Clinical Laboratory[JOURNAL]
Sun
200 papers
The Impact of Human ABO Blood Groups on Thrombin Generation in Platelet-Poor Plasma.
Sucker C, Siegel J, Gutensohn K
Clin Lab · 2026 Jun · PMID 42295299 · Publisher ↗
BACKGROUND: ABO blood group has been shown to influence plasma levels of von Willebrand factor (vWF) and factor VIII, contributing to individual variation in bleeding and thrombotic risk. Group O individuals typically pr...
BACKGROUND: ABO blood group has been shown to influence plasma levels of von Willebrand factor (vWF) and factor VIII, contributing to individual variation in bleeding and thrombotic risk. Group O individuals typically present with lower vWF and factor VIII levels, associated with a higher bleeding tendency, whereas non-O groups tend to have elevated levels and an increased risk of thrombosis. However, it remains unclear whether ABO blood group also affects thrombin generation, a central parameter of coagulation potential. METHODS: We performed a retrospective analysis of 1,423 patients who underwent routine thrombin generation testing using a calibrated automated thrombogram (CAT) in platelet-poor plasma. Thrombin generation parameters, including lag time, peak thrombin, and endogenous thrombin potential (ETP), were compared across ABO blood groups (O, A, B, AB). Statistical differences between groups were assessed using ANOVA and post hoc com-parisons, with a focus on potential clinical relevance. RESULTS: Statistically significant differences were observed in lag time and ETP between ABO blood groups. Group O individuals showed a slightly prolonged lag time and reduced total thrombin compared to non-O groups. However, the absolute magnitude of these differences was small, with median variations well within assay variability. Peak thrombin did not differ meaningfully between groups. CONCLUSIONS: Although minor statistical differences in thrombin generation parameters were observed among ABO blood groups, their magnitude is unlikely to translate into clinically relevant effects. These findings suggest that the influence of ABO blood group on bleeding or thrombotic risk is not primarily mediated via changes in thrombin generation, but rather through vWF-related mechanisms such as platelet adhesion or clearance.
Knowledge, Attitude, and Blood Donation Practices Among Medical Students in the Western Region of Saudi Arabia.
Zaini RG, Zaini R, Zaini MM … +1 more , Zaini MM
Clin Lab · 2026 Jun · PMID 42295298 · Publisher ↗
BACKGROUND: Blood donation is a critical public health practice, yet many eligible individuals do not participate, even among healthcare students who are expected to lead by example. Understanding the knowledge, attitude...
BACKGROUND: Blood donation is a critical public health practice, yet many eligible individuals do not participate, even among healthcare students who are expected to lead by example. Understanding the knowledge, attitudes, and practices of medical students regarding blood donation is essential to improving future donation rates and addressing misconceptions. METHODS: A cross-sectional survey was conducted among 243 undergraduate medical students from various institutions in the western region of Saudi Arabia. Participants completed a structured questionnaire assessing their knowledge of blood donation eligibility, transfusion risks, benefits, attitudes toward donation, and past donation behavior. Statistical analysis was performed to identify associations between demographic variables and blood do-nation knowledge and practices. RESULTS: The majority of participants were female (83%) and Saudi nationals (86%), with most aged between 23 - 25 years. Knowledge about blood donation eligibility was moderate: 75.6% correctly identified the minimum age for donation, while only 29.6% were aware of the recommended donation interval. Most recognized transfusion-transmissible infections such as HIV (98.7%) and hepatitis B (95.1%). A high proportion (91.3%) correctly identified saving lives as the main benefit of donation, though misconceptions like boosting immunity were noted. Attitudes were overwhelmingly positive; 85.2% viewed donation as a moral responsibility and 85% were willing to donate voluntarily. However, only 26.8% had previously donated blood. Male students were significantly more likely to have donated than female students (44% vs. 20%; p < 0.01). Common barriers included health concerns, fear of needles, and personal reasons. CONCLUSIONS: Despite strong awareness and positive attitudes, actual blood donation rates among medical students remain low. Gender differences and personal barriers significantly impact donation behavior. These findings underscore the need for targeted educational efforts, awareness campaigns, and institutional support to translate positive intentions into practice and improve donation rates among future healthcare providers.
Infantile Clostridium Difficile Infection Presenting with Severe Metabolic Acidosis: a Case Initially Diagnosed as Norovirus.
Chen Y, Wu S, Chen X
Clin Lab · 2026 Jun · PMID 42295297 · Publisher ↗
BACKGROUND: Clostridium difficile infection (CDI) is characterized by diarrheal illness with serious complications. Previous literature has not reported concurrent infections of Norovirus and Clostridium difficile (C. di...
BACKGROUND: Clostridium difficile infection (CDI) is characterized by diarrheal illness with serious complications. Previous literature has not reported concurrent infections of Norovirus and Clostridium difficile (C. difficile) leading to severe acidosis. METHODS: Here, we report a case of C. difficile in a 55-day-old Chinese infant with severe acidosis. RESULTS: We present a unique case of a patient with an initial Norovirus-positive test who received appropriate treatment but showed a poor response. Five days later, the patient tested positive for C. difficile toxins A and B. Treatment with oral vancomycin resulted in an excellent response. The patient improved clinically and remained afebrile, with cessation of diarrhea and correction of acidosis. CONCLUSIONS: This article reports a rare case of C. difficile infection in an infant presenting with persistent diarrhea and severe metabolic acidosis, which was initially diagnosed as Norovirus, despite the absence of obvious immune deficiency. This case emphasizes the importance of considering C. difficile infection in the differential diagnosis of unexplained diarrhea when routine tests are inconclusive.
