Journal of Medical Biochemistry最新文献

Background: Dexmedetomidine, an a2-adrenergic agonist, has been reported to modulate inflammatory responses and neuroendocrine stress in surgical settings. This meta-analysis evaluated its effects on serum biochemical markers of inflammation and stress in patients undergoing gastric cancer surgery.

Methods: Literature was retrieved from PubMed, CNKI, Wanfang, and VIP databases. Studies comparing dexmedetomidine anesthesia with conventional regimens in gastric cancer surgery were included. RevMan 5.2 was used for meta-analysis. Outcome indicators included interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a), cortisol, epinephrine, adrenocorticotropic hormone (ACTH), heart rate (HR), mean arterial pressure (MAP), and adverse events.

Results: Fifteen studies were analyzed. Compared with controls, dexmedetomidine significantly reduced serum levels of IL-6, TNF-a, cortisol, epinephrine, and ACTH (all P < 0.00001). It also decreased HR, MAP visual analog scale (VAS) scores, and incidence of adverse reactions.

Conclusions: Dexmedetomidine anesthesia effectively reduces biochemical markers of inflammation and stress in gastric cancer surgery, suggesting its beneficial role in modulating perioperative biochemical responses.

Background: Surfactant protein D (SP-D) and circulating exosomes have emerged as potential biochemical indicators of lung injury severity in acute respiratory distress syndrome (ARDS). This study aimed to evaluate the prognostic value of SP-D levels and selected biochemical parameters in bronchoalveolar lavage fluid (BALF) and plasma among ARDS patients receiving mechanical ventilation.

Methods: A total of 103 mechanically ventilated ARDS patients were enrolled between February 2020 and February 2023. Patients were classified into survival (n = 59) and death (n=44) groups based on 28-day mortality. On the day of diagnosis, SP-D and exosome levels in BALF and plasma, along with pH, lactate, and oxygenation-related indices, were measured and analyzed for prognostic relevance.

Results: SP-D levels in both BALF and plasma were significantly higher in non-survivors (P < 0.001), while exosome levels did not differ significantly. The death group also showed elevated lactate and lower pH levels (P< 0.05). ROC analysis demonstrated high predictive value for SP-D in BALF (AuC=0.804) and plasma (AU C= 0.864), as well as for lactate and oxygenation indices. A combined biomarker model yielded an AUC of 0.883 for predicting 28-day mortality.

Conclusions: SP-D concentrations in BALF and plasma, along with lactate and acid-base markers, serve as valuable biochemical predictors of short-term prognosis in ARDS patients undergoing mechanical ventilation.

Background: Pulmonary mucoepidermoid carcinoma (PMEC) is often misdiagnosed due to the lack of specificity of clinical symptoms. The ratio of neutrophil/lymphocyte ratio (NLR) and the ratio of platelet/lymphocyte ratio (PLR) are used in the diagnosis and prognostic assessment of a variety of diseases. This paper aims to verify the auxiliary diagnostic value of NLR and PLR in the peripheral blood of PMEC, and calculate several indices to confirm the reliability of the hypothesis.

Methods: A total of 26 patients with PMEC were enrolled as the case group, and 156 healthy patients were selected as the control group in this study according to the inclusion criteria and exclusion criteria. All clinical data were collected, and all subjects took blood from their fasting veins. The correlation analysis of NLR, PLR and tumour indicators was consistent with the normal distribution using Pearson analysis. The receiver operating characteristic (ROC) curve was used to calculate the diagnostic value of NLR and PLR.

Results: NLR and PLR levels were significantly increased in patients with PMEC compared with healthy controls. PLR was positively correlated with the patient's stage, and NLR was independent of the patient's stage in PMEC patients. NLR was positively correlated with the patient's tumour size, and PLR was independent of the patient's tumour size. ROC curve analysis showed that NLR and PLR could be used as diagnostic indicators to distinguish patients with PMEC from normal people.

Conclusions: NLR and PLR tests are simple, non-invasive, inexpensive, and have high patient compliance. As potential markers for screening PMEC patients, NLR and PLR have auxiliary value for further exploration and research, and are worth promoting in the clinical setting.

