Observation on formation of neutrophil extracellular traps in peripheral blood of patients with psoriasis / 中国免疫学杂志

Objective:To explore the clinical application value of neutrophil extracellular traps(NETs)in the evaluation of psoriasis patients.Methods:Peripheral blood(2 ml)of 63 patients with psoriasis and 27 healthy controls were collected,neutrophils were isolated by density gradient method,and the formation of NETs was observed by immunofluorescence staining.Calculated the pro-portion and fluorescence intensity of NETs,and analyzed their correlation with clinical classification,severity and serological indica-tors.Skin lesions of 5 patients with psoriasis were collected,and the NETs were observed by immunofluorescence method.Results:Proportion and fluorescence intensity of spontaneous NETs in patients with psoriasis were significantly higher than those in healthy con-trols,and were positively correlated with the PASI scores.Production of NETs in psoriasis patients with metabolic abnormalities or TNF-α abnormalities was higher than that in psoriasis patients without metabolic abnormalities or TNF-α normalcy.Expressions of NETs in psoriatic lesions were increased.Conclusion:Levels of NETs are correlated with disease severity of psoriasis and patients with metabolic abnormalities,and may be used as a clinical indicator to reflect the inflammatory state of psoriasis and metabolic comor-bidity of psoriasis for disease evaluation.

Expression of Hsa_circ_0003928 in diabetic foot ulcer and its relationship with severity and prognosis / 中国糖尿病杂志

Objective To investigate the expression of serum Hsa_circ_0003928 in patients with diabetic foot ulcer(DFU)and its relationship with the severity and prognosis of disease.Methods 113 DFU patients were selected as the study subjects.According to the severity of infection,19 cases were classified into level 1(no infection),40 cases at level 2(mild infection),20 cases at level 3(moderate infection),and 34 cases at level 4(severe infection).According to the prognosis of DFU patients,they were divided into good prognosis group(GP,n=63)and poor prognosis group(PP,n=50).The baseline data and levels of IL-6,C-RP and Hsa_circ_0003928 were compared among the four groups.Logistic regression was used to analyze the risk factors of poor prognosis in patients with DFU.The receiver operating characteristic(ROC)curve was used to analyze the value ofHsa_circ_0003928,C-RP and IL-6 in predicting the poor prognosis in DFU patients.Results The DFU duration,infection grade 3～4,serum creatinine,uric acid,BUN,C-RP,IL-6 and Hsa_circ_0003928 levels in PP group were significantly higher than those in GP group(P＜0.05 or P＜0.01).Grade 3～4 DFU patients had higher Hsa_circ_0003928 expression than grade 1～2(P＜0.01).Logistic regression analysis showed that long duration of DFU,infection grade 3～4,higher levels of BUN,C-RP,IL-6 and Hsa_circ_0003928 were risk factors for poor prognosis in DFU patients.ROC curve showed that Hsa_circ_0003928 had the greatest AUC(0.882,95％CI 0.819～0.942)in predicting poor prognosis in DFU patients,with sensitivity 87.5％and specificity 85.6％,respectively.Conclusion Elevated Hsa_circ_0003928 is associated with DFU severity and poor prognosis,which has certain predictive value for the prognosis of DFU patients.

Factors influencing the severity of alcohol use disorder and the construction of risk prediction model / 四川精神卫生

BackgroundAlcohol use disorder （AUD） is a common chronic and relapsing psychiatric disorders. Identifying severe AUD early and intervening promptly is crucial to prevent irreversible harm. Currently， the assessment of AUD severity primarily relies on psychiatric examination by clinicians， and there is limited research on the factors influencing AUD severity and the development of prediction models. ObjectiveTo analyze the factors influencing AUD severity， and construct a risk prediction model to aid in the assessment of disease progression in AUD patients. MethodsA retrospective analysis was conducted on 1 358 first-time hospitalized patients admitted to Nanning Fifth People's Hospital from January 1， 2017 to December 31， 2022. These patients met the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） criteria for AUD. Basic patient data was collected， and the patients were divided into two groups based on disease severity： mild-moderate group （n=330） and severe group （n=1 028）. The patients were randomly divided into training and test sets in a 7∶3 ratio. A Logistic regression model was constructed in the training set， and the predictive ability of the model for disease severity was evaluated using the receiver operating characteristic （ROC） curve in the test set. ResultsCompared with the mild-moderate group， the severe group had a higher proportion of patients living in urban areas （χ2=7.804）， were farmers （χ2=17.991）， had a higher frequency of alcohol consumption （more than 1 to 2 drinks/day） （χ2=35.267）， had a higher age at first drinking （t=-3.858）， had a greater number of comorbid somatic disorders （Z=-22.782）， and had higher proportions of γ-Glutamyl transpeptidase （χ2=259.940） and total bilirubin abnormalities （χ2=148.552） （P<0.01）. Logistic analysis conducted in the training set showed that being a farmer （OR=2.024， 95% CI： 1.352~3.029）， having an older age at first drinking （OR=1.075， 95% CI： 1.025~1.129）， drinking outside of mealtimes （OR=3.988， 95% CI： 2.408~6.606）， having total bilirubin abnormalities （OR=1.034， 95% CI： 1.000~1.069）， and having more comorbid somatic diseases （OR=4.386， 95% CI： 2.636~7.298） were identified as risk factors for disease severity in AUD patients. The area under curve （AUC） for this model in the test set was 0.906. ConclusionIn psychiatric hospitals， being a farmer， having an older age at first drinking， drinking outside of mealtimes， having abnormal total bilirubin levels， and having comorbidities with somatic illnesses may be risk factors for severe AUD.

