1.Experimental validation of machine learning identification of KDELR3 as a signature gene for osteoarthritis hypoxia
Wenfei XU ; Chunyu MING ; Qijie MEI ; Changshen YUAN ; Jinrong GUO ; Chao ZENG ; Kan DUAN
Chinese Journal of Tissue Engineering Research 2024;28(21):3431-3437
BACKGROUND:Hypoxia is strongly associated with the development and progression of osteoarthritic chondrocyte injury,but the specific targets and regulatory mechanisms are unclear. OBJECTIVE:A machine learning approach was used to identify KDEL(Lys-Asp-Glu-Leu)receptor 3(KDELR3)as a characteristic gene for osteoarthritis hypoxia and immune infiltration analysis,to provide new ideas and methods for the treatment of osteoarthritis. METHODS:The osteoarthritis-related datasets were downloaded from the GEO database and the GSEA website to obtain hypoxia-related genes.The osteoarthritis datasets were batch-corrected and immune infiltration analyzed using R language,and osteoarthritis hypoxia genes were extracted for differential analysis.Differentially expressed genes were analyzed for GO function and KEGG signaling pathway.Weighted correlation network analysis(WGCNA)and machine learning were also used to screen osteoarthritis hypoxia signature genes,and in vitro cellular experiments were performed to validate expression and correlate immune infiltration analysis using the datasets and qPCR. RESULTS AND CONCLUSION:(1)8492 osteoarthritis genes were obtained by batch correction and principal component analysis,mainly strongly associated with immune cells such as Macrophages M2 and Mast cells resting;200 hypoxia genes were also obtained,resulting in 41 osteoarthritis hypoxia differentially expressed genes.(2)GO analysis involved mainly biological processes such as response to nutrient levels and glucocorticoids;cellular components such as lysosomal lumen and Golgi lumen;and molecular functions such as 14-3-3 protein binding and DNA-binding transcriptional activator activity.(3)KEGG analysis of osteoarthritis hypoxia differentially expressed genes was associated with signaling pathways such as PI3K-Akt,FoxO,and microRNAs in cancer.(4)The characteristic gene KDELR3 was obtained after using WGCNA analysis and machine learning screening.(5)The gene expression of KDELR3 was found to be higher in the test group than in the control group in the synovium(P=0.014)but lower in the meniscus(P=0.024)after validation by gene microarray.(6)In vitro chondrocyte assay showed that the expression of KDELR3 was higher in cartilage than in the control group(P=0.005),while KDELR3 was closely associated with Macrophages M0(P=0.014)and T cells follicular helper(P=0.014).Using a machine learning approach,we confirmed that KDELR3 can be used as a hypoxic signature gene for osteoarthritis and may intervene in osteoarthritis pathogenesis by improving hypoxia,expecting to provide a new direction for better treatment of osteoarthritis.
2.Identification of ferroptosis signature genes in osteoarthritis based on WGCNA and machine learning and experimental validation
Wenfei XU ; Chunyu MING ; Kan DUAN ; Changshen YUAN ; Jinrong GUO ; Qi HU ; Chao ZENG ; Qijie MEI
Chinese Journal of Tissue Engineering Research 2024;28(30):4909-4914
BACKGROUND:Ferroptosis is strongly associated with the occurrence and progression of osteoarthritis,but the specific characteristic genes and regulatory mechanisms are not known. OBJECTIVE:To identify osteoarthritis ferroptosis signature genes and immune infiltration analysis using the WGCNA and various machine learning methods. METHODS:The osteoarthritis dataset was downloaded from the GEO database and ferroptosis-related genes were obtained from the FerrDb website.R language was used to batch correct the osteoarthritis dataset,extract osteoarthritis ferroptosis genes and perform differential analysis,analyze differentially expressed genes for GO function and KEGG signaling pathway.WGCNA analysis and machine learning(random forest,LASSO regression,and SVM-RFE analysis)were also used to screen osteoarthritis ferroptosis signature genes.The in vitro cell experiments were performed to divide chondrocytes into normal and osteoarthritis model groups.The dataset and qPCR were used to verify expression and correlate immune infiltration analysis. RESULTS AND CONCLUSION:(1)12 548 osteoarthritis genes were obtained by batch correction and PCA analysis,while 484 ferroptosis genes were obtained,resulting in 24 differentially expressed genes of osteoarthritis ferroptosis.(2)GO analysis mainly involved biological processes such as response to oxidative stress and response to organophosphorus,cellular components such as apical and apical plasma membranes,and molecular functions such as heme binding and tetrapyrrole binding.(3)KEGG analysis exhibited that differentially expressed genes of osteoarthritis ferroptosis were related to signaling pathways such as the interleukin 17 signaling pathway and tumor necrosis factor signaling pathway.(4)After using WGCNA analysis and machine learning screening,we obtained the characteristic gene KLF2.After validation by gene microarray,we found that the gene expression of KLF2 was higher in the test group than in the control group in the meniscus(P=0.000 14).(5)In vitro chondrocyte assay showed that type Ⅱ collagen and KLF2 expression was lower in the osteoarthritis group than in the control group in chondrocytes(P<0.05),while in osteoarthritis ferroptosis,mast cells activated was closely correlated with dendritic cells(r=0.99);KLF2 was closely correlated with natural killer cells(r=-1,P=0.017)and T cells follicular helper(r=-1,P=0.017).(6)The findings indicate that using WGCNA analysis and machine learning methods confirmed that KLF2 can be a characteristic gene for osteoarthritis ferroptosis and may improve osteoarthritis ferroptosis by interfering with KLF2.
