ABSTRACT
Objective To explore the clinical effect of Bayesian discriminant analysis in predicting the risk of macrosomia. Methods 169 fetal macrosomia and 169 non-macrosomia were enrolled in a 1:1 matched case-control study. Conditional Logistic regression was used to select the discriminant indexes,and the discriminant indexes were put into the Bayesian discriminant model to obtain the Bayesian discriminant function. The discriminant function was the retrospectively examined and externally tested. Results The results of conditional Logistic regression model indicated that mother's height, early pregnancy body mass index (BMI), gestational diabetes, gestational weeks, the height of uterine and abdominal circumference were associated with the birth of fetal macrosomia. The Bayesian discriminant function were established: Fetal macrosomia:y1=-27.802+8.420×Mother＇s height+8.719×early pregnancy BMI+10.485×gestational weeks+3.375×gestational diabetes+2.862×height of uterine and abdominal circumference; Non-macrosomia y2=-17.477+7.161×Mother＇s height+7.217×early pregnancy BMI+7.862×gestational weeks+2.036×gestational diabetes-0.085×height of uterine and abdominal circumference. Wilks′ Lambda λ=0.489, P<0.001, the Bayesian discriminant function was statistically significant. The internal and external conformity rates of the Bayesian discriminant model were all more than 80%. Conclutions The birth of fetal macrosomia is related to many factors. The Bayesian discriminant model in the present study is valuable to discriminate macrosomia and provide an objective reference for more accurate identification of macrosomia in the future.
ABSTRACT
<p><b>BACKGROUND</b>Active suppression by CD4+CD25+ regulatory T lymphocytes plays an important role in the down-regulation of T cell responses to foreign and self-antigens. This study was conducted to analyze whether the CD4+CD25+ regulatory T cells exist and function normally in tuberculous pleural effusion.</p><p><b>METHODS</b>The percentages of CD4+CD25+ T cells in pleural effusion and peripheral blood from patients with tuberculous pleurisy and peripheral blood from healthy control subjects were determined by flow cytometry. The expression of forkhead transcription factor Foxp3 was also examined. CD4+CD25+ and CD4+CD25(-) T cells from pleural effusion and blood were isolated, and were cultured to observe the effects of CD4+CD25+ T cells on proliferation response of CD4+CD25(-) T cells in vitro.</p><p><b>RESULTS</b>There were increased numbers of CD4+CD25+ T cells in tuberculous pleural effusion compared with peripheral blood from both patients with tuberculous pleurisy and normal subjects, and these cells demonstrated a constitutive high-level expression of Foxp3. Moreover, CD4+CD25+ T cells mediated potent inhibition of proliferation response of CD4+CD25(-) T cells.</p><p><b>CONCLUSION</b>The increased CD4+CD25+ T cells in tuberculous pleural effusion express a high level of Foxp3 transcription factor, while potently suppressing the proliferation of CD4+CD25(-) T cells.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Forkhead Transcription Factors , Lymphocyte Activation , Pleural Effusion , Allergy and Immunology , T-Lymphocytes, Regulatory , Physiology , Tuberculosis, Pleural , Allergy and ImmunologyABSTRACT
<p><b>BACKGROUND</b>Triggering receptors expressed on myeloid cells (TREM) proteins are a family of cell surface receptors expressed broadly by cells of the myeloid lineage. The aim of this study was to investigate the clinical significance of soluble TREM-1 (sTREM-1) in pleural effusions, and to determine the effects of pneumonia on pleural sTREM-1 concentrations.</p><p><b>METHODS</b>Pleural fluid was collected from 109 patients who presented to the respiratory institute (35 with malignant pleural effusion, 31 with tuberculous pleural effusion, 21 with bacterial pleural effusion, and 22 with transudate). The concentrations of sTREM-1, tumor necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) were determined in effusion and serum samples by enzyme linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>The concentrations of sTREM-1 in bacterial pleural effusion were significantly higher than those in malignant, tuberculous, and transudative groups (all P < 0.001). An sTREM-1 cutoff value of 768.1 ng/L had a sensitivity of 86% and a specificity of 93%. Pleural sTREM-1 levels were positively correlated with levels of TNF-alpha and IL-1beta. Patients with complicating bacterial pneumonia did not have elevated concentration of sTREM-1 in pleural effusion when compared with patients without pneumonia.</p><p><b>CONCLUSIONS</b>Determination of pleural sTREM-1 may improve the ability of clinicians to differentiate pleural effusion patients of bacterial origin from those with other etiologies. The occurrence of bacterial pneumonia did not affect pleural sTREM-1 concentrations.</p>