Serum soluble interleukin-2 receptor levels in patients with chronic hepatitis B virus infection and its relation with antiHBc

AIM： To investigate the relationship between serum soluble interleukin-2 receptor （sIL-2R） level and anti-HBc in patients with chronic hepatitis B virus （HBV） infection. METHODS： Sera from 100 patients with chronic HBV infection and 30 healthy controls were included in this study. The patients were divided into group A [HBsAg （＋）, HBeAg （＋） and anti-HBc （＋）, n = 50] and group B [HBsAg （＋）, HBeAg （＋） and anti-HBc （-）, n = 50]. sIL-2R levels were determined using ELISA. HBV DNA and alanine aminotransferase （ALT） were also detected. RESULTS： Serum sIL-2R levels were significantly higher in patients with chronic HBV infection than in healthy controls. Moreover, serum sIL-2R levels were significantly higher in patients with HBsAg （＋）, HBeAg （＋） and antiHBc （＋） （976.56±213.51×10^3 U/L） than in patients with HBsAg （＋）, HBeAg （＋） and anti-HBc （-） （393.41±189.54 ×10^3 U/L, P〈 0.01）. A significant relationship was found between serum sIL-2R and ALT levels （P〈 0.01） in patients with chronic HBV infection, but there was no correlation between sIL-2R and HBV DNA levels. The anti-HBc status was significantly related to the age of patients （P〈 0.01）. CONCLUSION： The high sIL-2R level is related to positive anti-HBc in chronic hepatitis B patients. Positive anti-HBc may be related to T-lymphocyte activation and negative anti-HBc may imply immune tolerance in these patients.

Changes in soluble interleukin-2 receptor level in serum and Na^+ -K^+ -exchanging ATPase activity in semen of infertile men caused by antisperm antibody

Aim: To explore the possible mechanisms of male infertility caused by antisperm antibody (AsAb). Methods: Thesoluble interleukin-2 receptor (sIL-2R) level in serum was analyzed by ELISA and Na^+ -K^+ -exchanging ATPase activi-ty in semen by phosphorus (Pi) assay. Results: The slL-2R level in serum was significantly higher and the Na^+ -K^+ -exchanging ATPase activity in semen significantly lower in AsAb positive infertile men when compared with thecontrols. Conclusion: The AsAb titer varies with the slL-2R level in serum. A decrease in Na^+ -K^+ -exchangingATPase activity in semen may play a role in male infertility caused by AsAb.

Study of the Effect of Leeching on Plasma Endothelin and Soluble Interleukin-2 Receptor in Patients with Systemic Lupus Erythematosus

Objective: to explore the mechanism of leeching in treating systemic lupus erythematosus (SLE). Methods: Forty-four patients with SLE were randomly divided into conventional corticosteroid treated group (control group, n =20) and conventional treatment group with leeching intervention added (leeching group, n =24). Before and after treatment the concentration of plasma endothelin (ET) and soluble interleukin-2 receptor (sIL-2R) were determined. Results: Before treatment the level of plasma ET and sIL-2R in the SLE patients were all higher than those in the normal healthy group, ( P <0.01). But after treatment the level of these in both groups were significantly improved than those of before treatment ( P <0.05), and comparison between these two treated groups showed that the difference between them was significant ( P <0.05). Conclusion: Leeching added to conventional treatment of SLE could be more effective in improving the level of plasma ET and sIL-2R, and ameliorating the impairment of renal tissues.

Elevated pancreatic enzymes, IgM, soluble interleukin-2 receptor in anti-GADab(+) type 1 diabetes

Type 1 diabetes can be classified into immune-mediated diabetes (type 1A) and idiopathic diabetes, which lacks immunological evidence for beta cell autoimmunity (type 1B). Type 1A diabetes is characterized by the presence of the anti-glutamic acid decarboxylase antibody (anti-GADab). Fulminant type 1 diabetes is classified as type 1B diabetes, and characterized by the absence of anti-GADab, flu-like symptoms, and elevated serum exocrine pancreatic enzymes. We report a type 1 diabetic patient who showed flu-like symptoms, elevated serum exocrine pancreatic enzymes, and an extremely high-titer of anti-GADab, manifesting the characteristics of both type 1A and fulminant type 1 diabetes.

