Journal of Medical Biochemistry最新文献

Background: Epilepsy is a prevalent neurological disorder, and evaluating its treatment strategies is highly significant. This study aimed to compare the effects of monotherapy with carbamazepine and levetiracetam on the results of coagulation tests, including prothrombin time, activated partial thromboplastin time, fibrinogen, and D-dimer levels, as well as on seizure control in patients with partial-onset epilepsy.

Methods: A total of 89 patients diagnosed with POE and treated at our hospital between January 2023 and January 2024 were enrolled. The patients were divided into the carbamazepine group and the levetiracetam group. Blood coagulation parameters, including prothrombin time, activated partial thromboplastin time, fibrinogen, and D-dimer levels, were measured at baseline (before treatment) and at 1, 3, and 6 months after medication initiation. Additionally, the frequency and severity of epileptic seizures were recorded for each group.

Results: In the carbamazepine group, prothrombin time, activated partial thromboplastin time, and D-dimer levels were significantly reduced at 1-, 3-, and 6-months post-treatment compared to pre-treatment levels. Conversely, these changes were less pronounced in the levetiracetam group. Fibrinogen levels decreased in both groups after treatment. The frequency of epileptic seizures was markedly reduced in all patients after treatment. There was no significant difference in seizure control rates between the carbamazepine and levetiracetam groups.

Conclusions: Carbamazepine may pose a higher risk of coagulation abnormalities but demonstrated strong efficacy in controlling epileptic seizures. Levetiracetam had a milder impact on coagulation parameters while offering comparable effectiveness in seizure management.

Background: To explore the predictive value of relevant detection indexes and pathological serum NLR, PLR, P53, and K67 levels in lymph node metastasis (LNM) in patients with early gastric cancer (EGC) after radical surgery.

Methods: Clinical data of EGC patients (297 cases, all of whom underwent radical gastrectomy for gastric cancer) admitted to Sichuan Integrative Medicine Hospital from March 2019 to March 2024 were retrospectively included. The clinical data and pathological results were recorded and compared, and the related predictive factors were analysed.

Results: There were 43 cases (14.48%) of postoperative LNM among the 297 EGC patients. The average number of lymph nodes detected in the LNM (-) group was 28.35 ± 8.23, which was lower than in the LNM (+) group (33 ± 15), *P* < 0.01. Binary multivariate logistic regression analysis identified the following as significant predictors of postoperative LNM in EGC patients: tumour size (OR: 2.582, 95% CI: 1.205-5.534), depth of invasion (OR: 2.953, 95% CI: 1.327-6.573), vascular invasion (OR: 2.724, 95% CI: 1.241-5.976), neuroaggression (OR: 2.681, 95% CI: 1.139-6.311), differentiation type (OR: 2.426, 95% CI: 1.140-5.119), and P53 (OR: 3.133, 95% CI: 1.183-8.301), P<0.05. The area under the ROC curve (AUC) for the model based on these indexes was 0.801. Compared with the LNM (-) group, the LNM (+) group had a lower overall survival rate at 1 and 2 years (P<0.05).

Conclusions: Clinically relevant detection indexes and pathological P53 levels in patients after EGC radical surgery have a good predictive effect on the occurrence of LNM, which can assist in formulating scientific and reasonable clinical treatment plans.

Background: To investigate the effects of modified ultrafiltration in extracorporeal circulation valve replacement surgery.

Methods: A total of 62 patients with valvular disease who underwent valve replacement were included. They were randomly divided into the conventional ultrafiltration group (CUF group, n=31) and the modified ultrafiltration group (MUF group, n=31). The hematocrit (Hct) values, volume of pleural fluid drainage at 24 hours after operation, Intensive Care Unit (ICU) stay time, postoperative 24-hour blood loss, bank blood usage, postoperative 24-hour urine volume, ventilator support time, cardiac function indexes, postoperative changes of respiratory function, and levels of inflammatory factors in both groups were compared.

