Table of Content

30 July 2026, Volume 41 Issue 7

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Role of aqueous humor matrix metalloproteinase-3 in the differential diagnosis of glaucoma subtypes

DING Xueqing, LIU Yu, TENG Jisen, CAO Wenjun, KONG Xiangmei, WANG Zhujian

2026, 41(7):  621-624.  DOI: 10.3969/j.issn.1673-8640.2026.07.001

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Objective To investigate the differences in aqueous humor matrix metalloproteinase（MMP）-3 levels among different subtypes of glaucoma patients and its value in the differential diagnosis of primary open-angle glaucoma（POAG）and Posner-Schlossman syndrome（PSS）. Methods A total of 100 glaucoma patients from Eye & ENT Hospital of Fudan University from January 2024 to June 2025 were enrolled，including 37 cases of PSS（PSS group），32 cases of POAG（POAG group） and 31 cases of angle-closure glaucoma （ACG）（ACG group），with 25 cases of age-related cataract（ARC）as control group. The intraocular pressure and aqueous humor MMP-3 levels were determined. Spearman correlation analysis was used to evaluate the correlation between aqueous humor MMP-3 levels and intraocular pressure. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of aqueous humor MMP-3 in differentiating PSS and POAG. Results The aqueous humor MMP-3 levels in PSS group and ACG group were higher than those in control group and POAG group（P<0.000 1），and there was no statistical significance between PSS group and ACG group（P>0.05）. There was no correlation between aqueous humor MMP-3 levels and intraocular pressure in PSS group，POAG group and ACG group（r values were -0.125，0.271 and 0.180，respectively，P>0.05）. The area under curve（AUC）for aqueous humor MMP-3 in differentiating PSS and POAG was 0.821. Conclusions Aqueous humor MMP-3 can be a biomarker for differentiating PSS and POAG.

Influence of serum levels of YKL-40，NGAL and SOCS1 in patients with multidrug-resistant tuberculosis after treatment on the conversion of sputum bacteria to negative state

GUO Meifeng, NI Leilei, ZHANG Xinyuan, WANG Guiqin, LI Jihan

2026, 41(7):  625-630.  DOI: 10.3969/j.issn.1673-8640.2026.07.002

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Objective To investigate the influence of serum chitinase protein 40（YKL-40），neutrophil gelatinase-associated lipocalin（NGAL）and suppressor of cytokine signaling 1（SOCS1）levels on sputum bacterial negativity after treatment in patients with multidrug-resistant tuberculosis（MDR-TB）. Methods A total of 149 MDR-TB patients from the Third Hospital of Cangzhou from March 2022 to February 2024 were enrolled. The clinical data were collected，and serum YKL-40，NGAL and SOCS1 levels were determined before and 1 month after treatment. According to the sputum culture results after 6 months of treatment，the patients were classified into sputum bacterial negativity group and non-sputum bacterial negativity group. The differences in serum levels of YKL-40，NGAL and SOCS1 in MDR-TB patients were compared before and after treatment. The differences in clinical data between sputum bacterial negativity group and non-sputum bacterial negativity group were compared. Multivariate Logistic regression analysis was used to evaluate the influencing factors of sputum bacterial negativity after MDR-TB treatment. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of serum YKL-40，NGAL and SOCS1 in judging sputum bacterial negativity after MDR-TB treatment. Results After treatment，the serum levels of YKL-40 and NGAL in MDR-TB patients were lower than those before treatment （P<0.001），while the level of SOCS1 was higher than that before treatment （P<0.001）. Serum YKL-40 and NGAL levels in sputum bacterial negativity group and non-sputum bacterial negativity group before treatment showed no statistical significance（P>0.05）. After treatment，serum YKL-40 and NGAL levels in sputum bacterial negativity group were lower than those in non-sputum bacterial negativity group（P<0.001），and serum SOCS1 levels were higher than those in non-sputum bacterial negativity group（P<0.001）. The number of drug resistance drugs and diabetes history and the proportion of retreated cases in sputum bacterial negativity group were lower than those in non-sputum bacterial negativity group（P<0.05），while other clinical data showed no statistical significance between the 2 groups（P>0.05）. Elevated serum YKL-40，NGAL and decreased SOCS1 were risk factors for non-sputum bacterial negativity after MDR-TB treatment（P<0.05）. The areas under curves（AUC）of single and combined determinations of serum YKL-40，NGAL and SOCS1 for judging sputum bacterial negativity after MDR-TB treatment were 0.834，0.866，0.845 and 0.954，respectively. Conclusions Serum YKL-40 and NGAL decrease，and SOCS1 increases in MDR-TB patients after treatment，which are related to sputum bacterial negativity. The combined determination of the 3 indicators has certain value in the assessment of sputum bacterial negativity after MDR-TB treatment.

