摘要:目的: 研究尿微量白蛋白与冠心病的相关性。 方法 : 按冠状动脉造影诊断标准将116例患者分为冠心病组(82人) 与非冠心病组(34人),测定晨尿白蛋白/ 肌酐浓度值(ACR),比较两组患者尿ACR 并分析ACR与冠脉病变程度的相关性。 结果 : 冠心病组ACR显著高于非冠心病组的; ACR与冠脉计分呈显著的直线正相关。 结论 :冠心病患者ACR水平升高,微量白蛋白尿与冠状动脉病变范围和程度密切相关, 且对冠状动脉狭窄程度具有独立预测价值。Abstract: Objective: To investigate the relationship between microalbuminuria and coronary artery disease(CAD). Methods : According to the diagnostic standard of coronary artery angiography,116 patients were divided into CAD group (82 patients) and nonCAD group (34 patients). The albumin and creatinine concentrationratio ratio(ACR) in morning urine samples from patients of both groups was estimated and compared. The correlation of ACR to the extent of coronary lesions was analyzed. Results : ACR in the CAD group was significantly higher than that in nonCAD group. A distinctly linear positive correlation existed between ACR and the score of the coronary lesions. Conclusion : ACR increase in patients with CHD.Micoalbuminuria was associated with the severity of coronary lesions in patients with CHD and is an independent predictor of CAD.
Objective To investigate the effect of ultra-filtration on reducing the matrix effects of the immersionof recombination human acellular dermal matrix (rhADM) on detecting residual bovine serum albumin (BSA) by ELISA.Methods Preparation of rhADM immersion: rhADM were rinsed, and then rhADM immersion were prepared. Physiologicalsal ine was used as immersion medium. Presaturation and ultra-filtration: marked the ultra-filtration tubes as PR1 (presaturation protocol 1), PR2 (presaturation protocol 2) and rhADM, respectively, added 2 mL of 1 mg/mL and 10 μg/mL BSA solution into PR1 and PR2 respectively, and added 2 mL of rhADM immersion into rhADM tubes (rhADM1 and rhADM2). The tubes were then centrifuged at 1 500 × g for 20 minutes. The above steps were repeated for 3 times. Take the inner-tube of ultrafiltration into unused centrifuge tube. Added 4 mL of 10 μg/mL BSA solution in PR1 and PR2 tubes, 4 mL of rhADM immersion in rhADM tubes, centrifuged at 1 500 × g for 20 minutes, and then the filtration was colleted. Detecting BSA concentration: the BSA concentrations of all samples were detected by using the quantitative measure of residual BSA ELISA kit. The recoveries of 10 μg/ mL BSA solution treated by presaturation protocol 1 and 2 were calculated (untreated 10 μg/mL BSA solution was as the basic sample, marked R10 and R20 respectively). The correlation coefficient between the logarithm of the filtrate dilution and the absorbance (A) value was calculated and compared with that of water exact without ultra-filtration. Results The BSA concentration of PR1 and R10 was (23.80 ± 1.58) μg/ mL and (9.04 ± 0.24) μg/mL, respectively. The BSA concentration of PR2 and R20 was (8.64 ± 0.24) μg/mL and (8.12 ± 1.01) μg/ mL, respectively. The average recovery of 10 μg/mL BSA was 263.4% ± 16.9% and 106.5% ± 3.0% when the ultra-filtration tubes were presaturaed by PR1 and PR2 (P lt; 0.01), respectively. The BSA recovery of PR2 met the detecting demand. The correlations between A value and sample dilution were increased, the correlationcoefficient was raised from — 0.727 to — 0.960 after rhADM immersion were treated by ultra-filtration. Conclusion Theresults show that the matrix effects can be reduced effectively by ultra-filtration, indicating that an acceptable recovery of BSA can be acquired when ultra-filtration tube is presaturated by sample water extract.
