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
The associations of polycyclic aromatic hydrocarbon(PAH)exposure with serum uric acid(SUA)or hyperuricemia have been rarely assessed.We aimed to investigate the relationships between urinary PAH metabolites and SUA or...The associations of polycyclic aromatic hydrocarbon(PAH)exposure with serum uric acid(SUA)or hyperuricemia have been rarely assessed.We aimed to investigate the relationships between urinary PAH metabolites and SUA or hyperuricemia among US adults and to explore the mediating role of systemic inflammation in the associations.A total of 10,307 US adults were conducted to assess the associations of seven urinary hydroxy–PAH with SUA and hyperuricemia and evaluate the role of C-reactive protein(CRP),a biomarker of systemic inflammation,in such associations.Results showed that each 1-unit increase in ln-transformed 2-hydroxynaphthalene(2-OHNa),1-hydroxyphenanthrene(1-OHPh),2&3-hydroxyphenanthrene(2&3-OHPh)and total hydroxyphenanthrene(OHPh)was associated with a 1.68(95%confidence interval(CI):0.19 to 3.17),2.46(0.78 to 4.13),3.34(1.59 to 5.09),and 2.99(1.23 to 4.75)μmol/L increase in SUA,and a 8%(odds ratio(OR):1.08,1.02 to 1.15),9%(OR:1.09,1.02 to 1.18),13%(OR:1.13,1.05 to 1.22),and 12%(OR:1.12,95%CI:1.03,1.21)increase in hyperuricemia,respectively.Co-exposure of seven PAHs was positively associated with SUA and hyperuricemia,with 2&3-OHPh showing the highest weight(components weights:0.83 and 0.78,respectively).The CRP mediated 11.47%and 10.44%of the associations ofΣOHPh and 2&3-OHPh with SUA and mediated 8.60%and 8.62%in associations ofΣOHPh and 2&3-OHPh with hyperuricemia,respectively.In conclusion,internal levels of PAH metabolites were associated with elevated SUA levels and the increased risk of hyperuricemia among US adults,and CRP played a mediating role in the associations.展开更多
Helicobacter pylori(H.pylori)infection induces pathological changes via chronic inflammation and virulence factors,thereby increasing the risk of gastric cancer development.Compared with invasive examination methods,H...Helicobacter pylori(H.pylori)infection induces pathological changes via chronic inflammation and virulence factors,thereby increasing the risk of gastric cancer development.Compared with invasive examination methods,H.pylori-related serum indicators are cost-effective and valuable for the early detection of gastric cancer(GC);however,large-scale clinical validation and sufficient understanding of the specific molecular mechanisms involved are lacking.Therefore,a comprehensive review and analysis of recent advances in this field is necessary.In this review,we systematically analyze the relationship between H.pylori and GC and discuss the application of new molecular biomarkers in GC screening.We also summarize the screening potential and application of anti-H.pylori immunoglobulin G and virulence factor-related serum antibodies for identifying GC risk.These indicators provide early warning of infection and enhance screening accuracy.Additionally,we discuss the potential combination of multiple screening indicators for the comprehensive analysis and development of emerging testing methods to improve the accuracy and efficiency of GC screening.Although this review may lack sufficient evidence due to limitations in existing studies,including small sample sizes,regional variations,and inconsistent testing methods,it contributes to advancing personalized precision medicine in high-risk populations and developing GC screening strategies.展开更多
Dear Editor,Local recurrence and cervical lymph node metastases are major causes of mortality in patients with head and neck squamous cell carcinoma(HNSCC).To date,none of the proposed strategies for predicting outcom...Dear Editor,Local recurrence and cervical lymph node metastases are major causes of mortality in patients with head and neck squamous cell carcinoma(HNSCC).To date,none of the proposed strategies for predicting outcomes in this disease have proven fully effective,and a comprehensive physical examination remains the primary method for early detection and monitoring of HNSCC.展开更多
BACKGROUND In recent years,metabolomics has emerged as a novel platform for biomarker discovery.However,the metabolic profiles associated with gastric carcinoma(GC)remain insufficiently explored.AIM To examine the dif...BACKGROUND In recent years,metabolomics has emerged as a novel platform for biomarker discovery.However,the metabolic profiles associated with gastric carcinoma(GC)remain insufficiently explored.AIM To examine the differences in metabolites between patients with GC and healthy controls,with the objective of identifying potential serum biomarkers for GC diagnosis through a non-targeted metabolomics approach.METHODS An untargeted metabolic analysis was conducted on serum samples from 6 patients with GC and 6 healthy controls.Subsequently,the differential metabolites identified were further validated in serum samples from an expanded cohort of 50 patients with GC and 50 healthy controls.The discriminative capacity of differential metabolites in distinguishing patients with GC from healthy controls was assessed utilizing the receiver operating characteristic curve analysis.The association between the serum levels of differential metabolites and the disease severity,as determined by the tumor-node-metastasis staging system,was evaluated using Spearman’s rank correlation coefficient.RESULTS Our findings revealed a significant alteration in the metabolic profile,characterized by 111 up-regulated and 55 down-regulated metabolites in patients with GC compared to healthy controls.Among the top 10 up-regulated metabolites,the serum concentrations of eight metabolites including fenpiclonil,methyclothiazide,5-hydroxyindoleacetate,3-pyridinecarboxylic acid,guanabenz,2,2-dichloro-N-(3-chloro-1,4-dioxo-2-naphthyl)acetamide,epigallocatechin gallate,and dimethenamid,were further validated to be significantly elevated in a cohort of 50 patients diagnosed with GC compared to 50 healthy control subjects(P<0.001).With the exception of 3-pyridinecarboxylic acid,the area under the curve values for the remaining seven metabolites exceeded 0.7,suggesting that these metabolites possess substantial diagnostic potential for distinguishing patients with GC from healthy individuals.Additionally,the serum concentrations of methyclothiazide(r=0.615,P<0.001),epigallocatechin gallate(r=0.482,P=0.004),and dimethenamid(r=0.634,P<0.001)demonstrated a significant positive correlation with the T stage in patients with GC.The serum concentrations of methyclothiazide(r=0.438,P=0.008)and epigallocatechin gallate(r=0.383,P=0.023)exhibited a significant positive correlation with the N stage in these patients.CONCLUSION This study provides insights into the metabolic alterations associated with GC,and the identification of these biomarkers may enhance the clinical detection and management of the disease.展开更多
BACKGROUND Exosomal microRNAs(miRNAs)have emerged as promising biomarkers for cancer diagnosis due to their stability,tumor specificity,and accessibility.How-ever,the diagnostic potential of serum exosomal miRNAs in m...BACKGROUND Exosomal microRNAs(miRNAs)have emerged as promising biomarkers for cancer diagnosis due to their stability,tumor specificity,and accessibility.How-ever,the diagnostic potential of serum exosomal miRNAs in metastatic pancreatic cancer remains underexplored.AIM To investigate the diagnostic potential of serum exosomal miRNAs in metastatic pancreatic cancer.METHODS A total of 36 patients were enrolled,comprising 8 patients in the discovery phase(4 with metastatic and 4 with non-metastatic pancreatic cancer)and 28 in the validation cohort(15 non-metastatic and 13 metastatic cases).Exosomes were isolated using the exoEasy Maxi Kit and characterized by transmission electron microscopy,nanoparticle tracking analysis,and western blotting.High-throu-ghput sequencing was conducted to identify differentially expressed serum exosomal miRNAs,which were subsequently validated using TaqMan probe-based reverse transcription-quantitative polymerase chain reaction.Bioinformatic analyses were performed to predict downstream target genes and explore their roles in metastatic progression.RESULTS Transmission electron microscopy revealed that the isolated exosomes were predominantly round or oval with well-defined membrane boundaries.Nano-particle tracking analysis showed a peak particle size of approximately 138 nm,accounting for 99.2%of total particles,consistent with the typical size range of exosomes.Western blotting confirmed the expression of exosome-specific markers CD63 and CD81.High-throughput sequencing identified 42 differentially expressed exosomal miRNAs between metastatic and non-metastatic groups.Among them,hsa-let-7f-5p was significantly upregulated in metastatic pancreatic cancer(P=0.007),as validated by reverse transcription-quantitative polymerase chain reaction.Target gene prediction indicated that hsa-let-7f-5p may be involved in metastasis through its interactions with nerve growth factor,cyclin-dependent kinase inhibitor 1A,high mobility group AT-hook 2,insulin-like growth factor 2 mRNA-binding protein 1,and insulin-like growth factor 2 mRNA-binding protein 3.CONCLUSION The elevated expression of serum exosomal hsa-let-7f-5p in metastatic pancreatic cancer suggests its potential as a non-invasive biomarker for distinguishing metastatic from non-metastatic disease.展开更多
