Clinical Laboratory[JOURNAL]
Sun
200 papers
The Clinical Application of RDW in Predicting the Severity of Liver Cirrhosis.
Jiang YX, Xie KJ, Sun HG
Clin Lab · 2026 May · PMID 42159107 · Publisher ↗
BACKGROUND: This study aims to explore the clinical significance of RDW (Red Cell Distribution Width) in patients with liver cirrhosis. METHODS: For this retrospective analysis, a total of 355 patients with liver cirrhos...
BACKGROUND: This study aims to explore the clinical significance of RDW (Red Cell Distribution Width) in patients with liver cirrhosis. METHODS: For this retrospective analysis, a total of 355 patients with liver cirrhosis were collected and divided into three groups according to the Child-Pugh classification: Group A (132 cases), Group B (113 cases), and Group C (110 cases). Additionally, 88 healthy controls were included. Various indicators, including total bilirubin, albumin, ALT, serum creatinine, INR, AST, and RDW were detected to observe the changes in these indicators among different grades of liver cirrhosis and the characteristics of their ROC curves. RESULTS: In the liver cirrhosis group, the levels of total bilirubin (TB), ALT, AST, and RDW were significantly higher than those in the healthy control group (p < 0.05). ALT and RDW increased progressively from Child-Pugh A to C grades, with statistically significant differences between groups (p < 0.05). The area under the ROC curve for RDW was 0.773, with a sensitivity of 94.1% and a specificity of 76.2% for diagnosing liver cirrhosis. RDW's diagnostic efficacy was second only to ALT, comparable to AST, and higher than albumin, PLT, INR, and TB. CONCLUSIONS: RDW is correlated with the degree of liver damage and closely related to the clinical grading of liver cirrhosis. Combining RDW with traditional liver cirrhosis indicators such as AST and ALT can help predict the prognosis of liver cirrhosis.
A Case of Falsely Elevated Total Bile Acids in a Pregnant Woman.
Li J, Yang C, Shou Y … +1 more , Bao G
Clin Lab · 2026 May · PMID 42159106 · Publisher ↗
BACKGROUND: Total bile acid (TBA) is commonly used in pregnant women as a diagnostic and monitoring marker for intrahepatic cholestasis of pregnancy (ICP). Over 90% of pregnant women suffering from ICP have an increase i...
BACKGROUND: Total bile acid (TBA) is commonly used in pregnant women as a diagnostic and monitoring marker for intrahepatic cholestasis of pregnancy (ICP). Over 90% of pregnant women suffering from ICP have an increase in serum TBA levels. METHODS: We present the case of a 27-year-old pregnant woman whose TBA level initially reached 152.5 µmol/L, far exceeding the threshold for concern in ICP. However, upon resampling and testing the following day, her TBA levels returned to within the normal reference range (< 10 µmol/L). To investigate this substantial fluctuation over a single day, we performed thorough maintenance and cleaning of the instrument before retesting the serum samples for TBA. Additionally, serum samples from both days were sent to two independent laboratories for reanalysis using different testing systems. RESULTS: Two samples were analyzed using different testing systems, yielding consistent results. The falsely elevated TBA levels were attributed to the patient's non-fasting state and the recent intake of a high-fat meal prior to blood collection. CONCLUSIONS: When TBA levels are unusually elevated in a pregnant woman without symptoms of ICP, a repeat test should be performed under strict fasting conditions. The patient should also be educated on the importance of adhering to fasting protocols for accurate blood testing.
Shenfu Injection Alleviates Pancreatitis-Induced Damage and Oxidative Stress by Upregulating CLDN4 to Protect Endothelial Cells.
Xu L, Jiang C, Wang T … +3 more , Zhou S, Li G, Zheng Y
Clin Lab · 2026 May · PMID 42159105 · Publisher ↗
BACKGROUND: Endothelial dysfunction represents a critical pathological feature of acute pancreatitis (AP). Shenfu injection (SFI) has been demonstrated to protect both endothelial cells and pancreatic tissues affected by...
BACKGROUND: Endothelial dysfunction represents a critical pathological feature of acute pancreatitis (AP). Shenfu injection (SFI) has been demonstrated to protect both endothelial cells and pancreatic tissues affected by AP; however, the precise mechanisms underlying its protective effects remain incompletely understood. The study investigated the protective role of SFI in oxidative-stressed endothelial cells and in acute pancreatitis through the regulation of CLDN4. METHODS: Human umbilical vein endothelial cells (HUVECs) were treated with oxidized low-density lipoprotein (ox-LDL) to create an oxidative stress environment, followed by SFI treatment to assess cell viability, apoptosis, and reactive oxygen species (ROS) levels. Additionally, shRNA technology was employed to knock down CLDN4 expression in order to evaluate its role in SFI-mediated protection. Finally, an AP rat model was established to investigate the effects of SFI on AP-induced pancreatic damage and the role of CLDN4. RESULTS: SFI significantly enhances cell viability, reduces apoptosis, and lowers ROS levels in HUVECs under oxidative stress. At the molecular level, SFI upregulates CLDN4 expression, and depletion of CLDN4 attenuates the protective effects of SFI against oxidative stress. In the AP rat model, SFI administration alleviated pancreatic tissue damage and reduced inflammation, while CLDN4 knockdown diminished these protective effects. CONCLUSIONS: These findings identify CLDN4 as a key mediator of SFI's protective effects on both oxidative-stressed endothelial cells and inflamed pancreatic tissues, underscoring its potential as a therapeutic target in AP.
