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Objective:To observe the efficacy of calcitriol combined with calcium receptor agonist therapy in patients with chronic renal failure-secondary hyperparathyroidism (CRF-SHPT) and its serum β2-Effects of β2-microglobulin ( β2-MG) and fibroblast growth factor-23 (FGF-23) levels. Methods:A total of 86 patients with CRF-SHPT who were admitted to the Department of Nephrology, Huzhou Hospital of Traditional Chinese Medicine, Zhejiang University of Traditional Chinese Medicine from Mar. 2020 to Mar. 2022 were included. Triol treatment) , combined treatment group (43 cases, calcitriol + calcium receptor agonist treatment) , the treatment effect was evaluated, and the serum phosphorus (P 3-) , serum calcium (Ca 2+) , ,and serum levels were measured before and after treatment intact parathyroid hormone (iPTH) , β2-MG, FGF-23 and renal function, blood lipid index levels, the occurrence of adverse reactions during the administration period, the measurement data were compared between groups using independent samples t test, count Comparison of data between groups was performed using the χ2 test. Results:The total effective rate (90.70%) in the combined treatment group was significantly higher than that in the control group (72.09%) ( χ2=4.91, P=0.027) ; the levels of P 3- and iPTH in the combined treatment group after treatment [ (220.16±23.76) ng/L, (1.22±0.14) mmol/L] were significantly lower than the control group [ (301.25±31.71) ng/L, (1.64±0.18) mmol/L], and the Ca 2+ level in the combined treatment group was significantly higher (2.59±0.41) mmol/L. Compared with the control group (2.26±0.34) mmol/L ( t=13.42, 12.08, 4.06, P=0.000, 0.000, 0.0000) , the serum levels of β2-MG and FGF-23 in the combined treatment group after treatment [ (34.67±4.12) mg/L, (71.36±8.05) ng/L] were significantly lower than the control group [ (40.36±4.87) mg/L, (78.97±8.73) ng/L] ( t=5.85, 4.20, P=0.000, 0.000) ; After treatment, the levels of triglyceride (TG) and total cholesterol (TC) in the combined treatment group [ (1.51±0.19) mmol/L, (4.11±0.51) mmol/L] were significantly lower than those in the control group[ (1.74±0.24) mmol/L, (4.75±0.59) mmol/L] ( t=4.93, 5.38, P=0.000, 0.000) ; Serum creatinine (Scr) , blood urea nitrogen (blood urea) in the two groups after treatment. There was no significant change in nitrogen) levels ( P>0.05) ; there was no significant difference in the incidence of adverse reactions between the combined treatment group and the control group during the treatment period ( P>0.05) . Conclusion:The treatment of CRF-SHPT patients with calcitriol combined with calcium receptor agonists can effectively reduce the iPTH level, improve the calcium-phosphorus imbalance and lipid metabolism disorder, and down-regulate the serum FGF-23 and β2-MG levels without damaging renal function of the residual of the patients.
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OBJECTIVE@#To investigate the prognostic value of serum and cerebrospinal fluid β2-microglobulin (β2-MG) in acute lymphoblastic leukemia (ALL) with central nervous system invasion after chemotherapy.@*METHODS@#40 patients with leukemia who had been confirmed to have central nervous system infiltration were selected for treatment at the Second Affiliated Hospital of Chongqing Medical University from January 2015 to May 2017, and the serum levels of β2-MG and CSF-β2MG were dynamically monitored and performed statistical analysis.@*RESULTS@#After chemotherapy, the changes in serum β2-MG were not statistically significant (P>0.05); the absolute level of CSF-β2MG and the percentage of relative baseline changes were statistically different in different clinical outcome groups(P<0.05), and the decreasing CSF-β2MG levels suggest a better prognosis, with cut-off values of 1.505 and -25%, respectively.@*CONCLUSION@#The best cut-off point may be a predictor of complete remission; the reduction of the absolute and relative levels of CSF-β2MG can suggest a good prognosis for patients.
