The binding reaction between methyl pheophorbide-a-Gd (MPA-Gd) and Human Serum Albumins (HSA) was studied by fluorescence and UV-Vis absorption spectra. The results indicated that the binding reaction of them was a si...The binding reaction between methyl pheophorbide-a-Gd (MPA-Gd) and Human Serum Albumins (HSA) was studied by fluorescence and UV-Vis absorption spectra. The results indicated that the binding reaction of them was a single static quenching process, MPA-Gd strongly bound HSA, the binding equilibrium constant K0=2.298×105 L·mol-1 at 25 ℃. The shortest binding distance(r) and energy transfer efficiency(E) between donor (HSA) and acceptor (MPA-Gd) was obtained by Frster′s nonradiative energy transfer mechanism as follows: r=4.03 nm, E=0.12. The enthalpy change (ΔH) and entropy change (ΔS) were calculated at 25 and 37 ℃. The results indicated that the hydrogen bonds played major role in the reaction. Furthermore, the displacement experiments indicated that MPA-Gd could bind to the site Ⅱof HSA.展开更多
The binding reaction between 10-hydroxycamptothecin （10-HCPT） and human serum albumins （HSA） is studied by means of fluorescence spectroscopy, UV-Vis absorption spectrum, IH NMR spectrum, and molecular simulation....The binding reaction between 10-hydroxycamptothecin （10-HCPT） and human serum albumins （HSA） is studied by means of fluorescence spectroscopy, UV-Vis absorption spectrum, IH NMR spectrum, and molecular simulation. The results indicate that the binding reaction of 10-HCPT and HSA is a single static quenching process, and the binding equilibrium constant for 10-HCPT binding with HSA is estimated K0-4.93×10^4 L · mol-I at 25 ℃ with the molar ratio of I ： 1. The distance （r） and energy transfer efficiency（E） between donor （HSA） and acceptor （10-HCPT） are obtained as follows, r=3.51 nm; E-0.27. The enthalpy change （△Hφ） and entropy change （△Sφ） are calcu- lated at different temperatures, and the hydrophobic force and shidipole force are the functions in the reaction. The results show that 10-HCPT binds within the subdomain II A of HSA by the hydrophobic force, and the 10-OH and 20-OH of 10-HCPT bind with both residue Leu-238 of HSA and Ala 291 of HSA by hydrogen bonds.展开更多
Holographic recording analysis was performed on the films that were sensitized with ammonium dichromate with albumin of hen and quail (Gallus gallus and Callipepla cali) as abiopolymeric photosensitive matrix. The sam...Holographic recording analysis was performed on the films that were sensitized with ammonium dichromate with albumin of hen and quail (Gallus gallus and Callipepla cali) as abiopolymeric photosensitive matrix. The samples were exposed to an He-Cd laser, λ = 442 nm, at various concentrations, and diffraction efficiencies were measured as a function to the energy, thickness, protein density, aging time, and spatial frequencies. The photosensitivity was measured as a function of storage time, and the gratings were recorded in real time. The photochemical processes involved in the formation of holographic image are described. The results indicate the behavior of colloidal systems based on albumin bird build holographic recording materials.展开更多
The binding characteristics of indigotin with human serum albumin （HSA） and bovine serum albumin （BSA） have been investigated by various spectroscopic techniques. Spectroscopic analysis revealed that the quenching...The binding characteristics of indigotin with human serum albumin （HSA） and bovine serum albumin （BSA） have been investigated by various spectroscopic techniques. Spectroscopic analysis revealed that the quenching mechanism between indigotin and HSA/BSA belonged to the static quenching. The displacement experiments suggested that indigotin primarily bound to tryptophan residues on proteins within site I. The thermodynamic parameters indicated that the binding of indigoti^HSA/BSA mainly depended on the hydrophobic interaction. The binding distance of indigotin to HSA/BSA was evaluated. The results by synchronous fluorescence, three- dimensional fluorescence, Fourier Transform Infrared spectroscopy （FT-IR） and circular dichroism （CD） spectra showed that the conformation of proteins altered in the presence of indigotin.展开更多
