Objective To explore the possible anti-inflammatory mechanism of intensive insulin therapy （IIT） by studying the effect of IIT on the levels of TNF-α, IL-6, C-reactive protein （CRP） and APACHE Ⅱ score in biliary pyemia. Methods Twenty eight patients with biliary pyemia who were admitted by our department and given an operation within 24 h form Jan. 2005 to Dec. 2008 were randomly divided into two groups by using random number table numbers: one group treated with IIT （IIT group, n=14） and another group treated with routine insulin therapy （RIT group, n=14）. The inflammatory factors, such as TNF-α, IL-6 and CRP were detected dynamically and the APACHEⅡ score was calculated. ResultsThe level of CRP and APACHEⅡ score on day 5 and 7 and the levels of TNF-α and IL-6 on day 3, 5 and 7 after operation in IIT group were significantly lower than those in RIT group （P＜0.05, P＜0.0１）. Compared with preoperative levels, the IL-6 and APACHEⅡ score in IIT group commenced to decrease on day 3 after operation （P＜0.05）, that was earlier than control group. Conclusion The treatment with IIT can suppress the composition of TNF-α, IL-6 and CRP, protect impaired hepatic cells, and reduce APACHEⅡ score, the degree of systemic inflammation and incidence of MODS.
ObjectiveTo examine and compare the value of procalcitonin (PCT), C-reactive protein (CRP) and interleukin (IL)-6 in diagnosing fetal sepsis in premature neonates. MethodsPreterm neonates with premature rupture of membrane between January 2010 and September 2012 were screened, and the serum levels of PCT, CRP and IL-6 were detected in the first day of life. All preterm neonates were divided into two groups according to the development of sepsis (45 cases with sepsis and 39 cases without sepsis). ResultsThe levels of PCT, CRP and IL-6 in premature neonates with sepsis were all significantly higher than those without sepsis. The cut-off value of PCT in diagnosis of sepsis was 2.14 μg/L, with a sensitivity and specificity of 76% and 85% respectively; the cut-off value of CRP in diagnosis of sepsis was 7.90 mg/L, with a sensitivity and specificity of 67% and 61% respectively. For IL-6, the cut-off value in diagnosis of sepsis was 13.80 ng/L, and its sensitivity and specificity were high to 90% and 94%, respectively. ConclusionIL-6 is the most reliable biochemical marker for the detection of early-onset sepsis in preterm neonates with premature rupture of membrane.
Objective To investigate the values of pneumonia severity index ( PSI) , CURB-65,plasma procalcitonin ( PCT) , C-reactive protein ( CRP) measurements for evaluation the severity of healthcare-associated pneumonia ( HCAP) .Methods A retrospective observational study was conducted on 92 hospitalized patients with HCAP admitted between June 2010 and December 2011. They were divided into different groups according to different severity assessment criteria. The variance and correlation of PCT,CRP,WBC and percent of neutrophil ( Neu% ) levels were compared among different groups. ROC curvewas established to analyze PSI, CURB-65, PCT and CRP levels for predicting the motality of HCAP patients.Results In the severe HCAP group, PSI and CURB-65 scoring and serum PCT, CRP, WBC, Neu% levels were significantly higher than those in the non-severe HCAP group( P lt; 0. 05) . In the high-risk HCAP group, PCT, CRP, WBC and Neu% levels were significantly higher than those in the low-risk HCAP group according to the PSI and CURB-65 scoring criteria( P lt;0. 05) .WBC and Neu% levels were also significantly higher than those in the moderate-risk group. PSI and CURB-65 scoring were positively correlated with PCT and CRP levels. PSI scoring gt;120 points or CURB-65 scoring gt;2 points on admission were predictors of mortality. Conclusions PSI and CURB-65 scoring are correlated with severity of HCAP. Combining serum PCT and CRP levels can improve the predictive accuracy of the severity of HCAP.
