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Sichuan Da Xue Xue Bao. Yi Xue Ban = Journal Of Sichuan University. Medical Science Edition[JOURNAL]
Sichuan Da Xue Xue Bao. Yi Xue Ban = Journal Of Sichuan University. Medical Science Edition[JOURNAL]
Sun
200 papers
[Construction of an Early-stage Risk Prediction Model for Trauma-Induced Coagulopathy].
Xu X, He M, Shao M … +5 more , Liu X, Yi Q, Zhang B, Huang Y, Tan C
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021909 · Full text
OBJECTIVE: Based on prospectively collected early clinical and laboratory data from trauma patients at admission, a risk prediction model for the early assessment of trauma-induced coagulopathy (TIC) in emergency trauma...
OBJECTIVE: Based on prospectively collected early clinical and laboratory data from trauma patients at admission, a risk prediction model for the early assessment of trauma-induced coagulopathy (TIC) in emergency trauma patients was constructed and validated. METHODS: This study analyzed the clinical data and laboratory results of 285 emergency trauma patients admitted between January 2024 and December 2024. The patients were randomly divided into a training set ( = 199) and a test set ( = 86) at a 7∶3 ratio. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of TIC and to construct a risk prediction model. The diagnostic efficacy of the model was evaluated by the area under the receiver operating characteristic curve (AUC). The calibration curve was plotted using the Bootstrap method to assess calibration, and the clinical net benefit was evaluated by decision curve analysis (DCA). RESULTS: Multivariate logistic regression analysis identified head trauma, mean arterial pressure (MAP), prothrombin time (PT), and thrombin time (TT) as independent predictors of TIC, and a predictive model was developed. The AUC of the model was 0.804 (95% CI: 0.737-0.871) in the training set and 0.847 (95% CI: 0.767-0.927) in the test set. The calibration curve showed a high level of agreement between the predicted and actual probabilities. DCA indicated that the model provided significant clinical net benefit across a broad range of risk thresholds (0.2-1.0). CONCLUSION: This study developed and validated a TIC risk prediction model that demonstrated excellent early predictive efficacy for TIC in emergency trauma patients.
[A Study on the Association Between Various Insulin Resistance Assessment Indices and IVF-ET Outcomes in Patients With Polycystic Ovary Syndrome].
Liu Y, Hu Z, Han J … +2 more , Gao R, Qin L
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021908 · Full text
OBJECTIVE: To explore the correlations between various insulin resistance (IR) assessment indicators and embryo quality and pregnancy outcomes during fertilization and embryo transfer (IVF-ET) in patients with polycysti...
OBJECTIVE: To explore the correlations between various insulin resistance (IR) assessment indicators and embryo quality and pregnancy outcomes during fertilization and embryo transfer (IVF-ET) in patients with polycystic ovary syndrome (PCOS). METHODS: A retrospective cohort design was used, including PCOS patients who received fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment for the first time from January 2019 to July 2022. Assessment indicators of insulin resistance (IR) based on fasting status (HOMA-IR, QUICKI, Li Guangwei Index, Bennett ISI), collectively referred to as static IR indicators, and assessment indicators based on the oral glucose tolerance test (OGTT) (area under the curve ratio, Matsuda Index, Gutt Index), collectively referred to as dynamic IR indicators, were selected. Patients were divided into the IR group (high level) and the non-IR group (low level) according to the median. Differences in the levels of various IR assessment indicators, embryo quality, and pregnancy outcomes were compared. The primary outcome indicators were the D3 high-quality embryo rate (high embryo rate), fresh cycle clinical pregnancy rate, cumulative pregnancy rate, and cumulative live birth rate; other outcomes were considered secondary indicators. A multivariate binary logistic regression model was used to adjust for confounding factors, and multiple comparison correction was applied to control false positives when analyzing the correlation between different levels of IR assessment indicators and embryo quality and pregnancy outcomes. RESULTS: A total of 571 PCOS patients were included, all of whom had fasting blood glucose and insulin data. Among these, 499 cases had complete OGTT data. Main outcome indicators: There was no statistical correlation between the levels of static IR indicators and the main outcome indicators. The levels of dynamic IR indicators (Gutt index) were associated with the pregnancy rate of good embryos, with an adjusted odds ratio (OR) of 0.88 (95% CI: 0.79-0.99, = 0.035). The levels of the Matsuda index were associated with the cumulative pregnancy rate, with an adjusted OR of 0.61 (95% CI: 0.39-0.97, = 0.036). Secondary outcome indicators: No statistically significant correlations were observed between the static IR indicators and dynamic IR indicators after multiple comparison correction. CONCLUSION: The Matsuda index and Gutt index based on OGTT are more sensitive than static fasting indicators in reflecting differences in reproductive outcomes among PCOS patients, and thus have significant clinical value.
[A Review of Archaeological Studies on Dento-maxillofacial Deformities].
Luo G, Deng D, Zhou J … +1 more , Zhou C
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021907 · Full text
Dentomaxillofacial deformities are highly prevalent oral diseases that exhibit pronounced temporal variation, and their occurrence and progression are closely associated with human evolution, lifestyle transitions, and g...
Dentomaxillofacial deformities are highly prevalent oral diseases that exhibit pronounced temporal variation, and their occurrence and progression are closely associated with human evolution, lifestyle transitions, and genetic background. Archaeological research provides critical evidence for tracing the origin and evolutionary trajectory of dentomaxillofacial deformities. This review systematically summarizes archaeological findings of dentomaxillofacial deformities from prehistoric to historical periods, focusing on occlusal types, prevalence, and their spatiotemporal distribution patterns. By integrating morphological data from teeth and jawbones, the study further explores the relationships between malocclusion and dietary structure, economic modes, and population migration. The results indicate that dentomaxillofacial deformities were relatively rare in early human populations but increased markedly following the advent of agriculture and the refinement of food processing, particularly manifesting as higher frequencies of dental crowding and deep overbite, suggesting a pivotal role of environmental factors in their development. Meanwhile, variations in malocclusion patterns across different populations reflect the combined influence of genetic background and cultural factors. These archaeological findings reveal that dentomaxillofacial deformities demonstrate clear temporal variability and environmental dependence, and they provide a historical framework for understanding the high prevalence and etiological mechanisms of modern malocclusion, as well as a theoretical basis for optimizing orthodontic prevention and treatment strategies.
