Future clinical prospects of C-peptide testing in the early diagnosis of gestational diabetes

Gestational diabetes is typically diagnosed in the late second or third trimester of pregnancy.It is one of the most common metabolic disorders among expectant mothers,with potential serious short-and long-term complications for both maternal and offspring health.C-peptide is secreted from pancreatic beta-cells into circulation in equimolar amounts with insulin.It is a useful biomarker to estimate the beta-cell function because it undergoes negligible hepatic clearance and consequently it has a longer half-life compared to insulin.Pregnancy induces increased insulin resistance due to physiological changes in hormonal and metabolic homeostasis.Inadequate compensation by islet beta-cells results in hyperglycemia.The standard oral glucose tolerance test at 24-28 wk of gestation sets the diagnosis.Accumulated evidence from prospective studies indicates a link between early pregnancy C-peptide levels and the risk of subsequent gestational diabetes.Elevated C-peptide levels and surrogate glycemic indices at the beginning of pregnancy could prompt appropriate strategies for secondary prevention.

Primary biliary cirrhosis: Clinical and laboratory criteria for its diagnosis

Primary biliary cirrhosis(PBC) is a chronic progressive cholestatic granulomatous, and destructive inflammatory lesion of small intralobular and septal bile ducts, which is likely to be caused by an autoimmune mechanism with a the presence of serum antimitochondrial antibodies and a potential tendency to progress to cirrhosis. Despite the fact that the etiology of this disease has beenunknown so far, there has been a considerable body of scientific evidence that can reveal the clinical and laboratory signs of PBC and the individual components of its pathogenesis and elaborate diagnostic criteria for the disease and its symptomatic therapy. Deficiencies in autoimmune tolerance are critical factors for the initiation and perpetuation of the disease. The purpose of this review is to summarize the data available in the literature and the author's findings on clinical and laboratory criteria for the diagnosis of PBC. This review describes the major clinical manifestations of the disease and the mechanisms of its development. It presents the immunological, biochemical, and morphological signs of PBC and their significance for its diagnosis. A great deal of novel scientific evidence for the problem of PBC has been accumulated. However, the inadequate efficiency of therapy for the disease lends impetus to the quest for its etiological factors and to further investigations of its pathogenetic mechanisms and, on this basis, to searches for new methods for its early diagnosis.

Clinical,Laboratory and Imaging Features of High Altitude Pulmonary Edema in Tibetan Plateau

Objective To analyze characteristics of high altitude pulmonary edema(HAPE)in Chinese patients.Methods We performed a retrospective study of 98 patients with HAPE.We reviewed the medical records and summarized the clinical,laboratory and imaging characteristics of these cases,and compared the results on admission with those determined before discharge.Results Forty-eight(49.0%)patients developed HAPE at the altitude of 2800 m to 3000 m.Ninty-five(96.9%)patients were man.Moist rales were audible from the both lungs,and moist rales over the right lung were clearer than those over the left lung in fourteen patients.The white blood cells[(12.83±5.55)versus(8.95±3.23)×109/L,P=0.001)]as well as neutrophil counts[(11.34±3.81)versus(7.49±2.83)×109/L,P=0.001)]were higher,whereas the counts of other subsets of white blood cells were lower on admission than those after recovery(all P<0.05).Serum levels of alkaline phosphatase(115.8±37.6 versus 85.7±32.4 mmol/L,P=0.020),cholinesterase(7226.2±1631.8 versus 6285.3±1693.3 mmol/L,P=0.040),creatinine(85.2±17.1 versus 75.1±12.8 mmol/L,P=0.021),uric acid(401.9±114.2 versus 326.0±154.3 mmol/L,P=0.041),and uric glucose(7.20±1.10 versus 5.51±1.11 mmol/L,P=0.001)were higher,but carbondioxide combining power(CO2CP,26.7±4.4 versus 28.9±4.5 mmol/L,P=0.042)and serous calcium(2.32±0.13 versus 2.41±0.10 mmol/L,P=0.006)were lower on admission.Arterial blood gas results showed hypoxemia and respiratory alkalosis on admission.Conclusions In the present research,men were more susceptible to HAPE than women,and in the process of HAPE,the lesions of the right lung were more serious than those of the left lung.Some indicators of routine blood test and blood biochemistry of HAPE patients changed.

