Programmed death receptor-1(PD-1)and its ligands PD-L and PD-L2 play an important role in the im-mune response.PD-1/PD-L1 or PD-L2 signal pathway has been extensively studied in cancer immunity,and is crucial in reg-ulating infection,autoimmunity and allergic inflammation.Studies have shown that PD-L1 and PD-L2 can regulate the activa-tion and function of T cells and the start or stop of adaptive immune response.This review summarized the basic character-istics of PD-1/PD-L1 or PD-L2 signaling pathway,its relationship with immune tolerance and its role in bronchial asthma.
Objective To investigate the effect of tenofovir dipivoxil fumarate on immune and inflammatory re-sponse levels in patients with chronic severe hepatitis B.Methods One hundred and fourty patients with chronic severe hepatitis B were selected from the Infectious Diseases Department of Haikou People's Hospital from March 2021 to March 2022.They were randomly divided into an observation group of 57 patients and a control group of 57 patients.The control group received routine support therapy and entecavir oral treatment,while the observation group received routine support therapy and tenofovir dipivoxil fumarate oral treatment.Compare the liver function indicators(ALT,AST,TBil,Alb),cellular immune related indicators(CD4+T lymphocyte ratio,CD8+T lymphocyte ratio,CD4+/CD8+ratio),and serum inflammatory related indicators(TGF)between two groups of patients within 6 months of treatment-β 1.IL-6,TRIM5 α、The levels of SOCS-1 and PD-1,as well as the incidence of adverse drug reactions.Results After 6 months of treatment,the serum ALT,AST,and TBil levels in the observation group were lower than those in the control group,while Alb levels were high-er than those in the control group(t/P=10.632/＜0.001,6216/＜0.001,6.090/＜0.001,3.943/＜0.001).The proportion of CD4+T lymphocytes and CD4+/CD8+ratio were higher than those in the control group,while the proportion of CD8+T lympho-cytes was lower than that in the control group(t/P=6229/＜0.001,5.567/＜0.001,3.737/＜0.001).The levels of serum TGF-β,IL-6 and PD-1 in the control group were lower than those in the control group;TRIM5 α The levels of SOCS-1 were higher than those of the control group(t/P=7249/＜0.001,5395/＜0.001,8.658/＜0.001,13.451/＜0.001,7.195/＜0.001).Dur-ing the treatment process,the total incidence of adverse drug reactions in the observation group was lower than that in the control group(x2/P=4.222/0.040).Conclusion Tenofovir dipivoxil fumarate can significantly improve liver function and cel-lular immune function in patients with chronic severe hepatitis B,while significantly inhibiting inflammatory reactions in the patient's body and reducing the incidence of adverse reactions caused by antiviral drugs.
Cervical cancer is the most common malignant tumor of female lower reproductive tract.At present,it is recognized that the continuous infection of high-risk human papillomavirus(HR-HPV)is the main cause of its incidence.For the prevention and treatment of cervical precancerous lesions and the prevention of cervical cancer,it is important to explore the mechanism of persistent infection of HR-HPV.Studies have shown that HR-HPV infection is related to vaginal micro ec-ological environment,such as vaginal microorganisms and vaginal local immune system.This paper deeply explores the cor-relation between vaginal micro ecological environment and HR-HPV infection,in order to find new ideas for the prevention and treatment of HR-HPV persistent infection,and provide a theoretical basis for further exploring the treatment of cervical cancer.