BACKGROUND Multiple lines of evidence have indicated that pro-inflammatory cytokines play a role in the pathophysiology of gastric carcinoma(GC).AIM To identify potential serum cytokine-based biomarkers for GC diagnos...BACKGROUND Multiple lines of evidence have indicated that pro-inflammatory cytokines play a role in the pathophysiology of gastric carcinoma(GC).AIM To identify potential serum cytokine-based biomarkers for GC diagnosis.METHODS The study cohort comprised 50 patients diagnosed with GC and 50 healthy control subjects.A panel of 7 pro-inflammatory cytokines,including interleukin(IL)-1β,IL-2,IL-6,IL-8,IL-12,tumor necrosis factor-α,and interferon-γ(IFN-γ)were quantified using multiplex Luminex assays.Comparative analyses were conducted to evaluate cytokine levels between the GC patients and healthy controls.The diagnostic potential of serum pro-inflammatory cytokines in differentiating GC patients from healthy individuals was assessed through receiver operating characteristic(ROC)curve analysis.The correlation between serum cytokine levels and disease severity,as classified by the tumor-node-metastasis staging system,was analyzed using Spearman's rank correlation coefficient.RESULTS In comparison to the control group,patients with GC demonstrated significantly elevated serum levels of IL-1β(t=-4.089,P<0.001),IL-6(t=-3.983,P<0.001),IL8(t=-5.460,P<0.001),and IFN-γ(t=-2.856,P=0.005).ROC curve analysis indicated that the area under the curve values for IL-1β,IL-6,and IL-8 exceeded 0.7,effectively distinguishing GC patients from healthy controls.Additionally,serum levels of IL-1β(r=0.424,P=0.012)and IL-6(r=0.742,P<0.001)were positively correlated with the T stage in GC patients.Similarly,serum concentrations of IL-1β(r=0.356,P=0.039)and IL-6(r=0.441,P=0.008)exhibited a positive association with the N stage in these patients.CONCLUSION These findings suggest that circulating pro-inflammatory cytokines,such as IL-1β,IL-6,and IL-8,may serve as potential biomarkers for the diagnosis of GC.展开更多
Fructose consumption has risen dramatically in recent decades due to the use of sucrose and high fructose corn syrup in beverages and processed foods,contributing to rising rates of hyperuricemia.The purpose of this e...Fructose consumption has risen dramatically in recent decades due to the use of sucrose and high fructose corn syrup in beverages and processed foods,contributing to rising rates of hyperuricemia.The purpose of this experiment was to explore the anti-hyperuricemia effects of an active oligopeptide(GPSGRP)derived from sea cucumber in fructose induced hyperuricemia mouse model,and to clarify the underlying mechanism in sight of gut microbiota and serum metabolites.Peptide GPSGRP treatment rebalanced uric acid metabolism and alleviated inflammatory response in mice.In addition,treatment with GPSGRP decreased the abundance of Bacteroides and Proteobacteria at the phylum level,Muribaculum,Prevotella and Bacteroides at the genus level,and inhibited the related pathways of purine metabolism and glycolysis/gluconeogenesis metabolism.Moreover,serum metabolites,including linoleic acid,indole and its derivatives,arachidonic acid and uridine,as well as related metabolic pathways,such as tricarboxylic acid cycle,ketone production and sugar production,were altered in response to GPSGRP treatment.This study provides a valuable reference for the application and development of marine biological peptides in uric acid management.展开更多
The association of copper(Cu)with preterm birth(PTB)and its subtypes,spontaneous preterm birth(SPB)and iatrogenic preterm birth(IPB),are still unclear.In addition,previous studies suggested that serum lipid was associ...The association of copper(Cu)with preterm birth(PTB)and its subtypes,spontaneous preterm birth(SPB)and iatrogenic preterm birth(IPB),are still unclear.In addition,previous studies suggested that serum lipid was associated with both Cu and PTB.Therefore,we explored the association of blood Cu in the first trimester with the risk of PTB and its subtypes,as well as the potential mediating effect of serum lipid using a nested case-control study.The concentrations of Cu in the serum and blood cells,and serum lipids in the first trimester were measured.The concentration of Cu in whole blood was calculated based on hematocrit.Compared to the lowest tertile of Cu concentrations in the first trimester,the highest tertile of Cu significantly increased the risk of SPB with adjusted odds ratios(AORs)of 2.75(95% confidence interval(CI):1.41-5.34)for serum and 3.75(95% CI:1.21-11.60)for whole blood,and significantly increased the risk of IPB with AORs of 3.25(95%CI:1.06-9.94)for blood cells.According to the mediation analysis,the indirect effect of triglyceride(β=0.016,95%CI:0.0002-0.042)was the only significant effect in the association between Cu and SPB,with the mediating proportion of 9.8%(95%CI:0.2%-33.4%).It suggested that a high level of serum Cu may be associated with an increased risk of SPB with a possible mediator of serum triglyceride,and a high level of blood cell Cu may be associated with an increased risk of IPB.展开更多
BACKGROUND Current diagnostic standards for post-endoscopic retrograde cholangiopancreato-graphy(ERCP)pancreatitis(PEP)rely on 24-hour post-ERCP amylase and lipase levels,delaying timely intervention and highlighting ...BACKGROUND Current diagnostic standards for post-endoscopic retrograde cholangiopancreato-graphy(ERCP)pancreatitis(PEP)rely on 24-hour post-ERCP amylase and lipase levels,delaying timely intervention and highlighting the need for earlier predic-tive biomarkers.AIM To evaluate the utility of 4-hour post-ERCP serum amylase and lipase levels in a large cohort to establish optimal cut-off values and improve early PEP prediction.METHODS This prospective study involved patients with naïve major papillae who under-went diagnostic or therapeutic ERCP between June 2021 and December 2024.Serum amylase and lipase levels were measured before ERCP and 4 hours and 24 hours after ERCP.The primary endpoint was to determine optimal cut-off values for 4-hour serum amylase and lipase levels for the early prediction of PEP.RESULTS PEP occurred in 117 patients(6.1%).Diagnostic performance assessment of 4-hour serum amylase and lipase for predicting PEP yielded area under the curves of 0.877 and 0.893,respectively.Optimal cut-off values were 1.2 times the upper nor-mal limit(119.5 IU/L)for amylase and 8 times the upper normal limit(488.5 IU/L)for lipase.At these thresholds,4-hour amylase demonstrated a sensitivity of 0.846,a specificity of 0.806,and a negative predictive value of 0.988.Similarly,4-hour lipase showed a sensitivity of 0.863,a specificity of 0.862,and a negative predictive value of 0.990.These biomarkers effectively predicted moderately severe to severe PEP in high-risk groups.CONCLUSION Early measurement of 4-hour serum amylase and lipase shows strong predictive capabilities for PEP,with clinically meaningful cut-off values.These biomarkers enable timely interventions,potentially reducing PEP-related adverse events and the overall healthcare burden.展开更多
BACKGROUND Serum calcium ion(Ca2+)is an economical and readily available indicator as a routine screening test for hospitalized patients.There are no studies related to serum Ca2+level and digestive tract malignancy.A...BACKGROUND Serum calcium ion(Ca2+)is an economical and readily available indicator as a routine screening test for hospitalized patients.There are no studies related to serum Ca2+level and digestive tract malignancy.AIM To evaluate the effectiveness of serum Ca2+level in predicting the prognosis of patients with colorectal cancer(CRC).METHODS We retrospectively collected the data of 280 patients diagnosed with CRC who underwent radical surgery at the Affiliated Cancer Hospital of Xinjiang Medical University.By analyzing the clinicopathological features,differences between serum Ca2+concentrations on the first day after surgery were determined.We used the receiver operating characteristic curve to assess the predictive ability of serum Ca2+for survival.Survival analyses were performed using the Kaplan-Meier method,and multivariate Cox proportional risk regression was used to determine association between calibration serum Ca2+levels and CRC survival outcomes.RESULTS By receiver operating characteristic curve analysis,the ideal threshold value for Ca2+the first postoperative day and delta serum calcium(δCa2+)value were 1.975 and 0.245,respectively.Overall survival(OS)and progression-free survival(PFS)were better in both the high Ca2+group and highδCa2+group on the first postoperative day.The variables identified through univariate analysis were incorporated into multivariate analysis and showed that tumor differ-entiation(P=0.047),T stage(P=0.019),N stage(P<0.001),nerve vascular invasion(P=0.037),carcinoembryonic antigen(P=0.039),baseline serum Ca2+level(P=0.011),and serum Ca2+level on the first day(P=0.006)were independent predictors of prognosis for patients undergoing feasible radical CRC surgery.Using the findings from the multifactorial analysis,we developed a nomogram and the calibration showed a good predictive ability.CONCLUSION Low serum Ca2+level on the first postoperative day is an independent risk factor for OS and PFS in CRC.展开更多