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Humans , Central Nervous System , Cerebrospinal Fluid , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Prognosis , Remission Induction , beta 2-MicroglobulinABSTRACT
Context: The fluctuations of proteins in multiple myeloma (MM) are well-known markers for checking the status of the patients. Aims: The objective of this study was to examine three proteins that have an important role in disease progression. Subjects and Methods: The study was performed with two groups: 30 MM stage I patients' (14 females/16 males; aged 60.83 ± 12.38 years) as case group and 40 healthy individuals (18 females/22 males; aged 57.65 ± 6.43 years) as control group. Both groups have been matched in gender and age. Bone sialoprotein (BSP), osteopontin (OPN), and β2-microglobulin (β2M) were measured with an enzyme-linked immunosorbent assay. Results: Serum BSP levels of MM-I patients was significantly higher than that of healthy controls (29.24 ± 5.57 vs. 20.89 ± 3.67, P = 0.001). OPN levels of MM-I patients were significantly lower than that of healthy individuals (12.03 ± 3.45 vs. 19.35 ± 4.67, P = 0.001). β2M levels of patients and controls were similar (1.49 ± 0.67 vs. 1.29 ± 0.55, P = 0.193). Conclusions: The results suggested that myeloma cells may affect the production of BSP and OPN, which possibly contributes to osteoclastic bone resorption in MM-I patients. Their levels may be a useful biomarker for assessing bone destruction in MM-I patients and distinguishing MM-I from healthy individuals
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Objective To explore the application value of serum cystatin C (Cys-C)and β2-micro-globulin (β2-MG)in the diagnosis and short-term efficacy evaluation of multiple myeloma (MM). Methods A total of 450 patients with MM admitted to Anqing Hospital of Chinese People's Liberation Army Navy and Jin-hua Central Hospital of Zhejiang Province from October 2016 to October 2018 were selected as subjects (MM group),according to the Durie-Salmon staging criteria,including 150 patients in stage Ⅰ,Ⅱ and Ⅲ. A total of 150 healthy subjects were selected as the control group. The levels of Cys-C and β2-MG in the serum of the subjects were determined. The differences of Cys-C and β2-MG levels between the two groups and the MM patients with different Durie-Salmon stages were compared. The differences of Cys-C and β2-MG levels between the patients with different short-term efficacy were compared. The receiver operating characteristic (ROC) curve was used to analyze the value of the two indicators in the evaluation of MM efficacy,and the correlation between Cys-C and β2-GM was analyzed. Logistic regression analysis was used to analyze the multiple factors affecting the clinical efficacy of MM patients. Results The levels of Cys-C and β2-MG in the serum of the patients with MM were (2. 11 ± 0. 78)mg/ L and (6. 07 ± 3. 08)g/ L respectively,and those in the control group were (0. 75 ± 0. 20)mg/ L and (1. 78 ± 0. 59)g/ L,with significant differences (t = 33. 848,P <0. 001;t = 28. 084,P < 0. 001). The Cys-C levels of Durie-Salmon stage Ⅰ,Ⅱ and Ⅲ patients were (0. 99 ± 0. 21)mg/ L,(1. 36 ± 0. 17)mg/ L and (3. 07 ± 1. 02)mg/ L respectively,and the difference was statistically significant (F = 44. 157,P < 0. 001). The β2-MG levels in the serum of patients with stage Ⅰ,Ⅱand Ⅲ were (2. 57 ± 0. 75)g/ L,(4. 66 ± 1. 43)g/ L,(8. 63 ± 2. 26)g/ L respectively,and the difference was statistically significant (F = 57. 285,P < 0. 001). In all the patients,338 patients were effective,accoun-ting for 75. 11％,and 112 patients were ineffective,accounting for 24. 89％ . The levels of Cys-C and β2-MG in the serum of the effective MM patients were (1. 28 ± 0. 23)mg/ L and (2. 82 ± 0. 78)g/ L,and those of ineffective patients were (2. 97 ± 0. 77)mg/ L and (6. 22 ± 1. 92)g/ L,with statistically significant differences (t = 35. 874,P < 0. 001;t = 26. 633,P < 0. 001). The sensitivity of serum Cys-C for predicting short-term efficacy was 83. 0％,the specificity was 76. 6％,and those of serum β2-MG were 89. 3％ and 73. 6％ . The area under curve (AUC)of the serum Cys-C was 0. 813 (95％ CI:0. 764-0. 862),and the AUC of serumβ2-MG was 0. 865 (95％ CI:0. 825-0. 906),with a statistically significant difference (Z = 2. 490,P =0. 011). Spearman correlation analysis showed a positive correlation between serum Cys-C and β2-MG (r =0. 539,P = 0. 041). Logistic regression analysis showed that both β2-MG (95％ CI:2. 386-5. 144,P <0. 001)and Cys-C (95％ CI:2. 367-9. 702,P < 0. 001)were independent factors affecting the short-term effi-cacy of MM. Multivariate analysis showed that β2-MG (95％ CI:3. 549-13. 739,P = 0. 001 )was an independent factor affecting the efficacy of MM. Conclusion The levels of serum Cys-C and β2-M in MM patients are significantly higher than those in healthy people,and they show an increasing trend with the pro-gression of MM disease,which can be used as markers for the pathological staging diagnosis of MM patients. The short-term efficacy of the patients can be evaluated by using the two indicators,and the clinical significance in efficacy evaluation of β2-MG is slightly better than that of Cys-C.
