Correlation of Enhancement Degree on Contrast-enhanced Ultrasound with Histopathology of Carotid Plaques and Serum High Sensitive C-Reactive Protein Levels in Patients Undergoing Carotid Endarterectomy

This study was undertaken to investigate the correlation of the enhancement degree on contrast-enhanced ultrasound(CEUS) with the histopathology of carotid plaques and the serum high sensitive C-reactive protein(hs-CRP) levels in patients undergoing carotid endarterectomy(CEA). Carotid CEUS was performed preoperatively in 115 patients who would undergo CEA, and the enhancement degree of the carotid plaques was evaluated by both the visual semiquantitative analysis and the quantitative time-intensity curve analysis. Serum hs-CRP levels were detected using the particle-enhanced immunoturbidimetric assay also before the operation. Additionally, the carotid plaque samples were subjected to histopathological examination postoperatively. The density of neovessels and the number of macrophages in the plaques were assessed by immunohistochemistry. The results showed that among the 115 patients, grade 0 plaque contrast enhancement was noted in 35 patients, grade 1 in 48 patients and grade 2 in 32 patients. The degree of plaque enhancement, the density of neovessels, the number of macrophages, and the hs-CRP levels were highest in the grade 2 patients. Correlation analysis showed that the enhancement degree of the carotid plaques was closely related to the immunohistochemical parameters of the plaques and the serum hs-CRP levels. It was suggested that the carotid plaque enhancement on CEUS can be used to evaluate the vulnerability of carotid plaques.

Myeloperoxidase and High-Sensitivity C-Reactive Protein for Predicting Major Adverse Cardiovascular Events in Patients with Coronary Heart Disease

Background: Research has shown that high-sensitivity C-reactive protein (hs-CRP) is a major inflammatory marker for prediction of acute coronary syndrome (ACS). Myeloperoxidase (MPO) also plays an important role in atherosclerosis initiation and development. In present study, the major adverse cardiovascular events (MACEs) of patients with coronary heart disease (CHD) were investigated. Methods: MPO, hs-CRP and ACS-related risk factors from 201 ACS (78 AMI and 123 UAP) and 210 non-ACS (84 SAP and 126 non-CHD) patients confirmed by coronary angiography were detected, and the data were analyzed with receiver operating characteristic (ROC) curve and Spearman’s correlation coefficients. MACEs of 285 CHD patients were investigated during the 4-year period follow-up from March 2010 to May 2014. Results: The areas under ROC curve for diagnosing ACS were 0.888 (95% CI 0.843 - 0.933) for MPO, and 0.862 (95% CI 0.815-0.910) for hs-CRP, respectively. There were significantly correlations between MPO and hs-CRP in both ACS and non-ACS groups. Regarding to ACS patients, both MPO and hs-CRP were positively correlated with BMI, TC, TG, LDL-C and Hcy. Prospective study demonstrated that the incidences of MACEs associated significantly with elevated MPO baseline level (yes vs no, OR 7.383, 95% CI 4.095 - 13.309) and high hs-CRP baseline level (yes vs no, OR 4.186, 95% CI 2.469 - 7.097) in CHD patients. Conclusions: The present study provides the epidemiological evidence that elevated baseline MPO and hs-CRP levels are both valuable predictors of MACEs in CHD patients. MPO and hs-CRP would prompt the progression of atherosclerosis and development from SAP to ACS.

Responses of serum inflammatory factor high-sensitivity C-reactive protein, interleukin-6, and tumor necrosis factor-alpha in elderly males with cerebral infarction Non-randomized concurrent control

