Objective To investigate the predictive value of plasma von Willebrand factor(VWF)antigen levels for the long-term prognosis of patients with acute myocardial infarction(AMI).Methods A total of 150 elderly patients diagnosed with AMI were selected and treated with percutaneous coronary intervention(PCI)at admission.The plasma VWF antigen level of the patients was detected within 24 hours after PCI.Patients were followed up for 12 months and were divided into the major adverse cardiac events(MACE)group and the non-MACE group according to the occurrence of MACE.The risk factors for MACE in AMI patients within 12 months were analyzed.The prognostic value of VWF antigen level in AMI patients were evaluated.The optimal cut-off value of plasma VWF antigen level was determined by receiver operating characteristic(ROC)curve.Patients were groups according to the optimal cut-off value.Kaplan-Meier curve was drawn to compare the occurrence of MACE in patients with different plasma VWF antigen levels.Results Among the 150 observed patients,7 patients were lost to follow-up,and eventually 143 patients were included.In 143 patients there were 53 patients(37.1%)in the MACE group and 90 cases(63.9%)in the non-MACE group.The age,B-type natriuretic peptide(BNP),D-dimer and VWF antigen levels were significantly higher in the MACE group than those in the non-MACE group.The results of the Cox proportional hazards model showed that age increase(HR=1.085,95%CI:1.014-1.160),increased plasma VWF antigen level(HR=1.030,95%CI:1.017-1.045)and increased BNP(HR=1.016,95%CI:1.004-1.027)were risk factors for elderly patients in the MACE group one year after surgery.The maximum approximately Youden index of plasma VWF antigen level for predicting MACE was 0.616,the optimal cut-off value was 162.5 μg/L,the sensitivity was 84.9%and the specificity was 76.7%.The results of survival analysis showed that the average time to MACE in the group with plasma VWF antigen≥162.5 μg/L was shorter than that in the group with plasma VWF antigen＜162.5 μg/L(7.7 months vs.11.6 months,Log-rank χ2=63.060,P＜0.001).Conclusion The increased plasma VWF antigen is an independent risk factor for AMI and can be used as a predictor of long-term prognosis in patients with AMI.

Objective To investigate the predictive value of plasma von Willebrand factor(VWF)antigen levels for the long-term prognosis of patients with acute myocardial infarction(AMI).Methods A total of 150 elderly patients diagnosed with AMI were selected and treated with percutaneous coronary intervention(PCI)at admission.The plasma VWF antigen level of the patients was detected within 24 hours after PCI.Patients were followed up for 12 months and were divided into the major adverse cardiac events(MACE)group and the non-MACE group according to the occurrence of MACE.The risk factors for MACE in AMI patients within 12 months were analyzed.The prognostic value of VWF antigen level in AMI patients were evaluated.The optimal cut-off value of plasma VWF antigen level was determined by receiver operating characteristic(ROC)curve.Patients were groups according to the optimal cut-off value.Kaplan-Meier curve was drawn to compare the occurrence of MACE in patients with different plasma VWF antigen levels.Results Among the 150 observed patients,7 patients were lost to follow-up,and eventually 143 patients were included.In 143 patients there were 53 patients(37.1%)in the MACE group and 90 cases(63.9%)in the non-MACE group.The age,B-type natriuretic peptide(BNP),D-dimer and VWF antigen levels were significantly higher in the MACE group than those in the non-MACE group.The results of the Cox proportional hazards model showed that age increase(HR=1.085,95%CI:1.014-1.160),increased plasma VWF antigen level(HR=1.030,95%CI:1.017-1.045)and increased BNP(HR=1.016,95%CI:1.004-1.027)were risk factors for elderly patients in the MACE group one year after surgery.The maximum approximately Youden index of plasma VWF antigen level for predicting MACE was 0.616,the optimal cut-off value was 162.5 μg/L,the sensitivity was 84.9%and the specificity was 76.7%.The results of survival analysis showed that the average time to MACE in the group with plasma VWF antigen≥162.5 μg/L was shorter than that in the group with plasma VWF antigen＜162.5 μg/L(7.7 months vs.11.6 months,Log-rank χ2=63.060,P＜0.001).Conclusion The increased plasma VWF antigen is an independent risk factor for AMI and can be used as a predictor of long-term prognosis in patients with AMI.

