1.Role and mechanism of Lck/Yes-related novel tyrosine kinases in macrophage M1 polarization
Xin YU ; Zhensheng GAO ; Weihua BIAN ; Xiangyong LIU ; Yeying SUN
Acta Universitatis Medicinalis Anhui 2026;61(2):209-216
ObjectiveTo investigate the role and mechanism of Lck/Yes-related novel protein tyrosine kinase (Lyn) on lipopolysaccharide (LPS)-induced M1-type polarization of macrophage. MethodsThe LentiCRISPR-V2 plasmid was digested with the restriction endonuclease BSMBI-V2, and the digested DNA fragments were recovered. The digested plasmid was ligated with Lyn-sgRNA using T4 ligase to generate the Lenti-Lyn-gRNA lentivirus. THP-1 cells were infected with the Lenti-Lyn-gRNA lentivirus to obtain a stable cell line with Lyn knockout, and a monoclonal THP-1 cell line with complete Lyn knockout (Lyn⁻/⁻) was established subsequently. Wild-type Lyn (LynWT) and Lyn⁻/⁻ THP-1 cells were induced with 100 ng/mL phorbol myristate acetate (PMA) for 48 h to differentiate into M0 macrophages, which were further polarized into M1 macrophages by stimulation with 100 ng/mL LPS for 24 h. Quantitative real-time polymerase chain reaction (qPCR) was performed to detect the expression of M0 macrophage markers, including integrin αM (CD11b), macrophage antigen (CD68), and monocyte differentiation antigen (CD14). The expression of Lyn in M1 macrophages differentiated from wild-type THP-1 cells (LynWT-M1) was measured by qPCR, and the ratio of phosphorylated Lyn to total Lyn (P-Lyn/Lyn) in LynWT-M1 cells was determined by Western blot. In M1 macrophages differentiated from Lyn-knockout THP-1 cells (Lyn⁻/⁻-M1), qPCR was used to detect the mRNA expression of inducible nitric oxide synthase (iNOS), interleukin-6 (IL-6), and chemokine (C-X-C motif) ligand 10 (CXCL-10). Western blot was conducted to assess the protein expression of iNOS, as well as the protein levels of molecules related to the Janus kinase 1 (JAK1)-signal transducer and activator of transcription 1 (STAT1)signaling pathway, including JAK1, phosphorylated JAK1 (P-JAK1), STAT1, and phosphorylated STAT1 (P-STAT1). Additionally, the expression of the M1 macrophage marker cluster of differentiation 80 (CD80) was analyzed by flow cytometry. ResultsThe Lyn-/- monoclonal cell line was successfully constructed. The expression of CD11b was significantly elevated in Lyn-/- M0 macrophages, and the differentiation of M1 macrophages was successful. Knockdown of Lyn inhibited mRNA expression of iNOS, IL⁃6, CXCL⁃10, protein expression of iNOS and CD80 expression in M1 macrophages (P<0.05). Western blot assay showed that Lyn knockdown inhibited protein expression of JAK1 and P-STAT1 (P<0.01). ConclusionAfter CRISPR/Cas9-mediated Lyn knockout, the expression levels of JAK1 and P-STAT1, the key molecules in the JAK/STAT signaling pathway of M1 macrophages, are significantly downregulated; concomitantly, the expression of M1 macrophage-specific secretory factors (iNOS, IL⁃6, CXCL⁃10 mRNA) and CD80 is also downregulated, which may be achieved via targeted regulation of the JAK1/P-STAT1-mediated JAK/STAT signaling pathway.
