BACKGROUND Population of patients with inflammatory bowel disease(IBD)is burdened by various extraintestinal manifestations which substantially contribute to greater morbidity and mortality.Growth-differentiation fact...BACKGROUND Population of patients with inflammatory bowel disease(IBD)is burdened by various extraintestinal manifestations which substantially contribute to greater morbidity and mortality.Growth-differentiation factor-15(GDF-15)is often overexpressed under stress conditions,such as inflammation,malignancies,heart failure,myocardial ischemia,and many others.AIM To explore the association between GDF-15 and IBD as serum concentrations of GDF-15 were shown to be an independent predictor of poor outcomes in multiple diseases.An additional aim was to determine possible associations between GDF-15 and multiple clinical,anthropometric and laboratory parameters in patients with IBD.METHODS This cross-sectional study included 90 adult patients diagnosed with IBD,encompassing both Crohn’s disease(CD)and ulcerative colitis(UC),and 67 healthy age-and sex-matched controls.All patients underwent an extensive workup,including colonoscopy with subsequent histopathological analysis.Disease activity was assessed by two independent gastroenterology consultants specialized in IBD,employing well-established clinical and endoscopic scoring systems.GDF-15 serum concentrations were determined following an overnight fasting,using electrochemiluminescence immunoassay.RESULTS In patients with IBD,serum GDF-15 concentrations were significantly higher in comparison to the healthy controls[800(512-1154)pg/mL vs 412(407-424)pg/mL,P<0.001],whereas no difference in GDF-15 was found between patients with CD and UC[807(554-1451)pg/mL vs 790(509-956)pg/mL,P=0.324].Moreover,multiple linear regression analysis showed that GDF-15 levels predict CD and UC severity independent of age,sex,and C-reactive protein levels(P=0.016 and P=0.049,respectively).Finally,an association between GDF-15 and indices of anemia was established.Specifically,negative correlations were found between GDF-15 and serum iron levels(r=-0.248,P=0.021),as well as GDF-15 and hemoglobin(r=-0.351,P=0.021).Accordingly,in comparison to IBD patients with normal hemoglobin levels,GDF-15 serum levels were higher in patients with anemia(1256(502-2100)pg/mL vs 444(412-795)pg/mL,P<0.001).CONCLUSION For the first time,we demonstrated that serum concentrations of GDF-15 are elevated in patients with IBD in comparison to healthy controls,and the results imply that GDF-15 might be involved in IBD pathophysiology.Yet,it remains elusive whether GDF-15 could serve as a prognostic indicator in these patients.展开更多
Objective:To identify the association between serum albumin levels and disease severity among adult patients with dengue in China's Mainland.Methods:This retrospective cohort study analyzed the data of adult patie...Objective:To identify the association between serum albumin levels and disease severity among adult patients with dengue in China's Mainland.Methods:This retrospective cohort study analyzed the data of adult patients(aged≥18 years)hospitalized with laboratory-confirmed dengue in a tertiary center for infectious diseases from 2013 to 2019 in China's Mainland.Serum albumin levels were estimated and compared between patients with severe dengue and non-severe dengue.Additionally,the association between serum albumin levels and severe dengue was evaluated using a generalized linear model[relative risks(RR)].Multivariate logistic regression analysis was performed to identify the potential predictors of severe dengue.Results:Overall,1568 patients were included in this study.Of these patients,34(2.17%)developed severe dengue.The median serum albumin levels were significantly lower in patients with severe dengue than that in those with non-severe dengue(33 g/L vs.37 g/L,P<0.001).After adjustment for age,sex,and comorbidities,hypoalbuminemia(RR 4.877,95%CI 2.193-11.461,P<0.001)was found to be a predictor of severe dengue.Serum albumin levels(OR 1.303,95%CI 1.161-1.462,P<0.001)and age(OR 1.038,95%CI 1.017-1.061,P<0.001)were significant risk factors for severe dengue.The area under the curve for serum albumin levels to distinguish severe dengue was 0.787.Conclusions:Lower serum albumin levels were significantly associated with disease severity in adult patients with dengue.Hypoalbuminemia on admission resulted in at least a four-fold increased risk of severe dengue.展开更多
The world’s agricultural production suffers huge losses estimated between 20% and 40% annually. 40% to 50% of such losses are due to pest and diseases which cause significant economic losses every year. Precise asses...The world’s agricultural production suffers huge losses estimated between 20% and 40% annually. 40% to 50% of such losses are due to pest and diseases which cause significant economic losses every year. Precise assessment of severity is crucial for suitable management of crop diseases. It helps famers to avoid yield losses, reduce production costs, ensure good disease management and so on. This paper is a review of plant diseases severity estimation solutions proposed by researchers the last few years and based on Image Processing Techniques (IPT), classical Machine Learning (ML) and Deep Learning (DL) algorithms. The analysis of these solutions has allowed us to identify their limitations and potential challenges in plant disease severity assessment.展开更多
Background:Cirrhosis with acute decompensation(AD)and acute-on-chronic liver failure(ACLF)are characterized by high morbidity and mortality.Cytolysin,a toxin from Enterococcus faecalis(E.faecalis),is associated with m...Background:Cirrhosis with acute decompensation(AD)and acute-on-chronic liver failure(ACLF)are characterized by high morbidity and mortality.Cytolysin,a toxin from Enterococcus faecalis(E.faecalis),is associated with mortality in alcohol-associated hepatitis(AH).It is unclear whether cytolysin also contributes to disease severity in AD and ACLF.Methods:We studied the role of fecal cytolysin in 78 cirrhotic patients with AD/ACLF.Bacterial DNA from fecal samples was extracted and real-time quantitative polymerase chain reaction(PCR)was performed.The association between fecal cytolysin and liver disease severity in cirrhosis with AD or ACLF was analyzed.Results:Fecal cytolysin and E.faecalis abundance did not predict chronic liver failure(CLIF-C)AD and ACLF scores.Presence of fecal cytolysin was not associated with other liver disease markers,including Fibrosis-4(FIB-4)index,‘Age,serum Bilirubin,INR,and serum Creatinine(ABIC)’score,Child-Pugh score,model for end-stage liver disease(MELD)nor MELD-Na scores in AD or ACLF patients.Conclusions:Fecal cytolysin does not predict disease severity in AD and ACLF patients.The predictive value of fecal cytolysin positivity for mortality appears to be restricted to AH.展开更多
AIM:To understand the demographic characteristics of patients in Southwestern Ontario,Canada with ulcerative colitis(UC)in order to predict disease severity. METHODS:Records from 1996 to 2001 were exam- ined to create...AIM:To understand the demographic characteristics of patients in Southwestern Ontario,Canada with ulcerative colitis(UC)in order to predict disease severity. METHODS:Records from 1996 to 2001 were exam- ined to create a database of UC patients seen in the London Health Sciences Centre South Street Hospital Inflammatory Bowel Disease Clinic.To be included, patients'charts were required to have information of their disease presentation and a minimum of 5 years of follow-up.Charts were reviewed using standardized data collection forms.Disease severity was generated during the chart review process,and non-endoscopic Mayo Score criteria were collected into a composite. RESULTS:One hundred and two consecutive patients'data were entered into the database.Demographic analyses revealed that 51%of the patients were male, the mean age at diagnosis was 39 years,13.7%had a first degree relative with inflammatory bowel disease (IBD),61.8%were nonsmokers and 24.5%were ex-smokers.In 22.5%of patients the disease was limited to the rectum,in 21.6%disease was limited to the sigmoid colon,in 22.5%disease was limited to the left colon,and 32.4%of patients had pancolitis. Standard multiple regression analysis which regressed a composite of physician global assessment of disease severity,average number of bowel movements,and average amount of blood in bowel movements on year of diagnosis and age at time of diagnosis was significant,R 2=0.306,F(7,74)=4.66,P<0.01. Delay from symptoms to diagnosis of UC,gender, family history of IBD,smoking status and disease severity at the time of diagnosis didnot significantly predict the composite measure. CONCLUSION:UC severity is associated with younger age at diagnosis and year of diagnosis in a longitudinal cohort of UC patients,and may identify prognostic UC indicators.展开更多
