Journal of Medical Biochemistry最新文献

Background: Neonatal hyperbilirubinemia (NHB) severity is traditionally assessed using serum total bilirubin levels alone; however, bilirubin measurement can be influenced by multiple physiological factors, limiting its accuracy. This study aimed to explore the correlation between blood lactate levels and NHB and evaluate whether blood lactate could serve as a novel, objective biomarker for predicting the severity and associated organ dysfunction in neonates with NHB.

Methods: A total of 123 children diagnosed with NHB and admitted to the obstetrics department from October 2021 to October 2022 were selected as the NHB group, and according to the severity of the disease, they were divided into mild, moderate, and severe. Fifty healthy neonates born in the department of obstetrics were selected as the control group. The levels of glucose-6-phosphate dehydrogenase (G6PD), creatine kinase isoenzyme (CK-MB), p2-microglobulin (P2-MG), aspartate aminotransferase (AST), blood lactic acid and total bilirubin in serum were compared. Pearson correlation analysis was used to analyse the correlation between blood lactate level and bilirubin level, and the ROC curve was used to determine the predictive value of blood lactate level for the severity of NHB in neonates.

Results: The NHB group had significantly higher levels of AST, CK-MB, p2-MG, blood lactic acid, and total bilirubin than the NHB group (P< 0.05). The G6PD level was significantly lower (P < 0 .0 5 ). Pearson correlation analysis showed a positive correlation between blood lactate and total bilirubin levels (r= 0.604, P< 0.001). ROC curve analysis indicated that blood lactate had superior predictive accuracy (AU C= 0.873, sensitivity = 81.3% , specificity = 86.0%) for assessing NHB severity compared to total bilirubin alone (AU C= 0.759, sensitivity = 86.2% , specificity = 82.0% ; P<0.05).

Conclusions: Neonates with NHB have higher serum levels of AST, CK-MB, p2-MG, blood lactate, and total bilirubin, while lower G6PD levels. The serum level of blood lactate is positively correlated with the total bilirubin level, which can be used to observe the severity of NHB in neonates.

Background: This is mainly because depression is a COM-mon psychiatric condition affecting more than 280 million people worldwide and is increasingly linked to an increased risk of thrombotic events, including deep vein thrombosis (DVT) and pulmonary embolism (PE). For example, under-lying pathophysiological mechanisms remain inadequately understood, and thus further research on the association between depression, systemic inflammation, platelet acti-vation and coagulation abnormalities is warranted. The objective of this study is to identify biological pathways link-ing thrombosis and depression by examination of inflam-matory and coagulation biomarkers, platelet activation, and risk of thrombosis as independent predictors. In addi-tion, the study investigates the possibility of nursing inter-ventions in reducing thrombotic complications among depressed individuals.

Methods: A case control study was performed with 500 subjects (250 who had major depressive disorder and 250 healthy control subjects) included. Enzyme-linked immuno-sorbent assays (ELISA) and quantitative polymerase chain reaction (qPCR) were employed to quantify key inflamma-tory (IL-6, TNF-a, CRP) and coagulation (D-dimer, fibrino-gen) biomarkers. An assessment of platelet activation (CD62P PAC1 binding, GPIIbIIIa activation) was per-formed by flow cytometry. The study was carried out by a longitudinal follow-up over 12 months and by multivariate regression models to identify independent risk predictors.

Results: Thrombophilic and inflammatory parameters were significantly higher in depressed patients as compared to controls (p< 0.001). The system was markedly hyperco-agulable, as platelet activation markers were significantly upregulated. Through multivariate regression analysis, we determined that thrombosis risk was independent of the severity level of depression (O R = 2.10 , p< 0.001), IL-6 levels (O R = 1 .9 2 , p < 0.0 01), and platelet activation (O R = 2.50, p< 0.001).

Conclusions: The results indicate that depression is an independent risk factor for thrombosis, through systemic inflammation and platelet hyperactivity. These results rein-force the value of linking psychiatric screening into throm-bosis risk assessment and suggest the possible benefits of targeted anti-inflammatory or antiplatelet interventions in the psychiatric population at high risk of thrombosis.

Background: Biochemical monitoring of cerebral oxygen metabolism is essential in the management of cranial brain injury (CBI). Jugular venous blood gas (JVBG) analysis provides real-time data reflecting cerebral biochemical states, offering a valuable window into brain oxygenation and metabolic demands. This study aimed to evaluate JVBG biochemical markers as indicators of CBI severity and as predictors of prolonged intensive care unit (ICU) stay, emphasizing their integration into machine learning models for clinical utility.

