Prealbumin Research Articles

The impact of dietary fiber on colorectal cancer patients based on machine learning

ObjectiveThis study aimed to evaluate the impact of enteral nutrition with dietary fiber on patients undergoing laparoscopic colorectal cancer (CRC) surgery.MethodsBetween January 2023 and August 2024, 164 CRC patients were randomly assigned to two groups at our hospital. The control group received standard nutritional intervention, while the observation group received enteral nutritional support containing dietary fiber. Both groups were subjected to intervention and continuously observed until the 14th postoperative day. An observational analysis assessed the impact of dietary fiber intake on postoperative nutritional status in CRC patients. The study compared infection stress index, inflammatory factors, nutritional status, intestinal function recovery, and complication incidence between groups. Additionally, four machine learning models—Logistic Regression (LR), Random Forest (RF), Neural Network (NN), and Support Vector Machine (SVM)—were developed based on nutritional and clinical indicators.ResultsIn the observation group, levels of procalcitonin (PCT), beta-endorphin (β-EP), C-reactive protein (CRP), interleukin-1 (IL-1), interleukin-8 (IL-8), and tumor necrosis factor-alpha (TNF-α) were significantly lower compared to the control group (p < 0.01). Conversely, levels of albumin (ALB), hemoglobin (HB), transferrin (TRF), and prealbumin (PAB) in the observation group were significantly higher than those in the control group (p < 0.01). Furthermore, LR, RF, NN, and SVM models can effectively predict the effects of dietary fiber on the immune function and inflammatory response of postoperative CRC patients, with the NN model performing the best. Through the screening of machine learning models, four key predictors for CRC patients were identified: PCT, PAB, ALB, and IL-1.ConclusionPostoperative dietary fiber administration in colorectal cancer enhances immune function, reduces disease-related inflammation, and inhibits tumor proliferation. Machine learning-based CRC prediction models hold clinical value.

Pathogenetic and prognostic aspects of copper and zinc deficiency in severely burned patients

Objective. To study the copper and zinc content in the severely burned patients’ blood serum and evaluate their capabilities as prognostic criteria for the burn disease outcome.Materials and methods. 37 patients with a burn area of 50,7±17,2 % of the body surface were examined, 7 of them died. The content of copper, zinc, albumin, globulins and prealbumin in blood serum was assessed within 14 days after receiving thermal injury.Results. A copper and zinc deficiency was found during the burn shock. In the future, the copper levels normalization and a tendency to the zinc concentration increase with normalization by 14 days after burn injury are noted. The micronutrient deficiency correlation with the albumin, prealbumin and globulins levels was found. The conjugacy between hypocyncemia and hypocupremia with the sepsis presence and the death probability was revealed. A decrease in zinc levels below 4,7 mmol/l leads to a 24-fold increase in the death chances and in copper content below 13 mmol/l – to a 10–fold increase in the chances. The sensitivity and specificity of the zinc concentration threshold value assessment was 71 % and 90 %, respectively, and the copper concentration was 80 % and 75 % respectively.Conclusion. During the burn shock hypocupremia and hypocyncemia are detected. Further normalization of the copper level and a tendency to zinc concentration normalization were revealed. Zinc and copper concentrations can serve as additional sepsis biomarkers. Threshold values of zinc and copper concentrations in blood serum have been determined which determine the fatal outcome risk of burn disease.

The effect of high-fiber diet based on gut microbiota in patients with chronic heart failure.

Objective: This research explored the effect of high-fiber diet based on gut microbiota on chronic heart failure (HF) patients. Methods: Chronic HF patients, who had undergone a dietary survey indicating a daily dietary fiber intake of less than 15g/d were divided into the control and study groups (n = 50). In addition to conventional heart failure treatment, the study group received dietary guidance, while the control group did not receive any dietary guidance and maintained their usual low-fiber dietary habits. After one year intervention, the daily dietary fiber intake, abundance of gut microbiota, plasma trimethylamine N-oxide (TMAO), albumin (ALB), prealbumin (PA), transferrin (TF), C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), left ventricular ejection fraction (LVEF), left ventricular end-diastolic index (LVEDVI), and left ventricular end-systolic volume index (LVESVI), Barthel index (BI), and 6 min walking distance (6 MWD) were compared. Results: After intervention, in both groups, the daily dietary fiber intake increased, abundance of Firmicutes, Proteobacteria, Actinobacteria, Fusobacteria decreased and that of Bacteroides increased; the plasma TMAO decreased; serum ALB, PA, and TF levels increased; serum CRP, TNF-α, IL-6, and IL-8 levels decreased, and the change was greater in the study group; LVEF elevated, LVEDVI and LVESVI reduced, and the differences between both groups were not significant; BI and 6 MWD elevated, and the study group was higher than the control group. Conclusion: High-fiber diet positively regulates the composition of gut microbiota, nutritional status and microinflammatory level in chronic HF patients, thereby improving patients' quality of life.

