Journal of Medical Biochemistry

Correlation analysis of serum Hcy, HMGB1, and TLR4 levels and mononuclear macrophage polarization in acute cerebral infarction

2026-03-03T10:20:08+01:00

[Objective] To explore the correlations between homocysteine (Hcy), high mobility group protein B1 (HMGB1), and Toll-like receptor 4 (TLR4) levels and the polarization of mononuclear macrophages among individuals who were admitted with acute cerebral infarction (ACI).

[Methods] The case group was made up of 214 ACI patients who were admitted to the hospital between August 2022 and August 2024, whereas the control group was made up of 100 healthy people who had physicals over the same time frame. A comparison was made between the two groups' admission serum Hcy, HMGB1, and TLR4 levels. The polarization conditions of the mononuclear macrophages in the two groups were compared [proportion of M1-type cells, proportion of M2-type cells, M1/M2 ratio, M1-type polarization markers (interleukin-1β, tumor necrosis factor-α), and M2-type polarization markers (interleukin-10, transforming growth factor-β)]. to investigate the connections between the polarization of mononuclear macrophages and the levels of Hcy, HMGB1, and TLR4 in ACI patients, as well as the associations between these levels and the prognosis of ACI patients. Serum levels of Hcy, HMGB1, and TLR4 were compared between the ACI patients who were split into groups with excellent and poor prognoses. The prognostic efficacy of Hcy, HMGB1, and TLR4 for the prognosis of ACI patients was evaluated using receiver operating characteristic (ROC) curves.

[Results] Serum Hcy, HMGB1, and TLR4 levels in the case group were considerably higher (P<0.05) than those in the control group. Interleukin-1β and tumor necrosis factor-α levels, the M1/M2 ratio, and the percentage of M1-type cells were all considerably greater (P<0.05) in the case group compared to the control group, although transforming growth factor-β and interleukin-10 levels were significantly lower (P<0.05). Serum Hcy, HMGB1, and TLR4 levels in ACI patients were found to be negatively correlated with interleukin-10 and transforming growth factor-β (P<0.05) and positively correlated with the proportion of M1-type cells, the M1/M2 ratio, and the levels of interleukin-1β and tumor necrosis factor-α (P<0.05), according to the results of the Pearson correlation analysis. Serum Hcy, HMGB1, and TLR4 levels were substantially higher (P<0.05) in the poor prognosis group than in the good prognosis group. With area under the curve (AUC) values of 80.00%, 77.80%, and 0.840 for sensitivity, specificity, and AUC, respectively. The ROC curve analysis showed that the combined prediction of Hcy, HMGB1, and TLR4 levels had a comparatively high efficacy in predicting the prognosis of ACI patients.

[Conclusion] Patients with ACI had elevated levels of Hcy, HMGB1, and TLR4 expression in their peripheral blood. These levels are anticipated to be biomarkers for the clinical diagnosis and treatment of ACI and are strongly correlated with the polarization of mononuclear macrophages and patient prognosis.

Serum superoxide dismutase (SOD), malondialdehyde (MDA) ,IL-6, IL-8, TNF-α, serum immune markers after Allogeneic Blood Transfusion in Patients with Gastrointestinal Bleeding

2026-03-03T10:20:08+01:00

Aim:this article was to analyze the changes serum superoxide dismutase (SOD), malondialdehyde (MDA) ,IL-6, IL-8, TNF-α, serum immune markers indicators in the serum of patients with gastrointestinal hemorrhage and the impact on the immune function of the body after allogeneic blood transfusion (ABT) during surgery.

Methods:80 patients who diagnosed with gastrointestinal bleeding (GIB) and required surgical treatment were enrolled. 40 patients in the experimental group (EG) were given intravenous infusion of 2 ~ 4 U of red blood cells during the surgery, and 40 patients in the control group (CG) were not treated with allogeneic blood transfusion during the surgery. The cubital venous blood of patients was drawn before the ABT and 1 day after the ABT to check the changes in the T cell subsets, natural killer cells (NKC), immune globulin, serum inflammatory factors, count of platelets, oxidative stress indicators, and hemostasis time.

Results: 1 day after ABT, NKC, CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in the EG were much lower as against prior to ABT; the immunoglobulin G (IgG) in the EG was lower (P< 0.05); the changes of IgA, and IgM in patients were not obvious (P> 0.05); and IL-6, IL-8, and tumor necrosis factor α (TNF)-α were greatly increased (P< 0.05). The counts of platelet the two groups were reduced prior to ABT and one day after ABT, but the changes were not obvious (P> 0.05). After ABT, the increase in serum superoxide dismutase (SOD) and the decrease in malondialdehyde (MDA) in the EG were greater as against the CG; The hemostasis time (the disappearance of coffee-like substances or the disappearance of blood in the excrement) and the time for occult blood to become negative in the EG were shorter as against the CG (all P< 0.05).

Conclusion: It suggested that the ABT was effective in the treatment of GIB, but it had a visible inhibitory effect on immune function. In addition, the amount of ABT had no visible effect on the platelet function of patients within a certain range, and the oxidative stress indicators of patients changed obviously after ABT, indicating that it can inhibit the peroxide response of patients with GIB.

Increased total plasma TGF-β1 levels and deregulated IgA - IgM axis in chronic obstructive pulmonary disease

2026-03-03T10:20:09+01:00

Background: Chronic obstructive pulmonary disease (COPD) is displayed as the obstruction of the small airways and includes “flare-ups”, sudden and significant worsening of symptoms, sometimes caused by infections.

Methods: COPD (n=38) and acute bronchitis (AB, n=35) patients were grouped based on age and examined at two time points: during flare-ups/infections and at day 30. We measured various biomarkers, including total plasma TGF-β1 levels, total IgA, total IgM, and Pseudomonas aeruginosa specific IgA levels.

