Objective To study the relation between the pathogenesis of gallstone and blood lipid and protein.Methods Then indexes of blood lipid and protein in 204 cases of gallstone patients were measured and analysed by statistical software SPSS. Results There was a significant difference between the gallstone group and control in the value of proalbumin, total cholesterol, high density lipoprotein and carrier protein B (Ｐ＜0.01), the value of total protein, triglyceride, low density lipoprotein cholesterol, very low density lipoprotein cholesterol and carrier protein A1 were higher than those in the control (Ｐ＜0.05). Conclusion The indexes mentioned above may play an important role in the gallstone formation.
Objective To search evidence of angiotensin-converting-enzyme inhibitors for microalbumin-uria in type 2 diabetes for guiding clinical practice. Methods We searched MEDLINE （ 1970 -Jun. 2005 ） to identify randomized controlled trials （RCT）of the effect on angiotensin-converting-enzyme inhibitors to prevent microalbuminuria in type 2 diabetes. Results One RCT （n =1 204）was identified. The result showed that angiotensin-converting-enzyme inhibitors were significantly more effective in prevention of microalbuminuria than other medicines in type 2 diabetes. However, angiotensin-converting-enzyme inhibitors may increase the risk of cardiac mortality. We explained the evidence to patients and they were satisfied with our explanation. Conclusions Angiotensin-converting-enzyme inhibitors can decrease the incidence of microalbuminuria in patients with type 2 diabetes and hypertension.
ObjectiveTo investigate the association between the admission fasting blood glucose-to-albumin ratio (FAR) and in-hospital outcomes in patients with abdominal aortic aneurysm (AAA) underwent open surgical repair (OSR) or endovascular aneurysm repair (EVAR). MethodsA retrospective study was conducted on patients with AAA who underwent OSR or EVAR at Nanjing Drum Tower Hospital from January 2020 to January 2024 and met the inclusion criteria. The receiver operating characteristic (ROC) curve was used to evaluate the discriminative ability of the FAR for in-hospital mortality after AAA surgery and to determine its optimal cutoff value. Patients were then divided into a low-FAR group (FAR below the cutoff) and a high-FAR group (FAR equal to or above the cutoff) based on this value. Logistic regression analysis, Cox proportional hazards regression models, and Kaplan-Meier survival curves were employed to examine the relation between FAR and postoperative in-hospital severe complications (Clavien-Dindo grade Ⅲ or above) as well as in-hospital all-cause mortality. ResultsA total of 191 patients were included in this study. The area under the ROC curve of FAR for predicting in-hospital mortality was 0.707 [95%CI (0.637, 0.770)], with an optimal cutoff value of 2.33. There were 164 in the low-FAR group and 27 in the high-FAR group. The incidence of postoperative in-hospital severe complications and in-hospital all-cause mortality were significantly higher in the high-FAR group compared to the low-FAR group [29.63% (8/27) vs. 12.20% (20/164), χ2=4.60, P=0.032; 14.81% (4/27) vs. 2.44% (4/164), χ2=6.03, P=0.014]. An elevated FAR was identified as a risk factor for both postoperative in-hospital severe complications [OR (95%CI)=1.49 (1.27, 1.88), P=0.018] and in-hospital all-cause mortality [HR (95%CI)=1.35 (1.29, 3.06, P=0.047]. Kaplan-Meier survival analysis showed significantly worse survival in patients with a high-FAR compared to those with a low-FAR (χ2=10.44, P=0.001). ConclusionElevated AAR is a risk factor for poor in-hospital outcomes in AAA patients treated with OSR or EVAR and may serve as a valuable marker for assessing in-hospital outcomes.