Objective To investigate the changes in serum Gal-1 and Gal-3 levels in patients with sepsis associat-ed acute kidney injury(SA-AKI)of different severity levels and their relationship with in-hospital mortality.Methods Two hundred and forty-three patients with sepsis admitted to the Intensive Care Department of Linfen Central Hospital in Shanxi Province from January 2020 to January 2023 were included,including 123 SA-AKI patients as the SA-AKI group and 120 patients with simple sepsis as the simple sepsis group.Patients in the SA-AKI group were divided into stage 1 subgroup(48 cases),stage 2 subgroup(43 cases),and stage 3 subgroup(32 cases)based on acute kidney injury(AKI)staging,and were divided into death subgroup and survival subgroup according to their in-hospital outcomes.Enzyme linked immu-nosorbent assay was used to detect serum Gal-1 and Gal-3 levels.Analyze the influencing factors of in-hospital mortality in SA-AKI patients through multiple logistic regression analysis.The predictive value of receiver operating characteristic(ROC)curve analysis of serum Gal-1 and Gal-3 levels on the risk of in-hospital mortality in SA-AKI patients.Results Compared with the simple sepsis group,the serum Gal-1 and Gal-3 levels in the SA-AKI group increased(t/P=34.417/＜0.001,15 207/＜0.001).The serum Gal-1 and Gal-3 levels in the 1st,2nd,and 3rd subgroups increased sequentially(F/P=302.934/＜0.001,51.068/＜0.001).Univariate analysis showed that age,AKI stage,use of vasoactive drugs,mechanical ventilation,acute physiological and chronic health assessment Ⅱ(APACHE Ⅱ)scores,blood lactate,Gal-1,and Gal-3 were the influencing fac-tors for in-hospital mortality in SA-AKI patients(x2/t=3.514,43.619,7.041,8.483,4.563,4.081,10282,6.335,P＜0.05 or 0.01).Multivariate logistic regression analysis showed that age ≥ 60 years,AKI stage 2-3,mechanical ventilation and APACHE Ⅱscore,elevated blood lactate,Gal-1,and Gal-3 levels were independent risk factors for in-hospital mortality in SA-AKI pa-tients[OR(95％CI)=1.683(1.145-2.476),2.710(1.107-6.633),3.670(1.398-9.631),1.548(1.070-2.240),1.532(1.123-2.093),1.438(1.042-1.984)1.040(1.016-1.065),1.192(1.071-1.327),P＜0.05 or 0.01].ROC curve analysis showed that the area under the curve(AUC)for predicting in-hospital mortality in SA-AKI patients was 0.720(0.454-0.960),0.771(0.558-0.971),and 0.830(0.686-0.967)for serum Gal-1 and Gal-3 levels alone and in combination,respectively.The combined pre-dictive value of the two indicators was greater than that of each indicator alone(Z=2.652,2.968,P=0.008,0.003).Conclu-sion The elevated levels of serum Gal-1 and Gal-3 are closely related to the worsening of the condition and in-hospital mortality in SA-AKI patients.The combined detection of serum Gal-1 and Gal-3 levels has a high predictive value for in-hospital mortality in SA-AKI patients.
Objective To study the serum levels of CD59 and Gremlin-1 in patients with acute exacerbation of idio-pathic interstitial pneumonia(ⅡP)and their correlation with recent prognosis.Method Ninety patients with acute exacerba-tion stage ⅡP diagnosed and treated in the Respiratory Department of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from March 2020 to February 2022 were selected as the research subjects(acute exacerbation stage group).60 stable stage ⅡP patients diagnosed and treated at the same time were selected as the stable stage group,and 60 healthy individuals examined at the same time were selected as the healthy control group.According to the 3-month follow-up survival status of patients with acute exacerbation stage ⅡP,they were divided into survival subgroup(n=59)and death subgroup(n=31).Enzyme linked immunosorbent assay was used to detect serum levels of CD59 and Gremlin-1.Pearson correlation analysis of the correlation between serum CD59,Gremlin-1 and clinical indicators in patients with acute exacerbation of ⅡP.Multivariate logistic regression analysis of factors affecting the prognosis of death in patients with acute exacerbation of ⅡP.The predictive value of serum CD59 and Gremlin-1 in predicting the prognosis of death in patients with acute exacerbation of ⅡP by analyzing the working characteristic curve of subjects.Results The levels of serum CD59 and Gremlin-1 in the acute exacerbation group were higher than those in the stable stage group and the healthy control group(t=30.916,47.431,34.379,54.420,P＜0.001).The ESR and HRCT scores,serum CD59 and Gremlin-1 levels in the death sub-group were significantly higher than those in the survival subgroup(t/P=2.580/0.012、4.546/＜0.001、26.388/＜0.001、20.842/＜0.001).The levels of serum CD59 and Gremlin-1 in patients with acute exacerbation of ⅡP were positively correlated with ESR and HRCT scores(r=0.621,0.736,0.705,0.689,all P＜0.001).HRCT score,CD59,and Gremlin-1 are high risk factors for mor-tality prognosis in patients with acute exacerbation of ⅡP[OR(95％CI)=1.589(1.258-2.006),1.593(1.252-2.028),1.733(1249-2.404)].The AUC of HRCT score,serum CD59,Gremlin-1,and combined detection for evaluating the prognosis of acute exacerbation stage ⅡP patients were 0.807,0.779,0.752,and 0.867,respectively.The AUC of combined detection was the highest(Z=5.183,4.349,5.127,P＜0.001).Conclusion The elevated levels of serum CD59 and Gremlin-1 in patients with acute exacerbation of ⅡP are influencing factors for the prognosis of death in patients with acute exacerbation.The combined detection of HRCT score,serum CD59,and Gremlin-1 has high evaluation value for the prognosis of death in pa-tients with acute exacerbation of ⅡP.