Results: Increased TGF-β1 levels were detected in COPD patients, with no significant change observed at day 30. A significant lowering of total plasma IgA level was observed in COPD patients on day 30. No significant difference in specific P. aeruginosa IgA levels were observed between the two patient groups, or over time. Interestingly, a correlation between total IgM and IgA levels was absent in COPD patients. While positive correlation between age and IgA level existed in acute bronchitis patients, this correlation was negative in COPD patients. A significant correlation was observed between total IgA and P. aeruginosa specific IgA in acute bronchitis patients. On the other hand, COPD patients showed no correlation at t=0 but a correlation was seen between total IgA and P. aeruginosa specific IgA1 at t=30, implying that flare-up resolution is accompanied with consolidation, a corresponding reinforcement or stabilization, of P. aeruginosa specific IgA levels in COPD patients.

Conclusion: Here we report on deregulated IgA - IgM axis in COPD, and call for thorough, larger scale studies of the humoral immune system in this pathology.

A Study on the Interaction Between Intestinal Microbiota, Inflammatory Cytokines, and the Expression of miR-330-3p and miR-515-5p in Patients with Ulcerative Colitis

2026-03-03T10:20:09+01:00

Background: Ulcerative colitis (UC) has a complex pathogenesis involving multiple factors. This study aims to explore the interplay among intestinal microbiota, serum inflammatory cytokines, and miR-330-3p, miR-515-5p in UC patients for novel treatment strategies.

Methods: The study enrolled 95 healthy controls, 88 UC patients in remission, and 91 in active diseases. Assessments included clinical data, intestinal microbiota detection (using culture methods), serum cytokine measurement (using ELISA assay), and miRNA expression analysis (using RT-qPCR). ROC curves evaluated diagnostic value, and multivariate logistic regression identified risk factors.

Results: From the control group to UC remission, and then to seizure UC, significant decreases were observed in Bifidobacterium, Lactobacillus counts, IL-10 levels, and miR-515-5p expression, while increases were noted in Enterobacteriaceae, Enterococcus counts, IL-6, TNF-α levels, and miR-330-3p expression (P<0.05). ROC curve analysis showed improved diagnostic accuracy for UC with the combination of miR-330-3p and miR-515-5p (AUC = 0.899, 95% CI: 0.936-0.978, sensitivity: 92.18%, specificity: 88.42%). miR-515-5p positively correlated with beneficial microbiota and IL-10 (r > 0.5, p<0.001) and negatively with harmful microbiota, IL-6, and TNF-α (r < -0.5, p < 0.001); miR-330-3p showed opposite correlations. miR-515-5p, Bifidobacterium, Lactobacillus, and IL-10 were protective factors for UC, whereas miR-330-3p, Enterobacteriaceae, Enterococcus, IL-6, and TNF-α were risk factors.

Conclusions: This study revealed interactions among intestinal microbiota, serum inflammatory cytokines, and miRNAs in UC patients, confirming the potential of miR-330-3p and miR-515-5p in UC diagnosis and assessment.

The Combination of Cyclin D1 and MRI Parameters Improves Breast Cancer Diagnosis and NACT Efficacy Assessment

2026-03-03T10:20:10+01:00

Objective: The purpose of this study is to evaluate the combined diagnostic performance of Cyclin D1 and magnetic resonance imaging (MRI) parameters in breast cancer (BC), while also assessing their ability to forecast treatment response to neoadjuvant chemotherapy (NACT), so as to provide evidence for individualized treatment strategies.

Methods: This study recruited 154 BC patients and 148 healthy women. Peripheral blood Cyclin D1 quantification utilized enzyme-linked immunosorbent assay (ELISA), and CA15-3 and CA27.29 (both tumor markers) measurements were made using automated electrochemiluminescence immunoassay. Magnetic resonance imaging (MRI) was conducted to obtain dynamic contrast-enhanced scans, from which radiomics parameters (PSIER, TSICS, ADC) were derived. Diagnostic accuracy for BC and predictive value for chemotherapy response were evaluated through correlation analysis (Pearson), receiver operating characteristic (ROC) curves, and multivariate regression modeling.

Results: Cyclin D1 levels were elevated in BC patients compared to healthy controls and showed a positive connection with CA15-3 and CA27.29 (P<0.05). The diagnostic performance of Cyclin D1 alone yielded an AUC of 0.830, whereas a combined model incorporating MRI parameters (PSIER, TSICS, and ADC) significantly improved discrimination (AUC=0.935, sensitivity 86.36%, specificity 87.84%). During NACT, Cyclin D1 levels declined dynamically. A predictive model integrating Cyclin D1 and imaging biomarkers achieved an AUC of 0.775 for identifying poor NACT responders (sensitivity 88.37%, specificity 56.76%)

Conclusion: The combination of Cyclin D1 and MRI parameters enhances both BC diagnostic accuracy and NACT efficacy prediction.

The influence of early serum heparin-binding protein (HBP) levels on the occurrence of sepsis in patients with severe burns

2026-03-03T10:20:10+01:00

[Objective] To evaluate the expression levels of early serum heparin-binding protein (HBP) in patients with severe burns and investigate its prognostic significance and predictive utility for sepsis development.

[Methods] The clinical data of 52 patients with severe burns who were admitted to our hospital between January 2023 and May 2025 were retrospectively analyzed. General information, including the patient's age, sex, body mass index (BMI), total burn area, and tracheal intubation or tracheotomy, was collected. Within 48 hours of the patient's admission, the patient's blood pressure, white blood cell count, serum procalcitonin (PCT), and serum C reactive protein (CRP) level were measured. The second assessment of acute physiology and chronic health within 48 hours of admission included the results of the sequential organ failure assessment (SOFA) and APACHE II. The patients were separated into two groups on the basis of their conditions at discharge: the nonsurviving group and the surviving group.