Correlation Analysis between Serum miR-133a-3p and PTPN22 Levels Expression and Disease Severity in Patients with Psoriasis Vulgaris / 现代检验医学杂志

Objective To explore the correlation between the serum levels expression of microRNA(miR)-133a-3p,protein tyrosine phosphatase nonreceptor type 22(PTPN22)and the severity of psoriasis vulgaris.Methods A total of 86 patients with psoriasis vulgaris who were admitted to Cangzhou People's Hospital from January 2022 to June 2022 were collected as the observation group.They were separated into a progressive group(n=41)and a quiescent group(n=45)based on the area and severity of the skin lesions.Meantime,86 healthy individuals undergoing plastic surgery examinations were regarded as the control group.Real time fluorescent quantitative PCR(qRT-PCR)method was applied to detect the relative expression levels of miR-133a-3p and PTPN22 in serum.Target Scan Human website was applied to predict the targeting relationship between PTPN22 and miR-133a-3p.Spearman method was applied to analyze the correlation between the expression levels of miR-133a-3p and PTPN22 in serum of patients with psoriasis vulgaris,the psoriasis area and the psoriasis area and severity index score(PASI).Logistic regression was applied to analyze the influencing factors of severity in patients with psoriasis vulgaris.Results Compared with the control group,the serum miR-133a-3p(1.85±0.46 vs 1.05±0.21)expression level in the observation group was increased,while the PTPN22 mRNA(0.76±0.13 vs 1.02±0.18)expression level was reduced,and the difference were statistically significant(t=14.671,10.859,all P<0.05).Compared with the quiescent group,the serum miR-133a-3p(2.05±0.52 vs 1.67±0.41)expression level in the progressive group was increased,while the PTPN22 mRNA(0.66±0.11 vs 0.85±0.15)expression level was reduced and the differences were statistically significant(t=3.780,6.643,all P<0.05).Target Scan Human website predicted that there may be a targeting relationship between miR-133a-3p and PTPN22.Spearman analysis showed that there was a positive correlation between serum miR-133a-3p and PASI score in patients with psoriasis vulgaris(r=0.469,P<0.05),while serum TPN22 mRNA level was negatively correlated with PASI score(r=0.469,P<0.05).Serum miR-133a-3p[OR(95%CI)=2.884(1.261～6.595)]was an independent risk factor for the severity of psoriasis vulgaris,while PTPN22[OR(95%CI)=0.562(0.367～0.860)]was an independent protective factor(all P<0.05).Conclusion The expression level of miR-133a-3p in serum of patients with psoriasis vulgaris was increased,while the expression level of PTPN22 was reduced.The two were closely related to the PASI score and may to some extent reflect the severity of psoriasis patients.

Impact of vaccination on COVID-19 severity during the second wave in Brunei Darussalam, 2021

@#Objective: Coronavirus disease (COVID-19) vaccinations have been shown to prevent infection with efficacies ranging from 50% to 95%. This study assesses the impact of vaccination on the clinical severity of COVID-19 during the second wave in Brunei Darussalam in 2021, which was due to the Delta variant. Methods: Patients included in this study were randomly selected from those who were admitted with COVID-19 to the National Isolation Centre between 7 August and 6 October 2021. Cases were categorized as asymptomatic, mild (symptomatic without pneumonia), moderate (pneumonia), severe (needing supplemental oxygen therapy) or critical (needing mechanical ventilation) but for statistical analysis purposes were dichotomized into asymptomatic/mild or moderate/severe/critical cases. Univariate and multivariable analyses were conducted to identify risk factors associated with moderate/severe/critical disease. Propensity score-matched analysis was also performed to evaluate the impact of vaccination on disease severity. Results: The study cohort of 788 cases (mean age: 42.1 + 14.6 years; 400 males) comprised 471 (59.8%) asymptomatic/mild and 317 (40.2%) moderate/severe/critical cases. Multivariable logistic regression analysis showed older age group (>45 years), diabetes mellitus, overweight/obesity and vaccination status to be associated with increased severity of disease. In propensity score-matched analysis, the relative risk of developing moderate/severe/critical COVID-19 for fully vaccinated (two doses) and partially vaccinated (one dose) cases was 0.33 (95% confidence interval [CI]: 0.16–0.69) and 0.62 (95% CI: 0.46–0.82), respectively, compared with a control group of non-vaccinated cases. The corresponding relative risk reduction (RRR) values were 66.5% and 38.4%, respectively. Vaccination was also protective against moderate/severe/critical disease in a subgroup of overweight/obese patients (RRR: 37.2%, P = 0.007). Discussion: Among those who contracted COVID-19, older age, having diabetes, being overweight/obese and being unvaccinated were significant risk factors for moderate/severe/critical disease. Vaccination, even partial, was protective against moderate/severe/critical disease.

