1.Astragaloside inhibits astrocyte activation and inflammatory response induced by inflammation
Jingwen YU ; Minfang GUO ; Bingxin ZHANG ; Bingtao MU ; Tao MENG ; Huiyu ZHANG ; Cungen MA ; Jinzhu YIN ; Lijuan SONG ; Jiezhong YU
Chinese Journal of Tissue Engineering Research 2024;28(31):5022-5028
BACKGROUND:Astrocytes play an important role in the pathology of central nervous system diseases.The phenotypic and functional changes in astrocytes suggest that it may be an effective therapeutic target for central nervous system diseases.Our previous studies have confirmed that astragaloside can inhibit the lipopolysaccharide-induced astrocyte inflammatory response.Whether astragaloside can regulate the phenotype and function of astrocytes through Notch-1 and its downstream signaling pathway remains unclear. OBJECTIVE:To explore the effect of astragaloside on astrocyte activation and inflammatory response induced by inflammation and its possible mechanism. METHODS:Cerebral cortex astrocytes derived from neonatal C57BL/6 mouse were cultured in vitro.CCK-8 assay was used to determine the optimum concentration of astragaloside and Notch active inhibitor DAPT.The astrocytes were divided into five groups:PBS group,lipopolysaccharide group,lipopolysaccharide + astragaloside group,lipopolysaccharide + DAPT group and lipopolysaccharide + DAPT + astragaloside group.The secretion level of inflammatory factors was detected by ELISA,and the level of nitric oxide was detected by Griess method.The astrocytes and splenic mononuclear cells were co-cultured in Transwell chamber to observe the migration of CD4T cells.The expression of astrocyte activation marker GFAP,A1 marker C3 and A2 marker S100A10 as well as Notch 1 and Jag-1 was detected by immunofluorescence staining.The expressions of CFB,C3,S100A10,PTX3,Notch-1,Jag-1,and Hes were detected by western blot assay. RESULTS AND CONCLUSION:(1)According to the results of CCK8 assay,the final concentration of astragaloside was selected as 25 μmol/L and the final concentration of DAPT was 50 μmol/L for follow-up experiments.(2)Compared with PBS group,interleukin-6,interleukin-12 and nitric oxide secretion levels in the lipopolysaccharide group were significantly increased(P<0.05,P<0.05,P<0.01).Compared with the lipopolysaccharide group,interleukin-6(all P<0.05),interleukin-12(P>0.05,P<0.05,P<0.05)and nitric oxide(P<0.05,P<0.01,P<0.01)secretion significantly reduced in the lipopolysaccharide + astragaloside group,lipopolysaccharide +DAPT group,lipopolysaccharide + DAPT + astragaloside group.(3)Compared with the PBS group,the expression of GFAP that is the marker of activated astrocytes and the migration of CD4 T cells were significantly increased in the lipopolysaccharide group(P<0.01).Compared with the lipopolysaccharide group,astrocyte activation was significantly inhibited and CD4 T cell migration was significantly reduced in the lipopolysaccharide + astragaloside,lipopolysaccharide +DAPT,lipopolysaccharide + DAPT + astragaloside group(P<0.05,P<0.05,P<0.01).(4)Compared with the PBS group,the expressions of A1 markers C3 and CFB in the lipopolysaccharide group were increased(P<0.01,P<0.05),and the expressions of A2 markers S100A10 and PTX3 were decreased(P<0.01,P<0.05).Compared with the lipopolysaccharide group,C3(all P<0.01)and CFB(both P<0.05)were significantly reduced and S100A10(all P<0.01)and PTX3(P<0.05,P<0.05 and P>0.05)were increased in the lipopolysaccharide + astragaloside,lipopolysaccharide +DAPT,lipopolysaccharide + DAPT + astragaloside group.(5)Compared with the PBS group,the expressions of Jag-1,Notch-1 and Hes in the lipopolysaccharide group were significantly increased(all P<0.01).Compared with the lipopolysaccharide group,the expressions of Jag-1(all P<0.01),Notch-1(all P<0.01)and Hes(P<0.05,P<0.01 and P<0.01)were significantly reduced in the lipopolysaccharide + astragaloside,lipopolysaccharide +DAPT,lipopolysaccharide + DAPT + astragaloside group.(6)The results indicate that astragaloside can promote the transformation of astrocytes from A1 to A2 by regulating Notch-1 signaling pathway,reduce the secretion of inflammatory factors and the migration of CD4 T cells,and thus inhibit astrocyte activation and inflammatory response.
