Establishment of reference intervals for serum amylase and lipase: a large sample study based on Chinese healthy children.

This study aimed to establish age- and sex-specific reference intervals for serum amylase and lipase in children by prospective investigation. A total of 6466 healthy Han children of 1 month ∼ <18 years were recruited in communities and schools in five administrative regions of Jilin Province, China. The serum amylase and lipase concentrations were measured on the VITROS 5600 integrated system. The reference intervals were defined by a nonparametric 95% percentile interval. Reference intervals of amylase were divided into four age-specific partitions. It increased rapidly between the ages of 1 month ∼ <1 year and 1 ∼ <5 years, slightly decreased between the ages of 5 ∼ <12 years, and increased slowly between 12 ∼ <18 years. Lipase concentrations showed sex differences after 1-year-old, with reference intervals in males divided into 2 divisions and 3 divisions in females. The lipase concentrations in both males and females showed an upward trend, and the lipase concentrations in females were higher than those in males. This study established reference intervals for amylase and lipase in healthy Chinese children and provided a more accurate explanation for the diagnosis and prognosis of clinical pediatric diseases.

Multiple skin abscesses associated with bacteremia caused by Burkholderia gladioli: A case report.

BACKGROUND: Burkholderia gladioli (B. gladioli) is regarded as a rare opportunistic pathogen. Only a few patients with abscesses caused by B. gladioli infections have been reported, and these are usually abscesses at the incision caused by traumatic surgery. CASE SUMMARY: A 74-year-old male patient with abscesses and pain throughout his body for 1 mo was admitted to our hospital. Some of the abscesses had ruptured with purulent secretions on admission. Color Doppler ultrasound examination of the body surface masses showed mixed masses 75 mm × 19 mm, 58 mm × 17 mm, 17 mm × 7 mm, and 33 mm × 17 mm in size in the muscle tissues of both the right and left forearms, the posterior area of the right knee and the left leg, respectively. Abscess secretions and blood cultures grew B. gladioli. The following 3 methods were used to jointly identify the bacterium: an automatic microbial identification system, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and full-length 16S rDNA sequencing. After 27 d of treatment with meropenem, etimicin, trimethoprim-sulfamethoxazole and other antibiotics, most of his skin abscesses were flat and he was discharged without any symptoms. CONCLUSION: This is the first reported case of multiple skin abscesses associated with bacteremia caused by B. gladioli. Our study provides important reference values for the clinical diagnosis and treatment of B. gladioli infections.

Early changes in laboratory tests predict liver function damage in patients with moderate coronavirus disease 2019: a retrospective multicenter study.

BACKGROUND: Most patients with coronavirus disease 2019 demonstrate liver function damage. In this study, the laboratory test data of patients with moderate coronavirus disease 2019 were used to establish and evaluate an early prediction model to assess the risk of liver function damage. METHODS: Clinical data and the first laboratory examination results of 101 patients with moderate coronavirus disease 2019 were collected from four hospitals' electronic medical record systems in Jilin Province, China. Data were randomly divided into training and validation sets. A logistic regression analysis was used to determine the independent factors related to liver function damage in patients in the training set to establish a prediction model. Model discrimination, calibration, and clinical usefulness were evaluated in the training and validation sets. RESULTS: The logistic regression analysis showed that plateletcrit, retinol-binding protein, and carbon dioxide combining power could predict liver function damage (P < 0.05 for all). The receiver operating characteristic curve showed high model discrimination (training set area under the curve: 0.899, validation set area under the curve: 0.800; P < 0.05). The calibration curve showed a good fit (training set: P = 0.59, validation set: P = 0.19; P > 0.05). A decision curve analysis confirmed the clinical usefulness of this model. CONCLUSIONS: In this study, the combined model assesses liver function damage in patients with moderate coronavirus disease 2019 performed well. Thus, it may be helpful as a reference for clinical differentiation of liver function damage. Trial registration retrospectively registered.

Determination of Age- and Sex-Specific 99th Percentile Upper Reference Limits for High-Sensitivity Cardiac Troponin I in Healthy Chinese Adults.

