The prognostic potential of pretreatment C-reactive protein to albumin ratio in stage IE/IIE extranodal natural killer/T-cell lymphoma

Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Methods One hundred and fourteen patients diagnosed with extranodal NK/T cell lymphoma at Sichuan Cancer Hospital from September 2011 to November 2016 were retrospectively reviewed. An optimal cutoff value of CRP/Alb for overall survival rate as an endpoint was obtained using the receiver operating curve (ROC). Results The optimal cutoff value of CRP/Alb was 0.15. For the low CRP/Alb group, the 3-year progression-free survival (PFS) was 78.6% and the 3-year overall survival (OS) was 80.7%. The 3-year PFS and OS values for the high CRP/Alb group were 41.6% and 45.2%, respectively. Differences for PFS (P < 0.001) and OS (P < 0.001) between the two groups were statistically significant. Univariate analysis showed that ECOG, IPI, CRP, GPS, and CRP/Alb were significantly associated with PFS. Similarly, all five were also significantly associated with OS. Multivariate analysis further confirmed that ECOG and CRP/ Alb were independent prognostic factors for both PFS and OS. Moreover, the cutoff value of CRP/Alb showed superior prognostic ability in discriminating between patients with different outcomes in low-risk group based on GPS, IPI, and KPI scores. Conclusion CRP/Alb is a promising prognostic marker for early-stage extranodal NK/T cell lymphoma.

C-reactive protein and cardiovascular diseases

Recently many new disease markers and risk factors have been proposed, but it is not yet clear how far the new markers are validated as predictive risk factors enable us to increase accuracy as well as enhancing our ability to predict cardiovascular (CV) events and to plan prevention and therapy.

Combined effects of serum C-reactive protein and A Body Shape Index(ABSI)on ischemic stroke incidence among Inner Mongolians in China

Objective We aimed to evaluate the combined effect of high serum C-reactive protein (CRP) and high A Body Shape Index (ABSI) on ischemic stroke incidence in an Inner Mongolian population in China.Methods A prospective cohort study was conducted among 2,589 participants from June 2002 to July 2012 in Inner Mongolia, China.

Inflammation and vascular disease: the role of C-reactive protein

Inflammation is an important component of active atherosclerotic disease. C-reactive protein (CRP)is a non-specific inflammatory marker that is increased in inflammatory conditions. Newer more sensitive assays (high sensitivity CRP) can detect the low levels of inflammation associated with vascular disease. CRP levels can give further risk assessment to individuals beyond predictions from traditional risk factors. This measurement is most useful in helping to discriminate risk in intermediate risk patients such as metabolic syndrome patients. Exercise and weight loss have been shown to significantly lower CRP levels. Lipid lowering therapies, especially with the statin class of medications, also lower CRP levels. A reduction in inflammation may be an important component of plaque stabilization and contribute to cardiovascular risk reduction.

Clinical perspective on C-reactive protein in prognostication of major adverse cardiac events in the elderly with established coronary heart disease

The systemic response to tissue injury, regardless of cause is characterized by a cytokine-mediated alteration in the hepatic synthesis of a number of different plasma proteins,known collectively as 'acute phase reactants'. These proteins include C-reactive protein, serum amyloid A protein, alphal glycoprotein, ceruloplasmin, alpha macroglobulins, complement components (C1-C4, factor B, C9, C11), alpha1antitrypsin, alpha1 antichymotrypsin, fibrinogen, prothrombin,factor Ⅷ, plasminogen, haptoglobin, ferritin, immunoglobulins and lipoproteins. The initiation of the acute phase response is linked to the production of hormone-like polypeptide mediators now called cytokines, namedly, interleukin 1(IL-1),tumor necrosis factor, interferon gamma, interleukin 6 (IL-6),leukemia inhibitory factor, ciliary neurotropic factor, oncostatin M, and interleukin 11 (IL- 11).……