Viral Contamination Source in Clinical Microbiology Laboratory

To understand the potential causes of laboratory-acquired infections and to provide possible solutions that would protect laboratory personnel, samples from a viral laboratory were screened to determine the main sources of contamination with six subtypes of Rhinovirus. Rhinovirus contamination was found in the gloves, cuffs of protective wear, inner surface of biological safety cabinet （BSC） windows, and trash handles. Remarkably, high contamination was found on the inner walls of the centrifuge and the inner surface of centrifuge tube casing in the rotor. Spilling infectious medium on the surface of centrifuge tubes was found to contribute to contamination of centrifuge surfaces. Exposure to sodium hypochlorite containing no less than 0.2 g/L available chlorine decontaminated the surface of the centrifuRe tubes from Rhinovirus after 2 min.

Evaluation of Clinical Laboratory Tests’ Turnaround Time in a Tertiary Hospital in Democratic Republic of the Congo

The delay in the delivery of laboratory results can be fatal and can even lead to the death of patients. This study was conducted at the clinical laboratory of the University Hospital of Kinshasa (UHK) from October 2020 to April 2021, aimed to evaluate the laboratory tests’ turnaround time (TAT) and to identify reasons for delay. TAT was quantified using a time and motion analysis approach. The evaluation of TAT consisted of comparing the overall intra-lab TAT with the suggested TAT using student t-test at 95% confidence intervals. Brainstorming was the root cause analysis tool used for identifying reasons for delay. In this study, the laboratory tests’ TATs were significantly higher (p < 0.001) comparing to international guidelines (60 minutes) and customers’ suggested TAT (120 minutes). Only 0.98% of the samples were reported within 60 minutes of patient reception and 1.47% within 120 minutes, i.e. an outlier rate of 98.5%. Root causes of delay related to Machinery, Management, Manpower, Materials, Method and Milieu. Because of many reasons, the laboratory is not meeting the established TAT. Preventive and curative measures must be undertaken to reduce the delay and improve the TAT.

The Importance of Molecular and Clinical Laboratory Tests in Diagnosis and Treatment of Coronavirus Disease

900 abusers were tested for the presence of drug abuse and coronavirus disease.In the early stage,the throat and noise samples of these patients were examined by polymerase chain reaction(PCR).The mean age of the study group is 42±23.Hematological and serological examinations were performed on 131 patients.All data were analyzed by t-test and one-way analysis of variance(ANOVA).Therefore,P<0.05 is considered as the significance of the test results.The results showed that 131 patients in the study group had positive results of PCR tests and nearby they had Covid-19.Approximately 90%of patients with coronavirus disease showed positive serological tests and lymphopenic condition.All of urine or blood samples in the 131 patients were positive for the presence of abuse drugs.C-reactive protein(CRP)is one of important serologic test that detected on these patients.This study showed the importance of molecular genetics test such as PCR and also hematology and serology tests in distinguish of coronavirus diseases.

Evaluation of Abuse Drugs and Clinical Laboratory Tests Variations in Whole Blood ＆ Urine Samples of Abusers