2.Research progress of platelet function in immune regulation: from basic to clinical
Weihua HUANG ; Qiu SHEN ; Heshan TANG ; Ziyang FENG ; Min YE ; He ZHANG ; Ying LIU ; Baohua QIAN ; Zhanshan CHA
Chinese Journal of Blood Transfusion 2025;38(11):1592-1601
Traditionally, platelets, which are anucleate cell fragments derived from blood cells, have been primarily associated with their pivotal functions in hemostasis and thrombosis. However, recent research has elucidated their significant role in immune regulation, highlighting their expression of various immune receptors, involvement in numerous immune-related signaling pathways, and activation of diverse effector functions. This paper elaborates on the fundamental biological characteristics and immune functions of platelets, the involvement of activated platelets in immune regulation, and their prospective applications in clinical therapy. Furthermore, the paper discusses future directions in platelet immune research, as well as the prospects and developmental trends in immunotherapy, aiming to furnish a thorough reference for the investigation and clinical utilization of platelets within the domain of immune regulation.
3.Therapeutic role of miR-26a on cardiorenal injury in a mice model of angiotensin-II induced chronic kidney disease through inhibition of LIMS1/ILK pathway.
Weijie NI ; Yajie ZHAO ; Jinxin SHEN ; Qing YIN ; Yao WANG ; Zuolin LI ; Taotao TANG ; Yi WEN ; Yilin ZHANG ; Wei JIANG ; Liangyunzi JIANG ; Jinxuan WEI ; Weihua GAN ; Aiqing ZHANG ; Xiaoyu ZHOU ; Bin WANG ; Bi-Cheng LIU
Chinese Medical Journal 2025;138(2):193-204
BACKGROUND:
Chronic kidney disease (CKD) is associated with common pathophysiological processes, such as inflammation and fibrosis, in both the heart and the kidney. However, the underlying molecular mechanisms that drive these processes are not yet fully understood. Therefore, this study focused on the molecular mechanism of heart and kidney injury in CKD.
METHODS:
We generated an microRNA (miR)-26a knockout (KO) mouse model to investigate the role of miR-26a in angiotensin (Ang)-II-induced cardiac and renal injury. We performed Ang-II modeling in wild type (WT) mice and miR-26a KO mice, with six mice in each group. In addition, Ang-II-treated AC16 cells and HK2 cells were used as in vitro models of cardiac and renal injury in the context of CKD. Histological staining, immunohistochemistry, quantitative real-time polymerase chain reaction (PCR), and Western blotting were applied to study the regulation of miR-26a on Ang-II-induced cardiac and renal injury. Immunofluorescence reporter assays were used to detect downstream genes of miR-26a, and immunoprecipitation was employed to identify the interacting protein of LIM and senescent cell antigen-like domain 1 (LIMS1). We also used an adeno-associated virus (AAV) to supplement LIMS1 and explored the specific regulatory mechanism of miR-26a on Ang-II-induced cardiac and renal injury. Dunnett's multiple comparison and t -test were used to analyze the data.
RESULTS:
Compared with the control mice, miR-26a expression was significantly downregulated in both the kidney and the heart after Ang-II infusion. Our study identified LIMS1 as a novel target gene of miR-26a in both heart and kidney tissues. Downregulation of miR-26a activated the LIMS1/integrin-linked kinase (ILK) signaling pathway in the heart and kidney, which represents a common molecular mechanism underlying inflammation and fibrosis in heart and kidney tissues during CKD. Furthermore, knockout of miR-26a worsened inflammation and fibrosis in the heart and kidney by inhibiting the LIMS1/ILK signaling pathway; on the contrary, supplementation with exogenous miR-26a reversed all these changes.
CONCLUSIONS
Our findings suggest that miR-26a could be a promising therapeutic target for the treatment of cardiorenal injury in CKD. This is attributed to its ability to regulate the LIMS1/ILK signaling pathway, which represents a common molecular mechanism in both heart and kidney tissues.
Animals
;
MicroRNAs/metabolism*
;
Angiotensin II/toxicity*
;
Mice
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Renal Insufficiency, Chronic/chemically induced*
;
Mice, Knockout
;
Disease Models, Animal
;
Male
;
Signal Transduction/genetics*
;
LIM Domain Proteins/genetics*
;
Mice, Inbred C57BL
;
Cell Line
;
Humans
4.Surveillance results of respiratory syncytial virus outbreaks in kindergarten and school in Shenzhen, 2017-2023
WANG Xin, FANG Shisong, WU Weihua, LIU Hui, SUN Ying, ZOU Xuan, TANG Xiujuan
Chinese Journal of School Health 2025;46(3):435-437
Objective:
To analyze respiratory syncytial virus(RSV) outbreaks surveillance results and the epidemiological characteristics in kindergarten and school in Shenzhen during 2017-2023 , so as to provide a scientific reference for control and prevention of RSV.
