ABSTRACT
Objective:To establish a candidate reference procedure for the enumeration of cell particles in urine and applied to the multi-center performance evaluation of an automated urine formed elements analyzer.Methods:According to the standardized mannual microscopic examination of fresh non-centrifuged urine samples and the recommended reference method for enumeration of cell particles in urine published by ISLH, we established a candidate reference procedure for the enumeration of cell particles in urine. From four class A tertiary hospitals′ clinical laboratories, three rigorous trained technicians per hospital tested the same specimen respectively using the reference procedure. Each specimen was repeatedly counted 5 times, obtaining the quantitative results of cell particles were obtained in urine. Four hospitals used the established candidate reference measurement procedure and the automated urine formed elements analyzer to detect 40 to 60 urine specimens from September 2020 to January 2021, and evaluate the established reference method, meanwhile evaluate the accuracy and consistency of the each count from automated urinalysis analyzer.Results:Using the candidate reference measurement procedures, the coefficient of variation of results derived from three trained technicians per hospital was less than 6.98% (red blood cells), 6.99% (white blood cells), 13.94% (epithelial cells) and met the quality requirements. The performance evaluation results of automated urine formed elements analyzer showed that the accuracy of red blood cells, white blood cells and epithelial cells met the requirements (bias≤4.98%) and was well consistent with the reference measurement procedure ( R2≥0.989). Conclusions:A candidate reference measurement procedure for the enumeration of urine cell particles was successfully established with satisfactory precision and accuracy. This procedure was applied to multicenter performance evaluation of an automated urine formed elements analyzer with good accuracy and consistency.
ABSTRACT
Current laboratory testing methods of antiphospholipid syndrome(APS) can not satisfy the clinical need for diagnosis and treatment. Inflammation plays an important role in the development of APS. The comprehensive effect of varieties of immune cells, molecular systems, and cytokines renders the body in a pro-inflammatory state. Understanding the inflammatory mechanisms in the pathogenesis of APS is conductive to achieving individualized treatment and improving the efficacy of APS patients. In this article, the inflammation mechanisms and related diagnosis and treatment protocols involved in APS are summarized, aiming to provide reference for the clinical treatment of APS.
ABSTRACT
There is an upward trend in the incidence of infertility, while its pathogenesis is very complex, including endocrine disorders and autoimmune diseases and so on. With the development of reproductive immunology, infertility caused by immune factors has attracted more attention. Various reproductive immune antibodies have been found in infertility patients. The role and prevalence of related autoantibodies in the pathogenesis of infertility vary from each other, thus their detection is of great significance for early diagnosing, treating and monitoring infertility patients.
ABSTRACT
Objective:To explore the predictive value of serum tissue inhibitor of metalloproteinases-2(TIMP-2), insulin-like growth factor-binding protein-7 (IGFBP-7), angiopoietin-2 (Ang-2) and laboratory examination indicators in patients with sepsis associated acute kidney injury (SAKI).Methods:Present study included 69 patients with sepsis, who were admitted to the emergency department of Peking University Third Hospital from April 2017 to August 2018. Within 72 hours of admission, 28 cases developed SAKI. General clinical features including sequential organ failure assessment (SOFA), acute physiological and chronic health status score Ⅱ (APACHE Ⅱ) and laboratory examination indicators including white blood cells (WBC), neutrophil/lymphocyte ratio (NLR), procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6), D-dimer, fibrinogen (Fib), urea, uric acid (UA) were analyzed and