2.Fasudil inhibits Aβ1-42-induced microglial inflammatory response by inhibiting activation of NLRP3 inflammasome
Minfang GUO ; Peijun ZHANG ; Jingwen YU ; Tao MENG ; Yanhua LI ; Na LI ; Mengdi LI ; Yulu LI ; Lijuan SONG ; Jiezhong YU ; Cungen MA
Chinese Journal of Immunology 2024;40(9):1833-1837
Objective:To explore mechanism of Fasudil reducing Aβ1-42 induced BV2 cell injury based on NLRP3 inflamma-some.Methods:BV2 cells were divided into:normal control group,Aβ stimulation group,Aβ+Fasudil intervention group,Aβ+MCC950(NLRP3 inhibitor)intervention group.Cell morphology was observed under microscope.Cell activity was determined of by CCK8.NO release was measured by Griess.NLRP3,caspase 1 and IL-18 expressions were detected by immunofluorescence staining.NLRP3,ASC,caspase 1,IL-1β and IL-18 expressions were detected by Western blot.Results:Compared with normal control group,BV2 cells in Aβ stimulation group were activated and showed amoeba-like shape,cell activity was decreased,NO production was increased,NLRP3,ASC,caspase 1,IL-1β and IL-18 expressions were increased.Fasudil intervention and MCC950 intervention inhibited cell injury induced by Aβ1-42 in which BV2 cell morphology tended to be normal,cell activity was increased,while produc-tion of NO was reduced,and NLRP3,ASC,caspase 1,IL-1β and IL-18 expressions were down-regulated,there was no significant difference between Fasudil intervention group and MCC950 intervention group.Conclusion:Fasudil may alleviate Aβ1-42 induced BV2 cell injury and inflammatory reaction by inhibiting NLRP3 inflammasome activation.
3.Knock-down of ROCK2 gene improves cognitive function and reduces neuronal apoptosis in AD mice by promoting mitochondrial fusion and inhibiting its division.
Minfang GUO ; Huiyu ZHANG ; Peijun ZHANG ; Jingwen YU ; Tao MENG ; Suyao LI ; Lijuan SONG ; Zhi CHAI ; Jiezhong YU ; Cungen MA
Chinese Journal of Cellular and Molecular Immunology 2023;39(8):701-707
Objective To explore the effect of knocking down Rho-associated coiled-coil kinase (ROCK2) gene on the cognitive function of amyloid precursor protein/presenilin-1 (APP/PS1) double transgenic mice and its mechanism. Methods APP/PS1 double transgenic mice were randomly divided into AD model group (AD group), ROCK2 gene knock-down group (shROCK2 group), ROCK2 gene knock-down control group (shNCgroup), and wild-type C57BL/6 mice of the same age served as the wild-type control (WT group). Morris water maze and Y maze were employed to test the cognitive function of mice. Neuron morphology was detected by Nissl staining. Immunofluorescence histochemical staining was used to detect the expression of phosphorylated dynamin-related protein 1 (p-Drp1) and mitochondrial fusion 1 (Mfn1). Western blot analysis was used to detect the expression ROCK2, cleaved-caspase-3 (c-caspase-3), B-cell lymphoma 2 (Bcl2), Bcl2-related protein X (BAX), p-Drp1, mitochondrial fission 1 (Fis1), optic atrophy 1 (OPA1), Mfn1 and Mfn2. Results Compared with AD group mice, the expression of ROCK2 in shROCK2 group mice was significantly reduced; the cognitive function was significantly improved with the number of neurons in the hippocampal CA3 and DG areas increasing, and nissl bodies were deeply stained; the expression of c-caspase-3 and BAX was decreased, while the expression of Bcl2 was increased; the expression of mitochondrial division related proteins p-Drp1 and Fis1 were decreased, while the expression of mitochondrial fusion-related proteins OPA1, Mfn1 and Mfn2 were increased. Conclusion Knock-down of ROCK2 gene can significantly improve the cognitive function and inhibit the apoptosis of nerve cells of APP/PS1 mice. The mechanism may be related to promoting mitochondrial fusion and inhibiting its division.