[Results] Compared with the nonsepsis group (8.2 ng/mL), the sepsis group had a considerably greater median early serum HBP level (20.8 ng/mL) (P<0.001). The area under the curve (AUC) of HBP for sepsis prediction, according to the ROC curve analysis, was 0.87 (95% CI: 0.82–0.92). The sensitivity was 85.0%, and the specificity was 82.1% at the cutoff value of 14.6 ng/mL. After controlling for confounding variables such burn area and inhalation injury, multivariate logistic regression analysis verified that HBP>14.6 ng/mL was an independent risk factor for the development of sepsis (OR=4.53, 95% CI: 2.67–7.69). According to survival analysis, patients in the high-HBP group had a significantly greater 28-day mortality rate (log-rank P<0.01).
Patients in the death group were older than those in the survival group were, and this difference was statistically significant (P=0.036). The area under the ROC curve (AUC) of the HBP level for predicting patient death during hospitalization was 0.798; its sensitivity and specificity were 88.33% and 70.00%, respectively, for HBP≥147.03 ng/mL. In patients with sepsis following severe burns, the AUC of the HBP level for the prediction of septic shock was 0.789. Its sensitivity and specificity were 90.00% and 63.20%, respectively, when the HBP concentration was greater than 147.03 ng/mL.

[Conclusion] The significantly elevated serum HBP level in patients with severe burns in the early stage is closely related to the risk of sepsis, and it can be used as a sensitive biomarker for early warning of sepsis.

Analysis of the clinical diagnostic efficacy of the novel serum markers lipase F, gastrokine 2 and the collagen X-type α1 chain in gastric cancer

2026-03-03T10:20:10+01:00

Objective: To explore the application value of three novel serum markers, collagen X-type α1 chain (COL10A1), gastrokine 2 (GKN2), and lipase F (LIPF), in the diagnosis of gastric cancer.

Methods: Differential markers of gastric cancer were mined from public databases (TCGA, GTEx). From November 2022 to October 2024, 108 healthy people and patients with stomach cancer who had gastroscopies and pathological examinations at our hospital were chosen to serve as research subjects. Of these, 60 patients had stomach cancer (28 in the early gastric cancer group and 32 in the advanced gastric cancer group), while 48 patients were in the healthy group. Receiver operating characteristic (ROC) curves were created in order to examine the relationship between the detection of gastric cancer and the serum levels of markers. Additionally, the application value of both the detection of new markers and the detection of conventional markers (PGI, PGII) in the diagnosis of gastric cancer was examined.

Results: Three differential markers of gastric cancer (COL10A1, GKN2 and LIPF) were mined from a public database. By detecting the levels of three markers in clinical blood samples, AUC of the combined detection of the three markers (COL10A1+GKN2+LIPF, 3MP) in differentiating group (3MP vs PGR: 0.842 vs 0.841) and the early gastric cancer group (0.877 vs 0.843) was greater than that of PGR (PGI/PGII). The combined conventional markers (PGI, PGII) and the combined detection of five markers (3MP+PGI+PGII, 5MP) had AUCs of 0.963 and 0.953, respectively.

Conclusion: COL10A1, GKN2 and LIPF are very promising serum markers for the diagnosis of gastric cancer. The joint detection of the serum levels of these three novel markers and PGI and PGII has important value for the early detection of gastric cancer.

The level of interleukin-6, serum calprotectin, and hypersensitive C-reactive protein in Crohn's disease-related mucosal damage

2026-03-03T10:20:10+01:00

[Objective] To evaluate calprotectin, hypersensitive C-reactive protein, and interleukin-6 for detecting digestive tract mucosal injury in Crohn's disease (CD) patients.

[Methods] 52 patients diagnosed with CD were selected. Fecal samples from the patients were collected to detect calprotectin (ELISA), and serum samples were collected to detect hs-CRP (Immunoturbidimetry) and IL-6 (Chemiluminescence). All patients with CD underwent colonoscopy or capsule endoscopy. According to the modified endoscopic severity index of CD (SES-CD). Comparisons were made between the two groups' variations in calprotectin, hs-CRP, and IL-6 levels, and ROC curves were drawn to analyze the diagnostic efficacy (AUC) of each index and combined detection for mucosal injury.

[Results] In the Mucosal injury group, the calprotectin, hs-CRP levels were significantly greater than those in the mucosal healing group. Calprotectin had the highest AUC (0.93, 95% CI: 0.88–0.98), sensitivity (88.5%), and specificity (89.2%) when the critical value was greater than 250μg/g, according to ROC analysis. The AUC of the three indicators' combined detection (logistic regression model) rose to 0.96, which was noticeably superior than that of a single indicator (P<0.05).

[Conclusion] Interleukin-6, serum calprotectin, and hypersensitive C-reactive protein levels are significantly correlated with the degree of mucosal injury in patients with CD. Among them, calprotectin has the best diagnostic value. The combined detection of these three factors can significantly improve the recognition of mucosal injury in the active stage of CD.

Correlation analysis of the combined detection of serum CEA, CA72-4, CA19-9 and PGI and postoperative recurrence of gastric cancer

2026-03-03T10:20:11+01:00

[Objective]: To determine if serum CEA, CA72-4, CA19-9, and PGI in gastric cancer patients following radical gastrectomy are associated with postoperative recurrence.

[Methods]: The gastric cancer group consisted of 102 patients who were admitted to our hospital between January 2022 and June 2024 and had undergone radical gastrectomy (RG); the control group consisted of 34 healthy volunteers who were examined during the same time period. Based on whether there was a recurrence following the procedure, patients with gastric cancer were split into two groups: 87 patients who did not experience a recurrence and 15 patients who did. The control group's serum levels of CEA, CA72-4, CA19-9, and PGI were assessed during physical examination, the day before surgery for gastric cancer patients, and at follow-up (or recurrence) one year later.

[Result] In the gastric cancer group, serum levels of PGI were lower than in the control group, whereas CEA, CA72-4, and CA19-9 were greater (all P<0.05). The recurrence rate (15/102 patients) was 14.71%. Poor differentiation degree, decreased PGI, and TNM stage III disease were all independent risk variables for recurrence following RG, according to univariate and multivariate logistic regression analyses (P<0.05). The sensitivity of the serum CEA level was 85.74%, and the specificity was 56.83%. The sensitivity of the serum CA72-4 concentration was 39.46%, and the specificity was 95.13%. Sensitivity of CA19-9 concentration was 58.91%, and the specificity was 78.11%. The AUC of the combined prediction of postoperative recurrence in patients with RG according to CEA, CA72-4, CA19-9 and PGI was greater than that of the individual predictions.