[Association Between Blood Routine Index and Metabolic Syndrome in High-altitude Tibetan Population].
Yan J, Zhang Y, Zhang J … +2 more , Wan Y, Xiong H
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021906 · Full text
OBJECTIVE: To investigate the relationship between blood routine indicators and the prevalence of metabolic syndrome (MetS) and its risk factors in the Tibetan population in Xizang. METHODS: From August 2021 to August 20...
OBJECTIVE: To investigate the relationship between blood routine indicators and the prevalence of metabolic syndrome (MetS) and its risk factors in the Tibetan population in Xizang. METHODS: From August 2021 to August 2023, a multi-stage stratified cluster random sampling method was used to conduct a questionnaire survey, anthropometric measurements, and laboratory examinations of the Tibetan population in the Lhasa, Ali, and Naqu areas of Xizang. A total of 2 832 people were included in the study. After adjusting for potential confounding factors, logistic regression analysis was used to examine the correlation between blood routine indicators and MetS. RESULTS: The prevalence of MetS was 11.5%, with rates of 12.9% among males and 10.6% among females. After adjusting for confounding factors, white blood cell count (WBC), hemoglobin (Hb), hematocrit (HCT), and platelet distribution width (PDW) were associated with MetS prevalence. Compared with the lowest tertile (Q1), the odds ratios (ORs) for Q2 and Q3 of WBC were 1.629 (95% CI: 1.164-2.279, = 0.004) and 1.621 (95% CI: 1.14-2.292, = 0.006), respectively. For Hb, the ORs in Q2 and Q3 were 0.523 (95% CI: 0.325-0.843, = 0.008) and 0.435 (95% CI: 0.212-0.889, = 0.022), respectively. The ORs for HCT in Q2 and Q3 were 1.818 (95% CI: 1.123-2.943, = 0.015) and 2.480 (95% CI: 1.208-5.089, = 0.013), respectively. The ORs for PDW in Q2 and Q3 were 0.562 (95% CI: 0.358-0.881, = 0.012) and 0.614 (95% CI: 0.381-0.991, = 0.046), respectively. CONCLUSION: WBC, Hb, HCT, and PDW in the complete blood count were associated with the prevalence of MetS, WBC and HCT were risk factors for the prevalence of MetS, while Hb and PDW were protective factors. It is recommended that complete blood counts be included in the monitoring and management of metabolic diseases.
[Perioperative Neurocognitive Disorders in Patients With Colorectal Cancer Undergoing General Anesthesia: Influencing Factors and Development of a Nomogram Prediction Model].
Tao W, Xia X, Dai Z … +1 more , Li R
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021905 · Full text
OBJECTIVE: To develop a risk prediction model for perioperative neurocognitive disorders (PND) in patients with colorectal cancer undergoing general anesthesia based on a nomogram. METHODS: A total of 207 patients underg...
OBJECTIVE: To develop a risk prediction model for perioperative neurocognitive disorders (PND) in patients with colorectal cancer undergoing general anesthesia based on a nomogram. METHODS: A total of 207 patients undergoing colorectal cancer surgery under general anesthesia from August 2021 to December 2024 were enrolled and randomly divided into a modeling cohort ( = 145) and a validation cohort ( = 62) at a 7∶3 ratio. Based on the occurrence of PND, the modeling cohort was further divided into PND group ( = 42) and non-PND group ( = 103), while the validation cohort was divided into PND group ( = 18) and non-PND group ( = 44). Logistic regression analysis was performed to identify influencing factors for PND in patients with colorectal cancer undergoing general anesthesia, and a nomogram prediction model was constructed. Receiver operating characteristic (ROC) curves and calibration curves were plotted, and Hosmer-Lemeshow goodness-of-fit test was conducted. RESULTS: Univariate analysis showed statistically significant differences between PND group and non-PND group in age, operative time, anesthesia depth, intraoperative blood loss, intraoperative mean regional brain oxygen saturation (rSO), mean platelet volume (MPV), platelet distribution width (PDW), visual analog scale (VAS) for pain, and Pittsburgh Sleep Quality Index (PSQI) ( < 0.05). Multivariate Logistic regression analysis revealed that age, anesthesia depth, intraoperative mean rSO, MPV, PDW, VAS, and PSQI were all influencing factors for PND in patients with colorectal cancer undergoing general anesthesia ( < 0.05). The area under the ROC curve (AUC) of the nomogram model was 0.861 (95% CI: 0.786-0.935) in the modeling cohort and 0.827 (95% CI: 0.752-0.902) in the validation cohort. Calibration curve analysis indicated that the predicted risk of PND was largely consistent with the actual incidence, and the Hosmer-Lemeshow test showed good model fit. Clinical decision curve analysis demonstrated high clinical applicability of the model. CONCLUSION: Advanced age, excessively light anesthesia depth, low intraoperative mean rSO, elevated serum MPV and PDW, severe pain, and poor sleep quality are influencing factors for PND in patients with colorectal cancer undergoing general anesthesia. The nomogram model established based on these factors exhibits good predictive performance.
[Pathogen Profile and Risk Factors for Hospital-Acquired Infection in Stroke Patients].
Xu T, Han B, Zhang H … +4 more , Shao C, Wang Y, Jiao Y, Zhang G
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021904 · Full text
OBJECTIVE: To investigate the risk factors for hospital-acquired infection in patients with stroke and to analyze the distribution of pathogens and characteristics of infection sites. METHODS: A retrospective cohort stud...
