BACKGROUND Low serum albumin levels are established predictors of adverse outcomes in various cardiovascular conditions.However,the role of serum albumin in mortality among elderly patients with chronic aortic regurgi...BACKGROUND Low serum albumin levels are established predictors of adverse outcomes in various cardiovascular conditions.However,the role of serum albumin in mortality among elderly patients with chronic aortic regurgitation(AR)has not been thoroughly investigated.This study aims to assess the relationship between serum albumin levels and mortality in this specific patient population.METHODS Our analysis included 873 elderly AR patients from the China Valvular Heart Disease study,with baseline serum albumin measured at enrollment.Mortality outcomes were monitored for two years post-enrollment,employing a Cox proportional hazards model with a two-piecewise Cox proportional hazards framework to investigate the nonlinear relationship between serum albumin levels and all-cause mortality.RESULTS During the 2-year follow-up period,we observed 63 all-cause deaths.The association between serum albumin levels and all-cause mortality displayed an approximating L-shaped curve,indicating a mortality threshold at 35 g/L.For serum albumin levels below 35 g/L,each 1 g/L decrease was associated with a 25%higher risk of all-cause mortality(HR=1.25,95%CI:1.07–1.45).In contrast,no significant change in mortality risk was observed when serum albumin levels were greater than or equal to 35 g/L.Moreover,when serum albumin is classified as hypoproteinemia(serum albumin<35 g/L),the higher risks of all-cause death were observed in hypoproteinemic patients(HR=2.93,95%CI:1.50–5.74).More importantly,the association between serum albumin and death was significantly stronger in overweight/obese patients(≥24 kg/m^(2)vs.<24 kg/m^(2),Pinteraction=0.006).CONCLUSIONS In elderly patients with AR,serum albumin levels showed an approximating L-shaped relationship with all-cause death,with thresholds of 35 g/L.Body mass index was significant effect modifiers of the association.These results suggest that serum albumin,as an inexpensive and readily available biochemical marker,may further improve the stratified risk of mortality in older AR patients.展开更多
BACKGROUND Blood glucose and serum albumin have been associated with cardiovascular disease prognosis,but the impact of admission-blood-glucose-to-albumin ratio(AAR)on adverse outcomes in critical ill coronary artery ...BACKGROUND Blood glucose and serum albumin have been associated with cardiovascular disease prognosis,but the impact of admission-blood-glucose-to-albumin ratio(AAR)on adverse outcomes in critical ill coronary artery disease(CAD)patients was not investigated.METHODS Patients diagnosed with CAD were non-consecutively selected from the MIMIC-IV database and categorized into quartiles based on their AAR.The primary outcome was 1-year mortality,and secondary endpoints were in-hospital mortality,acute kidney injury(AKI),and renal replacement therapy(RRT).A restricted cubic splines model and Cox proportional hazard models assessed the association between AAR and adverse outcomes in CAD patients.Kaplan-Meier survival analysis determined differences in endpoints across subgroups.RESULTS A total of 8360 patients were included.There were 726 patients(8.7%)died in the hospital and 1944 patients(23%)died at 1 year.The incidence of AKI and RRT was 63%and 4.3%,respectively.High AAR was markedly associated with in-hospital mortality(HR=1.587,P=0.003),1-year mortality(HR=1.502,P<0.001),AKI incidence(HR=1.579,P<0.001),and RRT(HR=1.640,P<0.016)in CAD patients in the completely adjusted Cox proportional hazard model.Kaplan-Meier survival analysis noted substantial differences in all endpoints based on AAR quartiles.Stratified analysis and interaction test demonstrated stable correlations between AAR and outcomes.CONCLUSIONS The results highlight that AAR may be a potential indicator for assessing in-hospital mortality,1-year mortality,and adverse renal prognosis in critical CAD patients.展开更多
Serum albumin has traditionally been used as a quantitative measure of a patient's nutritional status because of its availability and low cost. While malnutrition has a clear definition within both the American an...Serum albumin has traditionally been used as a quantitative measure of a patient's nutritional status because of its availability and low cost. While malnutrition has a clear definition within both the American and European Societies for Parenteral and Enteral Nutrition clinical guidelines, individual surgeons often determine nutritional status anecdotally. Preoperative albumin level has been shown to be the best predictor of mortality after colorectal cancer surgery. Specifically in colorectal surgical patients, hypoalbuminemia significantly increases the length of hospital stay, rates of surgical site infections, enterocutaneous fistula risk, and deep vein thrombosis formation. The delay of surgical procedures to allow for preoperative correction of albumin levels in hypoalbuminemic patients has been shown to improve the morbidity and mortality in patients with severe nutritional risk. The importance of preoperative albumin levels and the patient's chronic inflammatory state on the postoperative morbidity and mortality has led to the development of a variety of surgical scoring systems to predict outcomes efficiently. This review attempts to provide a systematic overview of albumin and its role and implications in colorectal surgery.展开更多
Larotaxel(LTX),a next-generation taxane chemotherapeutic agent,demonstrates broad-spectrum antitumor activity and enhanced efficacy against resistant cancers compared to paclitaxel in clinical studies.To overcome deli...Larotaxel(LTX),a next-generation taxane chemotherapeutic agent,demonstrates broad-spectrum antitumor activity and enhanced efficacy against resistant cancers compared to paclitaxel in clinical studies.To overcome delivery challenges and exploit the tumor microenvironment,LTX was conjugated via disulfide bonds to 2-hydroxy-1,3-bis(alkanoyl)glyceride to form prodrugs with different fatty acid chain lengths of triglyceride,LTX-SS-TG(C8)and LTX-SS-TG(C16).These dual-stimuli responsive prodrugs were designed for rapid,complete LTX release triggered by elevated glutathione(GSH)and lipase activity within tumors.Albumin is considered as an ideal drug carrier due to its biocompatibility and ligand-binding domains.We co-assembled the prodrugs with albumin and optimized the nanoparticle formation.Our findings revealed that alkanoyl chain length critically governed prodrug-albumin binding affinity,and improved the in vivo pharmacokinetic profile of nanoparticles.Specifically,the LTX-SS-TG(C16)NPs demonstrated superior albumin assembly,resulting in nanoparticles with an area under the curve(AUC)12.99 times higher than that of the LTX solution.And these nanoparticles achieved improved tumor-specific distribution,potent antitumor efficacy,and significantly improved safety.This study provides a novel strategy for optimizing LTX delivery via albumin-based prodrug nanoparticles,broadening its potential for clinical application.展开更多
A key characteristic to be elucidated,to address the harmful health risks of environmental perfluorinated alkyl substances(PFAS),is their binding modes to serum albumin,the most abundant protein in blood.Hexafluoropro...A key characteristic to be elucidated,to address the harmful health risks of environmental perfluorinated alkyl substances(PFAS),is their binding modes to serum albumin,the most abundant protein in blood.Hexafluoropropylene oxide-dimer acid(GenX or HFPO-DA)is a new industrial replacement for the widespread linear long-chain PFAS.However,the detailed interaction of new-generation short-chain PFAS with albumin is still lacking.Herein,the binding characteristics of bovine serum albumin(BSA)to GenX were explored at the molecular and cellular levels.Itwas found that this branched short-chain GenX could bind to BSA with affinity lower than that of legacy linear long-chain perfluorooctanoic acid(PFOA).Site marker competitive study and molecular docking simulation revealed that GenX interacted with subdomain IIIA to form BSA-GenX complex.Consistent with its weaker affinity to albumin protein,the cytotoxicity of branched short-chain GenX was less susceptible to BSA binding compared with that of the linear long-chain PFOA.In contrast to the significant effects of strong BSA-PFOA interaction,the weak affinity of BSA-GenX binding did not influence the structure of protein and the cytotoxicity of GenX.The detailed characterization and direct comparisons of serum albumin interaction with new generation short-chain GenX will provide a better understanding for the toxicological properties of this new alternative.展开更多