Distribution and in vitro drug susceptibility test of Nocardia in Xi'an

YANG Peihong, ZHOU Shan, KANG Beipei, YANG Yuqi, LIU Hao, ZHOU Ke

2026, 41(7):  631-636.  DOI: 10.3969/j.issn.1673-8640.2026.07.003

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Objective To understand the distribution of Nocardia in Xi'an and evaluate the differences between different in vitro drug susceptibility test methods，and to provide a reference for rational clinical drug use. Methods Totally，37 non-repetitive Nocardia isolates were collected from Xijing Hospital of Air Force Military Medical University from January 2015 to December 2023，and they were identified by mass spectrometry and confirmed by 16S rRNA gene sequencing. In vitro drug susceptibility test was performed by broth microdilution method and E test. Based on the results of broth microdilution method，the error rate of E test results was analyzed. Results The sequencing identification results of the 37 Nocardia isolates were as follows：10 isolates of Nocardia georgiana，5 isolates of Nocardia abscessus，4 isolates of Nocardia asteroides，Nocardia farcinica and Nocardia brasiliensis，3 isolates of Nocardia beijingensis，Nocardia caviae and Nocardia nova，and 1 isolate of Nocardia asiatica. No resistant isolates to linezolid and amikacin was found. The drug resistance rate to compound sulfamethoxazole was 2.70%，the drug resistance rates to imipenem，amoxicillin-clavulanic acid，ceftriaxone，tobramycin and minocycline were <22.00%，and the drug resistance rates to clarithromycin and ciprofloxacin were 51.35%-64.86%. Using broth microdilution method as reference method，the very major error（VME）rates of E test for minocycline，imipenem，tobramycin，doxycycline，amoxicillin-clavulanic acid，clarithromycin and moxifloxacin were 9.09%-100.00%. The major error（ME）rates for clarithromycin，amoxicillin-clavulanic acid and compound sulfamethoxazole were 25.00%，3.13% and 2.78%，respectively. Conclusions In Xi'an，Nocardia georgiana is the most common species isolated in clinical practice. Nocardia has a relatively high drug resistance rate to clarithromycin and ciprofloxacin，while linezolid，amikacin and compound sulfamethoxazole have good antibacterial activity against it. E test method has a higher VME and ME rates，and is not recommended for routine clinical use.

In vitro antibacterial activity of sulbactam/durlobactam and eravacycline against Acinetobacter

GAO Hongzhi, CAO Jinnan, HUANG Shenglei, ZHOU Chunmei, ZHOU Jiaye, WANG Beili, PAN Baishen, GUO Wei

2026, 41(7):  637-642.  DOI: 10.3969/j.issn.1673-8640.2026.07.004

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Objective To evaluate the in vitro antibacterial activity of sulbactam/durlobactam（SUL/DUR）and eravacycline（ERV）against Acinetobacter. Methods A total of 124 Acinetobacter isolates isolated from clinical specimens at Zhongshan Hospital of Fudan University from February to March 2025 were collected. The species were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The in vitro drug susceptibility was determined by automated bacterial susceptibility testing system. The minimum inhibitory concentrations（MIC）of conventional antibacterial agents for Acinetobacter baumannii（AB）were determined by broth microdilution and disk diffusion methods. The drug resistance genotypes of SUL/DUR-resistant Acinetobacter were determined by immunochromatography. Fourier transform infrared spectroscopy was used for homology analysis of SUL/DUR non-susceptible Acinetobacter. Hierarchical cluster analysis was performed using the unweighted group average method model，and a dendrogram was generated. Results The 84 of 124 Acinetobacter isolates were AB. The drug resistance rates of 84 AB isolates to tigecycline（TGC），ERV，colistin（COL）and SUL/DUR were 2.38%，3.57%，3.57% and 16.67%，respectively. Among the 16 SUL/DUR non-sensitive AB isolates，12 of them were bla_NDM-producing beta-lactamases. The isolation rate of carbapenem-resistant Acinetobacter baumannii（CRAB）was 97.61%（82/84）. The drug resistance rates of 40 other Acinetobacter species to TGC，ERV，COL and SUL/DUR were 0，0，2.5% and 2.5%，respectively. Additionally，the MIC₅₀ and MIC₉₀ of SUL/DUR against AB were 2 and 64 μg·mL^-1，respectively，and those of ERV were 0.25 and 0.50 μg·mL^-1，respectively. The MIC₅₀ and MIC₉₀ of SUL/DUR against other Acinetobacter species were 1 and 4 μg·mL^-1，respectively，and those of ERV were 0.32 and 0.64 μg·mL^-1，respectively. Conclusions SUL/DUR and ERV have good in vitro antibacterial activity against Acinetobacter.