Variability in indigenous Pakistani tomato lines and worldwide reference collection for Tomato Mosaic Virus (ToMV) and Tomato Yellow Leaf Curl Virus (TYLCV) infection / Variabilidade em linhagens indígenas de tomate do Paquistão e coleção de referência global para infecção por vírus do mosaico do tomateiro (ToMV) e vírus da folha amarela do tomate (TYLCV)

Local and exotic germplasm of tomato remains a major source for genetic improvement. Assessment of such lines for biotic stresses particularly viral diseases are the most important criteria for selection in Pakistan, where Tomato Yellow Leaf Curl Virus (TYLCV) and Tomato Mosaic Virus (ToMV) are the major diseases/viruses. A set of 40 accessions (including indigenous Pakistani lines and exotic germplasm from Europe, the United States, and Asia) were evaluated for their resistance/infection response to ToMV with artificial inoculation under greenhouse conditions. Infection response was quantified through disease scoring and DAS-ELISA test (for ToMV). A subset of 24 lines, was further screened for TYLCV using disease scoring and TAS-ELISA. The tested lines showed significant variability for resistance to ToMV. Only one accession (Acc-17878) was resistant to the ToMV whereas seven accessions i.e. Acc-17890, AVR-261, CLN-312, AVR-321, EUR-333, CLN-352, and CLN-362 expressed resistance to TYLCV. Correlation between phenotypic evaluation was confirmed by the ELISA results in both diseases, although both tools complemented to assess the viral infection status. In future, tomato breeding programs must consider breeding for ToMV and TYLCV resistance (using identified germplasm in our study) so as to deliver virus resistant tomato varieties.

O germoplasma local e exótico do tomate continua sendo uma importante fonte de melhoramento genético. A avaliação de linhagens para estresses bióticos, particularmente as doenças virais, é o critério mais importantes para seleção no Paquistão, onde o vírus da folha amarela do tomate (TYLCV) e o vírus do mosaico do tomateiro (ToMV) são as principais doenças/vírus. Um conjunto de 40 acessos (incluindo linhagens indígenas do Paquistão e germoplasma exótico da Europa, dos Estados Unidos e da Ásia) foi avaliado quanto à resistência/resposta à infecção ao ToMV com inoculação artificial em casa de vegetação. A resposta à infecção foi quantificada por meio de pontuação da doença e de teste DAS-ELISA (para ToMV). Um subconjunto de 24 linhas foi posteriormente rastreado para TYLCV usando pontuação de doença e TAS-ELISA. As linhas testadas apresentaram variabilidade significativa para resistência ao ToMV. Apenas um acesso (Acc-17878) foi resistente ao ToMV, enquanto sete acessos (Acc-17890, AVR-261, CLN-312, AVR-321, EUR-333, CLN-352 e CLN-362) expressaram resistência ao TYLCV. A correlação entre a avaliação fenotípica foi confirmada pelos resultados do ELISA nas duas doenças, embora ambas as ferramentas tenham se complementado para avaliar o estado da infecção viral. No futuro, os programas de melhoramento de tomate devem considerar aperfeiçoamentos para resistência ao ToMV e TYLCV (usando germoplasma identificado em nosso estudo) de modo a fornecer variedades de tomate resistentes a vírus.

Reduced HDL-cholesterol in long COVID-19: A key metabolic risk factor tied to disease severity

Abstract This controlled study investigated metabolic changes in non-vaccinated individuals with Long-COVID-19, along with their connection to the severity of the disease. The study involved 88 patients who experienced varying levels of initial disease severity (mild, moderate, and severe), and a control group of 29 healthy individuals. Metabolic risk markers from fasting blood samples were analyzed, and data regarding disease severity indicators were collected. Findings indicated significant metabolic shifts in severe Long-COVID-19 cases, mainly a marked drop in HDL-C levels and a doubled increase in ferritin levels and insulin resistance compared to the mild cases and controls. HDL-C and ferritin were identified as the leading factors predicted by disease severity. In conclusion, the decline in HDL-C levels and rise in ferritin levels seen in Long-COVID-19 individuals, largely influenced by the severity of the initial infection, could potentially play a role in the persistence and progression of Long-COVID-19. Hence, these markers could be considered as possible therapeutic targets, and help shape preventive strategies to reduce the long-term impacts of the disease.

Relationship between semen parameters, serum InhB, and INSL-3 levels, and the degree of varicocele

Abstract Background Varicocele is an abnormal expansion of the pampininias venous plexus in the scrotum, resulting in impaired sperm production and reduced sperm quality. The exact pathophysiological mechanism leading to varicocele-related infertility has not been fully elucidated. Although treatable, varicocele may lead to male infertility. Objective To investigate the relationship between semen parameters, serum InhB and INSL-3 levels, and the degree of varicocele in male patients. Methods Serum InhB and INSL-3 were detected. To evaluate the relationship between semen parameters and serum InhB and INSL-3 levels. To evaluate the value of semen parameters and serum InhB and INSL-3 levels in distinguishing disease severity in patients with varicocele. Results Serum INSL-3 in patients with varicocele decreased with the severity of the disease. Serum INSL-3 was positively correlated with total sperm count and frequency of normal sperm morphology. There was a weak correlation between serum InhB and semen volume, concentration, and total sperm. Patients with different disease severity were similar within the groups, with partial overlap or similarity between varicocele Grade I and Grade II, and significant differences between Grade III and Grade I and II. Semen volume, concentration, total sperm, normal sperm morphology, and serum InhB and INSL-3 levels could distinguish the degree of varicocele. Conclusion Semen parameters and the combination of serum InhB and INSL-3 levels in patients with varicocele are closely related to the severity of the disease. Serum INSL-3 is expected to be a potential biomarker for early clinical intervention.