BACKGROUND Despite being the gold standard,the use of glycated hemoglobin(HbA1c)and fasting plasma glucose(FPG)for diagnosing dysglycemia is imperfect.In particular,a low level of agreement between HbA1c and FPG in de...BACKGROUND Despite being the gold standard,the use of glycated hemoglobin(HbA1c)and fasting plasma glucose(FPG)for diagnosing dysglycemia is imperfect.In particular,a low level of agreement between HbA1c and FPG in detecting prediabetes and diabetes has led to difficulties in clinical interpretation.Glycated albumin(GA)and 1,5-anhydroglucitol(1,5-AG)may potentially serve as biomarkers for the detection and prediction of diabetes,as well as glycemic monitoring.AIM To explore the diagnostic performance of GA and 1,5-AG for screening dysglycemia;assess whether they can be used for glycemic monitoring in Chinese morbidly-obese patients;and examine their predictive ability for incident diabetes in a Chinese community-based cohort.METHODS GA and 1,5-AG concentrations were measured in 462 morbidly-obese patients from the Obese Chinese Cohort(OCC).A sub-group of diabetes subjects(n=24)was prospectively followed-up after bariatric surgery.Differences between baseline and post-surgery biomarker values were converted to percentage change from baseline to assess the response to glycemic control.Predictive ability of the biomarkers was assessed in 132 incident diabetes cases and 132 matched non-diabetes controls in the community-based Cardiovascular Risk Factor Prevalence Study(CRISPS).A prediction model was developed and compared with clinical models based on conventional risk factors.RESULTS GA exhibited an excellent diagnostic value with an area under the receiver operating characteristic curve(AUC)of 0.919(95%CI:0.884-0.955)for identifying diabetes and a high agreement in the classification of diabetes with both FPG and HbA1c in the OCC.GA demonstrated the fastest response to glycemic control.In CRISPS,the‘B3A’prediction model,which consisted of body mass index(BMI)and 3 biomarkers(HbA1c,GA and 1,5-AG),achieved a comparable predictive value[AUC(95%CI):0.793(0.744-0.843)]to that of a clinical model comprising BMI,HbA1c,FPG and 2-hour glucose(2hG)[AUC(95%CI):0.783(0.733-0.834);DeLong P value=0.736].The‘B3A’was significantly superior to a clinical model including BMI,HbA1c,FPG and triglycerides[AUC(95%CI):0.729(0.673-0.784);DeLong P value=0.027].CONCLUSION GA and 1,5-AG have the potential to act as robust biomarkers for the screening and risk prediction of diabetes.FPG and 2hG may be replaced by GA and 1,5-AG in future diabetes predictions.展开更多
BACKGROUND Liver cirrhosis is a progressive disease with high morbidity and mortality requiring effective management strategies to improve patient outcomes.Various therapies including albumin infusion,volume expanders...BACKGROUND Liver cirrhosis is a progressive disease with high morbidity and mortality requiring effective management strategies to improve patient outcomes.Various therapies including albumin infusion,volume expanders(VEs),and vasoactive agents are used to manage patients with cirrhosis.Despite numerous clinical trials,a comprehensive meta-analysis comparing the effectiveness of albumin infusion against alternative treatments is limited.This study provides the current and comprehensive synthesis of evidence,offering key insights for optimizing therapeutic strategies in patients with liver cirrhosis.AIM To systematically update available data on therapies of liver cirrhosis,we performed a meta-analysis to evaluate and compare the clinical efficacy of albumin infusion vs other VEs and vasoactive agents in patients with liver cirrhosis.METHODS A literature search from the PubMed and Embase databases(inception till June 2024)focused on hyponatremia(primary outcome)and various outcomes such as gastrointestinal bleeding,hepatic encephalopathy,severe infection,post-paracentesis-induced circulatory dysfunction(PICD),ascites reappearance,spontaneous bacterial peritonitis,hepatorenal syndrome,renal impairment,hospital stay,mortality,and safety was performed.The primary analysis pooled studies that compared albumin infusion with control.In the subgroup analysis,comparisons were made within the stratified treatment categories included in the control group.RESULTS Of the 2957 studies retrieved,31 studies(27 randomized controlled trials and 4 observational studies)comprising 6255 patients were included.Albumin use was significant in reducing odds of hyponatremia[odds ratio(OR)=0.67;95%confidence interval(95%CI)=0.53-0.85]and PICD(OR=0.38;95%CI=0.20-0.71),whereas the reduction in severe infection(OR=0.55;95%CI=0.28-1.07)did not reach statistical significance.In the subgroup analysis,albumin demonstrated a favorable improvement in lowering the incidence of hyponatremia vs inactive/standard medical therapy(OR=0.54;95%CI=0.27-1.09).For PICD,albumin use was significant compared with other VEs(OR=0.31;95%CI=0.11-0.85)but not with vasoconstrictors(OR=0.63;95%CI=0.21-1.91).In the overall subgroup analysis,a significant reduction was observed in hyponatremia(OR=0.67;95%CI=0.53-0.85)and PICD(OR=0.38;95%CI=0.20-0.71).CONCLUSION Human albumin has been shown to significantly reduce the incidence of hyponatremia and PICD in patients with liver cirrhosis,whereas its effect on severe infection remains suggestive but not statistically significant.展开更多
The level of urinary albumin is a critical indicator for the early diagnosis and management of chronic kidney disease(CKD).However,existing methods for detecting albumin are not conducive to point-of-care testing due ...The level of urinary albumin is a critical indicator for the early diagnosis and management of chronic kidney disease(CKD).However,existing methods for detecting albumin are not conducive to point-of-care testing due to the complexity of reagent addition and incubation processes.This study presents a smartphone-integrated handheld automated biochemical analyzer(sHABA)designed for point-of-care testing of urinary albumin.The sHABA features a pre-loaded,disposable reagent cassette with reagents for the albumin assay arranged in the order of their addition within a hose.The smartphone-integrated analyzer can drive the reagents following a preset program,to enable automatic sequential addition.The sHABA has a detection limit for albumin of 5.9 mg/L and a linear detection range from 7 to 450 mg/L.The consistency of albumin level detection in 931 urine samples using sHABA with clinical tests indicates good sensitivity(95.78%)and specificity(90.16%).This research advances the field by providing an automated detection method for albumin in a portable device,allowing even untrained individuals to monitor CKD in real time at the patient's bedside.In the context of promoting tiered diagnosis and treatment,the sHABA has the potential to become an essential tool for the early diagnosis and comprehensive management of CKD and other chronic conditions.展开更多
Objective:While albumin and the weight-standardized hand grip strength(HGS/W)serve as valuable prognostic indicators for cancer patients,their correlation with the prognosis in frail cancer patients remains inadequate...Objective:While albumin and the weight-standardized hand grip strength(HGS/W)serve as valuable prognostic indicators for cancer patients,their correlation with the prognosis in frail cancer patients remains inadequately explored.This study aimed to investigate the prognostic importance of the albumin level and HGS/W in cancer patients with frailty and to further investigate their combined prognostic value.Moreover,this comprehensive evaluation aimed to facilitate timely intervention and treatment for frail patients.Methods:The research enrolled 5,794 cancer patients identified with frailty from a multicenter research database.The diagnosis of frailty was based on the FRAIL scale.An Albumin-HGS/W score was constructed by combining the albumin and HGS/W values.Cox proportional hazard regression was utilized to examine the association between the albumin level and HGS/W and patient outcomes.Results:Among these patients,2,543 were females and 3,251 were males,with a median age of 60.0 years.Optimal stratification based on patient survival revealed the ideal threshold for HGS/W to be 0.48 for males and 0.39 for females,and for albumin to be 38 for both sexes.The fully adjusted model revealed that higher Albumin-HGS/W scores were correlated with a poorer patient prognosis.Notably,an Albumin-HGS/W score of 2 was associated with a higher risk of mortality compared with a score of 0 in the total population(HR:1.813,95%CI:1.580-2.080,P<0.001).Conclusions:Low albumin or HGS/W values are associated with low survival in cancer patients with frailty.Elevated Albumin-HGS/W scores were linked to decreased survival rates in cancer patients with frailty.展开更多
BACKGROUND Some studies have demonstrated that combination treatment with anlotinib and albumin-bound paclitaxel has superior efficacy in stage IV non-small cell lung cancer(NSCLC).Howbeit,there is limited research on...BACKGROUND Some studies have demonstrated that combination treatment with anlotinib and albumin-bound paclitaxel has superior efficacy in stage IV non-small cell lung cancer(NSCLC).Howbeit,there is limited research on the effects of combination therapy.AIM To determine the efficacy of anlotinib plus albumin-paclitaxel in stage IV NSCLC.METHODS Forty-two patients diagnosed with stage IV NSCLC who were treated at our hospital from January 2022 to February 2023 were selected as study subjects.According to the research protocol,the patients were divided into two groups:conventional therapy(albumin paclitaxel,n=20)and combination therapy(anlotinib plus albumin paclitaxel,n=22).The clinical effect,serum tumor markers,progression-free survival,overall survival,immune function,quality of life,mental state,and toxic side effects were compared between the two groups.RESULTS The disease remission rate,disease control rate,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)and Karnofsky Performance Scale(KPS)score in combined therapy were higher than conventional therapy.After treatment,levels of carcinoembryonic antigen,cytokeratin 19 fragment antigen 21-1,and vascular endothelial growth factor,self-rating anxiety scale,and self-rating depression scale score were all lower in combination therapy compared to conventional therapy.In addition,there was no remarkable difference in adverse reactions between the two groups.CONCLUSION Anlotinib combined with albumin-paclitaxel demonstrated therapeutic efficacy in stage IV NSCLC,reducing depression,anxiety,and tumor biomarker levels,while enhancing immune function,prolonging survival,and improving quality of life.展开更多