Prognostic value of the ratio of neutrophil-to-high-density lipoprotein cholesterol ratio in patients with heart failure with reduced ejection fraction

GAO Yuting, HOU Ze, ZHANG Yuxin, WANG Mengwei, LIAN Entao, WANG Xinyi, YE Yingnan, JIA Kegang

2026, 41(7):  643-649.  DOI: 10.3969/j.issn.1673-8640.2026.07.005

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Objective To investigate the value of neutrophil-to-high-density lipoprotein cholesterol ratio（NHR）in the prognosis assessment of patients with heart failure with reduced ejection fraction（HFrEF）. Methods A total of 284 HFrEF patients from TEDA International Cardiovascular Hospital from January 2021 to January 2023 were enrolled. The clinical data were collected，and blood routine test，biochemical indicators and echocardiography were determined and performed. NHR，lymphocyte-to-monocyte ratio（LMR）and high-density lipoprotein cholesterol-to-C-reactive protein ratio（HCR）were calculated. All the patients were followed up for 12 months，and the occurrence of major adverse cardiovascular events（MACE）such as cardiogenic death and rehospitalization due to heart failure was recorded. All the patients were classified into non-MACE group（167 cases）and MACE group（117 cases）. Cox regression analysis was used to evaluate the influencing factors of MACE in HFrEF patients. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of NHR in predicting the prognosis of HFrEF patients. Kaplan-Meier survival curve was used to analyze the occurrence of MACE in HFrEF patients. Results The B-type natriuretic peptide（BNP）and NHR in MACE group were higher than those in non-MACE group（P<0.001）. NHR，BNP，left atrial end-diastolic diameter（LAEDD）and low-density lipoprotein cholesterol（LDL-C）elevation and low-density lipoprotein cholesterol（LDL-C）reduction were all risk factors for MACE in HFrEF patients（P<0.05）. The areas under curves（AUC）of NHR，BNP，LAEDD and LDL-C single determinations and NHR + BNP combined determination for predicting MACE in HFrEF patients were 0.686，0.741，0.632，0.596 and 0.756，respectively. The optimal cut-off values of NHR and BNP according to the ROC curve were divided into high，low NHR groups（128 and 156 cases，respectively）and high，low BNP groups（135 and 120 cases，respectively）. The time of MACE occurrence in high NHR group and high BNP group was shorter than that in low NHR group and low BNP group（P<0.001）. The risk of MACE in high NHR group was 2.347 times higher than that in low NHR group [hazard ratio（HR）=2.347，95% confidence interval（CI）1.614-3.413，P<0.001]，and the risk of MACE in high BNP group was 3.443 times higher than that in low BNP group（HR=3.443，95%CI 2.226-5.327，P<0.001）. Conclusions NHR plays a role in the assessment of MACE in HFrEF patients，and the combined determination with BNP can improve the predictive efficacy.

