OBJECTIVE: To investigate the risk factors of different types of Henoch-Schönlein purpura (HSP) in Tibetan patients at high altitude, as to provide reference for correctly identifying high-risk patients. METHODS: A retrospective study was used to analyze the 304 HSP patients admitted to Tibet Autonomous Region People's Hospital from April 2014 to March 2022. The gender, age, allergic history, family history, clinical type, laboratory indexes (hemoglobin, platelet count, eosinophil, C-reactive protein (CRP), albumin, immunoglobulin G, immunoglobulin A, complement C3 and C4) were analyzed retrospectively. Univariate and multivariate Logistic regression analysis to screen for risk factors affecting different types of HSP. RESULTS: Renal HSP patients showed higher IgA [(9.2±1.7) g/L vs. (6.4±2.4) g/L, P=0.015], lower complement C3 [(203.3±21.6) mg/dL vs. (301.1±19.5) mg/dL, P=0.043], and complement C4 [(33.5±2.3) mg/dL vs. (53.0±7.2) mg/dL, P=0.032]. The patients with abdominal HSP showed lower levels of hemoglobin [(119.6±19.6) g/L vs. (146.6±47.3) g/L, P=0.038] and plasma albumin [24.8 (22.1, 33.9) g/L vs. 32.6 (24.6, 35.1) g/L, P=0.045]. The patients with articular HSP exhibited higher CRP [13.5 (0.2, 20.6) g/L vs. 7.5 (0.1, 15.2) g/L, P=0.036] and erythrocyte sedimentation rate (ESR) [24 (5, 40) mm/h vs. 15 (4, 30) mm/h, P=0.049]. Elevated IgA and decreased complement C4 were risk factors for renal HSP, anemia and decreased plasma albumin were risk factors for abdominal HSP, and elevated CRP was a risk factor for articular HSP. CONCLUSION The clinical characteristics of different types of HSP in plateau areas were different. Patients with high IgA, low complement C4, anemia, hypoalbuminemia, and significantly elevated CRP should be highly vigilant. Early and effective intervention can improve the clinical efficacy, avoid severe development, and improve the prognosis.
Humans ; Retrospective Studies ; Tibet/epidemiology* ; Complement C3/analysis* ; IgA Vasculitis/complications* ; Altitude ; Complement C4 ; C-Reactive Protein/analysis* ; Immunoglobulin A ; Risk Factors ; Anemia ; Hemoglobins/analysis* ; Serum Albumin/analysis*

OBJECTIVETo investigate the correlation among serum levels of manning-binding lectin (MBL), MBL-associated serine proteases-2 (MASP-2), complement Cand high-sensitive C reactive protein (HsCRP) in patients with rheumatoid arthritis (RA).

METHODSFasting venous blood were collected from 50 RA patients (25 in active stage and 25 in remission) and 40 healthy subjects for detecting serum levels of MBL, MASP-2, complement Cand HsCRP using enzyme-linked immunosorbent assay (ELISA) and immune turbidity assay.

RESULTSThe serum levels of MBL and MASP-2 were significantly lower and HsCRP level was significantly higher in patients with RA (in both acute stage and remission) than in the healthy control group (P<0.05), but complement Clevel was similar between the RA patients and control group. Bivariate Pearson correlation analysis showed that in RA patients, MBL was positively correlated with MASP-2 level (r=0.550, P=0.001) and negatively with HsCRP (r=-0.323, P=0.022) but not correlated with C(r=-0.022, P=0.882); MASP-2 was negatively correlated with HsCRP (r=0.453, P=0.453) and was not correlated with C(r=0.049, P=0.738). ROC curve analysis revealed the largest area under curve (AUC) of HsCRP (0.844, P=0.001) and smaller AUCs of MBL (0.025, P=0.001) and MASP-2 (0.266, P=0.001). HsCRP had a much higher sensitivity (84%) than MBL (10%) and MASP-2 (40%) in the diagnosis of RA.

