Value of N-Terminal Pro B-Type Natriuretic Peptide,High-Sensitivity C-Reactive Protein,and Homocysteine Levels in Predicting Cardiovascular Events in Chronic Heart Failure Patients After Discharge

Objective:To investigate the value of N-terminal pro B-type natriuretic peptide(NT-proBNP),high-sensitivity C-reactive protein(hs-CRP),and homocysteine(Hcy)levels in predicting cardiovascular events(CV)in patients with chronic heart failure(CHF).Methods:A total of 63 patients with CHF admitted to our hospital between June 2019 and July 2021 were selected.Their NT-proBNP,hs-CRP,and Hcy levels were detected at discharge,and a 12-month follow-up was done after their discharge to collect clinical data.The collected data were inclusive of data from 21 CHF patients with cardiovascular disease and 42 CHF patients without cardiovascular disease.The effect of NT-proBNP,hs-CRP,and Hcy levels on the occurrence of CV was analyzed.Results:The levels of NT-proBNP,hs-CRP,and Hcy in the group with cardiovascular disease were significantly higher than those in the group without cardiovascular disease(P<0.05);the levels of serum NT-proBNP,hs-CRP,and Hcy at discharge had certain value in predicting short-term CV in CHF patients(P<0.05).Conclusion:NT-proBNP,hs-CRP,and Hcy levels can be used to predict CV in CHF patients,thus having clinical application value.

Distribution of High-sensitivity C-reactive Protein Status in an Urban Population in China

Objectives To evaluate the distribution by age and sex of serum high-sensitivity C-reactive protein(hsCRP)in an urban Chinese population and to provide a profile prediction for the risk of bacterial infection,inflammatory diseases,or tissue damages in the body.Methods Serum hsCRP was determined using the Roche Tina-quant immuno-turbidimetric assay on a Hitachi 7600–010 automatic biochemical analyzer(Roche Diagnostics)in 1,572 males and 1,800 females,including 78 pregnant women,who were derived from the National Health and Nutrition Survey in2010–2012.Results The average hsCRP concentration in urban China was 0.68 mg/L for males and 0.65 mg/L for females.Significant differences in hsCRP were found among different age groups(P<0.05).Monitoring results showed no significant differences among the 6–11,45–59,and≥60-year-old groups in the comparison of hsCRP between males and females in large cities.However,hsCRP concentration was significantly higher in men aged 12–17 and 18–44 years than in women.Conclusion The distribution of the hsCRP status of residents in large cities in China was influenced by age and gender,and the hsCRP levels of both sexes increased gradually with age.In addition,hsCRP concentration was higher in healthy pregnant women than in non-pregnant women.Basing on our results,we recommend that this parameter be included in future national and international screening for early detection of various illnesses.

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。

Elevated IL-37 levels in the plasma of patients with severe coronary arterycalcification

Background Coronary artery calcification （CAC） is a predictor of cardiovascular events and plaque burden and is closely associatedwith chronic inflammation. Intedeukin （IL）-37 is a newly discovered member of the IL-1 family and is considered an anti-inflammatorycytokine. Our recent study on mice indicated that IL-37 could attenuate atherosclerosis and vascular calcification, which suggests that IL-37could be associated with the development of atherosclerosis and related diseases. The aim of this study was to investigate if IL-37 plays arole in the progression of CAC in patients. Methods Two hundred participants with suspected cardiovascular disease were recruited. Thelevels of plasma IL-37, osteoprotegerin （OPG）, hypersensitive C-reactive protein （hsCRP） together with other biochemical parameters weremeasured, and a coronary calcium assessment was carried out by multi-detector row CT. A score of 〈 10 AU （Agatston units） denotes anabsence of CAC, a score of 11-100 AU denotes mild CAC, 101-400 denotes moderate CAC, and 〉 400 AU denotes severe CAC. ResultsOur initial data showed that there were no apparent differences in plasma IL-37 levels among patients with or without mild or moderate CAC.However, IL-37 levels were significantly increased in patients with severe CAC （P 〈 0.001）. Similar results were observed for plasma OPGand hsCRP levels. When IL-37 levels in patients with severe calcification were compared with that in all of the other non-severe CAC groups,it became apparent that there was a significant positive correlation between IL-37 level and severe CAC （r = 0.360, P 〈 0.001; OR = 1.033）using Spearrnan＇s correlation and binary logistic regression analysis. Conclusions This study demonstrates that the anti-inflammatory cy-tokine IL-37 is associated with high coronary calcium levels, suggesting that IL-37 expression may be caused by the activation ofinf/amma-tion and that IL-37 might become a predictor of severe CAC in the future, which requires further investigation.

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.

