Journal of Medical Biochemistry

Meta-analysis of nifedipine and enalapril combination therapy for hypertensive patients with coronary heart disease

Kun Wang, Wenchao Ma, Leina Sun, Fangcheng Su — Sat, 02 Nov 2024 00:00:00 +0100

Background: Numerous clinical studies have demonstrated that the therapeutic efficacy of combining nifedipine and enalapril in treating hypertension with coronary heart disease surpasses that of nifedipine as a stand-alone treatment. However, the current evidence is not yet sufficient due to limitations in the sample size, and further validation is needed. To analyze and assess the clinical impact of nifedipine combined with enalapril on hypertension complicated with coronary heart disease, and provide evidence for rational drug use in clinic.

Methods: We employed a revised version of the Jadad scale to assess the quality of the research literature following a rigorous screening process. The statistical analysis was performed utilizing the software RevMan 5.4.1 for data analysis. Heterogeneity in the studies was evaluated based on the results of the Q test (P value), and the OR value of the combined effect was calculated using either the model with fixed effects or the one with random effects, with the results presented in a forest plot. Furthermore, a sensitivity analysis was conducted by excluding articles with the highest impact, and potential bias in publication was assessed through the utilization of a funnel plot.

Results: A total of 183 articles were initially identified, and after a comprehensive review, 14 clinical randomized controlled trials were chosen for analysis. The meta-analysis findings revealed that the trial group displayed a significantly higher overall effectiveness rate compared to the control group (OR=3.47, 95%CI 2.40-5.03). Additionally, the trial group exhibited a more pronounced reduction in blood pressure and greater enhancement in cardiac function (OR=5.55, 95%CI). Conversely, the control group had a lower occurrence of ischemic events compared to the trial group (OR=0.35, 95%CI 0.24-0.50). Sensitivity analysis confirmed the stability and reliability of the combined effect size results (OR=3.91, 95%CI 2.51-6.09, P<0.00001). However, based on an assessment using funnel plot results suggested potential bias in publication.

Conclusion: The combined administration of nifedipine and enalapril exhibits enhanced effectiveness compared to the sole use of nifedipine in individuals diagnosed with hypertension and coronary heart disease, rendering it a valuable alternative for clinical application.

The Feasibility of using Liver Function Indices and FibroScan in combination to predict the occurrence of anti-tuberculosis drug-induced liver injury in patients with liver disease

Shaoqiang Wu, Qiaohua Yang, Huai Li, Yongzhong Li — Tue, 06 Aug 2024 00:00:00 +0200

Background: The study aims to assess the feasibility of using a combined approach of liver function indices and FibroScan measurements as a predictive tool for the early detection of anti-tuberculosis drug-induced liver injury (DILI) in patients with existing liver disease.

Methods: A retrospective cohort study was conducted, including adult tuberculosis patients with documented liver disease. Liver function was assessed using standard biochemical parameters, and FibroScan examinations were performed to determine liver stiffness measurement (LSM). Patients were monitored for clinical and biochemical signs of DILI throughout treatment. Logistic regression models and Receiver Operating Characteristic (ROC) curves were used for data analysis. Statistical significance was set at p < 0.05.

Results: Patients who developed DILI showed significantly higher levels of ALT, AST, total bilirubin, GGT, and LSM, with strong positive correlations between these markers and DILI occurrence. Logistic regression analysis revealed elevated ALT, AST, TBIL, and GGT were strongly associated with an increased likelihood of DILI. The area under the ROC curves indicated excellent predictive accuracy of these parameters. A nomogram for predicting DILI based on the combined biomarkers was established.

Conclusion: The study demonstrates the feasibility of utilizing liver function indices and FibroScan measurements in combination to predict anti-tuberculosis DILI. The results highlight the importance of baseline liver health assessment and offer promising implications for clinical practice, aiding in individualized risk estimation and therapeutic decision-making for patients with liver disease initiating anti-tuberculosis therapy. Further validation in larger cohorts is warranted to strengthen the predictive model.

The effect of absorbable collagen suture for oral implant repair on wound healing and inflammation factors of gingival crevicular fluid

Jingjing Feng, Qiaolong Yu, Xiaoqing Liu — Tue, 13 Aug 2024 00:00:00 +0200

Background: To investigate the clinical value of absorbable collagen suture in the treatment of oral implant restoration.

Methods: A prospective, randomized, single-blind trial was conducted in patients undergoing dental implant restoration in our hospital. The patients were divided into an absorbable group (incision closure with absorbable collagen suture) and a conventional group (incision closure with conventional suture). The incision healing time, postoperative pain degree, incision healing grade, patient satisfaction, and the levels of tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8) and interleukin-6 (IL-6) in gingival crevicular fluid were compared between the two groups.

