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Preeclampsia: A comprehensive review 子痫前期:全面回顾。
IF 3.2 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-08-13 DOI: 10.1016/j.cca.2024.119922

Preeclampsia (PE) is a life-threatening disease of pregnancy and a prominent cause of neonatal and maternal mortality and morbidity. PE affects approximately 5–10% of pregnancies worldwide, posing significant risks to perinatal and maternal health. It is characterized by a variety of interconnected pathological cascades contributing to the stimulation of intravascular inflammation, oxidative stress (OS), endothelial cell activation, and syncytiotrophoblast stress that converge on a common pathway, ultimately resulting in disease progression. The present study was designed and executed to review the existing scientific literature, specifically focusing on the etiology (gestational diabetes mellitus and maternal obesity, insulin resistance, metabolic syndrome, maternal infection, periodontal disease, altered microbiome, and genetics), clinical presentations (hypertension, blood disorders, proteinuria, hepatic dysfunction, renal dysfunction, pulmonary edema, cardiac dysfunction, fetal growth restrictions, and eclampsia), therapeutic clinical biomarkers (creatinine, albuminuria, and cystatin C) along with their associations and mechanisms in PE. In addition, this study provides insights into the potential of nanomedicines for targeting these mechanisms for PE management and treatment. Inflammation, OS, proteinuria, and an altered microbiome are prominent biomarkers associated with progression and PE-related pathogenesis. Understanding the molecular mechanisms, exploring suitable markers, targeted interventions, comprehensive screening, and holistic strategies are critical to decreasing the incidence of PE and promoting maternal-fetal well-being. The present study comprehensively reviewed the etiology, clinical presentations, therapeutic biomarkers, and preventive potential of nanomedicines in the treatment and management of PE.

子痫前期(PE)是一种危及生命的妊娠疾病,也是导致新生儿和孕产妇死亡和发病的主要原因。全世界约有 5-10% 的妊娠会受到子痫前期的影响,对围产期和孕产妇的健康构成重大风险。PE 的特点是各种相互关联的病理级联反应刺激血管内炎症、氧化应激(OS)、内皮细胞活化和合胞滋养细胞应激,这些反应汇聚在一个共同的途径上,最终导致疾病进展。本研究旨在回顾现有的科学文献,尤其侧重于病因(妊娠糖尿病和孕产妇肥胖、胰岛素抵抗、代谢综合征、孕产妇感染、牙周病、微生物组改变和遗传学)、临床表现(高血压、血液紊乱、蛋白尿、肝功能异常、肾功能异常、肺水肿、心功能异常、胎儿生长受限和子痫)、治疗性临床生物标志物(肌酐、白蛋白尿和胱抑素 C)及其在 PE 中的关联和机制。此外,本研究还深入探讨了纳米药物针对这些机制进行 PE 管理和治疗的潜力。炎症、OS、蛋白尿和微生物组改变是与 PE 进展和相关发病机制有关的重要生物标志物。了解分子机制、探索合适的标记物、有针对性的干预措施、全面筛查和综合策略对于降低 PE 的发病率和促进母胎健康至关重要。本研究全面回顾了纳米药物在治疗和管理 PE 方面的病因、临床表现、治疗生物标志物和预防潜力。
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引用次数: 0
Retraction notice to “Polymorphisms of tumor necrosis factor-α, interleukin-10, cytochrome P450 3A5 and ABCB1 in Chinese liver transplant patients treated with immunosuppressant tacrolimus” [Clinica. Chimica. Acta 383(1–2) (2007) 133–139] 肿瘤坏死因子-α、白细胞介素-10、细胞色素 P450 3A5 和 ABCB1 在接受免疫抑制剂他克莫司治疗的中国肝移植患者中的多态性"[Clinica. Chimica. Acta 383(1-2) (2007) 133-139] 的撤稿通知。
IF 3.2 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-08-10 DOI: 10.1016/j.cca.2024.119865
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引用次数: 0
The growth factor content as an indicator of platelet counts in platelet-rich plasma 将生长因子含量作为富血小板血浆中血小板数量的指标。
IF 3.2 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-08-10 DOI: 10.1016/j.cca.2024.119901

Background

Platelet contains growth factors that enhance tissue repair mechanisms, including epidermal growth factor (EGF), platelet-derived growth factor (PDGF-AA and −AB), and transforming growth factor (TGF)-β. Autologous platelet-rich plasma (PRP) has been shown to significantly improve the treatment of tendon injuries compared with hyaluronic acid and placebo. The topic of agreement between platelet concentrations and growth factors has been covered in some previous studies, but growth factor levels did not correlate well with platelet concentrations.

