Objective To determine the concentration changes of medroxyprogesterone acetate （MPA） in serum and milk in the Chinese lactating women who used Depo Geston Methods Ten postpartum and breastfeeding women received an ...Objective To determine the concentration changes of medroxyprogesterone acetate （MPA） in serum and milk in the Chinese lactating women who used Depo Geston Methods Ten postpartum and breastfeeding women received an injectable contraceptive of Depo Geston （depo medroxyprogesterone acetate, DMPA, 150 mg/ampoule）. Serum and milk samples were collected in the 1^st, 2^st, 4^th, 6^th, 8^th 10^th and 12^th week after contraceptive injection. The concentrations of medroxyprogesterone acetate （MPA） in serum and milk were determined by radioimmunoassay. Results The highest MPA concentration in serum was observed at the 1^st week and then the level of serum MPA decreased obviously at the 2^na and 4^th week. After the 4^th week, the decline of serum MPA level slowed down. The concentration of milk MPA reached the highest level at 1^th week. But at the 2^nd week the average level of MPA in milk dropped by half The MPA concentration in the milk was changed in the range of 5.2-8.3 ng/mL in the following 10 weeks. During observation, the average ratios of concentration and area under curve （AUC） in milk/serum were both 0.55. There was a wide variation in MPA concentrations and ratios of milk/serum between subjects. Conclusion MPA concentrations maintained a certaim level at the 12^th week after DMPA injection. However, whether mather＇s intake of DMPA during feeding period has effect on children＇s growth, espcially pubertal growth, deserves further studies.展开更多
Initial prodiabetic risk profiles were invented here with three female study groups consisting of primarily healthy women (A1: 1990-1999, n = 160;A2: 2009, n = 88;A: n = 248, 36 ± 14 years;B: 2014: n = 65, aged 3...Initial prodiabetic risk profiles were invented here with three female study groups consisting of primarily healthy women (A1: 1990-1999, n = 160;A2: 2009, n = 88;A: n = 248, 36 ± 14 years;B: 2014: n = 65, aged 37± 11 years). Significantly higher blood pressure was found comparing intolerance versus tolerance to glucose (p p p = 0.02), of fasting blood glucose (p = 0.07) and of urine pathology (p = 0.07). High LDL-C of women who reported smoking at baseline was correlated with diastolic hypertension whereby alcohol problems overlapped (p = 0.036, A). Unhealthy combinations were found consisting of LDL-related intolerance to glucose, LDL-related smoking, of alcohol-related hypertriglyceridemia or of combined drinking and smoking testing urine pathology over the course of time. Obese women were at direct risk for hypertension in the presence of high LDL-C and submaximal ratio of serum albumin to triglycerides (Alb/Trig). Obese women reacted highly sensitive to critical alcohol consumption showing then macroalbuminuria. Current participants who disowned daily alcohol consumption showed healthy morning urines and normal fasting blood glucose. Mild decrease of HDL-C was observed during heavy smoking of relatively young women who had normal biomarkers. Women with intolerance to glucose were at direct risk for hypertension whereby high LDL-C and/or smoking triggered prodiabetic risk profiles. Obese women had elevated LDL-C during hypertension and reacted highly sensitive to alcohol-related proteinuria and/or hematuria.展开更多