Transcutaneous Electrical Acupoint Stimulation Improves Postoperative Nutrition and Promotes Early Recovery of Gastrointestinal Function in Patients with Colorectal Cancer

Objective: To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on the postoperative nutritional status and recovery of gastrointestinal function in colorectal cancer patients. Methods: Sixty-five patients with ASA grade I-II, undergoing laparoscopic radical colorectal cancer surgery under elective general anesthesia were selected. They were divided into two groups according to the random number table method: the TEAS group (T group) and the sham stimulation group (S group). Two groups of patients were given separate transcutaneous electrical acupoint stimulation and sham stimulation for 30 min at the Hegu (LI4), Neiguan (PC6), Zusanli (ST36), Shangjuxu (ST37), Xiajuxu (ST39), and Sanyinjiao (SP6) points. The intervention time point from the day before surgery, 30 minutes before the start of anesthesia induction, at the start of skin incision, and at the end of surgery to the first, second, and third postoperative days. Changes in serum total protein (TP), albumin (ALB), prealbumin (PA), and transferrin (TRF) were observed, postoperative recovery of gastrointestinal function, and the incidence of postoperative complications were observed. Results: There was no statistical difference between the general data of the two groups; TP, ALB, PA, and TRF in both groups decreased significantly (P<0.05) on postoperative day 1 and 3 compared with those on preoperative day 1. TP, ALB, PA, and TRF were significantly higher in patients in group T than in group S on postoperative days 3 and 7, and the differences were statistically significant (P<0.05). The time to first ventilation, time to defecation, and time to liquid diet were all significantly shorter in group T than in group S. The difference was statistically significant (P<0.05). The incidence of postoperative nausea, vomiting, and abdominal distension was significantly lower in group T than in group S, with a significant statistical difference (P<0.05). Conclusion: Transcutaneous electrical acupoint stimulation can improve postoperative serum protein levels and promote postoperative early recovery in patients with colorectal cancer.

Washed microbiota transplantation effectively improves nutritional status in gastrointestinal disease-related malnourished children.

Gut microbiota dysbiosis plays a critical role in malnutrition caused by food intolerance and intestinal inflammation in children, which needs to be addressed. We assessed the efficacy and safety of washed microbiota transplantation (WMT) for gastrointestinal disease-related malnourished children. This was a prospective observational study involving gastrointestinal disease-related malnourished pediatric patients who underwent WMT. The primary outcome was the clinical response rate at 3 mo post-WMT. Clinical response was defined as an improvement in the children's nutritional status of one level or more. The secondary outcomes were changes in gastrointestinal symptoms, laboratory nutritional indicators, and adverse events during the WMT procedure. 29 patients undergoing 74 WMTs were included for analysis. In total, 48.3% (14/29) of patients achieved clinical response post-WMT. Gastrointestinal symptoms, including diarrhea, mucous stool, abdominal pain, abdominal distention, and hematochezia, were significantly relieved post-WMT (all P < 0.05). Serum albumin and prealbumin levels were increased significantly post-WMT (P = 0.028 and 0.028, respectively). Eight self-limiting and transient adverse events, including diarrhea, abdominal pain, and abdominal distension, occurred after WMT. This study indicated that WMT might be effective and safe for improving nutritional status and gastrointestinal symptoms in gastrointestinal disease-related malnourished children at 3-mo follow-up. WMT was expected to be a new therapeutic option for these patients.

The Effect of Early Enteral Nutrition under the ERAS Model on Gastrointestinal and Immune Function Recovery in Patients Undergoing Gastric Tumor Surgery.

