Objective To screen the specific cytokines of tuberculous pleural effusion(plTB)by using liquid array technique to establish a diagnostic model and discuss its application value.Methods A total of 86 patients with plTB(plTB group)were included,including 41 patients in the confirmed plTB group and 45 patients in the clinically diagnosed plTB group.There were 42 other patients with pleural effusion in the control group.Seventeen cytokines in pleural effusion were analyzed by liquid array technology.Interleukin(IL)-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-9,IL-10,gamma-interferon-induced protein 10(IP-10),IL-15,IL-17F,IL-27,tumor necrosis factor(TNF)-α,monocyte chemotactic protein-1(MCP-1),the expression levels of macrophage inflammatory protein-3a(MIP-3α),macrophage colony-stimulating factor(M-CSF)and β-interferon(IFN-β)were detected.Difference factors between the confirmed plTB group and the control group were screened,and the receiver operating characteristic(ROC)curve was drawn in the confirmed plTB patients.IP-10,IL-27 and MCP-1 with AUC>0.850 and specificity>80%were combined to diagnose plTB,and were compared with adenylate deaminase(ADA)and T-SPOT.TB in pleural effusion to evaluate the diagnostic efficacy.Results The levels of IL-2,IP-10,IL-27,TNF-α and MCP-1 were higher in the confirmed plTB group than those in the control group(P＜0.05).The sensitivity and specificity of IP-10,IL-27 and MCP-1 in the diagnosis of plTB were 87.8%and 81.0%.The sensitivity of three-factor combined diagnosis in 45 patients with plTB was still as high as 86.7%,and there was no significant difference in sensitivity compared with that in the diagnosed plTB group(P＞0.05).In the plTB group,the sensitivity of IP-10,IL-27 and MCP-1 combined detection was 87.2%,which was higher than that of T-SPOT.TB(81.4%)and ADA(54.7%).Conclusion The application of liquid array technology to the joint detection of pleural effusion IP-10,IL-27 and MCP-1 can provide help for the diagnosis of plTB.

Objective:To explore the predictive value of pulmonary effective arterial elastance (Ea) in patients with heart failure (HF).Methods:This is a retrospective cohort study, which retrospectively included 284 patients with HF who underwent right heart catheterization at Heart Failure Center in Fuwai Hospital between September 2013 and February 2022. Data regarding baseline clinical characteristics, hemodynamic profiles, and prognosis were collected. Ea was calculated as mean pulmonary arterial pressure/stroke volume. Patients were divided into Ea<0.555 group and Ea≥0.555 group according to the median value of Ea (0.555 mmHg/ml, 1 mmHg=0.133 kPa). The primary outcome was the primary clinical event, set as the first occurrence of a series of composite events, including all-cause death, heart transplantation, left ventricular assist device implantation, and HF rehospitalization. Event-free survival was defined as the absence of primary clinical events. Spearman correlation analysis was used to calculate the correlation coefficient between Ea and parameters reflective of right heart function. The Kaplan-Meier analysis was used to compare the different groups for the estimation of outcomes with the log-rank test. We used Cox proportional-hazards regression models to estimate hazard ratios ( HR) for primary clinical event. Subgroup analysis was performed based on the age, gender, New York Heart Association (NYHA) functional class, left ventricular ejection fraction, presence of pulmonary hypertension, and serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) values. We used receiver operating characteristic (ROC) curve to calculate the area under the curve ( AUC) of Ea for predicting event-free survival in patients with HF. Results:The median age was 51 years, and 206 (72.5%) patients were male. Ea and pulmonary vascular resistance (PVR) were significantly correlated ( r=0.698, P<0.001). The correlation between Ea and pulmonary arterial elastance (PAC) were even more significant ( r=-0.888, P<0.001). Compared with Ea<0.555 group, Ea≥0.555 group presented with higher serum NT-proBNP values (4 443 (1 792, 8 554) ng/L vs. 1 721 (480, 4 528)ng/L, P<0.001), higher PVR (3.4 (2.5, 4.7) Wood vs. 1.4 (0.9, 2.2) Wood, P<0.001), lower cardiac output (3.0 (2.3, 3.9) L/min vs. 4.3 (3.8, 4.9) L/min, P<0.001), and lower PAC (1.6 (1.3, 2.0) ml/mmHg vs. 4.0 (3.0, 6.0) ml/mmHg, P<0.001). The median follow-up time was 392 (166, 811) days. The Kaplan-Meier survival curve demonstrated a lower event-free survival rate in the Ea≥0.555 group compared to the Ea<0.555 group ( Plog-rank<0.001). After multivariate adjustment, Ea ( HR=1.734, P<0.001) remained significantly associated with the primary outcome. Subgroup analysis indicated that Ea was associated with the primary outcome across all subgroups. The AUC was 0.724 ( P<0.001) for Ea to predict event-free survival calculated from ROC analysis. Conclusions:Ea is closely related to parameters reflective of right ventricular afterload. Increased Ea is an independent predictor of adverse outcomes in patients with HF.

