Journal of Medical Biochemistry

Analysis of Factors Influencing Weight Regain after Bariatric-Metabolic Surgery in Obesity Hypoventilation Syndrome Patients Based on Gastrointestinal Peptide Hormones

2025-11-02T16:18:06+01:00

Background: Obesity is becoming increasingly prevalent in modern society, leading to a rise in the incidence of obesity hypoventilation syndrome (OHS). This study analyzes the factors influencing weight regain in OHS patients following laparoscopic sleeve gastrectomy (LSG), based on gastrointestinal peptide hormones.

Methods: A total of 134 OHS patients who underwent LSG at our hospital between January 2023 and January 2024 were enrolled. The alterations in gastrointestinal peptide hormones, including insulin (INS), leptin (Lep), glucagon-like peptide-1 (GLP-1), and ghrelin (GHR), before and after surgery were measured. Subsequently, a 6-month follow-up was conducted. Patients with weight regain were identified, and the predictive value of gastrointestinal peptide hormones for weight regain was analyzed. Logistic regression was then employed to analyze the related factors affecting weight regain.

Results: Following the surgical procedure, a significant increase was observed in the levels of INS, Lep, and GLP, accompanied by a notable decrease in GHR levels among the patients (P < 0.05). During the follow-up period, 32 patients experienced weight regain. The receiver operating characteristic (ROC) curve analysis demonstrated that gastrointestinal peptide hormones exhibited outstanding predictive capabilities for postoperative weight regain. Moreover, through statistical analysis, it was determined that unfavorable dietary habits, lack of regular exercise, trace element deficiencies, and negative emotional states were independent risk factors influencing weight regain following LSG (P < 0.05).

Conclusion: There is a close correlation between gastrointestinal peptide hormones and post-LSG weight alterations in patients with OHS.

Traditional Chinese Medicine Constitution Types and Apolipoprotein B in Hyperuricemia: Associations with Cardiovascular Risk

2025-11-02T15:27:04+01:00

Background: To explore the correlation between different traditional Chinese medicine (TCM) constitution types and apolipoprotein B (ApoB) in patients with hyperuricemia (HUA), and to investigate the relationships between TCM constitutions, uric acid levels, and various cardiovascular risk factors.

Methods: A cross-sectional study involving 683 patients diagnosed with HUA was conducted. Patients' TCM constitutions were classified using the standardized "Classification and Determination of TCM Constitution" questionnaire. Serum uric acid (UA), lipid profiles, ApoB, and homocysteine (Hcy) levels were measured.

Results: Among 683 HUA patients, phlegm-dampness (22.99%) and damp-heat constitution (20.06%) were the most common TCM constitution types. UA, ApoB, and Hcy levels in patients with phlegm-damp constitution were significantly higher than those in other constitutions (P<0.05). UA levels were negatively correlated with HDL-C (r=-0.472, P=0.027) and positively correlated with ApoB (r=0.618, P=0.012), and Hcy (r=0.492, P=0.018). Male gender, BMI, ApoB, Hcy, and phlegm-dampness constitution are independent factors associated with UA levels. Patients with high ApoB levels had a significantly higher incidence of cardiovascular diseases compared to those with low ApoB levels (male: 42.73% vs 22.81%, P<0.001; female: 37.82% vs 25.21%, P=0.036). Logistic regression analysis revealed that phlegm-dampness constitution (OR=2.18, 95% CI: 1.42-3.35, P<0.001) and damp-heat constitution (OR=1.86, 95% CI: 1.21-2.87, P=0.005) were independently associated with increased risk of cardiovascular diseases.

Conclusion: Phlegm-damp and damp-heat constitutions are the most common TCM constitution types in HUA patients and are associated with higher levels of UA, ApoB, and Hcy. These constitution types are independently associated with increased cardiovascular risk.

THE ROLE OF MICRORNA-346 IN PROSTATE CANCER PROGRESSION: CLINICAL SIGNIFICANCE AND BIOMARKER POTENTIAL

2025-11-02T16:21:36+01:00

Objective: The aim of this study was to analyze the expression changes and clinical significance of microRNA-346 (MiRNA-346) in PCa genesis, development and hormone resistance transformation.

Method: Data of the middle-aged and elderly male patients who were treated in Tengzhou Central People’s Hospital from January 2017 to December 2023 were collected. The tissues and corresponding preoperative serum of 128 patients with newly diagnosed PCa and 130 patients with benign prostatic hyperplasia (BPH), 120 patients with hormone-sensitive PCa (HSPC), 116 patients with castration-resistant PCa (CRPC), and 150 healthy males of the same age who underwent physical examination in the physical examination center of our hospital were collected. Quantitative real-time polymerase chain reaction was used to detect the relative expression of miRNA-346 in the tissues and serum of the subjects. GraphPad Prism statistical analysis software was utilized to analyze the expression changes of miRNA-346 in the occurrence and progression of PCa and its correlation with clinical and pathological features.

Result: The expression of miRNA-346 was significantly lower in PCa patients than in BPH patients and healthy population (P<0.001), while there was no difference between BPH and healthy population (P=0.516). Tissue and serum expression were positively correlated (P<0.001). miRNA-346 was negatively correlated with tPSA, PHI, clinical stage, and Gleason score in PCa tissue/serum (P<0.001). Serum miRNA-346 in CRPC patients was negatively correlated with time to transformation (r=0.6575) and survival (r=0.5699) (P<0.001). Serum miRNA-346 was positively correlated with tPSA and ALP in HSPC and CRPC patients (P<0.001).