CONCLUSIONIn RA patients, MBL and MASP-2 are negatively correlated with HsCRP level. Serum MBL and MASP-2 levels decrease with the progression of joint injury in RA patients, suggesting their involvement in the pathological process of RA; but due to their low sensitivity, they are not appropriate indicators for evaluating the disease activity of RA.

Arthritis, Rheumatoid ; blood ; C-Reactive Protein ; analysis ; Case-Control Studies ; Complement C3 ; analysis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Mannose-Binding Lectin ; blood ; Mannose-Binding Protein-Associated Serine Proteases ; analysis

OBJECTIVETo investigate the value of serum IgA/C3 ratio in the diagnosis of IgA nephropathy and explore its relationship with the clinicopathological features of the patients.

METHODSSixty-six patients with IgA nephropathy, 111 with other glomerular diseases, and 40 healthy control subjects without kidney disease were tested for serum IgA and C3 levels using CRM470 adjusted standardized immune turbidimetric method, and the IgA/C3 ratio was calculated. According to Oxford and Lee's classification criteria, we analyzed the pathological grades of the renal biopsy samples from patients with IgA nephropathy. The ROC curve was used to assess the value of serum IgA and IgA/C3 ratio in predicting IgA nephropathy.

RESULTSPatients with IgA nephropathy had an elevated serum IgA/C3 ratio than those with other glomerular diseases and the control subjects, with an area under the ROC curve of 0.776. An elevated serum IgA/C3 ratio was not found to significantly correlate with the pathological grade of renal biopsy samples in patients with IgA nephropathy.

CONCLUSIONIn the absence of renal biopsy findings, serum IgA/C3 ratio can help in the diagnosis of IgA nephropathy.

Biopsy ; Case-Control Studies ; Complement C3 ; analysis ; Glomerulonephritis, IGA ; blood ; diagnosis ; Humans ; Immunoglobulin A ; blood ; Kidney ; pathology

OBJECTIVETo identify protein markers for the early diagnosis of pancreatic cancer by a comparative proteomic method.

METHODSComparative analysis on the pancreatic peripheral blood protein profiling from 20 pancreatic cancer patients, 10 chronic pancreatitis patients and 20 cancer-free controls from May 2007 to September 2008 was carried out by two-dimensional fluorescence electrophoresis (2D-DIGE). Differentially expressed proteins were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS). The significance difference proteins were confirmed by Western-blot.

RESULTSA differentially expressed proteins: complement 3 (C3) was identified. The gray level of C3 in pancreatic cancer tissue, chronic pancreatitis, and normal control group were 1.63 ± 0.28, 0.65 ± 0.13 (t = 11.81, P = 0.00) and 0.88 ± 0.19 (t = 9.93, P = 0.00), respectively. C3 was high expression in pancreatic cancer group compared with normal control group. The expression of C3 was higher in pancreatic cancer group than in chronic pancreatitis group. The high expression of C3 in pancreatic carcinoma was confirmed by Western blot.

CONCLUSIONS2D-DIGE and MALDI-TOF-MS technology is a quick, easy and practical method to screen for specific biomarkers in serum of patients with pancreatic carcinoma. The identified protein C3 in this study may be as specific serum biomarkers of pancreatic carcinoma.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; blood ; Case-Control Studies ; Complement C3 ; analysis ; Early Diagnosis ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms ; blood ; diagnosis ; Pancreatitis, Chronic ; blood ; Proteomics ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Two-Dimensional Difference Gel Electrophoresis

