Admission white blood cell count predicts short-term clinical outcomes in patients with uncomplicated Stanford type B acute aortic dissection

Objectives Inflammation has been shown to be related with acute aortic dissection （AAD）. The present study aimed to evaluate the association of white blood cell counts （WI3Cc） on admission with both in-hospital and long-term all-cause mortality in patients with uncom- plicated Stanford type B AAD. Methods From 2008 to 2010, a total of 377 consecutive patients with uncomplicated type B AAD were enrolled and then followed up. Clinical data and WBCc on admission were collected. The primary end points were in-hospital death and long-term all-cause death. Results The in-hospital death rate was 4.2%, and the long-term all-cause mortality rate was 6.9% during a median follow-up of 18.9 months. WBCc on admission was identified as a risk factor for in-hospital death by univariate Cox regression analysis as both a continuous variable and a categorical variable using a cut off of 11.0 × 109 cell/L （all P 〈 0.05）. After adjusting for age, sex and other risk factors, elevated admission WBCc was still a significant predictor for in-hospital death as both a continuous variable [hazard ratio （HR）： 1.052, 95% CI： 1.024-1.336, P = 0.002] and a categorical variable using a cut off of 11.0 × 109 cell/L （HR： 2.056, 95% CI： 1.673-5.253, P = 0.034）. No relationship was observed between WBCc on admission and long-term all-cause death. Conclusions Our results indicate that elevated WBCc upon admission might be used as a predictor for increased risk of in-hospital death in uncomplicated type B AAD. There might be no predictive value of WBCc for the long-term survival of type B AAD.

Usefulness of white blood cell count to mean platelet volume ratio for predicting long-term prognosis after primary percutaneous coronary intervention in patients with acute coronary syndrome

Background and Objective The white blood cell count to mean platelet volume ratio(WMR)has recently been described as a predictor of cardiovascular events in patients who undergo percutaneous coronary intervention(PCI).The aim of this study was to investigate the usefulness of admission WMR in predicting outcomes in patients with acute coronary syndrome(ACS).

Elevated White Blood Cell Count Is Associated with an Increased Risk of Insulin Resistance among Non-Diabetic Taxi-Motorbike Drivers Working in Cotonou, Benin

High white blood cell count (WBC) and insulin resistance (IR) are interrelated events that contribute to non-communicable diseases (NCDs), including type-2 diabetes (T2D). However, associations between IR and hematological parameters have never been explored in populations of Benin. The aims of this study were to determine the prevalence of IR and associated hematological parameters in taxi-motorbike drivers (TMDs) working in Cotonou. A total of 133 participants were analyzed in this cross-sectional study. Complete blood count, including WBC and platelet, as well as fasting plasma glucose and insulin, were performed by standard procedures. IR was assessed using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Factors associated with IR, their odds ratios (ORs) and 95% confidence intervals (CIs) were determined by logistic regression analysis. The mean age of the study participants was 39.3 years. The HOMA-IR cut-off (75th percentile) for IR was 5.9. The overall prevalence of IR was 24.1%. IR increased with the increase of exposure duration and WBC levels. Logistic regression analysis revealed that the risk of IR increased significantly with higher total WBC, with adjusted ORs (95% CI) for the second and third tertiles of 3.56 (1.10 - 11.58) and 4.01 (1.21 - 13.31), respectively. Similar patterns of associations were observed in an analysis restricted to non-drinkers, although these estimates lacked statistical significance. BMI > 24.2 kg/m2 was independently associated with an increased risk of IR (OR = 3.82, 95% CI: 1.33 - 11.03, P = 0.013). In conclusion, the prevalence of IR in TMDs was 24.1%. IR was significantly associated with elevated WBC count and BMI. WBC may serve as a biomarker to identify individuals at the greatest IR risk.

