Preoperative Body Weight and Albumin Predict Survival in Patients With Resectable Lung Neoplasms: Role of COPD

IntroductionThe impact of preoperative nutritional status on survival in lung cancer (LC) patients with underlying chronic obstructive pulmonary disease (COPD) is still unclear. We hypothesized that presurgical nutritional assessment may differentially predict mortality in patients with resectable LC with moderate COPD and relatively well-preserved nutritional status.MethodsNutritional assessment [body mass index (BMI), blood parameters including albumin and protein levels, and body weight loss], and other clinical parameters [cigarette smoking (CS) history, LC staging and histological subtypes, COPD severity, lung function, and adjuvant therapy] were evaluated in 125 patients from the LC Mar Prospective Cohort: 87 LC-COPD patients and 38 LC patients without COPD before thoracotomy. Ten-year overall survival (OS) was analyzed in all patients.ResultsPrior to thoracotomy, in LC-COPD patients compared to LC, BMI and albumin declined relatively, low levels of the parameters BMI, albumin, and total proteins were associated with poorer 10-year survival, especially in the LC-COPD. CS burden also correlated with impaired survival. COPD per se worsened the prognosis in LC patients.ConclusionsIn the present cohort of LC patients with resectable tumors and relatively well-preserved nutritional status, the parameters BMI and blood albumin and protein levels measured prior to thoracotomy predicted OS, especially in those with COPD. These are clinically relevant findings, since values of those nutritional parameters were within the normal ranges in the majority of the analyzed patients. A thorough nutritional preoperative assessment should be included in the study of patients with resectable LC, particularly in those with chronic airway obstruction.     

缺血修饰白蛋白在运动压力测试中的应用探讨

目的评估冠状动脉疾病患者进行运动压力测试后血液中缺血修饰白蛋白的水平。方法选取本院49例一周内出现胸痛的患者，进行冠脉造影与单车运动压力测试，采集开始运动测试时的血液样本测试缺血修饰白蛋白，作为基线水平，5分钟后再次采样测试缺血修饰白蛋白水平。结果49例患者中，共中有25例（冠状动脉疾病组）有冠状动脉狭窄，另外24例（非冠状动脉疾病组）无冠状动脉狭窄。而缺血修饰白蛋白水平在基线水平与运动水平并无差异，冠状动脉疾病纽与非冠状动脉疾病组基线水平分别为70．7±7．2U／mL、72．5±6．4U／mL，而运动后水平为74．1±5．1、75．8±6．8U／mL，冠状动脉疾病组与非冠状动脉疾病组对比结果分别为P=0．28，P=0．55，二者无明显统计学差异。同时在运动后缺血修饰白蛋白水平变化值两组分别为5．4±3．5、4．7±7．6U／mL，P=0．10；同样的，在心电图阳性组（16例）与心电图阴性组（33例）缺血修饰白蛋白水平变化也无明显差异（6．6±3．IU／mL、7．50±4．2U／mL，P=0．15）。结论缺血修饰白蛋白在运动测试中对于急性冠脉综舍症的诊断并不适用。     

血清-腹水蛋白梯度在腹水病因诊断中的价值

[目的]探讨血清腹水蛋白梯度( SAAG)在腹水病因诊断中的价值.[方法]将入诊的80例腹水患者,按腹水形成机制分为门脉高压组(42例)和非门脉高压组(38例),以同天采样同步检查的血清白蛋白浓度和腹水白蛋白浓度计算SAAG,比较2组SAAG与诊断的关系.[结果]门脉高压组的SAAG显著高于非门脉高压组(P＜0.01).[结论]SAAG对诊断腹水有重要价值,但不能完全代替其他检查方法,有时还需要联合监测以提高腹水诊断率.     

Expression of muscarinic acetylcholine receptors in hepatocytes from rat fibrotic liver

The pathological changes of parasympathetic nerve are considered as an independent prognostic factor of the survival rate of patients with chronic liver disease. The non-selective muscarinic acetylcholine receptors (mAchR) agonists and antagonists can affect the proliferation of hepatocytes and hepatic stellate cells, but the subtypes of mAchR expressions in HCs are still uncertain. Here, we investigate the expression of mAchR in hepatic fibrosis on rats. 3 ml/kg 40% carbon tetrachloride (CCL4) was given to induce hepatic fibrosis on rats and the hepatocytes were isolated. Compared to the normal state, the expression levels of m1, 3, 5 in fibrotic liver tissues or hepatocytes were obviously increased, while m2, 4 decreased. 10 μM pilocarpine or 10 μM acetylcholine could increase the alanine aminotransferase (ALT), hydroxyproline (Hyp), collagen I, III in the hepatocytes, and decreased albumin (ALB). They also changed the expressions of mAchR similarly as the fibrotic hepatocytes and livers. However, atropine could ameliorate the state of fibrotic hepatocytes. These data indicate that mAchR played an important role in the regulation of hepatic fibrosis process. Targeting mAchR would have therapeutic potential for hepatic fibrosis.     