ObjectiveTo investigate the predictive value of preoperative plasma fibrinogen and serum albumin score (FA score) for postoperative survival of hepatocellular carcinoma (HCC) after hepatectomy.MethodWe retrospectively analyzed the clinicopathological data and follow-up information of 275 patients with HCC who underwent hepatectomy in West China Hospital of Sichuan University from March 2009 to December 2013.ResultsThere’s no statistically significant difference in gender, ALT, total bilirubin, hepatitis B virus surface antigens, AFP, cirrhosis, macrovascular invasion, tumor differentiation, TNM stage, and postoperative adjuvant transarterial chemoembolization of HCC patients between FA score of 0 group and FA score of 1 and 2 group (P>0.05). There’s statistically significant difference in age, AST, tumor size, tumor number, microvascular invasion, and BCLC stage (P<0.05). Multivariate Cox proportional hazard regression analyses revealed that FA score (1 and 2) was an independent risk factor for HCC patients’ overall survival rate [HR=1.632, 95%CI was (1.141, 2.335), P=0.007] and early recurrence-free survival rate [HR=1.678, 95%CI was (1.083, 2.598), P=0.021], the overall survival rate and early recurrence free survival rate of HCC patients with FA score of 0 group were better than those of patients with FA score of 1 and2 group.ConclusionsThe preoperative FA score has a good prognostic value for survival of HCC patients who underwent hepatectomy. Preoperative FA score of 1 and 2 is an independent risk factor for overall survival rate and early recurrence free survival rate of HCC patients after hepatectomy.
Objective To investigate the value of fibrinogen to albumin ratio (FAR) combined with pulmonary embolism severity index (PESI) in the assessment of severity and prognosis of patients with acute pulmonary thromboembolism (APTE). Methods A retrospective study of hospitalized patients with confirmed APTE admitted to the Affiliated Hospital of Southwest Medical University from September 2013 to August 2021, divided into low-risk, intermediate-risk, and high-risk groups according to the Guidelines for the Diagnosis, Treatment and Prevention of Pulmonary Thromboembolism, and divided into survival groups and death groups according to the 30-day prognosis. The general data of all patients and relevant blood laboratory tests within 2 hours after admission were collected to calculate PESI and FAR. FAR and PESI levels were compared in APTE patients with different severity of disease and different prognosis. Independent risk factors for 30-day mortality in APTE patients were analyzed using logistic regression. Subject working characteristic curves were drawn to assess the differences in sensitivity, specificity and area under the curve of FAR, PESI and FAR combined with PESI in predicting 30-day death. Results Total of 235 APTE patients were included, divided into 85 in the low-risk group, 110 in the intermediate-risk group, and 40 in the high-risk group; 192 in the survival group and 43 in the death group according to 30-day survival. The differences in age, albumin (ALB), high-sensitivity troponin, D-dimer, fibrinogen (FIB), FAR, and PESI of APTE patients with different disease severity were statistically significant (P<0.05). FAR increased progressively with increasing severity of disease (P<0.05), and correlation analysis showed a positive correlation between FAR and PESI (r=0.614, P<0.05). Elevated FIB, FAR, PESI and decreased ALB were independent risk factors for 30-day death in patients with APTE (P<0.05). FAR, PESI, and FAR combined with PESI all had predictive value for 30-day death in APTE patients, and FAR combined with PESI predicted the largest area under the 30-day death curve. Conclusions FAR correlated with the severity and prognosis of APTE patients. FAR combined with PESI was more valuable in assessing the 30-day prognosis of APTE patients than FAR alone or PESI alone.
Objective To evaluate the early diagnostic value of ischemia modified albumin (IMA) for non-ST-segment elevation acute coronary syndromes (NSTEACS). Methods The study group consisted of 177 patients with suspected NSTEACS whose blood was collected within six hours after the onset of chest pain to determine cardiac troponin I (cTnI), and IMA was determined through the albumin cobalt binding (ACB) test. After standardized diagnosis and treatment and GRACE risk score, the patients then were divided into three groups according to the final diagnosis: the NSTEMI (non-ST-segment elevation myocardial infarction) group (n=34), the UA (unstable angina pectoris) group (n=56) and the NICP (non-ischemia chest pain) group (n=87). Meanwhile, 58 people taking the routine examination in the same hospital at that time were randomly selected as the control group. With the results of IMA, ROC curve analysis was used to determine the optimal cutoff of this assay for identifying patients with NSTEACS from those with NICP. Results of IMA, ECG and cTnI were correlated with final diagnosis, and their diagnostic sensitivity and specificity were evaluated for NSTEACS. Results The IMA concentration in the serum showed no significant difference between the NSTEMI group and the UA group, whereas there were significant differences between the former two groups and the NICP group. The sensitivity and specificity at a cutoff point 67.49 U/mL were 91.1% and 86.2%, respectively when the ROC curve area was 0.950. The correlation between the IMA concentration and GRACE risk score was negative. Conclusion IMA is an early sensitive indicator for NSTEACS and a useful predictor of prognosis.
