Research progress on acute lung injury/acute respiratory distress syndrome after liver transplantation / 器官移植

Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is a common complication after liver transplantation, which could prolong the length of postoperative intensive care unit stay, affect clinical efficacy of liver transplantation and even lead to the death of recipients. ALI/ARDS has attracted extensive attention from liver transplant surgeons in clinical practice. ALI/ARDS after liver transplantation may be directly caused by pulmonary factors (such as mechanical ventilation-related lung injury, lung infection and aspiration, etc.) or indirectly induced by non-pulmonary factors (such as severe infection outside the lungs, blood transfusion and ischemia-reperfusion injury, etc.). In this article, the diagnostic criteria, incidence, mechanism, risk factors, laboratory and clinical diagnostic approaches and treatment of ALI/ARDS after liver transplantation were reviewed, aiming to deepen the understanding and cognition of ALI/ARDS during the perioperative period of liver transplantation and provide reference for the diagnosis and treatment of ALI/ARDS following liver transplantation.

Systemic immune inflammation index in patients with recurrent aphthous stomatitis / Índice de inflamação imune sistêmica em pacientes com estomatite aftosa recorrente

Abstract Objectives: Recurrent Aphthous Stomatitis (RAS) a chronic idiopathic oral mucosal disease. But yet the etiology and pathogenesis of RAS are not exactly known, it is thought that inflammation play an important role in the pathogenesis. The aim of this study is to demonstrate the role of systemic inflammation among the possible etiological factors of RAS and to find the possible diagnostic correlation between Systemic Immune Inflammation Index (SII). Methods: Patients who were consulted the otolaryngology outpatient clinic and diagnosed with RAS between 2019-2021 were retrospectively analyzed. Neutrophil/Lymphocyte Ratio (NLR), Platelet/Lymphocyte Ratio (PLR) and SII values were calculated based on the results of complete blood count. Demographic and hematological parameters between control and RAS groups were compared. The statistical significance level was considered as <0.05. Results: There was no statistically significant difference between the control and RAS groups in terms of sex and age distributions (p = 0.566 and p = 0.173, respectively). SII, NLR and PLR values were significantly higher in the RAS group compared to the controls (p < 0.001, p < 0.001 and p = 0.001, respectively). A very strong correlation between SII and NLR, moderately strong correlation between SII and PLR and moderate correlation between NLR and PLR values were detected (respectively ρ: 0.813, 0.719, 0.532; p-values <0.001). Conclusion: SII, NLR and PLR has significantly higher levels in the RAS group compared to the control group, that it supports the role of systemic inflammation in the etiopathogenesis of RAS. In addition, the results show that SII is a valuable marker for inflammation. Level of evidence: 4. HIGHLIGHTS RAS is a chronic, idiopathic, ulcerative oral mucosal disease. SII is a new and inexpensive biomarker that can easily be calculated using the platelet, neutrophil, and lymphocyte count. SII may be a valuable marker to demonstrate the role of systemic inflammation in RAS etiopathogenesis. Vascular, thrombotic, and inflammatory processes are thought to have a role in RAS activation.