OBJECTIVE: To investigate the risk factors for hospital-acquired infection in patients with stroke and to analyze the distribution of pathogens and characteristics of infection sites. METHODS: A retrospective cohort study was conducted, enrolling 393 patients with stroke hospitalized at Beijing Tiantan Hospital, Capital Medical University, from January 2024 to July 2025. Among them, 184 patients were assigned to the infection group and 209 to the non-infection group. Multivariable logistic regression analysis was used to identify risk factors for hospital-acquired infection, and a nomogram prediction model was constructed. RESULTS: Multivariable logistic regression analysis identified cerebral infarction (odds ratio = 25.09, 95% confidence interval: 5.38-117.10), no history of alcohol consumption (odds ratio = 4.47, 95% confidence interval: 1.51-13.18), no history of cerebrovascular disease (odds ratio = 5.04, 95% confidence interval: 1.35-18.76), elevated neutrophil count (odds ratio = 1.29, 95% confidence interval: 1.08-1.55), and elevated C-reactive protein (odds ratio = 1.03, 95% confidence interval: 1.01-1.06) as independent risk factors for hospital-acquired infection in patients with stroke. Absence of nasogastric tube feeding (odds ratio = 0.09, 95% confidence interval: 0.03-0.31), no indwelling urinary catheterization (odds ratio = 0.21, 95% confidence interval: 0.06-0.77), and absence of postoperative coma (odds ratio = 0.07, 95% confidence interval: 0.01-0.36) were identified as protective factors. The nomogram model achieved an area under the curve of 0.96 (95% confidence interval: 0.94-0.98) in the training set and 0.94 (95% confidence interval: 0.90-0.99) in the validation set, with good calibration. Gram-negative bacteria were the predominant pathogens (70.2%), and the respiratory tract was the most common infection site (92.9%). Endotracheal intubation and impaired consciousness were identified as common risk factors for both pulmonary and Gram-negative bacterial infections. CONCLUSION: This study identified independent risk factors for hospital-acquired infection in patients with stroke, developed a nomogram model with good predictive performance, and preliminarily characterized the risk profiles associated with different infection types and sites. These findings provide a reference for early identification of high-risk patients and the formulation of targeted prevention and control strategies.
The Prevalence and Clinical Significance of the Centromere Protein-F-Like Immunofluorescence Staining Pattern in a Large ANA-positive Cohort.
Su Z, Zhang F, Zhang L … +7 more , Hayisaer Y, Yang B, Hu J, Wang L, Gao X, Zhang J, Huang Z
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021903 · Full text
OBJECTIVE: To investigate the prevalence and clinical significance of the centromere protein-F-like (CENP-F-like) immunofluorescence staining pattern in a large patient cohort and through literature review. METHODS: We r...
OBJECTIVE: To investigate the prevalence and clinical significance of the centromere protein-F-like (CENP-F-like) immunofluorescence staining pattern in a large patient cohort and through literature review. METHODS: We retrospectively analyzed antinuclear antibody (ANA) immunofluorescence assay results from 191274 patients at West China Hospital of Sichuan University between March 2018 and November 2020. Specific immunological markers were tested in sera with CENP-F-like patterns. Additionally, a narrative review of seven relevant studies was performed for comparison. RESULTS: In Southwest China, ANA positivity was found in 32.09% of patients, with the CENP-F-like pattern detected in 0.015% of all cases and 0.05% of ANA-positive individuals. The CENP-F-like pattern appeared predominantly at titers ≥ 1∶320, most often in isolation (68.97%), but also mixed with cytoplasmic speckled patterns. Patients with cancers accounted for the highest proportion (31.03%), including solid tumors and hematologic malignancies. Metastasis was observed in patients with solid tumors, while graft-versus-host disease (GVHD) occurred in those with hematologic malignancies post-transplantation. Autoimmune diseases (AIDs) were diagnosed in 20.69% of cases, all showing disease-specific autoantibodies. These findings were broadly consistent with previous reports and suggest a possible association between the CENP-F-like pattern and malignancies. CONCLUSION: The CENP-F-like pattern is rare in ANA tests but may be associated with clinically important conditions, particularly cancers and AIDs. The occurrence of metastasis and GVHD in patients with this pattern highlights its potential clinical relevance, and concurrent autoantibodies may assist in diagnosing AIDs.
[The Clinical Application and Development of Tumor Biomarkers in China].
Wang C
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021902 · Full text
Tumor biomarkers play an increasingly prominent role in early screening, auxiliary diagnosis, efficacy evaluation, and prognosis assessment, becoming an essential component of the precision oncology system. This article...
Tumor biomarkers play an increasingly prominent role in early screening, auxiliary diagnosis, efficacy evaluation, and prognosis assessment, becoming an essential component of the precision oncology system. This article systematically reviews the nearly two-century development history of tumor markers, from early protein-based markers to the genomics era. It focuses on the fundamental principles of standardized application of tumor markers in China, the current laboratory application status, and clinical application recommendations for key cancer types such as lung cancer and liver cancer. Additionally, it delves into multidimensional marker research supported by liquid biopsy technologies, including ctDNA genetic markers, DNA methylation, exosomes, and circulating tumor cells, as well as cutting-edge advancements and clinical translation challenges in areas such as artificial intelligence model construction. This review aims to provide insights for the innovative development and standardized application of tumor markers in China, thereby enhancing the precision of cancer prevention and control.
[Apply the Miettinen Formula to Assess the Health Benefits of the PM Simulation Intervention on Metabolic Syndrome].
Chen K, Han X, Yang Y … +1 more , Wang P
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021901 · Full text
OBJECTIVE: Quantify the health benefits of various strategies for reducing PM (aerodynamic diameter ≤ 2.5 μm) concentrations on the prevalence of metabolic syndrome (MetS) in the population, and provide more direct scien...