ObjectiveTo investigate the application value of albumin-bilirubin (ALBI) score in the treatment and prognosis of hepatocellular carcinoma (HCC).MethodThe literatures related to studies on the relationship between the ALBI score and the HCC were searched. The sources of ALBI score and its role in predicting the survival of patients after the liver cancer resection, liver transplantation, and non-surgical treatment such as radiofrequency ablation, radiotherapy, sorafenib treatment, and other therapies were reviewed.ResultsThe ALBI score was the independent prognostic factor after the hepatectomy. As a risk factor for the early recurrence of HCC after the radical hepatectomy, the ALBI score might help to determine the appropriate treatment based on the patient’s liver function when the recurrence occurred. As an independent predictor of mortality after the liver transplantation, the ALBI level 3 might be helpful in optimizing individual risk assessment for the liver transplantation. The ALBI score could be used as the reference tool for the clinicians to choose between the hepatectomy and non-surgical treatment in the patients with HCC.ConclusionsRole of ALBI score in evaluating liver function is no less useful than that of Child-Pugh grade. It plays an important role in evaluating prognosis and recurrence of patients with HCC, and is conducive to selection of individualized treatment for them, and formulation of treatment plan that maximizes benefit of patients.
ObjectiveTo explore repressive effects of transthyretitin (TTR) on the growth of human retinal endothelial cells (hREC) under high glucose and hypoxia environment.MethodshRECs were divided into 8 groups, including normal glucose group (5.5 mmol/L glucose), hypoxia group, high glucose group (25.0 mmol/L glucose), high glucose and hypoxia group, normal glucose group+TTR, normal glucose and hypoxia group+TTR, high glucose group+TTR, high glucose and hypoxia group+TTR. Flow cytometry was used to analyze cellular apoptosis. The expression level of Akt, p-Akt, eNOS, Bcl-2 and Bax protein were measured by Western blot.ResultsHypoxia could induce apoptosis as the apoptosis rate of normal and hypoxia group was higher than normal group (χ2=25.360, P＜0.05), high glucose and hypoxia group was higher that high glucose group (χ2=17.400, P＜0.05). The cell apoptosis rate of high glucose and hypoxia group+TTR were increased significantly as compared with high glucose and hypoxia group (χ2=9.900, P＜0.05). There was no statistically significant difference on the cell apoptosis rate between normal group and high glucose group, normal group+TTR and normal group, high glucose group+TTR and high glucose group, normal and hypoxia group+TTR and normal and hypoxia group (P＞0.05). Western blot showed that the expression of Akt did not change significantly in all eight groups（F=2.450, P＞0.05). Compared to normal group, the expression of p-Akt, eNOS, Bcl-2 in normal and hypoxia group were decreased (t=9.406, 5.306, 4.819), and the expression of Bax (t=−4.503) was increased (P＜0.05). Compared to high glucose group, same trend was found in high glucose and hypoxia group (t=8.877, 7.723, 6.500, −14.646; P＜0.05). The expression of p-Akt in normal and hypoxia group+TTR was higher than normal and hypoxia group (t=−5.024, P＜0.05) , but there was no difference on the expression of eNOS, Bcl-2, Bax between these two groups (t=−2.235, −2.656, −0.272; P＞0.05). Compared to high glucose and hypoxia group, the expression of p-Akt and Bcl-2 in high glucose and hypoxia group+TTR were decreased (t=4.355, 4.308; P＜0.05), the expression of Bax was increased (t=−4.311, P＜0.05), and there was no difference on the expression of eNOS between these two groups (t=−1.590, P＞0.05). There was no statistically significant difference in the expression of p-Akt, eNOS, Bcl-2, Bax between high glucose group and normal group (t=−3.407, −4.228, −4.302, −2.076; P＞0.05), normal group+TTR and normal group (t=−4.245, −4.298, −2.816, −1.326; P＞0.05), high glucose group+TTR and high glucose group (t=4.016, −0.784, 0.707, −0.328; P＞0.05).ConclusionUnder high glucose and hypoxia, transthyretitin suppress the growth of hREC through Akt/Bcl-2/Bax, but not Akt/eNOS signaling pathway.
