A review on cardiovascular risk in rheumatoid arthritis

A systemic inflammatory disease known as rheumatoid arthritis (RA) is distinguished by excessive cardiovascular disease (CVD) morbidity and death. Traditional CV risk factors may partially contribute to CV disease in RA. Shared inflammatory mediators, post-translational modifications of peptides/proteins and subsequent immune responses, changes in the composition and function of lipoproteins, increased oxidative stress, and endothelial dysfunction are some of the mechanisms that link RA and CVD. The detailed pathogenetic pathway by which this association between RA and CVD might be explained is still not entirely known. It is crucial for controlling cardiovascular risk in people with RA. Optimizing care of traditional risk factors in addition to those inherent to RA is necessary to lessen the burden caused by CVD. The potential effect of planned Cardiac risk management in these individuals is highlighted by findings for under diagnosis and inadequate treatment of conventional CVD risk factors in RA. Present cardiovascular standards suggest RA patients to be examined for and treated for CVD risk factors without appropriate treatment goals. Utilizing potent anti-rheumatic medications that can reduce disease activity and treating the conventional CV risk factors should both be part of the therapy of CV risk in RA. There is currently insufficient scientific data to develop therapy targets for RA-related CVD risk factors. Thus, more study is required on the traditional CVD risk factor screening and management in RA patients.

A randomized, placebo-controlled crossover trial to assess the influence of body weight on aspirin-triggered specialized pro-resolving mediators: protocol for the discover study

Background: Low-dose aspirin is ineffective for primary prevention of cardiovascular events in people with body weight greater than 70kg. While the prevalent explanation for this is reduced platelet cyclooxygenase-1 (COX-1) inhibition at higher body weights, supporting data are limited, thereby demanding further investigation of the reason(s) underlying this observation. We propose that aspirin-mediated cyclooxygenase-2 (COX-2) acetylation and the resulting synthesis of 15-epi-lipoxin A4, a specialized pro-resolving mediator, is suboptimal in higher weight individuals, which may contribute to the clinical trial findings. Methods: To test this hypothesis, we are conducting a double-blind, placebo-controlled, randomized, mechanistic crossover trial. Healthy men and women exhibiting a wide range of body weights take 81mg aspirin and 325mg aspirin for 3 weeks each, following 3-week placebo run-in and wash-out phases. Our target sample size is 90 subjects, with a minimum of 72 completing all visits estimated to be necessary to achieve power adequate to test our primary hypothesis. Our primary endpoint is the difference in change in plasma 15-epi-lipoxin A4 occurring with each dose of aspirin. Secondary endpoints include lipid mediator profiles, serum bioactive lipid profiles, and other endpoints involved in the resolution of vascular inflammation. Conclusions: Study enrollment began in November 2021 and is ongoing. The results of this study will improve our understanding of the mechanisms underlying aspirin’s role(s) in the prevention of adverse cardiovascular outcomes. They may also lead to additional studies with the potential to inform dosing strategies for patients based on body weight. Trial registration: This trial is registered with ClinicalTrials.gov identifier NCT04697719.

Clinical observation of preemptive analgesia with pentazocine for perioperative pain management in partial splenectomy / 中国基层医药

Objective:To investigate the clinical effect of preemptive analgesia with pentazocine on perioperative pain management in partial splenectomy.Methods:A total of 100 patients with traumatic splenic rupture who underwent partial splenectomy at Yiwu Central Hospital between October 2019 and November 2021 were randomly assigned to either the control group or the study group, with 50 patients in each group using the random number table method. Both groups received patient-controlled analgesia postoperatively. Additionally, the study group received intravenous pentazocine administration before surgery. The amount of anesthetic used during surgery, postoperative anesthesia recovery indices, postoperative pain response, serum inflammatory factor levels, and the number of effective patient-controlled analgesia pump presses within 48 hours postoperatively were recorded and evaluated. Any adverse drug reactions were also monitored.Results:The dosages of propofol [(462.24 ± 27.13) mg] and remifentanil [(365.98 ± 26.78) μg] in the study group were significantly lower than those in the control group [(511.82 ± 26.32) mg, (406.86 ± 26.08) μg, t = 14.49, 12.63, both P < 0.001). The recovery time of spontaneous breathing [(6.86 ± 0.97) minutes], anesthesia recovery time [(13.24 ± 0.82) minutes] and extubation time [(17.14 ± 1.07) minutes] were significantly shorter than those in the control group [(7.62 ± 0.90) minutes, (14.32 ± 0.84) minutes, (18.22 ± 1.06) minutes, t = 5.80, 8.58, 6.93, all P < 0.001]. The Visual Analogue Scale (VAS) scores in the study group were significantly lower than those in the control group at 24 and 48 hours after surgery, both in resting and coughing state ( t = 7.82, 9.31, 4.95, 8.47, all P < 0.001). The serum levels of tumor necrosis factor-alpha, interleukin-1, and interleukin-6 were significantly lower in the study group than in the control group ( t = 21.53, 25.61, 18.45, 16.90, 17.33, 14.86, all P < 0.001), while the serum level of interleukin-10 was significantly higher in the study group than in the control group ( t = -20.85, -19.61, both P < 0.001). The number of effective patient-controlled pump analgesia presses within 48 hours postoperatively in the study group [(6.24 ± 1.17) times] was significantly lower than that in the control group [(10.26 ± 1.34) times, t = 12.95, P < 0.05). In addition, the overall incidence of adverse drug reactions in the study group [4.00% (2/50)] was significantly lower than that in the control group [18.00% (9/50), χ2 = 5.01, P < 0.05]. Conclusion:Preemptive analgesia with pentazocine for patients undergoing partial splenectomy can effectively reduce the dosage of anesthetics during surgery and the dosage of analgesics after surgery, enhance the recovery from postoperative anesthesia, suppress postoperative inflammatory reactions, alleviate pain responses, and minimize the risk of adverse drug reactions.