[Conclusion]: Patients with RG who had elevated CEA, CA72-4, and CA19-9, decreased PGI, TNM stage III, and little differentiation are at independent risk for postoperative recurrence.

Correlation analysis of cognitive dysfunction and fluctuations in serum fibroblast growth factor 21 (FGF21) levels in the overweight group

2026-03-03T10:20:11+01:00

Objective: To explore the changing characteristics of cognitive function in overweight/obese (OWO) adolescents and analyze its relationship with the level of serum fibroblast growth factor 21 (FGF21).

Methods: A total of 175 adolescents were selected and divided into a normal body mass index (BMI) group (n=50), an overweight BMI group (n=50), and an obese BMI group (n=75). All participants underwent assessment of anthropometric indicators (height, weight, waist circumference, BMI Z score). Fasting venous blood was collected to measure the level of serum FGF21 (by enzyme-linked immunosorbent assay (ELISA)), as were metabolic parameters such as fasting plasma glucose (FPG), fasting insulin (FINS), glycated hemoglobin (HbA1c), and lipid profiles (TC, TG, LDL-C, HDL-C). Overall cognitive function was evaluated via the Chinese version of the Montreal Cognitive Assessment Foundation Scale (MoCA-B), executive function was evaluated via the Wisconsin Card Sorting Test (WCST) (with a focus on analyzing the number of persistent errors/PE and the number of completed classifications/CC), and working memory was evaluated via the number span test (DST). Independent sample t tests or Mann‒Whitney U tests were used to compare the differences between groups. Pearson or Spearman correlation analysis was used to explore the relationships between serum FGF21 levels and cognitive indicators and metabolic parameters. Multiple linear regression was used to analyze the independent association between serum FGF21 and cognitive function scores (after adjusting for potential confounding factors such as age, sex, BMI Z Score, and HOMA-IR).

Results: Compared with those of the normal individuals, the systolic blood pressure, diastolic blood pressure, fasting blood glucose, glycated hemoglobin and triglyceride levels of the adolescents in the obese group were greater (all P<0.05). Under the consistent or inconsistent stimulation conditions of the Flanker task, there was no statistically significant difference in the ACC between any two groups of adolescents. Compared with those in the normal body type group and the overweight group, the reaction time of adolescents in the obese group was prolonged (all P<0.05). In the n-back task, there was no statistically significant difference in the ACC between any two groups of adolescents. However, the response time of adolescents in the obese group in the 1-back and 2-back tasks was longer than that in the normal body type group and the overweight group (all P<0.05). Compared with those in the normal body type group, the serum FGF21 levels of adolescents in the obese group were greater (P=0.000). The results of the partial correlation analysis revealed that the reaction time of adolescents in the Flanker and n-back tasks was correlated with their BMI, body fat mass, waist circumference, waist‒hip ratio, FGF21 level, etc. (all P<0.05). Multiple linear regression analysis further confirmed that BMI was associated with prolonged response time in cognitively related behavioral tasks in adolescents (all P<0.05), and the level of FGF21 was correlated with the ACC in the 2-back task (P=0.000) and the response time to inconsistent stimuli (P=0.048).

Conclusion: Overweight adolescents have significant cognitive impairment, with significantly elevated serum FGF21 levels, and elevated FGF21 levels are independently associated with poorer overall cognitive and executive functions.

Changes of blood glucose and lipid metabolism in breast cancer patients with cancer-related fatigue during chemotherapy: a cross-sectional survey

2026-03-03T10:20:11+01:00

Objective: To cross-sectionally investigate the correlation of cancer-related fatigue (CRF) with quality of life (QoL) and physical fitness of breast carcinoma (BC) patients during chemotherapy, so as to provide reference and guidance for the future clinical development of better medical services for BC patients during chemotherapy. Methods: From February 2023 to July 2023, 400 BC patients treated at the Breast Surgery Department of the Fujian Cancer Hospital were selected as the research subjects. Physical fitness-associated indicators were investigated, including body composition, muscle function, cardiopulmonary function, and the scores of CRF Scale, QoL Questionnaire, and Exercise Self-Efficacy Scale were investigated. Further analysis was conducted on the differences in physical fitness between neoadjuvant chemotherapy (NACT) and postoperative adjuvant chemotherapy (POAC), as well as between patients with and without exercise habits. Results: Electrocardiogram showed that 244 (61.00%) had normal heart rhythm, but 29 (7.25%) still developed abnormal cardiac function. A greater number of patients receiving NACT showed low HDL-C than those undergoing POAC (P<0.05). In patients with exercise habits, there was a larger proportion of reduced hemoglobin (Hb) compared with those without exercise habits, with higher QoL questionnaire scores (P<0.05). Conclusions: CRF during chemotherapy was evident in BC patients. Among them, patients undergoing NACT show lower HDL-C levels, while those with exercise habits have lower Hb and higher QoL scores.

The Clinical Evaluation Value of the NRF2-Mediated Antioxidant Stress Mechanism in Elderly Patients with Type 2 Diabetes Mellitus Complicated by Osteoporosis

2026-03-03T10:20:11+01:00

Objective: The role of nuclear factor erythroid 2-related factor 2 (NRF2) as a central transcription factor in the regulation of cellular antioxidant stress is of significant interest, particularly in its potential clinical relevance for elderly patients with type 2 diabetes mellitus (T2DM)-associated osteoporosis (T2DM-OP).

