Clinical laboratory最新文献

Background: Antibiotic exposure has been reported as a risk factor for the development of ulcerative colitis; however, the clinical results were controversial. Therefore, we performed a meta-analysis to evaluate the association of antibiotic exposure with the new onset of UC.

Methods: A comprehensive literature search for relevant studies published up to February 2024, exploring the association between antibiotic exposure and new-onset UC, was performed by using Medline and Embase, and the statistical analysis was conducted by using the Stata software.

Results: A total of 16 articles were included in the study, including 12 case-control studies and 4 cohort studies. The pooled analysis revealed that antibiotic exposure was associated with an increased risk of new-onset UC (summary OR = 1.28, 95% CI = 1.26 - 1.31). Subgroup analyses showed that both case-control studies and cohort studies have yielded consistent conclusions.

Conclusions: This meta-analysis suggests that antibiotic exposure is a risk factor for the development of UC. It is, therefore, necessary to avoid unnecessary and excessive use of antibiotics.

Background: Candida auris is an opportunistic pathogen that has become widespread in recent years and shows resistance to multiple drugs. The aim of our study was to determine the antifungal susceptibilities of C. auris isolates, to perform a dendrogram from the mass spectra of strains obtained from matrix-assisted laser desorption ionization-time of flight mass spectrometry in order to evaluate the proteomic similarities of the strains and determine the geographical clade of C. auris strains in this study by the help of Multiplex RT-PCR.

Methods: The samples yielded 58 C. auris isolates. MALDI TOF MS (BioMerieux, France) was used for identification of the isolates and Sensititre Yeast One (Thermoscientific) system was used for antifungal susceptibility testing. Dendrograms of strain's spectra were generated by using the RUO/Saramis (BioMerieux, France) database and evaluated through hierarchical clustering analysis. The selected nine strains were examined at the clade level by using Multiplex RT-PCR. Results The susceptibility profile of the strains revealed resistance to Fluconazole in 84% (MICs ≥ 32) and resistance to Amphotericin B in 60% (MIC ≥ 2). All strains were found to be sensitive to Anidulafungin and Micafungin. The dendrogram of the main spectra of C. auris isolates showed a similarity range of 35 - 100%. The nine strains studied were identified as clade 1 (South Asian).

Conclusions: It was determined that C. auris strains were members of geographical clade 1, and the Amphotericin B resistance was found to be higher than expected. This situation poses a threat to critically ill patients.

Background: Tuberculous pleurisy (TP) is one of the most common types of extrapulmonary tuberculosis, often secondary to tuberculosis (TB). Clinical and imaging manifestations of non-tuberculous mycobacterial pulmonary diseases (NTM-PD) are usually similar to those of tuberculosis. Because of their similarity and the high incidence of tuberculosis, non-tuberculous mycobacterial infections are often overlooked for a long time. Especially in people without immunodeficiency.

Methods: Mycobacterium tuberculosis (MTB) in pleural effusion was found by metagenomic next-generation sequencing (mNGS). During anti-tuberculosis treatment, mNGS of lung tissue by ultrasound-guided percutaneous lung puncture revealed that this patient had combined NTM-PD.

Results: Mycobacterium chelonae (M. chelonae) was detected by mNGS, and after anti-NTM treatment, the patient's chest CT showed that the inflammation was absorbed more than before, and the patient's symptoms improved.

Conclusions: When TB is poorly treated with standardized anti-tuberculosis therapy, comorbid non-tuberculous mycobacterial infections may be considered, and mNGS may complement traditional pathogenetic testing.

Background: Different detection platforms can lead to significant differences in the results of CA19-9. Here, a case of a 38-year-old male colon cancer patient who underwent CA19-9 testing on two platforms after surgery.

Methods: We first inspect the instrument to confirm its normal operation and good indoor quality control. Then, we conduct dilution experiments to eliminate interference from heterophilic antibodies, compare and analyze inherent differences with other platforms, and regularly follow up to dynamically monitor the patient's condition.

Results: During follow-up, the patient's CA19-9 levels rose consistently on both platforms, leading to tumor recurrence two years later, missing optimal treatment.

Conclusions: Dynamic monitoring of tumor markers should be based on a stable platform and combined with imaging examinations. For abnormal elevated results, humanistic care is needed to address the patient's fear and doubts about the test results.

Background: Lung cancer is the most lethal cancer in men and women. Recently, it has been reported that circu-lating tumor cells (CTCs) are sensitive and reliable biomarkers for tracing relapse and metastasis of cancer patients. Many studies also showed that immune cellular dysfunctions in lung cancer patients are major reasons for cancer development. In this study, we explored the clinical significance of CTCs and T lymphocyte subtypes in lung cancer patients.

