Table of Content

30 December 2025, Volume 40 Issue 12

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Analysis of clinical and immunological characteristics of HIV-positive and HIV-negative monkeypox patients

WANG Jing, ZHANG Yifan, WANG Gang, LIN Feng, ZHANG Min, LI Xin, ZHANG Mingming, WAN Yanmin, ZHU Zhaoqin

2025, 40(12):  1139-1145.  DOI: 10.3969/j.issn.1673-8640.2025.12.001

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Objective To investigate the clinical and immunological characteristics of human immunodeficiency virus（HIV）-positive and HIV-negative monkeypox patients，and to clarify the impact of co-infection with HIV on the course of monkeypox. Methods A total of 54 monkeypox patients were enrolled from Shanghai Public Health Clinical Center from July 2023 to January 2024. Among them，31 patients were HIV-negative（people without HIV，referred to as the PWOH group） and 23 patients were HIV-positive（people with HIV，referred to as the PWH group）. All the patients were classified into 0-3 d group，4-7 d group and >7 d group based on the time from onset to sample collection. The clinical data and 41 laboratory index determination results were collected，and plasma monkeypox virus nucleic acid and IgG antibodies，IgM antibodies and neutralizing antibodies were determined. Results Among the 41 laboratory indexes，there was statistical significance in white blood cell（WBC） count，the percentage of basophils（BASO%），the percentage of lymphocytes（LYMPH%），the absolute value of neutrophils（NEUT#） and albumin-to-globulin（A/G） ratio between PWH group and PWOH group（P<0.05）. There was no statistical significance in clinical data，monkeypox virus nucleic acid positive rate and IgG antibodies，IgM antibodies and neutralizing antibodies between the 2 groups（P>0.05）. In the >7 d group，there was statistical significance in WBC count，LYMPH%，BASO%，the percentage of neutrophils（NEUT%），NEUT#，A/G ratio，albumin（Alb） and cholinesterase（CHE） between HIV-positive and HIV-negative monkeypox patients（P<0.05），while in the 0-3 d group and 4-7 d group，there was no statistical significance in laboratory indexes between HIV-positive and HIV-negative monkeypox patients（P>0.05）. In the 0-3 d group，4-7 d group and >7 d group，there was no statistical significance in monkeypox virus nucleic acid positive rate between HIV-positive and HIV-negative monkeypox patients（P>0.05）. In the 0-3 d group，4-7 d group and >7 d group，there was no statistical significance in IgG antibodies，IgM antibodies and neutralizing antibodies between HIV-positive and HIV-negative monkeypox patients（P>0.05）. Conclusions HIV-positive monkeypox patients who achieved immune reconstitution and have good control of HIV infection after antiretroviral therapy（ART） do not have their monkeypox condition worsened by co-infection with HIV，and it does not adversely affect the production of monkeypox virus antibodies.

Construction of a nomogram prediction model for the prognosis of patients with depressive disorder based on the characteristics of peripheral blood lymphocyte subsets