OBJECTIVE: Quantify the health benefits of various strategies for reducing PM (aerodynamic diameter ≤ 2.5 μm) concentrations on the prevalence of metabolic syndrome (MetS) in the population, and provide more direct scientific evidence to support air pollution control efforts. METHODS: By integrating PM exposure concentrations, population sizes of various cities in China, and relative risk data for PM-MetS from previous studies, the generalized impact fraction (GIF) for equivalent, fixed, threshold, and ratio interventions on PM concentrations was estimated using the Miettinen formula. Specifically, the proportion of MetS cases that could be reduced by lowering the current exposure level to a specified level of interest was calculated. RESULTS: Reducing PM concentrations by 5, 10, 15, or 20 μg/m³ can lead to decreases in the number of MetS cases by 10.54% (95% CI: 10.52%-10.57%), 19.94% (95% CI: 19.90%-19.99%), 28.24% (95% CI: 28.16%-28.33%), and 35.41% (95% CI: 35.27%-35.55%), respectively. When the concentration is controlled to the minimum observed value (5.95 μg/m³) or does not exceed the WHO annual average standard (10 μg/m³), the proportions of MetS cases that can be avoided are 22.71% (95% CI: 18.77%-26.65%) and 17.24% (95% CI: 16.86%-17.62%), respectively. Using the ratio intervention method, reducing PM concentrations by 30% and 50% can reduce the number of MetS cases by 7.41% (95% CI: 7.28%-7.53%) and 12.16% (95% CI: 11.96%-12.36%), respectively. CONCLUSION: All four PM intervention strategies can reduce the number of patients with MetS to varying degrees, with equivalent, minimum-value, and WHO threshold-based interventions demonstrating the greatest effects. Taking into comprehensive consideration, equivalent intervention is more efficient. In the future, efforts should be gradually focused on the correlation between actual environmental control measures and intervention strategies to directly guide the formulation of environmental protection policies.
[Combined Analysis of Dyslipidemia and Tumor Markers for the Diagnosis of Gastric Cancer].
Lu J, Xu R, Li T … +2 more , Zheng B, Li M
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021900 · Full text
OBJECTIVE: To investigate changes in serum lipid profile parameters combined with tumor markers in gastric cancer (GC) patients and their value in GC screening. METHODS: A total of 100 patients diagnosed with GC at Renji...
OBJECTIVE: To investigate changes in serum lipid profile parameters combined with tumor markers in gastric cancer (GC) patients and their value in GC screening. METHODS: A total of 100 patients diagnosed with GC at Renji Hospital (West) between May and September 2025 were consecutively enrolled as the GC group (54 cases in stage Ⅰ/Ⅱ and 46 cases in stage Ⅲ/Ⅳ). Additionally, 100 age- and sex-matched healthy individuals undergoing routine physical examinations were included as the healthy control (HC) group. The serum levels of nine lipid indicators (high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], total cholesterol [TC], triglycerides [TG], small and dense low-density lipoprotein cholesterol [sdLDL-C], apolipoprotein [Apo] A1, ApoB, ApoC2, and ApoC3) and five tumor markers (carcinoembryonic antigen [CEA], carbohydrate antigen [CA] 19-9, CA50, CA242, and CA72-4) were measured using an automatic biochemical analyzer and an electrochemiluminescence instrument. Intergroup differences were analyzed using the Mann-Whitney test. A stepwise Fisher discriminant analysis was used to establish a screening model based on lipid profiles and tumor markers. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis, and the model's diagnostic performance was validated using 30 GC patients and 30 healthy controls consecutively enrolled from September to December 2025. RESULTS: Compared with the HC group, the GC group showed significantly lower levels of ApoA1, ApoC3, TC, HDL-C, LDL-C, and sdLDL-C ( < 0.05), while CEA and CA50 levels were significantly higher ( < 0.05). Patients with stage Ⅲ-Ⅳ GC had lower levels of ApoA1, ApoB, TC, HDL-C, LDL-C, and sdLDL-C compared to those with stage Ⅰ-Ⅱ GC ( < 0.05). ROC analysis showed that among individual indicators, HDL-C had the highest diagnostic performance, with an area under the curve (AUC) of 0.797 (95% CI: 0.734-0.850), sensitivity of 78%, and specificity of 74%. The screening model including ApoA1, ApoC3, HDL-C, LDL-C, TC, sdLDL-C, CEA, CA50, and age achieved an AUC of 0.940 (95% CI: 0.891-0.971), with 83.75% sensitivity and 92.5% specificity, outperforming any single biomarker in diagnostic efficacy. CONCLUSION: The combined panel of ApoA1, ApoC3, HDL-C, LDL-C, TC, sdLDL-C, CEA, CA50 and age offers a potential auxiliary tool for detecting gastric cancer.
[Analysis of Clinical Characteristics and Diagnostic Indicators in Patients With Heparin-induced Thrombocytopenia After Cardiac Surgery].
Wang G, Yue P, Zhu G … +8 more , Xu Q, Wang X, Song D, Gao Z, Wang Y, Liu J, Zhang Y, Zhou Z
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021899 · Full text
OBJECTIVE: To investigate the diagnosis rate of heparin-induced thrombocytopenia (HIT), the incidence of new thrombosis, the dynamic evolution pattern of platelets, and the clinical characteristics in patients with suspe...