serum samples were obtained to detect the levels of biomarkers TIMP-2, IGFBP-7, and Ang-2. Multivariate logistic regression analysis was performed to determine independent risk factors of SAKI, and the receiver operating characteristic (ROC) area under the curve (AUC) was used to assess the early predictive value of biomarkers and laboratory examination indicators for SAKI.Results:Compared with the non-SAKI group, patients in the SAKI group had higher SOFA score, higher incidence of septic shock, higher NLR, PCT, CRP, D-dimer, and UA levels (all P<0.05). The levels of TIMP-2, IGFBP-7, TIMP-2×IGFBP-7 and Ang-2 in the SAKI group were 23.5 (17.3, 30.3)ng/ml, (185.6±47.2)ng/ml, 3.98(2.89, 6.00) (ng/ml) 2/1 000, 1 953 (950, 2 239) pg/ml respectively, which were significantly higher than those in the non-SAKI group (16.4[13.5, 22.4] ng/ml, [139.4±34.7]ng/ml, 2.28[1.57, 4.03](ng/ml) 2/1 000, 576[334, 1 076] pg/ml, respectively, all P<0.05). Logistic regression analysis showed that IGFBP-7 ( OR=1.039, 95%CI 1.000-1.079, P<0.05) and SOFA ( OR=1.521, 95%CI 1.144-2.022, P<0.05) are independent risk factors of SAKI. ROC curve analysis showed that the AUC of IGFBP-7 and SOFA scores for early prediction of SAKI was 0.805 (sensitivity 78.6%,specificity 78.3%), 0.832 (sensitivity 67.9%,specificity 82.9%) respectively. Combined both biomarkers, the AUC increased to 0.893 (sensitivity 82.1%, specificity 87.8%), the diagnostic performance was superior to IGFBP-7 or SOFA alone ( P<0.05). Conclusion:Elevated IGFBP-7 and SOFA are independent risk factors for sepsis associated acute kidney injury, and combined assessment with IGFBP-7 and SOFA can increase the diagnostic performance on the early detection of high-risk patients with SAKI.
ABSTRACT
Thyroid is the largest endocrine gland of human body, the main effect of thyroid hormone secreted by thyroid is to maintain the normal body-metabolism, growth and development and expecially for the development of bone and nervous system. Maternal thyroid hormones during pregnancy are very important for the development of fetuses and children, thyroid-related complications during pregnancy are associated with adverse pregnancy outcomes. The dysfunction of thyroid, the diagnosis of thyroid-related complications during pregnancy and the clinical manifestations were systematically introduced in the presence review.
ABSTRACT
Acute kidney injury (AKI) is a common complication in critically ill patients with complex etiology and high morbidity, which is closely related to the patient's mortality rate, hospital stay and long-term poor outcomes. Therefore, timely detection of AKI in the early reversible stage is particularly important to prevent its progression to renal failure and initiating renal replacement therapy. Therefore, exploring the relevant biomarkers in the occurrence and development of acute kidney injury has important clinical significance for the diagnosis and treatment of the disease. Tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein-7 (IGFBP-7) are used as cell cycle arrest proteins, which has shown certain advantages in the early diagnosis, risk stratification, prognosis judgment, and treatment effect of acute kidney injury. Cell cycle arrest protein [TIMP-2]×[IGFBP-7] plays a role in acute kidney injury caused by various reasons and can be used as a reference index for disease prognosis.
ABSTRACT
Antiphospholipid syndrome(APS) is a autoimmune system disorder caused by thrombosis and is usually accompanied with persistent positive. Antiphospholipid antibodies profiles(aPLs) is the key to diagnosing APS. The most frequently detectable aPLs in current clinical applications are anticardiolipin antibodies (aCL), anti-β2 glycoprotein Ⅰantibodies (anti-β2 GPI), and lupus anticoagulant (LA).However, it is found that the current laboratory diagnostic standard for APS based on these three aPL have many defects. The standard can′t meet the clinical needs. In this article, the research and development of antiphospholipid antibody in recent years are summarized, and the clinical value of non-classified standard antibodies such as IgA antibody isotype and anti-domain 1 β2-glycoprotein I antibody are reviewed.