Are monocyte-to-HDL and C-reactive protein-to-albumin ratios useful for the diagnosis and follow-up of Takayasu arteritis?

SUMMARY OBJECTIVE: In this study, we aimed to investigate the role of erythrocyte sedimentation rate, C-reactive protein, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio, red blood cell distribution width, mean platelet volume, monocyte/HDL ratio, and C-reactive protein/albumin ratio in the diagnosis and treatment follow-up of active and remission Takayasu arteritis patients compared with healthy control group. METHODS: This is a retrospective case-control study in which 56 Takayasu arteritis patients and 40 age- and sex-matched healthy control were included. The blood values of Takayasu arteritis patients were analyzed during their active period and post-treatment remission periods, after comparing them with the healthy control. Furthermore, all parameters were evaluated by receiver operating characteristic analysis. RESULTS: Erythrocyte sedimentation rate, C-reactive protein, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio, monocyte/HDL ratio, and C-reactive protein/albumin ratio values were significantly higher in active Takayasu arteritis patients compared with healthy control and remission Takayasu arteritis groups. In the receiver operating characteristic analysis performed in active Takayasu arteritis and Takayasu arteritis patients in remission, C-reactive protein had the highest power to indicate disease activity, followed by C-reactive protein/albumin ratio, erythrocyte sedimentation rate, and monocyte/HDL ratio. When Takayasu arteritis in remission was compared with the healthy control, a significant difference was found between erythrocyte sedimentation rate, C-reactive protein, red blood cell distribution width, and C-reactive protein/albumin ratio, while no significant difference was found between monocyte/HDL ratio values. CONCLUSION: C-reactive protein/albumin ratio and red blood cell distribution width can be used in the diagnosis of Takayasu arteritis, and C-reactive protein/albumin ratio, red blood cell distribution width, and monocyte/HDL ratio measurements can be used in the follow-up. As C-reactive protein/albumin ratio is more powerful than C-reactive protein in differentiating the Takayasu arteritis group from the healthy control group, evaluation of C-reactive protein/albumin ratio together with albumin instead of evaluation of C-reactive protein alone when diagnosing the disease may help us to obtain more accurate results in daily practice.

Estatinas, una alternativa en el tratamiento de la COVID-19 / Statins, an Alternative in the Treatment of COVID-19

Resumen Las estatinas son ampliamente utilizadas para el control de los niveles de colesterol en pacientes con hipercolesterolemia, lo cual permite prevenir enfermedades cardiovasculares. Además de controlar la síntesis endógena de colesterol, las estatinas tienen efectos pleiotrópicos diversos, como son las propiedades antiinflamatoria, antioxidante y de inmunomodulación. La enfermedad causada por el virus SARS-CoV-2 (COVID-19) provoca una tormenta de citocinas que contribuye a la generación del síndrome respiratorio agudo, que puede llevar a cuadros graves de esta enfermedad e incluso a la muerte del paciente. Diversos estudios realizados en enfermos con COVID-19 que recibieron estatinas, antes o durante el curso de la enfermedad, registraron cuadros menos graves, estancias hospitalarias más cortas y menor mortalidad. El beneficio de las estatinas en la COVID-19 debe ser explorado más ampliamente, ya que potencialmente pueden contribuir al control de esta pandemia que ha postrado a la humanidad.

Abstract Statins are widely used to control cholesterol levels in patients with hypercholesterolemia, which helps prevent cardiovascular diseases. In addition to controlling endogenous cholesterol synthesis, statins have diverse pleiotropic effects, such as anti-inflammatory, antioxidant, and immunomodulatory properties. The disease caused by the SARS-CoV-2 virus (COVID-19) causes a cytokine storm that contributes to the generation of acute respiratory syndrome, which can lead to severe symptoms of this disease and even the death of the patient. Various studies carried out on patients with COVID-19 who received statins, before or during the disease, registered less severe symptoms, shorter hospital stays and lower mortality. The benefit of statins in COVID-19 should be explored more widely, as they can potentially contribute to the control of this pandemic that has devastated humanity.

Correlation between inflammatory mediators and biochemical markers in patients with active pulmonary tuberculosis / Correlação entre mediadores inflamatórios e marcadores bioquímicos em pacientes com tuberculose pulmonar ativa