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Objective:To investigate the effects of hemodialysis (HD) and hemoperfusion (HP) combination treatment on maintenance hemodialysis (MHD) patients. Methods:A total of 80 MHD patients in Chongming Branch of Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from July 2017 to July 2018 were randomly divided into two groups, i.e., HD+HP group (n=40) and HD group (n=40). The patients were followed up every 3 months for 1 year. The changes of laboratory indexes, dialysis adequacy indicators and quality of life scores of Kidney Disease Quality of Life-Short Form (KDQOL-SF) were compared between the two groups, and the prognosis, causes of death and adverse events were recorded. Results:At the end of one-year treatment, levels of parathyroid hormone (PTH), β2-microglobulin (β2-MG), high sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and left ventricular mass index (LVMI) were significantly lower in HD+HP group than those in HD group (P0.05). The overall mortality rates of HD+HP group and HD group were 12.5% and 32.5%, respectively. No significant adverse events were observed during the follow-up. Conclusion:The effects of HD combined with HP on clearing middle and large molecular toxins, reducing microinflammation status, and improving renal anemia and left ventricular hypertrophy are better than those of only HD. There may be potential advantages of HD and HP combination in improving quality of life in MHD patients as well.
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Objective To study the effects of hemodialysis (HD) combined with hemoperfusion (HP) on sleep quality in maintenance hemodialysis (MHD) patients. Methods Sixty MHD patients admitted to Department of Blood Purification of Wuhan General Hospital of PLA from January to December 2016, 30 cases were treated with HD, and the other 30 cases were treated by HD+HP, the course of treatment was 12 weeks in both groups. The changes of serum β2-microglobulin (β2-MG) and parathyroid hormone (iPTH) were observed before treatment and 12 weeks after treatment; the sleep quality of all patients in the two groups were evaluated by Pittsburgh Sleep Quality Index (PSQI) Scale, and the correlations between the sleep quality of MHD patients andβ2-MG level, iPTH level were analyzed by Pearson linear correlation analysis. Results All the 60 patients completed the treatment. The serum β2-MG, iPTH levels and PSQI score after treatment were decreased obviously in HD+HP group compared with those before treatment, and the degrees of decrease in HD+HP group were more significant than those in the HD group [β2-MG (mg/L): 12.34±2.12 vs. 20.27±3.15, iPTH (ng/L): 224.54±100.28 vs. 398.42±155.37, PSQI score:8.56±0.86 vs. 12.45±0.88, all P < 0.05]. Pearson linear correlation analysis showed that the PSQI score was significantly positively correlated with serum β2-MG, iPTH level (r respectively was 0.416 and 0.462, both P < 0.01). Conclusion HD+HP therapy can significantly improve the sleep quality of MHD patients, and the mechanism may be related to the elimination of serum iPTH and β2-MG from the body of MHD patients.
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Objective: To investigate the clinical characteristics, treatment regimens, and outcomes of patients with primary breast dif-fuse large B-cell lymphoma (PB-DLBCL). Methods: Between January 2010 and January 2018, 21 patients with PB-DLBCL were diag-nosed, treated, and followed up at the First Affiliated Hospital of Zhengzhou University. All patients were female, with a median age of 49 years (ranging from 21 to 77 years) at presentation. All patients received chemotherapy, of which 17 patients received the CHOP regimen and 4 received the EPOCH regimen. Eight patients received chemotherapy followed by radiotherapy, and 13 received chemo-therapy alone. Six patients received prophylactic intrathecal injections. The incidences of refractory and progressive disease between patients who received different regimens were analyzed using the Chi-square test. The overall survival (OS) and progression-free sur-vival (PFS) rates were calculated using the Kaplan-Meier method, and differences in survival were compared using the Log-rank test. Multivariate analysis was performed with the Cox-regression model for those factors that were confirmed as significant in the univari-ate analysis. Results: The most common presentation was a painless mass. The 5-year OS and PFS rates were 74% and 66%, respective-ly. There was no significant difference in the incidence of refractory or progressive disease between the EPOCH and CHOP groups (P=0.603). Six of those who received prophylactic intrathecal injections had no central nervous system recurrence, and 2 patients who did not receive prophylactic intrathecal injections had central nervous system recurrence. Univariate and multivariate analyses showed that both the level of serum β2 microglobulin [P=0.044, hazard ratio (HR)=0.431, 95% confidence interval (CI): 0.432-0.967] and radio-therapy (P=0.002, HR=0.495, 95% CI: 1.073-2.508) were related to the OS of PB-DLBCL. Conclusions: PB-DLBCL often occurs in women, mostly involving the unilateral breast, which manifests mainly as a painless mass. The level of serum β2 microglobulin is a factor of poor prognosis in PB-DLBCL. The treatment modality of chemotherapy combined with radiotherapy can significantly improve the OS of PB-DLBCL. Prophylactic intrathecal injections may be useful to reduce the incidence of refractory disease or recurrence in the central nervous system.
