1.Progress in laboratory diagnosis of heparin induced thrombocytopenia
Chinese Journal of Laboratory Medicine 2016;39(10):795-800
Heparin induced thrombocytopenia ( HIT ) is a severe side effect of heparin with antibody-mediation.Laboratory assays can be divided into two major categories, about functional assays and HIT antibodiesdetection.Thefunctional assays, such as the serotonin release assay ( SRA ) and heparin-induced platelet activationassay( HIPA) , are sensitive and specific for HIT.They arethe reference standard assays generally, but have thedeficiencies of complicated operation and time-consuming, and cannot be used as a routine examination. TheHIT antibodiesdetections, such as ELISA, immune turbidimetry assay, chemiluminescent assay and lateral flow immunoassay, have high diagnostic sensitivityandareavailable at routine laboratories.They can exclude the diagnosis of HIT or beused to diagnose HIT effectively combined with the pre-test probability score(4Ts score) of HIT.
2.Circulating microRNAs as biomarker for venous thromboembolism diagnosis
Mengyuan DING ; Yang HE ; Changgeng RUAN
Chinese Journal of Laboratory Medicine 2016;39(10):791-794
Venous thromboembolism ( VTE) remains the third most common cardiovascular disease with a vague pathogenesis.Conventional biomarkers exhibit poor performance in the diagnosis, surveillance and prognosis of VTE.MicroRNAs ( miRNAs ) are a class of evolutionarily conserved small non-coding RNAs that are involved in the regulation of gene expression and protein translation An array of experimental studies has shown the importance of miRNAs for disease initiation/progression.Circulating miRNAs are found in plasma, serum and other body fluids in an apparently stable form.Recent evidence revealed that circulating miRNAs, a novel family of regulatory molecules, emerge as a promising class of biomarkers in many cardiovascular diseases, malignancies as well as VTE.This review describes current understanding of miRNA biogenesis and the origins and types of circulating miRNAs and gives an outline of recent work on circulating miRNAs as well as its challenges and perspectives of the clinical utility of circulating miRNA in VTE.
3.Clinical value of tuberculosis protein chip in the diagnosis of tuberculosis infection
Ke WANG ; Hongying DAI ; Yin ZHANG ; Yanzi ZHANG ; Tianjin ZHU ; Zhigui TANG ; Yongqiang. YUAN
Chinese Journal of Laboratory Medicine 2016;39(10):776-778
Objective To investigate the Mycobacterium tuberculosis infection status and Clinical Characteristics in Yongchuan District, Chongqing by Tuberculosis Protein Chip.Methods Compared the conventional method to detect Mycobacterium tuberculosis in infectious department outpatient of Yongchuan Hospital , Chongqing Medical University from July 2014 to June 2015.Tuberculosis protein chip was selected to detect the Mycobacterium tuberculosis infection in Yongchuan area.Chi-square Test was applied to analyze the results.Results The positive rate of Tuberculosis Protein Chip, T-SPOT.BT, DNA Chip, Golden immnnochromatog-raphy, Acid-fast staining were 81.5%, 90.7%, 89.5%, 63.5% and 38.3%respectively on 162 cases of Pulmonary tuberculosis.The five methods were considered significant difference on the diagnosis of Pulmonary tuberculosis ( P<0.05 ).The positive rate of Tuberculosis Protein Chip, T-SPOT, Golden immnnochromatog-raphy were 90.6%,T-SPOT 94.3%and 47.2% respectively on 53 cases of extrapulmonary tuberculosis, it was a significant difference with the three methods(P<0.05),but there was no significant difference with Tuberculosis Protein Chip and T-SPOT.BT ( P>0.05 ).The highest positive rates of anti-LAM was 94%.Conclusion The results of Tuberculosis protein chip are reliable on pulmonary tuberculosis and extrapulmonary tuberculosis diagnosis.