BACKGROUND The deleterious effects of surgical trauma and subsequent postoperative complications pose significant challenges to the smooth recovery of patients after gastric cancer(GC)resection despite the substantial...BACKGROUND The deleterious effects of surgical trauma and subsequent postoperative complications pose significant challenges to the smooth recovery of patients after gastric cancer(GC)resection despite the substantial curative benefits provided by surgical interventions for GC.Hence,the investigation of more optimal and efficacious treatment approaches has become an urgent necessity in the medical community.AIM To investigate the association of Sijunzi decoction plus chemotherapy with the gastrointestinal function and serum markers of patients after GC surgery.METHODS This study included patients who underwent GC surgery from June 2022 to February 2024.The control group included 45 patients who received chemotherapy(oxaliplatin+calcium folinate+5-fluorouracil),whereas the research group consisted of 54 patients who received Sijunzi decoction therapy in addition to the treatment administered in the control group.Comparative analyses were conducted from the following perspectives:Gastrointestinal function(defecation time,intestinal gas discharge time,and hospitalization time),serum markers[carcinoembryonic antigen(CEA),carbohydrate antigen(CA)125,and CA199],nutritional indicators total protein(TP)and transferrin(TRF),traditional Chinese medicine(TCM)syndrome score,and grades Ⅲ–Ⅳ adverse events(gastrointestinal reactions,renal/liver function impairment,and myelosuppression).RESULTS The two groups demonstrated similar defecation time(P>0.05),but the intestinal gas discharge time and hospitalization time were significantly shortened in the research group(P<0.05).Further,the research group exhibited significant CEA,CA125,and CA199 reductions after treatment,which were lower compared to the control group,as well as notable increases in TP and TRF that were statistically higher than the control group(all P<0.05).Furthermore,the research group demonstrated an evident decrease in TCM syndrome scores in areas,such as poor appetite,epigastric distension and pain,fatigue and weakness(P<0.01),and abdominal distension after eating,which are notably lower than those in the control group(P<0.01),with a comparable incidence of grades Ⅲ-Ⅳ adverse events(P>0.05).CONCLUSION Our research results indicate that Sijunzi decoction plus chemotherapy exerts a good rehabilitation-promoting effect on gastrointestinal function in patients after GC surgery and significantly downregulates abnormally increased CEA,CA125,and CA199 levels.展开更多
BACKGROUND Splenectomy is an effective yet invasive intervention for alleviating portal pressure in patients with hepatitis cirrhosis.However,the current prognostic indicators for predicting long-term overall survival...BACKGROUND Splenectomy is an effective yet invasive intervention for alleviating portal pressure in patients with hepatitis cirrhosis.However,the current prognostic indicators for predicting long-term overall survival of these patients have several limitations.AIM To assess the potential of preoperative total bilirubin-albumin(B/A)ratio as a prognostic indicator for patients with hepatitis cirrhosis undergoing splenectomy.METHODS A total of 257 patients diagnosed with hepatitis cirrhosis were retrospectively enrolled in the study.Normality test,t-test,Wilcoxon test,χ2 test,or Fisher’s exact test was employed to analyze the intraoperative and postoperative conditions of the patients.Receiver operating characteristic(ROC)curve analysis was utilized to depict the 10-year overall survival rate.RESULTS During the follow-up period,85.99%of the patients survived,with a median survival time of 64.6 months.Multivariate analysis revealed that total serum B/A ratio was an independent risk factor for overall survival(P=0.037).ROC curve analysis demonstrated that a B/A ratio of 0.87 was the optimal cut-off value.Consequently,the patients were categorized into two groups:High B/A group(n=64)and low B/A group(n=193).The median follow-up time for the high B/A group and low B/A group was 56.8 months and 67.2 months,respectively(P=0.045).Notably,the high B/A group exhibited a significantly lower 10-year overall survival compared to the low B/A group(P<0.001).Patients with hepatocellular carcinoma(HCC)had lower overall survival rates.Patients with a high B/A ratio exhibited a lower overall survival than those with a low B/A rate in the overall cohort and the subgroups of patients with HCC or not,early Child-Pugh grade,low albumin-bilirubin grade,and model for end-stage liver disease score≥10(log-rank test,P<0.001 for all).CONCLUSION The B/A ratio can serve as an effective prognostic indicator for overall survival in patients with hepatitis B virusrelated cirrhosis following splenectomy,and a higher B/A ratio may suggest a poorer prognosis.展开更多
BACKGROUND Serum carcinoembryonic antigen(CEA)levels and magnetic resonance imaging(MRI)findings are widely used for the diagnosis and treatment of rectal cancer;however,research investigating their correlation remain...BACKGROUND Serum carcinoembryonic antigen(CEA)levels and magnetic resonance imaging(MRI)findings are widely used for the diagnosis and treatment of rectal cancer;however,research investigating their correlation remains limited.AIM To investigate the correlation between baseline MRI features and serum CEA levels in patients diagnosed with primary rectal cancer.METHODS Eighty patients(age:42-78 years)diagnosed with primary rectal cancer were enrolled.Baseline MRI examinations were performed to evaluate tumor size,T stage,circumferential resection margin status,extramural vascular invasion(EMVI),and lymph node metastasis.Serum CEA levels were concurrently measured.Statistical methods were used to analyze correlations.RESULTS Tumor size,T stage,EMVI,and lymph node metastasis were significantly correlated with serum CEA levels(P<0.05).Multivariate analysis identified T stage and lymph node metastasis as independent factors influencing serum CEA levels.CONCLUSION This study confirmed the correlation between baseline MRI features and serum CEA levels in patients with primary rectal cancer,highlighting their potential utility for precise diagnosis,staging,and prognostic evaluation.展开更多
BACKGROUND Major depressive disorder(MDD)is characterized by persistent depressed mood and cognitive symptoms.This study aimed to discover biomarkers for MDD,explore its pathological mechanisms,and examine the associa...BACKGROUND Major depressive disorder(MDD)is characterized by persistent depressed mood and cognitive symptoms.This study aimed to discover biomarkers for MDD,explore its pathological mechanisms,and examine the associations of the identified biomarkers with clinical and psychological variables.AIM To discover candidate biomarkers for MDD identification and provide insight into the pathological mechanism of MDD.METHODS The current study adopted a single-center cross-sectional case-control design.Serum samples were obtained from 100 individuals diagnosed with MDD and 97 healthy controls(HCs)aged between 18 to 60 years.Metabolomics was performed on an Ultimate 3000 UHPLC system coupled with Q-Exactive MS(Thermo Scien-tific).The online software Metaboanalyst 6.0 was used to process and analyze the acquired raw data of peak intensities from the instrument.RESULTS The study included 100 MDD patients and 97 HCs.Metabolomic profiling identified 35 significantly different metabolites(e.g.,cortisol,sebacic acid,and L-glutamic acid).Receiver operating characteristic curve analysis highlighted 8-HETE,10-HDoHE,cortisol,12-HHTrE,and 10-hydroxydecanoic acid as top diagnostic biomarkers for MDD.Significant correlations were found between metabolites(e.g.,some lipids,steroids,and amino acids)and clinical and psychological variables.CONCLUSION Our study reported metabolites(some lipids,steroids,amino acids,carnitines,and alkaloids)responsible for discriminating MDD patients and HCs.This metabolite profile may enable the development of a laboratory-based diagnostic test for MDD.The mechanisms underlying the association between psychological or clinical variables and differential metabolites deserve further exploration.展开更多