Objective: Correlate inflammatory mediators and biochemical parameters in patients with active pulmonary tuberculosis (TB) treated at a public hospital in São Luís, MA. Methods: This is a case-control study of patients with a positive diagnosis of active pulmonary TB. Serum samples from patients and the control group were collected for the clinical trials, and epidemiological data were collected through medical records and interviews. The control group consisted of healthy volunteers with no previous contact with TB cases, matched by age and sex to the clinical group. To measure inflammatory cytokines, we used the Human IL-6 ELISA Set and Human IFN-γ ELISA Set kits. Oxidative stress was measured by quantification of thiobarbituric acid reactive substances (TBARS) and nitric oxide (NO). In biochemistry, the levels of uric acid, antistreptolysin "O" (AEO), alanine aminotransferase (ALT), amylase, aspartate aminotransferase (AST), calcium, total cholesterol, gamma-glutamyl transferase (Gamma GT), glucose, alkaline phosphatase, high-density lipoprotein (HDL), C-reactive protein (CRP) and triglycerides were measured. Results: The clinical group consisted of 53 patients. There was a substantial decrease in IFN-γ (p<0.0001) and a significant increase in IL-6 (p<0.0001). TBARS production increased significantly (p= 0.0414). There was no significant difference in NO production (p= 0.3194). In biochemistry, there was a significant increase in ALT (p= 0.0072), AST (p= 0.0016), Gamma GT (p= 0.0011), alkaline phosphatase (p<0.0001), CRP (p<0. .0001) and triglycerides (p= 0.0343), and a significant decrease in calcium (p<0.0001). A significant positive correlation was found between IL-6 and IFN-γ (p= 0.0448), as well as AST and ALT (p<0.0001); CRP and gamma GT (p<0.0001); Gamma GT and ALT (p= 0.0016); Gamma GT and AST (p=0.0004); triglycerides and cholesterol (p= 0.0002); alkaline phosphatase and gamma GT (p<0.0001); CRP and alkaline phosphatase (p<0.0001); triglycerides and calcium (p= 0.0121); cholesterol and calcium (p= 0.0261); glucose and cholesterol (p= 0.0373); and triglycerides and glucose (p= 0.0127) in biochemistry, with a significant negative correlation between glucose and uric acid (p= 0.0092); and CRP and HDL (p=0.0037). The correlation between inflammatory mediators and biochemical markers was positive between IL-6 and gamma GT (p= 0.0011); IL-6 and CRP (p<0.0001); IL-6 and alkaline phosphatase (p=0.0076); and NO and triglycerides (p= 0.0016), and significant negative correlation between IFN-γ and cholesterol (p= 0.0171) and TBARS and cholesterol (p= 0.0138). Conclusion: Immunosuppression of IFN-γ activity was observed. A correlation was found between IL-6 and inflammatory biochemical markers, indicating damage and injury caused by M. tuberculosis (AU).

Objetivo: Correlacionar mediadores inflamatórios e parâmetros bioquímicos em pacientes com tuberculose (TB) pulmonar ativa atendidos em um hospital público, em São Luís, MA. Métodos: Trata-se um caso-controle de pacientes com diagnóstico positivo para TB pulmonar ativa. Amostras de soro dos pacientes e grupo controle foram coletadas para os experimentos clínicos e os dados epidemiológicos foram coletados por meio de prontuários e entrevistas. O grupo controle foi formado por voluntários saudáveis sem contato prévio com casos de TB, pareados com idade e sexo ao grupo clínico. Para dosar citocinas inflamatórias, utilizaram-se os kits Human IL-6 ELISA Set e Human IFN-γ ELISA Set. Mediu-se o estresse oxidativo pela quantificação das espécies reativas do ácido tiobarbitúrico (TBARS) e óxido nítrico (ON). Na bioquímica, mediram-se os níveis de ácido úrico, anti-estreptolisina-O (AEO), alanina aminotransferase (ALT), amilase, aspartato aminotransferase (AST), cálcio, colesterol total, gama glutamil transferase (Gama GT), glicose, fosfatase alcalina, lipoproteína de alta densidade (HDL), proteína C reativa (PCR) e triglicerídeos. A análise estatística foi realizada pelo software Graph Pad Prism 8, com p<0,05 significativo. Re -sultados: O grupo clínico foi formado por 53 pacientes. Houve uma diminuição significativa de IFN-γ (p<0,0001), e aumento significativo de IL-6 (p<0,0001). A produção de TBARS aumentou significativamente (p= 0,0414). Não houve diferença significativa na produção de ON (p= 0,3194). Na bioquímica, houve aumento significativo em ALT (p= 0,0072), AST (p= 0,0016), gama GT (p= 0,0011), fosfatase alcalina (p<0,0001), PCR (p<0,0001) e triglice-rídeos (p= 0,0343), e diminuição significativa de cálcio (p<0,0001). Encontrou-se correlação positiva significativa entre IL-6 e IFN-γ (p= 0,0448), assim como AST e ALT (p<0,0001); PCR e gama GT (p<0,0001); gama GT e ALT (p= 0,0016); gama GT e AST (p= 0,0004); triglicerídeos e colesterol (p= 0,0002); fosfatase alcalina e gama GT (p<0,0001); PCR e fosfatase alcalina (p<0,0001); triglicerídeos e cálcio (p= 0,0121); colesterol e cálcio (p= 0,0261); glicose e colesterol (p= 0,0373); e triglicerídeos e glicose (p= 0,0127) na bioquímica, sendo negativa significativa entre glicose e ácido úrico (p= 0,0092); e PCR e HDL (p= 0,0037). A correlação entre marcadores infla-matório e bioquímicos foi positiva entre IL-6 e gama GT (p= 0,0011); IL-6 e PCR (p<0,0001); IL-6 e fosfatase alcalina (p= 0,0076); e ON e triglicerídeos (p= 0,0016), e negativa significativa entre IFN-γ e colesterol (p= 0,0171) e TBARS e colesterol (p= 0,0138). Conclusões: Observou-se imunossupressão da atividade de IFN-γ. Encontrou-se correlação entre IL-6 e marcadores bioquímicos inflamatórios, indicando dano e lesão causados por M. tuberculosis (AU).

