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Current laboratory testing methods of antiphospholipid syndrome(APS) can not satisfy the clinical need for diagnosis and treatment. Inflammation plays an important role in the development of APS. The comprehensive effect of varieties of immune cells, molecular systems, and cytokines renders the body in a pro-inflammatory state. Understanding the inflammatory mechanisms in the pathogenesis of APS is conductive to achieving individualized treatment and improving the efficacy of APS patients. In this article, the inflammation mechanisms and related diagnosis and treatment protocols involved in APS are summarized, aiming to provide reference for the clinical treatment of APS.
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Background/Aims@#This study aimed to explore the effect of gut microbiota-regulated Kupffer cells (KCs) on colorectal cancer (CRC) liver metastasis. @*Methods@#A series of in vivo and in vitro researches were showed to demonstrate the gut microbiota and its possible mechanism in CRC liver metastasis. @*Results@#Fewer liver metastases were identified in the ampicillin-streptomycin-colistin and colistin groups. Increased proportions of Parabacteroides goldsteinii, Bacteroides vulgatus, Bacteroides thetaiotaomicron, and Bacteroides uniforms were observed in the colistin group. The significant expansion of KCs was identified in the ampicillin-streptomycin-colistin and colistin groups. B.vulgatus levels were positively correlated with KC levels. More liver metastases were observed in the vancomycin group. An increased abundance of Parabacteroides distasonis and Proteus mirabilis and an obvious reduction of KCs were noted in the vancomycin group. P. mirabilis levels were negatively related to KC levels. The number of liver metastatic nodules was increased in the P. mirabilis group and decreased in the B. vulgatus group. The number of KCs decreased in the P. mirabilis group and increased in the B. vulgatus group. In vitro, as P. mirabilis or B. vulgatus doses increased, there was an opposite effect on KC proliferation in dose- and time-dependent manners. P. mirabilis induced CT26 cell migration by controlling KC proliferation, whereas B. vulgatus prevented this migration. @*Conclusions@#An increased abundance of P. mirabilis and decreased amount of B. vulgatus play key roles in CRC liver metastasis, which might be related to KC reductions in the liver.
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Although immune checkpoint inhibitors (ICIs) have great breakthrough in cancer treatment in recent years, most patients have not benefited from it on account of immune microenvironment. Studies have shown that tryptophan metabolism is not only involved in the formation of tumor immunosuppressive microenvironment but also plays an important role in the therapeutic application of ICIs. At present, inhibiting the kynurenine pathway of tryptophan metabolism is now in various stages of clinical trials, while the other two metabolic pathways, 5-HT and the indole pathway, also have aroused wide concern. This article reviews the latest developments in this field.
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The role of 5-hydroxytryptamine (5-HT)has attracted more and more attention in the development of tumor. In addition to the synthesis of 5-HT by enterochromaffin cells,some tumor cells and im-mune cells can also secrete 5-HT,and there are different 5-HT receptors on the surface of these cells. 5-HT plays multiple biological effects through activating different receptors. 5-HT promotes the proliferation and inva-sion of tumor and induces the angiogenesis of tumor tissues through activating its corresponding receptors,such as 5-HT1D,and so on. Furthermore,various 5-HT receptors are expressed on the surface of immune cells. On the one hand,physiological doses of 5-HT promote the proliferation and secretion of immune cells. On the other hand,pathologic 5-HT has an effect on inducing the differentiation of immune cells in the direction of immuno-suppression,thus participating in the occurrence and development of tumor.
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The role of 5-hydroxytryptamine (5-HT) has attracted more and more attention in the development of tumor. In addition to the synthesis of 5-HT by enterochromaffin cells, some tumor cells and immune cells can also secrete 5-HT, and there are different 5-HT receptors on the surface of these cells. 5-HT plays multiple biological effects through activating different receptors. 5-HT promotes the proliferation and invasion of tumor and induces the angiogenesis of tumor tissues through activating its corresponding receptors, such as 5-HT1D, and so on. Furthermore, various 5-HT receptors are expressed on the surface of immune cells. On the one hand, physiological doses of 5-HT promote the proliferation and secretion of immune cells. On the other hand, pathologic 5-HT has an effect on inducing the differentiation of immune cells in the direction of immunosuppression, thus participating in the occurrence and development of tumor.
