Table of Content

30 January 2026, Volume 41 Issue 1

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Role of vWF/ADAMTS13 ratio and vWF function in progression of immunoglobulin A nephropathy

WU Zhuolin, YUAN Junwei, ZHANG Ziqi, LIU Yu, XU Guanqun, WANG Xuefeng, LU Yeling

2026, 41(1):  1-7.  DOI: 10.3969/j.issn.1673-8640.2026.01.001

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Objective To investigate the role of the ratio of von Willebrand factor（vWF）to a disintegrin and metalloproteinase with a thrombospondin type 1 motif 13（ADAMTS13）and vWF function in evaluating the disease progression of immunoglobulin A nephropathy（IgAN）patients. Methods A total of 84 IgAN patients and 79 healthy subjects（healthy control group）from Ruijin Hospital of Shanghai Jiao Tong University School of Medicine were enrolled from December 2023 to February 2024. According to the Kidney Disease：Improving Global Outcomes（KDIGO）guidelines，the IgAN patients were classified into low-risk group（32 cases），intermediate-risk group（32 cases）and high-risk group（20 cases）. The general information and laboratory routine determination results were collected，and plasma vWF antigen（vWF：Ag），vWF collagen binding（vWF：CB），ADAMTS13 activity and vWF multimers were determined. The efficacy of each indicator in determining the high-risk status of IgAN patients was evaluated by receiver operating characteristic（ROC） curve. Results Compared with healthy control group，the levels of vWF：Ag，vWF：CB，vWF：Ag/ADAMTS13 ratio and vWF：CB/ADAMTS13 ratio in low-risk group，intermediate-risk group and high-risk group were increased（P<0.001）. Compared with healthy control group，the percentages of low-molecular-weight von Willebrand factor multimers（LMWM-vWF）and intermediate-molecular-weight von Willebrand factor multimers（IMWM-vWF）in high-risk group were increased（P<0.01），and the percentage of high-molecular-weight von Willebrand factor multimers（HMWM-vWF）and ADAMTS13 activity were decreased（P<0.05）. The levels of vWF：Ag and vWF：CB in high-risk group were higher than those in low-risk group（P<0.05），and the vWF：Ag/ADAMTS13 ratio and vWF：CB/ADAMTS13 ratio were higher than those in low-risk group（P<0.05）. The areas under curves（AUC）of vWF：Ag/ADAMTS13 ratio，vWF：CB/ADAMTS13 ratio，serum creatinine（SCr）and vWF：Ag in predicting the high-risk status of IgAN patients were 0.731，0.752，0.952 and 0.716，respectively. Conclusions The levels of vWF and ADAMTS13 in IgAN patients are abnormal，and the increase in vWF/ADAMTS13 ratio is related to the progression of kidney disease.

Roles of serum miR-10a and miR-16 in predicting major adverse cardiovascular events in elderly patients with CHF who have preserved ejection fraction or mildly reduced ejection fraction

CHEN Ling, QIAN Fangmin, WANG Yangui

2026, 41(1):  8-13.  DOI: 10.3969/j.issn.1673-8640.2026.01.002

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Objective To investigate the roles of miR-10a and miR-16 expressions in the occurrence of major adverse cardiovascular events（MACE）in elderly patients with chronic heart failure（CHF）. Methods A total of 158 elderly CHF patients from Ruijin Rehabilitation Hospital from January 2021 to January 2023 were enrolled，including 98 patients with heart failure with mildly reduced ejection fraction（HFmrEF）and 60 patients with heart failure with preserved ejection fraction（HFpEF）. The clinical data at admission were collected，and relevant laboratory indicators and serum relative expression levels of miR-10a and miR-16 were determined. All the patients were followed up for 1 year，and they were classified into MACE group and non-MACE group according to whether MACE occurred. Spearman correlation analysis or Pearson correlation analysis was used to evaluate the correlation between various indicators. Multivariate Logistic regression analysis was used to evaluate the influencing factors of MACE in elderly CHF patients. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of various indicators in judging the occurrence of MACE in elderly CHF patients. Results The relative expression levels of serum miR-10a and miR-16 and the level of cTnI，as well as the proportion of NYHA class Ⅲ-Ⅳ，in MACE group were higher than those in non-MACE group（P<0.05），and the LVEF level was lower than that in non-MACE group（P<0.05）. There was no statistical significance in the other indicators between the 2 groups（P>0.05）. The relative expression levels of serum miR-10a and miR-16 were positively correlated with NYHA classification（r values were 0.516 and 0.504，respectively），cTnI（r values were 0.528 and 0.529，respectively），and they were negatively correlated with LVEF（r values were -0.510 and -0.525，respectively，P<0.05）. Elevated expressions of miR-10a and miR-16 were independent risk factors for MACE in elderly CHF patients [odds ratios（OR）were 2.849 and 2.916，95% confidence intervals（CI）were 1.534-5.293 and 1.420-5.987，P<0.01]. The areas under curves（AUC）of single determinations of serum miR-10a，miR-16，cTnI，LVEF and combined determination of miR-10a and miR-16 for judging the occurrence of MACE in elderly CHF patients were 0.843，0.808，0.845，0.866 and 0.921，respectively. Conclusions The upregulation of serum miR-10a and miR-16 expressions is related to the occurrence of MACE in elderly CHF patients，and they may be used as assessment indicators for the prognosis risk of elderly CHF patients.

