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Objective:To analyze the risk factors for heart failure in patients with hemodialysis, and to construct a nomogram model.Methods:The clinical data of 218 patients with hemodialysis in Xianyang Central Hospital from January 2021 to April 2022 were retrospectively analyzed. Among them, 83 cases developed heart failure (heart failure group), and 135 cases did not develop heart failure (control group). The relevant clinical data were recorded, including age, sex, body mass index, disease duration, concurrent infection, blood calcium, blood phosphorus, soluble CD 146 (sCD 146), soluble growth-stimulated expression gene 2 protein (sST2), N-terminal brain natriuretic peptide precursor (NT-proBNP), time-averaged urea concentration (TACurea), tumor necrosis factor α (TNF-α), blood creatinine and 24 h urine volume. Receiver operating characteristic (ROC) curve was used to analyze the efficacy of each index in predicting heart failure in patients with hemodialysis. Multivariate Logistic regression was used to analyze the independent risk factors of heart failure in patients with hemodialysis. R language software 4.0 "rms" package was used to construct the nomogram model for predicting the heart failure in patients with hemodialysis, the calibration curve was internally validated, and the decision curve was used to evaluate the predictive efficacy of the nomogram model. Results:There were no statistical difference in gender composition, age, body mass index, disease duration, 24 h urine volume and blood creatinine between the two groups ( P>0.05); the rate of concurrent infection, blood phosphorus, sCD 146, sST2, NT-proBNP, TNF-α and TACurea in heart failure group were significantly higher than those in control group: 39.76% (33/83) vs. 8.89% (12/135), (1.53 ± 0.34) mmol/L vs. (1.27 ± 0.24) mmol/L, (43.60 ± 10.24) μmol/L vs. (28.08 ± 7.99) μmol/L, (49.00 ± 9.41) μg/L vs. (34.53 ± 8.05) μg/L, (38.57 ± 6.79) μg/L vs. (29.72 ± 5.64) μg/L, (5.18 ± 0.92) μg/L vs. (4.07 ± 1.13) μg/L and (24.28 ± 4.37) mmol/L vs. (17.96 ± 2.52) mmol/L, the blood calcium was significantly lower than that in control group: (1.95 ± 0.36) mmol/L vs. (2.31 ± 0.39) mmol/L, and there were statistical differences ( P<0.01). ROC curve analysis result showed that the optimal cut-off values of blood calcium, blood phosphorus, sCD 146, sST2, NT-proBNP, TNF-α and TACurea for heart failure in patients with hemodialysis were 2.01 mmol/L, 1.42 mmol/L, 34.15 μmol/L, 40.37 μg/L, 35.37 μg/L, 4.33 μg/L and 20.74 mmol/L. Multivariate Logistic regression analysis result showed that the blood calcium (≤2.01 mmol/L), blood phosphorus (>1.42 mmol/L), sCD 146 (>34.15 μmol/L), sST2 (>40.37 μg/L), NT-proBNP (>35.37 μg/L), TNF-α (>4.33 μg/L) and TACurea (>20.74 mmol/L) were independent risk factors for heart failure in patients with hemodialysis ( OR = 1.183, 1.582, 1.915, 1.105, 1.459, 1.347 and 1.717; 95% CI 1.102 to 1.191, 1.274 to 1.868, 1.716 to 2.105, 1.072 to 1.141, 1.225 to 1.703, 1.132 to 1.574 and 1.482 to 1.935; P<0.05 or <0.01). The blood calcium, blood phosphorus, sCD 146, sST2, NT-proBNP, TNF-α and TACurea were used as predictors to construct a nomogram model for predicting heart failure in patients with hemodialysis. Internal validation result showed that the nomogram model predicted the heart failure with good concordance in patients with hemodialysis (C-index = 0.811, 95% CI 0.675 to 0.948); the nomogram model predicted the heart failure in patients with hemodialysis at a threshold>0.18, provided a net clinical benefit, and all had higher clinical net benefits than blood calcium, blood phosphorus, sCD 146, sST2, NT-proBNP, TNF-α and TACurea. Conclusions:The nomogram model constructed based on blood calcium, blood phosphorus, sCD 146, sST2, NT-proBNP, TNF-α and TACurea has better clinical value in predicting the heart failure in patients with hemodialysis.
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The clinical data of 380 patients undergoing loop electrosurgical excision procedure(LEEP) conization for cervical intraepithelial neoplasia grade 3(CIN3) at the Affiliated Hospital of Xuzhou Medical University from January 2017 to December 2019 were retrospectively analyzed. Univariate and multivariate logistic regression analyses were used to determine the risk factors of positive margin and residual lesions following conization. One hundred and twelve cases (29.5%) had positive margins, and the risk factors for positive margins were positive high-risk human papillomavirus ( OR=4.92, 95% CI: 1.81-13.36), high-grade lesions on thin cytologic test (TCT)screening ( OR=3.95, 95% CI: 2.42-6.42), and glandular involvement ( OR=3.58, 95% CI: 1.93-6.63). The hysteretomy was performed following conization in 169 hundred and sixty-nine patients who had difficulty in follow-up or no fertility intension, among whom 51 (30.2%) had residual lesions; logistic regression analysis showed that positive margins on LEEP were a risk factor for residual lesions at the time of hysterectomy ( OR: 2.83, 95% CI: 1.44-5.59). The study indicates that positive HR-HPV, high-grade TCT lesions, and lesions involving glands are risk factors for positive margins in CIN3 patients undergoing LEEP conization; and positive margins is risk factor for residual lesions following conization,to which more attention should be paid in clinical practice.
