ABSTRACT
Objective:To investigate the effects of budegforo combined with doxofylline on inflammatory indexes, monocyte chemotactic protein 1 (MCP-1) and serum amyloid A protein (SAA) levels in patients with moderate and severe chronic obstructive pulmonary disease (COPD) during exacerbation period.Methods:The method of prospective study was adopted, 80 patients with moderate and severe COPD during exacerbation period who were treated in Gongan County People′s Hospital from January 2020 to December 2021 were selected as the research objects, and they were divided into the combined group and the budegforo group by random number table method, with 40 cases in each group. The budegforo group was treated with budegforo inhalation and the conventional maintenance therapy, the combined group was treated with doxofylline on the basis treatment of the budegforo group. The patients of the two groups were treated for 12 weeks. The clinical total effective rate and pulmonary function, inflammatory indexes and MCP-1, SAA levels before and after treatment and adverse reactions of the two groups were compared.Results:The clinical total effective rate in the combined group was higher than that in the budegforo group: 95.00%(38/40) vs. 75.00%(30/40), there was statistical difference ( χ2 = 4.80, P<0.05). After 12 weeks of treatment, the forced expiratory volume in one second (FEV 1), FEV 1 and forced vital capacity (FVC) ratio (FEV 1/FVC), percentage of FEV 1 in predicted value (FEV 1% pred), maximum voluntary ventilation (MVV), percentage of predicted value of diffusing capacity of the lung for carbon monoxide (DLCO% pred) in the combined group were higher than those in the budegforo group: (2.80 ± 0.56) L vs. (2.41 ± 0.27) L, (66.35 ± 8.20)% vs. (61.84 ± 9.77)%, (72.73 ± 7.57)% vs. (65.39 ± 5.41)%, (73.56 ± 7.06) L/min vs. (68.53 ± 6.25) L/min, (71.03 ± 5.85)% vs. (66.37 ± 7.08)%; residual volume (RV) to total lung capacity (TLC) ratio (RV/TLC) level was lower than that in the budegforo group: (45.32 ± 6.64)% vs. (51.73 ± 8.45)%, there were statistical differences ( P<0.05). After 12 weeks of treatment, the levels of interleukin(IL)-17, IL-22, MCP-1, SAA in the combined group were lower than those in the budegforo group: (21.46 ± 5.86) ng/L vs. (30.55 ± 8.74) ng/L, (155.62 ± 14.39) ng/L vs. (170.81 ± 16.70) ng/L, (89.57 ± 7.41) ng/L vs. (105.25 ± 8.70) ng/L, (45.21 ± 8.86) ng/L vs. (57.67 ± 7.16) ng/L, there were statistical differences ( P<0.05). There was no statistical difference in adverse reactions between the two groups ( P>0.05). Conclusions:The application of budegforo combined with doxofylline can improve the pulmonary function and clinical efficacy of patients with moderate and severe COPD during exacerbation period, and also play a positive role in reducing MCP-1 and SAA levels.
ABSTRACT
Objective To analyze the clinical characteristics of mycoplasma pneumoniae pneumonia(MPP)in children with atopic constitution and exploring the predictors of disease conditions.Methods A total of 250 children diagnosed with MPP in the Department of Pediatric Respiratory Medicine,Xinhua Hospital,Shanghai Jiaotong University School of Medicine from September 2019 to September 2022 were selected and divided into atopic group(n=149)and non-atopic group(n=101)according to whether they were atopic,to explore the clinical characteristics of MPP in children with atopic constitution and the risk factors of severe mycoplasma pneumoniae pneu-monia(SMPP).The efficacy of the combined test of lactate dehydrogenase(LDH),immunoglobulin E(IgE)and serum amyloid A(SAA)in predicting the development of SMPP in MPP children with atopic constitution was evaluated by the receiver operating character-istic(ROC)curve.Results Children in the atopic group had more pronounced symptoms of cough,wheezing,nasal congestion,croup,combined pleural effusion with severe pneumonia and the proportion requiring hormone therapy than those in the non-atopic group,and the differences were statistically significant(P＜0.05).Logistic regression analysis showed that serum IgE,SAA and LDH levels were in-dependent risk factors for the development of SMPP in MPP children with atopic constitution(P＜0.05);ROC curve analysis showed that the combined test of IgE,LDH and SAA could be used to predict the development of SMPP in MPP children with atopic constitution,with an area under the curve(AUC)of 0.881,sensitivity of 81.0％,and specificity of 85.0％.Conclusion MPP children with atopic con-stitution are more likely to develop SMPP and require hormone therapy.The combined detection of serum IgE,SAA and LDH can effec-tively predict the occurrence of SMPP in MPP children with atopic constitution.