Objective To explore the influencing factors of sepsis associated encephalopathy(SAE)and construct a column chart model to predict the occurrence of SAE.Methods Select 213 patients with sepsis admitted to the Intensive Care Unit(ICU)of Guizhou Medical University Affiliated Hospital from March 2021 to February 2023,and divide them into SAE group and non SAE group based on the occurrence of SAE.Collect various data for single factor analysis,and con-duct logistic regression analysis on the relevant factors of SAE occurrence;Use R software to construct a risk prediction model for SAE occurrence,and verify the discrimination and accuracy of the model through the area under the ROC cutve(AUC)and calibration curve.Results Among 213 patients with sepsis,84(39.44％)had SAE;SAE group APACHE Ⅱ score,SOFA score,middle cerebral artery PI,arterial blood lactate(BLA),serum S100 β、The levels of ALT,AST,IL-6,and the proportion of invasive mechanical ventilation were higher in the non SAE group than in the non SAE group(t(x2)/P=3.974/＜0.001,3.066/0.002,4.610/＜0.001,5.528/＜0.001,4.750/＜0.001,9.024/＜0.001,2.810/0.005,5.063/＜0.001,7239/0.007),lo-cal brain tissue oxygen saturation(rScO2)and albumin levels were lower than those in the non SAE group(t/P=4.935/＜0.001,3.650/＜0.001);The logistic regression analysis results showed that the main risk factors for the occurrence of SAE were high APACHE II score,high SOFA score,high middle cerebral artery PI,high arterial blood lactate,and high ALT,while high rScO2 and albumin were protective factors for the occurrence of SAE[OR(95％CI)=2.347(1.316～4.184),2.416(1.432～4.077),2204(1234～3.937),2.311(1306～4.088),2.326(1.376～3.933),0.468(0.271～0.809),0.561(0.342～0.919)];A column chart risk model was constructed based on 7 prediction indicators to predict the occurrence of SAE.The results showed that the AUC was 0.831(95％CI 0.773～0.889),and the probability of predicting SAE occurrence was similar to the actual probability,with a goodness of fit HL test x2=6282,P=0.616.Conclusion The column chart risk model construc-ted based on seven indicators:APACHE Ⅱ score,SOFA score,middle cerebral artery PI,rScO2,arterial blood lactate,ALT,and albumin has a good predictive effect on the occurrence of SAE.
A family follow-up and literature review of ataxia telangiectasia with ATM gene mutation were reported.
Objective To investigate the expression and significance ofmicroRNAs miR-155 and miR-182 in serum of hemodialysis patients with end-stage renal disease.Methods A total of 112 patients with end-stage renal disease who received diagnosis and treatment and underwent hemodialysis in the 971st Navy Hospital,Qingdao Municipal Hospital,and Qingdao Haici Hospital from May 2019 to May 2022 were collected as the end-stage renal disease group,and 112 healthy patients who underwent physical examination during the same period were selected as the healthy control group.Real-time quantitative PCR(qRT-PCR)was used to detect the expression of serum miR-155 and miR-182.Pearson method was used to analyze the correlation between serum miR-155 and miR-182 levels in patients with end-end renal disease.Logistic regression analysis was performed to analyze the influencing factors of the prognosis of dialysis patients with end-end renal disease.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum miR-155 and miR-182 expression levels in the prognosis of hemodialysis patients with end-stage renal disease.Results The serum expression levels of miR-155 and miR-182 in the end-renal disease group were significantly higher than those in the healthy control group(t/P=12.719/＜0.001,27.901/＜0.001).There were no significant differences in the ratio of males and females,age,BMI,proportion of primary disease,dialysis time,serum phosphorus(P),total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)between the two subgroups(P＞0.05),and compared with the survival subgroup,the hemoglobin(Hb)and albumin(Alb)of the death subgroup were signifi-cantly reduced(t/P=15.069/＜0.001,9.629/＜0.001),serum calcium(Ca)and high-sensitivity C-reactive protein(hs-CRP)and serum miR-155 and miR-182 were increased(t/P=21.174/＜0.001,40.68/＜0.001,6.629/＜0.001,8.497/＜0.001).The serum ex-pressions of miR-155 and miR-182 in hemodialysis patients with end-end renal disease were positively correlated(r=0.516,P＜0.001).Low Hb,high serum Ca,high hs-CRP,high Alb,high miR-155,and high miR-182 were independent risk factors for the prognosis of dialysis patients with end-renal disease[OR(95％CI)=3.189(1.052-9.670),4.387(1.175-16.375),5.527(1220-25.048),2.058(1251-3386),5561(2.413-12.817),3.189(1.052-9.670)];The area under the curve(AUC)of ser-um miR-155 and miR-182 and their combination were 0.827,0.793 and 0.956,respectively,which were better than those pre-dicted by serum miR-155 and miR-182 separately(Z/P=2.251/0.024,2.797/0.005).Conclusion The serum expression levels of miR-155 and miR-182 in hemodialysis patients with end-stage renal disease are elevated,and the combination of miR-155 and miR-182 may better predict the prognosis of hemodialysis patients with end-stage renal disease.