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Objective: To assess the clinical significance of changes in levels of serum β2 microglobulin (β2-MG), vascular endothelial growth factor (VEGF), and lactate dehydrogenase (LDH) in patients with diffuse large B-cell lymphoma (DLBCL) after treatment. Methods: A total of 89 patients with DLBCL who were admitted to the hospital between February 2015 an July 2017 were included in the DLBCL group and 40 normal, healthy persons admitted during the same period were selected as the control group. All DLBCL patients underwent standard chemotherapy after admission. Peripheral venous blood was collected before and after chemotherapy to determine any changes in serum β2-MG, VEGF, and LDH levels. Biomarker levels were also compared with those from normal, healthy subjects. The clinical and pathological data of all DLBCL patients were collected and the relationships between changes in biomarker levels, clinical and pathological parameters of DLBCL, and curative effects were analyzed. Results: The levels of serum β2-MG, VEGF, and LDH in the DLBCL group were higher than those in the control group (P<0.05) and all levels in DLBCL group decreased after chemotherapy (P<0.05). The effective rate of the R-CHOP group was higher than that of the CHOP group (P<0.05). Serum LDH levels were higher in patients with typical B symptoms than in those without such symptoms (P<0.05). Serum levels of β2-MG, VEGF, and LDH were higher in patients with Ann Arbor stageⅢ-Ⅳlymphoma, with bone marrow involvement, whose international prognostic index (IPI) was high-risk, and with treatment failure than in those with stageⅠ-Ⅱlymphoma, without bone marrow involvement, with low-risk IPI, and with treatment response (P<0.05). The levels of serum VEGF, β2-MG, and LDH were positively correlated with each other, and all three biomarkers were negatively correlated with treatment response (P<0.05). Conclusions: Levels of serum β2-MG, VEGF, and LDH are elevated in patients with DLBCL but are significantly decreased after treatment. Changes in expression levels of these three biomarkers are related to clinical stage, bone marrow involvement, IPI, and treatment response. These biomarkers can be used as a basis for monitoring DLBCL and evaluating curative effect and prognosis.
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Objective To investigate the clinical effect of lenalidomide combined with modified MP regimen in the treatment of multiple myeloma( MM) . Methods Eighty=four elderly multiple myeloma patients treated in Tangshan City Workers'Hospital from January 2013 December 2016 were enrolled in this study. The patients were randomly divided into treatment group ( 42 cases) and control group ( 42 cases) . The patients in the treatment group were given LMP regimen +α2b? interferon. The patients in the control group received the standard MPT regimen. The changes of the level of β2 microglobulin in the two groups before and after treatment were compared,and the total effective rate in the two groups was compared. Results No statistically significant difference was showed between the two groups in β2 microglobulin before treatment ( P>0. 05) . After treatment,β2 microglobulin concentration in the treatment group was (3. 11±0. 28) and was (4. 75±0. 36) in the control group,there was significant difference between two groups ( t=9. 094,P<0. 05); the total effective rate of the treatment group was 83. 33％,59. 52％ in the control group,there was significant difference between two groups ( t=5. 833,P=0. 016) . The incidence of adverse reactions in the treatment group was 9. 52％,the control group was 26. 19％,and the two groups were statistically significant ( t=3. 977,P=0. 046) . Conclusion The clinical effect of Lenalidomide combined with modified MP regimen in the treatment of MM is better than that of conventional treatment,the total effective rate is highwe,with less adverse reactions.
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Objective To prepare quality control material of β2-microglobulin (β2 MG),then evaluate the quality of it.Methods The quality control material of β2-MG was prepared with pooled serum from patients.Then according to Guidance on Evaluating the Homogeneity and Stability of Samples Used for Proficiency Testing and ISO Guide 35,the homogeneity and stability of it was evaluated.Results According to the result of homogeneity test,there was no statistically significant difference between within groups and between-groups (F=0.699,2.091,all P＞0.05) for 2 levels of quality control materi al.What was more,the stability test showed that it could stabilize for at least 5 days at 25 ℃ (t=-1.76,-2.64,all P＞ 0.05),28 days at 4 ℃ (t=-1.86,-2.44,all P＞0.05),4 months at-20 ℃ (t=0.26,-2.68,allP＞0.05),and 1 yearat -80℃ (t=-0.96,0.01,all P＞0.05).Conclusion Quality control material of β2-MG has simple preparation.The homogeneity and stability of it meets the standard requirements.
