Since 2015, US government announced the Precision Medicine Initiative, the concept of“precision medicine” is spreading rapidly, which has seemingly become the mainstream of future medicine.Laboratory medicine based on personalized information brought by the development of precision medicine will be an entirely new area, however its complexity is far beyond the current knowledge and laboratory medical scientists are encouraged to be actively involved in this emerging field.Opportunities and challenges may coexist, which mainly include: screening and evaluation of circulating biomarkers, selection and standardization of appropriate molecular diagnostic techniques, acquisition of high quality biological specimens and establishment of sample library, and comprehensive interpretation of the results in order to achieve and improve individualized precise prevention, diagnosis, and treatment for specific diseases and patients.

Objective To establish an automated spectrophotometic assay for serum total and free L-carnitine with enzymatic method(CAT-BTND). Methods To optimize the reaction conditions of hydrolysis,pH and L-carnitine Acetyl-transferase (CAT)concentration in the assay,to evalute the assay method and to measure the serum L-carnitine of health adults ( n =63) and children ( n =56). Results The calibration curve for L-carnitine was linear between 4 81 and 150 ?mol/L( r =0 999).The inter and intra average CV were 5 52% and 5 90% in free carnitine,5 78% and 6 14% in octanoylcarnitine.The mean recovery rate was 98 5% and 98 4% respectively.This method was free from interference by bilirubin(≤120 ?mol/L),hemoglobin(≤7 g/L),and ascorbate(≤500 ?mol/L).Total and free carnitine and acylcarnitine reference range: adults (48 5?17 7) ?mol/L , (39 2?14 2) ?mol/L and (9 3?5 3) ?mol/L(male, n =32),(42 7?17 3) ?mol/L, (32 4?18 0) ?mol/L and (10 5?5 5) ?mol/L respectively(female, n =31).Children (age between 9～12 years old) (57 3?19 3) ?mol/L , (45 1?14 4) ?mol/L and (12 3?10 4) ?mol/L(male, n =31), (59 4?15 7) ?mol/L, (46 6?12 6) ?mol/L and (12 8?7 8) ?mol/L respectively(female, n =25). Conclusion The procedure is rapid,accurate and automatable,and could be used to diagnose L-carnitine deficiency,and to estimate and monitor the effect of treatments.

Objective To evaluate an agarose gel electrophoresis for quantitative determination of Lipoprotein(a) cholesterol and its clinical application.Methods Quantification of LP(a)-C was performed by a new agarose gel electrophoresis method that allows the separation of LP(a) by Hellen REP system and the determination of LP(a)-C by enzymatic staining of cholesterol,The results of electrophoresis method were compared with the ones of INA and ITA. The specimens of 135 health men were assayed by electrophoresis for the reference range.Results The inter and intra CV of electrophoresis method at low, middle and high LP(a) concentration specimens were 4.7%～5.3% and 5.8%～6.4%. The linearity was 0.058～1.55 mmol/L. Interference with bilirubin (

Objective To develop a real-time fluorescence quantitative PCR method for detection of Legionella pneumophila as a tool for environmental and clinical examination. Methods A pair of degen-erated primers and one TaqMan-MGB probe were designed to test the conserved region at the macrophage in-fective potentiation (mip) gene of Legionella pneumophila. TaqMan MGB real-time quantitative PCR assay was developed with pMD-19T plasmid including mip gene of Legionella pneumophila as standard sample. The sensitivity and specificity of the real-time quantitative PCR was evaluated using the standard sample and dif-ferent strains. Results The detection limit of 0.71 copy/μl was obtained for the standard sample in a reac-tion system of 0.6μl of sense and antisense primers (20μmol/L), respectively, 0.4μl of probe (20μmol/L) and 6.0μl of DNA temple. Conditions for the PCR reactions were as follows. After an initial de-naturation at 95℃ for 20s, 40 amplification cycles were performed. Each cycle consisted of denaturation at 95℃ for 10 s, primer annealing at 50℃ for45s. The PCR Ct value of a standard strain and 12 isolates was in a scale of 13.23 and 16.04. However, the Ct values of the strains of Staphylococcus aureus, Salmonella typhimurium, Vibrio parahaemolyticus, Escherichia coli, Pseudomonas aeruginosa and Shigella sonnei were greater than 30. Conclusion The real-time quantitative PCR method has good sensitivity and specificity and the result has potentiality of applying for detecting Legionella pneumophila.

Ureaplasma urealyticum (UU) is closely related to human diseases including non-gonococcal urethritis (NGU), infertility, premature membranes and neonatal bronchopulmonary dysplasia. Researches on the pathogenicity of UU have become a hot topic in recent years, and suggest that many potential pathogenicity genes or putative pathogenicity islands are involved in its virulence. Moreover, the biovar and serum types of UU, the infection concentration and the state of the host immune system are also important to determine whether UU can cause human disease or not. In this article the recent progress of researches in the pathogenicity of UU is reviewed.
Humans ; Infertility ; microbiology ; Serotyping ; Ureaplasma urealyticum ; pathogenicity ; Urethritis ; microbiology

OBJECTIVETo investigate the pathogenesis of thromboembolism in patients with mitral stenosis in a pre-thrombotic state.

