BACKGROUND Gastric cancer(GC)is a prevalent malignancy with a substantial health burden and high mortality rate,despite advances in prevention,early detection,and treatment.Compared with the global average,Asia,notabl...BACKGROUND Gastric cancer(GC)is a prevalent malignancy with a substantial health burden and high mortality rate,despite advances in prevention,early detection,and treatment.Compared with the global average,Asia,notably China,reports disproportionately high GC incidences.The disease often progresses asymptoma-tically in the early stages,leading to delayed diagnosis and compromised out-comes.Thus,it is crucial to identify early diagnostic biomarkers and enhance treatment strategies to improve patient outcomes and reduce mortality.METHODS Retrospectively analyzed the clinical data of 148 patients with GC treated at the Civil Aviation Shanghai Hospital between December 2022 and December 2023.The associations of coagulation indices-partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen,fibrinogen degradation products(FDP),fasting blood glucose,and D-dimer(D-D)with TNM stage and distant metastasis were examined.RESULTS Prolongation of APTT,PT,and TT was significantly correlated with the GC TNM stage.Hence,abnormal coagulation system activation was closely related to disease progression.Elevated FDP and D-D were significantly associated with distant metastasis in GC(P<0.05),suggesting that increased fibrinolytic activity contributes to increased metastatic risk.CONCLUSION Our Results reveal coagulation indices,FDPs as GC biomarkers,reflecting abnormal coagulation/fibrinolysis,aiding disease progression,metastasis prediction,and helping clinicians assess thrombotic risk for early intervention and personalized treatment plans.展开更多
Liver diseases including hepatic injury,hepatitis,metabolic-associated fatty liver disease,and hepatocellular carcinoma have emerged as critical public health challenges globally.The fibrinogen(FG)superfamily proteins...Liver diseases including hepatic injury,hepatitis,metabolic-associated fatty liver disease,and hepatocellular carcinoma have emerged as critical public health challenges globally.The fibrinogen(FG)superfamily proteins,primarily comprising FG,FG-like protein(FGL)1,and FGL2,have been demonstrated to exert regulatory effects on hepatic tissue regeneration,lipid metabolism homeostasis,and oncogenic processes in hepatocytes.This review systematically examines the pathophysiological correlations between FG superfamily members and major hepatic disorders.Physiologically,FG superfamily proteins function as hepatoprotective mediators through their intrinsic capacity to enhance hepatic parenchymal regeneration and extracellular matrix remodeling.However,emerging evidence reveals their dual regulatory properties,whereby overactivation of these hepatokines paradoxically induces a pathological shift characterized by proinflammatory cascades,metabolic derangement potentiation,and tumor invasion and metastasis promotion.Specifically,we elucidate the molecular mechanisms underlying their involvement in hepatitis progression,metabolic-associated fatty liver disease pathogenesis,and hepatocellular carcinoma tumorigenesis.Furthermore,we highlight their therapeutic potential in hepatic disease management,particularly emphasizing that targeting the FGL1/lymphocyte activation gene 3 immune checkpoint axis represents a novel paradigm in precision cancer immunotherapy.展开更多
