Identificación del alelo HLA B*57: 01 en una población militar, de Lima-Perú / Identification of the allele HLA B*57: 01 in a military population, from Lima-Peru

El alelo HLA B*57:01 es un marcador genético asociado con la hipersensibilidad al fármaco anti-retroviral abacavir (ABC) y su frecuencia en la población peruana todavía es desconocida. El objetivo fue identificar el alelo HLA B*57:01 en una población militar de Lima, Perú. Se reclutaron 43 personas viviendo con VIH (PVV) quienes aceptaron participar a través de un consentimiento informado. La detección del alelo HLA B*57:01 se realizó mediante RPC en tiempo real (RT-PCR). Asimismo, se determinó la carga viral (CV), el recuento de linfocitos CD4 y la genotipificación del VIH. Se identificaron dos casos positivos al alelo HLA B*57:01 (4,7%). Además, uno de ellos presentó múltiples mutaciones de resistencia a los anti-retrovirales (ARV), incluyendo ABC. Se demostró por primera vez en el Perú la presencia del alelo HLA B*57:01.

The HLA B*57:01 allele is a genetic marker associated with hypersensitivity to the antiretroviral Abacavir (ABC) and its frequency in the Peruvian population is still unknown. The objective was to identify the HLA B*57:01 allele in a military population from Lima, Peru. Forty three people living with HIV (PLWH) were recruited, who agreed to participate through informed consent. Detection of the HLA B*57:01 allele was performed by real-time PCR (RT-PCR). Likewise, viral load (VL), CD4 lymphocyte count and HIV genotyping were determined. Two cases positive for the HLA B*57:01 allele (4.7%) were identified. In addition, one of them had multiple resistance mutations to antiretrovirals (ARVs), including ABC. The presence of the HLA B*57:01 allele was demonstrated for the first time in Peru.

Testes de Triagem Prevendo Metástase de Câncer na Etiologia do Derrame Pericárdico: HALP Score e PNI / Screening Tests Predicting Cancer Metastasis in the Etiology of Pericardial Effusion: HALP Score and PNI

Resumo Fundamento: A triagem do câncer é absolutamente necessária em pacientes com derrame pericárdico, pois o câncer é uma das doenças mais graves em sua etiologia. Estudos anteriores indicaram que o índice de inflamação imunológica sistêmica (IIS), o índice prognóstico nutricional (PNI) e o escore de hemoglobina, albumina, linfócitos e plaquetas (HALP) podem ser escores relacionados ao câncer. Objetivos: Este estudo foi iniciado considerando que esses sistemas de pontuação poderiam prever o câncer na etiologia de pacientes com derrame pericárdico. Métodos: Os pacientes submetidos à pericardiocentese entre 2006 e 2022 foram analisados retrospectivamente. A pericardiocentese foi realizada em um total de 283 pacientes com derrame pericárdico ou tamponamento cardíaco de moderado a grande no período especificado. Os índices de HALP, PNI e IIS foram calculados do sangue venoso periférico retirado antes do procedimento de pericardiocentese. O nível de significância estatística foi aceito em p<0,05. Resultados: O escore HALP foi de 0,173 (0,125-0,175) em pacientes com câncer. Detectou-se que em pacientes não oncológicos o escore foi de 0,32 (0,20-0,49; p<0,001). O escore de PNI foi de 33,1±5,6 em pacientes com câncer. Detectou-se que em pacientes não oncológicos o escore foi 39,8±4,8 (p<0,001). Conclusão: Os escores HALP e PNI são testes de triagem de câncer fáceis e rápidos que podem prever metástases de câncer na etiologia de pacientes com derrame pericárdico.

Abstract Background: Cancer screening is absolutely necessary in patients with pericardial effusion, given that cancer is one of the most serious diseases in the etiology of pericardial effusion. In previous studies, it was stated that the systemic immune-inflammation index (SII); the prognostic nutrition index (PNI); and the hemoglobin, albumin, lymphocyte, platelet (HALP) score can produce scores related to cancer. Objectives: This study began considering that these scoring systems could predict cancer in the etiology of patients with pericardial effusion. Methods: This study produced a retrospective analysis of patients who underwent pericardiocentesis between 2006 and 2022. Pericardiocentesis was performed in a total of 283 patients with moderate-to-large pericardial effusion or pericardial tamponade within the specified period. HALP, PNI, and SII scores were calculated according to the peripheral venous blood taken before the pericardiocentesis procedure. The statistical significance level was set at p<0.05. Results: The HALP score proved to be 0.173 (0.125-0.175) in cancer patients and 0.32 (0.20-0.49) in non-cancer patients (p<0.001). The PNI score proved to be 33.1±5.6 in cancer patients and 39.8±4.8 in non-cancer patients (p<0.001). Conclusion: The HALP score and PNI proved to be easy and fast cancer screening tests that can predict cancer metastasis in the etiology of patients with pericardial effusion.