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Objective To verify the performance of the ABI ViiA 7 Taqman HBV-DNA detecting system for confirming its sta-bility,accuracy and reliability.Methods According to the evaluation protocols of Clinical and Laboratory Standards Institute (CLSI),the performance of ABI ViiA 7 Taqman HBV-DNA detecting system was assessed in the aspects of precision,accuracy,lin-earity and comparability;the quantitative detection limit validation experiments was performed by diluting specimen until quantita-tive detection limit is lower than the lower limit of detection,and the detection results were compared with the quality target re-quirements and the analysis capability declared by manufacturers.Results The CV in within-run precision of this detection system was 1.485%,1.990% and 0.932% respectively;the total CV was 1.876%,3.361% and 1.891%,respectively;the maximum devia-tion of accuracy was -6.8%;the linear correlation coefficient was 0.998 3;the regression equation was Y =0.974 8X +0.050 7. The linear range was 1.00E2 - 2.00E8;the quantitative detection limit was 100 IU/mL;the comparability of ABIViiA7 and ABI7500:P =0.115,r2 =0.994,the linear regression equation was Y =0.987 2X +0.051 7.Conclusion The ABI ViiA 7 Taqman HBV-DNA detection system has excellent precision,accuracy,sensitivity and linearity and has a good correlation with ABI7500, which can be used for the detection of clinical specimens.
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Objective To observe the effects of parathyroidectomy(PTX) on bone metabolism and bone mineral density(BMD) in maintenance hemodialysis patients with secondary hyperparathyroidism (SHPT).Methods A total of 26 dialysis patients with SHPT were treated with PTX.Serum calcium,phosphorus,alkaline phosphatase(ALP) levels were determined by standard methods.The levels of serum intact parathyroid (iPTH),osteocalcin (OC),procollagen type Ⅰ aminoterminal propeptide (PINP),β-crosslaps (β-CTX) were measured by chemiluminescence.BMD was measured by dual energy X ray absorptiometry.iPTH,OC,PINP,β-CTX,serum calcium,phosphorus,ALP were measured before parathyroidectomy and 1,3,6,12,18,24 months after operation.Lumbar spine (LS) and femoral neck (FN) BMD were measured before and 24 months after PTX.Results Compared with that before operation,serum OC[(104.49±25.42) μg/L vs (695.46±355.62) μg/L,P ＜ 0.01] and PINP levels [(248.36 ± 159.38) μg/L vs (809.28 ± 283.50) μg/L,P＜ 0.01] progressively decreased 3 months after PTX,and serum β-CTX levels [(1.60±0.64) μg/L vs (3.37±1.34) μg/L,P ＜ 0.01] decreased 1 month after PTX.Compared with that before operation,BMD levels increased 24months after PTX in LS[(0.88±0.23) g/cm2 vs (0.78±0.23) g/cm2,P ＜ 0.01] andFN[(0.96±0.19) g/cm2 vs (0.84±0.24) g/cm2,P ＜ 0.01],and Z-scores were also increased in both LS[(-1.24±0.55) vs (-1.66± 0.24),P ＜ 0.01] and FN[(-1.51 ±0.72) vs (-1.93 ± 0.40),P ＜ 0.01].Correlation analysis showed that baseline iPTH was positively correlated with ⊿Z-score in FN (r=0.584,P=0.002) and LS (r=0.400,P=0.043),and so did the OC with ⊿Z-score in FN (r=0.651,P ＜ 0.001) and LS (r=0.509,P=0.008).Conclusion The levels of OC,PINP and β-CTX are reduced and BMD is improved in hemodialysis patients with SHPT after PTX.
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Objective To investigate the value of KIM-1 and NGAL in predicting the early diabetes nephropathy(DN).Meth-ods 132 cases of type 1 and type 2 diabetic patients were recruited in this study,patients were divided into four groups based on the urine albumin/creatinine and serum creatinine levels,as follows:normal albuminuria group (45 cases),mi-croalbuminuria group (36 cases),clinical albuminuria group (30 cases),renal failure group (21 cases),65 healthy subjects were recruited as control group.Urinary KIM-1 and NGAL levels were measured by enzyme linked immunosorbent assay (ELISA).Results With the progress of DN,urinary KIM-1 and NGAL levels gradually increased (P<0.05),the urinary KIM-1/Ucr level was positively correlated with ACR (r=0.822,P<0.01),and the urinary NGAL/Ucr was positively cor-related with ACR (r=0.842,P<0.01).Conclusion The urinary KIM-1 and NGAL level can predict the occurrence of ear-ly DN,and also monitor the progression of DN.
