iLABMED最新文献

Background

The reference interval (RI) for serum uric acid (SUA) is a critical parameter for clinical diagnosis. However, systematic studies reflecting SUA levels across different regions in China are lacking. We aim to establish reference intervals for SUA using samples from multiple centers across China.

Methods

This cross-sectional study collected serum samples from 9314 healthy individuals across 6 regions in China (Shenyang, Yinchuan, Chengdu, Hangzhou, Changsha, and Nanning) between June and December 2020. The samples were analyzed using standardized methods, and non-parametric statistics were applied to assess differences in SUA levels.

Results

The analysis revealed significant sex-based differences in SUA levels. The mean SUA level was 345.3 μmol/L in men and 276.9 μmol/L in women. The RI for men was 215.5–494.3 μmol/L, while that for women was 180.3–425.7 μmol/L. When stratified by sex and age, the RI for men aged 18–29 years was 226.4–508.9 μmol/L, and that for men aged 30–100 years was 213.4–485.1 μmol/L. For women, the RIs were 184.1–430.4 μmol/L (18–29 years), 176.5–414.1 μmol/L (30–49 years), 183.2–422.1 μmol/L (50–59 years), 185.8–429.2 μmol/L (60–79 years), and 194.5–478.6 μmol/L (80–100 years). Regional analysis also showed significant variation in SUA levels: the RI was 194.9–496.2 μmol/L in Shenyang, 192.5–447.8 μmol/L in Changsha, and 187.1–468.3 μmol/L for the combined regions of Nanning, Hangzhou, Chengdu, and Yinchuan.

Conclusion

We successfully established RIs for SUA across different age groups, sexes, and geographic regions in China.

Background

Malaria remains a global health challenge, with 249 million cases and 608,000 deaths reported in 2022. While China achieved malaria elimination, imported cases surged by 194.4% in 2023, underscoring the need for rapid diagnostics. Traditional methods like microscopy and rapid diagnostic tests (RDTs) face limitations in sensitivity and infrastructure requirements. This study aimed to establish and optimize a “one-pot” enzymatic recombinase amplification (ERA) assay for the molecular detection of Plasmodium falciparum and Plasmodium vivax, and to evaluate the efficacy of this assay through methodological verification and clinical performance.

Methods

We designed a specific ERA assay targeting the conserved regions of P. falciparum and P. vivax genetic material. We evaluated the sensitivity and specificity of this assay using synthetic plasmids and genomic material. Additionally, we tested the stability of the reaction by incorporating potential interfering substances into the reaction system. Finally, we analyzed the detection performance of the ERA method against real-time fluorescent quantitative PCR and rapid diagnostic tests using clinical samples.

Results

The detection process could be completed within 25 min at 35°C–40°C, and the results could be interpreted either under UV light or using a GeneScope instrument. The detection limit of the ERA assay was 250 copies/mL, which was 40 times more sensitive than fluorescent quantitative PCR. When evaluating the clinical performance using 75 clinical specimens, the detection rate of the ERA method was 94.54% compared with 89.09% for fluorescent quantitative PCR. The ERA assay and fluorescent quantitative PCR can achieve positive detection when blood samples were diluted 1024 times or even 4096 times. Comparatively, the detection capabilities of rapid diagnostic tests were significantly lower than that of the ERA assay.

Conclusion

The ERA method shows good performance in the detection of P. falciparum and P. vivax, and can be used as a complementary tool for malaria screening and clinical diagnosis.

Tuberculous meningitis (TBM), an extrapulmonary form of tuberculosis (TB), is characterized by low bacterial load and lacks efficient diagnostic techniques, often leading to delayed diagnosis and high rates of mortality and disability. We present a case highlighting the superior performance of a single-cell metabolic labeling probe for tuberculosis (SCMLP-TB) in achieving rapid and accurate diagnosis of TBM. A 16-year-old girl had a 2-month history of refractory fever and worsening headache. Brain magnetic resonance imaging showed slightly abnormal signals in the right frontal lobe sulci. Standard diagnostic methods such as acid-fast staining, mycobacterial culture, and cerebrospinal fluid analysis all yielded negative results. SCMLP-TB successfully detected Mycobacterium tuberculosis in cerebrospinal fluid within 2 h in this case of clinically suspected TBM. Metagenomic next-generation sequencing later confirmed this finding. An anti-tuberculosis four-drug fixed-dose combination regimen was initiated on day 7 of hospitalization, resulting in gradual symptom and radiological improvement after 8-month follow-up. This first clinical application of the SCMLP-TB technology for diagnosing TBM underscores its value in point-of-care testing for paucibacillary TB infection.