Conclusion: Serum miRNA-346 expression in the process of hormone resistance conversion in PCa is gradually increasing, making it a potential biomarker for monitoring PCa progression.

Non-invasive prenatal tests for chromosomal abnormality screening in in vitro fertilization elderly pregnant women in northwest China

2025-11-02T15:27:05+01:00

Background: The study aimed to explore the value of using non-invasive prenatal tests (NIPT) in the second trimester of pregnancy for chromosomal abnormality screening in vitro fertilization in elderly pregnant women and to analyze the reasons for inconsistent screening results in northwest China.

Methods: A total of 47,286 pregnant women aged 19-51 who underwent prenatal examinations were collected. NIPT detection found that the positive rate of pregnant women aged >35 with spontaneous pregnancy was 0.78%, and the positive rate of in vitro fertilization pregnancy was 0.82%. Then, the detection accuracy of NIPT for pregnant women aged >35 with in vitro fertilization was further analyzed.

Results: NIPT's sensitivity, specificity, and positive predictive value in detecting common chromosomal aneuploidies (T21, T18, and T13) in pregnant women aged >35 who received in vitro fertilization were 99.72%, 99.78%, and 66.45%, respectively. The mean gestational age, pregnancy number, AFP, and free β-HCG significantly differed between the positive and false positive groups (P < 0.05). Logistic analysis showed that the mean gestational age and AFP were independent risk factors for the failure of NIPT diagnosis (P < 0.05).

Conclusions: NIPT has a particular detection performance for common chromosomal aneuploidies in vitro fertilization in pregnant women. However, factors affecting detection accuracies must be considered when using it.

Development and Validation of a Nomogram Model to Predict Coronary Heart Disease in Snoring Patients With Hypertension and Non-glucose Metabolism Disorders

2025-11-02T15:27:05+01:00

Background: We developed and validated a nomogram to predict the risk of coronary heart disease in hypertensive patients who snore, excluding those with glucose metabolism disorders.

Methods: Records from 2105 snoring patients with hypertension and non-glucose metabolism disorders. A random grouping technique was utilized to split the data into validation and derivation datasets (split ratio = 0.7: 0.3). Least absolute shrinkage and selection operator regression was applied to select predictors and constructed a nomogram model based on multivariate Cox regression analysis. The discrimination and consistency of the nomogram were evaluated using the area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis (DCA) to assess its performance. We found age, male, waist-to-height ratio (WHtR), low and high-density lipoprotein cholesterol (LDL-C and HDL-C), and apnea index (AI) identified as predictors to generate this nomogram model.

Results: The C-index at 84 months was 0.703 (95% confidence interval 0.653–0.754) in the derivation set and 0.645 (95% confidence interval 0.562–0.728) in the validation set. The nomogram demonstrated good performance in the calibration curve and DCA.

Conclusions: So, our study proposed an effective nomogram model with potential application value for individualized prediction of coronary heart disease outcomes in snoring individuals with hypertension, excluding glucose metabolism disorders. And “AI” was proposed as a novel predictor.

The Impact of PDCA Cycle-Driven Nutritional Support on serum Biomarkers and Quality of Life and in Nasopharyngeal Carcinoma Patients Undergoing Radiotherapy

2025-11-02T16:25:41+01:00

Aim:This study aimed to evaluate the effectiveness of nutritional support guided by the PDCA cycle management model in nasopharyngeal carcinoma (NPC) patients undergoing radiotherapy.

Methods:A total of 100 NPC patients were randomly assigned to an observation group (OG) (n = 50) and a control group (CG) (n = 50). The CG received routine nutritional support, while the OG received PDCA cycle-based nutritional support. Key outcomes included blood nutritional biomarkers, quality of life (QoL), incidence of adverse reactions (ARs), and clinical efficacy.

Results: Post-treatment analysis revealed that the OG had a significantly higher total effective rate (72%) compared to the CG (38%) (P < 0.05). The OG demonstrated higher albumin, prealbumin, and total protein levels, along with lower CRP levels after treatment. Additionally, significant improvements were observed in cognitive, role, social, physical, and emotional functioning in the OG (P < 0.05). Furthermore, the AR rate was significantly lower in the OG (20%) compared to the CG (36%) (P < 0.05).

Conclusion: These findings suggest that PDCA cycle-based nutritional support improves clinical efficacy and QoL, minimizes nutritional risks and ARs, and enhances overall safety in NPC patients undergoing radiotherapy. Serum markers such as serum iron, ferritin, prealbumin, and CRP were effective in monitoring the impact of nutritional interventions on patients’ nutritional and inflammatory status.

Changes in nutrient proteins, inflammatory factors and immunoglobulins before and after enteral nutritional support in patients with cerebral hemorrhage

2025-11-02T16:26:39+01:00

Objective: Enteral nutrition support (ENS) is one of the necessary measures after surgical treatment of modern cerebral hemorrhage (CH), and this study will analyze the changes in nutrient proteins, inflammatory factors, and immunoglobulins before and after ENS in patients with CH, which will serve as a reference for future clinics when performing ENS.

Methods: 160 ICH patients (76 in the intermittent group and 84 in the continuous group) were included, and changes in indicators before and after EN intervention were retrospectively analyzed in both groups. Including nutrient proteins (albumin ALB, transferrin TRF, prealbumin PAB), inflammatory factors (IL-1β, IL-6, TNF-α), immunoglobulins (IgA, IgG, IgM) and gastrointestinal tolerance.

