1.Clinical application of serum neutrophil gelatinase-associated lipocalin combined with cystatin C, blood creatinine, urea nitrogen and urine neutrophil gelatinase-associated lipocalin in the diagnosis of early diabetic nephropathy in elderly patients
Lijuan WANG ; Meng WANG ; Qiangyi WANG ; Qian ZHANG ; Wensong LIU
Chinese Journal of Geriatrics 2025;44(5):590-596
Objective:To investigate the clinical application value of cystatin C(CysC), neutrophil gelatinase-associated lipocalin(NGAL), urea nitrogen(UREA), blood creatinine(Scr)and urinary neutrophil gelatinase-associated lipocalin(NGAL)in early diabetic nephropathy and their relationship with aging.Methods:A total of 140 diabetic patients aged 60 and above who were admitted to Beijing Hospital from July 2022 to November 2022 and 59 healthy people aged 60 and above who underwent physical examination in Beijing hospital during the same period were selected as the study subjects.In January 2023, 157 healthy people over 20 years old who underwent physical examination in Beijing Hospital were used as another group of research objects to explore the relationship between various indicators and aging.According to the urinary microalbumin/urinary creatinine(UACR)ratio, the patients were divided into three groups: 40 patients with simple diabetes mellitus(DM), 57 patients with early diabetic nephropathy(EDN), and 43 patients with diabetic nephropathy(DN).59 healthy subjects were used as control group(NC group).Serum NGAL, Scr, Cys C, UREA and urinary NGAL were detected, and NGAL was determined by latex immunoturbidimetry.Scr was determined by sarcosine oxidase method.Cys C was determined by immunoturbidimetry.Urease-glutamate dehydrogenase method was used to determine UREA.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of urea alone and combined diagnosis in EDN.The relationship between serum NGAL, Scr, Cys C, UREA and urinary NGAL and gender and aging were analyzed in 157 healthy individuals.Results:Compared to the NC group, serum NGAL, Scr, CysC, and UREA levels were significantly higher in the EDN and DN groups(all P<0.01), and the differences between EDN group, DN group and NC group were statistically significant( P<0.01).The values of these markers increased across the NC, DM, EDN, and DN groups.ROC curve shows: The area under curve(AUC)of serum NGAL, Scr, Cys C, UREA, urine NGAL, combined diagnosis 1 and combined diagnosis 2 were 0.655, 0.760, 0.789, 0.753, 0.628, 0.831, 0.827, respectively.The sensitivity of combined diagnosis 1 and combined diagnosis 2 was higher(63.2% and 66.7%), and the specificity of serum NGAL was higher(96.6%).The AUC values of Cys C, co-diagnosis 1, and co-diagnosis 2 were large and correlated(AUC=0.789, 0.831, 0.827, rs=0.501, 0.573, 0.567), and the diagnostic value of Cys C, co-diagnosis 1, and co-diagnosis 2 for EDN was high(AUC=0.789, 0.831, 0.827, Yoden index=0.442, 0.530, 0.531; sensitivity 56.1%, 63.2%, 66.7%; specificity 88.1%, 89.8%, 86.4%).Healthy individuals over 20 years of age: serum NGAL[(127.5±35.5)μg/L vs.(111.5±32.4)μg/L, P=0.004], Scr[(83.4±11.2)μmol/L versus(63.4±11.0)μmol/L, P<0.001], Cys C[(0.8±0.2)mg/L vs.(0.7±0.2)mg/L, P<0.001], and UREA levels were higher in males than females[(5.1±1.1)mmol/L vs.(4.6±1.1)mmol/ L, P=0.002]; urinary NGAL was higher in females than males[22.0(13.0, 37.8)μg/L vs.15.0(10.0, 30.5)μg/L, P=0.025].Cys C( F=16.582, P<0.001), urinary NGAL levels( F=-3.533, P<0.001)basically increased with age. Conclusions:CysC showed a higher diagnostic value for EDN than UREA, Scr, blood NGAL, and urine NGAL in patients aged 60 and above Combined diagnosis 1 and combined diagnosis 2 have higher value in monitoring the progress of DN.The levels of Cys C and urinary NGAL showed a gradually increasing trend with the increase of age, and the levels of serum NGAL, Scr, Cys C and UREA were higher in males than in females.Urinary NGAL was higher in females than males.