Role of chemical mediators and biological factors in tooth movement

In recent years, there have been various theories proposed to describe the mechanism causing tooth movement. These theories can be broadly categorized into two perspectives: one focusing on bone as the direct target of mechanical force, and the other highlighting the periodontal ligament (PDL) as the key target. While the direct view suggests that osteoclasts and osteoblasts are directly stimulated by compression and tension stresses, respectively, the indirect view suggests that the PDL responds to orthodontic forces. However, evidence challenges the direct view, as bone does not respond to static forces and implants/ankylosed teeth do not move. The indirect view proposes that orthodontic forces lead to areas of compression and tension within the PDL, causing various cellular responses and inflammatory reactions. Osteoclasts play a crucial role in bone resorption, influencing the rate of tooth movement. Inflammatory mediators, including chemokines, cytokines, prostaglandins, and neuropeptides, are released during orthodontic tooth movement, facilitating osteoclast recruitment and activation. Osteoclast genesis is influenced by factors such as TNF-?, IL-1, IL-6, and prostaglandins. Chemical mediators, including parathyroid hormone, vitamin D3, corticosteroids, and thyroxin, have been explored for their potential to accelerate tooth movement, but their systemic effects and practical application present challenges. Overall, understanding the biology of tooth movement involves considering the interactions among osteocytes, osteoclasts, and osteoblasts, as well as immune cells and inflammatory cytokines. Expediting tooth movement requires further research and the development of effective and safe strategies.

Diagnostic value of systemic immune inflammation index in acute appendicitis

SUMMARY OBJECTIVE: Clinical diagnosis of acute appendicitis is often difficult and involves a synthesis of clinical, laboratory, and radiological findings. The aim of this study was to investigate whether the systemic immune inflammation index can be used as an effective parameter in the diagnosis of acute appendicitis and its reliability in the differentiation of complicated vs. non-complicated appendicitis. METHODS: The study was conducted retrospectively with patients admitted to the emergency department with abdominal pain and diagnosed with acute appendicitis. In total, 150 patients and 150 control cases were included in the study. Demographic data, medical history, white blood cell count, platelet count, neutrophil count, systemic immune inflammation index values, Alvarado score, adult appendicitis score, and pathology result of appendectomy material were retrieved from the hospital automation system and recorded in the data form. RESULTS: Neutrophil-lymphocyte ratio and systemic immune inflammation index were significantly higher, and platelet-neutrophil ratio and lymphocyte-neutrophil ratio were significantly lower in the patient group compared to the control group (p<0.001). Receiver operating characteristic analysis revealed that the sensitivity and specificity of systemic immune inflammation index with a cutoff value of 840.13 was 82 and 66.7%, respectively, for the diagnosis of acute appendicitis. Correlation analysis revealed that systemic immune inflammation index, Alvarado score, and adult appendicitis score were positively correlated, and this correlation was statistically significant. CONCLUSION: Systemic immune inflammation index may be used to promote the diagnosis of acute appendicitis and may reduce the need for radiation exposure and diagnostic imaging tests such as contrast-enhanced abdominal computed tomography. It can also be used to differentiate between complicated and non-complicated acute appendicitis cases.

Correlation of probiotic consumption with serum inflammatory cytokines, endotoxin and post-stroke depression severity in patients with ischemic stroke / 国际脑血管病杂志

Objective:To investigate the correlation of probiotic consumption level with serum inflammatory cytokines, endotoxin and post-stroke depression (PSD) severity in patients with ischemic stroke.Methods:Patients with ischemic stroke visited the Department of Neurology, the Third Affiliated Hospital of Naval Medical University from May 2021 to June 2022 were prospectively included. At 6 months after discharge, the outpatient follow-up was conducted to investigate the consumption of probiotic products in the past six months, and depression was evaluated using the Self-rating Depression Scale (SDS). Multiple linear regression analysis was used to determine the correlation of consumption levels of probiotic products and serum inflammatory cytokines, endotoxin, and PSD severity.Results:A total of 168 patients with ischemic stroke were included, including 74 patients (44.0%) in the probiotic product high consumption group and 94 (56.0%) in the low consumption group. The incidence of PSD in the high consumption group was significantly lower than that in the low consumption group (22.97% vs. 38.30%; χ2=6.551, P=0.036). The serum pro-inflammatory cytokine interleukin-6 (IL-6) and endotoxin levels at the follow-up in the high consumption group were significantly lower than those in the low consumption group, while the anti-inflammatory cytokine IL-10 was significantly higher than that in the low consumption group (all P<0.05). Multiple linear regression analysis shows that the probiotic consumption level was significantly negatively correlated with the serum IL-6 ( β=-0.178, P=0.001) and endotoxin ( β=-0.107, P=0.035) at follow-up. PSD severity (SDS score) was negatively correlated with probiotic consumption level ( β=-0.309, P=0.001), and was positively correlated with IL-6 ( β=0.306, P=0.027) and endotoxin ( β=0.360, P=0.017) at follow-up. Conclusion:Probiotic products can reduce the severity of serum pro-inflammatory cytokines, endotoxin and PSD, and may be a non-drug treatment direction for PSD.