Blood cell counts and nonalcoholic fatty liver disease: Evidence from Mendelian randomization analysis

BACKGROUND Previous research has highlighted correlations between blood cell counts and chronic liver disease.Nonetheless,the causal relationships remain unknown.AIM To evaluate the causal effect of blood cell traits on liver enzymes and nonalcoholic fatty liver disease(NAFLD)risk.METHODS Independent genetic variants strongly associated with blood cell traits were extracted from a genome-wide association study(GWAS)conducted by the Blood Cell Consortium.Summary-level data for liver enzymes were obtained from the United Kingdom Biobank.NAFLD data were obtained from a GWAS meta-analysis(8434 cases and 770180 controls,discovery dataset)and the Fingen GWAS(2275 cases and 372727 controls,replication dataset).This analysis was conducted using the inverse-variance weighted method,followed by various sensitivity analyses.RESULTS One SD increase in the genetically predicted haemoglobin concentration(HGB)was associated with aβof 0.0078(95%CI:0.0059-0.0096),0.0108(95%CI:0.0080-0.0136),0.0361(95%CI:0.0156-0.0567),and 0.0083(95%CI:00046-0.0121)for alkaline phosphatase(ALP),alanine aminotransferase(ALT),aspartate aminotransferase,and gammaglutamyl transferase,respectively.Genetically predicted haematocrit was associated with ALP(β=0.0078,95%CI:0.0052-0.0104)and ALT(β=0.0057,95%CI:0.0039-0.0075).Genetically determined HGB and the reticulocyte fraction of red blood cells increased the risk of NAFLD[odds ratio(OR)=1.199,95%CI:1.087-1.322]and(OR=1.157,95%CI:1.071-1.250).The results of the sensitivity analyses remained significant.CONCLUSION Novel causal blood cell traits related to liver enzymes and NAFLD development were revealed through Mendelian randomization analysis,which may facilitate the diagnosis and prevention of NAFLD.

Data augmentation of ultrasound imaging for non-invasive white blood cell in vitro peritoneal dialysis

The limited amount of data in the healthcare domain and the necessity of training samples for increased performance of deep learning models is a recurrent challenge,especially in medical imaging.Newborn Solutions aims to enhance its non-invasive white blood cell counting device,Neosonics,by creating synthetic in vitro ultrasound images to facilitate a more efficient image generation process.This study addresses the data scarcity issue by designing and evaluating a continuous scalar conditional Generative Adversarial Network(GAN)to augment in vitro peritoneal dialysis ultrasound images,increasing both the volume and variability of training samples.The developed GAN architecture incorporates novel design features:varying kernel sizes in the generator’s transposed convolutional layers and a latent intermediate space,projecting noise and condition values for enhanced image resolution and specificity.The experimental results show that the GAN successfully generated diverse images of high visual quality,closely resembling real ultrasound samples.While visual results were promising,the use of GAN-based data augmentation did not consistently improve the performance of an image regressor in distinguishing features specific to varied white blood cell concentrations.Ultimately,while this continuous scalar conditional GAN model made strides in generating realistic images,further work is needed to achieve consistent gains in regression tasks,aiming for robust model generalization.

Automated White Blood Cell Disease Recognition Using Lightweight Deep Learning

White blood cells(WBC)are immune system cells,which is why they are also known as immune cells.They protect the human body from a variety of dangerous diseases and outside invaders.The majority of WBCs come from red bone marrow,although some come from other important organs in the body.Because manual diagnosis of blood disorders is difficult,it is necessary to design a computerized technique.Researchers have introduced various automated strategies in recent years,but they still face several obstacles,such as imbalanced datasets,incorrect feature selection,and incorrect deep model selection.We proposed an automated deep learning approach for classifying white blood disorders in this paper.The data augmentation approach is initially used to increase the size of a dataset.Then,a Darknet-53 pre-trained deep learning model is used and finetuned according to the nature of the chosen dataset.On the fine-tuned model,transfer learning is used,and features engineering is done on the global average pooling layer.The retrieved characteristics are subsequently improved with a specified number of iterations using a hybrid reformed binary grey wolf optimization technique.Following that,machine learning classifiers are used to classify the selected best features for final classification.The experiment was carried out using a dataset of increased blood diseases imaging and resulted in an improved accuracy of over 99%.

White Blood Cells Detection Using Spectral Tresholding

The study of the morphology of White Blood Cells (WBCs) further contributes to the clinical diagnosis of blood diseases. In this research paper, we come up with an image segmentation enhancement by combining Fourier Fast Transform on smear blood capture and classical thresholding. The Fast Fourier Transform (FFT) is a very powerful tool in image processing and it was used to segment and extract the WBCs. Our image processing method uses a Fast Fourier Transform combined with filtering and an Inverse Fast Fourier Transform for the extraction and visualization of the high frequency region of the image. In order to remove residual Red Blood Cells acting as noise in the expected result, a final thresholding step is added at the end of the processing. The results presented in this article report the tests performed using our mathematical implementation. Moreover, we were able to detect and differentiate the sub-families of WBCs.

