ObjectiveTo explore the correlation of serum neutrophil gelatinase-associated lipocalin (sNGAL) with inflammatory response in patients with community-acquired pneumonia (CAP) and assess the diagnostic value of sNGAL for severe CAP (SCAP).MethodsFrom January 2018 to June 2019, a total of 85 patients with CAP were enrolled in this study. Age, length of hospital stay, the levels of serum creatinine, blood urea nitrogen, white blood cell count,C-reactive protein (CRP), interleukin-6 (IL-6), and procalcitonin, and CURB-65 score were compared between patients with SCAP (n=34) and patients without SCAP (n=51). The correlations of sNGAL with serum creatinine, blood urea nitrogen, white blood cell count, CRP, IL-6, procalcitonin, and CURB-65 score were assessed with Spearman’s correlation analysis. The area under the receiver operating characteristic (ROC) curve for sNGAL diagnosing SCAP was examined. ResultsCompared with patients without SCAP, SCAP patients demonstrated older age, longer hospital stay, higher serum CRP and IL-6 concentritions, and higher CURB-65 score (P<0.05). The Spearman’s correlation test showed that sNGAL was positively correlated with serum CRP, IL-6, PCT and CURB-65 score (rs=0.472, 0.504, 0.388, and 0.405, respectively; P<0.01). According to ROC analysis, the area under curve of sNGAL for diagnosing SCAP were 0.816, with a sensitivity of 76.56% and a specificity of 74.4% when the cut-off value was 171.0 ng/mL.ConclusionssNGAL concentration is positively correlated with the serverity of CAP. It can be regarded as a reliable indicator for diagnosis of SCAP in patients with CAP.
ObjectiveTo investigate the clinical value of the C-reactive protein (CRP) ratio (CRP value on postoperative day 3/day 1) as an early predictor of postoperative severe complication after laparoscopic gastrectomy (LG) for gastric cancer.MethodsThis retrospective study examined the relationship between the occurrence of severe complication and the CRP ratio of 259 gastric cancer patients, who underwent LG in the Department of General Surgery of General Hospital of Fuxin Mining Industry Group of Liaoning Health Industry Group from January 2015 to January 2020. According to Clavien-Dindo (CD) grading system, gastric cancer patients were divided into the severe postoperative complication group (n=41, 15.8%) and the non-severe postoperative complication group (n=218, 84.2%). The relationship between CRP ratio and clinicopathologic characteristics of patients and the predictive value of CRP ratio for severe complication were analyzed.ResultsThe optimal cutoff value of CRP ratio of 2.2 offered 63.2% sensitivity, 91.0% specificity, 70.7% positive predictive value, and 85.8% negative predictive value for severe postoperative complication. The area under the receiver operating characteristic curve was 0.766. There had distinct differences (P<0.05) on body mass index, preoperative comorbidity, type of surgery, T stage, and TNM stage between the high CRP ratio group (CRP ratio >2.2, n=60) and the low CRP ratio group (CRP ratio ≤2.2, n=199). Logistic regression showed that preoperative comorbidity [OR=3.624, 95%CI (1.191, 11.206), P=0.023], later of TNM stage [OR=9.037, 95% CI (1.729, 47.226), P=0.009], and CRP ratio >2.2 [OR=20.473, 95%CI (7.948, 52.737), P<0.001] were independent risk factors for postoperative severe complication after LG.ConclusionThere must to be paid enough attention to the CRP ratio >2.2 on the day 1 and 3 after LG, it suggests that there might be a risk of severe postoperative complications.
ObjectiveTo investigate the pathogenesis and treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) by detecting the changes of serum interleukin-23 (IL-23) and C-reactive protein (CRP) levels of the OSAHS patients before and after treatment with continuous positive airway pressure (CPAP).MethodsFifty-eight patients with moderate to severe OSAHS diagnosed by polysomnography were recruited as an experimental group, 57 out-patient healthy subjects with matched age, sex and body mass index of the experimental group were enrolled as a control group. The serum concentrations of IL-23 and CRP in the experimental group were detected and compared before and after CPAP application for 3 months. The serum concentrations of IL-23 and CRP in the control group were also measured.ResultsThe serum levels of IL-23 and CRP in the OSAHS patients were significantly higher than those in the normal control subjects (P<0.05). The serum levels of IL-23 and CRP in the OSAHS patients after CPAP treatment were significantly lower than those before CPAP treatment (P<0.05). The serum concentrations of IL-23 and CRP were positively correlated with apnea hypopnea index (r=0.756, r=0.345, P<0.05, respectively), and negatively correlated with mean oxygen saturation (r=–0.715, r=–0.334, P<0.05, respectively).ConclusionsThe serum levels of IL-23 and CRP are positively correlated with the severity of OSAHS. After CPAP treatment, the levels of IL-23 and CRP decrease, which indicates that CPAP treatment may reduce the inflammatory reaction and correct anoxia of OSAHS patients.