Objective To analyze the correlation between serum high sensitivity C-reactive protein/albumin(hs CRP/Alb)ratio and cardiovascular events in maintenance hemodialysis(MHD)patients with end-stage renal disease(ESRD).Methods One hundred and sixty-four ESRD MHD patients admitted to the Nephrology Department of the 901st Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from May 2019 to February 2022 were selected.Based on the occurrence of cardiovascular events within one year of the patient's MHD,they were divided into a group of 103 patients without cardiovascular events and a group of 61 patients with cardiovascular events.Measure the patient's blood pressure and laboratory indicators before the first dialysis after admission,and calculate the hs CRP/Alb ratio.Pearson method was used to analyze the correlation between serum hs CRP/Alb ratio and levels of triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)in ESRD MHD patients;Multivariate logistic regression analysis was conducted to determine the risk factors for cardiovascular events in ESRD pa-tients within one year after receiving MHD treatment;The value of analyzing the working characteristics(ROC)curve of subjects in predicting cardiovascular events in ESRD patients within 1 year after receiving MHD treatment,including serum hs CRP,Alb,and hs CRP/Alb ratios.Results Compared with the group without cardiovascular events,the levels of TG,TC,LDL-C,hs CRP,and hs CRP/Alb in the cardiovascular event group were significantly increased(t/P=5.810/＜0.001,12.888/＜0.001,16.735/＜0.001,6.186/＜0.001,19.997/＜0.001),while the levels of HDL-C and Alb were significantly reduced(t/P=13.751/＜0.001,8.714/＜0.001);The serum hs CRP/Alb ratio in ESRD MHD patients was positively correlated with TG,TC,and LDL-C(r/P=0.472/0.017,0.581/＜0.001,0.673/＜0.001),and negatively correlated with HDL-C(r/P=-0.622/＜0.001);High levels of hs CRP and hs CRP/Alb ratio are both risk factors for cardiovascular events in ESRD patients within one year after receiving MHD treatment[OR(95％CI)=3.563(1.309-9.700),1.822(1.179-2.815)];The areas under the curve(AUC)predicted by high serum hs CRP,low Alb,high hs CRP/Alb ratio,and the combination of these three factors for cardiovas-cular events in ESRD patients within 1 year after receiving MHD treatment were 0.843,0.829,0.924,and 0.961,respectively.The AUC predicted by the combination of these three factors was higher than that predicted separately(Z/P=3.383/＜0.001,3.681/＜0.001,1.635/＜0.001).Conclusion The elevated serum hs CRP/Alb ratio in ESRD MHD patients with cardiovascular events is a risk factor that affects the occurrence of cardiovascular events one year after MHD treatment,and has certain predictive value for the occurrence of cardiovascular events.
Objective To observe the effects of 3,3'-diindolylmethane(DIM)on the proliferation and oxidative stress of H9c2 cells induced by Lipopolysaccharide(LPS).Methods From October to December 2022,the experiment was carried out in Hubei Key Laboratory of Metabolism and Related Chronic Diseases,People's Hospital of Wuhan University.H9c2 cells were stimulated with LPS(10 mg/ml)and different concentrations of DIM(10,20,30 μ Mol/L)for intervention.The live cell counting kit(CCK-8)was used to detect the proliferation ability ofH9c2 cells;By detecting intracellular reactive oxygen species(ROS)levels and analyzing the toxic effects of LPS on H9c2 cells.Results The CCK-8 results suggest that DIM has no significant effect on the activity ofH9c2 cells(P＞0.05);LPS can increase the level of ROS in H9c2 cells.When DIM and LPS act simultaneously,ROS levels are significantly reduced(LPS+DIM Ⅰ group:F=27.44,P＜0.001,LPS+DIM Ⅱ group:F=14.06,P＜0.001,LPS+DIM Ⅲ group:F=18.76,P＜0.001);LPS can enhance the proliferation activity of H9c2 cells(F=28.62,P＜0.01),and when DIM and LPS act simultaneously,it can significantly reduce the increase in proliferation activity of H9c2 cells by LPS(LPS+DIM Ⅰ group:F=7.451,P=0.002,LPS+DIM Ⅱ group:F=8.822,P=0.001,LPS+DIM Ⅲ group:F=10.460,P=0.001).Conclusion DIM can inhibit LPS induced oxidative stress in H9c2 cells and improve the proliferative activity of H9c2 cells.