Methods: A retrospective analysis was conducted on 100 ICU-admitted CBI patients. Serial measurements of JVBG parameters-jugular venous oxygen saturation (SjvO2), partial pressure of oxygen (PjO2), arteriovenous oxygen difference (AVDO2), and oxygen content difference (AVDL)-were performed over five days. Spearman correlation and random forest algorithms were employed to assess relationships between JVBG biomarkers, clinical severity (via Glasgow Coma Scale), and ICU duration.

Results: Patients with more severe CBI exhibited significantly reduced SjvO2 and PjO2, and elevated AVDO and AVDL (p < 0.001). Strong correlations were found between JVBG markers and clinical severity scores. A multivariable prediction model incorporating age, SaO2, and PaCO2 at one day post-admission yielded excellent predictive performance for prolonged ICU stay (AUC = 0.974; sensitivity = 100%; specificity = 94.8%).

Conclusions: JVBG biomarkers serve as clinically informative biochemical indicators for assessing CBI severity and forecasting ICU duration. Their integration into predictive algorithms may enhance precision in neurocritical care and support biochemical decision-making in intensive care settings.

Background: This study will analyse the changes in serum nutrient protein, a proinflammatory cytokine, and immunoglobulins before and after enteral nutrition support (ENS) in patients with intracerebral haemorrhage (ICH), which will serve as a reference for future clinics when performing ENS.

Methods: This retrospective observational study included 160 patients with ICH (76 in the intermittent group and 84 in the continuous group), and changes in indicators before and after EN intervention were retrospectively analysed in both groups, including serum nutrient protein (albumin ALB, transferrin TRF, prealbumin PAB), proinflammatory cytokine (IL-1 b, IL-6, TNF-a), immunoglobulins (IgA, IgG, IgM) and gastrointestinal tolerance.

Results: There was no difference in adverse reactions between the two groups during ENS (P>0.05). After ENS, ALB, TRF PAB, IgA, IgG, and IgM were significantly increased in both groups, while IL-1 b, IL-6, and TNF-a were decreased (P<0.05). After ENS, there was no difference in serum nutrient protein between the two groups (P>0.05). Still, proinflammatory cytokines were lower in the intermittent group than in the continuous group, while immunoglobulins were higher than in the intermittent group (P<0.05).

Conclusions: ENS exerts neuroprotection through the "intestinal barrier repair-immune remodeling-inflammation inhibition axis".

Background: Laboratories have a responsibility to produce accurate and reliable results to ensure patient safety and meet quality standards. Within the Six SIGMA quality management framework, various approaches may emerge depending on the total allowable error (TAE) limits defined by different standards. This study aimed to compare analyte SIGMA levels using CLIA 1988 and CLIA 2024 criteria, determine appropriate quality control procedures based on Westgard multirules, and identify potential sources of error using the Quality Goal Index.

Methods: SIGMA values for 17 biochemical analytes were calculated based on internal and external quality control data using the formula (TEa - bias)/CV The Quality Goal Index (QGI) was determined using the formula bias/(1.5xCV). All analytes were evaluated at the Karabuk Public Health Laboratory between November 2024 and March 2025.

Results: Amylase (Levels 1 and 2), total bilirubin (Level 1), high-density lipoprotein cholesterol (Levels 1 and 2), creatine kinase (Levels 1 and 2), and lactate dehydrogenase (Levels 1 and 2) demonstrated world-class SIGMA performance according to both CLIA 1988 and CLIA 2024 standards. However, a decline in SIGMA values was observed when calculated using the more stringent CLIA 2024 limits.

Conclusions: The comparison of CLIA 1988 and CLIA 2024 standards demonstrated that stricter TEa limits can significantly impact the performance of SIGMA. While some analytes maintained world-class performance, others exhibited a notable decline, necessitating enhanced quality control measures. These findings emphasise the need for laboratories to periodically reassess test performance in light of evolving regulatory standards to ensure continued analytical reliability and patient safety.

Background: To assess the importance of inflammatory factors in predicting outcomes in individuals diagnosed with acute myeloid leukemia.