OBJECTIVE: To investigate the diagnosis rate of heparin-induced thrombocytopenia (HIT), the incidence of new thrombosis, the dynamic evolution pattern of platelets, and the clinical characteristics in patients with suspected HIT after cardiac surgery; and to evaluate the diagnostic value of HIT antibodies (HIT-Ab), 4T's score, and Lillo-Le Louet (LLL) score for HIT. METHODS: A retrospective cohort study was conducted. A total of 307 patients with suspected HIT after cardiac surgery at Fuwai Hospital of the Chinese Academy of Medical Sciences from April 2023 to December 2024 were included. Clinical and laboratory data were collected. All patients underwent 4T's score, LLL score, and HIT-Ab testing. Patients were divided into the non-HIT group ( = 269) and the HIT group ( = 38) based on the final clinical diagnosis. The platelet evolution patterns and other clinical characteristics of the two groups were compared. HIT-Ab concentration was divided into four groups: negative (< 1.0 U/mL, = 257), weakly positive (1.0-4.9 U/mL, = 34), moderately positive (5.0-9.9 U/mL, = 11), and strongly positive (≥ 10 U/mL, = 5). Differences in the incidence of new thrombosis and the diagnosis rate of HIT among the groups were analyzed, and the diagnostic efficacy of HIT-Ab concentration, 4T's score, and LLL score for HIT was evaluated using receiver operating characteristic (ROC) curves. RESULTS: The diagnosis rate of HIT was 12.38% (38/307), and the incidence of new thrombosis in the HIT group was 63.16%, higher than the 34.57% in the non-HIT group ( < 0.001). Among HIT patients, 76.32% showed a biphasic decline pattern of platelets (pattern A), and their risk of HIT was significantly higher than that of patients with pattern B (odds ratio [OR] = 10.32, 95% confidence interval [CI]: 4.64-22.95). The incidence of new thrombosis increased stepwise with higher HIT-Ab concentration (32.7% in the negative group to 100% in the strongly positive group, < 0.001), and the diagnosis rate of HIT increased from 0 in the negative group to 64.71% in the weakly positive group, reaching 100% in the moderate/strong positive group. The areas under the ROC curves for HIT-Ab concentration, 4T's score, and LLL score for diagnosing HIT were 0.996 (95% CI: 0.991-1.000), 0.799 (95% CI: 0.727-0.870), and 0.860 (95% CI: 0.811-0.908), respectively. When the HIT-Ab concentration was 1 U/mL, the diagnostic sensitivity and negative predictive value (NPV) were both 100%. Compared with the traditional diagnostic criteria for high-risk HIT populations (4T's score cutoff of 4, LLL score cutoff of 2), the optimal cutoff value of 4T's score selected by the maximum Youden index was 5, and the optimal cutoff value of LLL score was 3. CONCLUSION: The incidence of new thrombosis in patients with suspected HIT after cardiac surgery increases stepwise with higher HIT-Ab levels. The diagnostic value of the LLL score for HIT is superior to that of the 4T's score. HIT-Ab testing has high sensitivity and negative predictive value, making it a reliable tool for guiding early discontinuation of heparin and excluding HIT. Combining HIT-Ab concentration, platelet evolution pattern, and clinical scores helps more accurately identify HIT risk, initiate alternative anticoagulation therapy, and optimize anticoagulation management strategies.
[A Study on the Relationship Between Cyclic Inflammatory Protein Fibroblast Growth Factor 21, Osteoporosis, and Fractures].
Zhou K, Wang Z, Zhang M
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021898 · Full text
OBJECTIVE: Systematically conduct a screening of the potential targets within circulating inflammatory proteins (CIPs) that have an impact on osteoporosis (OP) and fractures. Validate their association with bone mineral...
OBJECTIVE: Systematically conduct a screening of the potential targets within circulating inflammatory proteins (CIPs) that have an impact on osteoporosis (OP) and fractures. Validate their association with bone mineral density (BMD) via clinical samples, thereby offering novel evidence for the regulation of bone metabolism. METHODS: The study employs bidirectional Mendelian randomization analysis to investigate the causal relationship between CIPs and OP, as well as fractures. Two groups are included: patients with type 2 diabetes mellitus (T2DM) and healthy individuals. General patient data are collected, and fibroblast growth factor 21 (FGF21) and bone metabolism indicators are measured and compared among the T2DM group with OP (DOP), the T2DM group without OP (NDOP), and the control group. RESULTS: Among the 91 types of CIPs retrieved from the EBI GWAS Catalog database, the inverse variance weighting (IVW) analysis indicated that FGF21 potentially had a causal relationship with both OP and fractures that transpired within the past five years. An elevation in its level augmented the risk of OP (odds ratio [OR] = 1.003, 95% CI: 1.001-1.005; = 0.004) and the risk of fractures in the past five years (OR = 1.004, 95% CI: 1.000-1.008; = 0.038). Reverse Mendelian randomization demonstrated that OP and fractures in the past five years had no causal impact on the eight CIPs, including FGF21, identified in the forward analysis. Clinical investigations showed that the plasma FGF21 level in the DOP group (396.92 [308.98, 523.94] pg/mL) was higher than that in the NDOP group (346.88 [283.82, 466.86] pg/mL) and the control group (233.66 [169.95, 327.78] pg/mL) (all < 0.05). In all samples, subsequent to adjusting for age, body mass index, glycated hemoglobin, calcium, and phosphorus, FGF21 was negatively correlated with the T-value of the lumbar spine ( = －0.003, 95% CI: －0.004 to －0.002, < 0.0001) and the T-value of the total hip ( = －0.002, 95% CI: －0.003 to －0.001, < 0.0001). In T2DM, FGF21 was negatively correlated with the T-value of the lumbar spine ( = －0.003, 95% CI: －0.004 to －0.0014, < 0.0001) and the T-value of the total hip ( = －0.001, 95% CI: －0.0022 to －0.0005, = 0.002), and this negative correlation persisted after adjusting for the aforementioned covariates. CONCLUSION: FGF21 elevates the risk of OP and fractures that have occurred over the past five years, and a causal relationship exists. It serves as a potential risk factor for impaired bone health in T2DM.
[Nanomaterial-driven Lateral Flow Immunoassay: Technological Development and Application].
Zheng J, Hu X, Gu B
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021897 · Full text
In clinical testing, traditional research has focused on developing large analytical instruments capable of processing high sample volumes with fully automated and highly sensitive measurements. In recent years, however,...