Backgroundd The uric acid to albumin ratio(UAR)has emerged as a potential biomarker for systemic inflammation and oxidative stress,both of which are implicated in adverse outcomes following cardiac surgery.This study ...Backgroundd The uric acid to albumin ratio(UAR)has emerged as a potential biomarker for systemic inflammation and oxidative stress,both of which are implicated in adverse outcomes following cardiac surgery.This study aimed to explore the association between UAR and long-Term mortality in elderly patients undergoing heart valve surgery.MethodsA retrospective cohort study was conducted on 202 elderly patients who underwent valve surgery in the Cardiac Surgery Intensive Care Unit(CSICU)between January 2013 and April 2014.Patients were stratified into three groups based on UAR level(low:5.66-10.26;middle:10.29-13.47;high:13.48-31.88).The multivariable cox regression analysis with covariate adjustment and subgroup analyses were performed to evaluate the association between UAR and long-term mortality,with a median follow-up period of 7.9 years.Smooth curve fitting was used to evaluate the potential linear association between UAR and long-term follow-up mortality.Kaplan-Meier curves with log-rank tests were generated to compare survival distributions among UAR groups.Results In multivariate regression models,UAR demonstrated a significant positive association with long-term follow-up mortality after comprehensive covariates adjustment.The adjusted hazard ratios(HR)for long-term follow-up mortality was 1.22(95%CI:1.10-1.34,P<0.0001)per 1-unit increase in UAR.We further performed exploratory subgroup analyses which confirmed a higher UAR levels were independently associated with a higher risk of mortality.Kaplan-Meier analysis for event-free survival revealed higher occurrence of long-term follow-up mortality in the high UAR group(P=0.013).Conclusions Elevated UAR levels in elderly patients who underwent valvular surgery in the CSICU demonstrated an positivecorrelation with mortality risk.展开更多
BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA...BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA)as an independent predictor of the prognosis of patients admitted to the coronary care unit(CCU).AIM To use the RDW and albumin level to predict the prognosis of patients in the CCU.METHODS Data were obtained from the Medical Information Mart Intensive Care III database.The primary outcome was 365-day all-cause mortality,whereas the secondary outcomes were 30-and 90-day all-cause mortality,hospital length of stay(LOS),and CCU LOS.Cox proportional hazards regression model,propen-sity score matching,and receiver operating characteristic curve analyses were used.RESULTS The hazard ratio(95%confidence interval)of the upper tertile(RA>4.66)was 1.62(1.29 to 2.03)when compared with the reference(RA<3.84)in 365-day all-cause mortality.This trend persisted after adjusting for demographic and clinical variables in the propensity score-matching analysis.Similar trends were observed for the secondary outcomes of hospital and CCU LOS.Receiver operating characteristic curve analysis was performed by combining the RA and sequential organ failure assessment(SOFA)scores,and the C-statistic was higher than that of the SOFA scores(0.733 vs 0.702,P<0.001).CONCLUSION RA is an independent prognostic factor in patients admitted to the CCU.RA combined with the SOFA score can improve the predictive ability of the SOFA score.However,our results should be verified in future prospective studies.展开更多
BACKGROUND Gallbladder cancer(GBC)is known for its poor prognosis and challenging management.The preoperative fibrinogen to albumin ratio(FAR)has been proposed as a potential prognostic marker for predicting postopera...BACKGROUND Gallbladder cancer(GBC)is known for its poor prognosis and challenging management.The preoperative fibrinogen to albumin ratio(FAR)has been proposed as a potential prognostic marker for predicting postoperative outcomes in GBC patients,but its efficacy and prognostic value remain underexplored.AIM To evaluate the prognostic value of preoperative FAR in GBC outcomes.METHODS This retrospective cohort study included 66 patients who underwent curative surgery for GBC at our institution from January 2018 to January 2022.Preoperative FAR values were obtained within one week prior to surgery.Patients were followed through outpatient visits or telephone interviews,with overall survival(OS)as the primary endpoint.Statistical analyses,including receiver operating characteristic curve analysis and Kaplan-Meier survival estimates,were performed using SPSS software(version 27.0).RESULTS The cohort consisted of 36 male and 30 female patients,with a mean age of 61.81±8.58 years.The optimal FAR cut-off value was determined to be 0.088,with an area under the receiver operating characteristic curve of 0.7899,sensitivity of 68.96%,and specificity of 80.01%.Patients with FAR≤0.088 showed significantly better survival rates(1-year:60.5%,2-year:52.6%,3-year:25.9%)and a median OS of 25.6 months(95%confidence interval:18.8-30.5 months),compared to those with FAR>0.088 who had a median OS of 10.8 months(95%confidence interval:6.3-12.9 months).CONCLUSION Lower preoperative FAR is associated with longer OS in GBC patients,confirming its potential as a valuable prognostic indicator for improving outcome predictions and guiding patient management strategies in gallbladder cancer.展开更多
Effect of ellagitannins gut microbiota metabolites ellagic acid(EA)and urolithin A-urolithin D(UroA-UroD)on human serum albumin(HSA)glycation were firstly evaluated in this research.The inhibition mechanisms were inve...Effect of ellagitannins gut microbiota metabolites ellagic acid(EA)and urolithin A-urolithin D(UroA-UroD)on human serum albumin(HSA)glycation were firstly evaluated in this research.The inhibition mechanisms were investigated by methylglyoxal(MGO)trapping and radical scavenging ability assays,docking studies and nano LC-orbitrap-MS/MS technology.Results indicated that the inhibition of urolithins on HSA glycation was highly positive correlated with the number of phenolic hydroxy groups.Addition of UroD and EA could effectively enhance the content of free amino group,suppress dicarbonyl compounds and advanced glycation end-products(AGEs)formation,alleviated tryptophan and protein oxidation,inhibited HSA amyloid-like aggregation.They could also trap MGO and scavenge 1,1-diphenyl-2-picrylhydrazyl free radical(DPPH·)and2,2'-azino-bis-3-ethylbenzthiazoline-6-sulphonic acid free radical(ABTS^(+)·).Molecular docking indicated that EA and UroA-UroD interact with HSA mainly through hydrogen bound and hydrophobic interaction,among which 2 or 3 hydrogen bonds were formed.The number of glycation sites were reduced from 11 to10,10,7,and 10,respectively,when 90μmol/L of EA,UroA,UroC and UroD were added.However,weak inhibition was observed on UroA and UroB.These findings can provide scientific evidence for the application of ellagitannins-rich foods in alleviating diabetic complications.展开更多
Seed storage proteins and their abundance are closely related to the formation of rice quality and grain size.A better understanding of the molecular basis of seed storage proteins will provide important information f...Seed storage proteins and their abundance are closely related to the formation of rice quality and grain size.A better understanding of the molecular basis of seed storage proteins will provide important information for developing new rice breeding strategies.In this study,we report that a seed storage protein albumin,named OsRAL5,positively regulates rice quality and grain size.OsRAL5 is specifically expressed during the grain-filling stage,suggesting its key role in regulating seed development.Gene editing of OsRAL5 using the CRISPR/Cas9 system diminished grain size and weight,resulting in the development of white-core endosperm and a reduction in eating and cooking quality(ECQ).Conversely,the endosperm appearance became transparent,and both grain weight and ECQ improved in the OsRAL5 over-expressed lines.The major seed storage components differed significantly between the OsRAL5-edited(dOsRAL5-TS)and OsRAL5-overexpressed(OsRAL5-OE)lines compared with the wild type.The protein and total lipid contents both decreased in the dOsRAL5-TS lines and increased in the OsRAL5-OE lines.Collectively,the over-expression of OsRAL5 significantly increased nutritional content and simultaneously improved yield and ECQ.These results imply that OsRAL5 might be a promising candidate gene for breeding super rice varieties with increased yield potential and superior quality.展开更多
