Journal of Medical Biochemistry最新文献

Background: This study aimed to explore the impact of T helper 17 (Th17)/regulatory T (Treg) cells imbalance and inflammatory factors (IL-1b, IL-18, and TNF-a) on sagittal balance in patients with thoracolumbar kyphosis due to ankylosing spondylitis (AS) following vertebral column decancellation (VCD), to clarify the predictive efficacy of the Th17/Treg ratio and IL-1b, IL-18, and TNF-a in post-operative sagittal imbalance.

Methods: A total of 134 AS patients undergoing VCD were enrolled and categorised into an imbalance group (46 cases) and a balance group (88 cases), depending on post-operative sagittal balance. Measurements of the Th17/Treg ratio and inflammatory factor levels were conducted at three time points: preoperatively (T0), 24 hours postoperatively (T1), and 4 weeks postoperatively (T2). These data were analysed alongside sagittal parameters (SVA, PI-LL, and PT) to assess their correlations and predictive potential.

Results: At 4 weeks after surgery, the imbalance group showed significantly elevated Th17/Treg ratios and higher levels of IL-1b, IL-18, and TNF-a compared to the balance group (P<0.05). Th17/Treg ratios and inflammatory factors (IL-1b, IL-18, TNF-a) showed significant positive correlations with SVA, PI-LL, and PT (P<0.05). Notably, the combined assessment of Th17/Treg ratio and inflammatory factors sagittal imbalance had a sensitivity of 52.17% and specificity of 90.91 (P<0.001).

Conclusions: The findings suggest that Th17/Treg imbalance and excessive expression of IL-1b, IL-18, and TNF-a are strongly linked to postoperative sagittal imbalance in AS patients. These biomarkers may serve as valuable early predictors for assessing surgical outcomes.

Background: To evaluate the therapeutic effects of entecavir combined with reduced glutathione on serum type III procollagen (PCIII), plasma procollagen V (IVC), Tumour Necrosis Factor-a (TNF-a), interleukin-6 (IL-6), and nutritional status in patients with hepatitis B complicated by alcoholic liver cirrhosis.

Methods: This study included 92 patients with alcoholic liver cirrhosis and hepatitis B, treated between April 2022 and January 2024. Patients were randomised into two groups: group A received 0.5 mg of entecavir daily, and group B received 0.5 mg of entecavir daily plus 0.3 g of reduced glutathione 1-2 times per day for 2 months. Nutritional parameters, inflammatory markers, liver function, and malnutrition were compared between groups. Statistical analysis was performed using SPSS12.0, with independent t-tests for group comparisons and x2 tests for categorical data. A P-value <0.05 was considered statistically significant.

Results: Group B showed a higher effective treatment rate (97.82%) compared to group A (76.08%). Malnutrition improved significantly more in group B. After treatment, group B exhibited more significant reductions in BMI, TSF, AMC, PA, Hb, ALB, TNF-a, CRP, IL-6, TBIL, AST, ALT, HA, PCIII, and IVC than group A.

Conclusions: Entecavir combined with reduced glutathione improves liver function and nutritional status and reduces inflammatory markers in patients with hepatitis B and alcoholic liver cirrhosis, demonstrating high safety and effectiveness.

Background: Given the critical importance of inflammation, immune and endothelial function in acute respiratory failure (ARF), it is essential to evaluate therapeutic strategies that target these pathways to confirm their application value. This study aimed to investigate the impact of chain management (defined as a systematic protocol integrating dynamic risk assessment, standardised nursing pathways, multidisciplinary coordination, and real-time biomarker monitoring to optimise clinical decision-making) on inflammatory markers (interleukin [IL]-1b, IL-6, IL-8, tumour necrosis factor[TNF]-a, and procalcitonin[PCT]), vascular endothelial function, blood gas parameters, and T lymphocyte subsets in patients with ARF.

Methods: A retrospective analysis was conducted on 101 ARF patients admitted between October 2023 and December 2024. The patients were categorised into two groups: a conventional group (55 cases, receiving standard risk warning management) and a chain group (46 cases, undergoing chain management). Levels of inflammatory factors and vascular endothelial markers (nitric oxide[NO], endothelin-1 [ET-1], etc.) were measured using enzyme-linked immunosorbent assay (ELISA), blood gas function was evaluated with a blood gas analyser, and T lymphocyte subsets (CD3+, CD4+, and CD8+) were analysed via flow cytometry.

