Serum macrophage inflammatory protein-lαand high-sensitivity C-reactive protein levels in the paitents with obstructive sleep apnea-hypopnea syndrome and hypertension

Objectives To identify the effects of obstructive sleep apnea-hypopnea syndromemacrophage inflammatory protein -1α(MIP-1α) and high-sensitivity c-reactive protein(hs-CRP) levels,and its impact on cardiac structure and function in patients with hypertension.(OSAHS) on serum. Methods We studied 86 middle-aged subjects classified into four groups according to the absence or presence of OSAHS with and without hypertension.(1)OSAHS patients without hypertension(OSAHS group,n=29);(2)OSAHS patients with hypertension(OSAHS +HT group,n=27);(3) non-OSAHS patients with hypertension(HT group,n =27);(4)volunteers without OSAHS and hypertension(Control subjects, n=27).OSAHS patients were divided into mild,moderate and severe degree based on apnea hypopnea index(AHI).All participants underwent polysomnography and echocardiography. Serum MIP-1αand hs-CRP levels were tested by enzyme linked immunosorbent assay(ELISA).Results Body mass index(BMI),neck collar(NC),waist-to-hip ratio(WHR) in OSAHS group and OSAHS +HT group were significantly higher than those in Control group(PP<0.05).Serum MIP- 1αlevels in OSAHS+HT group was significant higher than HT groups(P<0.05).Serum MlP-1αlevels in those three groups were negative correlationwith AV(r=-0.238,P=0.08) and positively correlated with E/A ratio(r=0.307,P=0.02). Conclusions We have not foundthe cardiac systolic function change in early OSAHS patients with hypertension,while the diastolic function decreased obviously.Serum MIP-1αlevel shows earlier change than hs-CRP level in OSAHS patients which may contribute to the lesion of cardiac diastolic function.     

Effect of Losartan on the Cardiac and Renal Function in Patients With Chronic Heart Failure

Objectives To explore the effect of losartan on cardiac and renal function in patients with chronic heart failure (CHF). Methods Sixty-five patients with CHF were divided into two groups using a randomized, control and single blind method: losartan group (n=30) and convention group (n=35), with a treatment course of 8 weeks for both groups. The concentrations of cystatin C (cys C) in serum, microamount albumin (MA) in urine were measured by immunoturbidimetry. The concentration of aquaporin-2(AQP-2)was determined by enzyme-linked-immunosorbent assay (ELISA) and the heart contractile function was measured by echocardiography before and after treatment respectively. Results Comparing with routine treatment group, left ventricular end-diastolic dimension (LVEDd) decreased significantly, while left ventricular ejection fraction(LVEF)and left ventricular fractional shortening (LVFS) increased significantly in losartan group. The levels of cys C in serum and MA, AQP-2 in urine were significantly lower in losartan group than in routine treatment group. Conclusion Losartan can improve cardiac and renal function in patients with CHF.     

Stress doppler echocardiography in connective tissue disease patients without overt pulmonary arterial hypertension

Background Pulmonary arterial hypertension(PAH) is a common complication of connective tissue disease(CTD) and confers a worse prognosis. Stress doppler echocardiography(SDE) can detect early pulmonary vasculopathy and assess right heart function in patients with pulmonary arterial hypertension. In this study, the SDE was applied to analyze the degree of pulmonary vascular lesion and the function of right heart in CTD patients without overt PAH. Methods CTD patients without overt PAH were divided into exercised-induced pulmonary hypertension(EIPH) group and non-EIPH group depending on whether tricuspid regurgitation(TR) exceeded 3.1 m/s during exercise and assessed by echocardiography at rest and during exercise. The data of right ventricular function and the slope of the incremental of the mean pulmonary artery pressure and cardiac output(ΔmPAP/ΔCO) were analyzed. Results Forty-seven CTD patients without overt PAH(35 female, mean age 40.3±12.0 years) were enrolled and divided into EIPH group(n=21) and non-EIPH group(n=26). Patients with systemic sclerosis(SSc) were more likely to have EIPH(47.6% vs. 28.6%, P0.05) than those with systemic lupus erythematosus(SLE). Patients in EIPH group had a higher value of ΔmPAP/ΔCO than that of the non-EIPH group(4.5±3.1 vs. 2.2±1.3, P0.05). SSc was more prevalent in CTD patients and the symptoms of dyspnea occurred more often in EIPH group(52.4%), indicating a pressure-flow mismatch induced by exercise. However, the cardiac function demonstrated by left ventricular ejection fraction(LVEF), tricuspid annular plane systolic excursion(TAPSE),DTI-Derived S'-wave velocity(S') and right ventricular fractional area change(RVFAC), as well as functional reserve reflected by the changes of TAPSE, S', RVFAC before and after exercise, did not differ significantly between the two groups. Conclusions Although right ventricular(RV) reserve function does not change much before and after exercise, patients in EIPH group have a higher value of ΔmPAP/ΔCO than that of the non-EIPH group and more likely to have symptoms during exercise. Thus, to assess the potential for pulmonary vascular disease, echocardiography should be performed at rest and during exercise.[S Chin J Cardiol 2019;20(1):31-36]     

