Clinical laboratory最新文献

Background: Mutations in the NCSTN gene are believed to be involved in the pathogenesis of acne inversa (AI). Further, certain cytokines are overexpressed in the inflammatory milieu of AI skin. Considering its central role in cytokine regulation, the JAK/STAT signaling pathway should be examined as a pathogenic factor and potential therapeutic target in AI.

Methods: NCSTNflox/+, CAGGCre-ERTM mice were given 10 mg/kg/day tamoxifen for 6 days. Knockout of the NCSTN gene was confirmed by PCR. The levels of JAK1, JAK2, JAK3, and TYK2 in the skin tissue of NCSTN conditional knockout mice and WT mice were measured by IHC.

Results: By objective scoring using ImageJ software, JAK2 (p = 0.013) expression was increased in the dermis of KO mice, and JAK1 (p = 0.032), JAK3 (p = 0.028), and TYK2 (p = 0.029) were upregulated in the epidermis of KO mice versus WT mice.

Conclusions: This study suggests that the JAK/STAT pathway is important in AI, rendering it a potential therapeutic target. Targeting the JAK1/2 may be more prominent in the treatment of HS.

Background: Immunoglobulin A (IgA) is an important biomarker for clinical evaluation of immune system function and multiple myeloma. The hook effect may lead to a false decrease in IgA test results, especially at extremely high IgA concentrations, which may mask the true disease state and result in misdiagnosis or missed diagnosis.

Methods: We report a case of false decrease in IgA due to the hook effect.

Results: The detection values of IgA (6.89 g/L), IgM (0.33 g/L), and IgG (2.72 g/L) in the patient were significantly different from the serum globulin level (52.5 g/L). After dilution, the true value of IgA was retested to be 37.25 g/L. The original value of IgA was falsely reduced due to the hook effect.

Conclusions: When the IgA test results contradict the serum globulin levels, attention should be paid to the hook effect. Laboratory personnel should obtain the true level of IgA through sample dilution retesting to avoid misdiagnosis and missed diagnosis of multiple myeloma.

Background: The goal was to explore the seroprevalence in order to evaluate past infections and immunity status in type 2 diabetic individuals compared to the seroprevalence of the common members of Herpesviridae family viruses.

Methods: One hundred and fifty individuals (50 females, 100 males) were enrolled in this study, all from Taif city. Samples were collected by drawing 3 mL of peripheral blood into the yellow cap tubes for serum collection. The samples were collected between the 3rd and the 8th of February 2025. IgG serostatus was evaluated by using Synergy Neo2 microplate reader at a wavelength of 450 nm. Chi-squared test was applied for statistical analysis pur-poses.

Results: High IgG titer was detected among our study group, which is indicative of recent infection or vaccination. HSV-1 IgG seropositivity was higher in males (90%) than females (76%); VZV IgG seropositivity was lower in males (82%) than females (86%), while EBV IgG seropositivity was higher in males (82%) than females (58%). Different IgG titers were detected among the study groups, and coinfection were detected in 54% for HSV-1/VZV, 28% for EBV/VZV, 15.4% for HSV-1/EBV, and 14% among all three viruses.

Conclusions: Our study assessed the seropositivity of VZV, HSV-1, and EBV in T2DM patients. The prevalence among them was lower than other studies. Gender-based differences were detected as most detected cases were males except in VZV females were higher, coinfection is common among two viruses or the three together, indicating the essential importance of targeted regular screening and vaccination of T2DM patients.

Background: Helicobacter pylori (H. pylori) is a Gram-negative bacterial agent that colonizes the gastric mucosa and leads to chronic infections. Various techniques are available for the detection of H. pylori; however, many of these methods are invasive, costly, and can only be performed in tertiary laboratories. It is necessary to find cost-effective and non-invasive novel indicators that can identify H. pylori infection and its activity.

Objective: The objective of this study was to investigate the correlation between the CRP/albumin ratio (CAR), which is frequently analyzed in laboratory settings, and the presence of H. pylori, as well as the activation of H. pylori infection.

Methods: The medical records of patients who had upper gastrointestinal endoscopy at our hospital were reviewed retrospectively. The data were analyzed using suitable tests with the IBM SPSS 27 software.

Results: The study included 613 patients, comprising 375 females (61.2%) and 238 males (38.8%). Among the participants, 327 (53.3%) tested positive for H. Pylori, while 286 (46.7%) tested negative. All patients presented with dyspeptic symptoms, and other indications for UGISE included anemia, gastroesophageal reflux, epigastric discomfort, dysphagia, nausea and vomiting, bleeding, and scanning. Upon comparing the laboratory results of H. pylori-positive and -negative patients, no significant change in CRP values was observed (p > 0.05). The albumin level was statistically considerably elevated in H. pylori-negative pa-tients relative to -positive patients (p = 0.009). The CAR in H. pylori-positive patients was statistically substantially elevated compared to negative ones (p = 0.04).

Conclusions: We assert that CAR may serve as a valuable biomarker for confirming the presence of H. pylori infection and for reflecting the systemic inflammatory status of patients.

