The high incidence and mortality of acute kidney injury (AKI) have brought great challenges to global health. In recent years, China has made some achievements in the epidemiology, risk factors and treatment of AKI. However, further prevention and treatment are still facing difficulties. Based on current new ideas and research progress, this paper summarized and analyzed the management throughout the whole course of AKI, including AKI risk assessment, early prevention, early identification, treatment and follow-up. The aim is to make Chinese nephrologists realize the focus of AKI prevention and treatment, standardize the management of AKI, and explore the prevention and treatment strategy suitable for AKI in China.
Objective The management of pulmonary nodules is a common clinical problem, and this study constructed a nomogram model based on FUT7 methylation combined with CT imaging features to predict the risk of adenocarcinoma in patients with pulmonary nodules. Methods The clinical data of 219 patients with pulmonary nodules diagnosed by histopathology at the First Affiliated Hospital of Zhengzhou University from 2021 to 2022 were retrospectively analyzed. The FUT7 methylation level in peripheral blood were detected, and the patients were randomly divided into training set (n=154) and validation set (n=65) according to proportion of 7:3. They were divided into a lung adenocarcinoma group and a benign nodule group according to pathological results. Single-factor analysis and multi-factor logistic regression analysis were used to construct a prediction model in the training set and verified in the validation set. The receiver operating characteristic (ROC) curve was used to evaluate the discrimination of the model, the calibration curve was used to evaluate the consistency of the model, and the clinical decision curve analysis (DCA) was used to evaluate the clinical application value of the model. The applicability of the model was further evaluated in the subgroup of high-risk CT signs (located in the upper lobe, vascular sign, and pleural sign). Results Multivariate logistic regression analysis showed that female, age, FUT7_CpG_4, FUT7_CpG_6, sub-solid nodules, lobular sign and burr sign were independent risk factors for lung adenocarcinoma (P<0.05). A column-line graph prediction model was constructed based on the results of the multifactorial analysis, and the area under the ROC curve was 0.925 (95%CI 0.877 - 0.972 ), and the maximum approximate entry index corresponded to a critical value of 0.562, at which time the sensitivity was 89.25%, the specificity was 86.89%, the positive predictive value was 91.21%, and the negative predictive value was 84.13%. The calibration plot predicted the risk of adenocarcinoma of pulmonary nodules was highly consistent with the risk of actual occurrence. The DCA curve showed a good clinical net benefit value when the threshold probability of the model was 0.02 - 0.80, which showed a good clinical net benefit value. In the upper lobe, vascular sign and pleural sign groups, the area under the ROC curve was 0.903 (95%CI 0.847 - 0.959), 0.897 (95%CI 0.848 - 0.945), and 0.894 (95%CI 0.831 - 0.956). Conclusions This study developed a nomogram model to predict the risk of lung adenocarcinoma in patients with pulmonary nodules. The nomogram has high predictive performance and clinical application value, and can provide a theoretical basis for the diagnosis and subsequent clinical management of pulmonary nodules.
ObjectiveTo summarize the research progress of long non-coding RNA (lncRNA) in the regulation of malignant biological behavior of gallbladder cancer so as to provide references for its related research.MethodThe relevant literatures about studies of lncRNA in gallbladder cancer in recent years were reviewed.ResultsThe recent studies had shown that 19 lncRNAs associated with gallbladder cancer had played the important roles in regulating tumor cell proliferation, migration, invasion, apoptosis, “sponge” miRNAs, chemoresistance, and tumor metastasis. Among them, most lncRNAs tended to have carcinogenic properties, only a few had anticarcinogenic effect. Although the research suggested the mechanism and role of lncRNA to promote or inhibit the occurrence and development of gallbladder cancer, the current research on its mechanism was still limited. In addition, some lncRNAs were found to be specifically expressed in the serum of patients with gallbladder cancer, so which were expected to become biomarkers for tumor diagnosis and prognosis.ConclusionslncRNAs associated with gallbladder cancer have carcinogenic or anticarcinogenic effect, or chemoresistance. They play potential roles in diagnosis, prognosis, and (or) treatment of tumors, but molecular mechanisms of their effects are still limited.
