Clinical laboratory最新文献

Background: This study aimed to evaluate the correlation between preoperative CA19-9, CEA, CA125, and AFP levels of and prognosis for patients diagnosed with colorectal carcinoma.

Methods: This was a retrospective study, which involved 400 CRC patients treated with radical resection between January 2022 and December 2024 and categorized into two groups: development (n = 280) and validation (n = 120). Clinicopathological data, including age, gender, operative method, tumor size, tumor location, TNM stage, CA19-9, CEA, CA125, and AFP, was assessed. The patients got checked up every three months for the first year, and then every six months afterwards.

Results: Univariate and multivariate analyses revealed that age (> 70 years), tumor staging, N-stage, preoperative CA125, and CA19-9 were associated with the prognosis of CRC patients. Univariate analysis revealed that tumor size (p = 0.026, HR = 1.64, 95% CI = 0.81 - 3.35) and CEA (p = 0.029, HR = 2.73, 95% CI = 0.24 - 4.42) were associated with the prognosis of CRC patients.

Conclusions: This study revealed the prognostic impact of the tumor markers CA125, CA19-9, and CEA in patients with nonmetastatic CRC.

Background: Insufficient blood supply negatively affects transfusion-dependent patients. Sustaining adequate blood units relies on community education. As future healthcare professionals, medical science students may assist in increasing the number of blood donations. This study assessed blood donation knowledge among medical science students at Umm Al-Qura University in Makkah City, Saudi Arabia.

Methods: Twenty-three questions were administered in an online survey to assess knowledge, attitudes, and practices (KAP) of medical science students regarding blood donation. A chi-squared test was used to examine associations with the status of the blood donation.

Results: A total of 286 students from four departments responded to the questionnaire. Remarkably, higher contributions regarding knowledge and attitude questions were observed in female participants, compared to male participants. Furthermore, students that donated blood demonstrated greater awareness of their blood group (p < 0.05), minimum weight legibility, and knowledge regarding the duration of the blood donation procedure (p < 0.01).

Conclusions: This study assessed the KAP regarding blood donation among medical science students at Umm Al-Qura University, Saudi Arabia. Furthermore, the most commonly reported barrier was the belief that the individual was not sufficiently fit or healthy to donate. Consequently, targeted education is crucial to emphasize the importance of blood donation and mitigate hospital blood shortages, especially for patients who require blood transfusion units regularly.

Background: This study aimed to explore the severe anemia and cross-matching incompatibility caused by intravenous immunoglobulin (IVIG) administration and the selection of accurate red blood cells (RBC) for transfusion.

Methods: Cross-matching, direct antiglobulin test (DAT), free antibody test (FAT), and elution test (ET) were performed with the neonatal samples before and after IVIG administration simultaneously. The blood samples after IVIG administration were performed by cross-matching with antihuman globulin (AHG) microcolumn gel card (AHG-card) and AHG tube method (AHG-tube) with the same packed RBC suspension simultaneously. The laboratory results before and after IVIG administration and after packed RBC suspension transfusion were collected. The incidence of RBC transfusion adverse reactions was collected as well.

Results: Out of 30 neonates enrolled in this study, the indication of IVIG was sepsis in 18, necrotizing enterocolitis (NEC) in 10, and undetermined reason in 2. The IVIG administration ranges of dose, frequency, and dose/weight were 1.8 - 7.5 g, 1 - 3 times, and 0.8 - 2.9 g/kg. Cross-matching tests by AHG-card, DAT, FAT, and ET were all positive in 30 neonates after administration of IVIG, the elevation of lactic dehydrogenase (LDH) and unconjugated bilirubin and reduction of RBC and HGB were statistically significant after IVIG administration. The incompatibility cases of AHG-card and AHG-tube were 30 and 6, respectively. Compared with laboratory test results before IVIG administration, after packed RBC suspension transfusion, the RBC and HGB of 30 neonates increased significantly. No RBC transfusion adverse reaction was observed.