Results: Compared to the conventional group, the chain group demonstrated significantly shorter durations of mechanical ventilation and ICU stays (P<0.05). Moreover, the chain group exhibited more pronounced reductions in inflammatory factors, including IL-1b, TNF-a, and PCT (P<0.05). Improvements in vascular endothelial function were also more evident in the chain group, with higher NO levels and lower ET-1 levels (P<0.05). Additionally, the chain group achieved better blood gas outcomes, characterised by higher PaO2 and lower PaCO2 levels (P<0.05), as well as greater increases in CD3+ and CD4+ cell counts (P<0.05).

Conclusions: Chain management effectively mitigates inflammatory responses and enhances vascular immune function, endothelial function in ARF patients through multi-targeted interventions.

Background: This study aimed to evaluate and compare the diagnostic value of C-reactive protein (CRP), procalcitonin (PCT), neutrophil count (NC), and neutrophil-to-lymphocyte ratio (NLR) in peripheral blood for detecting bacterial infections in patients with non-small cell lung cancer (NSCLC) following chemotherapy.

Methods: A total of 122 NSCLC patients treated at our hospital between October 2021 and October 2024 were enrolled. Of these, 72 patients with confirmed bacterial infections post-chemotherapy were assigned to the infection group, while 50 patients without infections were included in the non-infection group. General clinical data, overall survival, and levels of CRP, PCT, NC, and NLR were compared between groups.

Results: Levels of CRP, PCT, NC, and NLR were significantly higher in the infection group compared to the non-infection group (P<0.05). There was no significant difference in overall survival between the two groups (P=0.749). Receiver operating characteristic (ROC) curve analysis showed that all four biomarkers had statistically significant diagnostic value (P<0.05), with PCT demonstrating the highest AUC (1.000), followed by NLR (0.981).

Conclusions: PCT and NLR are valuable biomarkers for diagnosing bacterial infections in NSCLC patients after chemotherapy. Due to their complementary diagnostic strengths, PCT offers high specificity and NLR high sensitivity, and their combined use may enhance early detection and improve clinical decision-making.

Background: This study evaluates the impact of cranial reconstruction therapy combined with lumbar drainage on inflammatory cytokine levels (IL-6, IL-1b, IL-8), serum albumin, and cerebrospinal fluid (CSF) biochemical markers in patients with lateral skull base temporal bone fractures and cerebrospinal fluid leakage. It also assesses the role of nutritional and psychological care in patient recovery.

Methods: A total of 130 patients with temporal bone fractures and CSF leakage who underwent craniotomy repair surgery between May 2022 and May 2024 were enrolled. Patients were randomly assigned to either a control group (CG), receiving craniotomy and standard nutritional care, or an observation group (OG), receiving cranial reconstruction combined with lumbar drainage and nutritional intervention. CSF protein, glucose, and chloride levels were measured on postoperative day 7. Systemic inflammation was assessed by measuring temperature, WBC count, CRP, IL-6, IL-1b, and IL-8 at 7 and 15 days postoperatively. Nutritional status was evaluated using serum albumin (ALB), total protein (TP) levels, and Subjective Global Assessment (SGA) scores before and after treatment.

Results: By postoperative day 7, IL-6 levels were significantly lower in OG (10.5±2.3 pg/mL) compared to CG (18.2±4.1 pg/mL), IL-1b was 8.4±1.7 pg/mL in OG versus 14.3±3.5 pg/mL in CG, and IL-8 levels were 15.2±3.1 pg/mL in OG versus 22.5±4.2 pg/mL in CG (all P<0.05). CSF protein levels were lower in OG, and glucose and chloride levels were higher (P<0.05), with all values within the normal range. Inflammatory markers (IL-6, IL-1b, IL-8, WBC, and CRP) showed a further reduction by day 15 (P<0.01) in OG. Serum albumin levels were significantly higher in OG postoperatively (P<0.01). No significant differences were observed between groups for TP and SGA scores.