Effectiveness and safety of modified decompressive craniectomy for traumatic brain injury and its impact on inflammatory mediators and prognosis / 解放军医学杂志

Objective To evaluate the efficacy and safety of modified decompressive craniectomy in treatment of traumatic brain injury and its impact on the serum levels of inflammatory mediators and prognosis.Methods According to different surgical methods,82 patients with traumatic brain injury admitted to the department of neurosurgery of Nanyang Central Hospital from June 2020 to January 2022 were divided into standard group(n=41)and modified group(n=41).The standard group was given standard decompressive craniectomy,and the modified group was given modified decompressive craniectomy.The intraoperative blood loss,operation time and hospital stay,the levels of neuron-specific enolase(NSE),S-100 calcium binding protein B(S-100β),C-reaction protein(CRP),procalcitonin(PCT),and interleukin-6(IL-6)before operation,6 hours after operation,and 3 days after operation,Glasgow Outcome Scale(GOS),incidence of complications,and incision healing grade 1 month after operation were compared between two groups.Results Compared with standard group,the hospital stay was significant shorter in modified group(P<0.05),and intraoperative blood loss and operation time were no significant difference in modified group(P>0.05).At 6 hours and 3 days after operation,the levels of NSE,S-100β,CRP,PCT and IL-6 in modified group were lower than those in standard group(P<0.05).Compared with standard group,the good prognosis rate based of GOS was higher in modified group[82.9%(34/41)vs.63.4%(26/41),P<0.05];the total incidence of complications was lower in modified group[2.4%(1/41)vs.19.5%(26/41),P<0.05];and the grade of incision healing was better in modified group(P<0.05).Conclusions Modified decompressive craniectomy in the treatment of traumatic brain injury could reduce stress of brain injury and surgical trauma,and the incidence of complications,help to speed up the postoperative recovery process,improve the rate of good prognosis and the grade of incision healing.Its efficacy and safety is better than standard decompressive craniectomy.

Intrathecal administration of Maresin 1 attenuates bone cancer pain by inhibiting the glial cells acti-vation and neuroinflammation in the spinal cord / 临床麻醉学杂志

Objective To investigate the effects of intrathecal administration of Maresin 1 on pain behavior and glial cells activation in spinal dorsal horn of mice with bone cancer pain(BCP).Methods Experiment Ⅰ,twenty-eight clean male C57BL/6 mice,aged 4-6 weeks,weighing 18-22 g,were ran-domly divided into two groups:sham 1 group(group S1)and BCP 1 group(group B1),14 mice in each group.BCP model was established in group B1 by injecting PBS 20 μl containing 2 × 105 lewis lung carcino-ma cells into the intramedullary space.Group S,received PBS 20 μl without tumor cells.Six mice in each group were randomly selected to determine the mechanical withdrawal threshold(MWT)and thermal with-drawal latency(TWL)1 day before implantation,3,7,14,21 days after implantation.Four mice were randomly sacrificed on days 7,14 and 21 in group S,and group B1.The expressions of spinal glial fibrillary acidic protein(GFAP)and ionized calcium-binding adapter molecule 1(Iba1)were detected by Western blot.Experiment Ⅱ,thirty-six clean male C57BL/6 mice were randomly divided into three groups:sham 2 group(group S2),BCP 2 group(group B2),and Maresin 1 group(group M),12 mice in each group.BCP models were established in groups B2 and M while group S2 received PBS 20 μl without tumor cells.Maresin 1 50 ng/5 μl were intrathecally injected from days 14 to 16 after tumor cells implantation.Six mice in each group were randomly selected to determine the MWT and TWL on days 14 to 18 after implantation.Mice were sacrificed on day 18 after pain behavior tests.The expressions of spinal GFAP and Iba1 were de-tected by Western blot and immunofluorescence staining.The levels of spinal IL-1 β,IL-6,and TNF-α were detected by ELISA.Results Experiment Ⅰ:compared with group S1,the MWT and TWL were significantly lower on days 7,10,14,and 21 after implantation in group B,(P＜0.05),the expressions of spinal GFAP and Iba1 were upregulated on days 7,14,and 21 after implantation in group B1(P＜0.05).Experiment Ⅱ:compared with group S2,the levels of spinal GFAP,Iba1,IL-1β,IL-6,and TNF-α were increased on day 18 after implantation in group B2(P＜0.05).Compared with group B2,the MWT and TWL were significantly higher on days 15-18 after implantation while levels of spinal GFAP,Iba1,IL-1β,IL-6,and TNF-α on day 18 were decreased in group M(P＜0.05).Conclusion Intrathecal administra-tion of Maresin 1 attenuates BCP maybe by inhibiting the glial cells activation and neuroinflammation in the spinal cord.

Observation on the therapeutic effect of LPE combined with semi whole blood replacement for postoperative anemia caused by infection / 实用医学杂志

Objective To observe the therapeutic effect of lymphatic plasma therapy(LPE)combined with semi whole blood exchange on patients with moderate to severe anemia caused by severe postoperative infection.Methods Thirty patients who developed severe postoperative infections with moderate to severe anemia and were treated with antibiotics for 48 to 72 hours but failed to meet the criteria were divided into an observation group(LPE combined with semi whole blood replacement surgery and antibiotic treatment,n = 15)and a control group(conventional antibiotic anti infection and blood transfusion treatment,n = 15).Evaluation indicators of infection and anemia between and within two groups before and after treatment,and the treatment effect were compared,respectively.Results There was no statistically significant difference in the observation indicators of infection and anemia between the two groups before treatment(P>0.05);After each treatment,there was a statistically sig-nificant difference in the evaluation and observation indicators of infection and anemia between the two groups(P<0.05);Observation group:There was a statistically significant difference in the observation and evaluation in-dicators of infection and anemia before and after treatment within the group(P<0.05);Control group:Compared within the group before and after treatment,there was no significant decrease in WBC,NEUT,and NEU observation indicators,and CRP and PCT observation indicators showed an upward trend,while RBC,HBG,and HCT did not show a significant increase.The difference was not statistically significant(P>0.05);Conclusions The com-bination of LPE and semi whole blood replacement surgery is superior to the conventional treatment regimen of anti-biotics alone for anti-infection and blood transfusion to improve anemia symptoms in the treatment of postoperative severe anemia.

