Journal of Medical Biochemistry

Biochemical Impact of Dexmedetomidine on Inflammatory and Stress Markers in Gastric Cancer Surgery: A Meta-Analysis

Xuhui Zhang, Wenjun Hu, Jinghua Wang, Rui Qin, Xinlei Wang, Zhenhua Zhang — Fri, 08 Aug 2025 00:00:00 +0200

Background: Dexmedetomidine, an α2-adrenergic agonist, has been reported to modulate inflammatory responses and neuroendocrine stress in surgical settings. This meta-analysis evaluated its effects on serum biochemical markers of inflammation and stress in patients undergoing gastric cancer surgery.

Methods: Literature was retrieved from PubMed, CNKI, Wanfang, and VIP databases. Studies comparing dexmedetomidine anesthesia with conventional regimens in gastric cancer surgery were included. RevMan 5.2 was used for meta-analysis. Outcome indicators included interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), cortisol, epinephrine, adrenocorticotropic hormone (ACTH), heart rate (HR), mean arterial pressure (MAP), and adverse events.

Results: Fifteen studies were analyzed. Compared with controls, dexmedetomidine significantly reduced serum levels of IL-6, TNF-α, cortisol, epinephrine, and ACTH (all P < 0.00001). It also decreased HR, MAP, visual analog scale (VAS) scores, and incidence of adverse reactions.

Conclusion: Dexmedetomidine anesthesia effectively reduces biochemical markers of inflammation and stress in gastric cancer surgery, suggesting its beneficial role in modulating perioperative biochemical responses.

Trends in Pregabalin Misuse and Abuse: A 25-Year Bibliometric Perspective

SALİHA AKSUN, Furkan Oguz KARALAR, Mert Uge, Berna Cafer — Mon, 18 Aug 2025 00:00:00 +0200

Abstract

Background/Aim: Pregabalin, initially developed as an antiepileptic drug, has since been widely used for conditions such as neuropathic pain, generalized anxiety disorder, and fibromyalgia. However, increasing concerns have emerged regarding its misuse and abuse potential, especially among opioid-dependent populations. This study aimed to perform a comprehensive bibliometric analysis to evaluate global research trends, identify prolific contributors, and explore collaborative networks related to pregabalin misuse.

Materials and Methods: A bibliometric design was employed using the Web of Science Core Collection database. The search was performed in February 2025, and publications were selected based on predefined criteria. A total of 449 eligible records were analyzed. The bibliometrix R package and its web application, Biblioshiny, within the RStudio environment, were used to conduct statistical and network analyses.

Results: Scientific publications addressing pregabalin misuse have markedly increased since 2010. The United States was the most prolific and central actor in global research collaborations, followed by the United Kingdom, Germany, and France. Prominent authors and institutions were found to form tight academic clusters. A steady rise in the usage of keywords such as “abuse,” “addiction,” and “opioids” was observed, particularly after 2016.

Conclusion: The growing literature on pregabalin misuse reflects heightened global awareness. Research remains centered in high-income countries, though emerging contributions from developing regions, including Türkiye, are notable. These findings underline the need for interdisciplinary cooperation, informed policy development, and enhanced clinical monitoring to address the risks associated with pregabalin misuse.

Clinical Values of serum carcinoembryonic antigen (CEA), glycoprotein antigen (CA) 50, CA19-9, and CA72-4, and the soluble fragment of cytokeratin 19 (CYFRA21-1) in early screening and prognosis prediction of colon cancer

Yingqiang Zhang, Ze Song, Jun Tang, Min Wu, Zhi Li — Thu, 31 Jul 2025 00:00:00 +0200

aim: To investigate the clinical values of serum tumor markers carcinoembryonic antigen (CEA), glycoprotein antigen (CA) 50, CA19-9, and CA72-4, and the soluble fragment of cytokeratin 19 (CYFRA21-1) in early screening and prognosis prediction of colon cancer.

Methods: 50 patients with colon cancer were enrolled into case group and 50 healthy people undergoing physical examination were enrolled into control group. The expressions of CEA, CA50, CA19-9, CA72-4, and CYFRA21-1 in two groups were compared.

Results: It was demonstrated that the expressions of CEA, CA50, CA19-9, CA72-4, and CYFRA21-1 among patients in case group were all superior to those among patients in control group (P<0.05), and the expressions of four tumor markers among patients in late group were remarkably superior to those among patients in early group (P<0.05). Postoperative expressions of CEA, CA50, CA19-9, CA72-4, and CYFRA21-1 were notably inferior to preoperative expressions (P<0.05). However, the expressions were apparently higher before treatment when postoperative recurrence and metastasis occurred (P<0.05). The positive detection rates of the combined detection of CA50, CA19-9, CA72-4, and CYFRA21-1 for recurrence and metastasis were all markedly superior to those of single indicator detection (P<0.05).

Conclusion: Tumor markers CEA, CA50, CA19-9, CA72-4, and CYFRA21-1 showed indication significance for detecting positive detection rate, tumor staging, and recurrence and metastasis of colon cancer. The combined detection could improve the detection rate of colon cancer and was conducive to early screening of colon cancer and the determination of prognosis of colon cancer.

Association of Serum Magnesium, Total and Ionized Calcium Levels with ICU Mortality: A 208-Hospital Retrospective Analysis

Boyang Cai, Yaoshen Liang, Wenli Zheng, Qiong Zeng, Linfeng Ye, Chunmei He — Wed, 30 Jul 2025 00:00:00 +0200