Due to the disease's broad clinical spectrum,it is currently unclear how to predict the future prognosis of patients at the time of diagnosis of coronavirus disease 2019(COVID-19).Real-time reverse transcription-p...Due to the disease's broad clinical spectrum,it is currently unclear how to predict the future prognosis of patients at the time of diagnosis of coronavirus disease 2019(COVID-19).Real-time reverse transcription-polymerase chain reaction(RTPCR)is the gold standard molecular technique for diagnosing COVID-19.The number of amplification cycles necessary for the target genes to surpass a threshold level is represented by the RT-PCR cycle threshold(Ct)values.Ct values were thought to be an adequate proxy for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)viral load.A body of evidence suggests that SARS-CoV-2 viral load is a possible predictor of COVID-19 severity.The link between SARS-CoV-2 viral load and the likelihood of severe disease development in COVID-19 patients is not clearly elucidated.In this review,we describe the scientific data as well as the important findings from many clinical studies globally,emphasizing how viral load may be related to disease severity in COVID-19 patients.Most of the evidence points to the association of SARS-CoV-2 viral load and disease severity in these patients,and early anti-viral treatment will reduce the severe clinical outcomes.展开更多
<strong>Background:</strong> Hyperglycemia is an important predictor of prolonged hospitalization and mortality. The objective of this study was to analyze the role of early hyperglycemia in predicting the...<strong>Background:</strong> Hyperglycemia is an important predictor of prolonged hospitalization and mortality. The objective of this study was to analyze the role of early hyperglycemia in predicting the severity of COVID-19 illness and mortality. <strong>Method:</strong> Retrospective study on 259 patients with COVID-19 with measurement of average glucose during 24 hours of admission. Association of Early Hyperglycemia categorized as <180 mg/dl or >180 mg/dl;was studied with mortality, requirement of ICU stay and prognostic markers. <strong>Results: </strong>Early hyperglycemia (>180 mg/dl) revealed a higher median value for CRP (109 mg/l [IQR;48 - 199]) in comparison to <180 mg/dl group (86 mg/l [IQR;26.3 - 153]) p = 0.03. ICU stay was higher in >180 mg/dl group;24 (15.9%) vs 14 patients (13%) [p = 0.51] in the <180 mg/dl group. Mortality in the group > 180 mg/dl was 8 (5.3%) while <180 mg/dl had a mortality rate of 4 (3.7%) [p = 0.547]. <strong>Conclusion:</strong> Hyperglycemia in the first 24 hours may anticipate an increased risk of ICU stay and a higher mortality rate. It may be a possible predictor of disease severity.展开更多
Recently we have shown the presence of catalytically active IgGs, capable to cleave histone H1 and bovine myelin basic protein (MBP), in blood serum of SLE patients. Here we present data that demonstrate the correlati...Recently we have shown the presence of catalytically active IgGs, capable to cleave histone H1 and bovine myelin basic protein (MBP), in blood serum of SLE patients. Here we present data that demonstrate the correlation between a) proteolytic activity towards histone H1 and MBP of IgG-antibodies from blood serum of SLE patients and b) disease severity level in these patients. IgGs were isolated from blood serum by chromatography on protein G-sepharose. Commercial preparations of bovine myelin basic proteins (MBP) and calf thymus histone H1 were used as substrates. Analysis of the proteolytic activity showed that 16 of 38 lgG-preparations (42,1%) obtained from blood serum of SLE patients were capable of cleaving both histone H1 and MBP with different efficiency. It was revealed that the presence in blood serum of lgGs possessing proteolytic activity towards both histone H1 and bMBP closely correlates with manifestation of the disease severity in SLE patients.展开更多
AIM To determine the association of circulating mi R-125 a/b expression with the risk and disease severity of Crohn's disease(CD), and with inflammatory cytokines.METHODS Plasma samples were collected from patient...AIM To determine the association of circulating mi R-125 a/b expression with the risk and disease severity of Crohn's disease(CD), and with inflammatory cytokines.METHODS Plasma samples were collected from patients with active CD(A-CD), or CD in remission(R-CD) and from healthy controls(HCs). The levels of the inflammatory cytokines interleukin-17(IL-17), tumour necrosis factor-α(TNF-α), and interferon-γ(IFN-γ) were measured by enzyme-linked immunosorbent assay. The expression of mi R-125 a/b was assessed by quantitative polymerase chain reaction(q PCR).RESULTS Twenty-nine A-CD patients, 37 R-CD patients, and 37 HCs were included in the study. Plasma mi R-125 a expression was decreased in A-CD patients comparedwith that in R-CD patients(P < 0.001) and HCs(P < 0.001). mi R-125 a expression levels enabled the differentiation of A-CD from R-CD patients [area under curve(AUC) = 0.854] and from HCs(AUC = 0.780), whereas mi R-125 b expression did not. mi R-125 a was negatively correlated with C-reaction protein(CRP)(P = 0.017), erythrocyte sedimentation rate(ESR)(P = 0.026), Crohn's disease activity index(CDAI)(P = 0.003), IL-17(P = 0.015), and TNF-α(P = 0.004) in A-CD patients. Furthermore, mi R-125 a was negatively associated with CRP(P = 0.038) and CDAI(P = 0.021) in R-CD patients. Regarding mi R-125 b, no association with CRP, CDAI, IL-17, TNF-α, or IFN-γ was found in A-CD or in R-CD patients. mi R-125 a levels gradually increased in A-CD patients who achieved clinical remission(P = 0.009) after 3-mo treatment, whereas they remained unchanged among patients who failed to achieve remission. No changes in mi R-125 b expression were detected in remission or non-remission patients after treatment. CONCLUSION Circulating mi R-125 a but not mi R-125 b is decreased in patients with active disease status and negatively correlates with disease severity and inflammatory cytokines in patients with CD.展开更多
Lysosomal acid lipase(LAL)plays a key role in intracellular lipid metabolism.Reduced LAL activity promotes increased multi-organ lysosomal cholesterol ester storage,as observed in two recessive autosomal genetic disea...Lysosomal acid lipase(LAL)plays a key role in intracellular lipid metabolism.Reduced LAL activity promotes increased multi-organ lysosomal cholesterol ester storage,as observed in two recessive autosomal genetic diseases,Wolman disease and Cholesterol ester storage disease.Severe liver steatosis and accelerated liver fibrosis are common features in patients with genetic LAL deficiency.By contrast,few reliable data are available on the modulation of LAL activity in vivo and on the epigenetic and metabolic factors capable of regulating its activity in subjects without homozygous mutations of the Lipase A gene.In the last few years,a less severe and non-genetic reduction of LAL activity was reported in children and adults with non-alcoholic fatty liver disease(NAFLD),suggesting a possible role of LAL reduction in the pathogenesis and progression of the disease.Patients with NAFLD show a significant,progressive reduction of LAL activity from simple steatosis to non-alcoholic steatohepatitis and cryptogenic cirrhosis.Among cirrhosis of different etiologies,those with cryptogenic cirrhosis show the most significant reductions of LAL activity.These findings suggest that the modulation of LAL activity may become a possible new therapeutic target for patients with more advanced forms of NAFLD.Moreover,the measurement of LAL activity may represent a possible new marker of disease severity in this clinical setting.展开更多
This review intends to uncover how information from large-scale genetic profiling(whole genome sequencing, and whole exome sequencing) of nonalcoholic fatty liver disease(NAFLD), as well as information from circulatin...This review intends to uncover how information from large-scale genetic profiling(whole genome sequencing, and whole exome sequencing) of nonalcoholic fatty liver disease(NAFLD), as well as information from circulating transcriptomics(cell-free mi RNAs) and metabolomics, contributes to the understanding of NAFLD pathogenesis. A further aim is to address the question of whether OMICs information is ready to be implemented in the clinics. The available evidence suggests that any new knowledge pertaining to molecular signatures associated with NAFLD and nonalcoholic steatohepatitis should be promptly translated into the clinical setting. Nevertheless, rigorous steps that must include validation and replication are mandatory before utilizing OMICs biomarkers in diagnostics to identify patients at risk of advanced disease, including liver cancer.展开更多