The emerging NIR-II imaging modality is promising for real-time visualization of living systems and multiple disease diagnoses,particularly through its enhanced tissue penetration and superior spatial resolution[1,2]....The emerging NIR-II imaging modality is promising for real-time visualization of living systems and multiple disease diagnoses,particularly through its enhanced tissue penetration and superior spatial resolution[1,2].Cyanine dyes possess the advantages of low administration dosage,high biocompatibility,and strong fluorescence emission intensity[3].Cyanine dyes can be easily structurally modified through molecular engineering methods,while the large hydrophobic conjugation systems hinder further in vivo imaging application.The traditional surfactant encapsulation strategy cannot effectively solve the aggregation caused-quenching issue of the dyes in aqueous solutions and may even mask their reaction active sites[4].Due to the special hydrophobic pocket to act as a probe carrier and the ability to serve as the pan-marker for multiple diseases,albumin is chosen as the preferred binding protein for cyanine dyes[5].Albumin interacts with cyanine dyes through a“hydrophobic pocket”and further improves its properties such as water solubility,biosafety,and fluorescence quantum yield.Cyanine dyes can modify the binding efficiency with albumin through structural design and regulate the targeting performance.This means that cyanine-tagged albumin can respond to pathological changes caused by different diseases and monitor the disease process in real time with high contrast through NIR-II fluorescence signals.Further development of cyanine-tagged albumin probes is helpful for in-depth comprehension of the binding mechanism and guiding the directed synthesis of cyanine molecules with specific protein binding behaviors and optical properties,thereby achieving precise targeting and high-performance NIR-II bioimaging of specific diseases.This point is essential for the design,preparation,and even clinical translation of NIR-II targeting dye molecules in precise diagnosis and treatment.展开更多
BACKGROUND Acute-on-chronic liver failure(ACLF)is a life-threatening syndrome associated with high short-term mortality.Accurate risk stratification is crucial for the mana-gement of ACLF.AIM To evaluate the prognosti...BACKGROUND Acute-on-chronic liver failure(ACLF)is a life-threatening syndrome associated with high short-term mortality.Accurate risk stratification is crucial for the mana-gement of ACLF.AIM To evaluate the prognostic value of the C-reactive protein to albumin ratio(CAR)and its dynamic changes in patients with ACLF defined by the Chinese Group on Study of Severe Hepatitis B(COSSH)criteria.METHODS A total of 126 consecutive patients diagnosed with COSSH-ACLF were pros-pectively enrolled.CAR was calculated at admission and on days 4,7,and 14.The primary and secondary outcomes were 28-day and 90-day mortality,respectively.Multivariate Cox regression analysis was conducted to identify independent predictors of mortality.A novel prognostic model(COSSH-CAR),integrating baseline and dynamic variables,was developed and compared with established prognostic scoring systems.RESULTS The 28-day and 90-day mortality rates were 27.8%and 40.5%,respectively.Baseline CAR was significantly higher in 28-day non-survivors than in survivors(2.68 vs 1.42,P<0.001).The dynamic change in CAR from baseline to day 7(ΔCAR-7)showed stronger predictive power for 28-day mortality[area under the receiver operating characteristic curve(AUC)=0.765]than baseline CAR(AUC=0.698),ΔCAR-4(AUC=0.706)orΔCAR-14(AUC=0.712).Multivariate analysis identifiedΔCAR-7(HR=1.53),baseline Model for End-Stage Liver Disease-Sodium(MELD-Na)score(HR=1.08),and hepatic encephalopathy grade(HR=1.92)as independent predictors of 28-day mortality(all P<0.05).The COSSH-CAR model,which incorporated these parameters,showed superior predictive performance(AUC=0.832)for 28-day mortality compared with established prognostic scores,including Child-Pugh(AUC=0.721),MELD-Na(AUC=0.768)and COSSH-ACLF(AUC=0.786)and effectively stratified patients into three risk categories with significantly different survival rates(P<0.001).CONCLUSION Dynamic changes in CAR during the first week provide important prognostic information in patients with COSSH-ACLF,surpassing baseline values and conventional inflammatory markers.The novel COSSH-CAR model improves risk stratification and may support clinical decision-making in the management of ACLF,pending ex-ternal validation in diverse populations.展开更多
AIM:To investigate whether blood urea nitrogen to serum albumin ratio(BAR)influences the onset and progression of diabetic retinopathy(DR)in diabetic patients.METHODS:The diabetic individuals were extracted from the N...AIM:To investigate whether blood urea nitrogen to serum albumin ratio(BAR)influences the onset and progression of diabetic retinopathy(DR)in diabetic patients.METHODS:The diabetic individuals were extracted from the National Health and Nutrition Examination Survey(NHANES)database spanning 1999 to 2018.The BAR was calculated as the ratio of blood urea nitrogen to serum albumin.To evaluate the association between BAR levels and DR,a generalized additive model and multivariate logistic regression analysis were performed.Additionally,subgroup analyses were conducted to determine whether other factors modified this association.RESULTS:The number of eligible individuals in the current research endeavor equaled 5798.The resulting data were indicative of the existence of a nearly linearly positive relationship between BAR levels and DR.Following confounding variable adjustment(age,gender,marital status,red blood cell,hemoglobin,lactate dehydrogenase,uric acid,creatinine,gender,red cell distribution width,highdensity lipoprotein,glucose,sodium,glycated hemoglobin,hypertension,and total cholesterol),the multivariate investigation implied that an elevated DR risk correlated with elevated levels of BAR(OR:1.46,95%CI:1.20-1.79).This relationship was noted to be reliable and stable across diverse analyses,following the conduction of sensitivity analysis(P for trend:0.0002).Subgroup analysis showed no statistically significant interactions between BAR and most other risk factors for DR.CONCLUSION:The study provides evidence of a positive association between elevated BAR levels and an increased risk of DR in diabetic individuals.展开更多
Ferroptosis can serve as a potent strategy for regulating cell death via lipid peroxidation and the imbalance of the antioxidant system resulting from iron accumulation in triple-negative breast cancer(TNBC)therapy.Ho...Ferroptosis can serve as a potent strategy for regulating cell death via lipid peroxidation and the imbalance of the antioxidant system resulting from iron accumulation in triple-negative breast cancer(TNBC)therapy.However,the ferroptosis accompanied with down-regulation of glutathione peroxidase 4(GPX4)lead to CD36-mediated tumor-infiltrating CD8^(+)T cells uptaking fatty acids,resulting in the negative action on immunotherapeutic efficacy.Herein,the albumin nanoparticles,abbreviated as LHS NPs,were designed by co-assembly of hemin,linoleic acid-cystamine,and a CD36 inhibitor sulfosuccinimide oleate,to bi-directionally manipulated ferroptosis in tumor and CD8^(+)T cells for TNBC therapy.LHS NPs exerted more efficient reactive oxygen species generation,glutathione depletion and malondialdehyde production by the combinatory strategy of classical and non-classical ferroptosis modes,which amplified the positive action on ferroptosis in tumor cells.Meanwhile,LHS manipulated the negative action of ferroptosis by inhibiting the CD36 mediated-lipid peroxidation in CD8^(+)T cells,thereby activating the immunotherapeutic efficacy with the improvements on induction of immunogenic cell death,proliferation of CD4+CD8^(+)T cells and natural killer cells,alleviation immunosuppressive regulatory T cells and myeloid-derived suppressor cells,and repolarization of the M2-to M1-phenotype tumor-associated macrophages.Thus,LHS NPs demonstrated an improved antitumor efficacy in suppressing the tumor growth and lungmetastasis of 4T1-tumormice.Our work gives novel insights for the bi-directionally manipulating ferroptosis in tumor and CD8^(+)T cells on TNBC chemoimmunotherapy.展开更多
Albumin is the single most abundant protein in the human serum. Its roles in physiology and pathology are diverse. Serum albumin levels have been classically thought to reflect the nutritional status of patients. This...Albumin is the single most abundant protein in the human serum. Its roles in physiology and pathology are diverse. Serum albumin levels have been classically thought to reflect the nutritional status of patients. This concept has been challenged in the last two decades as multiple factors, such as inflammation, appeared to affect albumin levels independent of nutrition. In general, cancer patients have a high prevalence of hypoalbuminemia. As such, the role of hypoalbuminemia in patients with colorectal cancer has received significant interest. We reviewed the English literature on the prognostic value of pretreatment albumin levels in colorectal cancer. We also consolidated the evidence that led to the current understanding of hypoalbuminemia as an inflammatory marker rather than as a nutritional one among patients with colorectal cancer.展开更多
基金supported by the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2017-12M-3-002)the Central High Level Hospital Clinical Research Operating Expenses,China(Zero Balance 2022-GSP-GG-15)the Natural Science Foundation Project of the Inner Mongolia Autonomous Region of China(2022LHQN08003).