Patients with gastric malignant tumors usually undergo surgical treatment when indicated. Surgical intervention causes significant trauma and can lead to considerable stress responses in patients. These patients experience increased malnutrition along with reduced immune function, which ultimately leads to the occurrence of postoperative complications. Therefore, this study explored the effects of early enteral nutrition on gastrointestinal and immune function in patients undergoing gastric cancer surgery under the Enhanced Recovery After Surgery (ERAS) model, aiming to support early postoperative recovery. A retrospective analysis was conducted on the clinical data obtained from gastric tumors patients who underwent surgery in the Affiliated Hospital of Jiangsu University, between January 2019 and December 2022. Based on the gastrointestinal management approaches, the patients were divided into a control group (n = 92) and an observation group (n = 92). The control group received routine gastrointestinal management and parenteral nutrition support, while the observation group underwent early enteral nutrition support under the ERAS model. The initial postoperative flatulence, the first instance of eating, and the initial bowel movement, as well as serum nutritional indicators [albumin (Alb), prealbumin (PA), hemoglobin (Hb)], immune markers [immunoglobulin G (IgG), immunoglobulin M (IgM), immunoglobulin A (IgA)], inflammatory markers [white blood cell (WBC), hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6)] were evaluated at different time points before and after surgery. Furthermore, the incidence of postoperative complications (abdominal distension, diarrhea, and infection) and the length of post-surgery hospitalization were documented for both patient cohorts. The observation group showed shorter time to first postoperative flatus, earlier food consumption, and an advanced first bowel movement than the control group (p < 0.05). On the third day after surgery, the serum concentrations of Alb, PA, Hb, IgG, IgM, and IgA were diminished in both groups compared to their preoperative levels (p < 0.05). Moreover, on the 7th day after surgery, the serum levels of Alb, PA, Hb, IgG, IgM, and IgA increased in both groups compared to the 3rd day (p < 0.05) but remained lower than before surgery levels (p < 0.05). Additionally, the serum Alb, PA, Hb, IgG, IgM, and IgA levels were significantly higher in the observation group than in the control group on the 3rd and 7th postoperative days (p < 0.05). Three days following surgery, WBC, hs-CRP, and IL-6 levels were elevated in both groups compared to their preoperative levels (p < 0.05). On the 7th day after surgery, WBC, hs-CRP, and IL-6 levels decreased in both groups compared to the 3rd day after surgery (p < 0.05) but remained higher than preoperative levels (p < 0.05). Moreover, WBC, hs-CRP, and IL-6 levels were relatively lower in the observation group than in the control group on the 3rd and 7th postoperative days (p < 0.05). Furthermore, the observation group exhibited a decreased overall frequency of postoperative complications compared to the control group (p < 0.05), along with shorter hospitalization following the surgery (p < 0.05). Our findings indicate that early enteral nutrition under the ERAS model can better promote the recovery of gastrointestinal and immune functions in patients undergoing gastric tumor surgery while reducing postoperative complications and facilitating early discharge of patients.

Practical Study on the Participation of Clinical Pharmacists in Multi-Disciplinary Teams Dealing With Nutrition Intervention Management in Ovarian Cancer.

This study aimed to explore the role of clinical pharmacists in guiding nutritional treatment in a multi-disciplinary team for patients with ovarian cancer (OC) and the significance of pharmaceutical nutritional intervention in overall management and drug administration. Fifty-nine patients with OC in our gynaecological oncology ward were retrospectively investigated. The patients were divided into a conventional therapy (CT) group (n = 30) and a pharmaceutical management (PM) group (n = 29) according to different nutritional therapies received. Nutritional monitoring indicators and clinical response indicators were used to evaluate the intervention effect. Serum albumin (ALB), haemoglobin (HGB) and prealbumin (PAB) levels at admission and discharge, exhaust time, time to return to a normal diet, time to first postoperative chemotherapy and length of hospital stay were measured. The PAB and ALB indicators in the PM group returned to the admission levels; the difference between the two groups was statistically significant (p < 0.05). There was no significant difference in HGB levels between the two groups (p > 0.05). The time to flatus, time to return to normal diet and time to first postoperative chemotherapy in the PM group were significantly shorter than those in the CT group, and the differences had statistical significance (p < 0.05). Patients in the PM group had a significantly shorter hospital stay than those in the CT group (12.5 ± 3.2 days vs 16.8 ± 4.1 days; p = 0.022). Nutritional treatment management by clinical pharmacists plays a key role in the antitumour treatment of patients with OC, effectively improving their nutritional status and thus promoting rapid postoperative recovery.

Nutrition-Associated Biomarkers in Predicting Intravenous Immunoglobulin Resistance and Coronary Artery Lesions in Kawasaki Disease: A Systematic Review and Meta-Analysis.