Function and Mechanism of TRPV4 in Promoting Vascular Calcification by Regulating RUNX2 through IL-6.
Yang WJ, Ma Z, Pei JS … +1 more , Jia S
Clin Lab · 2026 Jun · PMID 42295296 · Publisher ↗
BACKGROUND: Calcification is an active process where hydroxyapatite crystals deposit in arterial walls or aortic valves, leading to valvular calcification. This study aimed to identify useful molecular markers for vascul...
BACKGROUND: Calcification is an active process where hydroxyapatite crystals deposit in arterial walls or aortic valves, leading to valvular calcification. This study aimed to identify useful molecular markers for vascular calcification and decode the fundamental mechanisms underlying their biological function. METHODS: Two published vascular calcification datasets (GSE136593 and GSE159832) from the Gene Expression Omnibus database were downloaded and the data were analyzed using Partek Flow and Qiagen IPA software. We explored the functional expression and pathways of TRPV4 in vascular calcification. A7R5 cells were treated with TRPV4 agonist GSK1016790A (10 nM) and selective TRPV4 antagonist HC067047 (10 µM) for 3 weeks in Dulbecco's modified eagle medium and calcification medium (induced by β-glycerophosphoric acid). RESULTS: The transcriptomes of calcified and non-calcified blood vessels were found to be significantly distinct. Calcified blood vessels consistently increased TRPV4 expression and regulated the expression of inflammatory factors. TRPV4 was upregulated and strongly correlated with calcification both in human carotid plaque and in mouse carotid artery calcified plaque. TRPV4 promotes osteogenic differentiation and vascular smooth muscle cell calcification induced by β-glycerophosphorus. Western blot and RT-qPCR experiments revealed that TRPV4 promoted smooth muscle cell calcification and osteogenic differentiation by regulating RUNX2 by upregulating IL-6. CONCLUSIONS: TRPV4 regulates vascular calcification by activating IL-6 and suggest potential avenues for the development of interventions to prevent or treat vascular calcification.
Analysis and Diagnostic Significance of Cerebrospinal Fluid Laboratory Parameters in Patients with Post-Craniotomy Meningitis.
Xu Y, Yu H, Chen J … +5 more , Tong Y, Chen Y, Wang Y, Liang Y, Wu S
Clin Lab · 2026 Jun · PMID 42295295 · Publisher ↗
BACKGROUND: Post-craniotomy meningitis (PCM) is a common and serious infectious complication in neurosurgical practice, often associated with considerable morbidity and healthcare burden. Due to the lack of specificity i...
BACKGROUND: Post-craniotomy meningitis (PCM) is a common and serious infectious complication in neurosurgical practice, often associated with considerable morbidity and healthcare burden. Due to the lack of specificity in its clinical manifestations, early diagnosis remains a significant challenge. Although cerebrospinal fluid (CSF) culture is currently regarded as the diagnostic gold standard, its effectiveness is limited by stringent pathogen growth requirements and a relatively low positivity rate, rendering it insufficient to meet clinical needs. Therefore, this study aimed to evaluate the diagnostic value of routine and biochemical CSF parameters in the early identification of PCM. METHODS: A retrospective analysis was conducted on clinical data and CSF test results of 588 PCM patients admitted to our hospital from January 2019 through December 2023. Based on CSF culture results, patients were divided into a culture-positive group (n = 49) and a culture-negative group (n = 539). The distribution of major pathogens was analyzed, and differences in general clinical characteristics as well as routine and biochemical CSF parameters between the two groups were compared. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of relevant parameters for predicting CSF culture positivity. RESULTS: Significant differences were observed between the two groups in terms of gender, history of tumor or traumatic brain injury, ICU admission rate, CSF leakage, and external ventricular drainage (p < 0.05), suggesting that these factors may be associated with CSF culture positivity. The most frequently isolated pathogens in the positive group were Acinetobacter baumannii, Staphylococcus aureus, and Staphylococcus hominis. Regarding lab-oratory findings, the culture-positive group showed significantly higher polymorphonuclear cell counts, mononuclear cell counts, total white blood cell counts, and CSF total protein levels compared to the negative group (p < 0.05). ROC analysis revealed good diagnostic performance of these parameters, with AUC values of 0.9398, 0.8516, 0.8687, and 0.7048, respectively. The combined detection of these indicators further improved diagnostic accuracy, with an AUC of 0.9821, significantly outperforming individual parameters. CONCLUSIONS: Routine and biochemical CSF parameters hold significant clinical value for the early identification of PCM. In particular, elevated polymorphonuclear and mononuclear cell counts, total white blood cell counts, and CSF total protein levels are potentially sensitive markers for early screening.
Acute Mountain Sickness Symptoms Among International Students at King Khalid University: a Cross-Sectional Study.
Alkhaldy HY, Alqahtani MM, Alqahtani RS … +8 more , Alsultan YG, Humayd MFA, Asiri RA, Alqahtani RK, Hunaif GMA, Mansour AA, Alghamdi BA, Alshehri MA
Clin Lab · 2026 Jun · PMID 42295294 · Publisher ↗
BACKGROUND: Acute mountain sickness (AMS) can significantly affect new visitors to high altitudes, especially those who ascend rapidly via air travel. This study aimed to investigate Acute Mountain Sickness symptoms amon...
