Objective: To analyze the relationship between hemoglobin ( Hb ) and serum uric acid ( SUA ), so as to provide basis for preventing hyperuricemia ( HUA ) . Methods: As the research subjects, people who underwent physical examination in Zhejiang Provincial People's Hospital from January 1, 2017 to October 31, 2020 for 4 years in a row and who were non-HUA in 2017 were selected. The physical examination data were collected, including body mass index, blood pressure, blood routine, blood biochemical tests, etc. The subjects grouped by quartiles of Hb level in 2017. The occurrence of SUA elevation ( SUA increased ≥60 μmol/L from baseline ) , significantly SUA elevation ( SUA increased ≥120 μmol/L from baseline ), HUA ( SUA>420 μmol/L ) and severe HUA ( SUA ≥480 μmol/L ) in the next 3 years were taken as end events. The incidence, occurrence time and risk of end events in different Hb groups were analyzed. Results: A total of 4 073 subjects were selected and divided into 4 groups according to the Hb level from low to high, with 969 subjects in group A, 907 subjects in group B, 1 109 subjects in group C and 1 088 subjects in group D. SUA elevation was in 745 patients ( 18.29% ); significantly SUA elevation was in 105 patients ( 2.58% ); HUA was in 514 patients ( 12.62% ); severe HUA was in 94 patients ( 2.31% ). The incidence of SUA elevation and significantly SUA elevation showed a decreasing trend with the increase of Hb level ( P<0.05 ). The occurrence time of SUA elevation in group A to D was 2.788, 2.817, 2.860 and 2.814 years, and the difference was statistically significant ( P<0.05 ). There were no statistically significant differences in the occurrence time of other end events ( P>0.05 ). The multivariate Cox proportional hazards regression analysis showed that compared with group A, other Hb groups had lower risk ( HR=0.498-0.776, 95%CI:0.253-0.981 ) of SUA elevation, significantly SUA elevation and severe HUA after adjusting for gender, age, ALT, Scr, body mass index, etc. Conclusions With the increase of Hb level, the incidence of SUA elevation may decrease and the occurrence time is prolonged. Compared with the lowest Hb group, the higher Hb groups had lower risk of SUA elevation, significantly SUA elevation and severe HUA.

Objective To investigate the influence of factors related to metabolic syndrome(MS)on the outcome in subjects without diabetes mellitus in a community.Methods A two-year follow-up study was conducted in 885 subjects who were enrolled in the epidemiologic survey carried out in Pingliang Community, Shanghai in 2002.Oral glucose tolerance test,lipid prefde,blood pressure(BP),body mass index(BMI),waist and hip circumferences were measured.Results (1)The baseline of BMI,fasting plasma glucose(FPG),2h plasma glucose after glucose loading(2hPG),BP,triglyceride(TG)in the subjects with impaired glucose regulation(IGR)increased significantly as compared to those with normal glucose regulation(NGR)(all P

This study was purposed to investigate the change of early hemostatic function in patients with myeloproliferative diseases (MPD) and to explore its significance in combination with clinical data. The platelet aggregative function was measured by using ristomycin, adenosine diphosphate, collagen and adrenine as inductors, the plasma von Willebrand factor-associated antigen (vWF: Ag) level was measured by enzyme-linked immunosorbent assay (ELISA), the plasma von Wellebrand factor-ristomycin cofactor (vWF: Rco) activity was measured in 6 patients with obviously low ristomycin induced platelet aggregation (RIPA). The results showed that the platelet aggregative function obviously decreased in 35 patients, there were distinct differences in maximal platelet aggregative rate between patients and normal controls induced by 4 inductors respectively (P < 0.001, P < 0.001, P = 0.002, P < 0.001). There was no obvious difference between patients with MPD and healthy controls in plasma vWF: Ag level (P > 0.50). Plasma vWF: Rco activity in all 6 patients with MPD chosen was in the normal range, except one patient with essential thrombocytosis (ET) whose plasma vWF: Rco activity was much lower than normal. No correlation was found between platelet count and plasma vWF: Ag level in the patients (r = -0.180). No correlation was found between platelet count and maximal platelet aggregative rate induced by 4 inductors respectively in patients. It is concluded that the occurrence of abnormal platelet aggregative function is high in patients with MPD. The RIPA and vWF: Rco activity decrease in one patient with ET. However, the shortage of vWF polymer existed in his plasma have needs for further research. No correlation was observed between hemostasis and clinical manifestations. However, because of the high occurrence of platelet dysfunction in MPD patients, the clinical application of anti-platelet drugs should be considered carefully.
Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Myeloproliferative Disorders ; blood ; physiopathology ; Platelet Aggregation ; Platelet Function Tests ; von Willebrand Factor ; analysis