Introduction: Coronary artery disease (CAD) is one of the most common causes of death worldwide. In 2010, about 7 out of total 53 million deaths were due to ischemic heart disease. The aim of this study is to evaluate...Introduction: Coronary artery disease (CAD) is one of the most common causes of death worldwide. In 2010, about 7 out of total 53 million deaths were due to ischemic heart disease. The aim of this study is to evaluate the relationship of serum bilirubin level with the severity and complexity of coronary artery disease (CAD) in the patients undergoing primary percutaneous coronary intervention (PCI). Materials and Methods: 70 patients with STEMI who were undergoing primary PCI were included in the study. All the patients included in the study were subjected to full routine investigations and standard coronary angiographic projections. Total bilirubin level was measured and the patients were divided into two groups. Group 1 was with serum TB (and Group 2 was with serum TB (>1 mg/dl). Severity and complexity of coronary artery lesions will be assessed using Gensini score. Results: After PCI, the two studied groups were compared regarding the number of vessels affected by one and more than one vessel disease. Single vessel disease was frequent in Group 2 (71%) with significant p value (0.003). Cardiac enzymes (troponin I) was more in Group 1 (S. Bil value (0.02). Also (ALT, AST) were more in Group 1 (p value = 0.01). By comparing the 2 groups, there was a significant difference regarding (EF) between both which was less in Group 1 (S.TB 1), p value significance (0, 0001). Also GENSENI was more in Group 1 (S.TB 1) with mean (80.35 vs 34.71) and significant pvalue (0.0001). There was a highly significant negative correlation between serum bilirubin & GENSENI score (r = -0.762, p value 0.0001). Regarding the incidence of complications, incidence was more in Group 1 (S.TB 1), which means a significant difference between both groups with significant p value (0.0001). There was a significant negative correlation between serum bilirubin & incidence of complications (R = -0.38, pvalue 0.001). Also, there was a significant negative correlation between GENSINI score, complication and bilirubin among both groups (r: -0.762\-0.38) with p value (0.0001\0.001) respectively. Conclusion: In conclusion, our results suggested that the Serum Bilirubin level is inversely correlated with the severity of CAD. Also, the SB level is an independent predictor of cardiovascular events in CAD patients. Understandably, our findings need further verification by large-scale, multicenter clinical trials in the future.展开更多
AIM:To find out whether serum oxidizability potential correlates with exercise test(EXT) parameters and predicts their results in chronic ischemic heart disease(IHD) patients.METHODS:Oxidizability potential was determ...AIM:To find out whether serum oxidizability potential correlates with exercise test(EXT) parameters and predicts their results in chronic ischemic heart disease(IHD) patients.METHODS:Oxidizability potential was determined in a group of chronic IHD patients who underwent a symptom limited EXT upon initiation of a cardiac rehabilitation program.The thermo-chemiluminescence(TCL) assay was used to assess serum oxidizability potential.This assay is based on heat-induced oxidation of serum,leading to the formation of electronically excited species in the form of unstable carbonyls,which further decompose into stable carbonyls and light energy(low chemiluminescence).Measured photons emission is represented by a kinetic curve which is described by its amplitude and slope(= ratio).We assessed the correlations of TCL ratio with exercise duration,metabolic equivalents(METS),maximal heart rate(mHR),maximal systolic BP,> 1 mm S-T depression,diabetes,hypertension,smoking,left ventricular ejection fraction(LVEF) > or < 40%,previous myocardial infarction,and aorto-coronary bypass surgery and compared to the TCL ratio measured in a group of healthy controls.RESULTS:A high TCL ratio(%) correlated well with METS(r = 0.84),with mHR(r = 0.79) and with exercise induced S-T segment shift(r = 0.87,P < 0.05).A lower serum oxidizability potential,expressed as a low TCL ratio,thus suggestive of a previous high oxidative stress,was found in IHD patients compared to healthy controls,and,in particular,in patients with low LVEF%.The TCL ratio(%) in IHD patients was 193 ± 21,compared to 215 ± 13 in controls(P < 0.05),and was 188 ± 14.7 in patients with LVEF < 40% as compared to 200 ± 11.9 in those with LVEF > 40%(P < 0.01).A trend for lower TCL ratio(%) was found in diabetic,hypertensive,and post-coronary bypass surgery patients.A paradoxically low TCL ratio(low oxidizability potential) was observed in patients without S-T depression compared to patients with S-T depression(189 ± 22 vs 201 ± 15,P = NS),due to the fact these patients had a much lower LVEF% and a lower exercise capacity.CONCLUSION:Serum oxidizability potential is associated with EXT parameters,results,and IHD severity.TCL ratio is an "easy-to-measure marker" that might be incorporated into risk assessment and prediction in chronic IHD patients.展开更多
COVID-19 has become the global focus since December 2019[1].Patients usually experience cough,fever and flu-like symptoms.Most patients also experience dyspnoea.Elevated procalcitonin,lymphopenia are observed in COVID...COVID-19 has become the global focus since December 2019[1].Patients usually experience cough,fever and flu-like symptoms.Most patients also experience dyspnoea.Elevated procalcitonin,lymphopenia are observed in COVID-19 patients.Recently,a case series analysis has predicted that lymphopenia may be a very good prognostic marker for disease progression in COVID-19[2].展开更多
BACKGROUND Bifidobacterium longum 35624 has shown efficacy in improving irritable bowel syndrome(IBS)symptoms compared with placebo in double-blind randomized studies.However,few data are available from real-life clin...BACKGROUND Bifidobacterium longum 35624 has shown efficacy in improving irritable bowel syndrome(IBS)symptoms compared with placebo in double-blind randomized studies.However,few data are available from real-life clinical practice or from studies that used Rome IV criteria to diagnose IBS.AIM To assess the effect of B.longum 35624 on IBS severity and quality of life in a reallife setting.METHODS From November 2018 to January 2020,278 patients with IBS(according to Rome IV criteria)were enrolled in a prospective,open-label,multicenter observational study by private practice gastroenterologists to received one capsule of B.longum 35624(10^(9) colony-forming units)per day for 30 d.Participation in the study was independently proposed to patients during spontaneous consultations.Disease severity(assessed by the IBS severity scoring system)and patient quality of life(assessed by the IBS quality of life questionnaire)were compared between the inclusion visit(baseline)and the visit at the end of 30 d of treatment.The characteristics of patients were described at baseline.Continuous variables comparisons between inclusion and end-of-treatment visits were performed using the t-test and Kruskal-Wallis test.Categorical variables comparisons were performed using theχ^(2) test.RESULTSA total of 233 patients,with a mean age of 51.4 years and composed of 71.2%women,were included in the study.Of these patients,48.1%had moderate IBS and 46.4%had severe IBS.After a 30-d treatment period with one B.longum 35624 capsule per day,a significant decrease in IBS severity was observed compared to baseline(mean±SD,IBS severity scoring system scores:208±104 vs 303±81,P<0.001)and 57%of patients moved to lower severity categories or achieved remission.The quality of life of patients was also improved by the treatment(IBS Quality of Life questionnaire score:68.8±20.9 vs 60.2±20.5;P<0.001)and 63.8%of patients were satisfied with the treatment.CONCLUSION Thirty days of treatment with B.longum 35624 reduces disease severity and improves the quality of life of patients with IBS,particularly those with the most severe forms of IBS.展开更多
Red tip disease on pineapple (Ananas comosus) was first recognized about 20 years ago in a commercial pineapple stand located in Simpang Renggam, Johor, Peninsular Malaysia. Since its discovery, there has been no conf...Red tip disease on pineapple (Ananas comosus) was first recognized about 20 years ago in a commercial pineapple stand located in Simpang Renggam, Johor, Peninsular Malaysia. Since its discovery, there has been no confirmation on the causal agent of red tip disease. The epidemiology of red tip disease is still not fully understood. However, based on disease symptoms and field transmission mode, red tip disease seems to be strongly associated with viral infection. The aim of this work was to assess the feasibility of using an optical sensor to estimate red tip disease severity. This work was performed in a commercial pineapple plantation located in Simpang Renggam, Johor. Four observation plots bearing pineapple variety SR36 were demarcated based on crop growth stage. Each plot comprised a total of eighty corresponding measurements of percent Disease Severity (% DS) and Normalized Difference Vegetation Index (NDVI). Our data showed a strong correlation between % DS and NDVI. The 7- and 11-month plantings registered a correlation coefficient (r) of -0.83 and -0.88, respectively. The negative correlation infers that NDVI increases when disease severity is low. This is expected since healthy leaves reflect more near-infrared light and less visible light which results in a higher NDVI. The regression of NDVI on % DS for the 7-month planting was explained by: % DS = 181.6 - 185.6*NDVI. Meanwhile, the regression of NDVI on % DS for the 11-month planting was explained by: % DS = 213.2 - 219.8*NDVI. The linear fit between measured % DS and estimated % DS from the 7-month and 11-month plantings was relatively strong. This work has demonstrated that NDVI is a reliable predictor of % DS in pineapple.展开更多