BACKGROUND: Acute mountain sickness (AMS) can significantly affect new visitors to high altitudes, especially those who ascend rapidly via air travel. This study aimed to investigate Acute Mountain Sickness symptoms among international students at King Khalid University (KKU) in Abha, Saudi Arabia, situated at 2,250 meters above sea level. METHODS: A questionnaire based on the Lake Louise Scoring System for AMS was distributed to international students at KKU's housing campus. The survey explored the symptoms of acute mountain sickness (headache, diz-ziness/lightheadedness, fatigue and or weakness, and poor appetite and nausea), severity, duration, and management provided. Demographics and body mass index were also collected. A total of 203 respondents participated in the survey, with 99.4% being male and 72% aged 20 - 29 years. RESULTS: In total, 173 (62.6%) participants reported at least one AMS symptom within the first 24 hours of arrival. Fatigue/weakness 55 (27.1%), headache 39 (19.2%), loss of appetite 22 (10.8%), and dizziness 16 (7.9%) were the most prevalent symptoms. Regarding symptom severity, 23 (17.8%) reported severe symptoms while 57 (44.2%) reported moderate symptoms. Adaptation to the high-altitude environment varied among participants, with 58 (42.3%) adapting within days and 46 (33.6%) taking weeks. Notably, 26 (19.40%) respondents were still experiencing symptoms at the time of the survey. The most common actions taken to alleviate symptoms were over-the-counter medicine in 49 (24.1.1%), followed by rest in 34 (16.7.2%) and 28 (13.8%) sought medical help. Age, nationality, or prior awareness about AMS did not correlate with AMS symptoms. Those who visited the region for the first time, had chronic symptoms or diseases or had a lower body mass index were more likely to experience AMS symptoms. CONCLUSIONS: These findings showed a high prevalence of AMS symptoms among international students in Abha, Saudi Arabia, possibly because they arrived by flight. Being both a tourism destination and an academic center, a high-altitude specialized clinic and service is recommended. Further research is warranted to explore the longterm effects of high altitude on international student health and academic performance. In addition, effective strategies for mitigating altitude-related symptoms in this population should be developed.
A Machine Learning Framework for Predicting Nosocomial Escherichia coli Infections in Cervical Cancer.
Shan W, Shan Q, Xu X … +3 more , Chen J, Peng W, Li M
Clin Lab · 2026 Jun · PMID 42295293 · Publisher ↗
BACKGROUND: This study aimed to characterize the etiological profile of nosocomial infections in cervical cancer patients and to develop a machine learning-based prediction model for infections caused by the predominant...
BACKGROUND: This study aimed to characterize the etiological profile of nosocomial infections in cervical cancer patients and to develop a machine learning-based prediction model for infections caused by the predominant pathogen, Escherichia coli, to support clinical decision-making in anti-infective therapy and risk stratification. METHODS: We conducted a retrospective analysis of clinical data from 118 cervical cancer patients to evaluate the distribution and antimicrobial resistance patterns of infectious pathogens. Predictive factors for Escherichia coli infection were identified, and a corresponding prediction model was developed. All the statistical analyses were carried out via R software (version 4.3.2) and iResearch (version 2.9.2). RESULTS: A total of 151 pathogenic isolates were obtained, with the highest prevalence detected in mid-stream urine samples (69.54%, 105/151). Gram-negative bacteria constituted 76.82% (116/151) of the isolates, among which Escherichia coli was the most frequently identified species (50.33%, 76/151). Antimicrobial susceptibility testing revealed resistance rates exceeding 55% to ceftriaxone, ciprofloxacin, trimethoprim-sulfamethoxazole, and levofloxacin among Escherichia coli isolates, whereas high susceptibility was retained to carbapenems, piperacillin-tazobactam, and amikacin. Logistic regression analysis revealed that Escherichia coli infection was positively associated with earlier clinical stage, absence of anemia, and mid-stream urine sample type. Within the urinary infection subgroup, positive urinary nitrite was also correlated with increased infection risk. Feature selection utilizing multiple approaches informed the construction of the prediction model. Logistic regression and svm_cross_validation exhibited stable performance in the full sample analysis. Restricting the analysis to mid-stream urine samples substantially improved model performance. The svm-based model yielded AUC values of 0.81 and 0.89 in the training and test sets, respectively, and the logistic model achieved AUCs of 0.87 and 0.90, respectively. CONCLUSIONS: Nosocomial infections in cervical cancer patients are caused primarily by gram-negative bacilli within the urinary tract, with Escherichia coli representing the most prevalent pathogen. The machine learning model, which incorporates readily available clinical parameters such as disease stage, anemia status, and urinalysis results, demonstrated robust discriminatory performance in predicting Escherichia coli infection in mid-stream urine samples. This tool offers a practical approach for risk identification and guides a more targeted empiric therapy, holding promise for improving treatment outcomes in patients with cervical cancer.
Modified Double Filtration Plasmapheresis Exchange for Managing Sepsis-Induced Shock.
Zhang L, Wang G, Chen YR … +3 more , Zhao XY, Jiang J, Weng YB
Clin Lab · 2026 Jun · PMID 42295292 · Publisher ↗
BACKGROUND: This research primarily concentrated on investigating the impact of plasma exchange, especially the modified double filtration plasmapheresis (M-DFPP), in cases of septic shock (SS). Different from traditiona...