Impact of Lipoprotein (a) on the Quantification of LDL-Cholesterol.
Drobnik S, Koloi A, Scharnagl H … +6 more , Hollstein T, Kassner U, Dressel A, Drobnik W, Nauck M, März W
Clin Lab · 2026 May · PMID 42159104 · Publisher ↗
BACKGROUND: Accurate LDL-C measurement is essential for cardiovascular risk management. The established methods to determine LDL-C also include Lp(a)-C and potentially distort the actual LDL-C value. The need for Lp(a)-a...
BACKGROUND: Accurate LDL-C measurement is essential for cardiovascular risk management. The established methods to determine LDL-C also include Lp(a)-C and potentially distort the actual LDL-C value. The need for Lp(a)-adjusted LDL-C remains debated. Our study aimed to evaluate the impact of Lp(a) on the determination of LDL-C. METHODS: We included 3,923 datasets from two cohorts. LDL-C was determined by beta-quantification (LDL-CUC), the reference method recommended by the Lipid Research Clinics, and according to Friedewald (LDL-CFW), Martin/Hopkins (LDL-CMH), and Sampson (LDL-CSN). Correction of LDL-C was performed as follows: corrected LDL-C* = crude LDL-C - (Lp(a) x 0.23 + 1.00). Passing-Bablok regression and Spearman correlation were used for intermethod comparisons. RESULTS: Above 10 mg/dL Lp(a) had a significant effect on LDL-CUC. The effect increased with increasing concentrations of Lp(a) levels and, in relative terms, was most pronounced at lower LDL-C values. For Lp(a) > 58 mg/dL, the actual LDL-CUC was overestimated by ≥ 10%, which was considered clinically relevant. Similar overestimations were observed with the Friedewald, Martin/Hopkins, and Sampson formulas, with Friedewald showing the smallest deviation from LDL-C regardless of Lp(a)-correction. Artificial intelligence models showed that it was not possible to raise the suspicion of elevated Lp(a) from the conventional lipid profile. CONCLUSIONS: The influence of Lp(a) on the determination of LDL-C may lead to clinically significant overestimations of the actual LDL-C. Therefore, we recommend using Lp(a)-corrected LDL-C when 1) the Lp(a) concentration is high, 2) the LDL-C concentration is low, and 3) the LDL-C-lowering treatment is less effective than expected.
Expression and Clinical Significance of Pim-1 and RON in Lung Cancer Patients with Benign and Malignant Pleural Effusion.
Huang WP, Chen Y, Song YD … +2 more , Chen J, Wenren YB
Clin Lab · 2026 Apr · PMID 41979639 · Publisher ↗
BACKGROUND: This study aimed to investigate the expression differences and diagnostic value of Pim-1 and RON in lung cancer patients with benign and malignant pleural effusion. METHODS: Forty lung cancer patients with be...
BACKGROUND: This study aimed to investigate the expression differences and diagnostic value of Pim-1 and RON in lung cancer patients with benign and malignant pleural effusion. METHODS: Forty lung cancer patients with benign pleural effusion (BPE) and forty with malignant pleural effusion (MPE) were enrolled. The relative expression levels of Pim-1 and RON mRNA in pleural effusion were measured using real-time quantitative PCR (RT-qPCR). Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of Pim-1 and RON. RESULTS: Compared to the BPE group, Pim-1 expression levels were significantly increased in the MPE group (p < 0.05). RON expression levels were also significantly elevated in the MPE group (p < 0.01). ROC curve analysis revealed that the areas under the curve (AUC) for diagnosing MPE using pleural effusion Pim-1 and RON were 0.646 (95% CI 0.526 - 0.766) and 0.809 (95% CI 0.715 - 0.904), respectively. The AUC for the combined detection of Pim-1 and RON was 0.853 (95% CI 0.773 - 0.934). CONCLUSIONS: Pim-1 and RON are highly expressed in malignant pleural effusion, suggesting a role in lung cancer metastasis to the pleural cavity. Detection of Pim-1 and RON in pleural effusion demonstrates potential diagnostic value for MPE.
Analysis of Blood Group Antigens as Risk Factors for Thrombosis in Polycythemia Vera Patients.
