2022，and BALF Xpert MTB/RIF，BD-960 rapid culture and Roche culture were performed. According to clinical medical history and clinical diagnosis results（imaging，bronchoscopy），there were 136 cases with BGT and 74 cases without BGT. Taking clinical diagnosis as the golden standard，the efficiency of BALF Xpert MTB/RIF combined with BD-960 rapid culture and Roche culture in the diagnosis of BGT was evaluated. Results Among the 210 patients with suspected BGT，clinical diagnosis showed that there were 136 cases with BGT and 74 cases without BGT. Taking clinical diagnosis as the golden standard，the sensitivities，specificities，accuracies，positive predictive values，negative predictive values and Kappa values of Roche culture， BD-960 rapid culture and BALF Xpert MTB/RIF and combined determination in the diagnosis of BGT were 56.62%， 91.89%， 69.05%， 92.77%， 53.54%， 0.417；58.82%， 87.84%， 69.05%， 89.89%， 53.72%， 0.426；67.64%， 94.59%， 77.14%， 95.83%， 61.40%， 0.554 and 76.47%， 97.30%， 83.81%， 98.11%， 69.23%， 0.675， respectively. Conclusions The combined determination of BALF Xpert MTB/RIF， BD-960 rapid culture and Roche culture has high diagnostic value for BGT，which can improve diagnostic accuracy rate of BGT.

Influence of Helicobacter pylori Ⅰ and Ⅱ infection on chronic gastritis

WU Xiaoqiong, CHEN Dongmiao, LIANG Yumin, WANG Congrong

2025, 40(8):  798-803.  DOI: 10.3969/j.issn.1673-8640.2025.08.013

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Objective To analyze the relationship between different antibody subtypes of Helicobacter pylori （Hp） infection and the pathological characteristics of the stomach，as well as the correlations between serum pepsinogen （PG） Ⅱ，the ratio of pepsinogen Ⅰ-to-pepsinogen Ⅱ（PGⅠ/PGⅡ） and gastrin 17 （G-17） in patients with chronic gastritis and type Ⅰ Hp infection，inflammatory activity，atrophy degree and intestinal metaplasia degree. Methods A retrospective analysis was conducted on 236 patients with benign gastric diseases admitted to the Gastroenterology Department of Zengcheng Branch of Nanfang Hospital of Southern Medical University from July 2022 to February 2024. Among them，78 cases were positive for type Ⅰ Hp antibodies （type Ⅰ Hp infection group），47 cases were positive for type Ⅱ Hp antibodies （type Ⅱ Hp infection group），and 111 cases were negative for Hp antibodies （control group）. All the clinical data and relevant laboratory determination results were collected，and the differences among the groups were compared. By Spearman correlation analysis，the correlations between PG Ⅱ，PGR，G-17 and the activity of gastric inflammation，degree of atrophy （OLGA staging），degree of intestinal metaplasia （OLGIM staging），type Ⅰ Hp infection were evaluated. Results The type Ⅰ Hp infection group was positively correlated with the activity of gastric inflammation，OLGA stage and OLGIM stage （P<0.05）. When the activity of gastric inflammation was grade 3 （+++），the infection rate of the type Ⅰ Hp infection group was 4.9 times that of the type Ⅱ Hp infection group （P<0.05）. When the OLGA stage was stage Ⅲ，the infection rate of the type Ⅰ Hp infection group was 2.1 times that of the type Ⅱ Hp infection group （P<0.05）. When the OLGIM stage was stage Ⅲ，the infection rate of the type Ⅰ Hp infection group was 2.6 times than that of the type Ⅱ Hp infection group （P<0.05）. There was statistical significance in serum PGⅡ，PGR and G-17 levels among control group，type Ⅰ Hp infection group and type Ⅱ Hp infection group （P<0.05）. In patients with chronic gastritis，serum PGⅡ was positively correlated with type Ⅰ Hp infection，the activity of gastric inflammation，the degree of atrophy and the degree of intestinal metaplasia （P<0.05）. Serum PGR was negatively correlated with type Ⅰ Hp infection，the activity of inflammation，OLGA stage and OLGIM stage （P<0.05）. Serum G-17 level was positively correlated with type Ⅰ Hp infection and the activity of gastric inflammation and OLGIM stage（P<0.05）. Conclusions Type Ⅰ Hp infection has an influence on the development of benign gastric diseases，the levels of PGⅡ，PGR and G-17 in chronic gastritis patients are correlated with type Ⅰ Hp infection and gastric pathological changes，such as inflammatory activity，atrophy and intestinal metaplasia.