ABSTRACT
Objective@#To explore the cumulative effects of unintentional injury among children in rural area, in order to provide information for early intervention of unintentional injury.@*Methods@#Through multistage clustering sampling method, 2 109 primary caregivers of students from 8 rural primary and elementary schools of Heilongjiang Province were recruited. Strengths and Difficulties Questionnaire (SDQ), Injury Behavior Checklist (IBC), Perceptions of Risks and Hazards were used to collect as the risk factors, while Perceptions of Risks and Hazards (PSAPQ), Home Observation for Measurement of the Environment (HOME) and Knowledge, Attitude and Practice for Children Unintentional Injury (KAP) were also used as the protective factors. Risk factors index (RFI) and protective factors index (PFI) were computed in the study.@*Results@#The severity of unintentional injury were positively correlated with SDQ, IBC and perceptions of risks and hazards(r=0.15, 0.23, 0.12, P<0.01), and were negatively correlated with HOME, PSAPQ and KAP(r=-0.25, -0.14, -0.09, P<0.01). Hierarchical linear regression showed that the total scores of SDQ, IBC and environmental of HOME predicted the severity of unintentional injury which could explain 34% variant of unintentional injury. It also indicated that the severity of unintentional injury were positively correlated with RFI (β=0.21) and negatively correlated with PFI(β=-0.18), the interaction was significant(β=-0.11,R2=0.31)(P<0.01).@*Conclusion@#Both risk and protective factors of unintentional injury have cumulative effects on the severity of injury among rural children. The relationship between risk factors and injury could be mediated by protective factors.
ABSTRACT
Antiphospholipid syndrome(APS) is a non-inflammatory autoimmune disease caused by anti-phospholipid antibodies. In recent years, it has been found that over-activation of complement is the key factor leading to the formation of thrombosis and pathological pregnancy in APS. With more understanding of the role of complement activation in the pathogenesis of APS, methods of complement inhibition therapy have emerged one after another. Therefore, the detection of complement components is of great significance for the early diagnosis, treatment and monitoring of APS.
ABSTRACT
Rheumatic immune disease is a kind of disease caused by the abnormal of autoimmune system, the pathogenesis is complex and affected by many factors. Matrix metalloproteinases are a kind of proteolytic enzyme that can degrade extracellular matrix components, while the matrix metalloproteinase3 is the main enzyme that promote their degradation. In recent years, studies have found that matrix metalloproteinase-3 participates in the development of rheumatic immune disease. It is a potential marker not only can reflect the activity of some diseases, but also to evaluate therapeutic effect.
ABSTRACT
Antiphospholipid syndrome(APS) is a non-inflammatory autoimmune disease caused by anti-phospholipid antibodies. In recent years, it has been found that over-activation of complement is the key factor leading to the formation of thrombosis and pathological pregnancy in APS. With more understanding of the role of complement activation in the pathogenesis of APS, methods of complement inhibition therapy have emerged one after another. Therefore, the detection of complement components is of great significance for the early diagnosis, treatment and monitoring of APS.
ABSTRACT
Rheumatic immune disease is a kind of disease caused by the abnormal of autoimmune system, the pathogenesis is complex and affected by many factors. Matrix metalloproteinases are a kind of proteolytic enzyme that can degrade extracellular matrix components, while the matrix metalloproteinase3 is the main enzyme that promote their degradation. In recent years, studies have found that matrix metalloproteinase-3 participates in the development of rheumatic immune disease. It is a potential marker not only can reflect the activity of some diseases, but also to evaluate therapeutic effect.