Resumo Objetivo: A estomatite aftosa recorrente (EAR) é uma doença crônica idiopática da mucosa oral. Embora sua etiologia e patogênese não sejam totalmente conhecidas, acredita-se que a inflamação possa desempenhar um papel importante. O objetivo deste estudo é demonstrar o papel da inflamação sistêmica entre os possíveis fatores etiológicos da estomatite aftosa recorrente e encontrar uma possível correlação diagnóstica com o índice de inflamação imunológica sistêmica, SII. Método: Foram analisados retrospectivamente pacientes avaliados no ambulatório de otorrinolaringologia e diagnosticados com estomatite aftosa recorrente entre 2019-2021. A relação neutrófilos/linfócitos, a relação plaquetas/linfócitos e os valores de SII foram calculados com base nos resultados do hemograma completo. Parâmetros demográficos e hematológicos dos grupos controle e de pacientes foram comparados. O nível de significância estatística foi considerado como <0,05. Resultados: Não houve diferença estatisticamente significante entre os grupos controle e com estomatite aftosa recorrente quanto à distribuição por sexo e idade (p = 0,566 e p = 0,173, respectivamente). Os valores de SII, a relação neutrófilos/linfócitos e a relação plaquetas/linfócitos foram significantemente maiores no grupo de pacientes em relação aos controles (p <0,001, p <0,001 e p = 0,001, respectivamente). Foi detectada uma correlação muito forte entre SII e relação neutrófilos/linfócitos, uma correlação moderadamente forte entre SII e relação plaquetas/linfócitos e uma correlação moderada entre valores da relação neutrófilos/linfócitos e relação plaquetas /linfócitos (ρ: 0,813, 0,719, 0,532 respectivamente; p-valores <0,001). Conclusão: SII, relação neutrófilos/linfócitos e relação plaquetas/linfócitos apresentam níveis significantemente maiores no grupo com estomatite aftosa recorrente quando comparados ao grupo controle, o que corrobora o papel da inflamação sistêmica na sua etiopatogênese. Além disso, os resultados mostram que o SII é um marcador inflamatório valioso. Nível de evidência: 4. HIGHLIGHTS A estomatite aftosa recorrente é uma doença ulcerativa crônica idiopática da mucosa oral. O SII (do inglês Systemic Immune Inflammation Index) é um biomarcador novo e de baixo custo que pode ser facilmente calculado que usa a contagem de plaquetas, neutrófilos e linfócitos. O SII pode ser um marcador valioso para demonstrar o papel da inflamação sistêmica na etiopatogênese da estomatite aftosa recorrente. Acredita-se que processos vasculares, trombóticos e inflamatórios tenham um papel na ativação da estomatite aftosa recorrente.

Whey protein positively alters inflammatory markers and metabolic parameters of overweight and obese adults

@#Introduction: The effects of prolonged consumption of whey protein on health are controversial. This study aimed to determine whether whey protein positively alters health parameters of overweight and obese adults. Methods: Randomised controlled trial was conducted. Fifty-eight participants, aged 30-50 years, were randomly allocated into four groups and supplemented with 50 g protein for eight weeks (group 1: plant-based protein (PBP), group 2: whey protein isolate (WPI) with cocoa powder, group 3: PBP with whey protein concentrate (WPC), and group 4: WPI with milk powder). Body composition and biochemical parameters (kidney and liver functions, inflammation, oxidative stress, and antioxidant capacity) were evaluated at pre-intervention and 8 weeks after intervention. Results: At Week 8, group 3 had lower diastolic blood pressure, waist circumference, visceral fat, and risk of insulin resistance (p<0.05 for all). Group 2 had decreased levels of total cholesterol and low-density lipoprotein cholesterol (p<0.05 for all). A drop in triglyceride was seen in group 4 (p=0.026). Whey protein decreased alanine aminotransferase level (p=0.028), while PBP increased aspartate aminotransferase level (p=0.034). PBP or WPI with milk powder increased blood urea nitrogen level (p>0.05 for all). Interleukin-6 and lactoferrin levels fell in all groups (p<0.05), while hs-CRP increased in the PBP group (p=0.043). Group 2 experienced increased antioxidant capacity. However, levels of oxidative stress markers were significantly decreased in the PBP group and WPI with milk powder group. Conclusion: Whey protein revealed positive effects on anthropometric parameters and biochemical markers of overweight and obese adults. Therefore, proper supplementation of whey protein can potentially promote health.

Construction and verification of a nomogram prediction model of severe adult community-acquired pneumonia / 中华危重病急救医学

