Serum Neuron-specific Enolase Levels Research Articles

FDG-PET/CT Assessment of the Cerebral Protective Effects of Hydrogen in Rabbits with Cardiac Arrest.

Anatomical imaging methods and histological examinations have limited clinical value for early monitoring of brain function damage after cardiac arrest (CA) in vivo. We aimed to assess the cerebral protective effects of hydrogen in rabbits with CA by using fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT). Male rabbits were divided into the hydrogen-treated (n=6), control (n=6), and sham (n=3) groups. Maximum standardized uptake values (SUVmax) were measured by FDG-PET/CT at baseline and post-resuscitation. Blood Ubiquitin C-terminal hydrolase-L1 (UCH-L1) and neuron-specific enolase (NSE) were measured before and after the operation. After surgical euthanasia, brain tissues were extracted for Nissl staining. SUVmax values first decreased at 2 and 24 h after resuscitation before rising in the hydrogentreated and control groups. SUVmax values in the frontal, occipital, and left temporal lobes and in the whole brain were significantly different between the hydrogen and control groups at 2 and 24 h postresuscitation (P<0.05). The neurological deficit scores at 24 and 48 h were lower in the hydrogentreated group (P<0.05). At 24 h, the serum UCH-L1 and NSE levels were increased in the hydrogen and control groups (P<0.05), but not in the sham group. At 48 and 72 h post-CA, the plasma UCH-L1 and NSE levels in the hydrogen and control groups gradually decreased. Neuronal damage was smaller in the hydrogen group compared to the control group at 72 h. FDG-PET/CT could be used to monitor early cerebral damage, indicating a novel method for evaluating the protective effects of hydrogen on the brain after CA.

Increased Neuron Specific Enolase in a Hypoxic Ischemia Rat Model

Introduction: Acute brain injury caused by cerebral ischemia, either due to stroke or ischemic hypoxic-ischemic encephalopathy (HIE), represents a major neurological cause of death and disability worldwide. Neuronal cell injury has been shown to correlate with a significant increase in neuron-specific enolase (NSE) levels in in vitro studies. This study aims to measure NSE levels in the blood serum of rats with HIE. Methods: This study used an experimental post-test design in which occlusion of the right common carotid artery (CCA) was performed on Wistar rats, which were then placed in a hypoxic chamber and reperfused after 60 minutes (treatment group). Neurological scores were collected over the first 24 hours. After 48 hours, experimental animals were sacrificed and their serum NSE levels were measured using ELISA. Statistical analysis using a T-test was performed for independent samples. Results: A total of 16 male rats were included in the study. Neurological scores indicated that all HIE group rats experienced hemiparesis to varying degrees. NSE levels in the treatment group were significantly higher than in the control group (p &lt; 0.05). The mean NSE level in the treatment group was higher than that in the other group. Conclusion: Consistent with in vitro studies, we found that NSE was higher in the HIE rat model than in controls. These data support future studies to assess the fitness of serum NSE as a biomarker of brain damage.

Serum levels of neuron-specific enolase as a prognostic factor for disease progression in patients with GET/NEN in the pancreas and the small intestine.

The aim of this study was to assess the usefulness of neuron-specific enolase (NSE) concentrations as a prognostic factor in patients with neuroendocrine neoplasms and to determine the relationship between NSE and clinicopathological features. Serum NSE levels were measured in 179 NEN patients before treatment. It was found that NSE levels in patients with a primary pancreatic location were higher compared to patients with a small intestine lesion (P = 0.015). NSE levels were significantly higher in patients with primary pancreatic location with histological grade G2 compared with the group with low-grade G1 (P = 0.047). Patients with initial liver involvement showed significantly higher NSE levels compared to patients with tumour location in the pancreas (P = 0.009). Statistical analysis confirmed that higher NSE levels were associated with disease progression (P = 0.001) in both the overall study group and in patients with tumours in the pancreas and small intestine. During treatment monitoring, an increase in median NSE concentrations was observed in patients with persistent progression with subsequent blood draws, and a decrease in NSE concentrations was observed in patients with disease stabilisation. We showed that NSE concentrations have prognostic value for progression-free survival in addition to primary liver involvement. In conclusion, the most important results of the study include the demonstration of an association between NSE concentrations and clinical status, which confirms its usefulness in patient monitoring and as a potential predictive indicator for progression-free survival in patients with NENs.

Development of a strategy for assessing blood-brain barrier disruption using serum S100 calcium-binding protein B and neuron-specific enolase in early stage of neuroemergencies: A preliminary study.

