C-reactive protein,procalcitonin,interleukin-6,vascular endothelial growth factor and oxidative metabolites in diagnosis of infection and staging in patients with gastric cancer

AIM:The current study was to determine the serum/pLasma levels of VEGF,IL-6,malondialdehyde (MDA),nitric oxide (NO),PCT and CRP in gastric carcinoma and correlation with the stages of the disease and accompanying infection. METHODS:We examined the levels of serum VEGF,IL-6, PCT,CRP and plasma MDA,NO in 42 preoperative gastric cancer patients and 23 healthy subjects.There were infection anamneses that had no definite origin in 19 cancer patients. RESULTS:The VEGF levels (mean±SD; pg/mL) were 478.05±178.29 and 473.85±131.24 in gastric cancer patients with and without infection,respectively,and these values were not significantly different (P>0.05).The levels of VEGF, CRP,PCT,It-6,MDA and NO in cancer patients were significantly higher than those in healthy controls and the levels of CRP,PCT,It-6,MDA and NO were statistically increased in infection group when compared with non- infection group (P<0.001). CONCLUSION:Although serum VEGF concentrations were increased in gastric cancer,this increase might not be related to infection.CRP,PCT,IL-6,MDA and NO have obvious drawbacks in the diagnosis of infections in cancer patients. These markers may not help to identify infections in the primary evaluation of cancer patients and hence to avoid unnecessary antibiotic treatments as well as hospitalization. According to the results of this study,IL-6,MDA,NO and especially VEGF can be used as useful parameters to diagnose and grade gastric cancer.

C-reactive protein may be a prognostic factor for the whole gastroenteropancreatic neuroendocrine tumor group

BACKGROUND Long non-coding RNAs(lncRNAs) are a kind of single-stranded RNA of more than 200 nucleotides in length and have no protein-coding function. Amounting studies have indicated that lncRNAs could play a vital role in the initiation and development of cancers, including gastric cancer(GC). Considering the crucial functions of lncRNAs, the identification and exploration of novel lncRNAs in GC is necessary.AIM To identify independent prognostic markers for the whole gastroenteropancreatic neuroendocrine tumor(GEP-NET) group.METHODS Ninety-three patients diagnosed with GEP-NETs within a specified period were included in this study. Patient data were retrospectively analyzed. The relationships between all independent variables and 5-year survival status calculated during the follow-up period(months) were assessed. In addition, the relationships between the independent variables were investigated.RESULTS When 5-year survival rate was compared, a statistically significant relationship between the age at diagnosis, male gender, tumor size, tumor stage, liver and/or distant metastasis, and tumor grade determined by the Ki-67 level and mitotic count, and the level of C-reactive protein(CRP), was observed. The meansurvival(overall survival) of the study group was 102.5 ± 6.3(SD) mo. The percentages of 1, 3 and 5-year survival were 90%, 72%, and 61%, respectively. In63 of 93 patients, Ki-67 and the mitotic count determined the same grade. The Ki-67 levels in 29 patients and the mitotic count in only 1 patient were in the higher grade. The risk of death increased by 4% for every 1 year increase at the diagnosis age and was 2.0-fold higher for male patients, 3.0-fold higher for G3 according to the mitotic count, 3.7-fold higher for G3 according to the Ki-67 level, 12.7-fold higher for cases with tumor stage 3 or 4 by a 1 cm increase in the ratio of 9% in tumor size, and 6.1-fold higher for patients with liver metastasis for every 1 mg/dL increase in the ratio of 1.5% in CRP level. There was a significant difference between pancreatic and stomach NETs in favor of stomach tumors in terms of survival.CONCLUSION Tumor site, stage, grade and Ki-67 level affected patient survival, and it was observed that CRP affected disease progression(particularly if it was > 20 mg/dL). However, a relationship between surgical resection of the lesion and survival was not shown. Larger scale prospective studies are required to determine whether CRP level may be a poor prognostic factor for the entire GEPNET group.

