Anti-tumour necrosis factor agent and liver injury:literature review,recommendations for management

Abnormalities in liver function tests,including transient and self-limiting hypertransaminasemia,cholestatic disease and hepatitis,can develop during treatment with anti-tumour-necrosis-factor(TNF)therapy.The optimal management of liver injury related to antiTNF therapy is still a matter of debate.Although some authors recommend discontinuing treatment in case of both a rise of alanine aminotransferase more than5 times the upper limit of normal,or the occurrence of jaundice,there are no standard guidelines for the management of anti-TNF-related liver injury.Bibliographical searches were performed in Pub Med,using the following key words:inflammatory bowel disease(IBD);TNF inhibitors;hypertransaminasemia;drugrelated liver injury;infliximab.According to published data,elevation of transaminases in patients with IBD treated with anti-TNF is a common finding,but resolution appears to be the usual outcome.Anti-TNF agents seem to be safe with a low risk of causing severe drugrelated liver injury.According to our centre experience,we found that hypertransaminasemia was a common,mainly self-limiting finding in our IBD cohort and was not correlated to infliximab treatment on both univariate and multivariate analyses.An algorithm for the management of liver impairment occurring during antiTNF treatment is also proposed and this highlights the need of a multidisciplinary approach and suggests liver biopsy as a key-point in the management decision in case of severe rise of transaminases.However,hepatic injury is generally self-limiting and drug withdrawal seems to be an exception.

Zinc-α2-glycoprotein 1 attenuates non-alcoholic fatty liver disease by negatively regulating tumour necrosis factor-α

BACKGROUND Zinc-α2-glycoprotein 1 (AZGP1) plays important roles in metabolism-related diseases. The underlying molecular mechanisms and therapeutic effects of AZGP1 remain unknown in non-alcoholic fatty liver disease (NAFLD). AIM To explore the effects and potential mechanism of AZGP1 on NAFLD in vivo and in vitro. METHODS The expression of AZGP1 and its effects on hepatocytes were examined in NAFLD patients, CCl4-treated mice fed a high fat diet (HFD), and human LO2 cells. RESULTS AZGP1 levels were significantly decreased in liver tissues of NAFLD patients and mice. AZGP1 knockdown was found to activate inflammation;enhance steatogenesis, including promoting lipogenesis [sterol regulatory elementbinding protein (SREBP)-1c, liver X receptor (LXR), fatty acid synthase (FAS), acetyl-CoA carboxylase (ACC), and stearoyl CoA desaturase 1 (SCD)-1], increasing lipid transport and accumulation [fatty acid transport protein (FATP), carnitine palmitoyl transferase (CPT)-1A, and adiponectin], and reducing fatty acid β-oxidation [farnesoid X receptor (FXR) and peroxisome proliferator-activated receptor (PPAR)-α];accelerate proliferation;and reverse apoptosis in LO2 cells. AZGP1 overexpression (OV-AZGP1) had the opposite effects. Furthermore, AZGP1 alleviated NAFLD by blocking TNF-α-mediated inflammation and intracellular lipid deposition, promoting proliferation, and inhibiting apoptosis in LO2 cells. Finally, treatment with OV-AZGP1 plasmid dramatically improved liver injury and eliminated liver fat in NAFLD mice. CONCLUSION AZGP1 attenuates NAFLD with regard to ameliorating inflammation, accelerating lipolysis, promoting proliferation, and reducing apoptosis by negatively regulating TNF-α. AZGP1 is suggested to be a novel promising therapeutic target for NAFLD.

Nitric oxide and tumour necrosis factor alpha in the process of pseudoexfoliation glaucoma

