BACKGROUND Identification of myocardial injury has traditionally relied on high-sensitivity troponin T(hs-TnT)levels exceeding the 99th percentile threshold.However,patients with detectable hs-TnT levels below this th...BACKGROUND Identification of myocardial injury has traditionally relied on high-sensitivity troponin T(hs-TnT)levels exceeding the 99th percentile threshold.However,patients with detectable hs-TnT levels below this threshold represent a heterogeneous group with an inadequately characterized risk profile.AIM To investigate the association between hs-TnT levels below the 99th percentile and the presence of diabetic kidney disease(DKD)in patients with diabetes mellitus.METHODS This study analyzed data from the National Health and Nutrition Examination Survey obtained between 1999 and 2004,focusing on adults with type 2 diabetes mellitus.Serum hs-TnT concentrations were evaluated.DKD was defined as impaired glomerular filtration rate(<60 mL/minute/1.73 m^(2)),proteinuria(urinary albumin-to-creatinine ratio of≥30 mg/g),or both conditions in patients with diabetes mellitus.Weighted multivariable logistic regression analysis and restricted cubic spline analyses were employed to examine the independent association between hs-TnT and DKD,with the likelihood ratio test being used to evaluate nonlinearity.RESULTS The study included 2505 patients with a mean age of 55.02(standard error:0.72)years,of whom 44.87%were females.Among the participants,909(32.34%)were diagnosed with DKD.Multivariable logistic regression analysis indicated that,compared to the lowest tertile of hs-TnT(<5.93 ng/L),tertile 2(5.94-9.79 ng/L)had an odds ratio of 1.25(95%confidence interval:0.77-2.02,P=0.350),while tertile 3(9.80-21.88 ng/L)had an odds ratio of 2.07(95%confidence interval:1.13-3.80,P=0.022),with a significant trend(P for trend=0.022).Smoothed curve fitting demonstrated a linear association between hs-TnT levels and DKD in the overall population(P=0.061 for nonlinearity)and in male(P=0.136 for nonlinearity)and female(P=0.067 for nonlinearity)subgroups.Further stratification and sensitivity analyses yielded consistent conclusions.CONCLUSION Our study findings suggest that in individuals with type 2 diabetes,detectable hs-TnT levels below the 99th percentile are associated with DKD.展开更多
目的:基于组织常驻记忆性T细胞(tissue resident memory T cells,T_(RM))探讨刺络放血对咪喹莫特诱导的复发型银屑病小鼠的影响及作用机制。方法:采用背部涂抹咪喹莫特乳膏(Imiquimod,IMQ)二次诱导的方法建立复发型银屑病模型。将实验...目的:基于组织常驻记忆性T细胞(tissue resident memory T cells,T_(RM))探讨刺络放血对咪喹莫特诱导的复发型银屑病小鼠的影响及作用机制。方法:采用背部涂抹咪喹莫特乳膏(Imiquimod,IMQ)二次诱导的方法建立复发型银屑病模型。将实验随机分为分为正常对照组、模型组、刺络放血组、阳性对照组4组,每组6只C57BL/6小鼠,造模后刺络放血组小鼠在背部皮损夹脊穴区域进行刺络放血,阳性对照组小鼠在背部皮损区域均匀涂抹卡泊三醇软膏,正常对照组、模型组小鼠只抓取,不治疗,共治疗6 d。记录各组小鼠背部皮肤表现并进行银屑病面积与严重程度指数(PASI)评分;取各组小鼠背部皮肤HE染色法观察皮肤组织形态表现并行表皮厚度测量,免疫组化及流式细胞术检测各组小鼠背部皮肤组织CD_(8)^(+)T_(RM)与CD_(69)表达。结果:与正常对照组相比,模型组小鼠明显可见红斑、鳞屑、皮肤增厚等表现,PASI评分显著升高,病理切片可见角化过度、炎性细胞浸润、局部出血及表皮层明显增厚(P<0.01);与模型组相比,刺络放血组小鼠红斑、鳞屑、皮肤增厚等表现均减轻,PASI评分降低,病理切片角化过度、炎性细胞浸润、局部出血程度减轻,表皮层增厚减轻(P<0.05);刺络放血组与阳性对照组比较,差异无统计学意义(P>0.05)。与正常对照组相比,模型组小鼠背部皮肤组织CD_(8)^(+)T_(RM)及CD_(69)阳性细胞数显著增多(P<0.01);与模型组相比,刺络放血组小鼠背部皮肤组织CD_(8)^(+)T_(RM)及CD_(69)阳性细胞数有所减少(P<0.05);刺络放血组与阳性对照组比较,差异无统计学意义(P>0.05)。结论:刺络放血可能通过抑制机体T_(RM)细胞的表达起到改善银屑病的作用。展开更多
基金This study was approved by the Medical Ethics Committee of the Second Affiliated Hospital of Gannan Medical University(approval No.EFYJ20240113007).
