Renal calculus is a common urological disease with increasing prevalence worldwide. Thrombomodulin (TM) is a marker of endothelial injury and has been associated with various inflammatory conditions. This study aimed to investigate the correlation between plasma thrombomodulin levels and renal calculus. A total of 805 participants were enrolled in this cross-sectional study, including 577 healthy controls and 228 renal calculus patients. General demographic data and laboratory indicators were collected from the participants. TM levels were measured by chemiluminescence immunoassay. Univariate and multivariate logistic regression models were used to analyze the correlation between TM and renal calculus, and subgroup analyses were performed. Renal calculus patients showed significantly higher TM levels compared to healthy controls (8.12 vs. 7.6 ng/mL, P = 0.0001). Multivariate analysis revealed TM remained independently associated with renal calculus after adjusting for non-inflammatory covariates (OR = 1.121, P = 0.0031), with the association persisting after additional adjustment for inflammatory markers (OR = 1.176, P = 0.0015). A dose-response trend across TM quartiles was observed, which was partially mediated by inflammatory markers.Patients with UTI and renal calculus complicated by infection showed significantly higher levels of TM, CRP, WBC, and NEU compared to those with simple renal calculus and healthy controls (P < 0.0001). Elevated plasma TM levels are significantly associated with increased prevalence of renal calculus.This association may be mediated by endothelial dysfunction and inflammatory responses, suggesting that vascular endothelial dysfunction plays a crucial role in the pathogenesis of renal calculus.

目的 探讨未成熟网织红细胞比率(IRF)在预测新型冠状病毒肺炎(COVID-19)患者死亡风险中的价值.方法 选取该院2020年1月23日至3月31日确诊的108例COVID-19患者为病例组,其中生存患者88例,死亡患者20例,并以同期进行体检的57例健康者为健康对照组.收集患者的病例资料,比较生存和死亡患者、COVID-19不同临床分型患者网织红细胞绝对值(Ret#)、网织红细胞百分比(Ret％)、高荧光强度网织红细胞比率(HFR)、中荧光强度网织红细胞比率(MFR)、低荧光强度网织红细胞比率(LFR)、IRF.采用受试者工作特征曲线(ROC曲线)和曲线下面积(AUC)评价IRF对COVID-19死亡风险的诊断价值.结果 病例组IRF水平高于健康对照组,差异有统计学意义(P<0.05);死亡组IRF水平高于生存组,差异有统计学意义(P<0.05);IRF诊断COVID-19死亡风险的AUC为0.774(95％CI:0.66～0.89),以IRF=7.90％为诊断COVID-19死亡风险指标的Cut-off值,灵敏度为80.0％,特异度为73.6％.结论 IRF水平是早期预测CO-VID-19患者死亡风险的一个较好的指标.

目的 探讨高密度脂蛋白胆固醇(HDL-C)联合降钙素原(PCT)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)检测在评估腹腔感染患者严重程度中的价值.方法 选取华中科技大学同济医学院附属同济医院2018年1月至2019年7月收治的116例腹腔疾病患者为研究对象,依据感染程度不同分为复杂腹腔感染组45例,单纯腹腔感染组37例,以及无感染的对照组34例.分别检测3组患者在治疗前及治疗后血清中HDL-C、PCT、CRP、IL-6和白细胞(WBC)水平,统计患者序贯脏器衰竭评分(SOFA评分),分析其与感染程度的相关性.结果 治疗前,复杂腹腔感染组中患者血清HDL-C显著低于单纯腹腔感染组及对照组(P<0.05),PCT、CRP、IL-6和WBC显著高于单纯腹腔感染组及对照组(P<0.05).受试者工作特征曲线(ROC曲线)分析结果显示,HDL-C、PCT、CRP、IL-6、WBC联合检测的曲线下面积为0.972,均高于PCT(0.961)、HDL-C(0.877)、IL-6(0.766)、WBC(0.686)和CRP(0.661)单独检测.治疗后,复杂腹腔感染组及单纯腹腔感染组中患者血清HDL-C上升,PCT、CRP、IL-6和WBC下降,与治疗前比较,差异均有统计学意义(P<0.05).复杂腹腔感染组中死亡患者血清HDL-C低于好转出院患者(P<0.05),SOFA评分明显高于好转出院患者(P<0.05),而PCT、CRP、IL-6和WBC差异无统计学意义(P>0.05).结论临床检测腹腔感染患者血清中HDL-C、PCT、CRP、IL-6及WBC水平对评估患者感染的严重程度及治疗效果有一定的指导作用,治疗过程中患者血清HDL-C持续性处于较低水平可能提示预后不良.

