Objective:To compare the differences among four routine lipid testing systems in detecting high triglyceride (TG) serum samples and evaluate the accuracy and consistency of the four homogeneous low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) reagents using vertical auto profile (VAP) as the reference method.Methods:A retrospective study was conducted on 249 serum samples with elevated TG levels collected from the Department of Laboratory Medicine at the Second Xiangya Hospital of Central South University between January and October 2024. TG, total cholesterol (TC), LDL-C, and HDL-C were measured using four homogeneous detection systems: Beckman Coulter (USA), Wako Pure Chemical Industries (Japan), Mindray (China), and Roche Diagnostics (Germany). VAP was used to analyze lipoprotein subfractions, including very-low-density lipoprotein cholesterol (VLDL-C), intermediate-density lipoprotein cholesterol (IDL-C), LDL-C, lipoprotein(a) cholesterol [Lp(a)-C], and HDL-C. The mean coefficient of variation ( CV) across the four systems was calculated for each parameter. Pearson correlation and ordinal logistic regression (OLR) were used to assess correlations between the four HDL-C/LDL-C systems and VAP. Bland-Altman plots were generated to evaluate biases, and deviations were calculated. For parameters with significant deviations, multivariate linear regression and standardized coefficients were used to analyze correlations between biases and lipoprotein subfractions. Based on the Chinese Guidelines for Lipid Management (2023), LDL-C and non-HDL-C treatment goals were categorized into five risk levels (ultra-high, high, moderate, high-risk, and low-risk). VAP results defined LDL-C/non-HDL-C intervals, and the four systems′ concordance in risk classification was evaluated. Samples were grouped into A, B, C, D ( n=63, 62, 62, 62) by TG concentration, and ANOVA, chi-square, and Fisher exact tests assessed intergroup differences. Results:The mean CVs across systems for TG, TC, LDL-C, HDL-C, and non-HDL-C were 2.98%, 1.76%, 18.10%, 5.60%, 2.58%, respectively. Pearson correlations between LDL-C results (Beckman, Wako, Mindray, Roche) and VAP were 0.889, 0.854, 0.899, and 0.973; mean relative deviations were 54.8%, 41.0%, 49.3%, and 3.6%; classification accuracies were 6.0% (15/249), 21.3% (53/249), 9.2% (23/249), and 76.7% (191/249). HDL-C deviations were 18.7%, 15.1%, 11.1%, and 8.7%, with correlations ( r) of 0.883, 0.911, 0.959, and 0.950 (all P<0.001). LDL-C means showed no intergroup differences (A-D), but CV increased with TG levels ( P<0.001). HDL-C means and CVs showed no significant intergroup differences. Beckman, Wako, and Mindray LDL-C results exhibited significant positive biases correlated with TG and VLDL-C (multivariate regression; P<0.05); VLDL-C had the strongest influence (standardized coefficients: 0.820, 0.394, 0.813; P<0.001). Non-HDL-C classifications matched VAP in 92.4% (Beckman), 85.9% (Wako), 94.0% (Mindray), and 93.2% (Roche), with no intergroup differences. Conclusion:For high-TG sera, Beckman, Wako, and Mindray LDL-C exhibited significant positive biases correlated with TG and VLDL-C, while Roche LDL-C showed minimal deviation. TG, TC, HDL-C, and non-HDL-C results showed minimal variation across the four systems. All systems demonstrated comparable accuracy for non-HDL-C compared to VAP. The non-HDL-C measured by the four detection systems demonstrates high accuracy and consistency in atherosclerotic cardiovascular disease risk stratification and lipid-lowering goal assessment, and it is unaffected by TG levels.

Blood lipid testing serves as the foundation for clinical lipid management. Ensuring the accuracy of blood lipid test results, particularly the precision and stability of low low-density lipoprotein cholesterol (LDL-C) values, is crucial for evaluating therapeutic effects among individuals undergoing lipid management and developing subsequent effective lipid-modulatoring strategies. Clinical laboratories should not only focus on quality control measures during the pre-analytical, analytical, and post-analytical phases of testing but also pay attention to variations in laboratory indicators and cutoff values for high, moderate, and low-risk population stratification based on clinical guidelines. Additionally, it is essential to understand the impact of high triglyceride levels on LDL-C testing and provide relevant education to both doctors and patients. By revamping the traditional format of blood lipid test reports to align with the concepts and requirements of lipid management guidelines, laboratories can make a substantial valuable contribution to individual lipid management in the modern era of lipid detection and monitoring.

