Application of PCT, IL-6, CRP, and WBC for Diagnosing Neonatal Sepsis.

The purpose of this study was to investigate the diagnostic value of combined detection of PCT, IL-6, CRP, and WBC in neonatal sepsis. The study selected 50 neonatal sepsis patients treated in Pucheng County Hospital from April 2018 to June 2020 as the patient group, and 50 healthy newborns as the control group. Before treatment, white blood cell count (WBC) was performed on all neonates, and serum PCT, IL-6, and CRP levels were detected by ELISA. After treatment, serum levels of these four biomarkers in the effective/non-effective groups were observed. The results noted higher levels of these four biomarkers in the patient group rather than the control group before treatment, and in the effective group rather than the non-effective group after treatment. ROC analysis found that the area under curve (AUC), specificity and sensitivity of the combined detection were better than those of the single detection. In short, combined detection of these four biomarkers has a high diagnostic value for neonatal sepsis.

Somatic mutation contributing to clonal haematopoiesis is a risk factor of recurrent stroke in first-ever acute ischaemic stroke: a prospective cohort study.

BACKGROUND: Somatic mutation contributes to clonal haematopoiesis of indeterminate potential (CHIP) is related to age and associated with a higher risk of stroke and atherosclerotic cardiovascular disease. Here, we investigated the prognostic significance of CHIP in a large first-ever acute ischaemic stroke (AIS) cohort and explored the underlying mechanisms. METHODS: We studied a prospective cohort of 6016 patients who had a first-ever AIS in China. Whole-genome sequencing was performed to identify CHIP. High-sensitivity C reactive protein (hs-CRP) levels above 3 mg/L at baseline were defined as hyperinflammation. Recurrent stroke during the 3-month follow-up was the primary outcome. RESULTS: Among the 6016 patients who had a first-ever AIS, with a median age was 62 years (IQR, 54.0‒70.0), 3.70% were identified as CHIP carriers. The most common mutations occurred in the DNMT3A (30.0%) and TET2 (11.4%) genes. During a follow-up of 3 months, the presence of CHIP was associated with recurrent stroke (HR 1.62, 95% CI 1.04 to 2.51, p=0.03), recurrent ischaemic stroke (HR 1.64, 95% CI 1.04 to 2.58, p=0.03) and combined vascular events (HR 1.58, 95% CI 1.02 to 2.44, p=0.04) after adjusting for hsCRP levels at baseline in patients who had a first-ever AIS. Subgroup analysis demonstrated that CHIP was only associated with recurrent stroke when patients under hyperinflammation (OR 3.10, 95% CI 1.92 to 5.00, p<0.001) but not in those without hyperinflammation (OR 0.18, 95% CI 0.03 to 1.04, p=0.06, Pinteraction=0.002). CONCLUSION: Our results suggest that somatic mutations contributing to CHIP increase the risk of short-term recurrent stroke in patients who had a first-ever AIS. Hyperinflammation may be important in the relationship between CHIP and recurrent stroke.