Background: The global mortality rate for coronavirus disease 2019 ( COVID-19) is 3.68%, but the mortality rate for critically ill patients is as high as 50%. Therefore, the exploration of prognostic predictors for patients with COVID-19 is vital for prompt clinical intervention. Our study aims to explore the predictive value of hematological parameters in the prognosis of patients with severe COVID-19. Methods: Ninety-eight patients who were diagnosed with COVID-19 at Jingzhou Central Hospital and Central Hospital of Wuhan, Hubei Province, were included in this study. Results: The median age of the patients was 59 [28-80] years; the median age of patients with a good prognosis was 56 [28-79] years, and the median age of patients with a poor outcome was 67 [35-80] years. The patients in the poor outcome group were older than the patients in the good outcome group (P<0.05). The comparison of hematological parameters showed that lymphocyte count (Lym#), red blood cells (RBCs), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) were significantly lower in the poor outcome group than in the good outcome group (P<0.05). Further, the red cell volume distribution width-CV (RDW-CV) and red cell volume distribution width-SD (RDW-SD) were significantly higher in the poor outcome group than in the good outcome group (P<0.0001). Receiver operating characteristic (ROC) curves showed RDW-SD, with an area under the ROC curve (AUC) of 0.870 [95% confidence interval (CI) 0.796-0.943], was the most significant single parameter for predicting the prognosis of severe patients. When the cut-off value was 42.15, the sensitivity and specificity of RDW-SD for predicting the prognosis of severe patients were 73.1% and 80.2%, respectively. Reticulocyte (RET) channel results showed the RET level was significantly higher in critical patients than in moderate patients and severe patients (P<0.05), which may be one cause of the elevated RDW in patients with a poor outcome. Conclusions: In this study, the hematological parameters of COVID-19 patients were statistically analyzed. RDW was found to be a prognostic predictor for patients with severe COVID-19, and the increase in RET may contribute to elevated RDW.

目的 探讨血清降钙素原(PCT)对Stanford A型主动脉夹层患者术后发肺部感染的预测及预后评估价值.方法 选取2018年1月至2019年5月期间华中科技大学同济医学院附属同济医院收治的Stan-ford A型主动脉夹层并接受手术治疗的82例患者作为研究对象,依据其术后是否发生肺部感染分为52例感染组及30例对照组(未感染患者),采集两组患者的一般临床资料及术前、术后2 d、术后3 d的静脉血样本,检测其PCT及WBC水平.结果 感染组住院时间及预后死亡人数明显高于对照组,差异有统计学意义(P<0.05).感染组术后3 d PCT水平明显高于对照组,差异有统计学意义(P<0.05).感染组好转患者术后2 d、术后3 d的PCT水平与死亡患者比较,差异有统计学意义(P<0.05).结论 监测血清PCT水平对Stanford A型主动脉夹层患者术后发生肺部感染的预测及预后判断有一定的参考价值.

To retrospectively analyze epidemiological, clinical and hematological characteristics of COVID‐19 patients.

In December 2019, cases of severe coronavirus 2019 (COVID-19) infection rapidly progressed to acute respiratory failure. This study aims to assess the association between the neutrophil-to-lymphocyte ratio (NLR) and the incidence of severe COVID-19 infection. A retrospective cohort study was conducted on 210 patients with COVID-19 infection who were admitted to the Central Hospital of Wuhan from 27 January 2020 to 9 March 2020. Peripheral blood samples were collected and examined for lymphocyte subsets by flow cytometry. Associations between tertiles of NLR and the incidence of severe illness were analysed by logistic regression. Of the 210 patients with COVID-19, 87 were diagnosed as severe cases. The mean NLR of the severe group was higher than that of the mild group (6.6vs.3.3,P< 0.001). The highest tertile of NLR (5.1-19.7) exhibited a 5.9-fold (95% CI 1.3-28.5) increased incidence of severity relative to that of the lowest tertile (0.6-2.5) after adjustments for age, diabetes, hypertension and other confounders. The number of T cells significantly decreased in the severe group (0.5vs.0.9,P< 0.001). COVID-19 might mainly act on lymphocytes, particularly T lymphocytes. NLR was identified as an early risk factor for severe COVID-19 illness. Patients with increased NLR should be admitted to an isolation ward with respiratory monitoring and supportive care.

Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, accounting for ~80% of all lung cancer cases. The aim of the present study was to identify key genes and pathways in NSCLC, in order to improve understanding of the mechanism of lung cancer. The GSE33532 gene expression dataset, containing 20 normal and 80 NSCLC samples, was used. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to obtain the enrichment data of differently expressed genes (DEGs). Disease modules within NSCLC were constructed by Cytoscape, using protein-protein interaction (PPI) from the Search Tool for the Retrieval of Interacting Genes database. In addition, the Kaplan Meier plotter KMplot was used to assess the top hub genes in the PPI network. As a result, 1,795 genes were identified in NSCLC; 729 were upregulated and 1,066 were downregulated. The results of the GO analysis indicated that the upregulated DEGs were significantly enriched in 'biological processes' (BP), including 'cell cycle and nuclear division'; the downregulated DEGs were also significantly enriched in BP, including 'response to wounding', 'anatomical structure morphogenesis' and 'response to stimulus'. Upregulated DEGs were also enriched in 'cell cycle', 'DNA replication' and the 'tumor protein 53 signaling pathway', while the downregulated DEGs were also enriched in 'complement and coagulation cascades', 'malaria' and 'cell adhesion molecules'. The top 9 hub genes were cyclin-dependent kinase 9 (CDK1), polo-like kinase 1, aurora kinase B, cell division cycle 20, baculoviral initiator of apoptosis repeat containing 5, mitotic checkpoint serine/threonine kinase B, proliferating cell nuclear antigen (PCNA), centromere protein A and MAD2 mitotic arrest deficient-like 1, and the KMplot results revealed that the high expression levels of these genes resulted in significantly low survival rates, compared with low expression samples (P<0.05), with the exception of PCNA and CDK1. In the pathway crosstalk analysis, 26 nodes and 41 interactions were divided into two groups: One module of the two groups primarily included 'metabolism of amino acid' and the other primarily contained 'tumor necrosis signaling' pathways. In conclusion, the present study assisted in improving the understanding of the molecular mechanisms underlying NSCLC development, and the results may help the understanding of the biological mechanism of NSCLC.

Objective To study the relationship between serum 25-hydroxyvitamin and prediabetes.Methods Based on the diagnostic criteria of diabetes meatus of the ADA(2009),325 patients were selected as prediabetes group,and 203 healthy subjects were selected as control group.The biochemical parameters of human were measured and serum 25-hydroxyvitamin D [25(OH)D]was measured by enzyme linked immunoassay.Logistic regression analysis was used to analyze the relationship between prediabetes and its related factors.The odds ratios and 95%confidence interval of diabetes were calculated respectively according to quartiles of serum 25(OH)D.Results The total prevalence of predia-betes among more than 27 years old in Wuhan city was 18.3%.The levels of serum 25(OH)D in the prediabetes group and control group were(34.4±12.3)nmol/L and (43.5±18.4)nmol/L,and there were significant differences among two groups(P<0.01).Logistic analysis showed lower serum 25(OH)D level was a predictor of prediabetes[β=-0.31,OR=1.42,P=0.03].After adjusting for age,sex,BMI,blood pressure,TC,TG and HOMA-IR,the odds ratio of prediabetes was significantly Increased [OR=1.46,95%CI(1.15-1.86),P<0.05]when serum 25(OH)D levels were below23.5 nmol/L.Conclusion Lower serum 25(OH)D levels are associated with prediabetes,the decreased ser-um levels 25(OH)D increased onset risk of prediabetes.

Objective To explore the correlation between bilirubin concentrations and gestational diabetes mellitus (GDM) during mid-pregnancy.Methods The pregnant women were collected from the Central Hospital of Wuhan,Huazhong University of Science and Technology,the basic data were obtained through retrospective study.Vanadate oxidation method was used to test total bilirubin (TB) and direct bilirubin (DB),enzymatic method was used to test fasting GLU.Immune turbidimetry was used to test CRP and Alb.Results The morbidity of GDM was 7.86％ (102/1 297).The mean of total bilirubin and direct bilirubin in GDM were lower in non-GDM(5.8 ±2.2 and 6.4 ±2.4,P =0.023;2.4 ± 1.3 and 2.5 ±0.9,P =0.036).Two-piecewise linear regression analysis was further adopted to assess the correlation between total bilirubin、direct bilirubin and fasting glucose、1h blood glucose、2h blood glucose.In multiple logistic regression analysis,the relative risk (RR) of developing GDM was lower in the highest layer of the total bilirubin and direct bilirubin levels than that in the lowest layer (RR 0.54;95％ CI,0.31-0.95) and (RR 0.61;95％ CI,0.38-0.99).Conclusion The results suggested that pregnant women with higher serum bilirubin had lower risk for the development of GDM during mid-pregnancy.