The objective of this study was to detect the expression frequency of HLA-DR15 in patients with aplastic anemia (AA) and myelodysplastic syndrome (MDS), to investigate the relation of expression frequency with diseases and to analyze the relationship between immunoglobulin, T lymphocyte subsets and HLA-DR15. HLA-DR15 expression was detected by PCR-SSP; immunoglobulin was detected by immune turbidimetry; T cell subsets were detected by flow cytometry. The results showed that the expression rates of HLA-DR15 in AA and MDS as well as normal control groups were 78.6%, 63.2% and 24.6% respectively. The difference between AA, MDS and the normal control groups was statistically significant (p < 0.01). OR (odds ratios) values of AA and MDS groups were 11.262, 4.710 respectively. Compared with normal control group, expression rate of HLA-DR15 in hematologic malignancy group was not significantly different. The immunoglobulin level and abnormal T cell subsets in AA and MDS groups were statistically different between HLA-DR15 positive and negative groups (p > 0.05). It is concluded that the frequency of HLA-DR15 antigen in AA and MDS patients is significantly higher than that in normal control and hematologic malignancy group. OR value>1 showed a positive correlation between the diseases and HLA-DR15. HLA-DR15 is a susceptible gene in AA and MDS. The abnormalities of immunoglobulin level and ratios of T cell subsets in AA and MDS are common, but are not associated significantly with the expression of HLA-DR15.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anemia, Aplastic ; immunology ; metabolism ; Case-Control Studies ; Female ; Flow Cytometry ; HLA-DR Antigens ; immunology ; metabolism ; HLA-DR Serological Subtypes ; Histocompatibility Testing ; Humans ; Immunoglobulins ; immunology ; metabolism ; Male ; Middle Aged ; Myelodysplastic Syndromes ; immunology ; metabolism ; T-Lymphocyte Subsets ; immunology ; metabolism ; Young Adult

BACKGROUNDIntersinus septal cell (ISSC) is not a very uncommon frontal recess cell. But it is poorly described in literature. The clinical significance of this anatomic variant still remains unclear. The purpose of this study was to clarify the anatomy, classification of ISSC and its clinical significance in Chinese subjects.

METHODSWe prospectively identified ISSC in 200 consecutive subjects who had undergone computed tomography (CT) scans: 120 without frontal sinusitis (group 1) and 80 with frontal sinusitis (group 2). The ISSC was classified into two types: Type I ISSC communicated with frontal sinuses, type II ISSC communicated with frontal recess. The patients of frontal sinusitis had undergone functional endoscopic sinus surgery with the assistance of the classification of ISSC. Statistical analysis was performed to correlate the ISSC and its type to the presence of frontal sinusitis.

RESULTSThe ISSC was obvious when reviewing the coronal and axial CT scans. Of the 200 CT scans reviewed, ISSC were present in 90 (45%). Of the 120 scans in group 1, ISSC were present in 49 (41%), among which type I ISSC was in 22 (18%) and type II was in 27 (23%). Of the 80 scans in group 2, ISSC was present in 41 (51%), among which type I ISSC was in 16 (20%) and type II was in 25 (31%). There were no statistically significant differences about the frequency distribution of total ISSC, type I and II ISSC between group 1 and group 2.

CONCLUSIONSThe prevalence of ISSC was very high in Chinese patients. The classification of ISSC was helpful for surgeon to operate according to whether it communicated with frontal sinus or frontal recess. The type II ISSC could be relatively easily removed from frontal recess.

Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Endoscopy ; methods ; Female ; Frontal Sinus ; anatomy & histology ; pathology ; Frontal Sinusitis ; classification ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Prospective Studies ; Radiography ; Young Adult

Twenty-two compounds were isolated from the flowers of Scabiosa tschilliensis. Their structures were identified by spectroscopic methods as octacosanol (1), stearic acid (2), β-sitosterol (3), oleanolic acid (4), apigenin (5), luteolin (6), daucosterol (7), kaempferol-3-O-β-D-6-O-(p-hydroxycinnamoyl) -glucopyranoside (8), kaempferol-3-O-β-D- (3, 6-di-p-(hydroxycinnamoyl) -glucopyranoside (9), apigenin-7-O-β-D-glucopyranoside (10), luteolin-4'-O-β-D-glucopyranoside (11), apigenin-7-O-rutinoside (12), luteolin-7-O-β-D-glucopyranoside (13), apigenin-4'-O-β-D-glucopyranoside (14), caffeic acid methyl ester (15), loganin (16), adenosine (17), luteolin-6-C-β-D-glycopyranosyl (18), sweroside (19), sylvestrosides I (20), sylvestrosides II (21), urceolide (22). Among them, compounds 1, 2, 7-9, 12, 15, 17-18, 20-22 were isolated from the genus Scabiosa for the first time, and compounds 1-4, 6-9, 11-12, 14-22 were isolated from this plant for the first time. 13C-NMR data of 22 were reported for the first time.
Dipsacaceae ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Flowers ; chemistry ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization

OBJECTIVETo monitor the changes of hemolysis parameters and endothelial cell markers in thrombotic thrombocytopenic purpura (TTP) and reveal the clinical significance of these changes.

METHODSvWF-cleaving protease (vWF-CP) activity in 3 cases of TTP was detected by Western blot. The percentages of fragmented red cells (FRC) were counted throughout the entire clinical course. Levels of plasma thrombomodulin were detected by Western blot combined with density screening in TTP and healthy individuals (n = 3). Concentration of plasma VEGF was measured by enzyme-linked immunosorbent assay in TTP and healthy individuals (n = 9). Fundus fluorescein angiography was performed to search the evidence of microvascular thrombosis in one TTP patient with impaired visual acuity.