BACKGROUND： Cerebral infarction is poorly treated due to neuronal necrosis and secondary pathophysiological changes; for example, free radical production and inflammatory reactions. OBJECTIVE： To detect the levels of high-sensitivity C-reactive protein （hs-CRP）, interleukin-6 （IL-6）, and tumor necrosis factor- a （TNF- α ） in elderly males with cerebral infarction. DESIGN： Non-randomized current control study. SETTING： Cadre Medical Department, Guizhou Provincial People＇s Hospital. PARTICIPANTS： Forty elderly males （65-89 years old） with cerebral infarction were selected from Cadre Medical Department, Guizhou Provincial People＇s Hospital from February 2004 to December 2006. All patients met the diagnostic criteria of cerebral infarction modified at the 4th National Cerebrovascular Disease Academic Meeting, and were diagnosed on the basis of CT or MRI tests. Furthermore, 35 elderly male inpatients （65-87 years old） without cerebral infarction were selected as the control group. Included subjects provided confirmed consent and did not have heart disease, diabetes mellitus, lipid disorder, acute trauma, infection, rheumatism, or other inflammatory diseases. The study was approved by the local ethics committee. There were no significant differences in age, blood pressure, and lipid levels between the cerebral infarction group and the control group （P 〉 0.05）, and this suggested that the baseline data of both groups were comparable. METHODS： Fasting venous blood was drawn from cerebral infarction patients 24 hours after cerebral infarction attack and from control subjects 24 hours after hospitalization. A latex-enhanced immunoturbidimetric assay and an enzyme-linked immunosorbent assay were used to detect the levels of hs-CRP, IL-6, and TNF- α in the serum. MAIN OUTCOME MEASURES： The levels of hs-CRP, 1L-6, and TNF- α in the serum in both groups. RESULTS： Forty cerebral infarction patients and thirty-five control subjects were included in the final analysis without any loss. Levels of hs-CRP, IL-6, and TNF-α in the cerebral infarction group were significantly higher than those in the control group （P 〈 0.01 ）. CONCLUSION： Levels of serum inflammatory reactive factors are increased in elderly males with cerebral infarction.

Idiopathic Reactive Hypoglycemia: Mechanisms of Onset and Remission with High Protein Low Carbohydrate Diet

Objective: Idiopathic reactive hypoglycemia is defined as early postprandial hypoglycemia occurring on ingestion of high carbohydrate containing meal. Remission ensues with high protein low carbohydrate diet. This study assessed roles of insulin and glucagon in its onset and remission. Methods: Plasma glucose, insulin and glucagon were determined after an overnight fast and repeatedly until 180 minutes on ingestion of 3 meals;100 g glucose;100 g pure protein liquid and mixture of 50 g each at 14 days’ interval. Five adults with IRH and 6 age matched healthy volunteers participated. Results: In IRH, glucose ingestion induced prompt rise in glucose (5.1 ± 0.8 to10.5 ± 1.2 mM/L) followed later by hypoglycemia (2.6 ± 0.4 mM/L). Insulin rose from 7 ± 2 to 90 ± 18 mU/L. Glucagon rose initially (10% ± 2%) from elevated basal concentration (373 ± 57 mU/L) followed by later decline (-43% ± 12%). On protein ingestion, glucose declined followed by a restoration to basal level while both insulin and glucagon rose (28 ± 6 mU/L;148% ± 38%, p < 0.01). However, insulin response was lower and glucagon rise was greater when compared to responses on glucose ingestion (p < 0.01). With mixed meal, glucose (8.2 ± 0.6 mM/L), insulin (65 ± 12 mU/L) and glucagon (48% ± 7%) responses were lesser than rises following glucose ingestion (p < 0.05) and hypoglycemia did not occur. Conclusion: In IRH, initial hyperglycemia on glucose ingestion may be exacerbated by paradoxical glucagon rise and hypoglycemia may be induced by increased insulin and declining glucagon responses. Resolution of hypoglycemia with high protein low carbohydrate diet may be attributed to blunting of insulin response and concurrent glucagon rise.

High Sensitivity C-Reactive Protein Associated with Different Health Predictors in Middle-Aged and oldest old Chinese

Objective To describe the distribution of plasma high sensitivity C-reactive protein （hsCRP） and explore the relationship between hsCRP and metabolic risk factors among residents living in longevity areas of China. Methods 268 individuals aged between 40 and 59 years and 506 individuals aged over 90 years were selected from 5 longevity areas of China to participate in a cross section longitudinal cohort study. The participants were interviewed with general health related questionnaire to collect their demographic, behavioral and lifestyle data, as well as their chronic conditions, and meanwhile their physical and biomedical parameters including waist circumference （WC）, blood pressure （BP）, hsCRP, plasma lipids, and fasting blood glucose （FBG） were measured. Results The median of hsCRP was 0.99 mg/L in the middle-aged group and 2.76 mg/L in the oldest old group. No significant gender difference was observed between the above two groups. Among the oldest old individuals, 36.56% had an hsCRP level 〉3.0 mg/L. The prevalence of high hsCRP was 26.79% in the middle-aged group. The results of stepwise multiple linear regression analyses showed that HDL-C was independently associated with In （hsCRP） concentration in the middle-aged group, whereas In （TG）, HDL-C and FBG were correlated after adjustment for gender, study site, smoking, drinking, education and BMI in the oldest old group. Conclusion HDL-C is a stronger predictor of elevated hsCRP than other metabolic factors in the middle-aged population. For the oldest old persons, high TG, low HDL-C, and FBG predict elevated plasma hsCRP.