Method

In this study, autologous PRP was prepared by concentrating platelets through a J6-MI centrifuge. The automatic hematology analyzer Sysmex XN-20 was used to analyze the platelet concentration in PRP, and the PRP growth factors were determined by ELISA, including PDGF, transforming growth factor- β1 (TGF-β1), and EGF. Statistical analysis was conducted on data from 107 patients who received autologous PRP using Pearson correlation analysis.

Results

Pearson correlation analysis revealed PDGF, TGF, and EGF had a strong positive correlation with the platelet concentration of the final PRP product (r = 0.697, p < 0.0001; r = 0.488, p < 0.0001; r = 0.572, p < 0.0001, respectively)

Conclusions

There was a strong positive correlation between the concentration of platelets in the final PRP product and the levels of PDGF-AB, TGF-β, and EGF. These results suggested straightforward and cost-effective growth factor tests can provide valuable information about platelet content in PRP.

背景:血小板含有可增强组织修复机制的生长因子,包括表皮生长因子(EGF)、血小板衍生生长因子(PDGF-AA 和 -AB)和转化生长因子(TGF)-β。与透明质酸和安慰剂相比,自体富血小板血浆(PRP)已被证明能显著改善肌腱损伤的治疗效果。之前的一些研究已涉及血小板浓度与生长因子之间的一致性这一主题,但生长因子水平与血小板浓度并没有很好的相关性:本研究通过 J6-MI 型离心机浓缩血小板制备自体 PRP。使用 Sysmex XN-20 自动血液分析仪分析 PRP 中的血小板浓度,并通过 ELISA 方法测定 PRP 生长因子,包括 PDGF、转化生长因子-β1(TGF-β1)和 EGF。使用皮尔逊相关分析法对 107 名接受自体 PRP 患者的数据进行了统计分析:结果:Pearson 相关性分析表明,PDGF、TGF 和 EGF 与最终 PRP 产物的血小板浓度有很强的正相关性(r = 0.697,p<0.05)。
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引用次数: 0
Decreased plasma docosahexaenoic acid concentration in chronic obstructive pulmonary disease patients with pulmonary Hypertension: Findings from human lipidomics and transcriptomics analysis 患有肺动脉高压的慢性阻塞性肺病患者血浆中二十二碳六烯酸浓度降低:人体脂质组学和转录组学分析结果。
IF 3.2 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-08-10 DOI: 10.1016/j.cca.2024.119899

Oxylipins derived from polyunsaturated fatty acids (PUFAs) are important endogenous signaling molecules, but are little characterized in pulmonary hypertension (PH) due to chronic obstructive pulmonary disease (COPD). In this study, we identified novel plasma oxylipins associated with PH risk in COPD patients. The plasma oxylipin profiles of COPD patients without PH (COPD-noPH) or with PH (COPD-PH) were obtained from discovery and validation cohort, using the process of LC-MS/MS analysis. There was a significant decrease in the plasma levels of both free docosahexaenoic acid (DHA) and DHA-derived oxylipins in the COPD-PH group. The multivariable logistic regression model identified DHA and four DHA-derived oxylipins (13-HDHA, 10-HDHA, 8-HDHA and 16-HDHA) exhibited significant differences between the two groups after adjusting for sex, BMI, FEV1% predicted, and smoking status. The diagnostic value of these metabolites was further evaluated through ROC curve analysis. The transcriptome profiles in peripheral blood mononuclear cells (PBMCs) of COPD-PH patients and COPD-PH patients were detected through high-throughput sequencing. The enrichment analysis revealed that the upregulated differentially expressed genes (DEGs) were highly enriched in the interferon signaling pathway. In addition, DHA supplementation proved that DHA may inhibit the development of pH by reducing the secretion of interferons derived from PBMCs. This conjecture was further confirmed by the higher level of serum interferon-γ and interferon-α2 of COPD-PH patients than that of COPD-noPH patients. The present study highlights that decreased DHA and DHA-derived oxylipins levels are suggestive of a higher risk of pH development in COPD cases.