METHODSThe biochemical markers' levels in plasma for platelet activity [soluble P-selectin (GMP-140)], states of thrombin generation [antithrombin III (AT III) and protein C (PC)], fibrinolysis [D-dimer (DD), plasminogen activator inhibitor 1 (PAI-1), tissue plasminogen activator (t-PA) and FDP] and von Willebrand factor (vWF) were determined from blood specimens obtained from the femoral veins and arteries and the right and left atria of 43 consecutive patients (20 with atrial fibrillation and 23 with sinus rhythm) with mitral stenosis (MS), undergoing percutaneous mitral valvuloplasty. The same parameters were compared with those of 15 control subjects, who had no detectable heart disease, but with paroxysmal supraventricular tachycardia undergoing radiofrequency catheter ablation of the left accessory pathway through a transseptal passage.

RESULTSBlood from the left atrium contained an excessive amount of platelet activity, thrombin generation and fibrinolysis compared with the blood from the right atrium, and the femoral veins and arteries. However blood from the right atrium was much lower in these activities when compared with those from the left atrium, and the femoral veins and arteries in both groups. Compared with those in the control subjects, GMP-140 in the left atrium was significantly higher (P < 0.05) and AT III was significantly lower (P < 0.05) in patients with MS. Compared with the patients with MS and spontaneous left atrial echocontrast (LASEC) /= 2 had significantly higher levels of GMP-140 in plasma (P < 0.05), and significantly lower levels of AT III (P < 0.05) and PC (P < 0.01) levels in the left atrium. However, there were no significant differences between patients with atrial fibrillation and those with sinus rhythm regarding amounts of plasma coagulation markers in the left atrium. Univariate regression analysis revealed that LASEC was negatively correlated with plasma levels of blood from the left atria in the patients with MS.

CONCLUSIONCoagulability is increased in the left atria of patients with MS and is positively correlated with LASEC.

Adult ; Antithrombin III ; analysis ; Female ; Fibrin Fibrinogen Degradation Products ; analysis ; Heart Atria ; chemistry ; Humans ; Male ; Mitral Valve Stenosis ; complications ; P-Selectin ; blood ; Plasminogen Activator Inhibitor 1 ; blood ; Protein C ; analysis ; Regression Analysis ; Thromboembolism ; etiology ; Thrombophilia ; blood ; complications ; von Willebrand Factor ; analysis

Inflammatory bowel disease is chronic intestinal inflammatory disease with unknown etiology, which may be associated with environmental , genetic and immune factors.The personalized or accurate diagnosis and treatment are a new development trend for IBD clinical management .The detection of biomarkers is very important in the diagnosis , treatment and clinical management of IBD .In addition to the traditional biomarkers , the emerging new markers based on genetics , epigenetics , microbial and metabolomics have also shown better future applications in several areas , such as the applications of biomarkers in diagnosis and differential diagnosis of IBD .The determination of disease activity , severity and complications.The selection for treatments in IBD and prediction of therapeutic effects .These biomarkers will also contribute to personalized clinical management of IBD .

Objective:This study aimed to investigate the predictive value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) trajectory on future major adverse cardiovascular events (MACE) in patients with stable coronary artery disease (SCAD) after percutaneous coronary intervention (PCI).Methods:A retrospective cohort study was conducted on SCAD patients admitted to the Department of Cardiology at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, from January 2013 to December 2021. A total of 828 subjects were enrolled, comprising 592 males and 236 females, with an average age of (66.44±11.71) years. SCAD patients post-percutaneous coronary intervention (PCI) were stratified into three NT-proBNP trajectory groups: T1 Low-Low (219 cases), T2 Medium-Low (363 cases), and T3 High-High (246 cases). The median follow-up time was 2.1 years, and the maximum follow-up time was 9 years. The primary clinical endpoint event was MACE. The NT-proBNP concentration in patients′ serum was measured using enzyme-linked fluorescent assay, and different trajectory groups were determined using latent class trajectory modeling. The association between NT-proBNP trajectory and occurrence of MACE in SCAD patients was evaluated using Kaplan-Meier survival curves and multivariable Cox proportional hazards regression models.Results:A total of 67 (8.1%) major adverse cardiovascular events occurred, including 43 cases (5.2%) of all-cause mortality, 13 cases (1.6%) of heart failure death, 9 cases (1.1%) of non-fatal myocardial infarction, and 15 cases (1.8%) of non-fatal stroke. Kaplan-Meier survival curve analysis showed significant differences in survival rates among T1, T2, and T3 groups of SCAD patients for MACE, all-cause mortality, and heart failure death (all P<0.001). In the multivariable Cox regression analysis, the risk of MACE occurrence for patients in the T2 group and T3 group was 1.708 times (95% CI 0.72-4.05) and 3.842 times (95% CI 1.625-9.081) compared to the T1 group, respectively. Moreover, a statistically significant linear trend was observed for the risk of MACE occurrence across trajectory groups ( P<0.001). Conclusions:NT-proBNP trajectory groups after PCI in SCAD patients are strongly associated with the risk of MACE occurrence and can serve as an independent predictor for MACE. Dynamic monitoring of NT-proBNP during follow-up to obtain longitudinal trajectories helps identify high-risk SCAD patients and implement timely effective intervention measures.