Clinical application of neutrophil/lymphocyte ratio combined with high sensitive C reactive protein in evaluation of community acquired pneumonia

Objective:To explore the application value of neutrophil/lymphocyte ratio (NLR) combined with high sensitive C reactive protein (hs-CRP) in the evaluation of community acquired pneumonia (CAP). Methods:From November 2015 to October 2016, 58 cases of CAP patients admitted in our department were selected as research objects and were divided into low risk group and high risk group according to the PSI score and CURB-65 standard for evaluation. They were divided into improved group (48 cases) and death group (10 cases) according to prognosis. Hs-CRP was determined by immunoturbidimetric assay, procalcitonin (PCT) by immunofluorescence, NLR by count method of laser scattering, and white blood (WBC) was counted. The differences in WBC, PCT, NLR and hs-CRP between different risk groups were compared, and the correlation was evaluated using Spearman's rank correlation analysis method. The changes in indexes were observed in the improved and death cases. Results:The high risk group had higher NLR, PCT and hs-CRP than low risk group (P<0.05), while no significant difference was found in WBC (P>0.05). No correlation was found between NLR and WBC, while a strong correlation was found between hs-CRP and PCT. The WBC, PCT, NLR and hs-CRP levels were significantly lower in the improved group than the death group (P<0.05). Conclusions:NLR combined with hs-CRP, WBC, and PCT has a good assessment of the severity of CAR, and high levels of NLR, hs-CRP, WBC, and PCT predict the severity of the disease and poor prognosis.

Relationship of High Sensitivity C-Reactive Protein with Cardiovascular, Diabetic, and Hepatic Biomarkers

Biomarkers are early predictors of various disorders, circulating level of C-reactive protein is a sensitive biomarker of systemic inflammation and may also be associated with the development of diabetic, hepatic, and cardiovascular diseases. In the present study, we aimed to investigate the association between circulating levels of high sensitive C-reactive protein (hs-CRP) and various biomarkers for hepatic, diabetic, and cardiovascular health. The retrospective analysis included 438 individuals who were tested for these panels simultaneously at Vibrant America Clinical Laboratory. The study population included free-living individuals without any preexisting clinical conditions. Among the cardiovascular markers, a positive correlation and significant association was found between high levels of hs-CRP and serum levels of triglycerides (r = 0.0964, p −0.1423, p −0.1216, p < 0.0105) with circulating levels of hs-CRP. Among all the diabetic markers, glucose (r = 0.1547, p < 0.0011) and glycated serum protein (r = 0.1725, p < 0.0003) were positively correlated with circulating hs-CRP. In the hepatic panel, AST, a transaminase that plays a vital role in amino acid metabolism, was found to have a strong positive correlation with hs-CRP (r = 0.2139, p < 0.0001). In conclusion, the results clearly show the association of hs-CRP with diabetic, hepatic, and cardiovascular risk factors indicating its central value as a key marker for several lifestyle-associated disorders.

Maraviroc promotes recovery from traumatic brain injury in mice by suppression of neuroinflammation and activation of neurotoxic reactive astrocytes

Neuroinflammation and the NACHT,LRR,and PYD domains-containing protein 3 inflammasome play crucial roles in secondary tissue damage following an initial insult in patients with traumatic brain injury(TBI).Maraviroc,a C-C chemokine receptor type 5 antagonist,has been viewed as a new therapeutic strategy for many neuroinflammatory diseases.We studied the effect of maraviroc on TBI-induced neuroinflammation.A moderate-TBI mouse model was subjected to a controlled cortical impact device.Maraviroc or vehicle was injected intraperitoneally 1 hour after TBI and then once per day for 3 consecutive days.Western blot,immunohistochemistry,and TUNEL(terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling)analyses were performed to evaluate the molecular mechanisms of maraviroc at 3 days post-TBI.Our results suggest that maraviroc administration reduced NACHT,LRR,and PYD domains-containing protein 3 inflammasome activation,modulated microglial polarization from M1 to M2,decreased neutrophil and macrophage infiltration,and inhibited the release of inflammatory factors after TBI.Moreover,maraviroc treatment decreased the activation of neurotoxic reactive astrocytes,which,in turn,exacerbated neuronal cell death.Additionally,we confirmed the neuroprotective effect of maraviroc using the modified neurological severity score,rotarod test,Morris water maze test,and lesion volume measurements.In summary,our findings indicate that maraviroc might be a desirable pharmacotherapeutic strategy for TBI,and C-C chemokine receptor type 5 might be a promising pharmacotherapeutic target to improve recovery after TBI.

