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Objective:To investigate high mobility group protein 1(HMGB1), tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels and their clinical significance in elderly patients with viral pneumonia.Methods:One hundred and sixty elderly patients with viral pneumonia admitted to the Sixth Hospital Affiliated to Anhui Medical University were enrolled as research subjects.In addition, 40 elderly people who underwent regular physical examination were considered as the control group.Patients with viral pneumonia were divided into the low-risk group, middle-risk group and high-risk group according to CURB-65 scores and pneumonia severity index(PSI)scores.HMGB1, TNF-α and IL-6 levels were compared between different groups.The correlations of CURB-65 scores and PSI scores with HMGB1, TNF-α, IL-6 levels were analyzed.Multivariate Logistic regression analysis was used to examine influencing factors for the severity of viral pneumonia in elderly patients.Results:HMGB1, TNF-α and IL-6 levels were higher in research subjects than in the control group.As the severity of viral pneumonia increased, so did HMGB1, TNF-α and IL-6 levels(all P<0.05). HMGB1, TNF-α and IL-6 levels in the severe viral pneumonia group were significantly higher than those in the non-severe viral pneumonia group( P<0.05). HMGB1, TNF-α and IL-6 levels were positively correlated with CURB-65 scores and PSI scores(CURB-65 score: r=0.463, 0.392 and 0.497, P=0.015, 0.003 and 0.025; PSI score: r=0.596, 0.515 and 0.381, P=0.007, 0.011 and 0.009). HMGB1, TNF-α and IL-6 levels were influencing factors for the severity of viral pneumonia in elderly patients( OR=1.344, 1.422 and 1.351, P=0.006, 0.015 and 0.009). Conclusions:HMGB1, TNF-α and IL-6 levels are closely correlated with the severity of viral pneumonia and are helpful for early assessment of viral pneumonia.
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Objective:To investigate the potential factors influencing the extent of coronary artery lesion in acute coronary syndrome (ACS) patients with an emphasis on the role of serum SIRT1.Methods:We assessed the clinical data from 81 ACS patients admitted to China-Japan Friendship Hospital. Serum SIRT1 was detected by enzyme linked immunosorbent assay (ELISA), and the extent of coronary artery lesion was evaluated by SYNTAX score before revascularization. All the patients were divided into two groups: high SYNTAX score (severe coronary artery lesion, n=38) and low SYNTAX score (moderate coronary artery lesion, n=43), by means of the median of SYNTAX score. Potential factors influencing SYNTAX score were analyzed through multiple linear regression analysis. Results:Compared with the low SYNTAX score group, patients in the high SYNTAX score group had higher serum SIRT1 level [379.38 (490.14) ng/L vs. 242.95 (173.85) ng/L, P<0.001] and frequency of coronary artery disease family history (42.11% vs. 20.93%, P=0.039). There was no statistical difference among other factors between the two groups. Serum SIRT1 was positively correlated with SYNTAX score in ACS patients ( R=0.452, P<0.010). Serum SIRT1 (ln adjusted), age and estimated glomerular filtration rate were independently correlated with SYNTAX score (ln adjusted) in multiple linear regression analysis (Adjusted R2=0.330, P<0.001). Conclusions:For the first time, we discussed the correlation of serum SIRT1 with extent of coronary artery lesion in ACS patients. Cardiologists should pay more attention to high-risk patients in order to improve the prognosis of ACS patients through timely revascularization strategies.
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OBJECTIVE: To explore the effect of long-term low-level lead load on the immune function of occupationally exposed workers. METHODS: The convenient sampling method was used to select 57 lead-exposed workers as the observation group.These workers had the blood lead level of ≥300 μg/L and <400 μg/L.They worked in a battery plant from 2009 to 2018. Another 61 none-lead exposed logistical personnel with blood lead level of <100 μg/L were selected as the control group. The blood lead levels and immune function indicators were detected in these 2 groups, including serum immunoglobulin(Ig)G, IgA, IgM, complement(C) 3, C4, C-reactive protein(CRP), tumor necrosis factor alpha(TNF-α) level, blood intermediate cell(MID) count and MID ratio(MID%).The abnormal rates of the above immune indexes were calculated. RESULTS: The median blood lead level in the observation group was 338 μg/L. The levels of IgA(M: 2.3 vs 1.9 g/L), C3 [(10.8 ± 1.7) vs(10.1±1.5) mg/L] and C4(M: 2.6 vs 2.3 mg/L) of observation group decrease(P<0.05), the abnormal rate of IgG increased(1.6% vs 14.0%, P<0.05), compared with the control group. The other immune indexes of these two groups were compared, and the differences showed no statistical significance(P>0.05). Blood lead level was negatively correlated with C3 level and positively correlated with TNF-α level(Spearman correlation coefficients were-0.20, 0.19, P<0.05). CONCLUSION: Low level lead might have an impact on the immune system of lead-exposed workers.