Methods: A total of 92 patients with diagnosed lung cancer, including 23 squamous-cell carcinoma and 69 adenocarcinoma, were enrolled in this study. Another 10 patients with non-carcinoma nodules in their lungs were also recruited as a control group. Peripheral blood samples were drawn from the patients with lung cancer and from the control cases before the treatment. The identification of CTCs was carried out by a PatrolCTC detection method. The T lymphocyte subtypes were characterized by flow cytometry (FACS). Cytokines interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-17A (IL-17A), interleukin-10 (IL-10), and interferon  (IFN-) were detected by meso scale discovery (MSD) assay.

Results: Out of the enrolled patients, 69 (75%) patients with non-small cell lung cancer (NSCLC) were male and 23 (25 %) were female. Smoking and non-smoking history was 50% (46 cases) each. The case numbers for I - IV tumor-node-metastasis (TNM) stages were 23 (25.0%), 28 (30.4%), 16 (17.4%), and 25 (27.2%), respectively. The positive rates of the CTCs before treatment were 8.7% (2/23), 17.6% (5/28), 81.3% (13/16), and 100% (25/25) in stage I, II, III, and IV patients, respectively. Total CTCs, mixed CTCs, and mesenchymal CTCs (MCTCs) were strongly related to the progression-free survival (PFS) of the patients. In addition, total CTCs (≥ 6) and positive MCTCs also significantly correlated with recurrence and metastasis. The patients with high CTCs also had low levels of CD4, CD4/CD8 ratio, IL-2, and IFN. In contrast, IL-10 in high CTCs patients was significant elevated. These results indicate that the CTC numbers in lung cancer patients are an independent indicator for a worse PFS.

Conclusions: Higher total CTCs, mixed CTCs, and MCTCs in peripheral blood were significant biomarkers for predicting the prognosis of lung cancer patients. High CTCs also had a strong correlation with weak cellular immunity functions.

Background: The aim of the study was to improve the clinical cognition of nonaccelerating myelodysplastic/myeloproliferative neoplasms-unclassifiable (MDS/MPN-U) with 5q- karyotype and to avoid misdiagnosis or delayed diagnosis.

Methods: The clinical manifestations and laboratory results of a patient with nonaccelerating MDS/MPN-U with 5q- karyotype were analyzed, and related literature was reviewed.

Results: The patient was admitted to hospital mainly due to chest tightness and shortness of breath, aggravated for 4 days. After admission, combined with clinical manifestations, bone marrow cell morphology, immunology, multiparameter flow cytometry, cytogenetics and molecular biology, etc., the final diagnosis was MDS-MPN-U.

Conclusions: Research on the correlation between MPN-U and MDS with 5q deletion is still needed. Clinically, MPN-U combined with MDS is prone to misdiagnosis. In diagnosing MPN-U patients, it is essential to not only complete routine and immunological tests but also consider clinical manifestations and laboratory results. It is crucial to be vigilant about the possibility of concurrent diseases, especially cancer, and to choose targeted examinations in a timely manner to avoid missed or incorrect diagnoses.

Background: The causative agent of the coronavirus disease (COVID-19) is a virus from the SARS-CoV-2 group of viruses that cause severe acute respiratory syndrome. The aim of the study was to examine the differences in hematological analyses of patients suffering from COVID-19 with and without comorbidities, to determine the degree of the clinical picture based on the MEWS scale and to examine the persistence of inflammatory parameters with the severity of the clinical picture.

Methods: The research is a cross-sectional retrospective study, conducted in the laboratory diagnostics service of Tesanj General Hospital. It included 211 respondents positive for the coronavirus in the Tesanj General Hospital. The degree of severity of the clinical picture was determined on the basis of the MEWS scale.

Results: A total of 211 patients positive for coronavirus participated in the study, of which 61.1% (129) were male and 38.9% (82) were female. Based on the results, a statistically significant difference was found in the ratio of hematological parameters in subjects with and without comorbidities (p < 0.05). A strong positive correlation was found between the ratio of SE and D-dimer in subjects and the degree of severity of the clinical picture.

Conclusions: A statistically significant difference was recorded in the ratio of hematological parameters (lymphocytes, granulocytes, erythrocytes, hematocrit, and APTT) in subjects with and without comorbidities in all three of the observed groups (p < 0.05), while there were no statistically significant differences in other hematological parameters (p > 0.05).

