Total and differential white blood cell counts,high-sensitivity C-reactive protein,and cardiovascular risk in non-affective psychoses

Schizophrenia is associated with increased cardiovascular disease morbidity and mortality. Schizophrenia is also associated with immune and inflammatory abnormalities, including aberrant blood levels of lymphocytes, cytokines and high-sensitivity C-reactive protein (hsCRP). The purpose of this study is to investigate the relationship between total and differential white blood cell (WBC) counts, hsCRP, and indices of cardiovascular disease risk in patients with schizophrenia and related non-affective psychoses. 108 inpatients and outpatients age 18–70 with non-affective psychoses and 44 controls participated in this cross-sectional study. Subjects had a fasting blood draw between 8 and 9 am for glucose, lipids, total and differential WBC counts, and hsCRP. Vital signs and medical history were obtained. Patients with non-affective psychosis had significantly higher hsCRP levels than controls (p = 0.04). In linear regression analyses, lymphocyte and monocyte counts were a significant predictor of the total-to-HDL cholesterol ratio in subjects with non-affective psychosis (p ⩽ 0.02 for each). In binary logistic regression analyses, total WBC count was a significant predictor of an elevated 10-year estimated risk of myocardial infarction and cardiovascular disease in subjects with non-affective psychosis (p ⩽ 0.03 for each). Associations between total and differential WBC counts and cardiovascular disease risk indices were stronger in males than females with non-affective psychosis. Our findings provide further evidence that measurement of total and differential WBC counts may be germane to the clinical care of patients with schizophrenia and related disorders, and support an association between inflammation and cardiovascular disease risk in these patients.     

Systemic inflammatory response following acute myocardial infarction

Acute cardiomyocyte necrosis in the infarcted heart generates damage-associated molecular patterns, activating complement and toll-like receptor/interleukin-1 signaling, and triggering an intense inflammatory response. Inflammasomes also recognize danger signals and mediate sterile inflammatory response following acute myocardial infarction (AMI). Inflammatory response serves to repair the heart, but excessive inflammation leads to adverse left ventricular remodeling and heart failure. In addition to local inflammation, profound systemic inflammation response has been documented in patients with AMI, which includes elevation of circulating inflammatory cytokines, chemokines and cell adhesion molecules, and activation of peripheral leukocytes and platelets. The excessive inflammatory response could be caused by a deregulated immune system. AMI is also associated with bone marrow activation and spleen monocytopoiesis, which sustains a continuous supply of monocytes at the site of inflammation. Accumulating evidence has shown that systemic inflammation aggravates atherosclerosis and markers for systemic inflammation are predictors of adverse clinical outcomes (such as death, recurrent myocardial infarction, and heart failure) in patients with AMI.     

人周围血单个核及多形核白细胞糖皮质激素受体的测定及其临床意义

本文应用放射配体结合测定法,分别测定周围血单个核和多形核白细胞的糖皮质激素受体(GR),并对测定方法进行了检验。应用已建立的方法测定健康人75例、柯兴综合征10例、阿狄森病7例及席汉综合征8例GR的数目及亲和力。结果表明:多形核白细胞的GR明显高于单个核白细胞,两类白细胞GR间呈明显正相关;柯兴综合征和阿狄森病患者白细胞GR与健康人比较差异无显著性;席汉综合征患者白细胞GR明显低于健康人,亲和力在正常范围内,GR降低的机理及意义有待今后进一步探讨。     