Han JH, Cho HS, Hwang MJ … +8 more , Kang T, Lee H, Koh K, Lee SE, Kim HJ, Jekarl DW, Kim M, Kim Y
Clin Lab · 2026 Apr · PMID 41979638 · Publisher ↗
BACKGROUND: Polycythemia vera (PV) is characterized by the abnormal proliferation of red blood cells (RBCs). Thrombosis and associated cardiovascular diseases are leading causes of mortality in patients with PV. This stu...
BACKGROUND: Polycythemia vera (PV) is characterized by the abnormal proliferation of red blood cells (RBCs). Thrombosis and associated cardiovascular diseases are leading causes of mortality in patients with PV. This study aimed to investigate the association of Lutheran/BCAM (CD239) and other RBC antigens with thrombosis in PV. MATERIALS AND METHODS: This single-center, prospective study consecutively enrolled 50 PV patients, 39 with secondary polycythemia, and 20 healthy controls (HC) who visited the apheresis unit for phlebotomy between May 2022 and September 2023. The normalized expression levels of Lutheran/BCAM (CD239), Indian (CD44), LW/ ICAM (CD242), and Rh-related integrin-associated protein (IAP, CD47) antigens were assessed by flow cytometry. JAK2V617F expression was quantified and coagulation parameters were analyzed. Laboratory and clinical data were retrieved from the medical records. RESULTS: PV patients exhibited significantly higher mean fluorescence intensity (MFI) for Lutheran/BCAM: 45.2 ± 32.8 vs. 33.0 ± 14.4, p = 0.047, Indian (CD44): 13.5 ± 18.4 vs. 8.6 ± 1.1, p = 0.195, and IAP (CD47): 604.8 ± 193.2 vs. 514.9 ± 63.2, p = 0.036 compared to HC. The Indian (CD44) antigen was identified as a risk factor for thrombosis with an odds ratio (OR) of 1.359 (95% confidence interval [CI]: 1.003 - 1.842) in a multivariable model. Positive JAK2 measurable residual disease (JAK2-MRD) (expression was detected in 100% (25/25) of PV patients assessed, with a median variant allele frequency of 51.8% (95% CI: 45.4 - 65.0%). CONCLUSIONS: Higher expression of Indian (CD44) MFI levels in RBCs were associated with thrombotic events in patients with PV. Assessing RBC Indian (CD44) expression may serve as a potential biomarker for thrombotic risk stratification and prevention in PV.
Correlation of Serum CAR with Postoperative Quality of Life and Hip Recovery in Elderly Patients with Intertrochanteric Fracture.
Ling Y, Zhang M
Clin Lab · 2026 Apr · PMID 41979637 · Publisher ↗
BACKGROUND: Intertrochanteric fracture (ITF) is a common but devastating condition with high mortality in the elderly population. Early identification of high-risk patients to prevent poor prognosis is essential as treat...
BACKGROUND: Intertrochanteric fracture (ITF) is a common but devastating condition with high mortality in the elderly population. Early identification of high-risk patients to prevent poor prognosis is essential as treatment of postoperative adverse outcomes is complex. C-reactive protein (CRP)/albumin (ALB) ratio (CAR) is a predictor of prognosis in many diseases, but its correlation with postoperative prognosis in patients with ITF remains unclear. METHODS: One hundred and six elderly patients who underwent ITF surgery between May 2021 and May 2023 were retrospectively analyzed. Patients were evaluated based on postoperative Harris Score and SF-36 Score for good and poor recovery groups. CAR, ALB, and hemoglobin with statistically significant differences in univariate analysis were included in multifactorial logistic regression analysis to screen for independent influences. Predictive efficacy was analyzed using the ROC curve to obtain the area under the curve (AUC). Sample regression models were constructed to test whether there was a nonlinear relationship between ALB and CAR and the prognostic outcomes of patients with ITF. The correlation of ALB and CAR with Harris Score and SF-36 Score was analyzed by Pearson's correlation analysis. RESULTS: Elevated CAR (OR = 2.18, p = 0.00) was an independent risk factor for poor recovery in patients with ITF, while ALB (OR = 0.90, p = 0.03) was an independent protective factor against poor recovery. All CAR showed good predictive efficacy when the cutoff value took CAR > 1.79. In contrast, the predictive efficacy of ALB was low. Restricted cubic spline model and Pearson's correlation analysis showed a linear relationship between CAR, poor recovery in ITF patients, and a negative correlation with Harris Score and SF-36 Score. CONCLUSIONS: Serum CAR is significantly associated with poor postoperative prognosis in elderly patients with ITF and may be an independent risk factor for postoperative quality of life and hip recovery.
Immune Cells and Risk of Cervical Cancer: Evidence from a Mendelian Randomization Study.
Guo L, Yuan X, Zhou Y … +3 more , Zhang D, Hui H, Zhang Y
Clin Lab · 2026 Apr · PMID 41979636 · Publisher ↗
BACKGROUND: Immune dysfunction is involved in the development of cervical cancer. There is lack of causal evidence presenting the effects of immune cells on the risk of cervical cancer (CC). METHODS: The genetic informat...