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Objective This study aims to investigate the correlation of CD4+ CD25+ FOXP3+ Tregs and PD‐1+ CD4+ T cells located at cervical lesions and the prognosis of CIN .PD‐1 expression on T cells induces Tregs .Methods Cervical lymphocytes were collected from CIN patients and analyzed by FACS .Comparisons were made between populations of cervical Tregs and PD‐1+CD4+T cells in CIN regressors and non‐regressors .Results A median of 11 .8% of cervical CD4+ T cells were CD4+ CD25+ FOXP3+Tregs ,while a median of 30 .3% were PD‐1+ CD4+ T cells .The proportions of CD4+ CD25+ FOXP3+ Tregs and PD‐1+ cells were significantly lower in CIN regressors when compared with non‐regressors .Conclusion The prevalence of CD4+ CD25+ FOXP3+Tregs negative correlates with spontaneous regression of CIN ,suggesting that cervical Tregs may play an important role in HPV‐related neoplastic immunoevasion .
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Objective To investigate the relationship of urinary liver-type fatty-acid binding protein and progression of ne-phropathy in diabetic patients .Methods A total of 132 cases of type 1 and type 2 diabetic patients were recruited in this study , and were divided into four groups based on the urine albumin /creatinine and serum creatinine levels , including normal albuminuria group ( n =45), microalbuminuria group ( n =36), clinical albuminuria group ( n =30), and renal failure group ( n =21), Additional 65 healthy subjects were recruited as control group .The levels of urinary liver-type fatty-acid binding protein ( L-FABP) were measured with enzyme-linked immunosorbent assay (ELISA), and serum creatinine, urine creatinine, Liver function, hemoglobin, glycated he-moglobin (HbA1c), albumin (Alb), and 24h urinary protein were measured by respective biochemical or immunological methods . Results With the progression of diabetic nephropathy , the level of urinary L-FABP was gradually increased ( P 0.05).Conclusions The uri-nary L-FABP level can predict the occurrence of early diabetic nephropathy , and also monitor the progression of diabetic nephropathy .
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ObjectiveTo explore the value of immuomagnetic beads(IMB) technique for detection of intraperitoneal free cancer cells from colorectal cancer.MethodsPeritoneal lavage fluid was obtained from 80 patients with colorectal cancer during laparotomy.Peritoneal lavage cytology (PLC) and IMB were used to detect free cancer cells in peritoneal lavage fluid.10 patients with hysteromyoma during laparotomy were enrolled into the control group.ResultsThe positive rate of PLC was 8.8％ (7/80),the positive rate of IMB was 28.8％ (23/80).The positive case after useing PLC detect,IMB detect also was positive.The detected samples of control group were negative by these two methods.IMB was superior to PLC ( x2 =10.503,P =0.001 ).ConclusionIMB was more sensitive and specific than PLC,which could provide a effective method for finding intraperitoneal free cancer cells.
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Objective To observe the modulatory effects of NF-κB on dynamic changes of TNF-α、IL-1β and ICAM-1 in rats with severe acute pancreatitis (SAP),and to assess the effects of pretreatment with mycophenolate mofetil (MMF) on them.Methods A total of 104 male Wistar rats were randomly divided into normal group,sham operation group,SAP group and MMF group.(1) In normal group,rats had just an incision on abdomen wall and sutured (n =8) ; (2) In sham operation group,rats underwent laparotomy with flipping over the pancreas and gendy striking five times by using blunt instrument and abdomen was closed (n =32); (3) In SAP group,SAP in rats was induced by the retrograde injection of sodium taurocholate (STC) into the pancreatic duct (n =32) ; (4) In MMF group,MMF (250mg/kg)was injected intraperitoneally one hours after injection of STC (n =32).Rats were saerificed by abdominalaorta exsanguination separately at intervals of 3,6,12 and 24 h after modeling of pancreatitis.Histologic score of pancreatic tissue was assessed,and serum amylase (AMS) and serum C-reactive protein (CRP)were measured by automatic biochemical detector.The serum levels of inflammatory cyctokines (TNF-α,1L-1β and 1CAM-1 ) were measured by using ELISA,and expression of NF-κB mRNA in pancreatic tissue was measured by using quantitative PCR.Results Compared with sham operation group,histologic score of pancreatic tissue,serum amylase,TNF-α、IL-1β and ICAM-1 in SAP group were increased significantly (P ＜ 0.05 ).Pretreatment with MMF obviously deceased histologic score,and the serum levels of amylase,TNF-α,IL-1β and ICAM-1 and the expression of NF-κB mRNA were higher than those in SAP group in early stage (P ＜0.05 ).Conclusions Cytokines play an important role in early stage of SAP.MMF could attenuate the severity of inflammatory response through inhibiting cellular immunity and modulating the proinflammatory cytokines produced.