In clinical testing, traditional research has focused on developing large analytical instruments capable of processing high sample volumes with fully automated and highly sensitive measurements. In recent years, however, there has been increasing demand for analytical reagents for point-of-care testing (POCT), which do not require a specific location or professional operators. This trend is exemplified by the lateral flow immunoassay (LIFA), favored for its simple operation, rapid results, and user-friendly design. The fiber membrane-based structure of LIFA provides both cost-effectiveness and ease of disposal, addressing key concerns related to testing budgets and environments. Despite its compact size, LIFA incorporates multiple technological innovations, reflecting years of research and development. Current studies focus on advancing LIFA technology, paving the way for next-generation diagnostic devices. These advancements aim to redefine testing convenience and enhance the capacity to respond effectively to urgent public health challenges. The future of LIFA is gradually unfolding, with deeper integration into daily health management and emergency response systems. In this review, we present the historical development of LIFA and several cutting-edge LIFA technologies, including gold nanoparticle-based, magnetic, photothermal, fluorescent, and surface-enhanced Raman scattering approaches, aiming to inspire future LIFA research and development.
[Characterization of Immune Reconstitution Patterns in B-cell Subsets Mediated by B-cell Targeted Therapies].
Wang X, Zhang Y, Duan Z … +9 more , Wei M, Guo Y, Feng W, Yan L, Tao Y, Cai B, Zhang J, Li W, Li Y
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021896 · Full text
OBJECTIVE: To analyze the reconstitution patterns of fine B-cell subsets in patients following treatment with the CD20 monoclonal antibody ofatumumab and the CD19 monoclonal antibody inebilizumab, and to evaluate the cli...
OBJECTIVE: To analyze the reconstitution patterns of fine B-cell subsets in patients following treatment with the CD20 monoclonal antibody ofatumumab and the CD19 monoclonal antibody inebilizumab, and to evaluate the clinical application value of individualized fine B-cell subset dynamic profiling in guiding targeted therapy strategies. METHODS: This prospective study enrolled 30 patients with pemphigus receiving ofatumumab and 26 patients with neuromyelitis optica spectrum disorders (NMOSD) receiving inebilizumab at West China Hospital of Sichuan University between October 2023 and May 2025. Thirty healthy individuals were enrolled as controls for baseline comparison. Dynamic monitoring of fine B-cell subsets, anti-desmoglein (Dsg) antibodies, and immunoglobulins was performed at three post-treatment time points (1 month, 3 months, and 6 months). A natural cubic spline model was used to fit trend curves, combined with differential analysis to assess population-level immune reconstitution. RESULTS: At baseline (T0), patients in the pemphigus group had higher levels of several B-cell subsets compared to healthy controls. Total B-cell counts were 347.50 (250.40-621.8) cells/μL versus 217.50 (143.50-275.30) cells/μL, memory B-cell counts were 127.30 (74.63-196.70) cells/μL versus 57.00 (41.75-88.25) cells/μL, and plasmablast counts were 5.63 (2.02-11.48) cells/μL versus 1.00 (1.00-2.00) cells/μL. These differences were significant ( < 0.05). In contrast, NMOSD patients showed significantly higher plasmablast counts compared to healthy controls (2.07 [1.60-3.58] cells/μL vs. 1.00 [1.00-2.00] cells/μL) ( = 0.04). After three months, the proliferation rate of naive B cells increased, with counts rising from 0.95 cells/μL at T3 to 3.25 cells/μL at T6 ( = 0.001). Throughout the entire monitoring period, the proportion of memory B cells consistently remained higher than that of naive B cells and plasmablasts. In NMOSD patients, B-cell regeneration was slow after treatment. Total B-cell counts showed a significant increase only by T6 compared to T1 (from 0 cells/μL to 2.65 cells/μL, = 0.026), with the increase primarily due to naive B cells. Plasmablast counts in the pemphigus group were significantly higher than those in the NMOSD group at T1 and T3 ( < 0.01), but this difference disappeared by T6. Among the cohort, two pemphigus patients showed abnormal B-cell reconstitution, characterized by persistently elevated plasmablasts or undetectable Dsg antibody decline. One NMOSD patient exhibited a reversal in B-cell subset proportions, with memory B-cell counts exceeding naive B-cell counts, along with increased plasma cell counts and elevated IgG immunoglobulin levels. CONCLUSION: Targeted therapies against CD19 and CD20 induce distinctly different patterns of B-cell reconstitution. Ofatumumab treatment leads to a phased regenerative process in B cells, whereas inebilizumab treatment results in delayed regeneration. Increased plasmablasts, aberrant memory B-cell proliferation, and rebounding Dsg antibodies may signal potential adverse events. These findings support monitoring fine B-cell subsets for precise immunological assessment to guide personalized treatment.
[Establishment of a Noninvasive Diagnostic Model for Wilson Disease Using Metallomics and Machine Learning].
Zhou H, Xu H, Pan A … +4 more , Tang X, Zhang J, Xie L, Li Y
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021895 · Full text
OBJECTIVE: To analyze the differences in urine metal profiles between patients with Wilson disease (WD) and healthy controls, to identify early diagnostic biomarkers, and to develop a non-invasive diagnostic model using...