Background: Preeclampsia (PE), a pregnancy complication, affects 10% of pregnancies worldwide. The develop-ment of PE has been attributed to multiple genetic variations. The aim of this study was to evaluate the possible association between TCF7L2 gene polymorphisms (rs12255372 and rs12243326) and risk of preeclampsia in Egyptian women with and without gestational diabetes mellitus (GDM) as well as to assess the discrimination values of these polymorphisms as biomarkers for PE.

Methods: This case-control study included 120 pregnant women allocated into two groups: 80 preeclamptic women (40 with GDM and 40 without GDM) and a control group that included 40 normotensive pregnant women. Genotyping of rs12255372 and rs12243326 was performed by real-time polymerase chain reaction (RT-PCR).

Results: The mutant TT and hetero GT genotypes of rs12255372 for the TCF7L2 gene were significantly associated with increased risk of preeclampsia, and the dominant model was significantly linked in PE (p < 0.001), with odds ratio (OR) = 6.1; 95 % confidence interval (CI) = 3.74 - 10.12. The mutant and hetero genotypes (CC and TC, respectively) of rs12243326 were considerably linked to a high risk of preeclampsia (p < 0.001) as well as the dominant model with a p-value of less than 0.001 and OR (95% CI) = 0.185 (0.09 - 0.39). Furthermore, there were significant differences between preeclamptic groups compared to controls according to the co-dominant model (p < 0.001), while there was no significant difference between PE women with and without GDM for rs12255372 (p = 0.603). The high predictive accuracies of TCF7L2 gene polymorphisms (rs12243326 and rs12255372) and their combination as probable indicators for PE (accuracy = 91.05%) were observed with the receiver operating characteristic curve (ROC) analysis (p < 0.001).

Conclusions: The genetic polymorphisms of rs12255372 and rs12243326 for the TCF7L2 gene were associated with the risk of preeclampsia in Egyptian women. Thus, they could be biochemical markers for PE.

Background: Helper T cell 17 (Th17) and regulatory T cells (Treg) play an important role in the inflammatory response. However, the role of Th17/Treg imbalance in acute kidney injury is not yet established. The aim of the study was to analyze Th17/Treg imbalance in acute kidney injury caused by sepsis or other reasons.

Methods: An observational prospective study was conducted. We enrolled adult patients admitted to the intensive care unit (ICU) with acute kidney injury caused by sepsis or other reasons and then followed up until 28 days or discharge. Healthy volunteers were followed during the same period as the control group. We investigated the differences in renal injury markers and inflammatory indicators between acute kidney injury (AKI) patients and the control group. The clinical data and peripheral blood samples of all patients were collected immediately after enrollment. An analysis of the data was conducted to determine if the Th17/Treg ratio could serve as a predictive marker of sepsis induced acute kidney injury (SAKI) in AKI patients.

Result: A total of 104 AKI patients were enrolled in the study, including 60 SAKI, 44 AKI without sepsis, while 10 healthy volunteers served as the control group. Infections, especially thoracoabdominal infection leading to sepsis, were the major cause of AKI in the study population (58%). Th17/Treg ratio, the proportion of Th17 cells, the concentration of interleukin-10 (IL-10), and the concentration of interleukin-17 (IL-17) of AKI patients showed a significant increase compared to that in the control group. The proportion of Th17 cells and Treg cells as well as the Th17/Treg ratio of the SAKI group were higher than those of the AKI without sepsis group. Chronic kidney disease (CKD) and Th17/Treg ratio were independent risk factors for SAKI. The AUC demonstrated that the Th17/Treg ratio measured 0.775 (95% CI 0.683 - 0.851, p < 0.0001). The cutoff value of Th17/Treg ratio for predicting SAKI was 0.033. When the Th17/Treg ratio was > 0.033, the sensitivity of predicting SAKI was 0.967, and the specificity was 0.500. The 28-day mortality and renal function recovery rate between the SAKI group and the AKI without sepsis group did not differ.

Conclusions: There was an imbalance of Th17/Treg in acute kidney injury. Compared with AKI caused by other factors, Th17/Treg ratio was higher in SAKI patients. There was no difference in 28-day mortality and renal function recovery rate among AKI patients with different etiologies.

Background: ABO incompatibility is the most common cause of hemolytic disease of the fetus and newborn (HDFN). We investigated HDFN at our institute and discuss clinical characteristics and considerations during transfusions and laboratory testing.

Methods: We reviewed the medical records of newborns with HDFN due to ABO incompatibility over a period of 5 years. Laboratory results such as the ABO blood type of mothers and newborns, direct antiglobulin test, hemoglobin, and total bilirubin were collected. History of transfusion and phototherapy were also taken.

Results: During the 5 years, 275 newborns were diagnosed with HDFN by ABO blood type testing and crossmatching. Group O mothers were predominant, with 259 newborns, followed by B and A types, with 11 and five newborns, respectively. For the newborns, group A was the most common, with 151, followed by group B with 108 and AB with 16 newborns. The most common type of incompatibility was O/A, accounting for 54.9%, followed by O/B, B/AB, and A/AB at 54.9%, 4.0%, and 1.8%, respectively. DAT was conducted on only half of the group O mothers, and among them, 38.5% had positive results. For the 16 newborns of non-O mothers, six underwent DAT, and all were negative. Further, 21.6% and 31.3% of newborns from group O and non-group O mothers received transfusions, and 49.4% and 43.8% received phototherapy, respectively.