Interleukin-6 and its soluble receptor in patients with liver cirrhosis and hepatocellular carcinoma

AIM: To evaluate the immunohistochemical localization of interleukin-6 (IL-6) and IL-6 receptor (IL-6R) on tumor tissue specimens from patients with hepatocellular carcinoma (HCC) and the serum levels of IL-6 and sIL-6R in a group of patients with HCC as well as liver cirrhosis (LC) in a group of patients with LC alone and in a control group. METHODS: Three groups of subjects were studied: groupⅠ(n=83) suffering from HCC and LC, groupⅡ(n=72) suffering from LC alone and groupⅢ(n=42) as healthy controls. All patients had hepatitis C virus infection. Serum IL-6 and IL-6R levels were determined using a commercially available ELISA kit. Immunohistochemistry was performed using the streptavidin-biotin complex and rabbit polyclonal antibodies against IL-6 and IL-6R. RESULTS: Immunohistochemistry analysis showed a medium to strong cytoplasmic and membrane reactivity for IL-6 and IL-6R respectively, in at least 40% of cases of HCC, whereas liver cirrhosis patients and controls were negative for IL-6 or showed a very mild and focal dot-like cytoplasmic reaction for IL-6R. Serum IL-6 levels in HCC group were significantly higher than those in LC and control groups (P<0.0001). There was no significant difference in sIL-6R concentrations among 3 groups. When the patients with HCC were divided into groups according to Okuda's classification, a significant serum increase of IL-6 and sIL-6R level was observed from stageⅠto stageⅢ(P<0.02,P<0.0005). When HCC and LC patients were divided into 3 classes of cirrhosis severity according to Child-Pugh, values in HCC patients were significantly higher than those in LC patients for each corresponding class (P<0.01). CONCLUSION: IL-6 serum levels in HCC patients are higher than those in LC patients and controls, suggesting an increased production of this cytokine by neoplastic cells. sIL-6R values are similar in all groups, increasing only in stageⅢHCC patients. These data suggest that they have a closer relationship with the neoplastic mass rather than with the residual functioning hepatic mass.     

HBsAg levels in HBeAg-positive chronic hepatitis B patients with different immune conditions

AIM:To investigate hepatitis B surface antigen(HBsAg)levels in patients with HBeAg-positive chronic hepatitis B(CHB)and different immune conditions.METHODS:HBeAg-positive CHB patients with different immune conditions were enrolled in this cross-sectional study.These patients were grouped according to the following criteria:immune-tolerant patients,IT group;patients with a mild immune response in the immune clearance phase,IC-Mild group;and patients with a dramatic immune response in the immune clearance phase and exhibiting acute on chronic liver failure(ACLF),ACLF group.All these patients had not previously received antiviral therapy and were enrolled at a pre-settled ratio of2:2:1.Serum HBsAg levels and the correlation between serum HBsAg level and serum hepatitis B virus(HBV)DNA level were evaluated in these groups.RESULTS:In total,180 HBeAg-positive CHB patients[IT group(n=72),IC-Mild group(n=72),and ACLF group(n=36)]were enrolled in this study.The median serum HBsAg levels varied among the groups(P<0.001):IT,4.86 log10IU/mL;IC-Mild,3.97 log10IU/mL;and ACLF,3.57 log10IU/mL.Serum HBsAg level showed a moderate positive correlation with serum HBV-DNA level in the IC-Mild group(r=0.60,P<0.001),but exhibited a weaker correlation in the IT(r=0.52,P<0.001)and ACLF groups(r=0.51,P=0.001).The ratio of HBsAg/HBV DNA did not differ significantly among the IT,IC-Mild,and ACLF groups(medians:0.56,0.55,and 0.56,respectively;P=0.179).CONCLUSION:Serum HBsAg levels varied significantly in HBeAg-positive patients with different immune conditions.These findings may have important implications for understanding the immune clearance of HBV in HBeAg-positive CHB patients.     