Animals
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Mice
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Alzheimer Disease/pathology*
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Amyloid beta-Peptides/metabolism*
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Amyloid beta-Protein Precursor
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Apoptosis/genetics*
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bcl-2-Associated X Protein
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Caspase 3
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Cognition
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Disease Models, Animal
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Mice, Inbred C57BL
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Mice, Transgenic
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Mitochondrial Dynamics/genetics*
4.Efficacy of the Mini-Mental State Examination versus the Montreal Cognitive Assessment in screening cognitive impairment in patients with lacunar cerebral infarction
Fang PEI ; Tao MENG ; Sisi WANG ; Kaixuan ZHANG ; Xiaoqin LIU ; Xiting MI ; Juan WANG ; Jiezhong YU ; Cungen MA
Chinese Journal of Primary Medicine and Pharmacy 2022;29(1):45-50
Objective:To investigate the efficacy of the Mini-Mental State Scale (MMSE) versus the Montreal Cognitive Assessment Scale (MoCA) in screening cognitive impairment in patients with a lacunar cerebral infarction. Methods:138 eligible patients who received treatment in the Affiliated Hospital of Shanxi Datong University from January 2018 to October 2019 were recruited for this study. They received cognitive function evaluation by the MMSE and MoCA. These patients were grouped according to the median number of age or the median number of years of education. The sensitivity and consistency of the MMSE versus MoCA in screening cognitive impairment in patients with a lacunar cerebral infarction were analyzed using the χ2 test. The total cognitive scores of the MMSE and MoCA, and the scores of each cognitive domain such as memory, execution, visual space, attention, language, and orientation, were compared between groups using multiple linear regression analysis. Results:The sensitivity of MoCA in screening for cognitive impairment in low-age, high-age, low-year-education, and high-year-education groups and the whole population of patients with a lacunar cerebral infarction was 76.5%, 75.7%, 74.2%, 77.8%, 76.1%, respectively, which were significantly higher than those of MMSE (44.1%, 65.7%, 60.6%, 50.0%, 55.1%, χ2 = 12.17, 13.13, 9.33, 15.75, 23.86, all P < 0.01). The Kappa coefficients of low-age, high-age, low-year-education and high-year-education groups were 0.336, 0.391, 0.358, 0.389, and 0.373, respectively, all of which were less than 0.4 (all P < 0.01). These findings suggest that the consistency of the two scales in screening cognitive impairment is poor. The cognitive impairment detection rate by the MMSE was significantly higher in the high-age group than in the low-age group (65.7% vs. 44.1%, χ2 = 6.50, P < 0.05). The total cognitive scores of MMSE and MoCA and the scores of memory, execution, visual space, attention, language, and orientation in patients with a lacunar cerebral infarction were significantly lower in the high-age group or low-year-education group than in the low-age group ( tMMSE = 3.61, 2.49, 3.12, 4.26, 1.70, 3.69, 2.24, all P < 0.01; tMoCA = 3.83, 1.75, 3.28, 3.80, 2.21, 4.08, 2.52, all P < 0.05) or high-year-education group ( tMMSE = -2.87, -2.32, -0.85, -2.54, -0.73, -2.57, -2.96, all P < 0.01; tMoCA = -2.95, -1.12, -3.39, -1.54, -1.52, -3.09, -3.02, all P < 0.05). Conclusion:Combined application of MMSE and MoCA has a high clinical value in screening cognitive impairment in patients with a lacunar cerebral infarction. High-age patients with a lacunar cerebral infarction who receive low-year education have memory, execution, visual space, attention, language, and orientation impairments.