BACKGROUND Coronary heart disease(CHD)causes many adverse cardiovascular events and poses a threat to the patient’s health and quality of life.AIM To evaluate ultrasonography for evaluation of cardiac function and le...BACKGROUND Coronary heart disease(CHD)causes many adverse cardiovascular events and poses a threat to the patient’s health and quality of life.AIM To evaluate ultrasonography for evaluation of cardiac function and lesion degree in patients with CHD.METHODS A total of 106 patients with CHD(study group)and 106 healthy individuals(control group)in our hospital from March 2019 to September 2020 were selected for this study.All subjects were examined by ultrasound,and the mitral orifice’s early-to-late diastolic blood flow velocity ratio(E/A),left ventricular end-diastolic volume(LVDd),and left atrial diameter(LAD)were measured.Values were compared between the study group and healthy group,and the correlation between the ultrasonic parameters of patients with different cardiac function grades and the degree of CHD were assessed.In addition,the ultrasonic parameters of patients with different prognoses were compared after a follow-up for 6 mo.RESULTS E/A(1.46±0.34)of the study group was smaller than that of the control group(1.88±0.44),while LVDd(58.24±5.05 mm)and LAD(43.31±4.38 mm)were larger(48.15±3.93 and 34.94±2.81,respectively;P<0.05).E/A for patients with grade III disease(1.41±0.43)was smaller and their LVDd(60.04±4.21 mm)and LA(44.16±2.79 mm)were larger than those in patients with grade II disease(1.71±0.48,52.18±3.67 mm,and 39.68±2.37,respectively;P<0.05).Patients with grade IV disease had smaller E/A(1.08±0.39)and larger LVDd(66.81±5.39 mm)and LAD(48.81±3.95 mm)than patients with grade II and III disease(P<0.05).In patients with moderate disease,E/A(1.44±0.41)was smaller and LVDd(59.95±4.14 mm)and LAD(45.15±2.97 mm)were larger than in patients with mild disease(1.69±0.50,51.97±3.88 and 38.81±2.56 mm,respectively;P<0.05).In patients with severe disease,E/A(1.13±0.36)was smaller and LVDd(67.70±6.11 mm)and LAD(49.09±4.05 mm)were larger than in patients with moderate disease(P<0.05).E/A was negatively correlated with cardiac function classi-fication and disease severity,while LVDd and LAD were positively correlated with cardiac function classification and disease severity(P<0.05).E/A(1.83±0.51)for patients with good prognosis was higher than that for those with poor prognosis(1.39±0.32),while LVDd(49.60±4.39 mm)and LAD(36.13±3.05 mm)were lower(P<0.05).CONCLUSION The ultrasonic parameters of patients with CHD are abnormal,and differ significantly in patients with different cardiac function grades,lesion degree,and prognosis.展开更多
Objective:To study the ultrasound features of carotid atherosclerosis in patients with coronary heart disease and their correlation with disease severity. Methods:180 patients with coronary heart disease treated in ou...Objective:To study the ultrasound features of carotid atherosclerosis in patients with coronary heart disease and their correlation with disease severity. Methods:180 patients with coronary heart disease treated in our hospital between December 2010 and December 2015 were collected as observation group and divided into single-vessel disease group (n=50), double-vessel disease group (n=72) and triple-vessel disease group (n=58) according to the degree of coronary artery stenosis;50 healthy subjects receiving physical examination in our hospital during the same period were selected as control group. Carotid ultrasound was used to measure carotid atherosclerosis parameters, cardiac color Doppler ultrasound was used to detect cardiac function parameters, enzyme-linked immunosorbent assay (ELISA) was used to detect serum endothelial function indexes, and Pearson test was used to analyze the correlation between carotid ultrasound parameters and the cardiac function as well as endothelial function. Results:Carotid ultrasound parameters stiffness (β), elastic modulus (Ep), arterial compliance (AC) and pulse wave velocity (PWVβ) value of observation group were higher than those of control group, and with the increase of coronary artery lesion severity, the changes ofβ, Ep, AC and PWVβvalue increased (P<0.05);cardiac function parameters left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) value of observation group were higher than those of control group while left ventricular ejection fraction (LVEF) value was lower than that of control group, and with the increase of coronary artery lesion severity, the changes of LVEDD, LVESD and LVEF value increased (P<0.05);endothelial function indexes endothelin-1 (ET-1) and von willebrand factor (vWF) levels of observation group were higher than those of control group while nitric oxide (NO) level was lower than that of control group, and with the increase of coronary artery lesion severity, the changes of ET-1, vWF and NO levels increased (P<0.05). Carotid ultrasound parameterβ, Ep, AC and PWVβvalue in patients with coronary heart disease were directly correlated with the levels of cardiac function parameters and endothelial function indexes. Conclusions:The ultrasound parameter levels of carotid atherosclerosis in patients with coronary heart disease are directly correlated with the disease severity and can be used as the noninvasive and reliable means for early judgment of the disease.展开更多
Objective Most patients with knee osteoarthritis(OA)have alignment deformity with the change of Hip-knee-ankle(HKA)angle.The knee alignment influences load distribution at the tibial plateau.Meanwhile,change of subcho...Objective Most patients with knee osteoarthritis(OA)have alignment deformity with the change of Hip-knee-ankle(HKA)angle.The knee alignment influences load distribution at the tibial plateau.Meanwhile,change of subchondral trabecular bone microstructure is related to load bearing and OA progression.However,the relationship between knee alignment on the changes of subchondral trabecular bone microstructure and OA severity have been poorly investigated.The main goal of this work was to investigate variation in tibial plateaus subchondral trabecular bone microstructure in knee OA patients and their association with the severity of OA with the change of knee alignment.Methods Seventy-one knee OA patients planning to undergo total knee arthroplasty were enrolled in this study.The HKA angle and OA disease severity(OARSI score,compartment-specific Kellgren-Lawrence(K-L)grade and OARSI Atlas grade)based on full-leg standing posteroanterior radiographs were evaluated preoperatively in all patients.The tibial plateau collected during surgery was first used for micro-computed tomography(μCT)to analyze the subchondral trabecular bone microstructures,and then used for pathological sections to analyze cartilage degeneration(OARSI score).Pearson and spearman correlations were used to examine linear relationships between knee alignment,OA disease severity and subchondral trabecular bone microstructure.Patients were then divided into group I(HKA angle exceeds 0°in the valgus direction),group II(varus angle<10°)and group III(varus angle≥10°).The differences in subchondral trabecular bone microstructural parameters between the three groups were analyzed by the one-way ANOVA with a post hoc Tukey test.Results HKA angle was significantly correlated with all tibial plateau subchondral trabecular bone microstructure parameters.Regardless of the medial or lateral tibia,HKA angle was most strongly correlated with bone volume fraction(BV/TV),M:(r=0. 613,P<0.01);L:(r=-0.490,P<0.01).In addition,for the media-to-lateral ratios(M:L)of the subchondral trabecular bone microstructure parameters,the HKA angle is positively correlated with M:L BV/TV(r=0.658,P<0.01),M:L trabecular number(Tb.N)(r=0.525,,P<0.01),M:L trabecular thickness(Tb.Th)(r=0.636,P<0.01),and negatively correlated with M:L trabecular separation(Tb.Sp)(r=-0.636,P<0.01)and M:L Specific Bone Surface(BS/BV)(r=-0.792,P<0.01).The BV/TV,Tb.N,and Tb.Th of the medial tibia were sequentially incremented in the order of groupⅠ,Ⅱ,Ⅲof knee alignment,while the Tb.Sp and BS/BV were decreased in this order.The lateral tibia is the opposite.In addition,most of the severity indices of OA are associated with subchondral trabecular bone microstructures,of which OARSI score and BV/TV in medial tibia are the most relevant(r=0.787,P<0.01).HKA angle is significantly correlated with all OA severity grades in medial compartment,but only with OARSI score and Bone sclerosis grade in lateral compartment.Conclusions Tibial plateau subchondral trabecular bone microarchitecture is associated with the HKA angle and OA severity.With the increase of varus angle and the severity of OA,the subchondral trabecular bone in medial tibia has more obvious sclerosis changes and vice versa,suggesting that knee malalignment may promote abnormal subchondral trabecular bone remodeling by altering joint load distribution,thereby affecting the progression of OA.展开更多