Objective To determine the effectiveness of statins in reducing C-reactive protein in patients with cerebral infarction and the potency of C-reactive protein as an indicator for preventing cerebrovascular events. Methods We searched PubMed, EMbase, Central Register of Controlled Trials, CBMdisc and CNKI from the date of establishment through August 2008. Bibliographies of the retrieved articles were also checked. Data was extracted and evaluated by two reviewers independently with a designed extraction form. The RevMan 5.0 software was used to carry out meta-analysis. Results Twenty-three randomized trials involving 1946 patients were included. The results of meta-analyses showed the following: statins reduced C-reactive protein compared to the control group (WMD= –5.79, 95%CI –7.32 to –4.26); statins were associated with a reduction of carotid intima-media thickness (IMT) (WMD= –0.21, 95%CI –0.25 to –0.17); atorvastatin greatly reduced C-reactive protein than the simvastatin control group (WMD= –1.78, 95%CI –3.92 to 0.36); statins were associated with a slight improvement in neurological deficit (OR= 2.22, 95%CI 0.94 to 5.21). Conclusion The evidence currently available shows that statins can reduce C-reactive protein and carotid IMT in the patients with cerebral infarction compared to the control group. However, it is not clear whether statins reducing C-reactive protein is correlated to the improvement of neurological deficit and prognosis. Similar trials in future should focus on the relationship between the change of C-reactive protein and clinical outcomes.
ObjectiveTo explore the association between C-reactive protein/albumin ratio (CAR) and prognosis of lung cancer patients.MethodsWe searched PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang and Chongqing VIP databases for eligible studies evaluating the predictive role of CAR for the prognosis in lung cancer from establishment of databases to November 30, 2018. The Stata 12.0 software was used to conduct the meta-analysis and the pooled hazard ratio (HR) was used to assess the association between CAR and prognosis of lung cancer.ResultsA total of 1 903 lung cancer patients from 6 retrospective studies were included in the current meta-analysis and all the patients were from Asian countries. The results showed that patients with elevated pretreatment CAR were significantly correlated with worse overall survival [HR=1.75, 95% confidence interval (1.53, 1.99), P<0.001] with low heterogeneity (I2=25.9%, P=0.240). Subgroup analyses based on the country, pathology and treatment further demonstrated above findings.ConclusionsElevated pretreatment CAR is a negative predictor for prognosis in Asian patients with lung cancer. More researches with big sample size and high quality from non-Asian countries are still needed to verify our results.
Objective To explore the value of fecal calprotectin （FCP） in the activity evaluation for ulcerative colitis （UC）. Methods Sixty three patients with UC （UC group） and 30 patients with gastrointestinal symptoms but without abnormal results of colonoscopy （control group）， who were treated in The Forth Affiliated Hospital of China Medical University between Sep. 2007 to Dec. 2009 were enrolled to examine the FCP， C-creative protein （CRP）， and erythrocyte sedimentation rate （ESR）. Then comparison between UC group and control group was performed. Results Levels of FCP and CRP in active gradeⅠ，Ⅱ， and Ⅲ group were all significantly higher than those of control group and inactive UC group （P＜0.05）， with the increase of active grade of UC， the level of FCP gradually increased （P＜0.05）. The levels of CRP in active grade Ⅱ and Ⅲ group were all significantly higher than those of gradeⅠgroup （P＜0.05）， but didn’t differed between active grade Ⅱ and Ⅲ group （P＞0.05）. There were no significant difference among 5 groups on ESR （P＞0.05）. Levels of FCP （rs=0.807， P＜0.01）， CRP（rs=0.651， P＜0.01）， and ESR （rs=0.371， P＜0.05） in active grade group were significantly related to histological grade under colonoscopy. Conclusion FCP examination is simple， inexpensive， repeatable， and noninvasive， and FCP can be used as an marker of activity evaluation in UC.
ObjectiveTo investigate the relationship between preoperative C-reactive protein (CRP)/albumin ratio (CAR) and National Institutes of Health (NIH) risk classification in patients with gastric stromal tumors.MethodsClinical data of 108 patients with gastric stromal tumors admitted to the First Affiliated Hospital of Kunming Medical University from February 2010 to November 2016 were retrospectively collected. With the median of CAR as the critical value, patients were divided into high CAR group (CAR>0.048) and low CAR group (CAR≤0.048). Then observed the general clinicopathological characteristics and survival status of patients with higher and lower CAR value.ResultsThere were significant differences in NIH classification, tumor diameter, and mitosis between the high CAR group and low CAR group (P<0.05). Compared with the low CAR group, the tumors in the high CAR group had larger diameter, higher mitotic figure, and higher NIH grade. Survival analysis showed that the prognosis of the low CAR group was better than that of the high CAR group (χ2=15.152, P<0.001).ConclusionsCAR is closely related to the malignant index and NIH risk classification of gastric stromal tumors. It can be used as an index for evaluating the malignant degree of gastric stromal tumors, and it is expected to be an important reference factor for clinical NIH risk classification and prognosis.