Background

Infective endocarditis (IE) and myocarditis are serious heart diseases that can lead to life-threatening complications. These illnesses can have infectious origins, including viral, bacterial, or fungal pathogens. Traditional detection methods, such as culture-based methods, have limited ability to detect causative pathogens because of antibiotic use and the difficulty in cultivating intracellular and fastidious bacteria as well as viruses. In clinical settings, rapid diagnostics for pathogen identification are essential for timely treatment and appropriate antimicrobial therapy.

Methods

We successfully developed a method based on nanopore targeted sequencing (NTS) with pathogen-specific panels for testing myocarditis and IE. As part of this pilot study, a sample-to-results protocol was developed with an optimized in-house pipeline and bioinformatics analysis solution.

Results

The performance of NTS met our expectations for sensitivity, specificity, and turnaround time. The pathogen-specific panel testing was accomplished in a 10-h turnaround time, achieving a detection limit of 20 copies/test for the IE target panel and 10 copies/test for the myocarditis target panel. NTS achieved a clinical performance of 85.0% sensitivity and 96.3% specificity compared with culture testing methods, using 74 clinical specimens from patients (53 male, 21 female) associated with IE.

Conclusions

The rapid turnaround time of NTS is advantageous for managing acute infections, such as IE and myocarditis. NTS is a powerful tool for rapidly diagnosing infections in IE and myocarditis with significant potential for broader clinical applications.

Background

High altitude shock is attributed to myocardial ischemia and hypoxia. Jiuwei Shengmai powder has positive impacts on human physiology. However, it is unknown if it can mitigate myocardial ischemia and hypoxia. This study aimed to postulate the molecular mechanism that relieves myocardial hypoxia injury in officers and soldiers at high altitude after ingesting Jiuwei Shengmai powder by using network pharmacology and molecular docking.

Methods

The effective components and potential targets of Jiuwei Shengmai powder were detected by databases such as the traditional Chinese medicine systems pharmacology (TCMSP), PubChem, and UniProt. Target genes related to myocardial hypoxia injury were identified using Gene Cards, Online Mendelian Inheritance in Man, DrugBank, DisGeNET, the Comparative Toxicogenomics Database, and other databases. CytoScape was used to construct a “drug-active ingredient-target gene” network. Protein-protein interactions (PPIs) were predicted using the STRING database. Core gene target data were analyzed using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment utilizing R packages, while Autodock Vina was used to verify the molecular docking simulation.

Results

One hundred and sixteen active ingredients were identified in Jiuwei Shengmai powder and were shown to target 197 genes. Of these, 3073 core target genes were related to myocardial hypoxia injury, and 130 core genes were obtained after Veen intersection. There were 129 PPI nodes and 1769 edges. The docking binding energy was ≤ −5.0 kcal·mol⁻¹, indicating strong binding between the active compounds and targets. Quercetin and kaempferol are the main components in Jiuwei Shengmai powder that relieve myocardial hypoxia injury. Their core targets are interleukin-6 and activated cysteine proteinase-3 antibody, which are mainly related to PI3K-Akt-, mitogen-activated protein kinase (MAPK), tumor necrosis factor (TNF), and interleukin 17 (IL-17) signaling pathways.

Conclusions

This study provides a strong theoretical basis to understand the interaction of the components in Jiuwei Shengmai powder with human genes and proteins that should help to plan biochemical studies to better understand myocardial hypoxia injury mitigation.

Background

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to impose a significant global health burden. Limited data exist regarding antibody responses to breakthrough infections caused by the Delta and Omicron variants of SARS-CoV-2. This study aimed to compare antibody levels and their relationships with clinical features in patients with breakthrough infections.

Methods

Sera from patients with breakthrough infections were analyzed for IgG, IgM, IgA, and neutralizing antibodies (NAbs) using a fully automated chemiluminescence immunoassay analyzer. Antibody levels were then compared and correlated with clinical features.

