BackgroundIncreasing attention is focused on the relationship of inflammation biomarkers with malignant tumors. The purpose of the present study was to detect whether the preoperative the red distribution width (RDW) and the platelet distribution width (PDW) can be used to distinguish patients with gastric cancer (GC) or early stage GC from the healthy controls and predict the progression and prognosis of the GC.MethodsThe RDW and PDW values of 227 patients with GC and 164 patients with early GC were retrospectively analyzed comparing with 101 healthy controls. In addition, the clinicopathological features, survival curves and prognosis of the patients with GC were compared between the high and low groups according to the RDW and PDW values.ResultsSignificant higher RDW and lower PDW were detected in patients with GC and early GC compared to the healthy controls. A higher RDW was significantly associated with older age, a larger tumor diameter, deeper tumor infiltration, and lymph node metastasis while a lower PDW was significantly associated with male, older age, a larger tumor diameter, deeper tumor infiltration, elevated CEA and CA125. Increased RDW was significantly associated with worse overall survival (OS) and disease-free survival (DFS) for GC (P = 0.042 and P = 0.033, respectively) and early GC (P = 0.037 and P = 0.009, respectively) while decreased PDW indicated a significantly association with poor DFS for early GC (P = 0.006). Univariate and multivariate survival analysis showed that RDW and PDW can act as independent prognostic factors for DFS (P = 0.028 and P = 0.020) in patients with early GC.ConclusionThe preoperative RDW and PDW were simple and convenient predictive factors for the progression and prognosis of patients with GC.

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Objective: The emergence of carbapenem-resistant and hypervirulent Klebsiella pneumoniae (CR-hvKp) strains poses a significant public threat, and effective antimicrobial therapy is urgently needed. Recent studies indicated that apramycin is a potent antibiotic with good activity against a range of multi-drug resistant pathogens. In this study, we evaluated the in vitro activity of apramycin against clinical CR-hvKp along with carbapenem-resistant non-hvKp (CR-non-hvKp) isolates.Methods: Broth microdilution method was used to evaluate the in vitro activities of apramycin, gentamicin, amikacin, imipenem, meropenem, doripenem, ertapenem and other comparator "last-resort" antimicrobial agents, including ceftazidime-avibactam, colistin and tigecycline, against eighty-four CR-hvKp and forty CR-non-hvKp isolates collected from three Chinese hospitals. Multilocus Sequence typing (MLST), molecular capsule typing (wzi sequencing) and antimicrobial resistance genes were examined by PCR and Sanger sequencing. Pulsed-field gel electrophoresis and next generation sequencing were conducted on selected isolates.Results: Among the 84 CR-hvKp isolates, 97.6, 100, 97.6, and 100% were resistant to imipenem, meropenem, doripenem and ertapenem, respectively. Apramycin demonstrated an MIC 50 /MIC 90 of 4/8 µg/mL against the CR-hvKp isolates. In contrast, the MIC 50 /MIC 90 for amikacin and gentamicin were >64/>64 µg/mL. All CR-hvKp isolates were susceptible to ceftazidime-avibactam, colistin and tigecycline with the MIC 50 /MIC 90 values of 0.5/1, 0.25/0.5, 1/1, respectively. For CR-non-hvKp, The MIC 50/90 values for apramycin, gentamicin and amikacin were 2/8, >64/>64, and >64/>64 µg/mL, respectively. There were no statistical significance in the resistance rates of antimicrobial agents between CR-hvKp and CR-non-hvKp groups (p > 0.05). Genetic analysis revealed that all CR-hvKp isolates harbored bla KPC-2 , and 94% (n = 79) belong to the ST11 high-risk clone. 93.6% (44/47) of amikacin or gentamicin resistant strains carried 16S rRNA methyltransferases gene rmtB.

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The -1516G > T, -574G > T and +4259T > G SNPs within TIM-3 gene might play an important role as a genetic risk factor in the pathogenesis of ET.