Automated Artificial Intelligence Empowered White Blood Cells Classification Model

White blood cells (WBC) or leukocytes are a vital component ofthe blood which forms the immune system, which is accountable to fightforeign elements. The WBC images can be exposed to different data analysisapproaches which categorize different kinds of WBC. Conventionally, laboratorytests are carried out to determine the kind of WBC which is erroneousand time consuming. Recently, deep learning (DL) models can be employedfor automated investigation of WBC images in short duration. Therefore,this paper introduces an Aquila Optimizer with Transfer Learning basedAutomated White Blood Cells Classification (AOTL-WBCC) technique. Thepresented AOTL-WBCC model executes data normalization and data augmentationprocess (rotation and zooming) at the initial stage. In addition,the residual network (ResNet) approach was used for feature extraction inwhich the initial hyperparameter values of the ResNet model are tuned by theuse of AO algorithm. Finally, Bayesian neural network (BNN) classificationtechnique has been implied for the identification of WBC images into distinctclasses. The experimental validation of the AOTL-WBCC methodology isperformed with the help of Kaggle dataset. The experimental results foundthat the AOTL-WBCC model has outperformed other techniques which arebased on image processing and manual feature engineering approaches underdifferent dimensions.

A Novel Meta-Heuristic Optimization Algorithm in White Blood Cells Classification

Some human diseases are recognized through of each type of White Blood Cell(WBC)count,so detecting and classifying each type is important for human healthcare.The main aim of this paper is to propose a computer-aided WBCs utility analysis tool designed,developed,and evaluated to classify WBCs into five types namely neutrophils,eosinophils,lymphocytes,monocytes,and basophils.Using a computer-artificial model reduces resource and time consumption.Various pre-trained deep learning models have been used to extract features,including AlexNet,Visual Geometry Group(VGG),Residual Network(ResNet),which belong to different taxonomy types of deep learning architectures.Also,Binary Border Collie Optimization(BBCO)is introduced as an updated version of Border Collie Optimization(BCO)for feature reduction based on maximizing classification accuracy.The proposed computer aid diagnosis tool merges transfer deep learning ResNet101,BBCO feature reduction,and Support Vector Machine(SVM)classifier to forma hybridmodelResNet101-BBCO-SVM an accurate and fast model for classifying WBCs.As a result,the ResNet101-BBCO-SVM scores the best accuracy at 99.21%,compared to recent studies in the benchmark.The model showed that the addition of the BBCO algorithm increased the detection accuracy,and at the same time,decreased the classification time consumption.The effectiveness of the ResNet101-BBCO-SVM model has been demonstrated and beaten in reasonable ratios in recent literary studies and end-to-end transfer learning of pre-trained models.

NEW METHOD FOR WHITE BLOOD CELL DETECTION BASED ON RELEVANCE VECTOR MACHINE

A new method for the white blood cell （WBC） detection is presented based on the relevance vector machine （RVM）. Firstly,the sparse relevance vectors （RVs） are obtained while fitting the 1-D histogram by RVM. Then,the needed threshold value is directly selected from these limited RVs. Finally,the entire connective WBC regions are segmented from the original image. The method is used for the WBC detection. It reduces the interference induced by the illumination and the staining. It has advantages of the high computation efficiency and the no extra parameter setting. Experimental results demonstrate good performances of the method.

Normal Reference Value of Red Blood Cell Count of Chinese Presenile Men and Geographical Factors

This paper aims at providing a scientific basis for unifying the normal reference value standards of red blood cell count of Chinese presenile men. The paper, using microscopical counting method, studies the relationship between the normal reference values of 38,061 samples of red blood cell count of presenile men and eight geographical factors in 297 units in China. It is found that the correlation of geographical factors and the normal reference value of red blood cell count of presenile men is quite significant （F=303.00, P=-0.000）. By using the method of stepwise regression analysis, one regression equation is inferred. It is concluded that if geographical data are obtained in a certain area, the normal reference value of red blood cell count of presenile men in this area can be reckoned by using the regression analysis. Furthermore, according to the geographical factors, China can be divided into eight regions： Northeast China Region, North China Region, Shanxi-Shaanxi-Irmer Mongolia Region, Middle and Lower Reaches of the Changjiang River Region, Southeast China Region, Northwest China Region, Southwest China Region and Qinghai-Tibet Plateau Region.

