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Chen X.-W.,Central Hospital of Wenzhou City | Shi J.-W.,Central Hospital of Wenzhou City | Yang P.-S.,Central Hospital of Wenzhou City | Wu Z.-Q.,Central Hospital of Wenzhou City
Peptides | Year: 2014

Leptin is considered to be a modulator of the immune response. Hypoleptinemia increases the risk for Alzheimer's disease and vascular dementia. The present study aimed to investigate the ability of plasma leptin level to predict delirium in elderly patients after hip fracture surgery. Postoperative delirium (pod) was evaluated using the Confusion Assessment Method. Prolonged postoperative delirium (ppod) was defined as delirium lasting more than 4 weeks. Plasma leptin levels of 186 elderly patients and 186 elderly controls were measured by an enzyme-linked immunosorbent assay. Plasma leptin level was substantially lower in patients than in controls (4.6 ± 2.2 ng/ml vs. 7.5 ± 1.8 ng/ml, P < 0.001). It was identified as an independent predictor for pod [odds ratio, 0.385; 95% confidence interval (CI), 0.286-0.517; P < 0.001] and ppod (odds ratio, 0.283; 95% CI, 0.152-0.527; P < 0.001) using a multivariate analysis, and had high area under receiver operating characteristic curve for pod [area under curve (AUC), 0.850; 95% CI, 0.790-0.898] and ppod (AUC, 0.890; 95% CI, 0.836-0.931). The predictive value of leptin was markedly bigger than that of age for pod (AUC, 0.705; 95% CI, 0.634-0.770; P = 0.002) and ppod (AUC, 0.713; 95% CI, 0.642-0.777; P = 0.019). In a combined logistic-regression model, leptin improved the AUC of age to 0.890 (95% CI, 0.836-0.931) (P < 0.001) for pod and 0.910 (95% CI, 0.860-0.947) (P = 0.005) for ppod. Thus, preoperative plasma leptin level may be a useful, complementary tool to predict delirium and also prolonged delirium in elderly patients after hip fracture surgery. © 2014 Elsevier Inc. Source


Li X.-Y.,Central Hospital of Wenzhou City | Tang S.-H.,Central Laboratory | Zhou X.-C.,Central Hospital of Wenzhou City | Ye Y.-H.,Central Hospital of Wenzhou City | And 2 more authors.
Peptides | Year: 2014

Visfatin is identified a pro-inflammatory cytokine and its serum level is increased in various cancers. This study aimed to evaluate the prognostic value of preoperative serum visfatin level in breast cancers. Preoperative serum visfatin levels of 248 patients with breast cancer and serum visfatin levels of 100 healthy individuals and 100 benign women controls were determined using enzyme-linked immunosorbent assay. Unfavorable outcome was defined as first local recurrence, distant metastasis, second primary cancer of another organ, or death from any cause. Disease-free survival was defined as the time between surgery and the date of unfavorable outcome whichever appeared first. Overall survival was defined from surgery to death for any cause. The association of serum visfatin level with outcomes including mortality, unfavorable outcome, disease-free survival and overall survival was investigated by univariate and multivariate analyses. Preoperative serum visfatin level was substantially higher in patients than in healthy subjects and benign controls respectively. Elevated preoperative serum level of visfatin was identified an independent predictor of mortality, unfavorable outcome, disease-free survival and overall survival. Receiver operating characteristic curve analysis showed that serum level visfatin had high predictive value for mortality and unfavorable outcome. Thus, our results suggest that high preoperative serum visfatin level is associated with poor patient outcomes as well as may play a role as prognostic biomarker in breast cancer survival. © 2013 Elsevier B.V. All rights reserved. Source


Cai J.-Y.,Central Hospital of Wenzhou City | Lu C.,Central Hospital of Wenzhou City | Chen M.-H.,Central Hospital of Wenzhou City | Ba H.-J.,Central Hospital of Wenzhou City | And 3 more authors.
Clinica Chimica Acta | Year: 2013