Several studies explored the associations of pre-albumin (PA)/albumin (ALB) and ALB-combined indicators (prognostic nutrition index [PNI], albumin-to-globulin ratio [AGR], bilirubin-to-albumin [BAR], and C-reactive protein/albumin ratio [CAR]) with intravenous immunoglobulin (IVIG) resistance and coronary artery lesions (CALs) in Kawasaki disease (KD) patients. However, the results were controversial. A meta-analysis was conducted to reconfirm their associations and predictive performance. Databases of PubMed, EMBASE, and the Cochrane library were searched. The pooled standardized mean difference (SMD) or odds ratios (ORs) assessed the association, while the pooled area under the receiver operating characteristic curve (AUC) evaluated the predictive power. Ninety-four studies were included. Overall and subgroup meta-analyses demonstrated lower ALB and higher CAR were associated with IVIG resistance (ALB: SMD = -0.61; OR = 0.83; CAR: SMD = 1.47; OR = 1.69) and CALs (ALB: SMD = -0.56; OR = 0.92; CAR: SMD = 0.52). PNI was reduced in IVIG-resistant (SMD = -0.82) and coronary artery aneurysm (SMD = -0.18) patients in subgroup analysis and high PNI predicted the decreased risk of CALs in overall analysis (OR = 0.82). ALB, CAR, and PNI were a good or fair biomarker for differentiating IVIG-resistant (CALs) from IVIG-sensitive (non-CALs) patients (AUC > 0.6 or > 0.7). PA (SMD = -0.72) and BAR (SMD = 1.10) were differential in IVIG-resistant, but not in CAL patients compared with controls. AGR was not associated with CALs (p > 0.05). In conclusion, ALB, CAR, PNI, PA, and BAR may represent promising biomarkers for the prediction of IVIG resistance and CALs in KD patients.

The CRP/PAB ratio outperforms the LRINEC score in early diagnosis of Fournier's gangrene.

Fournier's gangrene (FG) is scarce and potentially fatal disease. Although the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score was established in 2004, its reliability as a diagnostic tool to differentiate between FG and perianal abscess is still debated. The objective of this study was to assess the reliability of the LRINEC score and other relevant inflammatory markers. The diagnostic effectiveness of these inflammatory factors was evaluated and compared. Retrospective observational study of patients with FG or with perianal abscess. Fifty-two patients with FG and 39 patients with perianal abscess treated in Shenyang Coloproctology Hospital between January 2019 and December 2023 were enrolled in the study. The area under the ROC curve (C-statistic) of a LRINEC score ≥6 for diagnosing FG was 0.736. Inflammatory markers, including C-reactive protein (CRP), procalcitonin (PCT), prealbumin (PAB), neutrophil-to-lymphocyte ratio (NLR), and systemic immune inflammation index (SII), demonstrated better diagnostic ability compared to the LRINEC score. Particularly, the compound inflammatory factor of CRP-to-PAB (CRP/PAB) ratio exhibited superior diagnostic ability compared to other markers (C-statistic: 0.908; p < 0.001). The LRINEC score demonstrated only modest discriminative performance in this study. Patients with PAB< 91mg/L and a CRP/PAB≥ 1.52 should undergo careful evaluation for the presence of FG. The elevated CRP/PAB ratio is considered an early indicator for FG, particularly in distinguishing it from deep perianal abscesses. Further investigation is warranted in future studies to support these findings.

A prognostic nomogram of non-small cell lung cancer based on tumor marker inflammatory nutrition score.

Patients diagnosed with non-small cell lung cancer (NSCLC) usually have a poor prognosis, so it is critical to identify effective biomarkers for prognosis prediction. The aim of this study is to establish a nomogram to evaluate the prognostic significance of blood markers in patients with NSCLC and provide reference for clinical work. A total of 486 patients with NSCLC who were admitted to hospital from January 2009 to December 2019 were retrospectively analyzed. The cohort was divided into a training set (n=340) and a validation set (n=146). Eleven blood indicators were selected as prognostic parameters by the least absolute shrinkage and selection operator (LASSO) model to establish tumor marker inflammatory nutrition (TMIN) score. Univariate and multivariate regression analyses were performed to establish a TMIN-nomogram model for predicting overall survival (OS) and progression-free survival (PFS). Receiver operating characteristic (ROC) survival curve, calibration curve and clinical decision curve analysis (DCA) were used to evaluate the predictive performance of the TMIN-nomogram model. The TMIN score were constructed for 11 of the most valuable prognostic variables, including white blood cells (WBCs), neutrophils (N), platelets (PLT), albumin (ALB), globulin (GLB), prealbumin (PAB), carcinoembryonic antigen (CEA), cytokeratin fragment 21-1 (CYFRA21-1), fibrinogen (FIB), platelet/lymphocyte ratio (PLR), and lymphocyte/monocyte ratio (LMR), and patients were divided into low-risk and high-risk groups using optimal cutovers. The TMIN score showed good predictive value for both OS and PFS. In addition, The TMIN score and sex, smoke, pathological classification, American Joint Committee on Cancer stage (AJCC stage), tumor diameter and Eastern Cooperative Oncology Group-performance status (ECOG-PS) and other clinical indicators showed a strong correlation. Univariate and multivariate analyses confirmed that TMIN score was an independent risk factor for OS and PFS in NSCLC patients. It is worth noting that the TMIN nomogram model of OS and PFS based on multivariate analysis combined with TMIN score has very good prognostic value for NSCLC patients. TMIN is a promising predictor for PFS and OS in NSCLC patients. The TMIN-nomogram prediction model can be used as an effective tool for the comprehensive prognosis evaluation of NSCLC patients.