Background: To investigate the associations of serum magnesium, total calcium, and ionized calcium levels with ICU mortality, addressing conflicting evidence on electrolyte imbalances in critically ill patients.
Methods: This retrospective cross-sectional study analyzed 16,249 adult ICU patients from 208 U.S. hospitals (2014-2015) using the eICU Collaborative Database. Serum magnesium, total calcium, and ionized calcium levels were measured within 24 hours of ICU admission. ICU mortality was the primary outcome. Multivariate logistic regression, adjusted for 15 confounders (e.g., age, sex, APACHE scores, comorbidities), and restricted cubic spline (RCS) models assessed linear and non-linear associations, with subgroup analyses by disease severity.
Results: In fully adjusted models, ionized calcium showed a significant non-linear association with ICU mortality (OR: 0.90 per 1 mmol/L increase, 95% CI: 0.83-0.97, P=0.009). Piecewise regression identified a threshold at 1.2 mmol/L: below this, each 1 mmol/L increase reduced mortality risk by 14% (OR: 0.86, 95% CI: 0.79-0.94, P=0.001); above it, risk increased by 97% (OR: 1.97, 95% CI: 1.12-3.49, P=0.019). This protective effect was stronger in patients with lower APACHE II scores (P-interaction=0.021). Magnesium (OR: 0.95, 95% CI: 0.79-1.14, P=0.594) and total calcium (OR: 1.02, 95% CI: 0.93-1.11, P=0.689) showed no significant associations.
Conclusion: Ionized calcium exhibits a U-shaped relationship with ICU mortality, with an optimal range near 1.2 mmol/L, particularly in less severe cases. These findings suggest prioritizing ionized calcium monitoring in ICU settings and warrant prospective validation.

Predictive Value of Biochemical Markers CRP, WBC, and Total Cholesterol for Postoperative Dry Eye Syndrome Following Phacoemulsification Cataract Surgery

Yenan Wang, Xizhe Wang, Zhen Li, Huiqing Yang, Xuxiang Zhang — Fri, 08 Aug 2025 00:00:00 +0200

Background: Dry eye syndrome is a common complication following phacoemulsification cataract surgery, potentially influenced by systemic biochemical factors. This study aimed to evaluate the predictive efficiency of three routinely measured biochemical markers—C-reactive protein (CRP), white blood cell count (WBC), and total cholesterol (TC)—in identifying patients at risk for postoperative dry eye syndrome.
Methods: A total of 87 patients undergoing phacoemulsification between January 2024 and February 2025 were enrolled and categorized into dry eye (n=49) and non-dry eye (n=38) groups. Blood samples were collected preoperatively to assess CRP, WBC, and TC levels using standard laboratory protocols. Baseline characteristics were compared, and multivariate logistic regression was conducted to identify independent risk factors. Receiver operating characteristic (ROC) curves were generated to determine the predictive performance of each marker and their combination.

Results: Patients in the dry eye group exhibited significantly elevated CRP, WBC, and TC levels compared to the non-dry eye group (P<0.001 for all). Multivariate analysis identified CRP (OR=12.679), WBC (OR=3.216), and TC (OR=1.258) as independent predictors. The area under the ROC curve (AUC) values for CRP, WBC, and TC were 0.791, 0.770, and 0.757, respectively, while the combined model yielded an AUC of 0.936, indicating superior diagnostic performance (P<0.01).

Conclusion: CRP, WBC, and TC levels are clinically accessible biochemical parameters that hold significant predictive value for dry eye syndrome following cataract surgery. Combined detection enhances prognostic accuracy and may guide early intervention strategies to reduce postoperative complications.

Impact of MMC-Assisted Glycemic Control Assistant on Biochemical Indicators of Glucose Metabolism in Type 2 Diabetes: A Retrospective Study

Peipei Shen, Hongjiao Yang — Thu, 04 Sep 2025 00:00:00 +0200

Background: Accurate biochemical monitoring is central to effective diabetes management. This study investigated the effect of the National Standardized Metabolic Management Center (MMC)-assisted glycemic control assistant on laboratory-based glucose metabolism parameters in patients with type 2 diabetes.

Methods: A retrospective study was conducted on 160 patients with type 2 diabetes, including 95 who received MMC-assisted digital management and 65 who received routine care. Key biochemical parameters—fasting plasma glucose (FPG), 2-hour postprandial glucose (2hPG), and glycated hemoglobin (HbA1c)—were measured using standardized enzymatic assays. Dietary behavior and diabetes self-management were also assessed using validated scales.

Results: Baseline biochemical markers and behavioral scores showed no significant differences between groups. After intervention, the MMC-assisted group demonstrated significantly lower levels of FPG (7.42±2.43 vs. 8.30±2.66 mmol/L, P=0.032), 2hPG (10.23±3.21 vs. 12.39±3.50 mmol/L, P<0.001), and HbA1c (7.26±2.05% vs. 7.98±2.34%, P=0.041) compared to controls. Improvements were also observed in dietary behavior and self-management, including better adherence to blood glucose monitoring and medication.

Conclusion: The MMC-assisted glycemic control assistant significantly improves biochemical markers of glucose metabolism in patients with type 2 diabetes. This laboratory-confirmed improvement supports the integration of digital tools into standardized metabolic disease management.

Prognostic utility of the lactate-to-albumin ratio for predicting 28-day all-cause mortality in critically Ill cases with acute sepsis: A retrospective study on the basis of MIMIC-IV critical care database

Jiaqi Cheng, Jiatong Hou, Yuefu Wang — Tue, 22 Jul 2025 00:00:00 +0200

Background: Sepsis constitutes a systemic dysregulated host response to infection and remains a predominant cause of ICU mortality globally. Given the limitations of conventional prognostic models (e.g., SOFA and APACHE II), incorporating variably subjective parameters, there is a pressing need to identify robust, objective biomarkers for early mortality risk stratification. This investigation delineated the prognostic significance of the lactate-to-albumin ratio (LAR) in predicting 28-day all-cause mortality (28-DACM) among critically ill septic cases.

Methods: It was attempted to undertake a retrospective analysis utilizing the MIMIC-IV database (2008–2019), comprising 5,398 adult cases who met Sepsis-3 diagnostic criteria. Clinical and laboratory data within the initial 24-h post-ICU admission were extracted. The LASSO regression algorithm was implemented as a regularization technique to mitigate multicollinearity, enhance model generalizability, and facilitate high-dimensional feature selection. It was attempted to evaluate the prognostic utility of LAR through Kaplan-Meier (KM) survival estimation, receiver operating characteristic (ROC) curve analysis, and multivariate logistic regression modeling.

