Clinical Laboratory[JOURNAL]
Sun
200 papers
Impact of Severe Cold Agglutination on Routine Red Blood Cell Parameters and Correction Strategies.
Yang Y, Wang Q, Lu M
Clin Lab · 2026 May · PMID 42159127 · Publisher ↗
BACKGROUND: In blood samples collected from patients with cold agglutinin disease (CAD), red blood cells (RBCs) aggregate due to antigen-antibody reactions mediated by auto-IgM-type cold agglutinins, forming reversible c...
BACKGROUND: In blood samples collected from patients with cold agglutinin disease (CAD), red blood cells (RBCs) aggregate due to antigen-antibody reactions mediated by auto-IgM-type cold agglutinins, forming reversible clumps. This phenomenon is relatively common in clinical hematology testing and can significantly interfere with routine parameter measurements by automated hematology analyzers, including red blood cell count (RBC), he-matocrit (HCT), mean corpuscular volume (MCV), and mean corpuscular hemoglobin concentration (MCHC). Notably, conventional methods such as 37℃ water baths often fail to correct severely cold-agglutinated specimens. METHODS: Cold agglutinated samples were subjected to a 30-minute 37℃ water bath, then immediately analyzed using the closed-whole blood-CDR/PLT-8X mode on a Mindray BC-7500 [NR] CS hematology analyzer to obtain results for the research parameters RBC-O and HF-MCV. RESULTS: Using the formulas HCT = RBC-O x HF-MCV, MCH = HGB/RBC-O, and MCHC = HGB/HCT, the red blood cell-related parameters such as HCT, RBC, MCV, MCH, and MCHC were calculated. CONCLUSIONS: Severely cold-agglutinated blood samples, when analyzed using the 37℃ water bath combined with the closed-whole blood-CDR/PLT-8X mode, can effectively correct the abnormal results of red blood cells (RBCs) and their related parameters caused by cold agglutinins.
Soluble versus Platelet-Bound P-Selectin as Biomarkers for Preeclampsia: a Dual Meta-Analysis of Diagnostic and Predictive Accuracy.
Sucker C, Entezami M, Schroer A
Clin Lab · 2026 May · PMID 42159126 · Publisher ↗
BACKGROUND: P-selectin exists in two biologically distinct forms, soluble in plasma (sP-selectin) and membrane-bound on activated platelets (CD62P). Both have been linked to the pathophysiology of preeclampsia, but their...
BACKGROUND: P-selectin exists in two biologically distinct forms, soluble in plasma (sP-selectin) and membrane-bound on activated platelets (CD62P). Both have been linked to the pathophysiology of preeclampsia, but their comparative diagnostic and predictive performance have not been systematically analyzed. We conducted an original dual meta-analysis comparing soluble and platelet-bound P-selectin for the diagnosis and early prediction of pre-eclampsia. METHODS: We systematically reviewed and pooled published data up to April 2025. Studies assessing sP-selectin via ELISA or CD62P via flow cytometry were included. Diagnostic and first-trimester predictive performance were analyzed separately. Pooled effect sizes (Hedges' g), relative risks (RR), predictive values (PPV, NPV), and number needed to predict (NNP) were calculated based on extracted group-level data. RESULTS: Soluble P-selectin was moderately elevated in manifest preeclampsia (g = 1.08, RR = 2.17, PPV = 78%) and showed predictive utility in early pregnancy (g = 0.95, RR = 2.10, NPV = 90%). Platelet-bound CD62P demonstrated markedly stronger associations in both settings: diagnostic (g = 4.85, RR = 17.1, PPV = 90%) and predictive (g = 2.50, RR = 3.0, NPV = 95%). Our pooled data analysis shows CD62P to be superior in clinical discrimination. CONCLUSIONS: This is the first direct, meta-analytic comparison of sP-selectin and CD62P in preeclampsia. Our original data synthesis confirms CD62P as a stronger biomarker in both diagnostic and predictive contexts. Where flow cytometry is available, CD62P should be preferred. sP-selectin remains useful as an early rule-out tool in screening protocols.
In Vitro and In Silico Evidence for Arak Extract as a Potent Inhibitor of NO/iNOS in Activated Macrophages.
Ellithy MM, Saleh AM, Ibrahim MN … +2 more , Alakilli SYM, El-Azab EF
Clin Lab · 2026 May · PMID 42159125 · Publisher ↗
BACKGROUND: The anti-inflammatory properties of Arak (Miswak, Salvadora persica) and its extracts have been firmly established through both in vitro and in silico studies. Nitric oxide (NO) plays a critical role as a sig...