AIMTo establish the role of nitric oxide (NO), ascorbic acid and tumour necrosis factor-α (TNF-α) in the pathogenesis of pseudoexfoliation glaucoma (XFG).METHODSOur study included 120 patients who were referred for cataract surgery. All patients were divided into four groups according to clinical findings: XFG, early and late pseudoexfoliation syndrome (XFS), and cataract (without pseudoexfoliation). Serum and aqueous humour levels of the ascorbic acid, NO and TNF-α were measured. The concentrations of the ascorbic acid and NO were measured by an appropriate spectrophotometric method. Enzyme-linked immunosorbent assay (ELISA) was used to determine TNF-α level.RESULTSAqueous humour concentration of ascorbic acid was significantly lower in patients with late XFS (0.61±0.11 mmol/L) and XFG (0.48±0.15 mmol/L) compared to patients with early XFS (0.9±0.15 mmol/L) and cataract (1.16±0.22 mmol/L), while there was no difference in serum concentration in all examined groups. Aqueous humour concentration of NO was significantly higher in patients with XFG (77.7±11.4 µmol/L) compared to patients with early XFS (50.27±9.34 µmol/L) and cataract (49.77±7.1 µmol/L), while serum concentration was increased in the early stage of XFS (73.26±8.29 µmol/L). Aqueous humour level of proinflammatory cytokine TNF-α was increased in patients with XFS (early 460.04±18.32 pg/mL; late 502.42±53.23 pg/mL) and XFG (510.34±43.07 pg/mL), while there was no difference in serum level in all examined groups of patients.CONCLUSIONReduced ascorbic acid and elevated NO and inflammation related cytokine TNF-α level in aqueous humour of the patients with developed XFG suggest that oxidative stress induces local inflammation.

Intragingival injection of Porphyromonas gingivalis-derived lipopolysaccharide induces a transient increase in gingival tumour necrosis factor-a, but not interleukin-6,in anaesthetised rats

This study used in vivo microdialysis to examine the effects of intragingival application of lipopolysaccharide（LPS） derived from Porphyromonas gingivalis（Pg-LPS） on gingival tumour necrosis factor（TNF）-a and interleukin（IL）-6 levels in rats. A microdialysis probe with an injection needle attached to the surface of the dialysis membrane was implanted into the gingiva of the upper incisor. For comparison, the effects of LPS derived from Escherichia coli（Ec-LPS） on IL-6 and TNF-a levels were also analysed. Pg-LPS（1 mg/1 m L） or Ec-LPS（1 or 6 mg/1 m L） was applied by microsyringe, with gingival dialysates collected every hour. Enzyme-linked immunosorbent assay（ELISA） revealed that gingival dialysates contained approximately 389 pg？m L21 of IL-6 basally; basal TNF-a levels were lower than the detection limit of the ELISA. Pg-LPS failed to alter IL-6 levels but markedly increased TNF-a levels, which remained elevated for 2 h after treatment. Neither IL-6 nor TNF-a were affected by Ec-LPS. Reverse transcriptase-polymerase chain reaction（RT-PCR） analysis revealed that the gingiva expresses Toll-like receptor（TLR） 2 and TLR4 m RNA. Immunohistochemical examination showed that TLR2 and TLR4 are expressed by gingival epithelial cells. The present study provides in vivo evidence that locally applied Pg-LPS, but not Ec-LPS, into the gingiva transiently increases gingival TNF-a without affecting IL-6. The present results suggest that TLR2 but not TLR4 expressed on gingival epithelial cells may mediate the Pg-LPS-induced increase in gingival TNF-a in rats.

AN EXPERIMENTAL STUDY OF THE TUMOUR NECROSIS FACTOR LEVELSIN AQUEOUS HUMOR AFTER TRAUMATIC CATARACT AND INTRAOCULAR LENS IMPLANTATION

Purpose. This paper studies the tumour necrosis factor (TNF) levels in aqueous humor after traumatic cataract extraction and posterior chamber (PC) intraocular lens (IOL) implantation in rabbits,and discusses the effect of TNF on postoperative anterior ocular inflammation. Methods. Twenty seven pigmented rabbits were divided into three groups: for the first group, the IOL were placed in the capsular bag after traumatic cataract extraction; for the second, the Extracapsular cataract extraction without IOL implantation; and for the third, the control group without surgical intervention. On the 1st, 3rd, 7th and 14th day postoperatively, aqueous humor samples were obtained. A modified double antibodies indirect sandwich ELISA was used to detected for the presence of TNF. The data were studied by means of analysis of variance in SAS software. Result. The TNF level was increased in aqueous humor and reached its maximum on the 1st postoperative days after traumatic cataract extraction and PC IOLs implantation, and the TNF levels are significantly higher (P<0 05) on the 1st, 3rd, 7th and 14th day postoperatively in traumatic cataract extraction and PC IOL implanted group than that in the non surgical intervention group and extracapsular cataract extraction group. Conclusions. The increase of TNF levels had a close relationship with presence of the IOL itself which induces the secretion of TNF. This suggested that TNF as the principal mediators of immunological and inflammatory responses, so that may play critical role in anterior ocular inflammative response after traumatic cataract extraction and IOL implantation.