Rapid disease progression in neuroemergencies is associated with blood-brain barrier (BBB) disruption. We investigated a less invasive strategy for assessing BBB status by evaluating S100 calcium-binding protein B (S100B) and neuron-specific enolase (NSE) at early stages of the hypoxic-ischemic brain injury (HIBI) cascade. This retrospective study used prospectively collected data from patients with out-of-hospital cardiac arrest (August 2019-July 2021). Albumin specimens obtained from serum and cerebrospinal fluid via arterial catheter and lumbar puncture were used to measure the albumin quotient (Qa), which is widely accepted as the gold standard method for detecting BBB disruption. Serum S100B and NSE levels were measured simultaneously following the return of spontaneous circulation. We conducted linear regression to evaluate the relationship between S100B and Qa and the predictive performance of S100B for abnormal Qa. The primary study outcome was abnormal Qa (>0.007). Forty-one patients were enrolled; 30 showed an abnormal Qa suggestive of BBB disruption. S100B levels were significantly higher than in those with a normal Qa (0.244 μg/L [interquartile range [IQR], 0.146-0.823 vs 0.754 μg/L [IQR, 0.317-2.228], P = .03). We report a positive correlation between serum S100B and Qa (R2 = 0.110; P = .04). The area under the receiver operating characteristics curve (AUROC) evaluating the predictive performance of S100B with respect to abnormal Qa was 0.718 (95% confidence interval, 0.556-0.847). The cutoff value for S100B (with respect to BBB disruption) in the total cohort was 0.283 μg/L (sensitivity, 80.0%; specificity, 72.7%). Subgroup analyses in patients with serum neuron-specific enolase (NSE) levels of <40.8 ng/mL (excluding those with established neuronal cell injury) showed an improved correlation coefficient (R2 = 0.382; P < .01) and predictive performance (AUROC, 0.836 [95% confidence interval, 0.629-0.954]) compared with the total cohort. Serum S100B obtained at an early stage of the HIBI cascade is associated with abnormal Qa, suggesting BBB disruption. The predictive performance of S100B and the correlation between serum S100B and Qa can be improved using a complementary strategy (i.e., evaluations of S100B and NSE levels) that combines considerations of cell damage in astrocytes and neurons.

GFAP and Neuron Specific Enolase (NSE) in the Serum of Suicide Attempters.

Background: To determine whether neuronal damage and/or neuroinflammation exist in the brain of suicide attempters and to find a novel biological biomarker to help distinguishing high risk individuals with suicide behavior, we aimed to measure glial fibrillary acidic protein (GFAP), neuron specific enolase (NSE), and nerve growth factor (NGF) in suicide attempters. Methods: In the present case-control study, the serum level of NSE, GFAP, and NGF were measured quantitatively in 43 suicide attempters and 43 healthy control participants aged 18 to 35 years. Data were analyzed using the nonpaired t test followed by the Mann-Whitney posttest. Results: The mean serum level of NSE and GFAP were significantly higher in suicide attempters compared with healthy control individuals (p = 0.003, p = 0.001, respectively), while no significant difference was detected in NGF serum level between the 2 groups. Conclusion: Our findings of increased level of NSE along with the significant increase in GFAP would propose the presence of low grade neuroinflammation in the brain of these participants. NSE/GFAP might be good markers that is easily accessible and can be considered as prognostic markers in high-risk suicide attempters.

Diagnostic value of serum tumor markers CEA, CYFRA21-1, SCCAg, NSE and ProGRP for lung cancers of different pathological types