BackgroundPreviously, we reported that calcium dobesilate (CaD), a vasoprotective agent mainly used for diabetic retinopathy, negatively interferes with enzymatic creatinine assays. Anewly developed enzymatic creatinine assay, the “Cr-R assay”, is commercially available and claims to have no interference from CaD. This study aimed to verify the performance of the Cr-R assay on clinical samples and to investigate the degree of CaD interference in a multicentre, real-world study.MethodsThe precision and accuracy ofthe Cr-R assay was evaluated in 23 hospitals in different regions of China. Interference was then calculated both in vitro and in clinical samples. Samples with potential interference were screened based on the different creatinine results between Cr-R and the creatinine assays commonly used in each participating hospital (Cr-C). Interference was confirmed by determining serum CaD concentration by directly using ultra-performance liquid chromatography (UPLC) methodand by assessing the “true” creatinine levels using the standard isotope dilution mass spectrometry (ID-MS/MS) method. ResultsTheprecision and bias and anti-interference ability of Cr-R assay on most platforms fulfilled the specification criteria. In the clinical setting, 67,469 samples were tested in 23 centres, and CaD concentration was measured in 818 samples, of which 257 contained CaD, accounting for 0.38% of the total and 31% of screened patients. In these 257 cases, the median CaD concentration was 11.356 (range, 1.350–121.519; IQR, 7.162–21.175) μg/mL. Creatinine levels measured using Cr-C assay were up to 35.1% (95%CI, 37.9–32.4 %; P < 0.001) lower than the “real” creatinine levels using the ID-MS/MSmethod. For Cr-R reagent, the average bias from the reference method was -6.2% (95%CI, -7.9–4.6%; P < 0.001), ranging from -17.9% to 7.1%.ConclusionsMulticentre tests confirmed that the precision, bias, and anti-CaD ability of the Cr-R assay met clinical needs. The prevalence of CaD interference should be considered when performing clinical enzymatic creatinine measurements.Other manufacturers should improve the anti-interference performance of creatinine reagents.

Background Several researches have been conducted on the associations between elements and diseases. Few studies have examined trace elements in young people’s hair. The objective of this study is to investigate the influence of age, gender and season on the contents of magnesium (Mg), calcium (Ca), Iron (Fe), copper (Cu), zinc (Zn), manganese (Mn), selenium (Se) and strontium (Sr) as well as to establish the reference intervals (RIs). Methods We conducted a retrospective study of 589 apparently healthy children and adolescents under 19 years old. Quantitative analysis has been carried out using inductively coupled plasma-mass spectrometry (ICP-MS). Eight nutrient elements in peripheral blood of children and adolescents in eastern China were grouped according to age, sex or season, and analyzed using and Mann-Whitney U test and spearman statistical analyses. RIs were defined by using 95% confidence interval. Results Precisions of ICP-MS detecting for Mg, Ca, Fe, Cu, Zn, Mn, Se and Sr are 2.8%~12.2%. The linearity were all > 0.999 and the bias were all within 10%. Differences between contents of particularly Mg, Fe, Cu and Zn in girls’ and boys’ whole blood were found, and higher contents of Mg, Cu for boys were measured in some age groups. Positive correlations for Fe, Zn, Se and Sr, while negative for Ca and Cu were found with age. And substantial differences between age groups were stated. In general, an increasing trend was found for bioelements (Fe, Zn,Se) both for girls and boys in all age groups, while for Ca and Cu changes were even decreasing for children and teenagers. The most frequently correlating element pairs were Fe-Zn, Mg-Se, and Fe-Se in five successive age groups. Lower contents of essential elements (Mg, Ca, Fe, Zn, Se) were found in summer comparing with other seasons. Finally, the reference interval of each element was initially established according to age and gender grouping. Conclusions The contents of elements in whole blood varies depending mainly on the gender and age of children and adolescents. Besides, season is also a factor that affects the contents of elements in the body. The reference intervals of elements in whole blood grouped by age and gender provide a reference basis for clinical diagnosis and treatment of element-related diseases.