OBJECTIVE:To analyze the distribution of thalassemia (referred to as "thalassemia") gene variant types in the population of the Wuhan area, aiming to provide a genetic basis for the precise prevention and control as well as clinical diagnosis of thalassemia in the Wuhan region. METHODS:In this study, 2 133 suspected thalassemia patients and individuals undergoing prenatal screening who visited the Department of Hematology, Obstetrics and Gynecology, Reproductive Medicine, Pediatrics, and Neurology at Wuhan First Hospital from October 2022 to October 2024 were selected as the research subjects. Peripheral blood samples were collected from the patients. The common 27 thalassemia genotypes of α- and β-thalassemia were initially screened using fluorescence PCR melting curve analysis technology. For samples where the fluorescence PCR melting curve results indicated unknown variants or where the clinical phenotype was inconsistent with the common genotypes, Sanger sequencing technology was used for review and verification. RESULTS:Among the 2 133 specimens analyzed, common thalassemia gene variants were detected in 210 cases (9.85%, 210/2 133). A total of 156 cases (8.05%, 156/1 938) of thalassemia gene variants were detected in females and 54 cases (27.69%, 54/195) in males. A total of 94 cases (4.41%, 94/2 133) of α-thalassemia were detected, including 46 cases (2.16%, 46/2 133) of silent α-thalassemia, 47 cases (2.20%, 47/2 133) of mild α-thalassemia, and 1 case (0.05%, 1/2 133) of intermediate α-thalassemia. Additionally, 111 cases of β-thalassemia were identified (5.20%, 111/2 133), including 51 cases of β/β+ thalassemia (2.39%, 51/2 133), 59 cases of β/β0 thalassemia (2.77%, 59/2 133), and 1 case of β+/HbE thalassemia (0.05%, 1/2 133). αβ-composite thalassemia gene variants were detected in 5 cases (0.23%, 5/2 133), including 1 complex variant with a genotype of --SEA/αα combined with CD41-42 (-TTCT) and 29(A>G), representing a heterozygous variant of three genotypes. Rare globin gene variants were detected in 3 cases, including HBB:c.60C>T, HBB:c.-146G>T, and HBA2:c.*12G>A. CONCLUSION:The Wuhan region exhibits a relatively high prevalence of thalassemia genes with notable gender disparities. While maintaining focus on thalassemia screening for females, enhanced males screening efforts and genetic counseling should be implemented in future prevention programs.

Background: Except host and environmental factors influencing individual human cytokine responses, pre-analytical handling procedures and detection methods also affect cytokine levels. Methods: In this study, we used cytometric bead array (CBA) and chemiluminescence (ECL). These two methods were used to test serum and plasma samples from 50 healthy adult volunteers and 50 rheumatoid arthritis (RA) patients' cytokine levels. We evaluated the impact of storage temperature, collection times, and additives in collection tubes on the measurement of IL-6, IL-8, and TNF-alpha. Results: The finding of this study first indicated that the CBA assay for IL-6 and IL-8 showed excellent agreement with ECL for the same analysis, but the CBA assay and ECL for TNF-alpha measurement showed less agreement. Furthermore, we used two detection methods to find plasma cytokines showing more stability than serum cytokines, when the samples were stored at 4 degrees C. Additionally, IL-8 concentration was affected by the storage conditions of whole blood from the time of collection until further processing at room temperature. We also found heparin tubes showed higher levels of IL-6 and TNF-alpha than other tubes at room temperature. Conclusions: In general, the best values for IL-6, IL-8, and TNF-alpha were found in EDTA samples, stored at 4 degrees C, and centrifuged quickly within 2 hours. The effect of pre-analytical handling procedures and detection methods on cytokine levels we identified would provide a basis for clinical cytokine detection.