To evaluate the diagnostic value of the serum tumor markers carcinoembryonic antigen (CEA), cytokeratin-19-fragment (CYFRA21-1), squamous cell carcinoma associated antigen (SCCAg), neuron-specificenolase (NSE) and pro-gastrin-releasing peptide (ProGRP) for lung cancers of different pathological types. This study was conducted among patients with established diagnoses of lung adenocarcinoma (LADC, n=137), lung squamous cell carcinoma (LSCC, n=82), small cell lung carcinoma (SCLC, n=59), and benign chest disease (BCD, n=102). The serum tumor markers were detected for all the patients for comparison of the positivity rates and their serum levels. ROC curve was used for analysis of the diagnostic efficacy of these tumor markers either alone or in different combinations. In patients with LADC, the positivity rate and serum level of CEA were significantly higher than those in the other groups (P < 0.05); the patients with LSCC had the highest positivity rate and serum level of SCCAg among the 4 groups (P < 0.05). The positivity rates and serum levels of ProGRP and NSE were significantly higher in SCLC group than in the other groups (P < 0.05). CYFRA21-1 showed the highest positivity rate and serum level in LADC group and LSCC group. With the patients with BCD as control, CEA showed a diagnostic sensitivity of 62.8% and a specificity of 93.1% for LADC, and the sensitivity and specificity of SCCAg for diagnosing LSCC were 64.6% and 91.2%, respectively. CYFRA21-1 had the highest diagnostic sensitivity for LADC and LSCC. The diagnostic sensitivity and specificity of ProGRP for SCLC were 83.1% and 98.0%, respectively. When combined, CYFRA21-1 and CEA showed a high sensitivity (78.8%) and specificity (86.3%) for diagnosing LADC with an AUC of 0.891; CYFRA21-1 and SCCAg had a high sensitivity (84.1%) and specificity (87.3%) for diagnosing LSCC with an AUC of 0.912. NSE combined with ProGRP was highly sensitive (88.1%) and specific (98.0%) for diagnosis of SCLC, with an AUC of 0.952. For lung cancers of different pathological types, the combination of all the 5 tumor markers showed no significant differences in the diagnostic power from a combined detection with any two of the markers (P>0.05). CEA, CYFRA21-1, SCCAg, NSE and ProGRP are all related to the pathological type of lung cancers and can be used in different combinations as useful diagnostic indicators for lung cancers.

Role of Neuron-Specific Enolase in the Diagnosis and Disease Monitoring of Sarcoidosis.

Sarcoidosis is a systemic granulomatous disease of unknown etiology. The diagnosis of sarcoidosis is based on clinicopathologic findings accompanied by the formation of granulomas in multiple organs, including the lung. Although angiotensin-converting enzyme (ACE) and soluble interleukin 2 receptor (sIL-2R) are traditionally used for the diagnosis of sarcoidosis, specific diagnostic markers remain to be determined. In the current study, we found that serum neuron-specific enolase (NSE) levels were elevated in patients with sarcoidosis. Serum NSE levels were positively correlated with serum ACE and sIL-2R levels. The sensitivity of NSE alone was modest, but its combination with sIL-2R and ACE had the highest sensitivity compared to those of each single marker. When comparing serum NSE and pro-gastrin-releasing peptide (ProGRP) levels in SCLC patients with those in patients with sarcoidosis and nonsarcoidotic benign diseases, serum NSE could be used to distinguish SCLC from sarcoidosis and nonsarcoidosis by setting at a cutoff value of 17.0 ng/ml with a sensitivity of 73.5% and a specificity of 90.2%, which were comparable to those of ProGRP. Serum NSE levels were associated with organ involvement and were higher in sarcoidosis patients who had been treated with oral corticosteroid (OCS) than in those who had never received OCS therapies; there was a positive association between elevated serum NSE levels and OCS use. Increased concentrations of serum NSE in patients at the nonremission phase decreased after spontaneous remission, whereas serum NSE levels fluctuated in accordance with serum ACE or sIL-2R levels during the follow-up period in patients with sarcoidosis. These findings suggest that NSE could be a marker for the diagnosis and monitoring of the clinical outcome of patients with sarcoidosis.

Auxiliary Diagnosis of Lung Cancer with Magnetic Resonance Imaging Data under Deep Learning.

This study was aimed at two image segmentation methods of three-dimensional (3D) U-shaped network (U-Net) and multilevel boundary sensing residual U-shaped network (RUNet) and their application values on the auxiliary diagnosis of lung cancer. In this study, on the basis of the 3D U-Net segmentation method, the multilevel boundary sensing RUNet was worked out after optimization. 92 patients with lung cancer were selected, and their clinical data were counted; meanwhile, the lung nodule detection was performed to obtain the segmentation effect under 3D U-Net. The accuracy of 3D U-Net and multilevel boundary sensing RUNet was compared on lung magnetic resonance imaging (MRI) after lung nodule segmentation. Patients with benign lung tumors were taken as controls; the blood immune biochemical indicators progastrin-releasing peptide (pro-CRP), carcinoembryonic antigen (CEA), and neuron-specific enolase (NSE) in patients with malignant lung tumors were analyzed. It was found that the accuracy, sensitivity, and specificity were all greater than 90% under the algorithm-based MRI of benign and malignant tumor patients. Based on the imaging signs for the MRI image of lung nodules, the segmentation effect of the RUNet was clearer than that of the 3D U-Net. In addition, serum levels of pro-CRP, NSE, and CAE in patients with benign lung tumors were 28.9 pg/mL, 12.5 ng/mL, and 10.8 ng/mL, respectively, which were lower than 175.6 pg/mL, 33.6 ng/mL, and 31.9 ng/mL in patients with malignant lung tumors significantly (P < 0.05). Thus, the RUNet image segmentation method was better than the 3D U-Net. The pro-CRP, CEA, and NSE could be used as diagnostic indicators for malignant lung tumors.

