Prognostic value of preoperative fibrinogen to albumin ratio in predicting postoperative outcomes in patients with gallbladder cancer

BACKGROUND Gallbladder cancer(GBC)is known for its poor prognosis and challenging management.The preoperative fibrinogen to albumin ratio(FAR)has been proposed as a potential prognostic marker for predicting postoperative outcomes in GBC patients,but its efficacy and prognostic value remain underexplored.AIM To evaluate the prognostic value of preoperative FAR in GBC outcomes.METHODS This retrospective cohort study included 66 patients who underwent curative surgery for GBC at our institution from January 2018 to January 2022.Preoperative FAR values were obtained within one week prior to surgery.Patients were followed through outpatient visits or telephone interviews,with overall survival(OS)as the primary endpoint.Statistical analyses,including receiver operating characteristic curve analysis and Kaplan-Meier survival estimates,were performed using SPSS software(version 27.0).RESULTS The cohort consisted of 36 male and 30 female patients,with a mean age of 61.81±8.58 years.The optimal FAR cut-off value was determined to be 0.088,with an area under the receiver operating characteristic curve of 0.7899,sensitivity of 68.96%,and specificity of 80.01%.Patients with FAR≤0.088 showed significantly better survival rates(1-year:60.5%,2-year:52.6%,3-year:25.9%)and a median OS of 25.6 months(95%confidence interval:18.8-30.5 months),compared to those with FAR>0.088 who had a median OS of 10.8 months(95%confidence interval:6.3-12.9 months).CONCLUSION Lower preoperative FAR is associated with longer OS in GBC patients,confirming its potential as a valuable prognostic indicator for improving outcome predictions and guiding patient management strategies in gallbladder cancer.

Red cell distribution width-to-albumin ratio is a simple promising prognostic marker in acute cholangitis requiring biliary drainage

Background: It is crucial to assess the severity of acute cholangitis(AC). There are currently several prognostic markers. However, the accuracies of these markers are not satisfied. The present study aimed to investigate the predictive value of the red cell distribution width(RDW)-to-albumin ratio(RAR) for the prognosis of AC. Methods: We retrospectively evaluated consecutive patients diagnosed with AC between May 2019 and March 2022. RAR was calculated, and its predictive ability for in-hospital mortality, intensive care unit(ICU) admission, bacteremia, and the length of hospitalization were analyzed. Results: Out of 438 patients, 34(7.8%) died. Multivariate analysis showed that malignant etiology [odds ratio(OR) = 4.816, 95% confidence interval(CI): 1.936-11.980], creatinine(OR = 1.649, 95% CI: 1.095-2.484), and RAR(OR = 2.064, 95% CI: 1.494-2.851) were independent risk factors for mortality. When adjusted for relevant covariates, including age, sex, malignant etiology, Tokyo severity grading(TSG), Charlson comorbidity index, and creatinine, RAR significantly predicted mortality(adjusted OR = 1.833, 95% CI: 1.280-2.624). When the cut-off of RAR was set to 3.8, its sensitivity and specificity for mortality were 94.1% and 56.7%, respectively. Patients with an RAR of > 3.8 had a 20.9-fold(OR = 20.9, 95% CI: 4.9-88.6) greater risk of mortality than the remaining patients. The area under the curve value of RAR for mortality was 0.835(95% CI: 0.770-0.901), which was significantly higher than that of TSG and the other prognostic markers, such as C-reactive protein-to-albumin ratio, and procalcitonin-to-albumin ratio. Lastly, RAR was not inferior to TSG in predicting ICU admission, bacteremia, and the length of hospitalization. Conclusions: RAR successfully predicted the in-hospital mortality, ICU admission, bacteremia, and the length of hospitalization of patients with AC, especially in-hospital mortality. RAR is a promising marker that is more convenient than TSG and other prognostic markers for predicting the prognosis of patients with AC.