Kang et al published a study recently in the World Journal of Gastroenterology introducing an interpretable machine learning model to predict anastomotic leakage after rectal cancer surgery,highlighting postoperative ...Kang et al published a study recently in the World Journal of Gastroenterology introducing an interpretable machine learning model to predict anastomotic leakage after rectal cancer surgery,highlighting postoperative serum calcium as a key predictive feature.While this represents a significant advancement,we argue that reliance on a static calcium threshold may limit clinical applicability.We advocate for a dynamic,trajectory-based assessment of serum calcium levels across perioperative time points,using modeling approaches such as time-series regression or mixed-effects models.Furthermore,the model’s robustness could be improved by incorporating systemic inflammation and nutritional indices such as C-reactive protein,procalcitonin,the neutrophil-to-lymphocyte ratio,and the systemic immune-inflammation index,supported by recent prospective studies.Finally,generalizability remains a concern,warranting broader validation and clearer clinical deployment strategies.By addressing these aspects,the model’s clinical translation and decision-making impact could be substantially enhanced.展开更多
Objective:Correlation of serum 25-hydroxyvitamin D level with senile hypertension and its stroke.Methods:Two hundred hypertensive patients admitted to the hospital from February 2022 to December 2023 were classified a...Objective:Correlation of serum 25-hydroxyvitamin D level with senile hypertension and its stroke.Methods:Two hundred hypertensive patients admitted to the hospital from February 2022 to December 2023 were classified as study subjects.They were divided into grade 2 hypertension group and grade 3 hypertension group,and 100 healthy medical checkups admitted during the same period were analyzed as study subjects.Results:Comparison of diagnostic results between grade 2 hypertension and grade 2 hypertensive stroke patients,there was a difference in 25(OH)D,(P<0.05).Comparison of test results between grade 3 hypertension and grade 3 hypertensive stroke patients,there was a difference in age,BMI,25(OH)D,GLU,LDL-C,(P<0.05).Serum 25-hydroxyvitamin D level is a high-risk factor for the occurrence of stroke in elderly hypertensive patients,so the probability of risk is higher,where 25(OH)D(ng/mL),GLU(mmol/L),there is a difference,(P<0.05).Conclusion:There is a greater relationship between the occurrence of stroke and serum 25-hydroxyvitamin D level in elderly hypertensive patients.The occurrence of the disease has a greater relationship with this indicator in patients and is also a high-risk factor that affects the patients’morbidity,so it is necessary to pay attention to the monitoring of this indicator after the onset of the disease in patients.展开更多
Chiral pesticides,such as penthiopyrad,consist of enantiomers with differing biological activities and toxicological profiles,potentially leading to environmental risks.This study investigates the stereoselective bind...Chiral pesticides,such as penthiopyrad,consist of enantiomers with differing biological activities and toxicological profiles,potentially leading to environmental risks.This study investigates the stereoselective binding of the R-(—)-and S-(+)-enantiomers of penthiopyrad to bovine and human serum albumin(BSA/HSA)using a combination of spectroscopic techniques,density functional theory(DFT)calculations,and molecular docking.The results indicate that S-(+)-penthiopyrad exhibits a significantly stronger quenching effect on the intrinsic fluorescence of both HSA and BSA than R-(—)-penthiopyrad,suggesting a higher binding affinity,which is consistent with DFT predictions.Specifically,the binding constants(ΔG)of S-(+)-penthiopyrad with BSA and HSA were−31.80 kJ/mol and−35.68 kJ/mol,respectively,compared to−30.42 kJ/mol and−33.82 kJ/mol for R-()-penthiopyrad.Circular dichroism(CD)spectroscopy and FTIR analysis show that both enantiomers induce conformational changes in albumin secondary structures,reducingα-helical content by 3.6%for S-(+)-penthiopyrad and 2.1%for R-(−)-penthiopyrad in BSA,and by 2.7%and 0.2%,respectively,in HSA.Molecular docking identifies site II(subdomain IIIA)as the primary binding region,with hydrogen bonding and hydrophobic interactions stabilizing the S-(+)-penthiopyrad complex more effectively.These findings underscore the higher environmental risk of S-(+)-penthiopyrad compared to R-(-)-penthiopyrad,advancing the molecular-level understanding of stereoselective behavior in chiral fungicides and guiding safer agrochemical development.展开更多
Objective:To analyze the efficacy of Bifidobacterium triple viable bacteria tablets on neonatal necrotizing enterocolitis(NEC)and its impact on serum factors of the patients.Methods:From January 2021 to May 2025,88 ne...Objective:To analyze the efficacy of Bifidobacterium triple viable bacteria tablets on neonatal necrotizing enterocolitis(NEC)and its impact on serum factors of the patients.Methods:From January 2021 to May 2025,88 neonates with NEC admitted to our hospital were selected as study subjects.During the study,these 88 patients were evenly divided into two groups,namely the observation group and the control group,with 44 patients in each group based on the random number table method.In terms of treatment,the control group was treated with meropenem,while the observation group received additional treatment with Bifidobacterium triple viable bacteria powder based on the treatment plan of the control group.The clinical efficacy and differences in serum inflammatory factor levels between the two groups were compared.Results:The efficacy of the observation group(90.91%)was better than that of the control group(72.73%)(P<0.05).After treatment,the levels of C-reactive protein(CRP)and procalcitonin(PCT)in both groups decreased compared to those before treatment,and the values of the above indicators in the observation group were lower than those in the control group(P<0.05).Conclusion:Based on conventional treatment for NEC neonates,the use of Bifidobacterium triple viable bacteria tablets has significant efficacy and can effectively reduce serum inflammatory factor levels.展开更多
Associations of per-and polyfluoroalkyl substances(PFAS)on lipid metabolism have been documented but research remains scarce regarding effect of PFAS on lipid variability.To deeply understand their relationship,a step...Associations of per-and polyfluoroalkyl substances(PFAS)on lipid metabolism have been documented but research remains scarce regarding effect of PFAS on lipid variability.To deeply understand their relationship,a step-forward in causal inference is expected.To address these,we conducted a longitudinal study with three repeated measurements involving 201 participants in Beijing,among which 100 eligible participants were included for the present study.Twenty-three PFAS and four lipid indicators were assessed at each visit.We used linear mixed models and quantile g-computation models to investigate associations between PFAS and blood lipid levels.A latent class growth model described PFAS serum exposure patterns,and a generalized linear model demonstrated associations between these patterns and lipid variability.Our study found that PFDA was associated with increased TC(β=0.083,95%CI:0.011,0.155)and HDL-C(β=0.106,95%CI:0.034,0.178).The PFAS mixture also showed a positive relationship with TC(β=0.06,95%CI:0.02,0.10),with PFDA contributing most positively.Compared to the low trajectory group,the middle trajectory group for PFDA was associated with VIM of TC(β=0.756,95%CI:0.153,1.359).Furthermore,PFDA showed biological gradientswith lipid metabolism.This is the first repeated-measures study to identify the impact of PFAS serum exposure pattern on the lipid metabolism and the first to estimate the association between PFAS and blood lipid levels in middle-aged and elderly Chinese and reinforce the evidence of their causal relationship through epidemiological studies.展开更多
基金supported by the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2017-12M-3-002)the Central High Level Hospital Clinical Research Operating Expenses,China(Zero Balance 2022-GSP-GG-15)the Natural Science Foundation Project of the Inner Mongolia Autonomous Region of China(2022LHQN08003).