Results: After ultrafiltration, the MUF group showed higher Hct value and reduced volume of pleural fluid drainage, blood loss, bank blood usage, urine volume and ventilator support time 24 hours after operation compared with the CUF group (P<0.05). After surgery, left ventricular ejection fraction (LVEF) levels were elevated, and those in the MUF group were higher than those in the CUF group. Left ventricular end-diastolic diameter (LVEDD) and heart rate (HR) were decreased in both groups after surgery. They were lower in the MUF group than in the CUF group (P<0.05). After ultrafiltration, the OI value in the MUF group was higher, and the alveolar-arterial oxygen partial pressure gradient (P (A-a)O2) value was lower than the CUF group (P<0.05). The plasma concentrations of interleukin 6 (IL-6) and tumour necrosis factor-alpha (TNF-a) were increased after cardiopulmonary bypass (CPB) in both groups and then decreased after ultrafiltration, and IL-6 and TNF-a levels in MUF group were lower than those in CUF group (P<0.05).

Conclusions: MUF attenuates the postoperative systemic inflammatory response, reduces the lung injury caused by CPB, and improves the lung function of patients in the early postoperative period, which benefits patient recovery after surgery and is valuable in heart valve replacement.

Background: The risk factors for thyroiditis, an inflammatory disease with a complex etiology, remain poorly understood. Blood metabolites are known to change during thyroiditis development, suggesting a close relationship between blood metabolites and thyroiditis progression. However, evidence for a causal link is lacking. We employed Mendelian randomization (MR) methodology to systematically investigate the putative causal relationships between blood metabolite profiles and two clinically distinct thyroiditis phenotypes-subacute and autoimmune thyroiditis-providing insights into their metabolic underpinnings.

Methods: We analyzed genomic and health data from 88 million Finnish Biobank participants in the Genome-Wide Association Study (GWAS). The primary analytical method was random-effects inverse variance weighting (IVW), supplemented by the weighted median method (WME) and Mr-Egger. We implemented comprehensive sensitivity analyses encompassing Cochran's Q test, Mr-Egger intercept, leave-one-out analysis (LOO), and Mr-PRESSO to assess heterogeneity, pleiotropy, and outliers. Extended genetic investigations incorporated the linkage disequilibrium score regression (LDSC) method, multivariable Mr (MVMR), and metabolic pathway analyses to provide deeper mechanistic insights.

Results: Ten metabolites were significantly associated with autoimmune thyroiditis, and fifteen with subacute thyroiditis. Nonadecanoate (19:0) and 1-palmitoylglycerophosphoinositol* were found to directly affect subacute thyroiditis. MVMR analyses identified pelargonate (9:0), carnitine, and ADpSGEGDFXAEGGGVR* as having an independent and direct effect on autoimmune thyroiditis. Additionally, metabolic pathways such as neomycin, kanamycin, and gentamicin biosynthesis, histidine metabolism, and starch and sucrose metabolism were linked to autoimmune thyroiditis, while phenylalanine, tyrosine, tryptophan biosynthesis, phenylalanine metabolism, and arginine biosynthesis were associated with subacute thyroiditis.

Conclusions: Our findings establish causal relationships between circulating metabolites and thyroiditis, revealing novel mechanistic insights through integrated genomic and metabolomic analyses. These results not only advance our understanding of thyroiditis pathogenesis but also suggest potential biomarkers for disease screening and therapeutic targets for intervention.

Background: Hemolysis is the most frequent preanalytical error in clinical laboratories, but its detection in point-of-care (POC) settings remains challenging due to the lack of sample separation. This study was planned to validate the hemolysis index (HI) threshold of GEM Premier 7000 blood gas analyzer for detecting hemolysis levels that may generate clinically significant interference in potassium measurement.

Methods: Heparinized whole blood samples were collected from healthy volunteers and divided into six aliquots; one was used as non-hemolyzed control, while hemolysis was mechanically induced in the remaining five aliquots by repeated aspirations through a fine-gauge needle. HI and potassium were measured on GEM Premier 7000.

Results: The final study population consisted of 18 volunteers. Both HI and potassium levels increased progressively and significantly with the number of fine-needle aspirations (p<0.001 for both). A strong positive correlation was observed between HI values and percentage increases in potassium concentration in hemolyzed aliquots (r=0.985, p<0.001). Receiver operating characteristic (ROC) curve analysis confirmed excellent diagnostic accuracy of HI in detecting potassium increases above the minimum total 7.4% allowable error threshold, with an area under the curve (AUC) of 1.00 and optimal cutoff of 102 mg/dL (0.94 sensitivity and 1.00 specificity). At the manufacturer-recommended 116 mg/dL threshold, the AUC was 0.95, with 0.89 sensitivity and 1.00 specificity.