Vascular damage plays a significant role in the onset and progression of Alzheimer’s disease(AD).However,the precise molecular mechanisms underlying the induction of neuronal injury by vascular damage remain unclear....Vascular damage plays a significant role in the onset and progression of Alzheimer’s disease(AD).However,the precise molecular mechanisms underlying the induction of neuronal injury by vascular damage remain unclear.The present study aimed to examine the impact of fibrinogen(Fg)on tau pathology.The results showed that Fg deposits in the brains of tau P301S transgenic mice interact with tau,enhancing the cytotoxicity of pathological tau aggregates and promoting tau phosphorylation and aggregation.Notably,Fg-modified tau fibrils caused enhanced neuronal apoptosis and synaptic damage compared to unmodified fibrils.Furthermore,intrahippocampal injection of Fg-modified tau fibrils worsened the tau pathology,neuroinflammation,synaptic damage,neuronal apoptosis,and cognitive dysfunction in tau P301S mice compared to controls.The present study provides compelling evidence linking Fg and tau,thereby connecting cerebrovascular damage to tau pathology in AD.Consequently,inhibiting Fg-mediated tau pathology could potentially impede the progression of AD.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
BACKGROUND Primary liver cancer,predominantly hepatocellular carcinoma(HCC),is a major cause of cancer-related mortality.Transarterial chemoembolization(TACE)is a key palliative option for unresectable HCC.However,pro...BACKGROUND Primary liver cancer,predominantly hepatocellular carcinoma(HCC),is a major cause of cancer-related mortality.Transarterial chemoembolization(TACE)is a key palliative option for unresectable HCC.However,prognostic outcomes after TACE vary significantly.This study evaluated the prognostic value of the fibrinogen and neutrophil-to-lymphocyte ratio(F-NLR)score,serum alpha-fetoprotein(AFP),and prealbumin(PA)in patients undergoing TACE.AIM To investigate the prognostic significance of F-NLR score,AFP,and PA in patients undergoing TACE.METHODS Variables such as F-NLR score,AFP,PA,and other clinical indicators were assessed.Follow-ups determined prognosis as good or poor.Statistical asse-ssments,including receiver operating characteristic analyses,were performed to evaluate the prognostic significance and develop an integrated predictive model.RESULTS A retrospective analysis of 162 patients with primary liver cancer undergoing TACE was conducted.Low F-NLR scores and AFP levels and high PA were significantly associated with a good prognosis.The combined model,which integrated F-NLR,AFP,and PA,demonstrated a favorable prognostic predictive capability,with an area under the curve of 0.933.CONCLUSION Preoperative F-NLR,AFP,and PA are valuable prognostic predictors in patients with HCC undergoing TACE.展开更多