Diagnostic role of combined determination of serum IP-10，Gas6 and CHI3L1 for liver fibrosis in patients with chronic hepatitis B

WANG Likun, LI Zhe, ZHANG Meng, NIU Junqiang, ZHANG Xiaohu

2026, 41(1):  14-19.  DOI: 10.3969/j.issn.1673-8640.2026.01.003

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Objective To investigate the levels of serum interferon-gamma-induced protein-10（IP-10），growth arrest-specific gene 6（Gas6）and chitinase 3-like protein 1（CHI3L1）in patients with chronic hepatitis B （CHB），and to investigate their clinical significance. Methods A total of 148 patients with CHB（CHB group）and 148 healthy subjects（healthy control group）were enrolled from Nanyang Central Hospital from May 2022 to May 2024. The CHB patients were classified into mild inflammation（G1-G2 stage）group（69 cases）and severe inflammation（G3-G4 stage）group（79 cases）according to the degree of liver inflammation. The CHB patients were classified into significant liver fibrosis（S2-S4 stage）group（80 cases）and non-significant liver fibrosis（S1 stage）group（68 cases）according to the degree of liver fibrosis. The clinical data and the determination results of liver function indicators [alanine aminotransferase（ALT），aspartate aminotransferase（AST），total bilirubin（TB），albumin（Alb）] were collected，and the levels of serum IP-10，Gas6 and CHI3L1 were determined. Spearman correlation analysis was used to evaluate the correlation between the levels of IP-10，Gas6 and CHI3L1 in CHB patients and the degrees of liver inflammation and liver fibrosis. Multivariate Logistic regression analysis was used to analyze the influencing factors of significant liver fibrosis in CHB patients. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of IP-10，Gas6 and CHI3L1 in diagnosing significant liver fibrosis in CHB patients. Results The levels of ALT，AST，TB，IP-10 and CHI3L1 in CHB group were higher than those in healthy control group（P<0.001），while the levels of Alb and Gas6 were lower than those in healthy control group（P<0.001）. The serum IP-10 and CHI3L1 levels in severe inflammation group were higher than those in mild inflammation group（P<0.001），and the serum Gas6 level was lower than that in mild inflammation group（P<0.001）. The serum IP-10 and CHI3L1 levels in significant liver fibrosis group were higher than those in non-significant liver fibrosis group（P<0.001），and the serum Gas6 level was lower than that in non-significant liver fibrosis group（P<0.001）. The serum IP-10，CHI3L1 and liver inflammation degree，liver fibrosis degree in CHB patients were positively correlated（P<0.05），while the serum Gas6 was negatively correlated with liver inflammation degree，liver fibrosis degree（P<0.05）. Elevated IP-10 and CHI3L1 and decreased Gas6 were risk factors for significant liver fibrosis in CHB patients [odds ratios（OR）were 5.832，4.774 and 0.467，95% confidence intervals（CI）were 2.611-13.026，2.704-8.428 and 0.328-0.665，P<0.001]. The areas under curves（AUC）of single and combined determinations of serum IP-10，Gas6 and CHI3L1 for diagnosing significant liver fibrosis in CHB patients were 0.818，0.822，0.734 and 0.918，respectively. Conclusions The combined determination of serum IP-10，Gas6 and CHI3L1 has a high diagnostic value for significant liver fibrosis in CHB patients，which may be used for evaluating the degree of liver fibrosis in CHB patients.