The mechanisms and effects about the interaction between serum albumins and silver nanoparticles have been intensively studied by means of transmission electron microscopy (TEM), circular dichroism (CD) and ultraviole...The mechanisms and effects about the interaction between serum albumins and silver nanoparticles have been intensively studied by means of transmission electron microscopy (TEM), circular dichroism (CD) and ultraviolet-visible (UV-Vis) spectroscopy. The adsorption of serum al-bumins on the surface of silver nanoparticles is observed by TEM. The studies with the surface plasmon bands indicate that the electrostatic and hydrophilic interactions are the major forces be-tween serum albumins and silver nanoparticles; the number of adsorbed monolayer serum albu-min molecules to a silver nanoparticle with the size of 60 nm is about 6.7×105. The far-UV CD spectra provide the evidence that the secondary structure of adsorbed serum albumins adopt a looser and more extended conformation, in which the content of -helix decreases, whereas the content of -sheet, turn and unordered coil increases. Using time-scanning UV-Vis spectra to monitor the interacting process, the particular twofold hysteresis effects are significantly found with the coverage of aggregated silver nanoparticles and the conformational transition of serum albumins, respectively. The rate constants and the thermodynamics parameters about the hysteretic processes are also calculated.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 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
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
Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with m...Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with meningitis symptoms at a referral hospital in Mersin,Turkey,between January 2019 and January 2022.Clinical findings and laboratory results,including leukocyte count,C-reactive protein(CRP),and procalcitonin levels in blood,were examined.Logistic regression,Chi square test,and receiver operating characteristics(ROC)curve analyses assessed the predictive value of these parameters.Results:A total of 199 participants were included in the study;99 patients were diagnosed with meningitis after lumbar puncture and 100 served as controls.Patients with meningitis exhibited significantly higher leukocyte counts(median:11890×10^(3)/μL vs.7905×10^(3)/μL,P<0.001)and CRP levels(median:6.00 mg/dL vs.0.95 mg/dL,P<0.001)compared to controls.Procalcitonin levels were significantly elevated in meningitis patients(median:0.21 ng/mL vs.0.10 ng/mL,P<0.001).Logistic regression identified albumin(OR=0.16,95%CI=0.06-0.40),and CRP(OR=1.18,95%CI=1.08-1.28)as independent predictors of meningitis.ROC analysis for CRP demonstrated a sensitivity of 80.6%and specificity of 70.0%at a cut-off value of 2.23 mg/dL(AUC=0.792).Conclusions:Elevated albumin levels and CRP contents in the blood were significant predictors of meningitis in emergency service.Early identification of predictive markers may aid in timely lumbar puncture and management of atypical cases.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 At present,there is a lack of non-invasive indicators to evaluate the changes in endoscopic activity between two visits for patients with Crohn's disease(CD).AIM To develop a model for predicting whethe...BACKGROUND At present,there is a lack of non-invasive indicators to evaluate the changes in endoscopic activity between two visits for patients with Crohn's disease(CD).AIM To develop a model for predicting whether endoscopic activity will improve in CD patients.METHODS This is a single-center retrospective study that included patients diagnosed with CD from January 2014 to December 2022.The patients were randomly divided into a modeling group(70%)and an internal validation group(30%),with an external validation group from January 2023 to March 2024.Univariate and binary logistic regression analyses were conducted to identify independent risk factors,which were used to construct a nomogram model.The model's performance was evaluated using receiver operating characteristic curves,calibration curves,and decision curve analysis(DCA).Additionally,further sensitivity analyses were performed.RESULTS One hundred seventy patients were included in the training group,while 64 were included in the external validation group.A binary logistic stepwise regression analysis revealed that the changes in the amplitudes of albumin(ALB)and fibrinogen(FIB)were independent risk factors for endoscopic improvement.A nomogram model was developed based on these risk factors.The area under the curve of the model for the training group,internal validation group,and external validation group were 0.802,0.788,and 0.787,respectively.The average absolute errors of the calibration curves were 0.011,0.016,and 0.018,respectively.DCA indicated that the model performs well in clinical practice.Additionally,sensitivity analysis demonstrated that the model has strong robustness and applicability.CONCLUSION Our study shows that changes in the amplitudes of ALB and FIB are effective predictors of endoscopic improvement in patients with CD during follow-up visits compared to their previous ones.展开更多