The development of osteoarthritis(OA)is not simply a result of cartilage damage and alteration of the a-lignment of forces,but the immune aspect also has a huge impact on OA,and BMSCs(bone marrow mesenchymal stem cells),as a kind of cells with multi-directional differentiation ability,have great potential in the role of immune regulation and tissue regeneration,and studies have shown that the pathogenesis of OA is closely related to This paper is a review of the biological properties,mechanisms of action,problems and prospects of BMSCs.
Objective To analyze the correlation between keratin 7(KRT7),p53 protein and clinical pathology and prognosis of bladder cancer.Methods Retrospective analysis was made on the clinical data of 105 patients with bladder cancer admitted to the Pathology Department of the Second People's Hospital of Lianyungang City,Jiangsu Province from February 2016 to March 2019.All patients received radical surgery for bladder cancer.During the surgery,the cancerous tis-sues and adjacent tissues were taken,and the expression levels of KRT7 and p53 proteins in cancerous tissues and adjacent tissues were detected by immunohistochemical method,Cox was used to analyze the prognostic factors of bladder cancer patients,and Kaplan Meier method was used to analyze the relationship between KRT7 protein,p53 protein expression and the prognosis of bladder cancer patients.Results The positive rate of KRT7 protein in cancer tissue is lower than that in adjacent tissues(x2/P=23.786/＜0.001),the positive rate of p53 protein is higher than that of adjacent tissues(x2/P=28.651/＜0.001);Patients with poorly differentiated T2 to T4 stages,tumor diameter ≥ 3 cm,and KRT7 protein positivity in cancer tissue are lower than those with moderately well differentiated Ta to Tl stages,and tumor diameter＜3 cm(x2/P=4.940/0.026,11.299/＜0.001,5.379/0.020),the positive rate of p53 protein is higher than that of patients with Ta-T1 stage,medium to high differentiation,and tumor diameter＜3 cm(x2/P=22.459/＜0.001,12.093/＜0.001,25.527/＜0.001);After 3 years of fol-low-up,4 of 105 bladder cancer patients lost the follow-up,and 34 of the remaining 101 patients died,with a case fatality rate of 33.66％.Cox analysis showed that T2～T4 stage,poor differentiation,tumor diameter ≥ 3 cm,KRT7 protein negative and p53 protein positive were the risk factors for the prognosis of bladder cancer patients[HR(95％CI)=3.935(1.730-8.952),3.575(1.572-8.133),3.515(1 545-7.996),4.933(2.169-11222),3.762(1.654-8.558)].The survival rate of KRT7 protein positive patients is higher than that of KRT7 protein negative patients(x2=5238,P=0.022);The survival rate of p53 pro-tein negative patients is higher than that of p53 protein positive patients(x2=5.115,P=0.024).Conclusion The expression of KRT7 and p53 protein in bladder cancer tissue is closely related to the degree of differentiation,tumor diameter,clinical stage and prognosis.
Objective To explore the application value of cardiopulmonary ultrasound indicators and weaning car-diopulmonary ultrasound scores in distinguishing cardiogenic factors of weaning failure in severe mechanical ventilation pa-tients.Method Four-eight patients who underwent mechanical ventilation at the Intensive Care Unit(ICU)of Hebei Provin-cial People's Hospital from July 2019 to May 2021 and experienced weaning failure were selected.According to the age strat-ification threshold of N-terminal B-type natriuretic peptide precursor(NT proBNP),weaning failure patients were divided into a cardiogenic weaning failure group(cardiogenic group)of 22 cases and a non cardiogenic weaning failure group(non car-diogenic group)of 26 cases.At the beginning of the weaning trial(0 min),bedside ultrasound was used to measure the pa-tient's right ventricular end diastolic diameter(RVEDD),left ventricular end diastolic diameter(LVEDD),left ventricular ejec-tion fraction(LVEF),inferior vena cava diameter(IVCD),early diastolic blood flow peak velocity(E)of the mitral valve,and early diastolic tissue velocity(e')of the mitral annulus/left ventricular sidewall,and E/e'was calculated.At the 0th and 15th minutes of the withdrawal test,lung ultrasound was used to observe the changes in the number of B-lines in the anterior chest wall of both lungs,and each indicator was converted into a binary variable.Using a binary logistic regression model to screen for independent influencing factors.According to partial regression coefficients β Value is used as a weight to as-sign a score.Use the total score as the withdrawal cardiopulmonary ultrasound score.Use ROC curves to evaluate the pre-dictive value of each parameter.Results The proportion of LVEF＜50％,E/e'＞14,IVCD ≥20 mm,and an increase of ≥6 B-lines in pulmonary ultrasound in the cardiogenic group were higher than those in the non cardiogenic group(x/P=11.679/0.001,16.121/＜0.001,11.679/0.001,13.890/＜0.001);Logistic regression analysis showed that LVEF＜50％,E/e'＞14,and an increase of ≥ 6 B-lines in pulmonary ultrasound were independent risk factors for cardiac factor weaning failure[OR(95％CI)=21.119(1.411-316.056),18.119(1.089-46.615),7.126(2.839-115.642)];ROC curve analysis showed that the area under the curve(AUC)for predicting cardiogenic factors of weaning failure by weaning cardiopulmonary ultrasound score was 0.913,which was higher than that predicted by LVEF and IVCD alone(Z/P=0.015/0.044,2.352/0.019),and there was no statistically significant difference in predicting changes in E/e and the number of pulmonary ultrasound B-lines(Z/P=0.928/0353,1.558/0.119).Conclusion Cardiopulmonary ultrasound technology has high application value in identif-ying withdrawal failures caused by cardiogenic factors,with the highest predictive value of withdrawal cardiopulmonary ul-trasound scores.
