In recent years, domestic and foreign scholars have carried out extensive research on the prognostic factors of gastric cancer. Among them, non-specific inflammatory markers and nutritional indicators are the most concentrated in gastric cancer. C-reactive protein, as an acute phase protein, has been widely used to diagnose acute and chronic inflammation throughout the body. Prealbumin is a sensitive indicator of nutrition with a shorter half-life, which can quickly reflect the nutritional status of the body. At present, C-reactive protein and prealbumin as sensitive indicators of inflammation and nutrition, have shown certain predictive value in terms of postoperative complications and prognosis of gastric cancer. This article reviews the use of C-reactive protein, prealbumin and their ratios in predicting postoperative complications and prognosis of gastric cancer, aiming to provide a reference for the diagnosis and treatment of patients after gastric cancer.
Objective To investigate the relationship between preoperative hemoglobin, albumin, lymphocyte and platelet (HALP) score, and clinicopathologic features of colon cancer, and to analyze the predictive value of HALP score for postoperative liver metastasis. Methods The clinical data of 163 patients with colon cancer admitted to the 909th Hospital of Joint Logistic Support Force (Dongnan Hospital of Xiamen University) from January 2018 to December 2019 were retrospectively analyzed. According to the occurrence of postoperative liver metastasis, the patients were divided into metastatic group (n=35) and non-metastatic group (n=128). The correlation between preoperative HAPL score and clinicopathologic features of colon cancer was analyzed. The predictive value of HALP score for postoperative liver metastasis of colon cancer was analyzed by using receiver operating characteristic (ROC) curve. The risk factors of liver metastasis after colon cancer surgery were analyzed by using univariate and multivariate logistic analysis. Kaplan-Meier risk curve was drawn, and log-rank test was used to analyze the predictive value of different HALP score for postoperative liver metastasis. Results HALP score were decreased in patients with maximum tumor diameter ≥5 cm, preoperative carcinoembryonic antigen (CEA) ≥5 μg/L, serous membrane and extrasserous infiltration, lymph node metastasis and vascular invasion, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that HALP score [OR=1.467, 95%CI (1.253, 1.718), P<0.001], maximum tumor diameter [OR=3.476, 95%CI (1.475, 5.358), P=0.013], preoperative CEA level [OR= 6.197, 95%CI (2.436, 6.248), P=0.005], and lymph node metastasis [OR=2.593, 95%CI (1.667, 6.759) , P=0.003] were risk factors for postoperative liver metastasis of colon cancer. ROC curve analysis showed that the area under the curve of HALP score for predicting liver metastasis after colon cancer surgery was 0.908 (0.841, 0.974), the maximum value of the Youden index was 0.738, the optimal cut-off value of the HALP score was 35.5, the sensitivity was 0.852, the specificity was 0.886. Kaplan-Meier risk curve showed that the risk of early postoperative liver metastasis in the low HALP score group was higher than that in the high HALP score group (χ2=8.126, P=0.004). Conclusion Low HALP score in patients with colon cancer is associated with adverse prognosisi related pathological features, and is an influential factor for postoperative liver metastasis of colon cancer, and has predictive value for patients with postoperative liver metastasis of colon cancer.
ObjectiveTo evaluate the prognostic value of the easy albumin-bilirubin (EZ-ALBI) score for postoperative complications and long-term prognosis of hepatocellular carcinoma (HCC) patients. MethodsThe data on consecutive 1 822 HCC patients who underwent hepatectomy were obtained and retrospectively analyzed from five medical centers, including West China Hospital, Sichuan Provincial People’s Hospital, The First People’s Hospital of Neijiang City, The Second People’s Hospital of Yibin City, and People’s Hospital of Leshan City. Non-conditional logistic and Cox proportional hazards regression were used to evaluate the aspect on the postoperative complications and long-term prognosis. ResultsThe patients in EZ-ALBI grade 2 had higher incidences of severe complication (Clavein-Dindo classification>2, P=0.001), post-hepatectomy liver failure (P=0.040), length of stay>10 d (P<0.001), perioperative transfusion (P<0.001), and 90 d mortality (P<0.001). The 1-, 3- and 5-year cumulative survival rates in EZ-ALBI grade 1 group were 85.5%, 67.0%, and 58.7% while in EZ-ALBI grade 2 group were 72.7%, 51.1%, and 39.8%. Multivariate Cox proportional hazards regression manifested that patients in EZ-ALBI grade 2 had a significantly worse overall survival [HR=1.24, 95%CI (1.04, 1.48), P=0.015]. ConclusionThe EZ-ALBI score is an easy and feasible classifying method to predict postoperative complications and survival of HCC.
Objective
To measure the concentration of serum transthyretin (TTR) of patients with different stages of diabetic retinopathy (DR).