Increased Expression and Activity of MMP-9 in C-reactive Protein-induced Human THP-1 Mononuclear Cells Is Related to Activation of Nuclear Factor Kappa-B

The relation between the expression and activity of MMP-9 in C-reactive protein （CRP）-induced human THP-1 mononuclear cells and the activation of nuclear factor kappa-B （NF-κB） was studied to investigate the possible role of CRP in plaque destabilization. Human THP-1 cells were incubated in the presence of CRP at 0 （control group）, 25, 50 and 100 μg/mL （CRP groups） for 24 h. In PDTC （a specific NF-κB inhibitor） group, the cells were pre-treated with PDTC at 10 μmol/L and then with 100 μg/mL CRP. The conditioned media （CM） and human THP-1 cells in different groups were harvested. MMP-9 expression in CM and human THP-1 cells was measured by ELISA and Western blotting. MMP-9 activity was assessed by fluorogenic substrates. The expression of NF-κB inhibitor α （IκB-α） and NF-κB p65 was detected by Western blotting and ELISA respectively. The results showed that CRP increased the expression and activity of MMP-9 in a dose-dependent manner in the human THP-1 cells. Western blotting revealed that IiB-α expression was decreased in the cells with the concentrations of CRP and ELISA demonstrated that NF-κB p65 expression in the CRP-induced cells was increased. After pre-treatment of the cells with PDTC at 10 μmol/L, the decrease in IκB-α expression and the increase in NF-κB p65 expression in the CRP-induced cells were inhibited, and the expression and activity of MMP-9 were lowered too. It is concluded that increased expression and activity of MMP-9 in CRP-induced human THP-1 cells may be associated with activation of NF-κB. Down-regulation of the expression and activity of MMP-9 may be a new treatment alternative for plaque stabilization by inhibiting the NF-κB activation.

Association of C-reactive protein and complement factor H gene polymorphisms with risk of lupus nephritis in Chinese population

BACKGROUND Complement overactivation is a major driver of lupus nephritis(LN).Impaired interactions of C-reactive protein(CRP)with complement factor H(CFH)have been shown as a pathogenic mechanism that contributes to the overactivation of complement in LN.However,genetic variations of neither CRP nor CFH show consistent influences on the risk of LN.AIM To examine whether genetic variations of CRP and CFH in combination can improve the risk stratification in Chinese population.METHODS We genotyped six CRP single nucleotide polymorphisms(SNPs)(rs1205,rs3093062,rs2794521,rs1800947,rs3093077,and rs1130864)and three CFH SNPs(rs482934,rs1061170,and rs1061147)in 270 LN patients and 303 healthy subjects.RESULTS No linkage was found among CRP and CFH SNPs,indicating lack of genetic interactions between the two genes.Moreover,CRP and CFH SNPs,neither individually nor in combination,are associated with the risk or clinical manifestations of LN.Given the unambiguous pathogenic roles of the two genes.CONCLUSION These findings suggest that the biological effects of most genetic variations of CRP and CFH on their expressions or activities are not sufficient to influence the disease course of LN.

The Role of C-Reactive Protein, Granulocyte Colony Stimulating Factor and Total Antioxidant Capacity in Diagnosis of Acute Appendicitis

Background and Aim: Despite the fact that acute appendicitis is the most common surgical emergency all around the world, its diagnosis is still based on clinical evaluation and accuracy of the diagnosis depending on experience. The aim of this study is to evaluate the role of inflammatory markers in diagnosis of acute appendicitis. Material and Method: The study includes 77 cases with histopathologically proven acute appendicitis and 17 control cases. Blood samples were obtained from all cases and C-reactive protein (CRP), Granulocyte Colony Stimulating Factor (G-CSF) and Total Antioxidant Capacity (TAC) were measured. Findings: In cases with acute appendicitis, CRP and G-CSF levels were found to be related to acute appendicitis;however, TAC was not affected by the disease process. Moreover, CRP and G-CSF levels were correlated with the disease severity. Conclusion: Both CRP and G-CSF can be used in diagnosis of acute appendicitis. Furthermore, increased CRP level can be a marker to show advanced cases. However, G-CSF is not an effective marker to show disease severity.

Linking inflammation and thrombosis:Role of C-reactive protein

C-reactive protein(CRP) is a biomarker of inflammation.Increased plasma levels of CRP are associated with an increased risk of myocardial infarction.However,the correlation between plasma CRP concentration and atherosclerotic plaque burden is poor.Based on these observations,it has been hypothesized that CRP increases the risk of myocardial infarction by promoting thrombosis.This article reviews available data that link enhanced CRP expression to increased risk of thrombosis,with a focus on the effects of CRP on hemostasis,platelet function,and fibrinolysis.Overall,the available data support the hypothesis that CRP is an important mechanistic link between inflammation and throm bosis.