Results: LAR values were remarkably escalated in non-survivors relative to survivors (median, 0.9 vs. 0.6; P < 0.001). ROC curve analysis unveiled that LAR outperformed lactate (AUC: 63.52%), albumin (AUC: 43.34%), and the SOFA score (AUC: 59.87%), achieving the highest discriminatory capacity (AUC: 64.71%; 95% CI: 62.85–66.58%). An optimal LAR threshold of 1.032 was identified, attaining sensitivity and specificity of 45.1% and 76.6%, respectively. KM analysis uncovered remarkably attenuated 28-day survival in cases with LAR ≥1.032 (P < 0.001). Multivariate logistic regression confirmed LAR as an independent predictor of 28-DACM (OR = 1.32; P < 0.001), following adjusting for confounding variables.

Conclusions: The LAR serves as a clinically accessible, objective biomarker with superior prognostic performance relative to established indicators in association with sepsis. Its integration into early risk assessment algorithms may enhance prognostication and inform timely therapeutic decision-making. Prospective, multicenter investigations are warranted to validate its external generalizability and clinical utility.

Prognostic Value of Surfactant Protein D and Biochemical Markers in BALF and Plasma of ARDS Patients Undergoing Mechanical Ventilation

Hu Han, Litao Zhang, Hui Guo, Xin Xu, Xi Zhao — Sat, 30 Aug 2025 00:00:00 +0200

Background: Surfactant protein D (SP-D) and circulating exosomes have emerged as potential biochemical indicators of lung injury severity in acute respiratory distress syndrome (ARDS). This study aimed to evaluate the prognostic value of SP-D levels and selected biochemical parameters in bronchoalveolar lavage fluid (BALF) and plasma among ARDS patients receiving mechanical ventilation.

Methods: A total of 103 mechanically ventilated ARDS patients were enrolled between February 2020 and February 2023. Patients were classified into survival (n=59) and death (n=44) groups based on 28-day mortality. On the day of diagnosis, SP-D and exosome levels in BALF and plasma, along with pH, lactate, and oxygenation-related indices, were measured and analyzed for prognostic relevance.

Results: SP-D levels in both BALF and plasma were significantly higher in non-survivors (P<0.001), while exosome levels did not differ significantly. The death group also showed elevated lactate and lower pH levels (P<0.05). ROC analysis demonstrated high predictive value for SP-D in BALF (AUC=0.804) and plasma (AUC=0.864), as well as for lactate and oxygenation indices. A combined biomarker model yielded an AUC of 0.883 for predicting 28-day mortality.

Conclusion: SP-D concentrations in BALF and plasma, along with lactate and acid–base markers, serve as valuable biochemical predictors of short-term prognosis in ARDS patients undergoing mechanical ventilation.

Efficacy of Sacubitril/Valsartan Sodium Combined with Simvastatin in Treating Chronic Heart Failure with Arrhythmia and Its Effects on IL-6, IL-8, and TNF-α

Jingjing Li, Zhihua Wang — Sat, 19 Jul 2025 00:00:00 +0200

Background: To explore, in conjunction with clinical practice, the efficacy of different pharmacological treatment regimens for patients with chronic heart failure complicated by arrhythmia, and their effects on inflammatory factor levels.

Methods: A total of 96 patients with chronic heart failure and arrhythmia treated at our hospital from June 2022 to January 2025 were selected and randomly assigned by envelope method into a combination therapy group and a simvastatin group. The simvastatin group received simvastatin monotherapy, while the combination group was treated with sacubitril/valsartan sodium plus simvastatin. Clinical efficacy was compared between the two groups. Cardiac function, inflammatory factors, arrhythmia episodes, blood lipid levels, and oxidative stress markers were assessed before and after treatment. Adverse reactions in both groups were also observed.

Results: The overall effective rate in the combination therapy group (93.75%) was significantly higher than that in the simvastatin group (72.92%) (χ2=7.500, P=0.006). After treatment, the combination group exhibited higher LVEF and lower LVESD and LVEDD levels compared to the simvastatin group (P<0.05). Serum levels of inflammatory factors (IL-6, IL-8, TNF-α) were significantly lower in the combination group than in the simvastatin group after treatment (P<0.05). Both the duration and frequency of arrhythmia episodes were reduced in the combination group compared to the simvastatin group (P<0.05). Post-treatment, LDL-C, TG, and TC levels were lower, and HDL-C was higher in the combination group than in the simvastatin group (P<0.05). MDA and SOD levels were also lower in the combination group after treatment (P<0.05). The incidence of adverse reactions was lower in the combination group (3.33%) compared to the simvastatin group (22.92%) (χ2=5.352, P=0.021).

Conclusion: For patients with chronic heart failure and arrhythmia, combined therapy with sacubitril/valsartan sodium and simvastatin demonstrates significant efficacy. It can alleviate inflammatory responses, improve cardiac function, reduce the frequency and duration of arrhythmia episodes, optimize lipid profiles and stress responses, and decrease adverse reactions. This approach is worthy of further clinical promotion.

Continuous Monitoring of Serum Markers for Early Detection of Periprosthetic Joint Infection in Osteoporotic Patients Undergoing Hip Arthroplasty: A Prospective Cohort Study

Yongming Sun — Thu, 31 Jul 2025 00:00:00 +0200

Background: Periprosthetic joint infection (PJI) is a significant complication following hip arthroplasty, especially in osteoporotic patients. Early detection is crucial for improving outcomes, but remains challenging. This study assesses the effectiveness of continuous monitoring of serum markers—C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR), D-dimer, white blood cell count (WBC), ferritin, soluble CD14 (sCD14), matrix metalloproteinase-9 (MMP-9), and serum amyloid A (SAA)—for early detection of PJI in osteoporotic patients undergoing hip arthroplasty.

Methods: A prospective cohort study included 150 osteoporotic patients undergoing hip arthroplasty. Inflammatory markers were measured preoperatively and at 24-, 48-, and 72-hours post-surgery, with weekly follow-ups for 6 weeks. PJI was diagnosed based on clinical, microbiological, and imaging criteria. Diagnostic performance of individual markers was assessed using Receiver Operating Characteristic (ROC) curves.