Epicatechin attenuates lead(Pb)-induced cognitive impairment in mice:regulation on Nrf2 signaling pathway,and interference on the interaction between Pb with albumin

Epicatechin(EC)was used in this study to antagonize the cognitive dysfunction caused by lead(Pb)exposure in mice.Eight-week-old male Kunming mice were treated with PbCl_(2)(20 mg/kg)and/or EC(50 mg/kg)by gavage administration for 4 weeks.Morris water maze test showed that EC could improve memory dysfunction induced by Pb.EC antagonized Ca^(2+)overload,activated Nrf2 signaling pathway and reduced the accumulation of Pb in the brain and serum,which suggested that EC might alter Pb distribution in mice.In vitro,spectroscopic analysis,potentiometric titration and docking studies were applied to inquiry into the interaction between bovine serum albumin(BSA)and Pb^(2+)in presence or absence of EC.EC was proved to chelate Pb^(2+)and reduced the interaction between BSA and Pb^(2+).In summary,EC might protect Pb-induced cognitive impairment by activating Nrf2 signaling pathway,and suppressing Pb accumulation via interference on the binding of Pb to albumin.

Combined preoperative albumin bilirubin score and hepatectomy percentage for evaluate the liver regeneration after partial hepatectomy

Surgical resection is a pivotal therapeutic approach for addressing hepatic space-occupying lesions,with liver volume restoration and hepatic functional recovery being crucial for assessing surgical prognosis.The preoperative albumin-bilirubin(ALBI)score,encompassing serum albumin and bilirubin levels,can be determined via blood analysis,effectively mitigating human error and providing an accurate depiction of liver function.The hepatectomy ratio,which is the proportion of the liver volume removed to the total liver volume,is critical in preserving an adequate liver tissue volume to ensure postoperative hepatic functional compensation,minimize surgical complications,and reduce mortality rates.Incorporating the preoperative ALBI score and hepatectomy ratio aids surgeons in assessing the optimal timing and extent of partial hepatectomy.The introduction of preoperative albumin bilirubin score and hepatectomy percentage is beneficial for the surgeons to evaluate the timing and magnitude of partial liver resection.

Combining systemic inflammatory response index and albumin fibrinogen ratio to predict early serious complications and prognosis after resectable gastric cancer

BACKGROUND Gastric cancer has a high incidence and fatality rate,and surgery is the preferred course of treatment.Nonetheless,patient survival rates are still low,and the incidence of major postoperative complications cannot be disregarded.The systemic inflammatory response,nutritional level,and coagulation status are key factors affecting the postoperative recovery and prognosis of gastric cancer patients.The systemic inflammatory response index(SIRI)and the albumin fibrinogen ratio(AFR)are two valuable comprehensive indicators of the severity and prognosis of systemic inflammation in various medical conditions.AIM To assess the clinical importance and prognostic significance of the SIRI scores and the AFR on early postoperative outcomes in patients undergoing radical gastric cancer surgery.METHODS We conducted a retrospective analysis of the clinicopathological characteristics and relevant laboratory indices of 568 gastric cancer patients from January 2018 to December 2019.We calculated and compared two indicators of inflammation and then examined the diagnostic ability of combined SIRI and AFR values for serious early postoperative complications.We scored the patients and categorized them into three groups based on their SIRI and AFR levels.COX analysis was used to compare the three groups of patients the prognostic value of various preoperative SIRI-AFR scores for 5-year overall survival(OS)and disease-free survival(DFS).RESULTS SIRI-AFR scores were an independent risk factor for prognosis[OS:P=0.004;hazards ratio(HR)=3.134;DFS:P<0.001;HR=3.543]and had the highest diagnostic power(area under the curve:0.779;95%confidence interval:0.737-0.820)for early serious complications in patients with gastric cancer.The tumor-node-metastasis stage(P=0.001),perioperative transfusion(P=0.044),positive carcinoembryonic antigen(P=0.014)findings,and major postoperative complications(P=0.011)were factors associated with prognosis.CONCLUSION Preoperative SIRI and AFR values were significantly associated with early postoperative survival and the occurrence of severe complications in gastric cancer patients.

