Clinical laboratory最新文献

{"title":"Analysis of the Interference Effects of Ethamsylate on the Determination of Serum Creatinine Levels Using Two Methods.","authors":"Chun-Se Huang, Xian-Ming Liang, Yun-Hui Liao, Ping Chen, Qing-Yong Huang","doi":"10.7754/Clin.Lab.2024.241116","DOIUrl":"https://doi.org/10.7754/Clin.Lab.2024.241116","url":null,"abstract":"<p><strong>Background: </strong>Accurate quantification of serum creatinine is clinically essential for evaluating renal function. The aim of this study was to investigate the interference of ethamsylate in the detection of serum creatinine via the sarcosine oxidase method and the picric acid method.</p><p><strong>Methods: </strong>Thirty fresh serum samples with gradient concentrations of creatinine were collected from patients in our hospital. In accordance with CLSI EP7-A2, paired difference experiments and dose-response experiments were conducted to detect serum creatinine by the sarcosine oxidase method and the picric acid method, respectively. In addition, the interference of ethamsylate on the detection of serum creatinine at different concentrations was observed to compare the interference effect of ethamsylate on the detection of serum creatinine by the sarcosine oxidase method and picric acid method.</p><p><strong>Results: </strong>Paired difference tests revealed that 0.3 g/L ethamsylate significantly negatively affected the determination of creatinine at low, medium, and high creatinine concentrations via the sarcosine oxidase method, and the interference values were -53.67 μmol/L, -93.33 μmol/L, and -318.33 μmol/L, respectively. There was positive interference in the determination of low-concentration creatinine by the picric acid method; the interference value was 7.67 μmol/L, but there was no interference in the determination of medium- and high-concentration creatinine. Dose-response experiments revealed that the interference effect of ethamsylate on the determination of creatinine at low, medium, and high concentrations was a cubic regression curve. In the samples with low, medium, and high concentrations of creatinine, the lowest effective doses of ethamsylate interfering with the sarcosine oxidase method were 5.78 mg/L, 6.36 mg/L, and 9.66 mg/L, respectively. The lowest effective doses of ethamsylate that interfered with the low-, medium-, and high-creatinine samples via the picric acid method were 70.16 mg/L, 617.36 mg/L, and 859.19 mg/L, respectively. The interference pattern analysis suggests that the degree of interference diminished as creatinine concentration increased.</p><p><strong>Conclusions: </strong>Both the sarcosine oxidase method and the picric acid method are affected by ethamsylate. The picric acid method was relatively less effective and was effective mainly for creatinine samples at low concentrations.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"71 6","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Syphilis need to be Examined in Cases of Blood and Body Fluid Exposure in Hospitals?","authors":"Hideharu Hagiya","doi":"10.7754/Clin.Lab.2024.241142","DOIUrl":"https://doi.org/10.7754/Clin.Lab.2024.241142","url":null,"abstract":"<p><strong>Background: </strong>Syphilis, caused by Treponema pallidum, represents a significant sexually transmitted infection capable of systemic manifestation. Current guidelines do not recommend syphilis serological screening following blood and body fluid exposure (BBFE) in healthcare settings. This cross-sectional study examined current practices of rapid plasma reagin (RPR) and T. pallidum hemagglutination (TPHA) testing in Japanese hospitals.</p><p><strong>Methods: </strong>A web-based questionnaire distributed in November 2023 assessed institutional testing policies and post-exposure protocols.</p><p><strong>Results: </strong>Among 23 responding institutions, preoperative screening included both RPR and TPHA in nine hospitals (39%) and TPHA alone in seven (31%). For non-preoperative screening, five hospitals (22%) conducted both tests, while six (26%) performed TPHA only. No consensus existed regarding test validity duration, and only one hospital maintained post-exposure prophylaxis protocols.</p><p><strong>Conclusions: </strong>Although approximately 75% of institutions conduct routine preoperative syphilis screening, the lack of evidence supporting BBFE transmission and prophylaxis necessitates practice reconsideration.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"71 6","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Unusual Actinotigum schaalii (Formerly Named Actinobaculum schaalii) Bacteremia.","authors":"Lu-Qing Zheng, Qing-Yong Wang","doi":"10.7754/Clin.Lab.2024.241238","DOIUrl":"https://doi.org/10.7754/Clin.Lab.2024.241238","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate unusual case reports about Actinotigum schaalii (A. schaalii) bacteremia patients in the past 20 years.