Methods:
Epidemiological data and surveillance results of RSV outbreaks in kindergarten and school from 2017 to 2023 were collected for descriptive analyses.
Results:
A total of 31 RSV outbreaks were identified in kindergarten and school in 2017-2023 in Shenzhen, 346 cases were reported, the average incidence rate was 22.02%. The most annual RSV outbreaks were reported in 2020 with 14 outbreaks, followed by 8 outbreaks in 2023. A total of 64.52% of RSV outbreaks were identified in kindergarten with rest occurring in primary school or middle school. The greatest monthly count of outbreak was 18 (58.06%) in September, followed by 3 outbreaks (9.68%) in March and October. A total of 244 swab samples were collected, 169 samples were positive for respiratory viruses, the positive rate was 69.26%, 121 samples were positive for RSV,from 31 respiratory syncytical virus outbreaks 57 and samples were positive for other respiratory viruses(9 samples were positive for two respiratory viruses). A toral of 14(45.16%) outbreaks are caused by RSV alone, 17 outbreaks (54.84%) were caused by RSV and other respiratory viruses.
Conclusions
Most RSV outbreaks in kindergarten and school are reported after 2020 in Shenzhen, most RSV outbreaks occur in kindergarten, peak seasons of RSV outbreaks are autumn and spring.
5.Endoscopic and clinicopathological features of Helicobacter pylori-negative early gastric cancer
Weihua WANG ; Fuguo LIU ; Xuan ZHOU ; Yuning CHU ; Zibin TIAN
Chinese Journal of Digestive Endoscopy 2025;42(8):608-615
Objective:To analyze the endoscopic and clinicopathological characteristics of Helicobacter pylori ( HP)-negative early gastric cancer (EGC). Methods:A retrospective study was conducted on data of patients who were diagnosed as having EGC at the Affiliated Hospital of Qingdao University between June 2013 and March 2024. Cases meeting the diagnostic criteria for HP-negative status were included. Endoscopic findings and histopathological features of HP-negative EGC were systematically analyzed. Results:Among 698 EGC patients, 29 (4.2%) were identified as HP-negative. The age at diagnosis was 59.9±10.0 years, with marked female predominance (69.0%, 20/29 VS 31.0% males, 9/29). A body mass index ≥24 kg/m 2 was observed in 69.0% (20/29). Regarding therapeutic approaches, endoscopic submucosal dissection was performed in 89.7% (26/29). Among the 29 patients with a total of 30 lesions, the majority were localized to the middle third of the stomach (40.0%, 12/30), or the upper third (36.7%, 11/30). Differentiated-type accounted for 73.3% (22/30) among the histological types, including 13 oxyntic gland adenoma (OGA) / gastric adenocarcinoma of fundic-gland type (GA-FG) (upper third: 7; middle third: 6), and 2 gastric adenocarcinomas of fundic-gland mucosa type (GA-FGM) (both upper third). White-light endoscopy revealed polypoid or small submucosal tumor-like protrusions with whitish or erythematous discoloration and characteristic branching dilated vessels on the surface. Among the OGA/GA-FG lesions, 8 exhibited indistinct demarcation lines (DL). Additionally, both GA-FGM lesions demonstrated poorly defined DL. Three gastric adenocarcinomas of foveolar-type (GA-FV) were identified (upper/middle/lower third: 1 each), with 2 presenting as erythematous elevated masses. Five signet ring cell carcinomas (upper/middle/lower third: 1/3/1) exhibited flat or shallow depressed morphology with whitish or erythematous discoloration under white-light endoscopy; 3 exhibited well-demarcated borders. Four pyloric gland adenocarcinomas and three poorly differentiated tubular adenocarcinomas showed no significant differences in endoscopic features on white-light and narrow-band imaging compared to HP-positive EGC. No intestinal-type adenocarcinomas were identified. Conclusion:HP-negative EGC exhibit distinct endoscopic and clinicopathological characteristics, including female predominance and frequent differentiated histology, and upper/middle-third localization of elevated lesions, primarily OGA/GA-FG.
