Objective To investigate the correlation between monocyte-lymphocyte ratio (MLR) and intensive care unit (ICU) results in ICU hospitalized patients. Methods Clinical data were extracted from Medical Information Mart for Intensive Care Ⅲ database, which contained health data of more than 50000 patients. The main result was 30-day mortality, and the secondary result was 90-day mortality. The Cox proportional hazards model was used to reveal the association between MLR and ICU results. Multivariable analyses were used to control for confounders. Results A total of 7295 ICU patients were included. For the 30-day mortality, the hazard ratio (HR) and 95% confidence interval (CI) of the second (0.23≤MLR<0.47) and the third (MLR≥0.47) groups were 1.28 (1.01, 1.61) and 2.70 (2.20, 3.31), respectively, compared to the first group (MLR<0.23). The HR and 95%CI of the third group were still significant after being adjusted by the two different models [2.26 (1.84, 2.77), adjusted by model 1; 2.05 (1.67, 2.52), adjusted by model 2]. A similar trend was observed in the 90-day mortality. Patients with a history of coronary and stroke of the third group had a significant higher 30-day mortality risk [HR and 95%CI were 3.28 (1.99, 5.40) and 3.20 (1.56, 6.56), respectively]. Conclusion MLR is a promising clinical biomarker, which has certain predictive value for the 30-day and 90-day mortality of patients in ICU.
ObjectiveTo evaluate prognostic value of change of immune status in locally advanced gastric cancer (LAGC) patients. Methods We retrospective collected 210 LAGC patients who underwent treatment in our department from January 2013 to December 2018, then we collected lymphocyte-to-monocyte ratio (LMR) and cLMR (change of lymphocyte-to-monocyte ratio, cLMR) before operation and after three cycles of adjuvant chemotherapy. We had developed a new immune state change score (ICS) based on preoperative LMR (pLMR) and cLMR, and explored its prognostic value. The definition of ICS in this study was: ICS=1, pLMR≤4.53 and cLMR≤1; ICS=2, pLMR≤4.53 and cLMR>1, or pLMR>4.53 and cLMR≤1; ICS=3, pLMR>4.53 and cLMR>1. Results The results of multivariate Cox proportional hazard regression model showed that ICS was an influencing factor for overall survival [ICS=2, RR=0.397, 95%CI (0.260, 0.608), P<0.001; ICS=3, RR=0.080, 95%CI (0.040, 0.162), P<0.001), patients with ICS scores of 2 and 3 had better overall survival. In addition, the prognostic accuracy of ICS was superior to pLMR and Clmr, and the C-index of ICS [0.806, 95%CI (0.746, 0.865)] was higher than that of pLMR [0.717, 95%CI (0.635, 0.799), P=0.003)] and cLMR [0.723, 95%CI (0.641, 0.806), P=0.005)]. Based on this, a Nomogram model included ICS, CEA, and pTNM staging was constructed to predict the 3-year and 5-year survival rates of patients. The calibration curve and C-index [0.821, 95%CI (0.783, 0.859)] showed high discrimination and accuracy of Nomogram, and decision curve analysis confirmed that the model had good clinical application value. Conclusions The dynamic changes in the patient’s immune status before and after adjuvant therapy are related to the overall survival of LAGC patients. As an evaluating system which combined the cLMR and pLMR, ICS can better predict the prognosis of LAGC patients.