Results: The absorbable group had faster incision healing times and lower postoperative pain scores on days 1 and 2, all with significant differences (P<0.05). Wound healing in the absorbable group was notably better, with a Grade A healing rate of 96.88% and a Grade B healing rate of 3.13%. In contrast, the conventional group had a Grade A healing rate of 81.25%, a Grade B healing rate of 17.19%, and a Grade C healing rate of 1.56%. These differences favored the absorbable group significantly (P<0.05).Before surgery, there were no statistically significant differences in the levels of TNF-α, IL-6, and IL-8 in gingival crevicular fluid between the absorbable and conventional groups (P>0.05). However, 3 days after surgery, the absorbable group showed significantly lower levels of TNF-α, IL-6, and IL-8 compared to the conventional group (P<0.05).Patient satisfaction rates for stability, aesthetics, chewing function, and pronunciation were similar between the two groups (P>0.05). However, patients in the absorbable group reported significantly higher comfort levels compared to those in the conventional group (P<0.05). Moreover, the complication rate in the absorbable group was significantly lower at 6.25% compared to 18.75% in the conventional group (P<0.05).

Conclusion: Absorbable collagen suture for oral implant prosthesis after suture, beneficial to wound healing and reduce postoperative pain and inflammation.

The Value of Thrombus Markers Applied in Patients with Respiratory Failure

Yingqun Chen, Zihan Yin, Junshi Wang, Cunliang Yan, Xuwei Lin, Lei Huang — Wed, 14 Aug 2024 00:00:00 +0200

Background: This work assessed the value of novel thrombus markers—thrombin-antithrombin complex (TAT), plasmin-α2-plasmin inhibitor complex (PIC), thrombomodulin (TM), and tissue plasminogen activator-inhibitor complex (t-PAIC) applied in patients with respiratory failure (RF), including their role in predicting thrombus formation, evaluating prognosis, and assessing disease severity.

Methods: eighty patients with RF were enrolled and categorized into mild (n = 10), moderate (n = 9), and severe (n = 71) groups based on disease severity. Meanwhile, patients were also classified into thrombus (n = 14) and non-thrombus (n = 76) groups based on the presence of thrombus. Furthermore, they were assigned into survival (n = 70) and death (n = 20) groups based on prognosis. Traditional coagulation indicators, thrombus markers, infection-related parameters, and respiratory-related indicators were compared among patients in different groups. This work explored the predictive effects of these indicators on the degree of respiratory failure, thrombus formation, and prognosis in various patient groups. Additionally, correlations of thrombus markers and traditional coagulation indicators to respiratory-related indicators and infection-related indicators were analyzed.

Results: upon admission, levels of thrombin-antithrombin complex (TAT), plasmin-α2-plasmin inhibitor complex (PIC), and tissue plasminogen activator-inhibitor complex (t-PAIC) in the thrombus group were sharply higher in contrast to those in the non-thrombus group, showing obvious differences (P<0.05). Patients in the death group experienced remarkably elevated TAT, PIC, t-PAIC, thrombomodulin (TM), and to the survival group (P<0.05). In addition, high-sensitivity C-reactive protein (hs-CRP) in the death group was higher to that in the survival group (P<0.05). Platelet count (PLT) and procalcitonin (PCT) were sharply lower in the survival group (P<0.05). In groups of varying severity, PCT exhibited an elevated level in the severe, demonstrating great differences to the mild to moderate groups (P<0.05). Besides, TAT, PIC, TM, and t-PAIC showed higher sensitivity and accuracy in predicting severe RF, with higher specificity in predicting thrombus formation in RF patients. In correlation analysis, a positive correlation was observed between TT, PCT, and the fraction of inspired oxygen (FiO₂). The activated partial thromboplastin time (APTT), PCT, and FiO₂ exhibited positive correlations. Additionally, a positive association existed between fibrinogen (FIB), hs-CRP, and PLT. A positive link was identified between D-dimer and hs-CRP, PIC and PLT, as well as t-PAIC and PCT.

Conclusion: Thrombus markers exerted a crucial effect in patients experiencing respiratory failure, serving as pivotal indicators for assessing the severity of the condition, identifying thrombotic risk, and predicting prognosis.

Effects of colchicine adjuvant therapy on disease control, serum NALP3, sICAM-1, MMP-9 and MMP-13 in patients with coronary heart disease and acute gout attack

Wed, 21 Aug 2024 00:00:00 +0200

Background: To investigate the impact of colchicine adjuvant therapy on disease control and serum levels of nucleotide-binding oligomerization domain-like receptor (NALP) 3, soluble intercellular adhesion molecule (sICAM)-1, matrix metalloproteinase (MMP)-9, and MMP-13 in patients with coronary heart disease (CHD) complicated by acute gout attacks.