Preoperative risk factors for early recurrence in patients with resectable pancreatic ductal adenocarcinoma after curative intent surgical resection

Background: Postoperative early recurrence(ER) in patients with pancreatic ductal adenocarcinoma(PDAC) is frequently encountered after curative intent surgery. Nonetheless, clinical significance and risk factors of ER after surgery for PDAC have not been extensively investigated. The aim of this study was to determine preoperative risk predictors for ER in patients with PDAC after upfront surgery. Methods: Eighty-one consecutive patients with PDAC who underwent curative intent surgical resection at Kangbuk Samsung Hospital between January 2004 and May 2015 were enrolled. ER was defined as tumor relapse within 6 months after surgery. Results: ER occurred in 26 patients(32.1%), whereas 49 patients(60.5%) had late recurrence( ≥ 6 months after surgery), and 6 patients had no recurrence(7.4%). Univariate analysis showed that C-reactive protein(CRP) > 3.0 mg/dL, modified Glasgow prognostic score(mGPS) = 2, decrease of total lymphocyte count by > 50% of baseline value in the preoperative period, prognostic nutritional index(PNI) < 45, neutrophilto-lymphocyte ratio(NLR) ≥ 3, and preoperative maximum standardized uptake value(SUVmax) were significantly associated with ER. Multivariate logistic regression analysis revealed that CRP > 3.0 mg/dL, decrease of total lymphocyte count by > 50% of baseline value, and preoperative SUVmax were significant and independent contributors of ER in patients with resectable PDAC who underwent curative intent surgery. Conclusions: Postoperative ER for resectable PDAC was frequent with poor prognosis after curative intent upfront surgery. It is reasonable to suggest that there is a subgroup of resectable PDAC patients at highrisk of ER and neoadjuvant therapy should be considered in these patients in a clinical trial setting.

Risk factors for development of pneumothorax in patients with COVID-19 at a government health facility in North India:An exploratory case-control study

Objective:To explore risk factors for the development of pneumothorax in patients with COVID-19 during the second COVID-19 wave at a northern Indian level 2 health facility.Methods:Patients suffering from SARS-CoV-2 infection during the second wave of the COVID-19 pandemic in India(January-June 2021)at a tertiary care teaching hospital and level 2 COVID care facility were included.Cases who suffered from SARS-CoV-2 infection but did not develop pneumothorax were selected as matched controls.All details regarding demographics,clinical presentation,treatment,and outcome were recorded in a semi-structured proforma.Results:Eleven patients with COVID-19 developed pneumothorax during the study period and 40 controls were included in the study.Five cases were smokers in comparison to only two in the control group.Type 2 diabetes mellitus was the most common comorbidity among both groups.Median change in C-reactive protein overall for cases and controls were around+14.0 and-41.9 and was statistically significant.Conclusions:Inflammatory markers like C-reactive protein have significant correlations with the development of pneumothorax in COVID-19-infected patients.There is no sex predisposition to develop pneumothorax among patients with COVID-19.

Clinical Analysis on the Effectiveness of Transvaginal Cervical Cerclage in Singleton Pregnancies and Its Predictive Factors

Objective: To evaluate the effectiveness of transvaginal cervical cerclage in singleton pregnancies with cervical incompetence, determine the predictive factors of success and failure, and then compare elective and emergency cerclage. Study Design: This was a retrospective study of 62 patients who underwent cervical cerclage in The First Hospital of Jilin University, China, between May 2015 and January 2018. Successful group was defined as those who delivered live babies and failure group who experienced abortion or stillbirth. Results: Out of 104 patients, 62 met inclusion criteria. In 62 cases, 47 (75.8%) succeeded and 15 (24.2%) failed. In successful group, 21 (44.7%) women delivered pretermly and 26 (55.3%) termly. No severe complications occurred except cervical laceration (2, 3.23%), premature rupture of membranes (13, 20.97%). In 62 cases, 40 (64.5%) have ≤2 previous second-trimester losses and 22 (35.5%) have >2 previous second-trimester losses. No significant differences were found in neonatal outcomes. Analysis revealed that higher postoperative C-reactive protein and presence of premature rupture of membranes were the strongest predictors of cerclage failure. Among 62 cases, 48 (77.4%) were allocated in elective and 14 (22.6%) in emergency cerclage. Pregnancy prolongation was significantly more (P = 0.014) in elective group with no significant differences in premature rupture of membranes, neonatal outcomes (all P > 0.05) except Apgar score at 5 min (P = 0.042). Conclusion: Achieving 75.8% live births proves that transvaginal cervical cerclage is an effective and safe technique in prolonging the gestational age, improving the obstetric outcomes in singleton pregnancies with cervical incompetence under various cerclage indications. Postoperative C-reactive protein and premature rupture of membranes are the predictive factors related to success or failure. Elective cerclage is more effective in prolonging the pregnancy compared to emergency cerclage, no significant differences are seen regarding neonatal outcomes and complications.