老年阻塞性睡眠呼吸暂停低通气综合征患者血清同型半胱氨酸水平及其机制研究

目的 探讨老年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清同型半胱氨酸(Hcy)水平及其与氧化应激的关系.方法 选择2007年1月至2010年6月在我院经多导睡眠仪(PSG)监测并确诊OSAHS的患者123例,依据年龄分为老年OSAHS组55例、非老年OSAHS组68例;另选同期经PSG监测排除OSAHS的正常对照100例,依据年龄分为老年对照组52例、非老年对照组48例.于睡眠呼吸监测次日晨起采取空腹肘静脉血4 ml,采用循环酶法测定Hcy,紫外分光光度比色法测定丙二醛(MDA)及谷胱甘肽(GSH),并记录睡眠呼吸监测相关指标.结果 血清Hcy在老年OSAHS组、老年对照组、非老年OSAHS组、非老年对照组中的水平差异具有统计学意义(F=28.26,P=0.000);组间两两比较结果显示,老年OSAHS组中的Hcy水平高于其余各组,老年对照组高于非老年对照组,非老年OSAHS组高于非老年对照组.各组MDA、GSH水平差异具有统计学意义(F=5.56,P=0.002、F=4.79,P=0.004);组间两两比较结果显示,MDA、GSH在老年OSAHS组中的水平均高于其余各组.多元线性回归分析显示,血清Hcy与年龄、MDA、GSH、睡眠呼吸紊乱指数(AHI)具有相关性(β值分别为0.07、0.50、0.23、2.00).结论 随增龄,Hcy水平增高并伴氧化应激的增强,以老年OSAHS患者表现尤为显著,氧化应激的存在可能是老年OSAHS患者血清Hcy水平增高的内在机制.

Abstract：

Objective To investigate the association between serum homocysteine (Hcy) level and oxidative stress in elderly patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). Methods The 123 patients from January 2007 to June 2010 were recruited and divided into the elderly OSAHS group (n=55) and the non-elderly OSAHS group (n=68). One hundred healthy subjects were selected and divided into the elderly control group (n=52) and the non-elderly control group (n=48). The PSG variables were recorded and the levels of Hcy, malondialdehyde (MDA) and glutathione (GSH) were detected after sleep in all subjects. Serum Hcy level was measured by cyclophorase, MDA and GSH levels were measured by spectrophotometer. Results There were statistical differences in Hcy concentration between four groups (F=28.26, P=0.000). The Hcy concentration was higher in elderly OSAHS group than in other groups, and was higher in elderly control group than in non-elderly control group, and was higher in non-elderly OSAHS group than in non-elderly control group. There were statistical differences in MDA and GSH concentrations between the four groups (F=5.56, P=0.002;F=4.79, P=0.004). The concentrations of MDA and GSH were higher in elderly OSAHS group than in other groups. Multiple regression analysis indicated a statistically significant relationship of Hcy concentration with age, MDA, GSH and AHI (β=0.07, 0.50, 0.23 and 2.00). Conclusions The concentration of Hcy increases and oxidative stress enhances with aging, especially in the elderly patients with OSAHS. The mechanism of high level of serum Hcy in elderly patients with OSAHS may be the high oxidative stress.     