BACKGROUND Neoadjuvant therapies induce tumor regression,resulting in improved surgical resection and pathologic complete response rates,as well as long-term diseasefree and overall survival(OS).In addition to the tum...BACKGROUND Neoadjuvant therapies induce tumor regression,resulting in improved surgical resection and pathologic complete response rates,as well as long-term diseasefree and overall survival(OS).In addition to the tumor regression score,serum inflammatory markers,including neutrophil,lymphocyte,platelet,and serum albumin levels,are used to determine prognosis.AIM To investigate the effect of histological features and serum inflammatory markers on the prognosis of gastric cancer following neoadjuvant treatment.METHODS Neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and serum albumin levels were retrospectively recorded for 177 patients receiving neoadjuvant 5-fluorouracil,leucovorin,oxaliplatin and docetaxel chemotherapy.Disease-free and OS were analyzed based on tumor histopathological features,type of surgery,regression scores,and serum inflammatory markers.RESULTS Patients over 65 years of age,those with lymphovascular or perineural invasion,hypoalbuminemia,and those who did not receive adjuvant therapy were found to be at higher risk for shorter recurrence/relapse intervals[hazard ratio(HR):1.64,P=0.04;HR:4.20,P<0.001;HR:1.87,P=0.03;HR:3.5,P<0.001;and HR:2.73,P=0.01,respectively].Lymphovascular invasion,R1 resection,lack of adjuvant treatment,and hypoalbuminemia negatively influenced OS(HR:3.68,P<0.003;HR:2.37,P=0.01;HR:3.99,P<0.001;and HR:2.50,P=0.01,respectively).No effect of NLR and PLR was observed.CONCLUSION Current neoadjuvant therapies prolong disease-free and OS.The practical application of serum inflammatory markers(NLR and PLR)is limited due to the lack of standard cut-off values.Nutritional status,hypoalbuminemia,and incomplete perioperative chemotherapy have been associated with poor prognosis.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
Maternal diabetes significantly increases the risk of adverse maternal and neonatal outcomes.Traditional self-monitoring of blood glucose is often invasive and limited in its ability to capture glycemic variability.Fl...Maternal diabetes significantly increases the risk of adverse maternal and neonatal outcomes.Traditional self-monitoring of blood glucose is often invasive and limited in its ability to capture glycemic variability.Flash continuous glucose monitoring(FCGM)offers a promising alternative;however,its reliability and correlation with biochemical markers such as hemoglobin A1c(HbA1c)and glycated albumin(GA)in pregnant women with gestational diabetes mellitus(GDM)and type 2 diabetes mellitus(T2DM)remain underexplored.AIM To evaluate the performance of the FreeStyle Libre H FCGM against plasma glucose and its correlations with HbA1c and GA.METHODS This prospective observational study involved 152 pregnant women with GDM or T2DM,with intermittent collection of venous plasma glucose,HbA1c,GA,and concurrent FCGM data at regular intervals at a single center.Relationships were evaluated using restricted cubic spline and mixed-effects models.Receiver operating characteristic curve analysis was performed to compare the ability of HbA1c and GA to detect suboptimal glycemic control.RESULTS Analysis of 507 FCGM-plasma glucose pairs revealed an overall mean absolute relative difference of 7.96%.Mean absolute relative differences were 9.22%,7.75%,and 4.15%for low(3.5-4.4 mmol/L),medium(4.5-7.8 mmol/L),and high(7.9-13 mmol/L)glucose levels,respectively.Most values fell within zone A or zone B on the Clarke and Parkes Error Grids.Bland-Altman analysis indicated a slight underestimation by FCGM(-0.121 mmol/L).Restricted cubic spline analysis revealed significant linear or nonlinear associations between HbA1c/GA and mean glucose,time in range,time above range,and coefficient of variation,but not time below range.Both HbA1c and GA were influenced by gestational age and pregestational body mass index.Receiver operating characteristic analysis showed that HbA1c had comparable or superior performance to GA in detecting suboptimal glycemic control based on FCGM-derived thresholds.CONCLUSION The FCGM system served as a validated reference for evaluating glycemic markers in pregnant women with T2DM and GDM.HbA1c reliably assessed average glycemia,while GA provided complementary insight.展开更多