Methods
A total of 176 patients with diabetes mellitus were included in this study. There were 104 males and 72 females. The patients aged from 21 to 74 years, with the mean age of (56±11) years. The diabetes duration raged from 1 to 30 years, with the mean diabetes duration of (10±7) years. The HbA1C was 5.2%?14.1%, with the mean HbA1C of (8.6±2.0)%. According to the fundus examination, 58 patients had DR (33.0%), but the other 118 patients not (67.0%). For these DR patients, 10 patients were in stage Ⅰ (5.7%), 26 patients in stage Ⅱ (14.8%), 8 patients in stage Ⅲ (4.5%), and 14 patients in stage Ⅳ (8.0%). The concentration of serum TTR was measured by enzyme-linked immunosorbentassay kit. The differences in the concentration of serum TTR between different DR stages were compared.Bivariate analysis was used to analyze the influencing factors of TTR.
Results
The concentrations of serum TTR of the patients without DR or with DR of stage Ⅰ to Ⅳ were (224.96±65.47), (383.68±102.99), (247.44±63.21), (228.2±45.89), (189.34±70.12) mg/L, respectively. The difference between different DR stages was statistically significant (F=14.690,P＜0.001).Bivariate analysis showed that the concentration of TTR was correlation to DR (r=0.179,P=0.017). There was no correlation between the concentration of TTR and diabetes duration (r=?0.027,P=0.727), hypertension (r=0.018,P=0.810), hyperlipoidemia (r=0.101,P=0.182), and the use of insulin (r=?0.032,P=0.675).
Conclusion
The concentration of serum TTR was increased in early DR patients, and gradually decreased with the progression of DR. The concentration of TTR is correlated to DR.
ObjectiveTo investigate the effect of maresin-1 (MaR1) on lung inflammation and MAPK signaling pathway in asthmatic mice.MethodsTwenty-four female BALB/c mice were randomly divided into normal group, asthma model group, MaR1 group and dexamethasone group. The asthma model was successfully established by using ovalbumin (OVA) combined with aluminum hydroxide, and then MaR1 and dexamethasone were respectively given to asthmatic mice. Serum, bronchoalveolar lavage fluid (BALF) and lung tissue were collected for further analysis. Pathological changes of lung tissue in mice were detected by hematoxylin-eosin and periodic acid-Schi?. Proportion of inflammatory cells in BALF classified by Swiss-Giemsa staining. Th2-related inflammatory cytokines, interleukin (IL)-4, IL-5, IL-13 and IgE in serum and BALF were detected by enzyme linked immunosorbent assay. The protein concentration of p-p38 and p-JNK in lung tissues were detected by Western blot.ResultsCompared with the normal group, the asthma model group had increased both airway inflammation and the number of goblet cells significantly (P<0.05). The number of various inflammatory cells in BALF had also increased significantly (P<0.05). The levels of IL-4, IL-5 and IL-13 in BALF and IgE and OVA-specific-IgE in serum were significantly increased (P<0.05). The protein contents of p-p38 and p-JNK in lung tissues were significantly increased (P<0.05). Compared with the asthma model group, both MaR1 and dexamethasone group had reduced inflammation and mucus secretion in lung tissue, number of inflammatory cells in BALF (P<0.05), levels of related inflammatory cytokines in BALF and IgE in serum (P<0.05), and expression of p-p38 and p-JNK proteins in lung tissue (P<0.05).ConclusionsMaR1 can inhibit the production and release of both Th2-related inflammatory cytokines and IgE, effectively reduce the inflammatory response and mucus production in lung tissues of asthmatic mice, with similar effect to dexamethasone. The mechanism may be related to the down-regulation of MAPKs signaling pathway.
ObjectiveTo systematically evaluate the potential value of C-reactive protein to albumin ratio (CAR) as an indicator of prognosis and survival in patients with pancreatic cancer. MethodsThe literatures were searched comprehensively in the PubMed, Embase, Web of Science, Cochrane Library, CBM, Wanfang, CNKI, and CQVIP databases from the establishment of the databases to May 20, 2021. The combined hazard ratio (HR) and 95% confidence interval (95%CI) were used to evaluate the correlation between the CAR and the overall survival (OS), progression-free survival (PFS), or disease-free survival (DFS) in the patients with pancreatic cancer. The Newcastle-Ottawa scale (NOS) was used to evaluate the quality of the non-randomized controlled studies, and the Stata SE 15.0 software was used for meta-analysis. ResultsA total of 2 985 patients with pancreatic cancer were included in this meta-analysis of 15 studies. The results of meta-analysis showed that the higher CAR value, the shorter OS [effect size (ES)=0.60, 95%CI (0.50, 0.69), Z=12.04, P<0.001], DFS [ES=0.63, 95%CI (0.47, 0.78), Z=3.61, P<0.001], and PFS [ES=0.41, 95%CI (0.19, 0.63), Z=7.91, P<0.001] in the patients with pancreatic cancer. The results of subgroup analysis of OS according to different countries, sample size, mean age, follow-up time, CAR cut-off value, and NOS score showed that the higher CAR value was related to the shorter OS (P<0.05). The result of linear regression analysis showed that there was no correlation between the CAR cut-off value and lnHR of OS (r2=0.947, P=0.455). Conclusion From results of this study, CAR is closely related to OS of patients, and it is expected to be used as a new reference index for monitoring and judging prognosis of patients with pancreatic cancer.
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.