Effects of different blood purification methods on nutritional status and inflammatory response in elderly patients with chronic renal failure / 中国医师进修杂志

Objective:To investigate the effects of different blood purification methods on their nutritional status and inflammatory response in elderly patients with chronic renal failure.Methods:A total of 120 elderly patients with chronic renal failure who were treated in Lishui People′s Hospital from January 2020 to January 2022 were selected as the research objects, and they were divided into the control group and the observation group according to the random number table method, with 60 cases in each group. The patients in the control group were given hemodialysis alone, and the patients in the observation group were given hemofiltration dialysis treatment on the basis of the patients in the control group. The nutritional status-related indicators, inflammation-related indicators and renal function-related indicators before and after treatment were compared between the two groups.Results:After treatment, the levels of serum total protein (TP), albumin (ALB), hemoglobin (HGB) and creatinine clearance (Ccr) in the observation group were significantly higher than those in the control group: (65.61 ± 4.82) g/L vs. (61.26 ± 3.51) g/L, (36.54 ± 4.52) g/L vs. (31.53 ± 3.32) g/L, (97.58 ± 5.84) g/L vs. (93.06 ± 5.17) g/L, (41.88 ± 4.87) ml/min vs. (34.51 ± 4.36) ml/min, while the levels of interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), creatinine (Cr) and blood urea nitrogen (BUN) were significantly lower than those in control group: (120.09 ± 9.36) ng/L vs. (157.17 ± 14.27) ng/L, (7.15 ± 1.16) mg/L vs. (14.17 ± 2.74) mg/L, (22.14 ± 6.67) ng/L vs. (33.87 ± 7.28) ng/L, (327.16 ± 44.35) μmol/L vs. (378.59 ± 48.27), (10.15 ± 2.03) mmol/L vs. (15.83 ± 3.31) mmol/L, there were statistical differences ( P<0.05). Conclusions:For elderly patients with chronic renal failure, the use of hybrid blood purification can significantly reduce toxins in the body and improve the nutritional status and inflammation of patients, which is worthy of clinical promotion.

Efficacy of montelukast sodium combined with methylprednisolone in the treatment of allergic purpura in children and its effects on inflammatory factors and immune function / 中国基层医药

Objective:To investigate the efficacy of montelukast sodium combined with methylprednisolone in the treatment of pediatric allergic purpura and its effects on inflammatory factors and immune function.Methods:A total of 94 children with allergic purpura who received treatment in Taizhou Women and Children's Hospital and Taizhou Hospital Medical Center (Group) Enze Hospital from March 2019 to March 2021 were included in this study. They were randomly divided into observation and control groups ( n = 47/group). The control group was treated with methylprednisolone. The observation group was treated with montelukast sodium combined with methylprednisolone. The course of treatment was 2 weeks in both groups. Efficacy and changes in inflammatory factors and immune function post-treatment relative to those pre-treatment were compared between the two groups. Results:Total response rate in the observation group [93.62% (44/47)] was significantly higher than that in the control group [74.47% (35/47), Z = 2.15, P < 0.05)]. After treatment, interleukin (IL-4), IL-6, and IL-18 levels in each group were significantly decreased compared with those before treatment ( tobservation group = 21.19, 22.26, 27.20, tcontrol group = 11.10, 13.21, 14.86, all P < 0.05). After treatment, IL-4, IL-6, and IL-8 levels in the observation group were (48.98 ± 5.21) ng/L, (34.10 ± 6.42) ng/L, and (53.29 ± 5.67) ng/L, respectively, which were significantly lower than (65.38 ± 7.08) ng/L, (47.83 ± 4.71) ng/L, (67.83 ± 7.10) ng/L in the control group ( t = 12.79, 11.82, 10.97, all P < 0.05). After treatment, CD3 +, CD4 +, and CD4 +/CD8 + in each group were significantly increased compared with those before treatment ( tobservation group = 14.27, 14.41, 17.61, tcontrol group = 6.90, 5.12, 7.40, all P < 0.05). After treatment, CD3 +, CD4 +, and CD4 +/CD8 + in the observation group were (68.94 ± 2.89)%, (39.94 ± 2.15)%, and (1.79 ± 0.13), respectively, which were significantly higher than (63.86 ± 3.28)%, (35.65 ± 2.31)%, and (1.53 ± 0.16) in the control group ( t = 7.96, 9.32, 8.64, all P < 0.05). After treatment, serum IgG and IgM levels in each group were significantly decreased compared with those before treatment ( tobservation group = 21.00, 7.99, tcontrol group = 8.38, 5.76, both P < 0.05). After treatment, serum IgG and IgM levels in the observation group were (1.43 ± 0.19) g/L and (9.74 ± 0.78) g/L, respectively, which were significantly lower than (1.95 ± 0.37) g/L and (10.89 ± 0.85) g/L in the control group ( t = 8.57, 6.83, both P < 0.05). Conclusion:Montelukast sodium combined with methylprednisolone is highly effective on allergic purpura in children. The combined therapy can reduce inflammatory responses and improve immune function in children.