Background Scopulariopsis/Microascus is a rare but devastating pathogen due to its intrinsic resistance to nearly all available antifungal agents. Microascus gracilis , an ascomycetous mould in the order Microascales , family Microascaceae , has recently emerged as a significant invasive pathogen causing opportunistic infections. Objectives and Methods We present a case of pleural infection caused by M. gracilis with pulmonary aspergillosis in an immunocompromised man after COVID-19 pneumonia. To further understand the characteristics of the pathogen isolated from the patient, we identified the strain through mycological characteristics, matrix-assisted laser desorption/ionization (MALDI) time-of-flight (TOF) mass spectrometry (MALDI-TOF MS) and internal transcribed spacer (ITS)-based sequencing, and performed in vitro drug susceptibility testing against common antifungal agents. Moreover, we assessed lymphocyte subsets and programmed cell death protein 1 (PD-1) expression in peripheral blood and pleural effusion to monitor the efficacy of therapy with thymosin-α-1 and intravenous immunoglobulin. Results Filamentous fungi isolated from pleural fluid were identified as M. gracilis based on classical morphology, mass spectrometry and molecular biology methods. The susceptibility results in vitro revealed that multiple antifungal agents were inactive against the strain. Adjuvant immunomodulatory treatment successfully increased the levels of CD3+ T and CD4+ T cells while decreasing the levels of CD3+PD-1+ and CD4+PD-1+ T cells in both peripheral blood and pleural effusion. Conclusions The immunocompromised host with opportunistic M. gracilis infection, rapid and accurate recognition through direct microscopic testing with calcofluor white and MOLDI-TOF MS, is the key to achieving a definite diagnosis, and a combination of antifungal therapy with immunomodulatory therapy is vital for improving survival. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was supported by the Wuhan Health Scientifc Research Key Project (No.WX18A06), and the Wuhan Health Scientifc Research Program(No.WH21C21). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics Committee/IRB of Wuhan No.1 Hospital gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present work are contained in the manuscript.

目的 探讨特发性膜性肾病(IMN)患者血清T细胞免疫球蛋白黏蛋白分子-3(Tim-3)及其配体癌胚抗原相关细胞黏附分子1(CEACAM1)与其肾功能进展的相关性.方法 选取2019年7月至2022年8月于该院住院并经肾组织活检确诊为IMN的80例患者作为IMN组,另选取77例同期体检健康者作为对照组.根据估算肾小球滤过率(eGFR)水平将IMN组分为肾功能正常组[eGFR>90 mL/(min·1.73 m2)],肾功能下降组[eGFR≤90 mL/(min·1.73 m2)].采用酶联免疫吸附试验比较各组血清Tim-3、CEACAM1水平,分析IMN患者血清Tim-3、CEACAM1水平与一般临床指标的相关性,采用多因素Logistic回归分析影响IMN患者肾功能下降的危险因素.结果 与对照组比较,IMN组血清Tim-3、CEACAM1水平升高(P<0.05);肾功能下降组血清Tim-3水平高于肾功能正常组(P<0.05);血清Tim-3水平与白蛋白、总蛋白、eGFR呈负相关(r=-0.266、-0.229、-0.374,P<0.05),与肌酐呈正相关(r=0.289,P<0.05);多因素Logistic回归分析结果显示,Tim-3水平升高是影响IMN患者肾功能下降的独立危险因素.结论 IMN患者血清Tim-3、CEACAM1水平升高,Tim-3/CEACAM1可能在IMN的发生发展中发挥重要作用,血清Tim-3水平可为IMN患者治疗及预后提供一定依据.

