Journal of Medical Biochemistry最新文献

Background: The temperature of irrigation fluid is a crucial yet frequently neglected factor affecting perioperative hemostasis during transurethral resection of the prostate (TURP). Although the clinical implications of hypothermia are well-documented, its biochemical effects on coagulation processes and endothelial markers are not fully elucidated.

Methods: Ninety patients with benign prostatic hyperplasia undergoing TURP were randomized into three groups based on irrigation fluid temperature: hypothermia (24-26 °C), mild hypothermia (28-35 °C), and preheating (36-37 °C). Peripheral blood was collected preoperatively and 6 h postoperatively to evaluate coagulation and endothelial indices, including prothrombin time (PT), activated partial thromboplastin time (APTT), platelet count (PLT), platelet aggregation rate (Pagt), and endothelin-1 (ET-1).

Results: Hypothermia significantly prolonged APTT and reduced PLT and Pagt compared with preheating (P < 0.05), indicating impaired intrinsic pathway activity and platelet dysfunction. PT remained unchanged across groups. ET-1 levels decreased in both hypothermia and preheating groups, with the greatest reduction in preheating, suggesting differential endothelial responses. Patients in the preheating group exhibited preserved coagulation stability and fewer adverse events (6.7%) compared with hypothermia (33.3%) and mild hypothermia (23.3%) groups (P = 0.038).

Conclusions: Hypothermic irrigation significantly prolonged APTT, reduced platelet count, and impaired aggregation capacity, while preheating maintained hemostatic homeostasis.

Background: This study aimed to characterize the expression profiles of the NOD-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome and its downstream effectors [Interleukin (IL)-1b, IL-18, and Gasdermin-D (GSDMD)] in degenerative knee osteoarthritis (KOA) and to establish an integrated biomarker model for predicting the likelihood of unfavorable rehabilitation outcomes.

Methods: We conducted a retrospective study involving 121 KOA patients and 94 age-matched healthy controls. Serum concentrations of NLRP3, IL-1 b, and IL-18 were quantified using ELISA, while GSDMD expression in peripheral blood mononuclear cells was assessed through flow cytometry. Conventional inflammatory markers (CRP ESR, and WBC) and neutrophil-to-lymphocyte ratio (NLR) were measured using automated analyzers. Receiver operating characteristic (ROC) curve analysis and multivariate logistic regression were performed to evaluate the diagnostic and prognostic utility of the integrated biomarker model.

Results: KOA patients exhibited significantly elevated levels of NLRP3, IL-1 b, IL-18, and GSDMD compared to healthy controls (P < 0.05). These biomarkers showed positive correlations with systemic inflammatory markers (CRP ESR) and negative associations with knee joint range of motion (ROM) (P < 0.05). The integrated biomarker model demonstrated robust diagnostic performance for KOA (AUC = 0.928, sensitivity 84.30% , specificity 87.23%). Notably, among treated patients, those with poor recovery (n=37) maintained significantly higher post-treatment levels of NLRP3 pathway components than those with favorable recovery (P < 0.05). The predictive model achieved excellent performance in identifying patients at risk of suboptimal rehabilitation (AUC = 0.911, sensitivity 94.59%, specificity 73.81%).

Conclusions: Our findings highlight the pivotal role of NLRP3 inflammasome activation and GSDMD-dependent pyroptosis in mediating poor rehabilitation outcomes in KOA. The predictive model achieved excellent performance in identifying patients at risk of suboptimal rehabilitation (AUC = 0.911, sensitivity 94.59%, specificity 73.81%).

Background: This study aimed to evaluate the association between low-cost inflammatory biomarkers and disease severity in ulcerative colitis (UC), with a focus on predicting acute severe ulcerative colitis (ASUC) and active disease (Mayo score >1).

Methods: An analytical cross-sectional study was conducted on 131 patients diagnosed with UC at Imam Khomeini Hospital, Iran, between 2022 and 2024. Demographic, clinical, and laboratory data - including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), CRP-to-albumin ratio (CAR), and faecal calprotectin - were collected. Disease activity was evaluated using the Mayo Endoscopic Score (MES). Statistical analyses included chi-square tests, ANOVA, and multivariable logistic regression adjusted for age, sex, and body mass index (BMI).