ABSTRACT
Bone turnover is balanced with coupling of bone formation and resorption at various rates leading to continuous remodeling of bone.Osteoporosis diagnosis, which is nowadays generally made based on bone mineral density(BMD)measurements, suffers from certain limitations.Bone turnover markers (BTMs)can help improve osteoporosis detection.BTMs can provide information that is useful for the management of patients with osteoporosis,for assessing the possible causes of secondary osteoporosis and the correct dosage;they are also potentially useful as surrogate biomarkers for fracture.(Chin J Lab Med,2018, 41:333-336)
ABSTRACT
Objective To explore the perioperative outcomes and safety of enhanced recovery after surgery (ERAS) in laparoscopic radical cystectomy (LRC).Methods We retrospectively evaluated outcome of 10 LRC patients on ERAS protocol from May 2017 to October 2017,and 39 LRC patients on conventional recovery after surgery(CRAS) protocol from July 2015 to November 2016.There were (60.9 ±11.4) years and (63.7 ± 12.1) years in ERAS group and CRAS group respectively(P =0.514);(25.5 ±2.7) kg/m2 and (24.4 ± 3.6) kg/m2 with body mass index (P =0.375).Both of the median of charlson comorbidity index (P =0.931) and American Society of Anesthesiologists score (P =0.254) were 2 There was no statistical significance between the two groups for type of urinary diversion and preoperative laboratory studies (P ＞ 0.05).Patients' perioperative outcomes,early (30-day) complications and postoperative readmission rate were compared.Results The ERAS group had less intraoperative crystalloid infusion [(950.0 ± 474.3) ml vs.(1 797.4 ± 448.1) ml,P ＜ 0.001],faster removed gastric tube (0 d vs.4 d,P ＜0.001),and shorter passing flatus time [(1.6 ± 0.8) d vs.(2.9 ± 1.4) d,P =0.006] than the CRAS group;however,no difference was found in terms of intraoperative colliod infusion [(1 110.0 ± 331.5)ml vs.(1 117.9 ± 397.9) ml,P =0.954].No patients from either group required conversion to open surgery.There was no significant difference between the two groups for operative time (P =0.311),estimated blood loss (P =0.073),drain days (P =0.681),postoperative hospital stay (P =0.509),overall blood transfusion (P =1.000),intensive care unit stay (P =1.000) and tumor characteristics (pathological stage,histology,nodes removed,positive nodes,lymph node-positive patients,positive surgical margins).The 30-day postoperative complications were documented in 5 (50％)and 23 (59％)patients in groups ERAS and CRAS (P =0.878),respectively.And the most common complication were minor complications (Clavien-Dindo grade 1 and 2) in both groups (100.0％ vs.86.9％,P =0.729).The 30-day readmission rate was 20.0％ (2 patients) in ERAS group and 10.3％ (4 patients) in CRAS group with no statistical significance(P =0.588).Conclusions Our ERAS protocol expedited bowel function recovery after RC and urinary diversion without increasing in 30-day complications compared with CRAS.The key of implement ERAS pathway is to explore and develop their own protocol conformed to their medical treatment enviroment.
ABSTRACT
Antiphospholipid antibody is a kind of autoantibodies that can react with different phospholipid components of the body .Many researches have suggested that antiphospholipid antibody can lead to many pathological pregnancies such as recurrent miscarriage , premature birth, stillbirth, pre-eclampsia by promoting placental thrombosis , damaging the functions trophoblast cells and many other pathways.Appropriate anticoagulation and immunotherapy in patients with pathological pregnancy induced by antiphospholipid antibodies can significantly improve the outcome of pregnancy .
ABSTRACT
In recent years the incidence of acute kidney injury (AKI) has increased, with a high mortality rate and poor prognosis.The key of improving the prognosis of AKI is early diagnosis and intervention.Due to the lack of biomarkers of early diagnosis in AKI, the effective early treatment is generally delayed.Traditional diagnosis biomarkers such as serum creatinine and blood urea are delayed and affected by various factors.Recently, some new potential early diagnostic biomarkers have been found.MicroRNA(hereinafter referred to as the miRNA) is a kind of endogenous non-coding small RNA, and studies have shown that it is related to the development of AKI.
ABSTRACT
Objective:To analyze the value of low dose enteral nutrition (EN) in treatment of septic shock combined with acute gastrointestinal injury Ⅲ (AGI Ⅲ).Methods:Clinical data of septic shock patients combined with AGI Ⅲ admitted at our hospital were analyzed.Patients were divided into two groups according to the nutrition therapy they received:treatment group (EN,n =41) and control group (no EN,n =46).The mortality and ICU hospital stays were collected.The intestinal barrier,inflammatory cytokines,and oxidative stress were evaluated before and after EN treatment.Results:For patients in the treatment group,the dosages of EN ranged from 200 to 410 kcal/d,with the median dose of 350 kcal/d.No significant differences were found on death rates between the two groups (24.4％vs 32.6％,P =0.398).Patients in the treatment group had shorter ICU hospital stays than those of the control group (11.8 ± 3.7 vs 16.2 ± 5.3,P ＜0.01).After one week EN treatment,patients in the treatment group had lower levels of CRP,IL-6,TNF-α,diamine oxidase,endotoxin and D-lactate than those of the control group (P ＜ 0.05).Conclusion:For septic shock patients combined with AGI Ⅲ,low dose EN can improve the intestinal barrier function and systemic inflammatory responses.
