Journal of Medical Biochemistry最新文献

The pre-analytical phase is the principal source of errors in laboratory medicine and continues to pose a challenge to laboratory professionals. We present the case of a 73-yearold female patient with a very low hemoglobin level (69 g/L) and positive indirect antiglobulin test result that indicates the key role of phlebotomy as an important error-prone process in which mistakes can have serious consequences for the patient's diagnosis and treatment. We conclude that there is still an urgent and continuous need to provide educational activities for healthcare professionals involved in blood collection, improve blood collection guideline adherence, and eliminate the errors which can affect diagnosis and treatment, thus jeopardising patient safety.

Background: This study aims to analyze the changes and significance of organ function indices in patients with severe Coronavirus Disease 2019 (COVID-19) pneumonia for prediction of major organ damages and guiding treatment schemes.

Methods: 63 patients with severe COVID-19 pneumonia were selected as the severe group and 73 patients with mild syndromes were selected as the mild group. SAS9.4 software was used for statistical analysis of the data.

Results: Levels of ALT, AST, cTnI, Cr, PT, APTT and Ddimer of the severe group were significantly higher while PLT was lower than those of the mild group. The data of all quantitative variables were converted into categorical variables. Significantly higher levels of AST, ALB, D-dimer and higher proportion of bilateral lung involvement were observed from the severe group comparing to those in the mild group, while the difference in the other indices between the two groups was insignificant in statistical perspective.

Conclusions: There are significant differences in the levels of multiple organ function indices between the severe group and the mild group of patients with COVID-19 pneumonia infection. Through examining the relevant indices, conditions of patients' multiple organ function damage could be predicted and used as guidance of treatment.

Background: The unpredictable course of Coronavirus Disease 19 (COVID-19) is making good severity assessment tools crucial. This study aimed to assess the usefulness of serum amyloid A (SAA) and other acute-phase reactants (APRs) in ambulatory care COVID-19 patients and identified relationships between these markers and disease outcomes.

Methods: From August to November 2020, patients seen in the outpatient department of the Clinic for Infectious and Tropical Diseases (Belgrade, Serbia) with confirmed COVID-19 were included. Patients were classified into mild, moderate, and severe disease groups based on World Health Organization criteria. SAA, C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT), ferritin, fibrinogen, D-dimer, albumin, and transferrin were measured. The median values of all APRs were compared between COVID-19 severity groups, hospitalized and non-hospitalized patients, and survivors and non-survivors. The Receiver operator characteristic (ROC) curve analysis was used for the classification characteristics assessment of individual APRs for the severity of illness, hospitalization, and survival.

Polycystic ovary syndrome (PCOS) is one of the most common gynecological diseases that affect the fertility in women in Basra governorate. The current study was designed in order to assess iron aberrations in PCOS patients by measuring the related parameters and their relationship with sex hormones in patients with PCOS. Serum samples were collected from 45 PCOS patients and 45 controls from a private women's clinic and were measured by ELISA in a private medical laboratory. The results showed a significant decrease in the level of hepcidin, transferrin and estradiol versus a significant increase in iron, ferritin, progesterone and testosterone. The current study showed a clear imbalance in the level of iron and its serum regulating parameters in in PCOS women, and there is an effective correlation between iron status and sex hormones.

Background: Surgical stress and pain result in activation of hypothalamus-pituitary-adrenal axis. The aim of this study was to establish the effects of postoperative pain and various modalities of analgesic administration on salivary and serum cortisol levels, as well as to establish the validity of salivary cortisol as a stress indicator in surgical patients.

Methods: A randomized controlled trial involved 60 patients scheduled for elective abdominal aortic aneurysm surgery. Patients were randomly divided into two groups depending on the model of postoperative analgesia. The first group (MI - morphine intermittently) included patients given morphine doses 0.1 mg/kg/6h s.c. intermittently. The second group (MPCA - morphine patient-controlled analgesia) included patients who received morphine via the PCA system - intravenous administration of morphine adjusted to a dose of 1 mg per shot and a lockout interval of 6 minutes.

Background: The usefulness of leukocyte cell population data (CPD) is currently being investigated. In COVID-19 pandemic several reports showed the clinical importance of hematological parameters. Our study aimed to assess CPDs in Sars CoV-2 patients as new disease markers.