Background: Treatment of end stage renal disease (ESRD) is based on preserving renal functions. Since renal anemia is frequently detected, we use parenteral iron treatments in patients with chronic kidney disease (CKD). However, there need to be more precise and sufficient studies on the effect of these treatments on the rate of decrease in the glomerular filtration rate (GFR). Therefore, we conducted a study comparing the rates of change in renal function in patients who had used parenteral iron for at least five years.

Methods: Our study is a retrospective cohort study, and 180 patients with CKD (86 women, 94 men, mean age: 63.5 ± 11.4 years) who had been followed and treated in nephrology outpatient clinics for at least five years and met the study criteria were included in the study. Patients were divided into three groups for iron therapy: not receiving iron therapy, iron carboxy maltose (ICM), and iron sucrose (IS) parenterally. Each group consisted of 60 people. The first and last creatinine and GFR values were compared for a 5-year follow-up in each group.

Results: There was no significant difference between the two groups, those using and those not using iron, regarding creatinine increase and GFR decrease rate. Additionally, no significant difference was detected in the GFR decline rates of patients using ICM and IS.

Conclusions: This study reduces the concerns that correcting anemia through parenteral iron therapy in patients with CKD may harm renal function.

Background: There has been no unified definition for neonatal hypoglycemia. Generally, neonatal hypoglycemia is diagnosed when the whole blood glucose concentration is below 2.2 mmol/L. The reasons are numerous. This case report presents an instance of a newborn with extremely low blood glucose levels immediately after birth from a diabetic mother, referred to as the "Infants of Diabetic Mothers", providing a practical case reference for early monitoring and timely intervention for Infants of Diabetic Mothers (IDMs).

Methods: The glucose concentrations in whole blood and serum were measured using a fingerstick glucometer and a fully automatic biochemical analyzer, respectively. The levels of insulin and C-peptide were detected using a fully automatic chemiluminescence method. The glycated hemoglobin was measured using a glycated hemoglobin analyzer.

Results: The mother's blood glucose value before delivery was 8.28 mmol/L. After delivery, the fingerstick blood glucose and serum glucose concentrations of the newborn were 2.6 mmol/L and 0.11 mmol/L, respectively. The levels of insulin and C-peptide were 805.55 pmol/L and 2,312.64 pmol/L, respectively. The value of glycated hemoglobin was 7.5%. Intravenous nutrition with a 100 mL of 10% glucose at an infusion rate of 12.7 mL/d was maintained. Then, 10% glucose was given to the neonate at an infusion rate of 7.7 mL/minute for 30 minutes. Eventually, the blood glucose levels were raised to 5.2 mmol/L.

Conclusions: Diabetes has a profound impact on both the mother and the newborn. Close monitoring and timely intervention are necessary to reduce neonatal complications and promote longterm healthy growth and development.

Backgrounds: Coronavirus disease 2019 (COVID-19) is a viral infection caused by severe acute respiratory syn-drome coronavirus 2 (SARS-CoV-2). The high mortality and morbidity rate and its course with a wide variety of clinical symptoms indicate that the disease affects many metabolic pathways. The aim of our study was to investi-gate the metabolic effects of SARS-CoV-2 by evaluating the urinary organic acid profile in patients with SARS-CoV-2 infection. Can metabolites in urine guide the diagnosis, follow-up, treatment, and prognosis of COVID-19?

Methods: Forty-two patients, including 30 SARS-CoV-2 RT-PCR positive patients and 12 SARS-CoV-2 RT-PCR negative controls, were studied. SARS-COV-2 RT-PCR of nasopharyngeal swab samples was studied. Urines were evaluated in the GCMS-QP2010 SE Gas Chromatograph Mass Spectrometer (SHIMADZU) device for organic acid profile in the metabolism laboratory. Urine organic acid profile was evaluated by studying 117 organic acids in each patient.

Results: Tiglylglycine, 2-hydroxybutyric acid, 4-hydroxyphenylpyruvic acid, 3-hydroxypropionic acid, erythro-4,5-dihydroxyhexanoic acid lactone, 2-hydroxyphenylacetic acid, N-acetyltyrosine, 3-phenyllactic acid, 5-hydroxyindolacetic acid, 3-hydroxysebacic acid, palmitic acid, 3-methylglutaconic acid, 3-methylglutaric acid, lactic acid, pyruvic acid-oxime, 3-hydroxysobutyric acid, and organic acids were found to be increased, compared to the control group.

Conclusions: Tiglylglycine has been specifically identified as a potential biomarker of respiratory chain disorders. The deterioration in lipid metabolism and pyruvate pathway in COVID-19 patients was evaluated as remarkable.