Application of multiple inflammatory markers combined with PIVKA-II in differential diagnosis of AFP-NHCC

Alpha-fetoprotein (AFP) is a proven blood biomarker widely used in clinical detection of liver cancer, and its concentration increases immediately after liver injury, with high diagnostic specificity and low sensitivity. However, in patients with AFP-negative hepatocellular carcinoma (AFP-NHCC), also known as small liver cancer, their early stage of AFP expression is usually low or close to the normal range. Compared with AFP-positive HCC, AFP-NHCC is more likely to be subjected to missed diagnosis due to solely dependence on the measurement of blood AFP. Therefore, it is necessary to find a reliable, effective, and economical detection method for the early diagnosis of AFP-NHCC. PIVKA-II is closely related to the occurrence, development, invasion, and metastasis of liver cancer, and is also a new hematological marker widely used in the diagnosis of liver cancer in recent years. PIVKA-II effectively makes up for the limitation of negative AFP. 63.2% &amp;ndash; 76.3% of patients with negative AFP showed positive PIVKA-II, and if only PIVKA-II detection was relied on, there would still be missed diagnosis in early patients with AFP-NHCC. In this retrospective study, we selected several commonly used inflammatory indicators to explore the diagnostic efficacy of PIVKA-II, an abnormal form of prothrombin, combined with inflammatory indicators in patients with early-stage AFP-NHCC and analyzed the relationship between some clinical features and hematological indicators in patients with AFP-NHCC. Serum levels of high-sensitivity C-reactive protein (hs-CRP), prealbumin (PA), neutrophil/lymphocyte ratio (NLR), and PIVKA-II were compared among three groups (AFP-NHCC group, benign lesion group, and healthy subjects). The diagnostic efficacy of PIVKA-II alone for AFP-NHCC and the diagnostic efficacy of three inflammatory indicators combined with PIVKA-II for AFP-NHCC were calculated, and their diagnostic specificity and sensitivity were compared. Compared with the other two groups, the AFP-NHCC group showed significant changes in three inflammatory markers and PIVKA-II, which may be related to the inflammatory progression of the tumor. Therefore, we recommend the establishment of a laboratory-based detection approach for diagnosing early-stage AFP-NHCC by combining PIVKA-II with inflammatory indicators hs-CRP, PA, and NLR, to facilitate diagnosis, treatment, and prognosis of AFP-NHCC.

Pressure Ulcers and Nutrients: From Established Evidence to Gaps in Knowledge.

Pressure ulcers (PUs) are caused by continuous pressure or friction on the skin that damages tissue, especially over bony prominences. A critical factor in the development and progression of PUs is poor nutritional status, which often involves deficiencies in essential nutrients such as proteins, vitamins (A, C, D, E, K, and the B complex), and trace elements (including zinc, selenium, copper, iron, and manganese). These micronutrients are vital for effective wound healing, as they play significant roles in cellular repair, immune function, and tissue regeneration. Laboratory tests for serum albumin, prealbumin, transferrin, retinol-binding protein, and anthropometric measures like height, weight, and body mass index (BMI) are used to evaluate a patient's nutritional status. Screening tools such as the Mini Nutritional Assessment (MNA), Malnutrition Universal Screening Tool (MUST), LPZ questionnaire, and Subjective Global Assessment (SGA) are commonly employed. Emerging evidence from various studies, including in vitro, in vivo, and clinical trials, underscores the importance of personalized nutritional interventions in managing PUs. Unlike generic dietary plans, tailored nutrition that addresses the specific needs of individuals shows greater potential in promoting wound healing and improving clinical outcomes. This synthesis of existing research highlights the critical influence of micronutrients on the healing process of PUs. It suggests that a personalized approach to nutrition, which takes into account individual patient requirements and deficiencies, is likely to be more effective than a one-size-fits- all strategy in the management of these complex wounds.

