Journal of Medical Biochemistry最新文献

Background: Butylphthalide (BP) is commonly used to treat vascular dementia (VD) following cerebral infarction (CI), but BP alone has limited efficacy. BP in combination with citicoline (COPC) or vascular rehabilitation capsules (VRC) is common in clinical practice, but few studies have compared the differences between these two treatment options.

Methods: Ninety-eight patients with VD after CI who were seen in our hospital from April 2020 to June 2022 were selected as the study population. Among them, 52 patients received BP combined with COPC (BP+COPC group), while the rest 46 received BP combined with VRC (BP+VRC group). Fasting venous blood was drawn from the patients before and after treatment. The levels of neurotrophic factor [nerve growth factor (NGF), neuron-specific enolase (NSE), brain-derived neurotrophic factor (BDNF)], oxidative stress [superoxide dismutase (SOD), malondialdehyde (MDA)], and inflammatory factors [Tumor necrosis factor-a (TNF-a), Interleukin-1 (IL-1b), C-reactive protein (CRP)] were measured. Cognitive and neurological improvements were assessed using the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and the National Institute of Health Stroke Scale (NIHSS). In addition, the patient's cerebral hemodynamics were examined by CT.

Results: After treatment, LOTCA increased in both groups and was higher in the BP+COPC group than in the BP+VRC group (P<0.05), while NIHSS decreased in the BP+COPC group than in the BP+VRC group (P<0.05). NSE, MDA, IL-1 , CRP, and TNF-a decreased in both groups after treatment, while NGF, BDNF, and SOD increased, again with more significant changes in the BP+COPC group (P<0.05). In addition, cerebral hemodynamics was more favourable in the BP+COPC group than in the BP+VRC group (P<0.05).

Conclusions: BP combined with COPC has superior improvement in neurologic function in patients with VD after CI.

Background: To evaluate the therapeutic effects of Tripterygium wilfordii glycosides on endometriosis (EMs) and their effects on serum sex hormone levels, tumour markers, and inflammatory factors (serum CA125, CA199, Estradiol, FSH, IL-6, TNF-a).

Methods: A total of 108 patients were randomly divided into control, progesterone, and Tripterygium wilfordii glycoside-treated groups, each receiving treatment for three months. The clinical efficacy and serum levels of estradiol, follicle-stimulating hormone, tumour markers (cancer antigen125 and cancer antigen199), and pro-inflammatory cytokines were compared before and after treatment.

Results: The Tripterygium wilfordii glycoside group exhibited a significantly higher clinically effective rate (90.74% versus 75.93%) and more significant reductions in estradiol, follicle-stimulating hormone, cancer antigen125, cancer antigen199, IL-6, TNF-a, and HSCRP levels than the control group.

Conclusions: Tripterygium glycosides exhibit significant clinical efficacy in treating patients with EMS by significantly improving serum sex hormone levels, reducing tumour marker levels, alleviating inflammatory reactions, and exerting minimal toxic side effects.

Vitiligo is an autoimmune disorder with a complex genetic and epigenetic aetiology, characterised by progressive skin depigmentation. Recent advancements in artificial intelligence (AI) have greatly impacted the understanding, diagnosis, and treatment of vitiligo. The genetic basis of vitiligo is linked to multiple single nucleotide polymorphisms (SNPs) in genes associated with immune function, apoptosis, and melanogenesis, necessitating the integration of AI for more efficient diagnostic tools and personalised therapies. Genome-wide association studies (GWAS) have identified approximately 50 vitiligo-susceptibility genes, including PTPN1, PTPN22, NLRP1, FASLG, and TYR. These genes influence the immune response and melanocyte function, with the transcription factor Nuclear Factor kappa B (NF-kB), playing a central role in inflammatory responses and redox signaling induced by oxidative stress, in conjunction with antioxidant enzymes such as GPx, GST, SOD, and CAT. AI technologies offer a promising avenue for diagnosing vitiligo by combining genetic, clinical, and imaging data, allowing for more accurate classification and personalised treatment strategies. By analysing vast datasets, AI algorithms can identify patterns within complex genetic markers and clinical features, facilitating earlier and more precise detection of vitiligo. Furthermore, AI-driven approaches can optimise therapeutic monitoring, enabling real-time treatment efficacy and disease progression assessment. Integrating AI in vitiligo genetic diagnostics can revolutionise the monitoring of the disorder, improving patient outcomes through personalised, data-driven interventions.

