Journal of Medical Biochemistry最新文献

Background: This study investigates the impact of food structure intervention based on the fast-track surgery (FTS) concept on the postoperative nutritional status, immune response, and recovery outcomes of patients with secondary hyperparathyroidism (SHPT). Specifically, it explores changes in serum calcium and phosphorus levels, immune-reactive parathyroid hormone (iPTH), inflammatory markers (CRf) IL-6, TNF-P), and rehabilitation outcomes following surgical intervention.

Methods: Fifty SHPT patients who underwent surgery at the Third Hospital of Hebei Medical University were randomly divided into two groups: a control group (CG) receiving conventional nursing care and an observation group (OG) receiving food structure intervention based on the FTS concept. Preand postoperative comparisons were made for nutritional indicators (hemoglobin, albumin), biochemical markers (calcium, phosphorus, calcium-phosphorus product, iPTH), inflammatory markers (CRF) IL-6, TNF-P), pain levels (Visual Analog Scale), muscle strength (MRC scale), and postoperative complications.

Results: The OG showed significantly improved nutritional status, with higher hemoglobin and albumin levels compared to the CG. Additionally, blood calcium levels and calcium-phosphorus product were significantly elevated, while blood phosphorus and iPTH levels were reduced in the OG. Inflammatory markers (CRf) IL-6, TNF-P) were significantly lower in the OG. Pain scores (VAS) were lower, muscle strength (MRC) was higher, and the incidence of complications was significantly reduced in the OG compared to the CG.

Conclusions: Food structure intervention based on the FTS concept enhances nutritional status, improves mineral metabolism, reduces postoperative inflammation, and accelerates recovery in SHPT patients. This study supports the implementation of FTS principles in perioperative care to improve outcomes and reduce complications for SHPT patients, offering valuable insights for optimising clinical management and nursing practices in this patient population.

Background: Differentiation of leukocytes is one of the key diagnostic procedures in clinical medicine, and correct identification of them in a blood smear is of essential importance. Light microscopy is the reference method for leukocyte differentiation; however, it is time-consuming and must be performed by a highly qualified specialist. For this reason, automatic analysers capable of precise and accurate differentiation of blood cells in the examined sample are increasingly present in haematology laboratories. This paper aims to evaluate the performance of the Sysmex XN-3100 analyser, manufactured by SYSMEX CORPORATION, Kobe, Japan., with a focus on the advantages and disadvantages of its digital microscopy in the differentiation of leukocytes and give brief guidelines on the possibilities and limitations of everyday work on the basis of the obtained results.

Methods: Digital optical microscopy on 253 samples was performed with primary data (preclassification) collected after the completion of the autoanalysis. Before validating the obtained results, the data were reviewed by a medical biochemistry specialist who confirmed or corrected them. This generated secondary data (reclassification). The two groups of data were statistically analysed using Passing-Bablok regression analysis, Bland-Altman analysis and Spearman correlation.

Results: The obtained results showed strong correlations between the primary and secondary analysis in all cells (highest in lymphocyte group (r=0.986), lowest in eosinophil group (r=0.870)) except immature granulocytes and blasts (significant deviation from linearity, p<0.01).

Conclusions: The haematology analyser Sysmex XN-3100 shows high performance in leukocyte analysis and differentiation using digital microscopy, but samples containing blasts and immature granulocytes must additionally be analysed by light microscopy.

Background: To analyse the effects of statins on the levels of sCD40, sCD146 and PAPP-An in patients with coronary heart disease (CHD).

Methods: 126 patients with CHD treated from September 2022 to September 2024 were divided into a study group (n = 84) and a control group (n=42). The study group was randomly divided into groups A (n=42) and B (n=42). Patients in the control group were routinely treated with vasodilator, furosemide, digitalis and other cardiotonic agents. Based on routine treatment, patients in the study group were treated with Atto vastatin calcium tablets in group An and rosuvastatin calcium tablets in group B. Both groups were treated with 20 mg, oral administration before bedtime, and the treatment cycle was 3 months. The cardiac function grade, blood lipid level, serum sCD40, sCD146 and PAPP-A levels and adverse reactions were compared before and after treatment.

Results: After treatment, the cardiac function of the three groups improved compared with that before treatment. The effect of patients in groups A and B was better than the control group. The blood lipid levels of the three groups were improved after treatment. The blood lipid levels of groups A and B were better than in the control group. The serum sCD40, sCD146, and PAPP-A levels between groups A and B were no different; after treatment, these in groups A and B were better than those in the control group. After treatment, there were some adverse reactions in all the three groups.