ObjectiveTo investigate the relationship between preoperative C-reactive protein (CRP)/albumin ratio (CAR) and National Institutes of Health (NIH) risk classification in patients with gastric stromal tumors.MethodsClinical data of 108 patients with gastric stromal tumors admitted to the First Affiliated Hospital of Kunming Medical University from February 2010 to November 2016 were retrospectively collected. With the median of CAR as the critical value, patients were divided into high CAR group (CAR>0.048) and low CAR group (CAR≤0.048). Then observed the general clinicopathological characteristics and survival status of patients with higher and lower CAR value.ResultsThere were significant differences in NIH classification, tumor diameter, and mitosis between the high CAR group and low CAR group (P<0.05). Compared with the low CAR group, the tumors in the high CAR group had larger diameter, higher mitotic figure, and higher NIH grade. Survival analysis showed that the prognosis of the low CAR group was better than that of the high CAR group (χ2=15.152, P<0.001).ConclusionsCAR is closely related to the malignant index and NIH risk classification of gastric stromal tumors. It can be used as an index for evaluating the malignant degree of gastric stromal tumors, and it is expected to be an important reference factor for clinical NIH risk classification and prognosis.
Objective To measure the level of circulating endothelial progenitor cells ( EPCs) in peripheral blood of patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD) , and to explore the relationship between EPCs and severity markers of the disease and cardiovascular adverse outcome predictors.Methods Forty patients with COPD were recruited, including 27 at acute exacerbation phase and 13 with stable COPD from December 2010 to December 2011. Sixteen healthy nonsmokers were included as controls. Circulating EPCs were isolated by Ficoll density-gradient centrifugation and purified by Magnetic Activated Cell Sorting system. High-sensitivity C-reactive protein ( hsCRP) was estimated by using a latex immunoturbidimetric assay kit, and matrix metalloproteinase-9 ( MMP-9) was measured by enzymelinked immunosorbent assay ( ELISA) . Arterial blood gas analysis and echocardiograph were performed in the AECOPD patients. The correlations between circulating EPCs, lung function, and cardiovascular markers were investigated. Results Circulating EPCs were significantly lower in AECOPD and stable COPD patients compared with the healthy controls [ ( 5.1 ±2.6) ×103 /mL and ( 6.0 ±3.2) ×103 /mL vs. ( 9.0 ±4.3) × 103 /mL, Plt;0. 05] . EPCs had a weak correlation with hsCRP ( P = 0. 033) , but not with MMP-9. In the AECOPD patients, EPC counts were significantly inversely correlated with PASP ( pulmonary artery systolic pressure) and NT-proBNP ( amino-terminal pro-brain natriuretic peptide) levels, and positively with left ventricular ejection fraction. No correlations were found between EPCs and lung function, blood gas, hospital stays or smoking index. Conclusions Circulating EPCs were significantly lower in AECOPD patients compared with healthy controls, in which systemic inflammation might be involved. Decreased EPCs were correlated with cardiac dysfunction in patients with AECOPD, which may account for the increased cardiovascular risk in this population.