Objective To explore the association between serum gamma glutamyl transpeptidase (GGT) and fasting blood-glucose,evaluating the modification effects of body mass index (BMI),age,sex,and lipids.Methods The normal control group (120 cases),the hospitalized patients with three times of the average fasting blood glucose (6.0 ～7.0 mg/dl) (128 cases),and the hospitalized patients with three times of the average fasting blood glucose (＞7.0 mg/dl) (124 cases) were selected in this study.Immune turbidimetry was used to test the serum of GGT,aspartate aminotransferase (AST),alanine aminotransferase (ALT),alkaline phosphatase (ALP),total cholesterol (TC),and triglycerides (TG).Enzymatic method was used to test glucose (GLU).High performance liquid chromatography-electrospray mass spectrometry was used to measure glycosylated hemoglobin A1c (HbAlc) in the blood.Results (1) The value of GGT was significantly higher in the patients with type 2 diabetes,but the fasting blood glucose was above of 7.0 compared to the other two groups (P ＜ 0.05).(2) After adjustment of many confounders,the significance of the highest GGT quartile band compared to the lowest was obviously among three groups (P ＜ 0.05).Conclusions GGT is expected to predict the development of disease in the process of treatment of type 2 diabetes.

目的：通过测定湖北地区0岁（小于1岁）健康儿童血清补体C3水平，观察其血清补体C3的分布情况。方法收集415例该院及儿童医院体检0岁健康儿童血清，应用美国贝克曼库尔特IM AGE800特定蛋白分析仪（免疫散射比浊法）测定其血清补体C3水平，并对结果进行统计分析。结果该地区健康0岁儿童血清补体C3水平男女间比较差异无统计学意义（ P＜0．05），其95％参考范围为0．57～1．60 g／L。结论当前临床沿用《全国临床检验操作规程》及厂家所给的成人补体C3正常参考范围不适用于本实验室0岁儿童，各实验室应根据自身情况制订正常参考范围。

Objective To explore early diagnostic value of CD64 in leukemia complicated with bacterial infection.Methods Fifty leukemia patients complicated with bacterial infection ,48 leukemia patients without bacterial infection and 38 normal con‐trol group were enrolled into this study.Peripheral venous blood was collected.Expression of CD64 and the ratio of CD4/CD8 were detected by flow cytometry.Immunoturbidimetric assay was adopted to detect procalcitonin(PCT)and C‐reactive protein (CRP) ,and bioelectrlcal impedance analysis used to determine neutrophilic granulocyte percentage(NEU% ).Results ①CD64 expression was significantly higher in the leukemia patients complicated with bacterial infection than in the other two groups(P<0.01). ②The ratio of CD4 to CD8 was significantly lower in the leukemia patients complicated with bacterial infection group than in the other two groups(P<0.01). ③The ROC curve showed that accuracy of PCT as an early diagnosis indicator for early infection was superior to CRP and NEU% ,and the specificity and sensitivity of CD64 in early diagnosis of leukemia combined with bacterial infection were higher than those of PCT.So CD64 had an advantage of early diagnosis in leukemia combined with bacterial infection.Conclusion CD64 has high specificity in diagnosis of bacterial infection ,and it played an important role in early diagnosis of leukemia complicated with bacterial infection.

Background and purpose: Plumbagin is the main active components of traditional Chinese medicine of plumbago zeylanica. The present studies show that plumbagin has a killing effect on tumor cells. This study aimed to investigate the function and primary mechanism of plumbagin on invasion and metastasis of human liver cancer SK-hep-1 cells. Methods: With the treatment of plumbagin in vitro, cell proliferation and adhesion of SK-hep-1 cells were detected by MTS staining, cell cycle of SK-hep-1 cells were detected by flow cytometry, the selfrenewal and propagation abilities of SK-Hep-1 cells were conducted by colony formation assay, invasion in cells were performed using transwell invasion assay, and the p21 and MMP-2/9 mRNA levels were detected by real-time RT-PCR.Results: With the treatment of plumbagin, SK-Hep-1 cells proliferation was decreased with plumbagin concentrationdependency and the IC50value of plumbagin in SK-Hep-1 cells was 22.04 mmol/L. The colony formation ability of SKHep-1 cells was decreased and the percentage of cells in G0/G1phase was increased in a dose-dependent manner, as compared to control. The cell adhesion and invasion abilities were decreased. The real-time RT-PCR showed that p21mRNA expression was increased and the MMP-2/9 mRNA was decreased. Conclusion: Plumbagin could suppress the proliferation and invasiveness of human liver cancer SK-hep-1 cells in vitro, and these effects may be by up-regulation of p21 and down-regulation of MMP-2 and MMP-9.