</p><p><strong>Methods: </strong>A retrospective review of A. schaalii bacteremia patients collected from MEDLINE between January 2005 and November 2024.</p><p><strong>Results: </strong>Of 34 cases, the identification (ID) of A. schaalii for clinical samples included blood (n = 34), urine (n = 6), valve (n = 1), and biopsy (n = 1). Polymicrobial infections were 32.4% (n = 11 out of 34) in this study. Antimicrobial susceptibility tests (ASTs) were performed in most cases. The A. schaalii isolates were sensitive to penicillin, β-lactam combination agent, lincosamide, tetracycline, nitrofuran, cephem, carbapenem, oxazolidinone, ansamycin, macrolide, and glycylcycline; but resistant to fluoroquinolone, nitroimidazole, aminoglycoside, and folate pathway antagonists.</p><p><strong>Conclusions: </strong>Microbiologists should perform the correct ID and suitable AST of the potentially invasive A. schaalii to help clinicians obtain the appropriate antimicrobial coverage for serious systemic infections.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"71 6","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance of Flow Cytometry in Medical Diagnosis.","authors":"Chao Ma, Weidong Liu","doi":"10.7754/Clin.Lab.2024.241141","DOIUrl":"10.7754/Clin.Lab.2024.241141","url":null,"abstract":"<p><strong>Background: </strong>Flow cytometry is a new technology with a wide range of application in modern medical examination. It mainly counts and sorts the tiny particles suspended in the fluid, so as to quickly analyze the results quantitatively and qualitatively. This is not only of great significance for scientific research, but also has a great impact on clinical examination.</p><p><strong>Methods: </strong>The importance of flow cytometry detection is analyzed through two typical cases, providing important diagnostic basis for clinicians.</p><p><strong>Results: </strong>Flow cytometry was used to screen out the typical characteristic images and data of the above two cases, and the data and results supported the clinician to diagnose the cause of the disease.</p><p><strong>Conclusions: </strong>Two cases proved the importance of flow cytometry in modern clinical examination. Flow cytometry can be applied in clinical examination. Its development and application provide important diagnostic reference evidence for clinical medicine and have gradually become one of the emerging technologies to promote the rapid development of medicine.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"71 6","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and Validation of a Blood Routine-Based Prediction Model for Myelodysplastic Syndrome Shunts in Anemia Patients.","authors":"Lining Wang, Xilan Wu, Ningning Du, Xiaogang Liu, Huizhong Xue, Linghong Kong","doi":"10.7754/Clin.Lab.2025.250247","DOIUrl":"https://doi.org/10.7754/Clin.Lab.2025.250247","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to construct and verify a prediction model of nomograms for blood routine examination in anemia patients and to provide shunt diagnosis and treatment of myelodysplastic syndrome (MDS) and non-MDS in anemia patients.</p><p><strong>Methods: </strong>A total of 296 were divided into a train set and a test set at a ratio of 7:3. Least absolute shrinkage and selection operator (Lasso) regression was used to screen risk factors. Multivariate logistic regression analysis was used to construct a prediction model for MDS in anemia patients. The bootstrap resampling method was used to verify the model internally. The area under the curve of the receiver operating characteristic (ROC) curve and clinical decision curve were used to evaluate the prediction ability and clinical applicability of the nomogram prediction model.</p><p><strong>Results: </strong>Among 207 anemia patients in the train set, the logistic regression analysis revealed that elevated MCV, increased RDW, and decreased PLT were all independent influencing factors of MDS. The nomogram prediction model constructed via the bootstrap method showed that the calibration curve fit well, indicating good model differentiation. The DCA curve and ROC curve showed that the net return rate of the clinical prediction model was high at any risk threshold and was verified by the validation set.</p><p><strong>Conclusions: </strong>The constructed anemia shunt MDS prediction model is simple and accurate and has certain value for early clinical screening of MDS patients with anemia and accurate formulation of subsequent diagnostic and treatment measures.