Objective:To compare the differences among four routine lipid testing systems in detecting high triglyceride (TG) serum samples and evaluate the accuracy and consistency of the four homogeneous low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) reagents using vertical auto profile (VAP) as the reference method.Methods:A retrospective study was conducted on 249 serum samples with elevated TG levels collected from the Department of Laboratory Medicine at the Second Xiangya Hospital of Central South University between January and October 2024. TG, total cholesterol (TC), LDL-C, and HDL-C were measured using four homogeneous detection systems: Beckman Coulter (USA), Wako Pure Chemical Industries (Japan), Mindray (China), and Roche Diagnostics (Germany). VAP was used to analyze lipoprotein subfractions, including very-low-density lipoprotein cholesterol (VLDL-C), intermediate-density lipoprotein cholesterol (IDL-C), LDL-C, lipoprotein(a) cholesterol [Lp(a)-C], and HDL-C. The mean coefficient of variation ( CV) across the four systems was calculated for each parameter. Pearson correlation and ordinal logistic regression (OLR) were used to assess correlations between the four HDL-C/LDL-C systems and VAP. Bland-Altman plots were generated to evaluate biases, and deviations were calculated. For parameters with significant deviations, multivariate linear regression and standardized coefficients were used to analyze correlations between biases and lipoprotein subfractions. Based on the Chinese Guidelines for Lipid Management (2023), LDL-C and non-HDL-C treatment goals were categorized into five risk levels (ultra-high, high, moderate, high-risk, and low-risk). VAP results defined LDL-C/non-HDL-C intervals, and the four systems′ concordance in risk classification was evaluated. Samples were grouped into A, B, C, D ( n=63, 62, 62, 62) by TG concentration, and ANOVA, chi-square, and Fisher exact tests assessed intergroup differences. Results:The mean CVs across systems for TG, TC, LDL-C, HDL-C, and non-HDL-C were 2.98%, 1.76%, 18.10%, 5.60%, 2.58%, respectively. Pearson correlations between LDL-C results (Beckman, Wako, Mindray, Roche) and VAP were 0.889, 0.854, 0.899, and 0.973; mean relative deviations were 54.8%, 41.0%, 49.3%, and 3.6%; classification accuracies were 6.0% (15/249), 21.3% (53/249), 9.2% (23/249), and 76.7% (191/249). HDL-C deviations were 18.7%, 15.1%, 11.1%, and 8.7%, with correlations ( r) of 0.883, 0.911, 0.959, and 0.950 (all P<0.001). LDL-C means showed no intergroup differences (A-D), but CV increased with TG levels ( P<0.001). HDL-C means and CVs showed no significant intergroup differences. Beckman, Wako, and Mindray LDL-C results exhibited significant positive biases correlated with TG and VLDL-C (multivariate regression; P<0.05); VLDL-C had the strongest influence (standardized coefficients: 0.820, 0.394, 0.813; P<0.001). Non-HDL-C classifications matched VAP in 92.4% (Beckman), 85.9% (Wako), 94.0% (Mindray), and 93.2% (Roche), with no intergroup differences. Conclusion:For high-TG sera, Beckman, Wako, and Mindray LDL-C exhibited significant positive biases correlated with TG and VLDL-C, while Roche LDL-C showed minimal deviation. TG, TC, HDL-C, and non-HDL-C results showed minimal variation across the four systems. All systems demonstrated comparable accuracy for non-HDL-C compared to VAP. The non-HDL-C measured by the four detection systems demonstrates high accuracy and consistency in atherosclerotic cardiovascular disease risk stratification and lipid-lowering goal assessment, and it is unaffected by TG levels.