Methods: Between July 2017 and December 2019, a total of 100 patients with a recent diagnosis of acute myeloid leukemia (AML) were recruited from the Hematology Department of our hospital's Cancer Center and assigned to the AML group. Additionally, 60 individuals with no underlying health conditions who underwent standard medical checkups during the same period were selected as the control group. Serum levels of IL-2, IL-4, IL-17A, TNF-a, IFN-g, and LIF were measured through ELISA. All participants in the AML group were followed up for three years. Based on the European Leukemia Network (ELN) genetic risk stratification criteria, patients were categorized into favorable, intermediate, and adverse prognosis subgroups. Inflammatory marker profiles were then compared among these subgroups.

Results: Compared to healthy individuals, the AML group presented significantly increased serum concentrations of IL-4, IL-17A, and TNF-a, while levels of IL-2, IFN-g, and LIF were significantly decreased (P < 0.05). Upon stratifying patients by prognostic classification, those in the favorable and intermediate prognosis categories exhibited notably lower IL-4, IL-17A, and TNF-a levels relative to the poor prognosis group (all P < 0.05). In contrast, levels of IL-2, IFN-g, and LIF were notably elevated in the subgroup with favorable prognostic profiles (all P < 0.05). Additional analysis of cytokine expression indicated that increased levels of IL-4, IL-17A, and TNF-a were linked to worse 3-year survival performance (P < 0.05). Conversely, higher expression of IL-2, IFN-g, and LIF was significantly associated with better long-term survival outcomes relative to patients with reduced expression levels (P < 0.05).

Conclusions: The abnormal levels of IL-4, IL-17A, TNF-a, IFNg and LIF in patients with acute myeloid leukemia are increased, while the abnormal levels of IL-2, IFNg and LIF are decreased, which has certain guiding effect on prognosis assessment and can be used as auxiliary indicators for prognosis assessment of AML.

Background: To explore the correlation between different traditional Chinese medicine (TCM) constitution types and apolipoprotein B (ApoB) in patients with hyperuricemia (HUA) and to investigate the relationships between TCM constitutions, uric acid levels, and various cardiovascular risk factors.

Methods: A cross-sectional study involving 683 patients diagnosed with HUA was conducted. Patients' TCM constitutions were classified using the standardise "Classification and Determination of TCM Constitution" questionnaire. Serum uric acid (UA), lipid profiles, ApoB, and homocysteine (Hcy) levels were measured.

Results: Among 683 HUA patients, phlegm-dampness (22.99% ) and damp-heat constitution (20.06% ) were the most common TCM constitution types. UA, ApoB, and Hcy levels in patients with phlegm-damp constitution were significantly higher than those in other constitutions (P< 0.05). UA levels were negatively correlated with HDL-C (r=-0.472, P= 0.027) and positively correlated with ApoB (r= 0.618, P= 0.012) and Hcy (r= 0.492, P= 0.018).

Conclusions: Phlegm-damp and damp-heat constitutions are the most common TCM constitution types in HUA patients and are associated with higher levels of UA, ApoB, and Hcy. These constitutional types are independently associated with increased cardiovascular risk.

Background: This study aimed to evaluate the prognostic significance of pre-treatment serum albumin levels and assess their association with clinical outcomes and surgical decisions in advanced ovarian cancer (O C) patients. Cortisol and tumour necrosis factor-alpha (TN F-a) were also measured to explore potential but secondary relationships.

Methods: A retrospective analysis was conducted on OC patients undergoing surgery at our hospital from June 2022 to June 2024 with complete clinical and pathological data. Patients were categorised into low ALB (< 35 g/L) and normal ALB (>35 g/L) groups based on pre-treatment serum ALB levels. Each group was further divided into primary debulking surgery (PDS) and neoadjuvant chemotherapy, followed by interval debulking surgery (NACT-IDS) subgroups. Clinicopathologic characteristics were analysed.

Results: Pre-treatment serum ALB levels positively correlated with progression-free survival (PFS) (r= 0 .2 9 8 9 , P< 0.05) and overall survival (OS) (r= 0.2702, P< 0.05), with the low ALB group exhibiting significantly lower PFS and OS (P< 0.05). In the low ALB group, significant differences were observed between PDS and NACT-IDS in ascitic fluid level, R0 cytoreduction rate, postoperative complications, and length of stay (P< 0.05), though PFS and OS were comparable (P> 0.05). Similarly, in the normal ALB group, significant differences were noted in FIGO staging, ascitic fluid level, haemoglobin (HGB) levels, intra-operative haemorrhage, blood transfusion volume, R0 cytoreduction rate, and length of stay (P< 0.05), while PFS and OS remained unaffected by treatment type (P> 0.05). Additionally, C-reactive protein (CRP) levels were significantly higher in the low ALB group (6.5± 1.1 mg/L vs 5.2± 1.0 mg/L, P< 0.05), indicating greater inflammation, whereas HGB levels were substantially lower (110.4± 15.8 g/L vs 118.7± 10.5 g/L, P= 0.021), reflecting poorer nutritional status. TNF-a levels showed a non-significant upward trend (P= 0.058), while cortisol levels were similar between groups (P= 0.073).