Objective To explore root cause of poor prognosis after successful endovascular treatment(EVT)in patients with acute ischemic stroke with large vascular occlusion(AIS-LVO)of anterior circulation.Methods Patients with AIS-LOV of anterior circulation who received successful EVT(postoperative modified thrombolysis incerebral infarction[mTICI]grade≥2b)were retrospectively and continuously collected in the Department of Neurology of Bozhou People's Hospital from January 2022 to March 2024.The baseline and clinical data of the patients were collected,including gender,age,vascular risk factors(hypertension,diabetes,coronary heart disease,hyperlipidemia,valvular heart disease,atrial fibrillation,smoking,and alcohol consumption),prior stroke or transient ischemic attack,baseline blood pressure,baseline National Institutes of Health Stroke scale(NIHSS)score,laboratory test indicators(pre-operative C-reactive protein and D-dimer,post-operative fasting blood glucose,lipid levels,homocysteine,etc).Meanwhile,the data of perioperative indicators was collected,including the time from onset to admission,the time from admission to puncture,the time from puncture to revascularization,the time from onset to puncture,the time from onset to revascularization,remedial measures(balloon dilation,stent placement,arterial thrombolysis)during the surgery or not,using tirofiban or not,postoperative complications(stroke-related pneumonia,stress ulcers,deep vein thrombosis,acute heart failure or renal failure,etc)or not.The patient's medical history and imaging data were collected,and these indicators were defined and collected,including Alberta stroke program early CT score(ASPECTS),location of occlusion(C1 segment of the internal carotid artery,C2 segment to C7 segment of the internal carotid artery,M1 segment of the middle cerebral artery),and the trial of org 10172 in acute stroke treatment(TOAST)classification and a postoperative transformation of cerebral infarction after ischemic stroke and symptomatic intracranial hemorrhage or not.According to the modified Rankin scale(mRS)score at 90 d after surgery,all patients were divided into poor prognosis group(mRS score≥ 3)and good prognosis group(mRS score≤2).The baseline and clinical data of two groups were compared using univariate analysis.Variables with P＜0.1 in the univariate analysis were selected as independent variables,and the poor prognosis was used as the dependent variable.Further,multivariate Logistic regression analysis was performed to identify the influencing factors of poor prognosis after EVT.Results Finally,a total of 192 patients with AIS-LVO of anterior circulation who received successful revascularization were included in this study.There were 101 male patients and 91 female patients.The poor prognosis group had 102 cases and the good prognosis group had 90 cases.Univariate analysis showed that the poor prognosis group had statistically significant differences with the good prognosis group in terms of age(Z=-3.088,P=0.002)and age distribution(x2=13.457,P=0.001),fasting blood glucose(Z=-3.347,P=0.001),baseline NIHSS score(Z=-4.469,P＜0.01),location of occlusion(x2=10.488,P=0.005),transformation of hemorrhage after ischemic stroke(x2=16.943,P＜0.01),and symptomatic intracranial hemorrhage(X2=25.449,P＜0.01),and the baseline ASPECTS of the poor prognosis group was significantly lower than that of the good prognosis group(Z=-4.547,P＜0.01).There were no significant differences in other baseline and clinical data(all P＞0.05).Further multivariate Logistic regression analysis showed that age＞80 years(OR,3.224,95％CI 1.033-10.058,P=0.044),baseline NIHSS score(OR,1.102,95％CI 1.013-1.199,P=0.023),baseline ASPECTS(OR,0.375,95％CI 0.212-0.665,P=0.001),and symptomatic intracranial hemorrhage(OR,7.127,95％CI 1.296-39.203,P=0.024)were independent influencing factors of poor prognosis.Conclusion The independent factors of 90 d poor prognosis after successful EVT in patients with AIS-LVO of anterior circulation are age＞80 years,baseline NIHSS score,baseline ASPECTS,and symptomatic intracranial hemorrhage.