BACKGROUND Acute pancreatitis(AP)is an inflammatory disease,which presents with epigastric pain and is clinically diagnosed by amylase and lipase three times the upper limit of normal.The 2012 Atlanta classification s...BACKGROUND Acute pancreatitis(AP)is an inflammatory disease,which presents with epigastric pain and is clinically diagnosed by amylase and lipase three times the upper limit of normal.The 2012 Atlanta classification stratifies the severity of AP as one of three risk categories namely,mild AP(MAP),moderately severe AP(MSAP),and severe AP(SAP).Challenges in stratifying AP upon diagnosis suggest that a better understanding of the underlying complex pathophysiology may be beneficial.AIM To identify the role of the chemokine receptor 8(CCR8),expressed by T-helper type-2 Lymphocytes and peritoneal macrophages,and its possible association to Interleukin(IL)-6 and AP stratification.METHODS This study was a prospective case-control study.A total of 40 patients were recruited from the Chris Hani Baragwanath Academic Hospital and the Charlotte Maxeke Johannesburg Academic Hospital.Bioassays were performed on 29 patients(14 MAP,11 MSAP,and 4 SAP)and 6 healthy controls as part of a preliminary study.A total of 12 mL of blood samples were collected at Day(D)1,3,5,and 7 post epigastric pain.Using multiplex immunoassay panels,real-time polymerase chain reaction(qRT-PCR)arrays,and multicolour flow cytometry analysis,immune response-related proteins,genes,and cells were profiled respectively.GraphPad Prism^(TM) software and fold change(FC)analysis was used to determine differences between the groups.P<0.05 was considered significant.RESULTS The concentration of IL-6 was significantly different at D3 post epigastric pain in both the MAP group and MSAP group with P=0.001 and P=0.013 respectively,in a multiplex assay.When a FC of 2 was applied to identify differentially expressed genes using RT2 Profiler,CCR8 was shown to increase steadily with disease severity from MAP(1.33),MSAP(38.28)to SAP(1172.45)median FC.Further verification studies using RT-PCR showed fold change increases of CCR8 in MSAP and SAP ranging from 1000 to 1000000 times when represented as Log10,compared to healthy control respectively at D3.The findings also showed differing lymphocyte and monocyte cell frequency between the groups.With monocyte population frequency as high as 70%in MSAP at D3.CONCLUSION The higher levels of CCR8 and IL-6 in the severe patients and immune cell differences compared to MAP and controls provide an avenue for exploring AP stratification to improve management.展开更多
文摘BACKGROUND Population of patients with inflammatory bowel disease(IBD)is burdened by various extraintestinal manifestations which substantially contribute to greater morbidity and mortality.Growth-differentiation factor-15(GDF-15)is often overexpressed under stress conditions,such as inflammation,malignancies,heart failure,myocardial ischemia,and many others.AIM To explore the association between GDF-15 and IBD as serum concentrations of GDF-15 were shown to be an independent predictor of poor outcomes in multiple diseases.An additional aim was to determine possible associations between GDF-15 and multiple clinical,anthropometric and laboratory parameters in patients with IBD.METHODS This cross-sectional study included 90 adult patients diagnosed with IBD,encompassing both Crohn’s disease(CD)and ulcerative colitis(UC),and 67 healthy age-and sex-matched controls.All patients underwent an extensive workup,including colonoscopy with subsequent histopathological analysis.Disease activity was assessed by two independent gastroenterology consultants specialized in IBD,employing well-established clinical and endoscopic scoring systems.GDF-15 serum concentrations were determined following an overnight fasting,using electrochemiluminescence immunoassay.RESULTS In patients with IBD,serum GDF-15 concentrations were significantly higher in comparison to the healthy controls[800(512-1154)pg/mL vs 412(407-424)pg/mL,P<0.001],whereas no difference in GDF-15 was found between patients with CD and UC[807(554-1451)pg/mL vs 790(509-956)pg/mL,P=0.324].Moreover,multiple linear regression analysis showed that GDF-15 levels predict CD and UC severity independent of age,sex,and C-reactive protein levels(P=0.016 and P=0.049,respectively).Finally,an association between GDF-15 and indices of anemia was established.Specifically,negative correlations were found between GDF-15 and serum iron levels(r=-0.248,P=0.021),as well as GDF-15 and hemoglobin(r=-0.351,P=0.021).Accordingly,in comparison to IBD patients with normal hemoglobin levels,GDF-15 serum levels were higher in patients with anemia(1256(502-2100)pg/mL vs 444(412-795)pg/mL,P<0.001).CONCLUSION For the first time,we demonstrated that serum concentrations of GDF-15 are elevated in patients with IBD in comparison to healthy controls,and the results imply that GDF-15 might be involved in IBD pathophysiology.Yet,it remains elusive whether GDF-15 could serve as a prognostic indicator in these patients.
基金supported by Special Program of Science and Technology of Guangdong Province(Grant No.:2013A020229001)the Major Program of Guangzhou Healthcare Collaborative Innovation(Grant No.:201803040006)Basic and applied basic research project jointly funded by the University of Guangzhou(Grant No.:2023A03J0810).
文摘Objective:To identify the association between serum albumin levels and disease severity among adult patients with dengue in China's Mainland.Methods:This retrospective cohort study analyzed the data of adult patients(aged≥18 years)hospitalized with laboratory-confirmed dengue in a tertiary center for infectious diseases from 2013 to 2019 in China's Mainland.Serum albumin levels were estimated and compared between patients with severe dengue and non-severe dengue.Additionally,the association between serum albumin levels and severe dengue was evaluated using a generalized linear model[relative risks(RR)].Multivariate logistic regression analysis was performed to identify the potential predictors of severe dengue.Results:Overall,1568 patients were included in this study.Of these patients,34(2.17%)developed severe dengue.The median serum albumin levels were significantly lower in patients with severe dengue than that in those with non-severe dengue(33 g/L vs.37 g/L,P<0.001).After adjustment for age,sex,and comorbidities,hypoalbuminemia(RR 4.877,95%CI 2.193-11.461,P<0.001)was found to be a predictor of severe dengue.Serum albumin levels(OR 1.303,95%CI 1.161-1.462,P<0.001)and age(OR 1.038,95%CI 1.017-1.061,P<0.001)were significant risk factors for severe dengue.The area under the curve for serum albumin levels to distinguish severe dengue was 0.787.Conclusions:Lower serum albumin levels were significantly associated with disease severity in adult patients with dengue.Hypoalbuminemia on admission resulted in at least a four-fold increased risk of severe dengue.
文摘The world’s agricultural production suffers huge losses estimated between 20% and 40% annually. 40% to 50% of such losses are due to pest and diseases which cause significant economic losses every year. Precise assessment of severity is crucial for suitable management of crop diseases. It helps famers to avoid yield losses, reduce production costs, ensure good disease management and so on. This paper is a review of plant diseases severity estimation solutions proposed by researchers the last few years and based on Image Processing Techniques (IPT), classical Machine Learning (ML) and Deep Learning (DL) algorithms. The analysis of these solutions has allowed us to identify their limitations and potential challenges in plant disease severity assessment.
基金This study was supported in part by National Institutes of Health(NIH)grant(K12 HD85036)University of California San Diego Altman Clinical and Translational Research Institute(ACTRI)/NIH grant(KL2TR001444)+14 种基金Pinnacle Research Award in Liver Diseases Grant(PNC22-159963)from the American Association for the Study of Liver Diseases Foundation(to Hartmann P)Deutsche Forschungsgemeinschaft(DFG,German Research Foundation)fellowship(LA 4286/1-1)the“Clinical and Translational Research Fellowship in Liver Disease”by the American Association for the Study of Liver Diseases(AASLD)Foundation(to Lang S)National Institutes of Health grants(R01 AA24726,R01 AA020703,U01 AA026939)Award Number BX004594 from the Biomedical Laboratory Research&Development Service of the VA Office of Research and DevelopmentBiocodex Microbiota Foundation Grant(to Schnabl B)services provided by NIH centers(P30 DK120515 and P50 AA011999)This study was also supported by the German Research Foundation(DFG)project(403224013-SFB 1382)(to Trebicka J)the German Federal Ministry of Education and Research(BMBF)for the DEEP-HCC project(to Trebicka J)the Hessian Ministry of Higher Education,Research and the Arts(HMWK)for the ENABLE and ACLF-I cluster projects(to Trebicka J)The MICROB-PREDICT(825694)DECISION(847949)GALAXY(668031)LIVERHOPE(731875)IHMCSA(964590)projects(all to Trebicka J)have received funding from the European Union’s Horizon 2020 research and innovation program.
文摘Background:Cirrhosis with acute decompensation(AD)and acute-on-chronic liver failure(ACLF)are characterized by high morbidity and mortality.Cytolysin,a toxin from Enterococcus faecalis(E.faecalis),is associated with mortality in alcohol-associated hepatitis(AH).It is unclear whether cytolysin also contributes to disease severity in AD and ACLF.Methods:We studied the role of fecal cytolysin in 78 cirrhotic patients with AD/ACLF.Bacterial DNA from fecal samples was extracted and real-time quantitative polymerase chain reaction(PCR)was performed.The association between fecal cytolysin and liver disease severity in cirrhosis with AD or ACLF was analyzed.Results:Fecal cytolysin and E.faecalis abundance did not predict chronic liver failure(CLIF-C)AD and ACLF scores.Presence of fecal cytolysin was not associated with other liver disease markers,including Fibrosis-4(FIB-4)index,‘Age,serum Bilirubin,INR,and serum Creatinine(ABIC)’score,Child-Pugh score,model for end-stage liver disease(MELD)nor MELD-Na scores in AD or ACLF patients.Conclusions:Fecal cytolysin does not predict disease severity in AD and ACLF patients.The predictive value of fecal cytolysin positivity for mortality appears to be restricted to AH.