Cardiac function evaluated by Tei index of tissue doppler imaging and brain natriuretic peptide in patients with acute coronary syndrome and hyperglycemia

Background Recent studies demonstrated that N-terminal pro-brain natriuretic peptide(NT-pro BNP) increases in patients with diabetes mellitus and raised concerns about the diagnostic validity of NT-pro BNP in assessment of cardiac function in patients with hyperglycemia.Current investigation was carried out to observe the influence of hyperglycemia on the correlation of NT-pro BNP and cardiac function index in patients with acute coronary syndrome(ACS).Methods Fifty patients with ACS were enrolled and divided into hyperglycemia group(fasting plasma glucose(FPG) ≥ 6.1 mmol/L) and euglycemia group(FPG 6.1 mmol/L).All the patients underwent routine transthoracic ecocardiagraphy and tissue Doppler imaging(TDI) investigation.Blood sample were obtained with 24 hours of hospitalization for measuring of NT-proBNP level.Relation between TDI-Tei index and the level of NT-proBNP were analyzed in the two groups respectively.Result TDI-Tei index,systolic index and diastolic index were all significantly higher in hyperglycemia group than that in euglycemia group(0.679 ± 0.139 vs 0.600 ± 0.093,P = 0.022;0.294 ± 0.074 vs 0.258 ± 0.035,P = 0.036;0.385 ± 0.069 vs 0.342 ± 0.068,P = 0.032).TDI-Tei index was significantly negatively correlated with the level of log NT-pro BNP in both hyperglycemia group and euglycemia group(rp = 0.673,P = 0.000;rp = 0.354,P = 0.000).Conclusions(1)Cardiac function in patients with ACS complicated with hyperglycemia is inferior to that in patients with euglycemia;(2)Assessment of cardiac function with NT-proBNP is reliable in patients with hyperglycemia.     

Study on the clinical features of Hashimoto's thyroiditis with elevated serum IgG4

正Objective To investigate the clinical features of Hashimoto’s thyroiditis (HT) with elevated serum IgG4levels and to guide the clinical practice.Methods Serum IgG4 concentrations were detected in patients with HT by nephelometric immunoassay.These patients were classified into two groups according to the IgG4 levels:positive group (IgG4≥1.35 g/L),and negative group (IgG4 1.35 g/L).The clinical characteristics of these two     

Thyroxine treatment for elderly patients with heart failure and sick euthyroid syndrome

Objectives To evaluate the effect of thyroid hormone therapy with low dose of thyroxin on cardiac function in elderly patients with heart failure and sick euthyroid syndrome.Methods Forty-seven patients(33 males and 14 females,mean age 85.9±4.6 years, ranging from 80 to 99 years)with chronic heart failure(NYHAⅡ-Ⅳ)and low triiodothyronine(T_3)state were randomly allocated to the treatment group or control group.The treatment group patients received oral administration of levothyroxine sodium(Euthyrox)25-50 mg/d in addition to conventional therapy of heart failure,whereas patients in control group were given conventional therapy only.Serum level of total T_3(TT_3),free T_3(FT_3),total thyroxine(TT_4),free thyroxine(FT_4),and thyroid-stimulating hormone(TSH)were determined.For both groups,left ventricular ejection fraction(LVEF)and stroke volume(SV)were assessed by two-dimensional echocardiography before and at 8 weeks after treatment.The changes of these parameters after the treatment were evaluated by adjusting heart rate in the two groups.Results The reduced serum T_3 level in the treatment group was corrected after thyroid hormone therapy, and these patients had a significant improvement in cardiac function after treatment.By contrast,in the control group only changes of serum TT_3 and TT_4 levels and SV and LVEF after treatment were statistically significant.The heart rate-adjusted mean SV and LVEF in both groups were also increased,which was significantly greater in the treatment group than in the control group.Conclusion In the elderly patients with heart failure and sick euthyroid syndrome,addition of thyroxine at a low dosage to the conventional treatment could effectively improve the low T_3 state and cardiac function independent of changes of heart rate.     