The prognosis of colorectal cancer(CRC)patients with peritoneal metastasis remains poor despite advancements in detection and treatment.Preoperative inflammatory and nutritional markers have emerged as significant pre...The prognosis of colorectal cancer(CRC)patients with peritoneal metastasis remains poor despite advancements in detection and treatment.Preoperative inflammatory and nutritional markers have emerged as significant predictors of prognosis in CRC,potentially guiding treatment decisions and improving patient outcomes.This editorial explores the prognostic value of markers such as the neutrophil-to-lymphocyte ratio,hemoglobin,and serum albumin levels.By integrating these markers into prognostic models,clinicians can better stratify patients,personalize treatment strategies,and ultimately enhance clinical outcomes.This review highlights the importance of these markers in providing a comprehensive assessment of patient condition and underscores the need for further research to validate their clinical utility and uncover underlying mecha-nisms.展开更多
目的:探究尿素氮与白蛋白比值(blood urea nitrogen to serum albumin ratio,B/A)对老年慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并肾功能不全患者,无创机械通气(non-invasi...目的:探究尿素氮与白蛋白比值(blood urea nitrogen to serum albumin ratio,B/A)对老年慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并肾功能不全患者,无创机械通气(non-invasive mechanical ventilation,NIV)预后的预测价值。方法:选择2021年1月至2023年1月,在连云港市第二人民医院肾内科,收治的老年AECOPD合并肾功能不全患者接受NIV患者220例,依据患者住院NIV治疗后28 d的生存情况分为:生存组(180例)和死亡组(40例),比较两组患者的B/A,运用Logistic回归性分析和受试者工作特征曲线ROC评价入院初24 h的B/A预测AECOPD合并肾功能不全患者NIV治疗后28 d预后的价值。结果:生存组白蛋白、血红蛋白和血小板显著高于死亡组患者(P <0.05),生存组尿素氮、B/A、急性生理和慢性健康评分(acutephysiology and chronic health evaluationⅡ,APACHEⅡ)显著低于死亡组患者(P <0.05)。Logistic回归分析结果显示B/A和APACHEⅡ评分是导致患者死亡的危险因素(P <0.05)。ROC分析显示,B/A的曲线下面积、敏感度、特异度均较APACHEⅡ评分增高,B/A与APACHEⅡ评分的AUC差异无统计学意义(t=1.686,P=0.093)。结论:B/A和APACHEⅡ评分均可用于评估老年AECOPD合并肾功能不全患者NIV预后,与APACHEⅡ评分比,B/A在评估老年AECOPD患者NIV预后的效能更高。展开更多
目的探讨并分析急性非ST段抬高心肌梗死(NSTEMI)患者经皮冠状动脉介入治疗(PCI)术后血清纤维蛋白原/白蛋白值(FAR)、γ-谷氨酰转肽酶(γ-GGT),N端脑钠肽前体(NT-proBNP)水平对预后的预测价值。方法回顾性分析2020年2月至2023年2月邯郸...目的探讨并分析急性非ST段抬高心肌梗死(NSTEMI)患者经皮冠状动脉介入治疗(PCI)术后血清纤维蛋白原/白蛋白值(FAR)、γ-谷氨酰转肽酶(γ-GGT),N端脑钠肽前体(NT-proBNP)水平对预后的预测价值。方法回顾性分析2020年2月至2023年2月邯郸市中心医院收治的实施PCI的急性NSTEMI患者93例,根据术后30 d主要不良心血管事件(MACE)发生情况将其分为MACE组(n=21)及无MACE组(n=72)。比较术前、术后30 d MACE组及无MACE组血清FAR、γ-GGT、NT-proBNP水平,采用单因素和多因素Logistic回归分析对影响急性NSTEMI患者术后30 d MACE发生的危险因素进行分析,采用受试者操作特征(ROC)曲线分析血清FAR、γ-GGT、NT-proBNP水平对急性NSTEMI患者术后MACE发生的预测价值。结果MACE组年龄为(65.37±3.46)岁;Killip分级为Ⅰ级2例,Ⅱ级3例,Ⅲ级5例,Ⅳ级11例;病变支数双支5例,3支16例;术后30 d血清FAR、γ-GGT、NT-proBNP水平分别为(2.87±0.55)%、(53.27±3.06)U/L、(914.35±84.35)ng/mL。无MACE组的年龄为(58.71±2.86)岁;Killip分级为Ⅰ级32例,Ⅱ级27例,Ⅲ级7例,Ⅳ级6例;病变支数为双支53例,3支19例;术后30 d血清FAR、γ-GGT、NT-proBNP水平分别为(2.12±0.51)%、(44.33±3.35)U/L、(656.82±75.63)ng/mL。MACE组和无MACE组的年龄、Killip分级、病变支数及术后30 d血清FAR、γ-GGT、NT-proBNP水平比较,差异均有统计学意义(P<0.05),两组性别、吸烟史、高血压史、高血脂史、糖尿病史及术前1 d血清FAR、γ-GGT、NT-proBNP水平比较差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,血清FAR、γ-GGT、NT-proBNP升高均为影响急性期NSTEMI患者术后MACE发生的独立危险因素(OR=3.074、2.686、3.340,P均<0.05)。ROC结果显示血清FAR、γ-GGT、NT-proBNP及其联合检测预测急性NSTEMI患者术后MACE发生的曲线下面积(AUC)分别为0.681、0.690、0.733和0.790,联合检测的AUC更高(P<0.05)。结论血清FAR、γ-GGT、NT-proBNP水平升高增加了急性NSTEMI患者PCI术后MACE的发生风险,三者联合检测对患者术后不良预后有一定预测价值。展开更多
