Objective:To discuss the changes and significance of CD4+CD25+regulatory T cells and cytokines in patients with rheumatic heart disease compared to the normal people.Methods:Clinical data of patients with RHD received treatment at our hospital from April 2012 to July 2010 was retrospectively analyzed.The normal control group was the healthy physical examination persons form the medical examination center at our hospital.The expression levels of growth factorβ1 (TGF-β1),tumor necrosis factor alpha (TNF-α),interleukin-10 (IL-10),interleukin-6 (IL-6) and CD4+CD25+regulatory T cells in the peripheral blood samples of the objects in the two groups were detected and compared.Results:A total of 76 patients were retrospective analyzed,including 40 in observe group and 60 in control group.The percent of CD4+CD25+T accounted for lymphocyte and the percent of CD4+CD25+Foxp3+Treg accounted for CD4+T in observe group were obviously lower than those in control group.The TGF-β1 and IL-10 in observe group were obviously lower than those in control group.The TNF-αand IL-6 in observe group were obviously higher than those in control group.The differences had statistical significance.Conclusion: The CD4+CD25+ regulatory T cells in patients with RHD were obviously decreased.The blood cytokines such as TGF-β1 and IL-10 were corresponding declined.

AIM:To determine the effects of Tongxinluo (TXL) on connexin 43 (Cx43) remodeling and ven-tricular arrhythmia ( VA) after myocardial infarction ( MI) in rats .METHODS:Male SD rats were randomly divided into sham-operated (sham) group (n=25) and operation group (n=75).The left anterior descending (LAD) was ligated in operated group , while the rats in sham group only underwent pericardiotomy .The rats in operation group which survived for 3 d after operation were randomly assigned to TXL group and MI group .The rats in TXL group was administrated with TXL (2 g? kg-1? d-1, intragastric administration) for 4 weeks, while normal saline was applied to the rats in sham group and MI group.The levels of interleukin-1β(IL-1β) and endothelin-1 (ET-1) in the tissue from the border zone were measured by ELISA after treatment .The distribution and the mRNA and protein expression of Cx 43 were detected by immunohisto-chemical staining , RT-PCR and Western blotting , respectively .The burst pacing was used to induce ventricular arrhythmia ( VA) .RESULTS:Compared with sham group , the levels of IL-1βand ET-1 and the incidence of VA were significantly increased , while the mRNA and protein expression of Cx 43 was markedly reduced with irregular distribution in MI group (P<0.05).Compared with MI group, the levels of IL-1βand ET-1 and the incidence of VA were significantly reduced , while the expression of Cx 43 at mRNA and protein levels was markedly increased with augmented linear distribution in the myocardial cell intercalated disc in TXL group (P<0.05).CONCLUSION:TXL reduces the incidence of VA after MI via inhibiting the Cx43 remodeling .

Objectives: To assess the diagnostic values of latex immunoturbidimetric assay (LIA) and particle immunofiltration assay (PIFA) for heparin-induced thrombocytopenia (HIT) . Methods: Samples from 94 patients with suspected HIT from May 2016 to July 2018 in our hospital were prospectively analyzed by the two immunoassays. Their medical records and further follow-up data were also collected and analyzed by our hematologists to make the 4Ts scores and confirm the diagnosis of HIT, respectively. Performance characteristics of the two immunoassays were assessed, including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) . Their post-test probabilities (PTP) were also calculated based on the 4Ts score. Results: Among 94 cases, 15 (16.0%) had a positive HIT, including 6 of 37 (16.2%) with an intermediate, and 9 of 15 (60.0%) with a high 4Ts score. PIFA operating characteristics were: sensitivity 100.0% (15/15) , specificity 51.9% (41/80) , PPV 28.3% (15/53) , NPV 100.0% (41/41) . The positive PTP in intermediate and high 4Ts score group were 28.7% and 75.7%, respectively, while negative PTP were all 0. At manufacturers’ cutoffs, LIA operating characteristics were: sensitivity 66.7% (10/15) , specificity 94.9% (75/79) , PPV 71.4% (10/14) and NPV 93.8% (75/80) . The positive and negative PTP in intermediate 4Ts score group were 71.8% and 6.3%, while 95.2% and 34.4% in high 4Ts score group, respectively. Receiver operating characteristic (ROC) analysis manifested that LIA was preferable than PIFA, and combining the 2 assays together was significantly better than single test. Conclusions 4Ts score is still an important tool for the diagnosis of HIT. Combining clinical score with heparin/PF4 antibody assay can increase the accuracy of confirming or excluding HIT. Although PIFA is inferior to LIA in the diagnostic value, its user friendliness and 100% NPV have major advantages. Combining the 2 assays together can achieve a higher diagnostic value.