ObjectiveTo investigate the prognostic value of preoperative serum albumin-to-globulin ratio (AGR) and neutrophil-lymphocyte ratio (NLR) in the overall survival (OS) of patients with esophageal squamous cell carcinoma (ESCC), and to establish an individualized nomogram model and evaluate its efficacy, in order to provide a possible evaluation basis for the clinical treatment and postoperative follow-up of ESCC patients. MethodsAGR, NLR, clinicopathological and follow-up data of ESCC patients diagnosed via pathology in the Department of Thoracic Surgery, The First Affiliated Hospital of Xinjiang Medical University from 2010 to 2017 were collected. The correlation between NLR/AGR and clinicopathological data were analyzed. Kaplan-Meier analysis and log-rank test were used for survival analysis. The optimal cut-off values of AGR and NLR were determined by X-tile software, and the patients were accordingly divided into a high-level group and a low-level group. At the same time, univariate and multivariate Cox regression analyses were used to identify independent risk factors affecting OS in the ESCC patients, and a nomogram prediction model was constructed and internally verified. The diagnostic efficacy of the model was evaluated by receiver operating characteristic (ROC) curve and calibration curve, and the clinical application value was evaluated by decision curve analysis. ResultsA total of 150 patients were included in this study, including 105 males and 45 females with a mean age of 62.3±9.3 years, and the follow-up time was 1-5 years. The 5-year OS rate of patients in the high-level AGR group was significantly higher than that in the low-level group (χ2=6.339, P=0.012), and the median OS of the two groups was 25 months and 12.5 months, respectively. The 5-year OS rate of patients in the high-level NLR group was significantly lower than that in the low-level NLR group (χ2=5.603, P=0.018), and the median OS of the two groups was 18 months and 39 months, respectively. Multivariate Cox analysis showed that AGR, NLR, T stage, lymph node metastasis, N stage, and differentiation were independent risk factors for the OS of ESCC patients. The C-index of the nomogram model was 0.689 [95%CI (0.640, 0.740)] after internal validation. The area under the ROC curve of predicting 1-, 3-, and 5-year OS rate was 0.773, 0.724 and 0.725, respectively. At the same time, the calibration curve and the decision curve suggest that the model had certain efficacy in predicting survival and prognosis. ConclusionPreoperative AGR and NLR are independent risk factors for ESCC patients. High level of AGR and low level of NLR may be associated with longer OS in the patients; the nomogram model based on AGR, NLR and clinicopathological features may be used as a method to predict the survival and prognosis of ESCC patients, which is expected to provide a reference for the development of personalized treatment for patients.
ObjectiveTo discuss the relationship between microalbuminuria (MAU) and antioxidant activity of plasma hyper density lipoprotein (HDL) in hypertensive patients, and investigate whether MAU could be a predictor of HDL antioxidant activity. MethodFrom December 2007 to March 2009, sixty consecutive primary hypertensive patients from the inpatient and outpatient departments of West China Hospital and Sichuan Electric Power Central Hospital were included in the study, and 30 healthy volunteers served as controls. MAU, plasma HDL and paraoxonase (PON1) activity were tested. ResultsPON1 activity was lower in hypertensive patients than the controls (P<0.05), and this degree of decline was positively related to MAU (P<0.05). ConclusionMAU reflects PON1 activity in hypertensive patients and can be a predictor to judge plasma HDL function in patients with hypertension.
ObjectiveTo evaluate the prognostic value of the easy albumin-bilirubin (EZ-ALBI) score for postoperative complications and long-term prognosis of hepatocellular carcinoma (HCC) patients. MethodsThe data on consecutive 1 822 HCC patients who underwent hepatectomy were obtained and retrospectively analyzed from five medical centers, including West China Hospital, Sichuan Provincial People’s Hospital, The First People’s Hospital of Neijiang City, The Second People’s Hospital of Yibin City, and People’s Hospital of Leshan City. Non-conditional logistic and Cox proportional hazards regression were used to evaluate the aspect on the postoperative complications and long-term prognosis. ResultsThe patients in EZ-ALBI grade 2 had higher incidences of severe complication (Clavein-Dindo classification>2, P=0.001), post-hepatectomy liver failure (P=0.040), length of stay>10 d (P<0.001), perioperative transfusion (P<0.001), and 90 d mortality (P<0.001). The 1-, 3- and 5-year cumulative survival rates in EZ-ALBI grade 1 group were 85.5%, 67.0%, and 58.7% while in EZ-ALBI grade 2 group were 72.7%, 51.1%, and 39.8%. Multivariate Cox proportional hazards regression manifested that patients in EZ-ALBI grade 2 had a significantly worse overall survival [HR=1.24, 95%CI (1.04, 1.48), P=0.015]. ConclusionThe EZ-ALBI score is an easy and feasible classifying method to predict postoperative complications and survival of HCC.