GAO Zikang, CHEN Jing

2025, 40(12):  1146-1152.  DOI: 10.3969/j.issn.1673-8640.2025.12.002

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Objective To construct a nomogram prediction model for the prognosis of patients with depressive disorder based on peripheral blood lymphocyte subsets，and to evaluate its clinical applicability. Methods A total of 166 patients with depressive disorder from Shaoxing Seventh People's Hospital from May 2021 to June 2022 were enrolled as modeling set. All the patients received conventional antidepressant treatment，and they were followed up for 1 year after discharge. The prognosis of patients with depressive disorder was evaluated using the Global Assessment Scale（GAS） at the last follow-up. Totally，77 patients with a GAS score ≤60 were classified in poor prognosis group，and 89 patients with a GAS score >60 were classified in good prognosis group. Another 72 patients with depressive disorder from Shaoxing Seventh People's Hospital from October 2022 to June 2023 were enrolled as validation set for external validation of the nomogram prediction model. The clinical data were collected，and the percentages of peripheral blood T lymphocyte subset percentages（CD3⁺%，CD4⁺%，CD8⁺%） and dehydroepiandrosterone sulfate（DHEAS） levels were determined. The CD4/CD8 ratio was calculated. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of each index in predicting poor prognosis in patients with depressive disorder. Binary Logistic regression analysis was used to evaluate the influencing factors of prognosis in patients with depressive disorder. Calibration curves and decision curves were used to internally validate and evaluate the performance of the nomogram prediction model. Results There was statistical significance in gender，CD3⁺%，CD4⁺%，CD8⁺%，CD4/CD8 ratio and DHEAS level between poor prognosis group and good prognosis group in the modeling set（P<0.001），while there was no statistical significance in the other clinical data between the 2 groups（P>0.05）. Gender，CD3⁺%，CD4⁺%，CD8⁺%，CD4/CD8 ratio and DHEAS were all risk factors for poor prognosis in patients with depressive disorder（P<0.05）. A nomogram prediction model for predicting the prognosis of patients with depressive disorder was constructed based on the regression equation. The area under curve（AUC） of the nomogram prediction model for predicting poor prognosis in patients with depressive disorder was 0.964，and the C-index was 0.963. The model had a good fit（Hosmer-Lemeshow χ²=11.507，P=0.175）. When the threshold probability was >0.14，clinical net benefit could be obtained，and the maximum net benefit was 0.30. In the validation set，the AUC of the nomogram prediction model for predicting poor prognosis in patients with depressive disorder was 0.920，and the model had a good fit（Hosmer-Lemeshow χ²=6.782，P=0.553）. Conclusions The nomogram prediction model constructed based on gender，CD3⁺%，CD4⁺%，CD8⁺%，CD4/CD8 ratio and DHEAS can effectively evaluate the prognosis of patients with depressive disorder，and has good clinical applicability.

Roles of PIV，SII and NPAR in the diagnosis of spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites

WANG Tian, ZHANG Yun, BAI Yi, ZHAI Weibin, ZHAO Hai

2025, 40(12):  1153-1158.  DOI: 10.3969/j.issn.1673-8640.2025.12.003

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Objective To investigate the diagnostic roles of inflammatory-related indicators such as pan-immune inflammation value（PIV），systemic immune-inflammation index（SII） and neutrophil percentage-to-albumin ratio（NPAR） for spontaneous bacterial peritonitis（SBP） in patients with liver cirrhosis and ascites. Methods A total of 443 patients with liver cirrhosis and ascites from Shaanxi Provincial People's Hospital from January 2019 to December 2023 were enrolled. The clinical data of all the patients at admission were collected，and blood routine test，C-reactive protein（CRP），albumin（Alb），total bilirubin（TB），creatinine（Cr），alanine aminotransferase（ALT） and aspartate aminotransferase（AST） were performed and determined. The neutrophil-to-lymphocyte ratio（NLR），lymphocyte-to-monocyte ratio（LMR），PIV，SII and NPAR were calculated. The patients were classified into SBP group（50 cases） and non-SBP group（393 cases） based on whether SBP occurred during hospitalization. Binary Logistic regression analysis was used to evaluate the influencing factors of SBP occurrence. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of each indicator in diagnosing SBP. Results There was statistical significance in the occurrence of hepatic encephalopathy，liver-kidney syndrome and liver failure between SBP group and non-SBP group（P<0.05），while there was no statistical significance in the other clinical data between the 2 groups（P>0.05）. There was statistical significance in white blood cell（WBC） count，the absolute value of neutrophils（NEUT#），the percentage of neutrophils（NEUT%），the percentage of lymphocytes（LYMPH%），the percentage of monocytes（MO#），CRP，Alb，TB，NLR，LMR，SII，PIV and NPAR between SBP group and non-SBP group（P<0.05），while there was no statistical significance in the other indicators between the 2 groups（P>0.05）. Hepatic encephalopathy and elevated TB were independent risk factors for SBP in patients with liver cirrhosis and ascites（P<0.05）. The areas under curves（AUC） for PIV，SII，LMR，NLR，LYMPH%，NPAR，CRP，NEUT% and TB in diagnosing SBP in patients with liver cirrhosis and ascites were 0.820，0.804，0.736，0.734，0.720，0.712，0.711，0.692 and 0.603，respectively. Conclusions PIV，SII and NPAR have certain auxiliary diagnostic value for the occurrence of SBP in patients with cirrhotic ascites.