目的探究纤维蛋白原样蛋白1(fibrinogen-like protein 1,FGL1)和膜联蛋白A11(annexin A11,ANXA11)对肺癌手术患者效用评估价值及与预后的相关性。方法将本院2020年1月至2023年12月接诊的98例肺癌患者纳入肺癌组,另选取98例健康人作为对...目的探究纤维蛋白原样蛋白1(fibrinogen-like protein 1,FGL1)和膜联蛋白A11(annexin A11,ANXA11)对肺癌手术患者效用评估价值及与预后的相关性。方法将本院2020年1月至2023年12月接诊的98例肺癌患者纳入肺癌组,另选取98例健康人作为对照组。受试者入院后分别于空腹状态下采取6 mL肘静脉血,采用ELISA法检测血清ANXA11水平,采用实时荧光定量PCR技术检测ANXA11表达水平。根据术后1个月肿瘤标志物变化、影像学表现和免疫功能指标变化情况分为治疗有效组(n=68)和无效组(n=30)。患者出院后均行12~36个月的随访,根据患者预后情况分为预后良好组(n=63)和预后不良组(n=35)。对比对照组和肺癌组/有效组和无效组/预后FGL1、ANXA11表达差异;ROC分析FGL1、ANXA11单一及联合检测对肺癌手术患者临床效用评估价值;Spearman分析FGL1、ANXA11表达与预后的关系。结果肺癌组FGL1和ANXA11表达水平明显高于对照组(均P<0.05);无效组FGL1和ANXA11表达水平明显高于有效组(均P<0.05);ROC结果显示FGL1、ANXA11单独及联合检测对肺癌手术患者效用评估的曲线线下面积分别为0.928,并且联合检测具有较高的特异性(95.59%)以及敏感度(90.00%),诊断价值显著高于单独检测ROC曲线线下面积(均P<0.05);预后不良组FGL1和ANXA11表达水平明显高于预后良好组(均P<0.05);Spearman相关性结果显示FGL1、ANXA11与肺癌手术患者预后呈显著正相关(r=0.771、0.793,均P<0.05)。结论肺癌患者的FGL1与ANXA11表达水平高于健康人,治疗无效者高于有效者,预后不良者高于良好者,二者单独及联合检测对患者手术治疗效用评估均有价值,且其与预后相关性显著。展开更多
目的通过研究缺氧缺血性脑病(HIE)新生儿血清神经纤维轻链(NF-L)、水通道蛋白9(AQP9)、纤维蛋白原样蛋白2(FGL2)水平的变化,分析三者与新生儿行为神经评估(NABA)评分的相关性。方法选取2022年1月~2024年7月山西省儿童医院收治的203例HI...目的通过研究缺氧缺血性脑病(HIE)新生儿血清神经纤维轻链(NF-L)、水通道蛋白9(AQP9)、纤维蛋白原样蛋白2(FGL2)水平的变化,分析三者与新生儿行为神经评估(NABA)评分的相关性。方法选取2022年1月~2024年7月山西省儿童医院收治的203例HIE患儿为研究组,根据病情程度分为轻度组(n=63)、中度组(n=81)和重度组(n=59),另选同期的健康新生儿203例为对照组,酶联免疫吸附试验(ELISA)检测血清NF-L、AQP9、FGL2水平,收集分析一般临床资料。受试者操作特征(ROC)曲线分析NF-L、AQP9、FGL2及NABA评分对新生儿重度HIE的诊断价值;Pearson法分析血清NF-L、AQP9、FGL2与NABA评分的相关性。结果与对照组相比,研究组血清NF-L(14.78±1.67ng/ml vs 10.65±1.21ng/ml)、AQP9(61.82±6.29pg/ml vs 42.62±4.31pg/ml)、FGL2(189.69±20.26ng/ml vs 132.51±14.84ng/ml)水平显著升高,差异具有统计学意义(t=28.533、35.877、32.440,均P<0.05);中度组、重度组血清NF-L(14.68±1.67ng/ml、18.62±2.03ng/ml),AQP9(63.51±6.44pg/ml、69.63±7.03pg/ml),FGL2(195.68±20.84ng/ml、210.65±22.36ng/ml)水平显著高于轻度组(11.32±1.33ng/ml、52.32±5.41pg/ml、162.35±17.55ng/ml),NABA(34.89±3.51分、29.88±3.43分)评分显著低于轻度组(36.54±1.52分),差异具有统计学意义(t_(中度组)=4.616~16.729,t_(重度组)=17.276~33.701,均P<0.05);NF-L、AQP9、FGL2与NABA评分均呈负相关(r=-0.432、-0.421、-0.402,均P<0.05);NF-L、AQP9、FGL2、NABA联合诊断患儿重度病情的曲线下面积(AUC)显著高于各项单独诊断,差异具有统计学意义(Z=2.066~3.307,均P<0.05)。结论HIE患儿血清NF-L、AQP9、FGL2水平显著升高,与NABA评分相关,可能成为评估HIE患儿病情的标志物。展开更多
Objective To investigate the mechanisms of electroacupuncture （EA） at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟 GV 26） for treating cerebral infarction. Methods Forty healthy SD rats were randomly divided in...Objective To investigate the mechanisms of electroacupuncture （EA） at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟 GV 26） for treating cerebral infarction. Methods Forty healthy SD rats were randomly divided into model group （n = 10）, EA group （n = 10）, normal group （n = 10）, and sham operation group （n = 10）. The model of acute cerebral infarction was established by blocking the middle cerebral artery with an intraluminal thread. EA was applied at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟GV 26） in the rats of EA group after the models were developed. The contents of D-dimer （D-D） and fibrinogen （Fib） were measured in each group. Results The contents of D-D and Fib increased signifi- cantly in model group as compared with normal and sham operation groups, respectively （P〈0.01）, and they decreased significantly in EA group as compared with model group （P〈0.01）. Conclusion EA can ob-viously decrease the contents of D-D and Fib, improve abnormal fibrinolysis, lower blood viscosity and ameliorate cerebral blood circulation in the rats with acute cerebral infarction.展开更多