INTRODUCTION: Age- and sex-specific reference intervals (RIs) for high-sensitivity cardiac troponin I (hs-cTnI) are not available in China. The objective of the present research was to determine the assay-specific 99th percentile upper reference limits (URLs) for hs-cTnI in healthy Chinese adults. METHODS: Apparently healthy individuals were first screened with a questionnaire. The reference population was selected according to the International Federation of Clinical Chemistry (IFCC) criteria using surrogate biomarker for diabetes, myocardial dysfunction, and renal dysfunction. The serum concentration of hs-cTnI was measured using the automatized VITROS 5600 Immunodiagnostic system (Ortho Clinical Diagnostics, Raritan, NJ, USA). RESULTS: A total of 2,183 healthy individuals (1,051 men and 1,132 women aged from 20 to 95 years) were enrolled in the study. The serum overall 99th percentile URLs of hs-cTnI were 11.1 ng/L (12.5 ng/L in men, 9.6 ng/L in women). In both men and women, the 99th percentile URLs were significantly higher in individuals ≥55 years old than those in the <55 years old, especially in women. Moreover, 78.8% of males and 70.1% of females presented with hs-cTnI concentrations above the limit of detection of 0.43 ng/L. CONCLUSION: The hs-cTnI-VITROS assay coincided with the performance standard of the IFCC for high-sensitivity cTnI assays. The 99th percentile URLs for hs-cTnI in healthy Chinese adults were different from the manufacturer declared and appeared heterogeneous, potentially susceptible to factors such as age and sex.

Establishment of reference intervals for serum amylase and lipase: a large sample study based on Chinese healthy children.

This study aimed to establish age- and sex-specific reference intervals for serum amylase and lipase in children by prospective investigation. A total of 6466 healthy Han children of 1 month ∼ <18 years were recruited in communities and schools in five administrative regions of Jilin Province, China. The serum amylase and lipase concentrations were measured on the VITROS 5600 integrated system. The reference intervals were defined by a nonparametric 95% percentile interval. Reference intervals of amylase were divided into four age-specific partitions. It increased rapidly between the ages of 1 month ∼ <1 year and 1 ∼ <5 years, slightly decreased between the ages of 5 ∼ <12 years, and increased slowly between 12 ∼ <18 years. Lipase concentrations showed sex differences after 1-year-old, with reference intervals in males divided into 2 divisions and 3 divisions in females. The lipase concentrations in both males and females showed an upward trend, and the lipase concentrations in females were higher than those in males. This study established reference intervals for amylase and lipase in healthy Chinese children and provided a more accurate explanation for the diagnosis and prognosis of clinical pediatric diseases.

Reference interval transference of common clinical biomarkers.

Clinical examination has become an important method of disease diagnosis, curative effect evaluation, prognosis judgment and health monitoring, and the biological reference interval is the reference standard to interpret test results and analyses of test information. In clinical tests, the reference interval is often affected by race, sex, age, geographical location and growth and development, so it is very important to establish a suitable reference interval for each laboratory. It is a huge and arduous task for each laboratory to establish its own reference interval. It is unrealistic for different measurement systems to establish reference intervals. According to the C28-A3c guideline from the Clinical and Laboratory Standards Institute (CLSI), clinical laboratories can appropriately transfer the reference intervals provided by other laboratories. This paper reviews whether the biomarkers in multiregional laboratories can transfer reference intervals between different measurement systems to expand the application of reference interval databases and ensure the accuracy and consistency of the test results.

The Function of T Follicular Helper Cells in the Autoimmune Liver Diseases.

T follicular helper (TFH) cells are recognized as a subtype of T cells that are involved in the germinal center formation and B cell development. When dysregulated, TFH cells may represent an important mechanism that contributes to a heightened humoral response and autoantibody production in autoimmune liver diseases (AILDs). TFH cells participate in the immune response associated with AILDs by expressing surface receptors such as programmed cell death protein-1, C-X-C motif chemokine receptor 5, and inducible T cell costimulators, as well as cytokines such as interleukin-21. TFH cells also downregulate chemokine (C-C motif) receptor 7 and promote the dysregulation of the T follicular regulatory/TFH axis. This review highlights the importance of TFH cells in AILDs.

Mechanism of thrombocytopenia in COVID-19 patients.

Since December 2019, a novel coronavirus has spread throughout China and across the world, causing a continuous increase in confirmed cases within a short period of time. Some studies reported cases of thrombocytopenia, but hardly any studies mentioned how the virus causes thrombocytopenia. We propose several mechanisms by which coronavirus disease 2019 causes thrombocytopenia to better understand this disease and provide more clinical treatment options.