Effect of flurbiprofen combined with prednisolone on interleukin-6 in elderly surgery patients

Objective: To determine the effect of flurbiprofen combined with prednisolone on interleukin-6 in elderly surgery patients. Methods: In this double-blind randomized controlled study, patients aged 65 to 80 who were undergoing spinal fusion surgery for disc herniation were administered flurbiprofen 100 mg (P group, flurbiprofen group), prednisolone 0.6 mg/kg (D group, prednisolone group), prednisolone 0.6 mg/kg plus flurbiprofen 100 mg (P + D group, flurbiprofen + prednisolone group) or normal saline (S group, saline group) 15 minutes before the induction of anesthesia. Plasma samples were collected before surgery (T0) and on day 1 (T1), day 2 (T2) and day 3 (T3) following surgery. At the same time, systemic inflammatory response syndrome (SIRS) was assessed by SIRS criteria. The levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) for collected samples were measured. Results: Other groups had significantly lower levels of IL-6, CRP and occurrence of SIRS than S group (p < 0.05). Compared to groups P and D, the levels of IL-6 and CRP in P + D group were significantly lower on T1 (p < 0.05). Peak levels of IL-6 in all groups were presented on T1 (p 0.05). The levels of CRP within three days were significantly different but did not show peak levels (p > 0.05). Conclusion: Compared to prednisolone or flurbiprofen, combining flurbiprofen with prednisolone in elderly surgery patients led to an increased suppression of IL-6.

慢性阻塞性肺疾病急性加重期血清瘦素与肺功能关系的临床研究

目的：探讨血清瘦素（ leptin ）与慢性阻塞性肺疾病（ chronic obstructive pulmonary disease， COPD）急性加重期患者肺功能的关系。方法选择COPD急性加重期患者35例、COPD稳定期患者38例及健康志愿者30例，抽取空腹血。用放免法测定血清瘦素、用酶联免疫吸附法（ELISA）测定肿瘤坏死因子-α（TNF-α）及用全自动生化仪检测C-反应蛋白（CRP）；检测肺功能，记录1 s用力呼气量（ FEVl ）、最大通气量（ MVV）、肺一氧化碳弥散量（ DLCO ）等指标、分析COPD急性加重期患者血清瘦素水平与TNF-α、CRP、肺功能等的相关性。结果①COPD急性加重期患者血清瘦素、TNF-α、CRP均明显高于COPD稳定期组和对照组，而FEVl、MVV、DLCO则明显低于后者；②COPD急性加重期患者血清瘦素与TNF-α、CRP呈正相关，与FEVl、MVV、DLCO呈负相关。结论血清瘦素可判断COPD急性加重期预后，可以评估肺功能损害风险。

Chemerin、C反应蛋白与2型糖尿病大血管病变的关系研究

目的探讨2型糖尿病(T2DM)患者血清chemerin、C反应蛋白(CRP)水平与2型糖尿病大血管病变的关系。方法用酶联免疫法(ELISA)检测30例正常对照组、30例单纯2型糖尿病和30例2型糖尿病大血管病变患者的血清chemerin水平,免疫比浊法检测CRP水平,同时测定各组身高、体质量、体质量指数(BMI)、收缩压、舒张压、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HLD-C)、空腹胰岛素(FIns)、颈动脉内膜厚度等。结果 2型糖尿病大血管病变组和单纯2型糖尿病组chemerin、CRP水平高于正常对照组(P<0.05),2型糖尿病大血管病变组高于单纯2型糖尿病组(P<0.05)。血清chemerin、CRP水平与收缩压、FPG、HbA1c、LDL-C、FIns、颈动脉内膜厚度等呈正相关,与HDL-C呈负相关(P<0.05)。结论血清chemerin、CRP水平是2型糖尿病患者大血管病变的主要危险因子,在2型糖尿病大血管病变的过程中起重要作用。