Roles of miR-944 and MARCH7 mRNA in prognosis assessment of non-small cell lung cancer patients

HUANG Ting, XU Yan, SHI Qingxing, PENG Ying

2025, 40(12):  1159-1164.  DOI: 10.3969/j.issn.1673-8640.2025.12.004

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Objective To investigate the relationship between the expression of miR-944 and membrane-associated ring finger protein 7（MARCH7） mRNA in cancer tissues of non-small cell lung cancer（NSCLC） patients and their clinical pathological characteristics and prognosis. Methods A total of 97 NSCLC patients from Liyang People's Hospital from July 2019 to July 2020 were enrolled. All patients' clinical data were collected，and cancer tissues and adjacent tissues（≥2 cm from tumor margin） were collected during surgery. The relative expression levels of miR-944 and MARCH7 mRNA were determined. All the patients were followed up for 3 years. The survival of all the patients was analyzed using Kaplan-Meier survival curve. Cox regression analysis was used to evaluate the factors affecting the prognosis of NSCLC patients. Results The relative expression levels of miR-944 and MARCH7 mRNA in cancer tissues of NSCLC patients were higher than those in adjacent tissues（P<0.05）. The relative expression levels of miR-944 and MARCH7 mRNA in NSCLC patients with TNM stage Ⅲa，lymphatic metastasis and low differentiation were higher than those in NSCLC patients with TNM stage Ⅰ-Ⅱ，no lymphatic metastasis and moderate to high differentiation（P<0.05）. The optimal cut-off values of miR-944 and MARCH7 mRNA in cancer tissues for predicting NSCLC patient death were 2.39 and 3.05，respectively. NSCLC patients were classified into miR-944 and MARCH7 mRNA high-expression and low-expression groups based on the optimal cut-off values. The 3-year overall survival rate of miR-944 high-expression group [27.03%（10/37）] was lower than that of miR-944 low-expression group [48.15%（26/54）]（Log-rank χ²=5.901，P=0.015）. The 3-year overall survival rate of MARCH7 mRNA high-expression group [28.13%（9/32）] was lower than that of MARCH7 mRNA low-expression group [45.76%（27/59）]（Log-rank χ²=9.998，P=0.002）. Lymphatic metastasis，TNM stage Ⅲa，low differentiation，high miR-944 expression and high MARCH7 mRNA expression were risk factors for NSCLC patient death（P<0.05）. Conclusions The miR-944 and MARCH7 mRNA are highly expressed in NSCLC cancer tissues and are related to the severity of disease and prognosis. They may be used as indicators for prognosis assessment in NSCLC patients.

Predictive roles of serum 25（OH）D and SAA for the response to immunosuppressive therapy in autoimmune hepatitis