Objective:To construct and verify the nomogram prediction model based on inflammatory indicators, underlying diseases, etiology and the British Thoracic Society modified pneumonia score (CURB-65 score) in adults with severe community acquired pneumonia (CAP).Methods:The clinical data of 172 adult inpatients first diagnosed as CAP at Taikang Xianlin Drum Tower Hospital from January 2018 to December 2021 were divided into severe and non-severe diseases groups according to the severity of their conditions. The baseline conditions (including gender, age, past history, comorbidities and family history), clinical data (including chief symptoms, onset time, CURB-65 score), first laboratory results on admission (including whole blood cell count, liver and kidney function, blood biochemistry, coagulation function, microbiological culture results) and whether the antimicrobial therapy was adjusted according to the microbiological culture results were recorded in both groups. Univariate analysis was used to screen for differential indicators between severe and non-severe patients. After covariate analysis, multi-factor Logistic regression analysis was performed based on the Aakaike information criterion (AIC) forward stepwise regression method to rigorously search for risk factors for constructing the model. Based on the results of the multi-factor analysis, a nomogram prediction model was constructed, and the discriminatory degree and calibration degree of the model were assessed using the receiver operator characteristic curve (ROC curve) and calibration curve.Results:A total of 172 adult CAP patients were included, 48 in severe group and 124 in non-severe group. The median age was 74 (57, 83) years old, onset time was 5.0 (3.0, 10.0) days, total number of comorbidities was 3 (2, 5), including 58 cases (33.7%) with hypertension and 17 (9.9%) with heart failure, 113 (65.7%) with CURB-65 score≤1, 34 cases (19.8%) had a CURB-65 score = 2 and 25 cases (14.5%) had a CURB-65 score≥3. Univariate analysis showed that there were statistically significant differences between the two groups in age, smoking history, CURB-65 score, heart rate, onset time, total comorbidity, pathogenic microorganisms, fibrinogen (FIB), D-dimer, C-reactive protein (CRP), procalcitonin (PCT), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Multi-factor Logistic regression analysis showed that hypertension [odds ratio ( OR) = 3.749, 95% confidence interval (95% CI) 1.411 to 9.962], heart failure ( OR = 4.616, 95% CI was 1.116 to 19.093), co-infection ( OR = 2.886, 95% CI was 1.073 to 7.760), history of smoking ( OR = 8.268, 95% CI was 2.314 to 29.537), moderate to high CURB-65 score ( OR = 4.833, 95% CI was 1.892 to 12.346), CRP ( OR = 1.012, 95% CI was 1.002 to 1.022), AST ( OR = 1.015, 95% CI was 1.001 to 1.030) were risk factors for severe CAP (all P < 0.05). The filtered indicators were included in the nomogram model, and the results showed that the area under the ROC curve (AUC) for the model to identify patients with severe adult CAP was 0.896, 95% CI was 0.840 to 0.937 ( P < 0.05), and the calibration curve showed that the predicted probability of severe CAP was in good agreement with the observed probability (Hosmer-Lemeshow test: χ2 = 6.088, P = 0.665). Conclusions:The nomogram model has a good ability to identify patients with severe adult CAP and can be used as a comprehensive and reliable clinical diagnostic tool to provide a evidence for timely intervention in the treatment of adults with severe CAP.

A comparative study of inflammatory marker highly sensitive C- Reactive Protein in depression patients exhibiting suicidal behaviour and depression patients without suicidal behaviour

Background: Recent research have found a link between inflammatory pathway and suicidal behaviour. hs-CRP, IL, TNF have been shown to have significant alterations in suicidality, however multiple covariates influence this relationship. One of the main limitations of most of the studies is that they have evaluated the CRP in patients demonstrating suicidal behaviour but not in depression. No study has been conducted in Indian subpopulation with parameters of our study. Aims of the study was to compare hsCRP levels between depression patients with suicidal behaviour and without suicidal behaviour.Methods: Authors compared 50 depression patients with suicidal behaviour and 50 depression patients without suicidal behaviour, diagnosed using ICD10. Hamilton Depression Rating Scale (HDRS‑17), Suicide behaviour Questionnaire- Revised (SBQ-R), Beck Scale for Suicidal Ideation (BSSI) were applied for assessment of depression and suicidality. Highly sensitive CRP was measured using autoanalyzer.Results: hsCRP levels were significantly high in depression patients with suicidal behaviour (4.12 mg/dl) than depression without suicidal behaviour (2.42 mg/dl). Duration of illness, HAM-D, BSSI and SBQ-R scores correlated positively with hsCRP levels.Conclusions: Depression with suicidal behaviour patients have a significantly higher hs-CRP levels than depression without suicidal behaviour. Patients of depression with suicidal behaviour group have a strong positive correlation between hs-CRP levels and HAM-D, BSSI and SBQ-R scores.