Proanthocyanidin B2 attenuates high-glucose-induced neurotoxicity of dorsal root ganglion neurons through the PI3K/Akt signaling pathway

High glucose affects primary afferent neurons in dorsal root ganglia by inhibiting neurite elongation,causing oxidative stress,and inducing neuronal apoptosis and mitochondrial dysfunction,which finally result in neuronal damage.Proanthocyanidin,a potent antioxidant,has been shown to have neuroprotective effects.Proanthocyanidin B2 is a common dimer of oligomeric proanthocyanidins.To date,no studies have reported the neuroprotective effects of proanthocyanidin B2 against high-glucose-related neurotoxicity in dorsal root ganglion neurons.In this study,10 μg/m L proanthocyanidin B2 was used to investigate its effect on 45 m M high-glucose-cultured dorsal root ganglion neurons.We observed that challenge with high levels of glucose increased neuronal reactive oxygen species and promoted apoptosis,decreased cell viability,inhibited outgrowth of neurites,and decreased growth-associated protein 43 protein and m RNA levels.Proanthocyanidin B2 administration reversed the neurotoxic effects caused by glucose challenge.Blockage of the phosphatidylinositol 3 kinase/Akt signaling pathway with 10 μM LY294002 eliminated the protective effects of proanthocyanidin B2.Therefore,proanthocyanidin B2 might be a potential novel agent for the treatment of peripheral diabetic neuropathy.

Relationship between coronary atherosclerosis plaque characteristics and high sensitivity C-reactive proteins, interleukin-6

Background The relationship between inflammatory markers and the characteristics of coronary atherosclerosis plaques is uncertain. The aim of the present study was to evaluate the relationship between the characteristics of coronary atherosclerosis plaques and inflammatory markers such as high sensitivity C-reactive proteins （Hs-CRP） and interleukin-6 （IL-6）. Methods All patients suspected of having coronary heart disease （CHD） underwent Siemens 64-slice CT angiography （64-SCTA） to distinguish the quality of plaque of coronary artery lesions. Blood samples were taken to measure levels of serum Hs-CRP and IL-6 in different plaque groups and the control group and compared with the value of 64-SCTA for detection of coronary artery plaque. Results The sensitivity of detecting coronary artery plaque by 64-SCTA was 87.4%, the specificity was 87.1%, the positive predictive value was 82.2%, and the negative predictive value was 91.0%. Comparing the levels of serum Hs-CRP and IL-6 among plaque groups, the mean levels of serum Hs-CRP and IL-6 in three plaque groups were significantly higher than those in the control group （P 〈0.01）. The mean levels of serum Hs-CRP and IL-6 in the soft plaque group and mixed plaque group were significantly higher than those in hard plaque group （P〈0.01）. Plaque burden in the soft plaque group and mixed plaque group was significantly higher than in the hard plaque group （P 〈0.01）, but there was no statistical difference between the soft plaque group and mixed plaque group （P=-0.246）. There was a negative correlation between the CT scale and Hs-CRP and IL-6 levels in the soft plaque group （r= -0.621, P〈0.01, and r= -0.593, P 〈0.01 respectively）. There was a positive correlation between the plaque burden and Hs-CRP and IL-6 levels in the soft plaque group （r=0.579, P〈0.05 and r=0.429, P〈0.05 respectively）. Conclusions 64-SCTA is an effective way to distinguish the different quality of coronary atherosclerosis plaque. Serum Hs-CRP and IL-6 levels can be considered as the indexes to judge the degree of CHD and may reflect the activity of plaque in CHD patients. Thus it is important for clinical diagnosis and risk evaluation of acute coronary syndrome （ACS） patients.

Associations of plasma homocysteine and high-sensitivity C-reactive protein levels with arterial stiffness in Chinese population： a community-based study