Correlation between monocyte subset distribution in patients with systemic lupus erythematosus and disease status

YIN Xiushan, TAN Xueling, HE Rendong, XING Yan

2026, 41(1):  20-27.  DOI: 10.3969/j.issn.1673-8640.2026.01.004

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Objective To investigate the correlation between peripheral blood monocyte subsets and disease status in patients with systemic lupus erythematosus（SLE）. Methods A total of 67 SLE patients（SLE group）and 46 healthy subjects（healthy control group）were enrolled from the Affiliated Hospital of North Sichuan Medical College from January to August 2022. The general data such as age and gender and the determination results of the percentage of monocytes（MO%），the percentage of classical monocytes（CM%），the percentages of intermediate monocytes（IM%），the percentages of non-classical monocytes（NCM%）and disease activity indicators [the absolute value of monocytes（MO#），erythrocyte sedimentation rate（ESR），C-reactive protein（CRP），complement（C）3，C4，anti-double-stranded DNA（dsDNA）antibody，anti-nuclear antibody （ANA）] were collected. Spearman rank correlation analysis was used to evaluate the correlation between MO#，CM%，IM% and disease activity indicators of SLE patients. Logistic regression analysis was used to evaluate the influencing factors of SLE disease activity. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of CM% and IM% in diagnosing SLE. Results Compared with healthy control group，MO#，MO% and IM% in SLE group were increased（P<0.001），CM% was decreased（P<0.001），and there was no statistical significance in NCM%（P>0.05）. MO#，MO% and IM% in SLE remission group were increased（P<0.05），while CM% and NCM% were not statistically significant（P>0.05）. Compared with SLE remission group，CM% in SLE active group was decreased（P<0.001），IM% was increased（P<0.001），and there was no statistical significance in MO#，MO% and NCM%（P>0.05）. CM% was negatively correlated to CRP and anti-dsDNA antibody levels in SLE active group（P<0.05），and it was positively correlated to C3 and C4 levels（P<0.05）. IM% was positively correlated with CRP and anti-dsDNA antibody levels（P<0.05），and it was negatively correlated to C4 level（P<0.05）. Age being younger and IM% being higher were risk factors for disease activity in SLE patients [odds ratios（OR）were 0.948 and 2.410，95% confidence intervals（CI）were 0.900-0.998 and 1.386-4.192，P<0.05]. The areas under curves（AUC）of CM% and IM% for diagnosing SLE were 0.785 and 0.827，respectively，and the AUC for evaluating SLE disease activity were 0.951 and 0.966，respectively. Conclusions The distribution of monocyte subsets is related to the disease activity of SLE，and it may be a new biomarker for the diagnosis and assessment of SLE disease activity.

Analysis of Y chromosome AZF gene microdeletions in 2 002 male infertile patients from Liuzhou

ZHONG Xin, CHEN Lizhu, YUAN Dejian, QIN Songqiang, HUANG Jun, HUANG Cheng, ZHANG Ling, XIE Li, WEI Xiaoni, ZHONG Qingyan, TANG Ning

2026, 41(1):  28-33.  DOI: 10.3969/j.issn.1673-8640.2026.01.005

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Objective To investigate the characteristics of Y chromosome azoospermia factor （AZF） gene microdeletions in male infertile patients in Liuzhou，and to provide a reference for clinical diagnosis and treatment. Methods A total of 2 002 male infertile patients at Liuzhou Maternal and Child Health Care Hospital and Liuzhou Hospital of Guangzhou Women and Children's Medical Center from April 2018 to June 2023 were enrolled. Y chromosome AZF gene microdeletions，karyotype analysis，semen routine examination and sperm DNA fragmentation rate determination were performed. Results Totally，152 cases（7.59%）were determined with Y chromosome AZF gene microdeletions，including 69 cases of basic site deletions and 83 cases of extended site deletions. Among the 152 patients with Y chromosome AZF gene microdeletions，45 cases were of the Zhuang ethnicity（29 cases of basic site deletions and 16 cases of extended site deletions），87 cases were of the Han ethnicity（29 cases of basic site deletions and 58 cases of extended site deletions）and 20 cases were of other ethnicities（11 cases of basic site deletions and 9 cases of extended site deletions）. Among the 12 patients with Y chromosome AZF gene extended site deletions，the semen routine examination results were normal. Among the 1 762 patients who underwent karyotype analysis，only 32 cases（1.82%）had Y chromosome abnormalities，and 13 cases were positive for Y chromosome AZF gene microdeletions. Among the 875 patients who underwent sperm fragmentation rate determination，244 patients had sperm fragmentation rates >30%，and 21 cases（8.61%）were determined with Y chromosome microdeletions. Totally，631 patients had sperm fragmentation rate <30%，and 32 cases （5.07%） were determined with Y chromosome microdeletions. Conclusions AZF gene microdeletion determination can increase the determination rate of abnormal Y chromosomes in males，but it can not determine the cause of male infertility. Multiple determination methods should be used for auxiliary diagnosis.

