Background: s/Aims: Anti-mitochondrial M2 antibody (AMA-M2) is a specific marker for primary biliary cholangitis (PBC) and it could be also present in non-PBC individuals. Methods: A total of 72,173 Chinese health check-up individuals tested AMA-M2, of which non-PBC AMA-M2 positive individuals were performed follow-up. Baseline data of both clinical characteristics and laboratory examinations were collected in all AMA-M2-positive individuals. Least absolute shrinkage and selection operator (LASSO) regression was performed to investigate the potential variables for developing PBC. Results: A total of 2,333 individuals were positive with AMA-M2. Eighty-two individuals had a medical history of PBC or fulfilled the diagnostic criteria of PBC at baseline, and 2,076 individuals were non-PBC. After a median follow-up of 6.6 years, 0.6% developed PBC, with an accumulative 5-year incidence rate of 0.5%. LASSO regression showed that levels of alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), immunoglobulin M (IgM), eosinophilia proportion (EOS%), gamma globulin percentage, and hemoglobin (HGB) were potential variables for developing PBC. Multivariate Cox regression is used to construct a predictive model based on 7 selected variables, and time-dependent receiver operating characteristic analysis showed that the area under the curve of the prediction model at 3, 5, and 10 years were, respectively, 1.000, 0.875, and 0.917. Conclusions This study offers insights into the onset of PBC among individuals who tested positive for AMA-M2 during routine health check-ups. The prediction model based on ALP, GGT, IgM, EOS%, gamma globulin percentage, HGB, and sex has a certain predictive ability for the occurrence of PBC in this population.

Background: s/Aims: Anti-mitochondrial M2 antibody (AMA-M2) is a specific marker for primary biliary cholangitis (PBC) and it could be also present in non-PBC individuals. Methods: A total of 72,173 Chinese health check-up individuals tested AMA-M2, of which non-PBC AMA-M2 positive individuals were performed follow-up. Baseline data of both clinical characteristics and laboratory examinations were collected in all AMA-M2-positive individuals. Least absolute shrinkage and selection operator (LASSO) regression was performed to investigate the potential variables for developing PBC. Results: A total of 2,333 individuals were positive with AMA-M2. Eighty-two individuals had a medical history of PBC or fulfilled the diagnostic criteria of PBC at baseline, and 2,076 individuals were non-PBC. After a median follow-up of 6.6 years, 0.6% developed PBC, with an accumulative 5-year incidence rate of 0.5%. LASSO regression showed that levels of alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), immunoglobulin M (IgM), eosinophilia proportion (EOS%), gamma globulin percentage, and hemoglobin (HGB) were potential variables for developing PBC. Multivariate Cox regression is used to construct a predictive model based on 7 selected variables, and time-dependent receiver operating characteristic analysis showed that the area under the curve of the prediction model at 3, 5, and 10 years were, respectively, 1.000, 0.875, and 0.917. Conclusions This study offers insights into the onset of PBC among individuals who tested positive for AMA-M2 during routine health check-ups. The prediction model based on ALP, GGT, IgM, EOS%, gamma globulin percentage, HGB, and sex has a certain predictive ability for the occurrence of PBC in this population.

Background: s/Aims: Anti-mitochondrial M2 antibody (AMA-M2) is a specific marker for primary biliary cholangitis (PBC) and it could be also present in non-PBC individuals. Methods: A total of 72,173 Chinese health check-up individuals tested AMA-M2, of which non-PBC AMA-M2 positive individuals were performed follow-up. Baseline data of both clinical characteristics and laboratory examinations were collected in all AMA-M2-positive individuals. Least absolute shrinkage and selection operator (LASSO) regression was performed to investigate the potential variables for developing PBC. Results: A total of 2,333 individuals were positive with AMA-M2. Eighty-two individuals had a medical history of PBC or fulfilled the diagnostic criteria of PBC at baseline, and 2,076 individuals were non-PBC. After a median follow-up of 6.6 years, 0.6% developed PBC, with an accumulative 5-year incidence rate of 0.5%. LASSO regression showed that levels of alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), immunoglobulin M (IgM), eosinophilia proportion (EOS%), gamma globulin percentage, and hemoglobin (HGB) were potential variables for developing PBC. Multivariate Cox regression is used to construct a predictive model based on 7 selected variables, and time-dependent receiver operating characteristic analysis showed that the area under the curve of the prediction model at 3, 5, and 10 years were, respectively, 1.000, 0.875, and 0.917. Conclusions This study offers insights into the onset of PBC among individuals who tested positive for AMA-M2 during routine health check-ups. The prediction model based on ALP, GGT, IgM, EOS%, gamma globulin percentage, HGB, and sex has a certain predictive ability for the occurrence of PBC in this population.