3.Two-sample Mendelian randomization analysis of causal relationship between eczema and autoimmune diseases
Chunli CHEN ; Siyu YAN ; Bangbei WAN ; Yangyiyi YU ; Jinrong ZENG ; Lina TAN ; Jianyun LU
Journal of Central South University(Medical Sciences) 2024;49(6):932-942
Objective:The causal relationship between eczema and autoimmune diseases has not been previously reported.This study aims to evaluate the causal relationship between eczema and autoimmune diseases. Methods:The two-sample Mendelian randomization(MR)method was used to assess the causal effect of eczema on autoimmune diseases.Summary data from the Genome-Wide Association Study Catalog(GWAS)were obtained from the Integrative Epidemiology Unit(IEU)database.For eczema and autoimmune diseases,genetic instrument variants(GIVs)were identified according to the significant difference(P<5×10-8).Causal effect estimates were generated using the inverse-variance weighted(IVW)method.MR Egger,maximum likelihood,MR-PRESSO,and MR-RAPS methods were used for alternative analyses.Sensitivity tests,including heterogeneity,horizontal pleiotropy,and leave-one-out analyses,were performed.Finally,reverse causality was assessed. Results:Genetic susceptibility to eczema was associated with an increased risk of Crohn's disease(OR=1.444,95%CI 1.199 to 1.738,P<0.001)and ulcerative colitis(OR=1.002,95%CI 1.001 to 1.003,P=0.002).However,no causal relationship was found for the other 6 autoimmune diseases,including systemic lupus erythematosus(SLE)(OR=0.932,P=0.401),bullous pemphigoid(BP)(OR=1.191,P=0.642),vitiligo(OR=1.000,P=0.327),multiple sclerosis(MS)(OR=1.000,P=0.965),ankylosing spondylitis(AS)(OR=1.001,P=0.121),rheumatoid arthritis(RA)(OR=1.000,P=0.460).Additionally,no reverse causal relationship was found between autoimmune diseases and eczema. Conclusion:Eczema is associated with an increased risk of Crohn's disease and ulcerative colitis.No causal relationship is found between eczema and SLE,MS,AS,RA,BP,or vitiligo.
4.Morphological characteristics of bone marrow and peripheral blood in 1 151 cases diagnosed with de novo acute leukemia
Haiyang WANG ; Zengtian SUN ; Xiaorui XU ; Jing YAN ; Wei SANG ; Zhenyu LI ; Jinrong LI ; Mengdi XU ; Jiulian YUAN ; Zhiyuan WANG ; Lingyu ZENG
Chinese Journal of Laboratory Medicine 2023;46(3):295-303
Objective:To observe and analyze the morphological characteristic of bone marrow and peripheral blood in patients diagnosed with de novo acute leukemia.Methods:From October 1, 2015 to December 31, 2021, 1151 patients aged 47 (26, 62) years, consisting of 602 males and 549 females with newly diagnosed acute leukemia in the Department of Hematology, Affiliated Hospital of Xuzhou Medical University, were collected to preform the morphological analysis in bone marrow and peripheral blood smears. Based on the comprehensive diagnosis results of morphology, immunology, cytogenetics, and molecular biology, comparison between acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL), AML with RUNX1-RUNXITI gene, AML with CBFβ/MYH11 gene, acute promyelocytic leukemia (APL) with PML/RARA gene, AML with NPM1 gene, the rest of the AML, Ph+ALL and Ph-ALL were performed by Chi-square test along with analysis of the differences in the ratio of wood bundle cells, pseudo-Chediak-Higashi (PCH) inclusions, cytoplasmic small particles, nuclear notches, leukemia cells with cup-like changes (cup cells); as well as the differences in the micromeganuclei, early immature granulocytes, plasma cells, high eosinophils and other accompanying cells and the distribution of "grape-like" aggregation. Finally, the morphological characteristics of acute leukemia cells, the appearance and arrangement of accompanying cells were summarized.Results:Between AML and ALL, there were statistically significant differences in cytoplasmic Auer bodies[(45.5%, 0%), χ 2=211.400, P<0.01], PCH inclusion bodies[(28.9%, 0%), χ 2=114.100, P<0.01], cytoplasmic fine particles[(20.7%, 2.9%), χ 2=53.798, P<0.01], nuclear notches[(0.7%, 6.1%), χ 2=30.906, P<0.01], and goblet cells[(4.9%, 0.3%), χ 2=13.495, P<0.01], micromegakaryus [(22.4%, 0.3%), χ 2=80.398, P<0.01], plasma cells[(87.6%, 10.6%), χ 2=604.241, P<0.01], hyperacidophils[(15.3%, 1.0%), χ 2=46.116, P<0.01] showed significant differences in the "grape-like" aggregation distribution. In AML with RUNX1-RUNXITI gene, the changes of vacuoles and PCH inclusion bodies are more obvious; in AML with CBFβ/MYH11 gene, the increase of hypereosinophils is more obvious; in APL with PML/RARA gene, the increase of woodbundle is more obvious. The morphology of nuclei chromatin, nucleolus, and vacuoles were also different among the groups. Comparison between Ph+ALL and Ph-ALL showed that Ph+ALL was more prone to develop early immature granulocytes and plasma cells (all P<0.05). Conclusion:There are significant differences between AML and ALL in the characteristics of leukemia cells, the regularity of accompanying cells, and the aggregation and distribution patterns. The subtypes of AML with specific genetic abnormalities have their own characteristics in the appearance of vacuoles, PCH inclusions, hypereosinophils, woodbundle cells, and goblet cells. Ph+ALL is more prone to present early immature granulocytes and plasma cells.
