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.
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.
ObjectiveTo observe and evaluate the predictive value of serum cystatin C (Cys-C) on the risk of sight-threatening diabetic retinopathy (STDR). MethodsA non-randomized controlled cross-sectional clinical study. Ninety-two patients with type 2 diabetes mellitus (T2DM) who were admitted to Department of Ophthalmology of Beijing Tsinghua Changgung Hospital from January 2022 to October 2022 were included in the study. Among them, 50 were male, 42 cases were female, with the mean age of (58.24±12.49) years. The mean duration of T2DM was (13.18±8.35) years, of which 38 cases had a duration of ≥10 years. Twenty-nine cases complicated with hypertension, of which 16 cases had a duration of ≥10 years. Seventeen cases complicated with chronic kidney disease stage 2 and 23 cases were treated with lipid-lowering drugs. Hemoglobin Alc, serum Cys-C, serum lipids and renal function were tested, and urinary microalbumin/creatinine ratio (ACR) was calculated. According to the 2003 American Academy of Ophthalmology "Clinical Guidelines for Diabetic Retinopathy (DR)" and international clinical DR severity grading standards, the patients were divided into STDR and non-STDR groups, with 44 and 48 cases in each group, respectively. STDR was defined as severe non-proliferative DR, proliferative DR, and macular edema. Logistic regression was used to analyze the independent risk factors of STDR in T2DM patients. Receiver operating characteristic curve (ROC curve) was used to calculate and analyze the area under ROC curve (AUC) and the predictive value of serum Cys-C and ACR in predicting STDR in T2DM patients. ResultsSerum Cys-C levels in STDR and non-STDR groups were 1.10 (0.94, 1.28) and 0.91 (0.83, 1.02) mg/L, respectively, with ACR of 4.29 (1.05, 21.89) and 1.39 (0.77, 3.80) mg/mmol, respectively. Compared with non-STDR group, serum Cys-C and ACR in STDR group were higher, and the difference was statistically significant (Z=－3.984, －3.280; P＜0.05). Multivariate logistic regression analysis showed that serum Cys-C was an independent risk factor for STDR (odds ratio=1.337, 95% confidence interval 1.145-2.090, P=0.033), and the risk of STDR increased by 33.7% for every 0.1 mg/L increase in serum Cys-C. ROC analysis results showed that serum Cys-C＞1.065 mg/L combined with ACR＞5.84 mg/mmol predicted the AUC of STDR in T2DM patients was 0.661, with the specificity of 95.8%. ConclusionsThe high serum Cys-C level is an independent risk factor for STDR in T2DM patients. Serum Cys-C has high predictive value for the occurrence of STDR.
Understanding the mass transfer behaviors in hollow fiber membrane module of artificial liver is important for improving toxin removal efficiency. A three-dimensional numerical model was established to study the mass transfer of small molecule bilirubin and macromolecule bovine serum albumin (BSA) in the hollow fiber membrane module. Effects of tube-side flow rate, shell-side flow rate, and hollow fiber length on the mass transfer of bilirubin and BSA were discussed. The simulation results showed that the clearance of bilirubin was significantly affected by both convective and diffusive solute transport, while the clearance of macromolecule BSA was dominated by convective solute transport. The clearance rates of bilirubin and BSA increasd with the increase of tube-side flow rate and hollow fiber length. With the increase of shell-side flow rate, the clearance rate of bilirubin first rose rapidly, then slowly rose to an asymptotic value, while the clearance rate of BSA gradually decreased. The results can provide help for designing structures of hollow fiber membrane module and operation parameters of clinical treatment.
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.
摘要:目的: 研究尿微量白蛋白與冠心病的相關性。 方法 : 按冠狀動脈造影診斷標準將116例患者分為冠心病組(82人) 與非冠心病組(34人),測定晨尿白蛋白/ 肌酐濃度值(ACR),比較兩組患者尿ACR 并分析ACR與冠脈病變程度的相關性。 結果 : 冠心病組ACR顯著高于非冠心病組的; ACR與冠脈計分呈顯著的直線正相關。 結論 :冠心病患者ACR水平升高,微量白蛋白尿與冠狀動脈病變范圍和程度密切相關, 且對冠狀動脈狹窄程度具有獨立預測價值。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.
ObjectiveTo investigate the predictive value of the preoperative peripheral blood neutrophil percentage-to-albumin ratio (NPAR) for survival after radical resection of hepatocellular carcinoma (HCC) and to construct a nomogram prediction model based on NPAR. MethodsAccording to inclusion and exclusion criteria, the HCC patients with China Liver Cancer Staging (CNLC) stage Ⅰa–Ⅱa who underwent radical hepatectomy at West China Hospital of Sichuan University from January 2010 to December 2020 were retrospectively collected and then randomly divided into a training set and a validation set with a 7∶3 ratio. The optimal cutoff value for NPAR was determined using X-tile. Cox proportional hazards regression model was used to identify the independent risk factors for overall survival (OS) in HCC patients and then construct a nomogram model. The predictive performance of the model was evaluated using the C-index, receiver operating characteristic (ROC) curve, and calibration curve, as well as validated in the validation set. ResultsA total of 3 423 HCC patients with CNLC stage Ⅰa–Ⅱa were enrolled in this study, with 2 397 in the training set and 1 026 in the validation set. There were no statistically significant differences in baseline characteristics between the training and validation sets (P>0.05). The optimal cutoff value for NPAR was 17.0, and patients with NPAR ≤17.0 (2 124 cases) had significantly better OS and relapse-free survival (RFS) than those with NPAR>17.0 (273 cases). The multivariate Cox proportional hazards regression model analysis showed that the alpha-fetal protein>400 μg/L, NPAR>17.0, multiple tumors, tumor diameter >5 cm, poor tumor differentiation, capsular invasion, microvascular invasion, and satellite lesions were the independent risk factors affecting postoperative OS in HCC patients (RR>1, P<0.05). The nomogram constructed based on these risk factors demonstrated good discriminations for OS and RFS (C-indexes of 0.708 and 0.709, respectively) and predictive performance in both the training and validation sets. ConclusionsPreoperative high NPAR (>17.0) in HCC patients with CNLC Ⅰa–Ⅱa stages is associated with significantly worse OS compared to those with low NPAR (≤17.0). The nomogram prediction model based on NPAR can effectively predict postoperative survival.