6.Ankle proprioception training can effectively improve the ankle proprioception, balance and gait of patients with thalamic infarction
Jiaojiao ZHAO ; Yanan ZHAO ; Jing ZHOU ; Chengxia LIU ; Zhizhong ZHU ; Weihua LI ; Weijia HOU
Chinese Journal of Physical Medicine and Rehabilitation 2025;47(9):799-803
Objective:To observe the effect of ankle joint proprioception training on ankle joint proprioception, balance and gait in patients with thalamic infarction.Methods:Fifty-six patients with thalamic infarction were divided into a control group and a treatment group, each of 28, using a random number table. Both groups were given conventional lower limb rehabilitation training, but the treatment group was additionally provided with ankle joint proprioception training. Before and after 4 weeks of the treatment, the Tecnobody proprioception testing system was used to determine the average trajectory error rate (ATE) and the time taken in the test. The Berg Balance Scale (BBS) and a balance tester were used to assess balance. A gait analyzer was used to collect spatial-temporal measures of the patients′ walking, including the stride amplitude, stride rate, the proportion of the time spent in the swing phase, and foot dorsiflexion and plantarflexion angles.Results:After the treatment, the time used, ATE, ankle proprioception, BBS scores, static balance test scores, stability limits, stride length, stride rate, swing phase time percentage, and foot dorsiflexion and plantarflexion angles had improved in both groups compared with before the treatment ( P≤0.05). Compared with the control group, the treatment group had a smaller average ATE, spent less time on the ankle proprioception test, had higher BBS scores, had lower scores on the static balance test, had larger limits of stability, took longer strides at a faster rate, and spent a greater percentage of time in the swing phase. That group also showed greater ankle dorsiflexion and plantarflexion on average ( P≤0.05). ATE difference of the affected lower limb and the time to complete the ankle proprioception test were positively correlated with the gap in the static balance ability test, and negatively correlated with the gaps in the BBS score, the limits of stability, stride length, stride rate, and the time share of the swing phase, as well as the dorsiflexion and plantarflexion angles of the foot. Conclusions:Ankle proprioception training, in addition to effectively improving ankle proprioception, can improve the balance and gait of persons with thalamic infarction. It is worthy of clinical application and promotion.
7.Identifying risk factors for acute graft-versus-host disease in patients with acute myeloid leukemia undergoing haploidentical hematopoietic stem cell transplantation
Dan FENG ; Wei LIANG ; Jiaxin CAO ; Yigeng CAO ; Xin CHEN ; Cuicui LIU ; Rongli ZHANG ; Weihua ZHAI ; Jialin WEI ; Qiaoling MA ; Donglin YANG ; Yi HE ; Sizhou FENG ; Mingzhe HAN ; Aiming PANG ; Hongtao WANG ; Jiaxi ZHOU ; Erlie JIANG
Chinese Journal of Hematology 2025;46(10):914-920
Objective:To identify the risk factors for acute graft-versus-host disease (aGVHD) in patients with acute myeloid leukemia (AML) undergoing haploidentical hematopoietic stem cell transplantation (HID-HSCT) .Methods:A total of 141 AML patients who underwent HID-HSCT at the Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences, from January 2020 to July 2021 were included. The cumulative incidence of aGVHD was analyzed using the Fine-Gray competing risk model, with relapse and death as competing events, to compare differences between groups. Potential risk factors were evaluated by univariable and multivariable Cox proportional hazards regression analyses to determine their independent effects on aGVHD.Results:Among the 141 patients, 86 (61.0%) were male and 55 (39.0%) were female, with a median age at transplantation of 34 years. Within 100 days post-transplant, 59 patients developed grade Ⅱ-Ⅳ aGVHD, whereas 86 patients experienced no or grade Ⅰ aGVHD (the grade 0-Ⅰ aGVHD group) . Survival analysis showed that the 3-year overall survival was 68.7% (95% CI: 57.7%-81.9%) in the grade Ⅱ-Ⅳ aGVHD group, compared with 78.8% (95% CI: 70.4%-88.3%) in the grade 0 - Ⅰ aGVHD