Associations of oxidative stress and inflammation and their role in the regulation of membrane fluidity of red blood cells in hypertensive and normotensive men: An electron spin resonance investigation

There is evidence showing that increased levels of oxidative stress and C-reactive protein (CRP) might be associated with obesity, hypertension, atherosclerosis and other cardiovascular diseases. This study was undertaken to investigate possible relationships among plasma 8-iso-prostaglandin F2α (8-iso-PG F2α: an index of oxidative stress), high-sensitivity (hs)-CRP and membrane fluidity (a reciprocal value of microviscosity) in hypertensive and normotensive men using an electron spin resonance (ESR)-method. The order parameter (S) for the spin-label agents (5-nitroxide stearate) of red blood cell (RBC) membranes in the ESR spectra was significantly higher in hypertensive men than in normotensive men, indicating that membrane fluidity was decreased in hypertensive men. Both plasma 8-iso-PG F2α and hs-CRP levels were significantly increased in hypertensive men compared with normotensive men. In addition, plasma plasma 8-iso-PG F2α levels were correlated with plasma hs-CRP levels. In contrast, plasma nitric oxide (NO)-metabolites were lower in hypertensive men than in normotensive men, and inversely correlated with plasma 8-iso-PG F2α and hs-CRP. The order parameter(S) of RBCs was correlated with plasma 8-iso-PG F2α and plasma hs-CRP, and inversely correlated with plasma NO-metabolites, suggesting that reduced membrane fluidity of RBCs might be associated with increased oxidative stress, inflammation and endothelial dysfunction. Multivariate regression analysis also showed that, after adjusting for general risk factors, both plasma 8-iso-PG F2α and hs-CRP were significant determinants of membrane fluidity of RBCs. The ESR suggests that associations of oxidative stress and inflammation might have a close correlation with impaired rheologic behavior of RBCs and microcirculatory dysfunction in hypertensive men.

Predicted pro-inflammatory hs-CRP score and non-alcoholic fatty liver disease

Background:Non-alcoholic fatty liver disease(NAFLD)is a major contributor to liver diseases globally,yet there are limited studies investigating the impact of diet and lifestyle factors on its development.This study aimed to examine the association between the prevalence of NAFLD and predicted pro-inflammatory high-sensitivity C-reactive protein(hs-CRP)score.Methods:We included 1,076 Korean adults who underwent a medical examination at the Seoul National University Hospital Gangnam Healthcare Center in Korea between May and December 2011 and updated in 2021.The predicted pro-inflammatory hs-CRP score was derived from pro-inflammatory demographic,lifestyle,dietary,and anthropometric factors,and NAFLD was diagnosed using liver ultrasound.Multivariable-adjusted odds ratios(ORs)and 95%confidence intervals(CIs)of NAFLD odds according to predicted pro-inflammatory hs-CRP score were estimated using logistic regression at a two-sided P<0.05.Results:Among the 1,076 participants,320 had NAFLD.The multivariable-adjusted ORs and 95%CIs for NAFLD by tertiles of predicted pro-inflammatory hs-CRP score were 1.00,3.30(2.06,5.30),18.25(10.47,31.81;P<0.0001)in men and women combined,1.00,1.77(1.10,2.84),and 3.26(2.02,5.28;P<0.0001)among men only,and 1.00,3.03(1.39,6.62),and 16.71(7.05,39.63;P<0.0001)among women only.Conclusions:Predicted pro-inflammatory hs-CRP score was associated with higher odds of NAFLD.Adopting dietary and lifestyle changes related to lower inflammation might be a valuable strategy for preventing NAFLD.

Influence of Simvastatin for In-stent Restenosis Rate and Blood Lipid Level and Inflammation Actor after Coronary Artery Stent Implantation

Objectives To investigate the effect of simvastatin on the probability of restenosis after stent implantation and serum level of lipids as well as high-sensitivity C-reactive protein (hs-CRP) in patients with coronary heart disease (CHD). Methods 118 patients with CHD after stenting therapy were divided into treatment group (n=62) and control group (n=56) randomly. All patients were treated with aspirin (100 mg/d) and clopidogrel (75 mg/d) while treatment group patients took simvastatin (40 mg qn) additionally. All patients underwent coronary angiography (CAG) to compare the difference of restenosis and the serum level of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), triglyceride (TG) as well as hs-CRP after the drug treatment for 6 months. Results The probability of restenosis was significantly lower in the treatment group than that of control group (P<0.01) and the results were similar between the patients with bare metal stent (P<0.01) and those with sirolimus-eluting stent (P<0.01). The serum levels of TC (P<0.01), LDL-c (P<0.01), TG (P<0.05) and hs-CRP (P<0.01) were obviously lower while the HDL-c (P<0.05) level was higher in the treatment group than those of control group. There was no death case. Conclusions Simvastatin could decrease the probability of restenosis significantly after coronary stent implantation with dose of 40 mg/d. It also has good performance on lipids control and lightening inflammatory reactions with its undoubtedly safety.

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.