5.Correlation between cognitive function and living ability of older adult patients living in a mining community
Shuhui XU ; Wenqi ZHANG ; Mingjie YAO ; Lei ZHANG ; Kaixuan ZHANG ; Jingxiang HAN ; Yining ZHAO ; Tao MENG ; Fang PEI ; Jiezhong YU ; Cungen MA
Chinese Journal of Primary Medicine and Pharmacy 2022;29(4):544-548
Objective:To investigate the correlation between cognitive function and living ability of older adult patients living in a mining community.Methods:A total of 180 older adult patients living in a mining community who received treatment during July-October 2019 were included in this study. They were randomly divided into the low-age group (< 68 years old, n = 94) and the high-age group (≥ 68 years old, n = 86). Cognitive function and living ability were evaluated using the Mini-Mental State Examination (MMSE), The Montreal Cognitive Assessment (MoCA), and the Activity of Daily Living Scale (ADL). The relationship between cognitive function and living ability was investigated using hierarchical analysis and Pearson correlation analysis. Results:The proportions of older adult patients with abnormal cognitive function identified by the MMSE and MoCA were 39.4% and 66.0%, respectively in the low-age group, and they were 32.6% and 61.6%, respectively in the high-age group. The MoCA had a greater performance in identifying abnormal cognitive function in each group than the MMSE ( χ2 = 26.69, 10.18, both P < 0.001). There were no significant differences in proportions of older adult patients with abnormal cognitive function identified by the MMSE and MoCA between low-age and high-age groups ( χ2 = 0.90, 0.36, both P > 0.05). The proportion of older adult patients with abnormal living ability was not significantly different between low-age and high-age groups (4.3% vs. 10.5%, χ2 = 2.58, P > 0.05). Compared with patients negative for MMSE items, living ability and instrumental activity of daily living increased by 7.0% and 9.4% in low-age patients positive for MMSE items (both P < 0.05). Compared with patients negative for MoCA items, living ability increased by 3.5% in low-age patients positive for MoCA items ( P < 0.05). Correlation analysis revealed that total scores of MMSE and MoCA were significantly negatively correlated with ADL score ( r = -0.26, -0.27, both P < 0.001) and instrumental activity of daily living score ( r = -0.27, -0.27, P < 0.001). Conclusion:Cognitive function and living ability are correlated in older adult patients living in a mining community. We should pay attention to the screening results of cognitive disorder in older adult patients and improve their living ability by improving their cognitive function.
6.Characteristics and related risk factors of mild cognitive impairment in middle-aged and elderly adults in a coal mine community
Kaixuan ZHANG ; Jingxiang HAN ; Yining ZHAO ; Libo LIU ; Sisi WANG ; Shaotong QU ; Wenqi ZHANG ; Shuhui XU ; Mingjie YAO ; Lei ZHANG ; Tao MENG ; Jiezhong YU
Journal of Chinese Physician 2022;24(2):231-235
Objective:To investigate the characteristic of mild cognitive impairment (MCI) in the adults aged 48 years and over in a coal mine community, and to analyze its associated risk factors.Methods:From July to October 2019, a questionnaire survey for basic information was conducted among 180 middle-aged and elderly adults who met the inclusion criteria in the Datong coal mine community. The cognitive function was evaluated by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The effects of gender, age, years of education, sleep, living alone, physical exercise, social activities, smoking and drinking status, body mass index and chronic diseases on cognitive level were analyzed by single factor stratification and multiple linear regression.Results:There was no significant difference in the positive rate of MCI screened by MMSE and MoCA in the age groups of 48-<64, 64-<72 and 72-90 (original and corrected P>0.05); The positive rate of MCI in MoCA screening (64.4%, 66.7%, 60.9%) was significantly higher than that in MMSE (35.6%, 45.6%, 28.1%) (all P<0.05); MMSE was positively correlated with MoCA score ( r=0.762, P<0.001). With the increase of age, the scores of memory, execution and visual space detected by MoCA decreased significantly (all P<0.05), while the scores of attention, language and orientation did not change significantly (all P>0.05). Univariate stratification showed that the significant influencing factors of MMSE or MoCA scores were gender, age, years of education and sleep status (all P<0.05). Multiple linear regression analysis showed that gender ( βMMSE=-0.192; βMoCA=-0.140), years of education ( βMMSE=0.209; βMoCA=0.328) and sleep status( βMMSE=-0.162; βMoCA=-0.136) were risk factors affecting MMSE and MoCA scores ( P<0.05). Conclusions:More middle-aged and elderly adults with MCI might be observed in a coal mine community, and the main characteristics of MCI are impaired memory, executive function and visual space. To prevent and reduce the occurrence of dementia, early interventions of MCI should be carried out among the adults with female, old age, low years of education and poor sleep quality.
