BACKGROUND： Serum high sensitive C-reactive protein （hs-CRP）, which regards as a high sensitive mark of systemic inflammatory response syndrome, can provide a lot of valuable information for the treatment and progn...BACKGROUND： Serum high sensitive C-reactive protein （hs-CRP）, which regards as a high sensitive mark of systemic inflammatory response syndrome, can provide a lot of valuable information for the treatment and prognosis of cerebrovascular disease. OBJECTIVE： To observe the differences of blood glucose, lipid, homocysteine and previous disease history among patients with acute cerebral infarction at various levels of hs-CRP and compare changes of hs-CRP of patients with various degrees of neurologic impairment. DESIGN： Contrast observation. SETTING： Department of Neurology, Shenzhou Hospital, Shenyang Medical College. PARTICIPANTS： A total of 102 patients with acute cerebral infarction were selected from Department of Neurology, Shenzhou Hospital of Shenyang Medical College from February 2005 to September 2006, including 55 males and 47 females aged from 55 to 86 years. All accepted patients met the diagnostic criteria of cerebral infarction established by the Fourth National Cerebrovascular Disease Academic Meeting and were diagnosed with CT or MRI examination. All patients provided the confirmed consent. Based on clinical criteria of neurologic impairment established by the Fourth National Cerebrovascular Disease Academic Meeting, patients were randomly divided into mild group （0 - 15 points, n =46）, moderate group （16 - 30 points, n =38） and severe group （31 - 45 points, n =18）. In addition, based on hs-CRP level within 72 hours, patients were divided into normal group （hs-CRP ≤3 mg/L, n =53） and increasing group （hs-CRP 〉 3 mg/L, n =-49）. METHODS： ① 2 mL venous blood was selected from hospitalized patients in the next morning to separate serum. Quantitative measurement of hs-CRP was dealt with Latex Enhnced Turbidimetric Immunoassay （LETIA）. ②Fasting venous blood was colleted from hospitalized patients in the next morning to measure numeration of white blood cells, fibrinogen, blood glucose, total cholesterol （TC）, triacylglycerol （TG）, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C） and homocysteine. ③Measurement data were compared with t test or analysis of variance. MAIN OUTCOME MEASURES： ①Comparisons of serum biochemical indexes among patients with various levels of hs-CRP; ②comparisons of risk factors among patients with various levels of hs-CRP; ③comparisons of levels of hs-CRP among patients with various degrees of clinical neurologic impairment. RESULTS： A total of 102 patients were involved in the final analysis. ①Plasma fibrinogen and numeration of leucocytes were more in the increasing group than those in the normal group （t =4.39, 3.54, P 〈 0.01）; while, there were no significant differences of blood glucose, TC, TG, HDL-C, LDL-C and homocysteine between the two groups （P 〉 0.05）. ② Percentage of patients with hypertension and diabetes mellitus （DM） was higher in the increasing group than the normal group （ Х^2=3.98, 4.23, P 〈 0.05）; while, percentage of patients with smoking in the increasing group was not significantly different from that of patients in the normal group （P 〉 0.05）. ③Level of hs-CRP of patients with severe neurologic impairment was higher than that of patients with moderate neurologic impairment （t =2.273, P 〈 0.05）; that of patients with moderate neurologic impairment was higher than that of patients with mild neurologic impairment （t =2.586, P 〈 0.05）; that of patients with severe neurologic impairment was obviously higher than that of patients with mild neurologic impairment （t = 4.913, P 〈 0.01）. CONCLUSION： ① With the increase of hs-CRP, plasma fibrinogen and numeration of leucocytes of patients with acute cerebral infarction is increased, especially, they are increased remarkably among patients who have history of diabetes mellitus and hypertension. ②Increase of level of hs-CRP can be regarded as one of marks to evaluate severity of acute stroke.展开更多
