Journal of Medical Biochemistry最新文献

Background: Patients with pancreatitis may be at increased risk of cardiovascular disease (CVD), but the biochemical mechanisms underlying this risk are not fully defined. Inflammatory biomarkers may provide valuable prognostic information.

Methods: We retrospectively analyzed 180 patients with pancreatitis (Jan 2021-Dec 2023). Serum levels of interleukin-8 (IL-8), procalcitonin (PCT), tumor necrosis factor-a (TNF-a), and C-reactive protein (CRP) were quantified using enzyme-linked immunosorbent assay (ELISA) and routine laboratory tests. Logistic regression was applied to identify independent biochemical predictors of CVD, and a risk prediction model was developed and validated using ROC curve analysis.

Results: IL-8, PCT, CRP and age emerged as independent predictors of CVD occurrence in pancreatitis patients (all P< 0.05). The biochemical prediction model demonstrated high accuracy, with an AUC of 0.893 in the training set and 0.978 in the validation set. Sensitivity and specificity exceeded 85% across datasets.

Conclusions: This study highlights the clinical and laboratory significance of inflammatory biomarkers in pancreatitis. The proposed biochemical model provides a reliable tool for predicting cardiovascular risk and may contribute to improved laboratory-guided risk assessment and patient management.

Background: To investigate the impacts of musculoskeletal ultrasound (MSK-US)-guided needle-knife on serum pain mediators, stress response, inflammatory markers, and coagulation function in lumbar disc herniation (LDH) patients.

Methods: In this prospective cohort study, we recruited 100 LDH patients admitted between February 2024 and January 2025 and assigned them to an MSK-US group (52 cases undergoing MSK-US-guided needle-knife) and a conventional group (48 cases receiving conventional needle-knife). Peripheral venous blood was collected before and within 2 hours postoperatively for IL-6, TNF-a, SP 5-HT, and hs-CRP measurements by ELISA, Cor, E, and NE determination using an automatic biochemical analyzer, b-EP detection by chemiluminescent immunoassay, and APTT, PT, FIB, and D-D quantification with a coagulation analyzer. Dynamic changes in these biomarkers were analyzed by betweenand within-group comparisons.

Results: Both groups demonstrated postoperative reductions in SP and 5-HT and an elevation in b-EP (P< 0.05), though no marked inter-group differences were noted (P> 0.05). The MSK-US group showed lower postoperative levels of Cor, E, NE, IL-6, hs-CRP D-D, and FIB than the conventional group (P< 0.05), suggesting MSK-US's ability to reduce inflammation, alleviate stress reaction, and lower hyperfibrinolysis risk.

Conclusions: MSK-US-guided needle-knife is effective in mitigating perioperative stress response and systemic inflammation in LDH patients while reducing the risk of coagulation disorders and providing a biomarker-driven framework for personalized postoperative management.

Background: To evaluate the biochemical and clinical significance of venous pressure therapy in preventing venous thromboembolism (VTE) through analysis of coagulation and fibrinolysis biomarkers, including fibrinogen (FIB), D-dimer (D-D), and activated partial thromboplastin time (APTT).

Methods: Randomized controlled trials published between 2013 and 2025 were systematically retrieved from PubMed, CNKI, VIP, and Wanfang databases. Eligible studies investigated venous pressure therapy and reported coagulation-related indices. Pooled effect sizes were calculated for key biochemical markers (FIB, D-D, APTT, PT, TT) and venous hemodynamic outcomes.

Results: Nineteen clinical studies met inclusion criteria. Meta-analysis revealed that venous pressure therapy significantly reduced plasma FIB and D-D levels, prolonged APTT, prothrombin time (PT), and thrombin time (TT), and improved venous blood flow velocity. These changes reflect improved anticoagulant activity, enhanced fibrinolysis, and reduced risk of thrombosis. Importantly, the observed modulation of biochemical markers correlated with a lower incidence of lower-extremity deep venous thrombosis.

Conclusions: Venous pressure therapy favorably alters coagulation and fibrinolytic biomarkers, underscoring their diagnostic value in monitoring therapeutic efficacy and thrombotic risk. These findings highlight the critical role of laboratory indices in guiding the prevention and management of VTE, supporting their integration into standardized clinical practice.

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.

Background: To investigate the connection betweenischemic stroke (IS) patients' risk of dying after being discharged and their residual cholesterol (RC) levels uponadmission.