Role of monoamine oxidase in assessing the severity of coronary artery lesions in ACS patients of different ages

TIAN Xiangquan, FAN Zhongcai

2026, 41(1):  34-40.  DOI: 10.3969/j.issn.1673-8640.2026.01.006

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Objective To investigate the role of monoamine oxidase（MAO）in assessing the severity of coronary artery lesions in patients with acute coronary syndrome（ACS）of different age groups. Methods A total of 262 ACS patients who underwent coronary angiography at Dazhu Hospital Affiliated to North Sichuan Medical College from January 2022 to August 2023 were enrolled. Totally，242 patients with normal coronary angiography results were used as control group. The clinical data（age，gender，smoking history，diabetes mellitus history，hypertension history，body mass index and so on）and routine biochemical determination results were collected. Serum MAO levels were also determined. All the patients were classified by age into young（18 years old to < 40 years old），middle-aged（40 years old to < 60 years old）and elderly（≥60 years old）groups. ACS patients were classified into single-vessel lesion group（80 cases），double-vessel lesion group（111 cases）and triple-vessel lesion group（71 cases）according to the results of coronary angiography. The severity of coronary artery lesions in ACS patients was evaluated using the Gensini score，and they were classified into low value（< 45 points）group（84 cases），medium value（45 points to < 65 points）group（108 cases）and high value（≥65 points）group（70 cases） according to the tertile method. A high Gensini score（indicating severe coronary artery lesions）was defined as Gensini score ≥45 points. Pearson correlation analysis was used to evaluate the correlation between MAO and other indicators. Multivariate Logistic regression analysis was used to evaluate the relationship between MAO and the risk of ACS occurrence. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of MAO in determining the occurrence of severe coronary artery lesions in ACS patients of different age groups. Results The MAO level in ACS group was higher than that in control group（P<0.001）. After adjusting for clinical data and routine biochemical indicators，high-level MAO was an independent risk factor for ACS occurrence [odds ratio（OR）=3.60，95% confidence interval（CI）2.27-5.71，P<0.001]. In control group，the MAO level of elderly patients was higher than that of middle-aged and young patients（P<0.05），and there was no statistical significance in the MAO levels between middle-aged and young patients（P>0.05）. In ACS group，the MAO levels of young，middle-aged and elderly patients were increased successively（P<0.001）. The MAO levels were increased successively among single-vessel group，double-vessel group，triple-vessel group and among low value，medium value and high value groups of Gensini score（P<0.001），and among all the groups，the MAO levels of young，middle-aged and elderly patients were increased successively（P<0.05）. MAO in ACS patients was positively correlated with cardiac troponin I（cTnI），high-sensitivity C-reactive protein（hs-CRP）and Gensini score（P<0.05）. The areas under curves（AUC）of serum MAO for diagnosing severe coronary artery lesions in elderly，middle-aged and young ACS patients were 0.867，0.843 and 0.732，respectively. Conclusions Serum MAO levels are related to the lesion vessel number and severity of coronary artery lesions in ACS patients and increase age-dependently. Its efficacy in determining the severity of coronary artery lesions in middle-aged and elderly ACS patients is higher.

Relationship between serum VCAM1，miR-181b-5p and the severity and prognosis of ARDS patients

YANG Li, WANG Jingwen, WANG Xin, ZHANG Yuexin, DUAN Dongkui

2026, 41(1):  41-46.  DOI: 10.3969/j.issn.1673-8640.2026.01.007

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Objective To investigate the relationship between the expression of serum vascular cell adhesion molecule-1 （VCAM-1） and miR-181b-5p and the severity and prognosis of acute respiratory distress syndrome （ARDS） patients. Methods A total of 128 ARDS patients from Nanyang Central Hospital from October 2020 to October 2023 were enrolled. All the patients were classified into mild group （42 cases），moderate group（50 cases）and severe group （36 cases） according to oxygenation index. The clinical data were collected，and white blood cell （WBC） count and serum VCAM-1，tumor necrosis factor-alpha（TNF-α），interleukin （IL）-6，IL^-1β and miR-181b-5p were determined. All the patients were followed up for 30 d，and the survival status of the patients was recorded. Pearson correlation analysis was used to evaluate the correlation between serum VCAM-1 and miR-181b-5p and the acute physiology and chronic health evaluationⅡ（APACHEⅡ） score，TNF-α，IL-6 and IL^-1β at admission. Logistic regression analysis was used to evaluate the influencing factors of death in ARDS patients. Receiver operating characteristic （ROC） curve was used to evaluate the efficacy of serum VCAM-1 and miR-181b-5p in predicting death in ARDS patients. Results The serum VCAM-1 levels in mild，moderate and severe groups were increased successively （P<0.001），and the relative expression levels of miR-181b-5p were decreased successively （P<0.001）. Compared with survival group，the APACHEⅡscore and serum TNF-α，IL^-1β，IL-6 and VCAM-1 levels in death group were increased （P<0.001），and the oxygenation index and the relative expression level of miR-181b-5p were decreased （P<0.001）. Serum VCAM-1 in ARDS patients was positively correlated with TNF-α，IL^-1β，IL-6 and APACHEⅡscore （r values were 0.458，0.397，0.412 and 0.527，respectively，P<0.001），and it was negatively correlated with miR-181b-5p （r=-0.389，P<0.001）. The miR-181b-5p was negatively correlated with TNF-α，IL^-1β，IL-6 and APACHEⅡscore （r values were -0.425，-0.399，-0.431 and -0.504，respectively，P<0.001）. Elevated TNF-α，IL^-1β，IL-6，VCAM-1 and decreased oxygenation index and miR-181b-5p were all risk factors for death in ARDS patients （P<0.05）. The areas under curves （AUC） of single determinations and combined determination of serum VCAM-1 and miR-181b-5p for predicting death in ARDS patients were 0.863，0.846 and 0.943，respectively. Conclusions The levels of serum VCAM-1 and the expression of miR-181b-5p are related to the severity of ARDS，and the combined determination has certain predictive value for the prognosis of patients.