Withdrawal of anti-tumour necrosis factor α therapy in inflammatory bowel disease

Anti-tumour necrosis factor α(anti-TNFα) therapy is an established treatment in inflammatory bowel disease.However, this treatment is associated with high costs and the possibility of severe adverse events representing a true challenge for patients, clinicians and health care systems.Consequently, a crucial question is raised namely if therapy can be stopped once remission is achieved and if so, how and in whom.Additionally, in a real-life clinical setting, discontinuation may also be considered for other reasons such as the patient's preference, pregnancy, social reasons as moving to countries or continents with less access, or different local policy or reimbursement.In contrast to initiation of anti-TNFα therapy guidelines regarding stopping of this treatment are missing.As a result, the decision of discontinuation is still a challenging aspect in the use of anti-TNFα therapy.Currently this is typically based on an estimated, case-by-case, benefit-risk ratio.This editorial is intended to provide an overview of recent data on this topic and shed light on the proposed drug withdrawal strategies.

An Experimental Study of the Tumour Necrosis Factor Level in Aqueous Humor after Transscleral Fixation of Intraocular Lens

Purpose: The tumour necrosis factor (TNF) level in aqueous humor after transscleral fixation of intraocular lens (IOL) implantation in rabbits and discuss the effect of TNF on postoperative anterior ocular inflammation.Methods: Twenty - seven pigmented rabbits were divided into three groups. Group 1: transscleral fixation of posterior chamber (PC) IOL implantation;Group 2; Lens of rabbits was removed without IOL implantation; Group 3; the comtrol group, without surgical intervention. On the 1st, 3rd, 7th and 14th postoperative days,aqueous humor samples were obtained. An modified double antibodies indirect sandwich ELISA was used to detected for the presence of TNF. The data were analyzed by using analysis of variance of SAS software. Results: It was found that TNF level in aqueous humor was increased after transscleral fixation of IOL implantation. TNF level reached its maximum on the 14th postoperative day in the IOL implanted group. TNF level on 1st, 3rd, 7th and 14th days postoperatively was

Effects of propofol on Bax and Bcl-2 expression induced by tumour necrosis factor-α in mouse spinal cord neurons in vitro

Objective:To study the effects of propofol on Bax and Bcl-2 expression induced by tumour necrosis factor-α(TNF-α) in mouse spinal cord neurons in vitro. Methods:Spinal cord neurons were isolated from fetal mice and cultured in Neurobasal medium with B27 supplement. On the 7^th day, cultured neurons were randomly divided into 6 groups: control group, propofol (50 umol/L)group, TNF-α group, propofol (25 umol/L) with TNF-α group, propofol (50 umol/ L) with TNF-α group, and propofol ( 100 umol/L)with TNF-α group. Propofol was added to the cultured cells respectively and the cells were incubated for 30 min. Then TNF-α was added to the cultured cells(the final concentration of TNF-α was 2 000 U/ml) and incubated for 24 h. The Bax and Bcl-2 expression were measured by immunocytochemical technique. Results:In TNF-α group, the expression of Eax increased and the expression of Bcl-2 decreased (P<0.01, vs control). However, treatment with various concentrations of propofol (25, 50, 100 umol/L) decreased the expression of Bax and increased the expression of Bcl-2 (P<0.05, P<0.05, P<0.05, vs TNF-α). Conclusion: Propofol can inhibit the apoptosis induced by TNF-α by modulating the expression of Bax and Bcl-2.

Tumour Necrosis Factor Alpha and Oxidative Stress in the Breath Condensate of Those with Non-Small Cell Lung Cancer

Background and Aims: Lung cancer is a leading cause of cancer mortality worldwide and is associated with the release of tumour necrosis factor-α (TNF-α), subsequent cellular apoptosis and the generation of oxidative stress. Exhaled breath condensate (EBC) analysis is a non-invasive method for sampling biofluids from the lower respiratory tract. This study aimed to evaluate possible biomarkers of lung cancer by measuring the levels of TNF-α and the oxidation of ascorbic acid in EBC. Patients with lung cancer were enrolled into the study prior to treatment, during treatment and post-treatment, and results compared with an age-matched control population. Material and Methods: Patients with Stage II-IV non small cell lung cancer (NSCLC) were recruited prior to and at stages of their treatment. EBC levels of TNF-α, and rate of ascorbic acid oxidation were measured. Results: A total of 19 patients with NSCLC (mean age 71.37 ± 7.77 yrs) and 25 age-matched control subjects were enrolled. Levels of EBC TNF-α were elevated in the EBC of patients with lung cancer compared with control subjects (1.02 ± 0.07 pg/ml vs. 0.51 ± 0.06 pg/ml, p < 0.0001). Moreover, the rate of ascorbic acid oxidation was significantly greater in the EBC of patients with lung cancer compared with control subjects (2.20% [0.4 – 11.0] vs. 1.00% [0.1 – 8.5], p = 0.0244). Conclusion: TNF-α and the rate of ascorbic acid oxidation was elevated in the EBC of patients with lung cancer regardless of treatment. Longitudinal studies in a larger population are required to evaluate these markers for the effect of treatment and prognosis.