ABSTRACT
Objective To evaluate the performance of two molecular point-of-care testing(POCT)prod-ucts in the diagnosis of influenza A virus(Flu A)and influenza B virus(Flu B)of clinical samples,and pre-liminarily evaluate the clinical diagnostic value of the changes of infection-related indicators in peripheral blood.Methods A total of 491 oropharyngeal swabs from patients with influenza-like symptoms who were treated in the hospital were recruited into this study from November 1,2019 to June 30,2023.These swabs were collected using reverse transcription real-time quantitative fluorescent polymerase chain reaction(RT-qPCR),and two POCT molecular products,XpertTM Xpress Flu/RSV and EasyNAT? Flu Assay,respectively.The diagnostic performance of two POCT molecular products was analyzed using RT-qPCR reaction as a standard.According to the results of RT-qPCR method,the subjects were divided into Flu A positive group,Flu B positive group and negative group(both Flu A and Flu B were negative).The levels of indicators in pe-ripheral blood of the three groups were compared to evaluate the value of these indicators in the clinical diag-nosis of Flu A and Flu B.Results Among the 491 patient specimens,the XpertTM Xpress Flu/RSV assay showed the sensitivity for Flu A was 96.88%,and the specificity was 99.75%,and the sensitivity for Flu B was 100.00%,and the specificity was 100.00%.EasyNAT? Flu Assay assay showed the sensitivity for Flu A was 94.79%,and the specificity was 96.81%,and the sensitivity for Flu B was 100.00%,and the specificity was 100.00%.And two POCT molecular methods performed well consistency(Kappa value was 0.974).There was no significant difference in the levels of C-reactive protein and serum amyloid A among the negative group,Flu A positive group,and Flu B positive group(P>0.05).But the levels of white blood cell count in the negative group were higher than those in the Flu A positive group and Flu B positive group(P<0.01).Conclusion In this paper,two typical molecular POCT products are studied.Their sensitivity and specificity are highly consistent with the results of RT-qPCR.Molecular POCT products have the advantages of flexibil-ity and rapidity,which are of great value for the improvement of clinical diagnosis and treatment.Molecular detection combined with peripheral blood infection related indicators is helpful for the early diagnosis of influ-enza virus infectious diseases.
ABSTRACT
Objective:To evaluate the predictive value of serum amyloid A (SAA) and neutrophil-lymphocyte ratio (NLR) for adverse pregnancy outcomes in patients with severe preeclampsia treated by multidisciplinary team.Methods:A total of 105 patients with severe preeclampsia admitted to the ICU of Hangzhou First People's Hospital from October 2014 to July 2022 were retrospectively enrolled. They were divided into the adverse pregnancy outcome group ( n = 62) and the non-adverse pregnancy outcome group ( n = 43) according to the pregnancy outcome. SAA, NLR and other laboratory indicators and related clinical data of all patients were collected within 24 h after admission. The general clinical data of the two groups were compared, and multivariate Logistic regression analysis was used to find the risk factors affecting adverse pregnancy outcome of patients with severe preeclampsia. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of SAA and NLR for adverse pregnancy outcomes in patients with severe preeclampsia treated by multidisciplinary team. Results:The ICU length of stay [4.00 (3.00, 5.00) vs. 3.00 (3.00, 4.00), P=0.022], acute physiology and chronic health evaluationⅡ (APACHEⅡ) score [9.00 (7.00, 11.25) vs. 7.00 (5.00, 9.00), P=0.002], white blood cell count [(12.29±4.25) vs. (10.41±4.00), P=0.025], SAA [37.85 (11.00, 72.83) vs. 9.00 (8.00, 20.70), P<0.001] and NLR [7.95 (5.22, 12.37) vs. 5.20 (3.25, 8.77), P=0.002] in the adverse pregnancy outcome group were higher than those in the non-adverse pregnancy outcome group. The gestational weeks [30.00 (26.75, 31.00) vs. 33.00 (32.00, 35.00), P<0.001], direct bilirubin [2.10 (1.50, 2.50) vs. 2.20 (1.90, 4.60), P=0.019] and alkaline phosphatase (99.00 (74.00, 124.25) vs. 133.00 (95.00, 188.00), P<0.001] levels in the adverse pregnancy outcome group were significantly lower than those in the non-adverse pregnancy outcome group ( P<0.05). Multivariate Logistic regression analysis showed that earlier gestational weeks ( OR=0.564, 95% CI: 0.408-0.780, P<0.001), higher SAA ( OR=1.028, 95% CI: 1.002-1.055, P=0.036) and APACHE Ⅱ score ( OR=1.282, 95%CI: 1.048-1.569, P=0.016) were the risk factors affecting adverse pregnancy outcomes in patients with severe preeclampsia. The area under the curve of SAA, NLR and SAA, NLR combined with APACHE Ⅱ score were 0.770, 0.678, and 0.844, respectively. The combined prediction efficiency of SAA, NLR and APACHE Ⅱ score was higher than that of single prediction ( P<0.05). Conclusions:SAA and NLR have good predictive efficacy for adverse pregnancy outcomes in patients with severe preeclampsia treated by multidisciplinary team. The predictive efficacy of SAA and NLR combined with APACHE Ⅱ score is higher than that of single index.
ABSTRACT
Objective:To explore the predictive value of inflammatory markers for convulsions in children infected with the severe acute respiratory syndrome coronavirus 2 Omicron variant.Methods:A total of 263 children infected with the Omicron variant admitted to various wards of Fujian Children′s Hospital from December 2022 to January 2023 were included in this study. Based on the presence or absence of convulsions, the children were divided into convulsions group (93 cases) and non-convulsions group (170 cases). Chi-square test and independent samples t-test were used to compare the clinical characteristics and laboratory indicators of the two groups. Binary logistic regression analysis was conducted to determine the relationship between inflammatory markers and convulsions, and receiver operator characteristic (ROC) curve was used to evaluate the efficacy of serum amyloid A (SAA) and interleukin-6 (IL-6) for predicting convulsions occurrence in children. Results:The convulsions group had proportions of 29.03%(27/93) with underlying medical conditions and 40.86%(38/93) with a history of febrile convulsions, which were both higher than the non-convulsions group′s proportions of 18.24%(31/170) and 5.29%(9/170), respectively. These differences were both statistically significant ( χ2=8.71 and 16.92, respectively, both P<0.05). In the convulsions group, levels of procalcitonin, serum ferritin, IL-6, SAA, aspartate aminotransferase, creatine kinase, creatine kinase-isoenzymes and fibrinogen were all significantly higher than those in the non-convulsions group. These differences were all statistically significant ( t=-2.00, -1.54, -2.71, -5.04, -1.30, -2.03, -1.38 and 1.57, respectively, all P<0.05). Erythrocyte sedimentation rate, C-reactive protein, lymphocyte count, blood urea nitrogen and serum creatinine in the convulsions group were all lower than those in the non-convulsions group, with statistically significant differences ( t=3.31, 2.05, 4.21, 2.37 and 1.85, respectively, all P<0.05). SAA and IL-6 were identified as independent risk factors for convulsions in children infected with Omicron variant (both P<0.01). The ROC curve analysis showed that the area under the curve of predictive value of combined SAA and IL-6 was 0.833 ( P<0.01), with a sensitivity of 0.724 and specificity of 0.843. The optimal cutoff values for SAA and IL-6 in predicting convulsions in children infected with the Omicron variant were 141.40 mg/L and 85.05 ng/L, respectively. Conclusions:The combination of SAA and IL-6 could serve as early predictive indicators for convulsions in children infected with the Omicron variant, which could provide valuable insights for timely clinical diagnosis and treatment.