Conclusions: Statins effectively treat sCD40, sCD146, and PAPP-An in patients with CHD. They can significantly improve their cardiac function and blood lipid levels and effectively regulate sCD40, sCD146, and PAPP-An levels in patients with coronary heart disease.

Background: This study aimed to evaluate the effects of recurrent laryngeal nerve anatomical exposure during thyroidectomy on serum TNF-a, CRP interleukins IL-6, IL-10, and IL-1b, treatment outcomes, complications, and patient prognosis, with a specific focus on inflammatory and stress markers, including interleukins.

Methods: 110 patients with thyroid lesions undergoing thyroidectomy were randomly assigned to two groups: Expose (n = 55), where the recurrent laryngeal nerve was exposed during surgery, and non-expose (n = 55), where it was not. Various outcome measures were assessed, including surgical efficacy, vocal cord function, serum inflammatory and stress markers (TNF-a, CRP interleukins IL-6, IL-10, and IL-1b), thyroid function changes, postoperative complications (including RLN I), and patient satisfaction. Additionally, quality of life (QoL) was evaluated.

Results: The Expose group exhibited a smaller flap area and shorter hospital stays than the non-expose group, though the surgery took longer (P< 0.05). On postoperative day 30, patients in the Expose group showed lower values of fundamental frequency, Jitter, and Shimmer in vocal cords, indicating improved vocal function (P < 0 .0 5). Furthermore, the Expose group had significantly higher QoL scores and a lower incidence of RLNI (3.64% vs. 20.00% , P< 0.05), with improved surgical satisfaction (96.36% vs. 76.36% , P< 0.05). Notably, the Expose group exhibited reduced inflammatory and stress markers levels, including lower TNF-a, CRP IL-6, and IL-1b, and higher IL-10, which correlated with reduced postoperative pain and inflammation.

Conclusions: Anatomical exposure of the recurrent laryngeal nerve during thyroidectomy enhances postoperative recovery, reduces the incidence of RLNI, and improves both vocal and parathyroid function. It also attenuates inflammatory and stress responses, as indicated by changes in serum cytokines, thereby enhancing quality of life and patient satisfaction. This approach offers significant advantages for patients undergoing thyroidectomy for various thyroid disorders.

Background: This study investigated the effects of different early resuscitation fluid replenishment rates (FRRs) on inflammation (serum interleukin-6 (IL-6) and C-reactive protein (CRP), PCT and complications in patients with severe acute pancreatitis (SAP).

Methods: Sixty-six patients with SAP were studied. According to the ratio of total fluid replenishment 24 h after admission to 72 h (FRR), the patients were rolled into a low FRR group (Low group), a moderate FRR group (Moderate group), and a high FRR group (High group), with 22 cases in each. Serum-related indexes, APACHE II score, HCT, systemic inflammatory response syndrome (SIRS) duration, length of hospital stay (LOS), and complication rate (CR) were determined and compared.

Results: The results suggested that ALT, AST, SCr, BUN, TBil, APACHE II, scores and HCT in the Moderate group were the lowest (P< 0.05), while those in the High group were the highest (P<0.05). After the patients were treated for 72 h, the IL-6, CRP and PCT in the Low and High groups were higher than those in the Moderate groups, exhibiting differences with P<0.05 and P<0.01, respectively. The SIRS duration and LOS in the Low and High groups were longer. They presented differences with P<0.05 and P<0.01 to the Moderate group, respectively. The rates of MODS, mechanical ventilation, pancreatic necrosis infection, and death in the Moderate group were the lowest (P<0.05).

Conclusions: the moderate FRR could effectively alleviate the inflammatory response of patients with SAP shorten the treatment time, and reduce the CR.

Background: Laparoscopic colorectal cancer surgery, while minimally invasive, induces systemic oxidative stress, inflammation, and immune dysfunction through surgical trauma and anesthesia-related stress. Esketamine, an NMDA receptor antagonist with antioxidant and anti-inflammatory properties, may mitigate these biochemical perturbations. This study evaluated esketamine's effects on serum biomarkers of oxidative stress (glutathione, catalase, malondialdehyde, superoxide dismutase), inflammatory mediators (TNF-a, CRP IL-6), and T lymphocyte subsets in patients undergoing laparoscopic colorectal cancer resection.

