Clinical Significance of Hemostatic Parameters in the Prediction for Type 2 Diabetes Mellitus and Diabetic Nephropathy.

It would be important to predict type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN). This study was aimed at evaluating the predicting significance of hemostatic parameters for T2DM and DN. Plasma coagulation and hematologic parameters before treatment were measured in 297 T2DM patients. The risk factors and their predicting power were evaluated. T2DM patients without complications exhibited significantly different activated partial thromboplastin time (aPTT), platelet (PLT), and D-dimer (D-D) levels compared with controls (P < 0.01). Fibrinogen (FIB), PLT, and D-D increased in DN patients compared with those without complications (P < 0.001). Both aPTT and PLT were the independent risk factors for T2DM (OR: 1.320 and 1.211, P < 0.01, resp.), and FIB and PLT were the independent risk factors for DN (OR: 1.611 and 1.194, P < 0.01, resp.). The area under ROC curve (AUC) of aPTT and PLT was 0.592 and 0.647, respectively, with low sensitivity in predicting T2DM. AUC of FIB was 0.874 with high sensitivity (85%) and specificity (76%) for DN, and that of PLT was 0.564, with sensitivity (60%) and specificity (89%) based on the cutoff values of 3.15 g/L and 245 × 109/L, respectively. This study suggests that hemostatic parameters have a low predicting value for T2DM, whereas fibrinogen is a powerful predictor for DN.

Clinical and Prognostic Significance of Lupus Anticoagulant Measurement in Patients With Lung Cancer.

Lupus anticoagulants is related to both recurrent thrombosis and cancer. Thrombotic complications occur more frequently in patients with lung cancer. The aim of this study is to investigate the association of lupus anticoagulants with hypercoagulability and thrombotic complications, as well as prognostic significance of lupus anticoagulants for patients with lung cancer. The study comprised 205 patients with non-small cell lung cancer. Plasma normalized LAC ratio, D-dimer, fibrinogen, activities of antithrombin, and FVIII before treatment were analyzed by coagulation analyzer, and routine hematologic and biochemical parameters were also evaluated. In patients, normalized LAC ratio, D-dimer, fibrinogen, and procoagulant activity of coagulating factor VIII levels significantly increased, whereas antithrombin activity significantly decreased compared with healthy controls (P < .001). Normalized LAC ratio was positively correlated with D-dimer, fibrinogen, and procoagulant activity of coagulating factor VIII, and negatively correlated with antithrombin activity, respectively (P < .01). D-dimer, procoagulant activity of coagulating factor VIII, and antithrombin levels revealed statistical difference in non-deep venous thrombosis patients with elevated or normal normalized LA ratio (P < .05). The incidence of deep venous thrombosis and tumor metastasis was higher, and 1-year survival rate was lower in elevated normalized LAC ratio patients than in normal ones, respectively (P < .01). There was higher normalized LAC ratio level in patients with deep venous thrombosis and/or metastasis (P < .05). In 1-year deceased patients, normalized LAC ratio level and the incidence of deep venous thrombosis and metastasis were higher than those in survivors, respectively (P < .05). Hazard regression analysis demonstrated normalized LAC ratio was independently associated with short survival time in patients with non-small cell lung cancer (hazard regression: 2.871, 95%confidence interval: 1.704-4.835; χ2: 19.130; P < .01). Our study suggests that lupus anticoagulants is a useful marker to predict thrombotic complications and prognosis in patient with lung cancer.

[The effects of individualized therapeutic programs on chronic hepatitis C and the influential factors of virological response].

OBJECTIVE: To investigate the effect of individualized therapeutic programs with combination of interferon and ribavirin (RBV) in chronic hepatitis C (CHC) and study the influential factors of virological response rates. METHODS: A total of 139 patients with CHC were enrolled and given the intensive treatment doses of interferon and RBV according to their basic clinical condition. At the treatment of 0, 4, 12, 24 weeks, the end of treatment and 24 weeks after treatment stop, the serum HCV RNA was determined. Timely adjustment to dosage and time periods was made according to the virological response to treatment, and the predictive value of rapid virological response (RVR) and complete early virological response (cEVR) for sustained virological response (SVR) were analyzed. RESULTS: At the 4th week of treatment, the level of serum HCV RNA was monitored in 120 patients, and 84.2% (101/120) of patients obtained RVR; among them, 90.7% (88/97) obtained SVR. The virus load of patients obtained RVR at pretherapy was lower than that of patients didn't obtained RVR [(5.883 ± 1.246) lg copies/ml vs(6.502 ± 0.693) lg copies/ml, P = 0.034]. The RVR rate of initial treatment patients with PEG-IFNα-2a [87.8% (79/90)] was significantly higher than that of retreatment patients with PEG-IFNα-2a [65.0% (13/20)] (P = 0.031). At the 12th week of treatment, the level of serum HCV RNA was monitored in 132 patients, and 92.4% (122/132) of patients obtained cEVR; among them, 90.8% (108/119) obtained SVR. The SVR rate of patients obtained cEVR was significantly higher than that of patients didn't obtained cEVR (5/9) (P = 0.007). There was no significant difference between the cEVR rate of initial treatment patients [94.7% (90/95)] and retreatment patients [85% (17/20)] with PEG-IFNα-2a (P = 0.158). CONCLUSIONS: cEVR was predictor of SVR. Individualized therapy can increase the obtaining probability of RVR, cEVR and SVR. Adjusting drug dose timely and extending treatment period of HCV RNA-negative based on virological response to treatment are important in CHC individualized therapy.