从多不饱和脂肪酸(PUFA)中提取的氧脂素是重要的内源性信号分子,但在慢性阻塞性肺疾病(COPD)引起的肺动脉高压(PH)中却鲜有发现。在这项研究中,我们发现了与 COPD 患者 PH 风险相关的新型血浆氧脂。通过 LC-MS/MS 分析,我们从发现队列和验证队列中获得了无 PH(COPD-noPH)或有 PH(COPD-PH)的 COPD 患者的血浆氧脂谱。在 COPD-PH 组中,血浆中游离的二十二碳六烯酸(DHA)和 DHA 衍生的氧脂素水平均明显下降。多变量逻辑回归模型发现,在调整性别、体重指数、预测 FEV1% 和吸烟状况后,DHA 和四种 DHA 衍生的氧脂素(13-HDHA、10-HDHA、8-HDHA 和 16-HDHA)在两组间存在显著差异。通过 ROC 曲线分析进一步评估了这些代谢物的诊断价值。通过高通量测序检测了 COPD-PH 患者和 COPD-PH 患者外周血单核细胞(PBMC)的转录组图谱。富集分析显示,上调的差异表达基因(DEG)高度富集于干扰素信号通路。此外,补充 DHA 还证明,DHA 可通过减少 PBMCs 干扰素的分泌来抑制 pH 的发展。COPD-PH 患者血清中干扰素-γ 和干扰素-α2 的水平高于 COPD-noPH 患者,进一步证实了这一猜想。本研究强调,DHA 和 DHA 衍生的氧脂素水平降低表明 COPD 患者出现 pH 的风险较高。
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引用次数: 0
Unveiling thiol biomarkers: Glutathione and cysteamine 揭示硫醇生物标志物:谷胱甘肽和半胱胺
IF 3.2 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-08-10 DOI: 10.1016/j.cca.2024.119915

The physiological and clinical importance of Glutathione and Cysteamine is emphasized by their participation in a range of conditions, such as diabetes, cancer, renal failure, Parkinson’s disease, and hypothyroidism. This necessitates the requirement for accessible, expedited, and cost-efficient testing that can facilitate clinical diagnosis and treatment options. This article examines numerous techniques used to detect both glutathione and cysteamine. The discussed methods include electroanalytical techniques such as voltammetry and amperometry, which are examined for their sensitivity and ability to provide real-time analysis. Furthermore, this study investigates the accuracy of gas chromatography-mass spectrometry (GC–MS) and high-performance liquid chromatography (HPLC) in measuring the concentrations of glutathione and cysteamine. Additionally, the potential of new nanotechnology-based methods, such as plasmonic nanoparticles and quantum dots, to improve the sensitivity of detecting glutathione and cysteamine is emphasized.

谷胱甘肽和半胱胺参与糖尿病、癌症、肾衰竭、帕金森病和甲状腺功能减退症等一系列疾病的治疗,这凸显了它们在生理和临床上的重要性。因此,有必要进行方便、快捷、经济高效的检测,以促进临床诊断和治疗方案的选择。本文探讨了用于检测谷胱甘肽和半胱胺的多种技术。所讨论的方法包括伏安法和安培法等电分析技术,这些方法的灵敏度和提供实时分析的能力都得到了检验。此外,本研究还探讨了气相色谱-质谱法(GC-MS)和高效液相色谱法(HPLC)在测量谷胱甘肽和半胱胺浓度方面的准确性。此外,还强调了基于纳米技术的新方法(如等离子纳米粒子和量子点)在提高谷胱甘肽和半胱胺检测灵敏度方面的潜力。
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引用次数: 0
Establishment of a rapid detection method for Mycoplasma pneumoniae based on RPA-CRISPR-Cas12a technology 基于 RPA-CRISPR-Cas12a 技术建立肺炎支原体快速检测方法。
IF 3.2 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-08-09 DOI: 10.1016/j.cca.2024.119906