A study of effect of low dose atorvastatin therapy on high sensitivity C-reactive protein in patients with modifiable and non-modifiable cardiovascular risk factors in central India

Background: Anti-inflammatory effects of statins have generated maximum interest, as has been demonstrated in a number of studies showing rapid decrease in CRP levels in patients of acute coronary syndromes. This CRP lowering property of statins has also translated into clinical benefits as suggested by reduction in rate of recurrent angina, recurrent myocardial infarction, and mortality.Methods: This prospective, open, and controlled study was conducted on 160 indoor and outdoor patients, for total duration of two years (2005-2006), in GMC Bhopal, MP, India.Results: In all the four groups, baseline serum hs-CRP was statistically significant (p value <0.01) higher than normal hs-CRP level. Mean reduction (%) in hs-CRP after 3 months of statin therapy was 83.6% in group A and 62.4% in group C which is highly significant (p value <0.001). In group B also, 26% hs-CRP reduction was noticed which is statistically significant (p value <0.01). Baseline hs-CRP was statistically significant high (p value <0.01) in hypertensive patients. Percentages reduction in group A (87%) and group C (66%) was statistically significant (p value <0.01). Baseline hs-CRP was statistically significant higher (p value <0.01) than normal population. After 3 months of statin therapy percentage reduction in group A and group C was statistically significant (p value <0.01). Conclusions: Low dose atorvastatin can significantly reduce CRP level in patients with risk factors for cardiovascular disease. Early initiation of low dose atorvastatin can reduce this inflammatory marker in both ACS and high risk for ACS patients and can prevent major adverse cardiac events.

A preoperative prediction model of microvascular invasion in hepatocellular carcinoma / 中华肝胆外科杂志

Objective To analyze the risk factors of microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC),and to establish a preoperative prediction model for MVI.Methods The clinical data of 159 patients with HCC from the First Hospital of Jilin University treated from January 2012 to December 2014 were retrospectively analyzed.There were 128 males and 31 females.Univariate and multivariate logistic regression analysis of factors influencing the presence of MVI in HCC patients were carried out.Independent risk factors were scored based on the β values of multivariate analysis.Receiver operating characteristics (ROC) curves were used to evaluate the predictive value of the scores for the risk factor for MVI.Results Univariate and multivariate logistic regression analyses showed that age ≥ 60 years (OR=0.263,95％ CI:0.112 ～ 0.614),tumor diameter ≥5 cm (OR=3.902,95％ CI:1.784 ～ 8.583),neutrophil to lymphocyte ratio (NLR) ≥ 1.83 (OR=2.414,95％ CI:1.065～5.472) and platelet to lymphocyte ratio (PLR) ≥ 72.30 (OR =2.578,95％ CI:1.068～ 6.223) were the influencing factors of MVI in patients with HCC (P＜0.05).The preoperative prediction model of MVI was established using the MVI independent risk factor scores.The area under the ROC curve was 0.793 (95％ CI:0.723～ 0.862).The optimal cutoff value for the presence of MVI was 2.75 points,and the sensitivity was 0.72 and the specificity was 0.78.The MVI positive rates of patients with risk scores of 0 to 1.5,2.0 to 3.5,and 4.0 to 5.0 were 18.6％,42.9％,and 78.3％,respectively.Conclusion Age,tumor diameter,NLR,and PLR were independent factors influencing MVI in patients with HCC.The preoperative model based on the independent risk factor scores can be used to predict the presence of MVI in HCC patients.

Comparison of Inflammatory Markers Including C-Reactive Protein between Treatment Resistant Schizophrenia and Non-Treatment Resistant Schizophrenia / 생물치료정신의학

OBJECTIVES: The present study is to investigate inflammatory markers and associated clinical factors between treatment resistant schizophrenia and non-treatment resistant schizophrenia.METHODS: Of the 116 schizophrenia subjects who were hospitalized for ac ute symptomatic treatment, 19 patients (16%) were treated with clozapine as a treatment resistant schizophrenia(TRS) and 97 patients(84%) were treated with other atypical antipsychotics as a non-treatment resistant schizophrenia(Non-TRS). Various inflammatory markers including C-reactive protein(CRP) and clinical factors were retrospectively evaluated with electrical medical records.RESULTS: There were significant differences between two groups in disease duration(p =0.015), number of admission (p =0.003), Clinical Global Impression(p <0.001) but other demographic and clinical variables including previous antipsychotics use did not show significant differences. In terms of hematologic profiles, TRS group demonstrated higher CRP level(p =0.006), lower neutrophil count(p =0.012), and lower hemoglobin level(p =0.003) compared with non-TRS group. Body mass index was significantly correlated with CRP(r=0.318, p =0.001).CONCLUSION: The elevated level of serum CRP in TRS suggests that treatment resistance in schizophrenia may be associated with inflammatory response. However, retrospective study design and small number of subjects could limit this interpretation.