Circulating glycated albumin levels and gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)is characterized by glucose intolerance that is first diagnosed during pregnancy,making it the most common complication associated with this period.Early detection and targeted treatment of GDM can minimize foetal exposure to maternal hyperglycaemia and subsequently reduce the associated adverse pregnancy outcomes.Previous studies have inconsistently suggested that the level of glycated albumin(GA)might predict GDM.AIM To review and synthesize existing evidence to evaluate the relationship between GA levels and the development of GDM.METHODS We sought to compare GA levels between GDM and control groups in this metaanalysis by systematically searching the Web of Science,PubMed,Cochrane Library,and Embase databases for articles published up to June 2023.The analysis utilized the weighted mean difference(WMD)as the primary metric.The data were meticulously extracted,and the quality of the included studies was assessed.Additionally,we conducted a subgroup analysis based on study region and sample size.We assessed heterogeneity using I2 statistics and evaluated publication bias through funnel plots.Additionally,trim-and-fill analysis was employed to detect and address any potential publication bias.RESULTS The meta-analysis included a total of 11 studies involving 5477 participants,comprising 1900 patients with GDM and 3577 control individuals.The synthesized results revealed a notable correlation between elevated GA levels and increased susceptibility to GDM.The calculated WMD was 0.42,with a 95%confidence interval(95%CI)ranging from 0.11 to 0.74,yielding a P value less than 0.001.Concerning specific GA levels,the mean GA level in the GDM group was 12.6,while for the control group,it was lower,at 11.6.This discrepancy underscores the potential of GA as a biomarker for assessing GDM risk.Moreover,we explored the levels of glycated haemoglobin(HbA1c)in both cohorts.The WMD for HbA1c was 0.19,with a 95%CI ranging from 0.15 to 0.22 and a P value less than 0.001.This observation suggested that both GA and HbA1c levels were elevated in individuals in the GDM group compared to those in the control group.CONCLUSION Our meta-analysis revealed a substantial correlation between elevated GA levels and increased GDM risk.Furthermore,our findings revealed elevated levels of HbA1c in GDM patients,emphasizing the significance of monitoring both GA and HbA1c levels for early GDM detection and effective management.

Preoperative Serum Albumin Levels and Postoperative Acute Kidney Injury in Off-Pump Coronary Artery Bypass Surgery: A Single-Center Study in Bangladesh

Background: Serum albumin, a vital plasma protein, helps maintain intravascular colloidal osmotic pressure, cardiac output, and renal function. Low preoperative serum albumin is linked to poor outcomes, including acute kidney injury (AKI), after off-pump coronary artery bypass (OPCAB) surgery. This study aimed to assess the relationship between preoperative serum albumin levels and early postoperative renal injury. Methods: This prospective comparative cross-sectional study was conducted from August 2019 to February 2021 at the National Heart Foundation Hospital & Research Institute, Bangladesh. It included 160 adult patients with normal preoperative renal function undergoing OPCAB. Patients were divided into two groups: Group A (serum albumin ≥ 4.0 gm/dl) and Group B (serum albumin Results: Preoperative serum albumin was significantly different between groups (Group A: 4.21 ± 0.05 gm/dl, Group B: 3.69 ± 0.04 gm/dl, p = 0.028). Group B had a higher incidence of hypertension (71.25% vs. 51.25%, p st and 3rd postoperative days were higher in Group B (p th day. Postoperative AKI occurred in 18.75% of Group A and 36.25% of Group B. Multivariate regression indicated that low preoperative serum albumin is an independent risk factor for postoperative AKI (p = 0.012, OR = 1.815, CI: 0.675 - 1.162). Conclusion: Preoperative serum albumin level is a valuable predictor of postoperative renal function. Ensuring high normal serum albumin levels before surgery can help minimize the risk of postoperative AKI.