BACKGROUND: Immune dysfunction is involved in the development of cervical cancer. There is lack of causal evidence presenting the effects of immune cells on the risk of cervical cancer (CC). METHODS: The genetic information of single nucleotide polymorphisms (SNPs) from European descents was employed and a two-sample Mendelian randomization (MR) strategy was designed. In total, 731 kinds of immune cells were included as the exposures. For cervical cancer, the data was from the cohort involving almost 24,0000 participants. The inverse variance weighted (IVW) approach served as the main strategy for causality inference. MR-Egger and weighted median were the alternative methods for comparison. Sensitivity analyses focusing on heterogeneity and pleiotropy were then carried out to verify the estimated effects. RESULTS: After selecting eligible SNPs for MR analysis, the IVW approach identified a total of 24 immune cell characteristics which were causally correlated with CC at p < 0.05. Among them, six immune cell phenotypes are confirmed to be related to an elevated risk of CC, while the remaining eighteen immune cell characteristics demonstrate protective effects against CC. MR-Egger and weighted median showed comparable results, and the detected associations passed the heterogeneity and pleiotropy tests. CONCLUSIONS: This Mendelian randomization study demonstrated causal associations between immune cells and CC, underscoring the intricate interactions of the immune system with CC. The results also provide insights into the mechanisms of CC development attributed to immunological regulation and highlight potential therapeutic targets for improving immune responses in patients with CC.
Performance Evaluation of the Newly Developed H-120 HbA1c Analyzer.
Xu A, Yu H, Ji R … +6 more , Huang Y, Xie W, Ye P, He R, Luo H, Ji L
Clin Lab · 2026 Apr · PMID 41979635 · Publisher ↗
BACKGROUND: The aim of this study is to evaluate the analytical performance of Mindray H-120, a newly developed and launched Hemoglobin A1c (HbA1c) analyzer that is based on ion-exchange high-performance liquid chroma-to...
BACKGROUND: The aim of this study is to evaluate the analytical performance of Mindray H-120, a newly developed and launched Hemoglobin A1c (HbA1c) analyzer that is based on ion-exchange high-performance liquid chroma-tography (HPLC). METHODS: In both standard and variant modes of the H-120 analyzer, precision, accuracy, linearity, and potential interference from Hb variants were assessed. In addition, the consistency of results between the H-120 analyzer and other commonly used analyzers was evaluated. RESULTS: The H-120 analyzer showed excellent precision and accuracy. The coefficients of variation (CVs) of repeatability and reproducibility were not greater than 0.5%. The H-120 analyzer provided results that were consistent with IFCC-assigned external quality control samples with a bias of ± 2.0%. The HbA1c level showed a good linear relationship between 3.0% and 20.1%. The results from the standard and variant modes for the H-120 analyzer were in perfect agreement (r = 1.000), and the HbA1c results showed a high level of consistency (r ≥ 0.998) when comparing the H-120 with the other two analyzers, D100 and Capillarys 3 TERA. The H-120 analyzer can detect nine of the ten most common Hb variants, and 83.8% of the variant samples do not affect HbA1c measurements. CONCLUSIONS: The H-120 analyzer offers outstanding fundamental performance, robust variant detection capabilities, and user-friendly, efficient operation, making it suitable for the requirements of clinical laboratories.
The Relationship between Maresin-1 Levels and Disease Activity in Patients with Crohn's Disease.
Turan T, Gül Ö, Üreten K … +2 more , Kisa Ü, Ergül B
Clin Lab · 2026 Apr · PMID 41979634 · Publisher ↗
BACKGROUND: Maresin-1 is considered to be a potential regulator of inflammatory disease through its anti-inflammatory and pro-resolving properties. However, no study to date has investigated Maresin-1 levels in Crohn's d...
BACKGROUND: Maresin-1 is considered to be a potential regulator of inflammatory disease through its anti-inflammatory and pro-resolving properties. However, no study to date has investigated Maresin-1 levels in Crohn's disease (CD). This study aimed to measure serum levels of Maresin-1 in patients with CD and to assess possible effects on disease activity. METHODS: Thirty patients with active CD, 30 patients with CD in remission, and 30 healthy individuals were included in the study. Clinical and demographic features of patients were obtained from the hospital database. Serum Maresin-1 levels were determined by enzyme-linked immunosorbent assay. RESULTS: Maresin-1 level was 215.74 (118.55 - 327.46) pg/mL in the active group, 413.29 (215.82 - 726.82) pg/mL in the remission group, and 753.4 (381.5 - 901.08) pg/mL in controls (p < 0.05). An inverse correlation was found be-tween Maresin-1 and CRP in patients with active CD (p = 0.039). A Maresin-1 cutoff value of < 607.38 pg/mL showed 96.67% sensitivity and 80% specificity for the identification of CD patients in remission from controls (AUC = 0.919), while a < 327.46 pg/L cutoff yielded a sensitivity of 100% and a specificity of 100% to distinguish active CD from controls (AUC = 0.999), and finally, a < 296.28 pg/mL cutoff was also significant in identifying pa-tients with active CD from those with remission (sensitivity: 96.67%, specificity: 80%, AUC = 0.946). According to multivariable logistic regression, CD patients with decreased Maresin-1 had increased likelihood of having active disease (OR: 0.942, 95% CI = 0.892 - 0.994, p = 0.031). CONCLUSIONS: This was the first study to examine circulating levels of Maresin-1 in CD patients and showed that patients with active disease and those in remission had significantly lower values compared to controls. Our results suggest that Maresin-1 levels might be involved in the pathogenesis of CD. Serum Maresin-1 could be used as a diagnostic biomarker in predicting inflammation in CD and may emerge as a target for treatment.