HBV相关性肝细胞癌及肝硬化患者外周血单个核细胞质谱分析

目的:建立HBV相关性肝细胞癌(HCC)及肝硬化(LC)患者外周血单个核细胞(PBMC)的双向凝胶电泳图谱,并识别鉴定其差异表达的蛋白质.方法:利用固相pH梯度双向凝胶电泳分离HBV相关性HCC(n=16)及LC患者(n=12)PBMC的总蛋白质,凝胶经蓝银显色后,PDQuest图像分析软件进行比较分析、识别差异表达的蛋白质,应用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF-MS)得到相应的肽质指纹图谱,然后搜索数据库鉴定部分差异蛋白质点.结果:得到了分辨率较高、重复性较好的HBV相关性HCC及LC患者PBMC双向凝胶电泳图谱,HBV相关性HCC及LC患者PBMC凝胶的平均蛋白质点数分别为1186±43及1013±41;组内的平均匹配率分别为91.6%,90.2%.对27个差异蛋白质点进行了质谱分析,鉴定出16个蛋白质,在HBV相关性HCC患者PBMC中表达明显增强的有热休克蛋白质(HSP)27、ras癌基因家族(RAB14)、肌动蛋白、α1-抗胰蛋白及RNA结合蛋白调节亚基等13个蛋白点;而PDX6、HSPA8及锰超氧化物歧化酶(MnSOD)在HCC患者PBMC中低表达.这些差异蛋白质点包括蛋白质合成与分解、分子伴侣、解毒和DAN修复相关蛋白质、三大代谢相关酶类、细胞结构相关蛋白质以及信号传导相关蛋白质六类.结论:建立了分辨率高且重复性较好的HBV相关性HCC及LC患者PBMC双向凝胶电泳图谱,并识别鉴定出了一些与HBV相关性HCC癌变相关的差异表达的蛋白质.     

Cytochemical studies of normal feline blood and bone marrow cells

Summary Blood and bone marrow cells of ten clinically healthy cats were stained for alkaline phosphatase (ALP), peroxidase (PO), chloroacetate esterase (CAE), alpha-naphthyl butyrate esterase (NBE), sudanophilia, and periodic acid-Schiff (PAS) reaction. Mature neutrophils in blood and bone marrow were devoid of ALP and NBE, but exhibited modest to strong PO, CAE, sudanophilia, and PAS reaction. In bone marrow, sudanophilia, PO, and CAE were prominent at the promyelocyte stage and diminished with cellular differentiation and maturation, while PAS reactivity increased with cell maturation usually from the myelocyte stage onwards. Myeloblasts were negative for all cytochemical reactions, but some large unidentifiable cells reacted strongly for ALP. Eosinophils were slightly reactive for ALP, CAE, and PAS, but not for PO, sudanophilia, and NBE. Basophil granules stained strongly for CAE, revealed PAS positivity, and stained negatively for PO, NBE, ALP, and sudanophilia. Slight ALP activity was detected in the intergranular cytoplasm of basophils. Lymphocytes and monocytes, with few exceptions, stained negatively. An occasional lymphocyte revealed slight globular NBE activity (NaF-resistant) and diffuse PAS reaction, while an occasional monocyte contained a few PO-positive and sudanophilic granules. Monocytes reacted modestly, whereas bone marrow macrophages reacted strongly for NBE (NaF-sensitive). Cells of the erythroid series stained negatively for all cytochemical reactions, megakaryocytes were PAS-positive, and platelets gave positive reactions for PAS and CAE.     

自体骨髓单个核细胞移植对急性前壁心肌梗死患者心功能的影响

目的观察经冠状动脉自体骨髓单个核细胞(MBMC)移植对急性前壁心肌梗死患者心功能的影响。方法选取40例急性前壁心肌梗死患者,根据患者的意愿分为干细胞移植组(20名,接受急诊PCI+标准药物+经冠脉注入骨髓单个核细胞治疗)和常规治疗对照组(20名,接受急诊PCI+标准药物治疗)。两组患者分别于术前、术后3个月、术后6个月进行6min步行试验、多普勒心脏超声、平衡法核素心血池显像(ERNA),并记录发病6个月内主要临床事件。结果同对照组相比,6min步行试验、超声心动图、ERNA术前与术后3个月两组差异无统计学意义(P>0.05),术后6个月移植组心功能改善明显(P<0.05),差异有统计学意义。结论自体骨髓单个核细胞经冠脉移植治疗急性心肌梗死近期可以改善患者心功能。     

Systemic inflammatory response to exhaustive exercise in patients with chronic obstructive pulmonary disease