2.Clinical application of serum neutrophil gelatinase-associated lipocalin combined with cystatin C, blood creatinine, urea nitrogen and urine neutrophil gelatinase-associated lipocalin in the diagnosis of early diabetic nephropathy in elderly patients
Lijuan WANG ; Meng WANG ; Qiangyi WANG ; Qian ZHANG ; Wensong LIU
Chinese Journal of Geriatrics 2025;44(5):590-596
Objective:To investigate the clinical application value of cystatin C(CysC), neutrophil gelatinase-associated lipocalin(NGAL), urea nitrogen(UREA), blood creatinine(Scr)and urinary neutrophil gelatinase-associated lipocalin(NGAL)in early diabetic nephropathy and their relationship with aging.Methods:A total of 140 diabetic patients aged 60 and above who were admitted to Beijing Hospital from July 2022 to November 2022 and 59 healthy people aged 60 and above who underwent physical examination in Beijing hospital during the same period were selected as the study subjects.In January 2023, 157 healthy people over 20 years old who underwent physical examination in Beijing Hospital were used as another group of research objects to explore the relationship between various indicators and aging.According to the urinary microalbumin/urinary creatinine(UACR)ratio, the patients were divided into three groups: 40 patients with simple diabetes mellitus(DM), 57 patients with early diabetic nephropathy(EDN), and 43 patients with diabetic nephropathy(DN).59 healthy subjects were used as control group(NC group).Serum NGAL, Scr, Cys C, UREA and urinary NGAL were detected, and NGAL was determined by latex immunoturbidimetry.Scr was determined by sarcosine oxidase method.Cys C was determined by immunoturbidimetry.Urease-glutamate dehydrogenase method was used to determine UREA.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of urea alone and combined diagnosis in EDN.The relationship between serum NGAL, Scr, Cys C, UREA and urinary NGAL and gender and aging were analyzed in 157 healthy individuals.Results:Compared to the NC group, serum NGAL, Scr, CysC, and UREA levels were significantly higher in the EDN and DN groups(all P<0.01), and the differences between EDN group, DN group and NC group were statistically significant( P<0.01).The values of these markers increased across the NC, DM, EDN, and DN groups.ROC curve shows: The area under curve(AUC)of serum NGAL, Scr, Cys C, UREA, urine NGAL, combined diagnosis 1 and combined diagnosis 2 were 0.655, 0.760, 0.789, 0.753, 0.628, 0.831, 0.827, respectively.The sensitivity of combined diagnosis 1 and combined diagnosis 2 was higher(63.2% and 66.7%), and the specificity of serum NGAL was higher(96.6%).The AUC values of Cys C, co-diagnosis 1, and co-diagnosis 2 were large and correlated(AUC=0.789, 0.831, 0.827, rs=0.501, 0.573, 0.567), and the diagnostic value of Cys C, co-diagnosis 1, and co-diagnosis 2 for EDN was high(AUC=0.789, 0.831, 0.827, Yoden index=0.442, 0.530, 0.531; sensitivity 56.1%, 63.2%, 66.7%; specificity 88.1%, 89.8%, 86.4%).Healthy individuals over 20 years of age: serum NGAL[(127.5±35.5)μg/L vs.(111.5±32.4)μg/L, P=0.004], Scr[(83.4±11.2)μmol/L versus(63.4±11.0)μmol/L, P<0.001], Cys C[(0.8±0.2)mg/L vs.(0.7±0.2)mg/L, P<0.001], and UREA levels were higher in males than females[(5.1±1.1)mmol/L vs.(4.6±1.1)mmol/ L, P=0.002]; urinary NGAL was higher in females than males[22.0(13.0, 37.8)μg/L vs.15.0(10.0, 30.5)μg/L, P=0.025].Cys C( F=16.582, P<0.001), urinary NGAL levels( F=-3.533, P<0.001)basically increased with age. Conclusions:CysC showed a higher diagnostic value for EDN than UREA, Scr, blood NGAL, and urine NGAL in patients aged 60 and above Combined diagnosis 1 and combined diagnosis 2 have higher value in monitoring the progress of DN.The levels of Cys C and urinary NGAL showed a gradually increasing trend with the increase of age, and the levels of serum NGAL, Scr, Cys C and UREA were higher in males than in females.Urinary NGAL was higher in females than males.