A Case of Waldenström's Macroglobulinemia Detected by the "Negative Creatinine" Alarm of Biochemical Results.
Wang TT, Dong XY, Lu YN … +3 more , Yan YK, Zhong C, Zhang LC
Clin Lab · 2026 Apr · PMID 41979633 · Publisher ↗
BACKGROUND: Test results and outliers are of great significance to disease diagnosis, especially in some inconspicuous hematological diseases. This report presents a case of Waldenström's macroglobulinemia diagnosed foll...
BACKGROUND: Test results and outliers are of great significance to disease diagnosis, especially in some inconspicuous hematological diseases. This report presents a case of Waldenström's macroglobulinemia diagnosed following abnormal biochemical test results. METHODS: The laboratory of our hospital conducted a review of the patient's specimen due to a negative creatinine value, despite normal reagents, quality controls, and instrument status. It was found that the specimen was non-lipemic, but it became turbid immediately after the addition of distilled water. Subsequent tests were carried out based on multiple abnormal findings. Biochemical tests were additionally performed, including blood immunoglobulin and serum protein electrophoresis. The presence of serum M protein was detected. RESULTS: The diagnosis of Waldenström's macroglobulinemia was confirmed through consultation between the clinical physician and the laboratory physician. CONCLUSIONS: In clinical practice, it is not uncommon for test results to be abnormal. The role of laboratory workers is to quickly and accurately identify the causes of these abnormalities, so that clinicians can promptly diagnose patients and proceed with subsequent treatments.
AKT2 for Modifying the Tumor Immune Microenvironment in Lung Adenocarcinoma.
Fu Z, Mo L, Li P … +4 more , Cai Y, Huang H, Zhan S, Li J
Clin Lab · 2026 Apr · PMID 41979632 · Publisher ↗
BACKGROUND: The phosphatidylionsitol 3-kinase (PI3K)-v-akt murine thymoma viral oncogene homolog (AKT)-mammalian target of rapamycin (mTOR) pathway has been extensively studied in lung adenocarcinomas (LUAD). This study...
BACKGROUND: The phosphatidylionsitol 3-kinase (PI3K)-v-akt murine thymoma viral oncogene homolog (AKT)-mammalian target of rapamycin (mTOR) pathway has been extensively studied in lung adenocarcinomas (LUAD). This study aimed to explore the correlation between this pathway and the tumor microenvironment. METHODS: Data from the Cancer Genome Atlas (TCGA) was utilized to analyze variations in the expression of v-akt murine thymoma viral oncogene homolog 2 (AKT2) between LUAD tissues and normal tissues and to assess its effect on the survival of patients. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis were performed. The "R language" was used to analyze the disparity between immune cell infiltration in tumor tissues and the correlation with AKT2 expression levels. RESULTS: AKT2 was significantly upregulated in LUAD. The high expression level of AKT2 was significantly associated with shorter overall survival. Gene Set Enrichment Analysis revealed that tumor immune-related pathways such as adaptive immune response based on somatic recombination of immune receptors built from immunoglobulin super-family domains were more active in the AKT2 high expression group. Tumor tissues with high AKT2 expression tended to have higher levels of regulatory T cells (Tregs) and CD8+ T cells and lower levels of activated dendritic cells and γδT cells. AKT2 expression was positively influenced by common immune checkpoints and correlated with TMB, suggesting that high AKT2 expression in LUAD may lead to significant immune evasion. CONCLUSIONS: Tumor microenvironment in high AKT2 expression patients demonstrated immunosuppressive characteristics such as reduced γδT cells aggregation and increased Tregs infiltration.
Nontargeted Metabolomics Analysis of Carbapenem-Resistant Pseudomonas aeruginosa.
Zhang Y, Yin X, Xie Y … +2 more , Wang X, Wang Y
Clin Lab · 2026 Apr · PMID 41979631 · Publisher ↗
BACKGROUND: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection is becoming increasingly severe in clinical practice, yet its host metabolic characteristics remain unclear. Based on metabolomics, this study comp...