ObjectiveTo explore the relationship between the levels of transferrin (TRF), prealbumin (PAB) and total bile acids (TBA) in serum and the loss of the hepatic reserve function in primary liver cancer (PHC) patients and the importance of the former factors for diagnosis of PHC. MethodsA total of 154 patients with PHC collected between March 2010 and February 2013 were included in our study. Based on the information of hepatic reserve function and the Child-Pugh classification standard, the patients were divided into Child-Pugh-A, B, and C groups with 67, 55 and 42 patients respectively. Another 58 healthy subjects were selected as the control group. Serum TRF, PAB and TBA levels were measured by automated chemiluminescence immunoassay, immune turbidimetric assay and enzymatic cycling respectively, and they were compared among the groups. ResultsTRF level of patients in the control group and Child-Pugh-A, B, and C groups was respectively (2.574±0.214), (1.618±0.135), (0.988±0.121), and (0.314±0.107) g/L, with significant differences among the groups (P<0.05). PAB level of patients in four groups was respectively (269.32±37.29), (165.22±21.01), (123.24±31.15), and (83.66±19.74) mg/L, with significant differences among the groups (P<0.05). TBA level in the above four groups was respectively (9.16±2.48), (65.13±4.25), (133.62±8.44), and (250.73±21.59) μmol/L, and there was also significant differences among the groups. A positive correlation between serum TRF and PAB was found (r=0.927, P<0.001), and negative correlations between serum TBA level and serum TRF and between TBA and PAB were found (r=-0.454, P<0.001; r=-0.432, P<0.001, respectively). ConclusionSerum TRF, PAB and TBA levels are closely related to the hepatic reserve function in PHC patients, and they can be used as an important indicator for PHC diagnosis.
Objective To formulate an evidence-based treatment plan for a patient with type 2 diabetes and microalbuminuria. Methods According to the patient’s clinical conditions, we put forward 5 clinical problems. We searched the Cochrane Library (Issue 4, 2005), ACP Journal Club (1991 to 2005), and MEDLINE (1991 to 2005) databases. Systematic review, meta-analysis and randomized controlled trials about the treatment of diabetic nephropathy were included. The treatment plan was developed accordingly. Results Thirteen eligible studies were included. Evidence indicated that an intensive intervention aimed at the multiple potential risk factors could be applied to delay or prevent the progression of diabetic nephropathy, which included intensive blood glucose control, tight blood-pressure control, lipid modulation, restriction of protein intake and smoking cessation. The individualized treatment plan was based on the high quality evidence as well as the patient’s specific condition. The patient is still being followed-up. Conclusion Interventions for risk factors of type 2 diabetes like changing living style, decreasing serum glucose, blood pressure, and level of blood fat help to release the clinical symptom and better the long-term living quality of patients.
Objective To prepare the immunonanospheres［SC3Ab-HSA(5-Fu)-NS］ against human colorectal cancer and evaluate its immunoreactivity and effects on cancer. Methods SC3Ab-HSA(5-Fu)-NS was prepared by intermolecular cross-linking the monoclonal antibody SC3Ab with human serum albumin nanospheres containing 5-Fu ［HAS(5-Fu)-NS］ via new hetero-bifunctional crosslinker SPDP. Condensation test and immunoflurecence were used to evaluate the immunoreactivity, the specific binding of SC3Ab-HSA(5-Fu)-NS with colorectal cancer cell line SW1116 was observed by microscope and electron microscope. The specific cytotoxic effects on target cells were evaluated in vitro by MTT assay. SC3AbHSA(5-Fu)-NS, HSA(5-Fu)-NS and 5-Fu were injected into nude mice bearing human colorectal carcinoma, to study the inhibitory activity of SC3Ab-HSA(5-Fu)-NS in vivo. Results The immunoreactivity of SC3Ab-HSA(5-Fu)-NS was well preserved. SC3Ab-HSA(5-Fu)-NS can bind the SW1116 cells specifically. The IC50 value for SC3Ab-HSA(5-Fu)-NS on SW1116 cells was 24.6 μg/ml,which was lower than that of HSA(5-Fu)-NS(345.3 μg/ml) and 5-Fu(325.6 μg/ml). The inhibitory rate of SC3Ab-HSA(5-Fu)-NS on the growth of colorectal cancer xenografts was significantly higher than that of HSA(5-Fu)-NS or 5-Fu(P＜0.001).Conclusion SC3Ab-HSA(5-Fu)-NS has immunoreactivity and specific active targeting to the colorectal cancer cells. The anticancer ability of SC3Ab-HSA(5-Fu)-NS is significantly higher than that of HSA(5-Fu)-NS and 5-Fu.