ABSTRACT
ObjectiveTo observe the possible mechanism of Xixin Decoction （洗心汤， XXD） in the prevention and treatment of Alzheimer 's disease（AD）. MethodsFifty rapid aging model mice （SAMP8） were randomly divided into model group， probiotic group， high-， moderate- and low-dose group of XXD， with 10 mice in each group. Another 10 homologous anti-rapid aging mice （SAMR1） were set as control group. After 10 weeks of feeding， the control group and the model group were given 10 ml·kg-1·d-1 of distilled water by gavage， while the probiotic group （0.39 g·kg-1·d-1）， the high-dose group of XXD （5.08 g·kg-1·d-1）， the moderate-dose group of XXD （2.54 g·kg-1·d-1）， and the low-dose group of XXD （1.27 g·kg-1·d-1） were given corresponding drugs or decoctions by gavage， once a day in all groups. After 10 weeks of intragastric administration， Morris water maze was used to detect the spatial learning and memory ability of mice in each group. HE staining was used to observe the pathological changes of hippocampal CA3 region and colon. The levels of β-amyloid 1-42 （Aβ1-42）， lipopolysaccharide （LPS）， serum amyloid A （SAA） and acetylcholine （ACH） in hippocampus and colon were detected by ELISA.The diversity of intestinal flora in mouse feces was detected by 16S rRNA sequencing. ResultsCompared to those in the control group， the levels of Aβ1-42，LPS， SAA increased， while the level of ACH decreased in the model group （P＜0.05 or P＜0.01）. Compared to those in the model group， the escape latency period of the probiotic group was significantly shortened on the 2nd and 5th days， while the escape latency period was shortened， and the residence time in the target platform quadrant increased in the high-dose XXD group during the 2nd to 5th days； the escape latency period was shortened significantly in the moderate-dose XXD group on the 5th day （P＜0.05 or P＜0.01）. Compared to those in the model group， the hippocampal neuron cells in the high- and moderate-dose XXD groups were arranged more closely， with decreased levels of SAA， Aβ1-42 and LPS， increased ACH level， Simpson and Shannon index （P＜0.05 or P＜0.01）； the arrangement of hippocampal neuron cells in the probiotic group and the low-dose XXD group was relatively loose； the proportions of Bacteroidetes and Prevotella were significantly reduced in the probiotic group and the high-dose XXD group， while that of Firmicutes and Lactobacillus significantly increased （P＜0.05 or P＜0.01）. Compared to those in the probiotic group and the high-dose XXD group， the number of goblet cells in the moderate-dose XXD group decreased， and the number of glands in the low-dose XXD group decreased with atrophy. The high-dose XXD group had decreased Aβ1-42 level in the hippocampus， increased ACH level in thehippocampus and colon tissue， and decreased SAA in the colon tissue than the moderate- and low-dose XXD groups （P＜0.05 or P＜0.01）； moreover， the SAA level in the hippocampus was significantly higher in the low-dose XXD group than the high- and moderate-dose groups （P＜0.01）. ConclusionXXD can improve the spatial learning and memory ability of SAMP8， reduce the production and deposition of LPS， SAA and Aβ1-42 in brain and intestine， and increase the content of ACH. The mechanism of its prevention and treatment of AD maybe related to regulating intestinal microecology， affecting flora diversity and improving inflammatory response.