Methods: A cohort of 196 patients with T2DM who received treatment were recruited and stratified into three groups according to T-scores derived from bone mineral density (BMD) assessments. Serum concentrations of 25-hydroxyvitamin D3, osteocalcin (OC), procollagen type I N-terminal propeptide (P1NP), β-isomerized C-terminal telopeptide of type I collagen (β-CTX), as well as nuclear factor erythroid 2-related factor 2 (NRF2), superoxide dismutase (SOD), and malondialdehyde (MDA) were quantified utilizing enzyme-linked immunosorbent assay techniques. Pearson correlation analysis was conducted to explore the relationships among NRF2, SOD, MDA, and BMD. Additionally, multivariate logistic regression analysis was employed to investigate the association between Asprosin levels and the risk of T2DM-OP.

Results: There were no apparent differences in baseline characteristics (gender, age, BMI, duration of diabetes mellitus, and metabolic parameters) among the three groups (P > 0.05). Analysis revealed that lumbar spine BMD decreased evidently with declining bone mass (normal bone mass group 1.13 g/cm², osteopenia group 0.93 g/cm², osteoporosis group 0.80 g/cm², P < 0.001). In the osteoporosis cohort, there was a significant elevation in the bone resorption marker β-CTX and the bone formation marker OC (P < 0.001), indicating a pronounced imbalance in bone turnover. Among oxidative stress factors, SOD activity and NRF2 levels progressively decreased with bone loss, while MDA levels increased (all P < 0.001), indicating declined antioxidant capacity and aggravated oxidative damage. Correlation analysis showed that NRF2 and SOD were positively correlated with BMD, whereas MDA was negatively correlated with BMD. Multivariate logistic regression further confirmed that low NRF2, low SOD, and high MDA were independent risk factors for T2DM-OP (P < 0.05). Receiver operating characteristic curve analysis demonstrated that NRF2 exhibited high sensitivity (80.36%) and specificity (77.86%) in predicting T2DM-OP, with an area under the curve of 0.856 (95% CI: 0.803–0.909, P < 0.001), comparable to bone turnover indicators.

Conclusion: The study reveals that the NRF2-mediated antioxidant response is crucial in the pathological progression of T2DM-OP, highlighting its potential as a new therapeutic target for prevention and treatment.

Neutrophil Redox Imbalance in Acute Coronary Syndrome

2026-03-03T10:20:12+01:00

Summary

Background: Oxidative stress contributes significantly to the pathogenesis of acute coronary syndrome (ACS), with neutrophils playing a pivotal role in mediating vascular injury through reactive oxygen species and myeloperoxidase (MPO)-derived oxidants. We aimed to assess the oxidative stress markers and antioxidant enzyme activities in neutrophils from ACS patients.

Methods: Neutrophils were isolated from 77 ACS patients and 33 control subjects. Oxidative stress was evaluated by measuring conjugated dienes, hydroperoxides, and chloramines. Antioxidant status was assessed via non-protein and total thiol levels, and enzymatic activities of superoxide dismutase (SOD), catalase, glutathione peroxidase (GPx-1), and glutathione reductase (GR). MPO peroxidase and chlorinating activities were also quantified.

Results: ACS patients exhibited significantly elevated levels of conjugated dienes (p < 0.005), chloramines (p < 0.005), thiols (p < 0.05), SOD activity (p = 0.01), and MPO chlorinating activity (p < 0.05). No significant differences were observed in catalase, GPx-1, GR, or MPO peroxidase activity. Significant correlations were found between lipid peroxidation markers and antioxidant parameters, particularly SOD and MPO chlorinating activity. Multiple regression identified SOD and chloramines as independent predictors of lipid peroxidation.

Conclusion: Neutrophils from ACS patients display a disrupted redox balance characterized by enhanced lipid peroxidation, increased thiol content, and selective activation of MPO chlorination. These results underscore the relevance of neutrophil-derived redox markers as potential diagnostic tools and treatment targets in ACS.

Keywords: acute coronary syndrome, neutrophils, oxidative stress

NSE/GCS in perioperative period on Seventh day as an independent predictor of 90-day outcome in patients with severe traumatic brain injury

2026-03-03T10:20:12+01:00

Summary:

Background and Objectives: Traumatic brain injury (TBI) can lead to secondary damage that affects patient prognosis. Neuron-specific enolase (NSE) in the blood is a marker of nerve damage, while the Glasgow Coma Scale (GCS) score indicates patient consciousness. The ratio of NSE to GCS (NGR) during the perioperative period can assess the 90-day prognosis in severe TBI patients.

Methods: This study involved 63 severe TBI patients. We collected their clinical and preadmission lab data. After admission, we provided personalized comprehensive treatment, including blood tests, interleukin 6 (IL-6), NSE, blood osmotic pressure (OSM), procalcitonin (PCT), and D-dimer (DD). We evaluated GCS score on Day 7 to calculate NGR. Using logistic regression and receiver operating characteristic (ROC) curve, we analyzed Pre-admission NLR0, and NSE7, GCS7, and NGR7 on the seventh day of admission.

Results: Patients with poor 90-day outcomes were older, had longer hospital stays, and showed higher NLR0 and IL-6 levels on admission (all P < 0.05). NLR0, NSE7, GCS7 scores, and NGR7 independently predicted poor outcomes in severe TBI patients. NGR7 showed a strong Pearson r value (r = -0.702, p < 0.0001) and the highest diagnostic accuracy for 90-day prognosis [area under the curve (AUC) = 0.932; 95% CI = 0.872-0.993, with a cut-off value of 4.69, sensitivity of 86.49%, and specificity of 92.31%]. TBI patients with higher NGR on the seventh day after admission were more likely to experience unfavorable neurological outcomes.

Conclusion: NGR on the seventh day after admission significantly predicts the 90-day outcomes in severe TBI patients.

Assoc. Prof. Dr. Doğan Köse Oxidative Stress and DNA Damage Profile in Cord Blood of Vitamin B₁₂-Deficient Newborns

2026-03-03T10:20:12+01:00

Background: Vitamin B₁₂ is an essential micronutrient that plays a critical role in DNA synthesis, methylation, and cellular energy metabolism. Its deficiency during the intrauterine period has been associated with increased oxidative stress and DNA damage, which may have lasting effects on the newborn. 8-hydroxy-2'-deoxyguanosine, a biomarker of oxidative DNA damage, is widely used to evaluate these processes. However, the effects of vitamin B₁₂ deficiency on such biomarkers at birth remain insufficiently investigated.