Immature granulocytes and neutrophil-to-lymphocyte ratio as markers of treatment response in subacute thyroiditis

ABSTRACT Objective Subacute thyroiditis is also known as subacute granulomatous thyroiditis, giant cell thyroiditis, painful thyroiditis, and De Quervain's thyroiditis. Immature granulocytes (IG) and neutrophil-to-lymphocyte ratio (NLR) are new inflammatory markers that are easily detected in routine complete blood count (CBC) tests. The aim of this study was to investigate the role of IG and NLR as markers of treatment response in patients with subacute thyroiditis. Subjects and methods The study included 41 patients with subacute thyroiditis treated and monitored in our outpatient clinic between April 2020 and April 2022. From a retrospective review of medical records, we recorded results of IG, NLR, thyroid-stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) from blood tests obtained routinely before and after treatment. Results Overall, 31 (75.6%) patients were women and 10 (21.4%) were men. The median age was 41 years (range 22-68 years). The laboratory tests showed the following median (range) results: IG, 0.03 (0.01-0.08); NLR, 3.6 (1.2-5.2); TSH, 0.02 mIU/L (0.01-3.35 mIU/L); fT4, 2.3 ng/dL (1.0-7.0 ng/dL); fT3, 5.6 pmol/L (2.6-15.2 pmol/L); ESR, 49 mm/h (17.0-87 mm/h); and CRP, 73 mg/dL (3.0-188 mg/dL). Conclusion Early diagnosis and treatment of subacute thyroiditis is fundamental. In the present study, the new inflammatory markers IG and NLR, measured routinely on CBC tests, decreased significantly after subacute thyroiditis treatment relative to pretreatment values. After treatment, the NLR change correlated with ESR and CRP changes, while the IG change correlated only with CRP change. These findings suggest that the markers IG and NLR may be used to evaluate treatment response in patients with subacute thyroiditis.

Prognostic nomogram based on pre-treatment HALP score for patients with advanced non-small cell lung cancer

Abstract Background To explore the correlation of pre-treatment Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score with the prognosis of patients with advanced Non-Small Cell Lung Cancer (NSCLC) undergoing first-line conventional platinum-based chemotherapy. Methods In this retrospective cohort study, 203 patients with advanced NSCLC were recruited from January 2017 to December 2021. The cut-off value for the HALP score was determined by Receiver Operating Characteristic (ROC) curve analysis. The baseline characteristics and blood parameters were recorded, and the Log-rank test and Kaplan-Meier curves were applied for the survival analysis. In the univariate and multivariate analyses, the Cox regression analysis was carried out. The predictive accuracy and discriminative ability of the nomogram were determined by the Concordance index (C-index) and calibration curve and compared with a single HALP score by ROC curve analysis. Results The optimal cut-off value for the HALP score was 28.02. The lower HALP score was closely associated with poorer Progression-Free Survival (PFS) and Overall Survival (OS). The male gender and other pathological types were associated with shorter OS. Disease progression and low HALP were correlated with shorter OS and PFS. In addition, nomograms were established based on HALP scores, gender, pathology type and efficacy rating, and used to predict OS. The C-index for OS prediction was 0.7036 (95% CI 0.643 to 0.7643), which was significantly higher than the C-index of HALP at 6-, 12-, and 24-months. Conclusion The HALP score is associated with the prognosis of advanced NSCLC patients receiving conventional platinum-based chemotherapy, and the nomogram established based on the HALP score has a better predictive capability for OS.

A preliminary study on the association between prognostic nutritional index and neutrophil-to-lymphocyte ratio with nutritional status and inflammation in febrile children's susceptibility to seizures

SUMMARY OBJECTIVE: The aim of this study was to evaluate the association between nutritional status, inflammation, and susceptibility to seizures in febrile children. METHODS: This observational single-center study was carried out from January 2020 to December 2023 with 324 children aged 6 months and 6 years; 106 were diagnosed with febrile seizure, 108 were febrile children, and 110 were healthy controls. The prognostic nutritional index and neutrophil-to-lymphocyte ratio were calculated, and the cutoff threshold was established through receiver operating characteristics. The study utilized correlation and univariate-multivariate logistic regression analysis. The comparison between simple and complex febrile seizure was conducted to analyze differences. RESULTS: The optimal cutoff values were identified as 61.25 for prognostic nutritional index and 1.04 for neutrophil-to-lymphocyte ratio. Our findings showed a significant negative association between febrile seizure and platelet count, high C-reactive protein, and high ferritin levels. Additionally, the febrile seizure group showed a significant positive correlation with high neutrophil-to-lymphocyte ratio values (≥1.04) and body temperature (≥38). Our findings revealed that high neutrophil-to-lymphocyte ratio, high C-reactive protein, and age less than 18 months were independently associated with seizure susceptibility in febrile children. CONCLUSION: High neutrophil-to-lymphocyte ratio values and low prognostic nutritional index scores may serve as novel surrogate independent factors for seizure susceptibility in febrile children. Febrile children who are less than 18 months old are more prone to experience seizures than older febrile children. Moreover, there was a correlation between febrile seizures and elevated C-reactive protein levels and neutrophil-to-lymphocyte ratio values.

Subpoblaciones de linfocitos T en adultos mayores cubanos con leucemia linfoide crónica / Subpopulations of T lymphocytes in Cuban older adults with chronic lymphoid leukemia