In this study, five hundred urine samples and five hundred blood samples of abusers were examined for the presence of alkaloid substances and abuse drugs in urines and bloods. These numbers of blood and urine samples of addicts in clinics of welfare organization, during detoxification treatment or maintenance treatment were screened for abuse drugs presence. The all of samples were tested through as a view of clinical laboratory methods. Age ranges of female patients were 35 ~ 15 and age range of males patients were 45 ~ 15. All patients filled questionnaire and satisfy forms too. First, all fresh urine and blood samples were examined to confirm presence drugs abuses, depend on their addiction and treatment, so all samples were confirmed by two tests. Then they were examined to other clinical laboratory tests. All data were analyzed by t-test and were Anova one way and two ways of Anova Turkey, and p 〈 0.05 was considered significant. The p-value of this study was p = 0.0001. The results of this study were showed that 4% of abusers had mild increase in hematocrite level and 2% of narcotic drugs abusers had mild lower level of blood sugars than normal range and 4% of participants had increase liver enzymes such ALT （alanine transferase）, AST （aspartat transferase）, ALP （alkaline phosphatease） and 1% of them had renal failure. Although blood level BUN （blood urea nitrogen） and creatinin were examined to evaluation of their renal failure .The results in Tabriz/Iran undrevision of welfare organization clinics were approximately showed that positive results of addiction are in each of urine and blood samples. Because some of abusers directly consumed full long time agonist or partial agonists＇ drugs such as methadone and buprenorphine for their maintenance therapy in clinics. Also doing test on blood samples has high importance in distinguishing and confirmation of drugs abuse in samples. Also in this study we conclude that among all drug analytical methods the cheapest and easiest test to screening opioids and other abuse drugs in urine and blood samples is strip test for rapid diagnosis, also tests on blood samples have high importance as a view point of accuracy to distinguishing of drugs abuse, and serum levels of some other parameters showed all abusers patients situation such as liver and renal dysfimction through clinical laboratory tests.

Evaluation of Laboratory Request Forms Completion in a Tertiary Medical Laboratory of the Democratic Republic of Congo

Background: The inadequacy in the completeness of the Laboratory Request Form (LRF) has been reported as one of the major sources of errors during the pre-analytical step of laboratory analysis. To prevent the occurrence of such errors, this study aimed at assessing the level of completeness of LRFs. Methods: A retrospective analysis of laboratory request forms was conducted at the Clinical Biology Laboratory of the Kinshasa University Clinic, DR Congo, between November 2021 to May 2022. The LRFs were evaluated according to the completeness of all sections including administrative data of the patient, data of physician who ordered the test, relevant patient’s clinical data and data of the biological sample. Results: From a total of 2842 LRFs evaluated, none was fully completed with all required information. Particularly, patient’s clinical data including the medical history, provisional diagnosis and current treatment, were the most absent in 99% LRFs. However, two sections related to patient’s ID and prescribed test were informed in 100% LRFs. Conclusion: The results of this preanalytical audit can serve as an improvement opportunity focused on strengthening awareness about complete filling of LRF.

Children, Influenza, Encephalopathy, Clinical Characteristics, Laboratory Index

Background: To explore the early clinical features and laboratory findings of influenza-associated acute necrotizing encephalopathy (IANE). Methods: The demographics data, clinical manifestations, and laboratory indicators of cases diagnosed with IANE and influenza with febrile convulsions (FS), respectively, admitted to Guangzhou Women and Children’s Medical Center from January 2016 to January 2020 were retrospectively analyzed. Results: Among the 25 cases of IANE, there were 9 males and 16 females, aged 3 to 6 years. The mortality rate was 40.00% (10/25). Influenza virus type A in 9 cases (36.00%) and influenza virus type B in 10 cases (40.00%). The main clinical manifestations of children with IANE were acute disorders of consciousness (64.00%, 16/25) and convulsions (72.00%, 18/25), which were statistically significant when compared with the FS group (P < 0.05). Typical changes on cranial MRI of IANE were cerebral edema, typically with symmetric necrosis of the thalamus and other brain structures. Significant differences (P < 0.05) existed between the IANE and FS groups in laboratory indicators for ALT, AST, CK-MB, LDH, cerebrospinal fluid (CSF) microprotein, CSF LDH, which were above the normal reference range. In addition, logistic regression analysis showed that LDH ≥ 348.5 U/L predicted a significantly higher risk of IANE. Conclusions: Children with influenza present early with acute impairment of consciousness or convulsive seizures, or with elevated AST, ALT, CK-MB, LDH, and CSF protein and CSF LDH, especially if blood LDH is ≥348.5 U/L, should be closely evaluated and alerted to the possibility of IANE.