背景随着人口老龄化的加剧,心力衰竭(heart failure,HF)患病率呈上升趋势,老年心力衰竭的预警、风险分层研究对改善预后具有重要意义。目的探讨血尿素氮-白蛋白比值(blood urea nitrogen to albumin ratio,BAR)对老年心力衰竭患者1年内...背景随着人口老龄化的加剧,心力衰竭(heart failure,HF)患病率呈上升趋势,老年心力衰竭的预警、风险分层研究对改善预后具有重要意义。目的探讨血尿素氮-白蛋白比值(blood urea nitrogen to albumin ratio,BAR)对老年心力衰竭患者1年内死亡的预测价值;建立包含BAR在内的列线图,并验证其临床价值。方法建模数据来自解放军总医院2016年1月—2021年10月诊断为心力衰竭的1259例老年患者,验证队列来自2021年10月—2022年10月诊断为心力衰竭的314例老年患者。以1年病死率为结局指标,采用Logistic回归分析筛选预后因素,根据预后因素构建列线图;ROC曲线、校准曲线和临床决策曲线分析(decision curve analysis,DCA)用于评估模型的区分度、一致性和临床效益;通过计算ROC曲线下面积和DCA,比较列线图与N端脑钠肽前体(N-terminal pro-B-type natriureticpeptide,NT-proBNP)及BIOSTATCHF预测模型的性能。结果训练队列和验证队列中分别有27.2%(343/1259)和25.2%(79/314)患者在1年内死亡。多因素Logistic回归结果显示,年龄、D-二聚体、NT-proBNP、BAR、血管紧张素转化酶抑制剂(angiotensin converting enzyme inhibitor,ACEI)/血管紧张素受体阻滞剂(angiotensin receptor blockers,ARB)使用与死亡结局独立关联(P<0.05)。基于以上5个因素构建列线图,列线图展现出良好的区分度(AUC=0.838,P<0.001)、一致性(Hosmer-Lemeshowχ2=4.251,P=0.834)和临床效益。列线图模型与NT-proBNP和欧洲BIOSTAT-CHF预测模型相比预测效能均更佳(0.838 vs 0.703和0.825,P<0.05)。DCA结果提示,列线图相比NT-proBNP、BIOSTAT-CHF预测模型均增加了更多的净获益。结论BAR是老年心力衰竭患者1年内死亡的独立预测因子。包含BAR在内的列线图展现出优异的辨别力和校准能力,为预后评估提供有力支持。展开更多
目的通过分析血清胱抑素C(Cys-C)、β2微球蛋白(β2-MG)、尿酸(UA)等联合项目与糖尿病肾病(DN)的相关性,从而找出准确诊断DN的相关因素。方法选取259名糖尿病(DM)患者,收集Cys-C、β2-MG、UA等相关项目指标,运用相应的统计学方法分析相...目的通过分析血清胱抑素C(Cys-C)、β2微球蛋白(β2-MG)、尿酸(UA)等联合项目与糖尿病肾病(DN)的相关性,从而找出准确诊断DN的相关因素。方法选取259名糖尿病(DM)患者,收集Cys-C、β2-MG、UA等相关项目指标,运用相应的统计学方法分析相关项目与尿白蛋白/肌酐比值(UACR)的关系。结果UACR≥30 mg/g作为DN的诊断临界点时,显示Cys-C、β2-MG、UA、收缩压(SBP)、餐后2 h血糖(2 h PG)、病程等6个项目是UACR的独立危险因素,当某一DM患者Cys-C≥1.435 mg/L、β2-MG≥2.055 mg/L、UA≥320μmol/L、SBP≥145 mmHg、2 h PG≥8.5 mmol/L、病程≥4.5年时,患者发展成早期DN的风险较大,相对应的临界值患病概率为81.5%。结论联合检测Cys-C、β2-MG、UA、SBP、2 h PG、病程等6个项目可以较好预测DN的发生。展开更多
文摘Objective To determine the concentration changes of medroxyprogesterone acetate （MPA） in serum and milk in the Chinese lactating women who used Depo Geston Methods Ten postpartum and breastfeeding women received an injectable contraceptive of Depo Geston （depo medroxyprogesterone acetate, DMPA, 150 mg/ampoule）. Serum and milk samples were collected in the 1^st, 2^st, 4^th, 6^th, 8^th 10^th and 12^th week after contraceptive injection. The concentrations of medroxyprogesterone acetate （MPA） in serum and milk were determined by radioimmunoassay. Results The highest MPA concentration in serum was observed at the 1^st week and then the level of serum MPA decreased obviously at the 2^na and 4^th week. After the 4^th week, the decline of serum MPA level slowed down. The concentration of milk MPA reached the highest level at 1^th week. But at the 2^nd week the average level of MPA in milk dropped by half The MPA concentration in the milk was changed in the range of 5.2-8.3 ng/mL in the following 10 weeks. During observation, the average ratios of concentration and area under curve （AUC） in milk/serum were both 0.55. There was a wide variation in MPA concentrations and ratios of milk/serum between subjects. Conclusion MPA concentrations maintained a certaim level at the 12^th week after DMPA injection. However, whether mather＇s intake of DMPA during feeding period has effect on children＇s growth, espcially pubertal growth, deserves further studies.