BACKGROUND: This research primarily concentrated on investigating the impact of plasma exchange, especially the modified double filtration plasmapheresis (M-DFPP), in cases of septic shock (SS). Different from traditional plasma exchange which simply removes some macromolecular pathogenic solutes and protein-binding solutes, M-DFPP, based on DFPP, switches the return and discard ports to remove inflammatory mediators more accurately with less plasma used. METHODS: A 67-year-old male patient suffered a right femoral neck fracture in a road accident and underwent right hemiarthroplasty. Twelve days post-surgery, he developed persistent lower abdominal pain and fever. Emergency surgical exploration revealed a retroperitoneal abscess caused by sigmoid colon perforation. Subsequently, the patient was admitted to the ICU for SS treatment. The treatment plan included fluid resuscitation, vasoactive medications, antibiotics, ventilator support, and M-DFPP. Each M-DFPP session exchanged 400 mL of plasma, which accounted for approximately 15% of the patient's total plasma volume. The patient underwent two M-DFPP sessions on the first and second days of admission, with a cumulative treatment time of 4 hours. The long treatment time was due to the need to ensure the stability of the patient's condition during the procedure. Slow-flow operation was adopted to minimize the risk of adverse reactions, such as hypotensive episodes or electrolyte imbalances. RESULTS: After two rounds of plasma exchange, there was a significant decline in plasma inflammatory factors related to SS, such as a decrease in TNF-α from 76.5 to 25.4 pg/mL, IL-6 from 1,000 to 178 pg/mL, and IL-8 from 7,500 to 512 pg/mL. The patient's hemodynamic condition improved remarkably, with heart rate decreasing from 128 to 95 beats per minute, blood pressure rising from 80/40 to 127/64 mmHg, and urine output increasing from 20 to 125 mL/hour. The dosage of vasoactive medications was gradually reduced until they were no longer required. However, due to ineffective management of the retroperitoneal infection, the patient's sepsis deteriorated on the 38th day of ICU admission, and the patient passed away on the 41st day. CONCLUSIONS: Compared with traditional continuous renal replacement therapies, M-DFPP is more efficient in eliminating inflammatory substances, simplifying the management of SS. It is a safe, user-friendly, and easily implementable method. Early application of M-DFPP can potentially reduce the damage of the body's inflammatory response to organs and lower the risk of organ failure. Future research is expected to further explore its effective-ness and optimal application strategies.
A Nomogram Prediction Model Integrating TEG and Clinical Features for Postoperative Lower Extremity DVT in TF Patients.
Liu Z, Long H
Clin Lab · 2026 Jun · PMID 42295291 · Publisher ↗
BACKGROUND: The goal was to identify risk factors for postoperative lower extremity deep vein thrombosis (DVT) in traumatic lower limb fracture patients and establish a nomogram prediction model for clinical risk assessm...
BACKGROUND: The goal was to identify risk factors for postoperative lower extremity deep vein thrombosis (DVT) in traumatic lower limb fracture patients and establish a nomogram prediction model for clinical risk assessment and management. METHODS: A total of 136 lower extremity traumatic fracture (LETF) patients admitted to the emergency surgery department were enrolled. Patients were divided into DVT and non-DVT groups based on postoperative color Doppler ultrasonography. Univariate and multivariable logistic regression analyses were performed to determine independent risk factors for DVT. A nomogram prediction model was constructed and validated using receiver operating characteristic curve analysis, calibration curve, and decision curve analysis (DCA). RESULTS: Among 136 patients, 52 developed DVT, while 84 did not. No significant differences were observed in age, gender, BMI, hypertension, coronary artery disease, time from injury to surgery, operative duration, or American Society of Anesthesiologists score (all p > 0.05). However, diabetes prevalence, intraoperative transfusion rate, hip versus tibiofibular fracture distribution, injury severity score (ISS) score ≥ 25, hemoglobin, hematocrit, fibrinogen (FIB), and D-Dimer (D-D) levels differed significantly (all p < 0.05). Thromboelastography (TEG) revealed significantly higher maximum amplitude (MA) and α-angle, but lower clot formation time (K) value in the DVT group (all p < 0.001). Multivariable analysis identified hip fracture, ISS ≥ 25, elevated FIB, elevated D-D, increased MA, and decreased K as independent risk factors (all p < 0.05). The nomogram demonstrated excellent predictive performance (area under the curve = 0.89, 95% confidence interval: 0.77 - 1.00), good calibration (Hosmer-Lemeshow test p > 0.05), and clinical utility on DCA. CONCLUSIONS: The TEG-based nomogram incorporating clinical features effectively predicts postoperative DVT risk in traumatic fracture patients, facilitating early identification of high-risk individuals and personalized pro-phylaxis to mitigate DVT incidence and improve outcomes.
Clinical and Laboratory Indicators Associated with Cirrhosis Severity.
Chen J, Lei JB, Li JX … +3 more , Chen GY, Song YH, Feng JA
Clin Lab · 2026 Jun · PMID 42295290 · Publisher ↗
BACKGROUND: This study aimed to evaluate clinical and laboratory indicators associated with varying cirrhosis severity, with the objective of supporting more accurate clinical assessment and stratification. METHODS: A re...
BACKGROUND: This study aimed to evaluate clinical and laboratory indicators associated with varying cirrhosis severity, with the objective of supporting more accurate clinical assessment and stratification. METHODS: A retrospective analysis was conducted on 180 patients diagnosed with cirrhosis and treated at the People's Hospital of Zhengzhou between January 1, 2020, and February 1, 2023. Patients were stratified into three groups based on the Child-Pugh classification: grade A (n = 73), grade B (n = 68), and grade C (n = 39). Statistical analyses were performed to identify associations between clinical and laboratory variables and cirrhosis severity. RESULTS: No statistically significant differences were observed among the three groups with respect to gender, age, diarrhea, abdominal distension, or abdominal pain (p > 0.05). Fever and spontaneous bacterial peritonitis were more frequently observed in patients with advanced disease (p < 0.05). The presence of hepatitis B, hepatitis C, cholestasis, malnutrition, circulatory disorders, and other etiologies showed no significant association with cirrhosis severity (p > 0.05). Similarly, portal vein diameter, upper gastrointestinal hemorrhage, alcohol use history, smoking status, and esophagogastric varices did not differ significantly among groups (p > 0.05). Laboratory parameters significantly associated with cirrhosis severity included serum calcium (Ca²⁺), white blood cell count (WBC), platelet count (PLT), C-reactive protein (CRP), hemoglobin (Hb), fibrinogen (FIB), total bile acids (TBA), apolipoprotein A1 (APOA1), direct bilirubin (DBIL), cholinesterase (CHE), cystatin C (CYSC), and bicarbonate (HCO3-) (p < 0.05). TBA and DBIL levels were positively correlated with disease severity, while FIB, APOA1, CHE, and HCO3- levels were negatively correlated. CONCLUSIONS: Fever, spontaneous bacterial peritonitis, and several laboratory markers, namely CRP, PLT, FIB, TBA, Ca²⁺, APOA1, CHE, CYSC, and HCO3-, may serve as relevant indicators for assessing cirrhosis severity. Recognition of these indicators may support improved clinical stratification and guide management decisions.
