Journal of Medical Biochemistry最新文献

Background: Serum ferritin (SF) monitors secondary iron overload in beta-thalassemia (b-thalassemia). Transferrin (TRF) has been shown to reverse iron accumulation in experimental models, but its role in transfusion-dependent beta-thalassemia (TDT) patients remains unclear. This study aims to explore the relationship between TRF and SF in TDT patients and to reveal the unique connection between specific genotypes and iron metabolism, providing potential therapeutic targets for clinical practice.

Methods: This cross-sectional study includes 817 TDT patients (b0/b0 genotype: n=560; b0/b+ genotype: n=257). We use genotype-phenotype analysis and employ logistic regression and restricted cubic spline (RCS) curves to assess the association between TRF and SF.

Results: Significant differences were observed between the b0/b0 and b0/b+ genotypes in terms of age at first transfusion, transfusion requirements, chelation initiation age, reticulocyte count, red blood cell count, red cell distribution width-coefficient of variation (RDW-CV), fetal haemoglobin (HbF) level, splenomegaly, and SF. b0/b0 patients presented with more severe clinical phenotypes. SF was significantly associated with TRF, HbF, RDW-CV, and chelation therapy. RCS analysis revealed a dose-response relationship with a negative linear correlation between TRF and SF (OR=0.26, P<0.001), indicating that higher TRF levels are linked to lower SF risk.

Conclusions: This study systematically confirms for the first time a significant negative correlation between high TRF levels and high SF risk in TDT patients. This new finding may help clinicians more effectively manage iron overload, especially in patients with different genotypes.

Background: This study aimed to evaluate the effectiveness and safety of the hybrid artificial liver support system (HALSS) in patients with chronic liver failure (CLF). It also sought to analyze the inflammatory response and patient prognosis.

Methods: A total of 126 CLF patients were divided into three treatment groups: plasma exchange (PEG), double plasma molecular adsorption system (DPMASG), and a combination therapy group (CG). Key parameters, including liver and kidney function, blood coagulation, T lymphocyte subgroups, and inflammatory cytokine levels (TNF-a, procalcitonin [PCT], interferon-gamma [IFN-g], IL-2, IL-6, and IL-10), were assessed before and after treatment. The clinical efficacy, adverse reactions, and short-term prognosis were compared across the groups.

Results: Compared to PEG and DPMASG, the combination group (CG) showed significant improvement in liver and kidney function markers, including reduced ALT, AST, total bilirubin (TBil), creatinine (Cr), INR, and prothrombin time (PT). Additionally, CG demonstrated increased levels of cholinesterase (ChE), albumin, and prothrombin activity (PTA). The CG group had a higher total clinical efficacy (92.0%) compared to PEG (76.3%) and DPMASG (78.9%). It also showed a lower rate of adverse reactions (8.0%) and improved one-year survival (36.0% vs. 18.4% and 21.1%, respectively). Furthermore, CG had the most favourable effects on inflammatory cytokine levels and T lymphocyte subsets, significantly reducing TNF-a, PCT, IFN-g, IL-2, IL-6, and IL-10.

Conclusions: The combination of PEG and DPMAS (HALSS) demonstrated superior clinical efficacy in improving liver and kidney function, reducing inflammation, and enhancing patient prognosis compared to single therapies. These findings support HALSS as a promising adjunctive therapy for CLF patients, improving short-term outcomes and long-term survival.

Background: The study aimed to demonstrate the impact of traditional Chinese medicine (TCM) matrine combined with omeprazole enteric-coated tablets on gastric mucosal histopathology, gastric function, inflammatory cytokines, and Helicobacter pylori (H. pylori) eradication in patients with chronic atrophic gastritis (CAG).

Methods: A retrospective collection of case data from 110 patients with CAG admitted to the TCM Department of the hospital was conducted. Patients were rolled into the test group (TG, matrine + omeprazole enteric-coated tablets) and the control group (CG, omeprazole enteric-coated tablets). The gastric mucosal histopathological scores, serological indicators (interleukin (IL)-2, IL-10, tumour necrosis factor (TNF-a), gastric function (motilin (MTL), gastrin (GAS), pepsinogen (PG)), H. pylori eradication rate, and clinical efficacy were compared.

Results: The degree of glandular atrophy, intestinal meta-plasia, dysplasia, and inflammatory activity index in patients of TG post-treatment were lower than CG (P<0.05). Post-treatment, IL-2, IL-10, and TNF-a levels in patients of TG were inferior to CG (P<0.05), and the H. pylori eradication rate in patients of TG (87.27%) was inferior to CG (63.64%) (P<0.05). The effective treatment rate in patients of TG post-treatment (92.73%) was higher than CG (78.18%) (P<0.05).

Conclusions: Matrine combined with omeprazole enteric-coated tablets significantly improved gastric mucosal histopathology, reduced inflammatory cytokine levels, enhanced gastric function, and increased the H. pylori eradication rate compared to omeprazole monotherapy.

Background: This work investigated the changes in myocardial enzyme profile (MEP) and short-term prognosis (STP) in patients with myocardial damage (MD) after transcatheter aortic valve replacement (TAVR).