Effects of Aprotinin on Serum Interleukin-2 and Soluble Interleukin-2 Receptor during Cardiopulmonary Bypass

Interleukin-2 and its receptor are of importance in regulating immunity responses. The changes of interleukin-2 (IL-2) and soluble interleukin-2 receptor (IL-2R) during heart valve (s) replacement operation and effects of aprotinin on them were observed. Twenty patients undergoing heart valve (s) replacement were randomly divided into two groups: control group (n=10) and apro- tinin group (n=10). In aprotinin group, 1 000 000 KIU aprotinin was given by vein injection and then 2 000 000 KIU was given as a bolus in prime. Blood samples were collected before CPB, right after CPB and on the 1st, 3rd and 7th postoperative day (POD) for serum IL-2 and sIL-2R determination. Results showed that after CPB, IL-2 was reduced and slL-2R increased. Meanwhile, serum IL-2R was lower in aprotinin group than that of control. It is concluded that the immunity depression after CPB is associated with low level of IL-2 and high level of sIL-2R and aprotinin can ameliorate the situation.

Glycosylation-independent binding to extracellular domains 11-13 of mannose-6-phosphate/insulin-like growth factor-2 receptor mediates the effects of soluble CREG on the phenotypic proliferation of vascular smooth muscle cells

Background The present study aimed to investigate the detailed mode and specific sites for their binding as well as the functional relevance of this binding in the phenotypic proliferation of vascular smooth muscle cells(SMCs). Methods CREG knocked-down SMCs were employed to evaluate the biological activity of wtCREG and mCREG.Expressions of SMC differentiation markers SM myosin heavy chain(SM-MHC),SM-actin,heavy caldesmon and myocardin were determined by Western blotting using specific antibodies. Cellular growth of SMCs was assessed by bromide dewuridine (BrdU) incorporation and cell cycle analysis on fluorescence-activated cell sorting(FACS).A solid-phase binding assay was used to study the binding of CREG to extracellular domains of M6P/IGF2R.The cellular co-localization of the two recombinant CREGs with M6P/IGF2R was detected on SMC surface by immunoprecipitation and immunofluorescence analysis.Results The molecular weight of wtCREG was around 30 kD while that of the mCREG was～25 kD.Treatment of wtCREG with PNGase F reduced its molecular weight from～30 kD to～25 kD,whereas PNGase F treatment had no effect on the molecular weight of mCREG.Both wtCREG and mCREG proteins enhanced SMC differentiation,inhibited BrdU incorporation,and arrested cell cycle progression when added to the culture medium.In CREG knocked-down SMCs,the amount of CREG detected by immunoblotting in M6P/IGF2R immunoprecipitates was significantly reduced when compared to normal cells.Both recombinant CREGs co-immunoprecipitated with M6P/IGF2R, although slightly reduced amount of the mutant CREG was detected in M6P/IGF2R immunoprecipitates.Immunostaining revealed that His-tagged CREGs co-localized with IGF2R on the cell surface in a glycosylation-independent manner.In vitro binding assay showed that CREGs bound to M6P/ IGF2R extracellular domains 7-10 and 11-13 in a glycosylation -dependent and -independent manner,respectively.Further blocking experiments using soluble M6P/IGF2R fragments and M6P/IGF2R neutralizing antibody indicated that the biological activities of recombinant CREGs in SMC growth and the up-regulation of SMC differentiation markers were all abolished by treatment with the M6P/IGF2R neutralizing antibody. However,although the growth inhibitory effect of wtCREG was nearly abolished by D7-10 or D11-13,the effect of mCREG was only reversed by Dll-13,indicating that the binding to domains 11-13 is required for CREG to modulate the proliferation of SMCs.Conclusions These data suggest that solubleCREG proteins can exert their biological function via binding to the extracellular domains 7-10 and 11-13 of cell surface M6P/IGF2R in both a glycosylation-dependent and -independent manner.