ObjectiveTo explore the clinical value of fibrinogen-albumin-ratio (FAR) in adult extracorporeal membrane oxygenation (ECMO) hemorrhage. MethodsThe clinical data of adult patients receiving ECMO in the West China Hospital from 2018 to 2020 were analyzed retrospectively. Patients were divided into a bleeding group and a non-bleeding group based on whether they experienced bleeding after ECMO. Logistic regression analysis was used to study the relationship between FAR and bleeding, as well as risk factors for death. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to analyze the predictive ability of FAR. According to the optimal cut-off value of FAR for predicting hemorrhage, patients were divided into a high-risk group and a low-risk group, and the occurrence of bleeding was compared between the two groups. ResultsA total of 125 patients were enrolled in this study, including 85 males and 40 females, aged 46.00 (31.50, 55.50) years. Among them, 58 patients received veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and 67 patients received veno-venous extracorporeal membrane oxygenation (VV-ECMO). There were 49 patients having bleeding, and the lactate level was higher (P=0.026), the platelet count before ECMO initiation and 24 h after ECMO initiation was lower (P=0.031, 0.020), the fibrinogen level 24 h after ECMO initiation was lower (P=0.049), and the proportion of myocarditis patients was higher (P=0.017) in the bleeding group than those of the non-bleeding group. In the subgroup analysis of ECMO mode, the higher D-Dimer, lactate level and lower FAR before and 24 h after ECMO initiation were associated with bleeding in the VA-ECMO group (P=0.017, 0.011, 0.033, 0.005). The 24 h FAR was independently correlated with bleeding (P=0.048), and AUC was 0.714. The cut-off value was 55.73. According to this optimal cut-off value, 25 patients were divided into the high-risk group (≤55.73) and 33 into the low-risk group (>55.73). There was a higher incidence of bleeding in the high-risk group compared to the low-risk group (unadjusted P=0.002; P=0.013 for multivariable adjustment). In the VV-ECMO group, the relationship between FAR and bleeding events was not significant (P>0.05). ConclusionLow 24 h FAR is an independent risk factor for bleeding in VA-ECMO patients, and the diagnostic cut-off value is 55.73.
ObjectiveTo explore repressive effects of transthyretitin (TTR) on the growth of human retinal endothelial cells (hREC) under high glucose and hypoxia environment.MethodshRECs were divided into 8 groups, including normal glucose group (5.5 mmol/L glucose), hypoxia group, high glucose group (25.0 mmol/L glucose), high glucose and hypoxia group, normal glucose group+TTR, normal glucose and hypoxia group+TTR, high glucose group+TTR, high glucose and hypoxia group+TTR. Flow cytometry was used to analyze cellular apoptosis. The expression level of Akt, p-Akt, eNOS, Bcl-2 and Bax protein were measured by Western blot.ResultsHypoxia could induce apoptosis as the apoptosis rate of normal and hypoxia group was higher than normal group (χ2=25.360, P＜0.05), high glucose and hypoxia group was higher that high glucose group (χ2=17.400, P＜0.05). The cell apoptosis rate of high glucose and hypoxia group+TTR were increased significantly as compared with high glucose and hypoxia group (χ2=9.900, P＜0.05). There was no statistically significant difference on the cell apoptosis rate between normal group and high glucose group, normal group+TTR and normal group, high glucose group+TTR and high glucose group, normal and hypoxia group+TTR and normal and hypoxia group (P＞0.05). Western blot showed that the expression of Akt did not change significantly in all eight groups（F=2.450, P＞0.05). Compared to normal group, the expression of p-Akt, eNOS, Bcl-2 in normal and hypoxia group were decreased (t=9.406, 5.306, 4.819), and the expression of Bax (t=?4.503) was increased (P＜0.05). Compared to high glucose group, same trend was found in high glucose and hypoxia group (t=8.877, 7.723, 6.500, ?14.646; P＜0.05). The expression of p-Akt in normal and hypoxia group+TTR was higher than normal and hypoxia group (t=?5.024, P＜0.05) , but there was no difference on the expression of eNOS, Bcl-2, Bax between these two groups (t=?2.235, ?2.656, ?0.272; P＞0.05). Compared to high glucose and hypoxia group, the expression of p-Akt and Bcl-2 in high glucose and hypoxia group+TTR were decreased (t=4.355, 4.308; P＜0.05), the expression of Bax was increased (t=?4.311, P＜0.05), and there was no difference on the expression of eNOS between these two groups (t=?1.590, P＞0.05). There was no statistically significant difference in the expression of p-Akt, eNOS, Bcl-2, Bax between high glucose group and normal group (t=?3.407, ?4.228, ?4.302, ?2.076; P＞0.05), normal group+TTR and normal group (t=?4.245, ?4.298, ?2.816, ?1.326; P＞0.05), high glucose group+TTR and high glucose group (t=4.016, ?0.784, 0.707, ?0.328; P＞0.05).ConclusionUnder high glucose and hypoxia, transthyretitin suppress the growth of hREC through Akt/Bcl-2/Bax, but not Akt/eNOS signaling pathway.