Application of reticulocyte hemoglobin content in diagnosing thalassemia in children

WANG Bing, YANG Yuwei, LIU Junmei, LI Yanqiu, PENG Bi

2026, 41(1):  47-51.  DOI: 10.3969/j.issn.1673-8640.2026.01.008

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Objective To investigate the clinical application role of reticulocyte hemoglobin content（Ret-He）in children with thalassemia. Methods From March 2018 to September 2024，300 children without iron deficiency thalassemia（TT0 group）[104 cases of α-thalassemia（A0 group），188 cases of β-thalassemia（B0 group）and 8 cases of α-+β-thalassemia]，110 children with iron deficiency thalassemia （TT1 group） [40 cases of α-thalassemia（A1 group）and 70 cases of β-thalassemia（B1 group）]，90 children with iron deficiency anemia（IDA）（IDA group）and 80 healthy subjects（control group）were enrolled from the Third Hospital of Mianyang. The data on thalassemia genotypes and red blood cell（RBC）count，hemoglobin（Hb），mean corpuscular volume（MCV），mean corpuscular hemoglobin（MCH），mean corpuscular hemoglobin concentration（MCHC），the percentages of reticulocytes（RET%），Ret-He and serum ferritin（SF）determination results were collected. The differences in related indicators among the groups were compared. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of Ret-He in diagnosing thalassemia in children and differentiating thalassemia with iron deficiency. Results Among the 410 children with thalassemia，the determination rates of α-，β- and α-+β-thalassemia were 37.56%，60.49% and 1.95%，respectively，and the main types of α- and β-thalassemia were --SEA（70.78%）and CD17（35.08%），respectively. The levels of Hb，MCV，MCH，MCHC，Ret-He and SF in TT0 group，TT1 group and IDA group were lower than those in control group，while RBC count and RET% were higher than those in control group（P<0.05）. The levels of RBC count，Hb and MCHC in TT0 group and TT1 group were higher than those in IDA group，while MCV，MCH and Ret-He were lower than those in IDA group（P<0.05）. The levels of Hb，MCV，MCH and MCHC in A0 group were higher than those in B0 group and B1 group，and the levels of MCV，MCH and MCHC in A0 group were higher than those in A1 group. The levels of MCHC in A1 and B1 groups were lower than that in B0 group（P<0.05）. The optimal cut-off values of Ret-He for diagnosing thalassemia in children and differentiating IDA from thalassemia with iron deficiency were 28.1 pg and 24.4 pg，respectively，with the sensitivities of 84.9% and 80.0%，the specificities of 81.2% and 70.0%，and the areas under curves（AUC）of 0.873 and 0.744，respectively. Conclusions Ret-He can be used as a screening indicator for thalassemia in children，and it also plays a role in differentiating IDA from thalassemia with iron deficiency in children.

Clinical role of gene mutation types and MCV，MCH levels in patients with thalassemia in Pidu District of Chengdu City