Objective:To investigate the prognostic value and related factors of heart-type fatty acid binding protein (H-FABP) in patients with heart failure.Methods:A total of 877 consecutive patients who were admitted to heart failure care unit of Fuwai hospital and diagnosed as heart failure from July 2015 to July 2017 were enrolled in this study. Baseline serum H-FABP concentration was measured by fluorescence lateral flow immunoassay. According to serum H-FABP levels, patients were divided into three groups: low H-FABP group (H-FABP≤4.04 ng/ml, n=292), middle H-FABP group (H-FABP 4.04-7.02 ng/ml, n=292) and high H-FABP group (H-FABP≥7.02 ng/ml, n=293). The general clinical characteristics were collected and compared among the three groups. According to whether heart failure was caused by coronary artery disease or not, patients with heart failure were divided into ischemic heart failure and non-ischemic heart failure. Multivariate linear regression analysis was performed to explore the independent risk factors of H-FABP. The primary endpoint events were the composite of all-cause death or heart transplantation. Multivariate Cox regression analyses, receiver operating characteristic (ROC) curves, risk prediction tests with multivariate Cox regression model and Kaplan-Meier analyses were conducted to investigate the relationship between H-FABP and the prognosis of heart failure. Results:Multivariate linear regression analysis showed that age, coronary artery disease, alanine aminotransferase, uric acid and N-terminal pro-B type natriuretic peptide (NT-proBNP) were positively associated with H-FABP (β=0.012, 0.238, 0.001, 0.345 and 0.063 respectively,all P<0.05), while female, hemoglobin, albumin, sodium, and estimated glomerular filtration rate (eGFR) were negatively associated with H-FABP (β=-0.184, -0.006, -0.016, -0.034 and -0.006 respectively, all P<0.05). One hundred and nineteen patients (13.6%) lost to follow-up, and 246 patients (32.5%) suffered from all-cause death or heart transplantation during the median follow-up duration of 931 (412-1 185) days. Multivariate Cox regression analysis showed that baseline H-FABP (log 2H-FABP) level was the independent predictor of all-cause death or heart transplantation in patients with heart failure ( HR=1.39, P<0.001). ROC curves showed that baseline H-FABP was a predictor of all-cause death or heart transplantation in patients with heart failure within 3 months, 1 year and 2 years (areas under the curves were 0.69, 0.69 and 0.71 respectively), and the best cut-off values were 5.85 ng/ml, 6.54 ng/ml and 6.54 ng/ml respectively. Risk prediction test with multivariate Cox regression model showed that baseline H-FABP could provide additional prognostic value in predicting all-cause death or heart transplantation for patients with heart failure on top of basic model and baseline NT-proBNP ( P<0.001). Taking 6.54 ng/ml and trisected levels of H-FABP as cut-off values respectively, Kaplan-Meier analyses showed that the survival rates were significantly different among the two or three groups ( P<0.001). Subgroup analyses showed that baseline H-FABP (log 2H-FABP) level was an independent predictor of all-cause death or heart transplantation in patients with ischemic heart failure ( HR=1.74, P<0.001), as well as in patients with non-ischemic heart failure ( HR=1.28, P=0.027). Conclusions:Age, sex, coronary artery disease, hemoglobin, albumin, alanine aminotransferase, sodium, eGFR, uric acid and NT-proBNP are associated with H-FABP level. Baseline H-FABP level is an independent predictor of all-cause death or heart transplantation in patients with heart failure. On top of basic model and baseline NT-proBNP, baseline H-FABP could provide additional prognostic value in predicting adverse events for patients with heart failure.

