Sepsis is a systemic inflammatory response syndrome caused by infection, with high fatality rate and complex pathogenesis. Early and accurate diagnosis is essential to improving the prognosis of patients with sepsis. This review briefly describes the basic pathogenesis of sepsis, and summarizes the current new technologies for detecting sepsis from two aspects: pathogen detection and host immune status detection, such as digital polymerase chain reaction, biosensors, fluorescent probes, single-cell RNA sequencing, and enzyme-linked immunospot assay. By comprehensively analyzing and applying these new techniques, it is helpful to improve the efficiency and accuracy of early diagnosis of sepsis and improve the clinical treatment effect of patients.
Objective To investigate the changes and clinical significance of high-density lipoprotein (HDL)-mediated cholesterol efflux capacity (CEC) in patients with diabetes mellitus. Methods Patients with diabetes attending West China Hospital of Sichuan University between January 2022 and June 2024 and healthy physical examination subjects during the same period (serving as the control group) were selected. The diabetic group was further divided into high glycated hemoglobin (HbA1c) with normal fasting plasma glucose (FPG) group and high HbA1c with high FPG group. CEC levels were compared among groups, correlations between CEC and glucose/lipid metabolism indices were analyzed, and binary logistic regression was used to assess the independent association between CEC and diabetes. Results A total of 260 patients with diabetes were enrolled, and 203 patients in the control group. Among them, there were 88 cases in the high HbA1c with normal FPG group and 172 cases in the high HbA1c with high FPG group. Compared with the control group [30.52% (26.99%, 32.25%)], CEC levels in the high HbA1c with normal FPG group [26.01% (23.81%, 28.21%)] and the high HbA1c with high FPG group [24.02% (17.40%, 27.49%)] were significantly lower (P<0.001). At the same HbA1c stratum, higher FPG was associated with lower CEC; at the same FPG stratum, higher HbA1c was associated with lower CEC. Correlation analysis showed that CEC was negatively correlated with FPG (r=?0.434, P<0.001) and HbA1c (r=–0.444, P<0.001), positively correlated with apolipoprotein A-Ⅰ (r=0.363, P<0.001), positively correlated with HDL-cholesterol (r=0.103, P=0.028). Multivariate logistic regression analysis showed that CEC was still associated with diabetes [odds ratio=0.785, 95% confidence interval (0.732, 0.842), P<0.001]. Conclusions HDL-mediated CEC is significantly impaired in patients with diabetes, and the degree of impairment worsens with increasing blood glucose and HbA1c levels. Routine lipid parameters cannot reflect HDL function, and CEC may serve as an independent indicator for evaluating the risk of diabetes and its cardiovascular complications.
ObjectiveTo analyze the microbiological characteristics of airway bacteria in adult patients with bronchiectasis and to analyze their correlation with the clinical features. MethodsPatients diagnosed with bronchiectasis in the Department of Respiratory and Critical Care Medicine of West China Hospital of Sichuan University from October 2017 to April 2018 were classified into the bronchiectasis group, while the control group was those who were found to have pulmonary nodules (diameter less than 10 mm) requiring bronchoscopy by physical examination. All subjects in both groups had not used antibiotics or hormones within 4 weeks and had no other respiratory diseases. Bronchoalveolar lavage fluid (BALF) from the lesion site of the branchial expansion group was collected, and BALF from the basal segment of the contralateral inferior bronchial lobe of the pulmonary nodule was collected in the control group. Bacterial culture and 16S rRNA gene sequencing were performed in both groups. ResultsSeventeen cases and six controls were enrolled in this study and the BALF specimens were collected. Eight cases were in stable period and nine cases were in acute period. The case group was divided into the bacteria-positive group and negative group based on bacterial culture of BALF. Shannon index in the bacteria-positive group was significantly lower than the bacteria-negative group and the control group. And Shannon index showed a negative correlation with positive bacterial culture in BALF. When Shannon index ≤4.5 was used to predict positive bacterial culture, the sensitivity and specificity were 83.3% and 90.9% respectively. The average relative abundance of bacteria was higher and the average sample distribution uniformity was lower in patients with acute period, compared with those in patients with stable period. Shannon index was negatively correlated with the acute exacerbation in patients. When Shannon index <5.0 was used to predict acute exacerbation, the sensitivity and specificity were 77.8% and 100.0%, respectively. ConclusionsShannon index in 16S rRNA gene sequencing results has certain predictive value for acute exacerbation stage. 16S rRNA gene sequencing combined with bacterial culture results can help guide clinicians to provide more precise treatment plans.
Objective To investigate the consistency of 25-hydroxyvitamin D (25-OH-VD) test results before and after a reagent generation change, assess the risk of misclassification associated with continued use of the previous reference interval after reagent replacement, and provide experimental evidence for the verification and revision of reference intervals following reagent changes in clinical laboratories. Methods The comparability of the two reagent generations was evaluated by simultaneously measuring samples using the pre-upgrade reagent (25-OH-VD Ⅰ) and the post-upgrade reagent (25-OH-VD Ⅲ). Healthy individuals who underwent physical examinations at the Health Management Center of West China Hospital, Sichuan University between March and June 2024 (25-OH-VD Ⅰ group, n=8203) and between March and June 2025 (25-OH-VD Ⅲ group, n=8203) were included. The distributions of results obtained using the two reagent generations across different concentration categories were compared. The consistency of the results was further evaluated through stratified analyses according to parathyroid hormone concentrations, and differences in the reference intervals between the two reagent generations were retrospectively analyzed. Results The relative differences between the results obtained using the 25-OH-VD Ⅲ and 25-OH-VD Ⅰ reagents ranged from –17% to +6%. In the 25-OH-VD deficiency category (<30 nmol/L), 428 individuals were identified using the 25-OH-VD Ⅰ reagent and 1195 using the 25-OH-VD Ⅲ reagent. In the insufficiency category (30-50 nmol/L), the corresponding numbers were 3324 and 4171, respectively. In the three parathyroid hormone strata of <1.6, 1.6-6.9, and >6.9 pmol/L, the median (lower quartile, upper quartile) of the 25-OH-VD concentrations measured using the 25-OH-VD Ⅲ reagent were 55.0 (41.9, 63.2), 44.9 (35.4, 57.6), and 39.1 (31.3, 49.4) nmol/L, respectively, all of which were lower than the corresponding values obtained using the 25-OH-VD Ⅰ reagent [70.8 (63.9, 79.1), 53.8 (42.6, 68.2), and 46.0 (37.1, 59.1) nmol/L, respectively; all P<0.05]. The P2.5-P97.5 reference interval for the 25-OH-VD Ⅲ reagent was 23.0-96.0 nmol/L, compared with 27.6-110.6 nmol/L for the 25-OH-VD Ⅰ reagent, representing decreases of 4.6 nmol/L in the lower limit and 14.6 nmol/L in the upper limit. Conclusions Significant differences were observed between the 25-OH-VD Ⅲ and 25-OH-VD Ⅰ reagents. Direct application of the reference interval established for the previous reagent may lead to overdiagnosis of vitamin D deficiency. Following a reagent generation change, laboratories should communicate the resulting differences to clinicians and, when necessary, establish a correction equation or revise the laboratory-specific reference interval.