LI Minghong, MIN Cuili, GUO Qingbo, MA Lujuan

2025, 40(12):  1165-1170.  DOI: 10.3969/j.issn.1673-8640.2025.12.005

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Objective To investigate the predictive roles of serum amyloid A（SAA） and 25-hydroxyvitamin D [25（OH）D] levels in patients with autoimmune hepatitis（AIH） for the response to immunosuppressive therapy. Methods A total of 141 patients with AIH（AIH group） and 141 healthy subjects（healthy control group） from Weifang Yidu Central Hospital from October 2019 to October 2023 were enrolled. The AIH group was classified into good response subgroup（113 cases） and poor response subgroup（28 cases） based on the response to immunosuppressive therapy within 4 weeks. The general data were collected. Serum SAA，25（OH）D， white blood cell（WBC） count，alanine aminotransferase（ALT），aspartate aminotransferase（AST），total bilirubin（TB），IgG and gamma-globulin levels were determined in AIH group before and after treatment for 4 weeks. The SAA，25（OH）D，ALT，AST and TB levels were determined in healthy control group. Pearson correlation analysis was used to evaluate the correlation between SAA，25（OH）D and AST，ALT and TB. Logistic regression analysis was used to evaluate the influencing factors of poor response to immunosuppressive therapy in AIH patients. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of single and combined determinations of SAA and 25（OH）D in predicting the response status of AIH patients to immunosuppressive therapy. Results SAA，AST，ALT and TB in AIH group were higher than those in healthy control group（P<0.001），and 25（OH）D was lower（P<0.001）. After treatment，SAA，AST，ALT，TB，IgG and gamma-globulin in AIH group were decreased（P<0.001），and 25（OH）D levels were increased（P<0.001）. Serum 25（OH）D levels in poor response subgroup before and after treatment were lower than those in good response subgroup（P<0.001），and SAA before and after treatment and AST，ALT，TB，IgG and gamma-globulin after treatment were higher（P<0.001）. SAA in AIH patients was positively correlated with AST，ALT and TB（r values were 0.062，0.147 and 0.325，respectively，P<0.05）. The 25（OH）D was negatively correlated with AST，ALT and TB（r values were -0.235，-0.183 and -0.275，respectively，P<0.05）. Pre- and post-treatment 25（OH）D decreasing，pre-treatment SAA increasing were risk factors for poor response to immunosuppressive therapy in AIH patients（P<0.05）. The areas under curves（AUC） of pre-treatment SAA，25（OH）D single and combined determinations for predicting poor response to immunosuppressive therapy in AIH patients were 0.792，0.881 and 0.910，respectively. Conclusions SAA and 25（OH）D are related to the response to immunosuppressive therapy，which can serve as effective indicators for evaluating therapeutic effect.

Roles of serum sPD-1 and sTWEAK levels in patients with ulcerative colitis in disease monitoring and prognosis assessment

ZHEN Di, JIA Bin, MENG Xianyi

2025, 40(12):  1171-1176.  DOI: 10.3969/j.issn.1673-8640.2025.12.006

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Objective To investigate the roles of serum soluble programmed death receptor-1（sPD-1） and soluble tumor necrosis factor-like weak apoptosis inducer（sTWEAK） levels in the monitoring of disease condition and prognosis assessment of patients with ulcerative colitis. Methods A total of 90 patients with ulcerative colitis and 57 healthy subjects（control group） from Qinhuangdao Integrated Traditional Chinese and Western Medicine Hospital of Hebei Port Group Co.，Ltd. were enrolled. The patients with ulcerative colitis were classified into remission group（31 cases），mild group（18 cases），moderate group（28 cases） and severe group（13 cases） according to modified Mayo scores. They were also classified into recurrence group（40 cases） and non-recurrence group（50 cases） according to whether the disease relapsed after 1-year follow up. The clinical data were collected，and the levels of sPD-1，sTWEAK，C-reactive protein（CRP） and tumor necrosis factor-alpha（TNF-α） were determined. Logistic regression analysis was used to evaluate the influencing factors of poor prognosis in patients with ulcerative colitis. Pearson correlation analysis was used to evaluate the correlation between sPD-1，sTWEAK and CRP，TNF-α. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of single determinations of CRP，TNF-α，sPD-1，sTWEAK and the combined determination of sPD-1 and sTWEAK in judging the poor prognosis of patients with ulcerative colitis. Results The levels of sPD-1 and sTWEAK in mild group，moderate group and severe group were successively increased（P<0.05），and they were higher than those in remission group and healthy control group（P<0.05）. There was no statistical significance in sPD-1 and sTWEAK levels between healthy control group and remission group（P>0.05）. The levels of sPD-1，sTWEAK，CRP and TNF-α in recurrence group were higher than those in non-recurrence group（P<0.05）. Serum sPD-1，sTWEAK and CRP，TNF-α were positively correlated（P<0.05）. The areas under curves（AUC） of single determinations of CRP，TNF-α，sPD-1 and sTWEAK for judging the poor prognosis of patients with ulcerative colitis was 0.707，0.664，0.789 and 0.752，respectively，and the AUC of the combined determination of sPD-1 and sTWEAK for judging poor prognosis was 0.866. The increasing of CRP，TNF-α，sPD-1 and sTWEAK levels were risk factors for the recurrence of ulcerative colitis（P<0.05）. Conclusions The expression levels of sPD-1 and sTWEAK in patients with ulcerative colitis are increased and are related to the poor prognosis of patients. They may be used as indicators for monitoring the disease condition and prognosis assessment of patients with ulcerative colitis.