Methods: Ninety-two patients with CHD and acute gout attacks admitted to our hospital from October 2021 to January 2023 were randomly divided into an observation group and a control group, with 46 patients in each group. The control group received conventional treatment, while the observation group received colchicine adjuvant therapy on top of the control group's treatment for 7 days. Clinical efficacy in both groups was assessed. Before and after treatment, cardiac function indicators (left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular posterior wall thickness (LVPWT)), vascular endothelial function indicators (sICAM-1, endothelin-1 (ET-1), and vascular endothelial growth factor (VEGF)), inflammatory factors (NALP3, MMP-9, MMP-13) levels, changes in immune cell populations (CD3+ lymphocytes, CD3+CD4+ lymphocytes, CD3+CD8+ lymphocytes ratio, and CD3+CD4+/CD3+CD8+ ratio) were compared, and the incidence of adverse reactions was recorded. Three months after treatment, the occurrence of major adverse cardiovascular events was also recorded.

Results: The total effective rate in the observation group was significantly higher than that in the control group (93.48% vs 79.07%) (P<0.05). After treatment, the levels of NALP3, MMP-9, and MMP-13 in both groups decreased, with the observation group being lower than the control group (P<0.05). After treatment, LVPWT and LVEDD levels in the observation group were lower than those in the control group, and LVEF was higher (P<0.05). After treatment, the levels of ET-1 and sICAM-1 in the observation group were lower than those in the control group, and VEGF levels were higher (P<0.05). After treatment, the proportions of CD3+ lymphocytes, CD3+CD4+ lymphocytes, and CD3+CD4+/CD3+CD8+ ratio were significantly higher in the observation group than in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). The occurrence of major adverse cardiovascular events in the observation group was lower than that in the control group (2.17% vs 13.04%).

Conclusion: Colchicine adjuvant therapy improves the efficacy of CHD patients with acute gout attacks, helps improve cardiac function and vascular endothelial function, reduces serum levels of NALP3, sICAM-1, MMP-9, and MMP-13, enhances patient immunity, and controls disease progression.

Predictive value of systemic immune inflammation index combined with coagulation index in traumatic coagulopathy in patients with severe trauma

Chen Wang, Yongyong Huang, Shiyun Liao, Jiming Song — Sun, 25 Aug 2024 00:00:00 +0200

Summary

Background: To explore the predictive value of systemic immune inflammation index combined with coagulation index in traumatic coagulation disease (TIC) in patients with severe trauma.

Methods: The clinical data of patients with severe trauma treated in our hospital from January 2022 to December 2022 were retrospectively selected. According to the outcome of TIC, the patients were divided into TIC group and non-TIC group, TIC group (n = 50) and non-TIC group (n = 50). The general data, SII and individual indexes of the two groups were compared, and the influencing factors of TIC were analyzed by multivariate Logistics regression. ROC analysis of systemic immune inflammation index combined with blood coagulation index to predict traumatic coagulation in patients with severe trauma.

Results: There was no significant difference in general data between the two groups. SII in TIC group was significantly higher than that in non-TIC group. NEU, PLT count, APTT, FIB D and PT in TIC group were higher than those in non-TIC group, while LYM, FIB was lower than that in non-TIC group. Logistics regression analysis showed that APTT, D-Dimer, FIB, PT and SII were independent influencing factors of TIC in patients with severe trauma. The area under the curve of TIC in patients with severe trauma with SII combined with coagulation index was 0.883, and the standard error was 0.032 (95%CI:0.8195~0.9461). The best cut-off value was 0.65.The sensitivity and specificity were 80.3, 84.2 respectively.

Conclusions: SII combined with coagulation index has high predictive value for TIC in patients with severe trauma. By monitoring these indexes, we can more accurately predict the occurrence of TIC and take effective treatment measures in time.

Analysis of risk factors for radiation-induced oral mucositis for nasopharyngeal carcinoma and prognostic value of EGF and sTREM-1

Puyu Jiang, Po Xue, Jiani Wu — Tue, 27 Aug 2024 00:00:00 +0200

Objective: We were dedicated to analyzing risk factors of radiation-induced oral mucositis (RIOM) for nasopharyngeal carcinoma (NPC) and the correlation between epidermal growth factor (EGF), soluble myeloid cell expression trigger receptor-1 (sTREM-1) and disease severity and their prognosis value.

Methods: A total of 124 patients with NPC who received radiotherapy from March 2013 to November 2016 were selected, and divided into the study group (n = 68) and the control group (n = 56) regarding the presence of RIOM. The risk factors of RIOM were evaluated by multivariate logistic regression, and correlation between EGF and sTREM-1 and the severity of RIOM and their predictive value were also assessed.

Results: Age (>55 years), smoking, poor oral hygiene and oral pH < 7 were risk factors for RIOM, and the use of oral mucosal protective agents was the protective factor (P < 0.05). The level of sTREM-1 increased and that of EGF reduced with the severity of the disease (P < 0.05). EGF level of patients was negatively correlated with the grade of RIOM; the combined detection of EGF and sTREM-1 levels had a greater AUC in predicting the prognosis of patients than sTREM-1 detection alone (P < 0.05).

Conclusion: In short, age (> 55 years), smoking, poor oral hygiene, and oral PH < 7 are risk factors for RIOM for NPC. The use of oral mucosal protective agents is a protective factor. EGF and sTREM-1 levels are associated with RIOM severity and indicate predictive value for patient outcomes.