文摘BACKGROUND Identification of myocardial injury has traditionally relied on high-sensitivity troponin T(hs-TnT)levels exceeding the 99th percentile threshold.However,patients with detectable hs-TnT levels below this threshold represent a heterogeneous group with an inadequately characterized risk profile.AIM To investigate the association between hs-TnT levels below the 99th percentile and the presence of diabetic kidney disease(DKD)in patients with diabetes mellitus.METHODS This study analyzed data from the National Health and Nutrition Examination Survey obtained between 1999 and 2004,focusing on adults with type 2 diabetes mellitus.Serum hs-TnT concentrations were evaluated.DKD was defined as impaired glomerular filtration rate(<60 mL/minute/1.73 m^(2)),proteinuria(urinary albumin-to-creatinine ratio of≥30 mg/g),or both conditions in patients with diabetes mellitus.Weighted multivariable logistic regression analysis and restricted cubic spline analyses were employed to examine the independent association between hs-TnT and DKD,with the likelihood ratio test being used to evaluate nonlinearity.RESULTS The study included 2505 patients with a mean age of 55.02(standard error:0.72)years,of whom 44.87%were females.Among the participants,909(32.34%)were diagnosed with DKD.Multivariable logistic regression analysis indicated that,compared to the lowest tertile of hs-TnT(<5.93 ng/L),tertile 2(5.94-9.79 ng/L)had an odds ratio of 1.25(95%confidence interval:0.77-2.02,P=0.350),while tertile 3(9.80-21.88 ng/L)had an odds ratio of 2.07(95%confidence interval:1.13-3.80,P=0.022),with a significant trend(P for trend=0.022).Smoothed curve fitting demonstrated a linear association between hs-TnT levels and DKD in the overall population(P=0.061 for nonlinearity)and in male(P=0.136 for nonlinearity)and female(P=0.067 for nonlinearity)subgroups.Further stratification and sensitivity analyses yielded consistent conclusions.CONCLUSION Our study findings suggest that in individuals with type 2 diabetes,detectable hs-TnT levels below the 99th percentile are associated with DKD.
文摘目的探讨增强T2^(*)加权血管成像(enhanced T2 star-weighted angiography,ESWAN)序列中R2^(*)值、相位值、幅度值在T2WI低信号肾脏病变良恶性鉴别诊断中的可行性。材料与方法回顾性收集行ESWAN检查、经病理组织学证实的145例T2WI低信号肾脏病变患者(共145个病灶,恶性病变112个,良性病变33个)的术前MRI图像。在肿瘤最大面积的层面上绘制肿瘤T2WI低信号的感兴趣区。通过Kruskal-Wallis检验、卡方检验对参数进行比较,将有统计学意义的参数进行联合,通过多变量logistic回归建立模型,分析差异有统计学意义的参数,并且绘制其鉴别T2WI低信号肾脏病变良恶性的受试者工作特征(receiver operating characteristic,ROC)曲线,采用DeLong检验评价其诊断效能。结果R2^(*)值和幅度值鉴别T2WI低信号肾脏病变良恶性差异具有统计学意义(P=0.001)。R2^(*)值的ROC曲线下面积(area under the curve,AUC)为0.891[95%置信区间(confidence interval,CI):0.829~0.937,P<0.001],敏感度、特异度分别为97.3%、72.7%;幅度值的AUC为0.869(95%CI:0.803~0.920,P<0.001),敏感度、特异度分别为86.6%、81.8%;相位值的AUC为0.563(95%CI:0.478~0.645,P=0.249),敏感度、特异度分别为67.9%、54.6%;R2^(*)值联合幅度值的AUC为0.886(95%CI:0.823~0.933,P<0.001),敏感度、特异度分别为97.3%、72.7%;R2^(*)值联合病变长径的AUC为0.894(95%CI:0.832~0.939,P<0.001),敏感度、特异度分别为92.0%、81.8%;幅度值联合病变长径的AUC为0.858(95%CI:0.790~0.910,P<0.001),敏感度、特异度分别为75.9%、90.9%。结论R2^(*)值、R2^(*)值联合病变长径、R2^(*)值联合幅度值是鉴别T2WI低信号肾脏病变良恶性的有效方法,R2^(*)值联合病变长径具有更好的诊断性能。