Results: There was no difference in adverse reactions between the two groups during ENS (P>0.05).After ENS, ALB, TRF, PAB, IgA, IgG, and IgM were significantly increased in both groups, while IL-1β, IL-6, and TNF-α were decreased (P<0.05). After ENS, there was no difference in nutrient proteins between the two groups (P>0.05), but inflammatory factors were lower in the intermittent group than in the continuous group, while immunoglobulins were higher than in the intermittent group (P<0.05).

Conclusion: ENS constitutes the core mechanism of neuroprotection through a multilayered linkage of “metabolic substrate supply - intestinal barrier repair - immune phenotype remodeling - inflammatory signaling inhibition”.

Clinical and diagnosis value of serum Cortisol, TNF-α, albumin in ovarian cancer patients

2025-11-02T16:27:36+01:00

Objective: This research aimed to evaluate the prognostic value of serum serum Cortisol, TNF-α, albumin in selecting treatment methods for advanced ovarian cancer (OC) patients.

Methods: A retrospective analysis was conducted on OC patients undergoing surgery at our hospital from June 2022 to June 2024 with complete clinical and pathological data. Patients were categorized into low ALB (< 35 g/L) and normal ALB (≥ 35 g/L) groups based on pretreatment serum ALB levels. Each group was further divided into primary debulking surgery (PDS) and neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) subgroups. Clinicopathologic characteristics were analyzed.

Results: Pretreatment serum ALB levels positively correlated with progression-free survival (PFS) (r = 0.2989, P < 0.05) and overall survival (OS) (r = 0.2702, P < 0.05), with the low ALB group exhibiting significantly lower PFS and OS (P < 0.05). In the low ALB group, significant differences were observed between PDS and NACT-IDS in ascitic fluid level, R0 cytoreduction rate, postoperative complications, and length of stay (P < 0.05), though PFS and OS were comparable (P > 0.05). Similarly, in the normal ALB group, significant differences were noted in FIGO staging, ascitic fluid level, hemoglobin (HGB) levels, intraoperative hemorrhage, blood transfusion volume, R0 cytoreduction rate, and length of stay (P < 0.05), while PFS and OS remained unaffected by treatment type (P > 0.05). Additionally, C-reactive protein (CRP) levels were significantly higher in the low ALB group (6.5 ± 1.1 mg/L vs. 5.2 ± 1.0 mg/L, P < 0.05), indicating greater inflammation, whereas HGB levels were significantly lower (110.4 ± 15.8 g/L vs. 118.7 ± 10.5 g/L, P = 0.021), reflecting poorer nutritional status. Tumor necrosis factor-alpha (TNF-α) levels showed a non-significant upward trend (P = 0.058), while cortisol levels were similar between groups (P = 0.073).

Conclusion: Selecting NACT-IDS for advanced OC patients with hypoalbuminemia can reduce incidence of postoperative complications and elevate cytoreductive effect. Thus, hypoalbuminemia can serve as a reference indicator for advanced OC patients to choose NACT-IDS.

ACCEPTANCE AND COMMITMENT THERAPY MODULATES IMMUNEINFLAMMATORY RESPONSES AND NEUROTROPHIC FACTORS HOMEOSTASIS IN ELDERLY STROKE PATIENTS: A RANDOMIZED CONTROLLED TRIAL

2025-11-02T16:28:30+01:00

Objective: This study examined the regulatory effects of Acceptance and Commitment Therapy (ACT) on T lymphocyte subsets, serum inflammatory cytokines, neurotransmitters, and oxidative stress markers in elderly cerebral stroke (CS) patients, providing insights into the multi-dimensional pathophysiological interactions and potential intervention strategies for chronic stroke recovery.

Methods: In this randomized controlled trial, 120 elderly stroke patients were allocated to either an ACT group (ACT intervention; n=60) or a routine group (conventional treatment; n=60). Comprehensive assessments were performed to quantify: (1) peripheral T lymphocyte distribution (CD3+, CD4+, CD8+ subsets, and CD4+/CD8+ ratio), (2) serum inflammatory cytokines (IL-1β, IL-6, IL-10, and TNF-α), (3) neurotransmitters (5-HT, NE, BDNF, and IGF-1), and (4) oxidative stress markers (SOD, MDA, CAT, and NO) using flow cytometry, HPLC-ECD, and ELISA. Statistical analyses were conducted with SPSS 22.0.

Results: Following treatment, CS patients exhibited reduced CD3+ and CD4+ T-cell levels along with a decreased CD4+/CD8+ ratio, while CD8+ T-cell proportions were elevated (P<0.05). Proinflammatory cytokine levels (IL-1β, IL-6, and TNF-α) were significantly suppressed, whereas anti-inflammatory IL-10 expression increased (P<0.05). Notably, ACT demonstrated superior efficacy in restoring immune balance and attenuating inflammation compared to conventional intervention (P<0.05). Furthermore, neurotransmitter levels were elevated, and oxidative stress markers were ameliorated in CS after treatment (P<0.05), suggesting that ACT enhances neurotrophic activity and mitigates oxidative injury.

Conclusion: ACT likely confers neuroprotection through multi-target mechanisms, including modulation of T-cell subset homeostasis, upregulation of neurotrophic factors, and suppression of oxidative stress. These findings provide a scientific foundation for integrating ACT into a psychobiological rehabilitation framework for elderly CS patients.