Conclusions: Our findings highlight the importance of considering ABO HDFN even in DAT-negative neonates. Reverse typing may provide important diagnostic value, especially in transfusion settings with ABO compatibility with the maternal blood group.

Background: Fulminant type 1 diabetes mellitus (FT1DM) is a new subtype of type 1 diabetes mellitus, first proposed by Japanese scholars. Its main clinical features include acute onset (< 1 week), pancreatic islet function failure, negative islet-related autoantibodies, and concurrent ketosis or diabetic ketoacidosis. A recent study in Japan indicated that the incidence of FT1DM accounts for 15 - 20% of all ketosis or ketoacidosis-related type 1 diabetes mellitus. However, cases of type 2 diabetes mellitus complicated with FT1DM are rarely reported.

Methods: A comprehensive analysis of the clinical characteristics and diagnosis-treatment process was conducted by monitoring key indicators such as the patient's blood glucose, glycated hemoglobin, pancreatic islet function, amylase levels, and diabetic autoantibodies, and integrating this data with the patient's medical history and relevant literature.

Results: The patient was diagnosed with type 2 diabetes mellitus complicated with fulminant type 1 diabetes mellitus.

Conclusions: Clinicians should enhance their understanding of fulminant type 1 diabetes to achieve early diagnosis and treatment.

Background: This study aimed to investigate the significance of serum lipid concentration in patients with multiple myeloma (MM) at different clinical stages and types, and the relationship between the change of serum lipid concentration before and after treatment, and to evaluate the application value of serum lipid index in MM disease.

Methods: Retrospectively, 130 patients who visited Shaoxing People's Hospital from July 2022 through July 2024, diagnosed with MM and meeting the inclusion criteria, were collected as the MM group. Additionally, 130 healthy individuals were collected as the NMM group. The study examined indicators such as triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) in both groups.

Results: Statistical analysis showed that TG, TC, HDL, and LDL concentrations in the MM group were lower than those in the NMM group (p < 0.05). In ISS staging, TC, LDL, and HDL concentrations were higher in stage I patients than in stage II and III patients, with a statistically significant difference (p < 0.05), and the difference in TG concentrations was statistically nonsignificant (p > 0.05). Among the common clinical subtypes, the TC and LDL concentrations of patients with light chain type were higher than those of patients with IgG type and IgA type, and the difference was statistically significant (p < 0.05); the TC and LDL concentrations of patients with IgG type were higher than those of patients with IgA type, and the difference was statistically significant (p < 0.05); and the differences between the different subtypes of the rest of the indicators were statistically nonsignificant (p > 0.05). In the remission group, MM patients showed increased TC, TG, HDL, and LDL concentrations after treatment compared to before, with statistically significant differences.

Conclusions: The serum TG, TC, HDL, and LDL concentrations of MM patients were lower than those of normal controls. The serum TC, HDL, and LDL concentrations of MM patients negatively correlated with the clinical stage of the disease (ISS stage), suggesting that the concentration of blood lipid can be used as a reference index for the clinical stage of multiple myeloma. Serum lipid indicators showed statistically significant differences among different protein subtypes (IgA, IgG, light chain type) in MM, indicating that combining lipid concentrations with MM clinical staging can help assess the progression of the disease. In the remission group, serum lipid concentrations in MM patients increased after treatment, which is significant for the monitoring of treatment efficacy in MM.

Background: In this study, we investigated the effect of using a 40x objective instead of the recommended 20x objective in the computer-assisted automated evaluation of anti-dsDNA antibodies using the Crithidia luciliae indirect immunofluorescence (CLIF) test. By using a 40x objective, we aimed to increase the accuracy and specificity of the CLIF test by improving image clarity and enabling easier interpretation by the expert physician.

Methods: Anti-dsDNA tests of 156 positive and 40 negative samples were evaluated using the automated EURO-Pattern system at 20x and 40x magnifications. The results were compared with the assessments of experienced physicians. Statistical analysis included chi-squared and kappa agreement tests. Sensitivity, specificity, and accuracy metrics were calculated for both objectives.

Results: When evaluated with the 20x objective, the system achieved a sensitivity of 100%, specificity of 29.85%, and accuracy of 50.26%, with a kappa coefficient of 0.199 (95% CI: 0.129 - 0.267). With the 40x objective, sensitivity was 94.55%, specificity was 90.30%, and accuracy was 91.53%, with a kappa coefficient of 0.805 (95% CI: 0.714 - 0.895). The agreement between the automated system and the expert evaluations significantly improved with the 40x objective.

Conclusions: Using a 40x microscope objective enhances the compatibility between automated systems and expert evaluations, providing clearer and larger images. This adjustment reduces false positives, increases accuracy, and facilitates decision-making for specialists, supporting the adoption of 40x objectives for routine laboratory use.