Prevalence and Seasonal Variation in Serum 25-Hydroxyvitamin D Concentrations Among Women of Reproductive Age.
Guo HX, Zhang ZH, Ren HW … +1 more , Wang HY
Clin Lab · 2026 Jun · PMID 42295289 · Publisher ↗
BACKGROUND: This study aimed to investigate serum 25-hydroxyvitamin D [25(OH)D] concentrations among women of reproductive age, stratified by age and season, in order to provide information for vitamin D-related health s...
BACKGROUND: This study aimed to investigate serum 25-hydroxyvitamin D [25(OH)D] concentrations among women of reproductive age, stratified by age and season, in order to provide information for vitamin D-related health strategies for this population. METHODS: A retrospective analysis was conducted on serum 25(OH)D concentrations in women of reproductive age who underwent preconception health examinations at the Physical Examination Department of Haidian District Maternal and Child Health Care Hospital between December 2022 and December 2024. Participants were stratified by age into two groups: advanced maternal age (≥ 35 years) and typical maternal age (< 35 years). Seasonal categorization included spring, summer, autumn, and winter. Intergroup comparisons were performed, and vitamin D nutritional status was classified based on established thresholds. RESULTS: A total of 2,325 women were included in the study. The mean serum 25(OH)D concentration was 34.45 ± 11.07 nmol/L. Vitamin D deficiency was observed in 92.47% of participants, insufficiency in 6.24%, and sufficiency in only 1.29%. Participants in the advanced maternal age group demonstrated significantly higher serum 25(OH)D concentrations compared to those in the normal maternal age group (p < 0.05). Seasonal variation in serum 25(OH)D concentrations was observed, with the highest levels recorded during summer and the lowest in spring. Concentrations in summer and autumn were significantly higher than those in winter and spring (p < 0.05); however, no significant differences were found between summer and autumn or between winter and spring (p > 0.05). CONCLUSIONS: A high prevalence of vitamin D deficiency was observed among women of reproductive age in Haidian District, Beijing, with significant variations by age and season. Routine assessment of serum 25(OH)D concentrations is recommended for women planning pregnancy to facilitate timely and appropriate vitamin D supplementation strategies.
Mendelian Randomization and Transcriptomic Analysis Identify HE4 as a Potential Biomarker for Chronic Obstructive Pulmonary Disease.
Li MX, Zeng ZF, Cao ZW
Clin Lab · 2026 Jun · PMID 42295288 · Publisher ↗
BACKGROUND: Human epididymis protein 4 (HE4), a member of the WFDC protein family, has been shown to exhibit abnormal expression in patients with chronic obstructive pulmonary disease (COPD). However, the causal relation...
BACKGROUND: Human epididymis protein 4 (HE4), a member of the WFDC protein family, has been shown to exhibit abnormal expression in patients with chronic obstructive pulmonary disease (COPD). However, the causal relationship between HE4 and COPD, as well as the involvement of other members of the WFDC family in COPD pathogenesis, remains unclear. This study aims to investigate the potential of WFDC proteins, particularly HE4, as biological markers for COPD through mendelian randomization (MR) and transcriptomic analysis. METHODS: A comprehensive search of the IEU OpenGWAS database was conducted, and single nucleotide polymorphisms (SNPs) associated with WFDC family members, including HE4 (WFDC2), WFDC3, WFDC5, WFDC10A, WFDC12, and WFDC13, were selected as instrumental variables for MR analysis. Two-sample MR was performed to examine the direct effects of WFDC proteins on COPD. Additionally, transcriptomic data related to COPD were obtained from the GEO database and analyzed using bioinformatics tools. Furthermore, the plasma level of HE4 was quantified using enzyme-linked immunosorbent assay (ELISA). RESULTS: MR analysis revealed a significant positive association between elevated HE4 expression and increased COPD risk (OR = 1.10, 95% CI = 1.02 - 1.18, p = 0.01). However, no causal relationship was found between the expression of other WFDC family members and COPD (all p > 0.05). Transcriptomic analysis showed that HE4 was overexpressed in the lung tissues of COPD patients compared to normal controls. In contrast, two other WFDC family members, WFDC3 and WFDC12, exhibited significantly lower expression in COPD lung tissue (both p < 0.05). ROC curve analysis indicated that HE4 (WFDC2) demonstrated a diagnostic potential for COPD with an area under the curve (AUC) of 0.78, while WFDC3 and WFDC12 showed lower AUCs of 0.50 and 0.57, respectively. ELISA detection demonstrated that the plasma level of secretory HE4 in COPD patients was significantly higher than that in healthy controls (p < 0.05). CONCLUSIONS: Clinical data and transcriptomic analysis each confirmed that HE4 is highly expressed in plasma, and HE4 is highly expressed in lung tissue. Increased expression of HE4 (WFDC2) is associated with an elevated risk of COPD, and its high expression in lung tissue holds promise as a diagnostic biomarker for COPD. This study provides valuable insights into the role of WFDC proteins in COPD and highlights the potential of HE4 as a biomarker for early diagnosis and risk stratification.