RESULTSThe lower vWF-CP activity was observed in TTP patients; the percentages of FRC in 3 cases of TTP were 1.65%, 2.50%, 3.32% respectively with an average of 2.49% at the onset of and decreased with the improvement of the disease. The levels of plasma TM and VEGF were significantly elevated in TTP than those in healthy individuals, and related to the severity of TTP. Fundus photography in one TTP patient with impaired visual acuity revealed vascular occlusion in fundus arteriole and venulae.

CONCLUSIONSA decreased vWF-CP activity is in favour of TTP diagnosis. Dynamic monitoring of plasma TM and VEGF as well as percentages of FRC are useful indexes for reflecting the severity and evaluating therapeutic response of TTP. Selective fundus fluorescein angiography is useful for the judgement of microvascular thrombosis in TTP.

ADAM Proteins ; blood ; ADAMTS13 Protein ; Biomarkers ; blood ; Blotting, Western ; Endothelial Cells ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Female ; Hemolysis ; Humans ; Male ; Middle Aged ; Purpura, Thrombotic Thrombocytopenic ; blood ; pathology ; Thrombomodulin ; blood ; Time Factors ; Vascular Endothelial Growth Factor A ; blood ; Young Adult

Sepsis is a potentially fatal condition characterized by the failure of one or more organs due to a disordered host response to infection. The development of sepsis is closely linked to immune dysfunction. As a result, immunotherapy has gained traction as a promising approach to sepsis treatment, as it holds the potential to reverse immunosuppression and restore immune balance, thereby improving the prognosis of septic patients. However, due to the highly heterogeneous nature of sepsis, it is crucial to carefully select the appropriate patient population for immunotherapy. This review summarizes the current and evolved treatments for sepsis-induced immunosuppression to enhance clinicians' understanding and practical application of immunotherapy in the management of sepsis.

OBJECTIVETo explore a operative approach and its effect to the central protrusion of lumbar intervertebral disc.

METHODSFrom February 1999 to December 2005,34 patients with central protrusion of lumbar intervertebral disc were treated with an improved operative procedure. The study involved 25 males and 9 females with an average of 46.4 years (range, 35 to 63 years). The involved level of herniation were at L4,5 in 20 cases and L5S1 in 14 cases. Pains happened on one leg fixedly and seriously with another lightly in 21 cases, on one leg initially and lightly with another seriously later in 8 cases, on bilateral legs alike in 5 cases. Preoperative CT film showed central type in 8 cases and laterocentral type in 26 cases. The corresponding spinous process was resected on the basis of unilateral fenestration. The supraspinous ligament was retained and pulled to the opposite side for revealing spinal canal, and then diskectomy was done. The above procedure was named "fenestration with the spinous process resection".

RESULTSAll the 34 patients were followed up for 1 to 5 years. The outcome was evaluated according to the standard of HOU Shu-xun, 20 cases were excellent, 11 good and 3 fair. The total rate of excellent and good was 91.2%.

CONCLUSIONThe "fenestration with the spinous process resection" not only completed decompression of spinal canal and diskectomy, but also retained opposite lamina and supraspinous ligament and maintained the stability of posterior vertebral column, which are a new improved approach for the central protrusion of lumbar intervertebral disc.

Adult ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged

OBJECTIVETo evaluate the effect of the diameter of abdominal aortic aneurysm (AAA) on endovascular exclusion (EVE) and its results.

METHODSFrom March 1997 to June 2007, 429 AAA patients were treated with endovascular stent-graft exclusion. According to the maximal diameter of abdominal aortic aneurysm, the patients were divided into two groups: group A (diameter < 55 mm, n = 274) and group B (diameter > or = 55 mm, n = 155). The diameter of AAA, involvement of iliac artery, length, diameter and distortion of aneurismal neck in the two groups were recorded and compared retrospectively.

RESULTSPatients in group B were significantly older than group A (73.7 vs 71.1 years, P < 0.05). More patients in group B was complicated with coronary artery disease than those in group A (P < 0.05). The mean diameter of AAA in group A was (46.6 +/- 6.8) mm, and (66.8 +/- 11.2) mm in group B (P < 0.05). Proximal aneurysmal necks were shorter, wider and more tortuous in group B than those in group A (P < 0.05). Extraperitoneal approach, embolism of inner iliac artery and reconstruction of another inner iliac artery and stretch technique were more applied in group B. There were more endoleak during operation in group B and more stent-grafts were used. There was significant difference in morbidity rate between the two groups, while no statistic difference in mortality. And in group B, there were a high rate of endoleak and secondary intervention post operation.

CONCLUSIONSThe diameter of AAA affects EVE and its results. In small aneurysms, EVE carries better outcome than in big aneurysms.

Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal ; pathology ; surgery ; Blood Vessel Prosthesis Implantation ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Stents ; Treatment Outcome