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.

Increased serum levels of soluble CD146 and vascular endothelial growth factor receptor 2 in patients with exudative age-related macular degeneration

AIM: To investigate serum levels of soluble CD146(s CD146) and vascular endothelial growth factor receptor 2(VEGFR2) in patients with age-related macular degeneration(AMD). METHODS: Eighty-eight patients with exudative AMD and 45 sex-and age-matched healthy controls were enrolled in this study conducted in China. Serum samples was obtained from the patients with exudative AMD and from the controls. Serum sCD146 and VEGFR2 protein levels were measured using an enzyme-linked immunosorbent assay.RESULTS: We found that serum sCD146 and VEGFR2 protein levels were significantly higher in the patients with exudative AMD group than in the controls(t=3.859, P<0.001 and t=3.829, P<0.001, respectively). Serum sCD146 levels were significantly higher in patients with classic choroidal neovascularization(CNV) than in those with occult CNV(t=9.899, P<0.001). There was a significant difference in the trend for exudative AMD in the highest versus lowest quartile of circulating sCD146 levels(χ2=10.29, P=0.001). The receiver operating characteristic curve analysis showed that the area under the curve was 0.696 for s CD146(95%CI: 0.601-0.791) with an optimum diagnostic cut-off value of 157.16 ng/mL, a sensitivity of 55.7%, and a specificity of 82.2%.CONCLUSION: The serum sCD146 level increases and may be a biomarker for exudative AMD.

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.

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.

Water-soluble lipopolymer delivery of N-methyl-D-aspartic acid receptor 2B siRNA relieves chronic neuropathic pain in rats

Spinal dorsal horn N-Methyl-D-aspartic acid receptor 2B （NR2B） overexpression plays an important role in the production and maintenance of neuropathic pain. Because small interfering RNA （siRNA） can inhibit NR2B expression, siRNA may provide a novel approach to treat neuropathic pain and possibly nerve injury. However, an efficient and safe vector for NR2B siRNA has not been discovered. This study shows that a water soluble lipopolymer （WSLP） comprised of low molecular weight polyethyleneimine （PEI） and cholesterol can deliver siRNA targeting NR2B for the treatment of neuropathic pain. Results show that intrathecal injection of WSLP/siRNA complexes for 3 days inhibit NR2B gene expression with reductions in mRNA and protein levels by 59% and 54%, respectively, compared with control rats （P 〈 0.01）. Injection of WSLP complexed with scrambled siRNA, or PEI with siRNA did not show this inhibitory effect. Moreover, injection of WSLP/siRNA complexes significantly relieved neuropathic pain at 3, 7, 12, and 21 days, while injection of WSLP with scrambled siRNA or PEI with siRNA did not. These results demonstrate that WSLP can efficiently deliver siRNA targeting NR2B in vivo and relieve neuropathic pain.

Administration of soluble activin receptor 2B increases bone and muscle mass in a mouse model of osteogenesis imperfecta

Osteogenesis imperfecta（OI） comprises a group of heritable connective tissue disorders generally defined by recurrent fractures, low bone mass, short stature and skeletal fragility. Beyond the skeletal complications of OI,many patients also report intolerance to physical activity, fatigue and muscle weakness. Indeed, recent studies have demonstrated that skeletal muscle is also negatively affected by OI, both directly and indirectly. Given the well-established interdependence of bone and skeletal muscle in both physiology and pathophysiology and the observations of skeletal muscle pathology in patients with OI, we investigated the therapeutic potential of simultaneous anabolic targeting of both bone and skeletal muscle using a soluble activin receptor 2B（ACVR2B） in a mouse model of type Ⅲ OI（oim）. Treatment of 12-week-old oim mice with ACVR2 B for 4 weeks resulted in significant increases in both bone and muscle that were similar to those observed in healthy,wild-type littermates. This proof of concept study provides encouraging evidence for a holistic approach to treating the deleterious consequences of OI in the musculoskeletal system.