Association of miR-223-3p and miR-223-5p gene expression with Levels of IgE, Vitamin D and Mg+2 in pediatric Asthma patients

2025-11-02T16:29:41+01:00

Background: Asthma, a global non-communicable disease, significantly impacts public health. Severe cases cause high morbidity and mortality rates, with childhood asthma rates in Iraq reaching 20%. The study investigated the expression levels of miR-223-3p and miR-223-5p genes linked to pediatric asthma and the impact of IgE, Vitamin D, and Mg+2 on asthma severity.

Methods: A study of 140 children aged 1-10 years with allergic asthma was conducted in Baghdad from November 2023 to February 2024. The patients were divided into three groups: those under 1, those aged 1-5, and those over 5. Serum IgE, Vit D3, and Mg+2 levels were determined using the Immunoglobulin E Test Kit.

Results: The results indicated a significant increase in the level of IgE in patients (353.812 ± 25.679 ng/ml) compared to the control group (25.320 ± 2.581 ng/ml) (p-value < 0.01, the serum level of Vit-D revealed a significant decrease in the patient group (16.907 ± 0.512 ng/mL) while in the control group, levels reached (32.746 ± 1.629 ng/mL), Mg⁺² serum level decreased in patient groups (2.168 ± 0.030 ng/dL) compared to control group (2.316 ± 0.028 ng/dL) at p-value < 0.01. also, this study shows that upregulation of gene expression in miR-223-3p and miR-223-5p genes are considered risk factors for allergic asthma. Conclusion: The study found that asthma patients had high IgE levels, low vitamin D3 and magnesium levels, and high gene expression in miR-223-3p and miR-223-5p genes, risk factors for allergic asthma.

Role of Growth Hormone/Insulin-Like Growth Factor-1 Axis Dysfunction and Inflammatory Cytokines in Pediatric Short Stature

2025-11-18T10:12:34+01:00

Background: Pediatric short stature is a prevalent clinical issue, often linked to dysfunction in the growth hormone/insulin-like growth factor-1 (GH/IGF-1) axis. Recent research suggests that inflammatory cytokines and serum markers may play a role in this dysfunction. This study aims to explore the molecular mechanisms contributing to GH/IGF-1 axis dysfunction, along with the levels of inflammatory cytokines and other relevant markers in children with short stature.

Methods: 150 children diagnosed with short stature (defined as height below the 3rd percentile for age and sex) were recruited from the endocrinology ward of a tertiary care hospital. A control group of 150 age- and sex-matched healthy children was included for comparison. Serum levels of GH, IGF-1, interleukin-6 (IL-6), interleukin-8 (IL-8), and other relevant markers were measured using enzyme-linked immunosorbent assay (ELISA). Genetic analysis was performed to identify potential mutations in GH/IGF-1 axis-related genes. Data were analyzed using SPSS software, with statistical significance set at p < 0.05.

Results: Children with short stature exhibited significantly lower serum levels of GH and IGF-1 compared to controls (p < 0.001). Elevated levels of IL-6 and IL-8 were found in the short stature group (p < 0.01). Genetic analysis revealed a higher frequency of mutations in the growth hormone receptor (GHR) gene in the short stature cohort. Correlation analysis showed a negative association between serum IL-6 levels and IGF-1 levels (r = -0.45, p < 0.001).

Conclusion: This study provides evidence that dysfunction in the GH/IGF-1 axis, along with elevated inflammatory cytokines, may contribute to the pathogenesis of pediatric short stature. Further research is needed to investigate potential therapeutic targets and interventions aimed at addressing these molecular mechanisms.

Molecular regulatory mechanisms of depression-related thrombosis risk

2025-11-02T16:31:52+01:00

Background: This is largely because depression is a common psychiatric condition affecting more than 280 million people worldwide and is increasingly linked to an increased risk of thrombotic events, including deep vein thrombosis (DVT) and pulmonary embolism (PE). For example, underlying pathophysiological mechanisms remain inadequatly understood and thus further research on the association between depression, systemic inflammation, platelet activation and coagulation abnormalities is warranted. The objective of this study is to identify biological pathways linking thombosis and depression by examination of inflammatory and coagulation biomarkers, platelet activation, and risk of thrombosis independent predictors. In addition, the study investigates the possibility of nursing interventions in reducing thrombotic complications among depressed individuals.

Methods: A case control study was performed with 500 subjects (250 who had major depressive disorder and 250 healthy control subjects) were included. Enzyme-linked immunosorbent assays (ELISA) and quantitative polymerase chain reaction (qPCR) were employed to quantify key inflammatory (IL-6, TNF-, CRP) and coagulation (D-dimer, fibrinogen) biomarkers. An assessment of platelet activation (CD62P, PAC1 binding, GPIIbIIIa activation) was performed by flow cytometry. The study was carried out by a longitudinal follow-up over 12 months and by multivariate regression models to identify independent risk predictors.

Results: Thrombophilic and inflammatory parameters were significantly higher in depressed patients as compared to controls (p 0.001). The system was markedly hypercoagulable, as platelet activation markers were greatly upregulated. Through multivariate regression analysis, we determined that thrombosis risk was independent of severity level of depression (OR = 2.10, p 0.001), IL-6 levels (OR = 1.92, p 0.001), and platelet activation (OR = 2.50, p 0.001).

Conclusion: The results indicate that depression is an independent risk factor for thrombosis, through systemic inflammation and platelet hyperactivity. These results reinforce the value of licking psychiatric screening into thrombosis risk assessment and suggest the possible benefits of targeted anti-inflammatory or antiplatelet interventions in the psychiatric population at high risk of thrombosis.