Henoch-Schonlein purpura (HSP) is common in childhood and often self-limiting. There have been limited studies on elderly-onset HSP nephritis (HSPN). A 76-yr-old man was transferred to our hospital with a 1-month history of oliguria, abdominal pain, edema and palpable purpura in the legs. Three months ago, he was admitted to another hospital with jaundice, and consequently diagnosed with early common bile duct cancer. The patient underwent a Whipple's operation. Antibiotics were administrated because of leakage in the suture from the surgery. However, he showed progressive renal failure with edema and purpura in the legs. Laboratory investigations showed serum creatinine 6.4 mg/dL, 24-hr urine protein 8,141 mg/day, myeloperoxidase anti-neutrophil cytoplasmic antibodies (MPO-ANCA) 1:40 and C3 below 64.89 mg/dL. Renal biopsy showed crescentic glomerulonephritis, as well as mesangial and extracapillary Ig A deposition. We started steroid therapy and hemodialysis, but he progressed to end-stage renal failure and he has been under maintenance hemodialysis. We describe elderly onset HSPN with MPO-ANCA can be crescentic glomerulonephritis rapidly progressed to end stage renal failure.
Aged ; Antibodies, Antineutrophil Cytoplasmic/*analysis ; Common Bile Duct Neoplasms/complications/surgery ; Complement C3/analysis ; Creatinine/blood ; Edema/drug therapy ; Enzyme-Linked Immunosorbent Assay ; Glomerulonephritis/pathology ; Humans ; Male ; Purpura, Schoenlein-Henoch/*diagnosis/drug therapy ; Renal Dialysis ; Renal Insufficiency/etiology/pathology ; Steroids/therapeutic use

OBJECTIVETo study serum acylation-stimulating protein (ASP) and complement 3 (C3) levels and their relationship with blood lipids in children with primary nephrotic syndrome (PNS).

METHODSBlood samples were obtained from 35 PNS children with proteinuria, 25 children with PNS at remission and 35 body mass index-matched healthy children (control group). Fasting serum ASP, C3, albumin and blood lipids were measured.

RESULTSThe serum ASP levels in the proteinuria group (101 ± 22 nmol/L) were significantly higher than those in the remission group (32 ± 8 nmol/L) and the control group (33 ± 8 nmol/L) (P<0.01). Serum C3 levels were not significantly different among the three groups. The serum concentrations of total cholesterol, triglyceride, low density lipoprotein and apolipoprotein B increased, in contrast, serum albumin level decreased significantly in the proteinuria group when compared with the remission and the control groups. Serum ASP levels were positively correlated with serum C3 (r=0.661; P<0.05) and triglyceride levels (r=0.354; P<0.05), whereas serum C3 levels were not correlated with serum triglyceride levels (r=0.319, P>0.05).

CONCLUSIONSThe increased serum ASP level may be associated with a complemental mechanism against hyperlipidemia in children with PNS.

Child, Preschool ; Complement C3 ; analysis ; Female ; Humans ; Infant ; Intercellular Signaling Peptides and Proteins ; blood ; Lipids ; blood ; Male ; Nephrotic Syndrome ; blood ; Serum Albumin ; analysis

OBJECTIVETo explore the potential changes in the immune function of patients with obstructive sleep apnea hypopnea syndrome (OSAHS).

METHODSWe carried out a retrospective cross-sectional study of 187 patients with established OSAHS and 20 healthy subjects (control). For all the patients, the medical history was carefully examined, and overnight sleep monitoring was carried out with detection of the humoral and cellular immunity.

RESULTSWe found a significant increase in the levels of C3 and a decrease in both the IgM level and NK cell percentage in OSAHS patients as compared to the control group (P<0.01). Correlation analysis indicated that C3 was positive correlated to AHI but inversely to the lowest pulse oxygen saturation (LSpO(2)); IgM showed a mild positively correlation to LSpO(2), and NK cells had a mild inverse correlation to AHI. The other immunological indices were not found to undergo noticeable changes or show correlations in OSAHS.

CONCLUSIONImmune function changes occur in patients with OSAHS, characterized primarily by deteriorations in the humoral and cellular immunity.

Adult ; Antibody Formation ; Complement C3 ; analysis ; Complement C4 ; analysis ; Cross-Sectional Studies ; Female ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Killer Cells, Natural ; immunology ; Male ; Middle Aged ; Retrospective Studies ; Sleep Apnea, Obstructive ; blood ; immunology