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ObjectiveTo evaluate the efficacy and safety of high-dose irbesartan in the treatment of mild and moderate proteinuria in patients with chronic kidney disease (CKD).MethodsA single center,prospective,observational study was performed.A total of 96 subjects were given irbesartan 150 mg/d for 4 weeks.Twenty-six were divided into single-dose ( 150 mg/d) irbesartan group when their clinical efficacy were eligible for improvement criteria and 70 were divided into high-dose (300-600 mg/d) irbesartan group when there were no effect for single-dose treatment.Both groups received treatment for 48 weeks.Then 24-hour quantitative urine protein,systolic pressure,diastolic pressure,TC,LDL-C,plasma albumin,serum creatinine,blood urea nitrogen,blood uric acid,serum potassium and ALT were determined.Results The proteinuria level after treatment in the single-dose irbesartan group was decreased by 68.3％ with a statistically significant difference( P ＜0.001 ).In the high-dose group,the dose of irbesartan was increased based on the ineffectiveness when treating with single-dose,and the proteinuria was decreased by 63.4％ (P ＜0.001 ).Total effective rate in treating proteinuria in high-dose group was 72.9％ (51/70).Among the blood pressure sub-groups,the effective rates for the normal blood pressure group and hypertension group in treating proteinuria were 68.2％ and 76.9％ respectively ( P ＞ 0.05 ).However,in the normal blood pressure group and hypertension group,the proteinuria was decreased by 61.9％ and 67.5％ respectively after treatment (P＜0.001,P＜0.01),while without difference between the two groups (P＞0.05).The effective rates of high doses of 300,450 and 600 mg/d of irbesartan in treating proteinuria were 70.8％,63.6％ and 66.7％,respectively.The difference in effective rates of treating proteinuria among different doses had no statistical significance ( P ＞ 0.05 ).No obvious increase of SCr value before and after treatment in high-dose group ( P =0.583 ).The increasing level of serum potassium in high-dose group after treatment was higher than that in the single-dose group ( P ＜ 0.05 ),but the highest concentration (4.8 mmol/L) was still within the normal range.The blood pressure of 3 cases who quit observation because of low blood pressure in high-dose group returned to normal after drug withdrawal.ConclusionHigh-dose irbesartan can effectively lower the mild and moderate proteinuria in CKD patients with a good safety and tolerance and the efficacy is independent of lowering blood pressure.
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Cancer-related fatigue is one of the most common and refractory clinical sympotoms in patients with cancer. Investigators have tried to study the molecular pathogenesis of cancer-related fatigue, and the cytokine has become a research focus. At present, a number of cytokines, including transformation growth factor, tumor necrosis factor, interleukin, proteolytic inducing factors, inflammatory cytokine are proved to be correlated to cancer-related fatigue.
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Objective Todeterminethecorrelationbetweenthrombomodulinand atherosclerosis in chronic kidney diseases (CKD) patients.Methods A total of 96 CKD patients in our hospital were enrolled in the study, including 32 maintenance hemodialysis(MHD) patients and 64 non-hemodialysis CKD patients with stage 2 to 5(non-HD) and 30 age- and gendermatched healthy volunteers were used as control.Intima-media thickness(IMT) and atherosclerotic plaquesof theextracranialcommoncarotidarteryweredetectedbyhigh-resolutionB-mode ultrasonography. Bloodlevelof thrombomodulinwasmeasuredusingELISA,andcreatinine,triglycerides, cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol were measured routinely as well.Correlation analysis of thrombomodulin with other parameters was performed.Results The thrombomodulin level was significantly higher in CKD patients as compared to healthy controls[(12.15±3.04) mg/L vs(3.12±0.23) mg/L, P＜0.05], and also significantly higher in MHD patients as compared to non-HD patients [(16.89±3.35) mg/L vs (9.78±2.49) mg/L, P＜0.05].The atherosclerotic plaques incidence and IMT value of carotid artery increased significantly in CKD patients compared with healthy volunteers.Thrombomodulin was positively correlated with IMT in CKD patients(r=0.335, P＜0.01).Multiple stepwise regression analysis showed that thrombomodulin, Tm (OR=1.13, 95％CI 1.010-1.121), SBP (OR=1.09, 95％GI 1.009-1.114), CRP(OR=1.22, 95％CI 1.216-2.007), and Scr were independent risk factors of IMT.ConclusionThrombomodulin is correlated with carotid atherosclerosis in CKD patients and may be used as a marker to evaluate the endothelial damage.