Exploring high-risk factors for the prediction of severe mycoplasma pneumonia in children.

As one of the most common causes of community-acquired pneumonia in children, the prevalence of mycoplasma pneumonia (MPP) has long been underestimated. This study aimed to analyze children's severe MPP (SMPP) by examining laboratory characteristics and identifying high-risk factors. Clinical data from 447 hospitalized children with MPP were retrospectively analyzed. Patients were categorized into ordinary MPP and SMPP groups. Initial laboratory results on admission were compared between groups, and risk factors for SMPP were assessed using receiver operating characteristic (ROC) and logistic regression analyses. Children with SMPP exhibited significantly higher levels of neutrophils, neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP), interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR), and lactate dehydrogenase (LDH), along with lower lymphocyte, albumin (ALB), and prealbumin (PAB) levels compared to the ordinary MPP group (all P<0.05). SMPP children also had a higher incidence of multiple pathogens (P<0.05). ROC analysis identified cutoff values for ESR, LDH, IL-6, CRP, neutrophil percentage, and NLR, with corresponding areas under the curve (AUCs) indicating their predictive values for SMPP. A combined analysis of these factors yielded an AUC of 0.732 (P<0.05). Multivariate logistic regression confirmed ESR >35.50 mm/h, LDH >360.50 U/L, IL-6 >20.28 pg/mL, and CRP >9.74 mg/L as independent high-risk factors for SMPP (P<0.05). ESR, LDH, IL-6, CRP, neutrophil percentage, and NLR are valuable predictors for early identification of SMPP in children. These findings provide essential insights for clinical management aimed at assessing and intervening in prognosis.

Oral Antacid Use Is Negatively Associated with Serum Prealbumin Levels in Japanese Individuals Undergoing Health Checkups.

The aim of this study is to investigate the association between physical and chemical digestion and nutrition markers (serum albumin (ALB), prealbumin (PAB), and vitamin B12 (B12) levels). During a detailed checkup at Fujita Health University, we examined the associations of physical (occlusal force, masticatory performance, and swallowing ability (via the 10-item Eating Assessment Tool, EAT-10)) and chemical (Helicobacter pylori (HP) eradication history, HP antibody levels, and oral antacid (proton pump inhibitors) use) digestion parameters with serum ALB, PAB, and B12 levels in 92 individuals (M:67, F:25). Forty-eight percent of the participants were older than 65 years of age, 19% had decreased occlusal force, 3.2% had decreased masticatory strength, 3.2% had decreased swallowing function, 24% had a history of HP eradication, 23% were HP antibody positive, and 16% were taking oral antacid medication. Additionally, 14% and 11% of the patients had low serum ALB and PAB levels, respectively, and 14% of the patients had B12 deficiency. Multivariate analysis adjusted for age, sex, body mass index, and C-reactive protein levels revealed that there were no significant associations between the physical digestion parameters and the serum PAB, ALB, or B12 levels. On the other hand, there was a significant association between oral antacid use and PAB levels (β = -3.3, p = 0.04). Independent of physical or chemical digestion parameters, serum PAB and B12 levels were significantly associated with protein and B12 intake, respectively. Oral antacid use may decrease serum PAB levels, indicating protein synthesis.

Enhancing nutritional management in peritoneal dialysis patients through a generative pre-trained transformers-based recipe generation tool: a pilot study.

Patients undergoing peritoneal dialysis (PD) often face nutritional deficiencies due to inadequate intake, nutrient loss, insufficient dialysis, and a state of micro-inflammatory. Traditional nutritional management methods have not fully met personalized needs. Therefore, this study aimed to develop and evaluate an application for generating recipes based on Generative Pre-trained Transformers to improve the nutritional status of these patients. This self-controlled prospective study included 35 patients undergoing PD from January to February 2024. The study was divided into two phases: the initial phase involved conventional dietary education under PD management, followed by a second phase where a new GPT-based dietary guidance tool was introduced. Patients adhered to the diets recommended by the tool. Nutritional intervention effects were assessed by comparing serum prealbumin, albumin, and phosphate levels before and after the intervention. After the intervention, the mean prealbumin levels significantly improved from 289.04 ± 74.60 mg/L to 326.72 ± 78.89 mg/L (p = 0.001). Although there was no statistical significance, the serum albumin levels in patients increased from 34.70 ± 5.94 g/L to 35.66 ± 5.14 g/L (p = 0.153). Serum phosphate levels remained stable and within safe limits (p = 0.241). The AI-based recipe generation application significantly improved serum prealbumin levels in PD patients without causing adverse changes in phosphate levels, confirming its efficacy and safety in nutritional management for these patients. This study highlights the potential and practical value of AI technology in nutritional management for patients with chronic disease, providing important evidence for future clinical applications.