Expression of Serum hs-CRP and Lp-PLA2 in Arrhythmia Patients and its Significance

Objective:The purpose of this study is to examine the expression ofserum high-sensitivity C-reactive protein(hs-CRP)and lipoprotein-associated phospholipase A2(Lp-PLA2)in patients with arrhythmia and its significance.Methods:We selected 136 arrhythmia patients(observation group)who were treated at our hospital from February 2016 to March 2018.Among these patients,50 had premature ventricular contractions,42 had atrial fibrillation,24 had atrial flutter,and 20 had ventricular tachycardia.Simultaneously,we selected 120 healthy volunteers as the control group.We measured serum levels of hs-CRP and Lp-PLA2 in these subjects.Results:The levels of Lp-PLA2 and hs-CRP of the observation group were 210.06±30.46 pg/mL and 13.54±3.16,respectively,which were significantly higher than those of the control group(P<0.05).The serum levels of Lp-PLA2 and hs-CRP of patients with atrial flutter were 260.87±32.24 and 19.84±5.10 pg/mL,respectively,which were significantly higher than those of patients with premature ventricular contractions,atrial fibrillation,and ventricular tachycardia(P<0.05).Serum levels of Lp-PLA2 and hs-CRP were posi-tively correlated(r=0.413,P<0.05).Conclusion:Serum levels of hs-CRP and Lp-PLA2 in arrhythmia patients were significantly elevated and showed some association with the type of arrhythmia.

H型高血压合并大动脉粥样硬化型急性缺血性脑卒中血浆抗凝血酶3、高敏C-反应蛋白、载脂蛋白-B水平及其意义

目的探讨大动脉粥样硬化型H型高血压(H-type hypertension,HH)合并急性缺血性脑卒中(Acute ischemic stroke,AIS)血浆抗凝血酶3(antithrombin,at3)、高敏C-反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、载脂蛋白-B(apolipoprotein-B,ApoB)水平及与脑卒中发病的相关性。方法选取2017年2月—2017年6月期间在海口市人民医院神经内科住院汉族患者30例HH合并大动脉粥样硬化型AIS患者,在海口市人民医院体检中心门诊就诊的30例汉族HH患者及30例汉族健康对照人群。HH合并大动脉粥样硬化型AIS患者参照2014中国脑血管病防治指南的AIS诊断标准,血浆同型半胱氨酸(homocysteine,Hcy)>10μmol/L。对HH合并大动脉粥样硬化型AIS患者,据改良Rankin量表(Modified Rankin Scale,mRS)对预后进行评估:≤2分,示预后良好亚组,3~5分,示:预后不良亚组,采用ELISA试验检测试验对象及不同预后亚组血浆Hcy、at3、hs-CRP、ApoB等水平,分析不同对象血浆Hcy、at3、hs-CRP、ApoB水平,以评估血浆Hcy、at3、hs-CRP、ApoB高低对AIS发病的影响。结果HH合并大动脉粥样硬化型AIS组血浆at3水平(0.15±0.07)g/L及HH组血浆at3水平(0.17±0.11)g/L与对照组比较血浆at3水平(0.31±0.08)g/L显著降低(P<0.000),HH合并大动脉粥样硬化型AIS组血浆hs-CRP(8.83±1.58)mg/L及HH组血浆hs-CRP(7.99±1.43)mg/L与对照组血浆hs-CRP(5.81±1.16)mg/L比较,HH合并大动脉粥样硬化型AIS组血浆ApoB(2.33±0.45)g/L及HH组血浆ApoB(2.23±0.53)g/L与对照组血浆ApoB(0.84±0.41)g/L比较均显著升高(P<0.05),HH合并大动脉粥样硬化型AIS组与HH组比较血浆hs-CRP显著升高,血浆at3、ApoB水平无明显差异,HH合并大动脉粥样硬化型AIS患者不同预后亚组间比较预后不良亚组血浆Hcy(25.76±5.39)umol/L较预后良好亚组血浆Hcy水平(15.33±4.21)umol/l、预后不良亚组血浆hs-CRP(10.35±1.79)mg/l较预后良好亚组血浆hsCRP(8.37±1.36)mg/l水平显著升高(P<0.05),预后不良亚组血浆at3(0.14±0.08)g/L与预后良好亚组血浆at3(0.17±0.09)g/L、预后不良亚组ApoB(2.38±0.56)g/L与预后良好亚组血浆ApoB(2.28±0.43)g/L水平差异无统计学意义(P>0.05)。结论HH合并大动脉粥样硬化型AIS患者中血浆Hcy水平、hs-CRP水平升高可以影响预后,水平越高预后越差。at3不但参与急性脑卒中患者发病后被激活凝血酶的清除,at3还可能参与了HH患者慢性动脉粥样硬化的发生、发展,从而促进其大动脉粥样硬化型AIS的发病可能。CRP作用于内皮细胞,促进急性血栓形成和慢性动脉粥样硬化的进展,进而增加卒中的风险。HH患者ApoB的分泌,可使动脉粥样硬化恶化,促使HH相关大动脉粥样硬化型AIS的发病。