Conclusions: IVIG administration can lead to severe anemia and cross-matching incompatibility using AGH-card. Safe and cautious IVIG administration is necessary for neonates. AGH-tube can be a solution for cross-matching incompatibility using AGH-card.

Background: Myelodysplastic neoplasms (MDS) are characterized by cytopenia and morphologic dysplasia in myeloid cells and are considered a disease of the myeloid lineage. MDS with concurrent lymphoid clonality is rare and mostly occurs in CD8 T-cells.

Methods: We evaluated a 74-year-old man who presented with anemia and lymphocytosis using peripheral blood immunophenotyping, bone marrow examination, and next-generation sequencing.

Results: The patient was diagnosed with MDS with low blasts and an SF3B1 mutation (MDS-SF3B1), concurrent with clonal CD4 T-cell lymphoproliferative disorder, supported by TCR gene rearrangement and distinct mutation profiles.

Conclusions: This is the first reported case of MDS-SF3B1 coexisting with clonal CD4 T-cell proliferation.

Background: This study aimed to determine the relationship between baseline blood lactate levels and lactate clearance (CL) and the need for hyperbaric oxygen therapy (HBOT) in patients with carbon monoxide (CO) poisoning.

Methods: This retrospective study included patients admitted to the emergency department for CO poisoning between January 1, 2017, and March 1, 2024. Patients were classified into normobaric oxygen therapy (NBOT) and HBOT groups based on the treatment received. Initial and peak lactate levels (measured 2 - 6 hours post-admission) were recorded in mmol/L from venous blood gas analysis. CL was calculated using the formula: CL = [(initial lactate - final lactate)/initial lactate] x 100.

Results: One hundred and sixty-nine patients were included in the study, out of which 78.7% (n = 133) did not receive HBOT, while 21.3% (n = 36) were treated with HBOT. Median lactate levels were significantly higher in the HBOT group (3 [1.2 - 10] mmol/L) compared to the NBOT group (2.1 [0.5 - 14.6] mmol/L) (p < 0.001). Median CL values were 35.29% (-50 - 89.06) for the NBOT group, and 35.28% (-31.58 - 87.95) for the HBOT group, and no significant association was found between CL and the treatment modality (p = 0.596). Receiver operating characteristic analysis identified lactate > 2.8 mmol/L as predictive of HBOT need, with 63.89% sensitivity and 72.93% specificity (area under the curve: 0.705, 95% confidence interval: 0.631 - 0.773, p < 0.0001).

Conclusions: In CO poisoning patients, initial lactate levels at admission may better indicate the need for HBOT than CL.

Background: Mercury is a highly toxic heavy metal, and mercury poisoning often presents with different symptoms in multiple systems. While lung and kidney damage have been studied separately, involvement of the endocrine system has rarely been reported. We report on a case with pulmonary embolism, nephrotic syndrome, and hypothyroidism in a woman who used a mercury-containing whitening cream.

Methods: Chest enhancement CT; Laboratory tests.

Results: Chest enhancement CT suggested the presence of pulmonary embolism. Laboratory tests suggested nephrotic syndrome and hypothyroidism, and blood and urine were positive for mercury. The patient made a full recovery after treatment with immunosuppressants and mercury chelators.

Conclusions: This case demonstrates the need for greater public awareness and stricter regulatory action to prevent health hazards associated with mercury in skin-lightening products.

Background: "Pertussis reappearance" and its epidemic pattern have changed, and the overall incidence group has shifted from infants and children to adolescents and adults.

Methods: We use real-time PCR technology for nucleic acid detection of multiple pathogens in respiratory specimens.

Results: Children infected with pertussis are prone to coinfection with other pathogens. In February and March of this year, ADV and HRV were highly prevalent in the local area. The child visited the hospital multiple times, increasing the possibility of cross infection, resulting in coinfection of pertussis with ADV and HRV.