Conclusions: Cranial reconstruction therapy combined with lumbar drainage accelerates the resolution of inflammation (IL-6, IL-1b, IL-8), improves cerebrospinal fluid biochemical markers, and enhances nutritional recovery (albumin levels), leading to better clinical outcomes. Including nutritional and psychological support further enhances patient recovery and quality of life. These findings underscore the importance of monitoring inflammatory and nutritional biomarkers to optimise postoperative management in patients with temporal bone fractures and CSF leakage.

Background: The aim of this study was to carried out an exploration of the predictive value of serum high-sensitivity C-reactive protein (hs-CRP) plus high levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) for the onset of ischemic stroke (IS). This study extends the understanding of their interplay by highlighting their mechanistic contributions to vascular inflammation and plaque instability, factors crucial in IS onset.

Methods: 526 IS patients were selected as the experimental group (EG). During the same period, 463 healthy individuals served as the control group (CG). The levels of Lp-PLA2, myeloperoxidase (MPO), total cholesterol (CHO), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), hs-CRP, and serum ferritin (SF) in the serum of subjects were compared. The predictive efficacy of combination of two for the onset of IS was assessed.

Results: The levels of Lp-PLA2, MPO, CHO, LDL, TG, hs-CRP, and SF in patients with IS were all markedly higher as against the CG (P<0.05). Multivariate Logistic regression analysis (MLRA) suggested that both hs-CRP and Lp-PLA2 were independently associated with the risk of IS (OR=1.334, 95% CI=1.713~1.954; 1.251, 1.011~1.921). The ROC curve analysis revealed that the predictive efficacy for IS of hs-CRP in combination with Lp-PLA2 (area under the ROC curve (AUC)=0.786) was markedly better as against hs-CRP alone (0.713) or Lp-PLA2 alone (0.698) (P<0.05). Mechanistically, their interaction may exacerbate vascular inflammation, promoting plaque instability, a crucial process in IS development.

Conclusions: This study reinforces that the combined detection of hs-CRP and Lp-PLA2 significantly improves IS risk prediction by offering a more comprehensive assessment of inflammatory and atherosclerotic status. Their interplay suggests potential therapeutic targets for preventing IS.

Background: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a specific biomarker associated with an increased risk of coronary artery disease (CAD) development. This study aims to determine the relationship between Lp-PLA2 activity and the risk of development and severity of CAD in patients with type 2 Diabetes mellitus (T2DM).

Methods: The cross-sectional study included 148 patients with T2DM, divided into two groups: patients with T2DM without confirmed CAD (n=56) and patients with T2DM and confirmed CAD (n=92), further divided into three sub-groups based on the stage of CAD, and a control group of healthy individuals (n=44). Venous blood samples were collected from all participants to measure glucose, cholesterol, triglycerides, HDL, LDL, C-reactive protein, urea, and creatinine levels using standard photometric methods. Lp-PLA2 activity was measured using a chemiluminescent immunoassay method.

Results: Patients with T2DM and confirmed CAD had significantly higher Lp-PLA2 levels than those without confirmed CAD and healthy individuals. A significant difference in Lp-PLA2 levels was found between the group without CAD, the patients with CAD divided into subgroups according to disease stage, and the healthy control group. A positive correlation was observed between Lp-PLA2 and BMI, glycated haemoglobin, total cholesterol, and HDL cholesterol. The optimal cutoff value for Lp-PLA2<250 ng/mL yielded a diagnostic sensitivity of 95.65% and specificity of 88.64% for patients with T2DM and diagnosed CAD.

Conclusions: Lp-PLA2 can be used as a predictor for developing and assessing the severity of CAD in patients with T2DM.

Background: To explore the prognostic value of cancer antigen 15-3 (CA15-3), Carbohydrate antigen 125 (CA125), and carcino-embryonic antigen (CEA) in breast cancer patients undergoing chemotherapy.

Methods: The data of 100 patients with breast cancer who received chemotherapy in a hospital from May 2022 to May 2024 were selected. Patients were divided into control and test groups based on different intervention methods and hospital stays. The control group receives routine nursing interventions. The test group implements exercise intervention under planned behaviour planning, with 50 cases in each group. Patients' exercise cognitive score, cancer-related fatigue, and serum tumour marker levels are compared before, 2 weeks, and 4 weeks of intervention.