He Jie Tang in the treatment of chronic hepatitis B patients

AIM: To explore the effect of He Jie Tang (decoction for medication) on serum levels of T lymphocyte subsets, NK cell activity and cytokines in chronic hepatitis B patients. METHODS: Eighty-five patients with chronic hepatitis B were divided randomly into two groups. Fifty patients in group Ⅰ were treated with He Jie Tang (HJT) and 35 patients in group Ⅱ were treated with combined medication. The levels of T-lymphocyte subsets (CD3+, CD4+, CD8+), NK cell activity, cytokines (TNF-α, IL-8, sIL-2R) were observed before and after the treatment. Another 20 normal persons served as group 3. RESULTS: The level of CD4+ cells and NK cell activity were lower, whereas the level of CD8+ cells in patients was higher than that in normal persons (t = 2.685, 3.172, and 2.754 respectively; P<0.01). The levels of TNF-α, IL-8, and sIL-2R in chronic hepatitis B patients were higher than those in normal persons (t = 3.526, 3.170, and 2.876 respectively; P<0.01). After 6 months of treatment, ALT, AST, and TB levels in the two groups were obviously decreased (t = 3.421, 3.106, and 2.857 respectively; P<0.01). The level of CD4+ cells and NK cell activity were increased whereas the level of CD8+ cells decreased (t = 2.179, 2.423, and 2.677 respectively; P<0.05) in group Ⅰ. The levels of TNF-α, IL-8, and sIL-2R in group I were decreased significantly after the treatment (t = 2.611, 2.275, and 2.480 respectively; P<0.05) but had no significant difference in group Ⅱ after the treatment (t = 1.906, 1.833, and 2.029 respectively; P>0.05). The total effective rate had no significant difference between the two groups (X2 = 2.882, P>0.05) but the markedly effective rate was significantly different between the two groups (X2 = 5.340, P<0.05). CONCLUSION: HJT is effective in treating chronic hepatitis B. HJT seems to exert its effect by improving the cellular immune function and decreasing inflammatory cytokines in chronic hepatitis B patients. The function of HJT in protecting liver function in the process of eliminating virus needs to be further studied.     

Serum high-sensitivity C-reaction protein and heart fatty acid binding protein level and cardiac accidents in patients with unstable angina pectoris

Objective To investigate the relationship between serum high-sensitivity C-reaction protein (hs-CRP) and heart fatty acid binding protein (h-FABP) on cardiac accidents in patients with unstable angina pectoris (UAP). Methods Serum levels of hs-CRP, h-FABP, cardiac troponin-Ⅰ(cTn-Ⅰ) and creatine kinase MB isoenzyme (CK-MB) were measured and cardiac accidents within 2 weeks after the test were observed in 74 patients (male     

Association between plasma inflammatory markers and morphology of coronary artery lesion in patients with coronary artery disease

The atherosclerotic plaque vulnerability may be related to inflammation,immunity,metabolism and blood clotting.One of the key factors affecting plaque stability is inflammatory reaction.This study was to investigate the relationship between vulnerability of coronary artery plaque evaluated with coronary angiography (CAG),intravascular ultrasound (IVUS) and the levels of plasma inflammatory markers.Methods Fifty-eight consecutive patients with acute coronary syndrome who had coronary lesion of a single vessel were divided into 3 groups based on angiographic morphology of the lesions:type Ⅰ lesion group (n =16),type Ⅱ lesion group (n =25) and type Ⅲ lesion group (n =17).The control group consisted of 17 patients with stable angina.Plasma levels of high sensitivity C reaction protein (hs-CRP),matrix metalloproteinase (MMP,including MMP-2 and MMP-9),CD40 ligand (CD40L) and pregnancy associated plasma protein-A (PAPP-A) were measured by ELISA.A subgroup of 28 patients (including 18 ACS patients and 10 stable angina control patients) who underwent IVUS study,were analyzed.Results The plasma levels of MMP-2,MMP-9 and PAPP-A in type Ⅱ lesion group were significantly higher than those in other groups (all P＜0.05).In type Ⅱ lesion group,linear correlation analyses showed significant positive correlation between levels of hs-CRP and MMP-2 (r=0.508);MMP-2 and MMP-9,CD40L,PAPP-A (r=0.647,0.704 and 0.751,respectively);MMP-9 and CD40L,PAPP-A (r=0.491 and 0.639,respectively);CD40L and PAPP-A (r=0.896).IVUS subgroup analysis showed that the area of plaques and plaque burden in culprit lesion,the incidence of high-risk plaques,remodeling index (RI) and positive remodeling percentage in ACS patients were significantly greater than those in control subgroup (P=0.000,0.037,0.028,0.015 and 0.040,respectively).Compared with control subgroup,the plasma levels of hs-CRP,MMP-2,MMP-9 and PAPP-A were markedly elevated (P=0.033,0.000,0.000 and 0.027,respectively).Conclusions CAG and IVUS combined with study on plasma levels of inflammation mediators are helpful in judging the vulnerability of coronary artery plaques.(J Geriatr Cardiol 2008;5:207-211)     