Clinical and laboratory features of COVID-19 patients infected with SARS-CoV-2 variant B.1.1.7 versus those infected with other SARS-CoV-2 strains:A retrospective observational study

Objective:To investigate the clinical symptoms of coronavirus disease 2019(COVID-19)patients with and without B.1.1.7 mutation.Methods:This retrospective observational study included COVID-19 patients who were divided into two groups,the mutation and the non-mutation group.Demographics characteristics,clinical characteristics,laboratory parameters,and mortality rates were recorded and compared between the two groups.Results:A total of 196 patients were included in the study.The relationship between the mutant virus status and sex,age,comorbidity,survival status,and disease severity was not significant(P>0.05).No significant differences were found in duration of hospitalization between the mutation and the non-mutation group(P>0.05).However,there was a statistically significant difference between patients with and without mutant viruses in hemoglobin,mean platelet volume,procalcitonin,low density lipoprotein,iron-binding capacity,potassium,calcium,C-reactive protein,folate,creatine kinase myocardial band,D-dimer,and international normalized ratio(P<0.05).Conclusions:No significant difference is found in mortality rate,disease severity or duration of hospitalization between the patients with and without variant B.1.1.7.Careful monitoring of COVID-19 patients is required for all variants.

Study of Behavioral Changes and Photosynthetic Activity of <i>Euglenas gracilis</i>in the Presence of Effluents from the Laboratory of Clinical Analysis

Healthcare waste has now been increasingly studied in terms of the risks or dangers that can cause the environment and human health. Waste generated in clinical analysis laboratories (CALs) deserves attention, because, due to the advent of the concept of emergent pollution, it is doubtful if the materials or reagents are disposed in the sewage by CALs, which are currently considered non-contaminated or with low risk potential, under current legislation, may actually impact the environment with actions not yet understood. This study was experimental and conducted at the Environmental Laboratory of the University of the Region of Joinville. It was used Euglena gracilis (primary trophic level) algae exposed to effluents from five sectors of a CAL: Biochemistry, Hematology, Viral Load, Tuberculosis and Immunochemistry. Samples were collected from the siphons attached to the wash sinks of the CAL materials. To verify changes in algae that denote environmental danger, behavioral changes were analyzed via NGTOX, and chlorophyll concentration was calculated by chlorophyll extraction according to Mendel’s method. Viral Load (VL) and Hematology (HT) sectors were the ones that most affected algae (Tukey test). In both sectors, there was inhibition of algae mobility and gravitaxy: in VL, due to the presence of chaotropic agents that denature organic structures;and in HT, due to the change in membrane permeability attributed to methylene blue. Also in HT, there was a search for algae adaptation by increasing the rise to the surface in order to overcome the lower luminosity due to the coloration of the environment, which also affects photosynthesis. Regarding the concentration of a-chlorophyll, the VL and HT were the most affected as well, being the first one the one that had more concentration reduction because of the presence of chaotropic agents. Considering new parameters evaluated, the discarded compounds need to be better evaluated for risk, as they affect algal photosynthesis. Procedures for removal of these compounds should be considered.

Improving Clinical Laboratory Quality through Reduction of Tests’ Turnaround Time in Democratic Republic of the Congo: Key Strategies

In Democratic Republic of the Congo (DRC), the laboratory TAT is significantly very long and do not comply with either international standards or the suggestions of customers. However, there is neither a national nor a local strategy to improve the laboratory TAT. The aim of the present study is to develop practical management strategies to shorten clinical laboratory tests’ TAT. This was a qualitative study conducted in Kinshasa. Focus groups and Lean tools were used respectively to generate a wide range of views from a variety of laboratory staff and to eliminate several form of waste in the laboratory flow process. Based on the identified root causes of delay, focus groups participants reported that there is a lot of scope for the improvement of TAT in DRC. Consistent attendance and punctuality are essential. The hospital management should implement the Laboratory Information Systems (LIS) and install Middleware. Total laboratory automation, inventory system for all reagents and supplies used in the laboratory, expansion of the sampling area, sufficient number of high-power machine and a clear job description are indispensable. LIS, 3.5 mL BD vacutainer BarricorTM tube and point-of-care testing (POCT) are necessary for workflow improvement. A reduction of 312 minutes was achieved by eliminating or decreasing non-value-added activities. Applying the suggested key strategies, and particularly the new workflow process, is a basis for improving the laboratory tests’ TAT. The algorithm presented can be easily implemented in other laboratories that face this type of problem.

