Effective laboratory markers for the estimation of disease severity and predicting the clinical progression of coronavirus disease-2019 (COVID-19) is urgently needed. Laboratory tests, including blood routine, cytokine profiles and infection markers, were collected from 389 confirmed COV-ID-19 patients. The included patients were classified into mild (n = 168), severe (n = 169) and critical groups (n = 52). The leukocytes, neutrophils, infection biomarkers [such as C-reactive protein (CRP), procalcitonin (PCT) and ferritin] and the concentrations of cytokines [interleukin (IL)-2R, IL-6, IL-8, IL-10 and tumor necrosis factor (TNF)-α] were significantly increased, while lymphocytes were significantly decreased with increased severity of illness. The amount of IL-2R was positively correlated with the other cytokines and negatively correlated with lymphocyte number. The ratio of IL-2R to lymphocytes was found to be remarkably increased in severe and critical patients. IL-2R/lymphocytes were superior compared with other markers for the identification of COVID-19 with critical illness, not only from mild but also from severe illness. Moreover, the cytokine profiles and IL-2R/lymphocytes were significantly decreased in recovered patients, but further increased in disease-deteriorated patients, which might be correlated with the outcome of COVID-19. Lymphopenia and increased levels of cytokines were closely associated with disease severity. The IL-2R/lymphocyte was a prominent biomarker for early identification of severe COVID-19 and predicting the clinical progression of the disease.

Carbapenemase-producing Klebsiella pneumoniae has recently spread rapidly throughout China. In this study, we characterized a carbapenem-resistant K. pneumoniae isolate that produced both KPC-2 and IMP-4 type carbapenemases. A clinical isolate of K. pneumoniae, resistant to both meropenem and imipenem, was recovered from a urine sample. Antibiotic susceptibility was determined using the broth microdilution method and Etest (bioMérieux, France). Pulsed-field gel electrophoresis and multilocus sequence typing (MLST) were used for gene type analysis. bla (KPC) and the encoding genes of ESBLs and plasmid-mediated AmpC enzymes were polymerase chain reaction (PCR) amplified and sequenced. Plasmids were analyzed by transformation, enzyme restriction and Southern blot. PCR analysis revealed that the isolate was simultaneously carrying bla (KPC-2), bla (IMP-4), bla (TEM-1), and bla (OKP-B) genes. MLST assigned the isolate to a novel sequence type, ST476. bla (KPC-2)-harbouring plasmids of the isolate and comparative strains had similar EcoRI and HindIII restriction maps, while IMP-4-harbouring plasmids had variable HindIII restriction maps. Coexistence of bla (KPC-2) and bla (IMP-4) was probably due to bla (IMP-4)-harbouring plasmid transmission into KPC-2-producing K. pneumoniae (ST476). The concomitant presence of these genes is alarming and poses both therapeutic and infection control problems.

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Objective: We assessd a microfluidic method of sperm selection. Methods: Sperm was collected from 33 infertile, but otherwise healthy donors. We established a microfluidic device consisting of a 250 µm diameter microchannel of 3 cm in length, to mimic the oviduct. Human tubal fluid was pumped through the tubule at 500 µm/s, and 5 ml sperm was added. The movement of sperm was observed for 30 min using a Live Cell Imaging System. Sperm motility was assessed by Computer-aided Sperm Analysis System, morphological parameters were observed by conventional light microscopy and transmission electron microscope, and DNA integrity was measured by comet assay. We compared the fitness of sperm selected using the microfluidic device with pre-selection sperm and sperm selected by density gradient and swim-up method. Results: Microfluidic selection improved motility parameters of all 33 samples. Sperm selected by microfluidic device had higher rates of average ratio of sperm fast swimming forward average sperm activity ratio, value derivation for the curvilinear, value derivation for straight-line velocities, value derivation for average path, amplitude of lateral head displacement, amplitude of cross frequency, progression ratios of linearity, progression ratios of wobble, progression ratios of straightness, and lower rates of deformity than sperm selected using conventional methods (p<0.05). Furthermore, the DNA integrity of sperm selection by our device was better maintained than that selected by traditional methods (p<0.05). Conclusion: This method can not only minimize damage tosperm structure, but also increase the effectiveness of selection.

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