Understanding the mass transfer behaviors in hollow fiber membrane module of artificial liver is important for improving toxin removal efficiency. A three-dimensional numerical model was established to study the mass transfer of small molecule bilirubin and macromolecule bovine serum albumin (BSA) in the hollow fiber membrane module. Effects of tube-side flow rate, shell-side flow rate, and hollow fiber length on the mass transfer of bilirubin and BSA were discussed. The simulation results showed that the clearance of bilirubin was significantly affected by both convective and diffusive solute transport, while the clearance of macromolecule BSA was dominated by convective solute transport. The clearance rates of bilirubin and BSA increasd with the increase of tube-side flow rate and hollow fiber length. With the increase of shell-side flow rate, the clearance rate of bilirubin first rose rapidly, then slowly rose to an asymptotic value, while the clearance rate of BSA gradually decreased. The results can provide help for designing structures of hollow fiber membrane module and operation parameters of clinical treatment.
Objective To investigate the effect of ultra-filtration on reducing the matrix effects of the immersionof recombination human acellular dermal matrix (rhADM) on detecting residual bovine serum albumin (BSA) by ELISA.Methods Preparation of rhADM immersion: rhADM were rinsed, and then rhADM immersion were prepared. Physiologicalsal ine was used as immersion medium. Presaturation and ultra-filtration: marked the ultra-filtration tubes as PR1 (presaturation protocol 1), PR2 (presaturation protocol 2) and rhADM, respectively, added 2 mL of 1 mg/mL and 10 μg/mL BSA solution into PR1 and PR2 respectively, and added 2 mL of rhADM immersion into rhADM tubes (rhADM1 and rhADM2). The tubes were then centrifuged at 1 500 × g for 20 minutes. The above steps were repeated for 3 times. Take the inner-tube of ultrafiltration into unused centrifuge tube. Added 4 mL of 10 μg/mL BSA solution in PR1 and PR2 tubes, 4 mL of rhADM immersion in rhADM tubes, centrifuged at 1 500 × g for 20 minutes, and then the filtration was colleted. Detecting BSA concentration: the BSA concentrations of all samples were detected by using the quantitative measure of residual BSA ELISA kit. The recoveries of 10 μg/ mL BSA solution treated by presaturation protocol 1 and 2 were calculated (untreated 10 μg/mL BSA solution was as the basic sample, marked R10 and R20 respectively). The correlation coefficient between the logarithm of the filtrate dilution and the absorbance (A) value was calculated and compared with that of water exact without ultra-filtration. Results The BSA concentration of PR1 and R10 was (23.80 ± 1.58) μg/ mL and (9.04 ± 0.24) μg/mL, respectively. The BSA concentration of PR2 and R20 was (8.64 ± 0.24) μg/mL and (8.12 ± 1.01) μg/ mL, respectively. The average recovery of 10 μg/mL BSA was 263.4% ± 16.9% and 106.5% ± 3.0% when the ultra-filtration tubes were presaturaed by PR1 and PR2 (P lt; 0.01), respectively. The BSA recovery of PR2 met the detecting demand. The correlations between A value and sample dilution were increased, the correlationcoefficient was raised from — 0.727 to — 0.960 after rhADM immersion were treated by ultra-filtration. Conclusion Theresults show that the matrix effects can be reduced effectively by ultra-filtration, indicating that an acceptable recovery of BSA can be acquired when ultra-filtration tube is presaturated by sample water extract.