Correlation between serum SOST，CHI3L1 and CYR61 levels and bone metabolism in patients with hyperthyroidism

ZHANG Xue, LI Yue, CHE Yongjun, ZHOU Xiaohong

2026, 41(7):  650-656.  DOI: 10.3969/j.issn.1673-8640.2026.07.006

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Objective To investigate the clinical value of serum sclerostin（SOST），chitinase-3-like protein 1（CHI3L1）and cysteine-rich protein 61（CYR61）levels in patients with hyperthyroidism（HT）secondary to osteoporosis（OP）. Methods A total of 162 HT patients（HT group）and 162 healthy subjects（healthy control group）were enrolled from Handan Central Hospital from January 2022 to July 2024. Based on bone density measurements，HT patients were classified into 3 groups：normal bone mass（55 cases），low bone mass（50 cases）and OP（57 cases）. The clinical data，thyroid function indicators and lipid profiles were collected. Serum SOST，CHI3L1，CYR61 levels and bone metabolism markers，including 25-hydroxyvitamin D [25（OH）D]，parathyroid hormone （PTH），type Ⅰ procollagen N-terminal propeptide（P1NP），beta-collagen crosslaps（β-CTX）and bone-derived alkaline phosphatase（B-ALP），were determined. Pearson correlation analysis was used to assess the correlations between serum SOST，CHI3L1，CYR61 levels and bone metabolism markers. Multivariate Logistic regression analysis was performed to identify risk factors for OP in HT patients. Receiver operating characteristic（ROC）curves were used to evaluate the diagnostic performance of each marker for HT secondary to OP. Results Compared with healthy control group，the HT group showed higher serum levels of SOST，CYR61，blood phosphorus，calcium，PTH，B-ALP，P1NP and β-CTX（P<0.001），and lower levels of CHI3L1 and 25（OH）D（P<0.001）. Blood phosphorus，calcium，PTH，B-ALP，P1NP and β-CTX were positively correlated with serum SOST and CYR61（P<0.05）but negatively correlated with CHI3L1（P<0.05）. 25（OH）D was negatively correlated with SOST and CYR61（P<0.05），but positively correlated with CHI3L1（P<0.05）. Serum levels of SOST，CYR61，blood phosphorus，calcium，PTH，B-ALP，P1NP，β-CTX，free triiodothyronine（FT₃），free thyroxine（FT₄）and thyrotropin receptor antibody（TRAb）increased in turn among normal bone mass，low bone mass and OP groups（P<0.001），while CHI3L1 and 25（OH）D levels decreased in turn（P<0.001）. No statistical significance were observed among the 3 groups regarding other clinical parameters（P>0.05）. After adjusting for FT₃，FT₄ and TRAb，increased SOST and CYR61 levels and decreased CHI3L1 level were independent risk factors for OP in HT patients（P<0.01）. The areas under curves（AUC）for single and combined determinations of serum SOST，CHI3L1 and CYR61 in diagnosing HT secondary to OP were 0.826，0.831，0.805 and 0.961，respectively. Conclusions Serum levels of SOST，CHI3L1 and CYR61 are correlated with bone metabolism markers in HT patients，and their combined determination offers high diagnostic efficacy for HT secondary to OP.

Role of combined determination of AVDL and LOI in short-term prognosis assessment of ACI patients