Conclusions: These results confirm that the novel GEM Premier 7000 blood gas analyzer provides accurate detection of hemolysis thresholds in whole blood that may impair potassium test reliability.

Background: Infectious mononucleosis (IM) is an infectious disease with different stages of onset, and the pathogenesis of IM remains unclear. This study aimed to investigate the levels of interleukin (IL)-10 family cytokines IL-10, -22, -24, and -26 in serum samples of patients with infectious mononucleosis (IM) and the potential diagnostic values.

Methods: Thirty children with IM were enrolled in the study, and serum samples were collected; 30 healthy children served as the controls. Serum samples from the patients and healthy controls were collected, and IL-10, -22, -24, and -26 were determined by the ELISA method. An automatic biochemical analyser detected the serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Moreover, potential diagnostic values of IL-10, -22, -24 and -26 have been analysed using ROC curve analysis, and the correlation between the levels of IL-10, -22, -24 and -26 in patients was analysed. Correlation between IL-10, -22, -24, and -26 and ALT and AST were analysed.

Results: IL-10, -22, -24, and -26 levels increased in serum samples of patients with IM compared to healthy controls. ROC analysis showed that the AUC of IL-10, -22, -24, and -26 were 0.8500, 0.7078, 0.8056, and 0.9167, respectively, suggesting that IL-10, -22, -24, and -26 were good biomarkers. Moreover, IL-10, -22, -24 and -26 levels were positively correlated with the ALT and AST of the patients.

Conclusions: IL-10, -22, -24, and -26 were upregulated in the serum of patients with IM, suggesting they may function as potential biomarkers.

Background: This study aimed to evaluate the effects of nutritional support combined with stratified nursing under delirium risk assessment on immune function and postoperative delirium in elderly hip fracture patients.

Methods: A total of 112 elderly hip fracture patients were divided into two groups: the study group (SG), which received stratified nursing and enteral nutrition, and the control group (CG), which received routine nursing with a normal diet. Key parameters were evaluated and compared, including serum IgA, IgG, IgM levels, total protein (TP), albumin (ALB), postoperative delirium incidence, nutritional status, recovery time, and overall patient outcomes.

Results: Compared to the CG, the SG demonstrated significant improvements in immune function, with increased IgA, IgG, and IgM levels, as well as higher haemoglobin, albumin, and total protein levels. The SG also experienced shorter hospital stays, earlier postoperative mobility, reduced postoperative delirium rates (1.79% vs. 14.29%), lower anxiety and depression scores, better sleep quality, and lower pain scores. Additionally, nursing satisfaction was significantly higher in the SG.

Conclusions: Nutritional support combined with stratified nursing under delirium risk assessment effectively enhances immune function, reduces postoperative delirium, and accelerates recovery in elderly hip fracture patients. This approach may serve as a valuable strategy in postoperative management to improve patient outcomes.

Background: This randomised controlled trial aimed to investigate the relationship between antioxidant markers (Superoxide Dismutase [SOD], Glutathione [GSH], Catalase, and Nitric Oxide [NO]) and the severity of ischemic stroke in affected individuals.

Methods: A single-blind randomised controlled trial was conducted from June 2022 to November 2024, including 364 patients aged 45-80 years diagnosed with ischemic stroke. Participants were randomly divided into two groups: Group A (n=193) received standard stroke rehabilitation therapy, while Group B (n=171) received additional antioxidant support. Serum levels of SOD, GSH, Catalase, and NO were measured. Stroke severity was evaluated using the modified Rankin Scale (mRS) and NIH Stroke Scale (NIHSS), with follow-up assessments at 2, 4, and 6 months post-treatment.

Results: Among the 364 participants, 203 (55.7%) were male, and 161 (44.3%) were female, with a mean age of 67.3±12.2 years. Serum SOD levels were higher in the experimental group (16.3±3.7 U/mL) compared to the control group (12.5±4.1 U/mL, p=0.014). GSH levels were also significantly higher in the experimental group (178±31 mmol/L) than in the control group (145±26 mmol/L, p=0.032). NO levels were higher in the experimental group (42.1±8.6 mmol/L) than in the control group (35.4±7.3 mmol/L, p=0.021). Catalase levels were 52.3±11.1 U/mL in the experimental group and 49.6±10.2 U/mL in the control group, with no significant difference between the groups (p=0.213). Significant inverse correlations were found between SOD, GSH, and NO levels and stroke severity (p<0.05), but catalase showed no such correlation (p=0.513).