Results: The mean age of participants was 45.8± 15.9 years. Elevated inflammatory markers were observed (CRP: 39.1 ± 32.6 mg/L; ESR: 44 .0± 21.5 mm/hr). Defecation frequency S6/day was significantly associated with ASUC (c2(2) = 101.10, p< 0.001). After adjustment, PLR in the third quartile (14-20) was independently associated with ASUC (O R = 2.57, p= 0.034). The percentage of monocytes was significantly higher in ASUC patients (F(1, 30) = 6.52, p= 0.016). No significant associations were found for NLR or CAR. PLR also differed significantly between active and inactive UC groups (median [ IQR] : 133.87 [96.15-190.63] vs. 129.61 [102.15-209.98], p= 0.029), although its discriminatory power was limited.

Conclusions: PLR and monocyte percentage may serve as accessible indicators for assessing UC severity and identifying patients at risk for ASUC. These findings support the supplementary use of routine inflammatory blood indices in the management of UC, especially in resource-limited settings.

Background: To investigate the value of AFP combined with degamma-carboxylprothrombin (DCP), vitamin K absence or antagonist-II (PIVKA) in predicting the efficacy of transhepatic arterial chemoembolisation (TACE).

Methods: The clinical data of 69 patients with hepatocellular carcinoma (HCC) who received TACE at our hospital between March 2020 and December 2024 were retrospectively analysed. Changes in the serum AFP and DCP levels of patients before TACE and after two consecutive TACE operations were analysed. The therapeutic effect of TACE was evaluated using the MRECIST criteria. The changes in AFP and DCP levels were compared with the imaging data from the same period (mRECIST criteria). The measurement data were tested for normality, and comparisons between two groups that conformed to a normal distribution were performed using two-way independent sample t-tests. The Mann-Whitney U test was used to compare normally distributed data between the two groups. The c2 test was used to compare the counting data between the two groups, and the Mann-Whitney U test was used to compare the rank-counting data between the two groups. Spearman correlation analysis was used to explore the correlation between mRECIST grade and AFP and DCP levels. The value of each index in the diagnosis of patients in the remission group was analysed by subject working characteristic curve analysis.

Results: According to the mRECIST criteria, 38 patients were in the remission group, and 31 were in the nonremission group. After treatment, the AFP and DCP levels in the remission group were significantly lower than those in the non-remission group (Z=-3.366 and -4.065, P<0.05). There were statistically significant differences in AAFP ADCP AAFP%, and ADCP% between the remission group and the nonremission group (Z=-4.837, -5.597, -4.210, and -5.851, respectively; P<0.001). The mRECIST stage was negatively correlated with AAFP and ADCP (RS = -0.552 and -0.593, P<0.001). The area under the working characteristic curve of AAFP% was 0.796, that of ADCP% was 0.912, that of AAFP% + ADCP% combined was 0.921, and that of AAFP% + ADCP% had the most significant diagnostic value.

Conclusions: A combined analysis of serum AFP and DCP levels before and after TACE can be used to evaluate the therapeutic effect of TACE in patients with hepatocellular carcinoma.

Background: This study investigates the biochemical impact of low molecular weight heparin (LMWH) on key immunological, coagulation, and inflammatory markers in patients with hyperlipidemic acute pancreatitis (HLAP). The objective is to elucidate the role of LMWH in modulating serum immunoglobulins (IgA, IgG, IgM), coagulation parameters (PT, TT, FIB, APTT), proinflammatory cytokines (TNF-a, IL-6, IL-8), and digestive enzyme activity (amylase), thereby providing insight into its therapeutic mechanism.

Methods: A total of 100 HLAP patients treated between January 2022 and December 2024 were assigned to a control group (CG) receiving standard medical treatment, and an experimental group (EG) receiving standard treatment plus LMWH. Biomolecular markers were analysed to assess changes in coagulation dynamics, inflammatory signalling, immunoglobulin response, and lipid metabolism. Comparative analysis between groups was conducted to evaluate the biochemical effects of LMWH.