YE Kai, QUAN Heng, NIU Ziguang, LI Yanning, XIA Dongge, WENG Yiyi, ZHANG Lei

2026, 41(7):  657-663.  DOI: 10.3969/j.issn.1673-8640.2026.07.007

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Objective To investigate the role of combined determination of arteriovenous difference of lactate（AVDL）and lactic acid oxygenation index （LOI） in the short-term prognosis assessment of patients with acute cerebral infarction（ACI）. Methods A total of 500 patients with ACI from the Affiliated Brain Hospital of Nanjing Medical University from July 2023 to June 2025 were enrolled. The clinical data were collected，and arterial and venous blood lactic acid levels，arterial blood oxygen saturation and internal jugular venous blood oxygen saturation were determined. AVDL and LOI were calculated. All the patients were followed up for 28 d after discharge，and the short-term prognosis was evaluated using the modified Rankin scale （mRS），and they were classified into poor prognosis group（mRS score 3-6，136 cases）and good prognosis group（mRS score 0-2，364 cases）. Pearson correlation analysis was used to evaluate the correlation between AVDL，LOI and the National Institutes of Health Stroke Scale（NIHSS）score within 24 h after admission. Binary Logistic regression analysis was used to evaluate the risk factors for poor prognosis in ACI patients. The efficacy of single and combined determination models for judging poor prognosis in ACI patients was evaluated using receiver operating characteristic （ROC） curve. Results The volume of cerebral infarction，D-dimer（DD），stenosis degree of the responsible vessel and admission NIHSS score were higher in poor prognosis group than in good prognosis group （P<0.05），and the absolute values of AVDL and LOI were higher in poor prognosis group than those in good prognosis group（P<0.05）. AVDL，LOI and admission NIHSS score were negatively correlated（r values were -0.105 and -0.098，P<0.05）. Large cerebral infarction volume，high DD，high stenosis degree of the responsible vessel，large negative value of AVDL，large negative value of LOI and high admission NIHSS score were all risk factors for poor prognosis in ACI patients（P<0.05）. Based on the above 6 risk factors，a combined determination model for judging poor prognosis in ACI patients was constructed using Logistic regression analysis. The areas under curves（AUC）of single and combined determination models of cerebral infarction volume，DD，stenosis degree of the responsible vessel，AVDL，LOI and admission NIHSS score，as well as the combined model without AVDL and LOI，for judging poor prognosis in ACI patients were 0.916，0.749，0.815，0.797，0.675，0.738，0.959 and 0.935，respectively. Conclusions AVDL and LOI are related to the degree of neurological dysfunction in ACI patients. The combined determination model constructed based on cerebral infarction volume，DD，stenosis degree of the responsible vessel，AVDL，LOI and admission NIHSS score has high clinical value in the short-term prognosis assessment of ACI patients.

Relationship between serum 25-hydroxyvitamin D，creatinine/cystatin C ratio and sarcopenia in elderly patients with type 2 diabetes mellitus

JIANG Yongli, LI Aihua, SHENG Chenglan

2026, 41(7):  664-669.  DOI: 10.3969/j.issn.1673-8640.2026.07.008

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Objective To investigate the clinical value of serum 25-hydroxyvitamin D [25（OH）D] and the ratio of creatinine（Cr）/cystatin C（Cys C）in elderly type 2 diabetes mellitus（T2DM）patients with sarcopenia. Methods A total of 202 elderly T2DM patients from Pudong New Area Geriatric Hospital from January to December 2024 were enrolled. All the patients were classified into sarcopenia group（50 cases）and non-sarcopenia group（152 cases）. The clinical data were collected，and fasting blood glucose，glycated hemoglobin A_1c（HbA_1c），insulin，blood lipids，Cr，25（OH）D and Cys C were determined. The Cr/Cys C ratio，homeostasis model assessment of insulin resistance（HOMA-IR）and estimated glomerular filtration rate（eGFR）were calculated. Logistic regression analysis was used to evaluate the influencing factors of sarcopenia in elderly T2DM patients. The correlations of 25（OH）D，Cr/Cys C ratio and HOMA-IR，eGFR were evaluated by bivariate Pearson correlation analysis. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of each indicator in diagnosing sarcopenia in elderly T2DM patients. Results The disease duration of T2DM，HbA_1c and HOMA-IR in sarcopenia group were higher than those in non-sarcopenia group（P<0.05），while serum 25（OH）D，Cr/Cys C ratio and eGFR were lower than those in non-sarcopenia group（P<0.05）. There was no statistical significance in the other data between the 2 groups（P>0.05）. After adjusting for confounding factors（types of hypoglycemic drugs，HOMA-IR，eGFR），long disease duration of T2DM，elevated HbA_1c and decreased 25（OH）D and Cr/Cys C ratio were all risk factors for sarcopenia in elderly T2DM patients（P<0.05）. Serum 25（OH）D，Cr/Cys C ratio were negatively correlated with HOMA-IR（r values were -0.198 and -0.203，P<0.01），and they were positively correlated with eGFR （r values were 0.196 and 0.185，P<0.01）. The combined determination model was established based on T2DM disease duration，HbA_1c，25（OH）D and Cr/Cys C ratio. The areas under curves（AUC）of serum 25（OH）D， Cr/Cys C ratio and the combined determination model for the diagnosis of sarcopenia in elderly T2DM patients were 0.704，0.735 and 0.841，respectively. Conclusions Decreased serum 25（OH）D and Cr/Cys C ratio are correlated with sarcopenia in elderly T2DM patients，and they may be screening indicators for sarcopenia in elderly T2DM patients.