Variability in indigenous Pakistani tomato lines and worldwide reference collection for Tomato Mosaic Virus (ToMV) and Tomato Yellow Leaf Curl Virus (TYLCV) infection

Abstract Local and exotic germplasm of tomato remains a major source for genetic improvement. Assessment of such lines for biotic stresses particularly viral diseases are the most important criteria for selection in Pakistan, where Tomato Yellow Leaf Curl Virus (TYLCV) and Tomato Mosaic Virus (ToMV) are the major diseases/viruses. A set of 40 accessions (including indigenous Pakistani lines and exotic germplasm from Europe, the United States, and Asia) were evaluated for their resistance/infection response to ToMV with artificial inoculation under greenhouse conditions. Infection response was quantified through disease scoring and DAS-ELISA test (for ToMV). A subset of 24 lines, was further screened for TYLCV using disease scoring and TAS-ELISA. The tested lines showed significant variability for resistance to ToMV. Only one accession (Acc-17878) was resistant to the ToMV whereas seven accessions i.e. Acc-17890, AVR-261, CLN-312, AVR-321, EUR-333, CLN-352, and CLN-362 expressed resistance to TYLCV. Correlation between phenotypic evaluation was confirmed by the ELISA results in both diseases, although both tools complemented to assess the viral infection status. In future, tomato breeding programs must consider breeding for ToMV and TYLCV resistance (using identified germplasm in our study) so as to deliver virus resistant tomato varieties.

RESUMO O germoplasma local e exótico do tomate continua sendo uma importante fonte de melhoramento genético. A avaliação de linhagens para estresses bióticos, particularmente as doenças virais, é o critério mais importantes para seleção no Paquistão, onde o vírus da folha amarela do tomate (TYLCV) e o vírus do mosaico do tomateiro (ToMV) são as principais doenças/vírus. Um conjunto de 40 acessos (incluindo linhagens indígenas do Paquistão e germoplasma exótico da Europa, dos Estados Unidos e da Ásia) foi avaliado quanto à resistência/resposta à infecção ao ToMV com inoculação artificial em casa de vegetação. A resposta à infecção foi quantificada por meio de pontuação da doença e de teste DAS-ELISA (para ToMV). Um subconjunto de 24 linhas foi posteriormente rastreado para TYLCV usando pontuação de doença e TAS-ELISA. As linhas testadas apresentaram variabilidade significativa para resistência ao ToMV. Apenas um acesso (Acc-17878) foi resistente ao ToMV, enquanto sete acessos (Acc-17890, AVR-261, CLN-312, AVR-321, EUR-333, CLN-352 e CLN-362) expressaram resistência ao TYLCV. A correlação entre a avaliação fenotípica foi confirmada pelos resultados do ELISA nas duas doenças, embora ambas as ferramentas tenham se complementado para avaliar o estado da infecção viral. No futuro, os programas de melhoramento de tomate devem considerar aperfeiçoamentos para resistência ao ToMV e TYLCV (usando germoplasma identificado em nosso estudo) de modo a fornecer variedades de tomate resistentes a vírus.

A STUDY OF HEMATOLOGICAL AND BIOCHEMICAL PARAMETERS IN ASSESSING SEVERITY IN COVID-19 PATIENTS

Background: The severity of COVID-19 could be evaluated by examining several blood parameters mainly white blood cell (WBC) count, granulocytes, platelet, and novel hemocytometric markers neutrophils to lymphocyte ratio (NLR), platelet-to-lymphocyte (PLR),lymphocyte to monocyte ratio (LMR) and biochemical parameters such as CRP,D-dimer,Serum ferritin, LFT, KFT etc. The present study has been carried out Methods and Material: on 100 RTPCR conrmed covid-19 patients over a period of one year from July 2021 to June 2022. Clinical features, investigations, and history of associated risk factors were extracted from case records.Samples were processed in Medonic M series ve part haematology analyzer.SELECTRA PRO M and ARCHITECT plus machine was used for LDH, AST, ALT,C- reactive protein (CRP),Serum creatinine and serum urea.Samples for electrolytes were processed in INNOLYTE MACHINE. The sample for D-dimer and PT INR were processed in STA SETELLITE Max haemostasis analyser. Samples for procalcitonin were processed in CARDIAMARKER HIA-1200 machine.Chi squre test was used for analyzing signicant correlation among different parameters and covid-19 severity.P value<0.05 was dened as statistically signicant for all statistical test. Statistical analysis used: Results:Retrospective observational study Among 100 RTPCR conrmed cases,40,36,20 and 4 were mild, moderate, severe and critical respectively.Total total neutrophils count signicantly raised in critical patients(p value<0.05) while absolute lymphocyte count was signicantly decreased in critical patients(p value<0.05).NLR was signicantly raised in critical patients and LMR,PLR were also signicantly related to disease severity.CRP,S.ferritin and D- dimer were signicantly raised in critical patients(p value<0.05).Besides above parameters, Serum LDH,Serum electrolytes,AST,AL,.PT-INR were also raised in critically ill patients(p value<0.05). The severity of COVID-19 can Conclusions: be identied at an early stage by following the different routine biochemical marker levels and subsequently improve prognosis.parameters

Epidemiology of COVID-19 cases and vaccination coverage in Seremban District, Malaysia, 2021

@#Objective: Malaysia’s first case of coronavirus disease (COVID-19) was reported in January 2020, with the first case in the state of Negeri Sembilan diagnosed on 17 February 2020. The National COVID-19 Immunisation Programme commenced in early March 2021 in Negeri Sembilan. This study describes the COVID-19 cases and vaccination coverage in Seremban District, Negeri Sembilan, during 2021. Methods: The demographic and clinical characteristics of COVID-19 cases and the district’s vaccination coverage were described. Vaccination coverage was plotted against COVID-19 cases on the epidemic curve. The chi-square test was used to examine the differences between the vaccination status of COVID-19 cases and severity category, hospitalization status and mortality. Results: In Seremban District, there were 65 879 confirmed cases of COVID-19 in 2021. The data revealed that the 21–30-year age group had the highest proportion of cases (16 365; 24.8%), the majority of cases were male (58.3%), and most cases were from the sub-district of Ampangan (23.1%). The majority of cases were Malaysian. Over half (53.5%) were symptomatic, with fever (29.8%) and cough (22.8%) being the most frequently reported symptoms. COVID-19 vaccination status was significantly associated with severity category, hospitalization and mortality (P < 0.001 for all categories). Discussion: This is the first study to describe two-dose vaccination coverage and the trend in COVID-19 cases in Seremban District. It was observed that COVID-19 cases had been reduced following more than 60.0% vaccination coverage.