The significance of plasma biomarkers in predicting heart failure among patients with acute myocardial infarction

Tue, 27 Aug 2024 00:00:00 +0200

Background: Acute myocardial infarction (AMI) is characterized by high mortality and disability rates. Timely and effective revascularization has saved the lives of many patients. However, some patients develop complications such as heart failure (HF) following myocardial infarction, which significantly affects their quality of life and may even be life-threatening. Therefore, the search for effective biomarkers to predict the occurrence of HF after AMI, along with early prevention and treatment strategies, will greatly improve clinical outcomes for patients with post-myocardial infarction HF

Methods: A total of 170 patients with acute myocardial infarction (AMI) were enrolled in this study, including 44 patients with post-AMI heart failure (HF) and 126 patients with post-AMI non-HF. We measured the serum biomarkers NT-proBNP, cTNT, PLR, NLR, and GDF-15 in all patients using enzyme-linked immunosorbent assay (ELISA). Subsequently, we performed t-tests to assess the predictive value of these biomarkers for post-AMI heart failure (HF).

Results: In the group of HF patients, cTNT, NT-proBNP, GDF-15 and NLR was significantly higher than in the group without HF, but PLR was not .The AUC of NLR to predict HF after AMI was 0.632 (95%CI:0.542-0.723), P=0.010, with a cut-off value of (3.86×10⁹⁾/L , GDF-15 was 0.661 (95%CI0.560-0.763), P=0.002, with a cut-off value of 1.35 ng/mL, and NT-proBNP was 0.82 (95%CI0.723-0.876), P<0.001, with a cut-off value of 1444 pg/mL.

Conclusions: In five biomarkers, there is predictive value in NT-proBNP , NLR, GDF-15 for patients with HF after AMI .

Correlation of GLUT4, LEPR, and TNF-α with endometrial receptivity in women with polycystic ovarian syndrome-induced infertility

Yan Dong, Wei Kong, Yifei Li, Yan Liu, Lin Li, Yan Li — Wed, 11 Sep 2024 00:00:00 +0200

Objective: To analyze the correlation of glucose transporter 4 (GLUT4), leptin receptor (LEPR) and tumor necrosis factor-α (TNF-α) with endometrial receptivity in patients with polycystic ovarian syndrome (PCOS)-induced infertility, so as to provide clinical evidence for future diagnosis and treatment of PCOS-induced infertility. Methods: Forty-two patients with PCOS-induced infertility admitted to our hospital from June 2020 to August 2023 (research group), as well as 35 concurrent cases of simple PCOS (control group) and 32 healthy women (normal group) were selected as the research participants. Peripheral blood GLUT4, LEPR and TNF-α levels were detected in all participants, and the diagnostic value of the three for PCOS in healthy women and for PCOS-induced infertility in PCOS patients was analyzed. In addition, the endometrial thickness and the endometrial blood flow pulsation index (PI) and resistance index (RI) of patients in the research group were measured, and the correlation of GLUT4, LEPR, and TNF-α with endometrial receptivity was discussed. Results: GLUT4 was lower in the research group compared with control and normal groups, while LEPR and TNF-α were higher (P<0.05); the control group showed lower GLUT4 and higher LEPR and TNF-α levels than the normal group (P<0.05). The diagnostic sensitivity and specificity of GLUT4, LEPR and TNF-α combined assay for PCOS-induced infertility in PCOS women were 88.57% and 75.00%, respectively, and those for PCOS in healthy women were 78.57% and 60.00%, respectively (P<0.05). In the research group, GLUT4 was positively correlated with endometrial thickness and negatively linked to RI and PI; while LEPR and TNF-α were negatively associated with endometrial thickness and positively correlated with RI and PI (P<0.05). Conclusions: GLUT4, LEPR and TNF-α are closely related to endometrial receptivity in patients with PCOS-induced infertility, and their combined detection can effectively evaluate the occurrence of PCOS and PCOS-induced infertility.

Serum galectin-3 and fibroblast growth factor-23 levels in relation with type 2 diabetes and cardiovascular risk

Thu, 03 Oct 2024 00:00:00 +0200

Aim: The clinical utility of galectin-3 and fibroblast growth factor 23 (FGF-23) needs to be further explored since previous studies show divergent results in relation to type 2 diabetes (T2D) and cardiovascular risk. Hence, the aim of this research was to explore galectin-3 and FGF-23 in relation to T2D, as well as to examine the potential association of these biomarkers with atherosclerotic cardiovascular disease (ASCVD) risk score in Montenegrin adults.

Methods: A total of 35 T2D patients and 36 controls were consecutively enrolled. Serum galectin-3 and FGF-23 were determined by ELISA. ASCVD risk score was calculated.

