Objective To investigate the expression difference of microRNA -21 (miRNA-21) in patients with chronic cardiac function and analyze its clinical significance. Methods Patients with chronic heart failure (trial group,150 cases) and the subjects without chronic heart failure (control group,45 cases) were enrolled. Patients with chronic heart failure were divided into three subgroups according to NYHA: group A (heart function classⅡ,49 cases),group B (classⅢ, 51 cases) and group C (class Ⅳ, 50 cases). miRNA-21 levels were detected by qRT-PCR method. The levels of B type natriuretic peptide urea (BNP),left ventricular end diastole diameter (LVEDD) and left ventricular ejection fraction (LVEF) were determined. Results miRNA-21 expression in patients with heart failure were higher than that of control group (P < 0.01),and miRNA-21 expression in group C was higher than that of group A.Correlation analysis showed that there was a positive correlation between expression of BNP (r = 0.763,P < 0.01), LVEDD (r = 0.691,P<0.01), and the level of miRNA-21 in patients with chronic heart failure.And a negative correlation between LVEF value and the level of miRNA-21 (r = -0.918,P < 0.01). Conclusion miRNA-21 might be a potential marker for diagnosis of heart failure and could be a basis for reference about prognosis evaluation.

Objective:To explore the characteristics of T lymphocyte subsets and cytokines in hyperlipidemia-induced acute pancreatitis (HLAP) and its prognostic value.Methods:This study included 184 patients with acute pancreatitis (AP) admitted to the First Affiliated Hospital of Xiamen University from January 2018 to May 2021. Based on disease etiology, there were 92 HLAP cases and 92 non-hyperlipidemia-induced AP (NHLAP) cases. Stratified by disease severity according to 2012 Atlanta classification criteria, the patients were divided into the severe subgroup (SAP) and non-severe subgroup (NSAP). Peripheral venous blood samples were taken from all patients on day 1, 3, and 5 after admission. T lymphocyte subsets were determined by flow cytometry, and cytokines were detected by flow fluorometry. The number of CD4 +% and CD8 +% and the expression of cytokines were compared by Student’s t test or Mann-Whitney U analysis. Logistic regression analyses were performed to identify risk factors for severe AP, and a receiver operating characteristic (ROC) curve was constructed to predict severe AP. Statistical significance was taken as P<0.05. Results:Compared with the NHLAP group, patients in the HLAP group had lower CD4 +%, while higher levels of IL-2 on day 1 ( P<0.05), and had also lower CD4 +%, while higher levels of IL-4, IL-6, and IL-10 on day 3 ( P<0.05). Furthermore, IL-6 and IL-10 levels of the HLAP group were significantly increased compared to the NHLAP group on day 5 ( P<0.05). IL-10 levels in the SAP subgroup were significantly higher than those in the NSAP subgroup on day 1 ( P<0.05). Compared with the NSAP subgroup, the SAP subgroup had elevated levels of IL-2, IL-4, IL-6, IL-10 and IFN-γ on day 3 (all P<0.05), and had lower CD4 +%, while increased levels of IL-6 and IL-10 on day 5 (all P<0.05). Multivariate Logistic regression analysis showed that IL-10 was an immune indicator of independent risk factor for severe AP in the HLAP group on day 1 ( OR=1.139, 95% CI: 1.038-1.251, P<0.05). Finally, ROC analysis showed that the area under the curve of IL-10 to assess HLAP with severe AP was 0.772, and the best cut-off value for predicting severe AP was 5.6 pg/mL, with a sensitivity of 83.3% and a specificity of 68.8%. Conclusions:Changes of CD4 +% and cytokines are different between the HLAP and NHLAP groups. IL-10 can be used as a predictor of early disease severity in patients with HLAP.