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.

外周血sIL-2R、CD4^(+)/CD8^(+)、TNF-α对初治活动性肺结核老年患者化疗疗效的评估价值

目的探讨外周血可溶性白细胞介素2受体(sIL-2R)、CD4^(+)淋巴细胞百分比/CD8^(+)淋巴细胞百分比比值(下称CD4^(+)/CD8^(+))、肿瘤坏死因子-α(TNF-α)对初治活动性肺结核老年患者化疗疗效的评估价值。方法将2019年12月至2022年12月该院收治的102例初治活动性肺结核老年患者纳入研究作为观察组,另选取102例年龄≥60岁且同期于该院体检的健康者作为对照组。比较两组外周血sIL-2R、TNF-α、CD4^(+)/CD8^(+)水平并分析sIL-2R、TNF-α、CD4^(+)/CD8^(+)间的相关性。观察组均采用2HRZE/4HR抗结核治疗方案,比较观察组治疗前、治疗1个月、治疗6个月时不同疗效患者外周血sIL-2R、TNF-α、CD4^(+)/CD8^(+);分析sIL-2R、CD4^(+)/CD8^(+)、TNF-α水平与疗效的相关性;采用受试者工作特征(ROC)曲线分析各指标用于老年患者化疗疗效评估的效能。结果观察组sIL-2R、TNF-α水平高于对照组,而CD4^(+)/CD8^(+)低于对照组,差异均有统计学意义(P<0.05)。观察组sIL-2R、TNF-α与CD4^(+)/CD8^(+)呈负相关(P<0.05),sIL-2R与TNF-α呈正相关(P<0.05)。治疗1个月、治疗6个月时显效患者sIL-2R、TNF-α水平低于有效患者,而后者又低于无效患者,显效患者CD4^(+)/CD8^(+)高于有效患者,而后者又高于无效患者,差异均有统计学意义(P<0.05)。sIL-2R、TNF-α水平与疗效呈负相关(P<0.05),CD4^(+)/CD8^(+)与疗效呈正相关(P<0.05)。ROC曲线分析显示,治疗1个月、6个月时sIL-2R、CD4^(+)/CD8^(+)、TNF-α联合用于评估疗效的曲线下面积(AUC)明显大于各时间点单项指标用于评估的AUC(P<0.05),而且治疗6个月时各指标联合评估的AUC大于治疗1个月(P<0.05)。结论初治活动性肺结核老年患者sIL-2R、CD4^(+)/CD8^(+)、TNF-α水平与患者疗效密切相关,将以上指标联合用于评估患者化疗疗效具有一定参考价值。

急性冠脉综合征患者血清sST2及NLRP3水平与介入术后无复流-慢血流的相关性分析

目的探讨急性冠脉综合征(acute coronary syndrome,Acs)患者血清可溶性生长刺激表达基因蛋白2(soluble growth stimulation expression gene 2 protein,sST2),核苷酸寡聚化结构域样受体热蛋白结构域相关蛋白3(nucleotide oligomerization domain like receptor heat protein domain associated protein 3,NLRP3)水平与经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后无复流-慢血流的关系。方法选择2020年1月~2022年12月佳木斯市中心医院收治的97例急性冠脉综合征患者,所有患者均接受PCI治疗,根据术后无复流-慢血流发生情况分为无复流-慢血流组(n=20)和对照组(n=77)。术前检测血清sST2及NLRP3水平,分析影响急性冠脉综合征患者PCI术后无复流-慢血流的因素以及sST2,NLRP3预测急性冠脉综合征患者PCI术后无复流-慢血流的价值。结果无复流-慢血流组血清sST2(14.32±2.65 ng/ml vs 11.02±2.13 ng/ml),NLRP3(68.23±10.17 pg/ml vs 42.05±8.23 pg/ml)水平高于对照组,差异具有统计学意义(t=5.860,12.055,均P<0.05)。多因素Logistic回归分析显示高血栓负荷(OR:7.791,95%CI:2.834~21.421)、高水平sST2(OR=2.071,95%CI:1.146~3.743)、高水平NLRP3(OR=2.008,95%CI:1.228~3.284)是急性冠脉综合征患者PCI术后无复流-慢血流的危险因素(均P<0.05)。sST2,NLRP3诊断急性冠脉综合征患者PCI术后无复流-慢血流的临界值分别为12.91ng/ml,55.39 pg/ml,曲线下面积分别为0.737,0.686,联合sST2,NLRP3诊断急性冠脉综合征患者PCI术后无复流-慢血流的曲线下面积为0.907,高于单独诊断(Z=2.662,2.856,均P<0.05)。结论急性冠脉综合征患者血清sST2,NLRP3水平增高与PCI术后无复流-慢血流的发生有关,联合检测sST2和NLRP3可提高对术后无复流-慢血流的诊断效能。