BACKGROUND: The anti-inflammatory properties of Arak (Miswak, Salvadora persica) and its extracts have been firmly established through both in vitro and in silico studies. Nitric oxide (NO) plays a critical role as a signaling molecule in the pathogenesis of inflammation, which is a fundamental process in the development of various diseases, particularly carcinogenesis and the malignant transformation of cells. Herbal-derived compounds have demonstrated promising potential in inhibiting inflammatory diseases. This study aimed to investigate the inhibitory effects of Arak extract and its bioactive compounds on inducible nitric oxide synthase (iNOS) and NO production using vitro and computational methods and to identify potential phytocompounds with high binding affinity to iNOS. METHODS: An in vitro evaluation was performed using LPS-stimulated RAW macrophage cell lines to assess the inhibitory effect of Arak extract on NO production. Additionally, advanced in silico techniques, including all-atom molecular dynamic (MD) simulations, were used to model the interaction between six phytocompounds and iNOS, identify binding sites, and assess the stability and conformational shifts of the ligand-protein complexes. RESULTS: The in vitro analysis revealed strong inhibition of NO production by Arak extract. Computational studies confirmed that six bioactive compounds from the extract exhibited high binding affinity to iNOS, inducing conformational changes that enhanced ligand positioning within the active site. Among these, the compound 1/iNOS complex showed stable ligand interactions over the simulation period, suggesting a robust inhibitory effect. CONCLUSIONS: This study highlights six promising phytocompounds from Arak extract as potent iNOS inhibitors. The results demonstrate the therapeutic potential of Arak in treating inflammation-related diseases. Further in vivo validation is warranted to confirm the clinical efficacy of these findings.
CD161⁺ NKT Cell Proportion as a Predictive Biomarker for Bortezomib Treatment Response in Newly Diagnosed Multiple Myeloma Patients.
Zhou S, Xu X, Cuo J … +5 more , Sun C, Hou Y, Wang X, Nana D, Weixun S
Clin Lab · 2026 May · PMID 42159124 · Publisher ↗
BACKGROUND: Multiple myeloma (MM) remains incurable, with drug resistance being a key clinical challenge. Impaired natural killer T (NKT) cell function may contribute to MM immune escape, while the significance of the in...
BACKGROUND: Multiple myeloma (MM) remains incurable, with drug resistance being a key clinical challenge. Impaired natural killer T (NKT) cell function may contribute to MM immune escape, while the significance of the inhibitory receptor CD161 expression on NKT cells is unclear. This study investigated the association between the peripheral blood CD3⁺CD56⁺CD161⁺ NKT cell proportion and response to bortezomib plus dexamethasone therapy in newly diagnosed MM (NDMM) patients. METHODS: Seventy-two NDMM patients receiving bortezomib plus dexamethasone and 37 healthy controls (HCs) were enrolled. Flow cytometry assessed the peripheral blood CD3⁺CD56⁺CD161⁺ cell proportion before and after treatment. Treatment response was evaluated according to IMWG criteria (responders: ≥ partial response [PR]; non-responders: ≤ stable disease [SD]). Receiver operating characteristic (ROC) curve analysis evaluated predictive value. Correlation with clinical parameters (ISS stage, LDH, β₂-MG, etc.) was analyzed. RESULTS: The baseline CD3⁺CD56⁺CD161⁺ proportion was significantly lower in NDMM patients than in HCs (2.25% vs. 4.20%, p < 0.05). After treatment, it increased to 3.10% (p < 0.05). Responders had a significantly higher baseline proportion than non-responders (3.40% vs. 1.60%, p < 0.0001). ROC analysis showed the baseline proportion predicted treatment response with an AUC of 0.789 (95% CI: 0.675 - 0.903). At the optimal cutoff of 1.85%, sensitivity was 87.9% and specificity was 71.8%. Patients with low proportions (< 1.85%) had a higher frequency of ISS stage III (p < 0.05) and significantly elevated LDH and β₂-MG levels (both p < 0.05). CONCLUSIONS: Low expression of peripheral blood CD3⁺CD56⁺CD161⁺ NKT cells is associated with increased tumor burden and bortezomib resistance in NDMM, suggesting its potential as a predictive biomarker for treatment response.
Application of Sigma Metric and TOPSIS Method to Comprehensively Analyze 15 Quality Indicators in Clinical Laboratory from 2019 Through 2024.
Huang Y, Long T, Mei S … +1 more , Zhang P
Clin Lab · 2026 May · PMID 42159123 · Publisher ↗
BACKGROUND: This study aimed to apply sigma metric and TOPSIS method to comprehensively analyze quality indicators from 2019 through 2024 and explore factors improving laboratory errors in the Department of Clinical Labo...