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Objective To investigate the effects and mechanism of interleukin 33 (IL-33) on renal tubular injury in mice with lupus nephritis.Methods Twelve-week-old female MRL/lpr mice were randomly divided into model group,IL-33 group and solvent control group with 10 rats in each group.Ten female MRL/MP mice of the same age were used as normal control group.The mice in IL-33 group were intraperitoneally injected with 100 μL of phosphate buffer saline (PBS),containing 2 μg of recombinant mouse IL-33,once a day for 14 days.The mice in control group and the model group were intraperitoneally injected with the same dose of PBS.All the mice were sacrificed at 14 weeks of age.Serum creatinine (Cr) and urea nitrogen (BUN) concentrations were determined by serum separation.The urine in 24 hours was collected testing urinary protein creatinine ratio and urinary protein quantification.The contents of E-cadherin,α-SMA,and JAK/STAT pathway signaling proteins,including JAK2,p-JAK2,STAT1,and p-STAT1,were detected by Western blot.Results The BUN,urinary protein creatinine ratio and urine protein level of the IL-33 group were significantly higher than those of the model group (all P＜0.05).The expression of renal tubular epithelial cells o-SMA in the IL-33 group was higher than that in the model group,and the difference was statistically significant (P＜0.05).Compared with the model group,the expression of E-cadherin in the tubular epithelial cells of IL-33 group decreased and the expression of p-JAK2 and p-STAT1 protein increased,and the differences were all statistically significant (all P＜0.05).Compared with the model group,the levels of JAK2 and STAT1 in IL-33 group change little,and the differences were not statistically significant (all P＞0.05).Conclusions IL-33 can cause tubulointerstitial lesions in lupus mice,and its mechanism may be related to the activation of JAK/STAT pathway.
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Objective To prepare SDF-1 α-loaded nanoliposome ( SNP )-SonoVue complex and investigate its tracing abilities, sustained-release property and effect on migration of bone marrow mesenchymal stem cells (BMSCs). Methods The SNP was prepared to detect its physical characteristics including particle size,zeta potential, morphology, encapsulation efficiency and drug loading.SNP-SonoVue was constructed to detect the sustained release situation of SNP and SNP-SonoVue after low frequency ultrasound ( LIFU ) irradiation, and the connection of SNP-SonoVue was observed by fluorescence microscope. Effects of SNP-SonoVue on migration of BMSCs were detected to evaluate its bioactivity. BMSCs were divided into 6 groups,including Group A: SDF-1α+ 1% serum medium;Group B: SNP- SonoVue+ 1% serum culture medium;Group C:SNP-SonoVue+ 1% serum culture medium + LIFU ( 1 MHz,0.5 W/cm2, expose 30 s stop 30 s, 4 min);Group D: BNP-SonoVue+1% serum medium;Group E:BNP-SonoVue+1% serum medium+LIFU ( 1 MHz, 0.5 W/cm2, expose 30 s stop 30 s, 4 min),Group F:PBS+1% serum culture medium (control group). Its tracing abilitie were investigated in vitro. Results The average particle size of SNP was(220.4±9.9)nm,and the particle dispersion index(PDI) was(0.172± 0.015), the average zeta potential was ( 35.6 ± 1.7) mv. It was showed spherical dispersion by transmission electron microscopy. The encapsulation efficiency was up to 96.7% and the drug entrapment content was 481.76 ng/mg. Flow cytometric showed the suitable conditions for SNP-SonoVue preparation was that the ratio of SNP quality(mg) to Sono Vue microbubbles number(a) was20:(2.8×109)to40:(2.8× 109). Fluorescence microscopy showed that shells of SonoVue microbubbles connected with large numbers of SNP labeled with red fluorescent DiI. Drug release experiment showed that the cumulative SDF-1α release amount of SNP and SNP-SonoVue exposed to LIFU respectively were ( 68.61 ± 3.97 )% and ( 63.21 ± 5.68)% in vitro within 7 days, and the difference was not statistically significant ( P ＞ 0.05 ). Cell migration experiments confirmed that the transfer function of BMSCs in Group A, Ggroup B and group C was significantly higher than that in control group ( P ＜ 0.05 ), but there was no significant difference among the Group A, Ggroup B and group C ( P ＞0.05). In vitro development experiment showed that the SNP-SonoVue complex had obviously enhanced development effect. Conclusions SNP-SonoVue complex is successfully prepared. It has obviously enhanced development effect and can lead to migration of BMSCs.
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Toll-like receptor 5 (TLR5) is one of the pattern recognition receptors and recognizes the flagellin protein of bacteria.It activates innate immune responses and induces production of a series of cytokines.TLR5 functions as a bridge linking innate and adaptive immunities.It is known that TLR5 plays an important role in the occurrence and development of certain infectious diseases.This review summarizes the relationships of TLR5 polymorphisms with the development of infectious diseases and discusses the possible pathogenesis.