Predictive value of ALBI combined with in severe acute pancreatitis / 中华急诊医学杂志

Objective:To analyze the predictive value of serological measures within 24 hours of admission in acute pancreatitis patients against patients with severe acute pancreatitis(SAP), because the severity of acute pancreatitis was characterized by a timely assessment and prediction by emergency department physicians upon visit.Methods:A total of 119 acute pancreatitis patients admitted in Emergency Department in Beijing Jishuitan Hospital, Capital Medical University from January 2022 to December 2022 were retrospectively collected. According to the revised Atlanta classification, patients were characterized by mild acute pancreatitis group (77 cases), moderately severe acute pancreatitis group (27 cases), and SAP group (15 cases). Basic characteristics, early disease severity scores and early serological indexes of the three groups were compared, independent risk factors of serological indexes affecting the occurrence of SAP were analyzed, and receiver operator characteristic curve was drawn, evaluate the predictive value of related serological indexes for SAP.Results:There were no significant differences in the basic characteristics of the three groups including of gender, age, BMI, type of pancreatitis and complications ( P>0.05), but there were significant differences in early BISPA, Ranson, APACHEⅡ and Panc3 scores among the three groups ( P<0.05).Albumin-bilirubin score ( OR=3.653, 95% CI 1.665-8.012, P=0.001), blood urea nitrogen ( OR=1.117, 95% CI 1.039-1.202, P=0.003) were independent risk factors for SAP. The areas under ROC curve predicted by albumin-bilirubin score, blood urea nitrogen and albumin-bilirubin score combined with blood urea nitrogen were 0.762, 0.776 and 0.857, respectively, which showed no statistical difference compared with earlier Ranson, BISAP and APACHE Ⅱ scoring systems, respectively ( P>0.05). Conclusions:Early albumin-bilirubin score and blood urea nitrogen indexes of acute pancreatitis patients have good predictive value for SAP. Albumin-bilirubin score combined with blood urea nitrogen can improve the predictive value of SAP, and the predictive effect is as good as early Ranson, BISAP and APACHEⅡ scoring systems.

Clinical features of keratoconus and influencing factors of disease severity / 中华实验眼科杂志

Objective:To investigate the clinical characteristics of patients with keratoconus, and to explore the factors influencing keratoconus severity.Methods:A cross-sectional study was performed.A total of 908 patients (1 476 eyes) with primary keratoconus were enrolled in Henan Eye Hospital from January 2019 to December 2021.The medical history data of patients were collected by face-to-face questionnaire survey.Refractive parameters were measured by subjective optometry.Intraocular pressure (IOP) was measured by a non-contact tonometer, and corrected IOP was calculated by Dresden formula.Corneal topography parameters was obtained using Pentacam HR.The subgroup analysis of clinical characteristics of all patients was performed by age (<21 years, 21~<31 years, ≥31 years) and gender.Disease severity was graded based on steep keratometry (Ks), namely mild (Ks<48 D), moderate (48 D≤Ks<55 D) and severe (Ks≥55 D). The influencing factors of disease severity in keratoconus were analyzed by ordered Logistic regression.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2019[5]). All subjects or guardians were informed of the purpose and significance of the study and written informed consent was obtained.Results:Of the 908 patients, 622 were with bilateral keratoconus and 286 were with unilateral keratoconus.The median age of onset was 20(17, 26) years, and the median age of diagnosis was 21(18, 27) years.The ratio of males to females was 3.05∶1.There were 9.80%(89/908) of the patients having a history of allergy, 25.55%(232/908) having a history of other systemic diseases, and 1.98%(18/908) having a family history of keratoconus.Of the 1 476 affected eyes, 27.57%(407/1 476) were diagnosed as severe keratoconus, and 61.94%(568/917) had a history of eye rubbing.The medians of sphericity, cylindricity, IOP, corrected IOP, Ks, thinnest corneal thickness (TCT), anterior corneal surface elevation (AE) and posterior corneal surface elevation (PE) were -4.00(-7.00, -1.75)D, -3.50(-6.00, -1.50)D, 12.00(10.30, 13.80)mmHg, 15.40(13.60, 17.00)mmHg, 49.85(46.40, 54.90)D, 460.00(425.00, 490.00)μm, 21.00(13.00, 34.75)μm, 51.00(33.00, 75.00)μm, respectively.The spherical refraction, IOP and corrected IOP were lower and the cylindrical refraction was higher in patients at age <21 years than in patients at age 21~<31 years, and the TCT of patients at age <21 years was higher than that at age ≥31 years, and the differences were statistically significant (all at P<0.05). Compared with female patients, male patients had younger onset age, lower spherical refraction, IOP and corrected IOP, as well as higher cylindrical refraction, AE and PE, showing statistically significant differences (all at P<0.05). The spherical refraction and IOP of male patients were lower than those of female patients at age <21 years, and the cylindrical refraction was higher in males than in females among the patients at age 21~<31 years, and the differences were statistically significant (both at P<0.05). Among the patients with onset age <21 years and diagnosis age <21 years, the ratio of males to females in patients with severe keratoconus was higher than those with mild and moderate disease, and the difference was statistically significant (both at P<0.05). Older age of onset was a protective factor for disease severity in keratoconus (odds ratio=0.981, 95% confidence interval: 0.963~0.999). Conclusions:The younger the onset age of keratoconus patients, the more severe the disease.Among the patients with severe keratoconus, there were more male patients, and males have a younger onset age and severer conditions.It is suggested that early screening of keratoconus in children and adolescents should be strengthened in clinical work, and more active prevention and treatment measures should be taken for younger patients, especially males.