Study on Related Factors of Aspirin Resistance in Acute Ischemic Stroke

Objective:To study the related factors of aspirin resistance(AR)in acute ischemic stroke.Methods:A total of 138 patients with acute ischemic stroke treated in hospital affiliated to Xuzhou medical university from August 2016 to August 2018 were the study subjects,examine his medical data from the past.They were divided into the AR group(40 cases)and the non-AR group(98 cases)according to whether AR appears.Gender,disease history,biochemical indicators and etc.were compared between the two groups.The independent risk factors of AR were investigated using univariate analysis and logistic regression analysis.Results:40 cases of AR occurred in 138 patients,with an incidence rate of 28.99%.Diabetes,platelet count(PLT),microRNA-19a(m iR-19a)expression,smoking,high-sensitivity C-reactive protein(hs-CRP),Low-density lipoprotein cholesterol(LDL-C),fibrinogen(FIB)and age difference between the AR group and non-AR group was statistically significant(P<0.05).Gender,hypertension,uric acid(UA),high-density lipoprotein cholesterol(HDL-C),triglycerides(TG),homocysteine(Hcy),total cholesterol(TC),and alanine aminotransferase(ALT)between the two groups were not significantly different(P>0.05).Logistic regression analysis showed that the independent risk factors for AR in acute ischemic stroke were diabetes(OR=2.773,95%CI:1.102~5.065,P=0.025),miR-19a(OR=3.021,95%CI:1.322~6.545,P=0.021),hs-CRP(OR=2.719,95%CI:1.301~5.022,P=0.028)and smoking(OR=1.983,95%CI:1.114~3.887,P=0.040).Conclusion:The incidence of AR is higher in acute ischemic stroke.Risk factors include diabetes,miR-19a expression,hs-CRP,smoking,etc.Clinical intervention measures can be taken to reduce the risk of AR and improve acute ischemic stroke prognosis.

Clinicopathologic significance of expression of nuclear factor-kB RelA and its target gene products in gastric cancer patients

AIM:To assess the prognostic significance of nuclear factor-kB (NF-kB) and its target genes in gastric cancer. METHODS:The tumor tissues of 115 patients with gastric cancer were immunohistochemically evaluated using monoclonal antibodies against NF-kB RelA. Preoperative serum levels of vascular endothelial growth factor (VEGF), interleukin-6 (IL-6) were assessed via enzyme-linked immuno-sorbent assay. C-reactive protein (CRP) and serum amyloid A (SAA) were measured via immunotrubidimetry. RESULTS:Positive rate of NF-kB RelA was 42.6%. NF-kB RelA expression in tumor tissues was also related to serum levels of IL-6 (P = 0.044) and CRP (P = 0.010). IL-6, SAA, CRP were related to depth of invasion, VEGF and SAA were correlated with lymph node metastasis. IL-6, VEGF, SAA and CRP were related to the stage. Univariate analysis demonstrated that immunostaining of NF-kB RelA, levels of IL-6, VEGF, SAA were significantly related with both disease free survival and over-all survival (OS). Multivariate analysis verified that NF-kB RelA [hazard ratio (HR): 3.40, P = 0.024] and SAA (HR: 3.39, P = 0.045) were independently associated with OS. CONCLUSION: Increased expression of NF-kB RelA and high levels of serum SAA were associated with poor OS in gastric cancer patients.