Food intolerance and skin prick test in treated and untreated irritable bowel syndrome

AIM: To correlate the clinical features of treated and untreated patients with irritable bowel syndrome (IBS) to the results of skin prick test (SPT) for food and inhalant allergens. METHODS: We recruited 105 subjects to form three different target groups: treated group (n=44) undergoing treatment for IBS, untreated group (n=31) meeting the RomeⅡcriteria without treatment for IBS, control group (n=30) with no IBS symptoms. RESULTS: SPT results were different among the three groups in which SPT was positive in 17 (38.6%) treated patients, in 5 (16.1%) untreated patients and in 1 (3.3%) control (P<0.01). The number of positive SPTs was greater in the IBS group than in the control group (P< 0.001). The number of positive food SPTs was higher in the treated IBS group than in the untreated IBS group (P=0.03). CONCLUSION: Positive food SPT is higher in IBS patients than in controls.     

Differences of plasma NT-pro BNP level in patients with left heart failure combining or not combining pulmonary hypertension

<正>Objective To observe the relationship between plasma levels of NT-pro BNP and pulmonary hypertension in patients with left heart failure(LHF).Methods A total of 391 LHF patients were enrolled in our study,according to pulmonary arterial pressure,the patients were divided into 3 groups:Control group,the patients without     

Clinical significance of serum procalcitonin in patients with ulcerative colitis

AIM:To investigate the association of procalcitonin(PCT)with ulcerative colitis(UC)activity.METHODS:Serum PCT levels,C-reactive protein(CRP)levels,the erythrocyte sedimentation rate,and the white blood cell count were analyzed in 18 patients with UC and 11 healthy volunteers.Serum PCT levels were analyzed by an electrochemiluminescence immunoassay.Severity assessments were based on Truelove and Witts’severity index.Correlation of serum PCT and CRP levels with UC activity was examined.Moreover,we assessed serum PCT and CRP levels in patients with a Mayo endoscopic subscore.RESULTS:Serum PCT levels in severe UC patients(n=7)(0.096±0.034 ng/mL)were significantly higher than in mild-to-moderate UC patients(n=11)(0.033±0.012 ng/mL)and healthy volunteers(n=11)(0.035±0.005 ng/mL)(P=0.0005 and P<0.0001,respectively).In addition,there was no difference in serum PCT levels between mild-to-moderate UC patients and healthy volunteers.Interestingly,patients with a Mayo endoscopic subscore of 3 points displayed significantly increased levels of serum PCT(0.075±0.043 ng/mL)compared with patients with a subscore of 2 points(0.03±0.011 ng/mL)(P=0.0302).Moreover,CRP levels in patients with severe UC or a Mayo endoscopic subscore of 3 points were not significantly higher than in patients with mild-to-moderate UC or a Mayo endoscopic subscore of 3 points.CONCLUSION:Serum PCT levels were significantly correlated with UC activity.     

心房颤动对不同心功能分级的患者血浆脑钠肽水平的影响

Objective To assess the effect of atrial fibriUation (AF) on plasma levels of NT-proBNP in patients with different cardiac functions. Methods One hundred and ninty-one patients with chronic heart failure (CHF) were divided into two groups: minor CHF group (NYHA Ⅰ/Ⅱ class) and sever CHF group (NYHA Ⅲ/Ⅳ class). In addition,84 patients without HF (non-HF group) were enrolled as control The plas-ma NT-proBNP were assayed and the effect of AF on the NT-proBNP levels was analyzed to determine inde-pendent of NT-proBNP levels in 3 groups. Results Patients with AF in non-HF had higher NT-proBNP levels than those with sinus rhythm (SR) [(2.95 ±0.41) vs (2.21±0.44) ng/L, P < 0.01], and multi-variables regression demonstrated that age, AF and left atrial diameter (LAD) were independent determinants of NT-proBNP levels (P <0.001). NT-proBNP levels in minor CHF were also higher in patients with AF than that in patients with SR [(3.26±0.40) ng/L vs (2.98±0.54) ng/L, P < 0.05] ; AF, LAD, left ventricular end-systolic dimension (LVESD) and left vontric-ular eject fraction (LVEF) were the independent factors of NT-proBNP levels (P < 0.05). However, there was no difference of NT-proBNP levels between patients with AF and patients with SR [(3.59±0.52) ng/L vs (3.56±0.55) ng/L,P =0.73] ; while age and LVEF were in-dependent factors (P < 0.05). In patients with LVEF < 0.40, AF had not significant affect on NT-proBNP lev-els [AF vs SR: (3.70±0.60) ng/L vs (3.46±0.56) ng/L,P >0.10]; however,AF patients with LVEF≥ 0.40, NT-proBNP levels were increased [AF vs SR: (3.08 ±0.57) ng/L vs (2.67±0.73) ng/L, P < 0.001]. Conclusion The effect of AF on plasma NT-proBNP was related with cardiac functions: in AF pa-tients without or with minor cardiac dysfunction (NYHA Ⅰ /Ⅱ class or LVEF≥0.40) ,NT-proBNP increased; in AF patients with sever cardiac dysfunction (NYHA Ⅲ/Ⅳ class or LVEF < 0.40), NT-proBNP had no sig-nificant changes.     