Effects of Tryptergium Wilfordii Polyglyco-sidium on the Tumour Necrosis Factor Levels in Aqueous Humor after Intraocular Lens Implantation

Purpose : Effects of Tryptergium Wilfordii Polyglycosidium (TWP) on the Tumour Necrosis Factor (TNF) levels in aqueous humor after intraocular lens (IOL) implantation were studied in rabbits.Methods: Twenty-seven pigmented rabbits were divided into three groups. In the first group, the IOL were placed in the capsular bag after lens extraction. In the second group, rabbits received TWP therapy after IOL implantation. And in the third group, rabbit received prednisone therapy after IOL implantation. Aqueous humor samples were aspirated on the 1st, 3rd, 7th, and 14th postoperative day. A modified double antibodies indirect sandwich EL ISA was used to detect for the presence of TNF. The data were closely studied by means of analysis of variance with SAS software.Results; It was found that TNF level in aqueous humor reached its maximum on the 7th postoperative day in the group with IOL implantation. It was also found that the TNF levels in aqueous humor on the 7th and 14th postoperative day were

Single nucleotide polymorphism in the tumor necrosis factor-alpha gene affects inflammatory bowel diseases risk

AIM: To investigate the role that single nucleotide polymorphisms (SNPs) in the promoter of the tumour necrosis factor-alpha (TNF-α) gene play in the risk of inflammatory bowel diseases (IBDs) in a New Zealand population, in the context of international studies. METHODS: DNA samples from 388 patients with Crohn's disease (CD), 405 ulcerative colitis (UC), 27 indeterminate colitis (IC) and 201 randomly selected controls, from Canterbury, New Zealand were screened for 3 common polymorphisms in the TNF-α receptor: -238 G→A, -308 G→A and -857C→T, using a TaqmanR assay. A meta-analysis was performed on the data obtained on these polymorphisms combined with that from other published studies. RESULTS: Individuals carrying the -308 G/A allele had a significantly (OR = 1.91, χ2 = 17.36, P < 0.0001) increased risk of pancolitis, and a 1.57-fold increased risk (OR = 1.57, χ2 = 4.34, P = 0.037) of requiring a bowel resection in UC. Carrying the -857 C/T variant decreased the risk of ileocolonic CD (OR = 0.56, χ2 =4.32, P = 0.037), and the need for a bowel resection (OR = 0.59, χ2 = 4.85, P = 0.028). The risk of UC was reduced in individuals who were smokers at diagnosis, (OR = 0.48, χ2 = 4.86, P = 0.028). CONCLUSION: TNF-α is a key cytokine known to play a role in inflammatory response, and the locus for the gene is found in the IBD3 region on chromosome 6p21, known to be associated with an increased risk for IBD. The -308 G/A SNP in the TNF-α promoter is functional, and may account in part for the increased UC risk associated with the IBD3 genomic region. The -857 C/T SNP may decrease IBD risk in certain groups. Pharmaco- or nutrigenomic approaches may be desir- able for individuals with such affected genotypes.

Comparison of Properties of Tumor Necrosis Factor-α Converting Enzyme (TACE) and Some Matrix Metalloproteases (MMPs) in Catalytic Domains

The crystal structural data of TACE, MMP-1, MMP-2, MMP-3 and MMP-9 were obtained from PDB database, and then their catalytic domains＇ properties including conformation, molecular surface hydrophobicity and electrostatic potential were analyzed and compared by using Insight II molecular modeling software. It was found that the conformation and molecular surface hydrophobicity of catalytic domains of TACE and MMPs were not obviously different, but the molecular surface electrostatic potential of catalytic domain of TACE＇ and MMPs had obvious differences. The findings are helpful in the Rational Drug Design of TACE selective inhibitor.