Early identified risk factors and their predictive performance of brain death in out-of-hospital cardiac arrest survivors

BackgroundEarly prediction of brain death (BD) after the return of spontaneous circulation (ROSC) in patients with cardiac arrest would be useful for the proper distribution of good quality transplantable organs and medical resources. We aimed to early identify independent risk factors of BD and their predictive performance in out-of-hospital cardiac arrest (OHCA) survivors. MethodsThis retrospective observational study included adult OHCA survivors from May 2018 to February 2021. Independent risk factors for progression to BD were identified by performing multivariate logistic regression analysis, including clinical, laboratory, biological parameters and prognostic factors, obtained within 6 h after ROSC. Neuron-specific enolase (NSE) level were categorized into quartile. The primary outcome was BD occurrence. ResultsOverall, 108 patients were included in this analysis, 31 (29%) of whom had BD. In multivariate logistic regression analysis, initial serum NSE levels in the fourth quartile compared to the first quartile (odds ratio [OR], 88.5; 95% confidence interval [CI]: 7.0–1113.6) and absence of pupil light reflex (PLR) (OR, 40.3; 95% CI: 3.8–430.3) were independently associated with BD. According to the receiver operating characteristic curve analysis, initial serum NSE levels and PLR showed good-to-excellent and fair-to-good prognostic performance, respectively (area under the curve [AUC], 0.90; 95% CI: 0.83–0.95 vs. 0.81; 95% CI: 0.72–0.88). Additionally, the combination of both the risk factors (AUC, 0.96; 95% CI: 0.90–0.99) showed significantly higher predictive performance for BD than when using them individually (P = 0.04 and P < 0.01, respectively). ConclusionHigh levels of initial serum NSE and PLR obtained within 6 h after ROSC may help early predict progression to BD in OHCA survivors. A large prospective multicenter study should be conducted to confirm these results.

Application Value of Serum TK1 and PCDGF, CYFRA21-1, NSE, and CEA plus Enhanced CT Scan in the Diagnosis of Nonsmall Cell Lung Cancer and Chemotherapy Monitoring

Objective To assess the application value of serum thymidine kinase 1 (TK1) and PC cell-derived growth factor (PCDGF), cytokeratin 19 fragment 21-1 (CYFRA21-1), neuron-specific enolase (NSE), and carcinoembryonic antigen (CEA) plus enhanced CT scan in the diagnosis of nonsmall cell lung cancer (NSCLC) and chemotherapy monitoring. Methods Between April 2019 and April 2021, 30 patients with NSCLC assessed for eligibility treated in our institution were included in the experimental group, and 30 healthy individuals screened out from physical examinations were recruited in the control group. The chemotherapy regimens included gemcitabine plus cisplatin, pemetrexed disodium plus cisplatin, and vinorelbine plus cisplatin. The application value of serum TK1, PCDGF, CYFRA21-1, NSE, CEA, and enhanced CT scan in the diagnosis and chemotherapy monitoring of NSCLC was analyzed. Results Before treatment, the eligible patients had significantly higher serum levels of TK1, PCDGF, CYFRA21-1, NSE, and CEA than those of the healthy individuals included (P < 0.05). Clinical efficacy was categorized into good and poor, and the good efficacy included complete response and partial response, with the poor efficacy including stable disease and progressive disease. Patients with good clinical efficacy had lower levels of serum TK1, PCDGF, CYFRA21-1, NSE, and CEA than those with poor efficacy (P < 0.05). Joint detection showed a larger area under the curve (AUC) (0.900; 95%CI, 0.812-0.988), a higher sensitivity, and a superior detection outcome to the stand-alone detection (P < 0.05). Diagnostic results were similar between joint detection and pathological examination (P > 0.05). Conclusion The application of serum TK1, PCDGF, CYFRA21-1, NSE, and CEA assay plus enhanced CT scan shows high sensitivity and diagnostic accuracy in the diagnosis and chemotherapy monitoring of nonsmall cell lung cancer and thus provides a diagnostic reference basis.