ZHOU Chaoqiong, CHEN Ting, KONG Lirui, MA Chunyu

2026, 41(1):  52-57.  DOI: 10.3969/j.issn.1673-8640.2026.01.009

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Objective To analyze the genotype distribution of thalassemia in the population of Pidu District of Chengdu City，and to investigate the clinical significance of mean corpuscular volume（MCV）and mean corpuscular hemoglobin（MCH）levels in patients with different genotypes of thalassemia，in order to provide a reference for clinical consultation and the formulation of auxiliary diagnostic schemes for thalassemia. Methods A total of 1 293 patients undergoing thalassemia genotyping at the Traditional Chinese Medicine Hospital of Pidu District and the Maternal and Child Health Hospital of Chengdu Pidu District from March 2023 to August 2024 were enrolled. The thalassemia genotypes and red blood cell-related determination data were collected. The patients were classified into 3 age groups：0-18 years old，19-50 years old and >50 years old. The differences in MCV and MCH levels among the 3 groups were compared. The differences in MCV and MCH levels among patients with different genders and different types of thalassemia were compared. The auxiliary diagnostic efficacy of 3 auxiliary diagnostic criteria for thalassemia（MCV<78 fL and/or MCH<27 pg，MCV<80 fL and/or MCH<27 pg，MCV<82 fL and/or MCH<27 pg）was compared. Results Among the 1 293 patients，440 cases（34.03%）were diagnosed with thalassemia. Among them，208 cases（47.27%，with 10 genotypes）were α-thalassemia，and 225 cases（51.14%，with 13 genotypes）were β-thalassemia. Totally，7 cases（1.59%，with 5 genotypes）were α- + β-thalassemia. The MCV and MCH levels in non-thalassemia group were higher than those in thalassemia group，and those in α-thalassemia group was higher than those in β-thalassemia group. In α-thalassemia group，patients with the mutation type of --^SEA/-α^3.7 had the lowest MCV and MCH levels，while those with the mutation type of -α^3.7/αα had the highest MCV and MCH levels. In β-thalassemia group，patients with the CD43 mutation had the lowest MCV and MCH levels，and those with the βE mutation had the highest MCV and MCH levels. The MCV and MCH levels of female thalassemia patients were higher than those of male thalassemia patients（P<0.001）. The MCV and MCH levels were the lowest in 0-18 years old group and the highest in 19-50 years old group. The determination rate of the 3 auxiliary diagnostic criteria was 8.55%（33/386）. The determination rates of α-thalassemia，β-thalassemia，and α- + β-thalassemia with the 3 criteria were 63.64%，33.33% and 3.03%，respectively，and the undetermined populations were the same. The undetermined genotypes of α-thalassemia were mainly -α3.7/αα，αCS/αα and -α4.2/αα；the undetermined genotypes of β-thalassemia were mainly CD41-42，IVS-Ⅱ-654 and CD17；the undetermined genotypes of α- + β-thalassemia were CD41-42 combined with -α3.7/αα（100%）. The undetermined rate for male thalassemia patients was 21.21%，and that for female thalassemia patients was 78.79%. The determination rate was the highest in 19-50 years old group（60.61%）and the lowest in >50 years old group（3.03%）. Conclusions The thalassemia genotypes in Pixu District of Chengdu City are diverse，and β-thalassemia is slightly more common than α-thalassemia. Gender，age and genotypes all affect the MCV and MCH levels of thalassemia patients，and quiescent-type α-thalassemia，19-50-year-old patients are more likely to be missed.

Etiological characteristics and prognostic risk factors of fungal bloodstream infections

YOU Xinglan, DING Hui, MA Danqing, CHEN Jing, DONG Zesong, HU Xiaolei

2026, 41(1):  58-62.  DOI: 10.3969/j.issn.1673-8640.2026.01.010

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Objective To analyze the etiological characteristics and prognostic risk factors of patients with fungal bloodstream infections，and to provide a reference for clinical prognosis assessment. Methods A total of 112 patients with fungal bloodstream infections from Lishui Central Hospital from January 2019 to December 2023 were enrolled. According to the survival status for 28 d after the occurrence of fungal bloodstream infection，they were classified into survival group and death group. The clinical data，types of fungi and results of in vitro drug susceptibility tests were collected. The differences in various indicators between survival group and death group were compared. Multivariate Logistic regression analysis was used to evaluate the risk factors affecting the prognosis of patients with fungal bloodstream infections. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of each risk factor in predicting patient mortality. Results A total of 182 fungi were isolated. The top 3 fungal species were Candida albicans（82 isolates，45.1%），Candida tropicalis（33 isolates，18.1%）and Candida glabrata（23 isolates，12.6%）. Among the 112 patients with fungal bloodstream infections，50 patients died，with a mortality rate of 44.6%. The patients were mainly distributed in the intensive care unit（46 cases，41.1%），hematology department（13 cases，11.6%），oncology department（9 cases，8.0%）and neurosurgery department（8 cases，7.1%）. Cardiovascular system diseases，no surgical operation and elevated DD，decreased PLT count were risk factors for death in patients with fungal bloodstream infection [odds ratios （OR） were 3.59，0.11，0.98 and 1.09，95% confidence intervals （CI） were 1.01-12.70，0.02-0.56，0.97-0.99 and 0.99-1.18，respectively，P<0.05]. The areas under curves（AUC）for PLT count and DD in predicting mortality were 0.755 and 0.739，respectively. Conclusions The pathogenic fungi of fungal bloodstream infections in Lishui Central Hospital are mainly Candida albicans. PLT count and DD have predictive value for the prognosis of patients.

