Research on the application and effect of flipped-classroom combined with TBL teaching model in WeChat-platform-based biochemical teaching under the trend of COVID-19.

BACKGROUND: Biochemistry is a core subject in clinical medical education. The traditional classroom teaching model led by teachers is often limited to the knowledge transfer of teachers and the passive acceptance of students. It lacks interactive and efficient teaching methods and is not enough to meet the learning needs and educational goals of modern students. The combination of WeChat public platform, flipped classroom and TBL teaching model is closer to the needs of real life and workplace, helping students to cultivate comprehensive literacy and the ability to solve practical problems. At the same time, this teaching model has yet to be used in biochemistry courses. OBJECTIVE: To explore the influence of the mixed teaching model of flipped classroom and combining TBL based on WeChat public platform upon undergraduates in biochemistry. METHODS: Using the mixed research method of quasi-experimental research design and descriptive qualitative research, 68 students were selected into the traditional and the blended teaching groups. Among them, the blended teaching group adopts the blended teaching model of flipped classroom combined with TBL based on the WeChat platform to learn biochemical courses. In this study, an independent sample t-test was intended to analyze the differences in final scores, a chi-square test was served to analyze the differences in satisfaction questionnaires, and thematic analysis was used to analyze semi-structured interview data. RESULTS: Compared with the traditional teaching model, the mixed teaching model significantly improved students' final exam scores (P < 0.05). The teaching satisfaction of the mixed teaching group was also higher than that of the traditional teaching group with statistical significance (P < 0.05). The results of the interviews with eight students were summarized into three topics: (1) Stimulating interest in learning; (2) Improving the ability of autonomous learning; (3) Recommendations for improvement. CONCLUSIONS: The combination of the WeChat platform and flipped classroom with TBL has a positive effect on improving medical students' autonomous learning ability and problem-solving ability. The research shows that the teaching mode of flipped classroom combined with TBL based on the WeChat platform is effective and feasible.

Development and Validation of a Delirium Risk Prediction Model for Elderly Patients Undergoing Elective Orthopedic Surgery.

Purpose: This study aimed to develop and validate a post-operative delirium (POD) nomogram in a population of elderly patients undergoing elective orthopedic surgery. Patients and Methods: A predictive model was developed based on a training dataset of 474 elderly patients undergoing elective orthopedic surgery from March 2021 to May 2022. POD was identified using the Confusion Assessment Methods (CAM). The least absolute shrinkage and selection operator (LASSO) method was used to screen risk factors, and prediction models were created by combining the outcomes with logistic regression analysis. We employ bootstrap validation for internal validation to examine the model's repeatability. The results were validated using a prospective study on 153 patients operated on from January 2022 to May 2022 at another institution. Results: The predictors in the POD nomogram included age, the Mini-Mental State Examination(MMSE), sleep disorder, neurological disorders, preoperative serum creatinine (Pre-SCR), and ASA classification. The c-index of the model was 0.928 (95% confidence interval 0.898 ~ 0.957) and the bootstrap validation still achieved a high c-index of 0.912. The c-index of the external validation was 0.921. The calibration curve for the diagnostic probability showed good agreement between prediction by nomogram and actual observation. Conclusion: By combining preoperative and intraoperative clinical risk factors, we created a POD risk nomogram to predict the probability of POD in elderly patients who undergo elective orthopedic surgery. It could be a tool for guiding individualized interventions.

Effect of Subanesthetic Dose of Esketamine on Perioperative Neurocognitive Disorders in Elderly Undergoing Gastrointestinal Surgery: A Randomized Controlled Trial.