Blood lipid testing serves as the foundation for clinical lipid management. Ensuring the accuracy of blood lipid test results, particularly the precision and stability of low low-density lipoprotein cholesterol (LDL-C) values, is crucial for evaluating therapeutic effects among individuals undergoing lipid management and developing subsequent effective lipid-modulatoring strategies. Clinical laboratories should not only focus on quality control measures during the pre-analytical, analytical, and post-analytical phases of testing but also pay attention to variations in laboratory indicators and cutoff values for high, moderate, and low-risk population stratification based on clinical guidelines. Additionally, it is essential to understand the impact of high triglyceride levels on LDL-C testing and provide relevant education to both doctors and patients. By revamping the traditional format of blood lipid test reports to align with the concepts and requirements of lipid management guidelines, laboratories can make a substantial valuable contribution to individual lipid management in the modern era of lipid detection and monitoring.

Peptides are increasingly important resources for biological and therapeutic development, however, their intrinsic susceptibility to proteolytic degradation represents a big hurdle. As a natural agonist for GLP-1R, glucagon-like peptide 1 (GLP-1) is of significant clinical interest for the treatment of type-2 diabetes mellitus, but its in vivo instability and short half-life have largely prevented its therapeutic application. Here, we describe the rational design of a series of α/sulfono-γ-AA peptide hybrid analogues of GLP-1 as the GLP-1R agonists. Certain GLP-1 hybrid analogues exhibited enhanced stability (t _1/2 > 14 days) compared to t _1/2 (<1 day) of GLP-1 in the blood plasma and in vivo. These newly developed peptide hybrids may be viable alternative of semaglutide for type-2 diabetes treatment. Additionally, our findings suggest that sulfono-γ-AA residues could be adopted to substitute canonical amino acids residues to improve the pharmacological activity of peptide-based drugs.

Objective:The results of the three lipid detection systems were compared to analyze their influence on risk stratification and clinical treatment in lipid management, especially the target goal cut-off point determination, and to find ways to reduce the impact on target goal determination of various lipid measurement system.Methods:A total of 196 serum samples with triglyceride TG <4.5 mmol/L were collected from people undergoing physical examinations and in-patients in the Second Xiangya Hospital of Central South University from August to October 2022. Triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were directly detected with Hitachi-Woke (HW), Roche and Mindray detection systems, respectively. The non high-density lipoprotein cholesterol (non HDL-C) was calculated by formula (TC-HDL-C) and LDL-C (F-LDL-C) was calculated by Friedewald formula, and results from various methodology were compared. The coefficient of variation ( CV) of these six indicators derived from the three detection systems were calculated to evaluate the consistency of the obtained results from different venders. In addition, the Pearson correlation coefficient was analyzed to evaluate the correlation of each indicator among different systems. According to the Chinese Guidelines for Blood Lipid Management, samples were divided into groups with LDL-C levels of <1.4, 1.4-<1.8, 1.8-<2.6, 2.6-<3.4 and ≥3.4 mmol/L according to the recommended LDL-C levels for different risk stratification levels. The sample size and percentage of LDL-C test results from different systems in the same group were counted to evaluate the impact of LDL-C differences between systems on clinical decision-making of blood lipid management. The correction factor was calculated through two methods: (1) The average deviation of LDL-C between systems was estimated by EP9-A3 method; (2) Multiple linear stepwise regression was used to establish the regression model of LDL-C difference and related indexes between systems. The two correction factors were used to correct the deviation of LDL-C value obtained from various systems, and Chi-square test was used to compare the difference of LDL-C grouping consistency rate before and after correction. Result:The average CV values of TG, TC, LDL-C, F-LDL-C, HDL-C, and non HDL-C among the three detection systems were 4.84%, 1.92%, 11.96%, 3.81%, 5.82% and 2.61%, respectively. Correlation analysis showed that when comparing the three systems in pairs, except for LDL-C derived from HW and Roche′s, and Mindray and Roche′s LDL-C ( R 2=0.938 and 0.947), the R 2 of other indicators were all greater than 0.97. The consistency rates of the three systems on LDL-C and F-LDL-C were 51.0% (100/196) and 90.8% (178/196), respectively, according to the risk stratification standard values and the difference was statistically significant ( P<0.05). When comparing in pairs, the consistency rates of Roche and HW, Mindray and HW, Mindray and Roche system LDL-C grouping were 60.7% (119/196), 82.7% (162/196), and 54.1% (106/196), respectively. After adjusting for mean deviation, the group consistency rate of Roche and HW increased to 73.7%-79.4% ( P<0.05), and the group consistency rate of Roche and Mindray increased to 72.3%-79.0% ( P<0.05). After adjusting for difference regression model, the group consistency rate of Roche and HW increased to 82.5%-84.0%, and the group consistency rate of Roche and Mindray increased to 81.0%-89.2%. However, there was no significant change in the group consistency rate of Mindray and HW after adjusting for both correction methods ( P>0.05) .Conclusions:There are significant differences in LDL-C derived from different detection systems, and the consistency rate of grouping according to the lipid-lowering standard value is relatively low, which may affect clinical decision-making in lipid management. Adjusted by the correction factor, the consistency rate of grouping between Roche and HW, Roche and Mindray systems with large differences in LDL-C can be improved. Using the difference multiple linear regression model as a correction factor is superior to the average deviation.