Effects of obstructive sleep apnea on inflammatory markers in patients with acute coronary syndrome / 中华急诊医学杂志

Objective To examine the prevalence of obstructive sleep apnea (OSA) in patients with acute coronary syndrome (ACS),and to evaluate the relationship of OSA with inflammatory biomarkers in ACS patients.Methods Patients with ACS treated at Beijing Anzhen Hopital from June 2015 to May 2017 were enrolled.Subjects were evaluated for OSA by sleep study,and were divided into a normal-mild OSA group (Apnea Hypopnea Index,AHI ＜ 15 times/h) and a moderate-severe OSA group (AHI ≥ 15 times/h).Laboratory examination and sleep study were monitored to analyze the effects of OSA on biomarkers by LSD-t test,Mann-whitney U test,or Chi-square test.Correlation analysis was performed to analyze the association of OSA with high sensitivity C-reactive protein (hs-CRP) by Spearman correlation anaylsis.Results A cohort of 836 patients with ACS were enrolled including 408 patients in the normal-mild OSA group and 428 patients in the moderate-severe OSA group.The levels of leukocyte(x 109L) [7.78 (6.33,9.86) vs 7.29 (6.01,9.16),P=0.006],neutrophils(× 109L) [5.05 (3.84,7.23)vs 4.80 (3.74,6.66),P=0.044],monocytes(x 109L) [0.42 (0.33,0.54) vs 0.39 (0.31,0.51),P=0.033],hsCRP(mg/L) [3.18 (1.10,11.52) vs 1.78 (0.65,6.46),P＜0.01],fibrinogen(g/L) [3.17 (2.87,3.74) vs 2.97 (2.59,3.50),P=0.002],and uric acid(μmol/L) [360 (302,422) vs 341(283,407),P=0.006] in the moderatesevere OSA group were significant higher than those in the normal-mild OSA group.AHI (correlation coefficient=0.171,R2=0.020,P＜0.01),ODI (correlation coefficient =0.201,R2=0.027,P＜0.01),and TSaO2 ＜ 90％ (correlation coefficient =0.105,R2=0.005,P＜0.01) were positively correlated with hs-CRP;minimal SaO2 (correlation coefficient=-0.100,R2=0.001,P=0.008) and mean SaO2 (correlation coefficient =-0.127,R2=0.006,P＜0.01) were negatively correlated with hs-CRP.Conclusions For patients with ACS,the level of inflammatory markers in the moderate-severe OSA group is significantly higher than that in the normal-mild OSA group.Hs-CRP is significantly associated with the severity of OSA.Diagnosis and monitoring of OSA should be considered in ACS management in the future.

Association Between Inflammatory Marker And Cognitive Impairment In Diagnosed Type 2 Diabetes Mellitus: A Case Control Study

Introduction: Type 2 diabetes mellitus (T2DM) is a common metabolic disease, especially in older people, with global prevalence estimates ranging from 2.8% in 2000 to a projected 4.4% in 2030 (Wild S et al.2004). Objectives: The present study was undertaken to assess association between inflammatory marker&Cognitive impairementin people with type 2 diabetes mellitus. Methods: The present study was conducted in Rajeev Gandhi Centre for Diabetes and Endocrinology and Department of Physiology on patients of Type 2 Diabetes Mellitus attending Diabetes clinic in Jawaharlal Nehru Medical college hospital, Aligarh Muslim University during year 2012-2013 after approval from the ethical committee of J. N. Medical College. Design of the study was case control.A detailed history and physical examination was carried out for every subject who entered the study as per pre-designed proforma. Results: For cognitive impairment, Type 2 DM subjects showed significantly decrease total MMSE score with decrease in orientation, registration,attention and calculation, recall and language in comparison to controls. Conclusion: The association between Type 2 DM and cognitive changes is becoming increasingly clear, rendering it necessary for physicians in charge of diabetic patients to have the means to assess cognitive performance as cognitive impairment among the older adults with Type 2 DM may worsen the health outcomes through negative impact on compliance with medical self care recommendations.