Blood\u2013brain barrier and gut barrier dysfunction in chronic kidney disease with a focus on circulating biomarkers and tight junction proteins

Kidney failure and associated uraemia have implications for the cardiovascular system, brain, and blood–brain barrier (BBB). We aim to examine BBB disruption, by assessing brain-derived neurotropic factor (BDNF), neuron-specific enolase (NSE) levels, and gut-blood barrier (GBB) disruption by trimethylamine N-oxide (TMAO), in chronic kidney disease (CKD) patients. Additionally, endothelial tight-junction protein expressions and modulation via TMAO were assessed. Serum from chronic kidney disease (CKD) female and male haemodialysis (HD) patients, and controls, were used to measure BDNF and NSE by enzyme-linked immunosorbent assays, and TMAO by mass spectrometry. Immunofluorescent staining of subcutaneous fat biopsies from kidney transplant recipients, and controls, were used to measure microvascular expression of tight-junction proteins (claudin-5, occludin, JAM-1), and control microvasculature for TMAO effects. HD patients versus controls, had significantly lower and higher serum levels of BDNF and NSE, respectively. In CKD biopsies versus controls, reduced expression of claudin-5, occludin, and JAM-1 were observed. Incubation with TMAO significantly decreased expression of all tight-junction proteins in the microvasculature. Uraemia affects BBB and GBB resulting in altered levels of circulating NSE, BDNF and TMAO, respectively, and it also reduces expression of tight-junction proteins that confer BBB maintenance. TMAO serves as a potential candidate to alter BBB integrity in CKD.

Reduced Concentrations of NSE, S100β, Aβ, and Proinflammatory Cytokines in Elderly Patients Receiving Ultrasound-Guided Combined Lumbar Plexus-Sciatic Nerve Block during Hip Replacement.

Objective The increase of hip fractures is related to the aging of the population, which has caused a huge medical burden in many countries. Hip replacement has been approved as a highly successful surgical intervention for the patients with hip fractures. Different anesthesia choices in the surgical intervention are associated with the prognosis of patients. This study focused on investigating the application of ultrasound-guided combined lumbar plexus-sciatic nerve block in elderly patients with hip fractures. Methods In this retrospective study, 62 elderly patients received combined spinal-epidural anesthesia and 58 elderly patients underwent ultrasound-guided combined lumbar plexus-sciatic nerve block during the surgery. Hemodynamic monitoring including pulse oxygen saturation (SpO2), heart rate and blood pressure, the assessment of pain intensity using Visual Analogue Scale (VAS), cognitive function assessment through Montreal Cognitive Assessment (MoCA) and biomarkers consisting of serum levels of neuron specific-enolase (NSE), S100 beta protein (S100-β), and amyloid beta protein (Aβ), as well as immune function by interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and high sensitivity C-reactive protein (hs-CRP) were detected in this study. Furthermore, length of hospital stay (LOS) and adverse reactions including hematoma, hypotension, nausea, and vomit were analyzed. Results The findings indicated that comparing with the patients receiving combined spinal-epidural anesthesia, those undergoing ultrasound-guided combined lumbar plexus-sciatic nerve block showed significantly lower level of heart rate, higher level of SpO2, and lower level of diastolic pressure and systolic pressure at 5 minutes and 30 minutes after anesthesia and after surgery (P < 0.05), indicated obviously lower VAS score at 12, 24, and 48 hours after surgery (P < 0.05), and revealed higher MoCA score at 12 days after surgery (P < 0.05). A significantly higher level of NSE, S100β, Aβ, IL-6, IL-1β, TNF-α, and hs-CRP was revealed in the two groups receiving different anesthesia methods at 10 days after surgery compared with that before surgery (P < 0.05). However, the patients receiving ultrasound-guided combined lumbar plexus-sciatic nerve block had obviously lower expression of NSE, S100β, Aβ, IL-6, IL-1β, TNF-α, and hs-CRP compared with the group accepting combined spinal-epidural anesthesia (P < 0.05). The two groups indicated no significant difference in incidence of hypotension and vomit, etc. (P < 0.05), but showed remarkable difference referring to total incidence of adverse reactions and LOS (P < 0.05). Conclusion The application of ultrasound-guided combined lumbar plexus-sciatic nerve block in hip replacement contributes to the stability of hemodynamics and alleviation of postoperative pain intensity. It can reduce cognitive and immune impairment of the elderly patients with hip fractures.

Serum S100B and NSE Levels Correlate With Infarct Size and Bladder-Bowel Involvement Among Acute Ischemic Stroke Patients.