Background: This study aimed to evaluate the involvementof serum inflammatory markers- N-terminal pro-brainnatriuretic peptide (NT-proBNP), hypersensitive-C reactiveprotein (hs-CRP), and interleukin-6 (IL-6) - in the pathological progression of severe community-acquired pneumonia (SCAP), examine their association with computedtomography (CT) scores, and assess their combined utilityfor diagnosis and outcome prediction.

Methods: We performed a propensity score-matched retrospective cohort study involving 164 SCAP patients(research group) and 164 age- and sex-matched healthycontrols (control group) enrolled between March 2024 andJanuary 2025. Serum NT-proBNP hs-CRP and IL-6 concentrations were quantified by enzyme-linked immunosorbent assay (ELISA), while chest computed tomography(CT) manifestations were evaluated using the AcuteExacerbation of Idiopathic Pulmonary Fibrosis (AE-IPF)scoring system. Comparative analyses of inflammatorymarkers and CT imaging findings were conducted, withsubsequent correlation studies, receiver operating characteristic (ROC) curve analysis, and multivariate regressionmodeling to determine their relationship with in-hospitalmortality.

Results: Following propensity score matching, demographic characteristics were well-balanced between groups (standardized mean differences <0.1). SCAP patientsdemonstrated significantly elevated serum levels of NTproBNP hs-CRP and IL-6 (P< 0.01), along with higher CTscores than controls. Strong positive correlations wereobserved between inflammatory marker concentrationsand CT scores (P< 0.01). The combined model outperformed individual biomarkers or CT alone in diagnosingSCAP (AUC 0.934, 95%CI 0.910 -0.959; P< 0.001) andpredicting mortality (AUC 0.839, 95%CI 0.759-0.919;P< 0.001). Multivariate analysis identified the elevation ofthese biomarkers as independent predictors of mortality inSCAP patients (P< 0.01).

Conclusions: NT-proBNP hs-CRP and IL-6 play pivotal rolesin promoting SCAP progression by driving inflammatorycascades and pulmonary tissue injury. The integratedassessment of these biomarkers with CT scoring significantly improves disease monitoring and prognostic assessment accuracy, potentially guiding individualized antiinflammatory interventions in SCAP management.

Background: To explore the correlation of sperm DNA fragmentation index (DFI) with semen quality, while assessing the diagnostic potential of DFI in male infertility, aiming to offer a novel biomarker and clinical approach for male fertility evaluation.

Methods: A cohort of 613 men who visited our hospital between April 2023 and February 2025 was included in this study. Semen analysis (assessing concentration, motility, morphology, etc.) and sperm chromatin dispersion testing were conducted to determine DFI. The diagnostic performance of DFI for infertility was evaluated using receiver operating characteristic (ROC) curve analysis. Subgroup analyses (oligozoospermia, asthenozoospermia, and oligoasthenozoospermia) were conducted to assess the discriminative power of DFI. After treatment, the patients were followed up for 1 year, and the predictive effect of DFI on the prognosis of successful fertility was analysed.

Results: Among infertile men (n = 92, incidence rate: 15.01%), DFI levels were significantly elevated compared to those with normal fertility (P< 0.05). ROC curve analysis demonstrated that DFI had a sensitivity of 60.87% and specificity of 84.07% (AUC= 0.774) in diagnosing infertility. Notably, DFI displayed the highest discriminative efficacy for oligoasthenozoospermia (AUC= 0.825). Finally, the sensitivity and specificity of DFI for predicting successful fertility in infertile men at 1 year were 83.08% and 62.96%, respectively (P< 0.001).

Conclusions: DFI demonstrates high diagnostic accuracy on the fertility of infertile men and has a high clinical potential.

Background: The pathophysiological mechanism underlying obesity and related diseases is still incompletely understood. A small number of studies employed sophisticated statistical techniques, such as principal component analysis (PCA), to investigate the relationship between oxidative stress, cardiometabolic biomarkers, and obesity in the adolescent population. Hence, we aimed to examine this relationship.

Methods: A total of 68 adolescents (i.e., 34 were overweight/obese, and 34 were sexand age-matched normal-weight controls) were included in the study. Total oxidant status (TOS) and total antioxidant status (TAS) were measured, whereas their ratios were calculated, i.e., pro-oxidant score [(TOS/TAS)*100] and antioxidant score (TAS/TOS). PCA was applied to reduce the number of determined data by grouping them into factors.