Mycoplasma pneumoniae can cause respiratory infections and pneumonia, posing a serious threat to the health of children and adolescents. Early diagnosis of Mycoplasma pneumoniae infection is crucial for clinical treatment. Currently, diagnostic methods for Mycoplasma pneumoniae infection include pathogen detection, molecular biology techniques, and bacterial culture, all of which have certain limitations. Here, we developed a rapid, simple, and accurate detection method for Mycoplasma pneumoniae that does not rely on large equipment or complex operations. This technology combines the CRISPR-Cas12a system with recombinase polymerase amplification (RPA), allowing the detection results to be observed through fluorescence curves and immunochromatographic lateral flow strips.It has been validated that RPA-CRISPR/Cas12a fluorescence analysis and RPA-CRISPR/Cas12-immunochromatographic exhibit no cross-reactivity with other common pathogens, and The established detection limit was ascertained to be as low as 102 copies/µL.Additionally, 49 clinical samples were tested and compared with fluorescence quantitative polymerase chain reaction, demonstrating a sensitivity and specificity of 100%. This platform exhibits promising clinical performance and holds significant potential for clinical application, particularly in settings with limited resources, such as clinical care points or resource-constrained areas.

肺炎支原体可引起呼吸道感染和肺炎,严重威胁儿童和青少年的健康。肺炎支原体感染的早期诊断对临床治疗至关重要。目前,肺炎支原体感染的诊断方法包括病原体检测、分子生物学技术和细菌培养,这些方法都有一定的局限性。在此,我们开发了一种快速、简单、准确的肺炎支原体检测方法,无需依赖大型设备或复杂操作。该技术将 CRISPR-Cas12a 系统与重组酶聚合酶扩增(RPA)相结合,可通过荧光曲线和免疫层析侧流条观察检测结果。经过验证,RPA-CRISPR/Cas12a 荧光分析和 RPA-CRISPR/Cas12 免疫层析与其他常见病原体没有交叉反应,已确定的检测限低至 102 copies/µL。该平台具有良好的临床表现,在临床应用方面具有巨大潜力,尤其是在资源有限的环境中,如临床护理点或资源有限的地区。
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引用次数: 0
Persistent acute kidney injury biomarkers: A systematic review and meta-analysis 持续性急性肾损伤生物标志物:系统综述与荟萃分析。
IF 3.2 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-08-08 DOI: 10.1016/j.cca.2024.119907

Background

Various biomarkers reportedly predict persistent acute kidney injury (AKI) despite their varying predictive performance across clinical trials. This study aims to compare the accuracy of various biomarkers in predicting persistent AKI in different populations and regions.

Methods

In this meta-analysis, we searched for urinary C–C motif chemokine ligand 14 (CCL14), Tissue inhibitor of metalloproteinase-2&insulin-like growth factor-binding protein-7 (TIMP-2&IGFBP7), Neutrophil Gelatinase-Associated Lipocalin (NGAL), plasma Cystatin C (pCysC), Soluble urokinase plasminogen activator receptor (suPAR), Proenkephalin (PenK) and urinary dickkopf-3:urinary creatinine (uDKK3:uCr) from various databases including Medline, PubMed, Embase, and Cochrane. This was geared towards predicting persistent AKI in adults (>18 years). Hierarchically summarized subject work characteristic curves (HSROC) and diagnostic odds ratio (DOR) values were used to summarize the diagnostic accuracy of the biomarkers. Further, meta-regression and subgroup analyses were carried out to identify sources of heterogeneity as well as evaluate the best predictive biomarkers in different populations and regions.