Background: Perioperative neurocognitive disorders (PND), including delayed neurocognitive recovery (dNCR) and postoperative cognitive dysfunction (POCD), are common postoperative complications in elderly patients and adversely affect their prognosis. The study was designed to explore the effects of esketamine on postoperative cognitive function in elderly patients who underwent gastrointestinal surgery under general anesthesia and its potential mechanism. Methods: Eighty-four patients aged 65 and above undergoing gastrointestinal surgery were randomly divided into 2 groups: the esketamine group (group S) and the control group (group C). Group S received intravenous sub-anesthetic doses of esketamine (0.15 mg/kg) 5 minutes before the initiation of surgery, while group C received the same volume of saline. A battery of neuropsychological tests was used to assess cognitive function before surgery, 7 days, and 3 months after surgery. The primary outcome was the incidence of dNCR at 7 days postoperatively and POCD at 3 months postoperatively in both groups. The secondary outcome measures included changes in the levels of serum interleukin-6 (IL-6) and calcium-binding protein ß (S100ß) before and 1 day after surgery. Results: The incidence of dNCR in group S was lower than that of group C (18.15% vs 38.24% P=0.033). Contrarily, there was no difference in both groups regarding POCD 3 months postoperatively (6.06% vs 14.37% P=0.247). Plasma IL-6 and S100ß levels were significantly elevated in both groups on postoperative day 1 (p<0.05), but esketamine pretreatment reduced these levels to some extent compared with group C (p<0.05). Conclusion: Sub-anesthetic doses of esketamine might reduce the incidence of dNCR and improve early postoperative cognitive function in elderly patients undergoing gastrointestinal surgery, which might be related to the anti-neuroinflammation effects of esketamine.

An emission-free controlled potassium pyrosulfate roasting-assisted leaching process for selective lithium recycling from spent Li-ion batteries.

Recycling critical metals from spent Li-ion batteries (LIBs) is important for the overall sustainability of future batteries. This study reports an improved sulfation roasting technology to efficiently recycle Li and Co from spent LiCoO2 LIBs using potassium pyrosulfate as sulfurizing reagent. By sulfation roasting, LiCoO2 was converted into water-soluble lithium potassium sulfate and water-insoluble cobalt oxide. Under optimal conditions, 98.51% Li was leached in water, with a selectivity of 99.86%. More importantly, sulfur can be recirculated thoroughly, and the sulfur atomic efficiency can be significantly enhanced by controlling the amount of potassium pyrosulfate. Li ions from the water leaching process were recovered by chemical precipitation. Furthermore, application of this technology to other spent LIBs, such as LiMn2O4 and LiNi0.5Co0.2Mn0.3O2, verified its effectiveness for selective recovery Li. These findings can provide some inspiration for high efficiency and environmentally friendly recovery metal from spent LIBs.

ABCA7 rs3764650 Polymorphism is Associated with Delayed Neurocognitive Recovery.

Background: Several studies have shown that ATP-binding cassette transporter A7 (ABCA7) gene variation is associated with cognitive impairment. This study was aimed to investigate the relationship between ABCA7 rs3764650 polymorphism and perioperative neurocognitive disorder (pNCD). Methods: A total of 132 elderly patients aged 65 and over who underwent elective non-cardiac surgery were enrolled in the study, while 28 healthy volunteers matching age and sex were recruited as the control group. A battery of neuropsychological tests was conducted 1 day before, 7 days, and 3 months after surgeries. Delayed neurocognitive recovery (dNCR) and postoperative mild or major neurocognitive disorder (POCD) were determined using the Z value method. The venous blood sample of the surgical patients was taken before the operation. Genotyping of rs3764650 was performed using polymerase chain reaction amplification and restriction fragment length polymorphism analysis. Results: The incidences of dNCR and POCD were 29.7% and 16.8% at 7 days and 3 months after surgery, respectively. The G allele frequency and GG frequency of dNCR patients were significantly higher than that of non-dNCR patients (43.3% vs 28.2%, P=0.035; 23.3% vs 4.2%, P=0.013, respectively) at 7 days following surgery. No significant differences in ABCA7 alleles between POCD and non-POCD patients were observed 3 months postoperatively. Conclusion: ABCA7 rs3764650 gene polymorphism is associated with dNCR and GG genotype might be a predisposing factor for postoperative cognitive impairment in Chinese Han elderly populations.