Diagnostic value and Clinical Significance of serum Proteins Ki-67, PI3K, and Fascin in Patients with Oral Squamous Cell Carcinoma

2025-11-02T16:32:44+01:00

Objective: This study was designed to explore the expression and significance of KI-67, phosphoinositide-3-kinase (PI3K), and Fascin in oral squamous cell carcinoma (OSCC). Methods: Thirty-five patients with OSCC admitted to our hospital from January 2019 to December 2020 were included. Tumor tissue and paracancerous tissue samples of all patients were collected. Immunohistochemical staining was performed to determine the expression of Ki-67, PI3K, and Fascin. Pearson correlation analysis was employed to analyze the association of clinicopathological characteristics with Ki-67, PI3K, fascia, and oral cancer. SPSS 23.0 was used for data analysis. Results: Significantly higher positive expression rates of Ki-67, PI3K, and Fascin were detected in OSCC tissues, well-differentiated OSCC tissues, and OSCC tissues with lymph node metastasis and cancer cells infiltrating to peripheral muscle, vs paracancerous tissues, moderately and poorly differentiated OSCC tissues, and OSCC tissues without lymph node metastasis, respectively (all P<0.05). The positive expression rates of Ki-67, PI3K, and Fascin were not statistically different between stage I+II and III+IV OSCC (P>0.05). Ki-67 was positively correlated with PI3K (r=0.930, P=0.019) and Fascin (r=0.928, P=0.019), and Fascin was positively correlated with PI3K (r=0.991, P=0.001). Conclusion: The relative expression levels of Ki-67, PI3K, and Fascin are related to lymph node metastasis, perifocal muscle invasion, and pathological staging of patients with OSCC, which indicates their potential involvement in the occurrence and progression of OSCC.

MARKERS OF INFLAMMATION AND IMMUNOLOGICAL COMPETENCE: ASSESSMENT IN THE EARLY POSTOPERATIVE PHASE OF CARDIAC SURGERY INVOLVING EXTRACORPOREAL CIRCULATION

2025-11-02T16:33:36+01:00

Background: To gain insight into the role and relevance of inflammatory and immunological markers in the comprehensive assessment of a patient’s immune response to surgical procedures. This study focused on investigating preoperative and postoperative serum levels dynamics of SAA, CRP, and proportion of HLA-DR⁺CD14⁺monocytes, CD14⁺ monocytes, and pro-inflammatory monocytes CD16⁺CD14⁺ in patients who underwent heart surgery using extracorporeal circulation (on-pump).

Methods: An observational, prospective study was conducted at the Heart Center of the Clinical Center of the University of Sarajevo on 53 patients divided into 3 age groups: 50 – 59, 60 – 69, and 70 – 80. The serum levels of CRP and SAA were quantitatively determined by immunonephelometry. At the same time, flow cytometry technology was applied to measure the proportion of CD14⁺ monocytes, HLA-DR⁺CD14⁺monocytes, and pro-inflammatory CD16⁺CD14⁺ monocytes.

Results: Measured values of CRP, SAA, proportion of monocytes CD14⁺, and proportion of pro-inflammatory monocytes CD16⁺CD14⁺ are significantly increased postoperatively compared to the preoperative values (p<0.05). The proportion of HLA-DR⁺CD14⁺ monocytes is lower postoperatively compared to preoperative values (p<0.001). Furthermore, there are no significant gender differences in the preoperative or postoperative parameters (p>0.05), with the notable exception of the preoperative proportion of CD14⁺monocytes (p<0.05). The analysis of age-related differences indicates no significant changes in the observed preoperative and postoperative parameters among the defined age groups (p>0.05).

Conclusion: Early monitoring of inflammatory and immunological markers in the postoperative phase could be valuable for healthcare professionals to implement prompt interventions to mitigate negative outcomes.

Six Sigma-Based Quality Assessment of Biochemical Analytes: A Comparative Analysis of Clinical Laboratory Improvement Amendments 1988 and 2024 Standards

2025-11-02T16:34:51+01:00

Background: Laboratories have a responsibility to produce accurate and reliable results to ensure patient safety and meet quality standards. Within the Six Sigma quality management framework, different approaches may emerge depending on the total allowable error (TEa) limits defined by various standards. This study aimed to compare analyte sigma levels using CLIA 1988 and CLIA 2024 criteria, determine appropriate quality control procedures based on Westgard multirules, and identify potential sources of error using the Quality Goal Index.

Methods: Sigma values for 17 biochemical analytes were calculated based on internal and external quality control data using the formula (TEa – bias)/CV. The Quality Goal Index (QGI) was determined using the formula bias/(1.5×CV). All analytes were evaluated at the Karabuk Public Health Laboratory between November 2024 and March 2025.

Results: Amylase (Levels 1 and 2), total bilirubin (Level 1), high-density lipoprotein cholesterol (Levels 1 and 2), creatine kinase (Levels 1 and 2), and lactate dehydrogenase (Levels 1 and 2) demonstrated world-class sigma performance according to both CLIA 1988 and CLIA 2024 standards. However, a decline in sigma values was observed when calculated using the more stringent CLIA 2024 limits.

Conclusions: The comparison of CLIA 1988 and CLIA 2024 standards demonstrated that stricter TEa limits can significantly impact sigma performance. While some analytes retained world-class performance, others showed a notable decline, requiring enhanced quality control measures. These findings emphasize the need for laboratories to periodically reassess test performance in light of evolving regulatory standards to ensure continued analytical reliability and patient safety.