文摘BACKGROUND Low serum albumin levels are established predictors of adverse outcomes in various cardiovascular conditions.However,the role of serum albumin in mortality among elderly patients with chronic aortic regurgitation(AR)has not been thoroughly investigated.This study aims to assess the relationship between serum albumin levels and mortality in this specific patient population.METHODS Our analysis included 873 elderly AR patients from the China Valvular Heart Disease study,with baseline serum albumin measured at enrollment.Mortality outcomes were monitored for two years post-enrollment,employing a Cox proportional hazards model with a two-piecewise Cox proportional hazards framework to investigate the nonlinear relationship between serum albumin levels and all-cause mortality.RESULTS During the 2-year follow-up period,we observed 63 all-cause deaths.The association between serum albumin levels and all-cause mortality displayed an approximating L-shaped curve,indicating a mortality threshold at 35 g/L.For serum albumin levels below 35 g/L,each 1 g/L decrease was associated with a 25%higher risk of all-cause mortality(HR=1.25,95%CI:1.07–1.45).In contrast,no significant change in mortality risk was observed when serum albumin levels were greater than or equal to 35 g/L.Moreover,when serum albumin is classified as hypoproteinemia(serum albumin<35 g/L),the higher risks of all-cause death were observed in hypoproteinemic patients(HR=2.93,95%CI:1.50–5.74).More importantly,the association between serum albumin and death was significantly stronger in overweight/obese patients(≥24 kg/m^(2)vs.<24 kg/m^(2),Pinteraction=0.006).CONCLUSIONS In elderly patients with AR,serum albumin levels showed an approximating L-shaped relationship with all-cause death,with thresholds of 35 g/L.Body mass index was significant effect modifiers of the association.These results suggest that serum albumin,as an inexpensive and readily available biochemical marker,may further improve the stratified risk of mortality in older AR patients.
基金supported by the National Nature Science Foundation of China(No.82370336&No.82330014)the Key Research and Development Plan of Heilongjiang Province(2022ZX06C23&JD2023SJ44)the Research Project of the First Affiliated Hospital of Harbin Medical University(No.2021M19).
文摘BACKGROUND Blood glucose and serum albumin have been associated with cardiovascular disease prognosis,but the impact of admission-blood-glucose-to-albumin ratio(AAR)on adverse outcomes in critical ill coronary artery disease(CAD)patients was not investigated.METHODS Patients diagnosed with CAD were non-consecutively selected from the MIMIC-IV database and categorized into quartiles based on their AAR.The primary outcome was 1-year mortality,and secondary endpoints were in-hospital mortality,acute kidney injury(AKI),and renal replacement therapy(RRT).A restricted cubic splines model and Cox proportional hazard models assessed the association between AAR and adverse outcomes in CAD patients.Kaplan-Meier survival analysis determined differences in endpoints across subgroups.RESULTS A total of 8360 patients were included.There were 726 patients(8.7%)died in the hospital and 1944 patients(23%)died at 1 year.The incidence of AKI and RRT was 63%and 4.3%,respectively.High AAR was markedly associated with in-hospital mortality(HR=1.587,P=0.003),1-year mortality(HR=1.502,P<0.001),AKI incidence(HR=1.579,P<0.001),and RRT(HR=1.640,P<0.016)in CAD patients in the completely adjusted Cox proportional hazard model.Kaplan-Meier survival analysis noted substantial differences in all endpoints based on AAR quartiles.Stratified analysis and interaction test demonstrated stable correlations between AAR and outcomes.CONCLUSIONS The results highlight that AAR may be a potential indicator for assessing in-hospital mortality,1-year mortality,and adverse renal prognosis in critical CAD patients.
文摘Serum albumin has traditionally been used as a quantitative measure of a patient's nutritional status because of its availability and low cost. While malnutrition has a clear definition within both the American and European Societies for Parenteral and Enteral Nutrition clinical guidelines, individual surgeons often determine nutritional status anecdotally. Preoperative albumin level has been shown to be the best predictor of mortality after colorectal cancer surgery. Specifically in colorectal surgical patients, hypoalbuminemia significantly increases the length of hospital stay, rates of surgical site infections, enterocutaneous fistula risk, and deep vein thrombosis formation. The delay of surgical procedures to allow for preoperative correction of albumin levels in hypoalbuminemic patients has been shown to improve the morbidity and mortality in patients with severe nutritional risk. The importance of preoperative albumin levels and the patient's chronic inflammatory state on the postoperative morbidity and mortality has led to the development of a variety of surgical scoring systems to predict outcomes efficiently. This review attempts to provide a systematic overview of albumin and its role and implications in colorectal surgery.
基金supported by National Natural Science Foundation of China(No.82273874)Liaoning Revitalization Talents Program(No.XLYC22202019).
文摘Larotaxel(LTX),a next-generation taxane chemotherapeutic agent,demonstrates broad-spectrum antitumor activity and enhanced efficacy against resistant cancers compared to paclitaxel in clinical studies.To overcome delivery challenges and exploit the tumor microenvironment,LTX was conjugated via disulfide bonds to 2-hydroxy-1,3-bis(alkanoyl)glyceride to form prodrugs with different fatty acid chain lengths of triglyceride,LTX-SS-TG(C8)and LTX-SS-TG(C16).These dual-stimuli responsive prodrugs were designed for rapid,complete LTX release triggered by elevated glutathione(GSH)and lipase activity within tumors.Albumin is considered as an ideal drug carrier due to its biocompatibility and ligand-binding domains.We co-assembled the prodrugs with albumin and optimized the nanoparticle formation.Our findings revealed that alkanoyl chain length critically governed prodrug-albumin binding affinity,and improved the in vivo pharmacokinetic profile of nanoparticles.Specifically,the LTX-SS-TG(C16)NPs demonstrated superior albumin assembly,resulting in nanoparticles with an area under the curve(AUC)12.99 times higher than that of the LTX solution.And these nanoparticles achieved improved tumor-specific distribution,potent antitumor efficacy,and significantly improved safety.This study provides a novel strategy for optimizing LTX delivery via albumin-based prodrug nanoparticles,broadening its potential for clinical application.
基金supported by the National Natural Science Foundation of China(Nos.31960196,31760255,and 82260637)Jiangxi Provincial Natural Science Foundation(No.20212BAB205016).
文摘A key characteristic to be elucidated,to address the harmful health risks of environmental perfluorinated alkyl substances(PFAS),is their binding modes to serum albumin,the most abundant protein in blood.Hexafluoropropylene oxide-dimer acid(GenX or HFPO-DA)is a new industrial replacement for the widespread linear long-chain PFAS.However,the detailed interaction of new-generation short-chain PFAS with albumin is still lacking.Herein,the binding characteristics of bovine serum albumin(BSA)to GenX were explored at the molecular and cellular levels.Itwas found that this branched short-chain GenX could bind to BSA with affinity lower than that of legacy linear long-chain perfluorooctanoic acid(PFOA).Site marker competitive study and molecular docking simulation revealed that GenX interacted with subdomain IIIA to form BSA-GenX complex.Consistent with its weaker affinity to albumin protein,the cytotoxicity of branched short-chain GenX was less susceptible to BSA binding compared with that of the linear long-chain PFOA.In contrast to the significant effects of strong BSA-PFOA interaction,the weak affinity of BSA-GenX binding did not influence the structure of protein and the cytotoxicity of GenX.The detailed characterization and direct comparisons of serum albumin interaction with new generation short-chain GenX will provide a better understanding for the toxicological properties of this new alternative.
基金Supported by the Hong Kong Research Grants Council Area of Excellence,No.AoE/M/707-18.