Background: This study aimed to evaluate the effectiveness and safety of closed reduction and internal fixation (CRIF) versus closed reduction and external fixation (CREF) in treating tibiofibular fractures, focusing on their impact on bone metabolism and inflammatory responses.

Methods: A retrospective analysis was conducted on the clinical data of 95 patients with tibiofibular fractures, categorised into the CRIF group (CRIFG) and the CREF group (CREFG). Clinical efficacy, Visual Analogue Scale (VAS) scores, serum bone metabolism markers, serum inflammatory cytokines, Generic Quality of Life Inventory-74 (GQOLI-74) scores, and adverse reactions (AR) were compared between the groups.

Results: The total clinical efficacy rates were 80.49% (33/41) in the CRIFG and 85.19% (46/54) in the CREFG (P>0.05). Compared to CRIFG, the CREFG group exhibited significantly lower VAS scores and higher GQOLI-74 scores across all dimensions. Additionally, the CREFG group showed increased levels of serum osteocalcin (BGP), bone alkaline phosphatase (BALP), and N-terminal propeptide of type 1 procollagen (P1NP), along with decreased levels of type I collagen carboxy-terminal peptide b special sequence (b-CTX). Inflammatory markers, including C-reactive protein (CRP), interleukin-6 (IL-6), IL-1b, and tumour necrosis factor-a (TNF-a), were significantly lower in the CREFG group. The total AR rate was also lower in CREFG (18.52% vs. 31.71%, P<0.05).

Conclusions: Compared to CRIF, CREF treatment is more effective in reducing pain, enhancing bone metabolism, alleviating inflammatory responses, and improving the overall quality of life (QoL) in patients with tibiofibular fractures.

Background: The analytical performance metrics of ethanol testing are critically important due to their legal implications when presenting and interpreting results. Measurement uncertainty (MU) and total analytical error (TAE) are essential approaches for evaluating and improving the quality of measurement procedures. This study aimed to calculate MU and TAE values, which assess the reliability of ethanol test results from different perspectives, and to evaluate the impact of MU values, calculated using two different methods, on the legal threshold.

Methods: MU values were calculated following the guidelines of Nordtest and ISO/TS 20914. TAE was determined using the formula TAE%=1.65×CV%+Bias%. External and internal quality data from ethanol testing conducted between July 1, 2022, and June 30, 2024, were used for calculations.

Results: The expanded MU values for ethanol testing were 13.95% according to the Nordtest Guide, 10.94% for low level and 9.59% for high level according to the ISO/TS 20914 Guide. The calculated TAE values were 12.59 for low levels, 11.47 for high levels, and 12.57 overall. MU and TAE values for ethanol testing in our laboratory remained within the allowable total error (±20%) according to CLIA 2024.

Conclusions: We believe each laboratory should report ethanol test results and their respective MU values, particularly when evaluating results close to legal thresholds. Furthermore, we suggest that scientific committees standardise the method for calculating MU and define a target limit.

Background: Meniere's disease (MD) is a prevalent condition in otolaryngology, with its annual incidence rate increasing. Consequently, understanding the underlying mechanisms of MD is of significant importance. The aim is to investigate the relationship between serum levels of interleukin-1b (IL-1b) and interleukin-18 (IL-18), as well as the activation status of NLRP6 inflammasomes, in patients with Meniere's disease and to evaluate their correlation with the severity of the disease, to improve the treatment strategy of Meniere's disease.