Causal effects of inflammatory cytokines on hemangioma mediated by blood metabolites: a two-step Mendelian randomization study

2025-11-02T15:27:09+01:00

Background: Hemangioma is the most prevalent infantile vascular tumor. The state of inflammation and metabolism may contribute to the occurrence and development of hemangioma, but their causal relationships have not been clearly elucidated. In this study, via Mendelian randomization (MR) analysis, we aimed to investigate the causal effect of inflammatory cytokines and blood metabolites on hemangioma, and to explore the potential mediating role of metabolites.

Methods: Applying large-scale genome-wide association studies (GWAS) dataset, we applied two-sample MR to infer causal relationships among 91 inflammatory cytokines, 1091 blood metabolites and 309 metabolite ratios，and hemangioma. In addition, a two-step MR was used to assess the potential mediating role of metabolites. Functional enrichment was also performed to explore the biological pathways involved.

Results: 9 cytokines exhibited significant causal effects on hemangioma. Cytokines such as CCL20, IFN-γ, Eotaxin and TRANCE were associated with an increased risk, while IL12B, CXCL11, TGF-α, OSM and IL17A were inversely associated. Additionally, 52 blood metabolites and metabolite-ratios were discovered to have causal effects on hemangioma. 18 metabolites and metabolite-ratios were associated with an elevated risk of hemangioma, whereas 34 metabolites and metabolite-ratios appeared to be protective factors. Mediation analysis further identified specific metabolites, such as Gamma-glutamylvaline, as mediators in cytokine-hemangioma pathways, suggesting that they might modulate cytokine-driven tumorigenesis.

Conclusion: As the first MR study focused on hemangioma, we identified key cytokines and metabolites which might exert a causal effect on hemangioma, with several metabolites functioning as intermediators in cytokine-induced tumorigenesis process. The complex interaction between inflammation and metabolism in hemangioma was revealed, laying a foundation for future studies to explore potential targeted treatments.

Correlation analysis of inflammatory chemokine CXCL8 and lymphoid axillary lymph node metastasis in breast cancer

2025-11-02T16:37:23+01:00

Background: In this study, we analyzed the relationship between serumchemokine CXC ligand 8 (CXCL8) and breast cancer (BC) and the predictive effect on axillary lymph node metastasis.

Methods: 121 BC patients and 104 healthy controls were included, and serum CXCL8 was detected by ELISA to compare the differences in the levels of CXCL8 and tumor markers in the two study groups. Pathological examinations revealed that 36 of the patients had axillary lymph node metastasis. To further evaluate the diagnostic value, the ROC curve was employed to analyze the ability of CXCL8, tumor marker and combined color Doppler ultrasound blood flow richness grade (Adler grade) to assess axillary lymph node metastasis in BC patients.

Results: Serum CXCL8 CEA, CA153, and CA27.29 were higher in BC patients than in controls (P < 0.05). Patients with lymph node metastasis had higher levels of CXCL8 CEA, CA153, and CA27.29 (P < 0.05). The AUC of CXCL8+tumor markers+Adler grade for the diagnosis of lymph node metastasis was 0.903 (95% CI: 0.850-0.957), with a sensitivity of 86.11% and a specificity of 82.35% (P < 0.001).

Conclusion: High expression of CXCL8 is closely associated with BC lymph node metastasis.

. Changes in serum cholyglycine and prealbumin levels, glutamyl transpetidase , and Alpha fetoprotein after Transcatheter Arterial Chemoembolization Combined with Microwave Ablation of Liver Cancer

2025-11-02T15:27:09+01:00

Introduction: It aimed to assess the clinical outcome of transcatheter arterial chemoembolization (TACE) and its combination with microwave ablation (MWA) in middle or advanced primary liver cancer(PLC), and to analyze the causes complications. Material and Method: According to the treatment methods, 100 patients with middle or advanced PLC were divided into TACE group (TACEG) and TACE+MWA group (combination group, CG) (50 cases in each). The TACEG was treated with TACE alone, and the CG adopted TACE combined with MWA. The quality of life (QoL)SF-36 score, serum liver function index, response, 1-year overall survival (OS) rate, and complication rate were observed before and following remedy. Result: As against the TACEG, following remedy, the CG had a higher SF-36 score,objective relief rate (ORR) (32% vs 50%), disease control rate (DCR)(82% vs 90%), and 1-year OS (60% vs 84%) and a lower 1-year complication rate (34% vs 16%);Following remedy, as against the TACEG, serum cholyglycine (CG) and prealbumin (PAB) levels were higher, and the levels of total bilirubin (TBil), direct bilirubin (DBil), alanine aminotransferase(ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), glutamyltranspetidase (GGT), and Alpha fetoprotein (AFP) were lower in the CG (all P<0.05). Conclusion: TACE combined with MWA is effective and safe in middle or advanced PLC, and can markedly improve liver function and postoperative survival rate(SR).

To study the correlation between blood lactate level and neonatal hyperbilirubinemia and to predict the severity of NHB in neonates

2025-11-02T16:39:01+01:00

Objective: To study the correlation between blood lactate level and hyperbilirubinemia in neonates and to analyze the predictive value of blood lactate level for the severity of NHB in neonates.