BACKGROUND: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection is becoming increasingly severe in clinical practice, yet its host metabolic characteristics remain unclear. Based on metabolomics, this study compares the metabolic profiles of patients infected with CRPA versus susceptible strains, aiming to identify potential diagnostic biomarkers and therapeutic targets. METHOD: This single-center case-control study enrolled 20 inpatients diagnosed with Pseudomonas aeruginosa infection at the Second People's Hospital between May 2023 and May 2024. Based on antimicrobial susceptibility testing, patients were divided into a CRPA group (n = 10) and a carbapenem-susceptible (CSPA) group (n = 10). Plasma samples from all patients underwent untargeted metabolomic analysis using ultrahigh-performance liquid chromatography-mass spectrometry. Differential metabolites were screened by applying principal component analysis, orthogonal partial least squares-discriminant analysis multivariate statistical analysis, and univariate analysis. These metabolites were subsequently annotated and subjected to pathway enrichment analysis using the Kyoto Encyclopedia of Genes and Genomes (KEGG), Human Metabolome Database, and ChemSpider databases. RESULTS: Metabolomic analysis identified 19 differentially abundant metabolites, more than half of which were involved in lipid metabolism. This was primarily characterized by the upregulation of glycerophospholipids (such as phosphatidylserine and phosphatidylinositol) and the downregulation of glycerophosphocholine, phosphatidylethanolamine, and certain sphingolipids. Beyond lipids, compounds such as cholic acids, p-cresol sulfate, and hippuric acid were also significantly upregulated. KEGG enrichment analysis revealed that the differential metabolites were predominantly enriched in pathways related to glycerophospholipid metabolism, sphingolipid metabolism, and ether lipid metabolism, indicating that disrupted lipid metabolism is a core metabolic feature of CRPA infection. CONCLUSIONS: This study demonstrates that the metabolic differences in CRPA-infected patients are concentrated in lipid metabolism, suggesting a close association between drug-resistant infections and host-pathogen lipid metabolic remodeling. Changes in relevant lipids hold value as potential diagnostic and prognostic biomarkers, while lipid metabolic pathways may also represent novel targets for future therapeutic interventions.
Novel Basophilic Crystals in Acute Myeloid Leukemia with EZH2/DNMT3A Mutations: Aggressive Case with Thrombosis.
Liu Z, He D, Wen X … +2 more , Xu S, Xiao D
Clin Lab · 2026 Apr · PMID 41979630 · Publisher ↗
BACKGROUND: This study reports a novel case of EZH2/DNMT3A-mutated AML featuring unique basophilic rectangular crystals in blasts, associated with aggressive disease and thrombotic complications. METHODS: A 56-year-old m...
BACKGROUND: This study reports a novel case of EZH2/DNMT3A-mutated AML featuring unique basophilic rectangular crystals in blasts, associated with aggressive disease and thrombotic complications. METHODS: A 56-year-old male underwent morphological analysis (light microscopy, cytochemistry), clinical monitoring, and molecular profiling. RESULTS: MPO-negative rectangular crystals (3 - 20 µm) persisted despite therapy, demonstrating chemoresistance. These crystals were distinct from Auer rods and associated with an aggressive clinical course, including fatal DVT/PE within 7 months. Molecular analysis revealed EZH2/DNMT3A mutations, suggesting epigenetic dysregulation underlying both crystal formation and thrombotic predisposition. CONCLUSIONS: This first-reported association between such crystals and EZH2/DNMT3A-mutated AML highlights their potential as high-risk markers. The findings implicate epigenetic dysregulation in treatment resistance and thrombogenesis, warranting cryo-EM studies to elucidate crystal composition and mechanisms. Clinically, this supports vigilant thromboprophylaxis and exploration of combined epigenetic/anticoagulant therapies for similar high-risk cases.
Prediction Model for Monoclonal Gammopathy of Renal Significance Risk in Nonmalignant Monoclonal Disorders.
Yang J, Li Q, Ying F … +2 more , Chen M, Zhang M
Clin Lab · 2026 Apr · PMID 41979629 · Publisher ↗
BACKGROUND: The aim is to identify independent risk factors for monoclonal gammopathy of renal significance (MGRS) and develop a predictive model for optimizing renal biopsy decision-making in suspected patients, thereby...