4.Serological assessment of pepsinogens in patients with gastric mucosal lesions using latex enhanced immunoturbidimetry
Fan WANG ; Xiangyi LIU ; Haitong GU ; Li LI ; Xinxin LU
Chinese Journal of Laboratory Medicine 2016;39(10):771-775
Objective To evaluate serum level of pepsinogenⅠ( PGⅠ) ,PGⅡ, and PGⅠ/PGⅡ-ratio ( PGR ) using latex enhanced turbidimetric immunoassay in patients with different gastric mucosal lesions, and to investigate their changes and clinical significance.Methods Case-control study.Two hundred and seventy-five patients who had enteroscopy and pathological examination from the department of gastroenterology and surgery from Beijing Tongren Hospital between January 2015 and January 2016 were enrolled.Endoscopic and histopathological examination confirmed the normal control group (n=20), chronic non-atrophic gastritis group ( n=68 ) , chronic atrophic gastritis group ( n=76 ) , including antral atrophic gastritis ( n=30 ) , gastric body atrophic gastritis ( n=26 ) , and multifocal atrophic gastritis ( n=20 );intestinal metaplasia group ( n=28 ) , intraepithelial neoplasia group ( n=9 ) , benign gastric ulcer group ( n=46) and intestinal gastric cancer group ( n=28).Latex-enhanced immune turbidity method were used to detect the patients fasting serum PGⅠand PGⅡ.Then the PGR was calculated.The normally distributed data of each group were statistically analyzed by ANOVA, the data between groups were nalyzed using the Mann-Whitney U test and Kruskal-Wallis test.Results Serum PGⅠ[ ( 74.23 ±22.36 ) ] ng/ml and PGR (6.92 ±2.16) in chronic atrophic gastritis group were lower than those in normal controls[PGⅠ(98.94 ± 21.00) ng/ml, PGR 8.13 ±2.47],(FPGⅠ =18.297,PPGⅠ <0.01,FPGR =4.713,PPGR <0.01).The serum PGⅠ[(44.46 ±26.72) ng/ml] and PGR (3.09 ±0.83) in the intestinal type of gastric cancer group were lower than those in the chronic atrophic gastritis group[PGⅠ(74.23 ±22.36)ng/ml, PGR 6.92 ±2.16], (ZPGⅠ =-3.921,PPGⅠ <0.01,ZPGR =-6.662,PPGR <0.01).PGⅠ[(129.95 ±43.39) ng/ml].PGⅡ[(21.09 ±6.78) ng/ml]in the gastric benign ulcer group were higher than those in the normal controls[PGⅠ (98.94 ±21.00) ng/ml, PGⅡ(12.64 ±1.84) ng/ml], FPGⅠ =10.803,PPGⅠ <0.01;FPGⅡ =39.130,PPGⅡ <0.01. PGⅠ[(52.44 ±10.37) ng/ml and PGR (5.47 ±1.59) in the multifocal atrophic gastritis group were lower than those in the antral atrophic gastritis[PGⅠ(94.95 ±14.45)ng/ml, PGR 8.39 ±1.48],ZPGⅠ =-5.941,PPGⅠ <0.01,ZPGR =-4.911,PPGR <0.01.The AUC of PGⅠand PGR for diagnosis of chronic atrophic gastritis were 0.752 and 0.683 respectively.The sequence combined detection sensitivity was 72.37%(55/76), and the specificity was 70.85%(141/199).The AUC of PG I and PGR for diagnosis of intestinal type of gastric cancer were 0.852 and 0.895 respectively.The sequence combined detection sensitivity was 71.42% ( 20/28 ) and the specificity was 81.78% ( 202/247 ) . Conclusion The Latex-enhanced immune turbidity method of combined detection of serum PGⅠ, PGⅡlevels and PGR can be used in the clinic to monitor the status and function of gastric mucosa and are informative for gastric cancer and precancerous lesions of gastric mucosa.
5.Detecting multiple lysosomal enzymes in dried blood spots by tandem mass spectrometry
Xia ZHAN ; Xuefan GU ; Na LIN ; Jun YE ; Wenjuan QIU ; Lianshu HAN ; Huiwen ZHANG ; Lili LIANG
Chinese Journal of Laboratory Medicine 2016;39(10):761-765
Objective Establish a method for measuring the activities of Galactocerebrosidase (GALC), α-Glucosidase(GAA), α-Galactosidase (GLA) and α-L-Iduronidase (IDUA) in dried blood spots specimen by tandem mass spectrometry ( MS/MS ).Methods A total of 2175 dried blood spot samples forinborn errors of metabolism in neonatalscreening center of Shanghai Xinhua hospital were collected in July and November, 2013.And twenty dried blood spot samples from patients withlysosomalstorage disorders( LSDs) of Shanghai Xin Hua Hospital were collected from September 2012 to January 2014.The extraction of DBS was incubated with enzyme substrates and internal standards.After liquid-liquid and solid-phase extraction, the extraction solution was dried under nitrogen and reconstituted.Then enzyme reaction products and internal standards were analyzed by MS/MS.Linearity, precision, accuracy and the limit of detection were evaluated.2175 dried blood spot samples were detected to establish the normal reference range for the activities of four enzymes according to 0.5th to 99.5th percentiles.20 specimens from patients withLSDs were detected to verify the reference range inclinical judgment.Results The intraassay and interassay precisions ranged from 1.7%to 11.8%, and the intraassay and interassay accuracies ranged from 85%to 115%.The linear coefficients for measured concentration of enzyme products/internal standards and theoretical concentration were 0.997-0.999.The limits of detection forGALC, GAA, GLA and GLA were 0.03 μmol/(L· h), 0.09 μmol/(L· h), 0.12 μmol/(L· h) and 0.16 μmol/(L· h) .The normal reference values for GALC, GAA, GLA and GLAwere 0.51-8.51μmol( L· h) ,1.99-22.22μmol/( L· h),1.68-41.59 μmol/(L· h) and 2.36-19.21 μmol/(L· h).The enzymes of 20 patients with LSDs were remarkably decreased compared to the normal range.The Krabbe, Pompe, Fabry, MPSⅠpatients can be effectively detected by this MS/MS method.Conclusions A MS/MS method for measuring GALC, GAA, GLA and IDUA enzyme activities in DBShas been established.
