Correlations of Inflammatory Cytokines in the Intestinal Mucosa, Serum Inflammation, Oxidative Stresses and Immune Changes with Vitamin Deficiency in Ulcerative Colitis Patients.

Ulcerative colitis (UC) is a chronic inflammatory disease. Studies in China and foreign countries have shown that vitamins have anti-inflammation and immunoregulation functions in patients with UC, but the specific mechanism is not yet clear. In this study, the levels of inflammatory cytokines in the intestinal mucosa, serum inflammatory indexes, oxidative stress indexes and immune-related indexes were detected, and their correlations with vitamin deficiency and clinical significance were discussed. Enzyme-linked immunosorbent assay (ELISA) was adopted to detect the serum level of 25-hydroxyvitamin D3, immunohistochemistry was applied to examine the expression of inflammatory cytokines in the intestinal mucosa, serum inflammatory indexes, oxidative stress indexes and immune-related indexes were measured, and their correlations were analyzed. Inflammatory and oxidative stress indexes in the UC group were notably higher than in the control group. The Vitamin deficiency group had more inflammatory cytokines than the normal vitamin group. Oxidative stress indexes such as superoxide dismutase (SOD) and malondialdehyde (MDA) in the vitamin deficiency group were significantly different from those in the normal vitamin group, but no difference was found in myeloperoxidase (MPO). Immune-related indexes, complement 3 (C3) and interferon-gamma (IFN-γ), in the normal vitamin group were higher than those in the vitamin deficiency group. Besides, interleukin-4 (IL-4) (r=-0.37, p=0.04) and IL-1ß (r=-0.31, p=0.04) had significant correlations with vitamins. Vitamins in patients with UC have significant correlations with inflammatory responses in vivo, which can be used to predict inflammatory responses in vivo and have strong clinical significance. Vitamins are also related to oxidative stresses to some extent but have little effect on immune-related indexes.

[Comparison study of five scoring systems for evaluating prognosis of patients undergoing transjugular intrahepatic portosystemic shunt procedures].

OBJECTIVE: To compare the model for end-stage liver disease (MELD), delta model for end-stage liver disease (deltaMELD), MELD and serum sodium (MELD-Na), MELD score to serum sodium ratio index (MESO), and integrated end-stage liver disease model (iMELD) scoring systems for their utility in evaluating medium-short term prognosis of cirrhotic patients who underwent the transjugular intrahepatic portosystemic shunt (TIPS) procedure. METHODS: A total of 101 patients with liver cirrhosis who underwent the TIPS procedure between January 2011 and May 2013 were enrolled and followed-up for 1, 3 and 6 months.The MELD, deltaMELD, MELD-Na, MESO, and iMELD scores were assessed for each patient, according to the clinical data.The accuracy of the five scoring systems for predicting prognosis was analyzed and compared by the area under the receiver operating characteristic (ROC) curve. RESULTS: Scores according to the different systems, which were recorded up to the patients' follow-up cut-off times (without death) were:MELD:19.35 +/- 5.78, deltaMELD:2.47 +/- 1.38, MELD-Na:18.23 +/- 7.82, MESO:1.57 +/- 0.43, and iMELD:33.76 +/- 9.58).For the patients who died, the scores were:MELD:24.36 +/- 5.67, deltaMELD:4.35 +/- 1.61, MELDNa:28.54 +/- 8.06, MESO:2.16 +/- 0.59, and iMELD:48.05 +/- 12.64.The differences between these five scores in the death group showed statistical significance (all P less than 0.01).As the scores of MELD, deltaMELD, MELDNa, MESO and iMELD increased, the survival rate of the patients decreased correspondingly.The differences between the survival rate and survival curve of each group showed statistical significance (P less than 0.01).The area under the curve was 0.735 for MELD, 0.769 for deltaMELD, 0.803 for MELD-Na, 0.740 for MESO and 0.816 for iMELD, and the differences did not show statistical significance (P more than 0.05). CONCLUSION: The MELD and MELD-based scoring systems (deltaMELD, MELD-Na, MESO and iMELD), can all predict medium-short term prognosis well.These five scoring systems showed no statistically significant difference in their predictive value.