文摘Initial prodiabetic risk profiles were invented here with three female study groups consisting of primarily healthy women (A1: 1990-1999, n = 160;A2: 2009, n = 88;A: n = 248, 36 ± 14 years;B: 2014: n = 65, aged 37± 11 years). Significantly higher blood pressure was found comparing intolerance versus tolerance to glucose (p p p = 0.02), of fasting blood glucose (p = 0.07) and of urine pathology (p = 0.07). High LDL-C of women who reported smoking at baseline was correlated with diastolic hypertension whereby alcohol problems overlapped (p = 0.036, A). Unhealthy combinations were found consisting of LDL-related intolerance to glucose, LDL-related smoking, of alcohol-related hypertriglyceridemia or of combined drinking and smoking testing urine pathology over the course of time. Obese women were at direct risk for hypertension in the presence of high LDL-C and submaximal ratio of serum albumin to triglycerides (Alb/Trig). Obese women reacted highly sensitive to critical alcohol consumption showing then macroalbuminuria. Current participants who disowned daily alcohol consumption showed healthy morning urines and normal fasting blood glucose. Mild decrease of HDL-C was observed during heavy smoking of relatively young women who had normal biomarkers. Women with intolerance to glucose were at direct risk for hypertension whereby high LDL-C and/or smoking triggered prodiabetic risk profiles. Obese women had elevated LDL-C during hypertension and reacted highly sensitive to alcohol-related proteinuria and/or hematuria.
文摘The prognosis of colorectal cancer(CRC)patients with peritoneal metastasis remains poor despite advancements in detection and treatment.Preoperative inflammatory and nutritional markers have emerged as significant predictors of prognosis in CRC,potentially guiding treatment decisions and improving patient outcomes.This editorial explores the prognostic value of markers such as the neutrophil-to-lymphocyte ratio,hemoglobin,and serum albumin levels.By integrating these markers into prognostic models,clinicians can better stratify patients,personalize treatment strategies,and ultimately enhance clinical outcomes.This review highlights the importance of these markers in providing a comprehensive assessment of patient condition and underscores the need for further research to validate their clinical utility and uncover underlying mecha-nisms.