The Use of Glycated Albumin in the Diagnosis of Gestational Diabetes Mellitus

Gestational diabetes mellitus is the most common endocrine disorder in pregnancy and a cause of maternal and fetal morbidities and mortalities. The oral glucose tolerance test is the gold standard for diagnosing gestational diabetes mellitus. Nevertheless, the oral glucose tolerance test is time-consuming and requires patient preparation. On the contrary, Glycated albumin does not require patient preparation or administration of any substance. Most studies on glycated albumin in pregnancy were among the non-African population, and black Americans have higher glycated albumin levels than Caucasians. This study determined the use of glycated albumin in diagnosing gestational diabetes mellitus among pregnant women. The study was a prospective study of 160 pregnant women between 24 and 28 weeks of gestation at the University of Port Harcourt Teaching Hospital. The diagnosis of gestational diabetes mellitus was based on the World Health Organization 2013 criteria. The diagnostic value of glycated albumin was determined using the area under the receiver operator characteristic curve. The prevalence of gestational diabetes mellitus was 9.4% and the mean glycated albumin was 16.91% (±2.77). The area under the receiver operator characteristic curve for glycated albumin was 0.845 (95% CI 0.733 - 0.956;p = 0.0001). The optimal cut-off value of glycated albumin in the diagnosis of gestational diabetes mellitus was 18.9%. Glycated albumin was useful in the diagnosis of gestational diabetes mellitus at 24 to 28 weeks of gestation.

C-reactive protein to albumin ratio predict responses to programmed cell death-1 inhibitors in hepatocellular carcinoma patients

BACKGROUND Over the years,programmed cell death-1(PD-1)inhibitors have been routinely used for hepatocellular carcinoma(HCC)treatment and yielded improved survival outcomes.Nonetheless,significant heterogeneity surrounds the outcomes of most studies.Therefore,it is critical to search for biomarkers that predict the efficacy of PD-1 inhibitors in patients with HCC.AIM To investigate the role of the C-reactive protein to albumin ratio(CAR)in evaluating the efficacy of PD-1 inhibitors for HCC.METHODS The clinical data of 160 patients with HCC treated with PD-1 inhibitors from January 2018 to November 2022 at the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed.RESULTS The optimal cut-off value for CAR based on progression-free survival(PFS)was determined to be 1.20 using x-tile software.Cox proportional risk model was used to determine the factors affecting prognosis.Eastern Cooperative Oncology Group performance status[hazard ratio(HR)=1.754,95%confidence interval(95%CI)=1.045-2.944,P=0.033],CAR(HR=2.118,95%CI=1.057-4.243,P=0.034)and tumor number(HR=2.932,95%CI=1.246-6.897,P=0.014)were independent prognostic factors for overall survival.CAR(HR=2.730,95%CI=1.502-4.961,P=0.001),tumor number(HR=1.584,95%CI=1.003-2.500,P=0.048)and neutrophil to lymphocyte ratio(HR=1.120,95%CI=1.022-1.228,P=0.015)were independent prognostic factors for PFS.Two nomograms were constructed based on independent prognostic factors.The C-index index and calibration plots confirmed that the nomogram is a reliable risk prediction tool.The ROC curve and decision curve analysis confirmed that the nomogram has a good predictive effect as well as a net clinical benefit.CONCLUSION Overall,we reveal that the CAR is a potential predictor of short-and long-term prognosis in patients with HCC treated with PD-1 inhibitors.If further verified,CAR-based nomogram may increase the number of markers that predict individualized prognosis.

