Biomarkers in medicine最新文献

Aims: To evaluate the effectiveness of Shock Index (SI), Modified Shock Index (MSI), and Age Shock Index (Age SI) in predicting blood transfusion need, surgical intervention, hospital outcomes, and injury severity in blunt trauma patients.

Methods: This retrospective study included 267 adult patients admitted with blunt trauma to the emergency department of a tertiary university hospital between 1 December 2018, and 1 December 2019. Patients with isolated hand/foot trauma, isolated traumatic brain injury, isolated spinal injuries, or minor trauma (AIS ≤2) were excluded. SI, MSI, and Age SI were calculated and analyzed.

Results: SI (p < 0.001), Age SI (p = 0.001), and MSI (p < 0.001) were significantly associated with blood transfusion and mortality. SI > 0.933 and MSI > 1.159 showed good predictive accuracy for blood transfusion; Age SI > 30.945 showed moderate accuracy. For mortality, SI > 1.015, MSI > 1.333, and Age SI > 67.065 demonstrated good predictive power (all p < 0.001). SI and MSI correlated moderately with injury severity (p < 0.001), with SI > 0.905 and MSI > 1.181 indicating significant predictive value.

Conclusion: SI, MSI, and Age SI can predict early blood transfusion and mortality in blunt trauma patients. SI and MSI appear more reliable than Age SI, particularly in predicting transfusion need and injury severity.

Aim: Our study aimed to investigate the relationship between oxidized low-density lipoprotein(ox-LDL), lectin-like ox-LDL receptor-1 (LOX-1), inducible nitric oxide synthase(iNOS), endothelin 1(ET-1), and asprosin levels with cardiovascular risk.

Method: The study is a case-control study. 177 patients (87 HT/90 controls) were included in the study. Biochemical parameters and blood pressure were measured. Cardiovascular risk was calculated using the European Society of Cardiology Cardiovascular Diseases (ESC CVD) risk calculator. Asprosin, oxLDL, LOX1R, ET1 and iNOS levels were measured using Enzyme-Linked ImmunoSorbent Assay (ELISA) kits in blood samples obtained after a minimum 8-hour fasting period. In statistical analyses, p < 0.05 was considered significant.

Results: Age was significantly higher in the patient group than in the control group(p < .001). Following adjustment for confounding variables, including age, sex, BMI and smoking status, ANCOVA analysis revealed that ET-1 [F(1,177) = 4.002, p = .047, ηp² = 0.133] and oxLDL [F(1,177) = 17.221, p < .001, ηp² = 0.262] levels were elevated in the control group relative to the HT group. The correlation analysis revealed a positive correlation between age and cardiovascular risk (p < .001). Furthermore, a negative correlation was identified between cardiovascular risk and ET1 (p < .05), iNOS (p < .001), asprosin (p < .05) and oxLDL ;(p < .001).

Conclusion: ET1 and ox-LDL were lower in the HT group treated with antihypertensive therapy compared to the control group. Moreover, asprosin was found to be low in patients with high cardiovascular risk.

Aim: The diagnosis, treatment, and prognosis of childhood diseases rely on accurately establishing reference intervals (RIs). The aim of this study was to determine the RIs of albumin (ALB), total protein (TP), and prealbumin (PA) in children in Nanning, China, according to age, gender, and ethnicity.

Methods: A total of 4001 apparently healthy children aged 0 ~ 18 years from the Nanning area were included. The levels of serum ALB, TP, and PA were measured by an Architect C16000 automatic chemical analyzer. Non-parametric methods were used to determine the 2.5th and 97.5th percentile RIs.

Results: Serum TP and PA levels increased with age (p < 0.001), whereas serum ALB level had no correlation with age (p > 0.05). Gender and ethnicity statistical differences were presented in serum ALB and PA except serum TP. Serum levels of ALB and PA in males were higher than those in females (p < 0.001). Serum ALB and PA showed lower concentrations in Zhuang children as compared to Han children (p < 0.05). All verification groups passed the verification of the RIs.

Conclusions: Age-, gender- and ethnicity-appropriate RIs for serum ALB, TP, and PA will provide a more accurate evaluation of pediatric-related diseases.

Background: Endogenous circular RNAs (circRNAs) have been implicated in the progression of cancer. This study aims to identify and evaluate the diagnostic efficacy of the newly found circALG8 and circCAMTA1 in patients with non-small cell lung cancer (NSCLC).