The aim of this study was to systemically analyze the proteins that adsorbed on the surface of hemodialysis membrane. The Fresenius F6 reused polysulfone dialyzers were selected as the research objects. The methodology we used encompassed the digestion of protein in rinsed solution and the separation of peptide mixture in virtue of RP-HPLC followed by ESI-MS/MS identification in orde to get their adsorption behavior, species and characteristics. The results illustrated that, after being rinsed by reverse osmosis (RO) water, 179 species of the protein adsorbed on the hemodialysis membrane, most of which were acidulous and middle or small weight protein molecules. The data from counting the numbers of peptides showed there were 5 species of high-abundant proteins (the contents being above 5% each), namely Ficolin-2 precursor, Complement C3 precursor (Fragment), Mannan-binding lectin serine protease 1 isoform 2 precursor, Complement-activating component of Ra-reactive factor precursor, and Mannan-binding lectin serine protease 1 isoform 3. These proteins are in close relationship with human immune system; moreover, they are of great significance to the clinical mechanism for cleaning reuse hemodialyzers and to the development of new hemodialysis materials.
Adsorption ; Complement C3 ; analysis ; Equipment Reuse ; Humans ; Lectins ; analysis ; Mannose-Binding Protein-Associated Serine Proteases ; analysis ; Membranes, Artificial ; Renal Dialysis ; instrumentation

OBJECTIVETo evaluate the performance of BNII auto-analyzer system in detecting C3 and C4.

METHODSCLSI protocols (EP15-A, EP6-A, EP9-A2) and other relevant literatures were use to or evaluate the precision, accuracy, linearity of C3 and C4 detection by the auto-analyzer system, and the results were compared with the recognized standards.

RESULTSThe relative bias of C3 and C4 was less than one third of the CLIA'88 standard and the precision met the clinical requirement. The results tested by DADE BNII system were not compatible with those by Roche Modular System. C3 showed good linearity in the tests (R2>0.975, P<0.05) with a linearity range of 0.18-5.1 g/L. The linearity of C4 was not available because of lack of high-level samples.

CONCLUSIONThe performances of DADE BNII System basically meet the recognized standards in clinical detection of C3 and C4, but the method comparison needs further validation.

Autoanalysis ; methods ; Blood Chemical Analysis ; instrumentation ; methods ; Complement C3 ; analysis ; Complement C4 ; analysis ; Humans ; Nephelometry and Turbidimetry ; instrumentation ; methods ; Proteins ; analysis ; Sensitivity and Specificity

OBJECTIVETo observe the clinical efficacy of Zengse Pill ( ZSP) on patients with vitiligo of qi-stagnancy and blood-stasis syndrome type (V-QB), and to preliminarily explore its mechanism of action.

METHODSSixty-five V-QB patients, with their diagnosis confirmed by clinical examination, were randomized by digital table method into two groups, with 31 patients in the control group and 34 in the treatment group. Cobamamide (2 tablets) was administered orally to all patients, and Psoralea tincture (a self-formulated preparation) was applied externally thrice a day. In addition, for patients in the treatment group, ZSP was given orally, at 5 pills per dose, 3 times every day. The therapeutic course for both groups was 3 months. Patients were re-examined every half-month, and changes in the skin lesions were observed and recorded. The levels of lymphocyte subsets, serum immune globulin, and complement C3 and C4 in patients were determined before and after the therapeutic course and compared with the corresponding indexes determined in 21 healthy subjects.

RESULTSThe total effective rate in the treatment group was 82.4%, which was markedly higher than that in the control group (54.8%), showing a significant difference (P<0.05). After treatment, CD(4) (+) percentage, CD(4) (+)/CD(8) (+) ratio, and blood levels of C3 and C4 increased, while CD(8) (+) percentage decreased in the treatment group (P<0.05 or P<0.01). All these indexes remained unchanged in the control group, and the respective comparisons between groups showed significant differences (P<0.01).

CONCLUSIONZSP has a definite clinical effect on the treatment of V-QB but with no evident adverse reactions, and it can increase the CD(4) (+) percentage, CD(4) (+)/CD(8) (+) ratio, and the levels of serum C3 and C4, thus regulating the immunity of the organism, which might be one of its mechanisms of action.

Adolescent ; Adult ; CD4-CD8 Ratio ; Complement C3 ; analysis ; Complement C4 ; analysis ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Immunoglobulins ; blood ; Lymphocyte Subsets ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Qi ; Vitiligo ; drug therapy ; immunology