SII、CRP/Alb及D-二聚体对PD-1抑制剂联合化疗的晚期非小细胞肺癌患者预后的评估价值

目的探究外周血免疫炎症指数(systemic immune inflammation index,SII)、CRP/Alb及D二聚体(D-Dimer)对接受PD-1抑制剂(PD-1 inhibitors)联合化疗治疗的Ⅲ期~Ⅳ期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的预后评估价值。方法收集安徽医科大学附属安庆第一人民医院呼吸与危重症医学科2021年1月1日至2023年10月20日接受两个及以上周期PD-1抑制剂联合化疗Ⅲ期~Ⅳ期的88例NSCLC患者,对其临床资料进行回顾性分析,使用ROC曲线确定SII、CRP/Alb及D-二聚体的最佳截断值,Kaplan-Meier法绘制生存曲线,比较不同SII、CRP/Alb及D-二聚体水平对客观缓解率(objective response rate,ORR)、疾病控制率(disease control rate,DCR)及中位无进展生存期(median progression-free survival,mPFS)的影响,并分析mPFS的影响因素。结果入组的Ⅲ期~Ⅳ期NSCLC患者,SII最佳截断值为484.78,高、低SII组患者的肿瘤分期、ECOG-PS评分比较,差异有统计学意义(P均<0.05);CRP/Alb最佳截断值为0.08,高、低CRP/Alb组患者的ECOG-PS评分、疗效比较,差异有统计学意义(P均<0.05);D-二聚体最佳截断值为1.71mg/L,高、低D-二聚体组患者的ECOG-PS评分比较,差异有统计学意义(P均<0.05)。高CRP/Alb组患者的ORR和DCR均低于低CRP/Alb组患者,差异有统计学意义(P均<0.05),高SII组、高CRP/Alb组和高D-二聚体组患者的mPFS均低于低SII组、低CRP/Alb组和低D-二聚体组患者,差异有统计学意义(P均<0.05)。多因素Cox回归分析结果显示,高SII、高CRP/Alb和高D-二聚体是接受PD-1抑制剂联合化疗的Ⅲ期~Ⅳ期NSCLC患者预后不良的预测因素。结论高SII、高CRP/Alb和高D-二聚体与晚期NSCLC患者缩短的mPFS相关,其可能是晚期NSCLC患者接受PD-1抑制剂联合化疗潜在有价值的预后危险因素;而高CRP/Alb与近期疗效较差独立相关,可作为判断晚期NSCLC患者接受PD-1抑制剂联合化疗治疗近期疗效的炎性指标。

The Effectiveness of Albumin Combined with Diuretics in Treating Ascites in Cirrhosis

Cirrhosis often leads to various complications during its progression,with ascites being one of the most common.Among these cases,5%to 10%are classified as refractory ascites.In recent years,clinical research on the treatment of cirrhotic ascites has yielded increasingly enriched results.In this paper,a large number of clinical data on the treatment of ascites using albumin combined with diuretics were collected,and it was found that there were more results in group control studies.It was believed that albumin combined with diuretic therapy could effectively improve symptoms,reduce the occurrence of adverse reactions,ensure the safety of patients,and have a good clinical application prospect.This paper reviews the efficacy of albumin combined with diuretics in the treatment of ascites in cirrhosis.

Study on the Clinical Application of Nutritional Management Combined with Clinical Monitoring of Glycated Albumin in Diabetic Nephropathy Dialysis Patients

Objective:To explore the clinical application of nutritional management combined with clinical monitoring of glycated albumin(GA)in diabetic nephropathy(DN)dialysis patients.Methods:A total of 20 diabetic nephropathy dialysis patients admitted to the People’s Hospital of Guandu District from January 2022 to February 2023 were included in the study.They were randomly divided into a conventional group(n=10)and an observation group(n=10).The study evaluated the blood glucose control,nutritional status,dialysis efficacy,and quality of life scores of both groups.Results:Before the intervention,there were no significant differences in fasting plasma glucose(FPG),GA,serum albumin,body mass index(BMI),dialysis efficiency values,urea clearance rate,or quality-of-life scores between the two groups(P>0.05).After the intervention,the observation group showed significantly lower FPG and GA levels,higher serum albumin,dialysis efficiency values,urea clearance rate,and improved quality-of-life scores compared to the conventional group(P<0.05),with no difference in BMI(P>0.05).Conclusion:Nutritional management combined with clinical monitoring of glycated albumin has a significant effect on the clinical application of diabetic nephropathy dialysis patients.It can effectively improve patients’blood glucose control and nutritional status,reduce the risk of complications,and enhance the quality of life,demonstrating clinical value for broader application.