Methods: From March 2021 to December 2023, 75 MD patients were selected from the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University for research, and a control group consisting of 75 age-matched healthy individuals was established. Each participant contributed a 5 mL peripheral venous blood sample, which was archived at -80 °C for subsequent analyses. The expression levels of NLRP6 messenger RNA in the blood samples were quantified using real-time fluorescence quantitative PCR methodology. Concentrations of interleukin-1b (IL-1b) and interleukin-18 (IL-18) were measured via enzyme-linked immunosorbent assay (ELISA). Through a comparative examination of NLRP6, IL-1b, and IL-18 levels between MD patients and the healthy controls, the study delved into the potential association between NLRP6 expression and the circulating levels of these two cytokines. In addition, special attention is paid to the differences between unilateral and bilateral MD patients in the above three indexes to evaluate their effectiveness as potential biomarkers for predicting the severity of hearing loss in MD patients.

Results: In individuals suffering from MD, a notable elevation was observed in the peripheral blood expression levels of NLRP6, IL-1b, and IL-18 (p<0.001). A correlation assessment disclosed a positive association between the blood NLRP6 content and both IL-1b and IL-18 concentrations among these patients. Notably, no substantial disparity emerged in the expression profiles of these three biomarkers when comparing unilateral versus bilateral MD cases (p>0.05). Furthermore, patients at advanced stages (III+IV) exhibited significantly heightened levels of NLRP6, IL-1b, and IL-18 compared to their counterparts in earlier stages (I+II) (p<0.001). Receiver operating characteristic (ROC) curve analyses demonstrated that the area under the curve (AUC) for NLRP6, IL-1b, and IL-18 stood at 0.8731, 0.8089, and 0.7838, respectively, suggesting their potential as proficient diagnostic markers capable of differentiating MD patients from healthy controls.

Conclusions: NLRP6, IL-1b, and IL-18 are highly expressed in the peripheral blood of MD patients. NLRP6, IL-1b, and IL-18 can serve as early diagnostic indicators for MD.

Background: Infertility remains a prevalent global reproductive challenge, significantly affecting the lives of couples worldwide. The aetiology of infertility can be affected by various factors that exhibit possible relationships with one another. The study aimed to investigate factors that can interact with and influence the pregnancy outcome in couples undergoing assisted reproductive technology procedures.

Methods: This retrospective study included 64 couples (64 men and their female partners) undergoing assisted reproductive technology procedures, having different pregnancy outcomes and lifestyle habits. Biomarkers of antioxidative and fatty acid status in the serum of both male and female partners, as well as the concentration of zinc in serum and seminal plasma of men, and their impact on assisted reproductive technology outcome were examined.

Results: We grouped the parameters using principal component analysis and identified the three most contributing factors to the pregnancy achievement - seminogram parameters in males and redox status scores in female participants; supplementation with vitamin D, magnesium, and zinc; and serum levels of omega-3 and omega-6 fatty acids.

Conclusions: The study concluded that seminogram parameters, intake of micronutrients, and levels of zinc, omega-3, and omega-6 fatty acids are contributing factors to the success of assisted reproductive technology. Further studies on a larger cohort are needed to confirm the predictive role of these factors on the success of assisted reproductive technology.

Background: Among individuals with diabetes mellitus, diabetic nephropathy (DN) is a common microvascular complication. As renal dysfunction progresses in DN patients, the risk of cardiovascular disease (CVD) significantly increases. The current effective treatment of DN and CVD demands identifying and managing their risk factors.

Methods: Patients diagnosed with DN from October 2022 to October 2023 were selected for cross-sectional study and divided into DN group (n=58) and DN/CVD group (n=40) based on the presence of CVD. Univariate analysis was conducted using clinical data, and statistically significant independent variables were analysed through multivariate Logistic regression to identify independent factors influencing CVD in DN patients. A regression model was developed to examine the non-linear relationship between C1q, UA, CRP, and the risk of CVD. The receiver operating characteristic curve was used to analyse the predictive efficacy of the indicators.

