目的分析白介素-4(interleukin-4,IL-4)联合急性生理与慢性健康评分(acute physiology and chronic health evaluation,APACHEⅡ)对耐碳青霉烯鲍曼不动杆菌(carbapenem-resistant Acinetobacter baumannii,CRAB)感染的预后评估价值。方...目的分析白介素-4(interleukin-4,IL-4)联合急性生理与慢性健康评分(acute physiology and chronic health evaluation,APACHEⅡ)对耐碳青霉烯鲍曼不动杆菌(carbapenem-resistant Acinetobacter baumannii,CRAB)感染的预后评估价值。方法将2021年11月至2023年10月在广东医科大学附属医院接受治疗的143例CRAB感染患者设为研究组,取同期院内治疗的碳青霉烯敏感鲍曼不动杆菌感染患者49例为对照组,根据研究组患者的临床结局区分为死亡组(n=46)和存活组(n=97)。对比研究组与对照组、死亡组与存活组患者IL-4和APACHEⅡ评分差异,采用Pearson相关性分析的方式,计算CRAB感染患者血清IL-4水平同APACHEⅡ评分的相关性,并采用绘制受试者工作(receiver operating characteristic curves,ROC)曲线的方式评估IL-4、APACHEⅡ评分以及联合诊断在预测CRAB感染患者不良临床结局中的应用价值。结果死亡组患者的IL-4水平以及APACHEⅡ评分显著高于存活组患者,组间差异具有统计学意义(P<0.05)。Pearson相关性分析结果显示血清IL-4水平与APACHEⅡ评分具有明显的正相关性(r=0.093,P<0.001)。血清IL-4、APACHEⅡ评分以及联合检测对CRAB感染患者预后评估AUC分别为0.712(95%CI=0.606~0.817,P<0.001)、0.849(95%CI=0.763~0.936,P<0.001)和0.956(95%CI=0.927~0.985,P<0.001)。结论CRAB患者不良预后者血清IL-4和APACHEⅡ评分较存活组显著升高,可以考虑将血清IL-4和APACHEⅡ评分联合应用于此类患者预后评估中,有助于为其临床治疗提供参考。展开更多
BACKGROUND Identifying hepatic fibrosis is crucial for nonalcoholic fatty liver disease(NAFLD)management.The fibrosis-8(FIB-8)score,recently developed by incorporating four additional variables into the fibrosis-4(FIB...BACKGROUND Identifying hepatic fibrosis is crucial for nonalcoholic fatty liver disease(NAFLD)management.The fibrosis-8(FIB-8)score,recently developed by incorporating four additional variables into the fibrosis-4(FIB-4)score,showed better performance in predicting significant fibrosis in NAFLD.AIM To validate the FIB-8 score in a biopsy-proven NAFLD cohort and compare the diagnostic performance of the FIB-8 and FIB-4 scores and NAFLD fibrosis score(NFS)for predicting significant fibrosis.METHODS We collected the data of biopsy-proven NAFLD patients from three Asian centers in three countries.All the patients with available variables for the FIB-4 score(age,platelet count,and aspartate and alanine aminotransferase levels)and FIB-8 score(the FIB-4 variables plus 4 additional parameters:The body mass index(BMI),albumin to globulin ratio,gamma-glutamyl transferase level,and presence of diabetes mellitus)were included.The fibrosis stage was scored using nonalcoholic steatohepatitis CRN criteria,and significant fibrosis was defined as at least fibrosis stage 2.RESULTS A total of 511 patients with biopsy-proven NAFLD and complete data were included for validation.Of these 511 patients,271(53.0%)were female,with a median age of 51(interquartile range:41,58)years.The median BMI was 29(26.3,32.6)kg/m2,and 268(52.4%)had diabetes.Among the 511 NAFLD patients,157(30.7%)had significant fibrosis(≥F2).The areas under the receiver operating characteristic curves of the FIB-8 and FIB-4 scores and NFS for predicting significant fibrosis were 0.774,0.743,and 0.680,respectively.The FIB-8 score demonstrated significantly better performance for predicting significant fibrosis than the NFS(P=0.001)and was also clinically superior to FIB-4,although statistical significance was not reached(P=0.073).The low cutoff point of the FIB-8 score for predicting significant fibrosis of 0.88 showed 92.36%sensitivity,and the high cutoff point of the FIB-8 score for predicting significant fibrosis of 1.77 showed 67.51%specificity.CONCLUSION We demonstrated that the FIB-8 score had significantly better performance for predicting significant fibrosis in NAFLD patients than the NFS,as well as clinically superior performance vs the FIB-4 score in an Asian population.A novel simple fibrosis score comprising commonly accessible basic laboratories may be beneficial to use for an initial assessment in primary care units,excluding patients with significant liver fibrosis and aiding in patient selection for further hepatologist referral.展开更多