两种C-反应蛋白分析方法的验证比对

目的：实验室对同一个测定项目CRP存在不同检测系统时,应对于不同检测系统进行数据比对和偏差评估,以确保检测结果的可比性,也便于临床医生的决策.方法：采用两种不同水平（高、 中、 低值）质控品和各个不同浓度的患者的抗凝全血和分离血清用于我室QuikRead CRP分析仪以及BNP全自动特定蛋白仪检测CRP进行方法对比和偏差的评估,为本实验室内不同检测系统测定结果可比性提供数据.结果：两种检测系统的的r=0.991,r2=0.981.在3个医学决定水平上的系统误差都在10％以内,可以适应临床对于CRP测定的要求.结论：门诊使用的QuikRead CRP分析仪以及免疫室使用的BNP全自动特定蛋白仪检测同一标本时具有良好的相关性其预期偏差也是可以接受的.

血清钙C-反应蛋白及血清淀粉酶样蛋白A水平对重症急性胰腺炎早期预测价值的研究

目的：探讨血清钙、C-反应蛋白（ C-reactive protein， CRP）及血清淀粉酶样蛋白A（ serum amylase like protein A ， SAA）水平对重症急性胰腺炎（ severe acute pancreatitis ， SAP）的早期预测价值。方法120例急性胰腺炎患者，分为轻症（ MAP）组91例，SAP组29例，同期健康体检者61例为对照组；比较三组血清钙、SAA和CRP水平。结果 MAP和SAP组CRP和SAA水平均较对照组显著升高，第2天达到峰值，SAP组显著高于MAP组；两组血清钙水平显著低于对照组，SAP组显著低于MAP组。三者联合测定的诊断敏感度96．9％和特异度97．4％。结论动态测定血清钙、SAA和CRP水平对评估SAP具有重要的临床价值。

Predictive value of C-reactive protein and the Pediatric Risk of Mortality Ⅲ Score for occurrence of postoperative ventilator-associated pneumonia in pediatric patients with congenital heart disease

Importance:Ventilator-associated pneumonia (VAP) is one of the most common complications after cardiac surgery in children with congenital heart disease (CHD).Early prediction of the incidence of VAP is important for clinical prevention and treatment.Objective:To determine the value of serum C-reactive protein (CRP) levels and the Pediatric Risk of Mortality Ⅲ (PRISM Ⅲ) score in predicting the risk of postoperative VAP in pediatric patients with CHD.Methods:We performed a retrospective review of clinical data of 481 pediatric patients with CHD who were admitted to our pediatric intensive care unit.These patients received mechanical ventilation for 48 hours or longer after corrective Surgery.On the basis of their clinical manifestations and laboratory results,patients were separated into two groups of those with VAP and those without VAP.CRP levels were measured and PRISM Ⅲ scores were collected within 12 hours of admission to the pediatric intensive care unit.The Pearson correlation coefficient was used to evaluate the association of CRP levels and the PRISM score with the occurrence of postoperative VAP.A linear regression model was constructed to obtain a joint function and receiver operating curves were used to assess the predictive value.Results:CRP levels and the PRISM Ⅲ score in the VAP group were significantly higher than those in the non-VAP group (P < 0.05).Receiver operating curves suggested that using CRP + the PRISM Ⅲ score to predict the incidence of VAP after congenial heart surgery was more accurate than using either of them alone (CRP + the PRISM Ⅲ score:sensitivity:53.2%,specificity:85.7%).When CRP + the PRISM Ⅲ score was greater than 45.460,patients were more likely to have VAP.Interpretation:Although using CRP levels plus the PRISM Ⅲ score to predict the incidence of VAP after congenial heart surgery is more accurate than using either of them alone,its predictive value is still limited.