Background Arterial stiffness increases with age and is also associated with traditional cardiovascular risk factors. Little is known about the relations of homocysteine and high-sensitivity C-reactive protein （hs-CRP） to arterial stiffness in the Chinese community. The aim of the present study was to investigate the association of plasma homocysteine and hs-CRP levels with arterial stiffness in a community-based cohort. Methods We related levels of homocysteine and hs-CRP to four measures of arterial stiffness （carotid-femoral pulse wave velocity （PWV）, carotid-radial PWV, carotid-ankle PWV and heart rate corrected augmentation index） in 1680 participants from two communities of Beijing, China. Arterial stiffness was measured within two days of the time of biomarker measurement. Results In univariate analysis, homocysteine was positively associated with the carotid-femoral PWV （r=0.211, P 〈0.0001）, carotid-radial PWV （r=0.120, P 〈0.0001） and carotid-ankle PWV （r=0.148, P 〈0.0001）, whereas it was inversely related to the augmentation index （r= -0.052, P=0.016）. Hs-CRP was positively associated with the carotid-femoral PWV （r=0.074, P=0.001） and carotid-ankle PWV （r=0.050, P=0.02）. In multiple-adjusted models （R2=0.57）, homocysteine levels remained a significant determinant of the carotid-femoral PWV （standardized 13=0.065, P=0.007）, whereas the association of hs-CRP with measurements of arterial stiffness was not present. Conclusions In the Chinese population, plasma homocysteine levels are associated with alterations of aortic stiffness, whereas plasma levels of hs-CRP are not independently related to artery stiffening.

Relationships of High-sensitive C-reactive Protein ant P-wave Dispersion in Lone Atrial Fibrillation

Background： Current evidence links atrial fibrillation （AF） to the inflammation. Inflammatory indexes such as high-sensitive C-reactive protein （hs-CRP） have been related to the development and persistence of AF. However, the role of inflammation in the atrial electrophysiological remodeling indexed by P-wave dispersion （Pa） remains unclear. Methods： The study consisted of 71 patients with lone paroxysmal AF （AF group） and 71 age- and gender-matched controls of paroxysmal supraventricular tachycardia without history of AF （control group）. Electrocardiography, P hs-CRP, and other clinical characteristics were compared between the two groups. Results： There was no significant difference between the two groups regarding age, gender, hyperlipidemia, etc. Compared to controls, left atrial diameter （44 ± 7 vs 39 ± 7 mm）, Pd （49 ± 13 vs 26 ± 8 ms）, and hs-CRP （2.17 [1.46-2.89] vs 1.12 [0.74-1.41] rag/L） were increased （P 〈 0.05）, respectively. Linear regression identified hs-CRP as an independent correlation ofPd level both in the total population and the AF group （r = 0.464 and 0.313; P 〈 0.001, respectively）. Multiple logistic regression revealed hs-C RP as an independent determinant of AF （odds ratio [OR] =l 5.430, 95% confidence interval： 6.031-39.476： P 〈0.001）. Further adjusted tbr Pd, both Pd and hs-CRP were independent predictors for AF, but the OR for hs-CRP in predicting AF has been attenuated from 15.430 to 6.246. Conclusions： In lone AF, P and plasma hs-CRP concentration are inter-associated and related to AF. The interaction between hs-CRP and AF may be mediated by Pe, suggesting an important role of inflammation in the atrial electrophysiological remodeling predisposing to AF.

Negative Association of Circulating MicroRNA-126 with High-sensitive C-reactive Protein and Vascular Cell Adhesion Molecule-1 in Patients with Coronary Artery Disease Following Percutaneous Coronary Intervention

Background： Percutaneous coronary intervention （PCI） causes endothelial damage, resulting in an inflammatory response with elevation of markers such as high-sensitive C-reactive protein （hs-CRP） and vascular cell adhesion molecule-1（VCAM-1）, which are associated with restenosis after PCI. Evidence suggests that microRNA-126 （miR-126） plays an important role in vascular inflammation, but its correlation with PCl-mediated inflammation has not been investigated. In this study, we investigated the effect of PCI on circulating miR-126 and inflammation markers such as hs-CRP and VCAM-1. Methods： We enrolled 130 patients with coronary artery disease （CAD） in the Second Hospital of Jilin University from October 2015 to December 2015. Among them, 82 patients with CAD, defined as at least one major epicardial vessel with 〉70% stenosis who planned to undergo PCI, were divided into acute coronary syndrome （ACS） group （46 patients） and stable angina （SA） group （36 patients）. Forty-eight patients confirmed by coronary angiography without PCI were used as controls. The plasmas of all patients were collected prior to PCI and at 30 min, 24 h, and 72 h after PCI. The plasma VCAM-1 and hs-CRP were detected by enzyme-linked immunosorbent assay, and the miR-126 was evaluated by quantitative reverse transcription-polymerase chain reaction. Results： Plasma concentrations of hs-CRP and VCAM-I in patients with either ACS （n = 46） or SA （n = 36） were significantly higher than in controls （n = 48） （P 〈 0.01） prior to PCI, and increased further at 24 h and 72 h after PCI, compared with prior PCI. Moreover, VCAM-1 was positively correlated with balloon time and pressure. In contrast, the plasma concentration of miR-126 was significantly lower in patients with CAD than in controls, and further decreased with time post-PCl. A negative correlation was observed between miR-126 and hs-CRP and VCAM-1 at 72 h after PCI. Conclusion： There was a negative correlation of miR-126 with the PCI-induced markers of inflammation such as hs-CRP and VCAM-1.