Intrahepatic and peripheral T-cell responses in genotype 1b hepatitis C virus-infected patients with persistently normal and elevated aminotransferase levels

AIM: To evaluate whether the cytokine responses in liver and serum differ in chronic hepatitis C patients with normal and high alanine aminotransferase (ALT) levels. METHODS: Thirty-three (16 with normal ALT level as group 1 and 17 with elevated ALT level as group 2) patients infected with genotype 1b hepatitis C virus (HCV) were examined. Liver infiltrating lymphomononuclear cells (LILMCs) were isolated from liver biopsy by collagenase type 1 and stimulated with phytohemagglutinin and interleukin 2 (IL-2). IL-10, IL-12, interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α) were determined in serum and LILMCs by ELISA. RESULTS: Serum cytokine levels were similar in both groups (P>0.05). Stimulated IFN-γ and TNF-α levels in LILMCs were increased in both groups. IL-12 and IL-10 levels stimulated with IL-2 were higher in group 1 than in group 2 (P = 0.023). Histological activity index (HAI) and stage had a negative correlation with TNF-α and IFN-γ levels in group 2. CONCLUSION: Increased T-helper type 2 (Th2) cytokine response may regress inflammatory and biochemical activity. Progression of histological abnormalities in persons with elevated ALT probably depends on insufficient Th2 cytokine response, which does not balance Th1 cytokine response.     

Hepatic blood inflow occlusion without hemihepatic artery control in treatment of hepatocellular carcinoma

AIM:To investigate the clinical significance of hepatic blood inflow occlusion without hemihepatic artery control (BIOwHAC) in the treatment of hepatocellular carcinoma (HCC).METHODS:Fifty-nine patients with HCC were divided into 3 groups based on the technique used for achieving hepatic vascular occlusion:group 1,vascular occlusion was achieved by the Pringle maneuver (n=20);group 2,by hemihepatic vascular occlusion (HVO) (n=20);and group 3,by BIOwHAC (n=19).We compared the procedures among the three groups in term of operation time,intraoperative bleeding,postoperative liver function,postoperative complications,and length of hospital stay.RESULTS:There were no statistically significant differences (P > 0.05) in age,sex,pathological diagnosis,preoperative Child’s disease grade,hepatic function,and tumor size among the three groups.No intraoperative complications or deaths occurrred,and there were no significant intergroup differences (P > 0.05) in intraoperative bleeding,hepatic function change 3 and 7 d after operation,the incidence of complications,and length of hospital stay.BIOwHAC and Pringle maneuver required a significantly shorter operation time than HVO;the difference in the serum alanine aminotransferase or aspartate aminotransferase levels before and 1 d after operation was more significant in the BIOwHAC and HVO groups than in the Pringle maneuver group (P < 0.05).CONCLUSION:BIOwHAC is convenient and safe;this technique causes slight hepatic ischemia-reperfusion injury similar to HVO.     