Association between Plasma Pentraxin 3 Levels and Bone Mineral Density in Elderly Koreans: the Dong-gu Study

BACKGROUND: We investigated the association between pentraxin 3 (PTX3), a novel inflammatory marker, and bone mineral density (BMD) in the general Korean population. METHODS: We selected a sub-cohort of 1,440 subjects (757 men and 683 women) from participants in the community-based Dong-gu Study. The mean age was 66.0 ± 8.1 years for men and 63.7 ± 7.9 years for women. The plasma PTX3 levels were measured using an enzyme-linked immunosorbent assay, and BMD was measured in the femoral neck and lumbar spine using dual-energy X-ray absorptiometry. Linear regression analyses were used to evaluate the association between the plasma PTX3 levels and BMD. RESULTS: PTX3 was inversely associated with the BMD of the lumbar spine (P = 0.010) and femoral neck (P < 0.001) in men but not in women. For men, the association with the BMD of the femoral neck remained after adjustment for multiple comparison (P = 0.020). CONCLUSION: This study suggests that PTX3 levels might be inversely associated with BMD in elderly men.

Research advances on the ratio ofmonocyte to HDL in the diagnosis and prognosis of coronary heart disease / 基础医学与临床

Atherosclerosis is the main cause of coronary heart disease, Now it is thought that atherosclerosis is a chronic inflammatory disease.The ratio of Monocytes to high-density lipoprotein (MHR) is a new inflammatory marker of coronary atherosclerosis, which is measured simply and cheaply.MHR is associated with short-term and long-term incidence of cardiovascular events and morbidity of Coronary heart disease, which can be used as predictor of coronary heart disease prognosis.

Study of effects of metformin on C-reactive protein level in Type-2 diabetes mellitus.

Background: Diabetes mellitus (DM) is extremely common; represent a significant global health problem. Type-2 DM is considered to be associated with a low grade inflammation, which may play a significant role in development of cardiovascular complications evidenced by C-reactive protein (CRP) is a an extremely sensitive marker of systemic inflammation. The study was undertaken to check the effect of metformin on CRP level in Type-2 DM. Methods: The study was prospective and non-randomized. Thirty newly diagnosed Type-2 DM selected for metformin therapy by medicine personnel were enrolled in the study based on inclusion and exclusion criteria. Patients were divided into pretreatment (before starting metformin therapy) and post-treatment group. Fasting blood sugar (FBS), postprandial blood sugar (PP2BS), CRP level were measured at the time of enrolment and 3 months after starting metformin monotherapy. Results: Results were analyzed using pair t-test. Metformin therapy was found to decrease CRP level significantly along with FBS, PP2BS level. p<0.05 value considered as statistically significant. Value was expressed as mean ± standard deviation. Conclusions: Treatment with 3 months metformin monotherapy for newly diagnosed Type-2 DM has shown a significant decrease in high-sensitivity-CRP level in Type 2 diabetes. This positive effect may be because of the decreased in the expression of proinflammatory cytokines and other mediators, including adhesion molecules, suggests that these processes may contribute to atherogenesis because atherosclerosis is also an inflammatory condition. However, this effect is probably dependent on improving glycemic control.

Relationship between Serum Inflammatory Marker and Psychotic Symptoms in Inpatients with Schizophrenia or Schizoaffective Disorder

OBJECTIVES: Despite the growing research interest in the role of immunological markers in schizophrenia, a few studies, with conflicting results, have focused on the association between high sensitivity C-reactive protein (hs-CRP) levels and clinical characteristics in schizophrenia. The aim of the present study was to examine the association of serum hs-CRP with psychopathology in schizophrenia. METHODS: Fifty-five inpatients with schizophrenia or schizoaffective disorder were enrolled. Serum levels of hs-CRP were measured, and each patient was assessed with the Korean version of the Positive and Negative Syndrome Scale (PANSS). RESULTS: In correlation analysis of hs-CRP with PANSS subscales, positive subscale score has significant positive correlation (r = 0.271, p = 0.046). In independent t-test analysis, subjects with hs-CRP > 0.3 mg/dL (elevated CRP group, n = 43) had significantly higher PANSS positive subscale score (t = -3.273, df = 24.107, p = 0.003) than those with hs-CRP < or = 0.3 mg/dL (normal CRP group, n = 12). CONCLUSIONS: Elevated serum levels of high sensitivity C-reactive protein in schizophrenia are associated with the severity of psychotic symptoms.