Results: Among the 150 patients, 12 (8%) developed PJI within 6 weeks. At 48 hours post-surgery, CRP, PCT, ESR, D-dimer, WBC, sCD14, and SAA were significantly higher in the PJI group compared to the non-infected group (p<0.05 for all). Ferritin and MMP-9 levels showed higher values in the infected group but did not reach statistical significance (p = 0.076 and p = 0.094, respectively). The combination of CRP, D-dimer, WBC, sCD14, and SAA demonstrated 90% sensitivity and 92% specificity for PJI detection.

Conclusion: Continuous monitoring of CRP, D-dimer, WBC, sCD14, and SAA offers a reliable approach for early detection of PJI in osteoporotic patients undergoing hip arthroplasty. These markers showed strong associations with infection, while ferritin and MMP-9 were less informative. This strategy may help improve early diagnosis and patient outcomes.

DIAGNOSTIC ACCURACY OF SPERM DNA FRAGMENTATION INDEX IN MALE INFERTILITY: A COHORT STUDY

Juan Zhang, Wei He — Thu, 17 Jul 2025 00:00:00 +0200

Objective: To explore the correlation of sperm DNA fragmentation index (DFI) with semen quality, while assessing the diagnostic potential of DFI in male infertility, aiming to offer a novel biomarker and clinical approach for male fertility evaluation.

Methods: A cohort of 613 men who visited our hospital between April 2023 and February 2025 was included in this study. Semen analysis (assessing concentration, motility, morphology, etc.) and sperm chromatin dispersion testing were conducted to determine DFI. The diagnostic performance of DFI for infertility was evaluated using receiver operating characteristic (ROC) curve analysis. Subgroup analyses (oligozoospermia, asthenozoospermia, and oligoasthenozoospermia) were conducted to assess the discriminative power of DFI. After treatment, the patients were followed up for 1 year, and the predictive effect of DFI on the prognosis of successful fertility was analyzed.

Results: Among infertile men (n=92, incidence rate: 15.01%), DFI levels were significantly elevated compared to those with normal fertility (P<0.05). ROC curve analysis demonstrated that DFI had a sensitivity of 60.87% and specificity of 84.07% (AUC=0.774) in diagnosing infertility. Notably, DFI displayed the highest discriminative efficacy for oligoasthenozoospermia (AUC=0.825). Finally, the sensitivity and specificity of DFI for predicting successful fertility in infertile men at 1 year were 83.08% and 62.96% (P<0.001).

Conclusion: DFI has an excellent evaluation effect on the fertility of infertile men and has a high clinical potential.

Effects of bariatric and metabolic surgery on bile acid synthase activity, conjugation enzyme gene and intestinal mucosal barrier function (D-LA, Zonulin -E8) in diabetic patients

Jingjing Zhang, Shadike Apaer, Shuo Zhang, Guanyou Liang, Tao Li, Xinling Cao — Wed, 04 Jun 2025 00:00:00 +0200

Objective: To observe the changes of bile acid synthase activity, conjugation enzyme gene and intestinal mucosal barrier function (D-LA, Zonulin, MFG-E8) in patients with type 2 diabetes mellitus (T2DM) after bariatric and metabolic surgery (BMS), and to provide an objective opinion on the clinical optimization of BMS.

Methods: 127 patients with T2DM who had received BMS treatment at our hospital from October 2023 to August 2024 were included in the study, and weight loss, glucose-lipid metabolism was detected before surgery and at 6 months after surgery. Furthermore, the study quantified the expression levels of key enzymes involved in bile acid synthesis and conjugation (CYP7A1, CYP27A1, FXR, FGF19) and markers indicative of intestinal mucosal barrier function (D-LA, Zonulin, MFG-E8).

Results: After BMS, the patient's weight was significantly reduced and glucolipid metabolism was significantly improved (P<0.05). In addition, CYP7A1 was decreased and FXR, FGF19 was elevated in patients after surgery (P<0.05). Regarding the intestinal mucosal barrier function, D-LA, Zonulin were decreased in patients after surgery (P<0.05). MFG-E8 was not significantly altered after surgery in patients with sleeve gastrectomy (P>0.05), while it was elevated after surgery in patients with Roux-en-Y gastric bypass compared to baseline (P<0.05).

Conclusion: BMS can effectively improve glucose-lipid metabolism and reduce body weight in T2DM patients, and its mechanism is related to regulating bile acid metabolism and promoting the recovery of intestinal barrier function.

Analysis of Recurrence Risk After Radical Surgery for Differentiated Thyroid Carcinoma Based on Fibroblast Growth Factor Receptor 4 and Inflammatory Cytokines

Yingying Sha, Yongjie Hu, Peifei Huang — Thu, 19 Jun 2025 00:00:00 +0200

Objective: This study aimed to evaluate the synergistic role of fibroblast growth factor receptor 4 (FGFR4) and inflammatory cytokines (interleukin-6 [IL-6], tumor necrosis factor-α [TNF-α], and C-reactive protein [CRP]) in predicting recurrence of differentiated thyroid carcinoma (DTC) after radical surgery, and to develop a combined predictive model for improved postoperative risk stratification.

Methods: We enrolled 102 DTC patients treated between February 2022 and January 2024, along with 98 healthy controls. Serum levels of FGFR4, IL-6, TNF-α, and CRP were measured preoperatively and postoperatively using ELISA. Independent risk factors were identified through logistic regression, diagnostic performance was assessed using ROC analysis, and correlations of FGFR4 and inflammatory cytokines with postoperative recurrence were evaluated.

Results: Preoperative levels of FGFR4, IL-6, TNF-α, and CRP were significantly elevated in DTC patients compared to healthy controls (P<0.05). A diagnostic model integrating these four markers demonstrated superior performance (AUC=0.931; sensitivity 94.12%, specificity 79.59%) over individual biomarkers (P<0.05). Among DTC patients, those with recurrence (n=26) exhibited significantly higher FGFR4 and inflammatory cytokine levels than the non-recurrent group (P<0.05). The combined model predicted 1-year recurrence with an AUC of 0.864 (sensitivity 73.08%, specificity 93.42%).