ABSTRACT
Objective:To investigate the correlation between sputum culture results and serum levels of C-reactive protein, amyloid A, and procalcitonin in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD).Methods:The clinical data of 131 older adult patients with AECOPD who received treatment in the Affiliated Hospital of Shaoxing University between January 2019 and January 2021 were retrospectively analyzed. According to sputum culture results, these patients were divided into a sputum culture positive group ( n = 52) and a sputum culture negative group ( n = 79). The sputum of patients was collected aseptically for isolation and identification of pathogens. The general data [age, gender, history of smoking, underlying diseases (hypertension, diabetes mellitus, coronary heart disease), albumin level, mechanical ventilation, method of sputum suction, duration of antibiotics medication, length of hospital stay] were recorded for each group. The risk factors for positive sputum culture were analyzed using binary logistic regression techniques. The efficiency of serum levels of C-reactive protein, amyloid A, and procalcitonin for predicting positive sputum culture was analyzed using the receiver operating characteristic curve. Results:There were 67 strains of pathogens isolated from 52 older adult patients with positive sputum culture of AECOPD. The main pathogens were Gram-negative bacteria (67.16%) [Klebsiella pneumonia (31.34%)], followed by Gram-positive bacteria (25.37%) and fungi (7.47%). Logistic regression analysis showed that mechanical ventilation ( OR = 2.75, P = 0.020), usage of broad-spectrum antibiotics ( OR = 2.95, P = 0.012), serum C-reactive protein level ≥ 20.96 mg/L ( OR = 2.44, P = 0.007), serum amyloid A level ≥ 18.03 mg/L ( OR = 2.67, P = 0.016) and serum procalcitonin level ≥ 2.08 μg/L ( OR = 2.51, P = 0.013) were independent risk factors of positive sputum culture in older adult patients with AECOPD. The receiver operating characteristic curve analysis showed that the area under the receiver operating characteristic curve depicting serum levels of C-reactive protein, amyloid A, and procalcitonin in combination for predicting AECOPD was 0.896, which is of predictive efficiency for positive sputum culture ( P < 0.05). Conclusion:The sputum culture pathogens in older adult patients with AECOPD are mainly Gram-negative bacteria. Increased serum levels of C-reactive protein, amyloid A, and procalcitonin are independent risk factors for Gram-positive bacteria. Combined detection of serum levels of C-reactive protein, amyloid A, and procalcitonin is highly efficient in the diagnosis of AECOPD and can be used to evaluate the sputum culture results in older adult patients with AECOPD.
ABSTRACT
Objective:To investigate the serum levels and clinical significance of Fc fragment of the IgG-binding protein (FCGBP), serum amyloid protein A1 (SAA1), and CXC chemokine ligand 10 (CXCL10) in children with mycoplasma pneumoniae pneumonia (MPP) and their relationship with prognosis.Methods:A prospective study was conducted on 122 children with MPP admitted to the department of pediatrics of the 970th Hospital of the Joint Logistics Support Force of the Chinese People′s Liberation Army from January 2019 to December 2021. According to the severity and prognosis of MPP, they were divided into mild and severe groups, good prognosis group, and poor prognosis group. Forty healthy children who underwent physical examination during the same period were set as the control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of FCGBP, SAA1, and CXCL10 in each subject, and to compare the differences in serum levels of FCGBP, SAA1, and CXCL10 among different groups. Multivariate logistic regression analysis was used to investigate the influencing factors of poor prognosis in MPP patients. The diagnostic value of individual and combined detection of serum procalcitonin (PCT), FCGBP, SAA1, and CXCL10 for poor prognosis in MPP children by analyzing the receiver operating characteristic (ROC) curve.Results:The levels of serum FCGBP [(115.68±10.57)ng/ml, (78.41±6.73)ng/ml, (12.55±3.25)ng/ml], SAA1 [(34.18±3.72)mg/L, (25.54±2.63)mg/L, (6.74±0.82)mg/L], and CXCL10 [(714.26±55.64)ng/L, (353.74±42.67)ng/L, (106.25±12.92)ng/L] in the severe MPP group were significant higher than those in the mild MPP group and the control group, with statistical significance (all P<0.05). The white blood cell (WBC), neutrophil percentage, C reactive protein (CRP), erythrocyte sedimentation rate (ESR), PCT, lactate dehydrogenase (LDH), D-dimer (D-D), FCGBP, SAA1, CXCL10 of the children in the poor prognosis group were significantly higher than those in the good prognosis group, and the differences were statistically significant (all P<0.05). Multivariate logistic regression analysis showed that increased PCT ( OR=1.603, 95% CI: 1.190-2.160), FCGBP ( OR=1.757, 95% CI: 1.115-2.770), SAA1 ( OR=1.900, 95% CI: 1.327-2.720) and CXCL10 ( OR=1.704, 95% CI: 1.212-2.397) were independent risk factors for poor prognosis of MPP children (all P<0.05). The combined detection of serum PCT, FCGBP, SAA1, and CXCL10 had a significantly higher diagnostic value for the risk of poor prognosis in children with MPP than a single indicator. Conclusions:The elevated levels of serum FCGBP, SAA1, and CXCL10 in children with MPP are associated with the severity of MPP and are independent risk factors for poor prognosis in MPP patients.
ABSTRACT
Objective:To investigate the level and significance of CD64 index, matrix metalloproteinase-9 (MMP-9) and serum amyloid A (SAA) in peripheral blood of patients with severe carbapenem resistant Enterobacteriaceae (CRE) infection.Methods:A total of 61 patients with severe CRE infection who were admitted to the neurosurgery department of Kashgar First People′s Hospital from January 2019 to January 2022 were selected as the CRE group, and 100 patients with severe carbapenem sensitive Enterobacteriaceae (CSE) infection were selected as the CSE group. The difference in clinical data between the two groups was compared, and the difference in clinical data between the dead and surviving patients in the CRE group was compared. The value of CD64 index, MMP-9 and SAA in differential diagnosis of CRE was analyzed. Logistic regression was used to analyze the influencing factors of prognosis in patients with CRE infection.Results:The age, hypertension, lung disease, liver and kidney disease, comorbidities≥2, antibiotic use≥2 combinations, antibiotic use time>10 days, proportion of carbapenem use, CD64 index, MMP-9, and SAA of the CRE group patients were significantly higher than those of the CSE group patients (all P<0.05). The area under the receiver operating characteristic (ROC) curve for CD64 index, MMP-9, and SAA differential diagnosis of CRE was 0.857, 0.701, and 0.655, respectively (all P<0.05). In the CRE group, the age , the score of Acute Physiological and Chronic Health Status Ⅱ (APACHE Ⅱ) score at admission, diabetes, liver and kidney diseases, comorbidities≥2, the proportion of carbapenems, CD64 index, MMP-9 and SAA of dead patients were significantly higher than those of survivors (all P<0.05). Logistic regression analysis showed that age, APACHE Ⅱ score at admission, comorbidities≥2, CD64 index, MMP-9, and SAA were influencing factors for the prognosis of severe CRE patients (all P<0.05). Conclusions:The peripheral blood CD64 index, MMP-9, and SAA have certain application value in the diagnosis of neurological severe CRE infection, and are also influencing factors for the prognosis of CRE infected patients.