Objective To explore the changes in serum immune status and predictive value of prognosis in elderly patients with chronic obstructive pulmonary disease(COPD)complicated with pulmonary infection.Methods One hun-dred and twenty elderly COPD patients with pulmonary infection admitted to the Department of Respiratory and Critical Care Medicine at Yangguang Ronghe Hospital in Weifang City from June 2021 to June 2022 were selected.They were divided in-to a survival group of 100 patients and a death group of 20 patients based on their prognosis after one year of treatment.Compare the levels of CD3+,natural killer(NK)cells,CD4+/CD8+,and their correlation with lung function indicators and COPD grading between two groups of patients.Application of multivariate logistic regression analysis to analyze the risk factors of pulmonary infection in elderly COPD patients;Draw ROC curves to evaluate the predictive value of CD4+/CD8+,CD3+,and NK cells in elderly COPD patients with pulmonary infection.Results Compared with the survival group,the levels of CD3+,NK cells,and CD4+/CD8+in the death group decreased(t/P=12.552/＜0.001,8.132/＜0.001,5.779/＜0.001).Comparison of serum CD3+,NK cells,and CD4+/CD8+levels in patients with different grades of COPD:Grade Ⅰ＞Grade Ⅱ＞Grade Ⅲ(F/P=82.514/＜0.001,35529/＜0.001,19.657/＜0.001).The expression of CD3+,NK cells,CD4+/CD8+was posi-tively correlated with FEV1/FVC,FEV1％pred,and negatively correlated with COPD grading(r=0556,0.560,-0.550,0.545,0.539,-0.567,0.572,0.587,-0.605,P＜0.001).Older age,longer disease course,higher proportion of COPD grade Ⅲ,are risk factors for prognosis in elderly COPD patients with pulmonary infection[OR(95％CI)=1.369(1.194～1.571),5.239(2.506～10.951),1.114(1.016～1212)],higher FEV1/FVC,higher FEV1％pred,higher CD3+,higher NK cells,and higher CD4+/CD8+are protective factors[OR(95％CI)=0.697(0.593～0.821),0.622(0.493～0.786),0.478(0.331～0.689),0.633(0.523～0.766),0.023(0.004～0.124)].The AUC of CD3+,NK cells,CD4+/CD8+,and the three combined tests for predicting the prognosis of elderly COPD with pulmonary infection were 0.640,0.637,0.840,and 0.935,respectively.The AUC of the three combined tests was greater than that of the individual predictors(P=0.001).Conclusion The expression of serum CD3+,NK cells,and CD4+/CD8+in elderly COPD patients with pulmonary infection decreases,and is related to lung function indicators and COPD grading.The combined detection of these three factors can effectively improve the predictive value of elderly COPD patients with pulmonary infection.
Objective To explore the diagnostic value of serum pyruvate kinase M2(PKM2)and procalcitonin(PCT)in sepsis.Methods One hundred and nineteen sepsis patients(sepsis group)admitted to the Intensive Care Unit(ICU)of Wuhan University People's Hospital from April 2022 to January 2023,and 73 non sepsis patients(non sepsis group)admitted to the ICU during the same period were selected as the study subjects.Detect and compare the serum lev-els of PKM2 and PCT in two groups of patients within 24 hours of admission,and use Spearman correlation test to analyze the correlation between serum PKM2 and PCT levels in sepsis patients;Using a multivariate logistic regression model to an-alyze the impact of various indicators on the occurrence of sepsis;Draw a receiver operating characteristic(ROC)curve to evaluate the diagnostic value of serum PKM2,PCT,and their combination in sepsis,and calculate the area under the curve(AUC).Results Compared with the non sepsis group,the serum PKM2 and PCT levels in the sepsis group were signifi-cantly increased(Z/P=9.373/＜0.001,9.013/＜0.001).There is a positive correlation between serum PKM2 and PCT levels in sepsis patients(r=0.322,P＜0.001).Multivariate logistic regression analysis showed that elevated levels of serum PKM2 and PCT were independent risk factors for sepsis occurrence[OR(95％CI)=1.182(1.078-1295),1582(1.186-2.110)].The ROC curve shows that the AUC of serum PKM2,PCT,and their combination for diagnosing sepsis were 0.903,0.888,and 0.941,respectively,with sensitivity of 0.863,0.918,and 0.932,and specificity of 0.798,0.748,and 0.857,respectively.The com-bined diagnostic efficacy of the two was higher than that of individual detection(Z/P=2.560/0.011,3.423/＜0.001).Conclu-sion The elevated serum PKM2 level in patients with sepsis is an independent risk factor for sepsis and is positively cor-related with PCT.Combined detection of the two has high diagnostic value.