7.Robust Benchmark Structural Variant Calls of An Asian Using State-of-the-art Long-read Sequencing Technologies
Du XIAO ; Li LILI ; Liang FAN ; Liu SANYANG ; Zhang WENXIN ; Sun SHUAI ; Sun YUHUI ; Fan FEI ; Wang LINYING ; Liang XINMING ; Qiu WEIJIN ; Fan GUANGYI ; Wang OU ; Yang WEIFEI ; Zhang JIEZHONG ; Xiao YUHUI ; Wang YANG ; Wang DEPENG ; Qu SHOUFANG ; Chen FANG ; Huang JIE
Genomics, Proteomics & Bioinformatics 2022;20(1):192-204
The importance of structural variants(SVs)for human phenotypes and diseases is now recognized.Although a variety of SV detection platforms and strategies that vary in sensitivity and specificity have been developed,few benchmarking procedures are available to confidently assess their performances in biological and clinical research.To facilitate the validation and application of these SV detection approaches,we established an Asian reference material by characterizing the genome of an Epstein-Barr virus(EBV)-immortalized B lymphocyte line along with identified benchmark regions and high-confidence SV calls.We established a high-confidence SV callset with 8938 SVs by integrating four alignment-based SV callers,including 109x Pacific Biosciences(PacBio)continuous long reads(CLRs),22 x PacBio circular consensus sequencing(CCS)reads,104x Oxford Nanopore Technologies(ONT)long reads,and 114×Bionano optical mapping plat-form,and one de novo assembly-based SV caller using CCS reads.A total of 544 randomly selected SVs were validated by PCR amplification and Sanger sequencing,demonstrating the robustness of our SV calls.Combining trio-binning-based haplotype assemblies,we established an SV benchmark for identifying false negatives and false positives by constructing the continuous high-confidence regions(CHCRs),which covered 1.46 gigabase pairs(Gb)and 6882 SVs supported by at least one diploid haplotype assembly.Establishing high-confidence SV calls for a benchmark sample that has been characterized by multiple technologies provides a valuable resource for investigating SVs in human biology,disease,and clinical research.