目的探讨多发伤患者院内死亡的独立危险因素并分析各危险因素的预测价值。方法采用回顾性队列研究分析2020年9月至2024年9月安徽医科大学第二附属医院急诊外科收治的245例多发伤患者临床资料,其中男177例,女68例;年龄18~87(50.4±14...目的探讨多发伤患者院内死亡的独立危险因素并分析各危险因素的预测价值。方法采用回顾性队列研究分析2020年9月至2024年9月安徽医科大学第二附属医院急诊外科收治的245例多发伤患者临床资料,其中男177例,女68例;年龄18~87(50.4±14.6)岁;损伤部位:头颈部(78例),胸部(154例),腹部(166例),四肢骨盆(91例);根据院内是否死亡分为死亡组(27例)和生存组(218例)。比较两组基线资料及临床资料,包括性别、年龄、致伤原因、损伤部位、损伤严重度评分(injury severity score,ISS)、到达抢救室时生命体征[呼吸次数、心率、平均动脉压(mean arterial pressure,MAP)、体温)]、血液学指标[白细胞计数(white blood cell count,WBC)、血红蛋白(hemoglobin,Hb)、血小板计数(platelet count,PLT)、尿素氮(urea nitrogen,BUN)、肌酐(creatinine,Cr)、钠离子(sodium ion,Na^(+))、钾离子(potassium ion,K^(+))、活化部分凝血活酶时间(activated part of the thromboplastin time,APTT)、凝血酶原时间(prothrombin time,PT)、国际化标准比值(international standard ratio,INR)、纤维蛋白原(fibrinogen,FIB)]等。先通过单因素分析比较死亡组和生存组间基线及上述临床资料差异,再采用多因素Logistic回归分析确定多发伤患者院内死亡的独立危险因素,通过MedCalc统计软件绘制受试者工作特征(receiver operating characteristic,ROC)曲线,分析各危险因素预测多发伤患者院内死亡的效能。结果单因素分析表明,两组间在损伤部位、ISS评分、休克指数、心率、体温、MAP、Hb、PLT、Cr、Na^(+)、APTT、PT、INR、FIB方面差异有统计学意义(P<0.05或0.01),两组间在性别、致伤原因、年龄、呼吸次数、WBC、BUN、K^(+)差异无统计学意义(P>0.05)。多因素Logistic回归分析表明MAP、Hb、PLT、APTT、PT、FIB与多发伤患者院内死亡有显著相关(P<0.05或0.01)。ROC曲线分析结果表明,MAP、Hb、PLT、APTT、PT、FIB预测多发伤患者院内死亡的曲线下面积(area under the curve,AUC)分别为0.925(0.885,0.955)、0.766(0.708,0.817)、0.725(0.664,0.780)、0.854(0.804,0.896)、0.900(0.855,0.934)、0.835(0.782,0.879)。结论MAP降低、Hb减少、PLT减少、APTT和PT延长、FIB降低是多发伤患者院内死亡的独立危险因素。展开更多
文摘BACKGROUND Gastric cancer(GC)is a prevalent malignancy with a substantial health burden and high mortality rate,despite advances in prevention,early detection,and treatment.Compared with the global average,Asia,notably China,reports disproportionately high GC incidences.The disease often progresses asymptoma-tically in the early stages,leading to delayed diagnosis and compromised out-comes.Thus,it is crucial to identify early diagnostic biomarkers and enhance treatment strategies to improve patient outcomes and reduce mortality.METHODS Retrospectively analyzed the clinical data of 148 patients with GC treated at the Civil Aviation Shanghai Hospital between December 2022 and December 2023.The associations of coagulation indices-partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen,fibrinogen degradation products(FDP),fasting blood glucose,and D-dimer(D-D)with TNM stage and distant metastasis were examined.RESULTS Prolongation of APTT,PT,and TT was significantly correlated with the GC TNM stage.Hence,abnormal coagulation system activation was closely related to disease progression.Elevated FDP and D-D were significantly associated with distant metastasis in GC(P<0.05),suggesting that increased fibrinolytic activity contributes to increased metastatic risk.CONCLUSION Our Results reveal coagulation indices,FDPs as GC biomarkers,reflecting abnormal coagulation/fibrinolysis,aiding disease progression,metastasis prediction,and helping clinicians assess thrombotic risk for early intervention and personalized treatment plans.