Introducción: la inmunosenescencia está asociada con un mayor riesgo de desarrollo de cáncer. Dentro de las hemopatías malignas que afectan a este grupo de edad, está la leucemia linfoide crónica (LLC), caracterizada por trastornos en la inmunidad adaptativa que incluye las subpoblaciones de linfocitos T. Objetivo: Determinar la frecuencia de las subpoblaciones de linfocitos T en los pacientes adultos mayores con leucemia linfoide crónica evaluados en el Instituto de Hematología e Inmunología de Cuba. Métodos: Se realizó un estudio transversal en 30 adultos mayores con leucemia linfoide crónica. Se cuantificaron los linfocitos TCD3+CD4+ y TCD3+CD8+ en sangre periférica por citometría de flujo. Para la lectura y el análisis de los datos se empleó un citómetro de flujo Beckman Coulter Gallios. Se utilizaron los valores porcentuales, la media y la desviación estándar. Se consideró estadísticamente significativo si p≤0.05. Resultados: Hubo un predominio de hombres que representaron el 56,7 por ciento y del grupo de 70-79 años de edad. No se reportó ningún adulto mayor con LLC con valores altos ni normales de linfocitos TCD3+CD4+. Predominaron los hombres con valores bajos porcentuales de linfocitos TCD3+CD4+, TCD3+CD8+ e inversión del índice CD4/CD8 en relación con las mujeres. Conclusiones: Los adultos mayores con LLC presentan alteraciones en el número de las subpoblaciones de linfocitos T. La acción de estas células en relación al crecimiento de células B malignas aún es desconocido y resulta importante determinar si esto puede reflejar un intento de evasión de las células tumorales al control inmunológico(AU)

Introduction: Immunosenescence is associated with an increased risk of cancer development. Among the malignant hemopathies that affect this age group, it is chronic lymphoid leukemia (CLL), characterized by disorders in adaptive immunity, which include subpopulations of T lymphocytes. Objective: To determine frequency of T lymphocyte subpopulations in older adult patients with chronic lymphoid leukemia evaluated at the Institute of Hematology and Immunology of Cuba. Methods: A cross-sectional study was conducted in 30 older adults with chronic lymphoid leukemia. TCD3+CD4+ and TCD3+CD8+ lymphocytes were quantified in peripheral blood by flow cytometry. A Beckman Coulter Gallios flow cytometer was used to read and analyze the data. The percentage values, the mean and the standard deviation were used. It was considered statistically significant if p≤0.05. Results: There was a predominance of men who represented 56.7 percent and the age group of 70-79 years. No older adults with CLL with high or normal values of TCD3+CD4+ lymphocytes were reported. Men predominated with low percentage values of TCD3+CD4+, TCD3+CD8+ lymphocytes and inversion of the CD4/CD8 ratio in relation to women. Conclusions: Older adult with CLL present alterations in the number of T lymphocyte subpopulations. The role of these cells in relation to the growth of malignant B cells it is unknown and it turns out important to determine if this may reflect an attempt to evade tumor cells from immune control(AU)

Recent advance in targeted therapies for myasthenia gravis / 中华神经医学杂志

Myasthenia gravis (MG) is an autoimmune disease of the nervous system mediated by autoimmune antibodies, dependent on T cells and involved in multiple complement. Recent years, targeted biologics have shown advantages in a number of clinical studies of myasthenia gravis. This review focuses on targeted therapy on B cells, complement, neonatal fragment crystal receptor (FcRn) and cytokine monoclonal antibodies, as well as on the latest research progress of chimeric antigen receptor T cells (CAR-T) or chimeric autoantibody receptor T cells (CAAR-T) in MG therapy, in order to provide the latest drug information for clinicians.

Study on the diagnostic value of lymphocyte subpopulations combined with chemokines in children with immunologic thrombocytopenic purpura / 安徽医科大学学报

Objective @#To explore the diagnostic value of lymphocyte subpopulations combined with chemokines in children with immunologic thrombocytopenic purpura ( ITP) . @*Methods @#132 children with proposed diagnosis of ITP were collected , and the children were divided into ITP and non ITP groups according to the diagnostic results of ITP related clinical diagnostic criteria. 6 ml of peripheral venous blood was drawn , the levels of CD4 + CD8 + and CD3 + were detected using flow cytometry , and the levels of chemokine (C-C motif) ligand 5 (CCL5) , Recombi nant Chemokine (C-X-C Motif) Ligand 1 (CXCL11) , and monocyte chemotactic protein 1 (MCP-1) were detec ted using enzyme linked immunosorbent assay , the blood platelet (PLT) was measured by a fully automated cell an alyzer. The children were divided into ITP and non ITP groups according to the clinical diagnostic criteria related to ITP. The lymphocyte subpopulations and chemokine levels of the two groups of children were compared , and the correlation between lymphocyte subpopulations and chemokine levels and PLT was analyzed . The ROC method was used to evaluate the diagnostic efficacy of individual and combined detection of each indicator for ITP. @*Results@#The levels of CD4 + and CD3 + in the ITP group were lower than those in the non ITP group (P < 0.05) , while the levels of CD8 + were higher than those in the non ITP group (P < 0.05) . The levels of CCL5 , CXCL11 , and MCP-1 in the ITP group were higher than those in the non ITP group (P < 0.05) . The correlation analysis results showed that CD4 + , CD3 + and platelet count were positively correlated in the ITP group(P < 0.05) , while CD8 + , CCL5 , CXCL11 , MCP-1 were negatively correlated with PLT (P < 0.05) . The ROC analysis results showed that the cut off values of CD4 + , CD8 + , CD3 + , CCL5 , CXCL11 , and MCP-1 for the diagnosis of ITP in children were 27.13% , 24.02% , 59.88% , 41.02 ng/L , 30.18 ng/L , and 188.27 ng/L , respectively. The AUC values were 0.893 , 0.880 , 0.629 , 0.801 , 0.892 , and 0.751 , respectively , The AUC of the parallel diagnosis ( meaning that one or more of CD4 + , CD3 + was below the cut off value and/or one or more of CD8 + , CCL5 , CXCL11 , MCP-1 was above the cut off value at the time of parallel testing) was 0.967 , indicating that one or more of them was lower than the cut off value and/or one or more of them was higher than the cut off value when tested separately. Its diag nostic efficacy was higher than that of each indicator tested separately (P < 0.05) .@*Conclusion @#There are signifi cant differences in lymphocyte subpopulations and chemokines between pediatric ITP patients and non ITP patients . CD4 + , CD8 + , CD3 + , CCL5 , CXCL11 , and MCP-1 can be used for the diagnosis of pediatric ITP. Combined de tection of various indicators can improve detection efficiency.