BACKGROUND: This study aimed to apply sigma metric and TOPSIS method to comprehensively analyze quality indicators from 2019 through 2024 and explore factors improving laboratory errors in the Department of Clinical Laboratory at the Renmin Hospital of Wuhan University. METHODS: Fifteen quality indicators (QIs) covering the total testing process were collected through the laboratory information system and manual statistics. After calculating the rates, they were converted into sigma values according to specific formula, and the turnaround time was expressed in minutes. The TOPSIS method was applied to comprehensively analyze the clinical laboratory medical quality in different years, specialties, and specimen types. Through sigma metric, the trend and quality difference of each indicator were analyzed year by year. TOPSIS method was used to rank the quality of different years, specialties, and specimen types and to identify quality problems and effective improvement measures. RESULTS: Due to Corona Virus Disease 2019 (COVID-19), the number of specimens in 2022 was the highest, while that in 2020 was the lowest, with blood specimens being the main type. The critical values notification and timely critical values notification were both 100% every year. The sigma values of all QIs were below six, among which the average sigma value of "incorrect sample type" was the highest, at 5.73. The average sigma value of "test covered by interlaboratory comparison" was the lowest, at 1.01. Comprehensive analysis revealed that the performance of QIs in 2024 ranked first. From 2019 through 2023, the rank of pre- and post-phase QIs was: 1) biochemistry, 2) immunity, 3) hematology, and 4) microbiology. In 2024, performance of immunity was the best. The sigma value of blood specimens was the highest among all sample types, and the average was above five. CONCLUSIONS: Although the quality performance of QIs fluctuated year by year, it showed a trend of continuous improvement. The detailed analysis of quality indicators in different years, specialties, and sample types still was unsatisfactory. There, clinical laboratories should take targeted improvement measures according to the problems reflected in the QIs.
A Novel Approach Targeting Coagulase-Negative Staphylococcal Infections: Rifabutin's Antibacterial Potential.
AbdulMajed H, Attallah DM, Mokhtar JA … +15 more , Alhussainy S, Alqarni MA, Alhussainy NH, Niyazi HA, Niyazi HA, Alsufyani HA, Alkuwaity KK, Alhazmi W, Sait AM, Mufrrih M, Alharbi MT, Altalhi R, Alharbi OS, Alfadil A, Ibrahem K
Clin Lab · 2026 May · PMID 42159122 · Publisher ↗
BACKGROUND: Coagulase-negative staphylococci (CoNS) are opportunistic pathogens that pose a significant chal-lenge in healthcare settings, particularly among patients with indwelling medical devices. Their ability to for...
BACKGROUND: Coagulase-negative staphylococci (CoNS) are opportunistic pathogens that pose a significant chal-lenge in healthcare settings, particularly among patients with indwelling medical devices. Their ability to form biofilms and exhibit resistance to β-lactam antibiotics, including methicillin, limits treatment options. The increasing prevalence of multidrug-resistant CoNS necessitates alternative therapeutic strategies. This study aimed to evaluate the in vitro antimicrobial activity of rifabutin against clinical isolates of CoNS, including Staphylococcus epidermidis, Staphylococcus saprophyticus, Staphylococcus haemolyticus, Staphylococcus hominis, and Staphylococcus lugdunensis. METHODS: A total of 70 clinical CoNS isolates were collected from patients at King Abdulaziz University Hospital in Jeddah, Saudi Arabia. Identification and susceptibility profiling were performed using the Vitek 2 system. The antimicrobial activity of rifabutin was assessed using the broth microdilution method to determine the minimum inhibitory concentration (MIC). Rifabutin was prepared in 5% dimethyl sulfoxide (DMSO) and tested in serial two-fold dilutions, with MIC values recorded as the lowest concentration that inhibited bacterial growth. Each experiment was conducted in triplicate to ensure reproducibility. RESULTS: The MIC values of rifabutin ranged from 0.016 to 0.063 µg/mL across the tested strains, with the majority of isolates showing an MIC of 0.0312 µg/mL (41.4%) and 0.063 µg/mL (37.1%), while a smaller proportion ex-hibited an MIC of 0.016 µg/mL (21.4%). The MIC distribution demonstrated consistent inhibitory effects of rifabutin across different CoNS species, with only a 1- to 2-fold variation in susceptibility. These findings suggest that rifabutin is effective against CoNS with a relatively uniform susceptibility profile, making it a promising candidate for the treatment of infections caused by these bacteria. CONCLUSIONS: Rifabutin demonstrates promising antimicrobial potential against CoNS, highlighting its potential as an alternative therapeutic agent for CoNS-related infections. Given its ability to overcome β-lactam resistance mechanisms, further studies, including in vivo assessments, are warranted to explore its clinical applicability.
GDF15 as a Marker of Ineffective Erythropoiesis and Erythroid Expansion in Thalassemia: a Clinical Perspective.