文摘BACKGROUND Despite being the gold standard,the use of glycated hemoglobin(HbA1c)and fasting plasma glucose(FPG)for diagnosing dysglycemia is imperfect.In particular,a low level of agreement between HbA1c and FPG in detecting prediabetes and diabetes has led to difficulties in clinical interpretation.Glycated albumin(GA)and 1,5-anhydroglucitol(1,5-AG)may potentially serve as biomarkers for the detection and prediction of diabetes,as well as glycemic monitoring.AIM To explore the diagnostic performance of GA and 1,5-AG for screening dysglycemia;assess whether they can be used for glycemic monitoring in Chinese morbidly-obese patients;and examine their predictive ability for incident diabetes in a Chinese community-based cohort.METHODS GA and 1,5-AG concentrations were measured in 462 morbidly-obese patients from the Obese Chinese Cohort(OCC).A sub-group of diabetes subjects(n=24)was prospectively followed-up after bariatric surgery.Differences between baseline and post-surgery biomarker values were converted to percentage change from baseline to assess the response to glycemic control.Predictive ability of the biomarkers was assessed in 132 incident diabetes cases and 132 matched non-diabetes controls in the community-based Cardiovascular Risk Factor Prevalence Study(CRISPS).A prediction model was developed and compared with clinical models based on conventional risk factors.RESULTS GA exhibited an excellent diagnostic value with an area under the receiver operating characteristic curve(AUC)of 0.919(95%CI:0.884-0.955)for identifying diabetes and a high agreement in the classification of diabetes with both FPG and HbA1c in the OCC.GA demonstrated the fastest response to glycemic control.In CRISPS,the‘B3A’prediction model,which consisted of body mass index(BMI)and 3 biomarkers(HbA1c,GA and 1,5-AG),achieved a comparable predictive value[AUC(95%CI):0.793(0.744-0.843)]to that of a clinical model comprising BMI,HbA1c,FPG and 2-hour glucose(2hG)[AUC(95%CI):0.783(0.733-0.834);DeLong P value=0.736].The‘B3A’was significantly superior to a clinical model including BMI,HbA1c,FPG and triglycerides[AUC(95%CI):0.729(0.673-0.784);DeLong P value=0.027].CONCLUSION GA and 1,5-AG have the potential to act as robust biomarkers for the screening and risk prediction of diabetes.FPG and 2hG may be replaced by GA and 1,5-AG in future diabetes predictions.
基金Supported by National Natural Science Foundation of China,No.82070604 and No.82270618the Shanghai Municipal Key Clinical Specialty,China,No.shslczdzk01103。
文摘BACKGROUND Liver cirrhosis is a progressive disease with high morbidity and mortality requiring effective management strategies to improve patient outcomes.Various therapies including albumin infusion,volume expanders(VEs),and vasoactive agents are used to manage patients with cirrhosis.Despite numerous clinical trials,a comprehensive meta-analysis comparing the effectiveness of albumin infusion against alternative treatments is limited.This study provides the current and comprehensive synthesis of evidence,offering key insights for optimizing therapeutic strategies in patients with liver cirrhosis.AIM To systematically update available data on therapies of liver cirrhosis,we performed a meta-analysis to evaluate and compare the clinical efficacy of albumin infusion vs other VEs and vasoactive agents in patients with liver cirrhosis.METHODS A literature search from the PubMed and Embase databases(inception till June 2024)focused on hyponatremia(primary outcome)and various outcomes such as gastrointestinal bleeding,hepatic encephalopathy,severe infection,post-paracentesis-induced circulatory dysfunction(PICD),ascites reappearance,spontaneous bacterial peritonitis,hepatorenal syndrome,renal impairment,hospital stay,mortality,and safety was performed.The primary analysis pooled studies that compared albumin infusion with control.In the subgroup analysis,comparisons were made within the stratified treatment categories included in the control group.RESULTS Of the 2957 studies retrieved,31 studies(27 randomized controlled trials and 4 observational studies)comprising 6255 patients were included.Albumin use was significant in reducing odds of hyponatremia[odds ratio(OR)=0.67;95%confidence interval(95%CI)=0.53-0.85]and PICD(OR=0.38;95%CI=0.20-0.71),whereas the reduction in severe infection(OR=0.55;95%CI=0.28-1.07)did not reach statistical significance.In the subgroup analysis,albumin demonstrated a favorable improvement in lowering the incidence of hyponatremia vs inactive/standard medical therapy(OR=0.54;95%CI=0.27-1.09).For PICD,albumin use was significant compared with other VEs(OR=0.31;95%CI=0.11-0.85)but not with vasoconstrictors(OR=0.63;95%CI=0.21-1.91).In the overall subgroup analysis,a significant reduction was observed in hyponatremia(OR=0.67;95%CI=0.53-0.85)and PICD(OR=0.38;95%CI=0.20-0.71).CONCLUSION Human albumin has been shown to significantly reduce the incidence of hyponatremia and PICD in patients with liver cirrhosis,whereas its effect on severe infection remains suggestive but not statistically significant.
基金funding by the China Postdoctoral Science Foundation(Grant No.:2021M701628)the National Natural Science Foundation of China(Grant No.:82202625)+3 种基金Science and Technology Projects in Guangzhou,China(Grant No.:SL2022A04J02086)President Foundation of Nanfang Hospital,Southern Medical University,China(Grant Nos.:2021B012,and 2021C050)National Science Fund for Distinguished Young Scholars,China(Grant No.:82025024)Key project of the National Natural Science Foundation of China(Grant No.:82230080).
文摘The level of urinary albumin is a critical indicator for the early diagnosis and management of chronic kidney disease(CKD).However,existing methods for detecting albumin are not conducive to point-of-care testing due to the complexity of reagent addition and incubation processes.This study presents a smartphone-integrated handheld automated biochemical analyzer(sHABA)designed for point-of-care testing of urinary albumin.The sHABA features a pre-loaded,disposable reagent cassette with reagents for the albumin assay arranged in the order of their addition within a hose.The smartphone-integrated analyzer can drive the reagents following a preset program,to enable automatic sequential addition.The sHABA has a detection limit for albumin of 5.9 mg/L and a linear detection range from 7 to 450 mg/L.The consistency of albumin level detection in 931 urine samples using sHABA with clinical tests indicates good sensitivity(95.78%)and specificity(90.16%).This research advances the field by providing an automated detection method for albumin in a portable device,allowing even untrained individuals to monitor CKD in real time at the patient's bedside.In the context of promoting tiered diagnosis and treatment,the sHABA has the potential to become an essential tool for the early diagnosis and comprehensive management of CKD and other chronic conditions.
基金supported by a Henan Province Science and Technology Research Project(No.252102311033)the National Key Research and Development Program(No.2022YFC2009600 and No.2022YFC2009601).
文摘Objective:While albumin and the weight-standardized hand grip strength(HGS/W)serve as valuable prognostic indicators for cancer patients,their correlation with the prognosis in frail cancer patients remains inadequately explored.This study aimed to investigate the prognostic importance of the albumin level and HGS/W in cancer patients with frailty and to further investigate their combined prognostic value.Moreover,this comprehensive evaluation aimed to facilitate timely intervention and treatment for frail patients.Methods:The research enrolled 5,794 cancer patients identified with frailty from a multicenter research database.The diagnosis of frailty was based on the FRAIL scale.An Albumin-HGS/W score was constructed by combining the albumin and HGS/W values.Cox proportional hazard regression was utilized to examine the association between the albumin level and HGS/W and patient outcomes.Results:Among these patients,2,543 were females and 3,251 were males,with a median age of 60.0 years.Optimal stratification based on patient survival revealed the ideal threshold for HGS/W to be 0.48 for males and 0.39 for females,and for albumin to be 38 for both sexes.The fully adjusted model revealed that higher Albumin-HGS/W scores were correlated with a poorer patient prognosis.Notably,an Albumin-HGS/W score of 2 was associated with a higher risk of mortality compared with a score of 0 in the total population(HR:1.813,95%CI:1.580-2.080,P<0.001).Conclusions:Low albumin or HGS/W values are associated with low survival in cancer patients with frailty.Elevated Albumin-HGS/W scores were linked to decreased survival rates in cancer patients with frailty.
基金Supported by Zhangjiakou Key R&D Program Projects,No.2021108D.