Prognostic value of von-Willebrand factor in patients with liver cirrhosis and its relation to other prognostic indicators

BACKGROUND Von-Willebrand factor(vWF)disposes certain prognostic value in patients with liver cirrhosis,but its relation to other prognostic indicators has not been fully investigated.AIM To analyze the relation between vWF and other prognostic indicators in cirrhotic patients and to evaluate its prognostic value for mortality.METHODS This analytic prospective study was carried out in a tertiary center and initially enrolled 71 patients with liver cirrhosis and portal hypertension.It analyzed the relation between vWF and the stage of the disease and several inflammatory and prognostic indicators.The prospective analysis,performed on a sample of 63 patients,evaluated the association between the selected variables[vWF,Model for End-stage Liver Disease(MELD)score,C-reactive protein(CRP),ferritin,vitamin D,activated partial thromboplastin time,thrombin time,D-dimer concentration]and the survival time as well as their predictive value in terms of 3-mo,6-mo and 1-year mortality.RESULTS vWF was significantly higher in patients with higher Child-Turcotte-Pugh class(P=0.0045),MELD group(P=0.0057),ferritin group(P=0.0278),and D-dimer concentration(P=0.0232).vWF significantly correlated with D-dimer concentration,ferritin,CRP,International Normalized Ratio,and MELD,Child-Turcotte-Pugh,Sequential Organ Failure Assessment,and CLIF-consortium organ failure(CLIF-C OF)scores.vWF,MELD score,and CRP were significantly associated with death and were significant predictors of 3-mo,6-mo,and 1-year mortality.Each vWF unit significantly increased the probability for 3-mo mortality by 1.005 times(P=0.008),for 6-mo mortality by 1.006 times(P=0.005),and for 1-year mortality by 1.007 times(P=0.002).There was no significant difference between the diagnostic performance of vWF and MELD score and also between vWF and CRP regarding the 3-mo,6-mo,and 1-year mortality.CONCLUSION In patients with liver cirrhosis,vWF is significantly related to other prognostic indicators and is a significant predictor of 3-mo,6-mo,and 1-year mortality similar to MELD score and CRP.

Hepatocyte Growth Factor Is a Reliable Marker for Efficient Anti-Bacterial Therapy within the First Day of Treatment

Rapid diagnosis and choice of appropriate antibiotic treatment might be life-saving in serious infectious diseases. Still the available markers that can evaluate and monitor the diagnosis and treatment are few. Hepatocyte growth factor (HGF) has been studied as a potent regenerative factor produced and released during injuries such as infectious diseases. Monitoring of HGF levels might predict therapy results better than C-reactive protein (CRP) within the first day of treatment in pneumonia. For further investigation of previous observations we aimed to study HGF as a first-day marker in over-representing infectious diseases in comparison to procalcitonin (PCT), CRP and body temperature. Fifty-one patients with community acquired infectious diseases were included consequently at admittance and the serum samples were collected before and within 18 - 24 hours of treatment. HGF levels decreased significantly in case of efficient antibiotic therapy and HGF was shown to be better than PCT, CRP and body temperature to evaluate treatment. In patients with pneumonia, monitoring of HGF was most reasonable. HGF might be used as a therapeutic marker within the first day of empiric antibiotic treatment during infection.

老年糖尿病患者红细胞分布宽度与外周动脉疾病的相关性研究

目的探讨老年2型糖尿病患者红细胞分布宽度(RDW)与外周动脉疾病(PAD)之间的相关性。方法选择老年2型糖尿病住院患者246例进行横断面研究,按RDW四分位数将患者分为最低四分位数组(A组)56例,低四分位数组(B组)63例,高四分位数组(C组)65例,最高四分位数组(D组)62例。收集临床一般资料及心血管病危险因素,检测空腹血糖、血脂、糖化血红蛋白、肌酐、白细胞、血红蛋白、平均红细胞体积、高敏C反应蛋白,测量踝臂指数(ABI)并进行分析。结果从A组到D组,ABI值逐渐降低,以中位数(四分位间距)表示,分别为1.05(0.14)、1.03(0.21)、1.02(0.26)、0.96(0.28),差异有统计学意义(P<0.05);PAD患病率逐渐升高,分别为14.3%、23.8%、35.4%、41.9%(P<0.05,P<0.01),估算肾小球滤过率水平逐渐降低(P<0.05);Spearman相关分析显示,RDW与ABI呈负相关(r= -0.1 59,P<0.05);logistic回归分析显示,校正性别、年龄及其他传统危险因素后,D组增加PAD风险(OR=3.906,95%CI:1.009～9.232,P<0.05)。结论老年2型糖尿病患者RDW与PAD相关,RDW增高患者发生PAD的风险增加。