Discrimination of unsound wheat kernels based on deep convolutional generative adversarial network and near-infrared hyperspectral imaging technology.

The quality of wheat kernels is critical to ensure crop yields. However, in actual breeding work, unsound kernels are scarce compared to healthy kernels. Limited data sets or unbalanced data sets make it difficult for many algorithms to accurately identify kernels in different states. A novel method based on deep convolutional generative adversarial network (DCGAN) and near-infrared hyperspectral imaging technology was proposed to identify unsound wheat kernels in this paper. Three classifiers, convolutional neural network (CNN), support vector machine (SVM) and decision tree (DT) were used. After expanding the samples, the results showed that the accuracy of the test set of the DT model increased from 51.67% to 80.83%, a total increase of 29.16%. And the CNN and SVM models increased by 8.34% and 14.17% respectively. This demonstrated that the DCGAN method had the ability to generate reliable data samples for unbalanced data sets for improving the performance of the classifier. On this basis, the training samples are further expanded for improving the performance of the classifier. The results showed that CNN model gained the most from incremental data, and its accuracy rate had been continuously improved from 79.17% to 96.67%, a total increase of 17.50%. This also demonstrated that the DCGAN method had the ability to expand a limited data set. In general, the joint model based on DCGAN and CNN combined with hyperspectral imaging technology had a good prospect in the identification of unsound kernels.

Sodium Bicarbonate Sub-Diaphragmatic Irrigation Relieves Shoulder Pain After Total Laparoscopic Hysterectomy: A Randomized Controlled Trial.

STUDY OBJECTIVE: To determine whether sub-diaphragmatic irrigation with sodium bicarbonate would relieve post-laparoscopic shoulder pain (PLSP) after total laparoscopic hysterectomy. DESIGN: Randomized double-blinded trial. SETTING: Teaching hospital. PATIENTS: Seventy patients undergoing total laparoscopic hysterectomy (TLH) for benign indications. INTERVENTION: We randomly allocated patients to intervention or control groups where sodium bicarbonate containing flushing liquid or normal saline was irrigated sub-diaphragm before sewing. MEASUREMENT & MAIN RESULTS: The primary outcome was PLSP following surgery measured by a numerical rating scale (NRS) (0 = no pain; 10 = worst pain imaginable). Secondary outcomes were abdominal incisional and visceral pain, analgesic use, and sodium bicarbonate related side effects. The incidence of PLSP in intervention group was significantly lower than that in control group (P < 0.05). Contrarily, incisional and visceral pain was similar in both groups (P = 0.1). The consumption of rescue analgesics in the intervention group was lower than that in the control group. Side effects were comparable in both study groups. CONCLUSION: Sub-diaphragmatic irrigation with sodium bicarbonate could effectively reduce shoulder pain, but not abdominal incisional and visceral pain, in patients undergoing TLH without an increase in side effects. REGISTRATION INFORMATION: Clinical trial registry number: http://www.chictr.org.cn/ (ChiCTR2100041765). REGISTRATION FINDINGS: http://www.chictr.org.cn/showproj.aspx?proj=66721 Link to clinical trial page and data repository: http://www.medresman.org.cn/pub/cn/proj/projectshshow.aspx?proj=2992.

Dexmedetomidine Directs T Helper Cells toward Th1 Cell Differentiation via the STAT1-T-Bet Pathway.