文摘Liver diseases including hepatic injury,hepatitis,metabolic-associated fatty liver disease,and hepatocellular carcinoma have emerged as critical public health challenges globally.The fibrinogen(FG)superfamily proteins,primarily comprising FG,FG-like protein(FGL)1,and FGL2,have been demonstrated to exert regulatory effects on hepatic tissue regeneration,lipid metabolism homeostasis,and oncogenic processes in hepatocytes.This review systematically examines the pathophysiological correlations between FG superfamily members and major hepatic disorders.Physiologically,FG superfamily proteins function as hepatoprotective mediators through their intrinsic capacity to enhance hepatic parenchymal regeneration and extracellular matrix remodeling.However,emerging evidence reveals their dual regulatory properties,whereby overactivation of these hepatokines paradoxically induces a pathological shift characterized by proinflammatory cascades,metabolic derangement potentiation,and tumor invasion and metastasis promotion.Specifically,we elucidate the molecular mechanisms underlying their involvement in hepatitis progression,metabolic-associated fatty liver disease pathogenesis,and hepatocellular carcinoma tumorigenesis.Furthermore,we highlight their therapeutic potential in hepatic disease management,particularly emphasizing that targeting the FGL1/lymphocyte activation gene 3 immune checkpoint axis represents a novel paradigm in precision cancer immunotherapy.
基金supported by a grant from the National Natural Science Foundation of China(82071183).
文摘Vascular damage plays a significant role in the onset and progression of Alzheimer’s disease(AD).However,the precise molecular mechanisms underlying the induction of neuronal injury by vascular damage remain unclear.The present study aimed to examine the impact of fibrinogen(Fg)on tau pathology.The results showed that Fg deposits in the brains of tau P301S transgenic mice interact with tau,enhancing the cytotoxicity of pathological tau aggregates and promoting tau phosphorylation and aggregation.Notably,Fg-modified tau fibrils caused enhanced neuronal apoptosis and synaptic damage compared to unmodified fibrils.Furthermore,intrahippocampal injection of Fg-modified tau fibrils worsened the tau pathology,neuroinflammation,synaptic damage,neuronal apoptosis,and cognitive dysfunction in tau P301S mice compared to controls.The present study provides compelling evidence linking Fg and tau,thereby connecting cerebrovascular damage to tau pathology in AD.Consequently,inhibiting Fg-mediated tau pathology could potentially impede the progression of AD.
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 Health Commission of Heilongjiang Province,No.0230404080031.
文摘BACKGROUND Primary liver cancer,predominantly hepatocellular carcinoma(HCC),is a major cause of cancer-related mortality.Transarterial chemoembolization(TACE)is a key palliative option for unresectable HCC.However,prognostic outcomes after TACE vary significantly.This study evaluated the prognostic value of the fibrinogen and neutrophil-to-lymphocyte ratio(F-NLR)score,serum alpha-fetoprotein(AFP),and prealbumin(PA)in patients undergoing TACE.AIM To investigate the prognostic significance of F-NLR score,AFP,and PA in patients undergoing TACE.METHODS Variables such as F-NLR score,AFP,PA,and other clinical indicators were assessed.Follow-ups determined prognosis as good or poor.Statistical asse-ssments,including receiver operating characteristic analyses,were performed to evaluate the prognostic significance and develop an integrated predictive model.RESULTS A retrospective analysis of 162 patients with primary liver cancer undergoing TACE was conducted.Low F-NLR scores and AFP levels and high PA were significantly associated with a good prognosis.The combined model,which integrated F-NLR,AFP,and PA,demonstrated a favorable prognostic predictive capability,with an area under the curve of 0.933.CONCLUSION Preoperative F-NLR,AFP,and PA are valuable prognostic predictors in patients with HCC undergoing TACE.