Correlation research of myeloperoxidase and the severity of coronary lesions in patients with acute coronary syndrome / 中国医师进修杂志

ObjectiveTo research the relationship between the plasma levels of myeloperoxidase (MPO) and the onset and progress of acute coronary syndrome (ACS) and the severity of coronary lesions in patients with ACS.MethodsSeventy-eight patients hospitalized with chest pain were enrolled,including 41 patients with ACS (ACS group),17 patients with stable angina pectoris(SAP,SAP group) and 20 patients serving as control (control group).Forty-one patients undergoing coronary angiography were divided into single vessel lesions group (7 patients),double vessel lesions group (7 patients),multiple vessel lesions group ( 12 patients) and no vessel lesions group ( 15 patients) based on the vessel lesions of the left anterior descending,left circumflex artery and right coronary artery.According to the diameter stenosis of major coronary artery,there were 15 patients in no vascular stenosis group,2 patients in mild vascular stenosis group,6 patients in moderate vascular stenosis group and 18 patients in severe vascular stenosis group.The levels of MPO were measured by enzyme-linked immunosorbent assays(ELISA).ResultsThe levels of MPO in ACS group [( 252.10 ± 27.07 ) μ g/L]were higher than those in SAP group[( 185.81 ± 17.85 ) μ g/L]and control group [( 140.42 ± 71.40) μ g/L](P ＜ 0.05 ),the levels of MPO in SAP group were higher than those in control group(P＜ 0.05 ).The levels of MPO in single vessel lesions group and multiple vessel lesions group were higher than those in no vessel lesions group (P ＜ 0.05 ),but there was no significant difference among single vessel lesions group,double vessel lesions group and multiple vessel lesions group (P ＞ 0.05 ).The levels of MPO in mild vascular stenosis group,moderate vascular stenosis group and severe vascular stenosis group were higher than those in no vascular stenosis group (P ＜ 0.05),but there was no significant differenceamong mild vascular stenosis group,moderate vascular stenosis group and severe vascular stenosis group(P ＞ 0.05 ).A positive correlation was observed between the levels of MPO and neutrophils (r =0.288,P=0.018 ),creatine kinase isoenzyme-MB(r =0.469,P=0.043 ),subject groups( r =0.757,P=0.000),vessel lesions (r =0.584,P=0.000) and the degree of vascular stenosis (r =0.491,P=0.001).Conclusion MPO may predict ACS and reflect the severity of coronary lesions in ACS as a novel inflammatory marker.

The effect of different dosage of aspirin on inflammatory biomarkers and prognosis in acute coronary syndrome / 中华内科杂志

Objective To observe and assess the effect of different dosages of aspirin on inflammatory biomarkers, hemorheology (platelet aggregation rate) and clinical prognosis in patients with acute coronary syndrome ( ACS). Methods ACS patients were randomly assigned to receive different dosages of aspirin treatment orally. Patients in group A,B and C took 100 mg, 500 mg and 1000 mg of aspirin per day respectively. They were treated and followed-up for 1 year. High-sensitivity C-reactive protein ( hsCRP) , IL-6, tumor necrosis TNFot and platelet aggregation rate were examined and major adverse cardiac events( MACE) were recorded. Results A total of 312 patients with ACS were enrolled in the study. The baseline characteristics of the three groups were not different with respect to age, gender, cardiovascular risk profile, level of inflammatory biomarkers and concomitant treatment before and after randomization. The levels of baseline serum hsCRP, IL-6 and TNFa were higher in subjects of the study as compared with normal reference value (P<0. 05, <0. 05, <0. 01) and they decreased significantly after therapy with 3 different doses of aspirin (detected at 30 days, 6 months and 12 months, P <0. 001 ) , but there were no significant differences among the three groups( P >0. 05) . Rehospitalization , MACE and the change of platelet aggregation ratio were not significantly different among the three groups. The incidence of gastrointestinal complaints was significantly higher in groups B and C than in group A ( P < 0. 05 ). Conclusions The levels of serum inflammatory biomarker increase in patients with ACS. Aspirin therapy may decrease the level of inflammatory markers significantly, but increasing the dosage of aspirin from 100 mg to 1000 mg daily does not decrease the level of inflammatory markers and the clinical MACEs further. However, the incidence of gastrointestinal complaints increase significantly with the increase of aspirin dosage.