2型糖尿病下肢血管病变患者介入治疗后血清NLRP3及sVCAM-1水平对再狭窄的意义

目的探讨2型糖尿病下肢血管病变患者介入治疗后血清NOD样受体蛋白3(NLRP3)及可溶性血管细胞黏附分子-1(sVCAM-1)水平对再狭窄的意义。方法回顾性分析2022年1月~2023年1月于河北省邯郸市中心医院血管介入科104例成功行血管介入治疗的2型糖尿病下肢血管病变患者的临床资料。根据介入后再狭窄发生情况分为再狭窄组(n=20)和无再狭窄组(n=84),比较两组患者一般资料及介入后24 h血清NLRP3、sVCAM-1水平,采用多因素Logistic回归模型分析再狭窄发生的影响因素;创建受试者工作特征(ROC)曲线,分析血清NLRP3、sVCAM-1检测对再狭窄的预测价值。结果与无再狭窄组相比,再狭窄组患者2型糖尿病病程、下肢动脉病变长度更长,Fontaine分期Ⅳ期占比、下肢动脉完全闭塞占比及血清糖化血红蛋白(HbA1c)、超敏C反应蛋白(hs-CRP)、NLRP3、sVCAM-1水平更高(P<0.05);多因素Logistic回归分析显示,下肢动脉完全闭塞、下肢动脉病变长度、HbA1c、NLRP3及sVCAM-1是2型糖尿病下肢血管病变患者介入后再狭窄发生的影响因素(P<0.05);ROC曲线显示,血清NLRP3、sVCAM-1联合检测对2型糖尿病下肢血管病变患者介入后再狭窄发生的预测价值较高,敏感度为95.00%,特异度为71.43%,ROC曲线下面积为0.929。结论血清NLRP3、sVCAM-1水平高表达均是2型糖尿病下肢血管病变患者介入治疗后再狭窄发生的危险因素,二者联合检测能提高2型糖尿病下肢血管病变患者介入治疗后再狭窄预测的准确性。

High glucose reduces Nrf2-dependent cRAGE release and enhances inflammasome-dependent IL-1βproduction in monocytes:the modulatory effects of EGCG