文摘目的探究纤维蛋白原样蛋白1(fibrinogen-like protein 1,FGL1)和膜联蛋白A11(annexin A11,ANXA11)对肺癌手术患者效用评估价值及与预后的相关性。方法将本院2020年1月至2023年12月接诊的98例肺癌患者纳入肺癌组,另选取98例健康人作为对照组。受试者入院后分别于空腹状态下采取6 mL肘静脉血,采用ELISA法检测血清ANXA11水平,采用实时荧光定量PCR技术检测ANXA11表达水平。根据术后1个月肿瘤标志物变化、影像学表现和免疫功能指标变化情况分为治疗有效组(n=68)和无效组(n=30)。患者出院后均行12~36个月的随访,根据患者预后情况分为预后良好组(n=63)和预后不良组(n=35)。对比对照组和肺癌组/有效组和无效组/预后FGL1、ANXA11表达差异;ROC分析FGL1、ANXA11单一及联合检测对肺癌手术患者临床效用评估价值;Spearman分析FGL1、ANXA11表达与预后的关系。结果肺癌组FGL1和ANXA11表达水平明显高于对照组(均P<0.05);无效组FGL1和ANXA11表达水平明显高于有效组(均P<0.05);ROC结果显示FGL1、ANXA11单独及联合检测对肺癌手术患者效用评估的曲线线下面积分别为0.928,并且联合检测具有较高的特异性(95.59%)以及敏感度(90.00%),诊断价值显著高于单独检测ROC曲线线下面积(均P<0.05);预后不良组FGL1和ANXA11表达水平明显高于预后良好组(均P<0.05);Spearman相关性结果显示FGL1、ANXA11与肺癌手术患者预后呈显著正相关(r=0.771、0.793,均P<0.05)。结论肺癌患者的FGL1与ANXA11表达水平高于健康人,治疗无效者高于有效者,预后不良者高于良好者,二者单独及联合检测对患者手术治疗效用评估均有价值,且其与预后相关性显著。
文摘目的通过研究缺氧缺血性脑病(HIE)新生儿血清神经纤维轻链(NF-L)、水通道蛋白9(AQP9)、纤维蛋白原样蛋白2(FGL2)水平的变化,分析三者与新生儿行为神经评估(NABA)评分的相关性。方法选取2022年1月~2024年7月山西省儿童医院收治的203例HIE患儿为研究组,根据病情程度分为轻度组(n=63)、中度组(n=81)和重度组(n=59),另选同期的健康新生儿203例为对照组,酶联免疫吸附试验(ELISA)检测血清NF-L、AQP9、FGL2水平,收集分析一般临床资料。受试者操作特征(ROC)曲线分析NF-L、AQP9、FGL2及NABA评分对新生儿重度HIE的诊断价值;Pearson法分析血清NF-L、AQP9、FGL2与NABA评分的相关性。结果与对照组相比,研究组血清NF-L(14.78±1.67ng/ml vs 10.65±1.21ng/ml)、AQP9(61.82±6.29pg/ml vs 42.62±4.31pg/ml)、FGL2(189.69±20.26ng/ml vs 132.51±14.84ng/ml)水平显著升高,差异具有统计学意义(t=28.533、35.877、32.440,均P<0.05);中度组、重度组血清NF-L(14.68±1.67ng/ml、18.62±2.03ng/ml),AQP9(63.51±6.44pg/ml、69.63±7.03pg/ml),FGL2(195.68±20.84ng/ml、210.65±22.36ng/ml)水平显著高于轻度组(11.32±1.33ng/ml、52.32±5.41pg/ml、162.35±17.55ng/ml),NABA(34.89±3.51分、29.88±3.43分)评分显著低于轻度组(36.54±1.52分),差异具有统计学意义(t_(中度组)=4.616~16.729,t_(重度组)=17.276~33.701,均P<0.05);NF-L、AQP9、FGL2与NABA评分均呈负相关(r=-0.432、-0.421、-0.402,均P<0.05);NF-L、AQP9、FGL2、NABA联合诊断患儿重度病情的曲线下面积(AUC)显著高于各项单独诊断,差异具有统计学意义(Z=2.066~3.307,均P<0.05)。结论HIE患儿血清NF-L、AQP9、FGL2水平显著升高,与NABA评分相关,可能成为评估HIE患儿病情的标志物。
基金subsidized by the research project item of the Department of Educationin Hubei Province:No.D200516006