Objectives Stroke is a major global health concern. Due to limited availability of neuroimaging particularly in rural and regional areas in India as well as its limitation, the interest in use of biochemical markers for stroke diagnosis, severity, and prognosis is increasing. Only a handful of studies on stroke biomarkers have been conducted in India. Hence, this study was conducted to investigate the correlation of serum neuron-specific enolase (NSE) and S100 calcium-binding protein B (S100B) levels with stroke severity according to infarct size in acute ischemic stroke patients. Material and Methods Sixty stroke patients were recruited for the study and were evaluated. Noncontrast computed tomography (CT) scan of the brain was performed for all patients within 48 hours of onset of symptoms. Infarct volume was measured by evaluating dimensions in three planes on CT head. Serum NSE and S100B levels were measured by commercially available immunoassay kits. Continuous data was represented as mean ± standard deviation. Categorical data was expressed in terms of percentages and proportions. Pearson's correlation coefficient was applied to assess correlation between NSE and S100B and infarct size. Infarct size was classified arbitrarily into three groups according to infarct volume (low, moderate, and large) and analysis of variance was applied for comparing mean S100B and NSE levels in the three groups. To assess the independent predictors of infarct size among stroke cases, multivariate logistic regression analysis was used. Association between serum S100B or NSE levels and clinical features was done by the Mann–Whitney U test. Results Correlation between serum S100B protein levels and NSE with larger infarct volume was highly significant ( r (S100B) = 0.611, p (S100B) < 0.0001; r (NSE) = 0.258, p (NSE) = 0.047). Using multivariate regression analysis, bladder and bowel involvement, prior stroke history, and dyslipidemia among stroke patients correlated with a larger infarct size. Mann–Whitney U test showed both NSE and S100B levels were significantly associated with bladder bowel involvement among stroke cases. Conclusion There was a positive correlation between serum S100B and NSE levels with infarct size. In addition, bladder-bowel involvement among stroke patients was associated with increased S100B levels. Therefore, levels of protein S100B and NSE may serve as indicator of infarct size and may be predictors of severe clinical presentations of acute ischemic stroke.

The role of biomarkers in drug-resistant trigeminal neuralgia: a prospective study in patients submitted to surgical treatment.

Molecular mechanisms underlying trigeminal neuralgia (TN) have been poorly understood. Recently, different biomarkers have been studied in several chronic neuropathic diseases or in neuronal damage, but their role in TN has not yet been investigated. Here, we firstly analyzed the serum levels of the neuron-specific enolase (NSE) (as an index of neuronal tissue damage) in TN patients submitted to surgical treatment. Different cytokines and interleukins related to inflammation were also studied. Blood samples from 40 patients were prospectively collected preoperatively and after the surgical procedure, namely microvascular decompression (MVD) and percutaneous balloon compression (PBC). Serum levels of uric acid, NSE, ferritin, CRP, IL-2R, and IL-6 were studied. The acute pain relief (APR) and the pre- and postoperative BNI were used to evaluate the clinical outcome. Overall, we obtained an APR in 87.5% of patients and a significant reduction of BNI after surgery (p < 0.0001). We observed a significant reduction of postoperative NSE values in the group of patients undergoing MVD (p = 0.0055) and a significant increase of postoperative NSE values in patients undergoing PBC (p < 0.05). Furthermore, in the group of patients undergoing MVD, we found a significant postoperative increase of CRP (p < 0.0001), ferritin (p = 0.001), and IL-6 (p = 0.01) values. The only patient who did not respond to MVD had NSE levels unchanged. Our results suggest the hypothesis that TN would be related to the neural damage instead of the systemic inflammatory status and indicate NSE as a possible biomarker of response in patients submitted to MVD.

Relationship between Neuron-specific Enolase Serum Levels with Lesion Volume and Clinical Outcome in Acute Stroke Patients

BACKGROUND: Neuron-specific enolase (NSE) is released in the cerebrospinal fluid and bloodstream in response to brain damage. Serum NSE levels can be used as a marker of brain nerve cells either in ischemic or hemorrhagic stroke, associated with lesion volume and functional outcome. AIM: The aim of the study was to evaluate the correlation between NSE serum level with lesion volume and functional outcome in acute stroke patients. METHODS: A cross-sectional study was conducted on 29 patients with ischemic stroke and 29 hemorrhagic strokes admitted to Haji Adam General Hospital. All the subjects were assessed with the National Institute of Health Stroke Scale (NIHSS) score, modified Rankin scale (mRS), and assessment of lesion volume. RESULTS: Subjects consist of 27 male (46.4%) and 31 female (53.4%), with mean age of 61.67 ± 12.26 years. The mean serum NSE levels in stroke patients were 19.79 ± 8.88 ng/ml and lesion volume was 25.09 ± 24.52 ml. There was a significant positive correlation of increase in serum NSE levels with infarct volume (r = 0.863 and p &lt; 0.001) and hemorrhagic volume (r = 0.644 and p &lt; 0.001) and clinical outcome assessed by NIHSS score (r = 0.761 and p &lt; 0.001) and mRS score (r = 0.762 and p &lt; 0.001) in ischemic stroke and NIHSS score (r = 0.525 and p = 0.003), and mRS score (r = 0.468 and p = 0.010) in hemorrhagic stroke. CONCLUSION: High NSE serum levels in the acute phase were associated with lesion volume and poor outcomes in stroke patients.