Interleukins and Acute Phase Proteins of Bovine Sera during Natural Helminth Burden in Ibadan Nigeria

Inflammatory reactions in the gastrointestinal tract play an important role in the pathogenesis of gastroenteritis in bovine helminthosis. This study determined the serum concentrations of cytokines induced acute phase proteins (Serum Amyloid A (SAA), Haptoglobin (Hp) and C-reactive protein (CRP)) and the levels of immunoreactive interleukins (IL-1, IL-2, IL-3, IL-4, IL-5 and IL-6) in cattle naturally infected with helminths. We sampled a total of 480 slaughtered cattle of both sexes in a major abattoir in Ibadan, Nigeria. Sedimentation, floatation and modified McMaster techniques were employed to determine the degrees of helminth infections. Animals with eggs per gram (epg) less than 200 were adjudged to be apparently healthy. The serum concentrations of interleukins and acute phase proteins were determined using the Technicon AutoAnalyzer Model AA II. It was found that mean SAA (μg/l) and CRP (%) levels were significantly (P 0.05). Therefore, some acute phase proteins are involved in the pathophysiology of bovine helminthosis and are closely related to the inflammatory activation of the disease. In lieu of these findings, it is suggested that systemic markers of inflammation can identify subjects at high risk of natural bovine helminthosis and that IL-6 and SAA may be used as indicators for bovine helminthosis.

心力衰竭时血清C反应蛋白浓度的变化

作者分别定量检测了32例急性左心衰竭、34例慢性充血性全心衰竭治疗前及治疗7～10天心衰显著好转后的血清C反应蛋白(CRP)浓度,并与40例心功能正常的心血管病患者作对照。结果发现,急性左心衰竭组中81.2％治疗前血清CRP浓度显著升高,治疗好转后CRP浓度迅速下降,两者有非常显著的差异(P<0.01);慢性充血性全心衰竭组CRP浓度轻微升高,但治疗前后无统计学差异((P>0.05);心功能正常者CRP无任何变化。同时,急性左心衰竭者CRP升高的程度与EF有直接关系(呈负相关,r=-0.571),提示 CRP升高的程度,对判断急性心衰的严重程度及治疗效果有一定的价值。

C-reactive protein functions as a negative regulator of macrophage activation induced by apoptotic DNA

C-reactive protein(CRP),an acute-phase protein with an ability to bind to nuclear antigen,has been reported to regulate cytokine secretion and modulate immune responses.We previously reported that activated syngeneic lymphocyte-derived apoptotic DNA(apopDNA)could induce macrophage activation and contribute to the initiation and progression of lupus nephritis.It is reasonable to hypothesize that CRP might regulate apopDNA-induced macrophage activation.Herein,CRP was shown to promote macrophage-mediated apopDNA uptake by binding to apopDNA(CRP/apopDNA complex).Notably,CRP/apopDNA treatment inhibited the production of inflammatory cytokines and chemokines by macrophages which could be induced by apopDNA alone.Further coculture and transwell studies revealed that CRP/apopDNA-induced macrophages prohibited apopDNA-induced macrophage activation in an IL-10 dependent manner.These results provide insight into the potential mechanism of CRP regulatory activity in macrophage activation induced by apopDNA in the context of lupus nephritis and other autoimmune diseases.

Severity Score as a Prognostic Factor for Management of Infections of Odontogenic Origin, a Study of 100 Cases