Role of PCT，DD，Lac and Alb combined with clinical scores in progression assessment of sepsis

HU Mingxi, GONG Qian, LI Mu, PENG Rong

2026, 41(1):  63-68.  DOI: 10.3969/j.issn.1673-8640.2026.01.011

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Objective To investigate the roles of D-dimer（DD），lactic acid（Lac），albumin（Alb），procalcitonin（PCT）combined with clinical scores [acute physiology and chronic health evaluationⅡ（APACHEⅡ）and sequential organ failure assessment（SOFA）scores] in the diagnosis and progression assessment of sepsis. Methods Totally，113 patients with sepsis and 87 patients with septic shock in the Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University from January to December 2023 were enrolled. The clinical data were collected，and the levels of PCT，DD，Lac and Alb were determined. According to the PCT determination results，the patients were classified into PCT 2-10 ng·mL^-1 group（95 cases），PCT 10-30 ng·mL^-1 group（51 cases），PCT 30-100 ng·mL^-1 group（32 cases）and PCT >100 ng·mL^-1 group（22 cases）. Multivariate Logistic regression analysis was used to evaluate the influencing factors of septic shock. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of single and combined determinations of each index in diagnosing septic shock. Results The levels of PCT，DD，Lac，SOFA score and APACHEⅡscore in septic shock group were higher than those in sepsis group（P<0.05），while the level of Alb was lower than that in sepsis group（P<0.05）. There was statistical significance in the levels of DD among different PCT levels in each group（P<0.001），and the level of DD was the highest in PCT 10-30 ng·mL^-1 group. The levels of Lac and SOFA score were increased successively in PCT 2-10 ng·mL^-1 group，PCT 10-30 ng·mL^-1 group，PCT 30-100 ng·mL^-1 group and PCT >100 ng·mL^-1 group（P<0.05），while the levels of Alb were decreased successively（P<0.05）. There was no statistical significance in APACHEⅡscore among different PCT levels in each group（P>0.05）. Increased Lac，SOFA score and APACHEⅡscore were risk factors for septic shock [odds ratios（OR）were 1.166，2.311 and 1.266，95% confidence intervals（CI） were 0.988-1.419，1.708-3.333 and 1.010-1.601，respectively，P<0.05）. The areas under curves（AUC） of single and combined determinations of PCT，DD，Lac，Alb，APACHEⅡscore and SOFA score for diagnosing septic shock were 0.613，0.622，0.690，0.572，0.791，0.809 and 0.867，respectively. Conclusions PCT，DD，Lac，Alb，APACHEⅡscore and SOFA score are related to the condition of patients with sepsis，and the combined determination is helpful for the early diagnosis of septic shock.

Application value of fecal calprotectin in disease status assessment and treatment efficiency monitoring of inflammatory bowel disease in children

ZHOU Jie, XU Jin, WU Ziwen, WU Yizhou, HUANG Zhiheng

2026, 41(1):  69-72.  DOI: 10.3969/j.issn.1673-8640.2026.01.012

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Objective To investigate the application role of fecal calprotectin（FC）in the disease status assessment and treatment efficiency monitoring of children with inflammatory bowel disease（IBD）. Methods From March 2021 to December 2024，118 children with IBD（IBD group）and 35 healthy subjects（healthy control group） were enrolled from the Children's Hospital of Fudan University. The FC levels were determined. According to the simple endoscopic score for Crohn's disease（SES-CD）and ulcerative colitis Mayo score（UCMS），the subjects were classified into remission group（32 cases），mild active group（45 cases），moderate active group（75 cases）and severe active group（84 cases）. The follow-up was compared with the colonoscopy results before and after treatment. According to whether the disease activity was reduced，they were classified into activity reduction group（53 cases）and activity non-reduction group（65 cases）. Spearman correlation analysis was used to evaluate the correlation between FC level and colonoscopy results. Results The FC level of IBD group was higher than that of healthy control group（P<0.05）. The FC level was positively correlated with the degree of disease activity（r=0.572，P<0.05）. The FC levels of remission group，mild active group，moderate active group and severe active group were gradually increased（P<0.05）. The FC level after treatment in activity reduction group was lower than that before treatment（P<0.05）. Conclusions The FC level of IBD children is high，and the FC level is correlated with colonoscopy results，which is beneficial for the disease status assessment and treatment efficiency monitoring of children with inflammatory bowel disease and has good clinical application value.