Results: A significantly higher concentration of TAS, TOS, and their pro-oxidant ratio (TOS/TAS)*100, while the antioxidant score of TAS/TOS was considerably lower in overweight/obese adolescents compared to normal-weight peers. TOS was the most significant predictor of obesity status (P= 0.001). PCA extracted 3 factors related to obesity status: Factor 1 (gender, creatinine, uric acid, total bilirubin, TAS, waist circumference, and urea), Factor 2 (ALT and AST), and Factor 3 (age, glucose, total protein, and TOS). Among them, Factor 2 (P= 0.003) and Factor 3 (P= 0.003) were independently associated with obesity.

Conclusions: The present study provides evidence of disrupted redox homeostasis in adolescents with obesity. Obesity is tightly connected with increased oxidative stress and a cluster of metabolic abnormalities. It is essential to identify risk factors promptly and develop a strategy to combat obesity and its associated diseases.

Background: Sepsis constitutes a systemic dysregulated host response to infection and remains a predominant cause of ICU mortality globally. Given the limitations of conventional prognostic models (e.g., SOFA and APACHE II), incorporating variably subjective parameters, there is a pressing need to identify robust, objective biomarkers for early mortality risk stratification. This investigation delineated the prognostic significance of the lactate-to-albumin ratio (LAR) in predicting 28-day all-cause mortality (28-DACM) among critically ill septic cases.

Methods: We performed a retrospective analysis utilizing the MIMIC-IV database (2008-2019), comprising 5,398 adult cases who met Sepsis-3 diagnostic criteria. Clinical and laboratory data within the initial 24-h post-ICU admission were extracted. The LASSO regression algorithm was implemented as a regularization technique to mitigate multicollinearity, enhance model generalizability, and facilitate high-dimensional feature selection. It was made to evaluate the prognostic utility of LAR through Kaplan-Meier (KM) survival estimation, receiver operating characteristic (ROC) curve analysis, and multivariate logistic regression modeling.

Results: LAR values were remarkably escalated in non-survivors relative to survivors (median, 0.9 vs. 0.6; P < 0.001). ROC curve analysis unveiled that LAR outperformed lactate (AUC: 63.52% ), albumin (AUC: 43.34% ), and the SOFA score (AUC: 59.87% ), achieving the highest discriminatory capacity (AUC: 64.71% ; 95% CI: 62.85-66.58%). An optimal LAR threshold of 1.032 was identified, attaining sensitivity and specificity of 45.1% and 76.6% , respectively. KM analysis uncovered remarkably attenuated 28-day survival in cases with LAR >1.032 (P < 0.001). Multivariate logistic regression confirmed LAR as an independent predictor of 28-DACM (OR = 1.32; P < 0.001), following adjusting for confounding variables.

Conclusions: The LAR serves as a clinically accessible, objective biomarker with superior prognostic performance relative to established indicators in association with sepsis. Its integration into early risk assessment algorithms may enhance prognostication and inform timely therapeutic decision-making. Prospective, multicenter investigations are warranted to validate its external generalizability and clinical utility.

Background: This study aimed to evaluate the impact of intraosseous (IO) access on inflammatory mediators, hematopoietic cell function, and coagulation-metabolic disturbances in patients presenting with emergency traumatic hemorrhagic shock (THS), thereby providing clinical evidence to refine IO resuscitation protocols in emergency settings.

Methods: We conducted a randomized controlled trial involving 84 THS patients admitted between February 2024 and February 2025. Participants were allocated equally into two groups: the IO group (n= 42), where vascular access was established via humeral or proximal tibial puncture, and the intravenous (IV) group (n= 42), where conventional peripheral or central venous access was prioritized. Serial measurements were performed at baseline (T0), 24 hours (T1), and 72 hours (T2) post-intervention to assess: (1) inflammatory mediators (IL-1 b, IL-6, IL-10, HMGB1, MDA); (2) hematopoietic parameters (CD34+ cell proportion, CFU-GM /BFU-E colony formation, CXCL12, EPO, and TPO ); (3) coagulation profiles (PT, APTT, and D-dimer); and (4) tissue perfusion indicators (blood lactate and lactate clearance rate). Comparative analyses were conducted both between groups and across different time points.