Objective To evaluate systematically the correlation between the expression level of human epididymis protein 4 (HE4) and lymph node metastasis of endometrial cancer (EC). Methods Computers were used to search for the literatures about the correlation between the expression level of HE4 and lymph node metastasis of EC in PubMed, Cochrane, Web of Science, CBM, CNKI, and Wanfang Database. The search time was from the database establishment to May 2021. Articles were screened in accordance with the inclusion and exclusion criteria, and the quality of literature was evaluated by Newcastle Ottawa scale. Stata12.0 was used to perform meta-analysis, and TSA was used to evaluate the sample size. Results A total of 2736 patients with EC were included in the 25 eligible studies. The results of meta-analysis showed that the expression level of HE4 in the EC-lymph-node metastasis group was significantly higher than that in the non-metastasis group (SMD=1.58, 95%CI: 1.13-2.03), and meta-regression analysis revealed that the results were related to the average age of patients in each study. TSA analysis exhibited that the total sample size of the included studies met the requirements. Conclusion The expression level of HE4 is correlated with lymph node metastasis of EC, and this correlation may be affected by age, body mass index, and other factors. The correlation weakens with the increase in age.

Objective: To evaluate the efficacy and safety of maintenance therapy with reduced dose of rhTPO in the patients with primary immune thrombocytopenia (ITP) who attained stable platelet (PLT) counts after daily administration of rhTPO. Methods: Treatment was started with a daily administration of rhTPO (300 U/kg) for 2 consecutive weeks. Patients who attained stable PLT≥50×10⁹/L were enrolled to maintenance therapy starting with every other day administration of rhTPO, then adjusted dose interval to maintain platelet count (30-100) ×10⁹/L. Results: A total of 91 eligible patients were enrolled. Fourteen patients discontinued the study due to noncompliance (12/14) and investigator decision (2/14) . Among 77 patients who completed the study, 38 patients with the administration of rhTPO at every other day or less could maintain PLT≥30×10⁹/L for 12 weeks. The percentage of patients with a platelet response (PLT≥30×10⁹/L) at 4^th week, 8^th week and 12^th week of maintain therapy was 92.6% (63/68) , 82.7% (43/52) and 85.0% (34/40) , respectively. Median platelet counts remained in the range of (70-124) ×10⁹/L. The overall incidence of rhTPO-related adverse events was 7.7%. All the adverse events were generally mild. Conclusion Extending the dose interval of rhTPO is feasible to maintain stable platelet count in the patients with ITP, but the optimal dose interval is uncertain and might vary with individuals.

Objective To explore the clinical value of spiral CT airway measurements on awake patients under OSAHS discussed. Methods The upper airway of 104 patients with OSAHS diagnosed with polysomnography (PSG) and 25 nor-mal controls were examined and compared. The cross-sectional areas, diameters, and the thickness of the pharyngeal wall of retropalate, lingua regions planes were scanned by MSCT scan in the waking state. Results The cross-section areas of upper airway of OSAHS were significantly smaller than those of the control group, the difference was significant (P<0.05). The cross-section areas decreased and the thickness of pharyngeal walls increased with the increase of severity of OSAHS. Conclusion Patients with OSAHS has upper airway anatomic strictures. MSCT scan can effectively localize the obstructed site and degree of upper airway accurately.