Objective:To investigate the relationship between serum levels of C1q tumor necrosis factorrelated protein 4(CTRP4)and hypersensitive C reactive protein(hs-CRP)and coronary heart disease(CHD)and its clinical value.Met...Objective:To investigate the relationship between serum levels of C1q tumor necrosis factorrelated protein 4(CTRP4)and hypersensitive C reactive protein(hs-CRP)and coronary heart disease(CHD)and its clinical value.Methods:128 patients underwent coronary angiography in our hospital,63 males,65 women,Based on blood sugar levels and coronary angiography,Divided into pure coronary heart disease(CHD)group 62 cases,Coronary heart disease with diabetes(DM+CHD)group 66 cases,A total of 126 patients were selected as control group,65 men,61 women,CTRP4 and hs-CRP levels in serum,Using Pearson correlation analysis to assess the correlation between Gennisi score and CTRP4、hs-CRP,Analysis of three groups of biochemical indicators,CTRP4、hs-CRP level changes and clinical significance.Results:The CTRP4、hs-CRP level of DM+CHD group was significantly higher than that of control group and CHD group(P DM+CHD 0.05).The CTRP4、hs-CRP level of the three-vessel coronary artery lesion group in the experimental group was higher than that in the two-vessel lesion group(P﹤0.05),Double branch lesion group was higher than single branch lesion group(P﹤0.05);Correlation analysis shows,There was a significant positive correlation between the CTRP4、hs-CRP level of CHD group and DM+CHD group and the Gennisi score(P DM+CHD 0.05).ROC curves show,CTRP4 and hs-CRP levels had predictive value(CHD group,AUC=0.940,0.934,DM+CHD group,AUC=0.980,0.964),Two associations(CHD:AUC=0.961,P﹤0.001,DM+CHD group:AUCDM+CHD 0.982,P﹤0.001)the predictive value is high.Conclusion:Serum CTRP4 and hs-CRP are positively related to the severity of coronary heart disease,and the sensitivity and specificity of predicting coronary heart disease are high,which is helpful for the identification and early prevention of coronary heart disease,and has certain clinical reference value.展开更多
BACKGROUND： Brief exposure to the anesthetic sevoflurane results in delayed neuroprotection, However, few studies have addressed delayed neuroprotection after preconditioning with a single administration of sevoflura...BACKGROUND： Brief exposure to the anesthetic sevoflurane results in delayed neuroprotection, However, few studies have addressed delayed neuroprotection after preconditioning with a single administration of sevoflurane. OBJECTIVE： To explore the relationship between a single preconditioning administration of sevoflurane and reactive oxygen species production and protein kinase C-epsilon （PKC-ε ） translocation. DESIGN, TIME, AND SETTING： The randomized, controlled, animal experiment was conducted at the Central Laboratory, Xiangya Hospital, Central South University, China from November 2007 to April 2008. MATERIALS： A total of 120 healthy, male, Sprague Dawley rats were equally and randomly assigned into five groups： sham operation, ischemia/reperfusion, sevoflurane, 2-mercaptopropionylglycine （2-MPG, a selective reactive oxygen species scavenger） ＋ sevoflurane （MPG ＋ sevoflurane）, and MPG. Sevoflurane （Baxter, USA） and MPG （Sigma, USA） were used in this study. METHODS： Intervention consisted of three procedures. （1） MPG injection： a selective reactive oxygen species scavenger, MPG （20 mg/kg）, was infused into the rat caudal vein in the MPG and MPG ＋ sevoflurane groups. （2） Sevoflurane preconditioning： 30 minutes following MPG injection, rats in the sevoflurane and MPG ＋ sevoflurane groups breathed a mixed gas of 2.4% sevoflurane and 97.6% oxygen for 60 minutes. Rats in the sham operation, ischemia/reperfusion, and MPG groups breathed 100% pure oxygen for 60 minutes. （3） IschemiaJreperfusion： 24 hours after sevoflurane or pure oxygen preconditioning, middle cerebral artery occlusion models were established in the ischemia/reperfusion, sevoflurane, MPG ＋ sevoflurane, and MPG groups. Following 2 hours ischemia/6 hours and 24 hours reperfusion, the carotid artery was separated, but the middle cerebral artery was not occluded, in the sham operation