文摘Objective To investigate the mechanisms of electroacupuncture （EA） at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟 GV 26） for treating cerebral infarction. Methods Forty healthy SD rats were randomly divided into model group （n = 10）, EA group （n = 10）, normal group （n = 10）, and sham operation group （n = 10）. The model of acute cerebral infarction was established by blocking the middle cerebral artery with an intraluminal thread. EA was applied at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟GV 26） in the rats of EA group after the models were developed. The contents of D-dimer （D-D） and fibrinogen （Fib） were measured in each group. Results The contents of D-D and Fib increased signifi- cantly in model group as compared with normal and sham operation groups, respectively （P〈0.01）, and they decreased significantly in EA group as compared with model group （P〈0.01）. Conclusion EA can ob-viously decrease the contents of D-D and Fib, improve abnormal fibrinolysis, lower blood viscosity and ameliorate cerebral blood circulation in the rats with acute cerebral infarction.
文摘目的探讨多发伤患者院内死亡的独立危险因素并分析各危险因素的预测价值。方法采用回顾性队列研究分析2020年9月至2024年9月安徽医科大学第二附属医院急诊外科收治的245例多发伤患者临床资料,其中男177例,女68例;年龄18~87(50.4±14.6)岁;损伤部位:头颈部(78例),胸部(154例),腹部(166例),四肢骨盆(91例);根据院内是否死亡分为死亡组(27例)和生存组(218例)。比较两组基线资料及临床资料,包括性别、年龄、致伤原因、损伤部位、损伤严重度评分(injury severity score,ISS)、到达抢救室时生命体征[呼吸次数、心率、平均动脉压(mean arterial pressure,MAP)、体温)]、血液学指标[白细胞计数(white blood cell count,WBC)、血红蛋白(hemoglobin,Hb)、血小板计数(platelet count,PLT)、尿素氮(urea nitrogen,BUN)、肌酐(creatinine,Cr)、钠离子(sodium ion,Na^(+))、钾离子(potassium ion,K^(+))、活化部分凝血活酶时间(activated part of the thromboplastin time,APTT)、凝血酶原时间(prothrombin time,PT)、国际化标准比值(international standard ratio,INR)、纤维蛋白原(fibrinogen,FIB)]等。先通过单因素分析比较死亡组和生存组间基线及上述临床资料差异,再采用多因素Logistic回归分析确定多发伤患者院内死亡的独立危险因素,通过MedCalc统计软件绘制受试者工作特征(receiver operating characteristic,ROC)曲线,分析各危险因素预测多发伤患者院内死亡的效能。结果单因素分析表明,两组间在损伤部位、ISS评分、休克指数、心率、体温、MAP、Hb、PLT、Cr、Na^(+)、APTT、PT、INR、FIB方面差异有统计学意义(P<0.05或0.01),两组间在性别、致伤原因、年龄、呼吸次数、WBC、BUN、K^(+)差异无统计学意义(P>0.05)。多因素Logistic回归分析表明MAP、Hb、PLT、APTT、PT、FIB与多发伤患者院内死亡有显著相关(P<0.05或0.01)。ROC曲线分析结果表明,MAP、Hb、PLT、APTT、PT、FIB预测多发伤患者院内死亡的曲线下面积(area under the curve,AUC)分别为0.925(0.885,0.955)、0.766(0.708,0.817)、0.725(0.664,0.780)、0.854(0.804,0.896)、0.900(0.855,0.934)、0.835(0.782,0.879)。结论MAP降低、Hb减少、PLT减少、APTT和PT延长、FIB降低是多发伤患者院内死亡的独立危险因素。