ABSTRACT
ABSTRACT Objective To compare serum amyloid A concentrations between overweight and eutrophic children and adolescents and to relate it to lipid profiles, glucose tolerance, and carotid intima-media thickness. Methods One hundred children and adolescents (mean age: 10.8±3.16 years) were included and divided into two groups: overweight and non-overweight. The following were evaluated: Z-score body mass index, carotid intima-media thickness, lipid metabolism biomarkers (lipid profile and apolipoproteins A1 and B), inflammatory biomarkers (ultra-sensitive C-reactive protein and serum amyloid A), and glucose homeostasis model assessment of insulin resistance. Results The groups were homogeneous in age, sex, and pubertal stage. Higher levels of triglycerides, apolipoprotein B, homeostasis model assessment of insulin resistance, ultrasensitive C-reactive protein, serum amyloid A, and carotid intima-media thickness were observed in the overweight group. In the multivariate analysis, age (OR=1.73; 95%CI: 1.16-2.60, p=0.007), Z-score body mass index (OR=3.76; 95%CI: 1.64-8.59, p=0.002), apolipoprotein-B (OR=1.1; 95%CI: 1.01-1.2, p=0.030), and carotid intima-media thickness (OR=5.00; 95%CI: 1.38-18.04, p=0.014) were independently associated with serum amyloid A levels above the fourth quartile of the studied sample (>9.4mg/dL). Conclusion Overweight children and adolescents had higher serum amyloid A concentrations than eutrophic children. There was an independent association between higher concentrations of serum amyloid A and Z-score, body mass index, apolipoprotein B, and carotid intima-media thickness, indicating the importance of this inflammatory biomarker in identifying the early risk of atherosclerosis.
ABSTRACT
Introducción la amiloidosis es una enfermedad rara, producto del plegamiento y depósito normal de proteínas en tejidos y órganos. Esta enfermedad puede tener un compromiso renal que se manifiesta con síndrome nefrótico y deterioro de la función renal y su etiología puede estar asociada a amiloidosis con compromiso sistémico, siendo la amiloidosis AL y la amiloidosis AA las más frecuentes, esta última está asociada a inflamación crónica grave de origen infecciosa o autoinmune. Para el diagnóstico es fundamental el estudio sistémico multidisciplinario (hematológico, cardiaco, autoinmune, infeccioso y neoplásico), y cuando hay compromiso renal: la biopsia con estudio completo de microscopía de luz, tinciones especiales incluyendo rojo congo, inmunofluorescencia y microscopía electrónica. Cuando no se logra establecer la causa, la espectrometría de masas es una ayuda crucial para el diagnóstico específico. Objetivo se presenta el caso de un paciente con un proceso inflamatorio crónico grave abdominal que evolucionó a síndrome nefrótico por amiloidosis AA, donde la espectrometría de masas ayudó a aclarar el diagnóstico. Presentación del caso se presenta el caso de un paciente con un proceso inflamatorio crónico grave abdominal que evolucionó a síndrome nefrótico por amiloidosis AA, donde la espectrometría de masas ayudó a aclarar el diagnóstico Discusión y conclusiones se considera que la espectrometría de masas es un estudio diagnóstico muy importante para establecer el diagnóstico etiológico de la amiloidosis cuando otros métodos no han logrado establecerlo.
Introduction Amyloidosis is a rare disease, resulting from the accumulation and deposition of insoluble proteins in tissues or organs. This disease may involve the kidney, resulting in nephrotic syndrome and renal failure. The amyloidosis has been associated with systemic involvement, with AL amyloidosis and AA amyloidosis being the most common. The last is associated with various inflammatory disorders as chronic infections and autoimmune diseases. A multidisciplinary approach is required to the diagnosis (hematologic, cardiac, autoimmune, infectious, neoplastic) and in cases of renal involvement, a kidney biopsy with complete study of light microscopy, special stains including congo red, immunofluorescence, electron microscopy is essential for diagnosis. In cases where the cause cannot be stablished, mass spectrometry is practical tool to the identification of the correct type of amyloidosis. Purpose Here, we present a patient with a chronic and severe abdominal inflammatory process that progressed to a nephrotic syndrome due to AA amyloidosis, in which mass spectrometry helped to clarify the diagnosis. Case presentation Here, we present a patient with a chronic and severe abdominal inflammatory process that progressed to a nephrotic syndrome due to AA amyloidosis, in which mass spectrometry helped to clarify the diagnosis Discussion and conclusion Mass spectrometry is considered a useful diagnostic test to confirm the etiology of amyloidosis, especially if other methods are insufficient to establish it.
ABSTRACT
Neonatal infection related diseases are the main causes of neonatal death and disability.Traditional inflammatory factors, such as peripheral blood leucocyte count, C-reactive protein and procalcitonin play an important role in indicating neonatal infectious diseases.However, its sensitivity, specificity and effectiveness still need to be improved.Many studies have shown that the expression of serum amyloid A(SAA)increase significantly in various infectious diseases of neonates, and it has received more and more attention as a new type of infection-related indicator.This article reviews the research progress on the structural characteristics of serum amyloid A, detection methods and its clinical application in various neonatal infectious diseases, follow-up of disease changes, guidance of antibiotic use and evaluation of prognosis.
