Objective To study the mechanism of nandrolone phenylpropionate (NP) on hepatic albumin mRNA and androgen receptor(AR) in burned rats. Methods Thirty-two Wistar rats with a deep second-degree cutaneous burn of 20% total body surface area were randomly divided into two groups:NP group (experimental group, 5 mg/kg NP) and normal saline as control group every other day. The expression copy quantity of albumin-mRNA and mean integrated absorbency(mIA) of AR in liver tissue were measured by quantitative fluorescent RT-PCR and immunohistochemistry respectively on the 4th, 7 th, 14th and 21st days of post-burned. Result The expression levels of ablumin-mRNA and AR in liver tissue in HP grouop were much higher than those in control group. The ablumin-mRNA and AR expression increased significantly(P lt; 0.05) after 7 and 14 days, whole the expression had no significant difference between NP group and control group on the 4th day. A positive correlation occurred between the expression level of albumin-mRNA and the quantity of AR in liver tissue(r=0.936, P lt; 0.05). Conclusion Nadrolone phenylpropionate up-regulated respectively the expression of albumin-mRNA and the density of AR in liver tissue.
Objective To make individualized evidence-based treatment for patients with diabetic nephropathy with albuminuria. Methods Based on the clinical questions we raised, evidence was collected and critically assessed. Patients’ willingness was also taken into consideration in the decision-making treatment Results Seventy studies were retrieved and finally 14 randomized controlled trials, 2 systematic reviews, 2 meta-analyses and 41 clinical guidelines were considered eligible. The evidence indicated that albuminuria was an independent cardiovascular risk factor of diabetic patients; angiotensin receptor antagonists might decrease the level of urinary albumin excretion in patients with type 2 diabetic nephropathy; and such patients might benefit from blood glucose and blood pressure control. The individualized treatment plans were developed based on the available evidence. After 1 month of treatment, the serum creatinine returned to normal and albuminuria became negative. Conclusion The individualized treatment plans based on the high quality evidence were optimal in reducing cardiovascular complications and urinary albumin excretion. However, long-term prognostic benefits need to be confirmed by further follow-up.
【Abstract】ObjectiveTo investigate the effects of rhGH on hypoalbuminemia in cirrhotic rats after partial hepatectomy. MethodsThirty rats were randomly divided into normal control group (n=6), liver cirrhosis group (LC group, n=6), liver cirrhosis and hepatectomy group (LCH group,n=6), PN (parenteral nutrition) group (n=6， given PN after hepatectomy) and rhGH+PN group (n=6,given rhGH and PN after hepatectomy). Liver function and blood glucose were measured. The expression of ALB mRNA was detected by RTPCR. Liver Ki67 immunohistochemistry was studied. ResultsCompared with PN group, serum ALP was lower; serum ALB and blood glucose were higher in rhGH+PN group. The expression of hepatic ALB mRNA was higher, and hepatic Ki67 labeling index was higher as well in this group. ConclusionrhGH can improve hypoalbuminemia after partial hepatectomy in cirrhotic rats with partial hepatectomy.
ObjectiveTo evaluate the screening performance of commonly used renal function indicators for chronic kidney disease (CKD) in subjects of different ages, so as to explore the appropriate screening regimen for Chinese population.MethodsA total of 2 131 adult subjects in Sichuan Orthopaedic Hospital or Mianyang Central Hospital from May 2016 to October 2017 were selected. They were divided into three groups according to age: group A (18–39 years, n=278), group B (40–64 years, n=1 167), and group C (≥65 years, n=686). Serum levels of creatinine (SCr), urea, and cystatin C [CysC; to calculate estimated glomerular filtration rate (eGFR) based on this index], as well as urine levels of albumin, total protein and creatinine were measured, and urine albumin to creatinine ratio (ACR) and urine protein to creatinine ratio (PCR) were calculated respectively. CKD was diagnosed according to the Kidney Disease: Improving Global Outcomes (KDIGO) Guideline (2012 Edition). The receiver-operating characteristic (ROC) curve analysis was finally performed to investigate the diagnostic performance of each indicator for CKD.ResultsThe prevalences of CKD in group A, B, and C were 10.8% (30/278), 16.4% (191/1 167), and 45.8% (314/686), respectively, and the difference among these groups was statistically significant (χ2=233.525, P<0.001). In addition, the levels of the six renal function indicators between CKD and non-CKD subjects also had statistically significant differences in different age groups (P<0 05="" otherwise="" roc="" curve="" analysis="" revealed="" that="" the="" diagnostic="" values="" of="" these="" indicators="" were:="" acr="" or="" pcr=""> eGFR or CysC > serum urea or SCr (AllP<0 05="" except="" that="" egfr="" cysc="" serum="" urea="" and="" scr="" in="" group="" a="" assessed="" the="" similar="" diagnostic="" performance="" among="" the="" three="" indicators="" recommended="" by="" kdigo="" guideline="" the="" diagnostic="" performances="" of="" acr="" and="" pcr="" in="" different="" age="" groups="" were:="" group="" b="" 0="" 915="" 0="" 914=""> group A (0.885, 0.890) > group C (0.841, 0.846), while the diagnostic performance of eGFR was group C (0.807) > group B (0.728) > group A (0.696). The best boundary values of ACR and PCR were lower while the value of eGFR was higher than the corresponding KDIGO recommended medical decision levels.ConclusionsACR is the first choice for screening CKD when the renal function index creatinine is normal. Moreover, eGFR can further improve the diagnostic value, especially in subjects over 65 years old.