Dexmedetomidine is an α2 adrenergic receptor agonist that has been reported to modulate the polarization of CD4+ T cells. However, the underlying mechanisms by which dexmedetomidine induces T-helper 1 (Th1) cell differentiation remain poorly understood. The aim of this study was to explore the potential mechanisms through which dexmedetomidine can induce Th1 cell differentiation. Purified CD4+ T cells were stimulated with anti-CD3/anti-CD28 and then treated with dexmedetomidine. Flow cytometry analysis was adopted to measure the concentration of Th1 cells. Enzyme-linked immunosorbent assay (ELISA) and real-time quantitative polymerase chain reaction (qPCR) were performed to detect protein levels and mRNA expression, respectively, of IFN-γ and IL-4. Western blotting was used to determine the phosphorylation of signal transducer and activator of transcription 1 (STAT1) and T-bet expression. The Th1 cell subset and IFN-γ levels were elevated in the dexmedetomidine-induced CD4+ T cells. Dexmedetomidine enhanced the phosphorylation of STAT1 and the expression of T-bet in the CD4+ T cells. Atipamezole (an α2 adrenergic antagonist) and fludarabine (a STAT1 inhibitor) reversed the dexmedetomidine-induced Th1 cell differentiation. These results suggested that dexmedetomidine induced Th1 cell differentiation via the STAT1-T-bet signaling pathway.

Recycling of mullite from high-alumina coal fly ash by a mechanochemical activation method: Effect of particle size and mechanism research.

High-alumina coal fly ash (HAFA) is a special solid waste since its alumina content can reach 40-50 wt%, which is seen as a potential resource for mullite material production. However, obtaining an ideal mullite material from HAFA is difficult because of its low Al2O3/SiO2 mass ratio. In this work, the microstructure characteristics of HAFA were systematically analyzed by combining multiple characterization techniques. It was found that HAFA had a core-shell structure with a mullite/corundum crystal core and a silica-rich amorphous phase shell. The novel mechanochemical activation-desilication process was used to remove amorphous phase from HAFA and elevate the Al2O3/SiO2 mass ratio. In particular, the effect of particle size after mechanical treatment and mechanism of the desilication process were extensively investigated. On decreasing the particle size, a high leaching rate of alumina was achieved during mechanochemical activation, thus generating a hydroxysodalite coating layer as desilication was suppressed, and the amorphous phase was effectively removed. The mineralogical phase of the desilicated HAFA is mainly mullite and corundum, and the Al2O3/SiO2 mass ratio was elevated from 1.29 to 3.02. Mullite refractory obtained from the desilicated HAFA exhibited excellent physical properties. This study provides insights into further high-valued utilization of HAFA.

Hyperspectral imaging technology combined with deep forest model to identify frost-damaged rice seeds.

In recent years, deep learning models have been widely used in the field of hyperspectral imaging. However, the training of deep learning models requires not only a large number of samples, but also the need to set too many hyper-parameters, which is time consuming and laborious for researchers. This study used hyperspectral imaging technology combined with a deep learning model suitable for small-scale sample data sets, deep forests (DF) model, to classify rice seeds with different degrees of frost damage. During the period, three spectral preprocessing methods (Savitzky-Golay first derivative (SG1), standard normal variate (SNV), and multivariate scatter correction (MSC)) were used to process the original spectral data, and three feature extraction algorithms (principal component analysis (PCA), successive projections algorithm (SPA), and neighborhood component analysis (NCA)) were used to extract the characteristic wavelengths. Moreover, DF model and three traditional machine learning models (decision tree (DT), k-nearest neighbor (KNN), and support vector machine (SVM)) were built based on different numbers of sample sets. After multivariate data analysis, it showed that the pretreatment effect of MSC was the most excellent, and the characteristic wavelength extracted by NCA algorithm was the most useful. In addition, the performance of DF model was better than these three traditional classifier models, and it still performed well in small-scale sample set data. Therefore, DF model was chosen as the best classification model. The results of this study show that the DF model maintains good classification performance in small-scale sample set data, and it has a good application prospect in hyperspectral imaging technology.

Graphene quantum dots modified flower like Bi2WO6 for enhanced photocatalytic nitrogen fixation.