Clinical significance analysis of peripheral blood inflammation indexes in schizophrenia / 中国现代医生

Objective To investigate the clinical significance of neutrophil to albumin ratio(NAR),neutrophil to lymphocyte ratio(NLR),monocyte to lymphocyte ratio(MLR),platelet to lymphocyte ratio(PLR)and systemic immune-inflammation index(SII)in schizophrenia.Methods A total of 215 patients with schizophrenia admitted to Nanning Social Welfare Hospital from January 2019 to June 2021 were included in schizophrenia group,and 113 healthy people who underwent physical examination in hospital during the same period were included in control group.NAR,NLR,MLR,PLR,SII of two groups were compared,and the correlation between them and the clinical symptom score of schizophrenia and changes after taking antipsychotic drugs were analyzed.Results The levels of NAR,NLR,PLR,MLR and SII in schizophrenia group were significantly higher than those in control group(P<0.05).Spearman correlation analysis showed that NAR,NLR,SII and scale for the assessment of positive symptom scores were negatively correlated(P<0.05).After treatment with antipsychotic drugs,all inflammatory indexes were decreased in schizophrenia group,but NAR and MLR were still significantly higher than those in control group(P<0.05).Conclusion There is an active state of immune inflammation in schizophrenia,and the levels of NAR and MLR do not decrease significantly after treatment with antipsychotic drugs,which may be related to the persistence of schizophrenia symptoms.

Predictive value of peripheral blood inflammatory indicators in patients with new-diagnosed multiple myeloma / 中国现代医生

Objective To explore the predictive value of peripheral blood inflammatory indicators such as neutrophil-to-lymphocyte ratio(NLR),monocyte-to-lymphocyte ratio(MLR)and platelet-to-lymphocyte ratio(PLR)on the prognosis of patients with primary diagnosis of multiple myeloma(MM).Methods Using a retrospective method,77 patients with first diagnosis of MM admitted to the Department of Hematology of Baise People's Hospital and 77 healthy medical checkups with peripheral blood NLR,MLR and PLR were collected and compared the differences.Then the patients with primary diagnosis of MM were categorized into high NLR group,low NLR group,high MLR group,low MLR group,high PLR group,low PLR group using the mean value as the critical value,and the prognosis of the patients in each group as well as the relationship with overall survival time(OS)were compared.Results The NLR,MLR,and PLR of patients with initial diagnosis of MM were significantly higher than those of healthy controls,and the differences were statistically significant(all P<0.05).Serum β2-microglobulin(β2-MG)levels were higher in patients with high NLR and high MLR than in the low NLR and low MLR groups,and the difference was statistically significant(P<0.05).Patients in the high NLR,high MLR and high PLR groups had less OS and poorer prognosis than those in the low NLR,low MLR and low PLR groups,and the differences were statistically significant(all P<0.05).Univariate Cox regression analysis showed that international staging system(ISS)stage,creatinine(Cr),β2-MG,albumin(ALB),NLR,MLR and PLR were associated with overall survival(P<0.05);multivariate Cox proportional risk regression analysis showed that NLR,MLR,and PLR were not independent risk factors affecting the prognosis of patients with primary diagnosis of MM,and the difference was not statistically significant(P>0.05).According to the number of inflammatory indexes(high NLR,high MLR,high PLR)that affected the prognosis,the patients were divided into 0 or 1 risk factor group,2 risk factor groups and 3 risk factor groups,and the comparison of OS between the three groups was statistically significant(P=0.001).The greater the number of concomitant risk factors for prognosis,the shorter the OS.Conclusion Elevated inflammatory indicators(NLR,MLR,PLR)in patients with primary diagnosis of MM were associated with less OS and poorer prognosis of the patients,and they may be used as indicators to assess the condition and prognosis of patients with primary diagnosis of MM.

Application and Biological Evaluation of Magnetic Cell Sorting Technology / 生物化学与生物物理进展

Magnetic cell sorting technology is a highly specific and rapid cell sorting technology using superparamagnetic nanocomposites for cell sorting, which is widely used in immunology, stem cytology, oncology, clinical medicine and other fields. Magnetic cell sorting technology is divided into positive isolation, negative isolation/untouched cell isolation, depletion, multi-step isolation and automated cell separation systems. In this review, we firstly give a brief introduction to the classification and application of magnetic cell sorting technology, then discuss several new techniques and challenges based on magnetic cell sorting in recent years, such as improving the sorting efficiency by improving the structure of magnetic materials and magnetic field structure. The necessity of biological evaluation of magnetic cell sorting products was emphatically analyzed. Through the biological evaluation, the advantages and disadvantages of magnetic cell sorting products can be understood, and the research and development ability could be improved. Therefore, 10 biological evaluation technical parameters related to magnetic cell sorting products were proposed: yield, purity, sterility, cytotoxicity, cell morphology, viability, light scattering characteristics of cells, fluorescent antibody labeling ability of cells, cell activation and cell proliferation. The 10 biological evaluation technical parameters play an important role in promoting the standardized application of magnetic cell sorting.