Conclusions: Early nucleic acid testing for Bordetella pertussis is helpful for the diagnosis of pertussis. Mixed infection pathogens are mainly viral infections. The common mixed infection pathogens in different regions are different and related to the prevalence of local pathogens.

Background: Terahertz metamaterial is a label-free affinity sensor that is particularly sensitive to changes in the surface dielectric environment, so it can be used to detect protein molecules, human tissues, and drug reaction processes. This study aimed to construct a detection system for multidrug-resistant Mycobacterium tuberculosis (MTB) based on terahertz metamaterials.

Methods: Linear padlock probes (PLP) were designed to contain sequences complementary to the DNA sequences of drug-resistant MTB (target sequences), and linear PLP hybridizes to the target sequence to form a circular PLP. The primers fixed on the magnetic beads hybridize with the circular PLP to initiate rolling circle amplification (RCA). We placed RCA nucleic acid products on terahertz metamaterials for terahertz measurements.

Results: We determined the detection system primer concentration to be 15 μmol/L and the RCA reaction time to be 2 hours. Under the abovementioned optimal conditions, the minimum detection limits of the terahertz metamaterial detection system for the target sequences of katG315, rpoB531, and rpsL43 were 7.7 × 10-5 pmol/L, 1.03 × 10-5 pmol/L, and 1.3 × 10-4 pmol/L, respectively.

Conclusions: This terahertz metamaterial-based detection system can achieve high-sensitivity and rapid detection of multiple drug-resistant MTB.

Background: Pulmonary cryptococcosis is common in patients with immunodeficiency, application of immunosuppressive and cytotoxic drugs. Its incidence has increased in recent years, with a greater number of patients with no underlying disease or history of exposure, and a greater number of immunocompetent patients. Its clinical presentation lacks specificity and imaging features are atypical, making it easy to misdiagnose or miss the diagnosis.

Methods: Diagnosis was confirmed by serum cryptococcal antigen after negative bronchoalveolar lavage fluid mNGS in an immunocompetent patient with atypical radiological findings.

Results: We present a 53-year-old female patient with pulmonary cryptococcosis who was immunocompetent, had atypical imaging, and was diagnosed by a negative bronchoalveolar lavage fluid mNGS test and confirmed by cryptococcal pod antigen test.

Conclusions: By analyzing and discussing the diagnosis and treatment process of the patient with cryptococcosis, we aim to strengthen clinicians' knowledge and diagnosis and treatment ability of pulmonary cryptococcosis in order to improve the early diagnosis and treatment rate of this disease and reduce misdiagnosis or omission.

Background: Coagulation factor XII (FXII) deficiency is a rare coagulation disorder, often incidentally detected during routine physical examinations, invasive procedures, or preoperative screenings, with no specific clinical manifestations. Here, we report a case of FXII deficiency.

Methods: A 46-year-old female patient was found to have unexplained prolonged activated partial thromboplastin time (APTT) during routine preoperative testing, without clinical bleeding symptoms. We performed an APTT mixing study, anti-cardiolipin antibody (ACA) testing, anti-β2-glycoprotein 1 (anti-β2-GP1) antibody testing, lupus anticoagulant (LA) screening, and coagulation factor assays to determine the cause of APTT prolongation.

Results: The APTT mixing study showed correction result. Coagulation factor assays revealed significantly reduced FXII activity (0.1%), while factors XI, X, II, VIII, IX, V, and VII levels were elevated. ACA (IgA/IgG/IgM) and anti-β2-GP1 antibodies (IgA/IgG/IgM) were negative. LA testing by dilute Russell's viper venom time (dRVVT) was negative, and the silica clotting time (SCT) suggested factor deficiency rather than an inhibitor. These findings confirmed that the patient's prolonged APTT was due to FXII deficiency.

Conclusions: When prolonged APTT is observed in a patient without bleeding symptoms, laboratory personnel should consider the possibility of FXII deficiency.