文摘BACKGROUND Some studies have demonstrated that combination treatment with anlotinib and albumin-bound paclitaxel has superior efficacy in stage IV non-small cell lung cancer(NSCLC).Howbeit,there is limited research on the effects of combination therapy.AIM To determine the efficacy of anlotinib plus albumin-paclitaxel in stage IV NSCLC.METHODS Forty-two patients diagnosed with stage IV NSCLC who were treated at our hospital from January 2022 to February 2023 were selected as study subjects.According to the research protocol,the patients were divided into two groups:conventional therapy(albumin paclitaxel,n=20)and combination therapy(anlotinib plus albumin paclitaxel,n=22).The clinical effect,serum tumor markers,progression-free survival,overall survival,immune function,quality of life,mental state,and toxic side effects were compared between the two groups.RESULTS The disease remission rate,disease control rate,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)and Karnofsky Performance Scale(KPS)score in combined therapy were higher than conventional therapy.After treatment,levels of carcinoembryonic antigen,cytokeratin 19 fragment antigen 21-1,and vascular endothelial growth factor,self-rating anxiety scale,and self-rating depression scale score were all lower in combination therapy compared to conventional therapy.In addition,there was no remarkable difference in adverse reactions between the two groups.CONCLUSION Anlotinib combined with albumin-paclitaxel demonstrated therapeutic efficacy in stage IV NSCLC,reducing depression,anxiety,and tumor biomarker levels,while enhancing immune function,prolonging survival,and improving quality of life.
基金supported by the Guangzhou Science and Technology Program(No.2023A04J0502)。
文摘Backgroundd The uric acid to albumin ratio(UAR)has emerged as a potential biomarker for systemic inflammation and oxidative stress,both of which are implicated in adverse outcomes following cardiac surgery.This study aimed to explore the association between UAR and long-Term mortality in elderly patients undergoing heart valve surgery.MethodsA retrospective cohort study was conducted on 202 elderly patients who underwent valve surgery in the Cardiac Surgery Intensive Care Unit(CSICU)between January 2013 and April 2014.Patients were stratified into three groups based on UAR level(low:5.66-10.26;middle:10.29-13.47;high:13.48-31.88).The multivariable cox regression analysis with covariate adjustment and subgroup analyses were performed to evaluate the association between UAR and long-term mortality,with a median follow-up period of 7.9 years.Smooth curve fitting was used to evaluate the potential linear association between UAR and long-term follow-up mortality.Kaplan-Meier curves with log-rank tests were generated to compare survival distributions among UAR groups.Results In multivariate regression models,UAR demonstrated a significant positive association with long-term follow-up mortality after comprehensive covariates adjustment.The adjusted hazard ratios(HR)for long-term follow-up mortality was 1.22(95%CI:1.10-1.34,P<0.0001)per 1-unit increase in UAR.We further performed exploratory subgroup analyses which confirmed a higher UAR levels were independently associated with a higher risk of mortality.Kaplan-Meier analysis for event-free survival revealed higher occurrence of long-term follow-up mortality in the high UAR group(P=0.013).Conclusions Elevated UAR levels in elderly patients who underwent valvular surgery in the CSICU demonstrated an positivecorrelation with mortality risk.
文摘BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA)as an independent predictor of the prognosis of patients admitted to the coronary care unit(CCU).AIM To use the RDW and albumin level to predict the prognosis of patients in the CCU.METHODS Data were obtained from the Medical Information Mart Intensive Care III database.The primary outcome was 365-day all-cause mortality,whereas the secondary outcomes were 30-and 90-day all-cause mortality,hospital length of stay(LOS),and CCU LOS.Cox proportional hazards regression model,propen-sity score matching,and receiver operating characteristic curve analyses were used.RESULTS The hazard ratio(95%confidence interval)of the upper tertile(RA>4.66)was 1.62(1.29 to 2.03)when compared with the reference(RA<3.84)in 365-day all-cause mortality.This trend persisted after adjusting for demographic and clinical variables in the propensity score-matching analysis.Similar trends were observed for the secondary outcomes of hospital and CCU LOS.Receiver operating characteristic curve analysis was performed by combining the RA and sequential organ failure assessment(SOFA)scores,and the C-statistic was higher than that of the SOFA scores(0.733 vs 0.702,P<0.001).CONCLUSION RA is an independent prognostic factor in patients admitted to the CCU.RA combined with the SOFA score can improve the predictive ability of the SOFA score.However,our results should be verified in future prospective studies.
文摘BACKGROUND Gallbladder cancer(GBC)is known for its poor prognosis and challenging management.The preoperative fibrinogen to albumin ratio(FAR)has been proposed as a potential prognostic marker for predicting postoperative outcomes in GBC patients,but its efficacy and prognostic value remain underexplored.AIM To evaluate the prognostic value of preoperative FAR in GBC outcomes.METHODS This retrospective cohort study included 66 patients who underwent curative surgery for GBC at our institution from January 2018 to January 2022.Preoperative FAR values were obtained within one week prior to surgery.Patients were followed through outpatient visits or telephone interviews,with overall survival(OS)as the primary endpoint.Statistical analyses,including receiver operating characteristic curve analysis and Kaplan-Meier survival estimates,were performed using SPSS software(version 27.0).RESULTS The cohort consisted of 36 male and 30 female patients,with a mean age of 61.81±8.58 years.The optimal FAR cut-off value was determined to be 0.088,with an area under the receiver operating characteristic curve of 0.7899,sensitivity of 68.96%,and specificity of 80.01%.Patients with FAR≤0.088 showed significantly better survival rates(1-year:60.5%,2-year:52.6%,3-year:25.9%)and a median OS of 25.6 months(95%confidence interval:18.8-30.5 months),compared to those with FAR>0.088 who had a median OS of 10.8 months(95%confidence interval:6.3-12.9 months).CONCLUSION Lower preoperative FAR is associated with longer OS in GBC patients,confirming its potential as a valuable prognostic indicator for improving outcome predictions and guiding patient management strategies in gallbladder cancer.
基金supported by the Natural Science Foundation of Jiangxi Province(20212BAB205017,20192ACB21011)National Science and Technology Award Reserve Cultivation Program Project of Jiangxi(20212AEI91001)。
文摘Effect of ellagitannins gut microbiota metabolites ellagic acid(EA)and urolithin A-urolithin D(UroA-UroD)on human serum albumin(HSA)glycation were firstly evaluated in this research.The inhibition mechanisms were investigated by methylglyoxal(MGO)trapping and radical scavenging ability assays,docking studies and nano LC-orbitrap-MS/MS technology.Results indicated that the inhibition of urolithins on HSA glycation was highly positive correlated with the number of phenolic hydroxy groups.Addition of UroD and EA could effectively enhance the content of free amino group,suppress dicarbonyl compounds and advanced glycation end-products(AGEs)formation,alleviated tryptophan and protein oxidation,inhibited HSA amyloid-like aggregation.They could also trap MGO and scavenge 1,1-diphenyl-2-picrylhydrazyl free radical(DPPH·)and2,2'-azino-bis-3-ethylbenzthiazoline-6-sulphonic acid free radical(ABTS^(+)·).Molecular docking indicated that EA and UroA-UroD interact with HSA mainly through hydrogen bound and hydrophobic interaction,among which 2 or 3 hydrogen bonds were formed.The number of glycation sites were reduced from 11 to10,10,7,and 10,respectively,when 90μmol/L of EA,UroA,UroC and UroD were added.However,weak inhibition was observed on UroA and UroB.These findings can provide scientific evidence for the application of ellagitannins-rich foods in alleviating diabetic complications.
基金supported by the Natural Science Foundation of Jiangsu Province,China(Grant No.BK20211137)China Agriculture Research System(Grant No.CARS-01)。
文摘Seed storage proteins and their abundance are closely related to the formation of rice quality and grain size.A better understanding of the molecular basis of seed storage proteins will provide important information for developing new rice breeding strategies.In this study,we report that a seed storage protein albumin,named OsRAL5,positively regulates rice quality and grain size.OsRAL5 is specifically expressed during the grain-filling stage,suggesting its key role in regulating seed development.Gene editing of OsRAL5 using the CRISPR/Cas9 system diminished grain size and weight,resulting in the development of white-core endosperm and a reduction in eating and cooking quality(ECQ).Conversely,the endosperm appearance became transparent,and both grain weight and ECQ improved in the OsRAL5 over-expressed lines.The major seed storage components differed significantly between the OsRAL5-edited(dOsRAL5-TS)and OsRAL5-overexpressed(OsRAL5-OE)lines compared with the wild type.The protein and total lipid contents both decreased in the dOsRAL5-TS lines and increased in the OsRAL5-OE lines.Collectively,the over-expression of OsRAL5 significantly increased nutritional content and simultaneously improved yield and ECQ.These results imply that OsRAL5 might be a promising candidate gene for breeding super rice varieties with increased yield potential and superior quality.