Therapeutic effect of recombinant Salmonella SGN1 on melanoma in mice and its mechanism of action / 中国生物制品学杂志

@#Objective To investigate the therapeutic effect of recombinant Salmonella SGN1 on murine melanoma model and the action mechanism,and to provide reference for clinical treatment of melanoma with SGN1.Methods The recombinant Salmonella SGN1 and control strain VNP-V were co-cultured with mouse melanoma B16F10 cells,and the effect of SGN1 on the proliferation of B16F10 cells in vitro was detected by cell counting method. The B16F10 subcutaneous tumor transplantation model in mice was constructed. SGN1,VNP-V and PBS(control group)were injected into the tumor at a single dose,with five mice in each group,and the inhibitory effect of SGN1 on tumor growth was observed. The pathological changes of tumor tissues in mice were observed by HE staining. The distribution of SGN1 in tumor tissues was observed by plate counting. Flow cytometry was used to evaluate the proportion of infiltrating T lymphocyte subsets. The expression of T-cell marker CD3 was detected by immunofluorescence and immunohistochemical staining.Results Compared with the control group,recombinant Salmonella SGN1 significantly inhibited the proliferation of mouse melanoma B16F10 cells in vitro(t = 6. 935,P < 0. 01). In tumor-bearing mice,SGN1 was tumor-targeted and significantly inhibited the growth of B16F10 subcutaneous transplanted melanoma in mice(t = 7. 566,P < 0. 001). HE staining showed that SGN1 significantly induced the necrosis of subcutaneous transplanted melanoma cells in mice. The results of immunofluorescence,immunohistochemistry and flow cytometry confirmed that SGN1 significantly increased tumor-infiltrating CD3~+ T-cells(t = 11. 91,8. 873 and 5. 300,respectively,each P < 0. 01).Conclusion The recombinant Salmonella SGN1 can significantly inhibit the proliferation of B16F10 cells and exert anti-tumor effects by promoting tumor cell necrosis and elevating CD3~+ tumor-infiltrating T-cells,providing a theoretical basis for the clinical treatment of melanoma with SGN1

Effectiveness of recombinant Mycobacterium tuberculosis fusion protein skin test in screening for latent tuberculosis infection among HIV/AIDS patients / 预防医学

Objective@#To evaluate the effectiveness of recombinant Mycobacterium tuberculosis fusion protein skin test (EC-ST) in screening for latent tuberculosis infection (LTBI) among HIV/AIDS patients, so as to provide insights into the applicability of EC-ST in LTBI screening among HIV/AIDS patients.@*Methods@#From April to June 2023, HIV/AIDS patients under management and treatment in Yangzhou City, Jiangsu Province, were selected as study subjects. Basic information was collected through questionnaire surveys. LTBI was screened by EC-ST and interferon-gamma release assay (IGRA). Taking IGRA results as the diagnostic standard, the positive rate, sensitivity, specificity and consistency rate of EC-ST, and the impact of CD4+T lymphocyte (CD4) counts on the screening effect of EC-ST were analyzed.@*Results@#A total of 523 HIV/AIDS patients were screened, including 458 males (87.57%) and 65 females (12.43%). The median age was 48.00 (interquartile range, 21.00) years. The positive rate of EC-ST was 7.27% and the positive rate of IGRA was 7.46%, with no statistically significant difference (P>0.05). The consistency rate of the two methods was 94.84%, and the Kappa value of 0.621 (95%CI: 0.489-0.752, P<0.05). The sensitivity of EC-ST was 64.10% and the specificity was 97.31%. Comparing the groups with CD4 counts <500 and ≥500 cells/μL, the consistency rates of the two methods were 95.32% and 94.44%, and the Kappa values were 0.568 and 0.650, respectively (both P<0.05). There were no statistically significant differences in the positive rates, sensitivity, and specificity of EC-ST (all P>0.05). Comparing the groups with CD4 counts <200 and ≥200 cells/μL, the consistency rates of the two methods were 96.55% and 94.62%, and the Kappa values were 0.648 and 0.619, respectively (both P<0.05). There were no statistically significant differences in the positive rates, sensitivity, and specificity of EC-ST (all P>0.05).@*Conclusion@#The effectiveness of EC-ST in screening for LTBI among HIV/AIDS patients is consistent with that of IGRA and is not affected by CD4 counts.

Cases report and diagnosis and treatment of passenger lymphocyte syndrome after liver and renal transplantation / 中国输血杂志

【Objective】 To summarize the clinical features, serological features, blood transfusion protocols and treatment of 3 cases of passenger lymphocyte syndrome(PLS) after ABO-incompatibility liver and renal transplantation in our hospital, in order to provide guidance for comprehensive clinical understanding and recognition of this disease, especially early recognition and treatment. 【Methods】 By collecting the basic information of the patients and the time of cross-matching incompatibility of homologous blood after transplantation, observing the skin yellow staining, detecting hemoglobin value and other hemolysis indexes, and blood group serological detection results before and after transfusion, the diagnosis and analysis were performed. The diagnosis and treatment effect of PLS were analyzed by collecting the clinical outcome information after immunization and blood transfusion. 【Results】 Three cases of ABO-incompatible liver transplantation showed decreased hemoglobin and hemolysis, incompatible cross-matching of homologous blood, and anti-A and anti-B IgG antibodies were confirmed by serological test. After treatment such as immunosuppression and plasma exchange, blood transfusion was effective, hemolysis was improved, and antibodies gradually disappeared. 【Conclusion】 ABO blood group antibody screening, unexpected antibody screening and direct antiglobulin test(DAT)should be performed regularly for ABO-incompatible liver and renal transplantation cases, in order to detect the PLS early. A series of laboratory tests related to PLS should be performed in time to diagnose and adjust the treatment plan, including transfusion strategy, when homologous cross-matching is incompatible.