Soluble Interleukin 2 Receptor-Alpha (sIL-2Rα) in the Peripheral Blood of Dogs—Comparison of Malignant Neoplasia with Other Diseases

Background: Cytokines are mediators of diseases. Expression levels in the blood could be of clinical relevance. Objective: sIL-2Rα is used as a marker for different malignancies in human medicine. The aim of this study was to show if sIL-2Rα is detectable and if there is any correlation to different diseases in dogs. Methods: For this purposes sIL-2Rα concentrations in the blood were measured in healthy dogs, in dogs with different non-neoplastic diseases and benign tumors and in dogs with malignant tumors. Serum levels of sIL-2Rα were measured by using a human specific enzyme linked immunosorbent assay (ELISA). Results: Measurement of sIL-2Rα was successful in most of the samples. Dogs with diseases have significantly increased serum levels of sIL-2Rα compared to healthy controls. sIL-2Rα serum levels are higher in patients with non-neoplastic diseases and benign tumors than in those with malignant neoplasia. There is a strong correlation between sIL-2Rα and leukocyte count. Conclusion: Measurements of sIL-2Rα in serum may be helpful in detecting stages and grades of inflammation in the progression of disease. sIL-2Rα could actually not be used as an indicator for malignant diseases in dogs like in humans. The strong correlation between sIL-2Rα and the leukocyte count indicates the inflammatory response to the disease. This could be helpful in giving a prognosis in some cases, because the inflammatory reaction is of prognostic relevance in different diseases including malignant and non-malignant neoplasia. Although the results of our research studies were very promising, further studies should be performed with a canine ELISA.

DETECTION OF PLASMA SOLUBLE INTERLEUKIN－2 RECEPTOR IN PATIENTS WITH SEVERE AND CHRONIC ACTIVE HEPATITIS B

Plasma levels of soluble interleukin-2 receptor (sIL-2R) in patients with chronic active hepatitis B (CAHB) or severe hepatitis B (SHB) were measured quantitatively by 'sandwich' ELISA with monoclonal antibodies in order to explore the change of sIL-2R levels, its clinical significance,and its relation to liver damage. The results showed that the plasma sIL-2R levels in patients with CAHB and SHB were much higher than those in normal controls (P < 0. 01 ), and the level ofplasma sIL-2R in patients with SHB was greatly higher than that in patients with CAHB. These results suggest that there is close relation between plasma level of sIL-2R, the clinical types of hepatitis B,and the severity of liver damage. In addition, there is no significant difference in plasma levels of sIL-2R between acute severe hepatitis B (ASHB), subacute severe hepatitis B (SASHB), and chronic severe hepatitis B (CSHB). No relation was found between sIL-2R level and hepatitis B virusreplication activity.

血清FGF-21 IL-13 sVEGFR-2与急性心力衰竭患者短期预后的关系

目的 探讨血清成纤维细胞生长因子-21(FGF-21)、白细胞介素-13(IL-13)、可溶性血管内皮生长因子受体-2(sVEGFR-2)水平与急性心力衰竭患者短期预后的相关性。方法 选取2019年1月至2020年12月在我院接受治疗的急性心力衰竭患者136例作为心力衰竭组。选取同期在我院健康体检者80例作为健康对照组。采用ELISA法检测血清FGF-21、IL-13、sVEGFR-2水平。随访1年,根据急性心力衰竭患者有无不良心血管事件发生分为预后良好组和预后不良组,并分析影响患者1年内临床结局的危险因素。采用ROC曲线,分析FGF-21、IL-13、sVEGFR-2对急性心力衰竭患者预后不良的诊断效能。结果 心力衰竭组血清FGF-21、IL-13高于健康对照组[FGF-21(pg/mL):74.81±16.29 vs. 19.37±5.11, IL-13(pg/mL):5.14±1.23 vs.1.62±0.54,P<0.001]、sVEGFR-2低于健康对照组(ng/mL:6.30±1.57 vs.15.18±4.29,P<0.05)。预后不良组血清FGF-21、IL-13、NT-proBNP分别高于预后良好组[FGF(pg/mL):92.31±20.84 vs.67.52±13.70, IL-13(pg/mL):6.94±1.75 vs.4.39±1.18, NT-proBNP(ng/L):4689.16±132.50 vs.2120.59±51.48],LVEF值、血清sVEGFR-2低于预后良好组[LVEF(%):45.27±6.13 vs.53.95±7.80, sVEGFR(ng/mL):4.85±1.24 vs.6.98±2.31,P<0.05]。多因素Logistic回归分析结果显示,LVEF(95%CI 0.265~0.840,P<0.001)及血清NT-proBNP(95%CI 1.002~2.317,P=0.015)、FGF-21(95%CI 1.438~5.019,P<0.001)、IL-13(95%CI 1.027~3.165,P=0.006)、sVEGFR-2(95%CI 1.190~4.283,P=0.002)是影响急性心力衰竭患者不良预后的独立危险因素。ROC曲线结果显示,血清FGF-21、IL-13、sVEGFR-2及三项联合检测预测急性心力衰竭患者不良预后的曲线下面积分别为0.810、0.775、0.821、0.918。结论 血清FGF-21、IL-13、sVEGFR-2水平与急性心力衰竭患者NYHA分级及临床预后密切相关,联合检测血清FGF-21、IL-13、sVEGFR-2对评估患者不良预后有较高参考价值。