Objective To investigate the risk factors of high peritoneal transport characteristics in patients with end-stage renal disease undergoing initial continuous ambulatory peritoneal dialysis. Method The clinical data of continuous ambulatory peritoneal dialysis patients who underwent initial peritoneal dialysis and catheterization in the Department of Nephrology, West China Hospital of Sichuan University from January 2011 to December 2017 and completed the peritoneal equilibration test were collected retrospectively. According to the ratio of dialysate to plasma ratio for creatinine at 4 hour [D/Pcr (4h)] in the standard peritoneal equilibration test, the patients were divided into 4 groups (low transport, low average transport, high average transport and high transport). Spearman correlation analysis was used to analyze the related factors of D/Pcr (4h). The risk factors of high peritoneal transport characteristics were analyzed by ordered multi classification logistic regression. Results A total of 647 patients were included. The average age of the patients was (45.85±14.03) years, and the average D/Pcr (4h) was 0.67±0.12. Among them, there were 89 cases (13.76%) in the high transport group, 280 cases (43.28%) in the high average transport group, 234 cases (36.17%) in the low average transport group and 44 cases (6.80%) in the low transport group. Diabetic patients with D/Pcr (4h) were higher than those without diabetes mellitus (0.72±0.12 vs. 0.66±0.12; t=?4.005, P<0.001). Correlation analysis showed that age and 24-h urine volume were positively correlated with D/Pcr (4h); serum albumin, triglyceride, potassium, calcium, magnesium, phosphorus, hemoglobin, serum uric acid and creatinine were negatively correlated with D/Pcr (4h); body surface area (BSA), high sensitivity C-reactive protein, ferritin, cholesterol, sodium, intact parathyroid hormone and estimated giomerular filtration rate had no correlation with D/Pcr (4h). Regression analysis showed that serum albumin [odds ratio (OR)=0.842, 95% confidence interval (CI) (0.809, 0.877), P<0.001], serum uric acid [OR=0.996, 95%CI (0.994, 0.998), P<0.001], magnesium [OR=0.389, 95%CI (0.156, 0.965), P=0.042], BSA [OR=3.916, 95%CI (1.121, 13.680), P=0.032] were correlated with the incidence of peritoneal high transport characteristics. Conclusion Low serum albumin, high BSA, low magnesium and low serum uric acid were independent risk factors for high transport characteristics in initial PD patients.
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.
ObjectiveTo explore the clinical value of fibrinogen-albumin-ratio (FAR) in adult extracorporeal membrane oxygenation (ECMO) hemorrhage. MethodsThe clinical data of adult patients receiving ECMO in the West China Hospital from 2018 to 2020 were analyzed retrospectively. Patients were divided into a bleeding group and a non-bleeding group based on whether they experienced bleeding after ECMO. Logistic regression analysis was used to study the relationship between FAR and bleeding, as well as risk factors for death. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to analyze the predictive ability of FAR. According to the optimal cut-off value of FAR for predicting hemorrhage, patients were divided into a high-risk group and a low-risk group, and the occurrence of bleeding was compared between the two groups. ResultsA total of 125 patients were enrolled in this study, including 85 males and 40 females, aged 46.00 (31.50, 55.50) years. Among them, 58 patients received veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and 67 patients received veno-venous extracorporeal membrane oxygenation (VV-ECMO). There were 49 patients having bleeding, and the lactate level was higher (P=0.026), the platelet count before ECMO initiation and 24 h after ECMO initiation was lower (P=0.031, 0.020), the fibrinogen level 24 h after ECMO initiation was lower (P=0.049), and the proportion of myocarditis patients was higher (P=0.017) in the bleeding group than those of the non-bleeding group. In the subgroup analysis of ECMO mode, the higher D-Dimer, lactate level and lower FAR before and 24 h after ECMO initiation were associated with bleeding in the VA-ECMO group (P=0.017, 0.011, 0.033, 0.005). The 24 h FAR was independently correlated with bleeding (P=0.048), and AUC was 0.714. The cut-off value was 55.73. According to this optimal cut-off value, 25 patients were divided into the high-risk group (≤55.73) and 33 into the low-risk group (>55.73). There was a higher incidence of bleeding in the high-risk group compared to the low-risk group (unadjusted P=0.002; P=0.013 for multivariable adjustment). In the VV-ECMO group, the relationship between FAR and bleeding events was not significant (P>0.05). ConclusionLow 24 h FAR is an independent risk factor for bleeding in VA-ECMO patients, and the diagnostic cut-off value is 55.73.