Background: Phosphorylated axonal neurofilament subunit H (pNF-H) is a biomarker of axonal injury. We investigated whether plasma pNF-H concentrations were associated with 6-month clinical outcomes and early neurological deterioration (END) of patients with acute intracerebral hemorrhage. Methods: Plasma pNF-H concentrations of 112 patients and 112 healthy individuals were quantified by ELISA. Unfavorable outcome was defined as modified Rankin Scale score >. 2. Associations of plasma pNF-H concentrations with END, 6-month mortality and unfavorable outcome were evaluated. Results: Plasma pNF-H concentrations were increased in patients than in healthy individuals [700.2 (430.8) pg/ml vs. 25.5 (32.4) pg/ml, P<. 0.001]. A logistic regression analysis selected plasma pNF-H concentration as an independent predictor for 6-month mortality [OR: 1.287, 95% CI: 1.140-1.524, P<. 0.001], 6-month unfavorable outcome (OR 1.265, 95% CI 1.121-1.517, P<. 0.001) and END (OR 1.246, 95% CI 1.109-1.498, P<. 0.001). A receiver operating characteristic curve analysis showed that plasma pNF-H concentration predicted 6-month clinical outcomes and END with high area under curves (all P<. 0.001). The predictive value of pNF-H was similar to that of the National Institutes of Health Stroke Scale score (all P>. 0.05). In a combined logistic-regression model, pNF-H did not improve the predictive value of National Institutes of Health Stroke Scale score (all P>. 0.05). Conclusions: Increased plasma pNF-H concentration was highly associated with 6-month clinical outcomes and END of patients with intracerebral hemorrhage. © 2013 Elsevier B.V.. Source


Dai J.-X.,Central Hospital of Wenzhou City | Cai J.-Y.,Central Hospital of Wenzhou City | Lin Q.,Central Hospital of Wenzhou City | Chen X.-D.,Central Hospital of Wenzhou City | And 3 more authors.
Journal of the Neurological Sciences | Year: 2016

Objective Circulating levels of thioredoxin (Trx), a potent anti-oxidant that modulates inflammation, cell growth and apoptosis, are increased in various critical care conditions. The purpose of this study was to establish the relationship between serum Trx levels and prognosis of aneurysmal subarachnoid hemorrhage (aSAH). Methods An enzyme-linked immunosorbent assay measurement of Trx was performed in serum from 132 patients and 132 healthy volunteers. Clinical outcomes included 6-month mortality and unfavorable outcome (Glasgow outcome scale score of 1-3). Results The serum Trx levels were significantly higher in patients than in controls (23.4 ± 12.2 ng/mL vs.8.5 ± 4.0 ng/mL, P < 0.001) and had close relation to the World Federation of Neurological Surgeons (WFNS) scores (r = 0.461, P < 0.001) and modified Fisher scores (r = 0.459, P < 0.001). Trx was an independent predictor for 6-month mortality (Odds ratio, 1.386; 95% confidence interval, 1.015-2.161; P < 0.001) and 6-month unfavorable outcome (Odds ratio, 1.297; 95% confidence interval, 1.012-2.002; P < 0.001). Based on receiver operating characteristic curve, TRX had similar prognostic value compared with WFNS scores and modified Fisher scores and also significantly improved their prognostic value for 6-month unfavorable outcome, but not for 6-month mortality. Conclusions Elevated plasma Trx levels are correlated with the severity and poor prognosis, substantializing Trx as a potential prognostic predictive biomarker following aSAH. © 2016 Elsevier B.V. All rights reserved. Source


Cai J.-Y.,Central Hospital of Wenzhou City | Chen X.-D.,Central Hospital of Wenzhou City | Ba H.-J.,Central Hospital of Wenzhou City | Lin J.-H.,Central Hospital of Wenzhou City | And 3 more authors.
Peptides | Year: 2014

Increased plasma adrenomedullin levels have been reported in critically ill patients. This study tested the hypothesis that plasma adrenomedullin levels are significantly increased in patients with acute spontaneous aneurysmal subarachnoid hemorrhage, and are predictive of clinical outcomes. Plasma adrenomedullin levels from 120 adult patients with spontaneous aneurysmal subarachnoid hemorrhage and 120 healthy volunteers during the study period were evaluated. Mortality and poor long-term outcome (Glasgow Outcome Scale score of 1-3) at 6 months were recorded. Data showed that circulating plasma adrenomedullin levels significantly increased in patients on admission compared with the volunteers. In patients who died or had poor outcome at 6 months, plasma adrenomedullin levels were significantly higher compared with survivors and patients with good outcome. Plasma adrenomedullin levels on presentation were highly associated with clinical severity assessed using World Federation of Neurological Surgeons score and Fisher score, emerged as the independent risk factor of 6-month mortality and poor outcome, and possessed similar predictive value to World Federation of Neurological Surgeons score and Fisher score based on receiver operating characteristic curves. A combined logistic-regression model did not demonstrate the additive benefit of adrenomedullin to World Federation of Neurological Surgeons score and Fisher score. Thus, higher plasma adrenomedullin levels on presentation are associated with clinical severity and worse outcomes in patients with acute spontaneous aneurysmal subarachnoid hemorrhage. © 2014 Elsevier Inc. Source

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