The application of Raman spectroscopy in the field of laboratory medicine is making continuous progress and development. The biosensor platform based on Raman spectroscopy provides a new means for accurate molecular diagnosis of diseases. In particular, as a fast and non-destructive detection method, surface-enhanced Raman scattering has the advantages of simple sample preparation, little interference from water and real-time detection, and shows great application potential in the field of medical examination. At the same time, with the integration of SERS and other technologies, including electrochemistry, new nano-materials, microfluidic, biochip, DNA nano-machine, artificial intelligence and machine learning, it will play a more and more important role in the field of medical laboratory. With the deepening of SERS research and the cross-integration between multiple disciplines, it will be widely used in biomedical detection and is expected to become an important technology platform for the next generation of precision diagnosis.

Objective To investigate the value of serum IgG4 level in the differential diagnosis of IgG4-related pancreatic and hepatobiliary disease (IgG4-PHD) and non-IgG4-related disease (non-IgG4-RD). Methods Clinical data were collected from 491 patients who were hospitalized and 50 individuals who underwent physical examination in Huaian No. 1 People's Hospital Affiliated to Nanjing Medical University, Subei People's Hospital, and The First Affiliated Hospital of Xuzhou Medical University from August 2014 to April 2021. The 491 patients were divided into IgG4-PHD group with 20 patients, non-IgG4-RD autoimmune disease group with 431 patients (104 patients with systemic lupus erythematosus, 79 with rheumatoid arthritis, 174 with Sjogren's syndrome, 16 with ankylosing spondylitis, 11 with scleroderma, 4 with adult-onset Still's disease, 30 with myositis, 3 with psoriasis, and 10 with primary sclerosing cholangitis), and malignant pancreatic/hepatobiliary tumor group with 40 patients, and the 50 individuals undergoing physical examination were enrolled as healthy control group. Scattering immunoturbidimetric assay was used to measure serum IgG4 concentration. The two-sample Mann-Whitney U test was used for comparison of normally distributed continuous data between groups, and the Fisher's exact test was used for comparison of categorical data between groups. The receiver operating characteristic (ROC) curve was plotted to determine the optimal cut-off value of serum IgG4 in the diagnosis of IgG4-PHD. Results The IgG4-PHD group had a significantly higher serum IgG4 level than the non-IgG4-RD autoimmune disease groups, the malignant pancreatic/hepatobiliary tumor group, and the healthy control group (all P < 0.05), and the Sjogren's syndrome group had a significantly lower serum IgG4 level than the healthy control group ( Z =2.958, P < 0.05). With serum IgG4 ≥1.35 g/L and IgG4 ≥2.01 g/L as the cut-off values, the IgG4-PHD group had a significantly higher positive rate than the non-IgG4-RD autoimmune disease group and the healthy control group (all P < 0.05). The ROC curve analysis showed that IgG4 had an area under the ROC curve of 0.980 in the differential diagnosis of IgG4-PHD and non-IgG4-RD autoimmune diseases, with a sensitivity of 100.00% and a specificity of 94.00% at the optimal cut-off value of 2.21 g/L. Conclusion Serum IgG4 level may also increase in non-IgG4-RD autoimmune diseases, while the cut-off value of 2.21 g/L can improve the differential diagnosis of IgG4-PHD and non-IgG4-RD autoimmune diseases, which requires further verification in clinical practice.