Prognostic implications of ischemia modified albumin in known cases of 86 elderly hypertensive South Asian aged 56–64 years – a hospital based study

ObjectiveTo study associated ischemia modified albumin in hypertensive participants and to compare the results with normotensive healthy controls.MethodsA total of 86 hypertensive patients and 86 age-sex matched normotensive healthy volunteers were selected for this study. The study was conducted for a period of 3 years from September 2007 to August 2010. Biochemical parameters and other parameters such as smoking habits, systolic and diastolic blood pressure and family history were recorded. Lipid profile, ischemia modified albumin, malondialdehyde and conjugated diene were measured by standard methods and results were compared between patients and controls.ResultsTotal cholesterol, triglycerides, low density lipoprotein cholesterol were significantly higher (P<0.001) in hypertensive subjects when compared to normotensive control. Also, significant differences were seen in high density lipoprotein cholesterol levels between both groups (P<0.001). The index of lipid per oxidation comprising both malondialdehyde and conjugated dienes were significantly higher in hypertensive compared to normotensive controls. Ischemia modified albumin levels were significantly increased among hypertensive compared to normotensive controls (P<0.001).ConclusionsHypertensive patients have increased oxidative stress and are accompanied with rise in ischemia modified albumin. Ischemia modified albumin could be incorporated as a diagnostic test parameter in hypertensive to avoid the future acute coronary complications.     

Skin permeation and metabolism of di(2-ethylhexyl) phthalate (DEHP)

Phthalates are suspected to be endocrine disruptors. Di(2-ethylhexyl) phthalate (DEHP) is assumed to have low dermal absorption; however, previous in vitro skin permeation studies have shown large permeation differences. Our aims were to determine DEHP permeation parameters and assess extent of skin DEHP metabolism among workers highly exposed to these lipophilic, low volatile substances.     

光谱法结合分子模拟与网络药理学分析青藤碱的蛋白输运与靶蛋白结合的连续药效机制

目的 为进一步全面研究青藤碱(sinomenine,SIN)对血清白蛋白(human serum albumin,HSA)和封闭蛋白3(claudin 3,CLDN3)两者的分子间作用机理,提供借鉴和有益参考。方法 利用光谱分析法结合物理建模和网络药理学,来研究SIN与HSA和CLDN3的分子间相互作用机理。结果 网络药理学结论表明,SIN与HSA和CLDN3两个蛋白的结合参数与已验证靶点相似,可发生相互作用。光谱实验表明,SIN与HSA和CLDN3发生分子间相互作用,微环境的疏水性增强,与HSA/CLDN3分子间作用的位域以色氨酸残基为主,产生了稳定的非共价复合物。由理论分析可知SIN与HSA/CLDN3的反应机制是静态猝灭,构象型态变迁过程是1个“二态”模型,仅存在1个结合位点,相互作用主要为疏水作用力、氢键和范德华力,两个体系均符合非辐射能量转移理论。物理建模结果表明,在SIN与HSA和CLDN3的分子间作用中,疏水作用力和氢键起着关键作用,且结合物稳定,与光谱实验结果一致。结论 HSA作为输运蛋白,CLDN3作为与子宫内膜癌密切相关的靶点蛋白,本研究将网络药理学、光谱分析和物理建模结合起来,在不进行细胞实验的情况下,就可验证该反应通路的预测。     

Nanomedicine for acute respiratory distress syndrome: The latest application,targeting strategy,and rational design

Acute respiratory distress syndrome (ARDS) is characterized by the severe inflammation and destruction of the lung air–blood barrier, leading to irreversible and substantial respiratory function damage. Patients with coronavirus disease 2019 (COVID-19) have been encountered with a high risk of ARDS, underscoring the urgency for exploiting effective therapy. However, proper medications for ARDS are still lacking due to poor pharmacokinetics, non-specific side effects, inability to surmount pulmonary barrier, and inadequate management of heterogeneity. The increased lung permeability in the pathological environment of ARDS may contribute to nanoparticle-mediated passive targeting delivery. Nanomedicine has demonstrated unique advantages in solving the dilemma of ARDS drug therapy, which can address the shortcomings and limitations of traditional anti-inflammatory or antioxidant drug treatment. Through passive, active, or physicochemical targeting, nanocarriers can interact with lung epithelium/endothelium and inflammatory cells to reverse abnormal changes and restore homeostasis of the pulmonary environment, thereby showing good therapeutic activity and reduced toxicity. This article reviews the latest applications of nanomedicine in pre-clinical ARDS therapy, highlights the strategies for targeted treatment of lung inflammation, presents the innovative drug delivery systems, and provides inspiration for strengthening the therapeutic effect of nanomedicine-based treatment.