Roles of serum miR-145-5p，miR-200C-3p and miR-1290 in prognosis assessment of patients with papillary thyroid carcinoma

ZHAO Yilin, XU Yan, YIN Hui

2025, 40(12):  1177-1182.  DOI: 10.3969/j.issn.1673-8640.2025.12.007

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Objective To investigate the roles of serum miR-145-5p，miR-200C-3p and miR-1290 expressions in the assessment of recurrence in patients with papillary thyroid carcinoma（PTC）. Methods A total of 93 patients with PTC（PTC group），91 patients with thyroid nodules（benign nodule group） and 94 healthy subjects（healthy control group） from Liyang People's Hospital were enrolled. The clinical data were collected，and the relative expression levels of serum miR-145-5p，miR-200C-3p and miR-1290 were determined. The patients with PTC were followed up for 2 years，and the recurrence situation was recorded. The patients were classified into non-recurrence group（73 cases） and recurrence group（20 cases）. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of serum miR-145-5p，miR-200C-3p and miR-1290 relative expression levels in predicting recurrence in PTC patients. Kaplan-Meier survival curve was used to analyze the recurrence situation of PTC patients. Results The relative expression level of serum miR-145-5p in PTC group was lower than those in benign nodule group and healthy control group（P<0.05），and the relative expression levels of miR-200C-3p and miR-1290 were higher than those in benign nodule group and healthy control group（P<0.05）. The relative expression level of serum miR-145-5p in benign nodule group was lower than that in healthy control group（P<0.05），and the relative expression levels of miR-200C-3p and miR-1290 were higher than those in healthy control group（P<0.05）. The relative expression level of serum miR-145-5p in patients with lymphatic metastasis was lower than that in patients without lymphatic metastasis（P<0.001），and the relative expression levels of miR-200C-3p and miR-1290 were higher than those in patients without lymphatic metastasis（P<0.001）. There was no statistical significance in the relative expression levels of serum miR-145-5p，miR-200C-3p and miR-1290 among patients with different genders，ages，maximum tumor diameters，TNM stages and vascular space infiltration（P>0.05）. The relative expression level of serum miR-145-5p in recurrence group was lower than that in non-recurrence group（P<0.001），and the relative expression levels of miR-200C-3p and miR-1290 were higher than those in non-recurrence group（P<0.001）. The areas under curves（AUC） of single and combined determinations of serum miR-145-5p， miR-200C-3p and miR-1290 for predicting recurrence in PTC patients were 0.805，0.842，0.861 and 0.942，respectively. The recurrence rate in miR-145-5p low-expression group was higher than that in miR-145-5p high-expression group（P=0.011），and the recurrence rates in miR-200C-3p and miR-1290 low-expression groups were lower than those in miR-200C-3p and miR-1290 high-expression groups（P<0.001，P=0.001）. Conclusions Serum miR-145-5p in PTC patients is lowly expressed，while miR-200C-3p and miR-1290 are highly expressed，and they are related to recurrence，which may serve as biomarkers for prognosis assessment of PTC.

