ObjectiveTo explore the clinical significance of plasma biomarkers of prethrombotic state in lung cancer patients. Methods90 patients with lung cancer (lung cancer group) and 90 normal controls (control group) of Han population in Shanghai Pulmonary Hospital from June 2010 to June 2012 were recruited in the study. Enzyme-linked immunosorbent assay (ELISA) was used to detect the plasma levels of von willebrand factor(vWF),P-selectin,and thrombin-antithrombine complex (TAT). Coagulation indicators were detected by ACLTOP full automatic coagulation analyzer. Solidification method was used to detect the plasma levels of prothrombin time (PT),activated partial thromboplastin time (APTT) and fibrinogen (FIB). Turbidimetric immunoassay was used to detect D-dimer concentration,and chemiluminescence substrate was used to assay antithrombin Ⅲ (AT-Ⅲ). ResultsIn the lung cancer group,the plasma levels of vWF,P-selectin,TAT,D-dimer and FIB were significantly higher than those in the control group (P<0.05),and the plasma levels of APTT and AT-Ⅲ were lower than those in the control group(P<0.05),while there was no significant difference in plasma PT level(P>0.05). In stage Ⅳ lung cancer subgroup,the plasma levels of vWF,P-selectin,TAT,D-dimer and FIB were significantly higher than those in the stage Ⅲ subgroup or the stage Ⅰ+Ⅱ subgroup (P<0.05). And the plasma levels of PT and APTT were significantly lower than those in the stage Ⅲ subgroup or the stage Ⅰ+Ⅱ subgroup (P<0.05). ConclusionThe patients with lung cancer exist obvious prethrombotic state. AT-Ⅲ,vWF, D-dimer, FIB,TAT,P-selectin and APTT can be used as reliable hematol markers in early diagnosis of prethrombotic state. vWF,P-selectin,TAT and D-dimer have higher sensitivity and specificity.
Objective To estimate the diagnostic value of mesothelin in ovarian cancer. Methods PubMed, The Cochrane Library, CBM, CNKI and WanFang Data databases were searched from inception to October 2016 to collect relevant diagnostic accuracy studies of mesothelin in ovarian cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Statistical analysis was performed using Meta-Disc 1.4, Stata 12.0 and RevMan 5.2 softwares. The pooled sensitivity, specificity and diagnostic odds ratio were calculated, the summary receiver operating characteristic curve (SROC) was drawn and the area under the curve (AUC) was calculated. Results Seventeen studies involving 2 052 patients were included. The pooled sensitivity, specificity, DOR were 0.63 (95%CI 0.60 to 0.67), 0.92 (95%CI 0.90 to 0.93) and 26.62 (95%CI 14.96 to 47.38), respectively. The AUC and Q index were 0.915 1 and 0.847 8, respectively. Conclusion The current evidence indicates that mesothelin has high specificity and low sensitivity, which can’t be used alone as a biomarker for the detection of ovarian cancer, but should be combined with other biomarkers.
Acute kidney injury (AKI), as a complex and severe kidney disease, has always been the hotspot of research. The epidemiological research of AKI in China has made significant progress, including initially reports on the domestic incidence of AKI, geographical distribution and risk factors; however, accompanying challenges like AKI prevention and treatment emerge. For improvement of the diagnosis and treatment of the AKI, this article summarizes and analyses the two challenges: early warning biomarkers and AKI treatment strategies, based on new ideas and research progress. The aim is to make Chinese nephrology scholars and specialists realize the focus of AKI prevention and protection of renal function, to standardize the treatment strategy of AKI, and to put forward the direction of future research.
Heart and kidney interact with each other. Cardio-renal syndrome (CRS) refers to conditions where acute or chronic dysfunction of either the heart or the kidney leads to dysfunction of the other. Conventional classification of CRS outlined five subgroups according to the clinical presentation. This review focused on the epidemiology, new bio- markers, drug management, and renal replacement therapy of type Ⅰ and type Ⅱ CRS, which emphasized the multi-discipline collaboration and individualized evaluation, in order to achieve goal-directed approach to renal replacement therapy.