ObjectiveEarly diagnosis of biliary atresia (BA) is crucial for improving patient prognosis. This study aimed to evaluate the accuracy of serum matrix metalloproteinase-7 (MMP-7) and gamma-glutamyl transferase (GGT) in diagnosing BA. MethodsWe conducted a comprehensive search of English-language databases (PubMed, Elsevier, Web of Science) and Chinese-language databases (CNKI, WanFang Data, VIP) for studies published from the inception of these databases up to December 30, 2024. Eligible studies included diagnostic data based on serum MMP-7 and GGT levels from children with BA and non-BA cholestasis. Results Through a systematic review and meta-analysis, a total of 24 publications encompassing 33 studies were included, covering a combined cohort of 6 879 children with cholestasis. The results of the binary diagnostic model analysis revealed that the pooled sensitivity and specificity of serum matrix metalloproteinase-7 (MMP-7) were 93% (95%CI 92 to 94) and 87% (95%CI 85 to 88), respectively. The positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) for MMP-7 were 8.63 (95%CI 5.88 to 12.66), 0.09 (95%CI 0.06 to 0.13), and 115.31 (95%CI 69.08 to 192.48), respectively. The area under the receiver operating characteristic curve (AUC) for MMP-7 was 0.9659, indicating excellent diagnostic performance. In comparison, gamma-glutamyl transferase (GGT) demonstrated a pooled sensitivity of 76% (95%CI 73 to 78) and specificity of 80% (95%CI 78 to 82). The corresponding PLR, NLR, and DOR for GGT were 3.50 (95%CI 2.77 to 4.43), 0.30 (95%CI 0.25 to 0.36), and 12.69 (95%CI 9.18 to 17.55), respectively. The AUC for GGT was calculated to be 0.849 4, reflecting moderate diagnostic accuracy. ConclusionSerum MMP-7 demonstrates higher diagnostic accuracy compared to GGT, which may significantly enhance the diagnostic efficiency for biliary atresia. However, due to its heterogeneity, further multicenter, large-sample, prospective studies that adhere strictly to experimental protocols are necessary to validate its diagnostic accuracy.
ObjectiveTo summarize the new biomarkers of deep venous thrombosis (DVT) and their research progress, so as to provide new ideas for the prevention, diagnosis and treatment of DVT. MethodThe literature about biomarkers of DVT in recent 5 years was reviewed and summarized. ResultsAccording to the results of literature review, a variety of common DVT biomarkers such as serum microrna, fibrin monomer, neutrophil capture net, and E-selectin were sorted out, but most of them had not been used in clinical DVT management. At present, the clinical diagnosis of DVT required the combination of positive D-dimer test and positive imaging examination, and there was no single biomarker for the diagnosis of DVT. ConclusionsBiomarkers are valuable in the diagnosis and treatment of DVT, but their sensitivity and specificity need to be optimized. Therefore, finding biomarkers with more diagnostic value is one of the future directions. At the same time, we also can consider fully combined with a variety of existing biomarkers, to improve the efficiency to the diagnosis of DVT.
ObjectiveTo evaluate the value of carcinoembryonic antigen (CEA), ferritin, D-dimer, fibrinogen degradation product (FDP), white blood cell (WBC) and C-reactive protein (CRP) in diagnosis and prognosis of severe community-acquired pneumonia (SCAP).MethodsThis was a prospective observational study. One hundred and seventy-seven candidates were divided into 3 groups: SCAP group including 61 SCAP patients, CAP group including 56 patients with normal community-acquired pneumonia group and HP group including 60 healthy people. Initial level of above biomarkers was compared and analyzed in the three groups. Then the efficiency of diagnosing and predicting the outcome of SCAP by single and combined index were evaluated by receiver operating characteristic (ROC) curve. Meanwhile the patients in SCAP group were divided into two groups according to the CEA level named CEA increasing group and normal group, between which the differences in prognosis and biomarker level were compared.ResultsThe initial level of all biomarkers increased in two pneumonia groups and exceeded the HP group (P< 0.01) while between SCAP and CAP groups, all indexes in SCAP group were higher than the CAP group (P< 0.001). The areas under the ROC of CEA, ferritin, D-dimer, CRP, WBC and united respectively were 0.800, 0.834, 0.769, 0.898, 0.756 and 0.956. The sensitivity of united index was 91.8% while specificity was 90.5%. Among SCAP group, only CEA level made sense to predict the prognosis (P< 0.01). There were significant differences in intubation rate, mortality, length of RICU stay and FDP, D-dimer between CEA increasing group and normal group (P< 0.05).ConclusionsHigh level CEA, ferritin, D-dimer, CRP and WBC have significant value in diagnosis of SCAP. And the combined index has higher diagnostic value than single one. SCAP with increased CEA level indicates more serious condition and poor prognosis.