Correlation between MTHFR gene C677T polymorphism，Hcy，one-carbon metabolism related B vitamins and gestational diabetes mellitus

WANG Qiang, LU Loukaiyi, LUO Xufan, CHEN Yisheng

2026, 41(7):  670-675.  DOI: 10.3969/j.issn.1673-8640.2026.07.009

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Objective To investigate the correlation between the C677T polymorphism of methylene tetrahydrofolate reductase（MTHFR） gene，homocysteine（Hcy） and one-carbon metabolism related B vitamins [vitamin B₆（Vit B₆），vitamin B₉（folic acid） and vitamin B₁₂（Vit B₁₂）] and gestational diabetes mellitus（GDM）. Methods A total of 651 pregnant women who conceived naturally at the Obstetrics and Gynecology Hospital of Fudan University from January 2023 to January 2024 were enrolled and classified into GDM group（92 cases） and control group（559 cases） based on whether they were diagnosed with GDM. The C677T polymorphism of MTHFR gene and Hcy，Vit B₆，folic acid and Vit B₁₂ levels were determined. Binary multivariate Logistic regression analysis was used to evaluate the risk factors for the occurrence of GDM. Results The proportions of C677T CT and TT genotypes and the T allele in GDM group were higher than those in control group（P<0.05）. The serum Hcy and folic acid levels in GDM group were higher than those in control group（P<0.05）. The serum Hcy level in TT genotype pregnant women in GDM group was higher than those in CC and CT genotype pregnant women（P<0.05），and there was no statistical significance in serum Hcy levels between CC and CT genotype pregnant women（P>0.05）. The serum Hcy level in CC genotype pregnant women in control group was lower than those in CT and TT genotype pregnant women（P<0.001），and there was no statistical significance in serum Hcy levels between CT and TT genotype pregnant women（P>0.05）. Elevated Hcy and folic acid were independent risk factors for the occurrence of GDM [odds ratios（OR） were 1.293 and 1.160，95% confidence intervals（CI） were 1.014-1.649 and 1.041-1.294，respectively，P<0.05]. Conclusions Serum Hcy and folic acid levels affected by the C677T polymorphism of MTHFR gene are related to the occurrence of GDM. The determination of the MTHFR gene C677T polymorphism is helpful for the prevention and management of GDM.

Role of lycorine in regulating NF-κB pathway to inhibit TNF-α-induced intestinal epithelial cell damage possibly

CHENG Yang, FENG Yiming, JIN Shu, CAI Xiaoyao, HU Yiwen, YAN Peiyi

2026, 41(7):  676-684.  DOI: 10.3969/j.issn.1673-8640.2026.07.010

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Objective To investigate the mechanism by which lycorine（Lyc） regulates nuclear factor-kappa B（NF-κB） pathway and inhibits tumor necrosis factor-alpha（TNF-α）-induced intestinal epithelial cell damage. Methods Human colorectal adenocarcinoma cell line Caco2 and human normal intestinal epithelial cell line NCM460 were selected. They were classified into control group（no treatment），Lyc group（treated with Lyc only），TNF-α group（treated with TNF-α only） and TNF-α+Lyc group（treated with TNF-α first and then Lyc）. The effects of different concentrations of TNF-α and Lyc on the viability of Caco2 cells and NCM460 cells were evaluated by CCK-8 assay to determine the appropriate experimental concentrations. The expressions of interleukin（IL）-6，inducible nitric oxide synthase（iNOS），cyclooxygenase-2（COX-2）and IL-1β in each group were determined by real-time fluorescence quantitative polymerase chain reaction. The expressions of zonula occludens-1（ZO-1），occludin（OCLN） and claudin-1（CLDN-1） in each group were determined by immunofluorescence and immunoblotting. The apoptosis of cells was determined by Calcein/PI staining. The expressions of Bax protein，Bcl2 protein and inhibitor of kappa B alpha（IκBα），phosphorylated inhibitor of kappa B alpha（p-IκBα），phosphorylated nuclear factor-kappa B p65（p-NF-κB p65）in each group were determined by immunoblotting. Results Compared with control group and Lyc group，the relative expression levels of IL-6 mRNA，iNOS mRNA，COX2 mRNA and IL-1β mRNA in TNF-α group were increased（P<0.05），and the protein expression levels of ZO-1，OCLN and CLDN-1 were decreased（P<0.05）. Compared with TNF-α group，the relative expression levels of IL-6 mRNA，iNOS mRNA，COX2 mRNA and IL-1β mRNA in TNF-α+Lyc group were decreased（P<0.05），and the protein expression levels of ZO-1，OCLN and CLDN-1 were increased（P<0.05）. The number of PI-positive cells in TNF-α group was higher than that in control group（P<0.05），and the number of PI-positive cells in TNF-α+Lyc group was lower than that in TNF-α group（P<0.05），but still higher than that in control group（P<0.05）. The expression of Bax protein in TNF-α group was higher than those in control group and Lyc group（P<0.05），and the expression of Bcl2 protein was lower than those in control and Lyc group（P<0.05）. The expression of Bax protein in TNF-α+Lyc group was lower than that in TNF-α group（P<0.05），and the expression of Bcl2 protein was higher than that in TNF-α group（P<0.05）. The p-IκBα/IκBα ratio and p-NF-κB/NF-κB ratio in TNF-α group were higher than those in control group（P<0.05）. The ratios of p-IκBα/IκBα and p-NF-κB/NF-κB in TNF-α+Lyc group were lower than those in TNF-α group（P<0.05），but still higher than those in control group（P<0.05）. Conclusions Lyc may inhibit TNF-α-induced intestinal epithelial cell damage by regulating NF-κB pathway.