ABSTRACT
From the aspect of social and demographic factors, disease-related factors, social support, coping style and other factors outlined in diabetic patients with diabetes distress, and diabetes theoretical development and current situation of diabetes distress interventions were reviewed, in order to implement targeted interventions for diabetes patients.
ABSTRACT
Purpose To observe the autophagy activation of renal tubular epithelial cells during rat renal ischemia-reperfusion ( I/R) injury, and then explore the possible mechanisms of the protective role of autophagy. Methods Forty male Wistar rats were randomly divided into the following four groups: (1) sham operation group (Sham), (2) I/R, (3) chloroquine intervention group (I/R+CQ), (4) rapamycin intervention group (I/R +Rap). The specimens of blood and kidney were collected after reperfusion of 24 hours. The serum creatinine ( Scre) and blood urea nitrogen ( BUN) levels were measured from blood samples. Tissue samples of the kidney were stained with HE to observe the pathological changes. Apoptotic cells in the kidney sections were detected using the termi-nal deoxynucleotidyl transferase dUTP nick end labeling ( TUNEL) assay. Immunohistochemistry was used to detect the expression of Beclin-1 and Caspase-3. The structures of autophagic vacuoles were revealed by transmission electron microscopy. Results Compared to I/R group, the I/R+CQ group presented higher levels of BUN and Scre (P<0. 05, P<0. 01), higher renal tissue injury scores (P<0. 01), increased TUNEL-positive cells (P<0. 05), down-regulation of Beclin-1 (P<0. 01) and up-regulation of Caspase-3 (P<0. 01), as well as reduced number of autophagic vacuoles (P<0. 05). On the contrary, I/R+Rap group exhibited lower levels of BUN and Scre (P<0. 01), decreased renal tissue injury scores (P<0. 05), increased TUNEL-positive cells (P<0. 05), up-regula-tion of Beclin-1 (P<0. 01) and down-regulation of Caspase-3 (P<0. 01), as well as increased autophagic vacuoles (P<0. 05). Conclusion Activated autophagy provided a protective role in the kidney I/R injury through inhibiting apoptosis, and the mechanisms may be involved in the regulation of Beclin-1 and Caspase-3.
ABSTRACT
Objective To investigate the application of combined detection of three serum markers,anti-cyclic citrullinated peptide antibody (anti-CCP),rheumatoid factor (RF),anti-keratin antibodies (AKA),for the diagnosis of rheumatoid arthritis.Methods This was a prospective study.Serum samples were randomly obtained from 137 RA patients,265 other autoinmmune diease patients,and 111 normal controls.All of the volunteers were outpatients or inpatients of Peking University Third Hospital from January 2011 to September 2013.Levels of AKA,anti-CCP antibody,RF were measured by indirect immunofluorescence,chemiluminescence,and immune turbidimetry,respectively.The values of 3 serum biomarkers and their varied combinations for RA diagnosis were systemically assessed.The results were compared using fourfold table chi-square (x2) test.Results When using one serum marker,anti-CCP had the highest accuracy (80.39％),Youden's index (YI) (0.51),and Kappa (κ) value (0.55) for the diagnosis of RA.While using three serum markers,anti-CCP + (AKA/RF),AKA /(anti-CCP + RF),anti-CCP/(AKA + RF) and (AKA + RF)/(anti-CCP + RF)/(AKA + anti-CCP) had the highest accuracy (80.94,80.94,80.66),YI (0.51,0.51,0.50),and κ value (0.55,0.56,0.54).Conclusion AntiCCP is the vital marker for RA diagnosis.Anti-CCP + (AKA/RF),AKA/(anti-CCP + RF),and (AKA +RF)/(anti-CCP + RF)/(AKA + anti-CCP) are the most ideal combinations for RA diagnosis.