文摘BACKGROUND Low serum albumin levels are established predictors of adverse outcomes in various cardiovascular conditions.However,the role of serum albumin in mortality among elderly patients with chronic aortic regurgitation(AR)has not been thoroughly investigated.This study aims to assess the relationship between serum albumin levels and mortality in this specific patient population.METHODS Our analysis included 873 elderly AR patients from the China Valvular Heart Disease study,with baseline serum albumin measured at enrollment.Mortality outcomes were monitored for two years post-enrollment,employing a Cox proportional hazards model with a two-piecewise Cox proportional hazards framework to investigate the nonlinear relationship between serum albumin levels and all-cause mortality.RESULTS During the 2-year follow-up period,we observed 63 all-cause deaths.The association between serum albumin levels and all-cause mortality displayed an approximating L-shaped curve,indicating a mortality threshold at 35 g/L.For serum albumin levels below 35 g/L,each 1 g/L decrease was associated with a 25%higher risk of all-cause mortality(HR=1.25,95%CI:1.07–1.45).In contrast,no significant change in mortality risk was observed when serum albumin levels were greater than or equal to 35 g/L.Moreover,when serum albumin is classified as hypoproteinemia(serum albumin<35 g/L),the higher risks of all-cause death were observed in hypoproteinemic patients(HR=2.93,95%CI:1.50–5.74).More importantly,the association between serum albumin and death was significantly stronger in overweight/obese patients(≥24 kg/m^(2)vs.<24 kg/m^(2),Pinteraction=0.006).CONCLUSIONS In elderly patients with AR,serum albumin levels showed an approximating L-shaped relationship with all-cause death,with thresholds of 35 g/L.Body mass index was significant effect modifiers of the association.These results suggest that serum albumin,as an inexpensive and readily available biochemical marker,may further improve the stratified risk of mortality in older AR patients.
基金supported by the Key Program of National Natural Science Foundation of China(No.82241088)the Natural Science Foundation of Hubei Province(No.2022CFB813).
文摘The associations of polycyclic aromatic hydrocarbon(PAH)exposure with serum uric acid(SUA)or hyperuricemia have been rarely assessed.We aimed to investigate the relationships between urinary PAH metabolites and SUA or hyperuricemia among US adults and to explore the mediating role of systemic inflammation in the associations.A total of 10,307 US adults were conducted to assess the associations of seven urinary hydroxy–PAH with SUA and hyperuricemia and evaluate the role of C-reactive protein(CRP),a biomarker of systemic inflammation,in such associations.Results showed that each 1-unit increase in ln-transformed 2-hydroxynaphthalene(2-OHNa),1-hydroxyphenanthrene(1-OHPh),2&3-hydroxyphenanthrene(2&3-OHPh)and total hydroxyphenanthrene(OHPh)was associated with a 1.68(95%confidence interval(CI):0.19 to 3.17),2.46(0.78 to 4.13),3.34(1.59 to 5.09),and 2.99(1.23 to 4.75)μmol/L increase in SUA,and a 8%(odds ratio(OR):1.08,1.02 to 1.15),9%(OR:1.09,1.02 to 1.18),13%(OR:1.13,1.05 to 1.22),and 12%(OR:1.12,95%CI:1.03,1.21)increase in hyperuricemia,respectively.Co-exposure of seven PAHs was positively associated with SUA and hyperuricemia,with 2&3-OHPh showing the highest weight(components weights:0.83 and 0.78,respectively).The CRP mediated 11.47%and 10.44%of the associations ofΣOHPh and 2&3-OHPh with SUA and mediated 8.60%and 8.62%in associations ofΣOHPh and 2&3-OHPh with hyperuricemia,respectively.In conclusion,internal levels of PAH metabolites were associated with elevated SUA levels and the increased risk of hyperuricemia among US adults,and CRP played a mediating role in the associations.
文摘Helicobacter pylori(H.pylori)infection induces pathological changes via chronic inflammation and virulence factors,thereby increasing the risk of gastric cancer development.Compared with invasive examination methods,H.pylori-related serum indicators are cost-effective and valuable for the early detection of gastric cancer(GC);however,large-scale clinical validation and sufficient understanding of the specific molecular mechanisms involved are lacking.Therefore,a comprehensive review and analysis of recent advances in this field is necessary.In this review,we systematically analyze the relationship between H.pylori and GC and discuss the application of new molecular biomarkers in GC screening.We also summarize the screening potential and application of anti-H.pylori immunoglobulin G and virulence factor-related serum antibodies for identifying GC risk.These indicators provide early warning of infection and enhance screening accuracy.Additionally,we discuss the potential combination of multiple screening indicators for the comprehensive analysis and development of emerging testing methods to improve the accuracy and efficiency of GC screening.Although this review may lack sufficient evidence due to limitations in existing studies,including small sample sizes,regional variations,and inconsistent testing methods,it contributes to advancing personalized precision medicine in high-risk populations and developing GC screening strategies.
文摘Dear Editor,Local recurrence and cervical lymph node metastases are major causes of mortality in patients with head and neck squamous cell carcinoma(HNSCC).To date,none of the proposed strategies for predicting outcomes in this disease have proven fully effective,and a comprehensive physical examination remains the primary method for early detection and monitoring of HNSCC.
文摘BACKGROUND In recent years,metabolomics has emerged as a novel platform for biomarker discovery.However,the metabolic profiles associated with gastric carcinoma(GC)remain insufficiently explored.AIM To examine the differences in metabolites between patients with GC and healthy controls,with the objective of identifying potential serum biomarkers for GC diagnosis through a non-targeted metabolomics approach.METHODS An untargeted metabolic analysis was conducted on serum samples from 6 patients with GC and 6 healthy controls.Subsequently,the differential metabolites identified were further validated in serum samples from an expanded cohort of 50 patients with GC and 50 healthy controls.The discriminative capacity of differential metabolites in distinguishing patients with GC from healthy controls was assessed utilizing the receiver operating characteristic curve analysis.The association between the serum levels of differential metabolites and the disease severity,as determined by the tumor-node-metastasis staging system,was evaluated using Spearman’s rank correlation coefficient.RESULTS Our findings revealed a significant alteration in the metabolic profile,characterized by 111 up-regulated and 55 down-regulated metabolites in patients with GC compared to healthy controls.Among the top 10 up-regulated metabolites,the serum concentrations of eight metabolites including fenpiclonil,methyclothiazide,5-hydroxyindoleacetate,3-pyridinecarboxylic acid,guanabenz,2,2-dichloro-N-(3-chloro-1,4-dioxo-2-naphthyl)acetamide,epigallocatechin gallate,and dimethenamid,were further validated to be significantly elevated in a cohort of 50 patients diagnosed with GC compared to 50 healthy control subjects(P<0.001).With the exception of 3-pyridinecarboxylic acid,the area under the curve values for the remaining seven metabolites exceeded 0.7,suggesting that these metabolites possess substantial diagnostic potential for distinguishing patients with GC from healthy individuals.Additionally,the serum concentrations of methyclothiazide(r=0.615,P<0.001),epigallocatechin gallate(r=0.482,P=0.004),and dimethenamid(r=0.634,P<0.001)demonstrated a significant positive correlation with the T stage in patients with GC.The serum concentrations of methyclothiazide(r=0.438,P=0.008)and epigallocatechin gallate(r=0.383,P=0.023)exhibited a significant positive correlation with the N stage in these patients.CONCLUSION This study provides insights into the metabolic alterations associated with GC,and the identification of these biomarkers may enhance the clinical detection and management of the disease.