二甲双胍对2型糖尿病患者血浆ET-1和血清hs-CRP、TNF2水平的影响

目的探讨了二甲双胍对DM2T2DM患者血浆ET-1和血清HS-CRP、TNF2水平的影响。方法应用放射免疫分析法和免疫比浊法对33例T2DM患者进行了血浆ET-1和血清HS-CRP、TNF2水平检测,并与35名正常健康人做比较。结果 T2DM患者在治疗前血浆ET-1和血清HS-CRP.TNF2水平均非常显著地高于正常人组(P<0.01)经二甲双胍治疗了3个月后,血浆ET-1和血清HS-CRP、TNF2水平与正常人比较无显著性差异(P>0.05)且ET-1水平与HS-CRP、TNF2水平成正相关(R=0.618 4、0.594 8 P<0.01)。结论二甲双胍具有改善血管内皮功能的作用。

Prognostic value of inflammation-based markers in patients with pancreatic cancer administered gemcitabine and erlotinib

AIM: To evaluate the value of systemic inflammationbased markers as prognostic factors for advanced pancreatic cancer(PC). METHODS: Data from 82 patients who underwent combination chemotherapy with gemcitabine and erlotinib for PC from 2011 to 2014 were collected retrospectively. Data that included the neutrophil-to-lymphocyte ratio(NLR), the platelet-to-lymphocyte ratio, and the C-reactive protein(CRP)-to-albumin(CRP/Alb) ratio were analyzed. Kaplan-Meier curves, and univariate and multivariate Cox proportional hazards regression analyses were used to identify the prognostic factors associated with progression-free survival(PFS) and overall survival(OS). RESULTS: The univariate analysis demonstrated the prognostic value of the NLR(P = 0.049) and the CRP/Alb ratio(P = 0.047) in relation to PFS, and a positiverelationship between an increase in inflammation-based markers and a poor prognosis in relation to OS. The multivariate analysis determined that an increased NLR(hazard ratio = 2.76, 95%CI: 1.33-5.75, P = 0.007) is an independent prognostic factor for poor OS. There was no association between the PLR and the patients' prognoses in those who had received chemotherapy that comprised gemcitabine and erlotinib in combination. The Kaplan-Meier method and the log-rank test determined significantly worse outcomes in relation to PFS and OS in patients with an NLR > 5 or a CRP/Alb ratio > 5.CONCLUSION: Systemic inflammation-based markers, including increases in the NLR and the CRP/Alb ratio, may be useful for predicting PC prognoses.

Protective effect of LIF-huM SCs on the retina of diabetic model rats

AIM:To investigate the protective effect of human umbilical cord mesenchymal stem cells(hUCMSCs)modified by the LIF gene on the retinal function of diabetic model rats and preliminarily explore the possible mechanism.METHODS:A stably transfected cell line of hUCMSCs overexpressing leukemia inhibitory factor(LIF)was constructed.Overexpression was verified by fluorescent quantitative polymerase chain reaction(qPCR).Forty-eight adult Sprague-Dawley rats were randomly divided into a normal control group(group A),streptozotocin-induced diabetic control group(group B),diabetic rats at 3mo injected with empty vector-transfected hUCMSCs(group C)or injected with LIF-hUCMSCs(group D).Four weeks after the intravitreal injection,analyses in all groups included retinal function using flash electroretinogram(F-ERG),retinal blood vessel examination of retinal flat mounts perfused with fluorescein isothiocyanate-dextran(FITCdextran),and retinal structure examination of sections using hematoxylin and eosin staining.Expression levels of adiponectin(APN),high-sensitivity C-reactive protein(hsCRP),and neurotrophin-4(NT-4)in each group was detected using immunohistochemistry,PCR,Western blotting,and ELISA,respectively.RESULTS:A stable transgenic cell line of LIF-hUCMSCs was constructed.F-ERG and FITC-dextran examinations revealed no abnormalities of retinal structure and function in group A,severe damage of the retinal blood vessels and function in group B,and improved retinal structure and function in group C and especially group D.qPCR,ELISA,and Western blot analyses revealed progressively higher APN and NT-4 expression levels in groups B,C,and D than in group A.hs-CRP expression was significantly higher in group B than in groups A,C,and D,and was significantly higher in group C than in group D(P<0.05).CONCLUSION:LIF-hUCMSCs protect the retina of diabetic rats by upregulating APN and NT-4 expression and downregulating hs-CRP expression in the retina.