Comparision of high sensitivity C-reactive protein and matrix metalloproteinase 9 in patients with unstable angina between with and without significant coronary artery plaques

Background Inflammation within vulnerable coronary plaques may cause unstable angina by promoting rupture and erosion. C-reactive protein （CRP） is the most reliable and accessible test method for clinical use for identifying coronary artery disease event. Matrix metalloproteinase 9 （MMP-9） is highly over-expressed in the vulnerable regions of a plaque. Our aim was to evaluate the plasma levels of MMP-9 and hsCRP in subjects with both unstable angina and coronary plaques, as well as in those with unstable angina without coronary plaques.

Testosterone replacement therapy improves insulin sensitivity and decreases high sensitivity C-reactive protein levels in hypogonadotropic hypogonadal young male patients

Background Many clinical studies suggest the inverse relationship between testosterone levels and insulin sensitivity in men, however the causative relationship of these two events is still not determined. The purpose of this study was to investigate the effects of testosterone replacement therapy （TRT） on insulin sensitivity, body composition, serum lipid profiles and high sensitivity C-reactive protein （hsCRP） in hypogonadotropic hypogonadal （HH） puberty undeveloped male patients. Methods In this prospectively designed study, we compared homeostasis model assessment of insulin resistance （HOMA-IR）, insulin areas under the curves （AUC） of 3-hour oral glucose tolerance test （OGTT） and other metabolic parameters between 26 HH patients and 26 healthy men. The patients＇ HOMA-IR, insulin AUC, body composition, lipid profiles, hsCRP and other parameters were compared before and after nine-month TRT. Results The average levels of total testosterone （TT） in HH and healthy group were （0.9±0.6） nmol/L and （18.8±3.4） nmol/L, respectively. HOMA-IR in HH group was significantly higher than the healthy group （5.14±5.16 vs 2.00±1.38, P 〈0.005）. Insulin AUC in 3-hour OGTT in HH group was significantly higher than the healthy group （698.6±414.7 vs 414.2±267.5, P 〈0.01）. Fasting glucose level in H H group was significantly higher than control group （（5.1±0.6） mmol/L vs （4.7±0.3） mmol/l, P 〈0.005）. Height, weight and grasp strength of the patients were significantly increased after 9-month TRT. Significant reductions in HOMA-IR （from 5.14±5.16 to 2.97±2.16, P 〈0.01）, insulin AUC （from 698.6±414.7 to 511.7±253.9, P 〈0.01） and hsCRP （from （1.49±1.18） mg/L to （0.70±0.56） mg/L, P 〈0.05） were found after TRT. Serum total cholesterol, LDL-C, HDL-C and triglyceride were all decreased, albeit with no significant difference compared to the level prior to TRT. Conclusions HOMA-IR, insulin AUC and fasting glucose level in HH young male patients were significantly higher than those of the control group, which suggests that low level of testosterone in male adolescents might be a risk factor for insulin resistance. TRT can significantly improve patients＇ insulin sensitivity and suppress serum hsCRP, which in return suggests that TRT may prevent the HH patients from developing diabetes mellitus and cardiovascular diseases （CVD） in future.

Matrix γ-carboxyglutamate protein and Fetuin-A, in wet type age-related macular degeneration

AIM: To evaluate the high sensitivity C-reactive protein(hs CRP), Fetuin-A and matrix γ-carboxyglutamate protein(MGP) as the main factors for vascular calcification and inflammation in serum of patients with advanced age-related macular degeneration(ARMD) in comparison to healthy controls. METHODS: The subjects were 40 patients with choroidal neovascularization(CNV) having a mean age of70.9 ±9.1y and a matched group of 49 apparently healthy control subjects. The ARMD was diagnosed using a slitlamp with superfield lens, fundus photography and fluorescein angiography. Measurement of hs CRP was done by nephelometry method. Levels of Fetuin-A and MGP were measured by enzyme-linked immunosorbent assay(ELISA) technique.RESULTS: hs CRP [0.45(0.07-2.63) mg/L vs 0.25(0.03-1.2) mg/L, P =0.02)] and Fetuin-A levels(50.27 ±5.04 vs44.99±10.28 ng/m L, P =0.009) were higher in the patients than in the control groups. We could not find significant difference in MGP level between two groups(P =0.08).There was not a significant correlation between MGP with Fetuin-A and hs CRP among the patients(P =0.7, P =0.9respectively). A significant negative correlation of hs CRP with Fetuin-A was observed in both case and control groups(P =0.004, r =-0.33 and P =0.001, r =-0.54,respectively).CONCLUSION: Although our study shows that serum hs CRP and Fetuin-A is increased in CNV patients as well as negatively correlated with both study groups, their direct role on pathogenesis of ARMD required future studies.

