Objective To explore the role of T cell-mediated immunity in the pathogenesis of venous thromboembolism ( VTE ) by analyzing the differential expression of T cell immune-related gene mRNAs peripheral blood mononuclear cells (PBMCs) between VTE patients and controls with GeneChip Human Genome. Methods Human eDNA microarray analysis was employed in PBMCs from 20 VTE patients and 20 hypertensive controls,and random variant model (RVM) corrected t-test was used for statistical analysis of differential gene expression.Results Six mRNA stripes including CD247,CD3D,CD3G,Granzyme A (GzmA),Granzyme B (GzmB) and Zeta-chain-associated protein kinase 70 (ZAP70)were found to be associated with T cell-mediated immunity.Significant down-regulation of these six mRNAs was found in the VTE group compared with the controls ( 15.3050 ± 0.6346 vs 15.8053 ± 0.5567,13.7878 ±0.7731 vs 14.3820 ±0.4857,13.3299 ± 0.9104 vs 14.1246 ± 0.6011,14.8893 ± 0.8675 vs 15.5305 ±0.4624,15.9113 ±0.8123 vs 16.4553 ±0.5055,14.3652 ±0.7717 vs 14.3652 ±0.7717;all P values ＜ 0.05 ).Conclusions T cells' function including antigen recognition,signal transduction and cytotoxicity was impaired in VTE patients.T cell-mediated immunity dysfunction probably plays an important role in the pathogenesis of VTE.

ssociated genes,especially down-regulated expression of T cell mediated function genes,in patients with PE indicates that the etiology of PE might be related to viral infection.

Objective:To investigate risk factors for the efficacy for appropriate medication use in elderly patients with type 2 diabetes mellitus(T2DM)and to establish a risk prediction model for the efficacy for appropriate medication use by using Logistic regression analysis and the receiver operating characteristic(ROC)curve.Methods:A total of 305 elderly patients with T2DM admitted to pharmacy department of our hospital from Jan.2018 to Aug.2018 were enrolled in this retrospective study.Of the 305 patients, 166(54.4%)were female, with a mean age of (74.9±7.2) years old, a disease course of (15.2±9.6) years and a hospital stay of (10.4±3.2) d, receiving (2.0±0.9) types of antidiabetic drugs.Patients were assessed by the Self-Efficacy for Appropriate Medication Use Scale(SEAMS), the Morisky Medication Adherence Scale-8(MMAS), the Adherence to Refills and Medications Scale(ARMS), the Charlson Comorbidity Index(CCI)and the Mini Mental State Exam(MMSE). Main biochemical indicators were recorded.The influencing factors for appropriate medication use efficacy were analyzed by Logistic regression analysis, and a risk prediction model was consequently established by the ROC curve.Results:According to SEAMS results, 233 patients(76.4%)had sufficient efficacy(≥26 points)and 72 patients(23.6%)had insufficient efficacy(<26 points). There were significant differences in parameters including age, disease course, hospital stay and fasting blood glucose(FBG)between the above two groups( P<0.05). Logistic regression analysis showed that age, FBG level and ARMS score had correlation with self-efficacy for appropriate medication use( P<0.05). ROC curves showed that the predictive efficiency of joint predictor Y [Logit(P)=-15.164+ 0.434X ARMS score-0.067X age-0.082X FBG reaching standard]was better than that of the other three single factors(AUC=0.910, 95% CI: 0.873-0.947, P<0.01)and could be used as an optimal predictor for the evaluation of self-efficacy for appropriate medication use. Conclusions:Compared with MMAS, ARMS is more suitable for medication adherence assessment in elderly T2DM patients.In clinical practice, pharmacists can provide individualized medication services through evaluating the efficacy of rational drug use and the risk prediction model, in order to elevate the ability of self-medication management and quality of life.

This investigation was directed to the metabolic syndrome and the islet beta-cell secretory function in the first-degree relatives (FDR) of type 2 diabetic patients in Sichuan province. A large cohort study was designed. Totally 1929 subjects were investigated. They were in two groups: FDR group comprising 505 first-degree relatives of type 2 diabetic patients, and Control group comprising 1424 controls without positive family history of Diabetes. Blood pressure, weight, waist, plasma glucose, lipids and insulin were measured. HOMA-IR and HOMA-beta indexes were used to evaluate insulin resistance and beta-cell secretion function. The insulin sensitivity index (ISI) and glucose disposition index (DI) were also used to evaluate insulin resistance. After adjustment for age and sex, HOMA-IR increased, ISI, DI and HOMA-beta decreased in FDR group when compared with controls (P < 0.05). The incidence of co-existed three or more metabolic disorders and metabolic syndrome was higher in FDR group than that in control group (P < 0.05). In FDR group, HOMA-IR increased, HOMA-beta, DI and ISI decreased while the number of co-existing metabolic disorders increased. But when the number of co-existing metabolic disorders > or = 4, HOMA-IR increased no longer and ISI decreased no more. Metabolic disorders occurred more frequently in FDR of diabetic patients than those in individuals without positive family history. As the number of co-existing metabolic disorders increased, the beta-cell secretion function and insulin sensitivity became worse. Our study indicated that it is necessary to keep on monitoring the metabolic index in FDR of type 2 diabetes and provide early preventive interventions.
Adult ; China ; epidemiology ; Cohort Studies ; Diabetes Mellitus, Type 2 ; genetics ; Female ; Glucose Tolerance Test ; Humans ; Insulin Resistance ; Islets of Langerhans ; physiopathology ; Male ; Metabolic Syndrome ; epidemiology ; genetics ; Middle Aged ; Surveys and Questionnaires