Results: Higher serum galectin-3 levels were shown in T2D patients (p=0.016) in comparison with control group. The increase in galectin-3 levels for 1 ng/mL showed 8.5% higher probability for T2D occurrence (OR=1.085, p=0.015). FGF-23 levels did not differ between control and T2D group. Serum galectin-3 correlated with FGF-23 (ρ=0.390, p=0.001). Both galectin-3 (ρ=0.306, p=0.010) and FGF-23 (ρ=0.332, p=0.005) correlated with ASCVD risk score in bivariate Spearman’s correlation analysis, but these correlations were not retained in binary logistic regression analysis.

Conclusion: Serum galectin-3 levels, but not FGF-23 are higher in T2D patients. Serum galectin-3 correlated with FGF-23. Although both biomarkers correlated with ASCVD risk score, a further statistical analysis did not confirm their independent associations with cardiovascular risk. Studies with large sample size are needed to further explore this issue.

Comprehensive analysis of α- and β-thalassemia genotypes and hematologic phenotypes

Heng Wang, Hai Huang, Yaping Chen, Dan Xie, Bangquan An, Shengwen Huang — Thu, 03 Oct 2024 00:00:00 +0200

Background: Guizhou Province is an area with high incidence of thalassemia. However, there are few large-sample studies on the correlation between genotypes and phenotypes in Guizhou Province. In this study, the phenotypes and genotypes of 1174 patients with thalassemia in Guizhou Province were collected, and the relationship between different genotypes and phenotypes was analyzed, providing a more accurate basis for genetic counseling, prevention and control of thalassemia.

Methods: A total of 1174 patients with thalassemia were collected in Guizhou Provincial People's Hospital from October 2020 to December 2021 by PCR-reverse dot blot (RDB) hybridization assay, and their red blood cell (RBC), hemoglobin (Hb), mean erythrocyte volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red blood cell distribution width (RDW), hemoglobin (HbA), hemoglobin A2(HbA2), and fetal hemoglobin (HbF) data were collected. The relationship between different genotypes and phenotypes was analyzed.

Results: Among 1174 cases of thalassemia or carriers, there were 617 cases of α-thalassemia, 512 cases of β-thalassemia, 45 cases of coinheritance of α- and β-thalassemia. The severity of anemia between α-thalassemia was positively correlated with the decrease of non-functional copy number of α-globin gene. The degree of anemia in non-deletion α-thalassemia was greater than that in deletion α-thalassemia. In β-thalassemia, β⁰ gene mutation did not produce β-globin, and β⁺ mutation expressed some β-globin, but it was lower than normal level. β⁰/β⁰ had no β-globin production, and long-term blood transfusion was required to maintain life. Compared with α-thalassemia, the degree of anemia in β-thalassemia whose clinical type was same as α-thalassemia was more serious. The anemia degree of coinheritance of α- and β-thalassemia was less than that of simple α-thalassemia or β-thalassemia.

Conclusion: The clinical phenotype of thalassemia is influenced by molecular mechanism, and the two kinds of thalassemia can interact with each other. The clinical severity is positively correlated with the imbalance of α peptide chain and β peptide chain. A comprehensive understanding of the hematologic phenotype differences between different genotypes and subtypes of thalassemia can provide more accurate data for genetic counseling of thalassemia.

Investigation of 25-hydroxy vitamin D deficiency in healthy adults aged 18-65 years in Istanbul, Türkiye

Gozde Ulfer — Sat, 02 Nov 2024 00:00:00 +0100

Background :To determine the prevalence of 25-hydroxy vitamin D (25(OH)D) deficiency in healthy adult patients who presented to our hospital in Istanbul province and to present the difference between vitamin 25(OH)D levels by gender, age group, season, and month.

Materials and Methods: The vitamin 25(OH)D levels of 9,778 adults who presented to the internal medicine checkup outpatient clinic of our hospital between January 2022 and December 2023 were analyzed retrospectively. Individuals with chronic disorders were excluded from the study. The adult patients included in the study were divided into two groups by age (18-50 and 51-65 years). Serum 25(OH)D levels were measured using the electrochemiluminescence immunoassay method. A serum 25(OH)D level was regarded as deficient if below 20 ng/mL, insufficient if 20-30 ng/mL, and sufficient if above 30 ng/mL. The 25(OH)D levels of the patients were investigated by age, gender, season, and month.

Results: After measurement, vitamin D levels were deficient in 57.2% of the patients (n=5,592), insufficient in 28.2% (n=2,756), and sufficient in 14.6% (n=1,430). The mean vitamin D level of the 18-50 age group was significantly lower than that of the group 51-65 age group (p=0.001; p<0.01). The vitamin D levels did not statistically significantly differ by gender (p=0.085, p>0.05). The mean vitamin D levels were 17.99±10.88 ng/mL in winter, 18.11±12.69 ng/mL in spring, 22.08±11.58 ng/mL in summer, and 21.67±10.82 ng/mL in fall. There were statistically significant differences according to the season and month of hospital presentation (p=0.001; p<0.01).