强直性脊柱炎合并急性早幼粒细胞白血病及弥散性血管内凝血1例并文献复习

目的探讨强直性脊柱炎(ankylosing spondylitis,AS)合并急性早幼粒细胞白血病(acute promyelocytic leukemia,APL)及弥散性血管内凝血(disseminated intravascular coagulation,DIC)的临床特点、诊断和治疗,深入了解三者之间的潜在关系和机制。方法报告1例AS合并APL及DIC的临床特点及治疗,结合文献进行归纳总结。结果患者APL达到完全缓解期,继续巩固治疗。AS、APL和DIC之间的关系涉及到人白细胞抗原-B27、肿瘤坏死因子-α和白介素-23/17轴和其他免疫功能。结论AS与APL、DIC之间的关系千丝万缕,从基因到免疫功能都存在着潜在的发病机制,其中的奥妙仍需探索。

土藤草颗粒对微晶型尿酸钠致家兔急性痛风性关节炎的药效学研究

目的观察土藤草颗粒对微晶型尿酸钠(monosodium urate,MSU)致家兔急性痛风性关节炎模型的药效学作用。方法选用取雄性日本大耳白兔,随机分为正常对照组,模型对照组,阳性药秋水仙碱组(0.18 mg·kg^(-1)),土藤草颗粒高、中、低剂量组分别为600、300、150 mg·kg^(-1)。通过家兔左后肢膝关节腔内注入MSU的方式建立急性痛风性关节炎模型,给药5天后收集关节液,检测关节腔积液中的白细胞数,测定关节液中炎症细胞因子白介素-6(interleukin-6,IL-6)、白介素-8(interleukin-8,IL-8)、肿瘤坏死因子-α(tumour necrosis factor-α,TNF-α)、白介素-1β(interleukin-1β,IL-1β)、前列腺素E2(prostaglandin E2,PGE2)含量;采血检测血尿酸值,给药前后血清中尿素(urea,UREA)、胆固醇(cholesterol,CHO)、血肌酐(serum creatinine,Cre)、血糖(glucose,GLU)及甘油三酯(triglyceride,TG)含量。结果土藤草颗粒高、中、低剂量组给药5 d后关节腔内白细胞数均有所下降,中剂量组与模型对照组比较有显著性差异(P<0.01);高、中剂量组有降低血尿酸的趋势;土藤草颗粒对家兔血清中UREA、CHO、Cre、GLU及TG含量均无影响;与模型对照组比较,土藤草颗粒高、中、低剂量组IL-6、IL-8、TNF-α及PGE2含量均明显降低,其中高、中、低剂量组的IL-6、TNF-α含量,高、中剂量组IL-8含量及中剂量组PGE2含量与之比较有显著性差异(P<0.01);土藤草颗粒高、中、低剂量组可以一定程度上降低关节液中IL-1β含量。结论土藤草颗粒对MSU致急性关节炎家兔模型有明显的治疗作用,可以减少动物关节腔内白细胞数量、抑制炎症细胞因子的表达,降低血清中尿酸含量。

血清IL-10/TNF-α比值对卵巢子宫内膜异位症患者腹腔镜术后疾病复发的预测价值

目的分析血清白介素-10(IL-10)/肿瘤坏死因子-α(TNF-α)比值对卵巢子宫内膜异位症(OEMs)患者腹腔镜术后疾病复发的预测价值。方法选取2019年1月至2021年12月唐山市妇幼保健院收治的223例OEMs患者作为研究对象,均接受腹腔镜保守性手术治疗。根据术后随访1年疾病复发情况分为复发组(n=27)与未复发组(n=196),比较两组基线资料及出院前末次检查时实验室指标,分析出院前血清IL-10/TNF-α比值对OEMs患者腹腔镜术后疾病复发的预测价值。结果223例患者术后随访1年期间疾病复发27例,复发率为12.11%。与未复发组相比,复发组术前病灶最大直径更大,美国生育医学会修订(r-ASRM)分期更高,出院前血清IL-10及TNF-α水平、IL-10/TNF-α比值更高(P<0.05)。受试者工作特征(ROC)曲线结果显示,出院前血清TNF-α水平预测OEMs患者腹腔镜术后疾病复发的曲线下面积(AUC)为0.640,预测价值较低;出院前血清IL-10水平及IL-10/TNF-α比值预测OEMs患者腹腔镜术后疾病复发的AUC分别为0.847、0.860,具有一定预测价值,且IL-10/TNF-α比值预测价值更高。结论出院前血清IL-10/TNF-α比值与OEMs患者腹腔镜术后疾病复发有关,可用于患者术后疾病复发的早期预测中。