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It has been demonstrated that surgery is currently still the most effective approach to completely cure gastric cancer. However, while only 30%-40% of gastric cancer can obtain curative outcome through pure surgery, most of patients with gastric cancer would died of recurrence or distant metastasis of the tumor. It appears to be more critical to search for other therapeutic strategies for gastric cancer other than surgery. Molecular targeting therapy has become the focus and hotspot of comprehensive treatment of gastric cancer.
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Objective To investigate the incidence and the relation between pulmonary hypertension (PH) and cardiac output in hemodialysis (HD) patients with PH. Methods The incidence of PH was estimated with Doppler echocardiography in 78 patients receiving HD. Left ventricular ejection fraction, cardiac volume, cardiac output and cardiac index were compared between patients with or without PH. Results PH was found in 20 patients (25.64%), among them15 had mild PH, 4 had moderate PH and 1 had severe PH. There was no statistical difference of ejection fraction, cardiac volume, cardiac output and cardiac index between the two groups. PH was not related to cardiac output. Conclusion HD can lead to PH, but cardiac output can not result in PH. Further investigations about the effect of elevated cardiac output induced by internal arteriovenous fistula and other factors on PH are needed.
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Objective To investigate the prevalence ,clinical features and prognosis of pulmonary arterial hypertension (PAH) in maintenance bemodialysis (MHD) patients for early diagnosis and treatment. Methods Complete clinical data of 184 MHD patients in Beijing Chaoyang Hospital between January 2000 and December 2007 were retrospectively analyzed. PAH diagnosis depended on echocardiography. Results Sixty-five (35.3%) patients were found having PAH, including 31 females and 34 males, with mean (56.84±14.58) years old. The mean bemadialysis duration was (29.69±21.61) months. Among 65 patients with PAH, arteriovenous fistula was used in 61 patients and central venous catheter in 4 patients. The systolic pulmonary arterial pressure (SPAP) was (44.56±8.25) mm Hg (1 mm Hg=0.133 kPa) in PAH group, which was significantly higher than (30.28±3.92) mm Hg in non-PAH group. There were significant differences of interval dialysis weight gain (IDWG), Hb, Hct, right atrial diameter, pulmonary artery diameter and right ventricular diameter between PAH group and non-PAH group (all P<0.05). Multivariate analysis revealed anemia, IDWG and right atrial diameter were independent factors (P< 0.05). There were no significant differences of age, dialysis duration, serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone (PTH) between two groups. Conclusions PAH is a common complication of MHD patients. Patients with mild PAH had few clinical manifestations and good therapeutic responses, but severe PAH may be associated with poor prognos is. Doppler echocardiography should be performed periodically to detect PAH in MHD patients.
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Objective To study the influence of NS4B on host defense system. Methods After cell line stably expressed NS4B was established, cell expression profiling caused by NS4B was studied using DNA microarray, and the results of microarray were verified via IFNGR1 fluorescence intensity analysis. Results The data showed that HCV-NS4B could suppress host defense system-associated gene ex-pression, in particular, IFN-γsignal transduction-related genes. Conclusion NS4B could play a role in persistence and resistance to IFN therapy in HCV infection.
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Objective To investigate the causes of upper gastrointestinal bleeding (UGB), and some relative factors. Methods The UGB in 1 869 patients examined endoscopically between 1982－ 1996. Results 1.The most common causes of UGB were peptic ulcer (31.5％ ), gastric cancer(19.3％ ), and AGML(17.5％ ), and the rate of severe bleeding was highest in esophageal varices(49.4％ ). 2.Between 1982－ 1986,1987－ 1991,and 1992－ 1996, the rates of UGB were 22.3％ ,12.0％ ,and 13.4％ respectively. 3. The rate of UGB in male and female patients were 17.5％ and 8.9％ ; their difference is statistically significant(P