White blood cell count and the incidence of hyperuricemia:insights from a community-based study

Hyperuricemia(HUA)is a risk factor for chronic kidney disease(CKD).The relationship between HUA and white blood cell(WBC)count remains unknown.A sampling survey for CKD was conducted in Sanlin community in 2012 and 2014.CKD was defined as proteinuria in at least the microalbuminuric stage or an estimated GFR of 60 mL/(min·1.73 m2).HUA was defined as serum uric acid>420µmol/L in men and>360µmol/L in women.This study included 1024 participants.The prevalence of HUA was 17.77%.Patients with HUA were more likely to have higher levels of WBC count,which was positively associated with HUA prevalence.This association was also observed in participants without CKD,diabetes mellitus,hyperlipidemia,or obesity.Multivariate logistic regression analysis showed that WBC count was independently associated with the risk for HUA in male and female participants.Compared with participants without HUA,inflammatory factors such as high-sensitivity C-reactive protein,tumor necrosis factor-α,and interleukin 6 increased in participants with HUA.Hence,WBC count is positively associated with HUA,and this association is independent of conventional risk factors for CKD.

Selection of Reference Genes in Equine White Blood Cells for Real Time PCR Normalization Following Extracorporeal Shock Wave Therapy

Selection of proper reference genes (RGs) is an essential step needed for accurate normalization of results from genomic studies. Expression of RGs is regulated by many factors such as species, age, gender, type of tissue, the presence of disease, and the administration of therapeutic treatment. The aim of the present study was to identify optimal RGs in a set of blood samples collected at different time points (0, 24, 48, 72 h) from horses following administration of extracorporeal shock wave therapy (ESWT). The mRNA expression of twelve RGs: HPRT1, ACTB, HSP90A, SDHA, GUSB, B2M, UBC, NONO, TBP, H6PD, RPL32, GAPDH was determined using real time quantitative polymerase chain reaction (qPCR). An SAS program developed on the algorithm of geNorm, SASqPCR, was used to determine stability of the expression and the number of optimal RGs. The results showed that the range of quantification cycle (Cq) values of the evaluated genes varied between 17 and 26 cycles, and that one optimal RG, ACTB, was sufficient for normalization of gene expression. Results of stability of expression demonstrated that ACTB was the optimal choice for all the samples studied. Notably, in samples collected at 72 h post ESWT, TBP showed a significant change in the expression level, and was not suitable for use as a RG. These results substantiate the importance of validating and selecting an appropriate RG.

Synovial White Cell Count in the Diagnosis of Septic Arthritis: Are Current Diagnostic Practices Appropriate?

Introduction & aims: Septic arthritis is an emergency, potentially causing irreversible joint destruction and disability. Synovial WCC and polymorphonuclear cell percentage are the best predictors of septic arthritis likelihood. Yet, synovial white cell and differential count are not routinely assessed. We aim to investigate the incidence of failure to perform these tests, and to develop correct synovial fluid analysis practices. Method: This is a retrospective analysis of native joints having undergone arthrocentesis for suspicion of septic arthritis at Box Hill Hospital (BHH) during September 2011 and September 2013 inclusive. Recruitment was from the Eastern Health Decision Support Service (DSS), a database compiled from all systems within Eastern Health, of which BHH is a member. The study was limited to large joints, including hip, knee and shoulder. All prosthetic joints were excluded from the patient population. All patient histories were examined for suspicion of septic arthritis and subsequent arthrocentesis. Pathology records were accessed to determine incidence of cell count and differential. Results: One hundred and thirty-six cases of joint aspirations were identified within the time frame, of which sixty-seven fitted our criteria for evaluation. All but two cases were delivered using the DSS, which was limited to data compiled only until June 2013. The two remaining cases were identified with a manual search of the radiology and pathology databases from June to September 2013. 22 of the 67 joint aspirates studied did not have a cell count carried out. Four of these 22 cases had a diagnosis of septic arthritis. In five aspirates, there was a failure to confirm a definite diagnosis and they were thus conservatively treated as a septic joint. The remaining acute joints in which no cell count was done were gout (7 cases), pseudogout (5 cases) and rheumatoid arthritis (1 case). Cell counts were not routinely detected for a variety of reasons. Eleven aspirates were deemed too viscous, and in eight cases the sample had clotted prior to pathologist assessment. Two cases had insufficient volume, and one sample was too bloodstained to calculate a cell count and differential;likely due to traumatic aspiration. Conclusions: 33% of acute monoarthritis’ evaluated over the study period failed to have a synovial fluid WCC and differential. This may be due to inadequate samples, or lack of appropriate collection tube. Better education is required for appropriate collection and test requesting wherein a diagnosis of septic arthritis is in question.