group, with the difference not being statistically significant ( P=0.190) . Univariable analysis identified donor age ( P=0.020, HR=1.020, 95% CI: 1.000-1.040) and the female donor-male recipient sex combination ( P=0.033, HR=1.980, 95% CI: 1.160-3.380) as risk factors for grade Ⅱ-Ⅳ aGVHD. Multivariable analysis confirmed that donor age ( P=0.005, HR=1.026, 95% CI: 1.008-1.047) and the female donor-male recipient sex combination ( P=0.002, HR=2.339, 95% CI: 1.354-4.037) were independent risk factors for aGVHD. Patients receiving grafts from donors aged >45 years had a significantly higher 100-day cumulative incidence of grade Ⅱ-Ⅳ aGVHD compared with those receiving grafts from donors ≤45 years [54.7% (95% CI: 42.3%-67.0%) vs 31.6% (95% CI: 21.0%-42.1%) , P=0.006]. Similarly, patients with the female donor-male recipient sex combination had a higher 100-day cumulative incidence of grade Ⅱ-Ⅳ aGVHD than those with other sex combinations [56.8% (95% CI: 40.4%-73.1%) vs 36.9% (95% CI: 27.5%-46.3%) , P=0.015]. Conclusion:Older donor age and the female donor-male recipient sex combination remain independent risk factors for aGVHD in patients with AML undergoing HID-HSCT.
8.Study on the correlation between H3N2 subtype influenza virus F195Y mutation and inadaptability in chicken embryos
Shunwu HUANG ; Jinyu DUAN ; Shiyu QI ; Hui LIU ; Ying SUN ; Weihua WU ; Xin WANG ; Yu′e HAO ; Shumei ZOU ; Dayan WANG ; Shisong FANG
Chinese Journal of Experimental and Clinical Virology 2025;39(2):175-181
Objective:This study aimed to explore the molecular mechanisms of the maladaptation of H3N2 influenza virus in chicken embryos, provide a theoretical basis for the restoration of H3N2 influenza vaccine production in chicken embryos.Methods:Samples of respiratory secretions from patients with influenza-like symptoms (Influenza-like Illness, ILI) caused by H3N2 influenza virus were inoculated into chicken embryos and Madin-Darby Canine Kidney cells (MDCK), respectively. After isolating the virus, hemagglutination experiments were conducted to detect hemagglutination titers and hemagglutination inhibition experiments were used to compare antigenic differences; further, whole-genome sequencing of H3N2 influenza virus was performed using second-generation high-throughput gene sequencing (Next Generation High-Throughput Gene Sequencing, NGS), and key amino acid sites of mutations were identified through sequence alignment; combined with sialic acid receptor binding experiments, the differences in the binding of wild-type and mutant receptor binding sites (RBS) to sialic acid receptors were compared; finally, molecular docking and molecular dynamics simulation method were used to explore the specific molecular mechanisms of how mutation sites affect the differences in the affinity of the RBS pocket for sialic acid receptors.Results:The hemagglutination assay result indicated that both chicken embryos and MDCK cells could isolate the influenza virus, and the hemagglutination inhibition test showed that no antigenic differences were produced in the isolated strains. NGS analysis revealed that the H3N2 virus underwent an F195Y mutation in the (RBS) region of the hemagglutinin (HA) protein after adaptation through chicken embryo passages. Receptor-binding experiments demonstrated that the F195Y mutation enhanced the virus′s binding ability to α2, 3-linked sialic acid glycan (Neu5Acα2-3Galβ1-4GlcNAcβ-PAA, 3′SLN), while the mutation did not affect the affinity of the RBS pocket for α2, 6-linked sialic acid glycan (Neu5Acα2-6Galβ1-4GlcNAcβ-PAA, 6′SLN). Molecular docking and molecular dynamics simulation result indicate that the F195Y mutation, by replacing a hydrophobic amino acid with a hydrophilic one, leads to a significant decrease in the structure of the RBS pocket, enhancing the binding stability of the H3N2 influenza virus with α2, 3-sln. This is specifically manifested by an increase in binding time and an increase in the number of hydrogen bonds at the RBS site with the receptor. Furthermore, the F195Y mutation does not alter the binding of the virus to other receptors.Conclusions:The F195Y mutation in the RBS pocket of H3N2 influenza virus is a key site affecting the viral chicken embryo inadaptability.