Establishment of a predictive model for initially treated tuberculosis with negative pathogen results based on multi-center laboratory data

PENG Rong, LI Mu, GONG Qian, WANG Fang, DENG Yanyan, WANG Xiaotong, TAN Meiyu, LIN Jianmin

2026, 41(7):  685-690.  DOI: 10.3969/j.issn.1673-8640.2026.07.011

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Objective To establish a tuberculosis（TB）predictive model based on the multi-center laboratory data of patients with pathogen-negative initially treated TB and conduct validation，and to provide a new auxiliary tool for the diagnosis of pathogen-negative TB. Methods Totally，101 patients with pathogen-negative initially treated TB（disease group）from Qingpu Branch of Zhongshan Hospital of Fudan University from January 2020 to December 2024 were enrolled. They were matched with 303 patients with pneumonia or pulmonary infection（control group）at a ratio of 1︰3. The data of about 2/3 of the cases in disease group and control group were randomly selected as modeling set，and the remaining data were used as validation set. The data from 56 TB cases from Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Tongren Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were provided，including 31 cases in disease group and 25 cases in control group，all of which were used as validation data. General information and laboratory determination data of all the study subjects at admission were collected. The differences in various indicators between disease group and control group were compared. LASSO regression was used to screen potential factors for predicting TB，and a nomogram model was established based on the results of multivariate Logistic regression analysis. Delong test and T-cell enzyme-linked immunospot assay（T-SPOT）was used to compare the efficacy of the model for diagnosing TB. The efficacy of the nomogram model in predicting TB risk was evaluated using receiver operating characteristic（ROC）curve and precision-recall（P-R）curve. Results LASSO regression identified 6 potential predictive factors，namely age，erythrocyte sedimentation rate（ESR），white blood cell（WBC）count，platelet-to-C-reactive protein ratio（PCR），tuberculosis antibody（TB-Ab）and T-SPOT. The areas under curves（AUC）of ROC curve and P-R curve of the nomogram model for predicting TB risk were 0.954 and 0.908，respectively. The AUC of ROC curve of T-SPOT for predicting TB risk was 0.895. The AUC of ROC curve and P-R curve of the validation data from the other 2 hospitals were 0.940，0.954 and 0.926，0.961，respectively，and the AUC of T-SPOT were 0.767 and 0.803，respectively. The validation results from all the 3 hospitals showed that the efficacy of the nomogram model in predicting TB risk was superior to T-SPOT（P<0.05）. Conclusions The established nomogram model can be used as an auxiliary diagnostic tool for pathogen-negative initial TB.