Conclusion: The synergistic interaction between FGFR4 and inflammatory cytokines plays a critical role in DTC. Their combined detection enhances postoperative recurrence risk prediction, offering a valuable tool for clinical risk stratification.

The role of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in the early diagnosis of pulmonary mucoepidermoid carcinoma and their clinical significance

Limin Yang, Cuicui Zhao, Wei Lei — Wed, 18 Jun 2025 00:00:00 +0200

Objective: Pulmonary mucoepidermoid carcinoma (PMEC) is often misdiagnosed due to the lack of specificity of clinical symptoms. The ratio of neutrophil/lymphocyte ratio (NLR) and the ratio of platelet/lymphocyte ratio (PLR) are used in the diagnosis and prognostic assessment of a variety of diseases. This paper aims to verify the auxiliary diagnostic value of NLR and PLR in peripheral blood of PMEC, and calculate several indexes to confirm the reliability of the hypothesis.

Methods: A total of 26 patients with PMEC were enrolled as case group and 156 healthy patients were selected as the control group in this study according to the inclusion criteria and exclusion criteria. All clinical data were collected and all subjects took blood from fasting veins. The correlation analysis of NLR, PLR and tumor indicators were consistent with the normal distribution using Pearson analysis. The receiver operating characteristic (ROC) curve was used to calculated the diagnostic value of NLR and PLR.

Results: NLR and PLR levels were significantly increased in patients with PMEC compared with healthy controls (^***P<0.001). PLR was positively correlated with the patient’s stage [95% confidence interval (CI): 0.3408-0.7434; r=0.4590, P<0.05], and NLR was independent of the patient’s stage in PMEC patients [95% CI:-0.1510-0.6479 ; r=0.3002, P>0.05]. NLR was positively correlated with the patient’s tumor size [95% CI:0.1929-0.7821; r=0.5532, P<0.05], and PLR was independent of the patient’s tumor size [95% CI:-0.1298-0.6199 ; r=0.2887, P>0.05]. ROC curve analysis showed that NLR and PLR could be used as diagnostic indicators to distinguish patients with PMEC from normal people.
Conclusion: NLR and PLR tests are simple, non-invasive, inexpensive and with high patient compliance. As potential markers for screening PMEC patients, NLR and PLR have auxiliary value for further exploration and research, and are worth promoting in the clinical setting.

Observation on the Effects of Intraosseous Access on Inflammatory Mediators, Hematopoietic Cell Function, and Coagulation-Metabolic Disturbances in Emergency Traumatic Hemorrhagic Shock Patients

Gaorong Deng, Lang Jiang, Xin Miao, Yuying Dong, Xiang Gao, Zongfang Li — Fri, 20 Jun 2025 00:00:00 +0200

Objective: This study aimed to evaluate the impact of intraosseous (IO) access on inflammatory mediators, hematopoietic cell function, and coagulation-metabolic disturbances in patients presenting with emergency traumatic hemorrhagic shock (THS), thereby providing clinical evidence to refine IO resuscitation protocols in emergency settings.

Methods: We conducted a randomized controlled trial involving 84 THS patients admitted between February 2024 and February 2025. Participants were allocated equally into two groups: the IO group (n=42), where vascular access was established via humeral or proximal tibial puncture, and the intravenous (IV) group (n=42), where conventional peripheral or central venous access was prioritized. Serial measurements were performed at baseline (T0), 24 hours (T1), and 72 hours (T2) post-intervention to assess: (1) inflammatory mediators (IL-1β, IL-6, IL-10, HMGB1, MDA); (2) hematopoietic parameters (CD34+ cell proportion, CFU-GM/BFU-E colony formation, CXCL12, EPO, and TPO); (3) coagulation profiles (PT, APTT, and D-dimer); and (4) tissue perfusion indicators (blood lactate and lactate clearance rate). Comparative analyses were conducted both between groups and across different time points.

Results: The IO group demonstrated significantly elevated levels of IL-1β, HMGB1, and MDA at T1 and T2 compared to the IV group (P<0.05), coupled with reduced IL-10 expression (P<0.05), indicating exacerbated inflammatory imbalance and oxidative stress. Hematopoietic evaluation revealed progressive declines in CD34+ cell populations, CFU-GM/BFU-E colony formation, and CXCL12 concentration in the IO group at T1 and T2 (P<0.05), despite modest compensatory increases in EPO and TPO that remained inferior to the IV group (P<0.05). Coagulation studies showed prolonged PT/APTT (P<0.01) and higher D-dimer levels (P<0.05) in the IO group, along with worse blood lactate levels and lactate clearance rates compared to the IV group (P<0.05), suggesting increased tissue hypoxia and coagulopathy risk.

Conclusion: While IO access enables rapid vascular access for resuscitation and reduces critical intervention time, our findings demonstrate that it may inadvertently aggravate systemic inflammatory dysregulation, impair hematopoietic function, and worsen coagulation-metabolic disturbances through mechanisms such as mechanical stimulation, hypothermic fluid infusion, and oxidative stress.

Relationship between Advanced Glycation End-products, Serum Carnosinase-1 and Diabetic Nephropathy and Diabetic Retinopathya

Yu Rong — Fri, 20 Jun 2025 00:00:00 +0200

Introduction: This article analyzed the relationship between serum advanced glycation end-products (AGEs), carnosinase-1 (CN-1) and diabetic nephropathy (DN) and diabetic retinopathy (DR).

Material and Method: 150 patients with type 2 diabetes mellitus (DM2) were grouped: DN and non-DN, DR and non-DR groups. Fasting venous blood was collected, and serum levels of AGEs and CN-1 were detected. Pearson’s correlation (PC) test was adopted for analyzing their correlation with DN and DR, and multivariate Logistic regression (MLR) analysis was adopted.