Correlation of serum immunoglobulins levels with disease severity and nutritional indexes in elderly patients with heart failure / 中国医师进修杂志

Objective:To observe the correlation between serum immunoglobulins levels with the disease severity and nutritional indexes in elderly patients with heart failure.Methods:The clinical data of 53 elderly patients with heart failure (observation group) from October 2020 to January 2022 in the Affiliated Hospital of Ningbo University Medical College were retrospectively analyzed, and 53 cases of health examination at the same time were selected as the control group. The disease severity was assessed by a 6-minute walk test (6MWT), and nutritional status was assessed by nutritional index. The serum levels of IgA, IgM and IgG were measured by PUZS-300 fully automated biochemical analyzer; the serum nutrient indexes were measured by enzyme linked immunosorbent assay, including total protein, albumin and proalbumin. Pearson method was used for correlation test; the value of IgA, IgM and IgG in predicting disease severity in elderly patients with heart failure was analyzed by the receiver operating characteristic (ROC) curve.Results:The IgA, IgM and IgG in observed group were significantly higher than those in control group: (4.31 ± 1.50) g/L vs. (1.63 ± 0.71) g/L, (18.50 ± 3.93) g/L vs. (11.33 ± 1.12) g/L and (4.58 ± 1.26) g/L vs. (1.96 ± 0.36) g/L, and there were statistical differences ( P<0.01). The 6MWT result showed that 23 cases were with mild status, 18 cases moderate, and 12 cases severe. The IgA, IgM and IgG in moderate and severe patients were significantly higher than those in mild patients: (4.34 ± 0.78) and (6.38 ± 0.91) g/L vs. (3.23 ± 0.94) g/L, (18.90 ± 2.09) and (23.81 ± 2.78) g/L vs. (15.44 ± 2.03) g/L, (4.77 ± 0.56) and (6.47 ± 0.34) g/L vs. (3.45 ± 0.44) g/L, the indexes in severe patients were significantly higher than those in moderate patients, and there were statistical differences ( P<0.05). Pearson correlation analysis result showed that IgA, IgM and IgG were positively correlated with disease severity in elderly patients with heart failure ( r = 0.801, 0.830 and 0.925; P<0.01). The nutritional index result showed that malnutrition was in 25 cases, and normal nutrition in 28 cases. The IgA, IgM and IgG in patients with malnutrition were significantly higher than those in patients with normal nutrition: (4.89 ± 0.80) g/L vs. (1.98 ± 0.69) g/L, (19.45 ± 2.01) g/L vs. (12.01 ± 1.28) g/L and (4.88 ± 0.59) g/L vs. (2.01 ± 0.47) g/L, the nutritional index, total protein, albumin and proalbumin were significantly lower than those in patients with normal nutrition: (49.44 ± 6.98) scores vs. (58.34 ± 8.12) scores, (62.87 ± 5.20) g/L vs. (66.74 ± 4.54) g/L, (33.21 ± 2.64) g/L vs. (39.12 ± 3.11) g/L and (185.55 ± 16.72) mg/L vs. (196.33 ± 18.90) mg/L, and there were statistical differences ( P<0.01 or <0.05). Pearson correlation analysis result showed that the IgA and IgM were negatively correlated with nutritional index, total protein, albumin and proalbumin in elderly patients with heart failure (IgA: r = - 0.456, - 0.353, -0.620 and -0.281; IgM: r = -0.445, -0.327, -0.611 and -0.321; P<0.01 or <0.05); IgG was negatively correlated with nutritional index, total protein and albumin ( r = - 0.425, - 0.359 and - 0.646; P<0.01), and it had no correlation with proalbumin ( P>0.05). ROC curve analysis result showed that the areas under the curve of IgA, IgM and IgG in predicting disease severity in elderly patients with heart failure were 0.891, 0.943 and 0.838, sensitivity of 76.70%, 90.00% and 73.33%, and specificity of 87.00%, 87.00% and 100.00%. Conclusions:The serum levels of IgA, IgM and IgG increased significantly in elderly patients with heart failure, who were also with abnormal immune function and decreased nutritional status. The serum levels of IgA, IgM and IgG correlate with disease severity and nutritional indexes.

Association of New Generation Anti-CCP Antibodies with Disease Severity and Functional Status in Rheumatoid Arthritis Patients

@#Introduction: Detection of anti-cyclic citrullinated peptide (anti-CCP) antibodies in patients with rheumatoid arthritis (RA) is associated with higher disease activity and lower functional ability. This study investigated the presence of the new generation of anti-CCP antibodies (anti-CCP2 IgG, anti-CCP2 IgA and anti-CCP3.1 IgG/IgA) and their association with disease severity and functional status of RA patients. Methods: A total of 46 RA patients and 40 healthy controls participated in this cross-sectional study that was conducted at the Rheumatology Clinic, Hospital Universiti Sains Malaysia. Blood samples were taken from all participants for anti-CCP2 IgG, anti-CCP2 IgA, and anti-CCP3.1 IgG/IgA analysis. Disease severity and functional status of RA patients were measured using the Disease Activity Score-28 (DAS28) and the modified Health Assessment Questionnaire (mHAQ) respectively. Results: Significantly higher proportion of RA patients were found with positive anti-CCP2 IgG (63.0%), anti-CCP2 IgA (37.0%), and anti-CCP3.1 IgG/IgA antibodies (63.0%) than the healthy controls. No significant association was found between anti-CCP antibodies status and mean DAS28 score of the RA patients. However, RA patients with negative anti-CCP2 IgG status had higher mean mHAQ score than patients with positive anti-CCP2 IgG status. Conclusion: Our study has demonstrated detection of the new generation anti-CCP antibodies in RA patients, supporting the use of autoantibodies in RA diagnosis. While no significant association was found between the presence of anti-CCP antibodies and disease severity of RA patients, the absence of anti-CCP2 IgG was associated with worse function and greater disability of the patients.