目的:研究CC亚族趋化因子单核细胞趋化蛋白-4(MCP-4/CCL13)在类风湿关节炎(RA)患者外周血的表达水平,并分析MCP-4的水平与疾病活动性的关系,以探讨MCP-4在RA发病机制中的作用。 方法:应用酶联免疫吸附实验(ELISA)定量方法测定40例RA患者、20例其它自身免疫性疾病患者和20例正常健康对照者血清MCP-4水平。分析RA组血清MCP-4水平是否与ESR、CRP、RF及双手放射学检查等指标具有相关性。结果:RA组血清MCP-4水平为(203.79±18.64)pg/mL,其它自身免疫性疾病对照组血清MCP-4水平为(207.76±40.37)pg/mL,正常健康对照组血清MCP-4水平为(125.13±11.08)pg/mL。RA组、其它自身免疫性疾病对照组血清MCP-4水平与正常健康对照组相比均有统计学意义(Plt;0.05),RA组与其它自身免疫性疾病对照组间无统计学意义(P=0.787),RA活动期患者血清MCP-4水平(214.86±24.46)pg/mL和非活动期患者血清MCP-4水平(190.27±29.11)pg/mL比较无统计学意义(P=0.065)。RA组血清MCP-4水平与ESR、CRP、RF及双手X片分期无相关性。结论:RA组的血清MCP-4水平高于正常健康对照组,但与ESR、CRP、RF及双手X片分期无相关性。MCP-4可能参与了RA的发病过程。
ObjectiveTo determine the nuclear factor kappa B (NFkB) activity in peripheral blood mononuclear cells (PBMC) in patients with acute cholangitis of severe type (ACST) and correlate the degree of NFkB activation with severity of biliary tract infection and clinical outcome.MethodsTwenty patients with ACST were divided into survivor group (14 cases) and nonsurvivor group (6 cases). Other 10 patients undergoing elective gastrectomy or inguinal hernia repair were selected as control group. Peripheral blood samples were taken 24 hours after operation, PBMC was separated and nuclear proteins were isolated from PBMC, and NFkB was determined with electrophoretic mobility shift assay (EMSA). The levels of TNFα, IL6 and IL10 in plasma were determined by using an enzymelinked immunoassay (ELISA). ResultsThe NFkB activity was 5.02±1.03, 2.98±0.51 and 1.02±0.34 respectively in three groups. It was increased in all patients with ACST, versus the control group (P＜0.05), and the patients of nonsurvivor group had higher levels of NFkB activation than those of survivor group (P＜0.05). The levels of TNFα and IL6 were (496.28±52.35) ng/L and (578.13±67.72) ng/L in nonsurvivor group; (284.47±39.41) ng/L and (318.67±34.92) ng/L in survivor group; (89.43±10.39) ng/L and (101.27±13.47) ng/L in control group. All patients with ACST had increased levels of TNFα and IL6, which were many fold greater than that of control group, and there was an evidence of significantly higher levels in nonsurvivor group than in survivor group (P＜0.05). All patients had also increased levels of IL10 as compared to control group (P＜0.05), but the IL10 concentrations in plasma were not significantly higher in nonsurvivors than that of in those survivors (Pgt;0.05). ConclusionNFkB activation in PBMCs in patients with ACST
ObjectiveTo explore the predictive value of systemic immune-inflammation index (SII) combined with neutrophil-monocyte ratio (NMR) on postoperative anastomotic leakage in elderly colon cancer. MethodsThe clinical data of 493 elderly colon cancer patients who attended the Department of General Surgery of the First Hospital of Lanzhou University from January 2018 to October 2023 were retrospectively analysed, and divided into an anastomotic leakage group (n=29) and a non-anastomotic leakage group (n=464) according to the occurrence of anastomotic leakage or not, and the differences between the two groups in terms of SII and NMR at different time points were compared. Area under the curve (AUC) of receiver operating characteristic (ROC) was used to compare the predictive value of SII, NMR and the combination of the two on the occurrence of anastomotic leakage after surgery in elderly colon cancer patients. Logistic regression was used to analyse the independent risk factors for postoperative anastomotic leakage in elderly colon cancer patients. ResultsThe SII and NMR in the anastomotic leakage group were higher than those in the non-anastomotic leakage group on the 3 rd and 5 th day after operation (P<0.05). ROC curve analysis showed that the AUC values for SII on postoperative day 3, NMR on postoperative day 5, and the combination of the two to predict anastomotic leakage were 0.613, 0.743, and 0.750, respectively. The results of DeLong’s test suggested that the difference between the AUC values of NMR on postoperative day 5 combined with SII on postoperative day 3 and SII on postoperative day 3 was statistically significant (P=0.047). Multifactorial logistic regression analysis showed that age, male, diabetes, preoperative radiotherapy and chemotherapy, tumor located in the left colon, SII on postoperative day 3, and NMR on postoperative day 5 were independent risk factors for postoperative anastomotic leakage in elderly patients with colorectal cancer (all P<0.05). ConclusionsPostoperative day 3 SII combined with postoperative day 5 NMR, postoperative day 3 SII, and postoperative day 5 NMR all have predictive value for postoperative anastomotic leakage in elderly patients with colorectal cancer. Both have the potential to serve as important predictors of postoperative anastomotic leakage in elderly patients with colon cancer.