Graphene quantum dots modified Bi2WO6 (GQD/Bi2WO6) composites is applied to photocatalytic N2 fixation. The as-prepared GQD/Bi2WO6 samples showed considerable increase in photocatalytic nitrogen fixation compared to the pure Bi2WO6 and GQD. The results revealed that GQD uniformly placed on the surface of Bi2WO6 and tight junction between the two samples helped to boost the photocatalytic activity. The PL, photocurrent and EIS analyses further demonstrated that the composite had the low recombination rate of photo-generated charges. Photocatalytic nitrogen fixation test indicated that GQD/Bi2WO6 with 10 wt% GQDs exhibited the highest ammonia synthesis rate in the presence of visible light, which is 8.88-fold and 33.8-fold higher than pure Bi2WO6 and GQD. Simultaneously, the GQD/Bi2WO6 sample has high stability.

Lattice-Refined Transition-Metal Oxides via Ball Milling for Boosted Catalytic Oxidation Performance.

Surface oxygen vacancy can greatly affect the properties of transition-metal oxides. However, engineering oxygen vacancy-abundant transition-metal oxides with high specific surface area (SSA) remains challenging. At present, the generation of oxygen vacancies in metal oxides is time-consuming and less environmentally friendly by chemical leaching methods that usually require additional waste treatment. Herein, a series of oxygen vacancy-abundant transition-metal oxides with high SSA are constructed via a lattice refining strategy. This strategy is realized by urea-assisted ball milling pyrolysis and is green, efficient, and universal. The oxygen vacancies promote the mobility of oxygen, leading to a boosted catalytic oxidation performance of aromatic sulfides. Such a strategy provides an efficient approach to manufacturing oxygen vacancies on transition-metal oxides, which may be beneficial for various related applications as an effective catalytic material.

NIR Hyperspectral Imaging Technology Combined with Multivariate Methods to Study the Residues of Different Concentrations of Omethoate on Wheat Grain Surface.

In this study, a hyperspectral imaging system of 866.4-1701.0 nm was selected and combined with multivariate methods to identify wheat kernels with different concentrations of omethoate on the surface. In order to obtain the optimal model combination, three preprocessing methods (standard normal variate (SNV), Savitzky-Golay first derivative (SG1), and multivariate scatter correction (MSC)), three feature extraction algorithms (successive projections algorithm (SPA), random frog (RF), and neighborhood component analysis (NCA)), and three classifier models (decision tree (DT), k-nearest neighbor (KNN), and support vector machine (SVM)) were applied to make a comparison. Firstly, based on the full wavelengths modeling analysis, it was found that the spectral data after MSC processing performed best in the three classifier models. Secondly, three feature extraction algorithms were used to extract the feature wavelength of MSC processed data and based on feature wavelengths modeling analysis. As a result, the MSC-NCA-SVM model performed best and was selected as the best model. Finally, in order to verify the reliability of the selected model, the hyperspectral image was substituted into the MSC-NCA-SVM model and the object-wise method was used to visualize the image classification. The overall classification accuracy of the four types of wheat kernels reached 98.75%, which indicates that the selected model is reliable.

Enhanced long-wavelength light utilization with polyaniline/bismuth-rich bismuth oxyhalide composite towards photocatalytic degradation of antibiotics.

Antibiotics in natural waters have posed serious threats to our ecosystem due to its potent biological toxicity. In the present work, a visible-light-driven PANI/Bi4O5Br2 composite photocatalyst was fabricated and used for the degradation of ciprofloxacin (CIP) and tetracycline (TC) antibiotics under visible light (λ ＞ 420 nm). The PANI/Bi4O5Br2 composite presented a significantly improved ability of CIP and TC photodegradation, which is about 2.2 times and 1.6 times to that of Bi4O5Br2, respectively. The promoted photocatalytic activity results from the interface interaction between PANI and Bi4O5Br2, which contributes to the electron-hole separation. The degradation process of CIP was monitored by mass spectrometry, and a possible degradation pathway was proposed based on the analysis of the product. A microbiological antibacterial experiment was designed, proving that the degraded products of CIP and TC have lower toxicity. Furthermore, long wavelength light irradiated (λ ＞ 550 nm) experiment indicated that the introduction of PANI helps to extend the light absorption region and use the long wavelength light more efficiently, thereby promoting the photocatalytic ability. The optimal composite applied for TC degradation was 0.1% PANI/Bi4O5Br2. Its reaction rate constant was 2.8 times to that of Bi4O5Br2 (λ ＞ 550 nm). Eventually, a possible photocatalytic mechanism over PANI/Bi4O5Br2 composite was proposed.