Methods: In this randomized controlled trial, 150 stage I-II colorectal cancer patients were allocated to esketamine (0.25 mg/kg bolus + 0.12 mg/kg/h infusion) or control (saline) groups during standardized anesthesia. Preand postoperative serum levels of oxidative stress markers (GSH, CAT, MDA, SOD), inflammatory cytokines (TNF-a, CRP IL-6), and immune cell subsets (CD3+, CD4+, CD8+, CD4+/CD8+ ratio) were quantified via ELISA and flow cytometry. Statistical analysis compared intergroup differences using t-tests and chi-square tests.

Results: Postoperatively, the esketamine group exhibited significantly attenuated oxidative stress, with higher GSH (72.43± 6.63 vs. 60 .1 6± 5.57 mg/mL, P < 0.05), CAT (92.56± 8.31 vs. 82.81 ± 7.75 U/mL), and SOD (84.53± 8.02 vs. 69 .93± 7.05 nU/mL), alongside lower MDA (6.41± 0.52 vs. 9.52± 0.63 mmol/L). Pro-inflammatory cytokines were reduced (TNF-a: 4 0 .32 ± 4.84 vs. 54.37± 5.80 pg/mL; IL-6: 50.83± 5.05 vs. 82 .38± 8.46 pg/mL, P < 0.05). Immune function preservation was evident through elevated CD3+ (4 5 .1 8 ± 5 .0 1 % vs. 37 .05 ± 4.92% ) and CD4+ T cells (26.51 ±2.76% vs. 19.78± 2.09%), with a balanced CD4+/CD8+ ratio (1.12± 0.12 vs. 0.72± 0.09).

Conclusions: Esketamine-based anesthesia significantly ameliorates postoperative oxidative damage, suppresses inflammatory cytokine release, and preserves cellular immune homeostasis, as evidenced by targeted biochemical and immunological analyses. These findings highlight esketamine's role in modulating perioperative biochemical pathways, potentially enhancing recovery in colorectal cancer surgery.

Background: To explore how Baoyuan and Taohong Siwu decoctions combined with Western medicine affect triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in elderly patients with coronary heart disease.

Methods: Ninety elderly patients with coronary heart disease who were hospitalized from January 2021 to December 2022 were selected and divided into two groups based on different treatment methods, with 45 patients in each group. The control group was treated with Western medicine alone, while the research group was treated with the combination of Baoyuan and Taohong Siwu decoctions based on the control group. The improvement of traditional Chinese medicine symptom scores, various blood lipid levels, and serum indicators of cardiac function were compared between two groups before treatment, 1 month, 2 months, and 3 months of treatment.

Results: Before treatment, the two groups had identical Traditional Chinese Medicine symptom scores, various blood lipid levels, and various serum indicators of cardiac function (P> 0.05). After treating 1 month, 2 months, and 3 months, the chest pain, tightness, fatigue, and sweating scores in the research group were lower (P< 0.05). The TG, TC, LDL-C, and HDL-C levels in the research group were lower (P< 0.05). The levels of plasma N-terminal brain natriuretic peptide (NT-proBNP) and monocyte chemoattractant protein-1 (MCP-1) in the research group were lower (P <0.05).

Conclusions: Combining Baoyuan and Taohong Siwu decoctions and Western medicine treatment can help improve the symptoms and signs of coronary heart disease in the elderly. It can reduce the levels of various indicators such as LDL-C, TG, TC, and HDL-C in the body and promote the improvement of cardiac function.

Background: This study explores the combined therapeutic effects of pediatric massage and vitamin D supplementation on the nutritional status, immune function (serum IL-4 and IL-5), and clinical outcomes in children with Bronchial asthma (BA).

Methods: A total of 60 children diagnosed with BA were randomly assigned to one of two groups: a control group receiving conventional treatment alone and an experimental group receiving conventional treatment alongside pediatric massage and daily vitamin D supplementation. Both groups were monitored over two months for changes in clinical symptoms, immune markers (CD 3+, CD4+, CD4+/CD8 + ratio), nutritional protein levels (albumin, transferrin, prealbumin, and total protein), and recurrence rates.