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.
Telomeres play an important role in maintaining genomic stability and cell life. Accumulating studies show that telomeres are closely related to human aging, cardiovascular diseases and cerebrovascular diseases. There are a series of researches about telomeres and atherosclerosis across the world, including studies on the relationship between atherosclerosis, cardiovascular diseases, cerebrovascular diseases and telomere length, and on telomere-targeted treatments for cardiovascular and cerebrovascular diseases. Telomeres may be a risk predictor or a new therapeutic target for atherosclerosis and cardiovascular diseases. This article reviews the relationship between telomeres and cardiovascular and cerebrovascular diseases, introduces the research progress of telomere length and cardiovascular diseases, cerebrovascular diseases, and the possible mechanisms of their association, aiming to provide a theoretical basis for exploring new therapeutic targets for atherosclerosis.
Pulmonary lymphangioleiomyomatosis (PLAM) is a rare chronic multi-system neoplastic disease that occurs in women of childbearing age. It lacks specific clinical manifestations and requires reliable biomarkers to achieve precise management. In recent years, with the emergence of emerging biomarkers, the detection rate of PLAM has been significantly improved, which can better monitor disease progression and provide timely feedback on the efficacy. These emerging biomarkers mainly include vascular endothelial growth factor-D, vitamin D-binding protein, CT score and prostaglandins. This article will focus on the current research results, and summarize the research progress of emerging biomarkers in PLAM diagnosis, prognosis evaluation, and disease monitoring, aiming to provide new ideas for the research and treatment of PLAM.
Intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs is the main treatment for diabetic macular edema (DME), however, 30% of patients still respond poorly to its treatment. At present, imaging markers that can indicate the prognosis of anti-VEGF drug treatment include ischemic index, deep retinal capillary plexus foveal avascular zone area, number of microaneurysms, blood flow density, disorder of the inner retinal layer, outer membrane and/or the degree of damage to the ellipsoid zone, strong reflex foci, intraretinal cysts, subretinal fluid. Biomarkers include high-sensitivity C-reactive protein, neutrophil to lymphocyte ratio, anti-fumarase antibody, intraocular aqueous humor cell adhesion molecule-1, interleukin (IL)-6, IL-8, etc. Understanding these clinical markers that may predict and evaluate the prognosis of anti-VEGF drug therapy can be beneficial to adjust the treatment plan, and more effectively monitor, treat, and manage DME patients.
The mechanisms behind diabetic retinopathy (DR) can be ascribed primarily to retinal microvascular abnormalities, excessive inflammatory response and neurodegeneration. Circular RNA (circRNA) is a type of endogenous non-coding RNA with a special circular structure, which is mainly composed of precursor RNA after shearing and processing. It is widely present in the retina and participates in the occurrence and development of various fundus diseases. CircRNAs express in an abnormal way in retina, serving as “the sponge” for miRNA so as to play roles in dysfunction of retinal vascular, inflammatory response and neurodegeneration in the development of DR. Further studies for circRNAs in DR will illustrate pathophysiology of DR more deeply, shedding light on circRNAs becoming novel biomarkers and molecular targets for diagnosis and treatment, thus achieving the goal of early diagnosis and precise therapy of DR.
The infection of Hepatitis B virus (HBV) can result in severe consequences, including chronic hepatitis, liver fibrosis, cirrhosis, and even liver cancer. Effective antiviral treatment has the potential to slow down the progression of the disease. HBV serum biomarkers play a crucial role in the dynamic management of chronic hepatitis B (CHB) patients. However, the conventional hepatitis B virus markers, such as hepatitis B serologic testing and HBV DNA, are insufficient to meet the clinical requirements. This review provided a comprehensive overview of the current research on the quantification of HBsAg and anti-HBc, HBV RNA and HBV core-associated antigen, which summarized the crucial role these markers play in the administration of antiviral medications, predicting the efficacy of treatment and anticipating the likelihood of virologic rebound following drug cessation, as well as assessing disease progression in CHB patients.