Objective To investigate the characteristics of intestinal flora and its correlation with peripheral blood microinflammatory factors in patients with pulmonary tuberculosis complicated with diabetes mellitus(PTB-DM).Methods A total of 162 patients with PTB-DM admitted to the hospital from September 2022 to September 2024 were selected as the PTB-DM group,and another 150 healthy subjects who underwent physi-cal examinations during the same period in the hospital were selected as the control group.The clinical data of all research subjects was collected.The composition of intestinal flora of the research subjects was analyzed by using 16S rRNA gene sequencing technology.The levels of peripheral blood microinflammatory factors[inter-feron-γ(IFN-γ),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)]in all research subjects were detected.The clinical data,composition of intestinal flora and levels of microinflammatory factors of the PTB-DM group were compared with those of the control group.Spearman correlation analysis was used to analyze the correlation between the relative abundance of intestinal flora and the levels of peripheral blood microin-flammatory factors in patients with PTB-DM.Results The relative abundances of Bacteroidales and Clostridi-ales in the PTB-DM group were significantly lower than those in the control group,while the relative abun-dances of Enterobacterales and Actinobacteriales were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of IFN-γ,IL-6 and TNF-α in the PTB-DM group were significantly higher than those in the control group,and the differences were statistically signifi-cant(P<0.05).The relative abundances of Bacteroidales and Clostridiales in the PTB-DM group were nega-tively correlated with the levels of IFN-γ,IL-6 and TNF-α.The relative abundances of Enterobacterales and Actinobacteriales were positively correlated with the levels of IFN-γ,IL-6 and TNF-α(all P<0.05).Conclu-sion There is a significant imbalance of intestinal flora in patients with PTB-DM,and the levels of microin-flammatory factors IFN-γ,IL-6 and TNF-α in peripheral blood are significantly increased,and are closely re-lated to the relative abundance of specific flora.

Objective:To investigate and analyze the mental health status and influencing factors of the troops stationed and training in remote islands and reefs during COVID-19 pandemic.Methods:A total of 577 officers and sailors were selected as objects of study from the troops stationed and training in remote islands and reefs in 2020 by convenient sampling method．The investigation was carried out by handing out and returning a questionnaire on-the-spot．The questionnaire was developed from the 90-item symptom list（SCL-90），and all the questions and choices in the questionnaire were uniformed according to the same instruction．A total of 579 questionnaires were handed out，and 577 valid questionnaires were collected；the effective rate was 99.65%．The univariate and multivariate analyses were used to screen the influencing factors related to the results of the above-mentioned investigation.Results:The average score of SCL-90 was 122.7±49.76，which was significantly lower than the military norm（ P<0.01）．The multivariate analysis showed that the total score was negatively correlated with the relationship with other colleagues，the relationship with parents，and the relationship with spouse（ P<0.01）；while it was positively correlated with the military situation in the South China Sea and the family economic situation（ P<0.05）. Conclusion:The mental health status of the troops stationed and training in remote islands and reefs were generally good．The mental status of the troops were closely related to intimate relationship，interpersonal relationship，and military environment.

Objective:To investigate the prevalence of hyperuricemia in tropical island population，and to analyze the risk factors of urinary calculi in patients with hyperuricemia or gout.Methods:A total of 638 samples of tropical island people who received annual physical examinations were the subjects of our study. Their general information，renal function indicators，and urological ultrasound data were collected. The intergroup comparison and binary Logistic regression were applied for statistical analysis.Results:The incidences of hyperuricemia and gout were 36.4% and 1.3%，respectively，in tropical island population. The incidences of urinary calculi in cases with normal uric acid，asymptomatic hyperuricemia，and gout were 14.3%，23.9%，and 72.7%，respectively. A positive correlation was found between serum creatinine and uric acid levels among the 638 cases（ r = 0.25， P < 0.001），and the level of urea nitrogen increased slightly with the increase of uric acid（ r = 0.07， P = 0.051）. The elevated serum uric acid（ OR = 1.0， P = 0.013）and history of gout（ OR = 7.9， P = 0.004）were risk factors for the occurrence of urinary calculi in tropical island population. The combination of these two parameters could predict the occurrence of urinary calculi with AUC = 0.601，which was slightly better than using serum uric acid level alone with AUC = 0.598（ P = 0.158）. Conclusion:The proportion of patients with hyperuricemia in tropical islands is significantly higher than that in non-tropical regions. The serum creatinine and urea nitrogen levels are positively correlated with uric acid levels among the cases. The elevated serum uric acid and history of gout are risk factors for the occurrence of urinary calculi in tropical island population. The combination of these two parameters has a certain role in predicting the occurrence of urinary calculi.