Mechanism study of OVA-induced allergic asthma in mice based on lipid metabolomics / 中国药理学通报

Aim To investigate the mechanism and search for potential biomarkers of ovalbumin ( OVA ) -induced asthma in mice base on lipidomics. Methods A BALB/c mouse model of asthma was prepared by OVA. TNF-α, IL-4, IL-10, IFN-γ levels in BALF and IgE level in serum were measured by ELISA. The inflammatory changes in mouse lung tissue were observed using HE staining. Lipid mediators ( LMs) in lung tissue and serum were quantified with UPLC-MS/ MS strategy. Results IgE level in serum and TNF-α, IFN-γ levels in BALF were higher (P <0.05) of asthmatic mice.Typical inflammatory manifestations were seen in lung tissue of asthmatic mice. A total of 57 lipid mediators were quantified with UPLC-MRM. LMs metabolic profiles differed significantly in serum and lung tissue between asthmatic and normal mice, 17 significantly different LMs were found in lung tissue and 6 LMs were found in serum, and the differential metabolites were produced through the cyclooxygenase (COX), lipoxygenase (LOX) and cytochrome P450 oxidase (P450) metabolic pathways. Conclusions OVA-induced allergic asthma can cause disorder of lip-id mediators, LMs and cytokines are involved in the occurrence and development of asthma. The differential LMs have potential research value as biomarkers for the development of allergic asthma.

Clinical effects of stereotactic-guided endoscopic hematoma removal combined with early systematic rehabilitation training on hypertensive intracerebral hemorrhage in the basal ganglia / 中国基层医药

Objective:To investigate the clinical effects of stereotactic-guided endoscopic hematoma removal combined with early systematic rehabilitation training on hypertensive intracerebral hemorrhage in the basal ganglia.Methods:A total of 130 patients with hypertensive intracerebral hemorrhage in the basal nucleus who received treatment in Zhejiang Veteran Hospital from June 2019 to December 2021 were included in this randomized control study. They were randomly divided into a control group and a study group ( n = 65 per group). The control group received minimally invasive hematoma puncture. The study group received stereotactic-guided neuroendoscopic hematoma removal. After surgery, early systematic rehabilitation training was carried out, and surgical indicators were recorded. The levels of serum inflammatory factors and stress factors were determined. The recurrence, death, and complications as well as prognosis of cerebral hemorrhage were recorded in each group. Results:The operative time in the study group was (85.39 ± 5.24) minutes, which was significantly longer than (64.17 ± 4.31) minutes in the control group ( t = -14.56, P < 0.001). Hematoma clearance rate in the study group was (94.66 ± 5.18) %, which was significantly higher than (76.82 ± 5.39) % in the control group ( t = -17.63, P < 0.001). At 24 hours after surgery, tumor necrosis factor-α, interleukin-1, norepinephrine, and hydrocortisone levels in the study group were (68.29 ± 5.36) ng/L, (237.62 ± 13.87) ng/L, (75.39 ± 5.82) μg/L, and (30.96 ± 2.97) μg/L, respectively, which were significantly lower than (74.61 ± 5.62) ng/L, (295.47 ± 14.69) ng/L, (91.62 ± 6.41) μg/L, and (38.25 ± 3.16) μg/L in the control group ( t = 7.95, 18.42, 16.84, 11.75, all P < 0.001). There was no significant difference in the 6-month mortality rate between the two groups ( P > 0.05). The recurrence rate of cerebral hemorrhage and the overall incidence of complications in the study group were (1.54% (1/65) and (10.77% (7/65) in the study group, respectively, which were significantly lower than 12.31% (8/65) and 27.69% (18/65) in the control group ( χ2 = 4.30, 5.99, both P < 0.05). The overall excellent and good prognosis rate within 6 months in the study group was 86.15% (56/65), which was significantly higher than 67.69% (44/65) in the control group ( χ2 = 6.24, P < 0.05). Conclusion:Compared with minimally invasive hematoma puncture and drainage surgery, stereotactic-guided neuroendoscopic hematoma removal takes longer time, but it can better effectively increase hematoma removal rate and alleviate stress and inflammatory reactions in patients with hypertensive intracerebral hemorrhage in the basal ganglia. Early systematic rehabilitation training combined with stereotactic guided neuroendoscopic hematoma removal can help reduce the risk of recurrence and complications of cerebral hemorrhage and improve prognosis.

Association and potential mediators between socioeconomic status and childhood obesity in China:findings from a national cohort study / 《全球健康杂志（英文）》

Objective:Socioeconomic status(SES)is associated with childhood obesity,but the underlying factors remain unknown.This study aimed to identify mediators that may explain SES disparities in childhood obesity in China.Methods:Nationally representative longitudinal data from the China Education Panel Survey of 11 019 chil-dren(13.03±0.79)collected from 2013-2014 to 2016-2017 academic years.Overweight/obesity was de-fined using Chinese national body mass index cut-points.Principal component analysis was used to con-vert the four SES indicators(maternal and paternal education,and occupation)into one comprehensive vari-able.Mediation analysis for SES disparities in childhood obesity was conducted using structure equation models.Results:The prevalence of overweight/obesity was 12.8％,and was higher in boys than in girls(17.8％vs.7.6％,P＜0.001)at baseline.Among boys,relative risk(RR)of obesity was 1.23(95％CI:1.09 to 1.40,P＜0.001)for per unit change in SES.There was no significant association between obesity and SES among girls.Mediation analyses showed that among boys,birth weight,being the only child in the family and children's self-perceived weight status mediated 70.0％of the effects of SES on obesity.No mediation effect was detected in girls.Conclusions:Chinese boys are more likely to be overweight or obese than girls.SES may impact childhood obesity through birth weight,being the only child in the family and children's self-perceived body weight status in boys,but not in girls.More attention should be made to address childhood obesity in high SES families among boys.Interventions targeting at these mediators are needed.