Risk factors for poor prognosis in elderly patients with severe fever and thrombocytopenia syndrome and their clinical significance

LI Song, XIANG Xu

2025, 40(12):  1183-1189.  DOI: 10.3969/j.issn.1673-8640.2025.12.008

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Objective To investigate the risk factors and clinical role of prognosis in elderly patients with severe fever with thrombocytopenia syndrome（SFTS）. Methods A total of 120 elderly SFTS patients at Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from April 2023 to June 2024 were enrolled. The patients were classified into good prognosis group（65 cases） and poor prognosis group（55 cases） based on their prognosis. They were classified into low age （≤69 years old）group（61 cases） and high age （>69 years old）group（59 cases） according to the median of age （69 years old）as well. The clinical data at admission and laboratory determination results within 1 d after admission were collected. Logistic regression analysis was used to evaluate the influencing factors of prognosis in elderly SFTS patients. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of various indicators in predicting poor prognosis of SFTS patients. Results The advanced age，the number of consciousness disorder and the levels of serum ferritin（SF），interleukin（IL）-1β，interleukin-2 receptor（IL-2R），IL-6，IL-8，IL-10 and tumor necrosis factor-alpha（TNF-α） in poor prognosis group were higher than those in good prognosis group（P<0.05），while the length of hospital stay and platelet（PLT） count were lower in poor prognosis group（P<0.05）. There was no statistical significance in the other clinical data and laboratory determination results between the 2 groups（P>0.05）. The white blood cell（WBC）count，the absolute value of neutrophils（NEUT#） and death number in high age group were higher than those in low age group（P<0.05），while there was no statistical significance in the other indicators between the 2 groups（P>0.05）. Advanced age，combined consciousness disorder and elevated IL-2R level were independent risk factors for poor prognosis in elderly SFTS patients [odds ratios（OR） were 1.107，7.308 and 1.001，95% confidence intervals（CI） were 1.017-1.204，2.022-26.413 and 1.000-1.002，respectively，P<0.05]. The areas under curves（AUC） of the single determinations of age，IL-2R and consciousness disorder and the combined determination for predicting poor prognosis of elderly SFTS patients were 0.650，0.785，0.689 and 0.857，respectively. Conclusions Elderly SFTS patients with poor prognosis have elevated cytokines in their bodies. Age>68，high IL-2R（>1 465 U·mL^-1） and consciousness disorder are related to the poor prognosis of elderly SFTS patients. Evaluating the prognosis of elderly SFTS patients by combining age，IL-2R and consciousness disorder is more effective.

A machine learning early warning model for acute promyelocytic leukemia based on blood cell analyzer parameters

CHANG Nan, WEI Yali, LU Qifeng, LI Tian, HOU Tingting, LI Yuan, ZHU Mengyu, SHEN Yajuan