Piolatto A, Tesio N, Teti M … +7 more , Kargutkar NS, Gaglioti CM, Voi V, Mandrile G, Longo F, Piga AG, Ferrero GB
Clin Lab · 2026 May · PMID 42159121 · Publisher ↗
BACKGROUND: Ineffective erythropoiesis is a hallmark of thalassemia syndromes. Growth differentiation factors, such as GDF15, play a crucial yet not fully understood role. METHODS: Serum GDF15 levels were measured by ELI...
BACKGROUND: Ineffective erythropoiesis is a hallmark of thalassemia syndromes. Growth differentiation factors, such as GDF15, play a crucial yet not fully understood role. METHODS: Serum GDF15 levels were measured by ELISA in 486 individuals (362 thalassemia patients, 53 β-trait carriers, and 71 healthy subjects) and analyzed alongside biochemical and clinical parameters. RESULTS: GDF15 levels were elevated in transfusion-dependent (TD) β-thalassemia (26-fold), non-transfusion-dependent (NTD) β-thalassemia (6-fold), and β-thalassemia carriers (2-fold) compared to healthy controls. Moreover, GDF15 levels were elevated in α-thalassemia patients (2-fold) compared to carriers. In TD β-thalassemia, GDF15 correlated inversely with hemoglobin and positively with erythropoietin. GDF15 also correlated with iron metabolism markers. Longitudinal analysis in a TD patient subgroup showed dynamic GDF15 changes post-transfusion, reflecting erythropoietic activity. Furthermore, GDF15 levels correlated with transfusion intervals, particularly in splenectomized patients. CONCLUSIONS: GDF15 represents a promising biomarker for assessing thalassemia severity, monitoring treatment responses, and guiding therapies.
Advanced Oxidation Protein Products Aggravate Inflammation of Henoch-Schönlein Purpura Nephritis Through the RAGE-NF-κB Pathway.
Wei F, Zheng W, Xu Y … +4 more , Chen M, Lin L, Zeng Q, Zhang H
Clin Lab · 2026 May · PMID 42159120 · Publisher ↗
BACKGROUND: Henoch-Schönlein purpura nephritis (HSPN) is the most serious complication of allergic purpura (HSP). Advanced oxidized protein products (AOPPs) are an important damage factor in chronic kidney disease, and i...
BACKGROUND: Henoch-Schönlein purpura nephritis (HSPN) is the most serious complication of allergic purpura (HSP). Advanced oxidized protein products (AOPPs) are an important damage factor in chronic kidney disease, and its expression level is also closely related to the pathogenesis of HSP. However, the role of AOPPs in HSPN reminds unclear. In the present study, we aimed to investigate the expression of AOPPs and its mechanism of inducing inflammation during the pathogenesis of HSPN in children. METHODS: We collected 20 patients with HSPN and 20 age- and gender-matched healthy controls in our hospital. ELISA, western blot, and immunofluorescence technique were performed to verify the above aim. RESULTS: Results showed that, as compared with the control group, serum levels of AOPPs in the HSPN increased significantly (p < 0.05). Serum IL-1β, IL-6 and TNF-α levels in the HSPN were also significantly higher than in the control group (p < 0.05). Moreover, the results showed that there was a positive correlation between serum AOPPs and inflammatory factor TNF-α, IL-6 and IL-1β level in children with HSPN. AOPPs treatment was found to significantly increase expression of RAGE, and p-P65, while the IκB was obviously reduced. Immunofluorescence showed that AOPPs significantly induce P65 nuclear metastasis. We further demonstrated that FPS-ZM1 (a selective RAGE inhibitor) and/or BAY 11-7082 (a selective NF-κB signaling pathway inhibitor) inhibited AOPPs-induced inflammation in HBZY-1 through blocking RAGE-NF-κB signaling pathway. CONCLUSIONS: Collectively, these results implicated that AOPPs may be related to the pathogenesis of HSPN, AOPPs might induce or aggravate inflammation of HSPN through regulating RAGE-NF-κB signaling pathway. Above all, it has important clinical guiding significance for the prognosis judgment of HSPN, and can also provide new therapeutic targets for the HSPN.
Diluted Russell Viper Venom Test for Lupus Anticoagulant Detection in Pregnancy Population.
Peng L, Wu L, Wang C … +2 more , Tang X, Zhang G
Clin Lab · 2026 May · PMID 42159119 · Publisher ↗
BACKGROUND: The association between lupus anticoagulants and pregnancy-related adverse outcomes is highly significant. Widely used in risk assessment, dilute Russell's viper venom time (dRVVT) is a common test for lupus...