group. MAIN OUTCOME MEASURES： In the ischemic hemisphere, PKC-ε translocation in the rat parietal cortex was measured by Western blot analysis. Infarct volume was calculated using the TTC assay. Neurological deficits were evaluated in rats using a scoring system of 8 points. RESULTS： After 6 hours reperfusion, the ratio of PKC-ε in membrane/（cytosol ＋ membrane） was significantly less in the sham operation group than in the ischemia/reperfusion, sevoflurane, MPG ＋ sevoflurane）, and MPG groups （P 〈 0.05）. The ratio of PKC-ε in membrane/（cytosol ＋ membrane） was significantly greater in the sevoflurane group than in the sham operation, ischemia/reperfusion, MPG ＋ sevoflurane, and MPG groups （P 〈 0.05）. No significant differences were observed in the ischemiaJreperfusJon, M PG ＋ sevoflurane, and MPG groups （P 〉 0.05）. Following 24 hours reperfusion, the ratio of PKC-ε in membrane/（cytosol ＋ membrane） was significantly less in the sham operation group than in the ischemia/reperfusion, sevoflurane, MPG ＋ sevoflurane, and MPG groups （P 〈 0.05）. No significant differences were detected in the ischemia/reperfusion, sevoflurane, MPG ＋ sevoflurane, and MPG groups （P 〉 0.05）. Compared with the ischemia/reperfusion, MPG ＋ sevoflurane, and MPG groups, infarct volume was significantly smaller, and neurological deficits were significantly improved, in the sevoflurane group （P 〈 0.05）. No significant differences in infarct volume and neurological deficits were observed among the ischemia/reperfusion, MPG ＋ sevoflurane, and MPG groups （P 〉 0.05）. Infarcts or neurological deficits were not detected in the sham operation group. CONCLUSION： A single preconditioning administration of sevoflurane reduced infarct volumes and improved neurological deficits in ischemic rats. Delayed neuroprotection may be mediated by reactive oxygen species and correlated to PKC- ε activation.展开更多
Background Rupture of unstable plaque with subsequent thrombus formation is the common pathophysiological substrate of acute coronary syndrome （ACS）. It is of potential significance to explore the blood indexes pred...Background Rupture of unstable plaque with subsequent thrombus formation is the common pathophysiological substrate of acute coronary syndrome （ACS）. It is of potential significance to explore the blood indexes predicting plaque characteristics. We investigated the relationship among soluble CD105, hypersensitive C-reactive protein （hs-CRP）, and coronary plaque morphology.Methods A clinical study from April 2004 to December 2006 was conducted in 130 patients who were divided into 3 groups： 56 patients （43.1%） in stable angina （SA） group, 52 patients （40.0%） in unstable angina （UA） group and 22 patients （16.9%） in acute myocardial infarction group. The concentrations of soluble CD105 and hs-CRP were measured in all of the patients by cardioangiography （CAG）. Plasma samples of arterial blood were collected prior to the procedure. The levels of soluble CD105 and hs-CRP were measured by enzyme-linked immunosorbent assay （ELISA）.Results Unstable and ruptured plaque was found more frequently in patients with acute myocardial infarction and UA. External elastic membrane cross-sectional area （EEM CSA）, plaque area, lipid pool area and plaque burden were significantly larger in the ruptured and unstable plaque group. Positive remodeling, thinner fabric-cap, smaller minimal lumen cross-sectional area （MLA）, dissection and thrombus were significantly more frequent in the ruptured and unstable plaque group. Remodeling index （RI） was positively correlated with the levels of soluble CD105 in the UA group （r=0.628, P〈0.01） and the acute myocardial infarction group （r=0.639, P〈0.01）. The levels of soluble CD105 and hs-CRP were higher in the ruptured plaque group. Soluble CD105 〉4.3 ng/ml was used to predict ruptured plaque with a receiver operating characteristic （ROC） curve area of 0.77 （95% confidence interval （CI）, 66.8%-87.2%）, a sensitivity of 72.8%, a specificity of 78.0% and an accuracy of 70.2% （P〈0.01）, similarly for hs-CRP 〉 5.0 mg/ml with a ROC curve area of 0.70 （95% CI, 59.2%-80.2%）, a sensitivity of 70.2%, a specificity of 76.2% and an accuracy of 67.2% （P〈0.01）.Conclusions The plaque characteristics correlate with the clinical presentation. The elevation of soluble CD105 and hs-CRP is related to the plaque instability and rupture.展开更多