BACKGROUND: The aim is to identify independent risk factors for monoclonal gammopathy of renal significance (MGRS) and develop a predictive model for optimizing renal biopsy decision-making in suspected patients, thereby improving biopsy positivity rates. METHODS: We retrospectively enrolled 291 patients from The First Affiliated Hospital of Wenzhou Medical University (January 2015 - December 2022). Clinical and laboratory indicators were collected. Independent predictors of MGRS were screened using Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression, followed by the construction of a nomogram model. Patients were randomly divided into training (n = 204, 70%) and validation (n = 87, 30%) cohorts. Model performance was evaluated in the independent validation set via ROC analysis, calibration curves, decision curve analysis (DCA), and Hosmer-Lemeshow (HL) test. RESULTS: Among 291 patients, 132 (45.4%) were MGRS-positive. Five independent predictors were identified: abnormal free light chain (FLC) ratio, advanced age, abnormal white blood cell count, hypoglobulinemia, and 24-hour urinary protein > 1.5 g. The model exhibited excellent discrimination, with an AUC of 0.823 (95% CI: 0.767 - 0.879) in the training set and 0.912 (95% CI: 0.854 - 0.971) in the validation set. Calibration parameters approxi-mated ideal values in both sets (training: intercept = -0.00, slope = 1.00; validation: intercept = -0.05, slope = 1.07). HL test confirmed optimal goodness-of-fit (training: χ² = 7.395, p = 0.495; validation: χ² = 3.631, p = 0.889). DCA demonstrated significant net clinical benefit across threshold probabilities. CONCLUSIONS: This validated MGRS predictive model (AUC > 0.9 in independent validation) shows high accuracy and clinical utility for noninvasive screening of high-risk patients and individualized renal biopsy decisions.
Serum Galectin-3 and Glial Fibrillary Acidic Protein Levels in Patients with Spinal Cord Injury in Relation to Injury Severity and Prognosis.
Ou Y, Zong HY
Clin Lab · 2026 Apr · PMID 41979628 · Publisher ↗
BACKGROUND: This research aimed to assess the link between serum galectin-3 (Gal-3) and glial fibrillary acidic protein (GFAP) levels and the severity and prognosis of spinal cord injury (SCI) patients. METHODS: Serum Ga...
BACKGROUND: This research aimed to assess the link between serum galectin-3 (Gal-3) and glial fibrillary acidic protein (GFAP) levels and the severity and prognosis of spinal cord injury (SCI) patients. METHODS: Serum Gal-3 and GFAP levels were measured in SCI patients. Serum Gal-3 and GFAP levels were analyzed in relation to SCI injury severity and prognosis. The prognostic value of serum Gal-3 and GFAP was assessed using ROC curve analysis. RESULTS: The American Spinal Injury Association Impairment Scale (AIS) categorized 59 patients into the severe SCI group (AIS A-B). Serum Gal-3 and GFAP levels were higher in patients with severe SCI than in patients with non-severe SCI. The 6-month follow-up AIS classified 60 patients as having a poor prognosis. Serum Gal-3 and GFAP levels were higher in poor-prognosis SCI patients than in good-prognosis SCI patients. A significant association between poor prognosis and serum Gal-3 and GFAP was demonstrated through multivariate logistic regression analysis. ROC curve analysis showed that the AUCs for serum Gal-3 and GFAP were 0.856 and 0.890, respectively. CONCLUSIONS: Serum Gal-3 and GFAP levels are significantly associated with injury severity at admission and 6-month prognosis in SCI patients. Serum Gal-3 and GFAP levels can be used as clinical risk factors for predicting SCI injury severity and 6-month prognosis.
Sudden Unexpected Death due to Brainstem Hemorrhage Associated with Cerebral Venous Malformation.
Wan Y, Sun A, Liu X … +1 more , Yu Y
Clin Lab · 2026 Apr · PMID 41979627 · Publisher ↗
BACKGROUND: Cerebral venous malformations (CVMs) generally remain silent and asymptomatic in the vast majority of cases. CVM-associated lethal intracerebral hemorrhage is extremely rare. METHODS: Here we presented a case...
BACKGROUND: Cerebral venous malformations (CVMs) generally remain silent and asymptomatic in the vast majority of cases. CVM-associated lethal intracerebral hemorrhage is extremely rare. METHODS: Here we presented a case with chest tightness, shortness of breath, fever and convulsive seizures. Chest and brain computed tomography, and laboratory testing were performed. RESULTS: The patient suffered a sudden cardiac arrest and expired despite aggressive resuscitation efforts. Autopsy analysis revealed a venous vascular malformation located in the pons and medulla oblongata, and brainstem hemorrhage and hematoma formation in the surrounding areas. CONCLUSIONS: CVMs, though exceptionally rare, can lead to fatal hemorrhage and therefore warrant heightened clinical vigilance. Proactive measures should be implemented to mitigate potential risk factors for this severe complication. When evaluating adult patients with recurrent convulsive episodes, clinicians need to consider prompt neuroimaging to rule out life-threatening intracranial hemorrhage.
Association of Platelet-to-HDL Cholesterol Ratio with Metabolic Syndrome in a Japanese Health Check-up Population.
Moriyama K, Okuda I, Tajima T … +3 more , Masuda Y, Sakai Y, Nishizaki Y
Clin Lab · 2026 Apr · PMID 41979626 · Publisher ↗
BACKGROUND: The platelet-to-high-density lipoprotein cholesterol (HDL-C) ratio (PHR) has been proposed as a composite biomarker reflecting both thrombogenic and lipid-related mechanisms. However, its relationship with me...