Influence of IgM-type M protein on determination results of apolipoprotein and lipoprotein and corrective measures

FAN Jiabao, ZHAO Meng, WU Xiaoling, XU Tao, ZHU Zhengqi, CHEN Mingliang, ZHAO Zhen

2026, 41(1):  73-77.  DOI: 10.3969/j.issn.1673-8640.2026.01.013

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Objective To evaluate the correction effects of pre-dilution method and polyethylene glycol（PEG） precipitation method on the interference of IgM-type M protein in serum on the determination results of apolipoproteins（apo） and lipoproteins. Methods The effects of pre-dilution method and PEG precipitation method on the determination results of apo A1，apo B，apo E，high-density lipoprotein cholesterol（HDL-C） and low-density lipoprotein cholesterol（LDL-C） in control serum samples were evaluated. The appropriate pre-dilution ratios and PEG6000 solution concentrations were screened，and their correction effects on the interference of M protein on the determination results of apo A1，apo B，apo E，HDL-C and LDL-C were evaluated. Results When the pre-dilution ratio was 1︰1，the determination results of apo A1，apo B，apo E，HDL-C and LDL-C in control serum samples were all within the allowable error range of internal quality control. When the PEG6000 solution concentrations were 2%，4% and 8%，the determination results of apo A1，apo B，apo E，HDL-C and LDL-C in control serum samples were all within the allowable error range. The consistency of the determination results of apo A1，apo B and apo E in 3 M protein-positive serum samples was poor at each dilution ratio of the pre-dilution method，but the determination results of HDL-C and LDL-C had good consistency. When the PEG6000 solution concentration was 8% in 3 M protein serum samples， the determination results were reliable. Conclusions The pre-dilution method can not eliminate the interference of M protein. The 8% PEG6000 solution can eliminate the interference of M protein on the determination results of apo A1，apo B，apo E，HDL-C and LDL-C，and it has no significant interference effect on the determination results of the same items in control serum samples，which is suitable for clinical promotion and application.

Application of metagenomic next-generation sequencing in diagnosing pulmonary infections in renal transplant patients

WANG Nan, YANG Zhenzhen, XIE Xin, WANG Hui, WANG Ping, SONG Yinsen

2026, 41(1):  78-83.  DOI: 10.3969/j.issn.1673-8640.2026.01.015

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Objective To investigate the diagnostic value of metagenomic next-generation sequencing （mNGS） in determining pathogens in bronchoalveolar lavage fluid （BALF） of renal transplant patients for pulmonary infections. Methods Totally，50 patients with pulmonary infections after renal transplantation from Zhengzhou People's Hospital from July 2020 to October 2023 were enrolled. The clinical data were collected.The BALF samples were collected，and mNGS and conventional methods were used to determine pathogens simultaneously. The consistency of the determination results of the 2 methods was analyzed. The diagnostic value of mNGS for bacterial，fungal，viral and mixed infections was evaluated. Results A total of 59 pathogens were determined in the BALF samples of 50 patients. Among them，mNGS determined 56 pathogens，while the conventional method determined 22 pathogens. The determination rate of pathogens by mNGS（98.0%）was higher than that by the conventional method（60.0%）（P<0.001）. The consistency rate of the determination results of the 2 methods was 62.0%，and the consistency was poor（Kappa=0.059）. The positive determination rates of bacteria，fungi and viruses by mNGS were 74.0%，62.0% and 86.0%，respectively，which were higher than those by the conventional method（the positive determination rates were 32.0%，16.0% and 36.0%，respectively）（P<0.05）. The determination rate of mixed infections by mNGS（86.0%）was also higher than that by the conventional method（24.0%）（P<0.001）. Moreover，the combined determination rate of mNGS and conventional method for mixed infections was 91.84%. Conclusions The mNGS can increase the determination rate of pathogens in BALF samples of renal transplant patients with pulmonary infections. The mNGS combined with conventional methods has advantages in the diagnosis of mixed infections and can provide a reference for early and precise identification of pathogens.

Research progress of CCCTC-binding factor in central nervous system diseases

GAO Shuo, WANG Peichang, HOU Yuli

2026, 41(1):  95-100.  DOI: 10.3969/j.issn.1673-8640.2026.01.017

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CCCTC-binding factor （CTCF） is a ubiquitous transcription factor expressed in organisms，containing a special 11-zinc finger structure that can bind to DNA sequences or proteins，and participates in the regulation of gene expression. As a central regulator of chromatin topology，CTCF is involved in regulating neuronal cell differentiation，neuroinflammation and synaptic function，and is related to Alzheimer's disease（AD），Parkinson's disease（PD）and glioma. This review focuses on the role of CTCF in central nervous system diseases，in order to understand the pathogenesis of central nervous system diseases and provide potential clinical therapeutic targets.