血清IL-1β、TNF-α及BDNF在双相情感障碍中的水平变化及相关性分析

目的分析血清炎症因子、脑源性神经营养因子(BDNF)在双相情感障碍(BD)患者中的水平变化,并分析其与BD临床症状的相关性。方法选取宿州市第二人民医院2021年1月—2023年1月收治的100例BD患者,根据BD病情分为BD发作组(47例)和BD缓解组(53例),另选取同期收治的100例单相抑郁情感障碍患者作为单相组、78例健康体检者作为健康组。采用酶联免疫吸附试验(ELISA)检测并比较4组患者的血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)和BDNF水平。比较4组患者血清IL-1β、TNF-α、BDNF水平及汉密顿抑郁量表(HAMD)、贝克-拉范森躁狂量表(BRMS)以及霍普金斯词语学习测验修订版(HVLT-R)评分,采用Pearson分析法分析血清IL-1β、TNF-α及BDNF水平与BD患者临床症状的相关性。结果BD发作组、BD缓解组和单相组患者的发病频率和病程比较差异有统计学意义(P<0.05),其中BD发作组和BD缓解组患者的发病频率及病程均高于单相组,且BD发作组患者的发病频率及病程高于BD缓解组(P<0.05);与健康组相比,单相组、BD发作组和BD缓解组患者血清IL-1β和TNF-α水平显著升高(P<0.05),且BD发作组和BD缓解组患者血清IL-1β和TNF-α水平高于单相组,BD发作组患者血清IL-1β和TNF-α水平高于BD缓解组(P<0.05);与健康组相比,单相组、BD发作组和BD缓解组患者BDNF水平显著降低(P<0.05),且BD发作组和BD缓解组患者BDNF水平低于单相组,BD发作组患者BDNF水平低于BD缓解组(P<0.05);与健康组相比,单相组、BD发作组和BD缓解组患者HAMD和BRMS评分均显著升高(P<0.05),BD发作组和BD缓解组患者BRMS评分高于单相组,BD发作组患者BRMS评分高于BD缓解组(P<0.05),且BD发作组和单相组患者HAMD评分高于BD缓解组,BD发作组患者HAMD评分高于BD缓解组(P<0.05);与健康组相比,单相组、BD发作组和BD缓解组患者HVLT-R评分显著降低(P<0.05),且BD发作组和BD缓解组患者HVLT-R评分低于单相组,BD发作组患者HVLT-R评分低于BD缓解组(P<0.05);Pearson相关性分析显示,BD患者血清IL-1β、TNF-α水平与发病频率、HAMD、BRMS呈正相关关系,与HVLT-R呈负相关关系(P<0.05);BD患者BDNF水平与HVLT-R呈正相关关系,与病程、发病频率、HAMD、BRMS呈负相关关系(P<0.05)。结论血清IL-1β、TNF-α及BDNF在BD患者中的水平变化与疾病的临床严重程度相关,可将其作为BD病理生理过程中潜在的生物标志物或治疗靶点。

血清CTRP9、AMH对多囊卵巢综合征患者IVF-ET助孕结局的预测价值

目的探讨行体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)助孕的多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者血清中补体C1q/肿瘤坏死因子相关蛋白9(complement C1q/tumour necrosis factor-related protein 9,CTRP9)、抗苗勒管激素(anti-mullerian hormone,AMH)对治疗结果的预测价值。方法选取2022年3月—2023年7月于重庆医科大学附属第一医院生殖中心行IVF-ET的85例PCOS患者。根据妊娠结局分为临床妊娠组43例与临床未妊娠组42例。记录2组患者的一般资料,测定血清CTRP9和AMH水平,分析其与妊娠结局的关系。结果临床未妊娠组血清CTRP9为(290.19±58.97)ng/mL,AMH为3.39(2.09,5.42)ng/mL,均低于临床妊娠组的(413.63±89.56)ng/mL、7.42(5.45,9.90)ng/mL(P<0.05)。血清CTRP9、AMH水平、优胚数是PCOS患者IVF-ET妊娠成功的保护因素(P<0.05)。血清CTRP9预测行IVF-ET的PCOS患者妊娠成功的敏感度与特异度为74.40%和90.50%,曲线下面积(area under the curve,AUC)值为0.836;血清AMH预测敏感度与特异度为83.70%和73.80%,AUC值为0.859;血清CTRP9和AMH联合预测的敏感度和特异度分别为88.40%和92.90%,AUC值为0.924,高于单独使用CTRP9或AMH预测的价值。结论血清CTRP9、AMH与PCOS患者IVF-ET治疗结局密切相关,且与单一指标检测比较,两者联合检测可提高预测价值。