Development and Validation of a Cuproptosis-Related Gene Signature for Prognostic Stratification in Papillary Renal Cell Carcinoma.
Li H, Cao L, Li R … +5 more , Xu L, Zhang S, Gao J, Chen Y, Lian X
Clin Lab · 2026 May · PMID 42159135 · Publisher ↗
BACKGROUND: Cuproptosis is defined as a novel form of regulated cell death triggered by copper accumulation, with emerging evidence linking cuproptosis-related genes (CRGs) to tumor progression. However, the prognostic r...
BACKGROUND: Cuproptosis is defined as a novel form of regulated cell death triggered by copper accumulation, with emerging evidence linking cuproptosis-related genes (CRGs) to tumor progression. However, the prognostic relevance of CRGs in papillary renal cell carcinoma (PRCC) remains elusive. This study aimed to construct and validate a cuproptosis-related gene prognostic signature for PRCC, and to explore its potential value in risk stratification, immune infiltration, and pathogenesis. METHODS: Transcriptomic profiles and clinical data were sourced from the Cancer Genome Atlas Program. Univariate Cox regression assessed the prognostic potential of 17 CRGs, while Lasso-penalized Cox regression identified risk genes for signature construction. Kaplan-Meier curves illustrated survival probabilities, and receiver operating characteristic curves were drawn to evaluate signature predictive performance. External validation was performed using data from the Gene Expression Omnibus. Biological functions were explored through Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses, with validation via gene set variation analysis (GSVA). Immune cell infiltration was assessed using QuanTIseq algorithm. RESULTS: The PRCC cohort from The Cancer Genome Atlas Program (TCGA) was randomly split into training (n = 183) and validation (n = 75) sets, with GSE2748 (n = 29) from GEO for external validation. Univariate Cox analysis identified 7 CRGs as prognostic factors in PRCC. A risk signature comprising 5 CRGs (DLST, PDHB, SLC25A3, ATP7A, and GLS) was developed using Lasso-penalized Cox regression. Kaplan-Meier curves indicated lower survival probabilities in patients with higher risk scores. ROC analysis demonstrated the cuproptosis risk signature's strong performance for overall survival at 1, 3, and 5 years. GO and KEGG analyses revealed that metabolic processes were the predominant pathways enriched in DEGs between high- and low-risk groups, a finding further validated by GSVA. Immune infiltration analysis highlighted macrophages and neutrophils as the dominant immune cells, with significantly higher Tregs observed in the tumor microenvironment of high-risk patients (p < 0.05). CONCLUSIONS: This study presents a novel five-gene prognostic signature for PRCC based on 17 CRGs, offering promising performance in risk stratification and providing insights into PRCC pathogenesis, particularly in cellular metabolism.
Rare Anti-f(ce) Detected During Cross-Matching.
Lee J, Lee H, Jekarl DW … +1 more , Han J
Clin Lab · 2026 May · PMID 42159134 · Publisher ↗
BACKGROUND: The f(ce) antigen is a compound Rh antigen expressed with both c- and e-antigens coded in same haplotype. Detection of anti-f(ce) has rarely been reported due to both its rarity and difficulty to analyze. Her...
BACKGROUND: The f(ce) antigen is a compound Rh antigen expressed with both c- and e-antigens coded in same haplotype. Detection of anti-f(ce) has rarely been reported due to both its rarity and difficulty to analyze. Here, we report anti-f(ce) detected during cross-matching, which was confirmed by two further tests. METHODS: A 66-year-old male who had never received a transfusion, was diagnosed with an abscess of the hip joint bursa in a previous institution. During therapy about 50 - 60 days ago, he received a total of 4 units of packed red blood cells (pRBC). Soon, he was transferred to our institution for an operation, and a post-operation pRBC transfusion was ordered. An initial antibody screening test (AST) using 2 cell-lines showed all negative results, but a subsequent cross-matching test showed incompatibility to 2 of 7 donor RBCs. Thus, an additional AST using 3 cell-lines and a further identification test revealed anti-f(ce) without any coexistent antibody. To reconfirm this antibody, "Rh CcEe subgroup profiling of incompatible donor RBCs" and "Re-AST using the patient's plasma after adsorption to incompatible pRBC" were planned. RESULTS: First, among all 18 cross-matched units of pRBCs, 16 units were compatible with the patient's serum, but 2 units were not. These incompatible units showed CcDe and cDEe phenotypes, respectively, suggesting that they might contain c- and e-antigen genes in cis. Second, Re-AST using the remnant plasma after adsorption to 1 (CcDe) of the above 2 incompatible units persistently showed anti-f(ce) in "3+". However, a modified test adding 1 more adsorption step that took 7 hours at 37℃ following the above typical method showed the same result but with a decreased strength "±". CONCLUSIONS: All pRBCs showed suitable Rh phenotypes to their cross-matched results, supporting that f(ce) antigen exists only when c- and e-antigens are coded in same haplotype. Adsorption of anti-f(ce), which consists of mainly IgG, seems to require a longer incubation time compared to the typical method. Further studies for the affinity and avidity of anti-f(ce) and optimal conditions to maximize these features are needed.
Diagnostic and Prognostic Significance of Apelin Early Ligand A (APELA) in Colorectal Cancer: Insights from Multi-Omics Analysis.