Conclusions: Selecting NACT-IDS for advanced OC patients with hypoalbuminemia may help reduce the incidence of postoperative complications and improve the likelihood of achieving optimal cytoreduction. While survival outcomes (PFS and OS) did not significantly differ between treatment approaches in this study, the observed surgical benefits suggest that hypoalbuminemia could be considered a supportive factor in treatment planning. However, this indicator should be used cautiously and in conjunction with other clinical parameters until further evidence is available. The roles of TNF-a and cortisol in this context remained inconclusive and warrant further investigation.

Background: This study examined the regulatory effects of Acceptance and Commitment Therapy (ACT) on T lymphocyte subsets, serum inflammatory cytokines, neurotrophic factors, antioxidant enzymes, and lipid peroxidation products in elderly cerebral stroke (CS) patients, providing insights into the multi-dimensional pathophysiological interactions and potential intervention strategies for chronic stroke recovery.

Methods: In this randomized controlled trial, 120 elderly stroke patients were allocated to either an ACT group (ACT intervention; n = 60) or a routine group (conventional treatment; n = 60). Comprehensive assessments were performed to quantify: (1) peripheral T lymphocyte distribution (CD3+, CD4+, CD8+ subsets, and CD4+/CD8+ ratio), (2) serum inflammatory cytokines (IL-1p, IL-6, IL-10, and TNF-a), (3) neurotrophic factors (5-HT, NE, BDNF, and IGF-1), and (4) antioxidant enzymes (SOD, CAT) and lipid peroxidation products (MDA, NO) using flow cytometry, HPLC-ECD, and ELISA. Statistical analyses were conducted with SPSS 22.0.

Results: Following treatment, CS patients exhibited reduced CD3+ and CD4+ T-cell levels along with a decreased CD4+/CD8+ ratio, while CD8+ T-cell proportions were elevated (P< 0.05). Proinflammatory cytokine levels (IL-1 b, IL-6, and TNF-a) were significantly suppressed, whereas anti-inflammatory IL-10 expression increased (P < 0 .0 5 ). Notably, ACT demonstrated superior efficacy in restoring immune balance and attenuating inflammation compared to conventional intervention (P< 0.05). Furthermore, neurotrophic factors levels were elevated, and oxidative stress markers were ameliorated in CS after treatment (P< 0.05), suggesting that ACT enhances neurotrophic activity and mitigates oxidative injury.

Conclusions: ACT likely confers neuroprotection through multi-target mechanisms, including modulation of T-cell subset homeostasis, upregulation of neurotrophic factors, and suppression of oxidative stress.

Background: This study analysed the relationship between serum chemokine CXC ligand 8 (CXCL8) and axillary lymph node metastasis (ALNM) in breast cancer (BC), evaluating its predictive value when combined with tumour markers and ultrasound imaging.

Methods: 121 BC patients and 104 healthy controls were included, and serum CXCL8 was detected by enzyme-linked immunosorbent assay (ELISA) to compare the differences in the levels of CXCL8 and tumour markers in the two study groups. Pathological examinations revealed that 36 of the patients had ALNM. To further evaluate the diagnostic value, the receiver operating characteristic (ROC) curve was employed to analyse the ability of CXCL8, tumour marker and combined colour Doppler ultrasound blood flow richness grade (Adler grade) to assess ALNM in BC patients.

Results: Serum CXCL8 carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 153, and CA27.29 were higher in BC patients than in controls (P< 0.05). Patients with ALNM had higher levels of CXCL8, CEA, CA153, and CA27.29 (P< 0.05). The combined model (CXCL8 + tumour markers + Adler grade) achieved an AUC of 0.903 (95% CI: 0 .8 5 0 -0 .9 5 7 ), with 86.11% sensitivity and 82.35% specificity (P< 0.001).

Conclusions: High expression of CXCL8 is closely associated with BC ALNM.