文摘BACKGROUND： Serum high sensitive C-reactive protein （hs-CRP）, which regards as a high sensitive mark of systemic inflammatory response syndrome, can provide a lot of valuable information for the treatment and prognosis of cerebrovascular disease. OBJECTIVE： To observe the differences of blood glucose, lipid, homocysteine and previous disease history among patients with acute cerebral infarction at various levels of hs-CRP and compare changes of hs-CRP of patients with various degrees of neurologic impairment. DESIGN： Contrast observation. SETTING： Department of Neurology, Shenzhou Hospital, Shenyang Medical College. PARTICIPANTS： A total of 102 patients with acute cerebral infarction were selected from Department of Neurology, Shenzhou Hospital of Shenyang Medical College from February 2005 to September 2006, including 55 males and 47 females aged from 55 to 86 years. All accepted patients met the diagnostic criteria of cerebral infarction established by the Fourth National Cerebrovascular Disease Academic Meeting and were diagnosed with CT or MRI examination. All patients provided the confirmed consent. Based on clinical criteria of neurologic impairment established by the Fourth National Cerebrovascular Disease Academic Meeting, patients were randomly divided into mild group （0 - 15 points, n =46）, moderate group （16 - 30 points, n =38） and severe group （31 - 45 points, n =18）. In addition, based on hs-CRP level within 72 hours, patients were divided into normal group （hs-CRP ≤3 mg/L, n =53） and increasing group （hs-CRP 〉 3 mg/L, n =-49）. METHODS： ① 2 mL venous blood was selected from hospitalized patients in the next morning to separate serum. Quantitative measurement of hs-CRP was dealt with Latex Enhnced Turbidimetric Immunoassay （LETIA）. ②Fasting venous blood was colleted from hospitalized patients in the next morning to measure numeration of white blood cells, fibrinogen, blood glucose, total cholesterol （TC）, triacylglycerol （TG）, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C） and homocysteine. ③Measurement data were compared with t test or analysis of variance. MAIN OUTCOME MEASURES： ①Comparisons of serum biochemical indexes among patients with various levels of hs-CRP; ②comparisons of risk factors among patients with various levels of hs-CRP; ③comparisons of levels of hs-CRP among patients with various degrees of clinical neurologic impairment. RESULTS： A total of 102 patients were involved in the final analysis. ①Plasma fibrinogen and numeration of leucocytes were more in the increasing group than those in the normal group （t =4.39, 3.54, P 〈 0.01）; while, there were no significant differences of blood glucose, TC, TG, HDL-C, LDL-C and homocysteine between the two groups （P 〉 0.05）. ② Percentage of patients with hypertension and diabetes mellitus （DM） was higher in the increasing group than the normal group （ Х^2=3.98, 4.23, P 〈 0.05）; while, percentage of patients with smoking in the increasing group was not significantly different from that of patients in the normal group （P 〉 0.05）. ③Level of hs-CRP of patients with severe neurologic impairment was higher than that of patients with moderate neurologic impairment （t =2.273, P 〈 0.05）; that of patients with moderate neurologic impairment was higher than that of patients with mild neurologic impairment （t =2.586, P 〈 0.05）; that of patients with severe neurologic impairment was obviously higher than that of patients with mild neurologic impairment （t = 4.913, P 〈 0.01）. CONCLUSION： ① With the increase of hs-CRP, plasma fibrinogen and numeration of leucocytes of patients with acute cerebral infarction is increased, especially, they are increased remarkably among patients who have history of diabetes mellitus and hypertension. ②Increase of level of hs-CRP can be regarded as one of marks to evaluate severity of acute stroke.