BACKGROUND Gastric cancer is among the most prevalent malignancies worldwide.Despite significant advancements in chemoradiotherapy,targeted therapy,and neoadjuvant therapy,conventional surgical intervention remains th...BACKGROUND Gastric cancer is among the most prevalent malignancies worldwide.Despite significant advancements in chemoradiotherapy,targeted therapy,and neoadjuvant therapy,conventional surgical intervention remains the cornerstone of gastric cancer management.Improvements in surgical techniques,coupled with the use of staplers and other advanced instruments,have substantially reduced the incidence of complications and mortality following gastric cancer surgery.However,dysphagia remains a common postoperative complication.AIM To retrospectively investigate the potential factors contributing to dysphagia in patients who have undergone laparoscopic radical gastrectomy for gastric cancer and to explore effective strategies for its postoperative management.METHODS In this retrospective study,we analyzed data from patients who underwent elective laparoscopic total gastrectomy at Lihuili Hospital,Ningbo University,between January 2018 and May 2022.A total of 115 eligible postoperative patients were included.Postoperatively,patients completed questionnaires and were categorized into two groups based on their responses:The dysphagia group(Eating Assessment Tool-10 score≥3)and the non-dysphagia group(Eating Assessment Tool-10 score<3).Risk factors associated with dysphagia following total gastrectomy were assessed usingχ2 tests,Fisher’s exact tests,t-tests,Pearson correlation coefficients,and univariate and multivariate regression analyses.RESULTS Multivariate analysis further identified anastomotic style,prolonged intubation time,advanced age,and low albumin(ALB)levels as independent risk factors for postoperative dysphagia.Implementing targeted preventive measures for high-risk groups may significantly enhance postoperative quality of life.CONCLUSION Univariate analysis revealed that anastomotic style,low serum ALB levels,advanced age,and prolonged intubation time were significantly associated with postoperative dysphagia in gastric cancer patients.Multivariate analysis further identified anastomotic style,prolonged intubation time,advanced age,and low ALB levels as independent risk factors for postoperative dysphagia.Implementing targeted preventive measures for high-risk groups may significantly enhance postoperative 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
文摘The binding reaction between methyl pheophorbide-a-Gd (MPA-Gd) and Human Serum Albumins (HSA) was studied by fluorescence and UV-Vis absorption spectra. The results indicated that the binding reaction of them was a single static quenching process, MPA-Gd strongly bound HSA, the binding equilibrium constant K0=2.298×105 L·mol-1 at 25 ℃. The shortest binding distance(r) and energy transfer efficiency(E) between donor (HSA) and acceptor (MPA-Gd) was obtained by Frster′s nonradiative energy transfer mechanism as follows: r=4.03 nm, E=0.12. The enthalpy change (ΔH) and entropy change (ΔS) were calculated at 25 and 37 ℃. The results indicated that the hydrogen bonds played major role in the reaction. Furthermore, the displacement experiments indicated that MPA-Gd could bind to the site Ⅱof HSA.
基金Supported by the Foundation of Shandong Province Educa-tion Bureau (J06060)
文摘The binding reaction between 10-hydroxycamptothecin （10-HCPT） and human serum albumins （HSA） is studied by means of fluorescence spectroscopy, UV-Vis absorption spectrum, IH NMR spectrum, and molecular simulation. The results indicate that the binding reaction of 10-HCPT and HSA is a single static quenching process, and the binding equilibrium constant for 10-HCPT binding with HSA is estimated K0-4.93×10^4 L · mol-I at 25 ℃ with the molar ratio of I ： 1. The distance （r） and energy transfer efficiency（E） between donor （HSA） and acceptor （10-HCPT） are obtained as follows, r=3.51 nm; E-0.27. The enthalpy change （△Hφ） and entropy change （△Sφ） are calcu- lated at different temperatures, and the hydrophobic force and shidipole force are the functions in the reaction. The results show that 10-HCPT binds within the subdomain II A of HSA by the hydrophobic force, and the 10-OH and 20-OH of 10-HCPT bind with both residue Leu-238 of HSA and Ala 291 of HSA by hydrogen bonds.