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"71 6","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Reactive Carbohydrate Determinants (CCDs) Causing Interference in Allergen-Specific IgE Antibody Analysis.","authors":"Jian-Qing Zhang, Hong-Gang Sun, Hong Chen, Li-Fang Wu","doi":"10.7754/Clin.Lab.2024.241223","DOIUrl":"https://doi.org/10.7754/Clin.Lab.2024.241223","url":null,"abstract":"<p><strong>Background: </strong>The use of CCD antibody adsorbents specifically adsorb CCDs, reducing non-specific IgE interference in chemiluminescence assays, thereby making the detection results of true allergen-specific IgE more accurate.</p><p><strong>Methods: </strong>Chemiluminescence assays were used to quantitatively detect allergens (total IgE and specific IgE) in patient serum, with heterophile antibody removers to exclude the interference of heterophile antibodies, and anti-CCD IgE adsorbents to exclude the interference of CCDs.</p><p><strong>Results: </strong>The detection results after using allergen heterophile antibody removers showed no difference from the original results, while the specific IgE returned to normal after using CCD-specific IgE adsorbents, with no significant change in total IgE.</p><p><strong>Conclusions: </strong>When multiple allergen sIgE are positive simultaneously, or when the allergen detection results do not match the patient's clinical symptoms, history of allergen exposure, or skin test results, it is necessary to perform anti-CCD IgE adsorption tests to improve the accuracy of allergen diagnosis.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"71 6","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Proportion of Lymphocytes and Eosinophils in Leukocytes as Early Screening Markers for Sepsis: a Mendelian Randomization Analysis.","authors":"Liang-Min Chen, Rong-Yan Han","doi":"10.7754/Clin.Lab.2024.241120","DOIUrl":"https://doi.org/10.7754/Clin.Lab.2024.241120","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore the potential role of white blood cell components in the early screening of sepsis using Mendelian randomization. The analysis considers five cell types: lymphocytes, monocytes, neutrophils, eosinophils, and basophils.</p><p><strong>Methods: </strong>Relevant genome-wide association study (GWAS) datasets were retrieved from the IEU Open GWAS Project. Subsequently, a two-sample Mendelian randomization (MR) analysis was conducted, with the proportions of the five cell types within white blood cells as the exposure factors and the occurrence of sepsis as the outcome variable. Specifically, Cochran's Q statistic was employed to test heterogeneity, and horizontal pleiotropy of instrumental variable SNPs was examined.</p><p><strong>Results: </strong>The Mendelian randomization analysis indicated that the proportion of lymphocytes may potentially predict the occurrence of sepsis, with a weighted median algorithm yielding an OR (95% CI) of 1.1536 (1.0018 - 1.3284). The proportion of eosinophils may potentially reduce the risk of sepsis, with p-values of 0.0349 and 0.0243 from the IVW and MR-PRESSO algorithms, respectively, and OR (95% CI) values of 0.9273 (0.8645 - 0.9947) and 0.9218 (0.8594 - 0.9888).</p><p><strong>Conclusions: </strong>An increased proportion of lymphocytes and a decreased proportion of eosinophils in white blood cells may serve as potential biological markers for the early detection of sepsis.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"71 6","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Myelomonocytic Leukemia Misdiagnosed as Histiocytic Necrotizing Lymphadenitis.","authors":"Si R Xu, Zhao Chen, Zhi P Deng","doi":"10.7754/Clin.Lab.2024.241145","DOIUrl":"10.7754/Clin.Lab.2024.241145","url":null,"abstract":"<p><strong>Background: </strong>Acute Myelomonocytic Leukemia (AMML) is a rare malignant neoplasm that is classified as a subtype of Acute Myeloid Leukemia (AML). In the case described herein, the initial pathology results from a lymph node biopsy leaned towards Histiocytic Necrotizing Lymphadenitis, but ultimately, immunohistochemistry of the lymph node confirmed the diagnosis of Acute Myelomonocytic Leukemia.</p><p><strong>Methods: </strong>Cervical lymph node biopsy.</p><p><strong>Results: </strong>In this case, the initial pathological diagnosis after cervical lymph node biopsy favored histiocytic necrotizing lymphadenitis. However, immunohistochemical analysis revealed the presence of immature cell proliferation in the lightly stained areas, characterized by irregular nuclear shapes and visible mitotic figures. Further investigation showed that these immature cells were positive for CD68 and Lys, weakly positive for myeloperoxidase (MPO), and partially positive for CD4, CD8, granzyme B (GrB), and TIA1. The Ki67 proliferation index was approximately 70%, indicating a high rate of cell proliferation. Based on these immunohistochemical findings, the patient was ultimately diagnosed with Acute Myelomonocytic Leukemia (AMML).