Does East Meet West?—The Association between Oriental Tongue Inspection and Western Clinical Assays of White Blood Cell Subsets

The autonomic nervous system (ANS) controls white blood cell (WBC) subsets;therefore, the status of ANS can be assessed by assaying WBCs. However, this requires invasive blood sampling, time, cost, and training. Therefore, this study focused on a traditional technique, tongue inspection, which is a simpler method. The purpose of this study was to investigate whether there is an association between the traditional method of tongue inspection and clinical assay of WBC subsets. Twenty-one female alopecia areata patients were divided into two age-matched groups: 1) alopecia areata totalis (AT);and 2) alopecia areata multiplex (AM). Images of patient tongues were captured by a digital camera and categorized before blood sampling. Finally, patients were divided into five groups (normal, Yin+, Yang–, Yin– and Yang+) based on the Eight Principles of traditional Chinese medicine (TCM). Concurrently, venous blood was obtained for WBC subsets. The absolute numbers of WBCs and granulocytes of the AT group were higher than those of the AM group. The AT group was Yin+ but not Yang+, whereas the AM group was Yang+ but not Yin+. Thus, the AT group showed more elements of “cold” (Yin > Yang) compared with the AM group with elements of “hot” (Yin < Yang). Tongue inspection suggested a possibility of consistence with those of WBCs although statistical significance was not obtained. Moreover, some Yin+ and Yang+ subjects showed some trend in similarities between tongue inspection and WBC subsets although this was not statistically significant. Therefore, traditional techniques (such as tongue inspection) acupuncture must be studied further to detect whether subtle effects are induced by acupuncture treatment. As this study is underpowered, a larger scale study including males is required in the future.

Evaluation of Total White Blood Cells and Cluster of Differentiation 4 Cells among Post-Menopausal Women in Elele, Nigeria

This study investigated some immune system related parameters among post-menopausal women in Elele, River state, Nigeria. Forty-two individuals participated in this study and forty control subjects were established as well. Blood was collected from the participants, and CD4 cells and total white blood cells count were analyzed using standard procedures. Result showed that test subjects and control values were 5.46 ± 1.64 × 109/L and 7.24 ± 1.47 × 109/L, respectively for total white blood cell and 1265.19 ± 458.56 cells/μl and 2159.53 ± 400.02 cells/μl respectively, for CD4 cells. There was significant difference (P < 0.001) among the test subject and control for both parameters. The results in the test subjects for both parameters were significantly lower compared to the control. The decline in immune system related parameters among the test subjects may predispose them at risk of multiple infections and other associated health conditions.

The Anti-Proliferative Effect of 5-Fluorouracil on Tumor Is Highly Associated with the Renewal of Peripheral White Blood Cells

The efficacy of chemotherapy is thought to be direct killing of tumor cells, but documented studies have been shown that immunity plays a role in its effectiveness. In a pilot study to observe the bone marrow suppression and regeneration in tumor bearing mice induced by single dose injection of 5-fluorouracil (5-FU), we unexpectedly found that tumors grew fast as bone marrow mononuclear cells (BMC) and peripheral white blood cells (PWBC) were decreased quickly during myelosuppression meanwhile significantly slow as repopulating of BMC and PWBC during bone marrow regeneration after 5-FU treatment, no matter whether in low or high dose administration, but the higher the dose was, the lower of the nadir of BMC and PWBC were reached to, as well as the much more powerful duration and strength of the repopulated BMC and PWBC, suggested that the immunity might be a predominant drive in 5-FU chemotherapy. Due to the fact that BMC is the source of PWBC which is its final maturational and functional form, it could be proposed that the anti-proliferative effect of 5-FU on tumor is highly associated with the renewal of PWBC.