Methods: This single-center, prospective case-control study included 48 term newborns with vitamin B₁₂ deficiency and 40 healthy controls matched for gestational age. Vitamin B₁₂, total oxidant status, total antioxidant status, oxidative stress index, and 8-hydroxy-2'-deoxyguanosine were measured from umbilical cord venous blood obtained immediately after delivery. Oxidant and antioxidant levels were determined using colorimetric methods, and oxidative DNA damage was assessed by enzyme-linked immunosorbent assay. Group comparisons were made using appropriate statistical tests, with significance set at p<0.05.

Results: Vitamin B₁₂ levels were significantly lower in the patient group. Levels of 8-hydroxy-2'-deoxyguanosine, total oxidant status, and oxidative stress index were significantly higher, whereas total antioxidant status showed no significant difference between groups.

Conclusions: Term newborns with vitamin B₁₂ deficiency exhibited increased oxidative stress and measurable oxidative DNA damage at birth. The unchanged total antioxidant status may reflect the immature antioxidant defense system in the neonatal period. Biomarker evaluation at delivery could assist in early identification and intervention for infants at risk of complications associated with intrauterine vitamin B₁₂ deficiency.

Predictive Value of Haematological Indices on Mortality in Patients with Empyema

2026-03-03T10:20:12+01:00

Background:Empyema is an infectious disease characterized by the accumulation of pus in the pleural space and accompanied by inflammation. Patients often present with fever, chest pain, dyspnea, or cough, and delayed diagnosis or treatment is associated with high mortality rates. Therefore, in this study, we aim to investigate the clinical utility of the Systemic Inflammation Response Index (SIRI), Pan-Immune Value (PIV), C-Reactive Protein (CRP)-Albumin-Lymphocyte (CALLY) index, and Systemic Immune-Inflammation Index (SII) in assessing the severity of empyema and predicting mortality risk.

Methods:Between January 2022 and October 2024, 73 patients diagnosed with empyema in the thoracic surgery clinic were included in the study. Patients were categorized based on the need for intensive care. Demographic and laboratory data (e.g., white blood cell count, platelet count, albumin levels, pleural fluid culture results, and C-reactive protein levels) were recorded. Differences between empyema patient groups, classified according to disease severity, were analyzed.

Results:Among the 73 patients included in our study, 4 deaths were recorded. It was observed that the CALLY index could be used for intensive care and ward triage (p:0.039). While the SII and SIRI indices were not suitable for triage purposes, the SIRI index was found to be useful for predicting mortality (p:0.01).

Conclusion:In empyema cases, the CALLY index can be used to determine the need for intensive care, while the SIRI index can help predict mortality risk.

Triglyceride-Glucose Index as a Biochemical Predictor of Hypertension in Patients with Type 2 Diabetes and Prediabetes: Evidence from the NHANES Database

2026-03-03T10:20:13+01:00

Background: The triglyceride-glucose (TyG) index, derived from fasting triglyceride and glucose levels, has emerged as a reliable biochemical marker of insulin resistance. However, its relationship with hypertension (HTN) in diabetic and prediabetic populations remains insufficiently studied.

Methods: Using data from 2,440 adults in the U.S. National Health and Nutrition Examination Survey (NHANES, 2011–2018), we investigated the association between the TyG index and HTN. Biochemical assays included enzymatic measurement of serum triglycerides (Beckman Coulter DxC800) and plasma glucose (hexokinase-based methods on Roche Cobas systems), from which the TyG index and related indices (TyG-BMI, TyG-WC, TyG-WHtR) were calculated. Logistic regression models adjusted for demographic, anthropometric, and biochemical covariates were used to estimate odds ratios (OR) for HTN risk.

Results: Participants with HTN exhibited significantly higher TyG index levels compared with non-hypertensives (8.44 vs. 8.38, P<0.01). In fully adjusted models, each unit increase in TyG was associated with a 31% higher risk of HTN (OR=1.31, 95% CI: 1.02–1.69). Stratified analyses revealed significant associations among Mexican Americans and individuals without prior cardiovascular or hepatic disease. TyG-WC and TyG-WHtR indices also correlated positively with HTN risk, whereas TyG-BMI did not.

Conclusion: Elevated TyG index and related biochemical indices are independently associated with increased HTN risk among individuals with diabetes or prediabetes. As a simple and reproducible biochemical parameter, the TyG index may serve as a valuable tool in laboratory medicine for early HTN risk identification and prevention strategies.

Combined Detection of HLA-B27, ESR, and CRP as Biochemical and Immunogenetic Markers in the Auxiliary Diagnosis of Ankylosing Spondylitis

2026-03-03T10:20:13+01:00

Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease in which early diagnosis is often challenging due to atypical clinical manifestations. Laboratory biomarkers such as human leukocyte antigen-B27 (HLA-B27), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) play an essential role in diagnostic evaluation.

Methods: A total of 120 AS patients and 100 healthy controls were enrolled. Venous blood samples were analyzed for HLA-B27 (flow cytometry), ESR (Westergren method), and CRP (immunoturbidimetry). The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was assessed, and diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis.

Results: HLA-B27 positivity was significantly higher in the AS group than in controls (92.5% vs. 5.0%, P<0.001). Both ESR and CRP levels were markedly elevated in AS patients and showed a progressive increase with higher BASDAI scores (P<0.05). ROC analysis demonstrated superior diagnostic efficacy of combined HLA-B27, ESR, and CRP detection (AUC=1.000, sensitivity 97.2%, specificity 93.3%) compared with single markers.

Conclusion: The combined detection of HLA-B27, ESR, and CRP provides a reliable laboratory-based diagnostic approach for ankylosing spondylitis, enhancing accuracy and clinical applicability. These findings highlight the importance of integrating biochemical and immunogenetic markers into routine diagnostic practice.