Results

Booster COVID-19 vaccination was associated with higher levels of NAb and IgG in breakthrough-infected individuals (β = 0.51, 95% confidence interval [CI]: 0.12–0.90, and β = 0.84, 95% CI: 0.35–1.33, respectively). Individuals infected with the Delta variant exhibited higher IgM and IgA levels compared with those infected with the Omicron variant (β = 0.80, 95% CI: 0.46–1.14, and β = 0.55, 95% CI: 0.13–0.98, respectively). The SARS-CoV-2 RNA clearance time was negatively correlated with NAb and IgG levels in Delta infections (correlation coefficient r_s = −0.31 and −0.26, respectively) and Omicron infections (r_s = −0.29 and −0.32, respectively).

Conclusions

Patients with breakthrough infections of the Delta variant exhibited higher IgM and IgA levels than those with breakthrough infections of the Omicron variant. Elevated NAb and IgG levels, associated with booster COVID-19 vaccination, correlated with shorter SARS-CoV-2 RNA clearance times. These findings underscore the enhanced immunogenicity of booster vaccination in mitigating the duration of viral RNA positivity.

Background

Tuberculosis (TB) remains a leading cause of mortality worldwide, particularly in developing nations. Currently, available diagnostic methods are often too costly or insufficiently sensitive for effective use in low- and middle-income countries. Developing a rapid, convenient, and accurate method for detecting the Mycobacterium tuberculosis complex (MTBC) is crucial to curtail the spread of TB.

Methods

Primers and probes targeting conserved regions of IS1081 were designed, and the RNase P gene was introduced as an internal control to prevent false-negative results. M. tuberculosis control was used to optimize the reaction temperature. Additionally, we calculated and compared the limit of detection, specificity, and coincidence rate between this platform and the TaqMan real-time fluorescence quantification method (RT-qPCR) using two sets of national reference panels and 10 strains of MTBC.

Results

An on-site MTBC-multiplex recombinase polymerase amplification (MTBC-mRPA) platform was established, with detection within 30 min over a broad temperature range (25°C–45°C). Probit analysis estimated a 95% limit of detection of 557.16 (95% confidence interval: 406.76–1062.67) bacteria/mL (p < 0.0001), close to the limit of detection of 461.84 (95% confidence interval: 342.55–881.57) bacteria/mL (p < 0.0001) of qPCR. The platform differentiated between non-tuberculous mycobacteria and other common respiratory bacteria, showing 100% specificity. The coincidence rate between multiplex real-time recombinase polymerase amplification (RT-mRPA) and RT-qPCR was 100%, indicating substantial similarity.

Conclusion

A simple, rapid, and visual MTBC-mRPA platform coupled with rapid DNA extraction was developed for sensitive and specific detection of MTBC, especially suitable for on-site screening of TB in low-resource settings.

Background

This study aims to determine prognostic indicators of synaptophysin (SYN) positive gastric cancer with neuroendocrine type by analyzing differences in serological indicators and survival between SYN-positive and SYN-negative gastric cancer patients and to provide a theoretical basis for the prognosis of patients.

Methods

The medical records of 1298 gastric cancer patients who had received surgical treatment between January 2019 and December 2021 at The First Medical Center of Chinese PLA General Hospital were assessed, and 59 patients were enrolled in this study, to analyze serological indices and survival differences between patients with SYN-positive and SYN-negative gastric cancer.

Results

There were statistically significant differences between the expression of SYN and genetic history, tumor differentiation degree, and Lauren's typing (p = 0.036, 0.040, and 0.017, respectively). The level of neuron-specific enolase in SYN-positive patients was higher than that in SYN-negative patients (p = 0.027). The level of hemoglobin (Hb) and mean corpuscular hemoglobin (MCH) was lower in SYN-positive patients when compared with SYN-negative patients (p = 0.023 and 0.019, respectively). The survival time of SYN-positive gastric cancer patients was statistically significantly different from that of SYN-negative gastric cancer patients (p = 0.0255).

Conclusions

SYN expression in patients with gastric cancer is correlated with the degree of differentiation and Lauren's typing. The prognosis of SYN-positive gastric cancer patients is worse than that of SYN-negative patients.