基金Thanks are due to The Instituto Nacional de Astrofisica Optica y Electronica(INAOE)for the infrastructure and economic support received.
文摘Holographic recording analysis was performed on the films that were sensitized with ammonium dichromate with albumin of hen and quail (Gallus gallus and Callipepla cali) as abiopolymeric photosensitive matrix. The samples were exposed to an He-Cd laser, λ = 442 nm, at various concentrations, and diffraction efficiencies were measured as a function to the energy, thickness, protein density, aging time, and spatial frequencies. The photosensitivity was measured as a function of storage time, and the gratings were recorded in real time. The photochemical processes involved in the formation of holographic image are described. The results indicate the behavior of colloidal systems based on albumin bird build holographic recording materials.
基金support by the Education Department of Sichuan Province (12ZA171)
文摘The binding characteristics of indigotin with human serum albumin （HSA） and bovine serum albumin （BSA） have been investigated by various spectroscopic techniques. Spectroscopic analysis revealed that the quenching mechanism between indigotin and HSA/BSA belonged to the static quenching. The displacement experiments suggested that indigotin primarily bound to tryptophan residues on proteins within site I. The thermodynamic parameters indicated that the binding of indigoti^HSA/BSA mainly depended on the hydrophobic interaction. The binding distance of indigotin to HSA/BSA was evaluated. The results by synchronous fluorescence, three- dimensional fluorescence, Fourier Transform Infrared spectroscopy （FT-IR） and circular dichroism （CD） spectra showed that the conformation of proteins altered in the presence of indigotin.
基金This work was supported by the National Natural Science Foundation of China(Grant No.20261001)CEMFoundation for N&T Joint Academythe Science Foundation of Guangxi Zhuang Autonomous Region.
文摘The mechanisms and effects about the interaction between serum albumins and silver nanoparticles have been intensively studied by means of transmission electron microscopy (TEM), circular dichroism (CD) and ultraviolet-visible (UV-Vis) spectroscopy. The adsorption of serum al-bumins on the surface of silver nanoparticles is observed by TEM. The studies with the surface plasmon bands indicate that the electrostatic and hydrophilic interactions are the major forces be-tween serum albumins and silver nanoparticles; the number of adsorbed monolayer serum albu-min molecules to a silver nanoparticle with the size of 60 nm is about 6.7×105. The far-UV CD spectra provide the evidence that the secondary structure of adsorbed serum albumins adopt a looser and more extended conformation, in which the content of -helix decreases, whereas the content of -sheet, turn and unordered coil increases. Using time-scanning UV-Vis spectra to monitor the interacting process, the particular twofold hysteresis effects are significantly found with the coverage of aggregated silver nanoparticles and the conformational transition of serum albumins, respectively. The rate constants and the thermodynamics parameters about the hysteretic processes are also calculated.
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.
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.
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.
文摘Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with meningitis symptoms at a referral hospital in Mersin,Turkey,between January 2019 and January 2022.Clinical findings and laboratory results,including leukocyte count,C-reactive protein(CRP),and procalcitonin levels in blood,were examined.Logistic regression,Chi square test,and receiver operating characteristics(ROC)curve analyses assessed the predictive value of these parameters.Results:A total of 199 participants were included in the study;99 patients were diagnosed with meningitis after lumbar puncture and 100 served as controls.Patients with meningitis exhibited significantly higher leukocyte counts(median:11890×10^(3)/μL vs.7905×10^(3)/μL,P<0.001)and CRP levels(median:6.00 mg/dL vs.0.95 mg/dL,P<0.001)compared to controls.Procalcitonin levels were significantly elevated in meningitis patients(median:0.21 ng/mL vs.0.10 ng/mL,P<0.001).Logistic regression identified albumin(OR=0.16,95%CI=0.06-0.40),and CRP(OR=1.18,95%CI=1.08-1.28)as independent predictors of meningitis.ROC analysis for CRP demonstrated a sensitivity of 80.6%and specificity of 70.0%at a cut-off value of 2.23 mg/dL(AUC=0.792).Conclusions:Elevated albumin levels and CRP contents in the blood were significant predictors of meningitis in emergency service.Early identification of predictive markers may aid in timely lumbar puncture and management of atypical cases.