Analysis on the Development Dilemma and Opportunity of Independent Clinical Laboratory Based on PEST-SWOT

Objective To study the current status of independent clinical laboratory(ICL)in China to offer some suggestions for further development of the industry because independent clinical testing is gradually occupying an important position in the medical market with the change of medical service mode.Methods The PEST-SWOT matrix model was constructed to sort out the strength and weakness,opportunities and threats of ICL and medical institutions.Results and Conclusion ICLs should enhance their social recognition by improving testing technology and industry operating standards.At the same time,it is also necessary to enhance their position in the clinical diagnosis industry and promote diversified competition in the field of clinical diagnosis so as to better help the development of national grading diagnosis and precision medicine.From the perspectives of SO,ST,WO,and WT,the development strategies of ICL are proposed,including personalized clinical diagnosis services and the construction of a database,and the family doctor system with community+ICL services.The remote diagnostic services should be implemented to help national graded diagnosis and treatment,and different operation schemes should be made to conform to market development.Besides,the access standards for ICL must be strictly required.Then,differentiated operations of enterprises should be valued for establishing industry brands and social awareness.Lastly,enterprises must focus on talents construction and management.

Significance of Laboratory and Clinical Manifestations of Antiphospholipid Syndrome

Clinical features of antiphospholipid syndrome Antiphospholipid syndrome(APS) is a form of immune mediated thrombophilia,characterized by thrombosis, recurrent fetal death and the presence of circulating antiphospholipid(aPL) antibodies directed against anionic phospholipids or protein-phospholipid complexes. Almost every vascular bed can be involved by

Bridging the divide: Harmonizing polarized clinical laboratory medicine practices

In today's healthcare,clinical laboratory medicine stands as a cornerstone of patient care,providing vital diagnostic insights that inform decisions in disease management.Yet,within this crucial field,a dichotomy persists between two predominant models of laboratory testing to support clinical practice:point-of-care testing(PoCT)and central laboratory testing[1].This schism,while born of practical necessity and evolving technology,presents both opportunities and challenges that warrant closer examination.

Optimal laboratory testing protocol for patients with acne taking oral isotretinoin

BACKGROUND Isotretinoin is a widely prescribed drug for various dermatological conditions,especially acne.Blood tests are routinely performed to monitor its side effects.However,the optimal testing schedule remains controversial.AIM To evaluate the laboratory monitoring tests and schedules of patients with acne taking isotretinoin to determine the most efficient testing regimen.METHODS We retrospectively reviewed electronic medical records from the Dermatology Department of Dongguk University Ilsan Hospital from 2005 to 2020 for patients prescribed isotretinoin for acne who underwent monthly blood tests.RESULTS Aspartate aminotransferase(AST),alanine aminotransferase(ALT),and trigly-ceride(TG)levels significantly changed between 5 and 6 mo when the total prescription period and dose variables were considered altogether.The high-density lipoprotein level also significantly changed between 5 and 6 mo.However,low-density lipoprotein(LDL)and total cholesterol levels significantly changed between 1 and 2 mo.CONCLUSION We recommend testing AST,ALT,and TG levels once every 5 to 6 mo.We also suggest testing LDL and total cholesterol levels during the first and second months.