基金Supported by A GI Section Grant from the University of Western Ontario,Ontario,Canada
文摘AIM:To understand the demographic characteristics of patients in Southwestern Ontario,Canada with ulcerative colitis(UC)in order to predict disease severity. METHODS:Records from 1996 to 2001 were exam- ined to create a database of UC patients seen in the London Health Sciences Centre South Street Hospital Inflammatory Bowel Disease Clinic.To be included, patients'charts were required to have information of their disease presentation and a minimum of 5 years of follow-up.Charts were reviewed using standardized data collection forms.Disease severity was generated during the chart review process,and non-endoscopic Mayo Score criteria were collected into a composite. RESULTS:One hundred and two consecutive patients'data were entered into the database.Demographic analyses revealed that 51%of the patients were male, the mean age at diagnosis was 39 years,13.7%had a first degree relative with inflammatory bowel disease (IBD),61.8%were nonsmokers and 24.5%were ex-smokers.In 22.5%of patients the disease was limited to the rectum,in 21.6%disease was limited to the sigmoid colon,in 22.5%disease was limited to the left colon,and 32.4%of patients had pancolitis. Standard multiple regression analysis which regressed a composite of physician global assessment of disease severity,average number of bowel movements,and average amount of blood in bowel movements on year of diagnosis and age at time of diagnosis was significant,R 2=0.306,F(7,74)=4.66,P<0.01. Delay from symptoms to diagnosis of UC,gender, family history of IBD,smoking status and disease severity at the time of diagnosis didnot significantly predict the composite measure. CONCLUSION:UC severity is associated with younger age at diagnosis and year of diagnosis in a longitudinal cohort of UC patients,and may identify prognostic UC indicators.
文摘Due to the disease's broad clinical spectrum,it is currently unclear how to predict the future prognosis of patients at the time of diagnosis of coronavirus disease 2019(COVID-19).Real-time reverse transcription-polymerase chain reaction(RTPCR)is the gold standard molecular technique for diagnosing COVID-19.The number of amplification cycles necessary for the target genes to surpass a threshold level is represented by the RT-PCR cycle threshold(Ct)values.Ct values were thought to be an adequate proxy for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)viral load.A body of evidence suggests that SARS-CoV-2 viral load is a possible predictor of COVID-19 severity.The link between SARS-CoV-2 viral load and the likelihood of severe disease development in COVID-19 patients is not clearly elucidated.In this review,we describe the scientific data as well as the important findings from many clinical studies globally,emphasizing how viral load may be related to disease severity in COVID-19 patients.Most of the evidence points to the association of SARS-CoV-2 viral load and disease severity in these patients,and early anti-viral treatment will reduce the severe clinical outcomes.
文摘<strong>Background:</strong> Hyperglycemia is an important predictor of prolonged hospitalization and mortality. The objective of this study was to analyze the role of early hyperglycemia in predicting the severity of COVID-19 illness and mortality. <strong>Method:</strong> Retrospective study on 259 patients with COVID-19 with measurement of average glucose during 24 hours of admission. Association of Early Hyperglycemia categorized as <180 mg/dl or >180 mg/dl;was studied with mortality, requirement of ICU stay and prognostic markers. <strong>Results: </strong>Early hyperglycemia (>180 mg/dl) revealed a higher median value for CRP (109 mg/l [IQR;48 - 199]) in comparison to <180 mg/dl group (86 mg/l [IQR;26.3 - 153]) p = 0.03. ICU stay was higher in >180 mg/dl group;24 (15.9%) vs 14 patients (13%) [p = 0.51] in the <180 mg/dl group. Mortality in the group > 180 mg/dl was 8 (5.3%) while <180 mg/dl had a mortality rate of 4 (3.7%) [p = 0.547]. <strong>Conclusion:</strong> Hyperglycemia in the first 24 hours may anticipate an increased risk of ICU stay and a higher mortality rate. It may be a possible predictor of disease severity.
文摘Recently we have shown the presence of catalytically active IgGs, capable to cleave histone H1 and bovine myelin basic protein (MBP), in blood serum of SLE patients. Here we present data that demonstrate the correlation between a) proteolytic activity towards histone H1 and MBP of IgG-antibodies from blood serum of SLE patients and b) disease severity level in these patients. IgGs were isolated from blood serum by chromatography on protein G-sepharose. Commercial preparations of bovine myelin basic proteins (MBP) and calf thymus histone H1 were used as substrates. Analysis of the proteolytic activity showed that 16 of 38 lgG-preparations (42,1%) obtained from blood serum of SLE patients were capable of cleaving both histone H1 and MBP with different efficiency. It was revealed that the presence in blood serum of lgGs possessing proteolytic activity towards both histone H1 and bMBP closely correlates with manifestation of the disease severity in SLE patients.
文摘AIM To determine the association of circulating mi R-125 a/b expression with the risk and disease severity of Crohn's disease(CD), and with inflammatory cytokines.METHODS Plasma samples were collected from patients with active CD(A-CD), or CD in remission(R-CD) and from healthy controls(HCs). The levels of the inflammatory cytokines interleukin-17(IL-17), tumour necrosis factor-α(TNF-α), and interferon-γ(IFN-γ) were measured by enzyme-linked immunosorbent assay. The expression of mi R-125 a/b was assessed by quantitative polymerase chain reaction(q PCR).RESULTS Twenty-nine A-CD patients, 37 R-CD patients, and 37 HCs were included in the study. Plasma mi R-125 a expression was decreased in A-CD patients comparedwith that in R-CD patients(P < 0.001) and HCs(P < 0.001). mi R-125 a expression levels enabled the differentiation of A-CD from R-CD patients [area under curve(AUC) = 0.854] and from HCs(AUC = 0.780), whereas mi R-125 b expression did not. mi R-125 a was negatively correlated with C-reaction protein(CRP)(P = 0.017), erythrocyte sedimentation rate(ESR)(P = 0.026), Crohn's disease activity index(CDAI)(P = 0.003), IL-17(P = 0.015), and TNF-α(P = 0.004) in A-CD patients. Furthermore, mi R-125 a was negatively associated with CRP(P = 0.038) and CDAI(P = 0.021) in R-CD patients. Regarding mi R-125 b, no association with CRP, CDAI, IL-17, TNF-α, or IFN-γ was found in A-CD or in R-CD patients. mi R-125 a levels gradually increased in A-CD patients who achieved clinical remission(P = 0.009) after 3-mo treatment, whereas they remained unchanged among patients who failed to achieve remission. No changes in mi R-125 b expression were detected in remission or non-remission patients after treatment. CONCLUSION Circulating mi R-125 a but not mi R-125 b is decreased in patients with active disease status and negatively correlates with disease severity and inflammatory cytokines in patients with CD.
文摘Lysosomal acid lipase(LAL)plays a key role in intracellular lipid metabolism.Reduced LAL activity promotes increased multi-organ lysosomal cholesterol ester storage,as observed in two recessive autosomal genetic diseases,Wolman disease and Cholesterol ester storage disease.Severe liver steatosis and accelerated liver fibrosis are common features in patients with genetic LAL deficiency.By contrast,few reliable data are available on the modulation of LAL activity in vivo and on the epigenetic and metabolic factors capable of regulating its activity in subjects without homozygous mutations of the Lipase A gene.In the last few years,a less severe and non-genetic reduction of LAL activity was reported in children and adults with non-alcoholic fatty liver disease(NAFLD),suggesting a possible role of LAL reduction in the pathogenesis and progression of the disease.Patients with NAFLD show a significant,progressive reduction of LAL activity from simple steatosis to non-alcoholic steatohepatitis and cryptogenic cirrhosis.Among cirrhosis of different etiologies,those with cryptogenic cirrhosis show the most significant reductions of LAL activity.These findings suggest that the modulation of LAL activity may become a possible new therapeutic target for patients with more advanced forms of NAFLD.Moreover,the measurement of LAL activity may represent a possible new marker of disease severity in this clinical setting.
基金Supported by Agencia Nacional de Promoción Científicay Tecnológica,No.PICT 2014-0432,No.PICT 2014-1816 and No.PICT 2015-0551
文摘This review intends to uncover how information from large-scale genetic profiling(whole genome sequencing, and whole exome sequencing) of nonalcoholic fatty liver disease(NAFLD), as well as information from circulating transcriptomics(cell-free mi RNAs) and metabolomics, contributes to the understanding of NAFLD pathogenesis. A further aim is to address the question of whether OMICs information is ready to be implemented in the clinics. The available evidence suggests that any new knowledge pertaining to molecular signatures associated with NAFLD and nonalcoholic steatohepatitis should be promptly translated into the clinical setting. Nevertheless, rigorous steps that must include validation and replication are mandatory before utilizing OMICs biomarkers in diagnostics to identify patients at risk of advanced disease, including liver cancer.