乙型病毒性肝炎患者血清IL-2、slL-2R、IL-13及PDGF测定的意义

目的:探讨乙型肝炎患者血清IL-2、sIL-2R、IL-13及PDGF水平的变化及测定的临床意义。方法:150例乙型肝炎患者分为3组(急性肝炎组20例、慢性肝炎组90例和重型肝炎组40例);设健康人45名作为对照组。前2项血清标志物均采用放射免疫分析;后2项血清指标则采用酶联免疫吸附试验测定。将测定结果进行统计分析。结果:本文测定数值显示,血清IL-2水平急性肝炎患者组水平与对照组比较略有降低,但无统计学意义(P>0.05);慢性肝炎和重型肝炎2组患者该指标水平则均显著低于对照组(P均<0.05)。sIL-2R水平显示急性、慢性及重型肝炎3组患者均非常显著地高于对照组(P均<0.01),且发现其递增规律与肝炎病情的严重程度呈明显的平行关系。IL-13水平测定结果也显示3组患者均显著高于对照组(P均<0.05)。PDGF测定值显示,急性肝炎组水平显著高于对照组(P<0.05),慢性肝炎和重型肝炎2组水平则较对照组升高更为显著(P均<0.01)。其水平的递增关系也与病情的严重程度相一致。结论:本文患者4项血清指标水平的变化与乙型肝炎的发病及病情进展有关;其测定有助于了解本病的发生机制和预后评估。

Effect of Kang’ai Injection (康艾注射液) on Serum Level of Soluble Interleukin-2 Receptor and Vascular Endothelial Growth Factor in Patients with Esophageal Carcinoma during Radiotherapy

Objective： To observe the effect of Kang＇ai Injection （康艾注射液, KAI） on serum level of soluble interleukin-2 receptor （sIL-2R） and vascular endothelial growth factor （VEGF） in patients with esophageal carcinoma （EC） during radiotherapy （RT）, and to investigate its synergistic effect with RT and its influence on immunological function of the body. Methods： One hundred and seventy patients with EC, who had missed the chance of surgical operational therapy, were assigned to the treated group （90 cases） and the RT group （80 cases）, and at the same time a control group consisting of 80 inpatients without tumors was set up. Patients in the RT group were treated with RT alone but KAI was given additionally to those in the treated group, with 50 ml given once per day via intravenous dripping, 15 days as one course, and 2 courses administered in total. The immediate therapeutic efficacy and changes of serum slL-2R and VEGF levels were observed, and the effect of KAI on patients＇ quality of life （QOF） was evaluated by Karnofsky scoring. Results： In 16 patients of the treated group it was completely remission （OR）, in 54 partially remission （PR）, in 18 it was stabilized disease （SD） and in 2 progressive disease （PD）, with the total effective rate （CR ＋ PR） as 77.8%, while in those of the control group it was 12, 46, 18, 4 and 72.5%, respectively, the immediate therapeutic efficacy in the treated group was somewhat better than that in the RT group, but showed no statistical significance （P〉0.05）. Serum levels of slL-2R and VEGF in all the patients before treatment were higher than those in the control group, which were decreased after treatment in both groups （P〈0.05）, but the improvement in the treated group was better than that in the RT group, showing significant difference （P〈0.05）, and patients＇ QOF improved more significantly in the former as well （62.2 % vs 40.0%, P〈 0.05）. Conclusion： KAI in combination with RT in treating patients with EC could enhance the immunological function of patients, improve their QOF and enhance their sensitivity to RT.