Results: Before the intervention, there was no difference in exercise cognition scores, cancer-related fatigue (CFS) scores, or serum tumour marker levels (P>0.05). After 2 and 4 weeks of intervention, the exercise attitude, exercise values, exercise behaviour control, and exercise motivation in the test group exceeded the control group (P<0.05). The behavioural, sensory, emotional, and cognitive fatigue scores in the test group were below the control group (P<0.05). The CA15-3, CA125, and CEA in the test group were below the control group (P<0.05).

Conclusions: Exercise intervention under planned behaviour planning is conducive to improving the cognition of breast cancer chemotherapy patients on exercise knowledge, alleviating body fatigue, and reducing the serum markers.

Background: Orthostatic hypotension (OH) in maintenance hemodialysis (MHD) patients is a frequent chronic complication. OH may lead to inadequate dialysis, cardiovascular complications, and death. This study explored the relationship between OH and various factors, including serum levels of parathyroid hormone (PTH), potassium (K+), calcium (Ca2+), blood phosphate (PO4), albumin (ALB) levels and Orthostatic Hypotension in Hemodialysis Patients.

Methods: 121 MHD patients were enrolled, and their clinical data were acquired. They were categorised into a control (Ctrl) group (normal patients) and an observation (Obs) group (OH patients) based on the diagnostic criteria for OH. Differences in clinical data between patients in different groups were compared, and binary logistic regression (BLR) analysis was performed to assess contributing factors.

Results: Among 121 MHD patients, 40 (33.06%) experienced OH. Comparative analysis demonstrated that patients in the OH group were significantly older, had higher supine systolic blood pressure, increased prevalence of diabetes, and elevated PTH levels, with concomitantly lower blood pressure responses at 1 and 3 minutes after standing, as well as reduced ALB and triglyceride levels (P<0.05). Binary logistic regression analysis further identified advanced age and comorbid diabetes as independent risk factors, whereas higher ALB levels were independently protective against OH.

Conclusions: This study confirms a relatively high incidence of OH in MHD patients and underscores that advanced age, diabetes, and low serum albumin levels are significant independent predictors of OH. These findings suggest that early identification and targeted intervention in high-risk patients could improve hemodialysis outcomes and reduce cardiovascular complications.

Background: This study aimed to explore the clinical efficacy of probiotics plus quadruple therapy on Serum levels of tumour necrosis factor-a (TNF-a), interleukin-6 (IL-6), C-reactive protein (CRP), gastrin (GAS) and motilin (MTL) in treating Helicobacter pylori (Hp)-positive gastric ulcer (GU).

Methods: One hundred and twenty-four patients with Hp-positive GU treated in our hospital from January 2021 to January 2024 were randomly separated into control and observation groups. The former received conventional quadruple therapy, and the latter received tetralogy of viable bifidobacterium tablets combined with conventional quadruple therapy. The clinical efficacy, Hp eradication rate, levels of inflammatory cytokines and gastrointestinal hormone, incidence of adverse reactions, and quality of life were compared in 2 groups.

Results: The total effective rate of the observation group was 96.77%, higher than that of the control group (82.25%). The Hp eradication rate in the observation group was higher than in the control group. After therapy, IL-6, TNF-a and CRP levels declined in 2 groups, and those in the observation group presented lower compared to the control group. After therapy, MLT level was elevated while GAS level was declined in 2 groups, and the improvements of MLT and GAS levels in the observation group were more significant than those in the control group. The incidence of diarrhoea in the observation group was lower than that in the control group, and there was no difference in the incidence of nausea and abdominal distension between 2 groups.

Conclusions: This study investigated the effects of probiotics combined with quadruple therapy on serum levels of tumour necrosis factor-a (TNF-a), interleukin-6 (IL-6), C-reactive protein (CRP), gastrin (GAS), and motilin (MTL) in patients with Helicobacter pylori (Hp)-positive gastric ulcer (GU). The results demonstrated that this combined treatment approach significantly improved Hp eradication rates, reduced inflammatory cytokine levels, and regulated gastrointestinal hormone secretion. Furthermore, patients receiving probiotics with quadruple therapy experienced better maintenance of intestinal flora balance and enhanced overall quality of life than those receiving conventional quadruple therapy alone. These findings suggest that integrating probiotics into standard treatment protocols for Hp-positive GU may offer a safer and more effective therapeutic strategy, addressing inflammation control and gastrointestinal health while improving patient outcomes.