文摘Introduction: Coronary artery disease (CAD) is one of the most common causes of death worldwide. In 2010, about 7 out of total 53 million deaths were due to ischemic heart disease. The aim of this study is to evaluate the relationship of serum bilirubin level with the severity and complexity of coronary artery disease (CAD) in the patients undergoing primary percutaneous coronary intervention (PCI). Materials and Methods: 70 patients with STEMI who were undergoing primary PCI were included in the study. All the patients included in the study were subjected to full routine investigations and standard coronary angiographic projections. Total bilirubin level was measured and the patients were divided into two groups. Group 1 was with serum TB (and Group 2 was with serum TB (>1 mg/dl). Severity and complexity of coronary artery lesions will be assessed using Gensini score. Results: After PCI, the two studied groups were compared regarding the number of vessels affected by one and more than one vessel disease. Single vessel disease was frequent in Group 2 (71%) with significant p value (0.003). Cardiac enzymes (troponin I) was more in Group 1 (S. Bil value (0.02). Also (ALT, AST) were more in Group 1 (p value = 0.01). By comparing the 2 groups, there was a significant difference regarding (EF) between both which was less in Group 1 (S.TB 1), p value significance (0, 0001). Also GENSENI was more in Group 1 (S.TB 1) with mean (80.35 vs 34.71) and significant pvalue (0.0001). There was a highly significant negative correlation between serum bilirubin & GENSENI score (r = -0.762, p value 0.0001). Regarding the incidence of complications, incidence was more in Group 1 (S.TB 1), which means a significant difference between both groups with significant p value (0.0001). There was a significant negative correlation between serum bilirubin & incidence of complications (R = -0.38, pvalue 0.001). Also, there was a significant negative correlation between GENSINI score, complication and bilirubin among both groups (r: -0.762\-0.38) with p value (0.0001\0.001) respectively. Conclusion: In conclusion, our results suggested that the Serum Bilirubin level is inversely correlated with the severity of CAD. Also, the SB level is an independent predictor of cardiovascular events in CAD patients. Understandably, our findings need further verification by large-scale, multicenter clinical trials in the future.
文摘AIM:To find out whether serum oxidizability potential correlates with exercise test(EXT) parameters and predicts their results in chronic ischemic heart disease(IHD) patients.METHODS:Oxidizability potential was determined in a group of chronic IHD patients who underwent a symptom limited EXT upon initiation of a cardiac rehabilitation program.The thermo-chemiluminescence(TCL) assay was used to assess serum oxidizability potential.This assay is based on heat-induced oxidation of serum,leading to the formation of electronically excited species in the form of unstable carbonyls,which further decompose into stable carbonyls and light energy(low chemiluminescence).Measured photons emission is represented by a kinetic curve which is described by its amplitude and slope(= ratio).We assessed the correlations of TCL ratio with exercise duration,metabolic equivalents(METS),maximal heart rate(mHR),maximal systolic BP,> 1 mm S-T depression,diabetes,hypertension,smoking,left ventricular ejection fraction(LVEF) > or < 40%,previous myocardial infarction,and aorto-coronary bypass surgery and compared to the TCL ratio measured in a group of healthy controls.RESULTS:A high TCL ratio(%) correlated well with METS(r = 0.84),with mHR(r = 0.79) and with exercise induced S-T segment shift(r = 0.87,P < 0.05).A lower serum oxidizability potential,expressed as a low TCL ratio,thus suggestive of a previous high oxidative stress,was found in IHD patients compared to healthy controls,and,in particular,in patients with low LVEF%.The TCL ratio(%) in IHD patients was 193 ± 21,compared to 215 ± 13 in controls(P < 0.05),and was 188 ± 14.7 in patients with LVEF < 40% as compared to 200 ± 11.9 in those with LVEF > 40%(P < 0.01).A trend for lower TCL ratio(%) was found in diabetic,hypertensive,and post-coronary bypass surgery patients.A paradoxically low TCL ratio(low oxidizability potential) was observed in patients without S-T depression compared to patients with S-T depression(189 ± 22 vs 201 ± 15,P = NS),due to the fact these patients had a much lower LVEF% and a lower exercise capacity.CONCLUSION:Serum oxidizability potential is associated with EXT parameters,results,and IHD severity.TCL ratio is an "easy-to-measure marker" that might be incorporated into risk assessment and prediction in chronic IHD patients.
文摘COVID-19 has become the global focus since December 2019[1].Patients usually experience cough,fever and flu-like symptoms.Most patients also experience dyspnoea.Elevated procalcitonin,lymphopenia are observed in COVID-19 patients.Recently,a case series analysis has predicted that lymphopenia may be a very good prognostic marker for disease progression in COVID-19[2].
文摘BACKGROUND Bifidobacterium longum 35624 has shown efficacy in improving irritable bowel syndrome(IBS)symptoms compared with placebo in double-blind randomized studies.However,few data are available from real-life clinical practice or from studies that used Rome IV criteria to diagnose IBS.AIM To assess the effect of B.longum 35624 on IBS severity and quality of life in a reallife setting.METHODS From November 2018 to January 2020,278 patients with IBS(according to Rome IV criteria)were enrolled in a prospective,open-label,multicenter observational study by private practice gastroenterologists to received one capsule of B.longum 35624(10^(9) colony-forming units)per day for 30 d.Participation in the study was independently proposed to patients during spontaneous consultations.Disease severity(assessed by the IBS severity scoring system)and patient quality of life(assessed by the IBS quality of life questionnaire)were compared between the inclusion visit(baseline)and the visit at the end of 30 d of treatment.The characteristics of patients were described at baseline.Continuous variables comparisons between inclusion and end-of-treatment visits were performed using the t-test and Kruskal-Wallis test.Categorical variables comparisons were performed using theχ^(2) test.RESULTSA total of 233 patients,with a mean age of 51.4 years and composed of 71.2%women,were included in the study.Of these patients,48.1%had moderate IBS and 46.4%had severe IBS.After a 30-d treatment period with one B.longum 35624 capsule per day,a significant decrease in IBS severity was observed compared to baseline(mean±SD,IBS severity scoring system scores:208±104 vs 303±81,P<0.001)and 57%of patients moved to lower severity categories or achieved remission.The quality of life of patients was also improved by the treatment(IBS Quality of Life questionnaire score:68.8±20.9 vs 60.2±20.5;P<0.001)and 63.8%of patients were satisfied with the treatment.CONCLUSION Thirty days of treatment with B.longum 35624 reduces disease severity and improves the quality of life of patients with IBS,particularly those with the most severe forms of IBS.
文摘Red tip disease on pineapple (Ananas comosus) was first recognized about 20 years ago in a commercial pineapple stand located in Simpang Renggam, Johor, Peninsular Malaysia. Since its discovery, there has been no confirmation on the causal agent of red tip disease. The epidemiology of red tip disease is still not fully understood. However, based on disease symptoms and field transmission mode, red tip disease seems to be strongly associated with viral infection. The aim of this work was to assess the feasibility of using an optical sensor to estimate red tip disease severity. This work was performed in a commercial pineapple plantation located in Simpang Renggam, Johor. Four observation plots bearing pineapple variety SR36 were demarcated based on crop growth stage. Each plot comprised a total of eighty corresponding measurements of percent Disease Severity (% DS) and Normalized Difference Vegetation Index (NDVI). Our data showed a strong correlation between % DS and NDVI. The 7- and 11-month plantings registered a correlation coefficient (r) of -0.83 and -0.88, respectively. The negative correlation infers that NDVI increases when disease severity is low. This is expected since healthy leaves reflect more near-infrared light and less visible light which results in a higher NDVI. The regression of NDVI on % DS for the 7-month planting was explained by: % DS = 181.6 - 185.6*NDVI. Meanwhile, the regression of NDVI on % DS for the 11-month planting was explained by: % DS = 213.2 - 219.8*NDVI. The linear fit between measured % DS and estimated % DS from the 7-month and 11-month plantings was relatively strong. This work has demonstrated that NDVI is a reliable predictor of % DS in pineapple.
文摘BACKGROUND Coronary heart disease(CHD)causes many adverse cardiovascular events and poses a threat to the patient’s health and quality of life.AIM To evaluate ultrasonography for evaluation of cardiac function and lesion degree in patients with CHD.METHODS A total of 106 patients with CHD(study group)and 106 healthy individuals(control group)in our hospital from March 2019 to September 2020 were selected for this study.All subjects were examined by ultrasound,and the mitral orifice’s early-to-late diastolic blood flow velocity ratio(E/A),left ventricular end-diastolic volume(LVDd),and left atrial diameter(LAD)were measured.Values were compared between the study group and healthy group,and the correlation between the ultrasonic parameters of patients with different cardiac function grades and the degree of CHD were assessed.In addition,the ultrasonic parameters of patients with different prognoses were compared after a follow-up for 6 mo.RESULTS E/A(1.46±0.34)of the study group was smaller than that of the control group(1.88±0.44),while LVDd(58.24±5.05 mm)and LAD(43.31±4.38 mm)were larger(48.15±3.93 and 34.94±2.81,respectively;P<0.05).E/A for patients with grade III disease(1.41±0.43)was smaller and their LVDd(60.04±4.21 mm)and LA(44.16±2.79 mm)were larger than those in patients with grade II disease(1.71±0.48,52.18±3.67 mm,and 39.68±2.37,respectively;P<0.05).Patients with grade IV disease had smaller E/A(1.08±0.39)and larger LVDd(66.81±5.39 mm)and LAD(48.81±3.95 mm)than patients with grade II and III disease(P<0.05).In patients with moderate disease,E/A(1.44±0.41)was smaller and LVDd(59.95±4.14 mm)and LAD(45.15±2.97 mm)were larger than in patients with mild disease(1.69±0.50,51.97±3.88 and 38.81±2.56 mm,respectively;P<0.05).In patients with severe disease,E/A(1.13±0.36)was smaller and LVDd(67.70±6.11 mm)and LAD(49.09±4.05 mm)were larger than in patients with moderate disease(P<0.05).E/A was negatively correlated with cardiac function classi-fication and disease severity,while LVDd and LAD were positively correlated with cardiac function classification and disease severity(P<0.05).E/A(1.83±0.51)for patients with good prognosis was higher than that for those with poor prognosis(1.39±0.32),while LVDd(49.60±4.39 mm)and LAD(36.13±3.05 mm)were lower(P<0.05).CONCLUSION The ultrasonic parameters of patients with CHD are abnormal,and differ significantly in patients with different cardiac function grades,lesion degree,and prognosis.