Effect of Qingre Huashi Sanjie Enema Prescription on MCP-1，TGF-β1，IL-6，and T Lymphoid Subsets in Patients with Sequelae of Pelvic Inflammatory Disease with Syndrome of Combined Dampness， Heat， and Stasis / 中国实验方剂学杂志

ObjectiveTo investigate the application value of Qingre Huashi Sanjie enema prescription in the treatment of the patients with sequelae of pelvic inflammatory disease （syndrome of combined dampness，heat，and stasis） and the effects of this prescription on inflammatory mediators and T lymphocyte subsets. MethodThe patients with sequelae of pelvic inflammatory disease （syndrome of combined dampness，heat，and stasis） treated from May 2022 to August 2023 were included in this study and randomized into two groups （79 cases）. The control group was treated with conventional Western medicine，and the observation group was treated with Qingre Huashi Sanjie enema prescription on the basis of the therapy in the control group. Both groups were treated for 12 weeks. The serum levels of monocyte chemoattractant protein-1 （MCP-1），transforming growth factor-β1 （TGF-β1），and interleukin-6 （IL-6） were measured by enzyme linked immunoserbent assay （ELISA） before and after treatment in both groups. The erythrocyte sedimentation rate （ESR） and fibrinogen （FIB） were measured by an automatic blood rheology analyzer before and after treatment in both groups. The serum levels of CD4+，CD4+/CD8+ before and after treatment in both groups were measured by flow cytometry. The traditional Chinese medicine （TCM） symptom score and the 36-item short form survey （SF-36） score were assessed before and after treatment. The uterine artery resistance index （RI），uterine artery pulsatility index （PI），and uterine artery peak systolic velocity （PSV） were measured by Doppler before and after treatment. The clinical efficacy and the occurrence of adverse reactions were compared between the two groups. ResultAfter treatment，the levels of MCP-1，TGF-β1，IL-6，ESR，and FIB decreased in both groups （P<0.01），and the decreases were larger in the observation group than in the control group （P<0.05，P<0.01）. After treatment，the serum levels of CD4+ and CD4+/CD8+ elevated in both groups （P<0.01） and the observation group had higher levels of CD4+ and CD4+/CD8+ than the control group （P<0.05，P<0.01）. The treatment in both groups decreased the TCM symptom score and TCM sign score and increased the SF-36 score （P<0.01），and the changes were more significant in the observation group than in the control group （P<0.05，P<0.01）. In addition，the treatment lowered RI and PI and elevated PSV （P<0.01），and the changes in these indicators were more significant in the observation group than in the control group （P<0.01）. The total response rate in the observation group was 93.67% （74/79），which was higher than that （79.75%，63/79） in the control group （χ2=6.645，P<0.05）. There was no significant difference in the occurrence of adverse reactions between the two groups. ConclusionFor the patients with sequelae of pelvic inflammatory disease （syndrome of combined dampness，heat，and stasis），Qingre Huashi Sanjie enema prescription can reduce inflammation，attenuate hypercoagulability，improve hemodynamics，and regulate the immune function，demonstrating a definite therapeutic effect.

Modified Danggui Beimu Kushen Pills Inhibit Tumor Growth and Regulates T Cell Subsets in H22 Hepatocellular Carcinoma-bearing Mice / 中国实验方剂学杂志

ObjectiveTo explore the effects of modified Danggui Beimu Kushen pills on tumor growth and T-cell subsets in H22 hepatocellular carcinoma-bearing mice and to provide an experimental basis for the treatment of hepatocellular carcinoma with modified Danggui Beimu Kushen pills combined with immune checkpoint antibodies. MethodA H22 hepatocellular carcinoma-bearing mouse model was established. The modeled mice were randomized into model， cisplatin， low- （4 g·kg-1·d-1）， medium- （8 g·kg-1·d-1）， and high-dose （16 g·kg-1·d-1） modified Danggui Beimu Kushen pills groups. After continuous administration for 14 days， the mice were sacrificed on day 15. The tumor volume was measured on days 0， 4， 8， 12， 15 of drug administration. Tumors were weighed and thymus index and spleen index were calculated. Spleen lymphocytes were co-cultured with H22 hepatoma cells， and the tumor cell-killing rate was detected by the cell counting kit-8 （CCK-8）. Real-time polymerase chain reaction was carried to determine the mRNA levels of programmed cell death protein-1 （PD-1） and lymphocyte activation gene-3 （LAG-3） in spleen and tumor tissues. The number of CD4+ and CD8+ T cells and the expression of PD-1 and LAG-3 were detected by immunohistochemistry （IHC）. ResultOn day 8 of drug administration， tumor volumes in all treatment groups decreased compared with that in the model group. On day 15， both tumor volume and tumor weight were significantly lower in the treatment groups than in the model group （P<0.01）， with the cisplatin group showing the most pronounced reduction. Compared with the model and cisplatin groups， medium- and high-dose modified Danggui Beimu Kushen pills increased the thymus index （P<0.01）. Compared with the model group， all treatment groups showed increased spleen index （P<0.05， P<0.01）， with the cisplatin group showing the most significant increase. Compared with the model and cisplatin groups， all the groups of modified Danggui Beimu Kushen pills demonstrated increased number of CD4+ and CD8+ T cells and tumor cell-killing rate in the spleen and tumor tissues （P<0.01） and down-regulated mRNA and protein levels of LAG-3 （P<0.05， P<0.01）. The high-dose group of modified Danggui Beimu Kushen pills had lower mRNA level of PD-1 in the tumor tissue than the model and cisplatin groups （P<0.01）. ConclusionModified Danggui Beimu Kushen pills may promote the proliferation and tumor microenvironment infiltration of CD4+ and CD8+ T cells in H22 tumor-bearing mice by down-regulating LAG-3 expression， thereby improving T-cell immune activity and inhibiting tumor growth. This study provides an experimental basis for the combination of modified Danggui Beimu Kushen pills and immune checkpoint antibodies in the treatment of hepatocellular carcinoma.

