Background The emergence of coronavirus disease 2019 (COVID-19) is a major healthcare threat. The current method of detection involves a quantitative polymerase chain reaction (qPCR)–based technique, which identifies the viral nucleic acids when present in sufficient quantity. False-negative results can be achieved and failure to quarantine the infected patient would be a major setback in containing the viral transmission. We aim to describe the time kinetics of various antibodies produced against the 2019 novel coronavirus (SARS-CoV-2) and evaluate the potential of antibody testing to diagnose COVID-19. Methods The host humoral response against SARS-CoV-2, including IgA, IgM, and IgG response, was examined by using an ELISA-based assay on the recombinant viral nucleocapsid protein. 208 plasma samples were collected from 82 confirmed and 58 probable cases (qPCR negative but with typical manifestation). The diagnostic value of IgM was evaluated in this cohort. Results The median duration of IgM and IgA antibody detection was 5 (IQR, 3–6) days, while IgG was detected 14 (IQR, 10–18) days after symptom onset, with a positive rate of 85.4%, 92.7%, and 77.9%, respectively. In confirmed and probable cases, the positive rates of IgM antibodies were 75.6% and 93.1%, respectively. The detection efficiency by IgM ELISA is higher than that of qPCR after 5.5 days of symptom onset. The positive detection rate is significantly increased (98.6%) when combining IgM ELISA assay with PCR for each patient compared with a single qPCR test (51.9%). Conclusions The humoral response to SARS-CoV-2 can aid in the diagnosis of COVID-19, including subclinical cases.
Accompanied with the broad application of interventional therapy, the incidence of acute kidney injury (AKI) has been recently increasing in clinical renal medicine. The pathogenesis of AKI is diverse and complex. In the context of the requirements for the diagnosis and treatment of a renal disorder, a large number of studies have explored biological markers and their usefulness to the early diagnosis and treatment of AKI, including glomerular injury, renal tubular injury, and others. These biomarkers provide an important basis for early monitoring of AKI, but are still not quite sufficient. More ideal biomarkers are needed to be identified. Therefore, future studies are necessary to explore more effective biomarkers for AKI clinical practice, which would play an important role in the early diagnosis and intervention treatment of AKI. This review summarizes the important biomarkers identified by previous studies and aims to highlight the advancements that might provide new methods for early clinical diagnosis and effective therapeutic options, along with prediction of response to treatment for AKI.
Context: Currently, short-term recurrence of pain is the biggest clinical challenge of celiac plexus neurolysis for patients with refractory abdominal cancer pain. Aim: To evaluate the analgesic effect and safety of celiac plexus neurolysis using ethanol injection combined with iodine-125 (125I) radioactive seed implantation for refractory abdominal cancer pain. Settings and Design: The study was a randomized controlled trial. Methods and Materials: About 10 patients with severe refractory abdominal cancer pain were enrolled in this study. The patients were randomly divided into group A (ethanol injection combined with 125I radioactive seed implantation, n = 5) and group B (ethanol injection alone, n = 5). The primary end point was pain relief measured by means of numerical rating scale (NRS). And the secondary end point was mean administration of analgesic drugs and the safety of the procedure. Statistical Analysis Used: Repeated measures of analysis of variance were used for statistical analysis. Results: The NRS scores were significantly reduced by 24 h postprocedure in both groups (group A: P = 0.001 and group B: P = 0.001). Group A did not show significant recurrence based on NRS scores during the follow-up period. In contrast, the NRS scores recurred significantly in group B by 1 month postprocedure (P = 0.026). The intake of analgesic drugs was significantly reduced in both the groups postprocedure (group A: P = 0.013 and group B: P = 0.013). Overall, it was significantly lower in group A than in group B (P = 0.041). No treatment-related deaths or major complications were observed. Conclusions: Celiac plexus neurolysis using ethanol injection in combination with 125I radioactive seed implantation has a longer analgesic duration than using ethanol injection alone. It could be a safe and long-lasting analgesic approach for managing refractory abdominal cancer pain.
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