CLINICAL SIGNIFICANCE OF ELEVATED SERUM SOLUBLE INTERLEUKIN-2 RECEPTOR IN GASTRIC CANCER

This is China’s pilot stndy in the assessment of the diagnostic value of serum soluble IL-2 receptor (sIL-2R) in gastric cancer.We measured its level by ELISA method in 45 patients with gastric cancer (without metastasis:32;with metastasis:5;recurrence:8)27 gastric ulcer,

TSH抑制疗法对分化型甲状腺癌患者术后血清Tg、VEGF、TSGF、CD44V6、sIL-2R及T淋巴细胞亚群水平的影响

目的:探讨促甲状腺激素(thyroid stimulating hormone,TSH)抑制疗法对分化型甲状腺癌(differentiated thyroid carcinoma,DTC)患者术后血清甲状腺球蛋白(thyroglobulin,Tg)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、肿瘤特异性生长因子(tumors pecific growth factor,TSGF)、白细胞分化抗原44变异型6(CD44V6)、可溶性白细胞介素-2受体(soluble interleukin-2receptor,sIL-2R)及T淋巴细胞亚群水平的影响。方法:选择2014年1月~2017年1月我院收治的接受甲状腺全切手术治疗的100例DTC患者,随机分为对照组和实验组,各50例。对照组患者常规给予甲状腺素替代治疗,实验组患者给予TSH抑制疗法(口服左甲状腺素钠片,控制血清TSH水平低于0.1mU/L),两组患者均给予治疗1个月。比较两组患者治疗前后血清Tg、VEGF、TSGF、CD44V6、sIL-2R水平及外周血CD3^+、CD4^+、CD8^+水平。结果:两组治疗前的血清Tg、VEGF、TSGF、CD44V6、sIL-2R水平比较,均无显著性差异(P>0.05);两组治疗后的血清Tg、VEGF、TSGF、CD44V6、sIL-2R水平相比治疗前均较低,且实验组治疗后血清Tg、VEGF、TSGF、CD44V6、sIL-2R水平变化均显著优于对照组(P<0.05)。两组治疗前的外周血CD3^+、CD4^+、CD8^+水平比较,均无显著性差异(P>0.05);两组治疗后的外周血CD3^+、CD4^+水平相比治疗前均较高、CD8^+水平相比治疗前均较低,且实验组治疗后血外周血CD3^+、CD4^+、CD8^+水平变化均优于对照组,具有显著性差异(P<0.05)。结论:DTC行甲状腺全切手术治疗后接受TSH抑制疗法能够有效降低血清Tg、VEGF、TSGF、CD44V6、sIL-2R水平,改善细胞免疫功能,值得在临床上推广应用。

Expression of sIL-2R before and after Chemotherapy in Patients with Breast Cancer

Objective： To investigate the difference of peripheral blood sIL-2R before and after chemotherapy in breast cancer patients, and evaluate the clinical value of the sIL-2R in breast cancer＇s diagnosis and therapy. Methods： The peripheral blood sIL-2R levels of the breast cancer patients with or without chemotherapy were detected by ELISA. The healthy persons were made as the control group. Results： The sIL-2R levels of the breast cancer patients were higher than that of the control group（P（0.05）; the sIL-2R＇s levels in I^II stage breast cancer were lower than that in Ill^IV stage breast cancer （P（0.05）; the sIL-2R levels of the patients before chemotherapy were higher than that of the patients undergone chemotherapy（P（0.05）; The level of the patient with chemotherapy was still higher than that of the control group （P（0.05）; the sIL-2R levels of the patients whose chemotherapies were noneffective were higher than that of the patients received effective chemotherapies （P（0.05）. There was no significant difference between the group with ER（＋） or PR（＋） and the group with ER（-） or PR（-）（P〉0.05）. Conclusion： The breast cancer patients have the high sIL-2R levels. There is a close relationship between the cancer incidence and the patients, immune situation. The level of sIL-2R could be a clinical index which can be used for evaluating the cancer degree, because the higher levels of sIL-2R can indicate that the immune ability of patient is worse. There is a significant difference between the sIL-2R levels of the patients before chemotherapy and that of the patients undergone chemotherapy.