目的探讨E2F转录因子2(E2F2)和多配体蛋白聚糖-4(SDC4)对急性胰腺炎患者病情评估及预后诊断的价值。方法将2018年4月至2020年4月西安市中心医院收治的45例轻症急性胰腺炎患者作为轻症组,56例重症急性胰腺炎患者为重症组;将同期20名来我...目的探讨E2F转录因子2(E2F2)和多配体蛋白聚糖-4(SDC4)对急性胰腺炎患者病情评估及预后诊断的价值。方法将2018年4月至2020年4月西安市中心医院收治的45例轻症急性胰腺炎患者作为轻症组,56例重症急性胰腺炎患者为重症组;将同期20名来我院进行健康体检者作为对照组。比较各组研究对象的一般资料及临床特征;比较三组研究对象的E2F2、SDC4 m RNA和蛋白表达水平;分析E2F2、SDC4表达水平与急性胰腺炎患者JPN评分的相关性;分析血清SDC4、E2F2水平和JPN评分对急性胰腺炎的诊断价值。结果轻症组和重症组的腹痛、恶心呕吐发生率无明显差异(P>0.05);重症组的腹胀、全身性并发症发生率高于轻症组(P<0.05);轻症组和重症组的血清淀粉酶、脂肪酶、降钙素原、乳酸脱氢酶(LDH)以及C反应蛋白(CRP)水平高于对照组(P<0.01);重症组的血清淀粉酶、脂肪酶、降钙素原、LDH、CRP水平及JPN评分高于轻症组(P<0.01)。轻症组和重症组的E2F2、SDC4 m RNA和蛋白表达水平显著高于对照组,且重症组高于轻症组(P<0.05)。E2F2和SDC4表达水平与急性胰腺炎患者JPN评分呈正相关(P<0.001);E2F2表达水平与SDC4表达水平呈正相关(P<0.001)。血清E2F2和SDC4水平对急性胰腺炎的诊断价值较高,与JPN评分相似。结论E2F2和SDC4可作为评估急性胰腺炎患者发病及预后的潜在指标。展开更多
It is controversial whether universal screening for bacterial vaginosis (BV) should be done in the early stages of pregnancy in order to prevent preterm birth. In particular, whether the intermediate vaginal flora typ...It is controversial whether universal screening for bacterial vaginosis (BV) should be done in the early stages of pregnancy in order to prevent preterm birth. In particular, whether the intermediate vaginal flora type should be included in the group to be treated for BV. This vaginal smear type is a mixture of Lactobacillus and Gardnerella or Bacteroides spp. We examined three vaginal flora types, excluding the mixed-type, with a Nugent Score of 4 and evaluated their significance in achieving term delivery. The subjects were pregnant women who were examined at our Hospital between June 2009 and December 2010. Their vaginal swabs were taken at their first prenatal visit and were studied by Gram staining. The resulting Nugent Score 4 organisms were further classified into the following four types: mixed-type, gram-positive cocci type, Bifidobacterium type, and non-bacterial type. The clinical courses for all the types except “mixed-type” were followed-up. Among the 566 pregnant women, 58 (10.2%) had a Nugent Score of 4. There were 38 cases of mixed-type (65.5%), 3 cases of gram-positive cocci type (5.2%), 10 cases of Bifidobacterium type (17.2%), and 7 cases of non-bacterial type (12.1%). The three women with the gram-positive cocci type attained successful term delivery despite two of them experiencing GBS infection and requiring treatment with penicillin and tocolytics. Among the 10 cases of Bifidobacterium type, 5 cases were term delivery with no therapy, 3 cases were term delivery with metronidazole treatment and 2 cases were preterm birth with maternal complications. Among the 7 cases of non-bacterial type, 6 cases were diagnosed with preterm PROM, and 5 of them resulted in preterm birth despite prophylactic antibiotic therapy. Classification of smears with a Nugent score of 4 into four bacterial morphotypes may be effective, for required treatment may vary depending on the morphotype.展开更多
Toll-like receptor 4 （TLR4） recognizes pathogen ligands and mediates signaling to initiate innate and adaptive immune responses. In this experiment, a 316 bp and 382 bp fragments of TLR4 gene named T4CRBR1 and T4CRB...Toll-like receptor 4 （TLR4） recognizes pathogen ligands and mediates signaling to initiate innate and adaptive immune responses. In this experiment, a 316 bp and 382 bp fragments of TLR4 gene named T4CRBR1 and T4CRBR2, of Chinese Holstein, Sanhe cattle, and Chinese Simmental was amplified by polymerase chain reaction （PCR）, respectively. The genetic polymorphisms in the three populations were detected