Objective: To identify the specific Hub genes in young hepatocellular carcinoma (HCC) patients, and to explore their biological and clinical significance by using bioinformatic methods. Methods: The data information of HCC and normal tissues of young (≤40 years old at diagnosis) and old (＞40 years old at diagnosis) HCC patients were obtained from GEO chip data set GSE45267. The differentially expressed genes (DEGs) in HCC tissues as comparing to normal tissues in the two groups were screened by using GEO2R and Venn chart software. The Protein-Protein Interaction (PPI) network of the specific DEGs in young group was constructed by bioinformatics tools STRING and Cytoscape to screen the Hub genes and significant modules. The Hub genes were verified by GEPIA database, and the overall survival time was analyzed by Kaplan-Meier. Finally, Gene Ontology (GO) Enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were used to analyze the DEGs specific to young group and the common DEGs of the two groups by DAVID. Results: Finally, 117 up-regulated and 179 down-regulated DEGs specific to the young group were screened out, and PPI network screened 10 most connected genes as Hub genes, among which 7 Hub genes were concentrated in the first module. Six up-regulated Hub genes, including TYMS, CDC6, BUB1, TPX2, OIP5 and KIF23, were indicated to associate with the poor prognosis in young HCC patients by GEPIA and Kaplan-Meier analysis. GO function and KEGG pathway analyses showed that the DEGs specific to young HCC patients were mainly involved in biological processes such as ATP binding, and were mainly enriched in S phase of cell cycle; while the common DEGs of two groups were mainly involved in biological processes such as cyclooxygenase P450 and cell division, and were mainly enriched in the G2/M phase of the cell cycle. Conclusion: In this study, 6 up-regulated DEGs specific to young group that suggested poor prognosis were identified, which may be the potential therapeutic and prognostic targets for young patients with HCC.

Clustered regularly interspaced short palindromic repeats/CRISPR-associated nuclease 9 (CRISPR/Cas9),a cluster of regularly spaced short palindromic repeats,is a natural immune defense system for bacteria and archaea to identify themselves and exogenous invading DNA fragments,protecting them from viruses.In recent years,CRISPR/Cas9 has become a revolutionary gene editing tool.Its specific targeted spot-cutting ability also plays an important role in nucleic acid detection,bacterial typing,etc.,and has shown great application potential in the field of medical testing.Based on the latest researches,this paper reviews the progress of CRISPR/Cas9 application in the new techniques of nucleic acid detection,pathogen typing and bacterial evolution in laboratory medicine,and also summarizes the application prospect of CRISPR technology in the field of laboratory medicine.

Objective In this study, we constructed a plasmid, specifically expressed SUMO protein, and to study the expression level of anti-SUMO antibody in the serum of patients with primary biliary cholangitis, systemic lupus erythematosus, rheumatoid arthritis, Connective tissue disease, sjogren′s syndrome which were typical of autoimmune diseases.And to investigate whether anti-SUMO antibodies can be used as specific serum markers of PBC.Methods Plasmids containing SUMO1, SUMO2 and SUMO3 fragments were prepared by PCR and ET cloning and introduced into E.coli for protein induction and purification, respectively.Dot blot was used to preliminarily screen anti-SUMO antibody-positive specimens from serum samples of PBC patients and were verified by western blot to obtain positive reference serum.Through the establishment of the optimal anti-SUMO antibody ELISA diagnostic system, the positive rates of three subtypes of anti-SUMO antibody in PBC, SLE, SS, RA and CTD were detected, and their differences were analyzed by chi-square test.ResultsThe anti-SUMO antibody label has a specificity of up to 99％in PBC and a sensitivity of around 86％.After chi-square test analysis, the positive detection rate of anti-SUMO antibody in PBC was higher than that of nonPBC autoimmune disease and healthy controls (P＜0.01).There was no significant difference in the expression of anti-SUMO antibody in other autoimmune disease populations (non-PBC autoimmune diseases) (P＞0.05).Conclusion The highly specific anti-SUMO antibody is expected to become a novel antibody for diagnosis of PBC, which is of great significance for improving the clinical diagnosis efficiency of PBC.