Result: There were 48 DN cases, 102 non-DN cases, 20 DR cases, and 130 non-DR cases in 150 patients with DM2. As against the non-DN group, the serum levels of AGEs and CN-1 in the subjects with DN were markedly increased. As against the non-DR group, the serum levels of AGEs and CN-1 in the subjects with DR were also markedly increased. The results of correlation analysis revealed that the levels of serum AGEs and CN-1 were positively correlated with the occurrence of DN and DR. Serum AGEs and CN-1 levels were independent risk factors (IRF) for DN and DR (all P <0.05).

Conclusion: AGEs and CN-1 may become new targets for the diagnosis and remedy of diabetic microvascular complications.

Molecular and Biochemical Characterization of Familial Hypercholesterolemia: Association of Genetic Variants and Lipid Parameters

Wed, 12 Nov 2025 00:00:00 +0100

Background: Familial hypercholesterolemia (FH) is characterised by elevated low-density lipoprotein cholesterol (LDL-C) levels and an increased risk of premature cardiovascular disease. The present study aimed to investigate the genetic background and associated biochemical profiles of patients with clinically suspected FH in Serbia.

Methods: A total of 101 patients with clinically suspected FH were recruited between 2015 and 2023 from the Clinic for Endocrinology, Diabetes and Metabolic Diseases in Serbia. Clinical diagnosis was established using the Dutch Lipid Clinic Network (DLCN) criteria. Fasting serum lipids (total cholesterol [TC], LDL-C, high-density lipoprotein cholesterol [HDL-C], triglycerides [TG], apolipoprotein A-I [ApoA-I], apolipoprotein B [ApoB], and lipoprotein(a) [Lp(a)]) were measured enzymatically. Genetic testing for LDLR, APOB, PCSK9, and LDLRAP1 genes was performed using next-generation sequencing on the Illumina NextSeq 550DX platform. Variants were classified according to the American College of Medical Genetics and Genomics (ACMG) guidelines. Statistical analyses were conducted in SPSS (version 30.0).

Results: Pathogenic or likely pathogenic variants were identified in 44 of 101 patients, yielding a mutation detection rate of 43.6%. Genetically confirmed FH patients exhibited significantly higher LDL-C (p<0.001), total cholesterol (p<0.001), triglycerides (p<0.001), and ApoB (p=0.001) compared with mutation-negative individuals, while HDL-C, ApoA-I (p=0.413), and Lp(a) (p=0.421) levels did not differ significantly between groups.

Conclusions: This study demonstrates the molecular and biochemical diversity of familial hypercholesterolemia in the Serbian population. Pathogenic FH mutations were associated with higher LDL-C, total cholesterol, and ApoB levels, underscoring the importance of combining genetic testing with lipid profiling for precise diagnosis and management.

Analysis of the Pathological Progression of Severe Community-Acquired Pneumonia Based on Serum Inflammatory Markers HMGB-1, IL-1β, and IL-6: A Propensity Score Matching Study

Wed, 25 Jun 2025 00:00:00 +0200

Objective: This study aimed to evaluate the involvement of serum inflammatory markers—high-mobility group box 1 (HMGB-1), interleukin-1β (IL-1β), and interleukin-6 (IL-6)—in the pathological progression of severe community-acquired pneumonia (SCAP), examine their association with computed tomography (CT) scores, and assess their combined utility for diagnosis and outcome prediction.

Methods: We performed a propensity score-matched retrospective cohort study involving 164 SCAP patients (research group) and 164 age- and sex-matched healthy controls (control group) enrolled between March 2024 and January 2025. Serum HMGB-1, IL-1β, and IL-6 concentrations were quantified by enzyme-linked immunosorbent assay (ELISA), while pulmonary radiographic findings was evaluated using the Acute Exacerbation of Idiopathic Pulmonary Fibrosis (AE-IPF) scoring system. Comparative analyses of inflammatory markers and CT imaging findings were conducted, with subsequent correlation studies, receiver operating characteristic (ROC) curve analysis, and multivariate regression modeling to determine their relationship with in-hospital mortality.

Results: Following propensity score matching, demographic characteristics were well-balanced between groups (standardized mean differences <0.1). SCAP patients demonstrated significantly elevated serum levels of HMGB-1, IL-1β, and IL-6 (P<0.05), along with higher CT scores than controls. Strong positive correlations were observed between inflammatory marker concentrations and CT scores (P<0.05). The combination of inflammatory markers and CT scoring showed enhanced diagnostic discrimination for SCAP (area under the curve [AUC]=0.9342) and superior predictive value for in-hospital mortality (AUC=0.9348) compared to individual parameters (P<0.05). Multivariate analysis identified the elevation of these biomarkers as independent predictors of mortality in SCAP patients (P<0.05).

Conclusion: HMGB-1, IL-1β, and IL-6 play pivotal roles in promoting SCAP progression by driving inflammatory cascades and pulmonary tissue injury. The integrated assessment of these biomarkers with CT scoring significantly improves disease monitoring and prognostic assessment accuracy, potentially guiding individualized anti-inflammatory interventions in SCAP management.

Oxidative stress in adolescents with overweight/obesity

Mon, 07 Jul 2025 00:00:00 +0200

Aim: The pathophysiological mechanism underlying obesity and related diseases is still incompletely understood. A small number of studies used sophisticated statistical techniques, such as principal component analysis (PCA), to examine the relationship between oxidative stress, cardiometabolic biomarkers, and obesity in adolescent population. Hence, we aimed to explore such a relationship.

Methods: A total of 68 adolescents (i.e., 34 were overweight/obese and 34 were sex- and age-matched normal-weight controls) were included in the study. Total oxidant status (TOS) and total antioxidant status (TAS) were measured, whereas their ratios were calculated, i.e., pro-oxidant score [(TOS/TAS)*100] and antioxidant score (TAS/TOS). PCA was applied for reducing the number of determined data by grouping them into factors.

Results: A significantly higher concentration of TAS, TOS, and their pro-oxidant ratio (TOS/TAS)*100, while the antioxidant score of TAS/TOS was significantly lower in overweight/obese adolescents compared to normal-weight peers. TOS was the most significant predictor of obesity status (P=0.001). PCA extracted 3 factors related to obesity status: Factor 1 (gender, creatinine, uric acid, total bilirubin, TAS, waist circumference, and urea), Factor 2 (ALT and AST), and Factor 3 (age, glucose, total protein, and TOS). Among them, Factor 2 (P=0.003) and Factor 3 (P=0.003) were independently associated with obesity.