Hemophagocytic lymphohistiocytosis is a syndrome of multiple organ system injury induced by hyper-cytokinemia and immune-mediated abnormal activation of immune cells.The application of chemo immunotherapy has effec-tively reduced the overall mortality rate,but the mortality rate of patients with early multiple organ dysfunction is still high.In recent years,the early application of blood purification has not only rapidly reduced immune inflammatory mediators,but also effectively protected and restored organ function,which has important clinical significance for improving the prognosis of patients.In the future,more clinical studies on large-scale blood purification therapy are needed to form standardized treatment plans,in order to maximize the benefits for patients.This article reviews the etiology,pathogenesis,and application of blood purification technology in recent years of HLH,in order to provide scientific reference for clinical diagnosis and treatment of HLH.
Objective To investigate the effect of balloon dilatation combined with Solitaire stent on vascular pa-tency and prognosis in patients with acute intracranial large vessel occlusion accompanied by atherosclerosis.Methods From January 2016 to May 2022,82 patients with acute intracranial large vessel occlusion accompanied by atherosclerosis were selected from the Department of Neurology,General Hospital of Taiyuan Iron and Steel(Group)Co.,Ltd.They were randomly divided into two groups:the control group and the observation group,with 41 cases in each group.The control group received Solitaire stent treatment,while the observation group received balloon dilation combined with Solitaire stent treatment.Observe 2 groups of surgical related indicators,vascular recanalization status,preoperative and postoperative 3-day cerebral blood flow perfusion[relative cerebral blood flow(rCBF),relative peak time(rTTP),relative mean transit time(rMTT),relative cerebral blood volume(rCBV)],vascular endothelial function[von Willebrand factor(vWF),endothelin-1(ET-1),nitric oxide(NO)],preoperative and discharge coma risk(GCS score)Degree of neurological impairment(NIHSS score),cognitive function(MOCA score),and complications.Results The observation group had fewer thrombus removal times than the control group,and the immediate postoperative vascular diameter was greater than the control group(t/P=5.162/＜0.001,3.446/0.001);There was no statistically significant difference in blood vessel recanalization rate between the observation group and the control group(P＞0.05);On the 3rd day after surgery,the rCBF level in the observation group was higher than that in the control group,while the rMTT and rTTP levels were lower than those in the control group(t/P=2217/0.029,4.714/＜0.001,4.919/＜0.001);The serum vWF and ET-1 levels in the observation group were lower than those in the control group 3 days after surgery,while the NO levels were higher than those in the control group(t/P=6.770/＜0.001,12.292/＜0.001,8.726/＜0.001);At discharge,the GCS and MOCA scores of the observation group were higher than those of the control group,while the NIHSS scores were lower than those of the control group(t/P=3.326/0.001,6.163/＜0.001,10.584/＜0.001);There was no statistically significant difference in the total incidence of complications between the observation group and the control group(P＞0.05).Conclusion Balloon dilatation combined with Solitaire stent in the treat-ment of acute intracranial large vessel occlusion with atherosclerosis can reduce the number of embolectomy,increase the diameter of blood vessels,improve the endothelial function of blood vessels,contribute to cerebral blood flow perfusion,promote disease prognosis,and have high safety.