OBJECTIVE: To analyze the differences in urine metal profiles between patients with Wilson disease (WD) and healthy controls, to identify early diagnostic biomarkers, and to develop a non-invasive diagnostic model using machine learning. METHODS: 63 WD patients and 63 matched healthy controls were included. Urine samples and clinical data were collected from all the participants. The concentrations of 51 urine metals were determined using inductively coupled plasma mass spectrometry (ICP-MS). Differences between the two groups were compared using the Wilcoxon signed-rank test. Differential metal features were selected based on detection rates > 50%, < 0.05 and |logFC| > 1, and feature selection was performed using elastic net regression. Non-metric multidimensional scaling was used to analyze the metal distribution between the two groups. Spearman correlation analysis and quantile g calculation models were used to analyze the correlation between metals and clinical indicators. A diagnostic model was developed using the random forest algorithm, and the performance was evaluated using receiver operating characteristic curves and confusion matrices. RESULTS: Urine metallomics analysis revealed statistically significant differences in the levels of Cu, Zn, Ca, Co, Sr, Ti, Y, Cs, Rb, Cd and Sn between the case and control groups. Cu/Zn, Cu/Se and Zn/Se ratios were significantly higher in the case group. Elastic net regression identified 14 key features, with Cu having the largest standardized regression coefficient ( = -14.628). Non-metric multidimensional scaling confirmed the separation of metal profiles between the two groups. Correlation analysis showed significant associations between Cu, Cu/Zn, and liver function indicators, with Spearman correlation coefficients ranging from -0.58 to 0.67. The quantile g calculation model suggested that metal mixtures had a significant negative effect on the A/G ratio. The random forest model exhibited excellent diagnostic performance, with an area under the curve (AUC) of 0.99 (95% CI: 0.97-1.00) in the training set and 0.97 (95% CI: 0.94-1.00) in the testing set, outperforming single indicators. CONCLUSION: Urine metallomics analysis indicated that the Cu/Zn ratio obtained superior diagnostic efficiency compared to traditional urine copper test. Additionally, the diagnostic model based on differential metal characteristics demonstrated high accuracy, providing a new method for the early non-invasive diagnosis of WD.
[Association Between T Lymphocyte Mitochondrial Function and Disease Activity in Anti-NMDAR Encephalitis].
Ma Y, Zhang E, Cao L … +5 more , Wang Z, Wang M, Li F, Ying B, Yan L
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021894 · Full text
OBJECTIVE: To investigate mitochondrial functional alterations in T lymphocytes of patients with anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDAR encephalitis, NMDAR-E) and their association with immune exhaus...
OBJECTIVE: To investigate mitochondrial functional alterations in T lymphocytes of patients with anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDAR encephalitis, NMDAR-E) and their association with immune exhaustion. METHODS: Twenty-five patients with NMDAR-E diagnosed in the Department of Neurology, West China Hospital, Sichuan University, between January and March 2025 (14 mild cases and 11 severe cases) and 16 healthy controls were enrolled. Flow cytometry was performed to characterize immune-cell distributions in paired peripheral blood and cerebrospinal fluid (CSF), and to evaluate the percentage of cells with low mitochondrial membrane potential (MMP-Low%), mitochondrial mass (MM), and PD-1 expression. RESULTS: In severe patients, the proportions of CD3 and CD4 T cells in CSF, the MMP-Low% of CD3, CD4, and CD8 T cells ( < 0.01), and the MM of CD3 ( < 0.01) and CD8 T cells ( < 0.05) were all significantly higher than those in matched peripheral blood. Compared with healthy controls, the MMP-Low% of naïve and central memory CD4 and CD8 T-cell subsets in peripheral blood was significantly decreased ( < 0.05), whereas the proportion of PD-1-positive cells was significantly increased in CD4naïve and central memory T-cell subsets ( < 0.01). CONCLUSION: CSF T cells in patients with anti-NMDAR encephalitis display a state of dysfunctional mitochondrial accumulation, suggesting a possible dysregulation of mitochondrial mass homeostasis under the central inflammatory milieu. Mitochondrial features of peripheral T cells indicate the presence of systemic immune exhaustion. The MMP-Low% of CSF CD8 T cells and the peripheral blood lymphocyte percentage may serve as potential immunometabolic biomarkers for distinguishing disease severity in NMDAR-E.
[Liquid Biopsy Revolutionizes the Precise Management of Tumors Across the Entire Course: Current Situation and Future Prospects].
Zeng J, Zhang J
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021893 · Full text
Tumors represent a global public-health concern, accounting for approximately one-sixth of all fatalities worldwide annually. Attaining precise management of patients across all stages of diagnosis, treatment, and survei...
Tumors represent a global public-health concern, accounting for approximately one-sixth of all fatalities worldwide annually. Attaining precise management of patients across all stages of diagnosis, treatment, and surveillance is not merely a significant challenge in contemporary clinical practice but also a crucial strategy for enhancing patient survival rates. In comparison with traditional testing approaches, liquid biopsy offers the benefits of being less invasive and enabling repeated sampling. Through the examination of biological specimens that can be readily and repeatedly obtained from the patient's body, liquid biopsy can furnish information throughout the entire continuum of disease diagnosis, treatment, and follow-up prognosis. Consequently, it emerges as a highly prospective substitute for tissue samples in the minimally invasive, real-time, and comprehensive monitoring of tumors in clinical contexts. This article conducts a systematic review of the common liquid biopsy markers in the oncology field and their latest detection technologies. It encompasses detection schemes for non-blood samples such as cerebrospinal fluid and feces. Moreover, it proposes a novel framework for the precise management of the entire tumor process based on "multi-marker combination + full sample coverage". The article further deliberates on a series of challenges currently encountered in developing liquid biopsy into a mature clinical testing project. These challenges include the standardization of sample testing procedures, the establishment of standardized reporting systems, and how to strike a balance between the popularity of detection methods and cost control, with the aim of promoting the development of liquid biopsy in tumor early screening, treatment innovation, and extensive application. We anticipate constructing a full-chain system spanning from basic research to transformational production and clinical application. We aim to develop an integrated detection platform, establish standardized reporting procedures and a well-established regulatory mechanism, offer patients full-cycle precise management from diagnosis to rehabilitation, and ultimately convert cancer from an "incurable disease" into a "preventable and controllable" chronic disease.
[Research Progress on the Biological Functions of Intestinal Eosinophils and Related Diseases].
Dou M, Zhang Y, Li M
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021892 · Full text
Intestinal eosinophils are multifunctional immune cells that play a crucial role in maintaining intestinal homeostasis and participating in various disease processes. Under physiological conditions, these cells contribut...