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Objective To understand the correlation of expression levels of serum stromal cell-derived factor 1α (SDF-1α), osteoprotegerin (OPG) and β2microglobulin (β2-MG) in patients with multiple myeloma (MM) with or without myeloma bone disease (MBD). Methods Eighty patients with MM who were admitted to the Affiliated Hospital of Inner Mongolia Medical University from January 2014 to June 2017 were selected; all of the patients met the international diagnostic criteria for MM. According to the symptoms such as bone pain, the patients were divided into group with MBD (45 cases) and group without MBD (35 cases). Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of SDF-1α and OPG, and radioimmunoassay was used to detect the expression of MM major prognostic indicator β2-MG. The MBD score was evaluated in 45 patients selected by random number table after sacroiliac joint X-ray and three-dimensional bone reconstruction. The χ 2test was used to compare the categorical variables; the two independent sample t-test was used to compare the continuous variables that conformed to the normal distribution between two groups, and the Pearson method was used for the correlation analysis. Results The expression level of serum SDF-1α in the group with MBD was significantly higher than that in the group without MBD [0.31±0.17) pg/ml vs. (0.18±0.06) pg/ml], and the difference was statistically significant (t ＝-4.21, P < 0.001). The expression level of serum OPG in the group with MBD was significantly lower than that in the group without MBD [(0.73±0.50) pg/ml vs. (1.08±0.31) pg/ml], and the difference was statistically significant (t＝ 3.62, P< 0.001). Pearson analysis showed that β2-MG level in the group was positively correlated with SDF-1α level (r＝ 0.84, P< 0.001), and negatively correlated with OPG level (r＝ -0.48, P<0.001). The β2-MG level in the group without MBD did not show a correlation with the SDF-1α and OPG levels. Conclusions In the serum of patients with MBD, the expression levels of β2-MG and SDF-1α are increased, and the expression level of OPG is decreased. SDF-1α and OPG may be new clinical biochemical indicators for diagnosis, treatment and prognosis assessment in MBD.
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Objective To investigate the expression levels of serum vascular endothelial growth factor (VEGF), lactate dehydrogenase (LDH), sugar chain antigen-125 (CA125), and β2-microglobulin (β2-MG) in peripheral blood of patients with diffuse large B-cell lymphoma (DLBCL) and their clinical significances. Methods Thirty cases of DLBCL diagnosed by pathology in Fenyang Hospital of Shanxi Province and Shanxi Dayi Hospital from December 2011 to June 2013, 20 cases of healthy individuals as normal control group were enrolled. The levels of serum VEGF, CA125 and β2-MG in peripheral blood were detected by enzyme-linked immunosorbent assay (ELISA). Serum levels of LDH were detected by the rate method for measuring. Results The expression levels of VEGF, LDH, CA125 and β2-MG in DLBCL patients were higher than those in the healthy control group [(368±194) vs. (156±48) pg/ml, t=5.718, P=0.000;(487±252) vs. (177±32) U/L, t= 6.658, P= 0.000; (58 ±16) vs. (19 ±10) U/ml, t= 9.701, P= 0.000; (3.1 ±1.5) vs. (1.6 ±0.3 ) mg/L, t=5.612, P=0.000]. The expression levels of serum VEGF and LDH in DLBCL patients with stage Ⅲ-Ⅳ were significantly higher than those in patients with stage Ⅰ-Ⅱ [(506±165) vs. (275±154) pg/ml, t= 3.896, P=0.000; (886 ±433) vs. (220 ±86) U/L, t= 5.244, P= 0.000]. The expression levels of VEGF and LDH in DLBCL patients with bone marrow infiltration were higher than those in patients without bone marrow infiltration [(505±201) vs. (299±152) pg/ml, t= 3.148, P= 0.004; (798±463) vs. (331±166) U/L, t= 3.113, P=0.005]. There were no significant differences in the expression levels of VEGF and LDH between patients with A symptoms and B symptoms (all P>0.05). The serum levels of CA125 and β2-MG in the observation group had not relationship with clinical stage, the presence of A or B symptoms and the presence of bone marrow infiltration (all P> 0.05). The high expression of VEGF had correlation with the high expression of LDH in the observation group (r=0.458, P<0.05). Conclusions The expression levels of VEGF, LDH, CA125 andβ2-MG in DLBCL patients before treatment are high, and the high expression levels of VEGF and LDH are closely related to the clinical stage, disease progression and invasion. Combined detection of VEGF and LDH may be a useful predictor of bone marrow involvement in patients with DLBCL.