Results

We screened 31 studies from 2,356 studies and assessed the diagnostic value of 7 biomarkers for persistent AKI. Overall, CCL14 had the best diagnostic efficacy with an AUC of 0.79 (95 % CI 0.75–0.82), whereas TIMP-2 & IGFBP7, NGAL, and pCysC had diagnostic efficacy of 0.75 (95 % CI 0.71–0.79),0.71 (95 % CI 0.67–0.75), and 0.7007, respectively. Due to a limited number of studies, PenK, uDKK3:uCr, and suPAR were not subjected to meta-analysis; however, relevant literature reported diagnostic efficacy above 0.70. Subgroup analyses based on population, region, biomarker detection time, AKI onset time, and AKI duration revealed that in the intensive care unit (ICU) population, the AUC of CCL14 was 0.8070, the AUC of TIMP-2 & IGFBP7 was 0.726, the AUC of pCysC was 0.72, and the AUC of NGAL was 0.7344; in the sepsis population, the AUC of CCL14 was 0.85, the AUC of TIMP-2&IGFBP7 was 0.7438, and the AUC of NGAL was 0.544; in the post-operative population, the AUC of CCL14 was 0.83–0.93, the AUC of TIMP-2&IGFBP7 was 0.71, and the AUC of pCysC was 0.683. Regional differences were observed in biomarker prediction of persistent kidney injury, with AUCs of 0.8558 for CCL14, 0.7563 for TIMP-2 & IGFBP7, and 0.7116 for NGAL in the Eurasian American population. In the sub-African population, TIMP-2 & IGFBP7 had AUCs of 0.7945, 0.7418 for CCL14, 0.7097 for NGAL, and 0.7007 for pCysC. for TIMP-2 & IGFBP7 was 0.7945, AUC for CCL14 was 0.7418, AUC for NGAL was 0.7097, and AUC for pCysC was 0.7007 in the sub-African population. Duration of biomarker detection, AKI onset, and AKI did not influence the optimal predictive performance of CCL14. Subgroup anal

背景:据报道,各种生物标志物可预测持续性急性肾损伤(AKI),尽管它们在临床试验中的预测性能各不相同。本研究旨在比较各种生物标志物在不同人群和地区预测持续性 AKI 的准确性:在这项荟萃分析中,我们搜索了尿液中的 C-C mot chemokine ligand 14 (CCL14)、组织金属蛋白酶抑制剂-2&胰岛素样生长因子结合蛋白-7 (TIMP-2&IGFBP7)、中性粒细胞明胶酶 (Neutrophil Gelatinasease) 和胰岛素样生长因子结合蛋白-7 (TIMP-2&IGFBP7)、中性粒细胞明胶酶相关脂联素(NGAL)、血浆胱抑素 C(pCysC)、可溶性尿激酶纤溶酶原激活物受体(suPAR)、前脑啡肽(PenK)和尿液中的 dickkopf-3:这些数据来自各种数据库,包括 Medline、PubMed、Embase 和 Cochrane。其目的是预测成人(18 岁以上)的持续性 AKI。分层总结的受试者工作特征曲线(HSROC)和诊断几率比(DOR)值用于总结生物标志物的诊断准确性。此外,我们还进行了元回归和亚组分析,以确定异质性的来源,并评估不同人群和地区的最佳预测生物标志物:我们从 2356 项研究中筛选出 31 项研究,评估了 7 种生物标志物对持续性 AKI 的诊断价值。总体而言,CCL14 的诊断效果最好,其 AUC 为 0.79(95% CI 0.75-0.82),而 TIMP-2 & IGFBP7、NGAL 和 pCysC 的诊断效果分别为 0.75(95% CI 0.71-0.79)、0.71(95% CI 0.67-0.75)和 0.7007。由于研究数量有限,PenK、uDKK3:uCr 和 suPAR 没有进行荟萃分析;但是,相关文献报告的诊断效果高于 0.70。基于人群、地区、生物标记物检测时间、AKI 发病时间和 AKI 持续时间的亚组分析显示,在重症监护室(ICU)人群中,CCL14 的 AUC 为 0.8070,TIMP-2 & IGFBP7 的 AUC 为 0.726,pCysC 的 AUC 为 0.72,NGAL 的 AUC 为 0.7344;在败血症人群中,CCL14 的 AUC 为 0.85,TIMP-2&IGFBP7 的 AUC 为 0.7438,NGAL 的 AUC 为 0.544;在术后人群中,CCL14 的 AUC 为 0.83-0.93,TIMP-2&IGFBP7 的 AUC 为 0.71,pCysC 的 AUC 为 0.683。在持续性肾损伤的生物标志物预测方面观察到了地区差异,在欧亚美洲人群中,CCL14 的 AUC 为 0.8558,TIMP-2 & IGFBP7 为 0.7563,NGAL 为 0.7116。在亚非人群中,TIMP-2 和 IGFBP7 的 AUC 为 0.7945,CCL14 为 0.7418,NGAL 为 0.7097,pCysC 为 0.7007。生物标记物检测时间、AKI 发病时间和 AKI 均不影响 CCL14 的最佳预测性能。CCL14相关研究的分组分析和元回归显示,CCL14是预测持续性2-3期AKI最合适的生物标记物,异质性源于样本大小和AKI分期:这项荟萃分析发现 CCL14 是预测持续性 AKI(尤其是持续性 2-3 期 AKI)的最佳生物标志物。
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引用次数: 0
Multiplex droplet digital PCR for 22q11.2 microdeletions screening and DiGeorge syndrome diagnostics 用于 22q11.2 微缺失筛查和迪乔治综合征诊断的多重液滴数字 PCR。
IF 3.2 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-08-08 DOI: 10.1016/j.cca.2024.119903