外周血BNP、NLR联合hsCRP/ALB检测对急性冠脉综合征患者PCI术后预后的预测价值

目的探讨外周血B型脑钠肽(BNP)、中性粒细胞与淋巴细胞比值(NLR)联合超敏C反应蛋白与白蛋白比值(hsCRP/ALB)检测对急性冠脉综合征(ACS)患者行经皮冠状动脉介入治疗(PCI)术后预后的预测价值。方法回顾性分析126例行PCI治疗的ACS患者资料,于入院后24 h内采集患者空腹静脉血测定外周血BNP、NLR、hsCRP/ALB水平,比较不同心功能的ACS患者外周血BNP、NLR及hsCRP/ALB水平,术后随访1 a,根据是否发生主要心脏不良事件(MACE)将患者分为预后良好组(n=93)和预后不良组(n=33),比较两组患者临床资料、外周血BNP、NLR及hsCRP/ALB水平,采用Cox回归分析影响ACS患者PCI术后预后的相关因素,采用受试者工作特征(ROC)曲线分析外周血BNP、NLR及hsCRP/ALB对ACS患者PCI术后预后的预测价值。结果Killip分级Ⅰ级患者外周血BNP、NLR及hsCRP/ALB水平显著低于Ⅱ级、Ⅲ级患者(P<0.5),Ⅱ级患者外周血BNP、NLR及hsCRP/ALB水平显著低于Ⅲ级患者(P<0.05);预后不良组患者年龄,BMI,Killip分级Ⅲ~Ⅳ级占比,Gensini积分,多个支架置入占比,血清LDL-C、Fib、hs-CRP、CTnI、NEU水平显著高于预后良好组(P<0.05,P<0.01),LVEF、LYM、血清ALB水平显著低于预后良好组(P<0.001);预后不良组患者外周血BNP、NLR及hsCRP/ALB显著高于预后良好组(P<0.001);多因素Cox回归分析显示,年龄,Killip分级,Gensini积分,外周血BNP、NLR及hsCRP/ALB是影响ACS患者PCI术后预后不良的危险因素(P<0.05,P<0.01);ROC曲线分析显示,外周血BNP、NLR及hsCRP/ALB单独及联合预测对ACS患者PCI术后预后的敏感度分别为75.76%、78.79%、81.82%、90.91%,特异度为72.04%、70.97%、69.89%、64.52%,AUC为0.753、0.797、0.835、0.935,联合检测价值更高。结论外周血BNP、NLR联合hsCRP/ALB检测对患者PCI术后预后具有较高的评估价值。

Interaction Between Gatifloxacin and Bovine Serum Albumin

Aim To study the reaction mechanism between gatifloxacin and bovine serumalbumin (BSA) at different pHs. Methods Fluorescence spectra and UV absorbance spectra were used.Results The binding constants were determined from a double reciprocal Lineweaver-Burk curves atdifferent pHs. The binding distance r under normal physiological condition was obtained according toFoster theory of non-radiative energy transfer. The binding force between gatifloxacin and BSA wasinferred by thermody-namical coordination. Conclusion The interaction between gatifloxacin and BSAseems to be strong and the main binding force is electrostatic force.

血清甲状腺激素、NLR及CRP/ALB与肺癌术后谵妄的关系

目的分析血清甲状腺激素、中性粒细胞淋巴细胞比值(NLR)及C反应蛋白/白蛋白比值(CRP/ALB)与肺癌术后谵妄的关系。方法选取2021年1月至2022年12月于北京市第六医院进行肺癌根治术患者118例作为研究对象。根据ICU意识混乱评分法进行谵妄评估,有35例患者发生术后谵妄(谵妄组),83例患者术后未发生谵妄(非谵妄组)。分析影响肺癌患者术后谵妄的单因素,采用多元Logistic回归分析影响肺癌术后谵妄的多因素;比较谵妄组不同谵妄程度患者血清甲状腺激素、CRP/ALB、NLR水平;采用Pearson相关系数分析血清甲状腺激素、CRP/ALB、NLR与肺癌术后谵妄的相关性。结果两组性别、合并患有高血压、ASA分级以及T_4、TSH、FT_4水平等指标比较,差异无统计学意义(P>0.05);两组年龄、合并患有糖尿病、睡眠障碍以及T_(3)、FT_(3)、CRP/ALB、NLR水平比较,差异有统计学意义(P<0.05);经多元Logistic回归分析显示:年龄≥60岁、合并患有糖尿病、睡眠障碍以及T_(3)<1.31 nmol/L、FT_(3)<5.15 pmol/L、CRP/ALB>0.120、NLR≥7.79均是影响肺癌发生术后谵妄的危险因素(P<0.05);轻度、重度术后谵妄患者T_4、TSH、FT_4水平比较,差异无统计学意义(P>0.05);轻度术后谵妄患者T_(3)、FT_(3)水平高于重度术后谵妄患者,CRP/ALB、NLR水平低于重度术后谵妄患者,差异均有统计学意义(P<0.05);Pearson相关性分析显示:T_(3)、FT_(3)与肺癌术后谵妄呈负相关,CRP/ALB、NLR与肺癌术后谵妄呈正相关(P<0.05)。结论肺癌根治术患者术后T_(3)、FT_(3)、CRP/ALB、NLR水平与术后谵妄发生有一定关联,通过检测上述指标水平可为临床评估术后谵妄严重程度提供参考资料。