Clinical features and prognosis of patients with novel coronavirus pneumonia complicated with diabetes

Objective:To analyze the clinical characteristics and laboratory examinations of patients with new coronavirus(COVID-19)and compare the effect and prognosis of patients with diabetes mellitus(DM)on COVID-19.Methods:56 cases of COVID-19 with DM and 85 age-matched admitted patients without DM who were admitted to the People's Hospital of Wuhan University from January 31,2020 to March 15,2020 were analyzed through a retrospective cohort study.Patients data were collected through electronic cases,and used SPSS 26.0 and Graphpad Prism 8.0 statistical software to compare changes in various indicators of patients in DM and non-DM groups and to draw the survival curves.Results:Compared with the non-DM group,the DM group has a higher percentage of mechanical ventilation,higher mortality and severe patients,with a higher proportion of initial symptoms of nausea and hypertension(P<0.05).There were no significant differences in the gender,initial symptoms(except nausea),the combined underlying diseases(except hypertension)between the two groups(P<0.05);The white blood cell,centroblast count,CRP,PCT,PT,D-dimer,total bilirubin,Urea,LDH,CK,MB,hs-TnI,CK-MB,NT-proBNP were higher in the DM group(P<0.05),and lymphocytes,single Nuclear cell,CD3,CD4,and CD8 counts were low(P<0.05).There was no statistically significant difference in platelet,IL-6,APTT,ALT,AST,Cr and CD19 counts between the two groups.Conclusion:Compared with COVID-19 patients with non-DM,COVID-19 patients with DM have a higher proportion of mortality and severe cases.Heart function,liver and kidney function,immune function damage and coagulation dysfunction are more obvious.Therefore,the monitoring of such patients should be strengthened,and active treatment should be performed to improve the prognosis.

An Accuracy Improvement for the Clinical Test Result by United ISO-GUM and QE

This research developed the technology which united ISO-GUM （International Organization of Standard-Guide to Express of Uncertainty in Measurement） and QE （Quality Engineer） strategically and employed both feature efficiently. Although to tow technology of purpose use is same, each has future. The purpose is scheduled to improve the accuracy as a result of the clinical examinations. The result of research was used for diagnosis by equivalent Quality Control （eqQC） of the same level when and where, that are needed for broader-based medical system of the time of IT-era. Since National Institute of Standard and Technology （NIST） is recommend use of complicated operation by ISO-GUM for uniting, realization required the newest high quality computer technology. The algorithm of the complexity system of operation is that Fast Fourier Transform （FFT）, Inverse Fast Fourier Transform （IFFT） and Multi-variance Analysis （MA） are needed in Fig. 4. The main new improving points are changed of ambiguous expression method of data, and the pursuit which the cause of worsens accuracy put into data. All data with an assurance reported the final result for patient or donor. Medical laboratory quality system service is offered essential in the laboratory to be correct result for health care by Good Laboratory Practices （GLP） useful ISO 15189. Quality Assurance （QA） is achieved though system reliability.

“大思政”背景下医学检验专业研究生课程思政教育方法探索

习近平总书记关于思政课的重要论述,已经成为新时代高校为党育人为国育才的新理念,强化医学生的职业素养教育,特别是医学伦理和科研诚信教育,通过加强这方面的教育,可以帮助学生树立正确的价值观和职业观,明确作为医务工作者的责任和使命。同时,这也有助于培养学生的道德判断能力和自我约束能力,使其在未来的职业生涯中能够自觉遵守职业道德规范,维护医疗行业的形象和声誉,这对于培养具备高度责任感和职业道德的医学检验专业硕士研究生至关重要。将思政元素引入研究生课程教学,并以此为导向,构建层次递进、相互支撑的课程体系,是培养高层次医学检验人才的重要条件。医学检验专业是一门实践性和技术性非常强的专业,其致力于培养具备现代医学检验技能和初步科研能力的应用型医学检验技术专门人才。这样的培养目标既符合现代医学发展的需求,也体现了对医学检验人才综合素质的高度重视。因此,在“大思政”背景下,医学检验专业研究生教学中融入课程思政尤为重要。从强化师资队伍建设、提升带教老师课程思政能力、促进思政元素与专业知识融合、重构完整的课程体系、构建医学检验专业课程思政建设下的考评体系以及形成具有医学检验专业特色的“大思政”格局等维度,探讨医学检验专业硕士研究生“课程思政”教育方法改革的思路,以期为医学检验专业硕士研究生“课程思政”教育方法改革提供借鉴。