Conclusions: This study identified a significant relationship between higher levels of SOD, GSH, and NO and improved stroke recovery, whereas catalase did not exhibit a meaningful association with stroke severity or functional outcomes. These findings highlight the potential role of specific antioxidant markers in stroke prognosis and recovery while suggesting that catalase may not play a critical role in ischemic stroke outcomes.

Background: This study aimed to evaluate the effect of combining paricalcitol with cinacalcet on the levels of intact parathyroid hormone (iPTH) and alkaline phosphatase (ALP) in patients with secondary hyperparathyroidism undergoing maintenance hemodialysis (MHD).

Methods: A retrospective analysis was conducted on the clinical records of 129 patients diagnosed with chronic kidney disease (CKD) and secondary hyperparathyroidism who received MHD between June and December 2022. The patients were categorised into three groups based on their treatment regimen: Group A (paricalcitol alone, n=43), Group B (cinacalcet alone, n=43), and Group C (combined paricalcitol and cinacalcet, n=43). Hemoglobin (Hb), serum albumin (Alb), calcium (Ca), phosphorus (P), iPTH, ALP, serum creatinine (Scr), and blood urea nitrogen (BUN) levels were measured at admission, 1 day, 3 months, and 6 months to compare the outcomes across the three groups.

Results: No significant differences among the groups were observed in Hb and Alb levels at 1 day post-admission (P>0.05). However, after 3 and 6 months of treatment, Hb and Alb levels increased in all groups, with Group C showing the greatest improvement (P<0.05). iPTH, Ca, and P levels were similar across all groups on day 1 (P>0.05), but by 3 and 6 months, all groups showed reductions, with Group C having the lowest levels (P<0.05). Similarly, ALP, Scr, and BUN levels decreased in all groups over time, with Group C again demonstrating the greatest reduction (P<0.05).

Conclusions: The combination of paricalcitol and cinacalcet was effective in reducing iPTH, calcium, phosphorus, and ALP and improving Hb and Alb levels in patients with secondary hyperparathyroidism on maintenance hemodialysis. This treatment approach offers significant benefits in managing SHPT.

Background: To investigate how serum sST2 and cfDNA can be used to inform evidence-based nursing practices for children with severe pneumonia and myocardial damage.

Methods: 100 children with severe pneumonia complicated with myocardial damage were recruited as research subjects. After assessing serum sST2 and cfDNA concentrations, the individuals were categorised into a control cohort (receiving standard treatment, n=50) and an experimental cohort (receiving evidence-based treatment guided by serum sST2 and cfDNA markers, n=50). Collected were the general details of the two patient groups. Biochemical analysis of patient serum sST2 and cfDNA changes was performed before and after care. Echocardiography was used to measure the left ventricular ejection fraction (LVEF) and left ventricular internal diameter (LVIDd) both before and after treatment of the patient. Levels of procalcitonin and C-reactive protein were assessed using enzyme-linked immunosorbent assay (ELISA) before and after patient treatment, while the white blood cell count in blood samples was determined using an automated haematology analyser. The patients' pneumonia resolution and length of hospital stay were compared. Patient satisfaction with care plans was compared through rating questionnaires.

Results: The general information of the two groups of patients showed no significant difference (P>0.05). Before receiving nursing care, there were no significant variations in serum sST2 and cfDNA levels among the two patient groups (P>0.05). Following the nursing period, the observation group exhibited decreased serum sST2 and cfDNA levels compared to the control group (P<0.05). Before nursing care, there were no significant variations in left ventricular ejection fraction and left ventricular internal diameter in diastole among the two cohorts of patients (P>0.05). Following nursing, the observation group exhibited a higher LVEF than the control group and a smaller LVIDd (P<0.05). Before receiving nursing care, there were no significant variations in procalcitonin, hs-CRP, and white blood cell count between the two patient groups (P>0.05). Following care, the observation group exhibited decreased levels of procalcitonin, hs-CRP, and white blood cell count compared to the control group (P<0.05). The pneumonia remission and hospitalisation duration in the observation group were significantly shorter than in the control group (P<0.05).

Conclusions: The importance of serum sST2 and cfDNA indicators in evidence-based nursing for children with severe pneumonia and myocardial damage is highlighted, showing significant improvement in treatment outcomes and patient satisfaction, confirming the crucial role of these biomarkers in enhancing nursing care plans.