Systemic inflammation may be present in patients with chronic obstructive pulmonary disease (COPD). Exercise is known to elicit an inflammatory response. We hypothesized that the systemic inflammatory response to exercise might be exaggerated in COPD patients compared to healthy subjects. Sixteen COPD patients and 11 healthy subjects performed a maximal incremental bicycle test. Before and at maximal exercise arterial blood samples were taken to determine circulating catecholamines, (subsets of) leukocytes, acute phase proteins, creatine kinase and myoglobin. At rest, increased levels of norepinephrine and systemic inflammation were present in COPD. The response of catecholamines to exercise was lower in COPD patients (P<0.01), which in part was due to the lower maximal exercise capacity of these patients (P<0.01). Exercise-induced leukocytosis showed similar responses in both groups, but occurred at higher levels in COPD. Although patients had increased levels of CRP at rest (P<0.001), exercise did not affect acute phase proteins. No systemic signs of muscle damage were found. The present study shows that COPD patients are exposed to systemic inflammation that is intensified by exhaustive exercise. The inflammatory response in COPD is not exaggerated compared to healthy subjects but occurs at a higher level and is observed at lower external workload.     

Serum calprotectin levels in elderly males and females without bacterial or viral infections

Objectives

Calprotectin is released from activated leukocytes and calprotectin can thus be used as a marker for leukocyte activation. Faeces calprotectin is not only used as a marker for inflammatory bowel disease but can also be used to detect leukocyte activation in other body fluids. The aim of the present study was to study serum calprotectin levels in non-infected elderly individuals to establish reference intervals for the marker.

Methods

Serum calprotectin was analyzed by immunoturbidimetry in 75 year old females and males without known infections. Individuals with CRP > 20 mg/L were excluded as this could indicate a subclinical infection. The calprotectin levels in the remaining 713 individuals were used to calculate reference values for this population. The Spearman rank correlations between calprotectin and 27 other laboratory biomarkers were also investigated.

Results

There was a strong positive Spearman rank correlation between calprotectin and CRP (p < 0.000001) and alkaline phosphatase (p < 0.000001). There were also significant negative correlations between calprotectin and ApoA1 and direct HDL-cholesterol.

Conclusions

The reference interval for serum-calprotectin for all study subjects was 0.3–2.6 mg/L. Leukocyte alkaline phosphatase contributes to serum alkaline phosphatase levels.     

Leukocytosis after fluid loading and induction of epidural anesthesia

The present study shows that leukocytosis occurs from fluid loading and from the small amounts of adrenaline given epidurally. Five healthy volunteers received an intravenous infusion of 25 ml·kg⁻¹ b.w. of Ringer's acetate solution over 15, 30, 45, and 80 min, and epidural anesthesia (EDA) was induced in 25 urology patients using mepivacaine 2% with or without adrenaline 1∶200 000. In the volunteers, we found that the total leukocyte count increased by up to 33% within 1 h after rapid volume loading. This increase was accounted for by neutrophils and lymphocytes. In the patients, the leukocyte count increased by 32% during the onset of EDA when mepivacaine with adrenaline was used. This increase was accounted for by lymphocytes. Our results suggest that caution is needed when interpreting the importance of a raised leukocyte count in samples taken in association with fluid loading and also when EDA is induced by a local anesthestic solution that contains adrenaline.     

心内直视术患儿体外循环前后静脉血白细胞基因表达的比较

目的：比较心内直视术患儿体外循环(CPB)前后静脉血白细胞基因表达的变化。方法：择期CPB下行心内直视手术的患儿8例，分别在CPB前(主动脉置管时)和CPB停机时采取静脉血标本5ml，提取RNA。以RNA为模板逆转录获取cDNA；然后以cDNA为模板体外转录得到生物素标记的cRNA，cRNA经提纯和片断化后与U133A基因芯片杂交。杂交后的芯片用专用激光共聚焦扫描仪采集荧光强度值，并用Affymerrix(r) Microarray Suite 5.0软件分析基因表达规律。结果:CPB前表达开放的基因共7023个，CPB后表达开放的基因7810个。与CPB前比较，有2873个基因出现差异性表达，1390个增高，1483个降低，差异性变化在3倍以上者共有96个，本研究按基因编码产物的功能对这部分基因进行了初步分析。结论:CPB引起心内直视术患儿静脉血白细胞基因出现明显的差异性表达，其特点与全身性炎性反应的临床认识相符，某些在功能上与肺损伤有关的基因表达异常升高。