Changes of pregnancy-associated plasma protein-A in patients with acute coronary syndrome

The term vulnerable patient has been proposed to define subjects susceptible to an acutecoronary syndrome （ACS） or sudden cardiac death based on plaque characteristics, blood abnormalities, or myocardial vulnerability. 1 It will be important in the future to identify both vulnerable patients and vulnerable plaques. Atherosclerotic arteries obtained at autopsy from patients who died suddenly of cardiac causes indicate that pregnancyassociated plasma protein-A （ PAPP-A ） was abundantly expressed in plaque cells and in the extracellular matrix of ruptured and eroded unstable plaques, but not in stable plaques. Here we examined circulating PAPP-A levels in patients with ACS in order to evaluate its potential use in identifying vulnerable patients.

Lipopolysaccharide Stimulates Surfactant Protein-A in Human Renal Epithelial HK-2 Cells through Upregulating Toll-like Receptor 4 Dependent MEK1/2-ERK1/2-NF-KB Pathway

Background： Surfactant protein-A （SP-A） contributes to the regulation of sepsis-induced acute kidney injury. In a previous study, we demonstrated that the expression of SP-A in the human renal tubular epithelial （HK-2） cells can be stimulated by lipopolysaccharide （LPS）. The present study evaluated the possible signal-transducing mechanisms of LPS-induced SP-A biosynthesis in the HK-2 cells. Methods： Tetrazolium salt colorimetry （MTT） assay was used to detect cell viability of HK-2 cells after LPS stimulation on different time points. HK-2 cells were stimulated with 100 ng/ml of LPS for different durations to determine the effects of LPS on SP-A and toll-like receptor 4 （TLR4） messenger RNA （mRNA） expression, as well as phosphorylation of mitogen-activated/ extracellular signal-regulated kinase （MEK） 1, extracellular signal-regulated kinase 1/2 （ERK1/2）, p38 mitogen-activated protein kinase （p38MAPK）, and nuclear factor-kappa B （NF-KB） inhibitor-alpha （IkB-a）. Then, HK-2 cells were pretreated with CLI-095, a TLR4 inhibitor, to analyze mRNA and protein levels of SP-A and TLR4 and expression of NF-KB ill the cytoplasm and nucleus of HK-2 before LPS exposure. Results： HK-2 cells exposed to 100 ng/ml of LPS for 1,6, and 24 h did not affect cell viability which showed no toxic effect of 100 ng/ml LPS on cells （P = 0.16）; however, the biosynthesis of SP-A mRNA and protein in HK-2 cells was significantly increased （P = 0.02）. As to the mechanism, LPS enhanced transmembrane receptor TLR4 protein expression. Sequentially, LPS time dependently augmented phosphorylation of MEKI, ERKI/2, and p38MAPK. In addition, levels of phospborylatedand nuclear NF-KB were augmented with LPS exposure for 2 h. LPS-induced SP-A and TLR4 mRNA as well as NF-KB expression were significantly inhibited by pretreatment with CLI-095. Conclusions： The present study exhibited that LPS can increase SP-A synthesis in human renal epithelial cells through sequentially activating the TLR4-related MEK1 -ERK 1/2-NF-kB-dependent pathway.

Research Progress of Combined Detection of WBC, CRP and SAA in Early Diagnosis of Respiratory Tract Infection in Children

Objective: To investigate the application of WBC, CRP and SAA combined detection in the early diagnosis of respiratory tract infection in children. Methods: Collect the literature reports on the early diagnosis of respiratory tract infection in children by the combined detection of WBC, CRP and SAA in recent years, and follow up the relevant literature reports from the selection of “new three routine” laboratory items for rapid diagnosis in pediatric outpatient department and the application of the combined detection of WBC, CRP and SAA in the early diagnosis of respiratory tract infection in children. Results: Many literature studies found that the combined detection of WBC, CRP and SAA has important clinical significance in the early diagnosis of respiratory tract infection in children. Conclusion: Through reviewing the relevant literature, we can understand the application of WBC, CRP and SAA combined detection in the early diagnosis of respiratory tract infection in children. To provide more accurate and reliable laboratory data for the early diagnosis and treatment of respiratory tract infection in children in the future.

The value of PAPP-A in the diagnosis and prognosis of GTD

Objective： To investigate the value of PAPP-A （pregnancy assouated plasma protein-A） in the diagnosis and prognosis of gestational trophoblastic disease （GTD）. Methods： The serum 13-HCG （β-human chorionic gonadotropin） and PAPP-A levels of 25 normal pregnant women, 28 patients with complete hydatidiform mole and 38 patients with invasive mole were measured by enzyme linked immunosorbent assay （ELISA） during the periods of diagnosis, treatment and follow-up. Results： Compared with control group, patients with complete mole and invasive mole had higher levels of β-HCG （P 〈 0.01）. But there was no significant difference between the complete and invasive mole group （P 〉 0.05）. The PAPP-A level of complete mole group was significantly higher than that of control group （P 〈 0.01）. The PAPP-A level of invasive mole group was significantly higher than that of complete mole group and control group（P 〈 0.05）. In complete mole group, serum β-HCG and PAPP-A levels of the patients with malignant sequelae were significantly higher than those with benign sequelae （P 〈 0.05）. The β-HCG level had no relationship with the clinical stage of invasive mole. However, the PAPP-A level increased with clinical advancement of invasive mole. The levels of β-HCG and PAPP-A gradually decreased after evacuation in patients with complete moles, but maintained positive or even increased in patients with subsequent malignancy diagnosis of hydatidiform mole and invasive mole, but Conclusion： The PAPP-A level can give us some help not only in early also in the prognosis of malignant sequelae.