9.Analysis of clinical features and prognostic factors of focal cerebral arteriopathy in children
Xiuwei ZHUO ; Zemou YU ; Lingbing MENG ; Ji ZHOU ; Weihua ZHANG ; Changhong REN ; Shuai GONG ; Lifang DAI ; Xinying YANG ; Shen ZHANG ; Ming LIU ; Hua CHENG ; Xiaojuan TIAN ; Jiuwei LI
Chinese Journal of Pediatrics 2025;63(2):174-179
Objective:To summarize the clinical characteristics of focal cerebral arteriopathy (FCA) in children, and to analyze its influencing factor of prognosis.Methods:A retrospective cohort study was conducted. Clinical data from 40 children with FCA who were hospitalized at the Department of Neurology, Beijing Children′s Hospital, Capital Medical University, from September 2015 to August 2024 were collected. A centralized follow-up was conducted in October 2024 via outpatient clinics or the internet. The pediatric stroke outcome measure (PSOM) was used to evaluate their outcomes. Based on the PSOM, the children were further divided into a group with normal neurological function and another group with abnormal neurological function. Differences between groups were analyzed using the Mann-Whitney U test and Fisher exact test. Univariate Logistic regression analysis was performed to identify the influencing factors for neurological outcomes in children with FCA. Results:A total of 40 children were included, with 20 males and 20 females, and the onset age of 9.2 (6.8, 12.5) years. Among them, 12 cases (30%) had a history of varicella within 1 year before onset. There were 23 cases (58%) presenting with transient ischemic attack (TIA) or recurrent fluctuating symptoms of onset, while 3 cases (8%) developed progressive stroke within the first month of onset. The M1 segment of the middle cerebral artery was the most commonly affected vascular site, with a total of 16 cases (40%). Arterial occlusion occurred in 8 cases (20%). Lumbar puncture was completed in 36 children, and white blood cell counts in cerebrospinal fluid was increased in 6 cases. All 23 patients who completed magnetic resonance vessel wall imaging (VWI) showed circular enhancement of the arterial wall. A total of 28 patients (70%) received antiplatelet or anticoagulation therapy, and 16 patients (40%) received hormone therapy. At admission, the pediatric National Institute of Health Stroke Scale (PedNIHSS) score was 6.0 (2.0, 8.8) points, which decreased to 0.5 (0, 3.0) points at discharge. The follow-up duration was 1.6 (0.8, 4.9) years, with 1 case lost to follow-up. There was 1 case presenting with recurrence course manifesting as TIA. Among the 39 cases who completed the follow-up, 23 cases (59%) were assessed as neurologically normal by PSOM, while 16 cases (41%) were assessed as neurologically abnormal. Among the 29 cases who completed the imaging review, magnetic resonance angiography (MRA) review in 23 cases indicated stability or improvement in the original arterial stenosis, with 6 cases experiencing transient worsening of arterial stenosis early in the disease course (within 2 months), which later improved. Arterial stenosis progression occurred in 6 cases at the final review of 29 cases who completed the imaging review, with 1 case developing progressive cerebral arteriopathy. The proportion of patients with headache, altered consciousness, and aphasia in the abnormal neurological function group, as well as the PedNISS scores at admission and discharge, were all higher than those in the normal neurological function group (all P<0.05). Univariate Logistic regression analysis revealed that only a PedNISS score>6 points at onset was an influencing factor for abnormal neurological function ( OR=20.58, 95% CI 3.93-107.70, P<0.001). Conclusions:Childhood FCA often presents with fluctuating onset, and the proximal segment of the middle cerebral artery is frequently affected. Progression of arterial stenosis is common within 2 months of the disease course, but clinical progression and new ischemic lesions are uncommon. Most patients have a favorable long-term prognosis. PedNIHSS score>6 points at admission is related to abnormal neurological function outcomes.