Objective To explore the method of demonstrating main operative section of facial recess approach with multi-slice CT by using double oblique muttiplanar reconstruction.MethodsSimilarly as surgical procedure of facial recess approach,30 (60 eras) normal temporal bones in cadavers were reconstructed to observe main operative sections and anatomical marks.Main images of operative section of facial recess approach were reconstructed using double oblique multiplanar reconstruction on multislice CT.With the reference of operative anatomical marks,the ratios of visibility of anatomical marks on the transverse plane,coronal plane,sagittal plane and double oblique were calculated and compared.The degree,of which major anatomical landmarks were displayed on the same plane ( axial,coronal,sagittal,or doubleoblique sagittal plane),was classified using the following criteria: level 4: 100％ of anatomical landmarks were presented in the same plane; level 3: 90％ to 99％ of anatomical landmarks were presented in the same plane; level 2: 80％ to 89％ of anatomical landmarks were presented in the same plane; level 1: 70％ to 79％ of anatomical landmarks were presented in the same plane ; level 0: ＜ 70％ of anatomical landmarks were presented in the same plane.Classification data were tested by chi-square test.Results Four key operative section were involved in facial recess approach,which were of oblique sagittal orientation.The central mark of the first key operative section was semicircular canal by using double oblique multi-planar reformation.On reconstructed images of the first key operative section,horizontal reference line was short process of incus,and the angle adjusting the reference line on the transverse plane was 22.15° ±5.22°.On the reconstructed images of the first key operative section,coronal reference line was tympanic segment of facial canal,and the angle adjusting the reference line on the coronal plane was 14.35° ± 4.02°.On the reconstructed images of the second key operative section,the central mark was fossa incudis,the horizontal reference line was short process of incus and the angle was 20.15° ± 5.52°,while the coronal reference line was tympanic segment of facial cana,and the angle was 13.15° ± 3.33°.On the reconstructed operative images of the third key section,the central mark was pyramidal eminence,the horizontal reference line was the horizontal portion of the facial nerve and the angle was 32.53° ±5.22°,while the coronal reference line was the tympanic segment of facial nerve,and the angle was 15.05° ± 4.43°.On the fourth reconstructed images of the key operative section,the central mark was the posterior border of round window,the horizontal reference line was the superior border of oval window,and the angle was 50.15° ± 8.02°,while the coronal reference line was the tympanic segment of facial nerve,and the angle was 15.25° ± 4.12°.For the four planes (double-oblique sagittal,axial,coronal,or sagittal plane),the results of the degree to which they could include the major anatomical landmarks in the same layer of the first section were: level 4 in 60 sides,level 2 in 12 sides and level 3 in 48 sides,level 2 in 15 sides and level 3 in 45 sides,level 3 in 10 sides and level 4 in 50 sides,respectively.The results of the second section were: level 4 in 60 sides,level 2 in 11 sides and level 3 in 49 sides,level 2 in 13 sides and level 3 in 47 sides,level 3 in 11 sides and level 4 in 49 sides,respectively.The results of the third section were: level 4 in 60 sides,level 2 in 10 sides and level 3 in 50 sides,level 2 in 11 sides and level 3 in 49 sides,level 3 in 9 sides and level 4 in 51 sides,respectively.The results of the fourth section were: level 4 in 60 sides,level 2 in 9 sides and level 3 in 51 sides,level 2 in 8 sides and level 3 in 52 sides,level 3 in 5 sides and level 4 in 55 sides,respectively.The four planes differed significantly in the degree to which they could include the major anatomical landmarks in the same layer ( x2 =123.3200,121.4231,122.4011,125.4213,all,P ＜ 0.05 ).The visibility ratio of every section is 100％ (60/60).Conclusion Double oblique multi-planar reformation is a new method to demonstrate landmarks of operative section of facial recess approach in one slice.The reconstructive images of operative section with double oblique multi-planer reconstruction may provide valuable information for operation.