Results: The IO group demonstrated significantly elevated levels of IL-1P, HMGB1, and MDA at T1 and T2 compared to the IV group (P< 0.05), coupled with reduced IL-10 expression (P< 0.05), indicating exacerbated inflammatory imbalance and oxidative stress. Hematopoietic evaluation revealed progressive declines in CD34+ cell populations, CFU-GM /BFU-E colony formation, and CXCL12 concentration in the IO group at T1 and T2 (P< 0.05), despite modest compensatory increases in EPO and TPO that remained inferior to the IV group (P< 0.05). Coagulation studies showed prolonged PT/APTT (P< 0.01) and higher D-dimer levels (P< 0.05) in the IO group, along with worse blood lactate levels and lactate clearance rates compared to the IV group (P< 0.05), suggesting increased tissue hypoxia and coagulopathy risk.

Conclusions: While IO access enables rapid vascular access for resuscitation and reduces critical intervention time, despite its procedural efficiency in rapid vascular access for resuscitation, IO may inadvertently aggravate systemic inflammatory dysregulation, impair hematopoietic function, and worsen coagulation-metabolic disturbances through mechanisms such as mechanical stimulation, hypothermic fluid infusion, and oxidative stress.

Background: The platelet-to-lymphocyte ratio (PLR) is a simple laboratory index that can be applied in the diagnosis and follow-up of various diseases, particularly those with a primary or accompanying systemic inflammatory component. However, its clinical utility is limited by the absence of established reference intervals in the general population. This study aimed to determine the reference interval for PLR.

Methods: This retrospective observational study included 4,672 adults who underwent regular systematic check-ups consisting of clinical examinations and basic laboratory analyses, including a complete blood count (CBC). The PLR reference interval was calculated using Clinical and Laboratory Standards Institute (CLSI) guidelines, which estimate percentiles and their 95% confidence intervals (CI). Verification of the reference interval was performed in a group of 95 healthy adults, matched by age and sex to the study cohort.

Results: The mean age of participants was 43± 10 years, with a predominance of males (83.7% ). The median PLR was 109 (25th percentile: 90; 75th percentile: 131). The lower limit of the reference interval was 62 (95% CI: 61-63), and the upper limit was 194 (95% CI: 188-198). Female participants had significantly higher PLR values compared with males (P < 0.0001), while elderly participants had significantly lower PLR values compared with the middle-aged and younger groups (P= 0.019). The determined reference interval was 70-231 for females and 61-183 for males. PLR values did not differ significantly between the primary study group and the validation group [108.0 (87-136) vs. 109.0 (90-131); P> 0.05].

Conclusions: In this representative sample, consisting primarily of young and middle-aged adults, the PLR reference interval was 70-231 for women and 61-183 for men. In individuals older than 65 years, PLR values may be lower.

Background: This study aimed to assess the clinical utility of serum tumour markers - carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 50, CA19-9, CA72-4, and the cytokeratin 19 fragment (CYFRA21-1) - for early detection and prognostic evaluation in colon cancer.

Methods: A total of 50 patients diagnosed with colon cancer and 50 healthy individuals were enrolled. Serum levels of CEA, CA50, CA19-9, CA72-4, and CYFRA21-1 were quantified and compared between groups. Correlations with tumour staging, recurrence, and metastasis were also analysed.

Results: All five serum markers were significantly elevated in colon cancer patients compared to controls (P< 0.05). Marker levels were notably higher in advanced-stage cases (stages III-IV) than in early-stage disease (stages I-II) (P< 0.05). Following surgery, marker levels declined significantly (P< 0.05), except in patients with recurrence or metastasis, who showed elevated preoperative values (P< 0.05). Combined detection yielded significantly higher positive detection rates, sensitivity, and specificity than individual marker assessments (P< 0.05).

Conclusions: CEA, CA50, CA19-9, CA72-4, and CYFRA21-1 are clinically relevant markers for the detection, staging, and prognostic prediction of colon cancer. Combined serum marker analysis substantially improves diagnostic precision and supports early screening and outcome assessment.