Objective To investigate the clinical distribution and antimicrobial resistance characteristics of carbapenem-resistant Acinetobacterbaumannii (CRAB).Methods CRAB isolated from all inpatients in a hospital in January-December 2015 were performed retrospective analysis,antimicrobial susceptibility testing result was analyzed.Results A total of 721 AB strains were detected,231 (32.04%)of which were CRAB,isolation rates of CRAB in quarter 1-4 were 48.99% (73/149),41.98%(68/162),27.39%(63/230),and 15.00%(27/180) respectively,which showed a decreased trend (P<0.001).CRAB mainly came from sputum specimen(n=140, 60.61%),followed by secretion of wound(n=33,14.28%)and urine specimen(n=24,10.39%).CRAB mainly distributed in intensive care unit,accounting for 43.72%(n=101),following by department of neurosurgery(n=37,16.02%),and burn/plastic surgery (n=22,9.52%).Resistance rates of CRAB to ampicillin/sulbactam, gentamicin,levofloxacin, and ciprofloxacin were 85.28% -90.48%,resistance rate to tobramycin was low (19.48%),no strains were found to be resistant to polymyxin B.Conclusion Antimicrobial resistance of CRAB is serious,it is necessary to focus on management of key departments,take scientific prevention and control measures, so as to effectively reduce the incidence of healthcare-associated infection.

Objective To monitor and analyze the distribution of pathogenic bacteria from CSF and its drug resistance change in Yangzhou area during 2011-2015 ,so as to provide the latest evidence for clinical rational use of antibacterial drugs .Methods The VITEK 2 automatic microbiological instrument was applied to identify bacteria and conduct the drug susceptibility test .The distri‐bution and drug susceptibility situation of isolated pathogenic bacteria were analyzed by using the WHONET 5 .6 software . Results In 2074 CSF bacterial culture from 2011 to 2015 ,74 strains(3 .57% ) of pathogenic bacteria were isolated ,in which the top three were Acinetobacter baumanni(21/74 ,28 .38% ) ,Klebsiella pneumonia (13/74 ,17 .57% )and Staphylococcus epidermis(12/74 , 16 .22% ) .The resistance rate of acinetobacter baumanni toantibacterial drugs was extremely serious ,showing muti‐drug or pan‐drug resistant phenomena .Conclusion Regular monitoring and analyzing the species and change of drug resistance in pathogenic bacteria isolated from CSF have an important significance to guide clinic to rationally use antibacterial drugs .

Objective To construct a lentiviral vector containing mir-7-3 gene and study the function of mir-7-3 gene and its role in glioma gene therapy.Methods The plasmid Lenti-GFP-mir-7-3 and packaging plasmids pRsv-REV,pMDlg-pRRE and pMD2G were co-transfected into the human embryonic kidney epithelial cell line 293T cells,and then,recombinant lentiviral FIV-CMV-GFP-mir-7-3 carried mir-7-3 gene and GFP gene was obtained; fluorescence expression of 293T cells was observed under fluorescence microscope.The supematant was collected,concentrated and identified,and then,it was used to transfect into the U251 glioma cells (positive transfection group); and blank control group (cells transfected with empty vector) and negative control group (parental cells) were also employed.Real time-PCR was used to examine the relative contents of mir-7-3 in U251 cells; Westem blotting was employed to detect the epidermal growth factor (EGFR) and serine/threonine kinase (AKT2) protein expressions; cell cycle was analyzed by flow cytometry and cell proliferative activities were measured by MTT method.Results Recombinant lentiviral FIV-CMV-GFP-mir-7-3 carried mir-7-3 gene and GFP gene was successfully constructed in 293T cells; electrophores showed that the sequence of RT-PCR product was consistent with the data ofmir-7-3 by DNA sequence analysis,indicating that the mir-7-3 gene was successfully cloned; strong green fluorwscence was observed by fluorwscent microscopy.The supernatant of lentivirus-transfected 293T cells was effectively infected into U251 cells and the relative content of mir-7-3 could be observed in the transfected U251 cells.As compared with those in the parental cells and the cells transfected with empty vector,the protein expressions of EGFR and AKT2 in the transfected group decreased significantly,reaching 38％ and 42％,respectively (P＜0.05).As compared with those in the parental cells and the cells transfected with empty vector,the cells at G0/G1 phase increased,the S phase fiaction was lower and the survival rates dramatically dropped in the mir-7-3 transfected cells 3,4,5 and 6 d after implanation.Conclusions The lentiviral vector containing mir-7-3 gene was constructed successfully.Mir-7-3 could specifically suppress EGFR and AKT2 expressions,induce gene silencing,inhibit cell growth,indicating that this way should be a new strategy in glioma gene therapy.