</p><p><strong>Conclusions: </strong>For patients presenting with cervical lymphadenopathy and fever, it is crucial to stabilize the condition while concurrently seeking the underlying cause. Timely completion of relevant examinations, including cervical lymph node biopsy, is essential for definitive diagnosis.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"71 6","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nocardia cyriacigeorgica Infection in a COPD Patient.","authors":"Bingyu Zhou, Huasong Gong, Shanshan Liu, Lina Jia, Zheng Li, Songzhe He","doi":"10.7754/Clin.Lab.2024.241206","DOIUrl":"10.7754/Clin.Lab.2024.241206","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary infections caused by Nocardia spp. exhibit diverse clinical manifestations. However, the clinical manifestations and imaging examinations of the disease lack specificity, leading to an increased misdiagnosis rate. Therefore, the etiological diagnosis is crucial for the confirmation of this disease. Nocardia cyriacige-orgica is an aerobic, weak acid-fast, Gram-positive opportunistic pathogen characterized by slow growth.</p><p><strong>Methods: </strong>In March 2024, a sputum specimen was sent for examination by the Department of Respiratory and Critical Care Medicine. The appearance was yellow purulent sputum, and no obvious \"sulfur particles\" were found. Gram staining of sputum revealed numerous Gram-positive bacilli with 90° branching and even tangled filamentous forms, and weak acid-fast staining was positive. Under aerobic conditions at a constant temperature of 37℃, we observed slow-growing colonies that were white, dry, and wrinkled on blood agar.</p><p><strong>Results: </strong>We used MALDI-TOF MS for identification, and by comparing the mass spectrum peaks of the isolate with the known mass spectrum peaks in the database (MS-IVD database version 3.0), the result was Nocardia cyriacigeorgica with 99.9% confidence. The patient was started on empiric antibiotic therapy with piperacillintazobactam (4.5 g, q 8 hour), along with supportive measures such as nebulized treatments, cough suppressants, bronchodilators, oxygen therapy, and gastric acid suppression. Due to the patient's acute exacerbation of chronic obstructive pulmonary disease (COPD), accompanied by multiple underlying diseases such as heart failure, chronic bronchitis, and gastrointestinal bleeding, the clinical focus was mainly on improving the main symptoms. The patient was kept under observation for Nocardia infection and did not receive targeted treatment.</p><p><strong>Conclusions: </strong>Through the review of this case and related literature, close cooperation between clinicians, laboratory departments, and imaging departments is essential in the diagnosis and treatment of this atypical pulmonary infection. Therefore, it is necessary that we analyze the laboratory diagnosis of this case to enhance the understanding of the disease and increase the actual positive rate.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"71 6","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Talaromyces Marneffei Infection Presenting with Cervical Lymphadenopathy as the Initial Manifestation.","authors":"Qianqian Shu, Zhao Chen, Youli Wen, Zhiping Deng","doi":"10.7754/Clin.Lab.2024.241228","DOIUrl":"10.7754/Clin.Lab.2024.241228","url":null,"abstract":"<p><strong>Background: </strong>Talaromyces marneffei (TM) is an opportunistic pathogenic fungus primarily prevalent in Southeast Asia. It mainly infects immunocompromised individuals and is rarely observed in those with normal immune function. Additionally, patients infected with TM exhibit non-specific clinical manifestations, which significantly increase the difficulty of diagnosis. In this case, the final diagnosis of TM infection was confirmed through pathological examination following a cervical lymph node puncture and biopsy.</p><p><strong>Methods: </strong>Lymph node biopsy.</p><p><strong>Results: </strong>Pathological findings following cervical lymph node puncture and biopsy revealed hyperplastic lymphoid follicles of varying sizes, with some follicles exhibiting coagulative necrosis. Surrounding these areas were proliferative granulomas. The histological changes were consistent with granulomatous lymphadenitis, indicative of TM infection. Consequently, antifungal therapy with voriconazole was administered.</p><p><strong>Conclusions: </strong>For patients with cervical lymphadenopathy, it is crucial to stabilize the condition while simultaneously identifying the underlying cause. Timely performance of relevant diagnostic procedures, such as cervical lymph node puncture and biopsy, is essential to establish a definitive diagnosis.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"71 6","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}