Objective To explore risk factors of stroke-associated pneumonia (SAP) for elderly stroke patients in ICU, and analyze the predictive value of human leukocyte antigen-DR (HLA-DR) on monocytes for SAP. Methods During January 2015 to August 2016, 155 elderly patients with stroke were recruited. The level of monocyte HLA-DR expression was measured after admission and the incidence of SAP was recorded. The risk factors for SAP were analyzed by univariate and multivariate analysis. ROC curve was drawn to analyze prognostic value of HLA-DR. Results SAP occurred in 75 cases with occurrence rate of 48.4%, including 42 early-onset cases and 33 later-onset cases. Age (OR=11.532), Glasgow Coma Scale (OR=7.124), dysphagia (OR=8.846), mechanical ventilation (OR=15.184), atrial fibrillation (OR=7.869), smoking history (OR=11.784), diabetes (OR=7.185) were independent risk factors (all P<0.05). The expression rate of monocyte HLA-DR in the SAP patients was significantly lower than those in the patients without SAP (allP<0.05). Through the ROC curve analysis, the expression rate of HLA-DR that below 78.65% was the optimum cut-off value for prediction of SAP with the area under ROC curve of 0.922, the sensitivity of 80.0% and the specificity of 85.0%. The sensitivity to predict early-onset SAP was 90.5% (38/42), and to predict later-onset SAP was 66.7% (22/33). Conclusions Age, severe coma, dysphagia, mechanical ventilation, atrial fibrillation, smoking history and diabetes are risk factors for SAP in elderly stroke patients in ICU. The detection of monocyte HLA-DR has reference value for early prediction of SAP especially for early-onset SAP with higher sensitivity.
ObjectiveTo investigate the expression and significance of cysteine-rich protein 61 (Cyr61) in patients with chronic obstructive pulmonary disease (COPD).MethodsBetween September 2017 and September 2018, 27 patients with benign tumor needing to surgical therapy, were divided into COPD group (15 patients) and non-COPD group (12 patients), according to lung function. Lung tissues were selected at the distance at least 5 cm from the tumor. The levels of Cyr61, interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) in serum were determined by enzyme-linked immunosorbent assay. Meanwhile, the expressions of Cyr61 in lung tissues were measured by immunohistochemistry technology between two groups. Furthermore, correlations among Cyr61, IL-8, MCP-1, smoking index, forced expiratory volume in the 1st second as percentage of predicted values (FEV1%pred), scores of COPD Assessment Test (CAT) were analyzed.ResultsSerum Cyr61, IL-8, MCP-1 levels were significantly higher in patients with COPD than in the non-COPD group (P<0.05), (2409.80±893.87)pg/mL, (76.27±10.53)pg/mL, (173.67±42.64)pg/mL vs. (1065.42±158.83)pg/mL, (57.33±8.29)pg/mL, (138.42±27.62)pg/mL, respectively. By immunohistochemistry technology, the expression levels of Cyr61 in lung epithelial cells and in lung macrophage cells of COPD patients were higher than in the non-COPD group (P<0.01). Positive correlations were found between serum IL-8, serum MCP-1, CAT scores, smoking index and serum Cyr61 (r=0.674, 0.566, 0.602, and 0.755, P=0.006, 0.028, 0.018, and 0.003, respectively) in COPD group. Furthermore, in COPD group, there were also positive correlations between serum IL-8, serum MCP-1, CAT scores, smoking index and intrapulmonary Cyr61 (r=0.542, 0.635, 0.809, and 0.580, P=0.037, 0.011, 0.001, and 0.038 respectively). Inverse correlation was found between serum Cyr61 and FEV1%pred (r=–0.772, P<0.01), and the same as between intrapulmonary Cyr61 and FEV1%pred (r=–0.683, P<0.01).ConclusionsCyr61 highly expresses in serum and in lung tissues of patients with COPD, and its expression is correlated with lung function of patients. The results indicate that Cyr61 may interact with IL-8 and MCP-1 in the pathogenesis of chronic obstructive pulmonary disease.