2025, 40(12):  1190-1196.  DOI: 10.3969/j.issn.1673-8640.2025.12.009

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Objective To construct a machine learning（ML） early warning model for acute promyelocytic leukemia（APL） based on blood cell analyzer parameters，and to analyze the specific parameter characteristics of APL to provide a reference for the early clinical diagnosis of APL. Methods Blood cell analyzer data from 958 patients with APL，other acute myeloid leukemia（AML） and lymphoid tissue tumors，as well as 985 healthy subjects，were collected from January 2018 to September 2024 at Shandong Provincial Hospital of Shandong First Medical University. The data from January 2018 to December 2023 were collected in the modeling set，and the data from January 2024 to September 2024 were collected in the external validation set. Three algorithms，including Lasso，support vector machine recursive feature elimination and random forest，were used to screen the modeling parameters. Five algorithms，including light gradient boosting machine，support vector machine，multi-layer perceptron，multinomial logistic regression and random forest，were used to construct the APL early warning model. Receiver operating characteristic curve was drawn，and the model with optimal area under curve（AUC） was selected. Ten-fold cross-validation and external validation were performed. The contribution of model features was explained using SHAP. Results Among the 5 ML models，the APL early warning model constructed by the light gradient boosting machine had the optimal overall performance in the test set（AUC of 0.974）. Its AUC for predicting APL in the test set was 0.976，and the area under the precision-recall curve（PR-AUC） was 0.906. The AUC and PR-AUC in ten-fold cross-validation were both >0.835. The AUC for predicting APL in the external validation set was 0.969，and the PR-AUC was 0.718. The SHAP explanation results showed that platelet（PLT） count，side scatter intensity in the monocyte region（MO_X） and mean corpuscular hemoglobin concentration（MCHC） had the most significant contribution to the APL early warning model. Conclusions The APL early warning model constructed based on blood cell analyzer parameters and the light gradient boosting machine algorithm can effectively support the early identification and diagnosis of APL.

Expression changes of plasma lncRNA PINK1-AS and miR-532-5p in patients with ischemic stroke and their effects on sleep quality and cognitive function

CHEN Kun, XU Guowei, WANG Qiuli

2025, 40(12):  1203-1208.  DOI: 10.3969/j.issn.1673-8640.2025.12.011

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Objective To investigate the relationship between the expression of plasma long non-coding RNA（lncRNA）PINK1-AS and miR-532-5p and poor sleep quality and cognitive dysfunction in patients with acute ischemic stroke （AIS）. Methods A total of 129 AIS patients（AIS group）and 124 healthy subjects（healthy control group）were enrolled from June 2021 to January 2024 at Zhengzhou Central Hospital of Zhengzhou University. The clinical data were collected，and the expressions of plasma lncRNA PINK1-AS and miR-532-5p were determined. The Pittsburgh sleep quality index（PSQI）and the Montreal cognitive assessment（MoCA）were used to evaluate sleep quality and cognitive function in AIS patients for 3 months after onset，and the subjects were classified into poor and good sleep quality groups （61 and 68 cases，respectively）and cognitive dysfunction and normal cognitive function groups（40 and 89 cases，respectively）. Pearson correlation analysis was used to evaluate the correlation between various indicators. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of the relative expression levels of plasma lncRNA PINK1-AS and miR-532-5p in predicting poor sleep quality and cognitive dysfunction in AIS patients. Results The relative expression level of plasma lncRNA PINK1-AS in AIS group was higher than that in healthy control group（P<0.001），and the relative expression level of plasma miR-532-5p was lower than that in healthy control group（P<0.001）. The relative expression level of plasma lncRNA PINK1-AS in poor sleep quality group was higher than that in good sleep quality group（P<0.001），and the relative expression level of plasma miR-532-5p was lower than that in good sleep quality group（P<0.001）. There was no statistical significance in clinical data between the 2 groups（P>0.05）. The relative expression level of plasma lncRNA PINK1-AS in cognitive dysfunction group was higher than that in normal cognitive function group（P<0.001），and the relative expression level of plasma miR-532-5p was lower than that in normal cognitive function group（P<0.001），with no statistical significance in clinical data between the 2 groups（P>0.05）. The expression of plasma lncRNA PINK1-AS in AIS patients was positively correlated with PSQI score（r=0.524，P<0.05） and negatively correlated with MoCA score（r=-0.512，P<0.05）. The expression of miR-532-5p was negatively correlated with PSQI score（r=-0.528，P<0.05）and positively correlated with MoCA score（r=0.527，P<0.05）. The areas under curves （AUC） of the relative expression levels of plasma lncRNA PINK1-AS and miR-532-5p for predicting poor sleep quality in AIS patients were 0.809，0.857 and 0.928，respectively，and the AUC for predicting cognitive dysfunction in AIS patients were 0.842，0.864 and 0.940，respectively. Conclusions Plasma lncRNA PINK1-AS is highly expressed，miR-532-5p is lowly expressed in AIS patients，and they are related to poor sleep quality and cognitive dysfunction in AIS patients.