Purpose: The main objective of the current study is to determine whether it is possible to correlate the longevity of the hospitalization period (LOS) to efficacy of surgical treatment regime and severity scoring. Materials and Methods: A total of 100 patients met our inclusion criteria. All patient records, including results of hematologic and biochemical parameters, were recorded. The patients were later subcategorized further according to a severity score (“Low, Moderate, Severe”) of their main facial space involvement. The main analysis of the study is a regression analysis model;all the variables (sex, age, CRP, white blood cell count, fever, space, and etiology) were stratified according to the overall hospital stay. A crosstab comparison was performed next;the variables were categorized and combined with hospital stay, and then entered in Spearman’s rank correlation coefficient or Spearman’s rho (ρ), 2-tailed (t) Test, and regression equation. The significance level was set at p Results: The most prevalent anatomical space infection was vestibular space abscess or cellulitis 33%, followed by an infraorbital space abscess or cellulitis 17%. Most commonly involved teeth are lower molars with 43% of the total, upper central sixth with 20% and upper molars with 10%;mandibular origin was found to be the cause in 54%. The regression equation showed no linear relation between CRP with the overall hospital stay (p > 0.05). No systemic temperature values were found to be correlated to any space involved or LOS. Log-rank chi-square effect tests indicated only a significant effect of severity, p =0.00016. The “Moderate & Severe” group compared to the “Low” group had a longer median LOS, 4.5 (2 to 8) vs 3 (1 to 8) respectively. Conclusion: The findings of this study have shown severity scoring to be statistically significant parameter in LOS prediction.

Is it sufficient to evaluate only preoperative systemic inflammatory biomarkers to predict postoperative complications after pancreaticoduodenectomy?

Postoperative morbidity and mortality rates are still very high among patients undergoing pancreaticoduodenectomy(PD).However,mortality rates secondary to morbidities that are detected early and well-managed postoperatively are lower among patients undergoing PD.Since early detection of complications plays a very important role in the management of these patients,many ongoing studies are being conducted on this subject.Recent endoscopic retrograde cholangiopancreatography and biliary drainage history of the patient study group is important for comparison of C-reactive protein(CRP),an inflammatory parameter evaluated in the retrospective study by Coppola et al published in the World Journal of Gastrointestinal Surgery and titled“Utility of preoperative systemic inflammatory biomarkers in predicting postoperative complications after pancreaticoduodenectomy:Literature review and single center experience”.Therefore,it may be more appropriate to compare CRP values in randomized patients.

Research Progress of Echocardiography Combined with Blood Related Detection Indexes in the Diagnosis and Treatment of Kawasaki Disease in Children

Aim: To explore the research progress of echocardiography combined with blood-related detection indicators in the diagnosis and treatment of Kawasaki disease in children. By collecting relevant literature reports, echocardiography and several blood-related detection indicators such as SAA, IL-6, PCT and CRP were screened out. It has good clinical application value in the clinical diagnosis and treatment of Kawasaki disease in children, but there is no report on the application of echocardiography combined with blood SAA, IL-6, PCT and CRP detection in the diagnosis and treatment of Kawasaki disease in children. The author intends to explore the role of echocardiography combined with blood SAA, IL-6, PCT and CRP detection in the diagnosis and treatment of Kawasaki disease in children, hoping to achieve better results.

Comparative Study of Radiological Changes in Hands and Feet in Patients Suffering from Early Rheumatoid Arthritis by Power Doppler Ultrasound and Direct Digital Radiography

Rheumatoid arthritis is a chronic multisystem disease of unknown cause. The characteristic feature of RA is persistent inflammatory synovitis. The natural history of disease is such that the early months of the disease are critical period during which reversible joint damage occurs. So early diagnosis of RA and appropriate drug application is the only way to save a patient from this crippling disease. In India, the cost of investigations is a significant factor for most of the patients. Ultrasonography or Power Doppler Ultra Sound (PDUS) has the advantage of being economic in spite of its sensitivity in assessing both inflammatory and destructive changes. The aim of the present study was to evaluate the diagnostic efficiency of PDUS in early rheumatoid arthritis. The study was performed with the patients attending Rheumatology Clinic. A total number of 106 patients of clinically suspected rheumatoid arthritis were studied as per selection criteria. Radiological examinations of hands were done by digital radiography and PDUS in a group of 53 patients, assessment of foot changes by PDUS and Digital Radiography were done in another similar group of 53 patients. Final diagnosis by ACR EULAR-2010 criteria is done for all the patients. The comparative study reveals that synovial vascularity as demonstrated by PDUS is much more effective in diagnosing early rheumatoid arthritis, both in hand and in feet than digital radiograph. PDUS of feet may yield earlier and better findings than hands, which is conventionally used in patients suffering from early rheumatoid arthritis.