联合应用重组可溶性IL-13受体α2及可溶性IL-5受体对支气管哮喘小鼠BALF嗜酸粒细胞凋亡及Eotaxin的影响

目的联合应用重组可溶性IL-13受体α2（sIL-13Rα2）及重组可溶性IL-5受体（sIL-5R）治疗支气管哮喘（简称哮喘）小鼠模型，观察对支气管肺泡灌洗液（BALF）嗜酸粒细胞（EOS）凋亡率以及嗜酸粒细胞趋化因子（Eotaxin）水平的影响并探讨其相关机制。方法将50只BALB／c小鼠随机分成5组：正常对照组、哮喘组、sIL-13Rα2治疗组、sIL-5R治疗组及联合治疗组。鸡卵白蛋白（OVA）建立哮喘小鼠模型。sIL-13Rα2治疗组、sIL-5R治疗组及联合治疗组每次激发前30min分别腹腔注射sIL-13Rα2100μg、sIL-5R100μg及sIL-13Rα2、sIL-5R各100μg干预，正常对照组及哮喘组生理盐水代替。应用流式细胞术（FCM）检测各组BALF中EOS凋亡率，酶联免疫吸附试验（ELISA）测定Eotaxin水平。结果①与正常对照组比较，哮喘组BALF中EOS数目百分比、Eotaxin水平均显著升高（P值均〈0．01），EOS凋亡率明显下降（P〈0．01）。②与哮喘组比较，sIL-13Rα2治疗组、sIL-5R治疗组及联合治疗组BALF中EOS数目百分比及Eotaxin水平均明显降低（P值均〈0．01），EOS凋亡率明显增高（P〈0．05）。③与单独治疗组比较，联合治疗组效果更佳（P〈0．05）。结论联合应用sIL-13Rα2及sIL-5R能够明显增加哮喘小鼠EOS凋亡，明显降低Eotaxin水平，可明显减少EOS肺部浸润，改善气道炎症，较单用更具有临床应用价值。

Disruption of the TWEAK/Fn14 pathway prevents 5-fluorouracil-induced diarrhea in mice

AIM To clarify the roles of TWEAK and its receptor Fn14 in 5-fluorouracil(5-FU)-induced diarrhea.METHODS Diarrhea was induced in wild-type(WT), Fn14 knockout(KO), and IL-13 receptor(IL-13R)α1 KO BALB/c mice using a single injection of 5-FU. Histological analysis, cytokine analysis, and flow cytometry was performed on ileal tissues and cells. Murine colon carcinomabearing mice were co-treated with an anti-TWEAK antibody and 5-FU. Embryonic fibroblast response to cytokines was also analyzed.RESULTS5-FU induced high Fn14 expression in epithelial cells. The severity of 5-FU-induced diarrhea was lower in Fn14 KO mice compared with WT mice. Administration of anti-TWEAK antibody reduced 5-FU-induced diarrhea without affecting the antitumor effects of 5-FU in vivo. 5-FU-induced expression of IL-13, IL-17 A, TNF-α, and IFN-γ in the ileum was Fn14 dependent. The severity of 5-FU-induced diarrhea was lower in IL-13Rα1 KO mice, indicating major role for IL-13 signaling via IL-13Rα1 in pathogenesis. We found that IL-13Rα2, an IL-13 neutralizing/cell protective receptor, was strongly induced by IL-33 in vitro and in vivo. IL-13Rα2 was upregulated in the ileum of 5-FU-treated Fn14 KO mice. Thus, the deletion of Fn14 upregulated IL-13Rα2 expression, which reduced IL-13 expression and activity. CONCLUSION Disruption of the TWEAK/Fn14 pathway affects several interconnected pathways, including those associated with IL-13, IL-33, and IL-13Rα2, to attenuate 5-FUinduced intestinal side effects.

Early detection of hepatocellular carcinoma co-occurring with hepatitis C virus infection: A mathematical model