Methods: A total of 123 children diagnosed with Neonatal hyperbilirubinemia (NHB) admitted to the obstetrics department from October 2021 to October 2022 were selected as the NHB group, and according to the severity of the disease, they were divided into mild, moderate, and severe. Fifty healthy neonates born in the department of obstetrics were selected as the control group. The levels of glucose-6-phosphate dehydrogenase (G6PD), creatine kinase isoenzyme (CK-MB), β2-microglobulin (β2-MG), aspartate aminotransferase (AST), blood lactic acid and total bilirubin in serum were compared. Pearson correlation analysis was used to analyze the correlation between blood lactate level and bilirubin level, and the ROC curve was used to determine the predictive value of blood lactate level for the severity of NHB in neonates.

Results: The NHB group had significantly higher levels of AST, CK-MB, β2-MG, blood lactic acid, and total bilirubin than the NHB group (P < 0.05). G6PD level was significantly lower (P < 0.05). According to Pearson, blood lactic acid level was positively correlated with total bilirubin level (r = 0.604, P < 0.001). The ROC curve showed that the AUC of blood lactic acid level in predicting the severity of NHB was 0.873, which was higher than that of total bilirubin alone (P < 0.05).

Conclusions: Neonates with NHB have higher serum levels of AST, CK-MB, β2-MG, blood lactate, and total bilirubin, while lower G6PD levels. The serum level of blood lactate is positively correlated with the total bilirubin level, which can be used to observe the severity of NHB in neonates.

Correlation of Serum sIL-2R, VEGF, and ES with Estrogen Levels in Papillary Thyroid Carcinoma Patients and Their Predictive Value for Postoperative Recurrence

2025-11-02T16:39:50+01:00

Objective: To explore the correlation of serum soluble interleukin-2 receptor (sIL-2R), vascular endothelial growth factor (VEGF), and endostatin (ES) with estrogen levels in papillary thyroid carcinoma (PTC) patients, and to assess the predictive efficacy of these biomarkers for PTC diagnosis and postoperative recurrence.

Methods: From March 2023 to March 2024, 132 newly diagnosed PTC patients and 128 healthy controls were enrolled. Serum sIL-2R, VEGF, and ES levels were quantified using enzyme-linked immunosorbent assay (ELISA), while estrogen levels (estrone [E1], estradiol [E2], estriol [E3]) were measured via chemiluminescent immunoassay. Patients were followed postoperatively for one year to monitor recurrence events, including local recurrence, lymph node metastasis, and distant metastasis. The diagnostic performance of the combined model was evaluated using receiver operating characteristic (ROC) curve analysis, and Pearson correlation analysis was conducted to examine the relationship between biomarkers and estrogen levels.

Results: Compared to controls, PTC patients exhibited significantly elevated serum sIL-2R, VEGF, and ES levels (P<0.05). The combined detection of these biomarkers demonstrated a sensitivity of 80.30% and specificity of 78.91% (AUC=0.8526) for PTC diagnosis. Additionally, E1 and E2 levels were significantly higher in PTC patients (P<0.05) and showed positive correlations with sIL-2R, VEGF, and ES (P<0.05), whereas E3 levels changed insignificantly (P>0.05). Recurrent patients had significantly higher sIL-2R, VEGF, and ES levels than non-recurrent patients (P<0.05). The combined predictive model for recurrence achieved a sensitivity of 96.88% and specificity of 61.00% (AUC=0.8494).

Conclusion: Elevated serum sIL-2R, VEGF, and ES levels in PTC patients indicate that their combined assessment may serve as a sensitive and specific tool for PTC diagnosis and postoperative recurrence risk stratification.

The clinical value of inflammatory factors in evaluating the prognosis of patients with acute myeloid leukemia

2025-11-19T04:10:45+01:00

Background: To assess the importance of inflammatory factors in predicting outcomes in individuals diagnosed with acute myeloid leukemia.

Methods: Between July 2017 and December 2019, a total of 100 patients with a recent diagnosis of acute myeloid leukemia (AML) were recruited from the Hematology Department of our hospital’s Cancer Center and assigned to the AML group. Additionally, 60 individuals with no underlying health conditions who underwent standard medical checkups during the same period were selected as the control group. Serum levels of IL-2, IL-4, IL-17A, TNF-α, IFN-γ, and LIF were measured through ELISA. All participants in the AML group were followed up for three years. Based on the European Leukemia Network (ELN) genetic risk stratification criteria, patients were categorized into favorable, intermediate, and adverse prognosis subgroups. Inflammatory marker profiles were then compared among these subgroups.

Results: Compared to healthy individuals, the AML group presented significantly increased serum concentrations of IL-4, IL-17A, and TNF-α, while levels of IL-2, IFN-γ, and LIF were significantly decreased (P < 0.05). Upon stratifying patients by prognostic classification, those in the favorable and intermediate prognosis categories exhibited notably lower IL-4, IL-17A, and TNF-α levels relative to the poor prognosis group (all P < 0.05). In contrast, levels of IL-2, IFN-γ, and LIF were notably elevated in the subgroup with favorable prognostic profiles (all P < 0.05). Additional analysis of cytokine expression indicated that increased levels of IL-4, IL-17A, and TNF-α were linked to worse 3-year survival performance (P < 0.05). Conversely, higher expression of IL-2, IFN-γ, and LIF was significantly associated with better long-term survival outcomes relative to patients with reduced expression levels (P < 0.05).