Lp-PLA2、hs-CRP和FIB联合检测在急性脑梗死诊断中的应用

目的探讨血浆脂蛋白相关磷脂酶A2(Lp-PLA2)、超敏C反应蛋白(hs-CRP)和纤维蛋白原(FIB)联合检测在急性脑梗死诊断中的临床价值。方法收集我院240例急性脑梗死的住院患者作为研究对象(脑梗组),以100例门诊体检健康人员为对照组,比较两组人群的一般临床数据及检验结果,记录患者入院时的NIHSS评分。分析急性脑梗死患者血浆Lp-PLA2、hs-CRP和FIB水平与其神经功能缺损程度的关系,进行多因素Logistic回归分析确定急性脑梗死的危险因素,利用ROC曲线评估患者血浆Lp-PLA2、hs-CRP和FIB水平对急性脑梗死的诊断价值。结果重度脑梗死患者的Lp-PLA2、hs-CRP和FIB水平均高于轻度及中度脑梗死患者(P<0.05);与对照组比较,脑梗组患者的血浆Lp-PLA2、hs-CRP和FIB水平均显著升高,差异均具有统计学意义(P<0.05)。血浆Lp-PLA2、hs-CRP和FIB水平与急性脑梗死发病风险显著相关(P<0.05)。Lp-PLA2、hs-CRP和FIB 3个指标中,Lp-PLA2的ROC曲线下面积最大,诊断价值最高;Lp-PLA2、hs-CRP和FIB联合检测能显著提高急性脑梗死的诊断效率。结论联合检测Lp-PLA2、hs-CRP和FIB对判断ACI患者神经功能缺损程度具有较高价值。

血清超敏C反应蛋白、胱抑素C与脓毒性休克患者心功能、肾功能损伤的关系

目的检测脓毒性休克患者血清超敏C反应蛋白(hs-CRP)、胱抑素C(Cys C)水平,探讨其与脓毒性休克患者心功能、肾功能损伤的关系。方法选取2020年5月—2023年12月我院收治的脓毒性休克患者50例,纳入休克组。另选取同期健康体检者48名,纳入参照组。比较2组研究对象hs-CRP、Cys C水平,分析脓毒性休克患者血清hs-CRP、Cys C水平与患者左室射血分数(LVEF)、二尖瓣舒张早期血流峰速(E)/二尖瓣环舒张早期速度(E’)、血浆脑钠肽(BNP)、心肌肌钙蛋白Ⅰ(c TnⅠ)、肾小球滤过率(GFR)及急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分的关系。结果2组研究对象年龄、性别分布、身体质量指数(BMI)及基础疾病患病情况等方面的差异均无统计学意义(P>0.05)。休克组患者的血清hs-CRP水平[(181.01±37.39)mg/L]和血清Cys C水平[(2.62±0.25)mg/L]显著高于参照组[(38.78±10.55)mg/L、(0.96±0.15)mg/L],差异均有统计学意义(P<0.05)。休克组患者的血清hs-CRP水平与LVEF、E/E’、BNP、c TnⅠ水平、APACHEⅡ评分有关(P<0.05),与GFR无相关性(P>0.05);休克组患者的血清Cys C水平与GFR水平、APACHEⅡ评分有关(P<0.05),与LVEF、E/E’、BNP及c TnⅠ水平均无相关性(P>0.05)。结论脓毒性休克患者血清hs-CRP、Cys C水平均显著高于健康体验者,推测其可能与心肌细胞受损、炎症因子水平升高、肾血流量降低等因素有关,可作为评估脓毒性休克患者心、肾功能损伤的参考指标。