Soluble receptor for advanced glycation end products(sRAGE)acts as a decoy sequestering of RAGE ligands,thus preventing the activation of the ligand-RAGE axis linking human diseases.However,the molecular mechanisms underlying sRAGE remain unclear.In this study,THP-1 monocytes were cultured in normal glucose(NG,5.5 mmol/L)and high glucose(HG,15 mmol/L)to investigate the effects of diabetesrelevant glucose concentrations on sRAGE and interleukin-1β(IL-1β)secretion.The modulatory effects of epigallocatechin gallate(EGCG)in response to HG challenge were also evaluated.HG enhanced intracellular reactive oxygen species(ROS)generation and RAGE expression.The secretion of sRAGE,including esRAGE and cRAGE,was reduced under HG conditions,together with the downregulation of a disintegrin and metallopeptidase 10(ADAM10)and nuclear factor erythroid 2-related factor 2(Nrf2)nuclear translocation.Mechanistically,the HG effects were counteracted by siRAGE and exacerbated by siNrf2.Chromatin immunoprecipitation results showed that Nrf2 binding to the ADAM10 promoter and HG interfered with this binding.Our data reinforce the notion that RAGE and Nrf2 might be sRAGE-regulating factors.Under HG conditions,the treatment of EGCG reduced ROS generation and RAGE activation.EGCG-stimulated cRAGE release was likely caused by the upregulation of the Nrf2-ADAM10 pathway.EGCG inhibited HG-mediated NLRP3 inflammasome activation at least partly by stimulating sRAGE,thereby reducing IL-1βrelease.

超声心动图联合sST2、sTREM-1在急性ST段抬高型心肌梗死诊断中的临床价值

目的研究超声心动图指标联合血清可溶性致癌抑制因子2(sST2)、可溶性髓样细胞触发受体-1(sTREM-1)在急性ST段抬高型心肌梗死(STEMI)诊断中的临床价值。方法选取2021年9月至2022年9月在河北省沧州中西医结合医院治疗的90例急性STEMI患者作为STEMI组,选取同期冠状动脉造影检查结果为阴性的90例胸痛患者为对照组,比较两组超声心动图指标左室射血分数(LVEF)、左室舒张末期内径(LVEDD)和血清sST2、sTREM-1水平;采用Pearson相关分析急性STEMI患者LVEF、LVEDD与血清sST2、sTREM-1水平的相关性。采用受试者工作特征(ROC)曲线分析血清sST2、sTREM-1、LVEF、LVEDD诊断急性STEMI的价值。采用多因素Logistic回归分析急性STEMI发生的影响因素。结果STEMI组LVEF低于对照组,LVEDD高于对照组,差异均有统计学意义(P<0.05)。STEMI组CK-MB、cTnI水平及心率、心绞痛史比例高于对照组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,急性STEMI患者LVEF与血清sST2、sTREM-1水平均呈负相关(r=-0.454、-0.463,P<0.05),LVEDD与血清sST2、sTREM-1水平均呈正相关(r=0.493、0.515,P<0.05)。LVEF、LVEDD及血清sST2、sTREM-1联合诊断急性STEMI的曲线下面积(AUC)为0.930,明显大于各项指标单独检测的AUC(Z=4.780、5.611、3.591、3.087,P<0.05)。多因素Logistic回归分析结果显示,sST2≥24.91 ng/mL、sTREM-1≥36.65 pg/mL是急性STEMI发生的危险因素(P<0.05)。结论血清sST2、sTREM-1联合超声心动图对急性STEMI患者的诊断效能较好。