Objective:To investigate and analyze the mental health status and influencing factors of the troops stationed and training in remote islands and reefs during COVID-19 pandemic.Methods:A total of 577 officers and sailors were selected as objects of study from the troops stationed and training in remote islands and reefs in 2020 by convenient sampling method．The investigation was carried out by handing out and returning a questionnaire on-the-spot．The questionnaire was developed from the 90-item symptom list（SCL-90），and all the questions and choices in the questionnaire were uniformed according to the same instruction．A total of 579 questionnaires were handed out，and 577 valid questionnaires were collected；the effective rate was 99.65%．The univariate and multivariate analyses were used to screen the influencing factors related to the results of the above-mentioned investigation.Results:The average score of SCL-90 was 122.7±49.76，which was significantly lower than the military norm（ P<0.01）．The multivariate analysis showed that the total score was negatively correlated with the relationship with other colleagues，the relationship with parents，and the relationship with spouse（ P<0.01）；while it was positively correlated with the military situation in the South China Sea and the family economic situation（ P<0.05）. Conclusion:The mental health status of the troops stationed and training in remote islands and reefs were generally good．The mental status of the troops were closely related to intimate relationship，interpersonal relationship，and military environment.

Objective:To investigate the prevalence of hyperuricemia in tropical island population，and to analyze the risk factors of urinary calculi in patients with hyperuricemia or gout.Methods:A total of 638 samples of tropical island people who received annual physical examinations were the subjects of our study. Their general information，renal function indicators，and urological ultrasound data were collected. The intergroup comparison and binary Logistic regression were applied for statistical analysis.Results:The incidences of hyperuricemia and gout were 36.4% and 1.3%，respectively，in tropical island population. The incidences of urinary calculi in cases with normal uric acid，asymptomatic hyperuricemia，and gout were 14.3%，23.9%，and 72.7%，respectively. A positive correlation was found between serum creatinine and uric acid levels among the 638 cases（ r = 0.25， P < 0.001），and the level of urea nitrogen increased slightly with the increase of uric acid（ r = 0.07， P = 0.051）. The elevated serum uric acid（ OR = 1.0， P = 0.013）and history of gout（ OR = 7.9， P = 0.004）were risk factors for the occurrence of urinary calculi in tropical island population. The combination of these two parameters could predict the occurrence of urinary calculi with AUC = 0.601，which was slightly better than using serum uric acid level alone with AUC = 0.598（ P = 0.158）. Conclusion:The proportion of patients with hyperuricemia in tropical islands is significantly higher than that in non-tropical regions. The serum creatinine and urea nitrogen levels are positively correlated with uric acid levels among the cases. The elevated serum uric acid and history of gout are risk factors for the occurrence of urinary calculi in tropical island population. The combination of these two parameters has a certain role in predicting the occurrence of urinary calculi.

Objective To establish and verify the fluctuation of reference intervals for biochestry parameters in routine physical exami-nation. Methods The results of biochemistry parameters,i.e., total protein (TP), albumin (Alb), total bilirubin (T-Bil), alanine aminotransferase (ALT), glucose (Glu), urea (Urea), creatinine (Cr), uric acid (UA), triacylglycerol (TG) and total cholesterol ( TC) from 2 089 healthy subjects in routine physical examination during consecutive 2014, 2015 and 2016 were randomly collected, in which all the results were within the reference range. The ratio (λ1) of the results of 2015 to those of 2014, and ratio (λ2) of the re-sults of 2016 to those of 2015 were calculated. λ1was analyzed statistically to establish the fluctuation of reference interval (CIλ). CIλ was verified by λ2.The personalized reference interval (CIp) was established by multiplying each result of 2015 and the upper and low-er limits of CIλ. The CIpwas verified by the results of 2016. The ratios of CIpto the upper and lower limits of conventional reference in-terval were calculated. Results The values of CIλwere as follows: TP: 0.91 to 1.08, Alb: 0.91 to 1.08, T-Bil: 0.58 to 1.74, ALT:0.49 to 1.99, Glu: 0.84 to 1.20, Urea: 0.67 to 1.50, Cr: 0.82 to 1.22, UA: 0.77 to 1.32, TG: 0.51 to 1.98 and TC: 0.80 to 1.26. Compared with conventional reference interval, the ratio of the upper and lower limits of CIp was lessened. Conclusion The personal-ized reference interval (CIp) which may increase the sensitivity of conventional reference intervals was established and verified.