Methods: Differentially expressed circRNAs were identified through plasma circRNA sequencing, followed by validation in NSCLC tissues and plasma samples using RT-qPCR. The stability of circALG8 and circCAMTA1 was determined by RNase R and actinomycin D assays. Receiver operating characteristic (ROC) curve analysis was employed to evaluate the diagnostic performance of these circRNAs in comparison to traditional tumor biomarkers.

Results: Both circALG8 and circCAMTA1 are significantly downregulated in tumor tissues and plasma from NSCLC patients, correlating closely with TNM staging. The two circRNAs are structurally stable circular RNA molecules, demonstrating considerable stability in plasma of NSCLC patients. The combined plasma circALG8 and circCAMTA1 hold the potential to serve as a diagnostic panel for early-stage NSCLC (AUC: 0.8987, p < 0.0001). Importantly, the combination of the plasma circRNA panel enhances the diagnostic efficacy of traditional tumor biomarkers (AUC: 0.9236, p < 0.0001) in early diagnosis of NSCLC.

Conclusion: Plasma-derived circALG8 and circCAMTA1 May function as a diagnostic panel, thereby improving the diagnostic accuracy for early-stage NSCLC.

Aim: This study assessed electro-impedimetric detection (EIS-MARTI) of anti-mycolate antibodies (AMAb) in TB patients before, during, and after treatment, compared to sputum culture (MGIT) as the gold standard.

Methods: A prospective pilot study enrolled 15 confirmed TB patients and 73 healthy controls at a Pretoria hospital (2016-2017). A prospective monitoring study followed 25 confirmed TB patients over 6 months of treatment at a Pretoria clinic (2019-2020) to evaluate biomarker behavior. Outcomes were analyzed using descriptive statistics, wherein diagnostic accuracy and predictive values were assessed by ROC curve analysis.

Results: EIS-MARTI detected 14/15 true TB-positive cases independent of HIV co-infection and 68/73 true TB-negatives in the pilot study. In the monitoring study, EIS-MARTI correlated with culture in 7/8 cases at treatment end, but not during the first 2 months.

Conclusion: AMAbs arise independently of HIV co-infection in active TB, recede during treatment, and are rapidly detected by a hand-held EIS-MARTI device. While suitability for treatment monitoring remains uncertain, EIS-MARTI shows promise for rapid, accurate TB diagnosis and confirming cure.

Background: Vascular cognitive impairment (VCI) is a cerebrovascular disease leading to mental decline. Appropriate biomarkers must be identified to facilitate the diagnosis of VCI. Therefore, we investigated changes in miR-140-5p and cystatin-C (Cys-C) expression in the serum of patients with VCI.

Methods: The miR-140-5p or Cys-C serum expression levels were determined using real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) or immunoturbidimetry. MMP-9 and IL-6 expression were detected in both groups. Correlations between serum-exhaled miR-140-5p or Cys-C and IL-6 or MMP-9 were analyzed using Pearson's method. A receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of miR-140-5p, Cys-C, and miR-140-5p combined with Cys-C for diagnosing VCI.

Results: miR-140-5p and Cys-C serum levels were significantly upregulated in patients with VCI, and the increase was more pronounced in patients with vascular dementia (VaD). In addition, miR-140-5p and Cys-C positively correlated with increased IL-6 and MMP-9 expression. The ROC analysis showed that the combination of miR-140-5p and Cys-C demonstrated the AUC was 100.0% (sensitivity: 100%; specificity, 98.3%).

Conclusion: The upregulation of miR-140-5p and Cys-C indicates that miR-140-5p and Cys-C may be related VCI development. The combined diagnosis of miR-140-5p has potential diagnostic value for diagnosis and screening of VCI.

Aim: This paper aims to perform a meta-analysis to provide the most updated and comprehensive evidence on the link between neutrophil-lymphocyte ratio (NLR) and the development and prognosis of hypertension.

Materials & methods: Cochrane Library, PubMed, Embase, and Web of Science were thoroughly searched for studies published from the inception of the databases up to 4 May 2024 using the keywords "Lymphocytes," "Neutrophils," "Ratio," and "Hypertension." The odds ratios (OR) and 95% confidence intervals (CI) were extracted for random-effects meta-analysis. We employed Egger's test to check publication bias, sensitivity analyses to identify studies that significantly impacted the meta-analysis results, and subgroup analyses to ascertain the source of heterogeneity.