BACKGROUND: The association between lupus anticoagulants and pregnancy-related adverse outcomes is highly significant. Widely used in risk assessment, dilute Russell's viper venom time (dRVVT) is a common test for lupus anticoagulants during pregnancy. However, pregnancy induces complex changes in the coagulation system, leading to inconsistent trends in coagulation indicators compared to healthy individuals. This study aimed to investigate the impact of the pregnancy process on dRVVT detection and clinical applications. METHODS: From July 2021 to February 2022, data from 2,709 pregnant women's dRVVT tests were analyzed, with 71 healthy non-pregnant individuals as a control. Screening tests (LA1), confirmation tests (LA2), and the LA1/ LA2 ratio were compared between early, mid, late pregnancy, and the control group. Using early pregnancy as the observational target, the correlation between the mentioned indicators and pregnancy outcomes were analyzed. Variance analysis and rank-sum tests were employed to assess the consistency, and logistic regression analysis was conducted for data analysis related to outcomes, with p < 0.05 considered statistically significant. RESULTS: There was no significant difference in LA1 between groups (p > 0.05). LA2 decreased and LA1/LA2 increased with advancing pregnancy (p < 0.05), consistently different from control group (p < 0.05). LA1 and LA1/ LA2 in early pregnancy were correlated with pregnancy outcomes and served as independent prognostic factors for adverse pregnancy outcomes (p < 0.01), with LA1/LA2 being the optimal outcome prediction indicator. CONCLUSIONS: As pregnancy progresses, LA2 decreases significantly, while LA1 remains unchanged. Existing dRVVT standards for adults may falsely elevate lupus anticoagulant detection during pregnancy. Establishing pregnancy-specific criteria for dRVVT is essential.
Alpha Thalassemia-Related Diabetic Nephropathy.
Wu F, Liu B, Wang Z
Clin Lab · 2026 May · PMID 42159118 · Publisher ↗
BACKGROUND: Thalassemia, an autosomal recessive hematologic disorder, causes renal dysfunction via chronic hypoxia, anemia, iron overload, and iron chelating agents. This case showed severe tubulointerstitial lesions wit...
BACKGROUND: Thalassemia, an autosomal recessive hematologic disorder, causes renal dysfunction via chronic hypoxia, anemia, iron overload, and iron chelating agents. This case showed severe tubulointerstitial lesions with diabetic nephropathy. METHODS: Comprehensive diagnostic evaluation included targeted laboratory investigations, renal imaging studies, percutaneous renal biopsy, and thalassemia genetic testing to elucidate etiological mechanisms. RESULTS: Laboratory findings confirmed microcytic hypochromic anemia with renal impairment. Imaging studies revealed pulmonary embolism, splenomegaly, and lower extremity deep vein thrombosis. Genetic analysis identified α-thalassemia. Renal histopathology demonstrated stage III diabetic nephropathy with severe tubulointerstitial fibrosis and tubular atrophy. CONCLUSIONS: Refractory anemia with renal dysfunction requires thalassemia exclusion. The cause of renal injury in thalassemia needs to be confirmed by renal biopsy.
Point of Care Testing (POCT)'s Blind Spot: It's the Structural Framework, not Speed.
Ahmed S, Jafri R, Jaffri B
Clin Lab · 2026 May · PMID 42159117 · Publisher ↗
Abstract loading — click title to view on PubMed.
Application of DTT to Eliminate Interference of Rheumatoid Factor on Serum hCG Detection.
Li G, Dan N, Wang Q … +1 more , Zhang C
Clin Lab · 2026 May · PMID 42159116 · Publisher ↗
BACKGROUND: The accuracy of serum human chorionic gonadotropin (hCG) detection is crucial for the diagnosis of gestational and trophoblastic tumors. Rheumatoid factor (RF), as a common autoantibody in patients with rheum...
BACKGROUND: The accuracy of serum human chorionic gonadotropin (hCG) detection is crucial for the diagnosis of gestational and trophoblastic tumors. Rheumatoid factor (RF), as a common autoantibody in patients with rheumatoid arthritis, often leads to interference in immune detection. METHODS: We report a case of using dithiothreitol (DTT) to successfully eliminate the interference of RF to hCG detection. RESULTS: After DTT pretreatment, serum RF level decreased from 293.5 IU/mL to 11.4 IU/mL, while hCG level decreased from 39.36 mIU/mL to 4.12 mIU/mL. The validation results of the Roche electrochemiluminescence platform (2.3 mIU/mL) confirmed that the increase of hCG was a false positive. CONCLUSIONS: When the serum hCG of patients with rheumatoid arthritis is abnormally high and there is no clinical manifestation of pregnancy or trophoblastic tumor, we should be alert to the possibility of RF interference. It is recommended to use DTT to pretreat samples. This can easily and efficiently eliminate interference, ensure the accuracy of detection, and avoid misdiagnosis.
Efficacy of Automated Urinalysis in Detecting Low-Level Bacteriuria and Discriminating Bacterial Gram Status.