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<p><b>Background</b>As a major complication after orthotopic liver transplantation (OLT), the occurrence of acute kidney injury (AKI) is frequently defined by serum creatinine (Cr); however, the accuracy of commonly used blood urea nitrogen (BUN), uric acid (UA), and β-microglobulin (β-MG) remains to be explored. This retrospective study compared the accuracy of these parameters for post-OLT AKI evaluation.</p><p><b>Methods</b>Patients who underwent OLT in three centers between July 2003 and December 2013 were enrolled. The postoperative AKI group was diagnosed by the Kidney Disease Improving Global Outcomes (KDIGO) criteria and classified by stage. Measurement data were analyzed using the t-test or Wilcoxon rank-sum test; enumerated data were analyzed using the Chi-square test or Fisher's exact test. Diagnostic reliability and predictive accuracy were evaluated using receiver operating characteristic (ROC) curve analysis.</p><p><b>Results</b>This study excluded 976 cases and analyzed 697 patients (578 men and 119 women); the post-OLT AKI incidence was 0.409. Compared with the no-AKI group, the AKI group showed very significant differences in Model for End-stage Liver Disease score (14.74 ± 9.91 vs. 11.07 ± 9.54, Z = 5.404; P < 0.001), hepatic encephalopathy (45 [15.8%] vs. 30 [7.3%], χ = 12.699; P < 0.001), hemofiltration (28 [9.8%] vs. 0 [0.0%], χ = 42.171; P < 0.001), and 28-day mortality (23 [8.1%] vs. 9 [2.2%], χ = 13.323; P <0.001). Moreover, mean values of Cr, BUN, UA, and β-MG in the AKI group differed significantly at postoperative days 1, 3, and 7 (all P < 0.001). ROC curve area was 0.847 of Cr for the detection of AKI Stage 1 (sensitivity 80.1%, specificity 75.7%, cutoff value 88.23 μmol/L), 0.916 for Stage 2 (sensitivity 87.6%, specificity 82.6%, cutoff value 99.9 μmol/L), and 0.972 for Stage 3 (sensitivity 94.1%, specificity 88.2%, cutoff value 122.90 μmol/L).</p><p><b>Conclusion</b>The sensitivity and specificity of serum Cr might be a high-value indicator for the diagnosis and grading of post-OLT AKI.</p>
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Adult , Female , Humans , Male , Middle Aged , Acute Kidney Injury , Blood , Blood Urea Nitrogen , Creatinine , Blood , Liver Transplantation , Retrospective Studies , Uric Acid , Blood , beta 2-Microglobulin , BloodABSTRACT
Objective To explore the diagnostic values of combined detection of serum procalcitonin (PCT) and β2 microglobulin (β2MG) in tsutsugamushi disease.Methods Serum PCT and β2MG were compared in cases of tsutsugamushi disease and fever patients at the same time,who were hospitalized at Fourth Affiliated Hospital of Guangxi Medical University from June 2014 to May 2017.The best diagnosis cut-off value of tsutsugamushi disease was calculated by receiver operating characteristic (ROC) curve.Results A total of 57 cases of tsutsugamushi disease,40 cases of sepsis,17 cases of acquired immunodeficiency syndrome (AIDS),17 cases of severe community-acquired pneumonia (SCAP),63 cases of common community-acquired pneumonia (CCAP),14 cases of pulmonary tuberculosis (PTB),20 cases of upper respiratory tract infection,13 cases of other infectious fever and 28 cases of non-infectious fever patients were selected.The level of serum PCT in tsutsugamushi disease [0.87 (0.68-1.34) μg/L] was higher than those in AIDS [0.47 (0.20-1.12) μg/L],CCAP [0.17 (0.09-0.51) μg/L],PTB [0.13 (0.05-0.18) μg/L],upper respiratory tract infection [0.23 (0.05-0.48) μg/L] and non-infectious fever [0.09 (0.06-0.13) μg/L],but was lower than those in sepsis [5.00 (1.04-18.78) μg/L] and SCAP [3.35 (0.76-14.41) p,g/L,P ＜ 0.05],while the difference was not significant compared with other infectious fever [0.76 (0.13-1.99) μg/L,P ＞ 0.05].The level of serum β2MG in tsutsugamushi disease [(5.67 (4.47-7.90) mg/L] was higher than those in sepsis [2.83 (2.10-4.54) mg/L],AIDS [3.85 (3.19-5.22) mg/L],SCAP [3.83 (2.98-5.58) mg/L],CCAP [1.99 (1.51-2.75) mg/L],PTB [1.92 (1.37-3.00) mg/L],upper respiratory tract infection [2.02 (1.25-2.74) mg/L],other infectious fever [2.45 (1.51-4.12) mg/L] and non-infectious fever [2.99 (2.06-4.30) mg/L,P ＜ 0.05].ROC curve showed that the most suitable diagnosis cut-off value of serum PCT in tsutsugamushi disease was 0.53 μg/L,the sensitivity was 94.7％,and the specificity was 60.4％.The critical value of serum β2MG was 3.74 mg/L in diagnosis of tsutsugamushi disease,its corresponding sensitivity and specificity were 91.2％ and 75.9％,respectively.The sensitivity and specificity of combined serum PCT and β2MG in diagnosis of tsutsugamushi disease was 87.7％ and 86.3％,respectively.Conclusion Combined detection with serum PCT and β2MG can improve early diagnosis of tsutsugamushi disease.