Results: When elevated, UA and C1q were independent factors for CVD. A linear relationship existed between UA and C1q and the risk of CVD in DN patients. C1q showed better predictive performance.

Conclusions: As UA and C1q levels rise, the risk of CVD in DN patients significantly increases. In DN patients, UA and C1q are associated with CVD development and progression, offering some supportive evaluation value for the patient's condition.

Background: The aim was to explore the effect of rituximab in combination with chemotherapy in treating diffuse large B-cell lymphoma and levels of vascular endothelial growth factor (VEGF), thymidine kinase 1(TK1) with interleukin-6 (IL-6), plasma T cells, NK cells as well as B cells.

Methods: Eighty patients admitted to Lujiang County People's Hospital from January 2022 to January 2024 were included. The control group accepted cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy regimens. The research group was treated with rituximab based on the control group. The clinical effects, vascular endothelial growth factor (VEGF), thymidine kinase 1 (TK1) and interleukin-6 (IL-6) levels, lymphocyte subsets index, quality of life and occurrence of adverse reactions were compared in both groups.

Results: The research group's total clinical effective rate was better than the control group's (P<0.05). After therapy, compared to the control group, vascular endothelial growth factor, thymidine kinase 1, and interleukin-6 levels in the research group presented lower (P<0.05), plasma T cells, natural killer cells along with B cells in the research group presented lower (P<0.05), and Quality of Life Core Questionnaire-Core 30 scores in the research group presented higher (P<0.05). There was no difference in adverse reactions between the two groups (P>0.05).

Conclusions: Rituximab combined with chemotherapy is effective in treating DLBCL patients, which can reduce serum-related factors promoting immune function and quality of life. Our study may provide compelling evidence for supporting the therapeutic regimen of rituximab combined with chemotherapy in DLBCL patients.

Background: Cardiorenal syndrome (CRS) is a complex clinical condition that leads to deterioration in both cardiac and renal functions. Empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, is a novel anti-diabetic drug that also improves cardiac and renal functions. However, little research exists on the efficacy and safety of empagliflozin in elderly type 2 diabetes mellitus (T2DM) patients with CRS. We aimed to evaluate the effectiveness and safety of empagliflozin in patients 65 and older with T2DM complicated by Type II and IV CRS.

Methods: A randomised, prospective study was conducted involving 200 patients 65 and older diagnosed with T2DM and CRS who were admitted to the cardiovascular department of Fujian Provincial Governmental Hospital from January 2020 to January 2024. Patients were randomised into an experimental group (n=100) treated with empagliflozin 10mg/day and a control group (n=100) receiving standard care. Blood glucose, cardiac and renal function indicators, adverse reactions and major adverse cardiovascular events were compared between groups. T-tests, Mann-Whitney U tests, Wilcoxon signed-rank tests, and chi-square tests were performed appropriately.

Results: After one-year follow-up, patients in the experimental group showed significant improvements in fasting blood glucose, glycated haemoglobin, serum creatinine, urinary microalbumin, NT-proBNP, left ventricular ejection fraction, and left ventricular end-diastolic diameter compared to the control group (P<0.05). Empagliflozin also reduced the incidence of major adverse cardiovascular events, with a non-significant increase in adverse reactions such as urinary tract infections and genital infections.

Conclusions: Empagliflozin demonstrates efficacy in improving glycemic control and cardiorenal function in T2DM patients over 65 with CRS. However, the drug's effect on biomarkers of acute myocardial injury and thrombosis requires further investigation. This study contributes to the growing body of evidence supporting the use of SGLT2 inhibitors in the management of CRS and emphasises the need for larger-scale, long-term studies to confirm these findings.