Although C-type lectin domain family 9A (Clec9A) on conventional type 1 dendritic cells (cDC1s) plays a critical role in cytotoxic CD8+ T cell response in cancers and viral infections, its role in chronic obstructive pulmonary disease (COPD) is unknown. We measured the expression of Clec9A in sera, bronchoalveolar lavage fluid (BALF), and peripheral blood mononuclear cells (PBMCs) from controls and COPD patients. The percentages of Clec9A+ DC and cytotoxic CD8+ T cell in the BALF were determined by flow cytometry between patients with COPD and non-obstructive chronic bronchitis (NOCB). Compared with healthy individuals, the serum levels of Clec9A were increased at different stages of COPD patients, and the mRNA and protein levels of Clec9A were both increased in COPD patients at GOLD stages III-IV. The percentage of Clec9A+ DCs was also increased in the BALF of COPD patients compared with NOCB patients. Moreover, enhanced Clec9A+ DCs recruitment was positively correlated with cytotoxic CD8+ T cell response in the BALF of COPD patients. This study suggests that Clec9A+ DCs participate in the CD8+ T cell-mediated chronic airway inflammation in COPD.

OBJECTIVEST cell immunoglobulin and mucin domain 3 (TIM-3) has been reported as an important regulatory molecule on T cells and plays a pivotal role in autoimmune diseases, but the impact on dendritic cells (DCs) is poorly explored. The formation of neutrophil extracellular traps (NETs) is considered as strongly implicated in the pathogenesis of autoimmune diseases, such as in myeloperoxidase-antineutrophil cytoplasmic autoantibody associated vasculitis (MPO-AAV). This study thus aimed to investigate the potential regulation roles of TIM-3 in the regulation of NETs-mediated DC activation in MPO-AAV.METHODSTwenty untreated patients with MPO-AAV and 20 healthy controls were enrolled in this study. The expressions of TIM-3 and toll-like receptor 4 (TLR4) in peripheral blood dendritic cells were analysed by flow cytometry, and the release of NETs by neutrophils was evaluated by immunofluorescence. In animal experiments, we measured the DC activation markers after the stimulation of NETs. Furthermore, we detected the NETs-mediated DC activation after TIM-3 blockade.RESULTSHere we found an increased spontaneous NET production in MPOAAV patients. We also revealed a markedly reduced expression of TIM-3 and an increased expression of TLR4 on DCs of active MPO-AAV patients. We found the NETs could induce the activation of DCs and promote Toll-like receptor 4 expression on DC surface. More interestingly, the blockade of TIM-3 could further enhance the NETs-mediated DC cytokine expression.CONCLUSIONSOur results demonstrated DC surface TIM-3 plays an important role in maintaining the NETs mediated immune homeostasis in MPO-AAV, suggesting an important role in MPOAAV development.

Coronavirus disease 2019 ( COVID- 19) is associated with immune dysregulation and cytokine storm. Exploring the immuneinflammatory characteristics of COVID-19 patients is essential to reveal pathogenesis and predict progression. In this study, COVID-19 patients showed decreased CD3(+), CD4(+), and CD8+ T cells but increased neutrophils in circulation, exhibiting upregulated neutrophil-to-lymphocyte and neutrophil-to-CD8+ T cell ratio. IL-6, TNF-alpha, IL-1 beta, IL-18, IL-12/IL-23p40, IL- 10, Tim-3, IL-8, neutrophil extracellular trap-related proteinase 3, and S100A8/A9 were elevated, whereas IFN-gamma and C-type lectin domain family 9 member A (clec9A) were decreased in COVID-19 patients compared with healthy controls. When compared with influenza patients, the expressions of TNF-alpha, IL-18, IL-12/IL- 23p40, IL-8, S100A8/ A9 and Tim-3 were significantly increased in critical COVID-19 patients, and carcinoembryonic Ag, IL-8, and S100A8/A9 could serve as clinically available hematologic indexes for identifying COVID-19 from influenza. Moreover, IL-6, IL-8, IL-1 beta, TNF-alpha, proteinase 3, and S100A8/A9 were increased in bronchoalveolar lavage fluid of severe/critical patients compared with moderate patients, despite decreased CD4(+) T cells, CD8(+) T cells, B cells, and NK cells. Interestingly, bronchoalveolar IL-6, carcinoembryonic Ag, IL-8, S100A8/A9, and proteinase 3 were found to be predictive of COVID-19 severity and may serve as potential biomarkers for predicting COVID-19 progression and potential targets in therapeutic intervention of COVID-19.