Methods: 2021 IS patients between the ages of 35 and 80were chosen as the study's subjects, and data on deathendpoints following discharge were gathered. The doseresponse association between the risk of death and the RCat admission was examined using restricted cubic spline(RCS) regression. The hazard ratio (HR) and 95% CI werecalculated via Cox regression to analyse the associationbetween the RC level at admission and the risk of deathafter discharge in patients with IS.

Results: According to the RCS model, RC levels were nonlinearly associated with deaths from IS and other causes(P<0.001). With the median RC level as the cutoff value,the subjects were divided into two groups: a low RC group(RC<0.72 mmol/L) and a high RC group (RC≥0.72mmol/L). Compared with those in the high RC group, theage and male ratio in the low RC group were significantlygreater. The fasting blood glucose (GLU), total cholesterol(TC), triglyceride (TG), low-density lipoprotein cholesterol(LDL-C), non-high-density lipoprotein cholesterol (nonHDL-C), apolipoprotein A-1 (ApoA-1), and apolipoproteinB (ApoB) levels, as well as diabetes rates, were lower (P=0.01). Cox regression analysis revealed that withoutadjusting for covariates, the high-level RC group presenteda lower risk of all-cause death than the low-level RC group(HR=0.765, 95% CI: 0.619~0.946, P=0.013) and alower risk of death from IS (HR = 0.638, 95% CI:0.435~0.936, P=0.022). After adjusting for sex, age,smoking status, drinking status, hypertension status, anddiabetes status, the high-level group still had a lower risk ofall-cause death (HR = 760, 95% CI: 0.614~0.941,P=0.012) and a lower risk of death from IS (HR=0.653,95% CI: 0.444-0.961, P=0.031). Male sex (HR=0.753,95% CI: 0.572~0.990, P=0.042). Age ≥65 years (HR=0.598, 95% CI: 0.391~0.916, P=0.018), nonsmokingstatus (HR=0.628, 95% CI: 0.408~0.967, P=0.035),nonalcoholic status (HR=0.656, 95% CI: 0.439~0.979,P=0.039), not complicated with hypertension (HR=0.321, 95% CI: 0.108~0.957, P=0.041), no diabetesmellitus (HR=0.607, 95% CI: 0.389~0.947, P=0.028).Compared with those in the high RC group, the IS patientsin the low RC group had a lower incidence of all-causedeath, IS death and other causes of death and a higher survival rate.

Conclusions: An RC<0.72 mmol/L at admission is associated with an increased risk of all-cause death and longterm IS death after discharge.

Background: This study analysed the clinical value of serum high-mobility group protein B1 (HMGB1) and soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) in the prognostic assessment of trauma patients.

Methods: This prospective cohort study included 92 patients with multiple injuries admitted to our hospital between December 2022 and December 2024. The patients at admission were divided into three groups according to their Injury Severity Score: the minor injury group (n=24), the moderate injury group (n = 58), and the severe injury group (n = 10). The patients were divided into the MODS group (n=20) and the non-MODS group (n=72) on the basis of whether they had multiple organ dysfunction syndrome (MODS) after admission. The patients were divided into a death group (n = 13) and a survival group (n=79) on the basis of their outcomes within 28 days after the occurrence of trauma. Venous blood was collected from an empty stomach at 24 hours, 72 hours and 7 days after injury. The levels of serum HMGB1 and sTREM-1 were determined using an enzyme-linked immunosorbent assay (ELISA). Moreover, the injury severity score (ISS), Acute Physiology and Chronic Health Evaluation (APACHE II), complications during hospitalisation (infection, MODS, etc.) and 28-day survival of the patients were recorded.

Results: The concentrations of serum HMGB1 and sTREM-1 in the trauma group were significantly greater than those in the control group (P< 0.01) and increased with increasing ISS. The peak levels of HMGB1 and sTREM-1 in the poor-prognosis group (death/complications) were significantly higher than those in the good-prognosis group (P< 0.001). The predictive efficacy (AU C= 0.891) of the combined detection of dual indicators for post-traumatic complications was greater than that of the single indicators (AU C= 0.812 for HMGB1 and A U C= 0.784 for sTREM-1), and the area under the ROC curve for the 28-day risk of death reached 0.927. Multivariate logistic regression analysis confirmed that both factors were independent risk factors for trauma prognosis (O R= 3.42 and O R= 2.98, respectively).

Conclusions: HMGB1 and sTREM-1 significantly increase in the early stage of trauma and are closely related to the severity of injury and poor prognosis. Combined dynamic monitoring can effectively predict complications and the risk of mortality, providing a crucial biomarker basis for early clinical intervention.