10.Clinical application and diagnostic value of 3 detection methods for acute pharyngitis of group A Streptococcus in outpatient children
Yanan LI ; Chengfeng GAO ; Tianming CHEN ; Mengyang GUO ; Xinying LI ; Kaihu YAO ; Weihua ZHANG ; Yuchuan LI ; Gang LIU
Chinese Journal of Pediatrics 2025;63(10):1103-1109
Objective:Using bacterial culture as the gold standard, to evaluate the agreement of rapid antigen detection test (RADT) and rapid nucleic acid test (RNAT) in diagnosing group A Streptococcus (GAS) pharyngitis in pediatric outpatients, and assess their potential clinical utility. Methods:This cross-sectional study prospectively collected throat swab specimens and clinical data of 338 children diagnosed with acute pharyngitis at the Department of Outpatient Beijing Children′s Hospital, Capital Medical University, between July 2023 and February 2024. The specimens were tested for GAS bacterial culture, RADT and RNAT. Using bacterial culture results as the reference standard, Kappa consistency analysis was performed to assess the diagnostic concordance between RADT and RNAT. Chi-square test was used to compare clinical characteristics between cases diagnosed by different methods.Results:In the 338 children diagnosed with pharyngitis, 195 were male and 143 were female, with an age at the visit of 7.4 (5.9, 7.4) years. The positivive rates for GAS detection were 25.7% (87/338) by bacterial culture, 20.7% (70/338) by RADT, and 41.7% (141/338) by RNAT. In terms of diagnostic performance, RADT exhibited a higher specificity (96.8% (243/251)) and better agreement with bacterial culture results ( κ=0.73), whereas RNAT showed greater sensitivity (95.4% (83/87)) but lower specificity (76.9% (193/251)) and moderate agreement ( κ=0.61). Among the 87 children with positive bacterial culture for GAS, 56 were male and 31 were female, with an age at visit of 7.3 (6.2, 8.8) years. Clinically, body temperature predominantly ranged from 38.1 to 39.0 ℃ in 48 cases (55.2%), and common accompanying symptoms included sore throat 62 cases (71.3%), cough 33 cases (37.9%), and cervical lymphadenopathy or tenderness 16 cases (18.4%). On physical examination, tonsillar enlargement was present in 73 cases (83.9%) and exudate in 37 cases (42.5%). The McIsaac score was most frequently 4 points, observed in 37 cases (42.5%). Laboratory tests showed a peripheral white blood cell (WBC) count of 14.5 (12.3, 18.7)×10?/L and C-reactive protein (CRP) concentration of 22.0 (10.1, 41.4) mg/L. There were no statistically significant differences in the proportion of fever, sore throat, cough, tender cervical lymphadenopathy, tonsillar exudates, or tonsillar enlargement, nor in WBC count or CRP, among children who tested positive by RADT, RNAT, or bacterial culture (all P>0.05). Conclusions:Compared with bacterial culture,the RADT demonstrates higher specificity, while the RNAT exhibits greater sensitivity. Both methods show good concordance with culture results and may serve as effective adjunctive tools for the early screening of GAS pharyngitis.


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