目的 观察新型冠状病毒肺炎(简称新冠肺炎)患者外周血T淋巴细胞亚群改变的特点及糖皮质激素对其影响.方法 对武汉市第一医院收治的进行了T淋巴细胞亚群检测的376例新冠肺炎患者进行回顾性分析,按照临床分型分为普通型、重型、危重型及死亡病例,对重型患者根据是否运用糖皮质激素治疗进行分组对比分析.结果 根据病情严重程度,包括普通型患者118例(31.4％),重型患者215例(57.2％),危重型患者43例(11.4％).死亡6例(1.6％),均为危重型.(1)重型患者与普通型患者比较,总淋巴细胞[(1 359.2±597.9)×106比(1703.7±702.4)×106/L,LSD-t=4.786,P＜0.001]、总 T 淋巴细胞[(949.2±454.0)×106比(1235.5±555.7)×106/L,LSD-t=5.175,P＜0.001]、CD8+T 细胞[(336.8±189.8)×106比(461.7±242.8)×106/L,LSD-t=5.332,P＜0.001]显著减少,CD4+/CD8+比值(1.81±0.92比 1.64±0.74,LSD-t= 1.574,P=0.116)增加无显著差异;危重型患者与重型患者比较,CD4+/CD8+比值(2.23±1.24比 1.81±0.92,LSD-t=2.627,P=0.009)显著增加,CD8+T 细胞[(232.5±159.8)×106比(336.8±189.8)×106/L,LSD-t=2.867,P=0.004]显著减少,总淋巴细胞[(1161.1±583.7)×106比(1359.2±597.9)×106/L,LSD-t=1.772,P=0.077]、总 T 淋巴细胞[(790.5±419.3)×106比(949.2±454.0)×106/L,LSD-t=1.846,P=0.066]减少,无显著差异;死亡患者与危重型患者比较均无显著差异.(2)在215例重型患者中,与未使用糖皮质激素患者比较,使用糖皮质激素治疗3～5 d后患者总T淋巴细胞[(770.6±480.3)×106比(986.3±440.7)×106/L,t=2.666,P=0.008]和 CD4+/CD8+比值(1.30±0.73比 1.91±0.92,t=3.771,P＜0.001)均显著性减少.结论 新冠肺炎患者T淋巴细胞亚群变化主要表现为T淋巴细胞数量减少和CD4+/CD8+比值增加,且与病情严重程度正相关;糖皮质激素治疗可缓解CD4+/CD8+比值上升,但加剧了T淋巴细胞减少.

Objective To discuss the genetic effects of abnormal chromosome karyotype and chromosome polymorphism in infertile patients and provide effective guidance for their diagnosis and counseling. Methods Chromosome examinations were performed on 3,219 infertile patients in the Department of Reproductive Medicine in Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology and Wuhan First Hospital from July 2011 to July 2018. Results The abnormal chromosome karyotype rate was 3.01% . Among them, there were 35 cases with abnormal sex chromosome number, and the rate of abnormal chromosome structure was 1.93 % , with most of abnormal chromosome structure were translocations. The rate of chromosomal polymorphism was 3.95 % . Conclusion Chromosomal abnormalities are important factors leading to infertility, and chromosomal polymorphism changes and their effects in infertility should be paid attention to.