Objective To investigate the changes of 8-isoprostane ( 8-isoPG) , leukotriene B4 ( LTB4 ) , TNF-α, IL-10 and hypersensitive C-reactive protein( Hs-CRP) in serum of patients with obstructive sleep apnea hypopnea syndrome ( OSAHS) . Methods Forty OSAHS patients ( 20 cases underwent therapeutic Auto-CPAP or UPPP treatment for over three months) and 30 normal controls were included in the study. Serum 8-isoPG, LTB4, TNF-α and IL-10 were measured by ELISA. Hs-CRP was detected by automatic biochemistry analyzer. Results ①The serum levels of 8-isoPG, LTB4, TNF-α, Hs-CRP were significantly higher and IL-10 was considerably lower after sleep in 40 OSAHS patients [ ( 36. 59 ±14. 89) ng/L, ( 14. 75 ±6. 25) μg/L, ( 1022. 13 ±97. 57 ) ng/L, ( 2. 46 ±1. 58 ) mg/L, ( 4. 68 ±3. 42) ng/L, respectively ] than those in the normal controls [ ( 19. 91 ±7. 76 ) ng/L, ( 1. 43 ±0. 72) μg/L, ( 540. 00 ±78. 70) ng/L, ( 0. 30 ±0. 16) mg/L, ( 7. 41 ±4. 49) ng/L, respectively] ( P lt;0. 01) . ② Serum 8-isoPG, LTB4, TNF-α, and Hs-CRP levels elevated gradually following the severity of OSAHS while serum IL-10 level was decreased( P lt; 0. 05) . ③Serum 8-isoPG, LTB4, TNF-α, and Hs-CRP levels in OSAHS patients after sleep were correlated positively with AHI ( r =0. 863, 0. 746, 0. 868, 0. 842,all P lt; 0. 01) and negatively with LSpO2 ( r = - 0. 623, - 0. 524, - 0. 618, - 0. 562, all P lt; 0. 01) and MSpO2 ( r = - 0. 654, - 0. 573, - 0. 537, - 0. 589, all P lt;0. 01) . SerumIL-10 level in OSAHS patients was correlated negatively with AHI ( r = - 0. 722, P lt; 0. 01) and positively with LSpO2 ( r = 0. 564, P lt; 0. 01) and MSpO2 ( r = 0. 505, P lt; 0.01) . ④ After three months of auto continuous positive air pressure( Auto-CPAP) or uvulopalatopharyngoplasty( UPPP) treatment, serum 8-isoPG, LTB4, TNF-α, and Hs-CRP levels of the OSAHS patients after sleep were obviously decreased [ ( 23. 10 ±9. 54) ng/L, ( 4. 02 ±2. 15) μg/L, ( 810. 25 ±135. 85) ng/L, ( 0. 79 ±0. 60) mg/L, respectively] , and serum IL-10 level was obviously increased[ ( 6. 93 ±3. 91) ng/L] ( P lt; 0. 01) . ⑤ serum 8-isoPG and IL-10 had no statistics difference and serum LTB4, TNF-α, Hs-CRP levels were higher in OSAHS underwent therapy compared with the normal controls. Conclusions The results suggest that inflammation and oxidative stress are activated and antiflammatory cytokines are decreased in the OSAHS patients. The serum levels of 8-isoPG, LTB4 , TNF-α, Hs-CRP and IL-10 may prove to be useful in severity monitoring and intervention efficacy judgement in OSAHS patients.
ObjectiveTo study the clinical value of procalcitonin (PCT), WBC count, and C-reactive protein (CRP) in diagnosis of common bile duct stones with acute bile duct infection and systemic inflammatory response syndrome (SIRS).MethodsA total of 80 patients with bile duct stones were retrospectively analyzed, which were divided into two groups, SIRS group (n=40) and non-SIRS group (n=40). The numerical value of PCT, WBC count, and CRP were detected on 1, 4, and 7 day after admission, and calculated the score of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) on 1 day after admission. Then analyzed the clinical value of PCT, WBC count, and CRP in diagnosis of common bile duct stones with acute bile duct infection and SIRS.ResultsEach area under the ROC curve of PCT, CRP, and WBC count were 0.81, 0.78, and 0.72, respectively, with significant difference (P<0.05). The PCT, CRP, and WBC count had a certain accuracy in diagnosis of common bile duct stones with acute bile duct infection and SIRS. The positive-relationship between PCT, CRP, WBC count and APACHE Ⅱ score was significant (r=0.91, P<0.01; r=0.88, P<0.01; r=0.69, P<0.01).ConclusionTo detect the numerical value of PCT, WBC count, and CRP had significant clinical value in diagnosis of common bile duct stones with acute bile duct infection and SIRS.
In recent years, domestic and foreign scholars have carried out extensive research on the prognostic factors of gastric cancer. Among them, non-specific inflammatory markers and nutritional indicators are the most concentrated in gastric cancer. C-reactive protein, as an acute phase protein, has been widely used to diagnose acute and chronic inflammation throughout the body. Prealbumin is a sensitive indicator of nutrition with a shorter half-life, which can quickly reflect the nutritional status of the body. At present, C-reactive protein and prealbumin as sensitive indicators of inflammation and nutrition, have shown certain predictive value in terms of postoperative complications and prognosis of gastric cancer. This article reviews the use of C-reactive protein, prealbumin and their ratios in predicting postoperative complications and prognosis of gastric cancer, aiming to provide a reference for the diagnosis and treatment of patients after gastric cancer.