文摘目的:探究尿素氮与白蛋白比值(blood urea nitrogen to serum albumin ratio,B/A)对老年慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并肾功能不全患者,无创机械通气(non-invasive mechanical ventilation,NIV)预后的预测价值。方法:选择2021年1月至2023年1月,在连云港市第二人民医院肾内科,收治的老年AECOPD合并肾功能不全患者接受NIV患者220例,依据患者住院NIV治疗后28 d的生存情况分为:生存组(180例)和死亡组(40例),比较两组患者的B/A,运用Logistic回归性分析和受试者工作特征曲线ROC评价入院初24 h的B/A预测AECOPD合并肾功能不全患者NIV治疗后28 d预后的价值。结果:生存组白蛋白、血红蛋白和血小板显著高于死亡组患者(P <0.05),生存组尿素氮、B/A、急性生理和慢性健康评分(acutephysiology and chronic health evaluationⅡ,APACHEⅡ)显著低于死亡组患者(P <0.05)。Logistic回归分析结果显示B/A和APACHEⅡ评分是导致患者死亡的危险因素(P <0.05)。ROC分析显示,B/A的曲线下面积、敏感度、特异度均较APACHEⅡ评分增高,B/A与APACHEⅡ评分的AUC差异无统计学意义(t=1.686,P=0.093)。结论:B/A和APACHEⅡ评分均可用于评估老年AECOPD合并肾功能不全患者NIV预后,与APACHEⅡ评分比,B/A在评估老年AECOPD患者NIV预后的效能更高。
文摘目的探讨并分析急性非ST段抬高心肌梗死(NSTEMI)患者经皮冠状动脉介入治疗(PCI)术后血清纤维蛋白原/白蛋白值(FAR)、γ-谷氨酰转肽酶(γ-GGT),N端脑钠肽前体(NT-proBNP)水平对预后的预测价值。方法回顾性分析2020年2月至2023年2月邯郸市中心医院收治的实施PCI的急性NSTEMI患者93例,根据术后30 d主要不良心血管事件(MACE)发生情况将其分为MACE组(n=21)及无MACE组(n=72)。比较术前、术后30 d MACE组及无MACE组血清FAR、γ-GGT、NT-proBNP水平,采用单因素和多因素Logistic回归分析对影响急性NSTEMI患者术后30 d MACE发生的危险因素进行分析,采用受试者操作特征(ROC)曲线分析血清FAR、γ-GGT、NT-proBNP水平对急性NSTEMI患者术后MACE发生的预测价值。结果MACE组年龄为(65.37±3.46)岁;Killip分级为Ⅰ级2例,Ⅱ级3例,Ⅲ级5例,Ⅳ级11例;病变支数双支5例,3支16例;术后30 d血清FAR、γ-GGT、NT-proBNP水平分别为(2.87±0.55)%、(53.27±3.06)U/L、(914.35±84.35)ng/mL。无MACE组的年龄为(58.71±2.86)岁;Killip分级为Ⅰ级32例,Ⅱ级27例,Ⅲ级7例,Ⅳ级6例;病变支数为双支53例,3支19例;术后30 d血清FAR、γ-GGT、NT-proBNP水平分别为(2.12±0.51)%、(44.33±3.35)U/L、(656.82±75.63)ng/mL。MACE组和无MACE组的年龄、Killip分级、病变支数及术后30 d血清FAR、γ-GGT、NT-proBNP水平比较,差异均有统计学意义(P<0.05),两组性别、吸烟史、高血压史、高血脂史、糖尿病史及术前1 d血清FAR、γ-GGT、NT-proBNP水平比较差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,血清FAR、γ-GGT、NT-proBNP升高均为影响急性期NSTEMI患者术后MACE发生的独立危险因素(OR=3.074、2.686、3.340,P均<0.05)。ROC结果显示血清FAR、γ-GGT、NT-proBNP及其联合检测预测急性NSTEMI患者术后MACE发生的曲线下面积(AUC)分别为0.681、0.690、0.733和0.790,联合检测的AUC更高(P<0.05)。结论血清FAR、γ-GGT、NT-proBNP水平升高增加了急性NSTEMI患者PCI术后MACE的发生风险,三者联合检测对患者术后不良预后有一定预测价值。
文摘结直肠癌是消化道中较为常见的恶性肿瘤,其目前多采用手术切除的方式进行治疗,术后吻合口漏(anastomotic leakage,AL)是外科手术常见感染性并发症。术后发生AL会影响患者预期化学治疗时间,增加患者经济负担及二次手术可能,延长住院时长,加剧医患矛盾等。炎症指标可用于AL的早期预测,便于临床科室给予治疗方案。降钙素原(procalcitonin,PCT)是具有广泛生物学活性的多效性蛋白质,在结直肠癌术后AL的预测或排除中有重要作用,C-反应蛋白/血清白蛋白比值(C-reactive protein/serum albumin ratio,CAR)是反映全身炎症、免疫水平和营养状态的重要指标。二者均在早期对AL的预测有效,二者的联合应用可能存在更大的预测价值。
文摘目的通过分析血清胱抑素C(Cys-C)、β2微球蛋白(β2-MG)、尿酸(UA)等联合项目与糖尿病肾病(DN)的相关性,从而找出准确诊断DN的相关因素。方法选取259名糖尿病(DM)患者,收集Cys-C、β2-MG、UA等相关项目指标,运用相应的统计学方法分析相关项目与尿白蛋白/肌酐比值(UACR)的关系。结果UACR≥30 mg/g作为DN的诊断临界点时,显示Cys-C、β2-MG、UA、收缩压(SBP)、餐后2 h血糖(2 h PG)、病程等6个项目是UACR的独立危险因素,当某一DM患者Cys-C≥1.435 mg/L、β2-MG≥2.055 mg/L、UA≥320μmol/L、SBP≥145 mmHg、2 h PG≥8.5 mmol/L、病程≥4.5年时,患者发展成早期DN的风险较大,相对应的临界值患病概率为81.5%。结论联合检测Cys-C、β2-MG、UA、SBP、2 h PG、病程等6个项目可以较好预测DN的发生。