Evaluation value of RDW-SD,RPR and RLR on decompensation stage of cirrhosis in primary biliary cholangitis / 重庆医学

Objective To analyze the evaluation value of the standard deviation of erythrocyte volume distribution width(RDW-SD),erythrocyte volume distribution width standard deviation and platelet ratio(RPR)and erythrocyte volume distribution width standard deviation and lymphocyte ratio(RLR)in the de-compensation stage of cirrhosis in primary biliary cholangitis(PBC).Methods The blood routine indexes of 68 patients with PBC admitted and treated in this hospital from January 2019 to June 2021 were retrospective-ly analyzed and divided into the compensation stage(n=36)and decompensation stage(n=32)according to the diagnostic standard.2 mL venous blood was extracted from the patient on an empty stomach in the early morning.The red blood cell(RBC),mean corpuscular volume(MCV),hemoglobin(Hb),hematocrit(HCT),mean erythrocyte hemoglobin content(MCHC),RDW-SD,white blood cell(WBC),neutrophil absolute value(N#),lymphocyte absolute value(L#),platelet count(PLT),mean platelet volume(MPV),platelet volume distribution width(PDW),etc.were detected.The platelet to lymphocyte ratio(PLR),RPR and RLR were calculated.The influencing factors of decompensation stage of PBC cirrhosis were analyzed by binary logistic regression,and the receiver operating characteristic(ROC)curve was used to analyze the diagnostic values of different indicators in the decompensation stage of PBC cirrhosis.Results There were statistically significant differences in age,RBC,Hb,HCT,RDW-SD,L #,PLT,RPR and RLR between the compensation group and decompensation group in PBC cirrhosis(P＜0.05).The binary logistic regression analysis showed that the age[odds ratios(OR)=1.087,95％confidence intervals(CI):1.015-1.165,P＜0.05],RDW-SD(OR=1.144,95％CI:1.030-1.270,P＜0.05)and RLR(OR=1.041,95％CI:1.007-1.075,P＜0.05)were the independent risk factors for progressing to the decompensation stage in the patients with PBC cirrhosis com-pensation stage.The ROC curve analysis showed that the areas under ROC curve(AUC)of RDW-SD,RPR and RLR for the diagnosis alone of decompensation stage of PBC cirrhosis were 0.726,0.778 and 0.798,re-spectively,and the differences were not statistically significant(P＞0.05).Conclusion Combined with the age factor,regular monitoring of RDW-SD,RPR and RLR levels has a high predictive value for the develop-ment of PBC cirrhosis compensation stage to decompensation stage.

Efficacy analysis of blood inflammation and liver function indexes in ICP diagnosis and delivery mode prediction / 重庆医学

Objective To observe the changes of laboratory blood indexes in patients with intrahepatic cholestasis of pregnancy(ICP),and analyze the value of blood inflammation indexes and liver function indexes in the diagnosis of ICP and the prediction of delivery mode.Methods A total of 251 patients diagnosed with ICP in this hospital from January 2021 to December 2022 were selected as the ICP group,and another 200 healthy pregnant women were selected as the control group.The patients with ICP were further divided into the severe ICP group(n=47)and the mild ICP group(n=204),the vaginal delivery group(n=113)and the cesarean section group(n=138)according to the severity of ICP and delivery mode.Mann-Whitney U test was used for comparison of parameters between groups,and Spearman method was used for correlation analy-sis.Receiver operating characteristic(ROC)curves were used to evaluate the efficacy of laboratory indicators in diagnosing ICP and predicting delivery mode.Results Neutrophil/lymphocyte ratio(NLR)[6.01(4.45,8.37)vs.3.36(4.12,3.51)]and aspartate transaminase(AST)level[20.00(16.00,33.00)U/L vs.15.00(13.00,18.00)U/L]in the ICP group were significantly higher than those in the control group(P＜0.05),and NLR in the severe ICP group was significantly higher than that in the mild ICP group[4.93(3.87,7.35)vs.4.14(3.12,5.17),P＜0.05].Correlation analysis showed that NLR was positively correlated with AST level(r=0.279,P＜0.001)and ICP severity(r=0.139,P=0.028)in patients with ICP.The area under ROC curve(AUC)of NLR combined with AST for ICP diagnosis was 0.882(95％CI:0.851-0.913).In ad-dition,cholinesterase(CHE)[6 020.00(5 499.50,6 703.50)U/L vs.5 341.50(4 651.75,6 259.25)U/L]and prealbumin(PA)[199.00(177.71,225.20)mg/Lvs.169.17(139.18,204.40)mg/L]levels in the va-ginal delivery group were significantly higher than those in the cesarean section group(P＜0.05),and the AUC of CHE combined with PA for predicting vaginal delivery in ICP patients was 0.727(95％CI:0.664-0.789).Conclusion NLR and AST have potential value in the diagnosis of ICP,and CHE and PA have poten-tial value in predicting delivery mode of ICP patients.