Objective To study the serum levels of cysteine protease inhibitor 6(CST6)and interleukin-17A(IL-17A)in patients with multiple myeloma bone disease(MMBD)and their relationship with the severity and prognosis of MMBD.Methods Eighty patients with MMBD diagnosed and treated in the Hematology Department of the First Affiliated Hospital of Xi'an Jiaotong University from February 2019 to January 2020 were selected as the MMBD group,and 50 pa-tients with multiple myeloma without bone disease diagnosed and treated during the same period were selected as the con-trol group.Enzyme linked immunosorbent assay was used to detect serum levels of CST6 and IL-17A;The correlation was analyzed using Spearman rank correlation analysis;The evaluation value of serum CST6 and IL-17A on the prognosis of MMBD by analyzing the working characteristic curve of subjects;Multivariate Cox regression analysis of factors affecting the prognosis of MMBD patients;Kaplan Meier survival analysis of the impact of serum CST6 and IL-17A levels on the prognosis of MMBD patients.Results Compared with the control group,the serum CST6 level in the MMBD group de-creased and the serum IL-17A level increased significantly(t/P=39.798/＜0.001,18241/＜0.001).Serum CST6 was significant-ly negatively correlated with MMBD bone disease grading,while serum IL-17A was significantly positively correlated with MMBD bone disease grading(r/P=-0.721/＜0.001,0.664/＜0.001);The area under the curve(AUC)of serum CST6,IL-17A,and their combination for evaluating the prognosis of MMBP patients were 0.812,0.888,and 0.931,respectively.The combination of the two had the highest AUC for evaluating the prognosis of MMBP patients(Z/P=5.147/＜0.001,4.784/＜0.001);The 3-year cumulative survival rate of the CST6 low expression subgroup is lower than that of the CST6 high expres-sion subgroup(x2=7.933,P=0.005),the 3-year cumulative survival rate of the IL-17A high expression subgroup was lower than that of the IL-17A low expression subgroup(x2=22.802,P＜0.001);ISS stage Ⅲ,bone disease grade 4,and high ser-um IL-17A are independent risk factors affecting the prognosis of MMBD patients.High serum CST6 is an independent protective factor affecting the prognosis of MMBD patients[OR(95％CI)=1.594(1252-2.028),1.589(1258-2.006),1.451(1.120-1.879),0.703(0.537-0.919)].Conclusion The decrease of serum CST6 and the increase of IL-17A levels in MMBD patients are independent factors affecting the prognosis of MMBD patients,which are related to the severity of their condi-tion.
Objective To analyze the relationship between serum long-chain non-coding ribonucleic acid taurine up-regulation gene 1(lncRNA TUG1)and microribonucleic acid-144(miR-144)expression and the prognosis of LN patients with lupus nephritis(LN).Methods A total of 104 LN patients admitted to the Department of Rheumatology and Immunol-ogy of Suining Central Hospital from January 2020 to June 2021 were selected as the LN group,and they were divided into 36 subgroups with poor prognosis and 68 cases with good prognosis according to whether end-stage renal disease(ESRD)occurred during the follow-up period,and 40 healthy patients with physical examination during the same period were select-ed as the healthy control group.The expression of serum lncRNA TUG1 and miR-144 was detected by real-time quantitative polymerase chain reaction kit.The binding sites of lncRNA TUG1 and miR-144 were predicted by TargetScan,and the corre-lation between serum lncRNA TUG1 and miR-144 expression in LN patients was analyzed by Pearson correlation.Multivari-ate logistic regression analysis was used to analyze the risk factors of poor prognosis in LN patients,and receiver operating characteristics(ROC)curves were used to analyze the predictive value of serum lncRNA TUG1 and miR-144 expression in poor prognosis of LN patients.Results Compared with the healthy control group,the expression of serum lncRNA TUG1 in the LN group decreased and the expression of miR-144 increased(t/P=15.885/＜0.001 and 15.808/＜0.001).The Tar-getScan website predicted that there was a binding site between lncRNA TUG1 and miR-144.Pearson correlation analysis showed that serum lncRNA TUG1 was negatively correlated with miR-144 expression in LN patients(r=-0.797,P＜0.001).After 2 years of follow-up,the incidence of ESRD in 104 patients with LN was 34.62％(36/104).Multivariate Logistic regres-sion analysis showed that stage 4 of chronic kidney disease and elevated miR-144 were independent risk factors for poor re-nal prognosis in patients with LN[OR(95％CI)=1.197(1.062～1349),1.108(1.047～1.172)],complete remission after induc-tion therapy and estimated glomerular filtration rate and elevated lncRNA TUG1 were independent protective factors[OR(95％CI)=0305(0.101-0.923),0.979(0.960-0.998),0.841(0.750-0.943)],ROC curve analysis showed that the expression of serum lncRNA TUG1 and miR-144 and the area under the curve(AUC)of the two combined predictions of poor renal prog-nosis in LN patients were 0.772,0.773 and 0.911,respectively,and the AUC predicted by the two was the largest(Z/P=3239/0.001、3247/0.001).Conclusion The low expression of serum lncRNA TUG1 and the high expression of miR-144 in LN patients were associated with poor renal prognosis,and the combined value of the two in predicting the poor renal prognosis of LN was higher.
The clinical data of a patient with serous cystadenoma of fallopian tube combined with supernumerary ovary and fallopian malformations were reported and literature review was conducted.