Conclusion: The present study provides evidence of disrupted redox homeostasis in adolescents with obesity. Obesity is tightly connected with increased oxidative stress and a cluster of metabolic abnormalities. It is important to recognize risk factors in a timely manner and develop a strategy to fight obesity and associated diseases.

the Diagnostic value of combined detection of serum NLR and CRP for migraine patients in attack stage: A prospective study

Yanluan Wan, Guanglan Liu, Chunfu Tao, Xiujuan Yuan, Haijian Zheng — Mon, 07 Jul 2025 00:00:00 +0200

Objective: We attempted to clarify diagnostic value of combined detection of NLR and serum CRP for migraine patients in attack stage.

Methods: A total of 50 migraine patients in attack stage undergoing treatment in our hospital from June 2023 to June 2024 were chosen as observation group. Additionally, 50 healthy people undergoing physical examination in our hospital were chosen as control group. We adopted questionnaires to obtain the demography, medical history and disease situation of patients in detail. The patients and health examinees received blood routine examination in case of no medication within 3 h after admission. The absolute values of neutrophil (N) and lymphocyte (L) were obtained, followed by calculation of NLR. The serum CRP level received measurement through immune nephelometry. The diagnostic value of NLR and serum CRP for migraine received analysis through receiver operating characteristic curve (ROC).

Results: the serum CRP and NLR levels were significantly higher in the observation group compared with the control group, (P < 0.05).in the observation group, serum CRP and NLR levels in patients with migraine with aura were basically comparable to those in patients without migraine with aura, with no significant difference (P>0.05). Meanwhile, the differences in serum CPP and NLR levels between patients with frequent migraine attacks and patients with infrequent migraine attacks were not statistically significant (P>0.05) Serum CRP or NLR could be utilized for diagnosing migraine patients in attack stage, and diagnosis of migraine through serum CRP or NLR alone presented no difference (P = 0.633). There was statistical significance between combined detection and serum CRP or NLR alone.

Conclusion: Inflammatory biomarkers serum CRP and NLR presented a marked elevation in migraine patients in attack stage. The combination of serum CRP and NLR in diagnosing migraine attack has certain diagnostic value.

Development and Validation of a Risk Prediction Model for Hepatorenal Syndrome in Hepatic Failure Patients Based on Glucose-6-Phosphate Dehydrogenase and Hepatic and Renal Function Biochemical Parameters

Hao Liu, Dewen Mao, Kan Zhang, Tingshuai Wang, Yanmei Lan, Minggang Wang — Mon, 07 Jul 2025 00:00:00 +0200

Objective: This study aimed to develop and validate a novel risk prediction model for hepatorenal syndrome (HRS) in hepatic failure (HF) patients by integrating glucose-6-phosphate dehydrogenase (G6PD) activity with conventional hepatic and renal function biochemical parameters, thereby enhancing early HRS detection beyond the limitations of traditional indicators.

Methods: We performed a retrospective analysis of 267 HF patients (82 with HRS, 185 without HRS) hospitalized between July 2020 and July 2022. G6PD levels and standard hepatic/renal function biochemical parameters (ALT, AST, TBil, GGT, BUN, Scr, UA, and CysC) were assessed. Key predictors were identified via Lasso regression, and a multivariate logistic regression model was developed. Model performance was evaluated using receiver operating characteristic (ROC) analysis, with internal validation conducted through a 70:30 training-validation split.

Results: HRS patients exhibited significantly lower G6PD activity than non-HRS HF controls (P < 0.05). While G6PD alone showed moderate predictive value (AUC = 0.742; sensitivity 59.76%, specificity 79.12%), the composite model integrating G6PD, GGT, UA, and CysC demonstrated markedly improved discrimination, achieving AUCs of 0.942 (95%CI:0.905-0.979) in the training cohort and 0.998(95%CI:0.0.993-1.000) in the validation cohort with both sensitivity and specificity outperforming individual indicators. The derived risk equation was Combined testing_Youden = -17.038 + -0.116 × G6PD + 0.102 × GGT + 0.016 × UA + 0.040 × Scr + 3.760 × CysC.

Conclusion: The integration of G6PD with hepatic (GGT) and renal (UA, CysC) function biochemical parameters significantly enhances HRS risk stratification in HF patients. This validated tool offers superior sensitivity and specificity for the early identification of HRS.

Predictive Value of TRIB3 Combined with BMPR2 for Major Adverse Cardiovascular Events in Elderly Coronary Heart Disease Patients Undergoing Percutaneous Coronary Intervention

Qiang Zhang, Aiqiao Dong, Tian Wang, Fei Kang, Huan Wang, Jing Sun — Tue, 08 Jul 2025 00:00:00 +0200

Background: This research aims to explore the correlation of Tribbles Pseudokinase 3 (TRIB3) and bone morphogenetic protein receptor type 2 (BMPR2) with coronary heart disease (CHD), as well as the evaluation value of the combined detection of the two for major adverse cardiovascular events (MACE) following percutaneous coronary intervention (PCI). Methods: The study enrolled 152 CHD patients (CHD group) who underwent PCI treatment between January 2023 and May 2024 and 136 healthy individuals (control group) who concurrently underwent physical examination in our hospital. The expressions of TRIB3 and BMPR2 in the serum of both groups were measured. The clinical implications of these two factors in CHD, along with their diagnostic value for CHD, were then analyzed. Subsequently, the CHD patients were subjected to a 6-month follow-up. During this period, the occurrence of MACE was recorded and the evaluation value of the combined detection of TRIB3 and BMPR2 for MACE was analyzed.