Combined evaluation of biomarkers as predictor of maintained remission in Crohn's disease

BACKGROUND The individual performances and the complementarity of Crohn's disease(CD)activity index(CDAI), C-reactive protein(CRP) and faecal calprotectin(Fcal) to monitor patients with CD remain poorly inves-tigated in the era of "tight control"and "treat to target" strategies.AIM To assess CDAI, CRP and Fcal variation, alone or combined, after 12 wk(W12) of anti-tumor necrosis factor(TNF) therapy to predict corticosteroids-free remission(CFREM = CDAI < 150, CRP < 2.9 mg/L and Fcal < 250 μg/g with no therapeutic intensification and no surgery) at W52.METHODS CD adult patients needing anti-TNF therapy with CDAI > 150 and either CRP >2.9 mg/L or Fcal > 250 μg/g were prospectively enrolled.RESULTS Among the 40 included patients, 13 patients(32.5%) achieved CFREM at W52. In univariable analysis, CDAI < 150 at W12(P = 0.012), CRP level < 2.9 mg/L at W12(P = 0.001) and Fcal improvement at W12(Fcal < 300 μg/g; or, for patients with initial Fcal < 300 μg/g, at least 50% decrease of Fcal or normalization of Fcal(< 100 μg/g)(P = 0.001) were predictive of CFREM at W52. Combined endpoint(CDAI < 150 and CRP ≤ 2.9 mg/L and FCal improvement) at W12 was the best predictor of CFREM at W52 with positive predictive value = 100.0%(100.0-100.0)and negative predictive value = 87.1%(75.3-98.9). In multivariable analysis, Fcal improvement at W12 [odd ratio(OR) = 45.1(2.96-687.9); P = 0.03] was a better predictor of CFREM at W52 than CDAI < 150 [OR = 9.3(0.36-237.1); P = 0.145]and CRP < 2.9 mg/L(0.77-278.0; P = 0.073).CONCLUSION The combined monitoring of CDAI, CRP and Fcal after anti-TNF induction therapy is able to predict favorable outcome within one year in patients with CD.

Effects of resistance training on cardiovascular health in non-obese active adolescents

AIM:To determine the benefits of a 10-wk resistance training programme on cardiovascular health in nonobese and active adolescents.METHODS:This is a pragmatic randomised controlled intervention.The study was carried out in a Hong Kong Government secondary school.Thirty-eight lean and active boys and girls were randomised to either the resistance training group or the control group.Students in the resistance training group received in-school 10-wk supervised resistance training twice per week,with each session lasting 70 min.Main outcome measures taken before and after training included brachial endothelial dependent flow-mediated dilation,body composition,fasting serum lipids,fasting glucose and insulin,high sensitive C-reactive protein,24-h ambulatory blood pressure and aerobic fitness.RESULTS:The only training related change was in endothelial dependent flow-mediated dilation which increased from 8.5%to 9.8%.A main effect of time and an interaction(P<0.005) indicated that this improvement was a result of the 10-wk resistance training.Main effects for time(P<0.05) in a number of anthropometric,metabolic and vascular variables were noted;however,there were no significant interactions indicating the change was more likely an outcome of normal growth and development as opposed to a training effect.CONCLUSION:Ten weeks of resistance training in school appears to have some vascular benefit in active,lean children.

Clinical Analysis of Erzhi Mingmu Decoction in the Treatment of Non-exudative Age-related Macular Degeneration

OBJECTIVE: To study the effect of Erzhi Mingmu Decoction in the treatment of non-exudative age-related macular degeneration. METHODS: A total of 100 patients with non-exudative age-related macular degeneration admitted to our hospital from May 2017 to May 2018 were selected. They were randomly divided into the study group and the control group. The control group was treated with oral vitamin C and vitamin E while study group was treated with Erzhi Mingmu Decoction based on the same treatment of the control group. Both groups were continuously treated for 1 month, the visual improvement, fundus changes, and changes of serum VEGF and CRP levels were compared before and after treatment. RESULTS: The number of patients with visual improvement was higher in the study group than that in the control group(P < 0.05). The number of patients with fundus improvement in the study group was more than that of the control group(P < 0.05). Serum VEGF levels were decreased in the 2 groups after treatment, and they were decreased more in the study group than those in control group(all P < 0.05). Serum CRP levels were decreased in the 2 groups after treatment, and the serum CRP levels were decreased more in the study group than those in control group(all P < 0.05). CONCLUSION: The treatment of non-exudative age-related macular degeneration with Erzhimingmu Decoction can significantly improve the vision of patients, improve the condition of the fundus, and reduce the levels of serum VEGF and CRP, which is worthy of clinical promotion and application.