Results: Compared to the control group, the LMWH-treated group demonstrated significant reductions in inflammatory mediators: TNF-a decreased by 38.2%, IL-6 by 34.5%, and IL-8 by 36.7% (all P<0.01). Serum amylase and urinary amylase levels declined by 41.3% and 39.6%, respectively (P<0.01). Coagulation profiles improved with PT prolonged by 13.8%, TT by 15.2%, FIB reduced by 12.4%, and APTT normalised by a 17.1% increase (P<0.01). Immune markers IgA, IgG, and IgM increased by 22.5%, 26.3%, and 24.8%, respectively (P<0.01). Additionally, the LMWH group showed better lipid regulation (TG reduced by 45.7%) and a lower complication rate (6% vs. 22%, P=0.02).

Conclusions: LMWH exhibits a multifaceted biochemical effect in HLAP patients, encompassing anti-inflammatory action, immunomodulation, and correction of coagulation abnormalities. These findings support LMWH as a potential adjunctive therapeutic agent in the biochemical management of HLAP warranting further molecular studies to explore its mechanistic pathways.

Background: Emerging evidence suggests that vitamin D may play a crucial role in the development of diabetic retinopathy (DR). However, the extent of vitamin D deficiency in individuals with DR remains uncertain. This study aimed to evaluate serum vitamin D levels in adults with DR.

Methods: A literature was retrieved using the Embase, PubMed and Cochrane databases to identify observational studies that evaluated the levels of 25(OH)DS, 1,25(OH)2D5 or total 25(OH)D in the serum of patients with DR. A total of 31 independent studies were included for meta-analysis.

Results: The pooled mean concentration of total 25(OH)D among individuals with diabetes was 16.04 ng/mL (95% CI: 15.13-16.96; I2 = 98.8%), while the mean serum level of 25(OH)D3 in those with DR was 10.68 ng/mL (95% CI: 5.94-15.41; I2 = 99.5%), both significantly below the normal reference range. The average concentration of 1,25(OH)2D3 was 31.14 pg/mL (95% CI: 24.35-37.94; I2 = 98.8%).

Conclusions: The evidence from this meta-analysis indicates an association between vitamin D deficiency and an increased risk of DR.

We present a case of hemolytic disease of the newborn (HDN) due to maternal alloimmunisation with anti-E and anti-c antibodies, resulting in severe anaemia, respiratory insufficiency, and hyperbilirubinemia in a term male neonate. Haematological evaluation using the automated analyser Sysmex XN-3100 (Sysmex Corporation, Kobe, Japan) yielded an erroneously elevated white blood cell (WBC) count of 1 6 3 x 1 0 / L , later manually corrected to 2 8 x 1 0 / L due to extreme nucleated red blood cell (NRBC) interference (> 2,000 NRBCs per 100 WBCs). This case illustrates the analytical limitations of modern haematology analysers in neonates with pronounced erythroblastosis. It emphasises the essential role of manual peripheral blood smear review and interdisciplinary clinical-laboratory correlation in ensuring diagnostic accuracy.

Background: To investigate the effects of a Health Promotion Model (HPM)-based comprehensive intervention on thyroid hormones, glucose-lipid metabolism, and inflammatory markers in patients with hyperthyroidism (HT) complicated by diabetes mellitus (DM), and to elucidate the potential mechanisms underlying these effects.

Methods: A total of 142 patients diagnosed with HT and DM between January 2024 and January 2025 were enrolled. Participants were divided into two groups: the HPM group (n = 64), which received a structured HPM-based intervention, and the conventional group (n = 78), which underwent standard management. Laboratory assessments were conducted before and after the intervention to evaluate thyroid hormones (FT3, FT4, TSH), glucose-lipid metabolism parameters (fasting plasma glucose [FPG], glycated hemoglobin [HbA1c], total cholesterol [TC], triglycerides [TG]), and inflammatory markers (high-sensitivity C-reactive protein [hs-CRP], interleukin-1p/6 [IL-1 b/IL-6]). Data were analyzed using SPSS 24.0.