Methods: 100 patients receiving TAVR surgery were selected and rolled into an observation group (Obs group, 50 cases) and a control group (Ctrl group, 50 cases) according to postoperative myocardial status. The changes in MEP before and after the TAVR and the STP within 3 days after surgery were compared and analysed.

Results: Creatine Kinase MB (CK-MB) levels were (21.6±8.8) IU/L, (17.2±7.1) IU/L, and (15.2±6.4) IU/L at 12 h, 24 h, and 72 h after TAVR, respectively, in the Obs group; and the cTnT levels were (0.284±0.13) ng/mL, (0.315±0.15) ng/mL, and (0.363±0.22) ng/mL, respectively, at the same time points. The CK-MB and cTnT levels in the Obs group were increased more obviously based on the conditions in the Ctrl group (P<0.05). After surgery, 23 cases of bleeding occurred in the Obs group, significantly more than 8 cases in the Ctrl group (P<0.05). Differences in ultrasonic test results were not obvious (P>0.05).

Conclusions: The MEP of patients after TAVR generally increased, and the increase in the degree of patients with MD was more significant, which may be an indicator to judge the postoperative MD. Patients with postoperative MD had a higher probability of postoperative bleeding.

Background: Oral lichen planus (OLP) is a chronic inflammatory disease that affects the mucosal tissues of the oral cavity. Its pathogenesis involves immune dysregulation, angiogenesis, and psychological stress. Identifying reliable biomarkers can enhance diagnosis, monitor disease progression, and guide personalised treatment strategies. This study aimed to investigate five key serum biomarkers in OLP patients, including angiopoietin-2 (Ang-2), vitamin D, IgA, IgG, and cortisol, to explore their associations with disease severity.

Methods: This observational, case-control study enrolled 100 OLP patients and 80 healthy controls. The OLP patients were classified into three subtypes: reticular (n=30), atrophic (n=35), and erosive (n=35). Fasting blood samples were collected, and serum levels of Ang-2, vitamin D, IgA, IgG, and cortisol were measured using ELISA, HPLC, immunoturbidimetry, and chemiluminescent immunoassays. Statistical analyses, including t-tests, ANOVA, and Pearson correlation, were performed to assess biomarker levels and their correlations with disease severity.

Results: Ang-2, IgA, and IgG levels were significantly elevated in OLP patients, particularly in the erosive subtype (P<0.001), with positive correlations between these markers and disease severity. Vitamin D and cortisol levels were significantly reduced in OLP patients compared to controls (P<0.01) and showed negative correlations with disease severity. These findings indicate the role of vascular, immune, metabolic, and stress-related factors in OLP pathogenesis.

Conclusions: Ang-2, vitamin D, IgA, IgG, and cortisol are valuable biomarkers for assessing OLP severity and guiding personalised treatment. Monitoring these biomarkers can aid in diagnosing OLP, tracking disease progression, and optimising therapeutic strategies.

Background: Prostate glandular tissue maintains a delicate balance between cellular proliferation and programmed cell death (apoptosis), ensuring the preservation of normal glandular architecture in healthy individuals. Disruption of this equilibrium - whether due to excessive proliferation or impaired apoptotic mechanisms - can contribute to the initiation and progression of prostate cancer. The objective of this study was to evaluate the expression and activity of caspase-3, caspase-1, and alkaline deoxyribonuclease (DNase) in prostate cancer tissue and tumour-adjacent tissue in comparison to clinically healthy prostate tissue. The aim was to determine whether alterations in these parameters could serve as early biomarkers for the transformation of surrounding tissue into a precancerous phenotype.

Methods: The concentration of caspase-3 and caspase-1, as well as the activity of alkaline DNase, were examined in prostate tissue samples, including cancerous tissue, adjacent tissue near the tumour, and surrounding healthy tissue.

Results: The results revealed a significant reduction in caspase-3 levels in cancerous tissue (p<0.05), with an even more pronounced decrease in the adjacent peritumoural tissue (p<0.05). In contrast, caspase-1 levels were markedly elevated in both cancerous tissue (p<0.00001) and the surrounding non-malignant peritumoural tissue (p<0.0005). Similarly, alkaline DNase activity (both total and specific) was significantly increased in cancerous tissue (p<0.00001), with a moderate but statistically significant elevation in the tumour-adjacent tissue (p<0.000017) compared to control tissue.

Conclusions: These findings suggest a disruption in the interplay between caspase-3 and alkaline DNase, potentially as a consequence of necrotic processes or enzyme release from inhibitory complexes. Furthermore, the increased expression of caspase-1 implies that inflammatory responses may play a role in tumourigenesis.

Background: Vitamin D is an essential vitamin that plays a key role in maintaining overall health. During pregnancy, the demand for vitamin D increases to support the growing needs of the fetus. Vitamin D deficiency is highly prevalent in pregnant women worldwide. Our study aimed to evaluate the vitamin D deficiency rate among pregnant women in the Republic of North Macedonia, along with influencing factors.

Methods: We conducted a prospective study of randomly selected pregnant women with different body mass indexes among vitamin supplementation users and non-users in two different seasons.