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Multiple myeloma is a condition of malignant plasma cell proliferation derived from a single B-cell lineage. These cells produce monoclonal immunoglobulins, most commonly either immunoglobulin G (IgG) or immunoglobulin A (IgA). The peak incidence of MM is in the seventh decade, whereas, it is a rare entity in young patients. Here we are presenting a case report of 33 years old male patient with diagnosis of Multiple myeloma WHERE are able to find and document the classical features of Multiple myeloma. Increased level of β2 microglobulin, serum creatinine, IL-6, IL-2 and plasmablastic type myeloma cells suggest poor prognosis of mm patients.
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Objective To study the effect of serum β2 micro-globulin(β2-MG) level change on the diagnostic efficiency of renal damage .Methods A total of 254 cases of hepatorenal diseases in our hospital from October 2015 to October 2016 were selected and divided into the liver damage group(87 cases) ,renal damage group(113 cases) and hepatorenal damage group(54 cases) according to the hepatorenal function .Contemporaneous 85 cases undergoing healthy physical examination were collected as the control group .The levels of ALT ,AST ,β2-MG and creatinine(Cr) were detected in each group .Results There was no correlation between the serum ALT level and serum β2-MG level in liver damage group(r=0 .046 ,P=0 .674) ,while the serum AST level was correla-ted with the serum β2-MG level(r=0 .251 ,P=0 .020) ,the ASL/ALT ratio was correlated with the serum β2-MG level(r=0 .633 , P=0 .000);the serum β2-MG level in the liver damage group was significantly higher than that in the control group (Z= -9 .418 , P=0 .000) ,the Cr/β2-MG ratio was lower than that in the control group (Z= -2 .779 ,P=0 .005) ,and the Cr/β2-MG ratio in the hepatorenal damage group was lower that in the renal damage group (Z= -1 .487 ,P=0 .137) .The receiver operating characteristic curve analysis showed that the area under curve(AUC) ,cutoff value ,standard error ,95% confidence interval(CI) ,specificity and sensitivity of β2-MG were 0 .970 ,2 .61 μg/L ,0 .012 ,0 .946 -0 .994 ,0 .988 and 0 .852 in the renal damage group and 0 .832 ,4 .26μg/L ,0 .04 ,0 .755-0 .910 ,0 .862 and 0 .741 in the hepatorenal damage group respectively .Conclusion Hepatorenal damage mainly affects the diagnosis of serum β2-MG on mild renal damage .
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β2-Microglobulin is a small molecule protein, consisting of a polypeptide chain.Previous studies have confirmed that serum β2-microglobulin is a biomarker that reflects early renal function injury, and renal function injury is closely correlated with ischemic stroke.Studies in recent years have shown that the level of serum β2-microglobulin increases significantly in patients with ischemic stroke.Thus, it can be used as a biomarker for the risk of ischemic stroke.