3.Study on quality standard of Yi medicine Gynura japonica and quality evaluation of medicinal materials from different producing areas
EQIXIAOLI ; Jixiu SHEN ; Jiang LUO ; DIJIUCIGA ; Yuan LIU ; Zhengming YANG ; Ying LI
China Pharmacy 2023;34(3):309-314
OBJECTIVE To improve the quality standard of Yi medicine Gynura japonica, and to evaluate its quality. METHODS Using 15 batches of G. japonica from different producing areas as samples, the contents of water, total ash, acid- insoluble ash and water-soluble extract were determined according to the method stated in part Ⅳ of Chinese Pharmacopoeia (2020 edition). The contents of total alkaloid (calculated by senecionine) was determined by UV spectrophotometry. The contents of senecionine and seneciphylline were determined by HPLC. Using above 7 indexes as evaluation indexes, cluster heat map analysis, principal component analysis (PCA) and entropy weight approximation ideal ranking (TOPSIS) were used to evaluate the quality of medicinal material comprehensively. RESULTS Among 15 batches of G. japonica, the moisture contents were 8.88%-12.60%, the total ash contents were 4.43%-11.02%, the acid-insoluble ash contents were 0.56%-3.45%, the water-soluble extract contents were 21.71%-53.91%, the total alkaloid contents (calculated by senecionine) were 0.15%-0.39%, and the contents of senecionine and seneciphylline were 0.01% -0.05% and 0.01%-0.06% respectively. According to the results of various indicators, it was preliminarily proposed that the water content in the sample of G. japonica should not exceed 13.00%, the total ash content should not exceed 11.50%, the acid-insoluble ash content should not exceed 3.70%, the water-soluble extract should not be less than 20.70%, the total alkaloid content should not be less than 0.15%, the contents of senecionine and seneciphylline should not be less than 0.01% both. The results of cluster heat map analysis showed that the 15 batches of samples could be divided into four categories; the results of PCA and TOPSIS showed that the samples with high-quality ranking were jsq-2, jsq-5, jsq-6 and jsq-10, and the samples with low-quality ranking were jsq-4, jsq-13 and jsq-14. CONCLUSIONS In this study, the quantitative analysis method of total alkaloids (calculated by senecionine), senecionine and seneciphylline in G. japonica is established, and the limits of each index are preliminarily determined. Among 15 batches of samples, the qualities of medicinal material collected from Linza Village of Ganluo County of Liangshan Yi Autonomous Prefecture, Machangping Village of Luojishan Town of Puge County of Liangshan Yi Autonomous Prefecture and other places are better.
4.Basic and clinical research progress of diffuse intrinsic pontine glioma
Xiangyi KONG ; Qiangyi ZHOU ; Keyin CHEN ; Shuai LIU ; Yu WANG ; Wenbin MA
Journal of International Oncology 2015;(5):371-373
Diffuse intrinsic pontine glioma( DIPG)is a highly invasive tumor located in the pons (middle)of the brain stem. They are usually diagnosed during childhood and account for 10% -15% of primary brain tumors in children. DIPG has a very poor prognosis. Fewer than 10% of DIPG patients survive more than 2 years after diagnosis. The imaging manifestations of DIPG are typical,and biopsy is only performed in atypi-cal cases. The tissue specimens of newly diagnosed DIPG are very few and limit its molecular biological research. Recent advances in surgical and molecular-analytic techniques have increased the safety of biopsy which has already been used in many clinical trials step by step. The research of DIPG′s molecular pathogenesis and treatment is sure to achieve new breakthroughs.
5.Protective effect of low-dose aprotinin on human blood platelets during cardiopulmonary bypass
Jianhua LI ; Zhuoqi WANG ; Qiangyi LIU
Chinese Journal of Anesthesiology 1995;0(12):-
To assess the effects of low dose aprotinin on platelets during cardiopulmonary bypass(CPB), 45 Patients, aged 20 to 45 years, ASA grade Ⅱ to Ⅲ,undcrgoing elective operation of cardiac valve replacement under fentanyl-enflurane-atracurium anesthesia, were randomly allocated to receiving aprotinin 2 ?106 KIU (group I,n=23 ) or equivalent volume of normal saline as control (group Ⅱ,n= 22) res12ectively,at the same time as CPB began to work. The blood samples were collected after induction of anes- thesia. 5 mins prior to CPB. 5, 15, 30 and 60 mins following CPB,and immedialely before withdrawal of CPB.to measure such 1parameters of platelet as level of cytoplasmic free Ca2+ (CFCa2+),activities of phosphollpase A2 (PLA2) and cyclouoxygenase (PCO) in membrane,aggregation rate (AGR),adhesion rate (ADR ) and count Individually. The lotal blood volume of postoperative tho- racic drainage solution (TBV ) and the re(]uircd blood volume of transfusioll (RBVT) were recorded. The results ahoys(l that dur lug CP14,the levels of CFCa2+ and activitics of PLA2 and PCO increased significantly,and the AGR,ADR and count of plstclet decreased markedly in both groups (P

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