SARS-CoV-2 RT-PCR cycle threshold value and its association with disease severity and mortality among hospitalized pediatric COVID-19 patients

Objective@#This study determined the association of SARS-CoV-2 RT-PCR cycle threshold (Ct) value with disease severity and mortality among hospitalized pediatric COVID-19 patients.@*Methodology@#This is a retrospective cohort study of patients aged 0-18 years with SARS-CoV-2 RT-PCR-confirmed COVID-19 from 1-September-2020 to 31-August-2022. The cohort was divided into those with high (>30), medium (> 20) and low (</= 20) Ct values. Association between Ct values and disease severity was determined using Chi-square test and association between Ct values and mortality was determined using logistic regression.@*Results@#There were 236 patients included with male predominance. Median age was 7 years. Most belonged to the 0-5 years age group. Most were severe to critical COVID-19 cases. Median day of illness on swab collection was 4 days. Majority presented with symptoms such as fever (54%), cough (22%) and dyspnea (22%). Eighty-four percent had co-morbidities, of which majority were cancer and neurologic diseases. Median Ct value was 30.81. Fifty-four percent had high Ct values. The median age of patients with a high Ct value was significantly lower than other cohorts. The median day of illness of patients with low Ct value was significantly shorter than other cohorts. There was no significant difference across the terciles in terms of presence of co-morbidities. Majority of patients for each cohort had high Ct values. There was no significant association between Ct value and COVID-19 disease severity on admission. Nearly fifty percent had critical disease and the all-cause mortality rate was 21.61%. There was no significant association between Ct value and mortality.@*Conclusions@#Ct value was not associated with disease severity and all-cause mortality after controlling for confounders. A look into medical interventions, emergence of variants, and other factors that may affect the clinical presentation, disease course, severity and outcome are recommended in future studies.

Predictive value of nutritional risk index, systemic immune inflammation index and triglyceride glucose index on the condition and prognosis of patients with acute pancreatitis / 西安交通大学学报(医学版)

【Objective】 To investigate the predictive value of nutritional risk index (NRI), systemic immune inflammatory index (SⅡ) and triglyceride glucose (TyG) index on the condition and prognosis of patients with acute pancreatitis (AP). 【Methods】 A total of 173 AP patients were divided into mild acute pancreatitis (MAP) group (n=79), moderate acute pancreatitis (MSAP) group (n=44), and severe acute pancreatitis (SAP) group (n=50) according to their severity. All the 50 SAP patients were divided into death group (19 cases) and survival group (31 cases) according to the death situation. The NRI, SⅡ and TyG indexes of each group were recorded and compared. The values of NRI, SⅡ and TyG index in predicting the occurrence and death of SAP were analyzed with ROC curve. Pearson correlation analysis of the correlation between NRI, SⅡ, and TyG index in SAP patients was made. 【Results】 NRI was significantly lower in SAP group (89.25±4.50) than in MSAP group (93.40±6.25) and MAP group (97.62±8.60), while SⅡand TyG index in SAP group (2 706.30±1 052.74, 7.84±1.21) were significantly higher than those in MSAP group (1 937.24±983.48, 6.52±1.05) and MAP group (1 280.58±717.36, 4.65±0.58) (P<0.001). NRI in death group (86.40±3.70) was significantly lower than that in survival group (91.46±5.28), while SⅡ and TyG index in death group (3 085.73±1 192.48, 9.05±1.37) were significantly higher than those in survival group (2 270.26±994.53, 6.70±1.10) (P<0.001). The ROC curve showed that the AUC of NRI, SⅡ and TyG index jointly predicting SAP occurrence and death was 0.850 (95% CI: 0.792-0.908) and 0.905 (95% CI: 0.843-0.966), respectively. Correlation analysis showed that NRI was negatively correlated with SⅡ and TyG index in SAP patients (r=-0.761, P<0.001, r=-0.813, P<0.001), while SⅡ was positively correlated with TyG index (r=0.842, P<0.001). 【Conclusion】 NRI, SⅡ and TyG index are related to the severity and death of AP patients, and the combination of the three indexes has good value in predicting the occurrence and prognosis of SAP.