ABSTRACT
Objective:To investigate the predictive role of dynamic changes of plasma biomarkers in patients with viral and mycoplasma community-acquired pneumonia (CAP).Methods:From January 2020 to June 2020, 141 patients with viral and mycoplasma CAP in People's Hospital of Ningxia Hui Autonomous Region were enrolled. Pneumonia severity index (PSI) scores [grade Ⅰ-Ⅱ(PSI score ≤ 70), grade Ⅲ (PSI score 71-90) and grade Ⅳ-Ⅴ(PSI score ≥ 91)], serum amyloid A (SAA), hypersensitive C-reactive protein (hs-CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) on the 1 day after admission were compared between the different pathogens (viral and mycoplasma) or different disease severity. The change in level of SAA, hs-CRP on the third day (Δ 3 d = 1 d-3 d) were compared among different disease outcome groups (patients were divided into improved group, stable group and exacerbation group based on PSI scores or lung CT images on the third day). The change in the level of SAA, hs-CRP on the seventh day (Δ 7 d = 1 d-7 d) were compared among different disease prognosis groups (patients were divided into survival group and death group based on 28-day survival data). The receiver operating characteristic curve (ROC) were drawn to evaluate the value of SAA in the evaluation of disease and prediction prognosis. Results:The level of SAA in mycoplasma group (43 cases) was significantly higher than that in virus group (98 cases) on the 1 day after admission. There were no significant differences in other plasma biomarkers between the two groups. The more severe the illness, the higher the SAA level on the 1 day after admission. The trends of other plasma biomarkers in the two groups were consistent with SAA. The levels of SAA in the patients with exacerbation of the virus group and mycoplasma group (12 cases, 9 cases) were significantly higher than those of the improved group (57 cases, 26 cases) and the stable group (29 cases, 8 cases). SAA increased gradually in the exacerbation group, decreased gradually in the improved group, and slightly increased in the stable group. ΔSAA 3 d were differences among three groups. The change trend of hs-CPR was consistent with SAA. The level of SAA in the death group was higher than that in the survival group on the seventh day. SAA increased in the death group and decreased in survival group with time from hospital admission. There were differences according to ΔSAA 7 d between death group and survival group. The change trend of hs-CPR was consistent with SAA. ROC curve showed that the value of SAA was better than hs-CRP in assessing the severity of patients on admission day, and the area under ROC curve (AUC) was respectively 0.777 [95% confidence interval (95% CI) was 0.669-0.886], 0.729 (95% CI was 0.628-0.830). The value of ΔSAA 3 d was better than SAA on the third day predicting disease trends, and AUC was respectively 0.979 (95% CI was 0.921-1.000), 0.850 (95% CI was 0.660-1.000). hs-CRP on the third day and Δhs-CRP 3 d had no predictive value. Both SAA on the seventh day and ΔSAA 7 d have predictive value for prognosis. AUC was respectively 0.954 (95% CI was 0.898-0.993) and 0.890 (95% CI was 0.689-1.000). SAA on the seventh day and ΔSAA 7 d were better than hs-CRP on the seventh day. Δhs-CRP 7 d have no predictive value. Conclusions:SAA is a sensitive and valuable indicator for CAP patients with viruses and mycoplasma. Dynamic monitoring of SAA can evaluate the patient's progression, prognosis, and assist diagnosis and treatment.
ABSTRACT
Objective:To investigate the predictive value of serum amyloid A/albumin (SAA/ALB) in the activity and prognosis of systemic lupus erythematosus (SLE).Methods:97 SLE patients initially diagnosed in Jincheng People′s Hospital from January 2018 to December 2020 were selected. According to whether the SLE disease activity index (SLE-DAI) was ≥5, SLE patients were divided into active and stable periods. The clinical data of active and stable SLE patients were compared. The independent influencing factors of active SLE were analyzed by logistic regression. The predictive value of SAA, ALB, SAA/ALB on active SLE and severe active SLE was analyzed by receiver operating characteristic(ROC) curve; Kaplan Meier survival curve was used to analyze the prognosis of patients with different SAA/ALB.Results:There were 97 SLE patients, including 64 in active phase and 33 in stable phase.Compared with the stable phase, the SLE-DAI, alanine aminotransferase (ALT) and α-Hydroxybutyrate dehydrogenase (α- HBDH), lactate dehydrogenase (LDH), SAA, SAA/ALB≥0.52 mg/g, urinary microalbumin/creatinine (ACR) in SLE patients of active phase were all higher, while the ALB, albumin/globulin (A/G) and complement (C3) levels were all lower, with statistically significant difference (all P<0.05). LDH, SAA/ALB ≥0.52 mg/g, A/G≥1.18 and C3≥0.60 g/L were all independent influencing factors of active SLE, and the OR were 1.321, 1.401, 0.744 and 0.663 respectively (all P<0.05). The area under the curve (AUC) of SAA and SAA/ALB in predicting active SLE were 0.755 and 0.861, respectively. AUC SAA/ALB>AUC SAA, with statistically significant difference ( P<0.05). The AUC of ALB in predicting stable SLE was 0.743. The AUC of SAA and SAA/ALB in predicting severe active SLE were 0.699 and 0.746, respectively. AUC SAA/ALB>AUC SAA, with statistically significant difference ( P<0.05). The AUC of ALB in predicting non severe active SLE was 0.671. Among the 64 active SLE patients, 21 had poor prognosis. The AUC of poor prognosis predicted by SAA/ALB was 0.736, and the best cut-off value was 0.78 mg/g. There was significant difference in the duration of remission between the high and low SAA/ALB groups (χ 2=6.507, P<0.05). Conclusions:SAA/ALB ≥0.52 mg/g was an independent factor for active SLE. SAA/ALB had a high predictive value for active SLE, severe active SLE and poor prognosis.