8.Comparisons of serum procalcitonin and fibrinogen degradation product levels between type 2 diabetes mellitus patients with Escherichia coli bloodstream and urinary tract infections
Huiqing WANG ; Jinhua ZHANG ; Yinyu LI ; Jimin ZHANG ; Zhengli HUANG ; Ximing SUN ; Shaoqing XUE ; Jiezhong YU
Chinese Journal of Primary Medicine and Pharmacy 2021;28(12):1761-1766
Objective:To compare serum procalcitonin and fibrinogen degradation product levels between type 2 diabetes mellitus patients with Escherichia coli bloodstream and urinary tract infections. Methods:The clinical data of 82 type 2 diabetes mellitus patients with Escherichia coli infections who received treatment between December 2014 and December 2019 in the First Affiliated Hospital of Datong University (The Fifth People's Hospital of Datong) were retrospectively analyzed. These patients were assigned to bloodstream infection ( n = 40) and urinary tract infection ( n = 42) according to the way of Escherichia coli infection. Serum procalcitonin and fibrinogen degradation product levels, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, C-reactive protein, white blood cell count, D-Dimer level, antithrombin III activity, and electrolytes were determined and compared between the two groups. Correlation between procalcitonin and other variables was analyzed. Multiple linear regression analysis was performed with procalcitonin level as a dependent variable and other relevant indexes as independent variables. Results:Body temperature, white blood cell count, neutrophil count, monocyte count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, procalcitonin level, C-reactive protein level, fibrinogen degradation product level, and D-Dimer level in the bloodstream injection group were (39.49 ± 0.64) ℃, (14.92 ± 11.78) × 10 9/L, (13.39 ± 11.60) × 10 9/L, (0.72 ± 0.36) ×10 9/L, (14.86 ± 10.52), (199.15 ± 160.69), (22.81 ± 17.86) μg/L, (133.44 ± 63.63) mg/L, (49.71 ± 41.44) mg/L, (16.56 ± 12.20) mg/L, respectively, which were significantly higher than those in the urinary tract infection group [(37.12 ± 1.20) ℃, (9.04 ± 3.95) × 10 9/L, (6.25 ± 4.02) × 10 9/L, (0.42 ± 0.29) × 10 9/L, (3.67 ± 3.34), (120.01 ± 44.08), (4.46 ± 8.69) μg/L, (39.22 ± 22.16) mg/L, (3.81 ± 3.41) mg/L, (0.84 ± 0.75) mg/L), t = 7.356, 2.578, 3.162, 2.958, 5.538, 2.591, 2.810, 4.825, 2.902, 2.375, all P < 0.05]. Platelet count, lymphocyte count, blood sodium level and antithrombin Ⅲ activity in the bloodstream infection group were (167.50 ± 104.93) × 10 9/L, (1.06 ± 0.58) × 10 9/L, (130.89 ± 6.50) mmol/L, (57.88 ± 16.28)% , which were significantly lower than those in the urinary tract infection group [(239.40 ± 82.52)× 10 9/L, (2.14 ± 0.71) × 10 9/L, (138.46 ± 5.96) mmol/L, (90.11 ± 8.90)%, t = -2.853, -6.313, -4.046, -7.350, all P < 0.05]. Correlation analysis revealed that serum procalcitonin level was positively correlated with body temperature ( r = 0.387), white blood cell count ( r = 0.355), neutrophil count ( r = 0.368), C-reactive protein ( r = 0.605), fibrinogen degradation product level ( r = 0.616), D-Dimer level ( r = 0.486) (all P < 0.05), and it was negatively correlated with sodium level ( r = -0.319) and antithrombin Ⅲ activity ( r = -0.465) (both P < 0.05). Multiple linear regression analysis results revealed that fibrinogen degradation product level and body temperature were greatly correlated with procalcitonin level. Conclusion:Inflammatory indicators procalcitonin level, body temperature, white blood cell count, neutrophil count, C-reactive protein, fibrinogen degradation product level and D-Dimer level were remarkably higher in type 2 diabetes mellitus patients with Escherichia coli bloodstream infection than those in type 2 diabetes mellitus patients with Escherichia coli urinary tract infection. Procalcitonin level was greatly correlated with body temperature and fibrinogen degradation product level.