Karino M, Karino M, Hanada H … +3 more , Sugo M, Yamato M, Takano T
Clin Lab · 2026 May · PMID 42159115 · Publisher ↗
BACKGROUND: Rapid and accurate diagnosis of urinary tract infections (UTIs) is essential to guide empirical therapy and curb antimicrobial resistance. However, conventional urine culture is too slow, hindering timely dia...
BACKGROUND: Rapid and accurate diagnosis of urinary tract infections (UTIs) is essential to guide empirical therapy and curb antimicrobial resistance. However, conventional urine culture is too slow, hindering timely diagnosis of UTI. UF‑5000, an automated flow cytometry urinalysis system equipped with the BACT-Info Gram-prediction feature, shows potential to expedite microbial screening. However, its performance under low bacterial loads re-mains unclear. METHODS: We retrospectively analyzed 1,529 clinical urine specimens using urinalysis and urine culture. Any bacterial growth in urine culture was considered a culture-positive result. Receiver operating characteristic (ROC) analysis of UF‑5000 bacterial and white blood cell counts was performed to determine the optimal cutoffs. The agreement between the BACT‑Info flag feature and urine culture results was assessed using Cohen's κ value. RESULTS: Urine cultures identified bacteria in 700/1,529 specimens (45.8%), with 585 (38.3%) showing ≥ 105 colony-forming units/mL. ROC analysis established a bacterial count cutoff of 195.2/µL, yielding a sensitivity of 0.851, specificity of 0.885, and area under the ROC curve of 0.940 (95% confidence interval, 0.928 - 0.951). It outper-formed the cutoff value based on white blood cell count. At equivalent amounts of bacterial culture, UF‑5000 bacterial counts were significantly higher for Gram‑negative than for Gram‑positive isolates (Welch's t-test: p < 0.001). Overall concordance between BACT‑Info and urine culture results was substantial for Gram‑negative flags (κ, 0.76; accuracy, 0.904) and moderate for Gram‑positive flags (κ, 0.51; accuracy, 0.799). For Gram-negative bacteria, the sensitivity, specificity, positive predictive value, and negative predictive value were 0.739, 0.974, 0.923, and 0.898, respectively. However, 17.2% of the specimens containing only Gram-negative bacteria were flagged as "Gram Positive?". This indicates the potential for improvement. CONCLUSIONS: The UF‑5000 system provides a rapid, low-labor, and cost-effective method for UTI screening, even at low levels of bacteriuria. However, it is intended to complement, not replace, conventional urine culture, which remains indispensable for definitive species identification and antimicrobial susceptibility testing. Its primary value lies in accelerating the diagnostic workflow and reducing unnecessary cultures when used in conjunction with urine culture.
The Value of Second-Generation Metagenomic Sequencing in the Diagnosis of Respiratory Infections.
Li Y, Liu J, Hu W … +4 more , Li C, Zhang L, Qiu S, Zhu S
Clin Lab · 2026 May · PMID 42159114 · Publisher ↗
BACKGROUND: This study aimed to compare the results of metagenomic next-generation sequencing (mNGS) and conventional culture detection of pathogenic bacteria in bronchoalveolar lavage fluid (BALF) of patients with respi...
BACKGROUND: This study aimed to compare the results of metagenomic next-generation sequencing (mNGS) and conventional culture detection of pathogenic bacteria in bronchoalveolar lavage fluid (BALF) of patients with respiratory tract infections and analyze the influencing factors and clinical significance of mNGS positive detection. METHODS: We retrospectively analyzed BALF samples from 90 respiratory infection patients at the First People's Hospital of Yongkang City from June 1, 2024, through January 28, 2025, using mNGS and conventional culture testing to compare the positivity rate, pathogen distribution, and consistency of the two methods. The relationship between mNGS detection positivity and clinical indicators of patients and patient prognosis was analyzed. RESULTS: The positive rate of mNGS detection was 77.78%, while the positive rate of conventional culture detection was 44.44%, and the difference was statistically significant (p < 0.05). mNGS can detect a wider variety of pathogens, mainly gram-negative bacilli, fungi, and atypical pathogens. mNGS has moderate consistency with conventional culture detection results in bacteria, fungi, and atypical pathogens, but low consistency in viruses and para-sites. The positive detection of mNGS is related to factors such as patient age, underlying diseases, peripheral blood white blood cells, and C-reactive protein, which are risk factors affecting the positive detection of mNGS. CONCLUSIONS: The pathogenic diagnosis of mNGS in BALF of patients with lower respiratory tract infections is su-perior to conventional culture detection; it can detect more and a wider range of pathogens, helping to promote rational drug use and improve patient prognosis in clinical practice.
Chlamydia psittaci Infection Presenting Initially with Gastrointestinal Symptoms.
Shu Q, Chen Z, Deng Z
Clin Lab · 2026 May · PMID 42159113 · Publisher ↗
BACKGROUND: Chlamydia psittaci (C. psittaci) is a pathogenic, gram-negative, aerobic, and obligate intracellular parasite. Humans are primarily infected by inhaling aerosols formed from the feces of infected birds. Previ...