Study on the Correlation between IL-6,SAA,CRP and Exertional Heat Stroke in Rats

Objective:To investigate the correlation between interleukin-6(IL-6),serum amyloid A(SAA),C-reactive protein(CRP)and exertional heat stroke in rats.Methods:A total of 90 adult Sprague-Dawley rats without specific pathogens were randomly divided into three groups:control group,classical group and exertion group,with 30 rats in each group.The control group was maintained at a temperature of(26±1)℃and humidity of(60±5)%,while the classical and exertion groups were exposed to a temperature of(40±0.5)℃and humidity of(70±5)%.Additionally,the exertion group underwent treadmill running under these conditions.The levels of IL-6,SAA,and CRP in the three groups were assessed and compared at various time points:before modeling,immediately after onset,and at 2,4,and 8 h after onset.Furthermore,Spearman correlation analysis was employed to examine.Results:The findings from the repeated measures analysis of variance indicated significant variations in the levels of IL-6,SAA,and CRP across the three groups(P<0.05).Both the classic and exertion groups exhibited higher levels of IL-6,SAA,and CRP compared to the control group,with the exertion group demonstrating even higher levels than the classic group(P<0.05).Additionally,Spearman correlation analysis revealed a positive correlation between the onset of heat stroke and the levels of IL-6,SAA,and CRP at the onset,as well as at 2,4,and 8 h post-onset(P<0.05).Furthermore,the types of heat stroke were found to be positively correlated with the levels of IL-6,SAA and CRP(P<0.05).Conclusion:The initiation and nature of heat stroke in rats are significantly associated with the concentrations of IL-6,SAA,and CRP.The concentrations of IL-6,SAA,and CRP within 8 h of onset can reliably forecast the occurrence of heat stroke in rats,serving as a basis for distinguishing classical heat stroke from exertional heat stroke.Nevertheless,the predictive and differentiating efficacy may diminish as the onset time prolongs.

The 3-60 criteria challenge established predictors of postoperative mortality and enable timely therapeutic intervention after liver resection

Background:To date,definitions of liver dysfunction(LD)after hepatic resection rely on late postoperative time points.Further,the used parameters are markedly influenced by perioperative management.Thus,we aimed to establish a very early postoperative score to predict postoperative mortality.Methods:Liver related parameters were evaluated after liver resection in a retrospective evaluation cohort of 228 colorectal cancer patients with liver metastasis(mCRC)and subsequent validation in a prospective set of 482 consecutive patients from 4 independent institutions undergoing hepatic resection was performed.Results:C-reactive protein(CRP,AUC=0.739,P<0.001)and antithrombinⅢ-activity(ATⅢ,AUC=0.844,P<0.001)on the first postoperative day(POD)were found to be elevated in patients with LD.Cut-off values for CRP at 3 mg/dL and for ATⅢat 60%significantly identified high-risk patients for postoperative LD and mortality(P<0.001)and thus defined the 3-60 criteria on POD1.The 3-60 criteria showed superior sensitivity and specificity compared to established criteria for LD[3-60 criteria:total positive patients:26 patients(70%mortality detected),odds ratio(OR):48.8;International Study Group for Liver Surgery:total positive patients:43(70%mortality detected),OR:23.3;Peak7:total positive patients:9(30%mortality detected),OR:27.8;50-50:total positive patients:9(30%mortality detected),OR:27.8].These results could be validated in a multi-center analysis and ultimately the 3-60 criteria remained an independent predictor of postoperative mortality upon multivariable analysis.Conclusions:The 3-60 criteria on POD1 predict postoperative LD and mortality early after liver resection with a comparable or better accuracy than established criteria,allowing for immediate identification of high-risk patients.