AIM: To develop a mathematical model for the early detection of hepatocellular carcinoma (HCC) with a panel of serum proteins in combination with α-fetoprotein (AFP).METHODS: Serum levels of interleukin (IL)-8, soluble intercellular adhesion molecule-1 (sICAM-1), soluble tumor necrosis factor receptor II (sTNF-RII), proteasome, and β-catenin were measured in 479 subjects categorized into four groups: (1) HCC concurrent with hepatitis C virus (HCV) infection (n = 192); (2) HCV related liver cirrhosis (LC) (n = 96); (3) Chronic hepatitis C (CHC) (n = 96); and (4) Healthy controls (n = 95). The R package and different modules for binary and multi-class classifiers based on generalized linear models were used to model the data. Predictive power was used to evaluate the performance of the model. Receiver operating characteristic curve analysis over pairs of groups was used to identify the best cutoffs differentiating the different groups.RESULTS: We revealed mathematical models, based on a binary classifier, made up of a unique panel of serum proteins that improved the individual performance of AFP in discriminating HCC patients from patients with chronic liver disease either with or without cirrhosis. We discriminated the HCC group from the cirrhotic liver group using a mathematical model (-11.3 + 7.38 × Prot + 0.00108 × sICAM + 0.2574 × β-catenin + 0.01597 × AFP) with a cutoff of 0.6552, which achieved 98.8% specificity and 89.1% sensitivity. For the discrimination of the HCC group from the CHC group, we used a mathematical model [-10.40 + 1.416 × proteasome + 0.002024 × IL + 0.004096 × sICAM-1 + (4.251 × 10-4) × sTNF + 0.02567 × β-catenin + 0.02442 × AFP] with a cutoff 0.744 and achieved 96.8% specificity and 89.7% sensitivity. Additionally, we derived an algorithm, based on a binary classifier, for resolving the multi-class classification problem by using three successive mathematical model predictions of liver disease status.CONCLUSION: Our proposed mathematical model may be a useful method for the early detection of different statuses of liver disease co-occurring with HCV infection.

Role of platelet TLR4 expression in pathogensis of septic thrombocytopenia

BACKGROUND： Infection-induced thrombocytopenia （TCP） is an independent risk factor for death of patients with sepsis, but its mechanism is unknown. This study aimed to explore the underlying mechanism of TCP based on the relationship between TLR4 expression and platelet activation in septic patients. METHODS： A total of 64 patients with sepsis were prospectively studied. Platelet count （PC）, mean platelet volume （MPV）, platelet distribution width （PDW）, platelet TLR4 expression, platelet PAC-1 expression, sCD40L and TNF-a concentrations were compared between the healthy control group （15 volunteers） and sepsis group （64 patients） at admission and on the 3, 5, and 9 days after admission. The changes of MPV and PDW in the TCP and non-TCP subgroups of sepsis before and after treatment were recorded. Prognostic index was analyzed. RESULTS：PC was lower in the sepsis group （P=0.006）, and MPV and PDW were higher in the sepsis group than those in the healthy control group （P=0.046, P=0.001）. Platelet TLR4 and PAC-1 expressions, and sCD40L and TNF-a levels increased more significantly in the sepsis group （P〈0.001）. PAC-1 expression and TNF-a level were higher in the TCP group than in the non-TCP group before and after treatment （P=0.023, P=0.011）. sCD40L concentration and platelet TLR4 expression were significantly higher in the treated TCP group than in the non-TCP group （P=0.047, P=0.001）. Compared to the non-TCP group, the rate of bleeding was higher （P=0.024） and the length of ICU stay was longer （P=0.013）. The APACHE II score and the 28-day mortality were higher in the TCP group （P〈0.01, P=0.048）. CONCLUSIONS：The elevation of platelet TLR4 expression in sepsis along with platelet activation is closely related to the incidence of thrombocytopenia. The occurrence of TCP is a sign of poor prognosis in sepsis patients.

Effect of Shenmai Injection(参麦注射液)on sIL-2R NK and LAK Cells of Patiente with Advanced Carcinoma

Serum interleukin-2 receptor (sIL-2R) level , activities of natural killer cell (NK) and lym-phokine activated killer (LAK) cells were determined in 60 patients with advanced carcinoma (AC) beforeand after treatment with Shenmai Injection (SMI) , forty healthy persons were taken as non-carcinoma control(NC) . The results showed that: Serum slL-2R level in AC were much higher than those in NC (P<0.05) andactivities of NK and LAK cells in AC were much lower than those in NC ( P< 0. 05) before treatment. Therewas no significant difference among gastric, colonic and lung cancer ( P >0. 05) . After treatment with SMI, itwas found that the level of slL-2R in all patients were obviously lowered ( P< 0. 05) while the activities of NKand LAK cells were signifficantly higher than that prior the treatment ( P < 0. 05) . Relevancy was not foundbetween sIL-2R and NK , LAK cells. These data suggested that the immune function was compromised in AC,and SMI has a wide effect of immuno-regulation.