Intestinal eosinophils are multifunctional immune cells that play a crucial role in maintaining intestinal homeostasis and participating in various disease processes. Under physiological conditions, these cells contribute to maintaining intestinal barrier function, regulating local microbiota homeostasis, promoting tissue repair, and modulating local immune responses by secreting various cytokines and bioactive mediators, thereby playing an essential role in sustaining intestinal homeostasis. In pathological conditions, however, eosinophils can release cytotoxic proteins and pro-inflammatory mediators, contributing to the pathogenesis of various intestinal diseases. This paper systematically reviews the biological characteristics and functional diversity of intestinal eosinophils, as well as their mechanisms of action in diseases such as parasitic infections, inflammatory bowel disease, intestinal fibrosis, food allergy, eosinophilic enteritis, and functional bowel disorders, aiming to provide a theoretical basis for the clinical intervention of related diseases.
[Next-Generation Sequencing-Based Detection of Gene Mutations and Its Association With Clinicopathological Features in Gastric Cancer].
Zhong H, Liu T, Bai L … +4 more , Li J, Song M, Zhou J, Chen H
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021891 · Full text
OBJECTIVE: To analyze the gene mutation profile of Chinese patients with gastric cancer and to explore its correlations with clinicopathological characteristics and prognosis. METHODS: Fifty-five patients with gastric ca...
OBJECTIVE: To analyze the gene mutation profile of Chinese patients with gastric cancer and to explore its correlations with clinicopathological characteristics and prognosis. METHODS: Fifty-five patients with gastric cancer were enrolled. Next-generation sequencing was performed to detect mutations in cancer-related genes, microsatellite instability, and tumor mutational burden. The associations of high-frequency mutated genes with clinicopathological features and progression-free survival (PFS) were analyzed. Key findings were validated and ethnic heterogeneity was assessed using The Cancer Genome Atlas stomach adenocarcinoma cohort ( = 436). RESULTS: Somatic mutations were identified in 85.45% (47/55) of patients. The most frequently mutated genes were (29.09%), (16.36%), (14.55%), (14.55%), and (12.73%). mutations were associated with T4 stage ( = 0.028) and diffuse-type gastric cancer ( = 0.008). mutations were enriched in signet-ring cell carcinoma ( = 0.012) and poorly differentiated tumors ( = 0.006). Pathogenic germline mutations were identified in 20% (11/55) of patients. Univariate survival analysis revealed that mutation was an independent poor prognostic factor for PFS (hazard ratio = 3.110, 95% confidence interval: 3.370-20.000). Validation in The Cancer Genome Atlas cohort confirmed that the poor prognostic effect of mutation was present only in the Asian subgroup (hazard ratio = 5.00, 95% confidence interval: 2.01-12.43), demonstrating significant ethnic heterogeneity. CONCLUSION: Chinese patients with gastric cancer exhibit a distinct gene mutation profile, and key gene mutations are closely associated with tumor aggressiveness. This multi-cohort validation study indicates ethnic differences in the prognostic value of genes such as , highlighting the importance of precision molecular classification in the Chinese population.
[Diagnostic Performance of Metagenomic Next-Generation Sequencing for Mucormycosis: A Retrospective Cohort Study].
Zhang W, Zhong S, Lu S … +2 more , Xiao X, Xie Y
Sichuan Da Xue Xue Bao Yi Xue Ban · 2026 Mar · PMID 42021890 · Full text
OBJECTIVE: Mucormycosis is a life-threatening invasive fungal infection with high mortality, yet traditional diagnostic methods are limited by low positivity rates. This study aims to evaluate the diagnostic performance...
OBJECTIVE: Mucormycosis is a life-threatening invasive fungal infection with high mortality, yet traditional diagnostic methods are limited by low positivity rates. This study aims to evaluate the diagnostic performance and clinical utility of metagenomic next-generation sequencing (mNGS) in mucormycosis. METHODS: A retrospective analysis was conducted on 135 patients with mNGS results positive for Mucorales fungi at West China Hospital of Sichuan University from November 1, 2022, to October 31, 2024. Based on comprehensive clinical diagnostic criteria (including proven and probable cases), patients were classified into a confirmed mucormycosis group and a non-mucormycosis group. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of normalized read counts (lgRPM) from different specimen types. Fungal species distribution and laboratory parameters were compared between the two groups. RESULTS: Among the 135 patients with positive mNGS results for Mucorales, 100 (74.1%) were ultimately diagnosed with mucormycosis. ROC curve analysis revealed that the diagnostic performance of mNGS varied by specimen type. For blood specimens, the area under the curve (AUC) was 0.772, with a specificity of 87.5% at the optimal cutoff value of 0.11 RPM. For bronchoalveolar lavage fluid specimens, the AUC was 0.717, with a sensitivity of 76.5% at the optimal cutoff value of 0.02 RPM. Combined analysis of all specimens showed that at the optimal cutoff value of 0.08 RPM (approximately 8 reads/100M), the sensitivity and specificity were 62.0% and 71.4%, respectively. Species distribution analysis showed that the proportions of (11.0% vs. 2.9%) and (9.0% vs. 2.9%) were significantly higher in the confirmed group than in the non-mucormycosis group ( < 0.05). Levels of C-reactive protein and interleukin-6 were also significantly higher in the confirmed group ( < 0.05). Notably, all seven renal perfusion fluid samples yielded false-positive mNGS results. CONCLUSION: mNGS technology can effectively improve the diagnostic yield for mucormycosis. However, results should be interpreted in conjunction with specimen type, read count, and clinical characteristics. BALF specimens offer high sensitivity, making them suitable for screening, while blood specimens demonstrate high specificity, making them valuable for confirmation. Positive results from low-biomass samples such as renal perfusion fluid warrant caution against false positivity. Fungal species identification and inflammatory markers may serve as adjunctive evidence for clinical diagnosis.
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