Effect of Dexmedetomidine-Assisted Intravenous Inhalation Combined Anesthesia on Cerebral Oxygen Metabolism and Serum Th1/Th2 Level in Elderly Colorectal Cancer Patients.

ObjectiveTo observe the effect of dexmedetomidine-assisted intravenous inhalation combined anesthesia on cerebral oxygen metabolism and serum Th1/Th2 levels in elderly patients with colorectal cancer.MethodFrom April 2018 to May 2020,100 elderly patients undergoing elective laparoscopic radical resection of colorectal cancer were prospectively selected and randomly divided into observation group and control group. Before induction of anesthesia, the loading dose of dexmedetomidine was given at 0.5 μg/kg, and the infusion time was 15 min. After tracheal intubation, 0.4 μg/kg/h dexmedetomidine was continuously pumped, and the infusion was stopped 40 min before the end of the operation. In the control group, the same amount of 0.9% sodium chloride was injected intravenously in the same way. 30 min before induction of anesthesia (T0), immediately before induction of anesthesia (T1), immediately after tracheal intubation (T2), 40 min before operation (T3), and immediately after operation (T4), record the blood oxygen content of the artery and internal jugular vein Difference (D(a-jv)O2), brain oxygen uptake rate (COER%), brain oxygen saturation (rSO2) mean. VAS scale, Ramsay scale, MoCA scale were taken at 6, 12, 24, and 48 h postoperatively to evaluate analgesia, sedation, and cognitive function. And monitor the levels of interferon-γ (IFN-γ), interleukin-4 (IL-4), myelin basic protein (MBP), neuron-specific enolase (NSE) and S100β. The occurrence of restlessness and adverse reactions during the recovery period of the two groups were compared.ResultThe levels of D(a-jv)O2, COER%, and rSO2 in the control group and observation group were higher than the preoperative basic values at T2, T3, and T4 (P < 0.05); The levels of D(a-jv)O2, COER%, and rSO2 in the observation group were lower than those in the control group at T2, T3, and T4 (P < 0.05). The VAS score and Ramsay score of the observation group were lower than those of the control group at 6, 12, 24, and 48 h after surgery, while the MoCA score was higher than that of the control group (P < 0.05). In addition, the serum IFN-γ, MBP, NSE and S100β levels of the observation group were lower than those of the control group (P < 0.05), and the ratio of IFN-γ/IL-4 was higher than that of the control group (P < 0.05). The overall incidence of adverse reactions in the observation group was lower than that in the control group [32.0% (16/50) vs. 12.0% (6/50), P < 0.05].ConclusionDexmedetomidine-assisted combined intravenous and inhalation anesthesia is beneficial to reduce perioperative cerebral oxygen metabolism and improve postoperative immunosuppression in elderly patients with colorectal cancer. It has a certain protective effect on nerve injury after operation, thus improving the cognitive function of patients and reducing the occurrence of adverse reactions.

Diagnostic, Prognostic, and Recurrence Monitoring Value of Plasma CYFRA21-1 and NSE Levels in Patients With Esophageal Squamous Cell Carcinoma.

This study was aimed to evaluate the clinical values of single markers and combination in the diagnosis, short-term efficacy and recurrence risk assessment of esophageal squamous cell carcinoma (ESCC).MethodsTotally 50 patients with I-IVa stage ESCC, 50 healthy controls and 11 patients with recurrent esophageal cancer after comprehensive treatment were enrolled. Serum biomarkers were collected and evaluated. Serum concentrations of carcinoembryonic antigen (CEA), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) and neuron specific enolase (NSE) were measured by enzyme-linked immunosorbent assay before and after treatment.ResultsThe diagnostic efficacy ROC curve area of CEA, CYFRA21-1 and NSE in esophageal cancer was 0.70, 0.71 and 0.64(all P <0.05), respectively, the sensitivity was 80%, 88.89% and 60% respectively, and the specificity was 53%, 58.5% and 58% respectively. The sensitivity and specificity of the combined detection were 68% and 78% respectively. The area under ROC curve was 0.75. CEA, CYFRA21-1 and NSE were significantly higher than the healthy control group and thus can be used as diagnostic markers of esophageal cancer (all P <0.05). After standard treatment, the clinical CR and PR rate of patients with positive CYFRA21-1 or NSE before treatment was significantly lower than that of patients with negative CYFRA21-1 or NSE (X2 = 4.52,P =0.03). A significant negative correlation was found between N stage and clinical efficacy (HR 2.48, 95%CI 1.07-5.73). After comprehensive treatment, the serum CYFRA21-1 and NSE levels in recurrent patients also increased significantly(all P<0.05), indicating these two markers play obvious roles in recurrence monitoring.ConclusionCYFRA21-1 and NSE may help to predict the response of ESCC to CRT, and play important roles in the diagnosis and recurrence monitoring of esophageal cancer. These markers have a diagnostic value of esophageal cancer when combined with CEA.