Background and aims

DiGeorge syndrome (DGS) is a genetic disorder manifesting in polymorphic symptoms related to developmental abnormalities of various organs including thymus. DGS is caused by microdeletions in the 22q11.2 region between several low copy repeats (LCR) occurring in approximately 1 in 4000 live births. Diagnosis of DGS relies on phenotypic examination, qPCR, ultrasound, FISH, MLPA and NGS which can be relatively inaccurate, time-consuming, and costly.

Materials and methods

A novel multiplex droplet digital PCR (ddPCR) assay was designed, optimized and validated for detection and mapping 22q11.2 microdeletions by simultaneous amplification of three targets — TUPLE1, ZNF74, D22S936 — within the deletion areas and one reference target — RPP30 — as an internal control.

Results

The assay reliable identified microdeletions when the template concentration was >32 copies per reaction and successfully detected LCR22A-B, LCR22A-C, LCR22A-D, and LCR22B-C deletions in clinical samples from 153 patients with signs of immunodeficiency. In patients with the microdeletions, flow cytometry detected a significant increase in B-cell and natural killer cell counts and percentages, while T-cell percentages and T-cell receptor excision circle (TREC) numbers decreased.

Conclusion

The designed ddPCR assay is suitable for diagnosing DGS using whole blood and blood spots.

背景和目的:迪乔治综合征(DGS)是一种遗传性疾病,表现为与胸腺等多个器官发育异常有关的多形性症状。DGS是由22q11.2区域几个低拷贝重复序列(LCR)之间的微缺失引起的,大约每4000个活产婴儿中就有1例。DGS 的诊断依赖于表型检查、qPCR、超声波、FISH、MLPA 和 NGS,这些方法可能相对不准确、耗时且昂贵:设计、优化并验证了一种新型多重液滴数字 PCR(ddPCR)检测方法,通过同时扩增缺失区内的三个靶标(TUPLE1、ZNF74、D22S936)和一个参考靶标(RPP30)作为内部对照,检测并绘制 22q11.2 微缺失图:当每次反应的模板浓度大于 32 个拷贝时,该检测方法能可靠地识别微缺失,并在 153 名有免疫缺陷症状的患者的临床样本中成功检测出 LCR22A-B、LCR22A-C、LCR22A-D 和 LCR22B-C 缺失。在微缺失患者中,流式细胞术检测到 B 细胞和自然杀伤细胞的数量和百分比显著增加,而 T 细胞百分比和 T 细胞受体切割圈(TREC)数量减少:结论:设计的 ddPCR 检测方法适用于使用全血和血斑诊断 DGS。
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引用次数: 0
Quality control for serological testing 血清学检测的质量控制。
IF 3.2 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-08-08 DOI: 10.1016/j.cca.2024.119905

Objectives

The quality control of serological assays remains controversial. The aim of this project was to describe the problems associated with a working model for controlling these assays and solutions, including using a source of well-defined targets and acceptable limits, a process to identify lot-to-lot reagent variation and an interpretation of the result that accounted for the clinical situation. False-negative results are problematic but can be reduced by identifying and comparing reagent lot variation with previous results.

Methods

The components of the Quality Assurance strategy are the following: Lot-to-lot reagent and calibrator variation assessment; dynamic, big-data approach to determine accurate targets and acceptable limits for manufacturer-provided QC material; negative QC monitoring process; use of commutable EQA with a sufficient method subgroup size to assess bias; clinical assessment of any statistically flagged error; and provision of support to the clinician for the interpretation of results.

Results

The model described has been used for twelve months, and acceptable variation has been maintained.

Conclusions

The paper presents a solution that emphasizes the early detection of reagent lot variation and patient risk rather than instrument control.