Monitoring the changes in plasm C-reactive protein,fibrinogen and blood white cell in patients with primary hypertension combined with acute cerebral infarction

BACKGROUND： Inflammatory reaction and the increased level of its accompanying active protein play an important role in the occurrence and development of cerebral infarction. C-reactive protein, fibrinogen and white blood cell, as the monitoring index of inflammatory reaction, are very important in the occurrence and development of acute cerebral infarction. OBJECTIVE： To make a comparison between patients with primary hypertension accompanied with acute cerebral infarction and with simple primary hypertension by observing the changes in plasma C-reactive protein and fibrinogen levels as well as white blood cell and differential counts and analyzing their significances. DESIGN ： Controlled observation SETTING ： Ward Building for VIP, Shenzhen Hospital, Peking University. PARTICIPANTS： Totally 133 patients with primary hypertension were selected from Ward Building for VIP, Shenzhen Hospital, Peking University during September 2003 to September 2005, The diagnostic criteria were based on the hypertension diagnosis criteria formulated by the 7^th World Health Organization-International Society of Hypertension Guidelines （WHO-ISH） in 1998. The informed consents were obtained from all the participants. The involved patients were assigned into two groups： primary hypertension group, in which, there were 65 patients with primary hypertension （ degree 2）, including 42 males and 23 females, with mean age of （61 ±14）years and mean blood pressure of （162.7±6.8）/（94.2±8.4） mm Hg （1 mm Hg =0.133 kPa）, and primary hypertension combined with cerebral infarction group, in which, there were 68 patients with primary hypertension combined with cerebral infarction （ meeting the diagnostic criteria formulated in the 4^th National Cerebrovascular Diseases Meeting in 1995 and diagnosed by skull CT or MRI to exclude the patients with lacunar infarction）, including 42 males and 26 females, with mean age of （56±15） years and mean blood pressure of （176.4±9.2）/（96.3±9.7） mm Hg. METHODS： Plasm C-reactive protein and fibrinogen levels, and white blood cell and differential counts of patients in the two groups were examined 24 hours after stroke. The above indexes were re-examined in the primary hypertension combined with cerebral infarction group 72 hours after stroke. White blood cell and differential counts were performed with laser method （East Asia FE-95001 RAM-1, Japan）. The level of C-reactive protein was measured with turbidimetry （BNII Automatic Systems For Analysis, USA）. The level of fibrinogen was measured with algorithm method when prothrombin time was normal and with Clauss method when prothrombin time was abnormal （ACL Automatic Coagulation Analyzer, USA）. MAIN OUTCOME MEASURES： The plasm C-reactive protein and flbrinogen levels, and white blood cell and differential counts 24 hours after stroke in two groups and 72 hours after stroke in primary hypertension combined with cerebral infarction group. RESULTS： All the 133 involved patients participated in the result analysis. The plasm C-reactive protein and fibrinogen levels, and white blood cell and neutrophil counts in patients with primary hypertension were all within the normal range. The plasm C-reactive protein and fibrinogen levels, and white blood cell and neu- trophil counts in patients with primary hypertension combined with cerebral infarction were significantly higher than those in patients with primary hypertension 24 hours after stroke and 72 hours after stroke respectively[24 hours after stroke：（32.12±11.76） mg/L vs. （5.02±3.21 ） mg/L;（4.64±0.75） g/L vs. （3.12±0.49） g/L; （9.32±81）×10^9 L^- 1 vs. （5.78±1.32）×10^9L^- 1 （7.85±2.38）×10^9 L^- 1 vs.（3.49±1.28）×10^9 L^-1,t =7.094, 5.759,4.106,5.491, respectively,all P〈 0.01; 72 hours after stroke： （47.62±18.43） mg/L vs. （32.12±11.76） mg/L; （5.08±0.82） g/L vs. （4.64±0.75） g/L, t =2.864,2.220, respectively, both P 〈 0.05]. CONCLUSION： The increase in fibrinogen level and white blood cell count are the important index in monitoring primary hypertension combined with acute cerebral infarction. The increase in plasm C-reactive protein and fibrinogen levels 72 hours after stroke indicates that plasma C-reactive protein and fibrinogen are very important in the development of disease.

