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Background: Scoring systems including CURB-65 and Pneumonia Severity Index (PSI) and novel or traditional biomarkers including procalcitonin (PCT) and c-reactive protein (CRP) are very significant for understanding the severity and prognosis in community-acquired pneumonia (CAP) patients, while prognostic items are useful for CAP prognostication and point-of-care decisions. The aim of this study was to investigate the usefulness of peripheral blood routine items in predicting ICU admission and 30-day mortality in CAP patients. Methods: A retrospective study was conducted. All adult patients with a primary diagnosis of CAP were included and peripheral blood routine tests were evaluated. Univariate analysis and multivariate logistic regression analysis were used to explore association of risk factors with 30-day mortality among CAP patients. Receiver operating characteristic curves (ROC) were used to evaluate the sensitivity and specificity of peripheral blood routine items and compared with CURB-65 scores in predicting ICU admission and/or 30-day mortality. Results: One hundred fifty patients were included and compared with non-ICU admission patients. There was a statistically significant difference in age, co-existing illness, RDW, WBC, and CURB-65 scores ranking in ICU admission patients (p < 0.05). In multivariate logistic regression analysis, we found RDW, WBC, and CURB-65 = 3 scores increased the risk of 30-day mortality by 4.01, 1.65, and 3.43 times, respectively. The area under the curve (AUC) of ROC curves of RDW combined with WBC and CURB-65 was 0.786 (95% CI 0.701 to 0.876) and 0.836 (95% CI 0.764 to 0.908), respectively and the sensitivity was 84.0% and 60.0%, respectively, and the specificity 66.7% and 93.7%, respectively. Conclusions: Elevated RDW and WBC increased mortality in adult CAP patients, RDW combined with WBC had a better sensitivity than CURB-65 scores in predicting ICU admission and/or mortality in CAP patients. [ABSTRACT FROM AUTHOR]

Background: Community-acquired pneumonia (CAP) is a common infectious disease. Inflammatory reaction and prognosis assessment in adult CAP patients are useful for CAP site of care decisions. Most CAP patients were diagnosed in an out-patient or emergency department, so a simple, cheap and rapidly available measurement to assess inflammatory reaction and prognosis has the prospect of broad application. The aim of this study was to investigate the usefulness of plasma D-Dimer in assessment of inflammatory reaction and prognosis in adult CAP patients. Methods: A retrospective study was conducted. All adult patients with a primary diagnosis of CAP were included and were evaluated by peripheral plasma D-Dimer test. All of the measurement data were analyzed with paired t-test and the enumeration data were analyzed with χ2 test. Correlative factor analysis was performed between D-Dimer levels and serum inflammatory markers (WBC, hs-CRP, PCT) and prognostic indexes (ICU admission and 30-day mortality). Receiver operating characteristic curves (ROC) were used to evaluate the sensitivity and specificity of D-Dimer in predicting ICU admission and/or 30-day mortality. Results: One hundred fifty patients were included. Compared with non-D-Dimer elevated group, serum inflammatory markers (WBC, hs-CRP, PCT) and prognostic indexes (ICU admission and 30-day mortality) were elevated in the D-Dimer elevated group (p < 0.05). D-Dimer had positive correlation with serum inflammatory markers (WBC, hs-CRP, PCT), the rates of ICU admission and 30-day mortality, and scores of CURB-65. The AUC of ROC curve of D-Dimer was 0.880 (95% CI 0.823 to 0.936), the sensitivity was 80.4% and specificity was 79.8%, D-Dimer levels are superior to hs-CRP and PCT in predicting 30-day mortality and/or ICU admission according to AUCs of the ROC curves. Conclusions: Elevated plasma D-Dimer in adult CAP patients is associated with an increased inflammatory reaction and ICU admission and 30-day mortality. It can be a simple, cheap, and rapidly available measurement to assess inflammatory reaction and prognosis in adult CAP patients. [ABSTRACT FROM AUTHOR]

Background: The CURB-65 scoring system is a simple tool in assessment and prognosis prediction for communityacquired pneumonia (CAP) patients. However, the variations in performance of CURB-65 in young and elderly patients, underestimation or overestimation of the severity, and mortality have often been reported. The aim of this study was to investigate the usefulness of serum high-sensitivity C reactive protein (hs-CRP) combined with CURB-65 in predicting ICU admission and 30-day mortality in CAP patients. Methods: We conducted a retrospective study. All patients over 18 years of age with a primary diagnosis of CAP were included, all of them received serum hs-CRP test and CURB-65 scaring evaluation. The main outcome measures were ICU admission and 30-day mortality. Receiver operating characteristic curves (ROC) were used to evaluate the sensitivity and specificity of the CURB-65 model and hs-CRP combined CURB-65 augmented model in predicting the main outcomes. Results: Data from 150 patients was analyzed, in which the rate for patients requiring ICU admission was 30.67%, and the ultimate mortality rate was 24%. The areas of ROC curves (AUC) of CURB-65 was 0.859 (95% CI 0.705 to 1.000), hs-CRP combined CURB-65 augmented model was 0.864 (95% CI 0.692 to 1.000), ROC curve analyses showed the augmented model had higher sensitivity than the CURB-65 model in predicting main outcomes (p = 0.001). Conclusions: Measurement of serum hs-CRP in addition to the CURB-65 model improved the clinical usefulness in predicting ICU admission and mortality in CAP patients. [ABSTRACT FROM AUTHOR]