基金supported by the Project for Enhancing the Scientific Research and Innovation Capacity of Doctoral Students of the Education Department of Jilin Province(JJKH20250061BS).
文摘The emerging NIR-II imaging modality is promising for real-time visualization of living systems and multiple disease diagnoses,particularly through its enhanced tissue penetration and superior spatial resolution[1,2].Cyanine dyes possess the advantages of low administration dosage,high biocompatibility,and strong fluorescence emission intensity[3].Cyanine dyes can be easily structurally modified through molecular engineering methods,while the large hydrophobic conjugation systems hinder further in vivo imaging application.The traditional surfactant encapsulation strategy cannot effectively solve the aggregation caused-quenching issue of the dyes in aqueous solutions and may even mask their reaction active sites[4].Due to the special hydrophobic pocket to act as a probe carrier and the ability to serve as the pan-marker for multiple diseases,albumin is chosen as the preferred binding protein for cyanine dyes[5].Albumin interacts with cyanine dyes through a“hydrophobic pocket”and further improves its properties such as water solubility,biosafety,and fluorescence quantum yield.Cyanine dyes can modify the binding efficiency with albumin through structural design and regulate the targeting performance.This means that cyanine-tagged albumin can respond to pathological changes caused by different diseases and monitor the disease process in real time with high contrast through NIR-II fluorescence signals.Further development of cyanine-tagged albumin probes is helpful for in-depth comprehension of the binding mechanism and guiding the directed synthesis of cyanine molecules with specific protein binding behaviors and optical properties,thereby achieving precise targeting and high-performance NIR-II bioimaging of specific diseases.This point is essential for the design,preparation,and even clinical translation of NIR-II targeting dye molecules in precise diagnosis and treatment.
文摘BACKGROUND Acute-on-chronic liver failure(ACLF)is a life-threatening syndrome associated with high short-term mortality.Accurate risk stratification is crucial for the mana-gement of ACLF.AIM To evaluate the prognostic value of the C-reactive protein to albumin ratio(CAR)and its dynamic changes in patients with ACLF defined by the Chinese Group on Study of Severe Hepatitis B(COSSH)criteria.METHODS A total of 126 consecutive patients diagnosed with COSSH-ACLF were pros-pectively enrolled.CAR was calculated at admission and on days 4,7,and 14.The primary and secondary outcomes were 28-day and 90-day mortality,respectively.Multivariate Cox regression analysis was conducted to identify independent predictors of mortality.A novel prognostic model(COSSH-CAR),integrating baseline and dynamic variables,was developed and compared with established prognostic scoring systems.RESULTS The 28-day and 90-day mortality rates were 27.8%and 40.5%,respectively.Baseline CAR was significantly higher in 28-day non-survivors than in survivors(2.68 vs 1.42,P<0.001).The dynamic change in CAR from baseline to day 7(ΔCAR-7)showed stronger predictive power for 28-day mortality[area under the receiver operating characteristic curve(AUC)=0.765]than baseline CAR(AUC=0.698),ΔCAR-4(AUC=0.706)orΔCAR-14(AUC=0.712).Multivariate analysis identifiedΔCAR-7(HR=1.53),baseline Model for End-Stage Liver Disease-Sodium(MELD-Na)score(HR=1.08),and hepatic encephalopathy grade(HR=1.92)as independent predictors of 28-day mortality(all P<0.05).The COSSH-CAR model,which incorporated these parameters,showed superior predictive performance(AUC=0.832)for 28-day mortality compared with established prognostic scores,including Child-Pugh(AUC=0.721),MELD-Na(AUC=0.768)and COSSH-ACLF(AUC=0.786)and effectively stratified patients into three risk categories with significantly different survival rates(P<0.001).CONCLUSION Dynamic changes in CAR during the first week provide important prognostic information in patients with COSSH-ACLF,surpassing baseline values and conventional inflammatory markers.The novel COSSH-CAR model improves risk stratification and may support clinical decision-making in the management of ACLF,pending ex-ternal validation in diverse populations.
基金Supported by the Wenzhou Municipal Basic Scientific Research Project(No.Y20220789).
文摘AIM:To investigate whether blood urea nitrogen to serum albumin ratio(BAR)influences the onset and progression of diabetic retinopathy(DR)in diabetic patients.METHODS:The diabetic individuals were extracted from the National Health and Nutrition Examination Survey(NHANES)database spanning 1999 to 2018.The BAR was calculated as the ratio of blood urea nitrogen to serum albumin.To evaluate the association between BAR levels and DR,a generalized additive model and multivariate logistic regression analysis were performed.Additionally,subgroup analyses were conducted to determine whether other factors modified this association.RESULTS:The number of eligible individuals in the current research endeavor equaled 5798.The resulting data were indicative of the existence of a nearly linearly positive relationship between BAR levels and DR.Following confounding variable adjustment(age,gender,marital status,red blood cell,hemoglobin,lactate dehydrogenase,uric acid,creatinine,gender,red cell distribution width,highdensity lipoprotein,glucose,sodium,glycated hemoglobin,hypertension,and total cholesterol),the multivariate investigation implied that an elevated DR risk correlated with elevated levels of BAR(OR:1.46,95%CI:1.20-1.79).This relationship was noted to be reliable and stable across diverse analyses,following the conduction of sensitivity analysis(P for trend:0.0002).Subgroup analysis showed no statistically significant interactions between BAR and most other risk factors for DR.CONCLUSION:The study provides evidence of a positive association between elevated BAR levels and an increased risk of DR in diabetic individuals.
基金supported by the National Nature Science Foundation of China(NO.82260699)the Science and Technology Leading Talents of Ningxia(NO.2022GKLRLX011)the West Light Foundation of The Chinese Academy of Sciences(the Science and Technology Department of Ningxia,Department of Science and Technology Cooperation[2021]NO.2).
文摘Ferroptosis can serve as a potent strategy for regulating cell death via lipid peroxidation and the imbalance of the antioxidant system resulting from iron accumulation in triple-negative breast cancer(TNBC)therapy.However,the ferroptosis accompanied with down-regulation of glutathione peroxidase 4(GPX4)lead to CD36-mediated tumor-infiltrating CD8^(+)T cells uptaking fatty acids,resulting in the negative action on immunotherapeutic efficacy.Herein,the albumin nanoparticles,abbreviated as LHS NPs,were designed by co-assembly of hemin,linoleic acid-cystamine,and a CD36 inhibitor sulfosuccinimide oleate,to bi-directionally manipulated ferroptosis in tumor and CD8^(+)T cells for TNBC therapy.LHS NPs exerted more efficient reactive oxygen species generation,glutathione depletion and malondialdehyde production by the combinatory strategy of classical and non-classical ferroptosis modes,which amplified the positive action on ferroptosis in tumor cells.Meanwhile,LHS manipulated the negative action of ferroptosis by inhibiting the CD36 mediated-lipid peroxidation in CD8^(+)T cells,thereby activating the immunotherapeutic efficacy with the improvements on induction of immunogenic cell death,proliferation of CD4+CD8^(+)T cells and natural killer cells,alleviation immunosuppressive regulatory T cells and myeloid-derived suppressor cells,and repolarization of the M2-to M1-phenotype tumor-associated macrophages.Thus,LHS NPs demonstrated an improved antitumor efficacy in suppressing the tumor growth and lungmetastasis of 4T1-tumormice.Our work gives novel insights for the bi-directionally manipulating ferroptosis in tumor and CD8^(+)T cells on TNBC chemoimmunotherapy.
文摘Albumin is the single most abundant protein in the human serum. Its roles in physiology and pathology are diverse. Serum albumin levels have been classically thought to reflect the nutritional status of patients. This concept has been challenged in the last two decades as multiple factors, such as inflammation, appeared to affect albumin levels independent of nutrition. In general, cancer patients have a high prevalence of hypoalbuminemia. As such, the role of hypoalbuminemia in patients with colorectal cancer has received significant interest. We reviewed the English literature on the prognostic value of pretreatment albumin levels in colorectal cancer. We also consolidated the evidence that led to the current understanding of hypoalbuminemia as an inflammatory marker rather than as a nutritional one among patients with colorectal cancer.