Results: The experimental group showed significantly faster symptom relief and improved immune function than the control group. This included enhanced immune markers, such as increased CD3+ and CD4+ counts and an improved CD 4+/CD 8+ ratio. Nutritional status also improved, as evidenced by higher levels of albumin, transferrin, prealbumin, and total protein. Additionally, the recurrence rate in the experimental group was notably lower (10%) compared to the control group. The experimental group also exhibited reduced levels of inflammatory cytokines, including IL-4 and IL-5, suggesting a beneficial effect on immune modulation.

Conclusions: The combination of pediatric acupressure and vitamin D supplementation can improve immune function and inflammatory response in children with BA, which is of clinical value.

Background: Primary lung cancer is one of the most prevalent malignant tumours in China. Small cell lung cancer (SCLC) is a highly malignant, undifferentiated tumour prone to metastasis and is usually diagnosed in its middle or late stages. Pro-gastrin-releasing peptide precursor (ProGRP) and neuron-specific enolase (NSE) tumour markers are recommended in the literature for early diagnosis. Objective: The purpose of this research is to probe the diagnostic value and therapeutic efficacy of serum levels of ProGRP and NSE in SCLC to enhance the level of clinical diagnosis.

Methods: A total of 84 SCLC patients who were admitted to our hospital from December 2022 to March 2024 were included in the SCLC group. The NSCLC group consisted of 45 patients diagnosed with NSCLC, while the benign lung disease group consisted of 57 patients diagnosed with non-cancerous lung conditions. Furthermore, the healthy control group comprised 60 healthy individuals. The serum levels of ProGRP and NSE were compared across all four groups.

Results: The SCLC group exhibited considerably elevated serum ProGRP and NSE levels compared to the healthy control group, benign lung disease group, and NSCLC group (P< 0.05). ProGRP and NSE values were higher in limited-stage SCLC than in extensive-stage SCLC (P < 0.05). The ROC curve displayed that the critical value of ProGRP for diagnosing SCLC was 136.49 pg/mL, the area under the curve (AUC) was 0.869, the sensitivity attained 80.00%, and the specificity reached 84.87%, indicating a better diagnostic efficacy than that of NSE (P< 0.05).

Conclusions: The tumour markers ProGRP and NSE levels are of paramount significance for the clinical diagnosis and staging of SCLC patients. ProGRP is a more specific and sensitive tumour marker for SCLC than NSE and can be employed as an auxiliary diagnostic tool for SCLC. Thus, it is worth promoting ProGRP in a clinical setting.

Background: Acute ischemic stroke (AIS) often leads to hemiplegia, significantly impairing neurological function, motor ability, and daily life activities. Early precision exercise rehabilitation has emerged as a promising intervention to enhance recovery. This study evaluated its effectiveness in improving neurological function, gait performance, and self-care ability and reducing inflammatory response in hemiplegic patients.

Methods: This retrospective cohort study included 230 patients with hemiplegia due to AIS, admitted within 72 hours of onset. Patients were divided into an Early Rehabilitation Group (EG, n = 132) and a Conventional Rehabilitation Group (CG, n = 98) based on the intervention received. The EG underwent early precision exercise rehabilitation, integrating neurofunctional training, motor-evoked potential (MEP) therapy, and functional electrical stimulation (FES), while the CG received traditional rehabilitation. The effectiveness was assessed using the National Institutes of Health Stroke Scale (NIHSS), Wisconsin Gait Scale (WGS), and Activities of Daily Living (ADL) scores. Serum inflammatory markers (TNF-a, hs-CRP IL-6, IL-18) were also measured before and after treatment.

Results: The EG demonstrated significantly more significant improvements in NIHSS (5.85± 1.31 vs 7.03± 2.54, P< 0.05), WGS (24.81± 3.06 vs. 31 .96 ± 4.62 , P< 0.05), and ADL scores (63.08± 4.93 vs. 51 .78 ± 6.34 , P< 0.05) compared to the CG. Walking frequency and speed were also higher in the EG (P< 0.05). Inflammatory markers significantly decreased post-treatment in the EG (TNF-a: P< 0.05, hs-CRP: P< 0.05, IL-6: P< 0.05, IL-18: P< 0.05), suggesting a reduction in systemic inflammation.

Conclusions: Early precision exercise rehabilitation significantly enhances neurological function, motor ability, and self-care capacity, reducing inflammatory response in hemiplegic AIS patients. These findings support its integration into clinical stroke rehabilitation protocols.