Objective To investigate the expressions of interleukin-33 (IL-33),soluble growth stimulation expressed gene 2 (sST2) and transforming growth factor β1 (TGF-β1) in the patients with systemic sclerosis (SSc) and their correlations.Methods Serum IL-33,sST2 and TGF-β1 levels from 25 SSc patients and 25 healthy controls were determined by an enzyme linked immunosorbent assay (ELISA).The expressions of IL-33 in the damaged skin tissue of SSc patients and normal skin tissue were detected with the immunohistochemical staining.Results Serum IL-33 and TGF-β1 levels in SSc patients were significantly higher than that in healthy controls (P ＜ 0.05),and serum IL-33 levels were positively correlated with TGF-β1 levels in SSc patients (P ＜ 0.05).Immunohistochemical staining results showed that the expression level of IL-33 in the damaged skin tissue of SSc patients were significantly higher than that in normal skin tissue (P ＜ 0.05).However,there was no significant difference in the expression level of sST2 between SSc patinets and healthy controls.Conclusion Serum IL-33 levels in SSc patients increase significantly,which is correlated with the expression of TGF-β1,indicating that IL-33 may play an important role in the process of inflammation and fibrosis of SSc via the regulation of TGF-β1.

Objective To investigate the serum levels of IL-33 and sST2 in antineutrophil cyto-plasmic antibody(ANCA)-associated vasculitis(AAV)and their correlation with the disease ac-tivity.Methods Enzyme linked immunosorbent assay(ELISA)was used to measure the levels of IL-33 and sST2 in 20 AAV patients,18 disease controls and 20 healthy individuals.MPO and RP3 were detected by ELISA and the nuclear types of ANCA by indirect immunofluorescence.Results The levels of serum sST2 were significantly higher in the AAV group(74.50 ± 31.79 pg/mL)than in disease control(58.83 ± 19.80 pg/mL)and healthy control(57.60 ± 6.21 pg/mL)groups(P<0.05).They were significantly higher in active AAV patients than in patients in remission.But the serum levels of sST2 were not correlated with the Birmingham Vasculitis Activity Score 2003 in AAV patients.There was no significant difference in the levels of IL-33 between AAV patients and controls.Conclusion sST2 is an effective clinical marker that can be used to monitor disease activi-ty in AAV patients.

目的 检测抗中性粒细胞胞浆抗体相关性血管炎(AAV)患者血清中类风湿因子(RF)的表达,并讨论RF与2003版伯明翰血管炎活动性评分(BVAS2003)量表的相关性.方法 收集华中科技大学同济医学院附属同济医院2017年3～9月确诊的76例AAV患者,全部研究对象于空腹抽取静脉血,应用酶联免疫吸附试验测定血清中IgM-RF,IgG-RF和IgA-RF的水平,同时采用免疫比浊法分析C反应蛋白(CRP)的浓度,利用BVAS2003量表对所有AAV患者进行评分.结果 36.8％的AAV患者血清中IgG-RF为阳性,且IgG-RF阳性患者CRP浓度较IgG-RF阴性患者明显升高,差异具有统计学意义(P<0.05),血清IgG-RF水平与BVAS2003分值呈正相关(r=0.26,P<0.05).结论 AAV患者血清IgG-RF滴度与疾病活动度具有相关性,提示IgG-RF水平可用于AAV疾病的活动度评估.

Objective To explore the clinical features of antineutrophil cytoplasmic antibodies-associated vasculitis com-bined with pulmonary fibrosis and the relationship of laboratory results.Methods Totally,33 patients with antineutrophil cyto-plasmic antibodies-associated vasculitis were divided into pulmonary fibrosis group(group A)and non-pulmonary fibrosis group (group B).Fourteen patients with connective tissue diseases-related pulmonary fibrosis served as disease control group,and 12 healthy people as normal control group.The levels of ANCA,plasma creatinine,high-sensitivity C-reactive protein,fibrinogen and D-dimer were detected.Results The creatinine level was significantly higher in group B than in disease control group and normal control group.The creatinine level was higher in group A than in disease control group and normal control group,with-out significant differences.The levels of FIB,D-D,and hsCRP were significantly higher in the group A,group B and disease con-trol group(all P< 0.05).In the group A,MPO expression was positively associated with FIB concentration(r= 0.64,P<0.05).Conclusion In pulmonary fibrosis disease,early detection of ANCA has clinical value in the diagnosis of AASV.And the higher concentration of M PO may hint thrombus formation.