基金Key research and development plan of the department of science and technology of Anhui province(No.1804h08020246)Key natural science research project of Anhui provincial colleges and universities(No.KJ2019A0401)Young talents project of Anhui provincial colleges and universities(No.gxyq2018039)。
文摘Objective:To investigate the relationship between serum levels of C1q tumor necrosis factorrelated protein 4(CTRP4)and hypersensitive C reactive protein(hs-CRP)and coronary heart disease(CHD)and its clinical value.Methods:128 patients underwent coronary angiography in our hospital,63 males,65 women,Based on blood sugar levels and coronary angiography,Divided into pure coronary heart disease(CHD)group 62 cases,Coronary heart disease with diabetes(DM+CHD)group 66 cases,A total of 126 patients were selected as control group,65 men,61 women,CTRP4 and hs-CRP levels in serum,Using Pearson correlation analysis to assess the correlation between Gennisi score and CTRP4、hs-CRP,Analysis of three groups of biochemical indicators,CTRP4、hs-CRP level changes and clinical significance.Results:The CTRP4、hs-CRP level of DM+CHD group was significantly higher than that of control group and CHD group(P DM+CHD 0.05).The CTRP4、hs-CRP level of the three-vessel coronary artery lesion group in the experimental group was higher than that in the two-vessel lesion group(P﹤0.05),Double branch lesion group was higher than single branch lesion group(P﹤0.05);Correlation analysis shows,There was a significant positive correlation between the CTRP4、hs-CRP level of CHD group and DM+CHD group and the Gennisi score(P DM+CHD 0.05).ROC curves show,CTRP4 and hs-CRP levels had predictive value(CHD group,AUC=0.940,0.934,DM+CHD group,AUC=0.980,0.964),Two associations(CHD:AUC=0.961,P﹤0.001,DM+CHD group:AUCDM+CHD 0.982,P﹤0.001)the predictive value is high.Conclusion:Serum CTRP4 and hs-CRP are positively related to the severity of coronary heart disease,and the sensitivity and specificity of predicting coronary heart disease are high,which is helpful for the identification and early prevention of coronary heart disease,and has certain clinical reference value.
文摘BACKGROUND： Brief exposure to the anesthetic sevoflurane results in delayed neuroprotection, However, few studies have addressed delayed neuroprotection after preconditioning with a single administration of sevoflurane. OBJECTIVE： To explore the relationship between a single preconditioning administration of sevoflurane and reactive oxygen species production and protein kinase C-epsilon （PKC-ε ） translocation. DESIGN, TIME, AND SETTING： The randomized, controlled, animal experiment was conducted at the Central Laboratory, Xiangya Hospital, Central South University, China from November 2007 to April 2008. MATERIALS： A total of 120 healthy, male, Sprague Dawley rats were equally and randomly assigned into five groups： sham operation, ischemia/reperfusion, sevoflurane, 2-mercaptopropionylglycine （2-MPG, a selective reactive oxygen species scavenger） ＋ sevoflurane （MPG ＋ sevoflurane）, and MPG. Sevoflurane （Baxter, USA） and MPG （Sigma, USA） were used in this study. METHODS： Intervention consisted of three procedures. （1） MPG injection： a selective reactive oxygen species scavenger, MPG （20 mg/kg）, was infused into the rat caudal vein in the MPG and MPG ＋ sevoflurane groups. （2） Sevoflurane preconditioning： 30 minutes following MPG injection, rats in the sevoflurane and MPG ＋ sevoflurane groups breathed a mixed gas of 2.4% sevoflurane and 97.6% oxygen for 60 minutes. Rats in the sham operation, ischemia/reperfusion, and MPG groups breathed 100% pure oxygen for 60 minutes. （3） IschemiaJreperfusion： 24 hours after sevoflurane or pure oxygen preconditioning, middle cerebral artery occlusion models were established in the ischemia/reperfusion, sevoflurane, MPG ＋ sevoflurane, and MPG groups. Following 2 hours ischemia/6 hours and 24 hours reperfusion, the carotid artery was separated, but the middle cerebral artery was not occluded, in the sham operation group. MAIN OUTCOME MEASURES： In the ischemic hemisphere, PKC-ε