Reducing the risk of a false result to patients requires optimal assay quality control and an effective mechanism to support the clinician’s use of these results in diagnosis and monitoring. The problems of serological assays are well-known, but there remain few integrated solutions in the literature.

目的:血清学检测的质量控制仍然存在争议。该项目的目的是描述与控制这些检测方法的工作模式相关的问题和解决方案,包括使用定义明确的目标和可接受限值的来源、识别批次间试剂差异的过程以及根据临床情况对结果的解释。假阴性结果是个问题,但可以通过识别试剂批次间的差异并与之前的结果进行比较来减少假阴性结果:质量保证策略的组成部分如下:方法:质量保证策略的组成部分如下:批次间试剂和校准物差异评估;动态大数据方法,以确定制造商提供的质控材料的准确目标和可接受限值;阴性质控监测流程;使用可换算的 EQA,并配备足够的方法子组规模以评估偏倚;对任何统计标记错误进行临床评估;以及为临床医生解释结果提供支持:结果:所述模型已使用 12 个月,并保持了可接受的差异:本文提出的解决方案强调及早发现试剂批次差异和患者风险,而不是仪器控制。要降低错误结果对患者造成的风险,就必须进行最佳的检测质量控制,并建立有效的机制,支持临床医生在诊断和监测中使用这些结果。血清学检测的问题众所周知,但文献中却鲜有综合解决方案。
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引用次数: 0
Derivation and external validation of mass spectrometry-based proteomic model using machine learning algorithms to predict plaque rupture in patients with acute coronary syndrome 利用机器学习算法推导和外部验证基于质谱的蛋白质组模型,以预测急性冠状动脉综合征患者的斑块破裂。
IF 3.2 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-08-06 DOI: 10.1016/j.cca.2024.119904

Background

A poor prognosis is associated with atherosclerotic plaque rupture (PR) despite after conventional therapy for patients with acute coronary syndrome (ACS). Timely identification of PR improves the risk stratification and prognosis of ACS patients.

Methods

A derivation cohort of 110 patients with ACS who underwent pre-intervention optical coherence tomography (OCT) were matched 1:1 to the PR and intact fibrous cap (IFC) groups according to traditional risk factors. Candidate PR proteins were identified via mass spectrometry (MS)-based proteomics using unbiased machine learning methods and were further validated by enzyme-linked immunosorbent assay (ELISA) in an external validation cohort of 85 patients with ACS. The performance of candidate biomakers was assessed using the receiver operating characteristic curve analysis.

Results

1121 proteins were identified and 535 filtered proteins were used for analysis. Nine candidate proteins were screened by five machine learning algorithms. Three proteins (APOC3, RAB39A, and KNG1) were significantly different between the PR and IFC in validation cohort. The performance of plasm APOC3, RAB39A, and KNG1 for differentiating PR and IFC was superior to that of the conventional biomarkers and risk factors.

Conclusion

The proteins (APOC3, RAB39A, and KNG1) serve as a potential novel diagnostic tool to identify PR in ACS patients.

背景:急性冠状动脉综合征(ACS)患者尽管接受了常规治疗,但动脉粥样硬化斑块破裂(PR)与不良预后有关。及时发现斑块破裂可改善急性冠状动脉综合征患者的风险分层和预后:方法:根据传统的风险因素,将 110 名接受干预前光学相干断层扫描(OCT)的急性冠状动脉综合征(ACS)患者按 1:1 的比例分为 PR 组和完整纤维帽(IFC)组。利用无偏见的机器学习方法,通过基于质谱(MS)的蛋白质组学确定了候选 PR 蛋白,并在由 85 名 ACS 患者组成的外部验证队列中通过酶联免疫吸附试验(ELISA)进行了进一步验证。使用接收器操作特征曲线分析评估了候选生物标记物的性能:结果:共鉴定出 1121 种蛋白质,535 种过滤蛋白质被用于分析。五种机器学习算法筛选出九种候选蛋白质。在验证队列中,三个蛋白质(APOC3、RAB39A和KNG1)在PR和IFC之间存在显著差异。质 APOC3、RAB39A 和 KNG1 在区分 PR 和 IFC 方面的表现优于传统的生物标志物和风险因素:结论:蛋白(APOC3、RAB39A 和 KNG1)是一种潜在的新型诊断工具,可用于鉴别 ACS 患者的 PR。
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Clinica Chimica Acta
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