9.Study on the relationship between procalcitonin level and insulin resistance in patients with diabetic foot infection
Huiqing WANG ; Guiying WANG ; Yinbing WANG ; Jinhua ZHANG ; Yinyu LI ; Jimin ZHANG ; Jiezhong WEI
Chinese Journal of Primary Medicine and Pharmacy 2020;27(9):1066-1069
Objective:To investigate the relationship between procalcitonin(PCT) and insulin resistance in diabetic foot infection.Methods:Sixty patients with diabetic foot infection hospitalized in the Fifth People's Hospital of Datong from March 2015 to March 2017 were selected and divided into three groups according to the value of PCT: slightly elevated group(L group, n=18), moderately elevated group(M group, n=21), highly elevated group(H group, n=21). Another 20 patients with type 2 diabetes mellitus were collected as control group.The PCT, C-reactive protein(CRP), white blood cell count(WBC), fasting and postprandial blood glucose, fasting insulin and insulin resistance index(HOMA-IR) were calculated and compared. Results:In the control group, the levels of PCT, HOMA-IR, CRP and WBC were (0.14±0.12)μg/L, (17.70±8.86), (32.90±24.19)mg/L, (8.01±2.21)×10 9/L, respectively, which in the L group were (0.31±0.14)μg/L, (20.42±9.71), (50.85±27.81)mg/L, (9.95±3.35)×10 9/L, respectively, which in the M group were (1.11±0.52)μg/L, (24.08±14.09), (64.31±40.21)mg/L, (10.86±2.25)×10 9/L, respectively, which in the H group were (5.31±3.04)μg/L, (31.73±14.13), (72.29±50.26)mg/L, (12.51±5.51)×10 9/L, respectively, and there were statistically significant differences among the four groups( F=50.744, 5.195, 4.303, 5.252, all P<0.01). With the increase of PCT, the levels of WBC, CRP and HOMA-IR were increased, and HOMA-IR was positively correlated with PCT( r=0.265, P=0.017). Conclusion:Serum level of PCT has correlation with infection degree of diabetic foot and is positively correlated with insulin resistance.
10.Relationship between visceral fat area and brachial-ankle pulse wave velocity in patients with diabetic nephropathy
Huiqing WANG ; Guiying WANG ; Yinbing WANG ; Jinhua ZHANG ; Fengjuan ZHANG ; Yinyu LI ; Jimin ZHANG ; Zhengli HUANG ; Yanjun CHI ; Ximing SUN ; Jiezhong YU
Chinese Journal of Primary Medicine and Pharmacy 2020;27(19):2305-2310
Objective:To investigate the clinical characteristics of different stages of type 2 diabetic nephropathy(DN), and to explore the possible factors affecting visceral fat area (VFA).Methods:From September 2018 to March 2019, 464 patients with type 2 diabetes who were hospitalized in the First Affiliated Hospital of Datong University were selected.Among them, 315 patients with urinary albumin/creatinine ratio(UACR)<30 mg/g were selected as normal proteinuria group, 72 patients with UACR 30-299 mg/g were selected as microalbuminuria group, 45 patients with UACR>300 mg/g were selected as massive proteinuria group, and 32 patients with serum creatinine higher than the reference value were selected as renal failure group.The serum creatinine of the first three groups was in the normal range.The clinical data of these patients such as blood pressure, body mass index(BMI), VFA, subcutaneous fat area(SFA), brachial-ankle pulse wave velocity(BAPWV), blood lipid, renal function and blood sugar were collected and compared among the four groups.Using VFA as strain and other indicators as independent variables, multivariate linear regression analysis was carried out.Results:There were statistically significant differences among the four groups in age, height, weight, BMI, head circumference, neck circumference, waist circumference, hip circumference and waist-hip ratio ( F=15.580, 4.679, 6.186, 3.553, 3.153, 2.689, 5.170, 3.114, 3.535, all P<0.05). The VFA of the normal proteinuria group, microalbuminuria group, massive proteinuria group and renal failure group were (102.25±37.09)cm 2, (104.12±40.93)cm 2, (119.63±48.82)cm 2, (110.54±41.58)cm 2, respectively, and the BAPWV were (1 546.97±330.18)cm/s, (1 595.52 ±381.27)cm/s, (1 459.63±285.61)cm/s, (1 703.89±318.64)cm/s, the differences were statistically significant among the four groups( F=3.344, 4.020, all P<0.05). There were statistically significant differences in alanine aminotransferase, creatinine, uric acid, total cholesterol, red blood cell, hemoglobin, ratio of neutrophils to lymphocytes (NLR) and ratio of platelets to lymphocytes (PLR) among the four groups ( F=3.405, 15.535, 6.552, 2.803, 6.158, 15.580, 3.764, 3.262, all P<0.05). With VFA as strain, multivariate linear regression analysis showed that waist circumference, BMI, TG and BAPWV were risk factors for VFA. Conclusion:DN is associated with multiple obesity-related indicators and inflammatory indicators such as NLR, PLR; VFA is associated with BAPWV.

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