Zhu Z
Clin Lab · 2026 May · PMID 42159133 · Publisher ↗
BACKGROUND: Colorectal cancer (CRC) is a major global health concern and is often diagnosed at advanced stages with poor clinical outcomes. Apelin early ligand A (APELA) has been identified as a potential contributor to...
BACKGROUND: Colorectal cancer (CRC) is a major global health concern and is often diagnosed at advanced stages with poor clinical outcomes. Apelin early ligand A (APELA) has been identified as a potential contributor to tumor progression, but its role in colon adenocarcinoma (COAD) remains unclear. METHODS: The present study integrated transcriptomic data obtained from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) to evaluate the APELA expression in COAD. Then, the expression profile, diagnostic/prognostic value, co-expression networks, and functional pathways of APELA were evaluated by in silico analysis approaches, such as R and STRING. Afterwards, the associated biological processes were explored by Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Set Enrichment Analysis (GSEA). RESULTS: Compared to normal controls, the APELA expression was significantly upregulated in CRC tissues. However, there was no significant difference between the normal mucosa and adenomas. Receiver operating characteristic (ROC) analysis indicated the potential of the APELA expression as a diagnostic marker. The high APELA expression correlated to the poor prognosis in COAD patients. The functional network analysis identified an asso-ciation of APELA to PI3K signaling regulation and revealed that its co-expressed genes were downregulated in NK CD56 bright cells. GO and KEGG enrichment highlighted the roles of APELA expression in angiogenesis and cell migration. GSEA revealed that the APELA expression was positively associated with respiratory electron transport and protein synthesis pathways but negatively associated with extracellular matrix (ECM) remodeling. CONCLUSIONS: APELA influences CRC progression through multiple pathways (ECM remodeling, metabolic adaptation, and immune modulation), suggesting its potential as a promising diagnostic and prognostic biomarker and a potential therapeutic target in CRC.
An Overview of Transfusion-Transmitted Infectious Agents among Blood Donors in Saudi Arabia.
Hamali HA
Clin Lab · 2026 May · PMID 42159132 · Publisher ↗
BACKGROUND: The safety of donated blood during transfusion is important; however, blood donation can entail risks owing to contamination of the blood with transfusion-transmitted infections (TTIs). Ensuring the safety of...
BACKGROUND: The safety of donated blood during transfusion is important; however, blood donation can entail risks owing to contamination of the blood with transfusion-transmitted infections (TTIs). Ensuring the safety of blood and blood components is a major global goal to guarantee their availability to patients. Unsafe blood not only affects the patients but also extends the risk to their partners, contributing to the spread of TTIs and posing a burden on society. This review emphasizes the trends and prevalence of TTIs among blood donors in Saudi Arabia over the years. METHODS: A systemic search of the main electronic databases were conducted for publications on TTIs among blood donors in Saudi Arabia. RESULTS: The overall prevalence of TTIs among blood donors varies from province to province with a higher incidence observed among older individuals. Despite an overall decline in TTIs among blood donors in the country, the frequency of these infections persists among donors. In addition, screening tests for occult HBV should be considered. CONCLUSIONS: The overall findings regarding TTIs in Saudi Arabia vary by province, with a higher incidence observed among older individuals. Comprehensive investigations into the overall incidence of TTIs in Saudi Arabia are warranted, with extensive studies from different regions and blood donation centers.
Mixed Phenotype Acute Leukemia with B/T Lineage and BCR-ABL1 Rearrangement: a Case Report and Literature Review.
Mamad H, Siyar H, Zirar J … +3 more , Regragui I, Benkirane S, Masrar A
Clin Lab · 2026 May · PMID 42159131 · Publisher ↗
BACKGROUND: We report a case of B/T mixed phenotype acute leukemia (MPAL) with BCR-ABL1 rearrangement in a 35-year-old male presenting with hemorrhage, infection, and hemodynamic instability. METHODS: Laboratory findings...
BACKGROUND: We report a case of B/T mixed phenotype acute leukemia (MPAL) with BCR-ABL1 rearrangement in a 35-year-old male presenting with hemorrhage, infection, and hemodynamic instability. METHODS: Laboratory findings showed bicytopenia (hemoglobin 79 g/L, platelets 17 x 10⁹/L), leukocytosis (7.7 x 10⁹/L). Peripheral blood and bone marrow smears showed 22% and 66% myeloperoxidase-negative blasts, respectively. Immunophenotyping identified coexisting T-lineage (cytoplasmic CD3+, CD2+, CD5+) and B-lineage (CD19+, CD79a+, cytoplasmic IgM+) populations. Fluorescence in situ hybridization confirmed BCR-ABL1. RESULTS: The diagnosis for our case was B/T MPAL with BCR-ABL1 rearrangement. The patient achieved com-plete remission with tyrosine kinase inhibitors per GRALL-2014 protocol and is awaiting matched sibling donor transplantation. CONCLUSIONS: This case demonstrates the diagnostic complexity and aggressive nature of BCR-ABL1-positive B/T MPAL.
PSPH and CXCL2 Predict Treatment Response in First-Episode Schizophrenia: a Retrospective Study.
Zheng J
Clin Lab · 2026 May · PMID 42159130 · Publisher ↗
BACKGROUND: The aim was to evaluate serum levels of Phosphoserine Phosphatase (PSPH) and Chemokine C-X-C Motif Ligand 2 (CXCL2) as biomarkers for predicting antipsychotic treatment response in male first-episode schizoph...