Methods: From February to April 2020 (1st wave) 540 and from September to December 2020 (2nd wave) 2821 patients respectively were enrolled. SARS CoV-2 infection diagnosis was carried out by Multiplex rRT-PCR from nasopharyngeal swabs. CPDs were detected by XN 2000 hematology analyzer (Sysmex Corporation). A comparison between two disease waves was performed. Additionally, C-reactive protein (CRP) and lactate dehydrogenase (LDH) were assayed.

Results: CPDs were classified into: cell complextity, DNA/RNA content and abnormal sized cells. We detected parameters increased from the reference population for all cell types for both 1st and 2nd wave (p<0.05). However, in the 2nd vs 1st wave 5 CPDs vs 9 CPDs were found. In addition we observed higher CPD values of the 1st compared to 2nd wave: (NE-SFL) (p<0.001), (LY-Y) (p<0.0001), (LY-Z) (p<0.0001), (MO-X) (p<0.0001), (MO-Y) (p<0.0001). These findings were confirmed by the higher concentrations of CRP and LDH in the 1st vs 2nd wave: 17.3 mg/L (8.5-59.3) vs 6.3 mg/L (2.3-17.6) (p<0.001) and 241.5 IU/L (201-345) vs 195 IU/L (174-228) (p< 0.001) (median, interquartile range) respectively.

Conclusions: CPDs showed increased cell activation in 1st wave patients confirmed by clinical and biochemical data, associated with worse clinical conditions. Results highlighted the CPDs as disease characterization markers or useful for a risk model.

Background: As BMP15, GDF9, and kisspeptin all play critical roles in folliculogenesis and fertilization, investigating the possible relationship between obesity and these three factors could prove crucial in relation to understanding the role of obesity in infertility. Thus, the present study sought to determine the effects of obesity on the serum BMP15, GDF9, and kisspeptin concentrations in women of reproductive age.

Methods: Ninety female participants were equally divided into three groups: class-1 obese (n=30), class-2 obese (n=30), and normal weight (control; n=30). The participants' serum BMP15, GDF9, and AMH concentrations were measured. Moreover, the serum kisspeptin concentrations were evaluated in the class-1 obese and control groups by means of the enzyme-linked immunosorbent assay (ELISA) method while the participants were in their menstrual period.

Results: The serum BMP15 and kisspeptin concentrations were found to be much higher in the control group than in both obese groups (p=0.001 and p=0.01, respectively). While the GDF9 concentration exhibited a statistically significant positive correlation with age, the BMP15 concentration exhibited a positive correlation with the kisspeptin and LH concentrations in the control group. In addition, a positive correlation was identified between the BMP15 concentration and both age and the glucose level and a negative correlation with the insulin level in both the obese groups.

Conclusions: Obesity appears to reduce the serum BMP15 and kisspeptin concentrations in obese women of reproductive age. This reduction may represent a milestone in reproductive dysfunction and may be used to predict the success of infertility treatment in obese women.

Background: To observe the short-term outcome of plasma adsorption PA therapy in amyotrophic lateral sclerosis (ALS).

Methods: 28 cases of als patients were recruited in this study, of which 20 were male and 8 were female with a mean age of 53.21±9.07 years and the average course of 33±23.35 months. The clinical manifestations were limb weakness (N=27), muscular atrophy (N=27), muscular tremor (N=5), dysphagia (N=12) and dysarthria (N=12). The clinical data of the patients recruited were graded by Amyotrophic Lateral Sclerosis Functional Rating Scale Revised (ALSFRSR) : <10 (N=1), 11-20 (N=4), 21-30 (N=6), 31-40 (N=12), >40 (N=5). All patients received PA therapy once a week for three successive times after examining the conditions of blood coagulation and virus infection. PA therapy was supplemented with neurotrophic therapy meanwhile. All patients' clinical manifestations and scores of ALSFRSR before treatment and one week after treatment were evaluated and compared. The levels of serum superoxide dismutase (SOD), interleukin-10 (IL-10), serum creatine kinase (CK) and lactate dehydrogenase (LDH) before and after treatment were compared.