by Single-Strand Conformational Polymorphism （SSCP） in the first locus and by digesting the fragments with restriction endonuclease Alu I in the second one. Results showed that both alleles （A and B） of two loci were found in all the three populations and the value of polymorphism information content （PIC） indicated that these were a moderate polymorphism. Statistical results of X^2 test indicated that two polymorphism sites in the three populations fitted with Hardy-Weinberg equilibrium （P 〉 0.05）. After sequencing, A-G single nucleotide polymorphism （SNP） was identified at nucleotide 4,525 in intron 1 of TLR4 gene and C-T SNP was identified at nucleotide 1,397 in exon 3 of TLR4 gene. Meanwhile, the effect of polymorphism of TLR4 gene on somatic cell score （SCS） was analyzed, the results indicated that the cattle with allele A in T4CRBR1 showed lower somatic cell score than that of allele B （P 〈 0.05）. In short, the allele A might play an important role in mastiffs resistance in bovine.展开更多
基金Supported by The Fatty Liver Research Fund,Faculty of Medicine Foundation,Chulalongkorn University。
文摘BACKGROUND Identifying hepatic fibrosis is crucial for nonalcoholic fatty liver disease(NAFLD)management.The fibrosis-8(FIB-8)score,recently developed by incorporating four additional variables into the fibrosis-4(FIB-4)score,showed better performance in predicting significant fibrosis in NAFLD.AIM To validate the FIB-8 score in a biopsy-proven NAFLD cohort and compare the diagnostic performance of the FIB-8 and FIB-4 scores and NAFLD fibrosis score(NFS)for predicting significant fibrosis.METHODS We collected the data of biopsy-proven NAFLD patients from three Asian centers in three countries.All the patients with available variables for the FIB-4 score(age,platelet count,and aspartate and alanine aminotransferase levels)and FIB-8 score(the FIB-4 variables plus 4 additional parameters:The body mass index(BMI),albumin to globulin ratio,gamma-glutamyl transferase level,and presence of diabetes mellitus)were included.The fibrosis stage was scored using nonalcoholic steatohepatitis CRN criteria,and significant fibrosis was defined as at least fibrosis stage 2.RESULTS A total of 511 patients with biopsy-proven NAFLD and complete data were included for validation.Of these 511 patients,271(53.0%)were female,with a median age of 51(interquartile range:41,58)years.The median BMI was 29(26.3,32.6)kg/m2,and 268(52.4%)had diabetes.Among the 511 NAFLD patients,157(30.7%)had significant fibrosis(≥F2).The areas under the receiver operating characteristic curves of the FIB-8 and FIB-4 scores and NFS for predicting significant fibrosis were 0.774,0.743,and 0.680,respectively.The FIB-8 score demonstrated significantly better performance for predicting significant fibrosis than the NFS(P=0.001)and was also clinically superior to FIB-4,although statistical significance was not reached(P=0.073).The low cutoff point of the FIB-8 score for predicting significant fibrosis of 0.88 showed 92.36%sensitivity,and the high cutoff point of the FIB-8 score for predicting significant fibrosis of 1.77 showed 67.51%specificity.CONCLUSION We demonstrated that the FIB-8 score had significantly better performance for predicting significant fibrosis in NAFLD patients than the NFS,as well as clinically superior performance vs the FIB-4 score in an Asian population.A novel simple fibrosis score comprising commonly accessible basic laboratories may be beneficial to use for an initial assessment in primary care units,excluding patients with significant liver fibrosis and aiding in patient selection for further hepatologist referral.