. Serum levels of MMP3 could be used as a potential biomarker for sports induced knee osteoarthritis

2026-03-03T10:20:13+01:00

Aim: Evaluating the serum concentrations of MMP3 may serve as a promising biomarker for the diagnosis of knee osteoarthritis caused by sports activities.

Material and Methods: we identified 50 eligible participants for our research who had not had any other knee procedures apart from meniscus removal. For the determination of serum MMP-3 levels, blood was taken from 50 eligible individuals using 3 simple 6 mL EDTA vacutainer tubes. Patients also had knee aspirations, both surgical and non-surgical. Out of the 25 attempts, a successful knee synovial fluid aspirate was obtained. Additionally, all 25 attempts to get a contralateral control knee aspirate were successful. The raw values of the cohorts' demographics, radiological, clinical, PROMs, and biomarkers.

Results: The duration of pain was 4.52±0.85 and 5.85±1.22 in non-operated and operated individuals, respectively. The VSA Pain score was 48.74±2.87 and 53.55±3.39, and the Lequesne algo functional index was 11.02±1.29 and 13.36±1.57 in non-operated and operated participants, respectively. We conducted a comparative analysis of MMP-3 and GAG levels in the knees of 25 patients who had successful bilateral knee synovial fluid aspirations, comparing the operated and non-operated knees. A comparative examination of MMP-3 levels in the synovial fluid shown that, despite the considerable time elapsed after the operation, the levels of MMP3 remain notably elevated in the operated knee (p = 0.01) . Additionally, the levels of synovial GAGs in the operated joint were dramatically reduced (p = 0.03) . An inverse connection was seen between the levels of MMP-3 and GAGs in the synovial fluid when analysing all 50 samples from both operated and non-operated knees. The correlation coefficient (r) was -0.88, indicating a strong negative relationship. The p-value was 0.04, suggesting statistical significance.

Conclusions: Our results suggest that MMP3 serum levels may be a simple blood test away from becoming a diagnostic tool for knee osteoarthritis and a possible predictor of the disease. To better assess athletes' joint health, it may be helpful to combine biomarkers with other diagnostic tools and have a comprehensive understanding of their athletic background.

Diagnostic vale of serum NSE, and s-100β and inflammatory markers levels in epilepsy

2026-03-03T10:20:13+01:00

Aim:To sodium valproate lore the effects of sodium valproate on serum inflammatory factors and s-100β levels in patients with emergency secondary epilepsy(SE).

Methods:This was a retrospective cohort of 120 patients with SE who received Sodium valproate that compared with a group who received carbamazepine regarding different therapeutic drugs. The general data, interleukin (IL)-2, IL-8, tumor necrosis factor (TNF)-α, neuron-specific enolase (NSE), serum acid calcium-binding protein s-100β, total effective rate(TER), seizure onset condition, and adverse reactions (Ars) of the two groups were compared at baseline and at 3 months later.

Results:There were no significant differences in age, gender, BMI, course of the disease, stroke type, or seizure type between the study groups (P>0.05). The results showed that IL-2 of the Sodium valproate group (53.17±4.95 µg/L) was lower versus Carbamazepine group (62.38±4.83 µg/L) (P<0.05). The IL-8 of the Sodium valproate grouppostoperatively (26.48 ± 2.73 µg/L) was lower versus Carbamazepine group (33.54±3.39 µg/L) (P<0.05). Postoperatively, the TNF-αin Sodium valproate group (32.18±4.26 µg/L) was lower versus the Carbamazepine group (41.03±4.92 µg/L) (P<0.05). The s-100β (0.29±0.15) µg/L in the Sodium valproate group was lower versus Carbamazepine group (0.54±0.14) µg/L (P<0.05). The TER of the Sodium valproate group (93.33%) was higher versus the Carbamazepine group of 75% (P<0.05). The number of epileptic seizures 0.81±0.08 times per year in the Sodium valproate group was versus 1.23±0.12 times per year in the Carbamazepine group. The duration of epilepsy in the Sodium valproate group (2.53±0.22 min/time) was shorter than that in the Carbamazepine group (3.08±0.24 min/time).

Conclusion: sodium valproate can drastically relieve the epileptic symptoms of patients with SE, and there was no great difference in ARs. Hence, it is safe and worthy of popularization and application.

Clinical Implications of Vasoactive Intestinal Peptide and 5-Hydroxytryptamine in Diabetic Neurogenic Bladder and Their Relationship with Post-Void Residual Urine Volume

2026-03-03T10:20:14+01:00

Objective: To elucidate the clinical significance of vasoactive intestinal peptide (VIP) and 5-hydroxytryptamine (5-HT) in diabetic neurogenic bladder (DNB). A key objective is to determine the diagnostic, stratifying, and prognostic value of their simultaneous detection, and to reveal the dynamic associations of these biomarkers with post-void residual urine volume (PVR).

Methods: The study population consisted of 30 DNB patients and 30 healthy individuals from the same timeframe (June 2024-April 2025). Laboratory assessments quantified serum VIP concentration by enzyme-linked immunosorbent assay (ELISA) and 5-HT concentration by liquid chromatography-mass spectrometry (LC-MS). PVR quantification relied on urodynamic examination and abdominal ultrasound. Over a 3-month follow-up, serial measurements of VIP and 5-HT were obtained. Statistical analyses, including Pearson correlation, receiver operating characteristic (ROC) curve analysis, and logistic regression modeling, were employed to assess the relationships of these biomarkers with PVR, bladder function classification, and patient prognosis.

Results: Significant reductions in VIP and 5-HT were observed in DNB patients relative to controls (P<0.05). The combined use of VIP and 5-HT achieved an AUC value of 0.878, with 83.33% sensitivity and 86.67% specificity, indicating better diagnostic efficacy than single-marker detection (P<0.05). VIP and 5-HT levels were inversely related to PVR (P<0.05). In DNB patients, both biomarkers increased gradually at one and three months post-treatment (P<0.05), paralleling urodynamic improvements. Patients with lower VIP and 5-HT levels three months after treatment had a greater propensity for upper urinary tract impairment, urinary tract infections, and disease advancement.