Results: A total of 309 pregnant women aged > 18 years were recruited from June 2022 to April 2023, with an average vitamin D concentration of 38.9 (36.6-40.2) nmol/L. During winter, 80.8 % of pregnant women had vitamin D deficiency.

Conclusions: Even though more than 77.3 % of pregnant women consume multivitamins containing vitamin D, vitamin D deficiency is highly prevalent among pregnant women, especially among obese pregnant women and during the winter months.

Background: Some primary aldosteronism (PA) patients with spontaneous hypokalemia achieved incomplete remission after surgical treatment. In this study, we aimed to construct a nomogram to predict surgical benefits for primary aldosteronism (PA) patients with typical symptoms, incorporating changes in plasma aldosterone, plasma renin activity (PRA), and aldosterone/renin ratio (ARR) to help clinicians assess prognosis and develop optimised treatment plans.

Methods: This retrospective cohort study enrolled 162 patients between January 2017 and January 2024. Baseline characteristics, clinical indicators, and biochemical results, including plasma aldosterone, PRA, ARR, and serum potassium, were compared among patients with different clinical and biochemical outcomes. A nomogram was developed and internally validated with risk factors selected from univariate and multivariate logistic regression analyses.

Results: Complete clinical and biochemical success was achieved in 69 (42.6%) and 129 (79.6%). Five risk factors were used to develop a nomogram. The area under the receiver operating characteristic curve (AUC) was 0.856 (0.788-0.924) in the training dataset and 0.726 (0.580-0.872) in the validation dataset. The calibration curve showed good agreement, and the decision curve analysis demonstrated the clinical utility of this model.

Conclusions: PA patients with older age, higher systolic blood pressure, lower plasma aldosterone, more than 5 years of hypertension, and an adrenal gland mass on the left side or both sides had more probability of achieving incomplete remission after the surgery.

Background: This study aimed to evaluate the therapeutic effects of glucocorticoids (GCs) combined with tacrolimus (TAC) in the treatment of Neural Epidermal Growth Factor-Like 1 (NELL1)-positive idiopathic membranous nephropathy (IMN), with a focus on clinical outcomes, nutritional status, and inflammatory response.

Methods: A total of 84 NELL1-positive IMN patients from Cangzhou Central Hospital (January 2020-February 2024) were randomly assigned to a research group (GCs+TAC) and a control group (GCs alone). The research group received methylprednisolone (0.5 g), prednisone (0.5 mg/kg), and tacrolimus (0.05 mg/kg/day), while the control group was treated with methylprednisolone and prednisone alone. Clinical parameters, including renal function, blood glucose, lipids, nutritional proteins, and cytokine levels (IL-6, IL-10, IL-2, IL-17), were measured at baseline and after six months of treatment. Nutritional status was assessed using the Nutritional Risk Screening 2002 (NRS 2002).

Results: The two groups had no significant differences in clinical efficacy or adverse reactions. However, the research group exhibited significant improvements in renal function, glycemic control, lipid profile, and nutritional status (P<0.05). Furthermore, the research group showed a more favourable cytokine profile, with more significant reductions in pro-inflammatory cytokines (IL-6, IL-17) and increases in anti-inflammatory cytokines (IL-10, IL-2) compared to the control group (P<0.05). Both groups had comparable safety profiles, with no significant increase in adverse events.

Conclusions: Combining GCs and TAC is an effective and safe therapeutic option for NELL1-positive IMN. It improves clinical outcomes, maintains nutritional stability, and modulates immune responses without increasing adverse reactions.

Background: To measure the diagnostic value of T2WI and DWI radiomics model, combined with advanced biomarkers, in distinguishing benign prostatic hyperplasia (BPH), prostate cancer (PCa) and prostatitis.

Methods: A total of 90 patients with prostate diseases were selected from our hospital from January 2022 to January 2024. All patients underwent T2WI and DWI MRI examinations. Regions of interest (ROI) were delineated, and imaging features were extracted using radiomics analysis. In addition, novel biomarkers, including Prostate Cancer Antigen 3 (PCA3), Sarcosine, Glypican-1 (GPC1), Urokinase Plasminogen Activator Receptor (uPAR), and Thymidine Kinase 1 (TK1), were analysed for their diagnostic significance. Feature selection was performed using LASSO regression, and a random forest model was established for classification. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of the T2WI and DWI radiomics model with and without biomarker integration.

Results: Among the 90 patients with prostate diseases, 50 cases were PCa, 20 cases of prostatitis and 20 cases of BPH were detected by biopsy. The PI-RADS v2 score in the PCa group presented elevation relative to those in the BPH and prostatitis groups (P<0.01). The ADC values in the PCa group were reduced relative to those in the BPH and prostatitis groups (P<0.01). The integration of biomarkers with radiomics analysis led to improved diagnostic performance. The AUC value, sensitivity, and specificity of the T2WI and DWI radiomics model were higher relative to those of PI-RADS V2.

Conclusions: The T2WI and DWI radiomics model, when combined with novel biomarkers, enhances the accuracy of distinguishing PCa, BPH, and prostatitis. This approach may provide an advanced diagnostic tool for personalised prostate disease management.