Relationship between Systemic Inflammatory Marker, Oxidative Stress and Body Mass Index in Stable COPD Patient / 결핵및호흡기질환

BACKGROUND: The main factors associated with weight loss in patients with COPD are not well known. Since chronic inflammation and oxidative stress play a major pathogenic role in COPD, these factors may be responsible for the patients' weight loss. Therefore, this study measured the body mass index (BMI) in COPD patients and evaluated the variables, such as systemic inflammatory marker, oxidative stress and lung function, that correlate with the BMI. METHOD: The stable COPD patients (M:F=49:4, mean age=68.25+/-6.32) were divided into the lower (25) BMI group. The severity of the airway obstruction was evaluated by measuring the FEV1. The serum IL-6 and TNF-alpha levels were measured to determine the degree of systemic inflammation, and the carbonyl protein and 8-iso-prostaglandin F2alpha level was measured to determine the level of oxidative stress. Each value in the COPD patients and normal control was compared with the BMI. RESULTS: 1) Serum 8-iso-prostaglandin F2alpha in COPD patients was significantly higher (456.08+/-574.12 pg/ml) than that in normal control (264.74+/-143.15 pg/ml) (p<0.05). However, there were no significant differences in the serum IL-6, TNF-alpha, carbonyl protein between the COPD patients and normal controls. 2). In the COPD patients, the FEV1 of the lower BMI group was significantly lower (0.93+/-0.25L) than that of the normal BMI (1.34+/-0.52L) and higher BMI groups (1.72+/-0.41L) (p<0.05). The lower FEV1 was significantly associated with a lower BMI in COPD patients (p=0.002, r=0.42). The BMI of very severe COPD patients was significantly lower (19.8+/-2.57) than that of the patients with moderate COPD (22.6+/-3.14) (p<0.05). 3). There were no significant differences in the serum IL-6, TNF-alpha, carbonyl protein and 8-iso-prostaglandin F2alpha according to the BMI in the COPD patients. CONCLUSION: The severity of the airway obstruction, not the systemic inflammatory markers and oxidative stress, might be associated with the BMI in stable COPD patients. Further study will be needed to determine the factors associated with the decrease in the BMI of COPD patients.

Oxidized LDL and inflammatory markers in ischemic heart disease / 대한내과학회지

BACKGROUND: There is increasing evidence that inflammation is an important determinant of the development of atherosclerosis and that oxidation of low-density lipoprotein (LDL) obviously plays an important role in the pathogenesis of atherosclerosis. We assessed the levels of oxidized LDL and inflammatory markers in patients with ischemic heart disease and normal group who has normal coronary angiograms. METHODS: Coronary angiography was performed in 142 patients. 107 patients of ischemic heart disease (stable angina pectoris 58, unstable angina pectoris 30, acute myocardial infarction 19) and 38 normal control subjects. We assessed the level of oxidized LDL and inflammatory markers, such as CRP, ESR, fibrinogen and leukocyte. RESULTS: CRP was 3.88+/-2.05 mg/dL in acute myocardial infarction group, and 0.29+/-0.15 mg/dL in normal control subject group (p<0.05). Fibrinogen was 541.6+/-45.1 mg/dL in acute myocardial infarction group, 321.4+/-25.6 mg/dL in normal control subject group (p<0.05). Leukocyte was 10942.1+/-737.6/mm3 in acute myocardial infarction group, 6394.3+/-235.1/mm3 in normal control subject group (p<0.05). Oxidized LDL was 23.0+/-4.0 EU/mL in acute myocardial infarction group, and 16.2+/-1.5 EU/mL in normal control subject group (p<0.05). CRP, ESR and fibrinogen values of the patients with stable angina pectoris and unstable angina pectoris were higher than that of normal control group, but there were no statistical significance. Oxidized LDL (ox-LDL) and Leukocyte value of the patients with unstable angina pectoris, acute myocardial infarction was significantly higher than that of the patients with stable angina pectoris and normal control subjects (p<0.05). CRP, ESR and fibrinogen values of the patients with acute myocardial infarction were also higher than that of normal control subjects. CONCLUSION: This study demonstrate that CRP, fibrinogen and oxidized LDL, leukocyte values of acute myocardial infarction group were significantly higher than that of control group and stable, unstable angina pectoris group. Oxidized LDL and Leucokyte values were also significantly elevated in unstable angina group, but CRP values were not in unstable angina group.