The Influence of Apple-or Red-Grape Pomace Enriched Piglet Diet on Blood Parameters,Bacterial Colonisation,and Marker Gene Expression in Piglet White Blood Cells

Proanthocyanidins and flavanoids, both subfamilies of the polyphenols, are highly concentrated in different fruits and berries as well as in fruit pomace. They have shown to exhibit anti-cancer, anti-microbial, anti-oxidative, and im- mune-modulatory effects in vertebrates. Herein the effect of additional apple pomace or red-grape pomace in conven- tional piglet starter feeds were investigated in 36 young growing piglets. Immunological marker gene expression was quantified by quantitative real-time RT-PCR in white blood cells, and intestinal bacterial flora was investigated from weaning to three weeks post weaning. Polyphenol content in red-grape pomace, gut content and tissues were analyzed with HPLC. Flavan-3-ols (epicatechin and catechin) and proanthocyanidins (B1, B2 and C1) were identified in the gas- tro-intestinal tract content, whereas only traces could be detected in various piglet organs. The blood parameters, he- moglobin and hematocrit, were affected and down-regulated in all groups over testing period. In both pomace treated groups more thrombocytes were present compared to the standard feeding group. It turns out, that the pomace diets had greatest impact on the bacterial content in the colon. Results demonstrate that feeding apple pomace and red- grape pomace tended to increase the number of total colonic bacteria. Steptococci/Enterococci increased in the red- grape pomace. C. perfringens was not detectable at the second time point. The number of lactobacilli increased in both applied diets. The number of Clostridium perfringens decreased with the age of the piglets. Trends of mRNA expression changes were found in white blood cell (WBC) between different feeding regimens, since the expression variability in the groups was very high. Between the different time points there were significant differences within the apple pomace group, where TNF? (p = 0.033), NF?B (p = 0.024) and Caspase 3 (p = 0.019) mRNA expression increased signifi- cantly during treatment. We conclude that both polyphenol rich feedings have the potential to positively influence the intestinal flora, blood parameters, and WBC mRNA gene expression pattern of immunological marker genes.

Role of plasma C-reactive protein and white blood cell count in predicting in-hospital clinical events of acute type A aortic dissection

Background A few recent studies have reported that inflammation is associated with the prognosis of acute aortic dissection （AD）. There is, however, no systemic investigation regarding the role of plasma C-reactive protein （CRP） and white blood cell （WBC） levels in predicting in-hospital clinical events of acute type AAD. Methods The levels of high-sensitivity CRP and WBC counts were systemically determined after admission in 36 patients with acute type A AD. The variations of plasma CRP and WBC levels in different time windows （admission, 1, 2, 3, 4, 6, 8 days） in patients with acute type AAD were analyzed between patients with events and without events. Results During hospitalization, five patients died, and increased levels of CRP and WBC were found in patients died with acute type A AD compared with patients survived （P 〈0.01, respectively）. Medical treatment may significantly decrease inflammatory response in survived patients with acute type A AD. Additionally, patients with complication of pleural effusion showed higher CRP and WBC levers （P=0.046, P=-0.018, respectively）. Lower WBC levels were found in survived patients treated medically （P=-0.001）. Moreover, mean CRP and WBC levels had positive correlations with aortic diameter （r=0.364, P--0.000; r=0.333, P=0.000, respectively） and age （r=0.270, P=0.000, respectively）, while negative correlations with the time from onset of symptoms to hospital admission （r= -0.229, P=0.000, r= -0.200, P=0.002, respectively）. Univariate analysis showed that age 〉65 years, CRP zl 2.05 rag/L, WBC 〉12.16×10^9/L, aortic diameter 〉48 mm, pleural effusion and diastolic blood pressure 〉105 mmHg were associated with hospital mortality. While CRP 〉12.05 mg/L, WBC ≥12.16×10^9/L, aortic diameter 〉48 mm were strongly associated with hospital mortality in multiple Logistic regression analysis. Conclusions The results suggested that CRP and WBC were preferred markers for predicting the clinical events in patients with acute type A AD, especially death during hospitalization. Therefore, further study enrolling larger cohort, prospective study would be warranted.