Results: After PA therapy, 14 patients have improved obviously in muscle strength, 4 patients in hypermyotonia partially, 3 patients in muscular tremor, 5 patients in dysarthria, 3 patients in salivation to some extent and 2 patients in swallowing function. The score of ALSFRSR after PA treatment (31.89±10.36) was remarkably higher than that before PA treatment (30.68±10.52) (P<0.01). The levels of SOD (155.10±21.87 IU/L) and IL-10 (138.06±185.88 pg/mL) after PA treatment were significantly higher than the levels before PA treatment (143.08.3±19.16 IU/L and 46.34±75.31 pg/mL, respectively) (P<0.05). The levels of CK (168.86±113.50 IU/L) and LDH (152.07±32.65 IU/L) after PA treatment were significantly lower than the levels before PA treatment (356.68±250.30 IU/L and 181.36±33.74 IU/L respectively) (P<0.01). At the end of follow-up period (November, 2019), five patients died of respiratory failure 16-21 months after PA treatment and two patents died of respiratory infection 15-20 months after PA treatment. 7 patients were still alive. The score of ALSFRS-R of these patients who survived at the end of follow-up (13.00±13.37) were significantly lower than before PA treatment (36.71±8.56) (P<0.05) and after PA treatment (38.14±8.82) (P<0.05).

Conclusions: Plasma adsorption (PA) therapy has shortterm therapeutic effects on als. The effects might be attributed to the anti-oxygen free radical effect by increasing SOD level and the anti-inflammation effect by increasing IL-10 level. As the efficacy of PA therapy was obtained in a small sample size and short follow-up period, the longterm observation of PA efficacy in treating als should be further investigated.

Background: To investigate the efficacy and safety of singleand double-volume exchange transfusion for neonatal hyperbilirubinemia (HB) and compare their effects on the internal environment of newborns.

Methods: The clinical data of 96 HB newborns admitted to and treated in our hospitals from January 2016 to October 2021 were retrospectively analyzed. Then, these newborns were divided into single volume group (80-110 mL/kg, n=48) and double volume group (150-180 mL/kg, n=48) by the exchange volume per unit body mass. The hematological indicators total serum bilirubin (TSB), peripheral blood red blood cell (RBC) count, white blood cell (WBC) count, platelet (PLT) count, serum albumin (ALB), prothrombin time (PT) and activated partial thromboplastin time (APTT), and changes in inner-environment indexes (blood gas, blood glucose, acid-base and electrolyte levels) were compared between the two groups of newborns before treatment and after once treatment. Additionally, the adverse reactions of exchange transfusion in the two groups of newborns were recorded.

Background: To elucidate clinical applications of detecting serum levels of H19 and CRP in predicting the severity of ulcerative colitis (UC).

Methods: Two hundred UC patients were recruited, and classified to mild/moderate group and severe group according to the Truelove-Witts grading system. Serum levels of H19 and CRP in UC patients were detected by turbidimetric inhibition immuno assay and qRT-PCR. Differences in serum levels of H19 and CRP between mild/moderate group and severe group were analyzed. By plotting ROC curves, the diagnostic potentials of H19 and CRP in UC were evaluated. Kappa conformance test was conducted to validate the conformance of detecting serum levels of H19 and CRP to clinical diagnosis of UC.

Results: Serum levels of H19 and CRP were higher in UC patients of severe group than those of mild/moderate group. Their levels were both positively correlated to the severity of UC. High sensitivity (83.3%) and specificity (80.0%), as well as the maximum Youden index (0.633) were obtained at the cut-off value for H19 level of 2.755, and AUC was 0.8835. Meanwhile, Kappa coefficient (k) was 0.760 at the cut-off value for H19 level of 2.755, showing a high conformance to clinical diagnosis of UC. In addition, acceptable sensitivity (68.49%) and high specificity (85.83%), as well as the maximum Youden index (0.543) were obtained at the cut-off value for CRP level of 6.390 mg/L, and AUC was 0.8018. k was 0.435, showing an acceptable conformance to clinical diagnosis of UC based on serum level of CRP.

Conclusions: Serum levels of H19 and CRP increase with the deterioration of UC. Detecting their serum levels has a consistent result to clinical diagnosis of UC, with a superior performance of H19 than that of CRP.