Conclusion: The prevalence of vitamin D deficiency (below 20 ng/mL) in healthy adults aged 18-65 years in Istanbul was 57.2%. This prevalence varied across seasons and months, indicating that sunlight is not being used sufficiently. Vitamin D deficiency in Istanbul presents a major problem that needs to be remedied.

- Analysis of the Effects of Group Progressive Resistance Training on Interleukin-8 (IL-8), Interleukin-18 (IL-18), Interleukin-6 (IL-6), Interleukin-12 (IL-12) and VO2max, VEmax, O2pulsemax, HRmax, and mMRC in Elderly Patients with Chronic Obstructive Pulm

Yijia Sun — Thu, 03 Oct 2024 00:00:00 +0200

Objective To investigate the effects of implementing group progressive resistance training on Maximal Oxygen consumption (VO_2max), Maximum Ventilation per minute (VE_max), Maximeal Oxygen pulse (O₂pulse_max), Maximum Heart Rate (HR_max), and Modified Medical Research Councildyspneascale (mMRC) in elderly patients with chronic obstructive pulmonary disease. Method: 114 elderly patients with chronic obstructive pulmonary disease treated in the hospital from May 2022 to May 2024 were collected and divided into two groups based on different training methods. The conventional group (n=57) received routine rehabilitation training, while the organization group (n=57) received group progressive resistance training. To compare the improvement of training compliance, Cardiopulmonary Exercise Testing (CPET) parameters, serum inflammatory factors, lung function indicators, and mMRC score between two groups before training, 2 weeks of training, and 4 weeks of training. Results: Before training, there was no statistically significant difference (P>0.05) between the two groups in terms of Training Compliance Score (TCS), CPET parameter indicators, serum inflammatory factors, and mMRC score. After 2 weeks and 4 weeks of training, both groups of patients showed an increase in reported scores on training frequency, training intensity, autonomous training, and self training. The levels of VO_2max, VE_max, O₂pulse_max, and HR_max in both groups increased. In the comparison of these two groups of indicators, organization was higher than conventional group, and the difference was statistically significant (P<0.05). The levels of Interleukin-8 (IL-8), Interleukin-18 (IL-18), Interleukin-6 (IL-6), and Interleukin-12 (IL-12) decreased in both groups, and the mMRC scores of both groups decreased. The comparison between the two results showed that the organization was lower than conventional, and the difference was statistically significant (P<0.05). Conclusion: Group progressive resistance training can help improve the compliance of elderly patients with chronic obstructive pulmonary disease with training, reduce the body's inflammatory response, improve VO_2max, VE_max, O₂pulse_max, HR_max levels, and alleviate breathing difficulties.

. Analyzing the serum biochemical factors that influence early neurological deterioration in ischemic stroke patients and developing a nomogram prediction model

Xiaoni Zhan, Yunyun Xu, Rongrong Ma — Thu, 03 Oct 2024 00:00:00 +0200

Objective: To investigate the risk factors associated with early neurological deterioration (END) in ischemic stroke (IS) patients and develop a predictive nomogram model. Methods: General clinical data from 220 IS patients treated between December 2022 and November 2023 were collected for observation. Based on the National Institutes of Health Stroke Scale (NIHSS) in the United States, patients were categorized into two groups: END (n = 69) and non-END (n = 151). Basic demographics, medical history, and biochemical test results of both groups were compared. Influencing factors were identified using the least absolute shrinkage and selection operator (LASSO) method, and these variables were included in a multivariate logistic regression analysis to construct a nomogram for predicting END in IS patients. Model performance was evaluated using internal validation with the Bootstrap method, assessing discrimination, calibration, and clinical validity. Results: Factors such as history of diabetes, fasting plasma glucose (FBG), triglyceride (TG), homocysteine (Hcy), and C-reactive protein (CRP) were identified as single factors for early functional deterioration in IS patients (P<0.05). A logistic regression model was established with END as the dependent variable and significant single factors (P<0.05) as independent variables. The results indicated that diabetes history (OR = 1.398, P = 0.301), TG (OR = 6.149, P<0.05), ASPECT score (OR = 7.641, P<0.05), FBG (OR = 2.172, P<0.05), CRP (OR = 1.706, P<0.05), NIHSS score 7 days post-admission (OR = 1.336, P<0.05), and Hcy (OR=1.425, P<0.05) were independent risk factors for END in IS patients (P<0.05). ROC analysis showed an ASPECT area under the curve of 0.910 (95% CI:0.864 to 0.944), with 84.06% sensitivity and 86.09% specificity. Hcy had an area under the curve of 0.808 (95% CI:0.750 to 0.858), with 79.71% sensitivity and 70.20% specificity. FBG had an area under the curve of 0.847 (95% CI:0.793 to 0.892), with 69.57% sensitivity and 95.36% specificity. TG had an area under the curve of 0.937 (95% CI: 0.896 - 0.965), with 91.30% sensitivity and 82.78% specificity. NIHSS had an area under the curve of 0.857 (95% CI: 0.803-0.900), with 89.86% sensitivity and 70.20% specificity. A nomogram model for END risk prediction was constructed based on the logistic regression analysis results, assigning preliminary scores for each of the 9 predictive factors. The total score, ranging from 0-100 points, was used to predict END risk in patients (0-100%).The constructed nomogram model showed that ASPECT was 59.2, Hcy was 84.0, FBG was 61.4, TG≧7.0 mmol/L was 39.4 and NIHSS was 98.1 with a total score of 345.7 which predicted the risk of END at 68.9%. Conclusion: ASPECT, Hcy, FBG, TG and NIHSS are independent influencing factors of END after IS. On this basis, a visual predictive nomogram model is constructed to accurately predict the risk of END in patients.