Objective:To analyze the early diagnostic value of plasma soluble cluster of differentiation 14 subtype (sCD14-ST, Presepsin) in sepsis in a population with suspected sepsis in fever clinic.Methods:A prospective observational study was conducted. The patients admitted to the fever clinic of Beijing Chaoyang Hospital from April to December 2022 were enrolled as the study objects. According to sequential organ failure assessment (SOFA) score, the patients were divided into low SOFA score group (SOFA score ≤3) and high SOFA score group (SOFA score > 3). Venous blood was collected at the time of admission. The level of plasma Presepsin was detected by chemiluminescence enzyme-linked immunoassay. The level of plasma procalcitonin (PCT) was detected by enzyme-linked immunofluorescence method. The level of C-reactive protein (CRP) was detected by scattering turbidimetry. White blood cell count (WBC) and neutrophil count (NEUT) were measured by automatic blood cell analyzer. For patients with fear of cold or chills, venous blood of upper limbs was taken for blood culture at the time of admission. The differences in inflammatory biomarkers were compared between the two groups. Binary multivariate Logistic regression analysis was used to screen the early risk factors of sepsis in fever outpatients with suspected sepsis. Receiver operator characteristic curve (ROC curve) was drawn to investigate the early diagnostic value of Presepsin and other inflammatory markers in sepsis, and to analyze the optimal cut-off value.Results:A total of 149 fever outpatients with suspected sepsis were enrolled, including 92 patients with low SOFA score and 57 patients with high SOFA score. Plasma PCT and Presepsin levels in the high SOFA score group were significantly higher than those in the low SOFA score group [PCT (μg/L): 0.77 (0.18, 2.02) vs. 0.22 (0.09, 0.71), Presepsin (ng/L): 1?129.00 (785.50, 1?766.50) vs. 563.00 (460.50, 772.25), both P < 0.01]. There was no significant difference in WBC, NEUT, CRP or positive rate of blood culture between the high and low SOFA score groups [WBC (×10 9/L): 11.32±5.47 vs. 11.14±5.29, NEUT (×10 9/L): 9.88±4.89 vs. 9.60±5.10, CRP (mg/L): 54.05 (15.95, 128.90) vs. 46.11 (19.60, 104.60), blood culture positivity rate: 42.3% (11/26) vs. 29.4% (10/34), all P > 0.05]. Multivariate Logistic regression analysis showed that Presepsin was an early risk factor for sepsis in suspected sepsis patients in fever clinics [odds ratio ( OR) = 16.96, 95% confidence interval (95% CI) was 6.35-45.29, P = 0.000]. ROC curve analysis showed that the early diagnostic value of Presepsin in sepsis was significantly better than WBC, NEUT, CRP, PCT, and blood culture [the area under the ROC curve (AUC) and 95% CI: 0.832 (0.771-0.899) vs. 0.522 (0.424-0.619), 0.532 (0.435-0.629), 0.533 (0.435-0.632), 0.664 (0.574-0.753), 0.554 (0.458-0.650)]. When the optimal cut-off value of Presepsin was 646.50 ng/L, its sensitivity and positive predictive value were higher than those of WBC, NEUT, CRP, and PCT (sensitivity: 89.5% vs. 38.6%, 68.4%, 38.6%, 57.9%; positive predictive value: 64.6% vs. 44.9%, 44.3%, 47.8%, 55.9%). Conclusion:Plasma PCT and Presepsin have early diagnostic value for sepsis in suspected sepsis patients in fever clinics, and Presepsin is more sensitive than PCT and can be used as a early marker of sepsis.