translocation in the rat parietal cortex was measured by Western blot analysis. Infarct volume was calculated using the TTC assay. Neurological deficits were evaluated in rats using a scoring system of 8 points. RESULTS： After 6 hours reperfusion, the ratio of PKC-ε in membrane/（cytosol ＋ membrane） was significantly less in the sham operation group than in the ischemia/reperfusion, sevoflurane, MPG ＋ sevoflurane）, and MPG groups （P 〈 0.05）. The ratio of PKC-ε in membrane/（cytosol ＋ membrane） was significantly greater in the sevoflurane group than in the sham operation, ischemia/reperfusion, MPG ＋ sevoflurane, and MPG groups （P 〈 0.05）. No significant differences were observed in the ischemiaJreperfusJon, M PG ＋ sevoflurane, and MPG groups （P 〉 0.05）. Following 24 hours reperfusion, the ratio of PKC-ε in membrane/（cytosol ＋ membrane） was significantly less in the sham operation group than in the ischemia/reperfusion, sevoflurane, MPG ＋ sevoflurane, and MPG groups （P 〈 0.05）. No significant differences were detected in the ischemia/reperfusion, sevoflurane, MPG ＋ sevoflurane, and MPG groups （P 〉 0.05）. Compared with the ischemia/reperfusion, MPG ＋ sevoflurane, and MPG groups, infarct volume was significantly smaller, and neurological deficits were significantly improved, in the sevoflurane group （P 〈 0.05）. No significant differences in infarct volume and neurological deficits were observed among the ischemia/reperfusion, MPG ＋ sevoflurane, and MPG groups （P 〉 0.05）. Infarcts or neurological deficits were not detected in the sham operation group. CONCLUSION： A single preconditioning administration of sevoflurane reduced infarct volumes and improved neurological deficits in ischemic rats. Delayed neuroprotection may be mediated by reactive oxygen species and correlated to PKC- ε activation.
文摘Background Rupture of unstable plaque with subsequent thrombus formation is the common pathophysiological substrate of acute coronary syndrome （ACS）. It is of potential significance to explore the blood indexes predicting plaque characteristics. We investigated the relationship among soluble CD105, hypersensitive C-reactive protein （hs-CRP）, and coronary plaque morphology.Methods A clinical study from April 2004 to December 2006 was conducted in 130 patients who were divided into 3 groups： 56 patients （43.1%） in stable angina （SA） group, 52 patients （40.0%） in unstable angina （UA） group and 22 patients （16.9%） in acute myocardial infarction group. The concentrations of soluble CD105 and hs-CRP were measured in all of the patients by cardioangiography （CAG）. Plasma samples of arterial blood were collected prior to the procedure. The levels of soluble CD105 and hs-CRP were measured by enzyme-linked immunosorbent assay （ELISA）.Results Unstable and ruptured plaque was found more frequently in patients with acute myocardial infarction and UA. External elastic membrane cross-sectional area （EEM CSA）, plaque area, lipid pool area and plaque burden were significantly larger in the ruptured and unstable plaque group. Positive remodeling, thinner fabric-cap, smaller minimal lumen cross-sectional area （MLA）, dissection and thrombus were significantly more frequent in the ruptured and unstable plaque group. Remodeling index （RI） was positively correlated with the levels of soluble CD105 in the UA group （r=0.628, P〈0.01） and the acute myocardial infarction group （r=0.639, P〈0.01）. The levels of soluble CD105 and hs-CRP were higher in the ruptured plaque group. Soluble CD105 〉4.3 ng/ml was used to predict ruptured plaque with a receiver operating characteristic （ROC） curve area of 0.77 （95% confidence interval （CI）, 66.8%-87.2%）, a sensitivity of 72.8%, a specificity of 78.0% and an accuracy of 70.2% （P〈0.01）, similarly for hs-CRP 〉 5.0 mg/ml with a ROC curve area of 0.70 （95% CI, 59.2%-80.2%）, a sensitivity of 70.2%, a specificity of 76.2% and an accuracy of 67.2% （P〈0.01）.Conclusions The plaque characteristics correlate with the clinical presentation. The elevation of soluble CD105 and hs-CRP is related to the plaque instability and rupture.