Influence of TMPRSS6 genotype on iron status parameters in stable COPD patients

Thu, 07 Nov 2024 00:00:00 +0100

Background: The SNP rs855791 has been linked to increased hepcidin levels, variations in serum iron, transferrin saturation and red blood cell indices. Our goal was to determine the prevalence of this polymorphism among COPD patients and to assess its impact on iron status parameters including hepcidin in patients with stable COPD.

Methods: We analysed iron status parameters and genetic data form 94 COPD patient: 29 patients with wild-type genotype (WT group) and 65 patients with either homozygous or heterozygous genotype (HH group). Additionally, the prevalence of SNP rs855791 was assessed in 192 volunteers.

Results: The frequency distribution of SNP rs855791 was comparable between the COPD patients and control subjects (p=0.791). Iron status parameters were within their respective reference values and did not show neither statistically nor clinically significant difference between the WT and HH group of COPD patients. However, after excluding patients with (sub)clinical vitamin B12 deficiency and/or hypoxemia, WT group of patients exhibited significantly lower erythropoietin levels (p=0.015). The area under the curve for EPO was 0.688 (95% CI: 0.545-0.830, p=0.015), with an optimal cut-off of 9.74, sensitivity of 61.2% (95% CI: 58.1-64.3) and specificity of 65.0% (95% CI: 61.8-68.3).

Conclusion: In patients with stable COPD, iron status parameters do not differ between WT and HH group of patients. After excluding those with (sub)clinical vitamin B12 deficiency and/or hypoxia, only statistical and not clinical difference in EPO levels was observed suggesting that EPO may regulate hepcidin levels and thus influence the development of iron deficiency and/or anaemia.

. The clinical value of serum hyaluronic acid, procollagen III, N-terminal propeptide levels sST2 and cfDNA in children with severe pneumonia complicated by myocardial damage

Haoran Jia — Thu, 03 Oct 2024 00:00:00 +0200

【Abstract】Objective: The paper aimed to explore the clinical value of serum hyaluronic acid, procollagen III, N-terminal propeptide levels sST2 and cfDNA in guiding strategies for children with severe pneumonia complicated by myocardial damage. Methods: 140 children with severe pneumonia admitted to our hospital from May 2022 to April 2024 were clinically recruited as research subjects. According to whether the patients had myocardial damage, they were separated into a group with complicated myocardial damage (n=90) and a group without complicated myocardial damage. group (n=50). Children with myocardial damage were separated into a control group and an observation group. The control group (n=45) was given traditional care, and the observation group (n=45) was based on biomarkers (sST2 and cfDNA) levels guide the development of nursing strategies. Statistics of patients' general information based on clinical files. The patient's serum hyaluronic acid, procollagen III, N-terminal propeptide, sST2 and cfDNA levels were detected through biochemical analysis. Logistic regression was used to unpack the risk element affecting myocardial damage in children with pneumonia. The effectiveness of each biomarker in predicting severe pneumonia complicated by myocardial damage was analyzed based on the ROC curve. The levels of myocardial injury markers NT-proBNP, CK, CK-MB and C-reactive albumen in the control group and observation group were tested by enzyme-linked immunosorbent assay and enzyme activity assay. The clinical treatment effects of the two groups of patients were compared. Results: There was no distinguish in the general record of the two groups (P>0.05). The serum levels of hyaluronic acid, procollagen III, N-terminal propeptide, sST2 and cfDNA in invalids with complicated myocardial damage were higher than the group without myocardial damage (P<0.05). Hypoalbuminemia, age <3 years old, elevated levels of serum hyaluronic acid, procollagen III, N-terminal propeptide, sST2 and cfDNA were independent risk factors for myocardial damage in children with severe pneumonia (P<0.05). The AUC of serum hyaluronic acid in predicting myocardial injury in children with severe pneumonia was 0.70, with a sensitivity of 70% and a specificity of 65%. The predicted AUC of procollagen III was 0.68, the sensitivity was 65%, and the specificity was 70%. The predicted AUC of NT-proBNP was 0.78, the sensitivity was 75%, and the specificity was 80%. The predicted AUC of sST2 was 0.76, the sensitivity was 78.43%, and the specificity was 73.25%. The predicted AUC of cfDNA was 0.75, the sensitivity was 76.49%, and the specificity was 74.31%. The joint prediction AUC was 0.92, the sensitivity was 87.60%, and the specificity was 77%. The serum NT-proBNP, CK, CK-MB and C-reactive protein levels in the observation group were lower than control group (P<0.05).The clinical symptoms and effective rates of the observation group were higher than the control group (P<0.05). The ineffective proportion decreased than the control group (P<0.05). Conclusion: Serum hyaluronic acid, procollagen III, NT-proBNP, sST2 and cfDNA, as biomarkers, have significant value in predicting severe pneumonia complicated by myocardial damage.

