Clinical laboratory最新文献

Background: Sepsis with renal failure is a common condition in intensive care units (ICUs) and is associated with poor prognosis. A unified consensus on the optimal transfusion hemoglobin concentration threshold is needed to improve outcomes. This study investigated the effects of different transfusion thresholds during hospitalization on the prognosis of patients with sepsis and renal failure.

Methods: A total of 2,972 patients were included in this study. By using the Medical Information Mart for Intensive Care (MIMIC-IV) database, data from patients with sepsis and renal failure were screened and divided into a low-threshold group (Hb ≤ 7 g/dL) and a high-threshold group (Hb > 7 g/dL) based on the average hemoglobin (Hb) level 24 hours before transfusion. Univariate and multivariate Cox regression analyses and inverse probability weighting were used to compare in-hospital and ICU mortality rates between the two groups. Additionally, 30-day, 60-day, and 90-day survival rates, length of hospital stay, and ICU stay duration were evaluated.

Results: Statistically significant differences in baseline characteristics were observed between the two groups. After propensity score matching to eliminate baseline characteristic differences, it was found that among the Cau¬casian population a higher transfusion threshold significantly reduced the risk of in-hospital mortality (HR, 0.774; 95% CI: 0.613 - 0.978, p < 0.05).

Conclusions: For patients with sepsis and renal failure, transfusion thresholds should be determined by considering the patient's race to achieve individualized transfusion strategies.

Background: Colorectal cancer (CRC) claims 900,000 lives per year. Colonoscopy offers reliable detection, but with low patient adherence rates. To significantly reduce CRC incidence and mortality, a more convenient screening measure for advanced precancerous lesions (APL) and CRC is urgently needed.

Methods: In this study, the clinical performance of a multitarget stool DNA (mt-sDNA) test combining fecal im-munochemical test (FIT) with the analysis of genetic biomarkers by real-time PCR was evaluated in a cohort of 208 subjects.

Results: The mt-sDNA test showed a sensitivity of 84.2% for CRC (all stages) and 39.6% sensitivity for APL detection with a specificity of 91.5%. Within the APL group, high-grade dysplasia, characterized by the highest risk of further cancer progression, were detected with 75% sensitivity.

Conclusions: The mt-sDNA test represents a significant advancement for non-invasive detection of APL and CRC and bears great potential to enhance CRC prevention, incidence, and mortality.

Background: Acute myeloid leukemia (AML) is a hematologic malignancy. It is the most common form of acute leukemia among adults. Recent treatment advances have drastically improved outcomes for these diseases, but the overall survival (OS) is still exceptionally low due to the infiltration of leukemic cells in the central nervous system (CNS).

Methods: Standard microscopic examination of cells in the cerebrospinal fluid (CSF), analysis of the chemical composition of the cerebrospinal fluid, and to integrate flow cytometry (FCM) to analyze the phenotypic characteristics of cells to find leukemia cells.

Results: Pandy's test was positive in CSF, protein content was measured at 102.60 mg/dL, and leukemia cells were observed under microscopes. It was the gold standard for diagnosis. FCM also found 99.6% leukemia cells (CD33bri/CD13-/HLA-DR+/CD11c+/CD64dim/CD56+/CD117-/CD34-/CD38+/CD45dim/CD19-/CD15+/CD14-). The chromosomal karyotype also showed abnormalities.

Conclusions: Early detection of leukemia cells invading the central nervous system by routine examination in cytogenetic abnormalities, monocytic subtypes of AML patients, such as routine smear examination of CSF, has great clinical value for early detection, diagnosis, and intervention of patients with CNSL.

Background: Familial hyperlipidemia (familial hypercholesterolemia, FH) is an autosomal genetic disorder. It includes type heterozygous familial hyperlipidemia (heterozygous familial hypercholesterolemia). HeFH is mainly caused by mutations in the LDLR, APOB, and PCSK9 genes and is characterized by elevated plasma low-density lipoprotein cholesterol levels.

Methods: We present a case of HeFH attributed to an APOB gene mutation. The whole-genome DNA of peripheral blood was extracted from the blood of the proband and their parents, and the exons of peripheral blood were sequenced through high-throughput sequencing. The selected mutation sites were verified by sequencing using the Sanger method.

Results: A heterozygous mutation, c.6551A>G (p.Y2184C), in exon 26 of the APOB gene (Chr2-21233189) was identified in both the proband and the mother. Combined with the clinical features, HeFH caused by this mutation was initially considered.

Conclusions: For patients with a high degree of clinical suspicion of FH, a definitive diagnosis should be established through genetic testing, enabling patients to receive early treatment and effectively prevent the occurrence of cardiovascular events.

Background: When Behçet's disease is complicated with gastrointestinal ulcers, it is referred to as intestinal Behçet's disease (BD). Clinically uncommon, this condition can involve the entire gastrointestinal tract, often presenting diagnostic challenges in differentiation from Crohn's disease.