雷公藤多苷联合他克莫司及激素治疗难治性肾病综合征的效果及对血清sTNF-R1、IGFBP-2、CFH水平的影响

目的 探讨雷公藤多苷联合他克莫司及激素治疗难治性肾病综合征(RNS)的疗效对血清可溶性肿瘤坏死因子受体1(s TNF-R1)、胰岛素样生长因子结合蛋白-2(IGFBP-2)、补体因子H(CFH)水平的影响。方法 研究对象为2018年8月至2021年8月于江南大学附属医院治疗的RNS患者102例,以随机数字表法分为对照组(n=51,采取甲泼尼龙片加他克莫司胶囊治疗)和观察组(n=51,在对照组基础上给予雷公藤多苷片治疗)。评估两组的治疗效果、血清相关指标,统计两组的不良反应。结果 观察组治疗总有效率(96.08%)高于对照组(80.39%)(χ^(2)=6.044,P=0.014);治疗后,观察组患者血清白蛋白、CFH水平[分别为(36.54±8.11) g·L^(-1)、(586.20±100.72)μg·m L^(-1)],高于对照组[分别为(32.58±6.12) g·L^(-1)、(540.11±100.47)μg·m L^(-1)],差异均有统计学意义(t=2.783,P=0.006;t=2.314,P=0.023);观察组患者24 h尿蛋白、肌酐、s TNF-R1、IGFBP-2水平[分别为(2.67±0.69) g、(82.25±16.13)μmol·L^(-1)、(1.56±0.45) ng·m L^(-1)、(51.34±10.44) ng·m L^(-1)],低于对照组[分别为(3.24±1.02) g、(92.68±17.35)μmol·L^(-1)、(1.91±0.58) ng·m L^(-1)、(57.79±12.58) ng·m L^(-1)],差异均有统计学意义(t=3.306,P=0.001;t=3.135,P=0.002;t=3.405,P=0.001;t=2.820,P=0.005);观察组复发率(1.96%)低于对照组(13.73%)(χ^(2)=4.883,P=0.027)。结论 公藤多苷联合他克莫司及激素治疗RNS效果佳,降低复发率,改善肾功能,减轻炎症,有望作为辅助治疗RNS的药物。

血清Wnt5a、sIL-2R检测在老年2型糖尿病合并肺部感染患者中的应用及与肺部感染病情严重程度、预后的关系

目的 分析血清Wnt5a、可溶性白细胞介素-2受体(sIL-2R)水平对老年2型糖尿病(T2DM)合并肺部感染的诊断价值,及与肺部感染病情严重程度、预后的关系。方法 选取2021年1月—2022年12月河南科技大学第一附属医院收治的84例老年T2DM合并肺部感染患者作为观察组,选取同期住院的30例T2DM患者作为糖尿病组,选取同期该院体检的健康志愿者30例作为对照组。比较3组Wnt5a、sIL-2R水平,绘制受试者工作特征(ROC)曲线评估Wnt5a、sIL-2R水平对老年T2DM合并肺部感染的诊断价值,采用Pearson法分析观察组Wnt5a、sIL-2R水平与实验室指标的相关性;将观察组根据肺部感染严重程度分为轻度、中度、重度3个亚组,比较3个亚组Wnt5a、sIL-2R水平;根据观察组预后情况分为康复组及死亡组,比较2个亚组Wnt5a、sIL-2R水平。结果 观察组及糖尿病组Wnt5a、sIL-2R、FPG较对照组升高(P <0.05),FEV1较对照组降低(P <0.05),观察组sIL-2R较糖尿病组升高(P <0.05),FEV1较糖尿病组降低(P <0.05)。84例患者共检出病原菌98株,其中革兰阳性菌最多(50.00%),革兰阴性菌其次(47.96%),真菌最少(2.04%)。联合检测的曲线下面积(AUC)、敏感性最高,分别为0.935(95%CI:0.873,0.973)、85.71%(95%CI:0.760,0.921),sIL-2R的特异性最高,为93.33%(95%CI:0.765,0.988)。Pearson相关性分析显示,Wnt5a、sIL-2R水平与FEV1水平呈负相关(r=-0.228和-0.227,均P <0.05)。Wnt5a、sIL-2R水平与FPG水平呈正相关(r=0.450和0.647,均P <0.05)。重度组Wnt5a、sIL-2R水平较轻度组高(P <0.05),中度组sIL-2R水平较轻度组高(P <0.05),重度组sIL-2R水平较中度组高(P <0.05)。死亡组Wnt5a、sIL-2R水平高于康复组(P <0.05)。结论 老年T2DM合并肺部感染患者血清Wnt5a、sIL-2R水平升高,其与患者肺功能、血糖水平有相关性,能够辅助临床判断T2DM患者是否具有肺部感染以及感染严重程度、预后情况。