ABSTRACT
@#To explore the effects of serum amyloid A (SAA) on the cognitive function and tau phosphorylation in Alzheimer''s disease (AD), two mouse models of AD were constructed: one is the APP/PS1 double transgenic mice mated with the Saa3 knockout (Saa3-/-) mice, and the other involves intracerebroventricular (ICV) injection of streptozotocin (STZ) into WT and Saa3-/- mice.The expression of Saa3 in mouse brain was evaluated using immunofluorescence staining.The body weight of STZ injection mice during modeling was measured.The motor coordination and balance, spontaneous exploratory activity, and anxiety level of these mice were assessed by Rotarod test, open field, and elevated plus maze, respectively.Spatial reference learning and memory were evaluated by Morris water maze.Western blot was used to detect the phosphorylation level of tau protein in mouse brain tissue.The results showed that the expression of Saa3 was increased in the brain of AD mice.The Saa3 gene deletion had no significant effect on motor coordination, balance and spontaneous exploratory activity in these mice, yet with alleviated anxiety level of AD model mice.Saa3 deficiency improved the impairment of learning and memory function of intracerebroventricular STZ injection mice and APP/PS1 mice. Deletion of Saa3 relieved the hyperphosphorylation of tau protein at specific sites in the brain of AD mice. The difference between the groups was statistically significant (P < 0.05). These results suggest that Saa3 is associated with cognitive function and tau pathology in AD, and that the inhibition of SAA may be a new strategy for the treatment of AD.
ABSTRACT
Abstract Background Psoriasis is a chronic systemic inflammatory disease frequently associated with serious comorbidities. Objectives To investigate the systemic inflammatory burden in psoriasis and to assess the correlation between traditional and novel inflammatory markers and the severity of the disease. Methods This cross-sectional study was conducted on 60 patients with psoriasis vulgaris and 50 healthy volunteers. Data including demographics, Psoriasis Area and Severity Index scores, and laboratory results were analyzed and compared. Results Compared with the control group, the psoriatic patients had significantly higher high sensitive C-reactive protein, serum amyloid A, erythrocyte sedimentation rate, leukocyte, neutrophil, neutrophil-to-lymphocyte ratio, monocyte to high density lipoprotein (HDL) cholesterol ratio, and aspartate aminotransferase levels, and significantly lower HDL cholesterol levels (p < 0.05). No significant difference was found in procalcitonin, lymphocyte, monocyte, hemoglobin, red blood cell distribution width, platelet, mean platelet volume, platelet distribution width, lymphocyte-to-monocyte ratio, anti-cyclic citrullinated peptide, glucose, alanine aminotransaminase, blood urea nitrogen, creatinine, triglyceride, total cholesterol, and LDL cholesterol levels between the two groups (p > 0.05). The Psoriasis Area and Severity Index score was positively correlated with high-sensitivity C-reactive protein, serum amyloid A, and monocyte to HDL cholesterol ratio, and negatively correlated with lymphocyte-to-monocyte ratio (p < 0.05). Study limitations This was a single-center study with relatively limited numbers of patients and controls. Conclusions The data show that high sensitivity C-reactive protein, serum amyloid A, erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio, and monocyte to HDL cholesterol ratio can be used as markers of systemic inflammation in patients with psoriasis. Moreover, high sensitivity C-reactive protein, serum amyloid A, monocyte to HDL cholesterol ratio and lymphocyte-to-monocyte ratio are closely related to the Psoriasis Area and Severity Index score, and they may be regarded as objective indicators in determining the disease severity.
Subject(s)
Humans , Psoriasis , Monocytes , Biomarkers , Cross-Sectional Studies , Cholesterol, HDLABSTRACT
@#To investigate the effect of serum amyloid A (SAA) on microglial migration and its mechanism,the migration ability of SAA-induced primary microglia and murine N9 microglia,and the effect of formyl peptide receptor 2 (FPR2) antagonist and TLR2 neutralizing antibody on SAA-induced migration of N9 microglia were all examined by Transwell assay. The expression changes of FPR2 and Toll-like receptor 2 (TLR2) in N9 microglia after SAA stimulation were detected by real-time PCR. The effect of SAA on the expression of downstream signaling pathway kinases in N9 microglia was detected by Western blot. The effect of signaling pathway inhibitors on SAA-induced N9 microglial migration was examined by Transwell assay. The results showed that SAA promoted the migration of primary microglia and N9 microglia in a concentration-dependent manner. FPR2 antagonist and TLR2 neutralizing antibody inhibited SAA-induced N9 cell migration. SAA promoted increased mRNA transcript levels of FPR2 and TLR2 in N9 microglia,and stimulated the activation of mitogen-activated protein kinases (MAPKs) and nuclear factor κB (NF-κB) signaling pathways in N9 microglia,as shown by increased extracellular regulated protein kinase (ERK),p38 and c-Jun N-terminal kinase (JNK) phosphorylation levels and decreased IκBα expression levels. Inhibitors of p38,JNK,and NF-κB signaling pathways inhibited SAA-induced migration of N9 microglia. The difference between the groups was statistically significant (P<0.05). These results indicate that SAA activates downstream p38,JNK,and NF-κB signaling pathways by acting on FPR2 and TLR2,thereby inducing microglia migration.