Objective:To investigate the effect of carotid artery stenting (CAS) on cognitive function in patients with severe carotid artery stenosis.Methods:From January 2019 to December 2020, consecutive patients with severe carotid artery stenosis (stenosis degree ≥70%) treated in the Department of Neurology, Bozhou People's Hospital were selected. According to different treatment schemes, all patients were divided into a CAS group and a control group. The CAS group received CAS combined with the best drug treatment, while the control group only received the best drug treatment. The cognitive function was evaluated by Montreal Cognitive Assessment (MoCA) before treatment and at 6 months after treatment.Results:During the study, 52 patients with severe carotid artery stenosis were enrolled, including 37 patients in the CAS group and 15 in the control group. There were no significant differences in demographic and baseline clinical data between the two groups. All patients in the CAS group completed procedure successfully without any complications. MoCA score in the CAS group was significantly higher than that before treatment ( P<0.001), but not in the control group. There was no significant difference in MoCA score between the patients in the CAS group and the control group before treatment; the MoCA score in the CAS group was significantly higher than that in the control group at 6 months after treatment ( P=0.007). Conclusion:CAS may improve the short-term postoperative cognitive function of patients with severe carotid artery stenosis.

Objective To measure the expression of BP180 antibody in sera of patients with bullous pemphigoid (BP) and/or nervous system diseases (ND),and to explore the relationship between BP and ND.Methods Clinical data were collected from some inpatients and outpatients with BP in Department of Dermatology,as well as some inpatients with ND in Department of Neurology,the Second Hospital of Jilin University between March 2012 and September 2013.Peripheral blood samples were obtained from 20 BP patients without a medical history of ND (BP group),20 patients with ND alone (ND group),20 BP patients with a medical history of ND (BP + ND group),and 20 healthy controls (healthy control group) separately.Enzyme-linked immunosorbent assay (ELISA) was performed to detect the serum level of BP180 antibody in the above groups.Statistical analysis was carried out with SPSS17.0 software by using chi-square test for comparing enumeration data,analysis of variance for comparing the anti-BP180 antibody titer or ages among the above 4 groups,and Games-Howell test for multiple comparisons.Results No anti-BP180 antibody was detected in any of the 20 subjects in the healthy control group.All of the patients in the BP group and BP + ND group were positive for anti-BP180 antibody,and the antibody titers were 128.347 ± 54.678 and 143.482±72.568 respectively.Of the 120 patients in the ND group,7 were positive for anti-BP180 antibody,including 4 with cerebral hemorrhage and 3 with cerebral thrombosis,and the highest anti-BP180 antibody titer of 39.638 was recorded in 1 patient with cerebral infarction.There was a significant difference in the anti-BP180 antibody titer among the 4 groups (F =55.624,P ＜ 0.05).In addition,there was no significant difference in the anti-BP180 antibody titer between the BP group and BP + ND group (P =0.878),while the anti-BP180 antibody titers significantly differed between the BP group and ND group,between the BP group and healthy control group,between the BP + ND group and ND group,between the BP + ND group and healthy control group,and between the ND group and healthy control group (P ＜ 0.05).Conclusion BP may occur in ND patients with an increased anti-BP180 antibody titer.

Objective To analyze the difference of the delivery date reckoned by traditional and modified formula for calculating the expected date of confinement (EDC).Methods The data of 2055 women (37-41+6 week) were collected who gave monotocousa term spontaneous birth in the Chongqing Health Center for Women and Children from Jan.2014 to Feb.2015.Of which 1300 were primipara,and 755 were multipara;and the data of 1224 women (39-41week) were collected,of which 832 were primipara,and 392 were multipara.The expected date was calculated with traditional and modified calculating formula,and then the actual delivery date was used for comparison and statistical analysis.Results The coincidence of actual delivery date with the estimated due date reckoned by traditional formula (39-41week) was 8.4％ in primipara and 9.7％ in multipara,and the coincidence reckoned by modified formula was 11.9％ in primipara and 14.8％ in multipara.The EDC estimated by modified formula was more precise than that calculated by traditional formula (P＜0.05).Conclusion The EDC calculated with modified formula is more accurate than that calculated with traditional formula.