Background: The goal was to establish a system for assessing molecular age (MA) based on common biomarkers of aging, disease, and end-of-life processes for assessing the development of chronic diseases at the molecular level., Methods: Routine clinical laboratory indexes, including biochemical lab tests and complete blood count, were used as common biomarkers in end-of-life patients, who underwent treatment at the intensive care unit (ICU) of a hospital and died within one month. Biomarkers that were significantly different both between the patients and the controls and between the young and elderly groups could be used for the establishment of a MA index at the molecular level., Results: Only albumin (ALB) was suitable as an index of MA. MA score could be obtained by using survival probability as dependent variable and using age and Alb as independent variable. MA score was 0.02Alb - 0.01age + 0.45. MA score was presented as the value of survival probability. MA score was < 0.5 in 94.3% of the ICU patients with chronic disease. For normal individuals an MA score < 0.5 was found in 5.1%. The percentage of patients an MA score < 0.50 was considerably higher in cancer, COPD, and cardiocerebrovascular diseases groups than in the elderly group, although the chronological age of elderly group was similar with the diseases groups., Conclusions: When considering death, the MA score is suitable for assessing the prechronic disease and health status at the molecular level and could provide a simple and effective tool for the early diagnosis and management of chronic conditions.

Background: Schizophrenia (SCH) is a highly heritable disease that occurs mostly in young adults. Genetic factors usually play important roles in the onset of SCH. Human leukocyte antigen complex (HLA) genes are considered to be the important genetic predisposition factor and the genetic markers in SCH and other diseases., Methods: To screen SCH-associated HLA alleles, alleles for HLA-DRB1 and HLA-DQB1 loci were determined using the PCR-SSP typing kit. Statistically significant differences between observed and expected frequencies of allele combinations were identified. To further determine allele combinations related to SCH, an analysis of the age of onset of SCH in the patient who carried an allele or specific allele combination was conducted. Finally, a crossvalidation of the two sets of analytical results was carried out. Statistical differences in frequency values between the SCH group and the control population were observed for five HLA alleles., Results: The results of cross-validation showed that there was a significant difference for a combination of DRB1*07 and DQB1*02, whereas no significant differences were observed for the other four alleles., Conclusions: We suggested that the combination of DRB1*07-DQB1*02 may be related to SCH susceptibility. The cross-validation design using age and HLA alleles could enable additional discoveries pertaining to the relationship between specific HLA allele combinations at different loci and the onset of complex diseases.

Background: The target substances of biomacromolecules are primarily unstable in biological, chemical, and immunological activity, whereby, the standardized substances are obtained with considerable difficulty. We explored the possibility of using a mixed serum sample as a natural reference material for measurement of biomacromolecules in serum., Methods: Eight serum samples were selected randomly from a clinical laboratory. Then, 2, 4, and 8 serum samples were mixed (in equal quantity) resulting in 4, 2, and 1 sample groups, respectively, to compare mean measurement results of biochemical indices between single samples and mixed samples. Moreover, 40 serum samples were selected randomly from a clinical laboratory. From those samples, three groups were set up comprising 20, 10, and 5 sample groups by mixing equal quantities of 2, 4, and 8 serum samples, respectively. These samples were used to compare standard deviation (SD). The sixteen indices tested comprised proteins, enzymes, and organic molecules and were measured by an automatic biochemical analyzer., Results: The mean values from mixed samples were much closer to the mean values from the single serum samples. The SD values of the 2, 4, or 8 mixed serum samples were close to the expected value., Conclusions: These data suggest that the design of the reference material (i.e., a mixed serum sample) was suitable for the measurement of biological samples.

Background: The purpose of the present study is to develop a quantitative system that will allow objective assessment of a stress gradient and to examine the relationship between stress and health., Methods: The stress group consisted of patients with fractures. The low stress group consisted of strong manual workers, mental workers, and those who had experienced stressful social events. The subjects in the control group were healthy. We measured the levels of 2 laboratory parameters--high sensitive C-reactive protein and fasting plasma glucose--using automated analyzers. The above-mentioned two indicators were transformed into quailtative indicators based on the median value derived from the healthy population (values above and below the median value were designated as positive and negative, respectively). Apart from one person who was positive for both indicators and was thus considered positive for stress, the remaining individuals were all negative for stress., Results: The positive rates of stress were 82.4% and 39.8% in the stress group and low stress group respectively. These values were significantly different from control group (P <0.05)., Conclusions: We have successfully developed a simple, precise, and sensitive method for the quantification of stress.

Background: To investigate the markers of systemic function by using laboratory parameters as life parameters., Methods: Lymphocyte count, albumin, and creatinine levels were measured using automatic analyzers in young, healthy individuals (20-39 years) and senior individuals (80-95 years) as well as in terminally ill patients. We developed a mathematic model and scoring system (indexes of systemic function, ISF) based on the above mentioned biological markers., Results: ISF scores were significantly lower in the senior group (P < 0.05) than those in the young, healthy group. A significant decrease was observed in the ISF of the terminally ill group and that of the senior group (P < 0.05)., Conclusions: Our results suggest that the ISF scoring system of systemic function can be used to objectively evaluate the systemic function in individuals with different health statuses.