益生菌颗粒联合腹腔镜手术治疗子宫内膜异位症患者的效果及对妊娠的影响

目的探讨益生菌颗粒联合腹腔镜手术治疗子宫内膜异位症(EMS)患者的效果及对妊娠的影响。方法选取2021年3月—2022年5月接受腹腔镜手术的EMS 100例,采用随机数字表法将其分为对照组和研究组,每组50例。2组均接受腹腔镜手术,对照组在术后使用醋酸戈舍瑞林治疗,研究组在对照组基础上联合益生菌颗粒治疗。比较2组的妊娠率、生活质量(健康调查简表SF-36评分)、性激素指标[卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))、孕酮(P)、睾酮(T)、泌乳素(PRL)]、炎性因子[白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)]及不良反应。结果研究组总妊娠率高于对照组(P<0.05)。治疗后,2组健康调查简表SF-36各项目评分均高于治疗前,且研究组高于对照组(P<0.05)。治疗后,2组血清FSH、LH、E_(2)、P、T、PRL、IL-6及TNF-α水平均低于治疗前,且研究组低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论EMS患者接受腹腔镜手术治疗后,应用醋酸戈舍瑞林联合益生菌颗粒,可提升妊娠率及生活质量,还能降低血清性激素及炎性因子水平。

慢性阻塞性肺疾病患者血清IL-2、IL-33、TNF-α变化的研究进展

慢性阻塞性肺疾病是呼吸系统疾病中最为常见的一种疾病,是以气流受阻为特征的一种疾病,随着空气污染的加剧以及人口老龄化的发展,慢性阻塞性肺疾病的发病率呈现不断升高的趋势,且病死率也在不断上升,对人类健康造成极大威胁。多数研究表明,慢性阻塞性肺疾病发生与发展与众多炎症因子有关,炎症因子的变化对病情具有一定的指示作用。对炎症因子的早期监测,控制其变化对于缓解病情的发展具有重要价值。

岐黄针疗法治疗寒湿痹阻型膝骨关节炎的临床观察

【目的】观察岐黄针疗法治疗寒湿痹阻型膝骨关节炎的临床疗效及其对患者血清白细胞介素1β(IL-1β)和肿瘤坏死因子α(TNF-α)的影响。【方法】将60例寒湿痹阻型膝骨关节炎患者随机分为观察组和对照组,每组各30例,对照组给予常规针刺疗法治疗,观察组给予岐黄针疗法治疗,治疗1次为1个疗程,共治疗3个疗程。治疗3个疗程后,评价2组临床疗效,观察2组患者治疗前后西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分的变化情况,以及视觉模拟量表(VAS)评分的变化情况。比较2组患者治疗前后IL-1β和TNF-α水平的变化情况。【结果】(1)观察组总有效率为83.33%(25/30),对照组为80.00%(24/30),2组比较差异无统计学意义(P>0.05)。(2)治疗后,2组患者的WOMAC评分均明显改善(P<0.05)。观察组在改善WOMAC评分方面稍优于对照组,但差异无统计学意义(P>0.05)。(3)治疗后,2组患者的VAS评分均明显改善(P<0.05)。观察组在改善VAS评分方面稍优于对照组,但差异无统计学意义(P>0.05)。(4)治疗后,2组患者的TNF-α水平均明显改善,但差异无统计学意义(P>0.05)。观察组在改善TNF-α水平方面稍优于对照组,但差异无统计学意义(P>0.05)。(5)治疗后,2组患者的IL-1β水平均明显改善(P<0.05)。观察组在改善IL-1β水平方面稍优于对照组,但差异无统计学意义(P>0.05)。【结论】岐黄针疗法取穴少、耗材少、操作时间短。其治疗寒湿痹阻型膝骨关节炎,可缓解患者的疼痛症状,改善患者的关节功能,疗效显著,其作用机制可能与抑制外周血IL-1β水平相关。