6.Applying percentile method combined with ROC curve to determine the reference values for 11 amino acids in newborns measured by non-derivatized tandem mass spectrometry
Yanyun WANG ; Ling LYU ; Yun SUN ; Bing YANG ; Yahong LI ; Tao JIANG
Chinese Journal of Laboratory Medicine 2016;39(10):756-760
Objective To determine the reference values of 11 amino acids measured by non-derivatized tandem mass spectrometry ( MS/MS).Methods 22 430 healthy newborns and 14 children with metabolic dysfunction in Nanjing were enrolled in this study.The levels of the 11 amino acids, including Ala, Arg, Cit, Gly, Leu +Ile, Met, Orn, Phe, Pro, Tyr and Val, were measured by non-derivatized tandem mass spectrometry using dry blood spots.After pre-setting up different cutoff values according to the amino acid levels of the newborns, reference value ranges of the 11 amino acids were determined by using the method of percentile combined with ROC curves.Results According to the results of frequency distribution histogram, the levels of the 11 amino acids of newborns belong to approximate normal distribution.By analysis of ROC curves, the cut-off values for amino acids were 0.2%-99.8%.Conclusion It established reference values of 11 amino acids in newborn and provided basis for the other screening center to make the cut-off value.
7.Evaluation of the actual demand for laboratory tests in the clinical managementof venous thromboembolism
Chinese Journal of Laboratory Medicine 2016;39(10):747-750
Venous thromboembolism ( VTE ) is a common vascular disease.It has become an important public health problem because of its high incidence, recurrence and mortality rate.Because the clinical symptom of VTE is relatively hidden, it is difficult to diagnose and treat it.This article focuses on the clinical diagnosis,treatment and laboratory examination of VTE.
8.Deciphering the platelet function test inacute coronary syndrome patients subjected to anti-platelet therapy
Chinese Journal of Laboratory Medicine 2016;39(10):743-746
Anti-platelet therapy plays a key role in acute coronary syndrome ( ACS ) treatments.Platelet function tests could monitor the effect of anti-platelet drugs′, however, it is still under debate that whether platelet function monitoring could be used to adjust antiplatelet therapy.Additionally, there are a number of platelet function assays, and each of them has specifically advantages and disadvantages.This article reviewed evidence-based information, guidelines, consensus and clinical experience about platelet function monitoring in ACS patients, which was intend to help laboratory technicians and clinicians understanding the value of platelet function tests in monitoring anti-platelet therapy.
9.Risk evaluation and monitoring of prophylaxis and treatment in tumor-associated venous thromboembolism
Chinese Journal of Laboratory Medicine 2016;39(10):739-742
Being one of the most important complications and also one of the leading cavses of death, venous thromboembolism ( VTE) could significantly increase the morbidity and mortality of patients with tumor.Therefore, accurate assessment of VTE risk and early prophylaxis according to the risk level are important to reduce the incidence of VTE, as well as to improve the quality of life and disease prognosisin patients with cancer.In this paper, we introduced the laboratory indicators that could be used for risk assessment of tumor-associated VTE and monitoring of prophylaxis and treatment in tumor patients with VTE.We aimed to strengthen the awareness of tumor-associated VTE and expected to provide help for clinical practice.
10.The research, diagnosis, and treatment of thrombotic disease in China
Chinese Journal of Laboratory Medicine 2016;39(10):729-732
The International Society on Thrombosis and Haemostasis has proposed to hold World Thrombosis Day on October 13 annually from 2014 to improve awareness and education of thrombosis. Thrombotic diseases are multidisciplinary disorders involving multiple systems.Thus, multidisciplinary team treatment for thrombotic diseases should be developed in China.A comprehensive study of genetic factors for thrombotic diseases is expected to achieve early diagnosis and risk prediction for this type of disease, and thus precision diagnosis and individualized treatment can be achieved.