ObjectiveTo explore the value of procalcitonin-to-albumin (PAR) in patients with acute respiratory distress syndrome (ARDS).MethodsA retrospective study was carried on patients diagnosed with ARDS from December 2016 to March 2018. The receiver-operating characteristics (ROC) curve was used to identify the cutoff value of PAR. The association of PAR and 28-day mortality was evaluated using univariate and multivariable Cox regression.ResultsIn the final analysis, there were a total of 255 patients included. Of whom 164 (64.3%) was male, 91 (35.7%) was female and the mean age was 52.1±14.5 years old. The 28-day mortality of all the patients was 32.9% (n=84). ROC curve revealed that the cutoff value of PAR was 0.039 (specificity: 0.714, sensitivity: 0.702) and area under the curve was 0.793 (95%CI: 0.735 - 0.850, P<0.001). The following variables were considered for multivariable adjustment: age, body mass index, pneumonia, aspiration, sepsis, surgery, PaO2/FiO2, red blood cell counts and PAR (P<0.01 in univariate analysis). After multivariable analysis, only age (HR: 1.033, 95%CI: 1.009 - 1.059, P=0.008), PaO2/FiO2 (HR: 0.992, 95%CI: 0.985 - 1.000, P=0.044) and PAR (HR: 4.899, 95%CI: 2.148 - 11.174, P<0.001) remained independently associated with 28-day mortality (P<0.05).ConclusionHigh PAR predicts a poor outcome in ARDS patients, therefore it appears to be a prognostic biomarker of outcomes in patients with ARDS.
Objective To evaluate the predictive value of lactate dehydrogenase (LDH) to albumin (Alb) ratio (LAR) in the prognosis of severe pneumonia patients complicated with DIC. Methods A total of 312 patients with severe pneumonia hospitalized in the intensive care unit (ICU) of the Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University from January 1, 2018 to March 1, 2023 were retrospectively collected. The clinical parameters, such as gender, age, underlying diseases, and lactate dehydrogenase, albumin etc. l of the first test on admission were collected. LAR, sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) within 24 hours were calculated. The firstly endpoint of the study was the incidence of disseminated intravascular coagulation (DIC), the secondary endpoint was the 30-day in-hospital mortality in severe pneumonia patients with DIC. Univariate and multivariate logistic regression were used to analyze the risk factors of severe pneumonia with DIC. The receiver operating characteristic curve (ROC curve) was drawn and the area under the ROC curve (AUC) was calculated to evaluate the predictive value of LAR for the incidence of DIC in patients with severe pneumonia. Results The level of LAR was higher in the severe pneumonia patients with DIC than the severe pneumonia patients without DIC [LAR median ratio 12.72 (8.72, 21.89) vs. 7.23 (5.63, 10.90), P<0.001]. Multiple logistic regression analysis showed that LAR [OR=1.071, 95%CI 1.038 - 1.106, P<0.001] was the independent risk factor of the incidence of DIC in the patients with severe pneumonia. ROC curve analysis showed that the AUC for LAR to predict the incidence of DIC was 0.723, 95%CI 0.650 - 0.796, P<0.001. When the LAR cut-off value was 8.08, the sensitivity was 79.7% and the specificity was 56.1%. Kaplan-Meier survival analysis curve showed that the patients in the above LAR cut-off value group had a significantly lower 30-day survival rate than those in the below LAR cut-off value group (P<0.001). In the subgroup analysis and numerical variable transformed analysis, LAR was still the risk factor of DIC. Conclusion The increased LAR is a high risk factor of the incidence of DIC and mortality in patients with severe pneumonia, which is useful for predicting prognosis of patients with severe pneumonia.
ObjectiveTo explore the association between frailty and in-hospital mortality in older patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Elderly patients who were hospitalized with AECOPD from June 2022 to December 2022 at a large tertiary hospital were selected. The independent prognostic factors including frailty status were determined by multivariate logistic regression analysis. Mediation effect analysis was used to evaluate the mediating relationships between C-reactive protein (CRP) and albumin and in-hospital death. ResultsThe training set included 1 356 patients (aged 86.7±6.6), 25.0% of whom were diagnosed with frailty. The multiple logistic regression analysis showed that frailty, mean arterial pressure, Charlson comorbidity index, neutrophil–lymphocyte ratio, interleukin-6, CRP, albumin, and troponin T were associated with in-hospital mortality. Furthermore, CRP and albumin mediated the associations between frailty and in-hospital mortality. ConclusionFrailty may be an adverse prognostic factor for older patients admitted with an AECOPD. CRP and albumin may be parts of mechanism between frailty and in-hospital death.