参松养心胶囊联合沙库巴曲缬沙坦治疗阵发性心房颤动合并慢性心力衰竭对hs-CRP、BNP、AngⅡ及心功能的影响

目的 探讨参松养心胶囊联合沙库巴曲缬沙坦治疗阵发性心房颤动合并慢性心力衰竭对高敏C反应蛋白(High sensitivity C-reactive protein, hs-CRP)、脑钠肽(Brain natriuretic peptide, BNP)、血管紧张素Ⅱ(AngiotensinⅡ,AngⅡ)及心功能的影响。方法 选取100例阵发性心房颤动合并慢性心力衰竭患者,随机分为对照组与观察组,每组50例,对照组在常规治疗基础上给予沙库巴曲缬沙坦口服,观察组在常规治疗基础上给予参松养心胶囊联合沙库巴曲缬沙坦口服治疗,疗程6个月。观察血清hs-CRP、BNP、AngⅡ、左心室射血分数(Left ventricular ejection fraction, LVEF)、左室收缩末期内径(Left ventricular end systolic diameter, LVESD)、左室舒张末期内径(Left ventricular end diastolic diameter, LVEDD)变化。结果 两组治疗前血清hs-CRP、BNP、AngⅡ比较差异无统计学意义(P>0.05),治疗后下降(P<0.05),且观察组低于对照组(P<0.05);两组治疗前LVEF、LVESD、LVEDD比较差异无统计学意义(P>0.05),治疗后LVEF升高(P<0.05),且观察组高于对照组(P<0.05),治疗后LVESD、LVEDD下降(P<0.05),且观察组低于对照组(P<0.05);两组治疗前阵发性心房颤动发作次数、阵发性心房颤动持续时间、心室率比较差异无统计学意义(P>0.05),治疗后下降(P<0.05),且观察组低于对照组(P<0.05);对照组转为持续性心房颤动、心力衰竭恶化、缺血心源性死亡率分别为20.00%、22.00%、4.00%,观察组分别为4.00%、6.00%、0.00%,转为持续性心房颤动、心力衰竭恶化发生率对照组高于观察组(P<0.05);观察组治疗疗效优于对照组(P<0.05)。结论 参松养心胶囊联合沙库巴曲缬沙坦治疗阵发性心房颤动合并慢性心力衰竭有助于促进hs-CRP、BNP、AngⅡ下降,改善患者心功能,改善预后。

冠心病患者PCI术后认知功能改变的相关研究

目的观察经皮冠状动脉介入治疗(PCI)和冠状动脉造影(CAG)对冠状动脉粥样硬化性心脏病(冠心病)患者围术期认知功能的影响,并探讨相应临床化验指标与认知功能障碍的相关性。方法连续收集于北京安贞医院心内科住院治疗的冠心病患者203例为研究对象,其中接受冠状动脉(冠脉)造影55例(CAG组),接受冠脉支架植入治疗148例(PCI组)。于术前及术后6 h,通过“基本认知能力测验”(BCAT)软件系统分别对两组患者术前及术后的加工速度、工作记忆及情景记忆进行检测,同时提取患者术前的相关实验室检查及手术相应临床指标。采用Wilcoxon符号秩检验比较患者的术前及术后认知功能评分的差异,采用皮尔逊相关系数评估各项实验室检查指标及临床指标与术后加工速度、工作记忆及情景记忆得分的相关性,采用多元线性回归评估各检查指标对于术后加工速度、工作记忆及情景记忆得分的影响。结果CAG组患者术前、术后各项认知功能评分均无显著性差异,而PCI组患者在加工速度、情景记忆两个维度上,术后的认知功能评分高于术前评分(P<0.05),在工作记忆维度上无显著性差异(P>0.05)。相关分析表明PCI组患者的年龄与术后工作记忆得分有显著负相关关系(r=-0.258,P<0.01),手术用时与术后情景记忆得分有显著负相关关系(r=-0.206,P<0.05),血清超敏C反应蛋白(hs-CRP)与术后加工速度得分有显著负相关关系(r=-0.273,P<0.01),血清同型半胱氨酸(Hcy)与术前和术后加工速度得分有显著负相关关系(r=-0.288,P<0.01),血清游离三碘甲状腺原氨酸(FT3)与术后情景记忆得分有显著正相关关系(r=0.296,P<0.01)。多元线性回归结果显示,年龄是PCI组患者术后工作记忆得分的独立危险因素(β=-0.238,P<0.05),hs-CRP和Hcy是PCI组患者术后加工速度得分的独立危险因素(β=-0.218~-0.207,P<0.05),FT3是PCI组患者术后情景记忆得分的独立保护因素(β=0.224,P<0.05)。结论冠心病患者接受PCI治疗可加重患者围术期认知功能障碍,应在术前注意筛查患者的认知功能状况并及时进行干预。年龄、手术时间、血清hs-CRP和Hcy水平的增高以及FT3水平的降低是PCI手术患者术后认知功能减低的重要影响因素,血清hs-CRP、Hcy及FT3水平对冠脉介入治疗术后认知功能障碍可能具有早期预测作用。