Conclusion: The abnormal levels of IL-4, IL-17A, TNF-a, IFNγ and LIF in patients with acute myeloid leukemia are increased, while the abnormal levels of IL-2, IFNγ and LIF are decreased, which has certain guiding effect on prognosis assessment and can be used as auxiliary indicators for prognosis assessment of AML.

Investigating the Causal Association Between Plasma Lipids and the Risk of Squamous Cervical Cancer: A Two-Sample Mendelian Randomization Study

2025-11-02T15:27:10+01:00

Purpose: This study aimed to investigate the causal relationship between plasma lipid levels—total cholesterol (TC), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)—and the risk of squamous cervical cancer (SCC) using Mendelian Randomization (MR).

Materials and Method: Genome-wide association study (GWAS) data for plasma lipid traits were obtained from the Global Lipids Genetics Consortium (GLGC), and SCC outcome data were sourced from the FinnGen consortium. The primary analysis was conducted using the inverse variance weighted (IVW) method, supported by MR-Egger regression, weighted median, and weighted mode approaches. Sensitivity analyses were performed to assess the robustness of the results, and the Steiger test was used to evaluate the directionality of the associations.

Results: The IVW analysis revealed that higher plasma levels of TC (OR: 1.777; 95% CI: 1.118–2.825; p = 0.015) and LDL-C (OR: 1.674; 95% CI: 1.013–2.767; p = 0.044) were associated with an increased risk of SCC. No significant associations were found between TGs (OR: 0.644; 95% CI: 0.343–1.212; p = 0.173) or HDL-C (OR: 1.050; 95% CI: 0.616–1.790; p = 0.857) and SCC.

Conclusions: This study provides evidence of a causal relationship between elevated plasma TC and LDL-C levels and a higher risk of SCC, highlighting a novel aspect of SCC etiology. These findings may inform further functional and clinical research in the progression of SCC.

Clinical Utility of Jugular Venous Blood Gas Biomarkers for Assessing Traumatic Brain Injury Severity and Predicting ICU Stay Duration: A Biochemical and Predictive Modeling Approach

2025-11-02T15:27:10+01:00

Background: Biochemical monitoring of cerebral oxygen metabolism is essential in the management of traumatic brain injury (TBI). Jugular venous blood gas (JVBG) analysis provides real-time data reflecting cerebral biochemical states, offering a valuable window into brain oxygenation and metabolic demands. This study aimed to evaluate JVBG biochemical markers as indicators of TBI severity and as predictors of prolonged intensive care unit (ICU) stay, emphasizing their integration into machine learning models for clinical utility.

Methods: A retrospective analysis was conducted on 100 ICU-admitted TBI patients. Serial measurements of JVBG parameters—jugular venous oxygen saturation (SjvO₂), partial pressure of oxygen (PjO₂), arteriovenous oxygen difference (AVDO₂), and oxygen content difference (AVDL)—were performed over five days. Spearman correlation and random forest algorithms were employed to assess relationships between JVBG biomarkers, clinical severity (via Glasgow Coma Scale), and ICU duration.

Results: Patients with more severe TBI exhibited significantly reduced SjvO₂ and PjO₂, and elevated AVDO₂ and AVDL (p < 0.001). Strong correlations were found between JVBG markers and clinical severity scores. A multivariable prediction model incorporating age, SaO₂, and PaCO₂ at one day post-admission yielded excellent predictive performance for prolonged ICU stay (AUC = 0.974; sensitivity = 100%; specificity = 94.8%).

Conclusion: JVBG biomarkers serve as clinically informative biochemical indicators for assessing TBI severity and forecasting ICU duration. Their integration into predictive algorithms may enhance precision in neurocritical care and support biochemical decision-making in intensive care settings.

. Prognostic value of serum IL-2, IFN-γ, TNF-α, IL-6, and IL-8, IL-10 in elderly Patients underwent Thoracotomy

2025-11-02T16:36:35+01:00

Objective: To investigate the effect of different fluid therapy on TH1 and TH2 cytokines ( IL-2, IFN-γ, TNF-α, IL-6, and IL-8 , IL-10 ) during perioperative period of thoracotomy in elderly patients.

Methods:A total of 60 elderly patients who underwent thoracotomy from January 2022 to April 2024 were divided into the control group (CG) and the observation group (OG), with 30 cases in each group. The CG received routine fluid management, while the OG received goal-directed fluid management. The postoperative recovery status, fluid intake and output, hemodynamic indexes, TH1 and TH2 cytokine levels were compared between both groups.

Results: The postoperative extubation time, drainage time, ICU stayand hospitalization time in the OG were reduced than those in the CG (P<0.05). The urine volume, crystalloid volume, colloid volume and total volume of fluid in the OG werereduced than those in the CG (P<0.05). At 1 h after surgery (T2), the HR and MAP levels of the two groups were reduced than those before surgery (T1) (P<0.05); at the end of surgery (T3), the HR and MAP of the CG were raised than those at T1 (P<0.05); at T2, the HR and MAP levels in the OG were raised than those in the CG (P<0.05); at T3, the HR and MAP levels in the OG were reduced than those in the CG (P<0.05). 1 day after operation, the levels ofIL-2, IFN-γ, TNF-α, IL-6, and IL-8 were raised than those before surgery, (P<0.05), and the levels of IL-10 wasreduced than those before treatment (P<0.05).

Conclusion: Perioperative goal-directed fluid therapy for elderly patients with thoracotomy is beneficial to maintain perioperative hemodynamic stability, improve serum levels of TH1 and TH2 cytokines, reduce the body's inflammatory response, and facilitate early postoperative recovery.