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Objective To systematically review the short-term and long-term efficacy of eversion carotid endarterectomy (eCEA) and patch carotid endarterectomy (pCEA) for the treatment of carotid artery stenosis.Methods The published literature on eCEA and pCEA control studies in medline,PubMed,Ovid,CNKI and CBM (1970.5-2016.10) databases were retrieved by computers.Two reviewers selected literature and extracted data independently according to the inclusion and exclusion criteria.Cochrane Collaboration Network Special Software Rev Man 5.2 was used to analyze the meta-analysis of short-term and long-term outcome measures.Results A total of 1 137 articles were retrieved.Ten studies were included and analyzed (3 of them were randomized controlled trial).A total of 3 213 patients were enrolled,including surgical intervention 3 299 case/time (1 512 in the eCEA group and 1 787 in the pCEA group).The results of meta-analysis showed that:(1) the mean operative time in the pCEA group was shorter 22±8 min than that in the pCEA group.The intraoperative utilization ratio of shunt tube,eCEA was significantly lower than pCEA,they were 12.6 %(53/421) and 50.2% (357/711) respectively (OR,0.11,95%CI 0.08-0.15,P<0.01).The postoperative incidence of stroke within 30 d (OR,0.42,95%CI 0.23-0.76,P=0.004) and the incidence of stroke after 30 d in eCEA were lower than those in pCEA (OR,0.26,95%CI 0.09-0.78,P=0.02).There was significant difference.(2) eCEA reduced the incidence of restenosis at day 30 after procedure (OR,0.57,95%CI 0.38-0.86,P=0.008).Conclusion Compared with pCEA,eCEA has the advantages of reducing the operation time and lowering the utilization rate of shunt tube.At the same time,eCEA can reduce the occurrence of stroke within 30 d and 30 d after procedure,and significantly reduce the incidence of restenosis.
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BACKGROUND:Vascular smooth muscle is the main cell component of constructing vascular wall tissue structure and maintaining vascular tension.Studies have shown that smooth muscle progenitor cells obtained from peripheral blood can differentiate into vascular smooth muscle cells.OBJECTIVE:To compare smooth muscle progenitor cells dedved from human peripheral blood with mature vessel wall smooth muscle cells in cell morphology and proliferation potential.DESIGN,TIME AND SETTING:Cell culture and observation trials were performed at the Key Laboratory of Molecular Medicine in Jiangxi province from October 2008 to April 2009.MATERIALS:Peripheral blood 20mL were adopted from 6 healthy volunteers,and great saphenous vein were sourced from 6 patients with varicose vein.METHODS:Mononuclear cells were isolated from human peripheral blood and cultured in fibronectin,platelet derived growth factor-BB and EGM-2 medium.At the same time,the smooth muscle cells were obtained from great saphenous vein with the collagenase digestion method.High-glucose DMEM medium was used for the culture.MAIN OUTCOME MEASURES:Cellular morphology;Cellular immumofluorescence method and RT-PCR method were used to detect the expression of α-SMA and calponinl.MTT method was used to analyze the proliferation activity.RESULTS:The smooth muscle progenitor cells denved from human peripheral blood exhibited biological characteristics of vascular smooth musc Je cells.they were found to express α-SMA and calponin1.The proliferation activity of smooth muscle progenitor cells was also greater than vascular smooth muscle cells.CONCLUSlON:Peripheral blood mononuclear cells in the stimulus of platelet-derived growth factor can differentiate into smooth muscle progenitor cells.Compared to smooth muscle cells,smooth muscle progenitor cells proliferate better,and are not easy to age in a long time of cultivation.Smooth muscle progenitor cells are a ideal ceil source of tissue engineered vessel.
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Objective To study an effective method for culturing of human vascular smooth muscle cells (hVSMCs) in tissue engineered blood vessels (TEBVs) in vitro.Methods A 3-cm segment of human long saphenous vein was harvested under sterile conditions.The primary culture and subculture were done by modified tissue-piece inoculation and trypsin digestion respectively.The cells were purified by mechanical treatment and differential attachment.PDGF was combined with high concentration of glucose DMEM as the culture medium.The cultured cells were identified by morphology and immunohistochemistry with contrast microscope and SABC kit,and RT-PCR method detected the expression of ?-SMA and calponin 1.Results The cultured cells possessed"peak and valley"characteristics for VSMCs under microscope.Immunohistochemical staining showed positive expression of intracytoplasmic ?-actin,and RT-PCR detected positve expression of ?-SMA and calponin 1.Conclusions Culture medium of PDGF combined with high concentration of glucose DMEM,and with differential attachment method can provide highly purified hVSMCs with good structure and function.