Objective:To investigate the clinical efficacy of P-GEMOX (pegaspargase, gemcitabine and oxaliplatin) as a first-line regimen for the treatment of primary extranasal nasal-type NK/T cell lymphoma (NKTCL).Methods:The clinical manifestations, treatment response and prognosis of 7 patients with primary extranasal nasal-type NKTCL who underwent P-GEMOX chemotherapy as a first-line therapy in Shenzhen People's Hospital from September 2015 to October 2018 were retrospectively analyzed.Results:The median age of 7 patients with primary extranasal nasal-type NKTCL was 41 years old (27-74 years old), which was more commonly found in males (6 cases); the primary and invading extranasal sites included ileocecal, lymph nodes, skin, testis, adrenal gland, central nervous system, etc. The P-GEMOX regimen was used as a first-line therapy, although some patients had a short-term effect, all patients eventually progressed rapidly and died. The overall survival time was 2 weeks to 21 months.Conclusion:The short-term efficacy of P-GEMOX as a first-line therapy for the treatment of primary extranasal nasal-type NKTCL is acceptable, but the long-term efficacy is poor.

To detect the expression of miR-221/222 in serum and plasma cells in patients with monoclonal gammopathy of undetermined significance(MGUS) and multiple myeloma(MM), and to explore the possibility of miR-221/222 as biomarkers in the diagnosis and prognosis predicting of MGUS and MM.Bone marrow and serum samples from 14 patients with newly diagnosed MGUS, 81 patients with newly diagnosed or relapsed MM and 10 controls were collected from Sir Run Run Shaw Hospital of Zhejiang University and Tongde Hospital of Zhejiang Province during January 2013 and December 2015. The expressions of miR-221/222 in serum and in sorted CD138 positive plasma cells were detected by qRT-PCR, and the relative expression of miR-221/222 (Δct) was compared between the groups. Serum levels of miR-221 before and after treatment were compared in both remission group (=22) and refractory group (=13) in MM patients, and its correlation with serum level of β-MG was assessed using Pearson's correlation analysis.Serum levels of miR-221/222 in MGUS and MM groups were significantly higher than those in control group (all<0.01), while miR-221/222 levels in plasma cells were significantly lower in MGUS and MM groups than those in the control group (<0.05 or<0.01). No significant difference in miR-221/222 levels in serum and plasma cells was observed between MGUS group and MM group (all>0.05). There was no correlation between miR-221/222 levels in serum and plasma cells (=0.024 and -0.127, all>0.05), but miR-221 levels were correlated with miR-222 levels in both serum and plasma cells (=0.534 and 0.552, all<0.01). Receiver operating characteristic (ROC) curves showed that the areas under the curve (AUCs) of serum miR-221/222, plasma cell miR-221/222 in diagnosis of MGUS/MM were 0.968, 0.976, 0.801 and 0.727, respectively. There was no significant difference in serum level of miR-221 among MM patients with different paraprotein isotypes (>0.05), but serum level of miR-221 in patients with relapsed MM was higher than that in patients with newly diagnosed MM (<0.01). Compared with the patients with MGUS or MM stageⅠ and Ⅱ, patients with MM stage Ⅲ were of higher serum levels of miR-221 (<0.01). Serum level of miR-221 decreased after chemotherapy in the remission group (=51.5,<0.01), but such decrease was not observed in the refractory group (=67.5,>0.05). Serum level of β-MG was positively correlated with serum level of miR-221 (=0.524,<0.01).miR-221/222 in serum and plasma cells may be biomarkers for early diagnosis of MGUS, and are helpful for diagnosis and efficacy evaluation of MM.
Biomarkers ; analysis ; blood ; Bone Marrow ; chemistry ; Disease Progression ; Humans ; MicroRNAs ; analysis ; blood ; Monoclonal Gammopathy of Undetermined Significance ; genetics ; physiopathology ; Multiple Myeloma ; chemistry ; genetics ; physiopathology ; Myeloma Proteins ; analysis ; Paraproteinemias ; genetics ; physiopathology ; Prognosis ; Recurrence