ObjectiveTo explore the changes of plasma prealbumin (PA), homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) levels before and after treatment in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and analyze the correlation of PA and Hcy with hs-CRP and body mass index (BMI).MethodsA total of 132 hospitalized AECOPD patients with GOLD lung function as grade III-IV were recruited as an experimental group and 45 healthy subjects as a control group. The levels of plasma PA, Hcy and hs-CRP were measured by automatic biochemical analyzer, and the main indexes of pulmonary function were determined in all subjects.ResultsCompared with the control group, the level of plasma PA before and after treatment in the experimental group decreased significantly [(146.49±36.53) mg/L and (219.60±41.29) mg/L vs. (269.48±42.63) mg/L], the level of plasma Hcy before and after treatment increased significantly [(16.44±5.21) μmol/L and (12.61±4.56) μmol /L vs. (10.13±3.25) μmol/L], and the levels of plasma hs-CRP before and after treatment increased significantly [(45.24±29.94) mg/L and (7.71±3.41) mg/L vs. (5.01±1.52) mg/L] (all P<0.05). The levels of plasma PA, Hcy and hs-CRP after treatment were significantly better than before treatment in the experimental group (allP<0.01). The plasma PA values before and after treatment were negatively correlated with the level of hs-CRP before and after treatment, and positively correlated with BMI (bothP<0.05).ConclusionsThe levels of plasma PA, Hcy and hs-CRP are significantly different before and after the treatment in AECOPD patients and the healthy controls. PA is negatively correlated with hs-CRP and positively correlated with BMI. The detection of plasma PA and Hcy can help to determine the condition and efficacy of patients with COPD, and PA can reflect the level of inflammation and nutritional status to a certain extent.
Objective To evaluate the predictive value of CURB-65 score combined with blood urea nitrogen to albumin ratio (B/A) for intensive care unit (ICU) admission and death in adults with community-acquired pneumonia (CAP). Methods A retrospective analysis was performed on 523 patients with CAP hospitalized in the Second Affiliated Hospital of Kunming Medical University from January 2018 to January 2022. According to whether the patients were admitted to ICU, they were divided into an ICU group (n=36) and a general ward group (n=487). The patients were divided into a death group (n=45) and a non-death group (n=478) according to the death situation during hospitalization. Basic data (age, gender, history of underlying diseases, etc.), hospital stay, antibiotic use days, CURB-65 score, white blood cell count (WBC), neutrophil count (NEUT), procalcitonin (PCT), C-reactive protein (CRP), serum albumin (Alb), blood urea nitrogen (BUN), and BUN to Alb ratio (B/A) of the two groups were compared respectively. Receiver operating characteristic (ROC) curve were plotted to evaluate the predictive value of CURB-65 score, B/A, and their combination for death during ICU admission and hospitalization in patients with CAP. Logistic regression was used to analyze risk factors for in-hospital death in the patients with CAP. Results The number of days in hospital, the number of days of antibiotic use, the number of deaths during hospitalization, the proportion of hypertension, diabetes, CURB-65 score, WBC, NEUT, PCT, CRP, BUN and B/A in the ICU group were significantly higher than those in the general ward group. Age, male, combined hypertension, diabetes, coronary heart disease, ICU admission, CURB-65 score, WBC, NEUT, PCT, CRP, BUN and B/A in the death group were significantly higher than those in the non-death group, and Alb in the ICU group and the death group were significantly lower (all P<0.05). Correlation analysis showed that B/A was positively correlated with PCT, CRP, WBC, NEUT and CURB-65 scores (correlation coefficient r values were 0.486, 0.291, 0.260, 0.310, 0.666, all P<0.001). The area under ROC curve of CURB-65 combined with B/A to predict ICU admission and death of CAP patients was 0.862 (95%CI 0.807 - 0.918, sensitivity 91.7%, specificity 66.4%) and 0.908 (95%CI 0.864 - 0.952, sensitivity 93.3%, specificity 75.7%), respectively. Multivariate logistic regression analysis showed that diabetes, high CURB-65 score, low Alb level and B/A≥4.755 mg/g were independent risk factors for death of CAP patients during hospitalization (P<0.05). Conclusions There is a significant correlation between elevated B/A and ICU demand and mortality in CAP patients. Combined use can improve the predictive value of CURB-65 score for ICU admission and mortality in CAP patients.
ObjectiveTo discuss the relationship between microalbuminuria (MAU) and antioxidant activity of plasma hyper density lipoprotein (HDL) in hypertensive patients, and investigate whether MAU could be a predictor of HDL antioxidant activity.
MethodFrom December 2007 to March 2009, sixty consecutive primary hypertensive patients from the inpatient and outpatient departments of West China Hospital and Sichuan Electric Power Central Hospital were included in the study, and 30 healthy volunteers served as controls. MAU, plasma HDL and paraoxonase (PON1) activity were tested.
ResultsPON1 activity was lower in hypertensive patients than the controls (P<0.05), and this degree of decline was positively related to MAU (P<0.05).
ConclusionMAU reflects PON1 activity in hypertensive patients and can be a predictor to judge plasma HDL function in patients with hypertension.