Results: In the CHD group, the concentration of TRIB3 was significantly elevated compared to the control group, existing a notable decline in TRIB3 levels after treatment (P<0.05). In contrast, the level of BMPR2 in the CHD group was significantly lower than that of the control group, and it increased significantly following treatment (P<0.05). In the CHD group, TRIB3 and BMPR2 were closely correlated with cardiac troponin I (cTnI) and left ventricular ejection fraction (LVEF) (P<0.05). The combined detection of TRIB3 and BMPR2 had a diagnostic sensitivity of 76.32% and a specificity of 91.18% for CHD (P<0.05). The follow-up results showed that 25 patients experienced MACE. Compared with non-MACE patients, the post-treatment level of TRIB3 was significantly higher in MACE patients, while the level of BMPR2 was statistically lower (P<0.05). The diagnostic sensitivity and specificity of the combined detection of TRIB3 and BMPR2 for MACE were 60.00% and 90.55%, respectively (P<0.05).

Conclusion: Both TRIB3 and BMPR2 demonstrated excellent evaluation effects on the occurrence of CHD and the incidence of MACE after PCI.

PLATELET TO LYMPHOCYTE RATIO IN THE HEALTHY POPULATION OF VOJVODINA

Tanja Šašić Ostojić — Sun, 09 Nov 2025 00:00:00 +0100

BACKGROUND: Platelet to lymphocyte ratio (PLR) is a simple laboratory index that may be applied in diagnostics and follow up the different diseases, with primary or accompanying systemic inflammatory component. However, due to lack of reference interval in general population, clinical application of PLR index is limited. The aim of this study was to determine the reference interval of PLR index.

METHODS: Retrospective observational study included 4672 adult examinees, which underwent regular systematic check-up, including clinical examination and basic laboratory analyses (complete blood count-CBC). The PLR reference interval was calculated using the Clinical and Laboratory Standards Institute guidelines estimating percentiles and their 95% confidence intervals-CI). Verification of reference interval was performed on the group of 95 healthy adults, age and gender matched to the examined one.

RESULTS: The mean age of all examinees was 43±10 years, dominantly males (83.7%). PLR median value was 109(25^thpercentile:90-75^thpercentile:131; lower limits of the median-62(95%CI:61-63); upper limits of the median-194(95%CI:188-198)). Female had significantly higher PLR levels compared to male (P<0.0001), while in elderly, PLR was significantly lower, compared to middle and young aged (P=0.02). Determined reference interval for female was 70-231 and for male it was 61-183. PLR did not significantly differ between initially examined and second group of examinees [108.0(87-136) vs. 109.0 (90.0-131.0)], p>0.05.

CONCLUSIONS: In representative sample of examinees, where the majority was of young and middle age, PLR reference interval for women is 70-231, while for men is 61-183. In persons older than 65, the values of PLR index may be lower.

Analysis of risk factors for pre-diabetes to diabetes among cadres in Huzhou: a 5-year retrospective study

Yan Wu, Jun Yao, Shitong Xing, Ying Zhang, Yan Shen — Fri, 24 Oct 2025 00:00:00 +0200

Objective To analyze the risk factors of Diabetes Mellitus (DM) through a five-year retrospective study of prediabetes mellitus (Pre DM) cadres. Methods The cadres who underwent physical examination and were diagnosed as pre-diabetes in the First People's Hospital of Huzhou City from April 2019 to November 2024 were selected as the research objects, and their basic information (age, gender, body mass index, etc.), lifestyle (diet, exercise, smoking and drinking, etc.), family medical history, biochemical indicators (blood sugar, blood lipid, blood pressure, etc.) and other data were collected. People were divided into two groups according to whether they developed diabetes, and the risk factors of diabetes were determined by univariate analysis and multivariate Logistic regression analysis. Results A total of 174 pre-diabetic cadres were included, and 30 of them developed diabetes. Univariate analysis showed that there were differences in age, body mass index, fasting blood glucose, triglyceride, uric acid, blood pressure, blood lipid, liver function and lack of exercise of renal function between the two groups (P < 0.05). The results of multivariate Logistic regression analysis showed that age, BMI, SBP, TG, TC, BUN, TBIL and ALT were independent risk factors for the development of diabetes in pre-diabetic cadres' health care population within 5 years (P < 0.05). Conclusion This study shows that age, BMI, blood pressure, blood lipid level, liver and kidney function indexes and gender are important risk factors for PDM patients to develop into DM. Monitoring and managing these factors can reduce the risk of PDM patients progressing to DM. This provides personalized health management suggestions for PDM cadres and health care people, and also provides theoretical support for the formulation of relevant health policies.

english Multifaceted Roles of Superoxide Dismutases (SODs) in Cellular Homeostasis and Cancer Progression: Redox Regulation and Therapeutic Implications

Duygu Aydemir, Nuriye Nuray Ulusu — Thu, 25 Sep 2025 00:00:00 +0200

Superoxide dismutases (SODs) are critical metalloenzymes involved in detoxifying reactive oxygen species (ROS), playing a pivotal role in maintaining redox homeostasis and cellular integrity. Comprising three isoforms—SOD1 (cytosolic Cu/Zn-SOD), SOD2 (mitochondrial Mn-SOD), and SOD3 (extracellular Cu/Zn-SOD)—these enzymes catalyze the dismutation of superoxide radicals into hydrogen peroxide and oxygen. Altered SOD expression and function are closely linked to cancer initiation, progression, metastasis, and therapy resistance. SOD1 and SOD2 promote tumor survival by regulating redox-sensitive signaling pathways, including MAPK, PI3K/Akt, and NF-κB. The mTORC1-SOD1 axis emerges as a key mediator of cancer cell adaptation to hypoxia and nutrient deprivation. SOD2 overexpression enhances redox signaling and tumorigenicity, while its inhibition sensitizes tumors to chemotherapeutic agents like 5-fluorouracil. SOD3, traditionally viewed as protective, shows dual roles depending on the cancer context, with implications in angiogenesis, metastasis, and prognosis. Moreover, synthetic MnSOD mimetics—such as Mn porphyrins, salens, and mitochondrial-targeted antioxidants—offer therapeutic potential by modulating oxidative stress in tumor microenvironments, acting as both radiosensitizers and radioprotectors. These findings highlight the multifaceted functions of SOD enzymes in cancer biology and underscore their value as diagnostic biomarkers and therapeutic targets in redox-based cancer treatment strategies.