Therapeutic ultrasound ameliorates hyperalgesia and edema on CFA-induced persistent inflammatory response in mice

Abstract Background: The present study investigated the effects of pulsed and continuous ultrasound (USP and USC) in edema and hyperalgesia after chronic inflammatory process induced by Complete Freund's Adjuvant-CFA and analyzing the relationship of the application frequency of ultrasound, in pro- and anti-inflammatory cytokine production. Methods: Forty-five animals were divided into 9 groups; all animals from groups 2 to 9 were subjected to a persistent inflammation model induced by CFA in mice. We report the effects and the underlying action mechanisms of USP and USC in the animals which were irradiated two, three or five times a week on the left hind paw. The analyses performed in this study were: evaluation of hind paw edema through the plethysmometer, evaluation of thermal hyperalgesia through withdrawal test using a water container at 44.5°C (± 0.5°C), and the plantar region of the left paw which was removed for analysis of cytokines. Results: Our results showed that USP and USC consistently reduced paw edema, and pulsed ultrasound showed a higher significant effect than the continuous mode. Moreover, groups with irradiation frequency of five times a week presented an inhibition of the edema, and groups with frequency of three or two times a week reduced mainly hyperalgesia, in comparison with the control group. The beneficial effects of the US then seem to be associated with upregulation of anti- and pro-inflammatory mediators, such as IL-10 and IL-6, respectively. Conclusion: This study provided evidence that ultrasound constitutes an important non-pharmacological intervention for the management of inflammatory and pain states.

Evaluation of the relationship between blood cell markers and inflammation, disease activity, and general health status in ankylosing spondylitis

SUMMARY OBJECTIVE: The aim of this study was to assess the relation of systemic immune inflammation index, systemic inflammation response index, and systemic inflammation aggregate index with disease activity, functional status, and general health status in ankylosing spondylitis. METHODS: Patients with ankylosing spondylitis and healthy volunteers were included in this cross-sectional study. Demographic data; disease activity measurements such as the Bath Ankylosing Spondylitis Disease Activity Index, the Ankylosing Spondylitis Disease Activity Score with C-reactive protein, and the Ankylosing Spondylitis Disease Activity Score with erythrocyte sedimentation rate; functional status such as the Bath Ankylosing Spondylitis Functional Index; and general health status such as the Assessment of Spondyloarthritis International Society Health Index of the patients were recorded. C-reactive protein, erythrocyte sedimentation rate, platelet to lymphocyte ratio, neutrophil to lymphocyte ratio, monocyte to lymphocyte ratio, systemic immune inflammation index, systemic inflammation response index, and systemic inflammation aggregate index values were recorded. Patients were grouped as active and remission according to the Bath Ankylosing Spondylitis Disease Activity Index score and as inactive-low and high-very high disease activity according to the Ankylosing Spondylitis Disease Activity Score. The correlation of laboratory parameters with disease-related parameters was tested. RESULTS: The indexes were significantly higher in patients compared to controls (p<0.001, for platelet to lymphocyte ratio p=0.03). No significant differences existed in any blood cell-derived indexes among patient groups categorized by disease activity (p<0.05 for all). Systemic immune inflammation index was weakly correlated with Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ρ=0.197 and p=0.049) and Ankylosing Spondylitis Disease Activity Score-erythrocyte sedimentation rate (ρ=0.201 and p=0.045). Systemic immune inflammation index was not correlated with Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, and Assessment of Spondyloarthritis International Society Health Index. No correlation was found between other indexes and disease-related variables. Platelet to lymphocyte ratio, systemic immune inflammation index, systemic inflammation response index, and systemic inflammation aggregate index showed a weak positive correlation with C-reactive protein and erythrocyte sedimentation rate (ρ=0.200-0.381). CONCLUSION: Systemic immune inflammation index, systemic inflammation response index, and systemic inflammation aggregate index can be used to indicate systemic inflammatory burden in ankylosing spondylitis patients. However, these indexes are not effective in indicating patients' disease activity, general health status, and functional status.

Naringenin attenuates cerebral ischemia/reperfusion injury by inhibiting oxidative stress and inflammatory response via the activation of SIRT1/FOXO1 signaling pathway in vitro

Purpose: To explore the protection of naringenin against oxygen-glucose deprivation/reperfusion (OGD/R)-induced HT22 cell injury, a cell model of cerebral ischemia/reperfusion (I/R) injury in vitro, focusing on SIRT1/FOXO1 signaling pathway. Methods: Cytotoxicity, apoptosis, reactive oxygen species (ROS) generation, malondialdehyde (MDA) content, 4-hydroxynonenoic acid (4-HNE) level, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) activities were measured by commercial kits. Inflammatory cytokines levels were determined by enzyme-linked immunosorbent assay (ELISA). The protein expressions were monitored by Western blot analysis. Results: Naringenin significantly ameliorated OGD/Rinduced cytotoxicity and apoptosis in HT22 cells. Meanwhile, naringenin promoted SIRT1 and FOXO1 protein expressions in OGD/R-subjected HT22 cells. In addition, naringenin attenuated OGD/R-induced cytotoxicity, apoptosis, oxidative stress (the increased ROS, MDA and 4-HNE levels, and the decreased SOD, GSH-Px and CAT activities) and inflammatory response (the increased tumor necrosis factor-α, interleukin [IL]-1ß, and IL-6 levels and the decreased IL-10 level), which were blocked by the inhibition of the SIRT1/FOXO1 signaling pathway induced by SIRT1-siRNA transfection. Conclusion: Naringenin protected HT22 cells against OGD/R injury depending on its antioxidant and anti-inflammatory activities via promoting the SIRT1/FOXO1 signaling pathway.