Synthesis of porous carbon via a waste tire leavening strategy for adsorptive desulfurization.

Adsorptive desulfurization is an effective technology for removing harmful sulfur under mild conditions. Carbon materials have many advantages and are often used in adsorption desulfurization research, but until now have been synthesized using complicated methods and have shown limited adsorption capacity. Using an NaHCO3-assisted leavening method, waste tires were in the current work used as raw materials to produce hierarchically porous carbon that exhibits a high specific surface area and abundant oxygen-containing functional groups. In contrast to the sulfur removal by the carbon material prepared using a commonly used method, the as-prepared carbon material shows excellent adsorption performance, and was able to achieve an ultra-deep desulfurization of pentanethiol, specifically removing up to 99.7% of the sulfur from a model fuel with an initial sulfur concentration of 28 ppm. Therefore, we have provided a simple method for synthesizing adsorbents with high adsorption performance, and we expect these adsorbents to be used for industrial adsorptive desulfurization.

Zinc-Finger Nucleases Induced by HIV-1 Tat Excise HIV-1 from the Host Genome in Infected and Latently Infected Cells.

Highly active anti-retroviral therapy (HAART) cannot clear infected cells harboring HIV-1 proviral DNA from HIV-1-infected patients. We previously demonstrated that zinc-finger nucleases (ZFNs) can specifically and efficiently excise HIV-1 proviral DNA from latently infected human T cells by targeting long terminal repeats (LTRs), a novel and alternative antiretroviral strategy for eradicating HIV-1 infection. To prevent unwanted off-target effects from constantly expressed ZFNs, in this study, we engineered the expression of ZFNs under the control of HIV-1 LTR, by which ZFN expression can be activated by the HIV-1 (Trans-Activator of Transcription) Tat protein. Our results show that functional expression of ZFNs induced by Tat excise the integrated proviral DNA of HIV-NL4-3-eGFP in approximately 30% of the population of HIV-1-infected cells. The results from HIV-1-infected human primary T cells and latently infected T cells treated with the inducible ZFNs further validated that proviral DNA can be excised. Taken together, positively regulated expression of ZFNs in the presence of HIV-1 Tat may provide a safer and novel implementation of genome-editing technology for eradicating HIV-1 proviral DNA from infected host cells.

Mitofusin 2 Regulates Axonal Transport of Calpastatin to Prevent Neuromuscular Synaptic Elimination in Skeletal Muscles.

Skeletal muscles undergo atrophy in response to diseases and aging. Here we report that mitofusin 2 (Mfn2) acts as a dominant suppressor of neuromuscular synaptic loss to preserve skeletal muscles. Mfn2 is reduced in spinal cords of transgenic SOD1G93A and aged mice. Through preserving neuromuscular synapses, increasing neuronal Mfn2 prevents skeletal muscle wasting in both SOD1G93A and aged mice, whereas deletion of neuronal Mfn2 produces neuromuscular synaptic dysfunction and skeletal muscle atrophy. Neuromuscular synaptic loss after sciatic nerve transection can also be alleviated by Mfn2. Mfn2 coexists with calpastatin largely in mitochondria-associated membranes (MAMs) to regulate its axonal transport. Genetic inactivation of calpastatin abolishes Mfn2-mediated protection of neuromuscular synapses. Our results suggest that, as a potential key component of a novel and heretofore unrecognized mechanism of cytoplasmic protein transport, Mfn2 may play a general role in preserving neuromuscular synapses and serve as a common therapeutic target for skeletal muscle atrophy.

Quercetin synergistically reactivates human immunodeficiency virus type 1 latency by activating nuclear factor­κB.