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.
文摘BACKGROUND At present,there is a lack of non-invasive indicators to evaluate the changes in endoscopic activity between two visits for patients with Crohn's disease(CD).AIM To develop a model for predicting whether endoscopic activity will improve in CD patients.METHODS This is a single-center retrospective study that included patients diagnosed with CD from January 2014 to December 2022.The patients were randomly divided into a modeling group(70%)and an internal validation group(30%),with an external validation group from January 2023 to March 2024.Univariate and binary logistic regression analyses were conducted to identify independent risk factors,which were used to construct a nomogram model.The model's performance was evaluated using receiver operating characteristic curves,calibration curves,and decision curve analysis(DCA).Additionally,further sensitivity analyses were performed.RESULTS One hundred seventy patients were included in the training group,while 64 were included in the external validation group.A binary logistic stepwise regression analysis revealed that the changes in the amplitudes of albumin(ALB)and fibrinogen(FIB)were independent risk factors for endoscopic improvement.A nomogram model was developed based on these risk factors.The area under the curve of the model for the training group,internal validation group,and external validation group were 0.802,0.788,and 0.787,respectively.The average absolute errors of the calibration curves were 0.011,0.016,and 0.018,respectively.DCA indicated that the model performs well in clinical practice.Additionally,sensitivity analysis demonstrated that the model has strong robustness and applicability.CONCLUSION Our study shows that changes in the amplitudes of ALB and FIB are effective predictors of endoscopic improvement in patients with CD during follow-up visits compared to their previous ones.
文摘BACKGROUND Neoadjuvant therapies induce tumor regression,resulting in improved surgical resection and pathologic complete response rates,as well as long-term diseasefree and overall survival(OS).In addition to the tumor regression score,serum inflammatory markers,including neutrophil,lymphocyte,platelet,and serum albumin levels,are used to determine prognosis.AIM To investigate the effect of histological features and serum inflammatory markers on the prognosis of gastric cancer following neoadjuvant treatment.METHODS Neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and serum albumin levels were retrospectively recorded for 177 patients receiving neoadjuvant 5-fluorouracil,leucovorin,oxaliplatin and docetaxel chemotherapy.Disease-free and OS were analyzed based on tumor histopathological features,type of surgery,regression scores,and serum inflammatory markers.RESULTS Patients over 65 years of age,those with lymphovascular or perineural invasion,hypoalbuminemia,and those who did not receive adjuvant therapy were found to be at higher risk for shorter recurrence/relapse intervals[hazard ratio(HR):1.64,P=0.04;HR:4.20,P<0.001;HR:1.87,P=0.03;HR:3.5,P<0.001;and HR:2.73,P=0.01,respectively].Lymphovascular invasion,R1 resection,lack of adjuvant treatment,and hypoalbuminemia negatively influenced OS(HR:3.68,P<0.003;HR:2.37,P=0.01;HR:3.99,P<0.001;and HR:2.50,P=0.01,respectively).No effect of NLR and PLR was observed.CONCLUSION Current neoadjuvant therapies prolong disease-free and OS.The practical application of serum inflammatory markers(NLR and PLR)is limited due to the lack of standard cut-off values.Nutritional status,hypoalbuminemia,and incomplete perioperative chemotherapy have been associated with poor prognosis.
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 National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-015the Healthcare Quality and Safety Incubation Program of Peking Union Medical Foundation,No.XHFY2406.