AIM: To investigate the effect of peripheral administration of arginine vasopressin (AVP) on lipopolysaccharide (LPS)-induced fever and hyperalgesia in rats and its relationship with interleukine-1β (IL-1β) and prostaglandin E2 (PGE2).METHODS: The core temperature (Tc), brown adipose tissue (BAT) temperature and activity were measured by telemetry in adult male Sprague-Dawley rats at an ambient temperature of 23 ℃ during a 12 h light/12 h dark photoperiod (lights on at 06:00 and lights off at 18:00).The rats were intraperitoneally injected with LPS (50 μg/kg), AVP (10 μg/kg) or V1a vasopressin receptor antagonist (V1a antagonist, 30 μg/kg) at 10:00 or 11:30.Hyperalgesia was assessed by measuring the latency to withdraw a hindpaw from radiant heat (Hargreaves test).The concentrations of IL-1β and PGE2 in the serum were tested by ELISA.RESULTS: Intraperitoneal administration of LPS induced periods of biphasic fever accompanied by hyperalgesia.AVP reversed LPS-induced fever, and decreased the hyperalgesia and BAT thermogenesis.Peripheral administration of V1a antagonist enhanced the fever produced by LPS, but did not affect the hyperalgesia.AVP significantly attenuated LPS-induced IL-1β and PGE2 production.CONCLUSION: Peripheral administration of AVP reverses LPS-induced fever and decreases hyperalgesia by reduction of BAT thermogenesis and inhibition of IL-1β and PGE2.Endogenous AVP attenuates the fever induced by LPS, but does not affect the nociceptive thresholds.

Objective To explore the antioxidant activities of puerarin on aged rats.Methotds Ten 2-month-old SD rats were selected as control group.Thirty 12-month-old SD rats were divided into negative control group,positive control group and puerarin group.Rats in medication were given an oral administration of 25 mg/kg puerarin and 15 mg/kg U-74006F,while other rats were given an administration of same volume of distilled water.Two months later,all the rats were sacrificed and blood was collected,and serum level of malondialdehyde (MDA) and activities of total antioxidant activity (T-AOC),superoxide dismutase (SOD) and glutathione (GSH-Px) were measured.The levels of MAD and activities of T-AOC,SOD and GSH-Px in liver and brain were also detected.Besides,the mRNA expressions of SOD and CAT in liver were analyzed in all the groups.Results The serum level of MDA and the activities of T-AOC,SOD and GSH-Px in aged rat group were significantly lower than young rat group.After the treatment of puerarin and U-74006F,the serum and liver levels of MDA decreased and the activities of SOD,T-AOC and GSH-Px increased significantly,and were significantly higher than aged rat group.The level of MDA decreased and the activities of SOD,T-AOC and GSH-Px increased significantly in brain after the treatment of U-74006F.Puerarin had no effects on MAD,SOD and GSH-Px except increased the activity of T-AOC.The mRNA expression of SOD and CAT of aged rat were significantly lower than young rat group,and after puerarin treatment this phenomenon was weakened.Conclusion Puerarin can increase the activities of antioxidant factors and had notable antioxidant functions on aged rats.

Objective To explore the antioxidant activities of puerarin on aged rats.Methotds Ten 2-month-old SD rats were selected as control group.Thirty 12-month-old SD rats were divided into negative control group,positive control group and puerarin group.Rats in medication were given an oral administration of 25 mg/kg puerarin and 15 mg/kg U-74006F,while other rats were given an administration of same volume of distilled water.Two months later,all the rats were sacrificed and blood was collected,and serum level of malondialdehyde (MDA) and activities of total antioxidant activity (T-AOC),superoxide dismutase (SOD) and glutathione (GSH-Px) were measured.The levels of MAD and activities of T-AOC,SOD and GSH-Px in liver and brain were also detected.Besides,the mRNA expressions of SOD and CAT in liver were analyzed in all the groups.Results The serum level of MDA and the activities of T-AOC,SOD and GSH-Px in aged rat group were significantly lower than young rat group.After the treatment of puerarin and U-74006F,the serum and liver levels of MDA decreased and the activities of SOD,T-AOC and GSH-Px increased significantly,and were significantly higher than aged rat group.The level of MDA decreased and the activities of SOD,T-AOC and GSH-Px increased significantly in brain after the treatment of U-74006F.Puerarin had no effects on MAD,SOD and GSH-Px except increased the activity of T-AOC.The mRNA expression of SOD and CAT of aged rat were significantly lower than young rat group,and after puerarin treatment this phenomenon was weakened.Conclusion Puerarin can increase the activities of antioxidant factors and had notable antioxidant functions on aged rats.