Methods: In this case, atypical BD was diagnosed through endoscopic examination, whereas latent tuberculosis infection (LBTI) was confirmed via T-SPOT and PPD tests.

Results: Methylprednisolone was administered during acute flare-ups to promote rapid ulcer healing. Adalimumab, meanwhile, provided swift treatment for intestinal BD and helped maintain long-term remission in affected patients. Additionally, isoniazid and rifampicin were used for the treatment of LBTI.

Conclusions: This case demonstrates the complex and variable clinical course of BD, characterized by highly atypical presentations. As symptoms continue to develop and worsen over time, TNF-α inhibitors play a pivotal role in achieving long-term remission during treatment.

Background: Group B streptococcus (GBS) causes neonatal invasive disease, mainly sepsis and meningitis. Understanding the clinical characteristics, laboratory tests, and antibiotic resistance patterns of GBS invasive infections provides reliable epidemiological data for preventing and treating GBS infections.

Methods: Clinical characteristics and laboratory test results from 86 patients with neonatal invasive disease (45 cases of early-onset disease [EOD] and 41 cases of late-onset disease [LOD]) recruited from Fujian Maternity and Child Health Hospital between January 2012 and December 2021 were analyzed.

Results: The number of neonates with invasive GBS infections declined for 10 years. Respiratory symptoms, the first clinical presentation in EOD, were predominant (71.1%), including groan, tachypnea, and cyanosis, whereas LOD more often presented with fever (78%). Pneumonia was the most common complication (57.0%). There were 35 patients (77.8%) with pneumonia and 18 patients (40.0%) with respiratory failure in the EOD cases, which were more than those in LOD cases. Neonates in the EOD cases were more prone to myocardial damage, cerebral injury, and metabolic acidosis than those in the LOD cases. The proportion of purulent meningitis (63.4%) and anemia (29.3%) in LOD was higher than those in EOD. White blood cell count of the EOD group was higher than that of the LOD group, whereas the proportion of patients with leukopenia was lower in the EOD group (24.4%) than in the LOD group (46.3%). All the GBS strains were susceptible to penicillin, ampicillin, linezolid, quinupristin, vancomycin, or tigecycline. Erythromycin and clindamycin resistance rates were 82.6% and 84.9%, respectively. A D-test revealed 48.6% iMLSB phenotype (inducible clindamycin resistant), and cMLSB phenotype (47.3%), L-phenotypes (2.7%), and M-phenotypes (1.4%) were also found.

Conclusions: The number of cases of neonatal invasive GBS infections has decreased in recent years. Patients with invasive GBS-EOD infections have insidious onset symptoms and should be diagnosed early based on clinical symptoms and laboratory examination results. GBS strains are resistant to erythromycin and clindamycin, which is not suitable for prophylactic and empirical treatment in the neonatal population in this region.

Background: The aim of this study was to explore the clinical application value of serum inflammatory markers in the diagnosis and treatment of benign prostatic hyperplasia (BPH) in elderly men.

Methods: From April 2023 through July 2023, 110 BPH patients and 120 healthy individuals who underwent examinations at our hospital were selected as study subjects. The concentrations of C-reactive protein (CRP), procalcitonin (PCT), serum amyloid A (SAA), complement 3 (C3), and complement 4 (C4) were measured in both groups.

Results: The concentrations of CRP and SAA in the BPH patient group were significantly higher than those in the healthy control group (p < 0.05). There was a significant correlation between BPH and the concentrations of CRP and SAA, but no correlation with PCT, C3, or C4. ROC curve analysis indicates that both SAA and CRP have high diagnostic efficacy for BPH. Furthermore, the combined use of SAA and CRP provides the better diagnostic performance. This combined approach has the potential to support physicians in guiding diagnosis and treatment.

Conclusions: Serum inflammatory markers can serve as independent factors for BPH. Among them, CRP and SAA are significantly positively correlated with BPH, which is of great significance for the non-invasive diagnosis of BPH.

This retracts the article DOI: 10.7754/Clin.Lab.2012.120913.

Background: The Bombay and para-Bombay blood groups are rare blood types that are significant to clinical blood transfusions. Accurate para-Bombay blood group identification is important for the safety of transfusions.

Methods: Serological and molecular biology methods were used to detect one case of ABO blood type. Genotypes of the para-Bombay blood group in the Chinese population were searched and summarized, and the safety of blood transfusion for this group was discussed.

Results: The ABO genotype of the case was B101/O01 and the FUT1 gene haplotype was c.649T and 881_882 delTT, while the phenotypes were Bmh, h2/h649, Le(a-b-), and Se357/Se357,716.

Conclusions: The h649/h2 FUT1 genotype is newly discovered and is responsible for the para-Bombay blood group in the Chinese population. Accurate identification of this blood group using serology and molecular methods is significant to ensure the safety of blood transfusions.