Bovine Serum Albumin (BSA) Microspheres Containing Methotrexate (MTX) I.Pharmaceutical Aspects

Microspheres Ⅰ,Ⅱ and Ⅲ were produced by emulsion technique.Microsphere I was solidified by glutaraldehyde crosslinking,microsphere Ⅱ was solidified by glutaraldehyde crosslinking and further treated with glycine solution and microsphere Illwas solidified by heating denaturation only.The results showed that the microsphere diameter produced by cross[inking was bigger than that prepared by heating.The microsphere Ⅱ had higher hydrophilicity than Microsphere I had.The methotrexate (MTX) contents in microspheres Ⅰ and Ⅱ were 2.73±0.053%,2.87±0.119% respectively. microsphere Ⅲ was only blank microspheres with MTX adsorbed on their surfaces.In vitro release studies,microspheres I and I have maintained sustained release of MTX till the next day,it was found that the drug releases from microspheres Ⅰ and Ⅱ were governed by Higuchi diffusion law.

不同肠内营养制剂用于2型糖尿病患者对血糖及血清UA、PA、ALB的影响

目的探究康全力、能全力与瑞能三种不同肠内营养制剂用于2型糖尿病(T2DM)患者对血糖及血清尿酸(UA)、前白蛋白(PA)、白蛋白(ALB)等的影响。方法选取2020年1月至2023年3月于涟水县人民医院重症医学科内分泌与代谢性疾病科治疗的99例T2DM患者为研究对象,按非随机临床同期对照研究及患者自愿原则分为康全力组、能全力组和瑞能组,每组各33例。三组患者分别给予康全力、能全力和瑞能三种不同肠内营养制剂治疗,均连续治疗2个月,比较糖代谢、营养指标、血脂、炎症因子水平和不良反应发生情况。结果治疗后三组糖代谢指标均显著降低,其中康全力组患者治疗后糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2hPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)与能全力组和瑞能组相比均显著降低(P<0.05);治疗后三组血清UA明显下降,PA和ALB水平明显升高(P<0.05),但组间差异无统计学意义(P>0.05);治疗后三组HDL-C均显著升高,康全力组LDL-C、TC和TG均显著降低(P<0.05),能全力组、瑞能组LDL-C、TC和TG未见显著改变(P>0.05),其中康全力组治疗后HDL-C与另外两组相比显著高,LDL-C与另外两组相比显著低,TC和TG与瑞能组相比显著低(P<0.05);治疗后三组IL-6、CRP水平与治疗前相比均显著降低(P<0.05),治疗后康全力组、能全力组IL-6和CRP水平与瑞能组相比显著低(P<0.05);治疗后康全力组、能全力组和瑞能组的不良反应发生总概率为12.12%、21.21%和15.15%,差异无统计学意义(P>0.05)。结论康全力在调节糖脂代谢、缓解炎症反应方面效果较其他肠内营养制剂更突出。