BACKGROUND: The aim was to evaluate serum levels of Phosphoserine Phosphatase (PSPH) and Chemokine C-X-C Motif Ligand 2 (CXCL2) as biomarkers for predicting antipsychotic treatment response in male first-episode schizophrenia patients. METHODS: Bioinformatics analysis identified upregulated PSPH and CXCL2 expression in PBMCs of schizophrenia patients. Clinical data from 297 male patients (treated with olanzapine from 2019 to 2024) were retrospectively analyzed. After 4 weeks, patients were categorized into improvement (n = 118) and non-improvement (n = 179) groups. Serum PSPH and CXCL2 levels were measured by ELISA. Predictive value was assessed via ROC and multivariate logistic regression. RESULTS: The non-improvement group had higher PSPH/CXCL2 levels. Both biomarkers correlated positively with PANSS scores (r = 0.249, 0.335; p < 0.001). Logistic regression confirmed PSPH/CXCL2 levels, pre-treatment PANSS, shorter disease duration, and younger age as independent predictors (p < 0.05). Combined PSPH/CXCL2 showed superior predictive performance (AUC = 0.823, p < 0.05). CONCLUSIONS: Serum levels of PSPH and CXCL2 can be considered as potential biomarkers for predicting the efficacy of antipsychotic treatment in male patients with first-episode schizophrenia.
Comparative Study of Carbapenemase Inhibitor and NG-Test CARBA5 for the Detection of Carbapenemase of Enterobacteriaceae.
Wang X, Xiao W, Qu Y … +3 more , Sun M, Chang Y, Xu Q
Clin Lab · 2026 May · PMID 42159129 · Publisher ↗
BACKGROUND: This study aimed to evaluate the application of carbapenemase inhibitor and NG-test CARBA5 in the detection of carbapenemase genotype for Enterobacteriaceae. METHODS: We collected non-repetitive CRE (carbapen...
BACKGROUND: This study aimed to evaluate the application of carbapenemase inhibitor and NG-test CARBA5 in the detection of carbapenemase genotype for Enterobacteriaceae. METHODS: We collected non-repetitive CRE (carbapenem-resistant Enterobacterales) isolated from patients at the Affiliated Cancer Hospital of Zhengzhou University in 2022. The carbapenemase type and gene type were detected by carbapenemase inhibitor test and NG-test CARBA5 assay, respectively. RESULTS: Sensitivity and specificity of the carbapenemase inhibitor test detecting five common carbapenemases were 100.00% and 98.36%, respectively. Sensitivity and specificity of NG-test CARBA5 were 95.90% and 99.18%, respectively. CONCLUSIONS: The carbapenemase inhibitor test and NG-test CARBA5 showed high sensitivity and specificity in detecting carbapenemase of Enterobacteriaceae.
The Predictive Value of Lactate Dehydrogenase (LDH) for Lymphovascular Invasion in Endometrial Cancer: a Retrospective Cohort Study.
Lin Q, Wang Q, Lin Q … +2 more , Zhou X, Xiao Y
Clin Lab · 2026 May · PMID 42159128 · Publisher ↗
BACKGROUND: This study aims to explore the predictive value of serum lactate dehydrogenase (LDH) for lymphovascular invasion in endometrial cancer. METHODS: A retrospective analysis was performed on a cohort of 147 patie...
BACKGROUND: This study aims to explore the predictive value of serum lactate dehydrogenase (LDH) for lymphovascular invasion in endometrial cancer. METHODS: A retrospective analysis was performed on a cohort of 147 patients diagnosed with endometrial cancer at Fujian Provincial Cancer Hospital between January 2018 and January 2020. The study focused on preoperative relevant test indicators, including lactate dehydrogenase (LDH) levels and the extent of postoperative lymphovascular invasion (LVI). Patients were stratified based on the degree of LVI, and intergroup differences were assessed using the chi-squared test (χ²). Stratification was conducted according to the median values of LDH, CA125, glucose (Glu), and Ki67. Survival analyses and comparisons of differences were executed using Kaplan-Meier survival curves and the log-rank test. Spearman's rank correlation coefficient was used to perform a correlation analysis between LDH and other biological indicators. Independent prognostic factors influencing patient outcomes were identified via multivariate Cox regression analysis. A prognostic nomogram was subsequently developed from the Cox regression results to estimate survival probabilities at 1, 2, and 4 years. Furthermore, the predictive efficacy of LDH was assessed through the construction of time-dependent receiver operating characteristic (ROC) curves. A p-value of less than 0.05 was deemed statistically significant. RESULTS: The levels of serum lactate dehydrogenase (LDH), cancer antigen 125 (CA125), glucose (Glu), and Ki67 were significantly elevated in the group with lymphovascular invasion (LVI+) compared to the group without lymphovascular invasion (LVI-) (p < 0.05). Elevated LDH levels were inversely associated with patient survival log-rank p < 0.05), whereas no significant associations were observed between CA125, Glu, Ki67 levels, and patient survival. Spearman's correlation analysis revealed a significant correlation between LDH and Glu levels (p < 0.05). Cox regression analysis identified LDH as an independent prognostic factor, with elevated LDH levels increasing the risk of mortality by 2.120 times (95% confidence interval: 1.351 - 3.327, p = 0.001). The prognostic nomogram demonstrated that patients with lower total scores had higher probabilities of survival at 1, 2, and 4 years. Time-dependent receiver operating characteristic (ROC) analysis indicated that the predictive efficacy of LDH was limited, with area under the curve (AUC) values of 0.654, 0.653, and 0.719 for 1, 2, and 4 years, respectively. CONCLUSIONS: Lactate dehydrogenase (LDH) can serve as a potential biomarker for assessing lymphovascular metastasis and prognostic outcomes in endometrial cancer.
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