BACKGROUND: Chlamydia psittaci (C. psittaci) is a pathogenic, gram-negative, aerobic, and obligate intracellular parasite. Humans are primarily infected by inhaling aerosols formed from the feces of infected birds. Previously reported cases of C. psittaci infection are rare. The lack of specific clinical manifestations of psittacosis and the limited detection sensitivity of traditional methods lead to inadequate or delayed diagnosis. In this case, the pres-ence of C. psittaci was confirmed by next-generation sequencing (NGS) of bronchoalveolar lavage fluid. METHODS: Bronchoscopy, next-generation sequencing. RESULTS: After using bronchoscopy to obtain bronchoalveolar lavage fluid, NGS indicated the presence of C. psittaci. Therefore, anti-infective treatment was administered. CONCLUSIONS: For patients with severe pneumonia, it is essential to perform bronchoscopy promptly. The etiological agent of the infection can be identified through NGS of bronchoalveolar lavage fluid obtained via bronchoscopy. Subsequently, appropriate anti-infective treatment should be initiated swiftly based on the specific identified pathogen.
Myelodysplastic Neoplasm with Biallelic TP53 Inactivation in a Well-Controlled HIV Patient.
Roh SK, Chang SH
Clin Lab · 2026 May · PMID 42159112 · Publisher ↗
BACKGROUND: Human immunodeficiency virus (HIV) infection represents a chronic disease that must be treated with lifelong antiretroviral therapy (ART). Individuals with HIV are at increased risk of developing some cancers...
BACKGROUND: Human immunodeficiency virus (HIV) infection represents a chronic disease that must be treated with lifelong antiretroviral therapy (ART). Individuals with HIV are at increased risk of developing some cancers, including hematolymphoid malignancies. However, knowledge of myelodysplastic neoplasm (MDS) in HIV patients remains limited. Several studies have shown that HIV-positive MDS patients present at a younger age, progress more rapidly to acute myeloid leukemia (AML), and have poorer overall survival. Moreover, these patients have an increased prevalence of high-risk cytogenetic and molecular alterations. We report the first case of MDS with biallelic TP53 inactivation according to the new WHO classification in an HIV patient in a well-controlled environment. METHODS: A bone marrow examination (BME) was performed to determine the cause of the patient's pancytopenia. In addition, karyotyping, FISH, and next-generation sequencing (NGS) were performed to diagnose the subtype of the disease. RESULTS: BME showed multilineage dysplasia and increased blasts, chromosome and FISH results were abnormal, and two TP53 mutations were detected by NGS. CONCLUSIONS: When considering the possibility of hematological malignancies in HIV patients with cytopenia, it is necessary to include MDS. Furthermore, more active investigations, including BME, especially genetic testing, are needed to determine the incidence, pathophysiology, and outcome of MDS in HIV patients.
Severe Herpes Simplex Virus Encephalitis in an Adult.
Li JY, Wang JJ, Liu Y … +2 more , Bu X, Cheng AB
Clin Lab · 2026 May · PMID 42159111 · Publisher ↗
BACKGROUND: Herpes simplex encephalitis is rare. The diagnosis and treatment of such infections are often delayed, and disability rate is high. METHODS: Appropriate laboratory tests, next generation sequencing, and magne...
BACKGROUND: Herpes simplex encephalitis is rare. The diagnosis and treatment of such infections are often delayed, and disability rate is high. METHODS: Appropriate laboratory tests, next generation sequencing, and magnetic resonance imaging were used in this study. RESULTS: A 33-year-old healthy male with fever and headache as the predominant clinical features. Neurological manifestations are insidious and delayed. Timely diagnosis of disseminated herpetic encephalitis using brain magnetic resonance imaging and high-throughput genetic testing of cerebrospinal fluid. After treatment with acyclovir, antiviral drugs, and glucocorticoids, the patient's condition improved significantly without significant complications. CONCLUSIONS: Physicians treating patients with fever, headache, and refractory hyponatremia as the main clinical features should be alert to herpes simplex encephalitis.
Elevated Plasma Vitamin D Levels are Associated with Pain Characteristics and Duration in Patients with Postherpetic Neuralgia.
Liu J, Guan K, Wang X … +1 more , Li J
Clin Lab · 2026 May · PMID 42159110 · Publisher ↗
BACKGROUND: Aim is to analyze the correlation between plasma vitamin D (VD) level and pain characteristics and duration in patients with postherpetic neuralgia (PHN). METHODS: 116 patients with PHN were prospectively col...