文摘BACKGROUND Exosomal microRNAs(miRNAs)have emerged as promising biomarkers for cancer diagnosis due to their stability,tumor specificity,and accessibility.How-ever,the diagnostic potential of serum exosomal miRNAs in metastatic pancreatic cancer remains underexplored.AIM To investigate the diagnostic potential of serum exosomal miRNAs in metastatic pancreatic cancer.METHODS A total of 36 patients were enrolled,comprising 8 patients in the discovery phase(4 with metastatic and 4 with non-metastatic pancreatic cancer)and 28 in the validation cohort(15 non-metastatic and 13 metastatic cases).Exosomes were isolated using the exoEasy Maxi Kit and characterized by transmission electron microscopy,nanoparticle tracking analysis,and western blotting.High-throu-ghput sequencing was conducted to identify differentially expressed serum exosomal miRNAs,which were subsequently validated using TaqMan probe-based reverse transcription-quantitative polymerase chain reaction.Bioinformatic analyses were performed to predict downstream target genes and explore their roles in metastatic progression.RESULTS Transmission electron microscopy revealed that the isolated exosomes were predominantly round or oval with well-defined membrane boundaries.Nano-particle tracking analysis showed a peak particle size of approximately 138 nm,accounting for 99.2%of total particles,consistent with the typical size range of exosomes.Western blotting confirmed the expression of exosome-specific markers CD63 and CD81.High-throughput sequencing identified 42 differentially expressed exosomal miRNAs between metastatic and non-metastatic groups.Among them,hsa-let-7f-5p was significantly upregulated in metastatic pancreatic cancer(P=0.007),as validated by reverse transcription-quantitative polymerase chain reaction.Target gene prediction indicated that hsa-let-7f-5p may be involved in metastasis through its interactions with nerve growth factor,cyclin-dependent kinase inhibitor 1A,high mobility group AT-hook 2,insulin-like growth factor 2 mRNA-binding protein 1,and insulin-like growth factor 2 mRNA-binding protein 3.CONCLUSION The elevated expression of serum exosomal hsa-let-7f-5p in metastatic pancreatic cancer suggests its potential as a non-invasive biomarker for distinguishing metastatic from non-metastatic disease.
文摘BACKGROUND Multiple lines of evidence have indicated that pro-inflammatory cytokines play a role in the pathophysiology of gastric carcinoma(GC).AIM To identify potential serum cytokine-based biomarkers for GC diagnosis.METHODS The study cohort comprised 50 patients diagnosed with GC and 50 healthy control subjects.A panel of 7 pro-inflammatory cytokines,including interleukin(IL)-1β,IL-2,IL-6,IL-8,IL-12,tumor necrosis factor-α,and interferon-γ(IFN-γ)were quantified using multiplex Luminex assays.Comparative analyses were conducted to evaluate cytokine levels between the GC patients and healthy controls.The diagnostic potential of serum pro-inflammatory cytokines in differentiating GC patients from healthy individuals was assessed through receiver operating characteristic(ROC)curve analysis.The correlation between serum cytokine levels and disease severity,as classified by the tumor-node-metastasis staging system,was analyzed using Spearman's rank correlation coefficient.RESULTS In comparison to the control group,patients with GC demonstrated significantly elevated serum levels of IL-1β(t=-4.089,P<0.001),IL-6(t=-3.983,P<0.001),IL8(t=-5.460,P<0.001),and IFN-γ(t=-2.856,P=0.005).ROC curve analysis indicated that the area under the curve values for IL-1β,IL-6,and IL-8 exceeded 0.7,effectively distinguishing GC patients from healthy controls.Additionally,serum levels of IL-1β(r=0.424,P=0.012)and IL-6(r=0.742,P<0.001)were positively correlated with the T stage in GC patients.Similarly,serum concentrations of IL-1β(r=0.356,P=0.039)and IL-6(r=0.441,P=0.008)exhibited a positive association with the N stage in these patients.CONCLUSION These findings suggest that circulating pro-inflammatory cytokines,such as IL-1β,IL-6,and IL-8,may serve as potential biomarkers for the diagnosis of GC.
基金sponsored by the One Health Interdisciplinary Research Project,Ningbo University,Open Fund of Key Laboratory of Aquacultural Biotechnology Ministry of Education in Ningbo University,and K.C.Wong Magna Fund of Ningbo Universitythe National Natural Science Foundation China(32270115)+1 种基金National Key R&D Program of China(2018YFD0901102)Fundamental Research Funds for the Provincial Universities of Zhejiang(SJLY2021015)。
文摘Fructose consumption has risen dramatically in recent decades due to the use of sucrose and high fructose corn syrup in beverages and processed foods,contributing to rising rates of hyperuricemia.The purpose of this experiment was to explore the anti-hyperuricemia effects of an active oligopeptide(GPSGRP)derived from sea cucumber in fructose induced hyperuricemia mouse model,and to clarify the underlying mechanism in sight of gut microbiota and serum metabolites.Peptide GPSGRP treatment rebalanced uric acid metabolism and alleviated inflammatory response in mice.In addition,treatment with GPSGRP decreased the abundance of Bacteroides and Proteobacteria at the phylum level,Muribaculum,Prevotella and Bacteroides at the genus level,and inhibited the related pathways of purine metabolism and glycolysis/gluconeogenesis metabolism.Moreover,serum metabolites,including linoleic acid,indole and its derivatives,arachidonic acid and uridine,as well as related metabolic pathways,such as tricarboxylic acid cycle,ketone production and sugar production,were altered in response to GPSGRP treatment.This study provides a valuable reference for the application and development of marine biological peptides in uric acid management.
基金supported by Beijing Natural Science Foundation(No.7222248)the National Natural Science Foundation of China(No.81673177).
文摘The association of copper(Cu)with preterm birth(PTB)and its subtypes,spontaneous preterm birth(SPB)and iatrogenic preterm birth(IPB),are still unclear.In addition,previous studies suggested that serum lipid was associated with both Cu and PTB.Therefore,we explored the association of blood Cu in the first trimester with the risk of PTB and its subtypes,as well as the potential mediating effect of serum lipid using a nested case-control study.The concentrations of Cu in the serum and blood cells,and serum lipids in the first trimester were measured.The concentration of Cu in whole blood was calculated based on hematocrit.Compared to the lowest tertile of Cu concentrations in the first trimester,the highest tertile of Cu significantly increased the risk of SPB with adjusted odds ratios(AORs)of 2.75(95% confidence interval(CI):1.41-5.34)for serum and 3.75(95% CI:1.21-11.60)for whole blood,and significantly increased the risk of IPB with AORs of 3.25(95%CI:1.06-9.94)for blood cells.According to the mediation analysis,the indirect effect of triglyceride(β=0.016,95%CI:0.0002-0.042)was the only significant effect in the association between Cu and SPB,with the mediating proportion of 9.8%(95%CI:0.2%-33.4%).It suggested that a high level of serum Cu may be associated with an increased risk of SPB with a possible mediator of serum triglyceride,and a high level of blood cell Cu may be associated with an increased risk of IPB.
基金Supported by National Research Foundation of Korea,No.NFR-2022R1C1C1006242the Hallym University Medical Center Research Fund.
文摘BACKGROUND Current diagnostic standards for post-endoscopic retrograde cholangiopancreato-graphy(ERCP)pancreatitis(PEP)rely on 24-hour post-ERCP amylase and lipase levels,delaying timely intervention and highlighting the need for earlier predic-tive biomarkers.AIM To evaluate the utility of 4-hour post-ERCP serum amylase and lipase levels in a large cohort to establish optimal cut-off values and improve early PEP prediction.METHODS This prospective study involved patients with naïve major papillae who under-went diagnostic or therapeutic ERCP between June 2021 and December 2024.Serum amylase and lipase levels were measured before ERCP and 4 hours and 24 hours after ERCP.The primary endpoint was to determine optimal cut-off values for 4-hour serum amylase and lipase levels for the early prediction of PEP.RESULTS PEP occurred in 117 patients(6.1%).Diagnostic performance assessment of 4-hour serum amylase and lipase for predicting PEP yielded area under the curves of 0.877 and 0.893,respectively.Optimal cut-off values were 1.2 times the upper nor-mal limit(119.5 IU/L)for amylase and 8 times the upper normal limit(488.5 IU/L)for lipase.At these thresholds,4-hour amylase demonstrated a sensitivity of 0.846,a specificity of 0.806,and a negative predictive value of 0.988.Similarly,4-hour lipase showed a sensitivity of 0.863,a specificity of 0.862,and a negative predictive value of 0.990.These biomarkers effectively predicted moderately severe to severe PEP in high-risk groups.CONCLUSION Early measurement of 4-hour serum amylase and lipase shows strong predictive capabilities for PEP,with clinically meaningful cut-off values.These biomarkers enable timely interventions,potentially reducing PEP-related adverse events and the overall healthcare burden.