Objective To investigate the role of the renin-angiotensin system(RAS)in the pathogenesis of acute kidney injury(AKI)after laparoscopic radical nephrectomy(LRN)and the predictive value of RAS activation status for AKI.Methods Eighty-two patients undergoing LRN at the Third Medical Center of General Hospital of PLA from December,2023 to March,2024 were enrolled,including 57 with postoperative AKI and 25 without AKI according to KDIGO criteria.Blood and urine samples were collected from the patients before and at 24 h after the operation for analyzing the correlation of urinary aldosterone,plasma ACE2,Ang1-7,Nrf-2,and IL-10 levels with postoperative AKI.Univariate and multivariate logistic regression analyses and ROC curve were employed to identify the risk factors for postoperative AKI and their predictive value for AKI.Results Compared with those without postoperative AKI,the patients with AKI had significantly higher postoperative urinary aldosterone levels and lower plasma ACE 2,Ang 1-7,Nrf-2,and IL-10 levels(P<0.05).Postoperative urinary aldosterone level was positively correlated with AKI and negatively with estimated glomerular filtration rate(eGFR)(P<0.05);plasma levels of ACE 2,Nrf-2,and IL-10 were all negatively correlated with AKI and positively with eGFR.Urinary aldosterone was a risk factor and plasma ACE 2,Ang 1-7,Nrf-2 and IL-10 were protective factors for AKI,and among them urinary aldosterone was an independent risk factor(AUC=0.651)and plasma Nrf-2 was an independent protective factor(AUC=0.679).The unconventional RAS pathway indices had an AUC of 0.758,and aldosterone combined with the unconventional pathway indices had an AUC of 0.788 for predicting postoperative AKI.Conclusion Activation of the conventional RAS pathway and suppression of the unconventional pathway contribute to AKI following LRA possibly by affecting eGFR.Aldosterone combined with the unconventional pathway indicators can predict the occurrence of AKI after LRN.

Objective To investigate the role of the renin-angiotensin system(RAS)in the pathogenesis of acute kidney injury(AKI)after laparoscopic radical nephrectomy(LRN)and the predictive value of RAS activation status for AKI.Methods Eighty-two patients undergoing LRN at the Third Medical Center of General Hospital of PLA from December,2023 to March,2024 were enrolled,including 57 with postoperative AKI and 25 without AKI according to KDIGO criteria.Blood and urine samples were collected from the patients before and at 24 h after the operation for analyzing the correlation of urinary aldosterone,plasma ACE2,Ang1-7,Nrf-2,and IL-10 levels with postoperative AKI.Univariate and multivariate logistic regression analyses and ROC curve were employed to identify the risk factors for postoperative AKI and their predictive value for AKI.Results Compared with those without postoperative AKI,the patients with AKI had significantly higher postoperative urinary aldosterone levels and lower plasma ACE 2,Ang 1-7,Nrf-2,and IL-10 levels(P<0.05).Postoperative urinary aldosterone level was positively correlated with AKI and negatively with estimated glomerular filtration rate(eGFR)(P<0.05);plasma levels of ACE 2,Nrf-2,and IL-10 were all negatively correlated with AKI and positively with eGFR.Urinary aldosterone was a risk factor and plasma ACE 2,Ang 1-7,Nrf-2 and IL-10 were protective factors for AKI,and among them urinary aldosterone was an independent risk factor(AUC=0.651)and plasma Nrf-2 was an independent protective factor(AUC=0.679).The unconventional RAS pathway indices had an AUC of 0.758,and aldosterone combined with the unconventional pathway indices had an AUC of 0.788 for predicting postoperative AKI.Conclusion Activation of the conventional RAS pathway and suppression of the unconventional pathway contribute to AKI following LRA possibly by affecting eGFR.Aldosterone combined with the unconventional pathway indicators can predict the occurrence of AKI after LRN.

Objective:The aim of this study is to establish the reference interval of refined immune cell subsets by multi-parameter flow cytometry.Methods:In this cross sectional study, a total of 326 healthy participants were included and divided into two groups based on age: 18-40 years old group and 41-60 years old group. Peripheral venous blood was collected in a fasting status. Flow cytometry tests were performed according to previous consensus article. The analysis of reference interval was conducted according to the documents of Clinical and Laboratory Standards Institute (CLSI) EP28-A3c and Health Industry Standards of the People′s Republic of China WS/T 402-2024.Results:The T,B,NK,DC and monocyte refined immune cell subsets applicable to the reference range of the general population mainly include: CD3 +(56.4%-83.3%),CD4 +TEMRRA (0.2%-11.6%), CD4 +TEM (14.9%-52.8%), CD4 +CD28 +(76.3%-99.9%), CD19 +CD5 +(9.7%-45.8%), CD19 +CD27 -(45.7%-90.0%), CD19 +CD27 +(9.8%-54.0%), CD3 +CD16 +CD56 +(1.3%-20.2%), CD3 -CD19 -CD20 -CD14 -CD56 -HLA-DR +(0.4%-2.0%), Monocyte Mo1 subset CD14 +CD16 -(46.3%-94.6%), monocyte Mo2 subset CD14 +CD16 +(2.8%-49.7%), etc. When the Z-value between different age groups was higher than Z* (3.50 cut-off value), the reference intervals of these subsets should be established independently according to age. Conclusions:In this study, the reference intervals of refined subsets of immune cells by multi-parameter flow cytometry has been preliminarily established. For those subgroups that meet the grouping criteria, age should be fully considered in clinical applications and laboratory validation.