Objective: To study the diagnostic strategy of β-thalassemia through retrospective analysis of 3 cases of β-thalassemia. Methods: Three patients were admitted to the Department of Pediatrics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2014 to June 2015. The clinical manifestations, hemoglobin electrophoresis and gene detection of these patients and their parents were analyzed, diagnostic ideas and key points were discussed when beta thalassemia gene detection did not explain clinical manifestations or hemoglobin electrophoresis. Results: Case 1, boy, 5 years old, was diagnosed as compound heterozygotes of β41-42 and IVS-Ⅱ-654 with hereditary persistence of fetal hemoglobin(HPFH) according to the clinical manifestations of mild anemia, normal size of liver and spleen, 92.8% fetal hemoglobin (HbF) and gene analysis. Case 2, girl, 3 years old, was confirmed the diagnosis of thalassemia intermedia with β41-42 heterozygote compound and ααα^anti3.7 heterozygote in accordance with the manifestations of severe anemia, hepatosplenomegaly, 8.6% HbF, 4.1% hemoglobin A₂(HbA₂) and gene analysis. Case 3, girl, 3 years old, with severe anemia, hepatosplenomegaly, 51.2% HbF and 3.7% HbA₂, was diagnosed as thalassemia major with compound heterozygotes of PolyA (T→C) and β17 by DNA sequencing. Conclusion The diagnosis of β-thalassemia should be confirmed by clinical manifestations of hemolytic anemia, hemoglobin electrophoresis, gene diagnosis and family survey.

Objective To establish and verify the personalized reference interval of blood cells.Methods The results of blood cells from 2 089 health subjects in 2014,2015 and 2016 were collected.The ratio of the later results to the previous results was defined as the fluctuation (λ).The ratio (λ1) of the results of 2015 to the results of 2014 was calculated and λ1 was analyzed statistically to establish the fluctuation reference interval (CIλ).The ratio (λ2) of the results of 2016 to the results of 2015 was calculated.λ2 was used to verify λ2.The personalized reference interval (CIp) was established by multiplying each result of 2015 and CIλ.CIp was verified by results of 2016.The ratio of the upper and lower limits of CIp was calculated.The ratio of the upper and lower limits of the reference interval (WS/T 405) was calculated.Results The values of CIλ were as follows:WBC (0.66 to 1.53),L(0.67 to 1.51),M (0.50 to 2.00),N(0.56 to 1.78),E(0.4 to 2.51),PLT(0.76 to 1.32),RBC(0.92 to 1.12),Hb(0.92 to 1.11),Hct(0.91 to 1.12),MCV(0.95 to 1.07),MCH(0.95 to 1.05)and MCHC(0.94 to 1.06).The validation tests of CIλ and CIp showed that both CIλ and CIp were suitable for this laboratory.Compared with the reference interval of professional criteria,the ratio of the upper and lower limits of the CIp was smaller than that of traditional criteria.Conclusion CIp for this laboratory was established and verified.Compared with traditional criteria,CIp should be more personalized and highly sensitive.

Objective To investigate the diagnostic value of serum LP ( a) and C-reactive protein ( CRP) in patients with ca-rotid atherosclerosis vulnerable plaque .Methods One hundred and twenty-eight patients with acute cerebral infarction coupled with carotid atherosclerosis were selected for the study , and they were divided into the vulnerable plaque group (90 cases) and the stable plaque group(38 cases) in accordance with the detection results from color Doppler ultrasonorgraphy .Then, the levels of LP(a) and CRP in the two groups were measured .Results The levels of LP(a) and CRP in the vulnerable plaque group were significantly higher than those in the stable plaque group , and statistical significance could be seen , when comparisons were made between the 2 groups ( P<0.01).Conclusion The higher levels of LP(a) and CRP might indicate that there was probably a transfer from the stable plaque to the vulnerable plaque .

Objective To investigate the effect of blood-bag placement mode in the refrigerator on the expression of adherent molecules in the preservation of human erythrocytes onboard the ship.Methods On the first day of deployment to sea, 4 blood samples were collected from 4 healthy volunteers.Erythrocyte suspension was equally aliquoted into four portions, one as the control group was placed vertically in the refrigerator of the hospital and the other three as the experiment group were preserved in the same refrigerator on-board the ship in 3 different placement modes ( the layer-upon-layer mode, the upright mode and the vertical suspension mode) .After completion of the training, the preserved samples were immediately sent to the laboratory for the detection of the expressions of CD47, CD58, and CD44.Results The expression levels of CD44 and CD47 in the erythrocytes of whole blood placed on the shipboard refrig-erator were significantly higher, as compared with those of the control group in the hospital.The expression levels of CD58 in the eryth-rocytes placed in the layer-upon-layer mode decreased significantly.Conclusion From the aspect of the expression of erythrocyte, the upright placement mode was most suitable for the preservation of blood in the shipboard refrigerator.