Value of peripheral blood T-lymphocyte subsets and cytokines in the diagnosis of Mycoplasma pneumoniae pneumonia in children / 国际检验医学杂志

Objective To analyze the value of peripheral blood T-lymphocyte subsets and cytokines in the diagnosis of Mycoplasma pneumoniae pneumonia(MPP)in children.Methods A total of 120 children with MPP who were admitted to the hospital from January 2020 to January 2023 were selected as the observation group,80 children with pulmonary tuberculosis(TB)were selected as the control group.During the same pe-riod,120 healthy children who were examined at the hospital check-up center were selected as the health group.The clinical data from each group were retrospective analyzed,and fasting venous blood from subjects was collected.The levels of T-lymphocyte subsets CD3+,CD4+and CD8+were detected by flow cytometry in each group,and the CD4+/CD8+was calculated.The levels of interferon(IFN)-y,interleukin-8(IL-8),inter-leukin-10(IL-10)and interleukin-13(IL-13)were measured by enzyme-linked immunosorbent assay,and the levels of peripheral blood T-lymphocyte subsets and cytokines in each group were compared.The receiver op-erating characteristic(ROC)curve was used to assess the value of peripheral blood T-lymphocyte subsets and cytokines in the diagnosis of MPP in children.Results The levels of CD3+,CD4+,CD4+/CD8+,IL-13,and IL-10 in the observation group and control group were significantly lower than those in the health group(P＜0.05),while CD8+,IL-8,and IFN-γ levels were significantly higher than those in the health group(P＜0.05).Compared with the control group,the observation group had higher levels of CD3+,CD8+,IL-8,IFN-γand lower levels of CD4+,CD4+/CD8+(P＜0.05),and there were no statistically significant differences in IL-8 and IL-13 levels between the two groups(P＞0.05).The ROC curve results showed that the area under the curve(AUC)or CD3+,CD4+,CD8+,CD4+/CD8+,IL-8,IFN-γ,IL-13,and IL-10 for the diagnosis of MPP in children were 0.751,0.687,0.784,0.864,0.798,0.672,0.650,and 0.811,and AUC of the combined detection was 0.924.Conclusion Children with TB and MPP have significantly decreased immune function in the early stages of the disease,and abnormal expression of peripheral blood T-lymphocyte subsets and cytokines.Com-pared with TB children,MPP children have lower levels of CD4+,CD4+/CD8+,and higher levels of CD3+,CD8+,IL-10 and IFN-γ,and the T-lymphocyte subsets and cytokine levels are closely related to the changes in the patients'condition.The combined detection of CD3+,CD4+,CD8+,CD4+/CD8+,IL-8,IFN-γ,IL-13 and IL-10 provides a theoretical basis for identifying and diagnosing early MPP in children.

Correlation between serum HbA1c,LAG-3 and thyroid nodules in patients with type 2 diabetes mellitus / 国际检验医学杂志

Objective To explore the correlation between serum glycosylated hemoglobin(HbA1c),lym-phocyte activation gene-3(LAG-3)and thyroid nodules in patients with type 2 diabetes mellitus(T2DM).Methods A total of 120 T2DM patients with thyroid nodules admitted to the Third Hospital of Hebei Medi-cal University from July 2021 to July 2022 were included as the study group,and 100 simple T2DM patients(without thyroid nodules)were included as the control group during the same period.According to the patho-logical examination results of thyroid nodules,the study group was grouped into a benign nodule group(85 ca-ses)and a malignant nodule group(35 cases).Enzyme linked immunosorbent assay was applied to detect the serum LAG-3 level of all study subjects.Fully automated glycated hemoglobin analyzer was applied to detect HbA1c level in all study subjects.Spearman method was applied to analyze the correlation between serum HbA1c,LAG-3,and thyroid imaging report and data system(TI-RADS)scores in patients with T2DM and thyroid nodules.Multivariate Logistic regression was applied to analyze the influencing factors of T2DM with thyroid nodules.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of HbA1c and LAG-3 levels in T2DM with thyroid nodules.Results Compared with the control group,the level of HbA1c in the study group was obviously higher(P<0.05),while the level of LAG-3 was obviously lower(P<0.05).Compared with the benign nodule group,the serum LAG-3 level in the malignant nodule group was obviously lower(P<0.05),while the level of LAG-3 was obviously lower(P<0.05).Spearman analysis showed a positive correlation between HbA1c level and TI-RADS score in T2DM patients with thyroid nod-ules(r=0.378,P<0.001),while the serum LAG-3 level was negatively correlated with TI-RADS score(r=-0.472,P<0.001).The results of multivariate Logistic regression analysis showed that HbA1c was a risk factor for the occurrence of thyroid nodules in T2DM patients(P<0.05),and LAG-3 was a protective factor for the occurrence of thyroid nodules in T2DM patients(P<0.05).The combination of HbA1c and LAG-3 in the diagnosis of T2DM with thyroid nodules was superior to their individual diagnosis(Zcombination-HbA1c=2.542,P=0.011;Zcombination-LAG-3=3.098,P=0.002).Conclusion Patients with T2DM combined with thyroid nodules have obviously lower serum LAG-3 level and higher HbA1c level,and the two are related to the malignancy of thyroid nodules.