Objectives This study aims to examine the possible association between C-reactive protein (CRP) concentration and cognitive impairment in patients with post-stroke epilepsy. Methods Patients with post-stroke epilepsy admitted to Western China Hospital from January 2010 to June 2016 were consecutively enrolled in our study. CRP levels were assessed within one week of stroke onset, and then correlated with cognitive status assessed two years after stroke using the Six-Item Screener. Results Among the 96 patients with post-stroke epilepsy who included in our study, 24 patients were found to have cognitive impairment during the two years follow-up period. Our data showed a significant association between CRP levels and cognitive performance in these patients (31.5±36.2 vs. 11.9±19.4, P=0.029). In addition, this association persisted even after adjusting for potential confounders［OR=1.021, 95%CI (0.997, 1.206), P=0.037］. Conclusions Following ischemic stroke, higher CRP levels is associated with subsequent cognitive decline in patients with epilepsy. Association and prospective studies in larger sample size are needed in order to validate our findings, especially studies in which baseline CRP level and CRP level during follow-up are closely monitored.
ObjectiveTo explore the correlation of serum neutrophil gelatinase-associated lipocalin (sNGAL) with inflammatory response in patients with community-acquired pneumonia (CAP) and assess the diagnostic value of sNGAL for severe CAP (SCAP).MethodsFrom January 2018 to June 2019, a total of 85 patients with CAP were enrolled in this study. Age, length of hospital stay, the levels of serum creatinine, blood urea nitrogen, white blood cell count,C-reactive protein (CRP), interleukin-6 (IL-6), and procalcitonin, and CURB-65 score were compared between patients with SCAP (n=34) and patients without SCAP (n=51). The correlations of sNGAL with serum creatinine, blood urea nitrogen, white blood cell count, CRP, IL-6, procalcitonin, and CURB-65 score were assessed with Spearman’s correlation analysis. The area under the receiver operating characteristic (ROC) curve for sNGAL diagnosing SCAP was examined. ResultsCompared with patients without SCAP, SCAP patients demonstrated older age, longer hospital stay, higher serum CRP and IL-6 concentritions, and higher CURB-65 score (P<0.05). The Spearman’s correlation test showed that sNGAL was positively correlated with serum CRP, IL-6, PCT and CURB-65 score (rs=0.472, 0.504, 0.388, and 0.405, respectively; P<0.01). According to ROC analysis, the area under curve of sNGAL for diagnosing SCAP were 0.816, with a sensitivity of 76.56% and a specificity of 74.4% when the cut-off value was 171.0 ng/mL.ConclusionssNGAL concentration is positively correlated with the serverity of CAP. It can be regarded as a reliable indicator for diagnosis of SCAP in patients with CAP.
ObjectiveTo explore the association between frailty and in-hospital mortality in older patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Elderly patients who were hospitalized with AECOPD from June 2022 to December 2022 at a large tertiary hospital were selected. The independent prognostic factors including frailty status were determined by multivariate logistic regression analysis. Mediation effect analysis was used to evaluate the mediating relationships between C-reactive protein (CRP) and albumin and in-hospital death. ResultsThe training set included 1 356 patients (aged 86.7±6.6), 25.0% of whom were diagnosed with frailty. The multiple logistic regression analysis showed that frailty, mean arterial pressure, Charlson comorbidity index, neutrophil–lymphocyte ratio, interleukin-6, CRP, albumin, and troponin T were associated with in-hospital mortality. Furthermore, CRP and albumin mediated the associations between frailty and in-hospital mortality. ConclusionFrailty may be an adverse prognostic factor for older patients admitted with an AECOPD. CRP and albumin may be parts of mechanism between frailty and in-hospital death.