文摘Objective:To study the ultrasound features of carotid atherosclerosis in patients with coronary heart disease and their correlation with disease severity. Methods:180 patients with coronary heart disease treated in our hospital between December 2010 and December 2015 were collected as observation group and divided into single-vessel disease group (n=50), double-vessel disease group (n=72) and triple-vessel disease group (n=58) according to the degree of coronary artery stenosis;50 healthy subjects receiving physical examination in our hospital during the same period were selected as control group. Carotid ultrasound was used to measure carotid atherosclerosis parameters, cardiac color Doppler ultrasound was used to detect cardiac function parameters, enzyme-linked immunosorbent assay (ELISA) was used to detect serum endothelial function indexes, and Pearson test was used to analyze the correlation between carotid ultrasound parameters and the cardiac function as well as endothelial function. Results:Carotid ultrasound parameters stiffness (β), elastic modulus (Ep), arterial compliance (AC) and pulse wave velocity (PWVβ) value of observation group were higher than those of control group, and with the increase of coronary artery lesion severity, the changes ofβ, Ep, AC and PWVβvalue increased (P<0.05);cardiac function parameters left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) value of observation group were higher than those of control group while left ventricular ejection fraction (LVEF) value was lower than that of control group, and with the increase of coronary artery lesion severity, the changes of LVEDD, LVESD and LVEF value increased (P<0.05);endothelial function indexes endothelin-1 (ET-1) and von willebrand factor (vWF) levels of observation group were higher than those of control group while nitric oxide (NO) level was lower than that of control group, and with the increase of coronary artery lesion severity, the changes of ET-1, vWF and NO levels increased (P<0.05). Carotid ultrasound parameterβ, Ep, AC and PWVβvalue in patients with coronary heart disease were directly correlated with the levels of cardiac function parameters and endothelial function indexes. Conclusions:The ultrasound parameter levels of carotid atherosclerosis in patients with coronary heart disease are directly correlated with the disease severity and can be used as the noninvasive and reliable means for early judgment of the disease.
基金supported by grants from the National Natural Science Foundation of China ( 11572197, 11872251)Shanghai Clinical Medical Center ( 2017ZZ01023)+1 种基金Shanghai Municipal Key Clinical Specialty,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine ( JYLJ201821,CK2018011)Shanghai Jiao Tong University School of Medicine ( TM201814)
文摘Objective Most patients with knee osteoarthritis(OA)have alignment deformity with the change of Hip-knee-ankle(HKA)angle.The knee alignment influences load distribution at the tibial plateau.Meanwhile,change of subchondral trabecular bone microstructure is related to load bearing and OA progression.However,the relationship between knee alignment on the changes of subchondral trabecular bone microstructure and OA severity have been poorly investigated.The main goal of this work was to investigate variation in tibial plateaus subchondral trabecular bone microstructure in knee OA patients and their association with the severity of OA with the change of knee alignment.Methods Seventy-one knee OA patients planning to undergo total knee arthroplasty were enrolled in this study.The HKA angle and OA disease severity(OARSI score,compartment-specific Kellgren-Lawrence(K-L)grade and OARSI Atlas grade)based on full-leg standing posteroanterior radiographs were evaluated preoperatively in all patients.The tibial plateau collected during surgery was first used for micro-computed tomography(μCT)to analyze the subchondral trabecular bone microstructures,and then used for pathological sections to analyze cartilage degeneration(OARSI score).Pearson and spearman correlations were used to examine linear relationships between knee alignment,OA disease severity and subchondral trabecular bone microstructure.Patients were then divided into group I(HKA angle exceeds 0°in the valgus direction),group II(varus angle<10°)and group III(varus angle≥10°).The differences in subchondral trabecular bone microstructural parameters between the three groups were analyzed by the one-way ANOVA with a post hoc Tukey test.Results HKA angle was significantly correlated with all tibial plateau subchondral trabecular bone microstructure parameters.Regardless of the medial or lateral tibia,HKA angle was most strongly correlated with bone volume fraction(BV/TV),M:(r=0. 613,P<0.01);L:(r=-0.490,P<0.01).In addition,for the media-to-lateral ratios(M:L)of the subchondral trabecular bone microstructure parameters,the HKA angle is positively correlated with M:L BV/TV(r=0.658,P<0.01),M:L trabecular number(Tb.N)(r=0.525,,P<0.01),M:L trabecular thickness(Tb.Th)(r=0.636,P<0.01),and negatively correlated with M:L trabecular separation(Tb.Sp)(r=-0.636,P<0.01)and M:L Specific Bone Surface(BS/BV)(r=-0.792,P<0.01).The BV/TV,Tb.N,and Tb.Th of the medial tibia were sequentially incremented in the order of groupⅠ,Ⅱ,Ⅲof knee alignment,while the Tb.Sp and BS/BV were decreased in this order.The lateral tibia is the opposite.In addition,most of the severity indices of OA are associated with subchondral trabecular bone microstructures,of which OARSI score and BV/TV in medial tibia are the most relevant(r=0.787,P<0.01).HKA angle is significantly correlated with all OA severity grades in medial compartment,but only with OARSI score and Bone sclerosis grade in lateral compartment.Conclusions Tibial plateau subchondral trabecular bone microarchitecture is associated with the HKA angle and OA severity.With the increase of varus angle and the severity of OA,the subchondral trabecular bone in medial tibia has more obvious sclerosis changes and vice versa,suggesting that knee malalignment may promote abnormal subchondral trabecular bone remodeling by altering joint load distribution,thereby affecting the progression of OA.
基金Supported by the South African National Research Foundation,No.121277the University of the Witwatersrand Individual Research,No.001283844110151211055142the Faculty of Health Sciences,University of the Witwatersrand Seed Funding,No.0012518441101512110500000000000000004550.
文摘BACKGROUND Acute pancreatitis(AP)is an inflammatory disease,which presents with epigastric pain and is clinically diagnosed by amylase and lipase three times the upper limit of normal.The 2012 Atlanta classification stratifies the severity of AP as one of three risk categories namely,mild AP(MAP),moderately severe AP(MSAP),and severe AP(SAP).Challenges in stratifying AP upon diagnosis suggest that a better understanding of the underlying complex pathophysiology may be beneficial.AIM To identify the role of the chemokine receptor 8(CCR8),expressed by T-helper type-2 Lymphocytes and peritoneal macrophages,and its possible association to Interleukin(IL)-6 and AP stratification.METHODS This study was a prospective case-control study.A total of 40 patients were recruited from the Chris Hani Baragwanath Academic Hospital and the Charlotte Maxeke Johannesburg Academic Hospital.Bioassays were performed on 29 patients(14 MAP,11 MSAP,and 4 SAP)and 6 healthy controls as part of a preliminary study.A total of 12 mL of blood samples were collected at Day(D)1,3,5,and 7 post epigastric pain.Using multiplex immunoassay panels,real-time polymerase chain reaction(qRT-PCR)arrays,and multicolour flow cytometry analysis,immune response-related proteins,genes,and cells were profiled respectively.GraphPad Prism^(TM) software and fold change(FC)analysis was used to determine differences between the groups.P<0.05 was considered significant.RESULTS The concentration of IL-6 was significantly different at D3 post epigastric pain in both the MAP group and MSAP group with P=0.001 and P=0.013 respectively,in a multiplex assay.When a FC of 2 was applied to identify differentially expressed genes using RT2 Profiler,CCR8 was shown to increase steadily with disease severity from MAP(1.33),MSAP(38.28)to SAP(1172.45)median FC.Further verification studies using RT-PCR showed fold change increases of CCR8 in MSAP and SAP ranging from 1000 to 1000000 times when represented as Log10,compared to healthy control respectively at D3.The findings also showed differing lymphocyte and monocyte cell frequency between the groups.With monocyte population frequency as high as 70%in MSAP at D3.CONCLUSION The higher levels of CCR8 and IL-6 in the severe patients and immune cell differences compared to MAP and controls provide an avenue for exploring AP stratification to improve management.