文摘BACKGROUND Serum calcium ion(Ca2+)is an economical and readily available indicator as a routine screening test for hospitalized patients.There are no studies related to serum Ca2+level and digestive tract malignancy.AIM To evaluate the effectiveness of serum Ca2+level in predicting the prognosis of patients with colorectal cancer(CRC).METHODS We retrospectively collected the data of 280 patients diagnosed with CRC who underwent radical surgery at the Affiliated Cancer Hospital of Xinjiang Medical University.By analyzing the clinicopathological features,differences between serum Ca2+concentrations on the first day after surgery were determined.We used the receiver operating characteristic curve to assess the predictive ability of serum Ca2+for survival.Survival analyses were performed using the Kaplan-Meier method,and multivariate Cox proportional risk regression was used to determine association between calibration serum Ca2+levels and CRC survival outcomes.RESULTS By receiver operating characteristic curve analysis,the ideal threshold value for Ca2+the first postoperative day and delta serum calcium(δCa2+)value were 1.975 and 0.245,respectively.Overall survival(OS)and progression-free survival(PFS)were better in both the high Ca2+group and highδCa2+group on the first postoperative day.The variables identified through univariate analysis were incorporated into multivariate analysis and showed that tumor differ-entiation(P=0.047),T stage(P=0.019),N stage(P<0.001),nerve vascular invasion(P=0.037),carcinoembryonic antigen(P=0.039),baseline serum Ca2+level(P=0.011),and serum Ca2+level on the first day(P=0.006)were independent predictors of prognosis for patients undergoing feasible radical CRC surgery.Using the findings from the multifactorial analysis,we developed a nomogram and the calibration showed a good predictive ability.CONCLUSION Low serum Ca2+level on the first postoperative day is an independent risk factor for OS and PFS in CRC.
基金Supported by Liaoning Provincial Science and Technology Plan Joint Plan,No.2023JH2/101700149。
文摘BACKGROUND The deleterious effects of surgical trauma and subsequent postoperative complications pose significant challenges to the smooth recovery of patients after gastric cancer(GC)resection despite the substantial curative benefits provided by surgical interventions for GC.Hence,the investigation of more optimal and efficacious treatment approaches has become an urgent necessity in the medical community.AIM To investigate the association of Sijunzi decoction plus chemotherapy with the gastrointestinal function and serum markers of patients after GC surgery.METHODS This study included patients who underwent GC surgery from June 2022 to February 2024.The control group included 45 patients who received chemotherapy(oxaliplatin+calcium folinate+5-fluorouracil),whereas the research group consisted of 54 patients who received Sijunzi decoction therapy in addition to the treatment administered in the control group.Comparative analyses were conducted from the following perspectives:Gastrointestinal function(defecation time,intestinal gas discharge time,and hospitalization time),serum markers[carcinoembryonic antigen(CEA),carbohydrate antigen(CA)125,and CA199],nutritional indicators total protein(TP)and transferrin(TRF),traditional Chinese medicine(TCM)syndrome score,and grades Ⅲ–Ⅳ adverse events(gastrointestinal reactions,renal/liver function impairment,and myelosuppression).RESULTS The two groups demonstrated similar defecation time(P>0.05),but the intestinal gas discharge time and hospitalization time were significantly shortened in the research group(P<0.05).Further,the research group exhibited significant CEA,CA125,and CA199 reductions after treatment,which were lower compared to the control group,as well as notable increases in TP and TRF that were statistically higher than the control group(all P<0.05).Furthermore,the research group demonstrated an evident decrease in TCM syndrome scores in areas,such as poor appetite,epigastric distension and pain,fatigue and weakness(P<0.01),and abdominal distension after eating,which are notably lower than those in the control group(P<0.01),with a comparable incidence of grades Ⅲ-Ⅳ adverse events(P>0.05).CONCLUSION Our research results indicate that Sijunzi decoction plus chemotherapy exerts a good rehabilitation-promoting effect on gastrointestinal function in patients after GC surgery and significantly downregulates abnormally increased CEA,CA125,and CA199 levels.
文摘BACKGROUND Splenectomy is an effective yet invasive intervention for alleviating portal pressure in patients with hepatitis cirrhosis.However,the current prognostic indicators for predicting long-term overall survival of these patients have several limitations.AIM To assess the potential of preoperative total bilirubin-albumin(B/A)ratio as a prognostic indicator for patients with hepatitis cirrhosis undergoing splenectomy.METHODS A total of 257 patients diagnosed with hepatitis cirrhosis were retrospectively enrolled in the study.Normality test,t-test,Wilcoxon test,χ2 test,or Fisher’s exact test was employed to analyze the intraoperative and postoperative conditions of the patients.Receiver operating characteristic(ROC)curve analysis was utilized to depict the 10-year overall survival rate.RESULTS During the follow-up period,85.99%of the patients survived,with a median survival time of 64.6 months.Multivariate analysis revealed that total serum B/A ratio was an independent risk factor for overall survival(P=0.037).ROC curve analysis demonstrated that a B/A ratio of 0.87 was the optimal cut-off value.Consequently,the patients were categorized into two groups:High B/A group(n=64)and low B/A group(n=193).The median follow-up time for the high B/A group and low B/A group was 56.8 months and 67.2 months,respectively(P=0.045).Notably,the high B/A group exhibited a significantly lower 10-year overall survival compared to the low B/A group(P<0.001).Patients with hepatocellular carcinoma(HCC)had lower overall survival rates.Patients with a high B/A ratio exhibited a lower overall survival than those with a low B/A rate in the overall cohort and the subgroups of patients with HCC or not,early Child-Pugh grade,low albumin-bilirubin grade,and model for end-stage liver disease score≥10(log-rank test,P<0.001 for all).CONCLUSION The B/A ratio can serve as an effective prognostic indicator for overall survival in patients with hepatitis B virusrelated cirrhosis following splenectomy,and a higher B/A ratio may suggest a poorer prognosis.
基金Supported by Zhejiang Provincial Natural Science Foundation of China,No.LTGY24H160006Jiaxing Medical Key Discipline,No.2023-ZC-015.
文摘BACKGROUND Serum carcinoembryonic antigen(CEA)levels and magnetic resonance imaging(MRI)findings are widely used for the diagnosis and treatment of rectal cancer;however,research investigating their correlation remains limited.AIM To investigate the correlation between baseline MRI features and serum CEA levels in patients diagnosed with primary rectal cancer.METHODS Eighty patients(age:42-78 years)diagnosed with primary rectal cancer were enrolled.Baseline MRI examinations were performed to evaluate tumor size,T stage,circumferential resection margin status,extramural vascular invasion(EMVI),and lymph node metastasis.Serum CEA levels were concurrently measured.Statistical methods were used to analyze correlations.RESULTS Tumor size,T stage,EMVI,and lymph node metastasis were significantly correlated with serum CEA levels(P<0.05).Multivariate analysis identified T stage and lymph node metastasis as independent factors influencing serum CEA levels.CONCLUSION This study confirmed the correlation between baseline MRI features and serum CEA levels in patients with primary rectal cancer,highlighting their potential utility for precise diagnosis,staging,and prognostic evaluation.
基金Supported by National Natural Science Foundation of China,No.32300926Youth Project of Science and Technology Research Program of Chongqing Education Commission of China,No.KJQN202402810Science and Health Joint Medical Research Project of Chongqing Nanan District,No.2020-12.
文摘BACKGROUND Major depressive disorder(MDD)is characterized by persistent depressed mood and cognitive symptoms.This study aimed to discover biomarkers for MDD,explore its pathological mechanisms,and examine the associations of the identified biomarkers with clinical and psychological variables.AIM To discover candidate biomarkers for MDD identification and provide insight into the pathological mechanism of MDD.METHODS The current study adopted a single-center cross-sectional case-control design.Serum samples were obtained from 100 individuals diagnosed with MDD and 97 healthy controls(HCs)aged between 18 to 60 years.Metabolomics was performed on an Ultimate 3000 UHPLC system coupled with Q-Exactive MS(Thermo Scien-tific).The online software Metaboanalyst 6.0 was used to process and analyze the acquired raw data of peak intensities from the instrument.RESULTS The study included 100 MDD patients and 97 HCs.Metabolomic profiling identified 35 significantly different metabolites(e.g.,cortisol,sebacic acid,and L-glutamic acid).Receiver operating characteristic curve analysis highlighted 8-HETE,10-HDoHE,cortisol,12-HHTrE,and 10-hydroxydecanoic acid as top diagnostic biomarkers for MDD.Significant correlations were found between metabolites(e.g.,some lipids,steroids,and amino acids)and clinical and psychological variables.CONCLUSION Our study reported metabolites(some lipids,steroids,amino acids,carnitines,and alkaloids)responsible for discriminating MDD patients and HCs.This metabolite profile may enable the development of a laboratory-based diagnostic test for MDD.The mechanisms underlying the association between psychological or clinical variables and differential metabolites deserve further exploration.