文摘目的探讨E2F转录因子2(E2F2)和多配体蛋白聚糖-4(SDC4)对急性胰腺炎患者病情评估及预后诊断的价值。方法将2018年4月至2020年4月西安市中心医院收治的45例轻症急性胰腺炎患者作为轻症组,56例重症急性胰腺炎患者为重症组;将同期20名来我院进行健康体检者作为对照组。比较各组研究对象的一般资料及临床特征;比较三组研究对象的E2F2、SDC4 m RNA和蛋白表达水平;分析E2F2、SDC4表达水平与急性胰腺炎患者JPN评分的相关性;分析血清SDC4、E2F2水平和JPN评分对急性胰腺炎的诊断价值。结果轻症组和重症组的腹痛、恶心呕吐发生率无明显差异(P>0.05);重症组的腹胀、全身性并发症发生率高于轻症组(P<0.05);轻症组和重症组的血清淀粉酶、脂肪酶、降钙素原、乳酸脱氢酶(LDH)以及C反应蛋白(CRP)水平高于对照组(P<0.01);重症组的血清淀粉酶、脂肪酶、降钙素原、LDH、CRP水平及JPN评分高于轻症组(P<0.01)。轻症组和重症组的E2F2、SDC4 m RNA和蛋白表达水平显著高于对照组,且重症组高于轻症组(P<0.05)。E2F2和SDC4表达水平与急性胰腺炎患者JPN评分呈正相关(P<0.001);E2F2表达水平与SDC4表达水平呈正相关(P<0.001)。血清E2F2和SDC4水平对急性胰腺炎的诊断价值较高,与JPN评分相似。结论E2F2和SDC4可作为评估急性胰腺炎患者发病及预后的潜在指标。
文摘It is controversial whether universal screening for bacterial vaginosis (BV) should be done in the early stages of pregnancy in order to prevent preterm birth. In particular, whether the intermediate vaginal flora type should be included in the group to be treated for BV. This vaginal smear type is a mixture of Lactobacillus and Gardnerella or Bacteroides spp. We examined three vaginal flora types, excluding the mixed-type, with a Nugent Score of 4 and evaluated their significance in achieving term delivery. The subjects were pregnant women who were examined at our Hospital between June 2009 and December 2010. Their vaginal swabs were taken at their first prenatal visit and were studied by Gram staining. The resulting Nugent Score 4 organisms were further classified into the following four types: mixed-type, gram-positive cocci type, Bifidobacterium type, and non-bacterial type. The clinical courses for all the types except “mixed-type” were followed-up. Among the 566 pregnant women, 58 (10.2%) had a Nugent Score of 4. There were 38 cases of mixed-type (65.5%), 3 cases of gram-positive cocci type (5.2%), 10 cases of Bifidobacterium type (17.2%), and 7 cases of non-bacterial type (12.1%). The three women with the gram-positive cocci type attained successful term delivery despite two of them experiencing GBS infection and requiring treatment with penicillin and tocolytics. Among the 10 cases of Bifidobacterium type, 5 cases were term delivery with no therapy, 3 cases were term delivery with metronidazole treatment and 2 cases were preterm birth with maternal complications. Among the 7 cases of non-bacterial type, 6 cases were diagnosed with preterm PROM, and 5 of them resulted in preterm birth despite prophylactic antibiotic therapy. Classification of smears with a Nugent score of 4 into four bacterial morphotypes may be effective, for required treatment may vary depending on the morphotype.
基金This work was supported by the fifteenth "Five Years Key Programs" for Science and Technology Development of China (No. 2002BA518A14)the National High Science and Technology Foundation of China (863) (No. 2002AA242011).
文摘Toll-like receptor 4 （TLR4） recognizes pathogen ligands and mediates signaling to initiate innate and adaptive immune responses. In this experiment, a 316 bp and 382 bp fragments of TLR4 gene named T4CRBR1 and T4CRBR2, of Chinese Holstein, Sanhe cattle, and Chinese Simmental was amplified by polymerase chain reaction （PCR）, respectively. The genetic polymorphisms in the three populations were detected by Single-Strand Conformational Polymorphism （SSCP） in the first locus and by digesting the fragments with restriction endonuclease Alu I in the second one. Results showed that both alleles （A and B） of two loci were found in all the three populations and the value of polymorphism information content （PIC） indicated that these were a moderate polymorphism. Statistical results of X^2 test indicated that two polymorphism sites in the three populations fitted with Hardy-Weinberg equilibrium （P 〉 0.05）. After sequencing, A-G single nucleotide polymorphism （SNP） was identified at nucleotide 4,525 in intron 1 of TLR4 gene and C-T SNP was identified at nucleotide 1,397 in exon 3 of TLR4 gene. Meanwhile, the effect of polymorphism of TLR4 gene on somatic cell score （SCS） was analyzed, the results indicated that the cattle with allele A in T4CRBR1 showed lower somatic cell score than that of allele B （P 〈 0.05）. In short, the allele A might play an important role in mastiffs resistance in bovine.