BACKGROUND: Aim is to analyze the correlation between plasma vitamin D (VD) level and pain characteristics and duration in patients with postherpetic neuralgia (PHN). METHODS: 116 patients with PHN were prospectively collected as the PHN group, and another 102 non-PHN patients were selected as the control group. The plasma VD levels were detected by enzyme-linked immunosorbent assay. The factors affecting the plasma VD levels of PHN patients were analyzed by one-way and logistic regression analysis. The correlation between the plasma VD levels of the PHN patients with pain characteristics and duration was analyzed by Pearson correlation. RESULTS: Plasma VD levels [(26.63 ± 2.95) ng/mL] in patients in the PHN group were significantly lower compared with those in the control group [(31.39 ± 2.98) ng/mL] (p < 0.001). Plasma VD level was associated with LANSS score (OR = 1.302), pain type (OR = 3.218) and pain duration (OR = 1.392) in patients with PHN (all p < 0.01). Plasma VD levels were negatively correlated with LANSS score (r = -0.346) and pain duration (r =- 0.381) in patients with PHN. CONCLUSIONS: Plasma VD levels are significantly lower in patients with PHN, and plasma VD levels determine pain characteristics and duration.
Detection of Pneumocystis Jirovecii in Immunocompetent Children with Lower Respiratory Tract Infection.
Liao SS, Xiao ZG, He QQ … +1 more , Chen AP
Clin Lab · 2026 May · PMID 42159109 · Publisher ↗
BACKGROUND: Few studies have been conducted on Pneumocystis jirovecii infection in immunocompetent children with respiratory symptoms, and co-infection patterns are limited. This study aimed to describe the detection of...
BACKGROUND: Few studies have been conducted on Pneumocystis jirovecii infection in immunocompetent children with respiratory symptoms, and co-infection patterns are limited. This study aimed to describe the detection of Pneumocystis jirovecii by targeted next-generation sequencing (tNGS) in immunocompetent children with lower respiratory tract infection (LRTI) and compare co-infection patterns. METHODS: From March through July 2023, 117 immunocompetent children with LRTI underwent bronchoalveolar lavage fluid (BALF) testing via tNGS at the Maternal and Child Health Hospital in Meizhou (Guangdong, China). The prevalence of Pneumocystis jirovecii and co-infection with other pathogens were analyzed. RESULTS: Respiratory pathogens were identified in 114 children (97.4%), and Pneumocystis jirovecii was detected in 18 (15.4%). The median age of the Pneumocystis jirovecii positive group was significantly younger than that of the negative group (0.8 vs. 3.9 years, p = 0.008). Co-infections with Pneumocystis jiroveci were common, but only cytomegalovirus and human respiratory syncytial virus showed a positive correlation and Mycoplasmoides pneumoniae showed a negative correlation. Two out of three children treated with trimethoprimsulfamethoxazole and fifteen children with no specific therapy recovered well from clinical and radiological signs. Literature review showed that Pneumocystis jirovecii was relatively common in immunocompetent children with respiratory symptoms (0.8% to 32.4%). CONCLUSIONS: The clinical significance of detection of Pneumocystis jiroveci in immunocompetent children with LRTI should be further investigated, and specific therapy could be considered individually based on clinical symptoms, radiological features, and co-infection patterns.
Differential Expression of Glucocorticoid-Related Genes and Immune Cell Infiltration in Nasopharyngeal Carcinoma.
Long B, Hu G
Clin Lab · 2026 May · PMID 42159108 · Publisher ↗
BACKGROUND: Effective therapies are lacking for nasopharyngeal carcinoma (NPC), a malignancy with high incidence and frequent recurrence in Southeast Asia. Therefore, novel approaches for effective NPC treatment develope...
BACKGROUND: Effective therapies are lacking for nasopharyngeal carcinoma (NPC), a malignancy with high incidence and frequent recurrence in Southeast Asia. Therefore, novel approaches for effective NPC treatment developed based on a deeper understanding of the molecular mechanisms underlying its pathogenesis are urgently needed. To this end, this study investigated glucocorticoid-related genes associated with NPC. METHODS: In this study, bioinformatic analyses were performed using datasets from the Gene Expression Omnibus, and 780 differentially expressed genes (DEGs) were identified, including 280 upregulated and 500 downregulated genes. RESULTS: Among the results of the bioinformatic analyses, enrichment analysis of these glucocorticoid-related DEGs revealed their strong associations with critical biological processes, including monocyte chemotaxis, lymphocyte regulation, and the IL-17 signaling pathway. Meanwhile, nine core genes of interest were identified by protein-protein interaction network analysis. Immune cell infiltration analysis illustrated variations in the abundance of immune cell types within the tumor microenvironment in NPC. CONCLUSIONS: This study revealed the important role of glucocorticoid-related genes in promoting NPC progression. Our findings provide a robust foundation for developing targeted therapeutic strategies for patients with NPC based on innovative biomarkers.
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