ABSTRACT
Objective@#Understand the clinical characteristics of confirmed pneumonia patients infected with new corona virus in secondary epidemic areas and guide the diagnosis and treatment of novel pneumonia in secondary epidemic areas and provide a reference for clinical prevention and control of the epidemic situation.@*Methods@#The clinical data of 33 patients admitted with pneumonia caused by a novel coronavirus in the Second Affiliated Hospital of Wenzhou Medical University from January 15 to February 1, 2020, were retrospectively reviewed. At the onset of the disease, we analyzed the primary symptoms such as fever, cough, fatigue, chest tightness, chest pain and also a significant blood test results of the patients. According to the patient's contact history, it was divided into the direct infection group of the main epidemic area and the indirect contact infection group of the main epidemic areas. The difference between clinical manifestations among the two groups was analyzed.@*Results@#The main clinical symptoms of patients with novel coronavirus pneumonia in the secondary epidemic area were respiratory tract and systemic symptoms. After grouping according to the presence and absence of direct contact in the main epidemic area, there was no significant difference in baseline data between the two groups, and there was no significant difference in symptoms and signs between the two groups (P < 0.05). Some patients had serum amyloid protein (SAP) increased abnormall.@*Conclusions@#The respiratory tract and systemic symptoms are the primary symptoms of the patients with the new type of coronavirus pneumonia in the secondary epidemic area, which are not typical. The abnormal increase of serum amyloid protein (SAA) may be used as an auxiliary index for diagnosis and treatment.
ABSTRACT
Objective@#To explore the Expressions of multiple inflammation markers in the patients with 2019 novel coronavirus pneumonia (COVID-19) and their clinical values, and to provide theoretical basis for clinical diagnosis and treatment.@*Methods@#A total of 164 patients, diagnosed with COVID-19 and admitted to Guangzhou Eighth People's Hospital from January to February 2020, were selected as the research group and divided into three groups (ordinary, severe, and critically severe pneumonia) according to the disease severity. Meandwhile 66 non-infected patients during the same period were selected as negative control group. The expressions of WBC, LYM, CRP, SAA, and PCT were retrospective studied and compared between groups. The diagnostic values of WBC, CRP, SAA and the combination of these three markers in all patients with COVID-19 and in different severity groups were analyzed by ROC curve.@*Results@#Compared with control group (WBC count :8.13(6.51,9.42)×109/L, LYM count:2.00(1.28,2.43)×109/L), WBC count [4.94(4.05, 6.67) ×109/L] and LYM count [1.33(0.94, 1.96) ×109/L] of COVID-19 patients were significantly reduced (Z=-7.435, P<0.01; Z=-4.906, P<0.01) . Compared with the control group [CRP: 1.36 (0.57~5.67) mg/ml; SAA:[4.98 (4.80~15.75) mg/mL], CRP [7.93 (2.45~23.98) mg/ml] and SAA [34.13 (4.83~198.40) mg/ml] were increased in research group (Z=-5.72, P<0.01; Z=-4.166, P<0.01) . PCT in the control group and the research group were 0.100 0(0.030 6~0.100 0)ng/ml and 0.044 5(0.031 6~0.077 0)ng/ml, respectively. There was no statistical difference between two groups (Z=-1.451, P=0.147) . The areas under the ROC curve (AUC) of WBC, CRP and SAA in patients with COVID-19 were 0.814, 0.742, 0.673, respectively (P<0.01), while the AUC of the combination of three indexes for COVID-19 diagnosis was 0.882, with 83.33%(55/66) specificity and 84.76% (139/164) sensitivity, P<0.01.The AUCs of WBC, CRP, and SAA for predicting severe and critically severe COVID-19 were 0.799, 0.779, and 0.886 , respectively (P<0.01), and the AUC of the combination of three indexes for the diagnosis of severe and critically severe COVID-19 was 0.924, with 78.67% (118/150) specificity and 14/14 sensitivity (P<0.01).@*Conclusion@#Combining detection of WBC, CRP and SAA can improve the specificity and sensitivity of COVID-19 diagnosis, with a high diagnostic value for severe and critically severe COVID-19.
ABSTRACT
This study aimed to investigate the predictive factors for uveitis recurrence (UR) risk in Behcet's disease (BD) patients. BD patients (n=164) with a history of uveitis were recruited, and demographic data, clinical features, and laboratory tests were recorded. Uveitis was defined as anterior uveitis, intermediate uveitis, posterior uveitis, panuveitis referring to the "International Uveitis Study Group recommendations for the evaluation of intraocular inflammatory disease". In total, there were 70 UR patients and 94 non-UR patients. Compared to non-UR patients, UR patients appeared to be older and presented with increased uveitis occurrence rate and times within 3 months, oral ulcers occurrence rate, as well as higher concentrations of triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), and serum amyloid A (SAA). Multivariate logistic model disclosed that uveitis occurrence times within 3 months, oral ulcers, TG, LDL, and SAA independently predicted higher risk of UR. Furthermore, receiver operating characteristic curve analysis showed that the combination of uveitis occurrence times within 3 months, oral ulcers, TG, LDL, and SAA exhibited a high predictive value for UR risk with an area under the curve of 0.983 (95%CI: 0.969−0.998). In conclusion, uveitis occurrence times within 3 months, oral ulcers, TG, LDL, and SAA might be potential predictive factors for UR risk in BD patients, which can help in prevention and management of the disease.