ObjectiveTo investigate whether the miR-33s negatively regulates LPS-induced production of inflammatory cytokines by targeting p38 MAPK. MethodsHuman monocytes THP-1 cells were cultured in vitro and transfected with miR-33s mimic (25 nmol/L) or miR-33s inhibitor (25 nmol/L)by TransIT-X2® Dynamic Delivery System for 24 h. Then the transfected THP-1 cells were stimulated by LPS of 10.0 ng/mL for 24 h. The expression of miR-33s and p38 MAPK protein were measured by semi-quantitative RT-PCR. The concentrations of TNF-α,IL-6 and IL-1β in the cultured supernatant were assessed by ELISA. ResultsThe transfection of miR-33s mimic significantly increased the release of TNF-α,IL-6 and IL-1β(P<0.05). The expression of p38 MAPK protein was also significantly reduced(P<0.05). However,the pre-treatment of miR-33s inhibitor reversed the LPS-induced release of TNF-α,IL-6,and IL-1β,and the expression of p38 MAPK protein of THP-1 cells. ConclusionmiR-33s may play an important role in the regulation in inflammatory factors released from THP-1 cells by targeting p38 MAPK.
目的 研究C-C亚族趋化因子单核细胞趋化蛋白-4（MCP-4/CCL13）在系统性红斑狼疮（SLE）患者外周血的表达水平，并分析MCP-4的水平与狼疮肾炎的关系，以探讨MCP-4在SLE发病机制中可能起的作用。 方法 选取2007年9月－2010年8月在四川大学华西医院和宜宾市第一人民医院诊断明确的SLE及类风湿关节炎（RA）患者各40例。另收入正常健康对照组（20例），应用酶联免疫吸附试验定量方法测定SLE组、RA患者和正常健康对照者血清中MCP-4的水平，SLE患者根据有无肾脏受累分为非狼疮肾炎组和狼疮肾炎组，其中非狼疮肾炎组20例，狼疮肾炎组20例，并分析SLE组血清MCP-4水平是否与抗核抗体、补体C3、C4等指标及SLE疾病活动指数SLEDAI评分相关性，血清MCP-4水平采用方差分析、LSD-t检验和Spearman相关进行统计分析。 结果 血清MCP-4水平SLE组为（216.32 ± 12.65）pg/mL，RA组为（203.79 ± 18.64）pg/mL，正常健康对照组为（125.13 ± 11.08）pg/mL。SLE组、RA组血清MCP-4水平与正常健康对照组相比均有统计学意义（P＜0.05），SLE组与RA组比较血清MCP-4水平无统计学意义（P＞0.05）；SLE患者中狼疮肾炎组与非狼疮肾炎组比较血清MCP-4水平无统计学意义（P＞0.05）。SLE组血清MCP-4水平与抗核抗体、补体C3、C4等指标及SLEDAI评分无相关性。 结论 MCP-4在SLE组患者血清中表达增高，MCP-4可能参与了SLE的发病过程，可能成为SLE新的血清学有用指标并作为治疗的靶点。