Efficiency improvement of laboratory specimen testing through automatic quality control and retest functions based on online refrigerator

CAO Guojun, ZHANG Bo, DING Yaodong, DING Lili, HUANG Mingying, HOU Jianping, GUAN Ming

2026, 41(7):  691-695.  DOI: 10.3969/j.issn.1673-8640.2026.07.012

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Objective Based on the practical application of a post-analytical on-line refrigerator module integrated with a total laboratory automation（TLA）system in a clinical laboratory，to evaluate the effects of automatic quality control and automatic retest functions on improving specimen testing efficiency and shortening turn-around time（TAT）. Methods The data from 1 week in July and 1 week in August 2023 were extracted from the laboratory information system（LIS）of the Pudong Campus，Huashan Hospital，Fudan University. For 25 biochemical analytes，precision，first-batch specimen loading time，and TAT compliance rates across different blood collection time periods were compared between automatic quality control and conventional manual quality control. A 7-day on-board stability verification protocol for analytes stored in the on-line refrigerator was established，and the efficiency of manual retest and TLA-based automatic retest was compared. Results Among the 25 biochemical analytes，the cumulative coefficient of variation（CV） with automatic quality control were lower than those with conventional manual quality control in 88%（22/25） of low-level quality control materials and 92%（23/25）of high-level quality control materials （P<0.05）. Except for total bilirubin and direct bilirubin，the remaining 23 analytes met the allowable imprecision criteria for 7-day on-board storage in the on-line refrigerator. Automatic quality control enabled pre-run operation with zero manual intervention；the first-batch specimen loading time occurred 43 min earlier on average than with manual quality control，and the mean pre-loading waiting time of specimens was reduced from 112 min to 67 min（P<0.05）. TAT compliance rates improved significantly across all blood collection time periods. The time required for automatic retest（23 min）was markedly shorter than that for manual retest（52 min），representing a 56% improvement in retest efficiency. In the automatic quality control and automatic retest mode，the mean overall daily TAT was 114 min，37% shorter than that in the manual QC mode（178 min）. Conclusions The on-line refrigerator integrated with the TLA system supports automatic quality control and automatic retest functions. Its testing quality is comparable to or even superior to the manual mode，and it provides favorable lean management benefits by shortening TAT，improving overall laboratory efficiency，and reducing labor requirements.

Research progress on the relationship between platelets and complements

YU Mengyao, WANG Chunyan, QIAO Rui, HUANG Shengkai, GONG Hengwen, CUI Chanjuan

2026, 41(7):  708-713.  DOI: 10.3969/j.issn.1673-8640.2026.07.016

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There is a complex relationship between immune system activation and thrombosis，especially in the complement system of the innate immune response. The complement system is a part of the immune system，not only providing natural defense and mediating inflammatory responses，but also being associated with the activation of platelets and thrombosis. Some components of the complement system，such as complement 3（C3），complement 5（C5） and membrane attack complex，can participate in regulating platelet activation and thrombosis，and activated platelets will further activate the complement system. However，the mechanism of this interaction still needs further exploration. This review focuses on the research on the relationship between platelets and complements in recent years，as well as the role of this relationship in diseases characterized by thrombosis and complement activation.

Research progress on anti-interferon-gamma autoantibodies mediating adult-onset immunodeficiency syndrome

LIU Yaoting, ZHONG Jiayun, ZHOU Lin

2026, 41(7):  714-718.  DOI: 10.3969/j.issn.1673-8640.2026.07.017

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Adult-onset immunodeficiency syndrome（AOID） is a rare immune system disorder characterized by the production of neutralizing anti-interferon-gamma（IFN-γ） autoantibodies（nAIGA） in patients' bodies. These nAIGA can neutralize IFN-γ，causing impairment in interferon signal transduction and affecting the phosphorylation of signal transducer and activator of transcription 1（STAT1） and the secretion of interleukin-12（IL-12） in mononuclear-macrophages，resulting in severe T helper cell（Th）1 immune response deficiency. These AOID patients often suffer from various opportunistic pathogen infections，such as Mycobacterium，Malphigian basidiomycetes，Aspergillus and Salmonella infections. Since anti-interferon-gamma autoantibody syndrome mostly occurs in previously healthy adults，it is named AOID based on its pathogenesis and clinical characteristics. Currently，the pathogenesis，diagnosis and treatment of AOID are not yet clear and standardized. This review comprehensively elaborates on the research progress in the pathogenesis，clinical characteristics，determination methods，diagnosis and treatment of nAIDA-mediated AOID，with the aim of enhancing clinicians' understanding of AOID，and to provide a reference for the formulation of standard treatment plans.