Objective: To investigate the effect of mucor hypha on human pulmonary microvascular endothelial cell (HPMVEC) and the intervention of N-cadherin antibody.Method: The proliferative phase of HPMVEC, divided into mucor infection model group (mucor hypha group, 1×10CFU mucor hypha and HPMVEC co-culture at 37℃,5% CO2 and saturated humidity for 12h),N-cadherin monoclonal antibody intervention group (N-cadherin antibody group, HPMVEC and 1mg/ml N-cadherin antibody co-culture at room temperature for 1h, before the infection of mucor hypha, then followed by mucor hypha group operation) and blank control group (sterile deionized water instead of mucor hypha,and the absence of the N-cadherin antibody, then followed the mucor hypha group method of parallel experiment.The supernatant of each group was collected at 0h, 1h, 2h, 6h and 12h, and the levels of TF and vWF were detected by ELISA.Results: Comparison with groups, the levels of TF and vWF secreted in the supernatants of the mucor hypha group were significantly increased as time-dependent(P<0.05 or P<0.01).Comparison between groups, the levels of TF and vWF secreted in the supernatants of the mucor hypha group were sig-nificantly higher than the blank control group at each time point(P<0.05 or P<0.01), and after incubated with N-cadherin monoclonal antibody, the levels of TF and vWF released in the supernatants were significantly lower than the untreated mucor hypha group at each time point(P<0.05 or P<0.01).Conclusion: The increased level of TF and vWF induced by mucor hypha infected with HPMVEC, which can be effectively down-regulated by N-cadherin monoclonal antibody,it suggested the N-cadherin monoclonal antibody can be used to prevent the injury and thrombosis of vascular endothelial cells caused by infection of mucor hypha.

Objective To explore the clinical diagnostic value and significance of five kinds of serum tumor markers including carcinoembryonic antigen (CEA),carbohydrate antigen 125 (CA125),neuron-specific enolase (NSE),cytok-eratin 19 fragment (CYFRA21-1),squamous cell carcinoma antigen (SCC)for lung cancer.Methods 60 patients diag-nosed first as lung cancer and 60 patients with other tumor disease at the same period were enrolled in this study.The levels of serum CEA,CA125,NSE,CYFRA21-1 were detected by chemiluminescence assay,The levels of serum SCC were detected by Eletro-chemiluminescence assay.The clinical values of the 5 kinds of serum tumor markers for lung cancer diagnosis were compared and analyzed.Results The levels of five kinds of tumor markers in lung cancer patients were significantly higher than those in healthy people(all AUC>0.700).CA125 in the diagnosis of lung cancer and other tumors significantly(AUC=0.706,P<0.05);SCC in the diagnosis of squamous cell carcinoma was significantlyχ2=6.963,P<0.05;CYFRA21-1 in the diagnosis of small cell lung cancer and non-small cell lung cancer significantlyχ2=9.367,P<0.05,instead of NSE no significantχ2=2.279,P>0.05.Conclusion CA125 in the diagnosis of lung cancer with other tumor groups or healthy people have significant advantages,SCC diagnosis of squamous cell carcinoma can be better,The significant advantage of CYFRA2 1-1 in the diagnosis ofsmall cell lung cancer and non-small cell lung cancer.