血清sIL-2R、IL-27及IL-36对重症急性胰腺炎并发急性肾损伤的预测价值

目的分析血清可溶性白细胞介素2受体(sIL-2R)、白细胞介素(IL)-27及IL-36对重症急性胰腺炎(SAP)并发急性肾损伤(AKI)的预测价值。方法选取2020年1月至2023年3月该院收治的SAP患者126例作为研究对象,根据其是否并发AKI分为AKI组(45例)和非AKI组(81例)。比较两组临床资料。采用多因素Logistic回归分析影响SAP患者并发AKI的危险因素,绘制受试者工作特征(ROC)曲线分析血清sIL-2R、IL-27及IL-36单独及3项指标联合检测对SAP患者并发AKI的预测价值。采用Pearson相关分析AKI患者血清sIL-2R、IL-27及IL-36水平与肝、肾功能指标的相关性。结果两组住院时间、序贯器官衰竭评估(SOFA)评分、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、血红蛋白、尿量、血肌酐(Scr)、尿素氮、清蛋白、sIL-2R、IL-27及IL-36水平比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,清蛋白水平降低,SOFA评分、APACHEⅡ评分、Scr、尿素氮、sIL-2R、IL-27及IL-36水平升高是SAP患者并发AKI的危险因素(P<0.05)。ROC曲线分析结果显示,血清sIL-2R、IL-27及IL-36单独预测SAP患者并发AKI的曲线下面积(AUC)分别为0.815、0.768、0.861,3项指标联合预测SAP患者并发AKI的AUC为0.925。Pearson相关分析结果显示,AKI组患者血清sIL-2R、IL-27及IL-36水平与SOFA评分、APACHEⅡ评分、Scr、尿素氮水平均呈正相关(P<0.05);AKI组患者血清sIL-2R、IL-27及IL-36水平与清蛋白水平均呈负相关(P<0.05)。结论血清sIL-2R、IL-27及IL-36水平升高是影响SAP患者并发AKI的危险因素,3项指标联合检测对预测SAP并发AKI具有较好的价值。

急性冠脉综合征患者血清ACE2、suPAR水平与氧化应激损伤及不良预后的关系

目的 探讨急性冠脉综合征(Acute coronary syndrome, ACS)患者血清血管紧张素转化酶2(Angiotensin converting enzyme 2,ACE2)、可溶性尿激酶型纤溶酶原激活物受体(Soluble urokinase type plasminogen activator receptor, suPAR)与氧化应激损伤及不良预后的关系。方法 选择2019年9月-2022年9月大兴区人民医院收治的125例ACS患者作为ACS组,并选取与之性别、年龄相匹配的50例冠脉造影结果完全正常者作为对照组,比较两组血清ACE2、suPAR及氧化应激指标[丙二醛(Malondialdehyde, MDA)、过氧化脂质(Lipid peroxide, LPO)、超氧化物歧化酶(Superoxide dismutase, SOD)]水平,并分析血清ACE2、suPAR与氧化应激、不良预后的关系。结果 与对照组比较,ACS组ACE2、suPAR、MDA、LPO升高(P<0.05),SOD下降(P<0.05)。轻度病变、中度病变、重度病变患者ACE2、suPAR及冠脉狭窄Gensini评分显著上升(P<0.05)。ACS患者ACE2、suPAR与MDA、LPO、Gensini评分呈正相关(P<0.05),与SOD呈负相关(P<0.05)。与预后良好患者比较,预后不良患者年龄、发病至就诊时间、Gensini评分、ACE2、suPAR、MDA、LPO升高(P<0.05),LVEF、SOD降低(P<0.05)。年龄、发病至就诊时间、Gensini评分、ACE2、suPAR、MDA、LPO是ACS预后不良的危险因素(P<0.05),LVEF、SOD为其保护因素(P<0.05)。血清ACE2联合suPAR预测ACS预后不良的效能较高,其曲线下面积(Area under curve,AUC)为0.894。结论 ACS患者血清ACE2、suPAR高表达与氧化应激损伤、不良预后显著相关。