Conclusion: The combined detection of VIP and 5-HT enables effective evaluation of DNB severity, forecasts disease progression, and offers a foundation for timely intervention through dynamic monitoring.

Clinical Biochemical Evaluation of Trace Elements and Insulin-Like Growth Factor-I in Children with Short Stature: Diagnostic and Correlative Insights from the Guangzhou Cohort

2026-03-03T10:20:14+01:00

Background: Trace elements and insulin-like growth factor-I (IGF-I) are critical biochemical regulators of skeletal growth and endocrine function. However, limited data are available regarding their laboratory correlations in pediatric short stature. This study aimed to evaluate the biochemical profiles of calcium, magnesium, zinc, and lead, together with serum IGF-I levels, and to assess their diagnostic significance in children with growth retardation in the Guangzhou region.

Methods: A total of 876 children aged 2–12 years were enrolled, including 276 with growth retardation, 300 with short stature, and 300 healthy controls. Serum trace elements and IGF-I concentrations were determined using standardized clinical chemistry assays in a hospital laboratory. Intergroup differences were analyzed using ANOVA, and multivariate logistic regression was employed to identify independent biochemical predictors of growth retardation.

Results: Children with growth retardation exhibited significantly lower serum levels of calcium, magnesium, and zinc, and elevated blood lead concentrations compared with controls (P<0.05). IGF-I levels were reduced (109.18 ± 45.08 vs. 111.46 ± 55.44 ng/mL, P=0.012) and correlated positively with calcium, magnesium, and zinc levels. Multivariate analysis identified low calcium, magnesium, zinc, and IGF-I, as well as elevated lead, as independent predictors of growth retardation.

Conclusion: Alterations in serum trace elements and IGF-I represent measurable biochemical indicators associated with pediatric growth retardation. Integrating trace element and IGF-I assessments into routine biochemical testing may improve early diagnosis and monitoring of short stature in clinical practice.

Retrospective analysis of the curative effect of Kanglaite injection on pancreatic cancer

2026-03-03T10:20:14+01:00

Objective To systematically evaluate the curative effect of Kanglaite Injection (KLT) in the treatment of pancreatic cancer (PC) by retrospective analysis. Methods The clinical data of 172 patients with pancreatic cancer were analyzed, and the therapeutic effect, survival time and tumor markers of patients receiving Kanglaite injection combined with conventional chemotherapy were compared with those receiving conventional chemotherapy. Results The univariate results showed that the two groups had WBC, LY#, MO#, NE#, ALB, FFA, CA199, CA125 in age, sex, tumor site, stage of pancreatic cancer, radiotherapy and metastasis, and laboratory indexes. Multivariate analysis showed that the use of KLT in pancreatic cancer patients was significantly related to gender and survival outcome, and KLT could prolong the survival of PC patients. In addition, Chi-square test showed that patients with KLT could reduce the influence on monocyte count and albumin abnormality, which suggested that patients with KLT could reduce the adverse reactions. Conclusion Kanglaite injection combined with conventional radiotherapy and chemotherapy plays a significant role in improving therapeutic effect, improving immune function and prolonging survival expression, and will not increase the incidence of serious adverse reactions. It is a safe and effective comprehensive treatment scheme.

Role of Coagulation Irregularities in Cholangiocarcinoma: A review

2026-03-03T10:20:14+01:00

Cholangiocarcinoma (CCA) is a malignancy that originates from the biliary epithelium, presenting either intrahepatically or extrahepatically. It is characterized by a late-stage diagnosis and a poor overall prognosis. D-dimer, a biomarker indicative of coagulation and fibrinolysis activation, is believed to play a significant role in cancer progression, with elevated plasma levels correlating positively with metastatic disease and advanced cancer stages.

In intrahepatic CCA, fibrinogen has been identified as an independent prognostic factor, associated with adverse outcomes and reflects systemic inflammatory responses. The increased expression of urokinase-type plasminogen activator has been linked to lymphatic invasion and metastatic spread in CCA patients. Additionally, a preoperative elevation in prothrombin time may predict reduced survival rates for individuals underging potentially curative surgical interventions. P-selectin, which interacts predominantly with leukocyte ligands, has the potential to promote tumorigenesis and facilitate metastatic dissemination of mucin-producing carcinomas. Moreover, prolonged activated partial thromboplastin time may provide valuable insights into the extent of parenchymal involvement in CCA.

This review aims to elucidate the role of coagulation abnormalities within the pathophysiology of cholangiocarcinoma.

Assessing Intra- and Inter-Analyzer Imprecision in Automated Hematological Laboratories

2026-03-03T10:20:14+01:00

Background: Reliable hematology results are crucial for patient diagnosis and monitoring. Maintaining low variability is particularly important for key parameters like hemoglobin, white blood cells, and platelets, especially in automated laboratory workflows where multiple hematological analyzer are connected within the same line.

Methods: Two residual whole blood samples, one normal and one pathological, were analyzed in ten consecutive replicates on a Sysmex XN-10 analyzer (XN‑1) and then on a second connected analyzer (XN‑2). Intra-analyzer and inter-analyzer imprecision were calculated as coefficients of variation (CV%).

Results: Intra-analyzer CVs for the normal sample ranged from 0.3% for hemoglobin to 1.5% white blood cells, while inter-analyzer CVs remained below 2%. For the pathological sample, intra-analyzer CVs were 0.3–1.0%, and inter-analyzer CVs reached up to 2.1% for hematocrit and platelets. Red blood cells count, mean corpuscular volume and neutrophils showed CVs <1.9%. Higher variability was observed for low-abundance populations such as eosinophils and basophils (up to 20%).

Conclusion: Sysmex XN-10 analyzers display a strong intra- and inter-analyzer precision for most routine hematology tests, supporting their routine usage in automated hematological lines.