BACKGROUND: The platelet-to-high-density lipoprotein cholesterol (HDL-C) ratio (PHR) has been proposed as a composite biomarker reflecting both thrombogenic and lipid-related mechanisms. However, its relationship with metabolic syndrome (MetS) has not been extensively evaluated in the general Japanese population. METHODS: We conducted a cross-sectional analysis of 17,581 adults (7,400 women) who underwent health check-ups between 2007 and 2024. PHR was calculated as the platelet count divided by HDL-C. MetS was defined according to the Japanese criteria. The association between PHR and MetS and its components was assessed using multivariable linear and logistic regression. Receiver operating characteristic (ROC) analysis was used to evaluate the discriminatory ability of PHR compared to other simple markers. RESULTS: PHR was significantly higher in participants with MetS (p < 0.001) and correlated with key components, including waist circumference, triglycerides (TG), and fasting plasma glucose. In multivariable logistic regression, PHR was independently associated with MetS in both sexes. The area under the curve (AUC) for PHR was 0.687 (95% confidence interval [CI]: 0.674 - 0.700) in men and 0.724 (95% CI: 0.700 - 0.748) in women. These values were modestly lower than those for TG and TG/HDL-C, but PHR showed utility as a non-redundant marker. CONCLUSIONS: PHR is independently associated with MetS and its components in the Japanese population. Although its discriminatory performance is modest, PHR may serve as a supplementary marker in health check-up settings for identifying individuals at risk of metabolic disorders.
Myocardial Dysfunction and Stress-Induced Cardiomyopathy Induced by Septic Shock After Hip Arthroplasty.
Liu Y, Qiao Y, Ren ZK … +3 more , Qu HF, Li JY, Cheng AB
Clin Lab · 2026 Apr · PMID 41979625 · Publisher ↗
BACKGROUND: Stress-induced cardiomyopathy, also known as Takotsubo cardiomyopathy or apical ballooning syndrome, is a disease of acute reversible myocardial injury characterized by transient localized systolic left ventr...
BACKGROUND: Stress-induced cardiomyopathy, also known as Takotsubo cardiomyopathy or apical ballooning syndrome, is a disease of acute reversible myocardial injury characterized by transient localized systolic left ventricular insufficiency. METHODS: Appropriate laboratory tests are carried out, Next Generation Sequencing (NGS), Echocardiography. RESULTS: Postoperative echocardiography showed myocardial dysplasia of the left ventricle and abnormal wall motion of the left ventricular phases. NGS: Burkholderia cepacia onionis, human herpesvirus type 6B, and human polyomavirus type 2. The patient's condition improved after aggressive anti-infective and symptomatic treatment. CONCLUSIONS: Because of the difficulty in distinguishing acute coronary syndromes from stress-induced cardiomyopathy, we should be on the lookout for stress-induced cardiomyopathy in any patient who develops a severe physical or emotional reaction during the perioperative period, with electrocardiographic abnormalities and refractory hypotension. Prompt and effective treatment can reverse myocardial damage.
Evaluation of ELISA Test Results of the Changing Blood Donor Profile in Istanbul, Single Center Experience (2020 - 2024).
Şanli K, Öncel B, Ceylan AN … +6 more , Kömeç S, Evren K, Kuru N, Durmuş MA, Gümüş A, Karabulut N
Clin Lab · 2026 Apr · PMID 41979624 · Publisher ↗
BACKGROUND: Ensuring a safe blood supply is a critical responsibility of transfusion services. In Türkiye, demographic shifts, including a growing number of immigrant donors, have necessitated ongoing evaluation of trans...
BACKGROUND: Ensuring a safe blood supply is a critical responsibility of transfusion services. In Türkiye, demographic shifts, including a growing number of immigrant donors, have necessitated ongoing evaluation of transfusion-transmissible infections (TTIs) and screening protocols to analyze the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis among blood donors and to evaluate demographic trends and false-positive rates in serological screening. METHODS: This retrospective study analyzed ELISA screening results from 110,419 blood donations collected be-tween 2020 and 2024 at a regional blood center in Türkiye. Demographic data, seroprevalence of TTIs, confirmatory testing outcomes, and changes over time were examined. RESULTS: Most donors were male (89.4%) and Turkish citizens (95.8%), with a mean age of 34.5 years. HBV reactivity was observed in 0.4% of donors, significantly higher among Turkish nationals and older individuals (p < 0.05). HCV and HIV reactivity were each detected in 0.2% of donors, while syphilis antibodies were found in 0.2%. Foreign donors, particularly women, exhibited higher reactivity for HBV and HCV. Co-infections were identified in a subset of donors (2.9% of syphilis-positive cases). False-positive rates were notably high for anti-HCV (85.6%) and anti-HIV (80.2%), with HBsAg showing the lowest (4.6%). CONCLUSIONS: The evolving donor profile and increasing false-positive rates highlight the need for more specific screening assays and revised donor management strategies. Continuous surveillance and multicenter studies are essential to maintain transfusion safety in an increasingly diverse population.
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