Results: 10 articles involving 78,194 patients were enrolled. The pooled data indicated that NLR was a significant predictor of hypertension risk (OR = 1.11, 95% CI = 1.05-1.17, p = 0.004). Additionally, NLR was notably linked with all-cause (OR = 2.02, 95% CI = 1.29-3.15, p = 0.002) and cardiovascular deaths (OR = 2.10, 95% CI = 1.51-2.61, p < 0.0001) in hypertensive patients. Sensitivity analyses validated the robustness of the findings, and subgroup analyses ascertained a source of heterogeneity.

Conclusion: NLR is a reliable and valuable biomarker for predicting both the risk of hypertension and outcomes in hypertensive patients.

Aims: We aimed to explore the prognostic role of circulating DNA-related markers to improve clinical decision-making in patients with lung malignancies.

Methods: A systematic search was performed on PubMed, Scopus, and Web of Science.

Results: About 133 articles were included, comprising 5750 EGFR-positive, 1583 ALK-positive, and 9657 patients without specified genetic groups. Circulating tumor DNA (ctDNA) response was a significant prognostic marker associated with improved overall survival (OS) (HR = 0.36 [0.27, 0.47], I2 = 0%) and progression-free survival (PFS) (HR = 0.31 [0.18, 0.55], I2 = 67.33%) in advanced non-small cell lung cancer (NSCLC). Meta-analysis of tumor mutational burden (TMB) in the same group demonstrated trends toward poorer survival outcomes for higher TMB -pooled HR of 1.63 (95%-CI: 0.92, 2.88, I2 = 71.23%) for OS and 1.09 (95%-CI: 0.63, 1.89, I2 = 86.66%) for PFS. Finally, meta-analysis in advanced EGFR-positive NSCLC implicated significant prognostic effect of EGFR response positivity on OS and PFS -pooled HR of 0.39 and 0.27, respectively.

Conclusion: Circulating DNA markers entailed valuable information in patient prognostication and depicting treatment efficacies in lung cancer. Further studies are needed to decipher more robust criteria for the presently accepted markers - namely ctDNA and EGFR response measures. Additionally, there are several markers - i.e. TMB - that have more exploratory clinical benefits.

Background: Inflammatory markers are associated with the severity of disease and outcomes in rheumatic mitral stenosis (RMS). This study explored the connection between newer inflammatory indices - specifically, the systemic immune inflammation index (SII) and systemic inflammation response index (SIRI) - and clinical outcomes in RMS patients who underwent percutaneous balloon mitral valvuloplasty (PBMV).

Methods: A total of 131 patients with severe RMS who received PBMV at Tehran Heart Center between August 2015 and February 2021 were assessed. Inflammatory markers were measured prior to the procedure. Echocardiographic parameters, Wilkins scores, and complications were analyzed over a three-year follow-up period. ROC curves and multivariate logistic regression were employed to evaluate predictive associations.

Results: The average age of participants was 47.9 years, and 79.4% were female. Lower systolic pulmonary pressure and younger age were associated with a greater success rate of PBMV. Frequent complications included mitral regurgitation (47.5%) and readmission (27.5%). Higher levels of NLR, MLR, SII, and SIRI were correlated with increased Wilkins scores. SIRI was an independent predictor of PBMV success.

Conclusion: SIRI demonstrated the highest predictive capability for PBMV success, with 71% sensitivity and 80% specificity. It was also associated with complications and mid-term outcomes in severe RMS.

Background: Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging indicates myocardial scarring and has prognostic value in myocarditis. The Pan-Immune-Inflammation Value (PIV) is a novel biomarker reflecting systemic inflammation; however, its association with LGE in myocarditis remains uninvestigated. This study aims to evaluate whether PIV levels can predict the presence of LGE in patients with myocarditis.

Aims: We retrospectively analyzed 141 patients with myocarditis between 2021 and 2024. PIV, troponin levels, and other inflammatory markers were analyzed for their association with LGE.

Results: LGE was observed in 68.8% of the patients, with a higher proportion of males in the LGE+ group. The LGE+ group showed significantly elevated levels of PIV (1.661.2 ± 22.269) and troponin (786.2 ± 10.711 ng/L) compared to the LGE- group. Multivariate regression analysis confirmed PIV (OR: 1.002, p = 0.005) and troponin (OR: 1.003, p = 0.001) as predictors of LGE. ROC analysis identified a PIV threshold of >1153.2, achieving 95% specificity with a positive predictive value of 92.9% for LGE presence.

Conclusions: Our findings indicate that elevated PIV levels are significant predictors of LGE, suggesting that PIV may serve as a valuable tool in assessing risk and guiding follow-up strategies for patients with myocarditis.