Correlation between levels of hs-CRP and PCT in serum and alveolar fluid and disease severity in children with lobar pneumonia / 中国热带医学

@#Abstract: Objective　To explore the correlation between levels of hypersensitive C-reactive protein (hs-CRP) and procalcitonin (PCT) in serum and alveolar fluid and severity of disease in children with lobar pneumonia. Methods　A total of 112 children diagnosed with lobar pneumonia from September 2020 to September 2021 were selected as the research subjects. The levels of hs-CRP and PCT in serum and alveolar fluid were detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). The children were divided into severe group (clinical pulmonary infection score, CPIS≥6 points) and mild group (CPIS<6 points) according to the severity of disease, and further classified into good prognosis group (cured, improved) and poor prognosis group (uncured) according to their treatment outcomes. The correlation of levels of hs-CRP and PCT in serum and alveolar fluid with disease severity in children and their predictive value on prognosis were analyzed. Results　The levels of serum hs-CRP and PCT in severe group were (17.73±3.26) μg/L and (8.59±1.84) μg/L, which were significantly higher than corresponding (12.58±3.09) μg/L, and (5.62±1.59) μg/L in mild group (P<0.05); the levels of hs-CRP and PCT in alveolar fluid in severe group were (21.25±4.18) μg/L and (8.71±1.54) μg/L, which were significantly higher than corresponding (13.79±2.76) μg/L and (5.38±1.69) μg/L in mild group (P<0.05). The levels of hs-CRP and PCT in serum and alveolar fluid were positively correlated with CPIS scores (r=0.398, 0.441; 0.475, 0.586, P<0.05). The levels of hs-CRP and PCT in serum in poor prognosis group were (20.09±4.20) μg/L and (13.35±2.91) μg/L, which were significantly higher corresponding (8.75±2.19) μg/L and (6.28±1.31) μg/L in good prognosis group (P<0.05). The levels of hs-CRP and PCT in alveolar fluid were (23.70±4.29) μg/L and (10.73±2.04) μg/L, which were higher than corresponding (15.08±3.56) μg/L and (5.79±1.10) μg/L in poor prognosis group (P<0.05). There was no significant difference in AUC between combined detection of serum indicators and combined detection of alveolar perfusion fluid indicators in predicting the prognosis of children with lobar pneumonia (P>0.05). Conclusions　The levels of hs-CRP and PCT in serum and alveolar fluid of children with lobar pneumonia are significantly increased and positively correlated with the severity of disease. However, the predictive value of the combined detection of serum indicators and combined detection of alveolar perfusion fluid indicators for the prognosis of children with lobar pneumonia is comparable.

Correlation between macrophage chemotaxis and disease severity in patients with knee osteoarthritis / 中国骨伤

OBJECTIVE@#To investigate the enhancement of macrophage chemotaxis in patients with knee osteoarthritis (KOA) and its correlation with the disease severity.@*METHODS@#Eighty patients with KOA admitted from July 2019 to June 2022 were enrolled as the observation group and divided into 29 cases of moderate group, 30 cases of severe group and 21 cases of extremely severe group. At the same time, 30 healthy subjects were included as the control group. The gene expressions of NF-κB, CXC chemokine receptor 7 (CXCR7) and CXC chemokine ligand 12 (CXCL12) in macrophages of each group were analyzed. Visual analogue scale(VAS) was used to evaluate the degree of joint pain. Joint function was evaluated by knee Joint Society Scoring system(KSS). Finally, data analysis was carried out.@*RESULTS@#The expression levels of NF-κB, CXCR7 and CXCL12 in moderate group, severe group and extreme recombination group were higher than those in control group. The VAS, the expression of NF-κB, CXCR7 and CXCL12 in the severe group and the extreme recombination group were higher than those in the moderate group, whereas KSS was lower than that in the moderate group. The VAS, expression levels of NF-κB, CXCR7 and CXCL12 in the extremely severe group were higher than those in the severe group, and KSS was lower than that in the severe group (all P<0.01). The expression levels of NF-κB, CXCR7 and CXCL12 in macrophages were positively correlated with VAS score, but negatively correlated with KSS(all P<0.01). The expression levels of NF-κB, CXCR7 and CXCL12 in macrophages were positively correlated with the severity of disease. After excluding the influence of traditional factors (gender, age and disease duration), multiple linear regression analysis further showed that the expression levels of NF-κB, CXCR7 and CXCL12 were still positively correlated with the severity of disease(all P<0.01).@*CONCLUSION@#The chemotaxis of macrophages in patients with KOA increased with the aggravation of the disease, and was related to the degree of pain and function impairment.

Diagnostic value of serum ferritin as an indicator of disease severity in children with dengue infection

Background: Dengue fever is an acute febrile illness, ranging from asymptomatic to severe state in connection with hosts immune response. Several biochemical markers such as decreased platelet count, prolonged prothrombin duration, and increased hematocrit level have been recommended to evaluate disease severity. Due to lack of their clinical relevance, evaluation of serum ferritin is distinguishing feature to predict the disease severity at the early stage of infection. Aims and Objectives: The aim of the study was to assess the levels of serum ferritin as an early predictor of infection severity in children with dengue fever. Materials and Methods: Seventy-four patients diagnosed with dengue fever by non-structural protein 1 antigen positive and ?12 years of age were recruited. Hematological investigation such as platelet count, C-reactive protein (CRP), complete blood picture, liver function tests, renal function tests, and serum ferritin was assessed. Cases were monitored for disease progression status and platelet count too. Categorical variables were assessed by Chi-square test and descriptive statistics were used to represent demographic data. Results: The mean differences of the levels of platelet count, CRP, total cholesterol, triglycerides, and low-density lipoprotein were statistically significant among severe and non-severe dengue cases. Serum ferritin levels in children with severe dengue fever showed 876.42 ng/ml, 1048.94 ng/ml and 1573.20 ng/ml on 3rd, 4th, and 5th day, respectively. Whereas, cases with non-severe dengue showed 431.12 ng/ml, 612.20 ng/ml, and 698.41 ng/ml on 3rd, 4th, and 5th day, respectively. Conclusion: Serum ferritin levels were significantly increased with severity dengue fever on 3rd, 4th, and 5th day of infection. Thus, serum ferritin is an efficient biomarker in estimating the dengue fever severity and progression at early stage of infection in children.