Highly active antiretroviral therapy (HAART) is very effective in suppressing human immunodeficiency virus type 1 (HIV­1) replication. However, the treatment is required to be administered for the remainder of an individual's lifetime due to latent HIV­1 reservoirs. The 'shock­and­kill' strategy, which involves using agents to reactivate latent HIV­1 and subsequently killing latently infected cells in the presence of HAART, was recently proposed. Unfortunately, no agents have currently demonstrated an ability to reactivate latent HIV­1 in vivo in the absence of toxicity. Therefore, the identification of novel latency activators is required. In order to identify a potential novel agent, the present study investigated the effect of quercetin on latent HIV­1 reactivation using an established model of HIV­1 latency. As a marker for reactivation of HIV­1 in C11 Jurkat cells, the expression of green fluorescent protein, controlled by HIV­1 long terminal repeat, was observed by fluorescence microscopy. The results of the present study demonstrated that quercetin effectively reactivated latent HIV­1 gene expression alone, and led to synergistic reactivation when combined with prostratin or valproic acid. In addition, the present study provides evidence that quercetin may reactivate HIV­1 expression by inducing nuclear factor­κB nuclear translocation, and that the toxicity of quercetin is lower when compared with various additional activators of HIV­1. Combined, the results of the present study indicate that quercetin may be an effective agent to disrupt HIV­1 latency and may be useful in future eradication strategies.

T cell subsets and immunoglobulin G levels are associated with the infection status of systemic lupus erythematosus patients

Systemic lupus erythematosus (SLE) is a chronic, autoimmune disorder that affects nearly all organs and tissues. As knowledge about the mechanism of SLE has increased, some immunosuppressive agents have become routinely used in clinical care, and infections have become one of the direct causes of mortality in SLE patients. To identify the risk factors indicative of infection in SLE patients, a case control study of our hospital's medical records between 2011 and 2013 was performed. We reviewed the records of 117 SLE patients with infection and 61 SLE patients without infection. Changes in the levels of T cell subsets, immunoglobulin G (IgG), complement C3, complement C4, globulin, and anti-double-stranded DNA (anti-ds-DNA) were detected. CD4+ and CD4+/CD8+ T cell levels were significantly lower and CD8+ T cell levels were significantly greater in SLE patients with infection than in SLE patients without infection. Additionally, the concentrations of IgG in SLE patients with infection were significantly lower than those in SLE patients without infection. However, complement C3, complement C4, globulin, and anti-ds-DNA levels were not significantly different in SLE patients with and without infection. Therefore, clinical testing for T cell subsets and IgG is potentially useful for identifying the presence of infection in SLE patients and for distinguishing a lupus flare from an acute infection.

T cell subsets and immunoglobulin G levels are associated with the infection status of systemic lupus erythematosus patients.

Systemic lupus erythematosus (SLE) is a chronic, autoimmune disorder that affects nearly all organs and tissues. As knowledge about the mechanism of SLE has increased, some immunosuppressive agents have become routinely used in clinical care, and infections have become one of the direct causes of mortality in SLE patients. To identify the risk factors indicative of infection in SLE patients, a case control study of our hospital's medical records between 2011 and 2013 was performed. We reviewed the records of 117 SLE patients with infection and 61 SLE patients without infection. Changes in the levels of T cell subsets, immunoglobulin G (IgG), complement C3, complement C4, globulin, and anti-double-stranded DNA (anti-ds-DNA) were detected. CD4+ and CD4+/CD8+ T cell levels were significantly lower and CD8+ T cell levels were significantly greater in SLE patients with infection than in SLE patients without infection. Additionally, the concentrations of IgG in SLE patients with infection were significantly lower than those in SLE patients without infection. However, complement C3, complement C4, globulin, and anti-ds-DNA levels were not significantly different in SLE patients with and without infection. Therefore, clinical testing for T cell subsets and IgG is potentially useful for identifying the presence of infection in SLE patients and for distinguishing a lupus flare from an acute infection.