The Method of Lipemia Clearance Should be Based on the Characteristics and the Method of Testing in the Emergency Laboratory.

BACKGROUND: This study aimed to compare the lipemia removal efficiency of highspeed centrifugation, lipid scavengers, and dilution for biochemical analytes. METHODS: We collected 30 cases of lipemic plasma in an emergency laboratory and divided them into 4 aliquots. Lipemia was removed by highspeed centrifugation, lipid scavenger, dilution, and ultracentrifugation, then analytes were measured by an AU5800 analyzer. Taking ultracentrifugation as reference, the efficiencies of the other three methods were evaluated based on the deviation. RESULTS: When highspeed centrifugation was used for lipemia removal, DBIL (18.62%), and Magnesium (6.09%) could not satisfy the criterion. When lipid scavengers were applied to remove lipemia, CRP (-86.70%), TP (-8.29%), CKMB (-44.85%), DBIL (37.96%), Glu (4.20%) and phosphate (14.32%) were not suggested as lipid scavengers. For dilution, nearly half of the analytes could satisfy the criterion, including AMY (2.41%), CRP (5.54%), ALT (2.85%), GGTL (-1.73%), ALP (-0.04%), Glu (-0.84%), LDH (0.06%), CK (0.68%), BUN (3.80%), CREA (-1.54%), UA (5.42%), and magnesium (0.43%). CONCLUSIONS: Neither of the methods for lipid removal could satisfy all emergency department tests for lipid removal. This finding suggests that removing lipemia in the clinical laboratory should be based on the characteristics and the method of testing.

Clinical Characteristics of COVID-19 Patients' Postvaccination.

To investigate the clinical characteristic of domestic coronavirus disease 2019 (COVID-19) patients after vaccination campaign conducted in China. According to vaccination status and months from first vaccine dose to infection detection, patients were divided into unvaccinated, <3 months, 3-6 months, and >6 months groups. The information of demographic and clinical characteristics, laboratory and thoracic computed tomography (CT) findings, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid and IgM, IgG antibodies was retrospectively collected. Therapeutic approaches, temperature-normalizing and viral shedding times, outcomes were also summarized. SARS-CoV-2 antibody levels were further analyzed based on the other following variables: time from second vaccine dose to infection, vaccine dose, the interval from the first to the second dose, and vaccine brand. Among 208 COVID-19 patients, 13 (6.28%) were unvaccinated. No significant differences in demographic and clinical characteristics, laboratory and CT findings, and SARS-CoV-2 nucleic acid loads were detected between groups (all p > 0.05). In comparison with the unvaccinated group, the median SARS-CoV-2 IgG levels were noticeably increased in those vaccinated groups (0.603 in unvaccinated, 15.925 in <3 months, 14.04 in 3-6 months, and 4.94 in >6 months, respectively, p < 0.05). However, SARS-CoV-2 IgG levels were not altered between groups divided based on the other variables. Vaccination does not affect the clinical characteristics in COVID-19 patients. COVID-19 patients with vaccination have high SARS-CoV-2 IgG levels. Underscore the necessity of rapid implementation of vaccination campaigns can be speculated.

Proportion of Uterine Malignant Tumors in Patients with Laparoscopic Myomectomy: A National Multicenter Study in China.

BACKGROUND: The Food and Drug Administration recently announced that the use of morcellation may cause fibroids or pelvic dissemination and metastasis of uterine sarcoma; therefore, the use of morcellation is limited in the USA. A large sample study is necessary to assess the proportion of uterine malignant tumors found in patients with laparoscopic myomectomy. METHODS: A national multicenter study was performed in China. From 2002 to 2014, 33,723 cases were retrospectively selected. We calculated the prevalence and recorded the clinical characteristics of the patients with malignancy after morcellation application. A total of 62 cases were finally pathologically confirmed as malignant postoperatively. Additionally, the medical records of the 62 patients were analyzed in details. RESULTS: The proportion of postoperative malignancy after morcellation application was 0.18% (62/33,723) for patients who underwent laparoscopic myomectomy. Nearly 62.9% (39/62) of patients had demonstrated blood flow signals in the uterine fibroids before surgery. And, 23 (37.1%) patients showed rapid growth at the final preoperative ultrasound. With respect to the pathological types, 38 (61.3%) patients had detectable endometrial stromal sarcoma, 13 (21.0%) had detectable uterine leiomyosarcoma, only 3 (3.2%) had detectable carcinosarcoma, and 5 (8.1%) patients with leiomyoma had an undetermined malignant potential. CONCLUSIONS: The proportion of malignancy is low after using morcellation in patients who undergo laparoscopic myomectomy. Patients with fast-growing uterine fibroids and abnormal ultrasonic tumor blood flow should be considered for malignant potential, and morcellation should be avoided.

Characterization of Antigenic Relatedness between GII.4 and GII.17 Noroviruses by Use of Serum Samples from Norovirus-Infected Patients.

A novel GII.17 norovirus variant caused major gastroenteritis epidemics in China in 2014 to 2016. To explore the host immune factors in selection of the emergence of this new variant, we characterized its antigenic relatedness with the GII.4 noroviruses that have dominated in China for decades. Through an enzyme-linked immunosorbent assay (ELISA) and a histo-blood group antigen (HBGA) blocking assay using sera from GII.4 and the GII.17 variant-infected patients, respectively, we observed limited cross-immune reactivity by the ELISA but little reactivity by the HBGA blocking assay between GII.4 norovirus and the new GII.17 variant. Our data suggest that, among other possible factors, GII.4-specific herd immunity had little role in the emergence of the new GII.17 variant. Thus, GII.17 may be an important active antigenic type or immunotype that needs to be considered for future vaccine strategies against human noroviruses.