耐碳青霉烯类肺炎克雷伯菌感染患者NLRP3、CRP/ALB、IL-6表达水平及其预后相关影响因素

目的分析耐碳青霉烯类肺炎克雷伯菌感染患者核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、C-反应蛋白/白蛋白(CRP/ALB)、白介素-6(IL-6)表达水平及其预后相关影响因素。方法2022年1月至2023年6月中江县人民医院、成都市第二人民医院、德阳市人民医院收治的294例耐碳青霉烯类肺炎克雷伯菌感染患者进行研究,根据预后情况分为预后不良组51例、预后良好组243例。通过单因素、多因素分析耐碳青霉烯类肺炎克雷伯菌感染患者预后的影响因素,比较不同预后患者NLRP3、CRP/ALB、IL-6表达水平,绘制受试者工作特征(ROC)曲线分析NLRP3、CRP/ALB、IL-6单独及联合检测对耐碳青霉烯类肺炎克雷伯菌感染患者预后的预测价值。结果预后不良组患者年龄、病情危重程度为重度、深静脉置管、糖尿病、多器官功能衰竭、使用血管活性药物、使用镇静药、使用强心类药物比例高于预后良好组(P<0.05)。多因素Logistic分析结果显示病情危重程度为重度、深静脉置管、多器官功能衰竭、使用血管活性药物为耐碳青霉烯类肺炎克雷伯菌感染患者预后不良的危险因素(P<0.05)。与预后良好组比较,预后不良组血清NLRP3、CRP/ALB、IL-6水平更高(P<0.05)。绘制ROC曲线分析NLRP3、CRP/ALB、IL-6指标联合检测对耐碳青霉烯类肺炎克雷伯菌感染预后不良的预测价值最高,曲线下面积(AUC)为0.910,敏感性86.27%,特异性为87.24%。结论耐碳青霉烯类肺炎克雷伯菌感染患者存在预后不良风险,危险因素较多,联合检测NLRP3、CRP/ALB、IL-6对其预测价值较高。

Prognostic significance of the fibrinogen-to-albumin ratio in gallbladder cancer patients

AIM To investigate the prognostic role of fibrinogen-toalbumin ratio(FAR) on patients with gallbladder cancer(Gbc) in this study.METHODS One hundred and fifty-four Gbc patients were retro-spectively analyzed, who received potentially curative cholecystectomy in our institute from March 2005 to December 2017. Receiver operating characteristic curve(ROc curve) was used to determine the optimal cut-offs for these biomarkers. In addition, Kaplan-Meier survival analysis as well as multivariate analysis were applied for prognostic analyses.RESULTS ROc curve revealed that the optimal cut-off value for FAR was 0.08. FAR was significantly correlated with age(P = 0.045), jaundice(P < 0.001), differentiation(P = 0.002), resection margin status(P < 0.001), T stage(P < 0.001), TNM stage(P < 0.001), and c A199(P < 0.001) as well as albumin levels(P < 0.001). Multivariate analysis indicated that the resection margin status [hazard ratio(HR): 2.343, 95% confidence interval(c I): 1.532-3.581, P < 0.001], TNM stage(P = 0.035), albumin level(HR = 0.595, 95%c I: 0.385-0.921, P = 0.020) and FAR(HR: 2.813, 95%c I: 1.765-4.484, P < 0.001) were independent prognostic factors in Gbc patients.CONCLUSION An elevated preoperative FAR was significantly correlated with unfavorable overall survival in Gbc patients, while an elevated preoperative albumin level was a protective prognostic factor for patients with Gbc. The preoperative FAR could be used to predict the prognosis of Gbc patients, which was easily accessible, costeffective and noninvasive.

Hypoalbuminemia in colorectal cancer prognosis:Nutritional marker or inflammatory surrogate?

Albumin is the single most abundant protein in the human serum. Its roles in physiology and pathology are diverse. Serum albumin levels have been classically thought to reflect the nutritional status of patients. This concept has been challenged in the last two decades as multiple factors, such as inflammation, appeared to affect albumin levels independent of nutrition. In general, cancer patients have a high prevalence of hypoalbuminemia. As such, the role of hypoalbuminemia in patients with colorectal cancer has received significant interest. We reviewed the English literature on the prognostic value of pretreatment albumin levels in colorectal cancer. We also consolidated the evidence that led to the current understanding of hypoalbuminemia as an inflammatory marker rather than as a nutritional one among patients with colorectal cancer.