Objective To understand the distribution and drug resistance of common pathogenic bacteria which cultured from blood specimens in the past 3 years. Methods Pathogens were cultured using BD blood culture systems and French Merieux blood culture system. VITEK-2 Compact automatic bacterial identification instrument was used for identification and drug sensitivity test of the isolated pathogens. Results In the past 3 years, there were 950 isolated pathogenic bacteria, mainly gram-negative bacteria. In the years 2011-2013, the culture rates of Escherichia coli were 41.9%, 28.6%, and 27.3%, respectively. In which, the isolation rate of extended-spectrumβ-lactamases (ESBLs) was 43.8%~60.8%. In 2013, the culture rate of coagulase negative staphylococci was 20.1%. From 2011 to 2013 , the isolation rates of methicillin-resistant Staphylococcus aureus were 13.3%, 33.3%and 43.2%, respectively, for methicillin-resistant coagulase-negative staphylococci were 50.0%, 76.9%and 86.1%, respectively. Conclusion Distribution and antibiotic resistance of pathogenic bacteria cultured from blood specimens have a significant change in the past 3 years. Clinician should use the antibiotics reasonably according to the result of blood culture.

Objective To investigated the association of serum level of growth arrest-specific protein 6 (Gas6) with the disease activity in patients with systemic lupus erythematosus. Methods The expression levels of Gas6 were detected by enzyme linked immunosorbent assay in 102 SLE patients and 67 healthy persons; and statistical methods were used to analyze the expressions of Gas6 in the patients with different clinical symptoms. Results The expression of Gas6 was significantly higher in the SLE group [54.59 (2.41 ~ 614.93) ng/mL] than in the healthy control group [19.22 (15.06 ~ 384.93) ng/mL, P < 0.05]. And serum Gas6 levels were significantly higher in the patients with dsDNA (+) , renal disorder , rash and vasculitis than the patients without symptoms (P < 0.05). The expression of Gas6 was correlated with SLEDAI significantly (r = 0.569, P < 0.01). Conclusions Gas6 plays an important role in the pathogenesis of SLE and it is an effective biomarker for the disease activity in patients with systemic lupus erythematosus.

细胞死亡可根据其表观形态学分为：细胞凋亡、坏死、细胞自噬等；也可根据有无核酸酶或不同类别的蛋白酶的参与分为：半胱天冬酶参与的细胞死亡，钙激活中性蛋白酶参与的细胞死亡，组织蛋白酶和谷氨酰胺转胺酶参与的细胞死亡；还可以根据功能方面分为：程序性的细胞死亡，意外的细胞死亡，生理性的细胞死亡或病理性的细胞死亡；或者根据免疫学特性分为：免疫原性的细胞死亡或无免疫原性的细胞死亡。2009年细胞死亡命名委员会（Nomenclature Committee on Cell Death，NCCD）［1］建议统一根据形态学标准定义和分类细胞死亡，目前发现细胞死亡种类有凋亡（ Apoptosis ）、自噬性细胞死亡（ Autophagic cell death ）、坏死（ Necrosis ）、角化性细胞死亡（ Cornification ）、非典型细胞死亡，包括有丝分裂崩溃（ Mitotic catastrophe ）、失巢凋亡（Anoikis）、沃勒变性（Wallerian degeneration）、副凋亡（ Paraptosis ）、细胞焦亡（ Pyroptosis ）、内亡（Entosis）、兴奋性中毒（Excitotoxicity）、铁死亡（Fer-roptosis）。死亡细胞的有效清除对一个有机体的存活是必要的。正在死亡的或者已经死亡细胞的通过吞噬作用清除，根据不同的细胞死亡模式即凋亡、自噬和坏死，存在不同的机制来保证细胞残骸的清除。

Objective To investigate the serum level of VEGF in COPD patients and its correlation with cell apoptosis. Methods The level of VEGF was measured from 62 COPD patients and 46 healthy persons. Flow cytom-etry was used to detect mononuclear cell apoptosis. Results The expression of VEGF in the COPD group was signifi-cantly higher than that in the healthy control group (P<0. 05). 2 and 24 hours after culture, the percentage of apop-totic mononuclear cells in the COPD group was significantly lower than that in the control group (P<0. 05). Serum VEGF expression was negatively correlated with peripheral blood mononuclear cell apoptosis ( r = -0. 35, P <0. 05). Conclusion VEGF plays an important role in the cell apoptosis from pations with COPD.