Serum nutritional predictive biomarkers and risk assessment for anastomotic leakage after laparoscopic surgery in rectal cancer patients.

Anastomotic leakage (AL) is one of the severest complications after laparoscopic surgery for middle/low rectal cancer, significantly impacting patient outcomes. Identifying reliable predictive factors for AL remains a clinical challenge. Serum nutritional biomarkers have been implicated in surgical outcomes but are underexplored as predictive tools for AL in this setting. Our study hypothesizes that preoperative serum levels of prealbumin (PA), albumin (ALB), and transferrin (TRF), along with surgical factors, can accurately predict AL risk. To determine the predictive value of preoperative serum nutritional biomarkers for rectal cancer AL following laparoscopic surgery. In the retrospective cohort study carried out at a tertiary cancer center, we examined 560 individuals who underwent laparoscopic procedures for rectal cancer from 2018 to 2022. Preoperative serum levels of PA, ALB, and TRF were measured. We employed multivariate logistic regression to determine the independent risk factors for AL, and a predictive model was constructed and evaluated using receiver operating characteristic curve analysis. AL occurred in 11.96% of cases, affecting 67 out of 560 patients. Multivariate analysis identified PA, ALB, and TRF as the independent risk factor, each with an odds ratio of 2.621 [95% confidence interval (CI): 1.582-3.812, P = 0.012], 3.982 (95%CI: 1.927-4.887, P = 0.024), and 2.109 (95%CI: 1.162-2.981, P = 0.031), respectively. Tumor location (< 7 cm from anal verge) and intraoperative bleeding ≥ 300 mL also increased AL risk. The predictive model demonstrated an excellent accuracy, achieving an area under the receiver operating characteristic curve of 0.942, a sensitivity of 0.844, and a specificity of 0.922, demonstrating an excellent ability to discriminate. Preoperative serum nutritional biomarkers, combined with surgical factors, reliably predict anastomotic leakage risk after rectal cancer surgery, highlighting their importance in preoperative assessment.

Efficacy of probiotics combined with enteral nutrition therapy on intestinal flora, digestive tract symptoms and endogenous environment in patients with gastric cancer undergoing chemotherapy.

To investigate the effects of probiotics combined with enteral nutrition therapy on intestinal flora, digestive tract symptoms and endogenous environment in patients with gastric cancer undergoing chemotherapy. In this retrospective study, eighty patients with gastric cancer undergoing chemotherapy admitted to Affiliated Hospital of Hebei University from January 2021 to September 2023 were included and divided into two groups by random number table method: the enteral nutrition group and the probiotics combined enteral nutrition group (n=40 each group). The differences in the number of intestinal flora, nutritional indicators, immune function, endotoxin, D-lactic acid levels between the two groups, and the digestive tract symptoms of the two groups before and after treatment were compared and recorded. The levels of serum total protein (TP), prealbumin (PAB), albumin (ALB) and transferrin (TF) in both groups were higher than those before treatment, and those in the probiotics combined with enteral nutrition group were higher than those in the enteral nutrition group (p< 0.05). The levels of immunoglobulin A (lgA), immunoglobulin M (lgM) and immunoglobulin G (lgG) in the two groups were lower than before treatment, and those in the probiotics combined with the enteral nutrition group were lower than those in the enteral nutrition group (p< 0.05). Probiotics combined with enteral nutrition results in various benefits in the treatment of patients with gastric cancer undergoing chemotherapy, improving immunity, and reducing gastrointestinal symptoms.

A-091 Evaluation of the Analytical Performance of the New Prealbumin Assay on the Atellica CH Analyzer