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Objective To investigate the clinical significance of β2-microglobulin(β2-MG),glycated hemoglobin(HbA1c) and cystain C(CysC) in the diagnosis of early diabetic kidney injury.Methods Seventy cases of diabetic nephropathy(group DN) and 110 cases of simple diabetes(group DM) admitted and treated in our hospital from June to November 2015 were selected as the research subjects and performed the contrastive study with the 50 volunteers undergoing physical examination (control group)in the same period.The levels of β2-MG,HbA1c,CysC,SCr and Urea were compared among three groups.Results Compared with the control group,the SCr and Urea levels in the DM group had no statistically significant difference (P>0.05),while the β2-MG,HbA1c and CysC levels in the DM group were significantly higher than those in the control group(P<0.05);the levels of β2-MG,HbA1c,CysC,SCr and Urea in the DN group were significantly higher than those in the control group and DM group,the differences were statistically significant (P<0.05).The positive rates of single index detection and combined detection of β2-MG,HbA1c and CysC I the DN group were significantly higher than those in the DM group,and the differences were statistically significant (P<0.05).Conclusion For the patients with diabetes,β2-MG,HbA1c and CysC can better reflect the early damage of renal function,their joint detection is conducive to the diabetic treatment and disease condition monitoring.
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Objective To evaluate urinary β2-microglobulin (β2-MG) and retinoid binging protein (RBP) in monitoring of early renal impairment in chronic hepatitis B (CHB) patients with long-term adefovir dipivoxil (ADV) treatment. Methods Three hundred and fifty five with CHB admitted in Shaoxing Municipal Hospital from June 2009 to June 2011 were enrolled in the study, among whom 180 cases study group) were treated with ADV monotherapy (n=100) or ADV + lamivudine (LAM) combination therapy (n=80); and 175 cases (control group) were treated with entecavir (ETV). Serum creatinine, urinary β2-MG, RBP and creatinine were measured and glomerular tration rate (eGFR) was estimated regularly during 5-year follow up. Kaplan-Meier method was used to calculate the cumulative incidence of changes in urinary β2-MG and RBP. Results Five-year follow-up results showed that in study group 2, 6, 10, 14 and 24 cases developed urinary β2-MG abnormality in year 1, 2, 3, 4 and 5 of treatment, respectively; and 2, 7, 11, 16 and 20 cases developed urinary RBP abnormality in year 1, 2, 3, 4 and 5 of treatment, respectively; eGFR decreased 20%-30% from baseline in 20 cases, 30%-50% in 13 cases and >50% in 2 cases. The decrease of eGFR ≥30% in 5 years was significantly correlated with urinary RBP and β2-GM abnormality. However, both serum creatinine and eGFR remained stable during the 5 years of follow-up in control group; only 2 cases developed urinary β2-MG abnormality and 3 cases developed urinary RBP abnormality. Conclusions Urinary RBP and β2-MG are sensitive biomarkers of early renal injury during long-term ADV treatment in CHB patients, and ADV should not be used as first-line treatment for CHB.
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Objective To study the diagnosis value of serum retinol binding protein (RBP),cystatin C(Cys C) and β2 microglobulin (β2-M) in early renal injures of gcstational diabetes mellitus (GDM) patients.Methods 85 case of GDM pregnant women admitted to Shiyan Maternal and Child Health-Care Hospital from Jan.2009 to Jan 2015 were chosen as research objects,and were divided into simple diabetes group (35 cases),micro proteinuria group (30 cases) and massive proteinuria group (20 cases) according to the urinary albumin excretion rate (UAER),while 30 cases of healthy pregnant women were recruited randomly during the same period as control group.The 24h urine protein,serum RBP and renal function indicators [blood urea nitrogen (BUN),creatinine (Ser),Cys C and β2 M],the positive rates of RBP,Cys C,β2-M and combined detection of RBP,Cys C,β2-M of the four groups were compared.Results The 24h urine protein in simple diabetes group,micro proteinuria group and massive proteinuria group were significantly higher than that in the control group (t=3.91～ 16.33,all P＜0.01),the difference between the 3 groups were statistically significant (t=6.78～ 16.94,all P＜0.01).The levels of BUN,Scr,Cys C,β2-M and RBP in micro proteinuria group and massive proteinuria group were significantly higher than those in control group and simple diabetic group (t=3.68 ～ 18.54,all P＜0.01),there were significant difference in above indexes between micro proteinurine group and massive proteinuria group (t=4.70～ 10.87,all P＜0.01).The positive rates of RBP,Cys C,β2-M and combined detection of RBP,Cys C and β2-M in micro proteinuria group and massive proteinuria group were significantly higher than those in control group and simple diabetic group (x2 =20.27～38.57,all P＜0.01).There was no significant difference in the positive rates between micro proteinuria group and massive proteinuria group (x2 =0.62～0.93,all P＞0.05).The positive rate of combined detection of the three indicators was higher than that of the single detection in the same group (x2=3.97～6.65,P＜0.05 or P＜0.01).Conclusion The detection of serum Cys C,RBP and β2-M has a high clinical value in the diagnosis of early renal damage in patients with GDM.The positive rate of combined detection of 3 indexes was higher than that of single index.