文摘Maternal diabetes significantly increases the risk of adverse maternal and neonatal outcomes.Traditional self-monitoring of blood glucose is often invasive and limited in its ability to capture glycemic variability.Flash continuous glucose monitoring(FCGM)offers a promising alternative;however,its reliability and correlation with biochemical markers such as hemoglobin A1c(HbA1c)and glycated albumin(GA)in pregnant women with gestational diabetes mellitus(GDM)and type 2 diabetes mellitus(T2DM)remain underexplored.AIM To evaluate the performance of the FreeStyle Libre H FCGM against plasma glucose and its correlations with HbA1c and GA.METHODS This prospective observational study involved 152 pregnant women with GDM or T2DM,with intermittent collection of venous plasma glucose,HbA1c,GA,and concurrent FCGM data at regular intervals at a single center.Relationships were evaluated using restricted cubic spline and mixed-effects models.Receiver operating characteristic curve analysis was performed to compare the ability of HbA1c and GA to detect suboptimal glycemic control.RESULTS Analysis of 507 FCGM-plasma glucose pairs revealed an overall mean absolute relative difference of 7.96%.Mean absolute relative differences were 9.22%,7.75%,and 4.15%for low(3.5-4.4 mmol/L),medium(4.5-7.8 mmol/L),and high(7.9-13 mmol/L)glucose levels,respectively.Most values fell within zone A or zone B on the Clarke and Parkes Error Grids.Bland-Altman analysis indicated a slight underestimation by FCGM(-0.121 mmol/L).Restricted cubic spline analysis revealed significant linear or nonlinear associations between HbA1c/GA and mean glucose,time in range,time above range,and coefficient of variation,but not time below range.Both HbA1c and GA were influenced by gestational age and pregestational body mass index.Receiver operating characteristic analysis showed that HbA1c had comparable or superior performance to GA in detecting suboptimal glycemic control based on FCGM-derived thresholds.CONCLUSION The FCGM system served as a validated reference for evaluating glycemic markers in pregnant women with T2DM and GDM.HbA1c reliably assessed average glycemia,while GA provided complementary insight.
文摘BACKGROUND Gastric cancer is among the most prevalent malignancies worldwide.Despite significant advancements in chemoradiotherapy,targeted therapy,and neoadjuvant therapy,conventional surgical intervention remains the cornerstone of gastric cancer management.Improvements in surgical techniques,coupled with the use of staplers and other advanced instruments,have substantially reduced the incidence of complications and mortality following gastric cancer surgery.However,dysphagia remains a common postoperative complication.AIM To retrospectively investigate the potential factors contributing to dysphagia in patients who have undergone laparoscopic radical gastrectomy for gastric cancer and to explore effective strategies for its postoperative management.METHODS In this retrospective study,we analyzed data from patients who underwent elective laparoscopic total gastrectomy at Lihuili Hospital,Ningbo University,between January 2018 and May 2022.A total of 115 eligible postoperative patients were included.Postoperatively,patients completed questionnaires and were categorized into two groups based on their responses:The dysphagia group(Eating Assessment Tool-10 score≥3)and the non-dysphagia group(Eating Assessment Tool-10 score<3).Risk factors associated with dysphagia following total gastrectomy were assessed usingχ2 tests,Fisher’s exact tests,t-tests,Pearson correlation coefficients,and univariate and multivariate regression analyses.RESULTS Multivariate analysis further identified anastomotic style,prolonged intubation time,advanced age,and low albumin(ALB)levels as independent risk factors for postoperative dysphagia.Implementing targeted preventive measures for high-risk groups may significantly enhance postoperative quality of life.CONCLUSION Univariate analysis revealed that anastomotic style,low serum ALB levels,advanced age,and prolonged intubation time were significantly associated with postoperative dysphagia in gastric cancer patients.Multivariate analysis further identified anastomotic style,prolonged intubation time,advanced age,and low ALB levels as independent risk factors for postoperative dysphagia.Implementing targeted preventive measures for high-risk groups may significantly enhance postoperative 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.