Role of coagulation function in bacterial bloodstream infection among malignant tumor patients

SHI Shaoxin, CHEN Xueting, XU Xiaofeng, LU Renquan, GUO Lin, ZHUANG Yihui

2025, 40(8):  804-809.  DOI: 10.3969/j.issn.1673-8640.2025.08.014

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Objective To investigate the diagnostic and prognostic value of coagulation indicators in patients with malignant tumors complicated with bacterial bloodstream infection （BSI）. Methods A total of 206 patients with malignant tumors complicated with BSI （positive group） and 238 patients with malignant tumors without BSI （control group） admitted to Fudan University Shanghai Cancer Center from January 2019 to December 2023 were enrolled. Basic information，pathogen infection status and coagulation function determination results of the patients were collected. The positive group patients were followed up and classified into good prognosis group （162 cases） and poor prognosis group （44 cases） based on their prognosis. Multivariate Logistic regression analysis was used to evaluate the influencing factors of BSI in patients with malignant tumors. Receiver operating characteristic （ROC） curve was used to evaluate the diagnostic efficacy of coagulation indicators for BSI in patients with malignant tumors. Results Prothrombin time （PT），activated partial thromboplastin time （APTT），thrombin time （TT），fibrinogen （Fib），D-dimer （DD），and fibrin （fibrinogen） degradation product （FDP） in the positive group were higher than those in the control group （P<0.05）. PT，TT，Fib，DD and FDP were risk factors for BSI in patients with malignant tumors （P<0.05）. The areas under curves of PT，TT，Fib，DD，FDP single and combined determinations for the diagnosis of BSI in patients with malignant tumors were 0.814，0.608，0.596，0.784，0.771 and 0.879，respectively. The age，PT，APTT and TT in poor prognosis group were higher than those in good prognosis group（P<0.001），and Fib was lower than that in good prognosis group （P<0.001）. Conclusions PT，TT，Fib，DD and FDP can be used to assist in the diagnosis of BSI in patients with malignant tumors，and the combined determination of the 5 indicators has better diagnostic efficacy. PT，APTT，TT and Fib are related to the prognosis of patients with malignant tumors complicated with BSI.

Influence of SULF1 expression on cell proliferation in gastric cancer

XU Lei, JIN Yiying, HUANG Nan, MA Ji, PAN Qiuhui

2025, 40(8):  810-816.  DOI: 10.3969/j.issn.1673-8640.2025.08.015

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Objective To investigate the expression of sulfatase 1（SULF1） in gastric cancer and its influence on cell proliferation. Methods Differentially expressed genes were screened from the Gene Expression Omnibus（GEO） datasets（GSE33335 and GSE79973） and verified in the Cancer Genome Atlas（TCGA） database. The SULF1 gene was selected for further analysis. The expression of SULF1 in normal gastric epithelial tisssues and gastric cancer tissues was analyzed using the Human Protein Atlas（HPA） database. The relationship between serum SULF1 levels and overall survival of gastric cancer patients was analyzed using the Kaplan-Meier Plotter database. Fifty patients with gastric cancer（gastric cancer group） and 30 healthy subjects（healthy control group） from Tongji University Affiliated Tenth People's Hospital from August to September 2023 were enrolled. The clinical data were collected，and serum SULF1 levels were determined. The expressions of SULF1 protein and mRNA in human gastric mucosal cell line GES-1 and human gastric cancer cell lines AGS，MKN-28，MKN-45，BGC-823 and SGC-7901 were determined. Stable SULF1 knockdown cell lines（SULF1 knockdown group） were constructed，and cell proliferation was determined by CCK-8 assay and colony formation assay. Results Six differentially expressed genes with the most significant upregulation were screened from the GEO database and verified in the TCGA database. Immunohistochemical analysis in the HPA database showed that SULF1 protein was highly expressed in gastric cancer tissues（P<0.05）. Serum SULF1 levels in gastric cancer patients were higher than those in healthy control group（P<0.001）. The overall survival of SULF1 high-expression group was shorter than that of SULF1 low-expression group（P<0.01）. Compared with control group（negative control stable cell line），the relative expression levels of SULF1 protein and mRNA in SULF1 knockdown group（BGC-823 cells，SGC-7901 cells） were decreased（P<0.001），and cell proliferation ability was weakened（P<0.001）. Conclusions SULF1 is highly expressed in gastric cancer and acts as an oncogene to promote gastric cancer cell proliferation. Gastric cancer patients with high expression of SULF1 have a poorer prognosis.