Abstract Background Analytical performance studies for the new Atellica® CH Prealbumin (PALB) Assay were performed to evaluate precision, detection capability, linearity, and method comparison with the Atellica® CH Prealbumin (PreAlb) Assay. Methods Precision was conducted with 3 reagent lots per CLSI EP05-A3. Daily, two runs were performed, separated by &amp;gt;2 hours with 2 replicates/run, for 20 days, using normal human serum, QC material (Bio-Rad Liquid Assayed Multiqual® Level 3), and normal human serum spiked with prealbumin (Cliniqa Prealbumin spike). Reproducibility was determined per CLSI EP05 A3 and internal protocols. Samples were assayed n=5 in 1 run for 5 days using 3 instruments and 3 reagent lots. Method comparison (MC) studies were conducted with 3 reagent lots per CLSI EP09C-ED3. Individual native serum samples were tested in singlicate on two Atellica® CH analyzers. Passing &amp; Bablok regression used PALB assay as test assay and PreAlb assay as predicate assay. Where needed, MC samples were spiked with concentrated prealbumin (Clinqa Prealbumin spike) to cover the assay measuring interval. LoB and LoD testing were conducted with 3 reagent lots per CLSI EP17-A2. For LoB, four blank samples were run (n=6) per day for three days, total 72 per reagent lot. For LoD, and additional four low samples were run (n=6) per day for three days on 3 lots, on one instrument, total 72 per lot. Linearity studies followed CLSI EP06 A; low and high pools were diluted and spiked (9 levels; n=5 per level). Results The linear range was 3.0-70.0 (30-700) mg/dL (mg/L). Results are presented in the table below for detection capability, repeatability, and method comparison. Reproducibility was 2.7-6.5% at 15.0-58.4 mg/dL (150-584 mg/L). Conclusions The PALB assay detection capability, precision, linearity, and method comparison with the PreAlb assay results were acceptable. This assay is fit for use in a clinical laboratory.

A-053 Evaluation of the Analytical Performance of Atellica CH Prealbumin and β2-Microglobulin Chemistry Assays on the Atellica CI Analyzer

Abstract Background The Atellica® CI Analyzer is an automated, mid-throughput, integrated chemistry and immunoassay analyzer utilizing both Atellica® CH and Atellica® IM assays. This study was designed to evaluate the analytical performance of the Atellica® CH Prealbumin (PALB) and β2-Microglobulin (B2M) Assays on the Atellica CI Analyzer. Methods The Atellica CI PALB and B2M assays use the same reagents and calibrators as the Atellica CH assays. Precision and method comparison (MC) were used as performance indicators for the Atellica CI Analyzer. Precision studies were performed according to CLSI EP05-A3 using native, QC, and contrived human serum samples. One aliquot of each sample pool was tested in duplicate in two runs per day &amp;gt;2 hours apart on each analyzer for 20 days. Method comparison (MC) studies were performed per CLSI EP09-A3. Individual serum samples were analyzed using the Atellica CH and Atellica CI Analyzers. Linearity and verification of detection capability studies were demonstrated for both assays. Results Representative precision, and MC results are presented in the table. Over the two assays tested, repeatability and within-lab %CVs were &amp;lt;4.0% and &amp;lt;4.6%, respectively. Slopes determined using the Deming linear regression model were approximately equal to 1. The Atellica CH PALB assay is linear from 3.0-70.0 mg/dL (30-700 mg/L); LoB, 1.1 mg/dL (11 mg/L); LoD. 1.9 mg/dL (19 mg/L); LoQ, 3.0 mg/dL (30 mg/L). The Atellica CH B2M assay is linear from 0.25-18.00 mg/L; LoB, 0.10 mg/L; LoD, 0.20 mg/L. Conclusions Atellica CH PALB and B2M Assays on the Atellica CI Analyzer demonstrated good precision and equivalent performance to the same assays on the Atellica CH Analyzer.

A machine learning-based predictive model discriminates nonalcoholic steatohepatitis from nonalcoholic fatty liver disease

BackgroundNon-alcoholic fatty liver disease (NAFLD) is a leading cause of liver-related morbidity and mortality. The diagnosis of non-alcoholic steatohepatitis (NASH) plays a crucial role in the management of NAFLD patients. ObjectiveThe aim of our observational study was to build a machine learning model to identify NASH in NAFLD patients. MethodsThe clinical characteristics of 259 NAFLD patients and their initial laboratory data (Cohort 1) were collected to train the model and carry out internal validation. We compared the models built by five machine learning algorithms and screened out the best models. Receiver operating characteristic (ROC) curves, sensitivity, specificity, and accuracy were used to evaluate the performance of the model. In addition, the NAFLD patients in Cohort 2 (n = 181) were externally verified. ResultsWe finally identified six independent risk factors for predicting NASH, including neutrophil percentage (NEU%), aspartate aminotransferase/alanine aminotransferase (AST/ALT), hematocrit (HCT), creatinine (CREA), uric acid (UA), and prealbumin (PA). The NASH-XGB6 model built using the XGBoost algorithm showed sufficient prediction accuracy, with ROC values of 0.95 (95 % CI, 0.91–0.98) and 0.90 (95 % CI, 0.88–0.93) in Cohort 1 and Cohort 2, respectively. ConclusionsNASH-XGB6 can serve as an effective tool for distinguishing NASH patients from NAFLD patients.