ObjectiveTo summarize the biomarkers related to the efficacy of immune checkpoint inhibitors for hepatocellular carcinoma (HCC).MethodReviewed and summarized the literatures on the basic and clinical application of biomarkers related to programmed cell death protein 1/programmed cell death-ligand 1 (PD-1/PD-L1) inhibitors and their combination with targeted therapy.ResultsThe combination of immunotherapy and targeted therapy had brought great hope for the treatment of patients with advanced HCC, but there were still some patients who could not benefit from it. Recent studies had shown that expression of PD-L1 in tumor tissue, tumor mutational burden, tumor-infiltrating lymphocytes, peripheral immune cells, circulating tumor DNA, gut microbiome, and so on, could predict the efficacy of immunotherapy or targeted therapy combined with immunotherapy for HCC.ConclusionsThere is no specific biomarker to predict the efficacy of immunotherapy and its combination regimen for HCC. More prospective studies are needed to confirm the predictive value of these biomarkers and to establish a multi-factor predictive model or immune score to screen patients who may benefit, which is of great significance for precise immunotherapy of HCC.
Objective To determine the prognostic biomarkers and new therapeutic targets of the lung adenocarcinoma (LUAD), based on which to establish a prediction model for the survival of LUAD patients. Methods An integrative analysis was conducted on gene expression and clinicopathologic data of LUAD, which were obtained from the UCSC database. Subsequently, various methods, including screening of differentially expressed genes (DEGs), Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and Gene Set Enrichment Analysis (GSEA), were employed to analyze the data. Cox regression and least absolute shrinkage and selection operator (LASSO) regression were used to establish an assessment model. Based on this model, we constructed a nomogram to predict the probable survival of LUAD patients at different time points (1-year, 2-year, 3-year, 5-year, and 10-year). Finally, we evaluated the predictive ability of our model using Kaplan-Meier survival curves, receiver operating characteristic (ROC) curves, and time-dependent ROC curves. The validation group further verified the prognostic value of the model. Results The different-grade pathological subtypes' DEGs were mainly enriched in biological processes such as metabolism of xenobiotics by cytochrome P450, natural killer cell-mediated cytotoxicity, antigen processing and presentation, and regulation of enzyme activity, which were closely related to tumor development. Through Cox regression and LASSO regression, we constructed a reliable prediction model consisting of a five-gene panel (MELTF, MAGEA1, FGF19, DKK4, C14ORF105). The model demonstrated excellent specificity and sensitivity in ROC curves, with an area under the curve (AUC) of 0.675. The time-dependent ROC analysis revealed AUC values of 0.893, 0.713, and 0.632 for 1-year, 3-year, and 5-year survival, respectively. The advantage of the model was also verified in the validation group. Additionally, we developed a nomogram that accurately predicted survival, as demonstrated by calibration curves and C-index. Conclusion We have developed a prognostic prediction model for LUAD consisting of five genes. This novel approach offers clinical practitioners a personalized tool for making informed decisions regarding the prognosis of their patients.
Objective To explore key genes and mechanisms of depression aggravating Crohn disease. Methods In March 2023, the Public Health Genomics and Precision Health Knowledge Base and Gene Expression Omnibus database were used to identify the overlapping differentially expressed genes between Crohn disease and depression and the key genes were screened by Metascape, STRING, Cytoscape, and protein interaction network analysis. The Gene Expression Omnibus database was used to analyze the correlations between key genes and clinical pathologies such as Crohn Disease Endoscopic Index of Severity and intestinal microvilli length. Results There were 137 overlapping differentially expressed genes between Crohn disease and depression, and 25 key genes were further screened out. Among them, CREB1, FKBP5, MAPT, NTSR1, OXTR, PROK2, POMC, HTR2B, and PPARGC1A genes were significantly correlated with multiple clinical parameters. The functions of PROK2 and PROK2-related genes were mainly enriched in neutrophil and granulocyte migration, neutrophil and granulocyte chemotaxis, etc. Conclusions There are 25 key genes, especially CREB1, FKBP5, MAPT, NTSR1, OXTR, PROK2, POMC, HTR2B, and PPARGC1A, that possibly contribute to the establishment and deterioration of Crohn disease caused by depressive disorder. Among these genes, PROK2 showes the possibility of regulating immune cell (neutrophils and CD8+ T cells) infiltration.
ObjectiveTo summarize the recent research progress of circRNA in gastric cancer, and to explore the clinical value of circRNA as new therapeutic target and diagnostic or prognostic biomarker for gastric cancer.MethodThe studies on circRNA and related literatures in gastric cancer were reviewed.ResultsAs a new member of the non-coding RNA family, circRNA played a key role in regulating the proliferation, invasion, migration, apoptosis, and therapeutic resistance of gastric cancer cells. At the same time, based on the stability and tissue-specific characteristics, circRNA possessed great potential as biomarker for early diagnosis or prognosis evaluation of gastric cancer.ConclusionscircRNA plays an important role in the initiation and progression of gastric cancer. As a diagnostic and prognostic biomarker and a new therapeutic target for gastric cancer, circRNA has great potential for clinical transformation.