基金Supported by Clinical Translational Medicine Project of the Department of Science and Technology of Anhui Province,No.202427b10020138.
文摘Kang et al published a study recently in the World Journal of Gastroenterology introducing an interpretable machine learning model to predict anastomotic leakage after rectal cancer surgery,highlighting postoperative serum calcium as a key predictive feature.While this represents a significant advancement,we argue that reliance on a static calcium threshold may limit clinical applicability.We advocate for a dynamic,trajectory-based assessment of serum calcium levels across perioperative time points,using modeling approaches such as time-series regression or mixed-effects models.Furthermore,the model’s robustness could be improved by incorporating systemic inflammation and nutritional indices such as C-reactive protein,procalcitonin,the neutrophil-to-lymphocyte ratio,and the systemic immune-inflammation index,supported by recent prospective studies.Finally,generalizability remains a concern,warranting broader validation and clearer clinical deployment strategies.By addressing these aspects,the model’s clinical translation and decision-making impact could be substantially enhanced.
基金Analysis of a Clinical Study of Vitamin D Supplementation in Improving the Prognosis of H-type Hypertension in the Elderly(Project No.:2341ZF140)。
文摘Objective:Correlation of serum 25-hydroxyvitamin D level with senile hypertension and its stroke.Methods:Two hundred hypertensive patients admitted to the hospital from February 2022 to December 2023 were classified as study subjects.They were divided into grade 2 hypertension group and grade 3 hypertension group,and 100 healthy medical checkups admitted during the same period were analyzed as study subjects.Results:Comparison of diagnostic results between grade 2 hypertension and grade 2 hypertensive stroke patients,there was a difference in 25(OH)D,(P<0.05).Comparison of test results between grade 3 hypertension and grade 3 hypertensive stroke patients,there was a difference in age,BMI,25(OH)D,GLU,LDL-C,(P<0.05).Serum 25-hydroxyvitamin D level is a high-risk factor for the occurrence of stroke in elderly hypertensive patients,so the probability of risk is higher,where 25(OH)D(ng/mL),GLU(mmol/L),there is a difference,(P<0.05).Conclusion:There is a greater relationship between the occurrence of stroke and serum 25-hydroxyvitamin D level in elderly hypertensive patients.The occurrence of the disease has a greater relationship with this indicator in patients and is also a high-risk factor that affects the patients’morbidity,so it is necessary to pay attention to the monitoring of this indicator after the onset of the disease in patients.
基金the National Natural Science Foundation of China(No.32372611)the Outstanding Youth Fund of Natural Science Foundation of Anhui Province(No.2208085Y07)Research Funds of Joint Research Center for Food Nutrition and Health of IHM(No.2024SJY04).
文摘Chiral pesticides,such as penthiopyrad,consist of enantiomers with differing biological activities and toxicological profiles,potentially leading to environmental risks.This study investigates the stereoselective binding of the R-(—)-and S-(+)-enantiomers of penthiopyrad to bovine and human serum albumin(BSA/HSA)using a combination of spectroscopic techniques,density functional theory(DFT)calculations,and molecular docking.The results indicate that S-(+)-penthiopyrad exhibits a significantly stronger quenching effect on the intrinsic fluorescence of both HSA and BSA than R-(—)-penthiopyrad,suggesting a higher binding affinity,which is consistent with DFT predictions.Specifically,the binding constants(ΔG)of S-(+)-penthiopyrad with BSA and HSA were−31.80 kJ/mol and−35.68 kJ/mol,respectively,compared to−30.42 kJ/mol and−33.82 kJ/mol for R-()-penthiopyrad.Circular dichroism(CD)spectroscopy and FTIR analysis show that both enantiomers induce conformational changes in albumin secondary structures,reducingα-helical content by 3.6%for S-(+)-penthiopyrad and 2.1%for R-(−)-penthiopyrad in BSA,and by 2.7%and 0.2%,respectively,in HSA.Molecular docking identifies site II(subdomain IIIA)as the primary binding region,with hydrogen bonding and hydrophobic interactions stabilizing the S-(+)-penthiopyrad complex more effectively.These findings underscore the higher environmental risk of S-(+)-penthiopyrad compared to R-(-)-penthiopyrad,advancing the molecular-level understanding of stereoselective behavior in chiral fungicides and guiding safer agrochemical development.
基金Project Name:Correlation Analysis between Intestinal Flora and Differential Proteins in Intestinal Tissue of Neonatal Necrotizing Enterocolitis(Project No.:FYX202336)。
文摘Objective:To analyze the efficacy of Bifidobacterium triple viable bacteria tablets on neonatal necrotizing enterocolitis(NEC)and its impact on serum factors of the patients.Methods:From January 2021 to May 2025,88 neonates with NEC admitted to our hospital were selected as study subjects.During the study,these 88 patients were evenly divided into two groups,namely the observation group and the control group,with 44 patients in each group based on the random number table method.In terms of treatment,the control group was treated with meropenem,while the observation group received additional treatment with Bifidobacterium triple viable bacteria powder based on the treatment plan of the control group.The clinical efficacy and differences in serum inflammatory factor levels between the two groups were compared.Results:The efficacy of the observation group(90.91%)was better than that of the control group(72.73%)(P<0.05).After treatment,the levels of C-reactive protein(CRP)and procalcitonin(PCT)in both groups decreased compared to those before treatment,and the values of the above indicators in the observation group were lower than those in the control group(P<0.05).Conclusion:Based on conventional treatment for NEC neonates,the use of Bifidobacterium triple viable bacteria tablets has significant efficacy and can effectively reduce serum inflammatory factor levels.
基金supported by the National Natural Science Foundation of China(No.82404365)the Noncommunicable Chronic Diseases-National Science and Technology Major Project(No.2023ZD0513200)+7 种基金China Medical Board(No.15-230)China Postdoctoral Science Foundation(Nos.2023M730317and 2023T160066)the Fundamental Research Funds for the Central Universities(No.3332023042)the Open Project of Hebei Key Laboratory of Environment and Human Health(No.202301)the National Key Research and Development Program of China(No.2022YFC3703000)the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(No.2022-JKCS-11)the CAMS Innovation Fund for Medical Sciences(No.2022-I2M-JB-003)the Programs of the National Natural Science Foundation of China(No.21976050).
文摘Associations of per-and polyfluoroalkyl substances(PFAS)on lipid metabolism have been documented but research remains scarce regarding effect of PFAS on lipid variability.To deeply understand their relationship,a step-forward in causal inference is expected.To address these,we conducted a longitudinal study with three repeated measurements involving 201 participants in Beijing,among which 100 eligible participants were included for the present study.Twenty-three PFAS and four lipid indicators were assessed at each visit.We used linear mixed models and quantile g-computation models to investigate associations between PFAS and blood lipid levels.A latent class growth model described PFAS serum exposure patterns,and a generalized linear model demonstrated associations between these patterns and lipid variability.Our study found that PFDA was associated with increased TC(β=0.083,95%CI:0.011,0.155)and HDL-C(β=0.106,95%CI:0.034,0.178).The PFAS mixture also showed a positive relationship with TC(β=0.06,95%CI:0.02,0.10),with PFDA contributing most positively.Compared to the low trajectory group,the middle trajectory group for PFDA was associated with VIM of TC(β=0.756,95%CI:0.153,1.359).Furthermore,PFDA showed biological gradientswith lipid metabolism.This is the first repeated-measures study to identify the impact of PFAS serum exposure pattern on the lipid metabolism and the first to estimate the association between PFAS and blood lipid levels in middle-aged and elderly Chinese and reinforce the evidence of their causal relationship through epidemiological studies.