Results: Compared to the conventional group, the HPM group exhibited significantly greater improvements in thyroid function, with more pronounced reductions in FT3 and FT4 (P< 0.001) and a greater increase in TSH (P< 0.001). Regarding glucose-lipid metabolism, significantly larger decreases in FPG, HbA1c, TC, and TG were identified in the HPM group (P< 0.001). Among inflammatory markers, the HPM group showed significant reductions in hs-CRP IL-1 b, IL-6, MIP-1a, and MMP-9 (P< 0.001), whereas the conventional group only exhibited improvements in hs-CRP and IL-1 b (P< 0.001).

Conclusions: The HPM-based intervention effectively disrupts the 'thyroid-glycolipid-inflammation' axis in HT-DM comorbidity through cognitive restructuring, behavioral modification, and environmental support.

Background: This study aimed to develop an early prediction model for postoperative acute kidney injury (AKI) in patients with acute type A aortic dissection (ATAAD) undergoing total a rch replacement (TAR) combined with frozen elephant trunk (FET) implantation. Specifically, it investigated the association between preoperative cystatin C levels and postoperative AKI while incorporating other relevant risk factors into the analysis.

Methods: A single-centre case-control study was conducted, including 202 patients treated between January 2018 and December 2019. Patients were divided into an AKI group (n=73) and a non-AKI group (n = 129) based on postoperative renal outcomes.

Results: Univariate analysis revealed that a preoperative history of hypertension (P = 0.013), white blood cell (WBC) count (P< 0.001), serum creatinine (P < 0.001), blood urea nitrogen (P < 0.001), and cystatin C (P< 0.001) were significantly associated with postoperative AKI. Postoperative variables, including duration of mechanical ventilation (P< 0.001), length of ICU stay (P< 0.001), acute respiratory failure (P = 0 .0 1 8 ), acute cerebrovascular events (P= 0.042), and 30-day mortality (P< 0.001) also differed significantly between groups. Multivariate logistic regression incorporating preoperative variables identified cystatin C (OR: 11.541, 95% CI: 3.811 -34.953 , P< 0.001), WBC count (OR: 1.122, 95% CI: 1.013-1.242, P= 0.028), and history of hypertension (OR: 3.080, 95% CI: 1.188-7.990) as independent risk factors for postoperative AKI. Survival analysis further confirmed a significant association between preoperative cystatin C levels and the incidence of AKI in both crude and subgroup analyses. A clinical prediction model was developed based on the multivariate results. Internal validation showed a concordance index (C-index) of 0.804 for the training set and 0.609 for the validation set.

Conclusions: Preoperative cystatin C level was identified as an independent predictor of postoperative AKI. Incorporating cystatin C with other preoperative clinical risk factors may enhance the predictive accuracy for postoperative AKI in patients with ATAAD undergoing total arch replacement with FET implantation.

Background: The diagnostic value of AFP CA19-9 and CEA as biomarkers in gastric carcinoma remains uncertain. This research explores their role in forecasting patient survival and disease progression.

Methods: A total of 630 early-stage gastric cancer patients who underwent gastrectomy between January 2018 and June 2024 were analysed. Pathological evaluations were conducted, and serum concentrations of CEA, CA19-9, and AFP were measured. Statistical methods were employed to evaluate the relationship between these markers, tumour characteristics, and their impact on prognosis.

Results: The mean age of patients was 59 years. The 1-year and 5-year survival rates were 98.3% and 91.4%, respectively. The positivity rates for CEA, CA19-9, and AFP were 5.1%, 6.2%, and 2.3%, respectively, resulting in an overall detection rate of 12.4%. The mean serum concentration of CEA was 4.8 ng/mL, the median concentration of CA19-9 was 45.2 U/mL, and the concentration range of AFP was from 3.5 ng/mL to 12.7 ng/mL. Elevated levels of CEA and CA19-9 were associated with metastasis of lymph nodes and higher tumour stages, while AFP showed no meaningful association with disease characteristics. Multivariate analysis identified age over 65, lymph node metastasis, and high CEA levels as independent risk factors for poorer outcomes in gastric cancer.

Conclusions: Although CEA, CA19-9, and AFP individually show low detection rates in gastric cancer, their combined use improves diagnostic accuracy. Elevated CA19-9 is associated with lymph node metastasis, and high CEA independently indicates a poorer prognosis. Additional research is necessary to clarify the clinical utility of these biomarkers in early detection and prognostic evaluation.