心房颤动对不同心功能分级的患者血浆脑钠肽水平的影响

Objective To assess the effect of atrial fibriUation (AF) on plasma levels of NT-proBNP in patients with different cardiac functions. Methods One hundred and ninty-one patients with chronic heart failure (CHF) were divided into two groups: minor CHF group (NYHA Ⅰ/Ⅱ class) and sever CHF group (NYHA Ⅲ/Ⅳ class). In addition,84 patients without HF (non-HF group) were enrolled as control The plas-ma NT-proBNP were assayed and the effect of AF on the NT-proBNP levels was analyzed to determine inde-pendent of NT-proBNP levels in 3 groups. Results Patients with AF in non-HF had higher NT-proBNP levels than those with sinus rhythm (SR) [(2.95 ±0.41) vs (2.21±0.44) ng/L, P < 0.01], and multi-variables regression demonstrated that age, AF and left atrial diameter (LAD) were independent determinants of NT-proBNP levels (P <0.001). NT-proBNP levels in minor CHF were also higher in patients with AF than that in patients with SR [(3.26±0.40) ng/L vs (2.98±0.54) ng/L, P < 0.05] ; AF, LAD, left ventricular end-systolic dimension (LVESD) and left vontric-ular eject fraction (LVEF) were the independent factors of NT-proBNP levels (P < 0.05). However, there was no difference of NT-proBNP levels between patients with AF and patients with SR [(3.59±0.52) ng/L vs (3.56±0.55) ng/L,P =0.73] ; while age and LVEF were in-dependent factors (P < 0.05). In patients with LVEF < 0.40, AF had not significant affect on NT-proBNP lev-els [AF vs SR: (3.70±0.60) ng/L vs (3.46±0.56) ng/L,P >0.10]; however,AF patients with LVEF≥ 0.40, NT-proBNP levels were increased [AF vs SR: (3.08 ±0.57) ng/L vs (2.67±0.73) ng/L, P < 0.001]. Conclusion The effect of AF on plasma NT-proBNP was related with cardiac functions: in AF pa-tients without or with minor cardiac dysfunction (NYHA Ⅰ /Ⅱ class or LVEF≥0.40) ,NT-proBNP increased; in AF patients with sever cardiac dysfunction (NYHA Ⅲ/Ⅳ class or LVEF < 0.40), NT-proBNP had no sig-nificant changes.     

心房颤动对不同心功能分级的患者血浆脑钠肽水平的影响

Objective To assess the effect of atrial fibriUation (AF) on plasma levels of NT-proBNP in patients with different cardiac functions. Methods One hundred and ninty-one patients with chronic heart failure (CHF) were divided into two groups: minor CHF group (NYHA Ⅰ/Ⅱ class) and sever CHF group (NYHA Ⅲ/Ⅳ class). In addition,84 patients without HF (non-HF group) were enrolled as control The plas-ma NT-proBNP were assayed and the effect of AF on the NT-proBNP levels was analyzed to determine inde-pendent of NT-proBNP levels in 3 groups. Results Patients with AF in non-HF had higher NT-proBNP levels than those with sinus rhythm (SR) [(2.95 ±0.41) vs (2.21±0.44) ng/L, P < 0.01], and multi-variables regression demonstrated that age, AF and left atrial diameter (LAD) were independent determinants of NT-proBNP levels (P <0.001). NT-proBNP levels in minor CHF were also higher in patients with AF than that in patients with SR [(3.26±0.40) ng/L vs (2.98±0.54) ng/L, P < 0.05] ; AF, LAD, left ventricular end-systolic dimension (LVESD) and left vontric-ular eject fraction (LVEF) were the independent factors of NT-proBNP levels (P < 0.05). However, there was no difference of NT-proBNP levels between patients with AF and patients with SR [(3.59±0.52) ng/L vs (3.56±0.55) ng/L,P =0.73] ; while age and LVEF were in-dependent factors (P < 0.05). In patients with LVEF < 0.40, AF had not significant affect on NT-proBNP lev-els [AF vs SR: (3.70±0.60) ng/L vs (3.46±0.56) ng/L,P >0.10]; however,AF patients with LVEF≥ 0.40, NT-proBNP levels were increased [AF vs SR: (3.08 ±0.57) ng/L vs (2.67±0.73) ng/L, P < 0.001]. Conclusion The effect of AF on plasma NT-proBNP was related with cardiac functions: in AF pa-tients without or with minor cardiac dysfunction (NYHA Ⅰ /Ⅱ class or LVEF≥0.40) ,NT-proBNP increased; in AF patients with sever cardiac dysfunction (NYHA Ⅲ/Ⅳ class or LVEF < 0.40), NT-proBNP had no sig-nificant changes.