Sequence characteristics of VP4 gene of group A rotavirus in Xiamen

LIN Jiancheng, GAO Libin, ZHAN Weiwu, WU Haiming, CHEN Xi, XU Jin

2025, 40(12):  1209-1215.  DOI: 10.3969/j.issn.1673-8640.2025.12.012

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Objective To understand the VP4 gene sequence and genetic variation characteristics of type P rotavirus in Xiamen，as well as its differences from those of other regions at home and abroad. Methods From January to December 2021，100 fecal samples from children <10 years old with positive rotavirus determination result at the Children's Hospital of Xiamen were collected. Nucleic acid polymerase chain reaction（PCR） was used for the genotyping of rotavirus G genotype and P genotype. The full-length VP4 gene sequence of rotavirus A was determined by first-generation sequencing technology. The sequences were analyzed and compared using biological softwares such as DNA Star and MEGA. Results The main prevalent strain of G gene in the 100 diarrhea samples was G9 type（88 strains），the main prevalent strain of P genotype was P[8] type（87 strains），and the main prevalent combination of G/P gene was G9P[8] type（80 strains）. The evolutionary tree analysis showed that the local strains in Xiamen（Amoy） had different degrees of differences in the evolutionary tree compared with other local strains at home and abroad. The amino acid comparison analysis showed that the amino acid primary structure of the local strain in Xiamen（Amoy） had different degrees of variations compared with different local strains at home and abroad. Conclusions The full-length VP4 gene of rotavirus A can show that the strain has the ability to adapt and mutate rapidly in China. It is recommended to continuously monitor the genetic variation of rotavirus.

Application and prospect of microsatellite instability determination in tumor diagnosis and treatment

BAO Wen

2025, 40(12):  1227-1231.  DOI: 10.3969/j.issn.1673-8640.2025.12.015

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Microsatellite instability（MSI） refers to the length alteration of microsatellite loci in tumors compared with normal tissues due to the insertion or deletion of repeat units，which is caused by mutations in DNA mismatch repair-related genes and represents the state of microsatellite alleles. With the development of MSI determination technologies，the determination can be used for screening Lynch syndrome，diagnosing and treating tumors，or stratifying the prognosis of colorectal cancer. It helps to identify colorectal cancer patients with DNA mismatch repair deficiency features as early as possible and provide medication guidance for adult advanced solid tumors with MSI. This review focuses on the application and prospects of MSI determination in tumor diagnosis and treatment.

Application role of metagenomic next-generation sequencing in diagnosis of pulmonary infections

SHI Jian, LEI Jing, GENG Yan

2025, 40(12):  1232-1236.  DOI: 10.3969/j.issn.1673-8640.2025.12.016

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Pulmonary infection is a prevalent infectious disease worldwide，with high incidence and mortality rates. Early identification of pathogenic microorganism is crucial for the correct diagnosis and treatment of the disease. Traditional laboratory testing methods have problems such as long determination time，relatively narrow pathogen spectrum and low positive determination rate，which pose challenges for clinical diagnosis of pulmonary infection and rational drug use. Metagenomic next-generation sequencing （mNGS） is an emerging pathogen microorganism determination technology，featuring high efficiency，rapidity and a wide pathogen spectrum. It is particularly significant in the determination of rare or newly emerging pathogens and has gradually been applied in the auxiliary diagnosis of infectious diseases，compensating for the limitations of traditional determination methods. This review focuses on the overview of mNGS，the impact of different specimen types on determination and its application in pulmonary infection-related research，with the aim of providing a reference for clinical diagnosis of pulmonary infection.