Correlation and clinical significance of placental tissue selectin (E), angiotensin II and its receptors, and oxidized lipid levels in patients with preeclampsia

Sun, 13 Oct 2024 00:00:00 +0200

Background: The purpose was to analyze the levels of placental tissue selectins (E), angiotensin II (AngII) and its receptors (ATRs), and oxidized lipids (malondialdehyde (MDA), 8-isoprostane 2a) in patients with preeclampsia (PE). (8-iso-PGF2a)) correlation and clinical significance.

Methods: Select 30 PE pregnant women who were admitted to our hospital from March 2023 to January 2024 as the case group, and select another 30 normal pregnant women who were registered in our hospital during the same period as the health group .The general information of the two groups and placental tissue selectin (E), plasma AngII, ATRs, placental tissue MDA, 8-iso-PGF2a and blood pressure levels (systolic blood pressure (SBP), diastolic blood pressure (DBP)) were compared. Pearson correlation was used to analyze the correlation between the expression of selectin (E), AngII, ATRs, MDA, 8-iso-PGF2a and the levels of SBP and DBP. Linear regression analysis was used to analyze the correlation between the expression of selectin (E), AngII, ATRs, MDA, 8-iso-PGF2a, SBP, DBP and other indicators and the occurrence of PE. ROC curves were drawn to analyze the value of placental tissue selectin (E), AngII, ATRs, MDA, and 8-iso-PGF2a individually and jointly in predicting the risk of PE.

Results The expression of placental tissue selectin (E), AngII, ATRs, MDA, 8-iso-PGF2a and the levels of SBP and DBP in the case group were higher than those in the healthy group (P<0.05). Pearson correlation showed that the expression levels of placental tissue selectin (E), AngII, ATRs, MDA, and 8-iso-PGF2a were positively correlated with SBP and DBP (r>0, P<0.05). Linear regression analysis showed that placental tissue selectin (E), AngII, ATRs, MDA, 8-iso-PGF2a expression and SBP, DBP levels were closely related to the occurrence of PE (P<0.05). The results of drawing the ROC curve showed that the AUCs of placental tissue selectin (E), AngII, ATRs, MDA, and 8-iso-PGF2a expression in predicting the occurrence of PE were 0.854, 0.756, 0.745, 0.885, 0.900, and 0.905 respectively.

Conclusion Placenta tissue selectin (E), AngII, ATRs, MDA, and 8-iso-PGF2a are highly expressed in pregnant women with PE. The expression of the above indicators is related to maternal blood pressure levels and the occurrence of PE, and their combination can effectively increase predictive value of the risk of PE.

prof Analysis of CXCL12 and S100A12 levels in peripheral blood and synovial fluid and their correlation with severity in patients with knee osteoarthritis

Yili Ye — Fri, 02 Aug 2024 00:00:00 +0200

Abstract: To investigate the expression of CXCL12 and S100A12 in peripheral blood (PB) and synovial fluid (SF) of patients with knee osteoarthritis (OS) and to analyze the correlation between them and the severity of knee OS. 60 patients with kneeOS treated in our hospital from January 2020 to December 2022 were selected as the experimental group, and 60 healthy knee joints with similar age were selected as the control group. The fasting venous blood of 120 subjects was drawn in the early morning, and the SF was extracted during joint operation or sodium hyaluronate injection. Put the collected PB and SF in the refrigerator at-80℃. The levels of CXCL12 and S100A12 in PB and SF were detected by enzyme linked immunosorbent assay (Elisa). The correlation between the levels of CXCL12 and S100A12 in PB and SF and Kmurl L grade and WOMAC score. The levels of CXCL12 and S100A12 in PB and SF in the observation group were raised than those in the control group. There were significant differences in the levels of CXCL12 and S100A12 in PB and SF in the experimental group. The higher the Kmurl grade of knee OS, the higher the concentration of CXCL12 and S100A12 in PB and SF. The levels of CXCL12 and S100A12 in PB of knee OS were positively correlated with WOMAC score (r = 0.767, 0.521 respectively, P < 0.05), see figure 1. The levels of CXCL12 and S100A12 in SF of knee OS were positively correlated with WOMAC score (r = 0.663, 0.357 respectively, P < 0.05). The levels of CXCL12 and S100A12 in PB and SF are positively correlated with the severity of knee OS. The levels of CXCL12 and S100A12 in PB and SF can provide basis for the evaluation and prognosis of knee OS.