Value of cerebral hypoxic-ischemic injury markers in the early diagnosis of sepsis associated encephalopathy in burn patients with sepsis

Value of cerebral hypoxic-ischemic injury markers in the early diagnosis of sepsis associated encephalopathy in burn patients with sepsis

Evaluation of the effects of total intravenous anesthesia and inhalation anesthesia on postoperative cognitive recovery.

To compare the effects of total intravenous anesthesia (TIVA) and inhalation anesthesia (IA) used in lumbar disc herniectomy on postoperative cognitive recovery based on the mini-mental state examination (MMSE) score and neuron-specific enolase (NSE) levels. The study sample consisted of 80patients aged 18-65years who were scheduled for elective lumbar disc herniectomy. The patients were divided into two groups according to the anesthesia technique applied, such as TIVA or IA. The patients in the TIVA group were administered remifentanil and propofol and those in the IA group were administered sevoflurane for maintenance. The MMSE was applied to the patients before the operation and 1h and 24 h postoperatively. Venous blood samples were obtained for the measurement of NSE before the operation and on the 24 h postoperatively. The mean preoperative MMSE scores were similar in the two groups. In the TIVA group, the preoperative and postoperative MMSE scores at 1 h were similar but were higher at 24 h postoperatively compared to the previous two scores (p = 0.001 and p < 0.001, respectively). In the IA group, the preoperative and postoperative 24 h MMSE scores were similar but lower at 1h postoperatively than the other two scores (p = 0.006 and p < 0.001, respectively). In the TIVA group, there was asignificant decrease in the postoperative serum NSE levels than the preoperative values (p = 0.038). The use of IA may result in higher cognitive dysfunction 1h after the operation compared to TIVA. The effects of both methods on cognitive functions were similar at 24 h postoperatively.

A panel of serum biomarkers, including damage, apoptosis and neurotrophic markers, for the assessment of prognosis of the course of ischemic stroke

Identification of the relationship between clinical and neuroimaging data and the content of serum biomarkers (damage marker - neuron-specific enolase (NSE), apoptosis - p53 protein and neuroplasticity - brain-derived neurotrophic factor (BDNF)) in acute, early and late recovery periods of ischemic stroke. Eighty patients in the acute, early and late recovery periods of ischemic stroke, aged from 49 to 75 years, were examined. The comparison group included 20 patients with chronic cerebral ischemia, comparable to the study group. A clinical assessment was carried out on the following scales: The National Institutes of Health Stroke Scale (NIHSS), the European Stroke Scale (ESS), the modified Rankin scale, the Bartel Index and SS-QOL. In the acute, early and late recovery periods of ischemic stroke, the dynamics of biomarker levels (NSE, p53 protein, BDNF) in blood serum and brain MRI in T1, T2, FLAIR, DWI modes were quantified. In patients with a favorable course in the acute period of stroke, low values of the NSE level and a trend towards increased levels of serum BDNF by the 10th day of the disease were noted. For the first time, it was found that high NSE and stable BDNF levels or a tendency to their decrease were observed in the acute period in patients with an unfavorable course of ischemic stroke. In the early recovery period of ischemic stroke, a strong correlation was established between the degree of independence and disability of patients, and the levels of serum NSE and BDNF. A significant inverse correlation was proved between the severity of neurological deficit, assessed on the ESS, in the late recovery period of ischemic stroke (12 months) and the level of BDNF in blood serum (r=-0.464). The selected complex of biochemical methods allowed us to assess the severity of damage, the activity of apoptotic and compensatory neurotrophic capabilities of brain tissue in ischemic stroke, as well as their relationship with clinical and neuroimaging data. We have shown the prognostic significance of the selected markers, which will allow, with an integrated approach, more accurate prediction of the further course and outcome of stroke.