Background: Ghrelin, a brain-intestinal hormone, is a growth hormone (GH) secretagogue. Because it regulates appetite and is secreted most prominently before meals, it is often described as a "hunger hormone". It consists of 28 amino acids. Given the connection between nutritional status and energy metabolism, it suggests that disorders in these areas can lead to anorexia, especially during aging. This review article aims to demonstrate ghrelin's influence on the histological, hormonal, and stereological characteristics of pituitary cells, as well as its potential clinical applications.

Methods: To write this review, we performed an electronic literature search through Google Scholar and PubMed databases with the terms ghrelin, structure, pituitary cells, metabolism, and aging, with reference to the authors and co-authors of published works related to this topic, as well as the option "related articles", which were associated with the content of this publication.

Results: The topic of this review article relates to the structure, morphometric and hormonal characteristics of adrenocorticotropic (ACTH), somatotropic (GH), and gonadotropic (FSH and LH) pituitary cells in control and ghrelin-treated rats.

Conclusions: This review showed that central administration of nanomolar doses of ghrelin in rats modulates the immunohistomorphometric and hormonal characteristics of pituitary hormone-producing cells. The changes are particularly significant in the volume of corticotropes, somatotropes, and luteinising hormone (LH)-producing cells, their volume density, and the levels of hormones they secrete, compared with the control group.

Background: Procalcitonin (PCT), a biomarker closely associated with bacterial infections, has emerged as a valuable tool in guiding antibiotic therapy. In sepsis management, it may help optimise antibiotic use and improve clinical outcomes. This retrospective cohort study aimed to evaluate the effectiveness of PCT-guided antibiotic therapy in adult sepsis patients, with a particular focus on biochemical responses.

Methods: We retrospectively analysed medical records of 110 adult sepsis patients admitted between January 2019 and December 2023. Patients were allocated to either a standard antibiotic group (n = 53) or a PCT-guided antibiotic group (n = 57). Key variables included demographic data, treatment duration, infection control metrics, and white blood cell (WBC) count, C-reactive protein (CRP), and PCT levels, among others, before and after therapy.

Results: Compared with the standard group, the PCT-guided group exhibited significantly greater reductions in WBC, CRP and PCT levels (P< 0.05), shorter antibiotic duration, fewer secondary infections, and improved antibiotic de-escalation rates. A higher complete response rate (17.54% vs. 3.77%) was observed in the PCT-guided group. No significant difference was found in 28-day mortality.

Conclusions: PCT-guided antibiotic therapy led to more favourable changes in key biochemical markers and clinical outcomes, supporting its role as a biomarker-driven approach to antibiotic optimisation in sepsis management.

Background: In vitro fertilization-embryo transfer (IVF-ET) remains a challenging treatment for infertility, particularly in patients with repeated implantation failures. Dalteparin sodium (DS), a low-molecular-weight heparin, has shown promise in improving IVF outcomes due to its antithrombotic and immunomodulatory properties. This study evaluated the impact of DS combined with luteal phase support (LPS) on serum markers, interleukins, pregnancy outcomes, quality of life (QOL), and social support in women with prior in vitro fertilisation (IVF) failures.

Methods: This retrospective study included 80 patients with a history of repeated IVF failure who underwent assisted reproduction at our centre. Patients were randomised to receive either LPS alone (Ctrl; n = 40) or LPS plus daily subcutaneous DS (Exp; n=40). Serum levels of b-hCG, FSH, E2, LH, CA-125, and interleukin-6 (IL-6) were measured and compared between the groups.

Results: The Exp group demonstrated significantly higher clinical pregnancy rates (CPR) and embryo implantation rates (EIR) compared to the Ctrl group (P < 0 .0 5 ). Additionally, the miscarriage rate (MCR) was significantly lower in the Experimental group (P< 0.05). Moreover, the Exp group exhibited significantly lower serum levels of CA-125 and IL-6 compared to the Ctrl group (P< 0.05). Improvements in quality of life (QOL) measures were also observed in the Exp group, with significant increases in physiological function, social function, emotional function, and mental health (P< 0.05). No significant difference in the incidence of adverse reactions (ARs) was found between the two groups (P> 0.05).

Conclusions: The combination of LPS and DS appears to be a safe and effective strategy for improving pregnancy outcomes and QOL in patients with repeated IVF failure. This combined treatment may exert its beneficial effects by modulating key serum markers and interleukins, such as CA-125 and IL-6, involved in implantation and pregnancy maintenance.