5.Efficacy of acidified aliphatic ester in the treatment of atopic dermatitis in mouse models and preliminary exploration of its mechanisms of action
Chunli CHEN ; Siyu YAN ; Dan WANG ; Lihua GAO ; Lina TAN ; Siyuan TANG ; Wei LIU ; Jinrong ZENG ; Jianyun LU
Chinese Journal of Dermatology 2023;56(9):822-831
Objective:To investigate the efficacy of acidified aliphatic ester in the treatment of atopic dermatitis (AD) in mouse models, and to preliminarily explore its mechanisms of action.Methods:Twenty female BALB/c mice aged 6 to 8 weeks were randomly divided into 2 groups: 5 mice in the blank control group were topically treated with absolute ethanol on both ears (14.3 μl per ear) every day, and 15 mice in the model group were topically treated with calcipotriol liniment (14.3 μl per ear) and 20 g/L ovalbumin (25 μl per ear) on both ears every day for 10 consecutive days to establish AD-like mouse models. From day 11, 15 mice in the model group were randomly divided into 3 groups (5 mice in each group), including AD model group, aliphatic ester group, and acidified aliphatic ester group; in the forenoon, all the 3 groups continued to be topically treated with calcipotriol liniment and ovalbumin to maintain AD-like models; in the afternoon, the aliphatic ester group and acidified aliphatic ester group were topically treated with aliphatic ester and acidified aliphatic ester respectively (10 μl per ear), and no treatment was given to the AD model group. Changes in body weight, ear thickness, ear skin lesion scores, and scratching frequency were observed. Ear skin swabs were obtained from the mice on days 10 and 14 for 16S rRNA gene - based microbial diversity tests. On day 14, mice were sacrificed after reflectance confocal microscopy examinations of the ear skin, ear tissues were resected for hematoxylin and eosin staining, mast cell staining, and real-time fluorescence-based quantitative PCR (RT-qPCR), and blood samples were collected for detection of serum IgE levels. One-way analysis of variance was used for analysis of data that met homogeneity of variance criteria, and least significant difference- t test for multiple comparisons. Results:On day 14, the severity of mouse ear lesions was the highest in the AD model group, followed in turn by the aliphatic ester group, acidified aliphatic ester group, and blank control group; compared with the AD model group, the acidified aliphatic ester group showed significantly decreased mouse ear thickness ( F = 897.50, P < 0.001), skin lesion scores ( F = 268.80, P < 0.001), scratching frequency ( F = 64.36, P < 0.001), and epidermal thickness ( F = 256.20, P < 0.001). In addition, RT-qPCR indicated that the expression of inflammatory factors such as interleukin (IL) -33, thymic stromal lymphopoietin, IL-4, and tumor necrosis factor-α in lesional areas, and the degree of mast-cell infiltration were all significantly lower in the acidified aliphatic ester group than in the AD model group ( F = 3.38, 8.70, 41.73, 44.30, 134.30, P = 0.049, = 0.001, < 0.001, < 0.001, <0.001, respectively). Microbial diversity tests showed that the acidified aliphatic ester treatment could inhibit the colonization of Staphylococcus spp. in the ears of AD-like mouse models, and the Shannon index and Simpson index significantly differed among the 4 groups ( F = 9.00, 7.92, P = 0.001, 0.002, respectively) . Conclusion:Acidified aliphatic ester could improve skin lesions of AD-like mouse models, possibly by regulating immunity, suppressing inflammation, and restoring skin microecological diversity.
6.Ozonated oil alleviates dinitrochlorobenzene-induced allergic contact dermatitis via inhibiting the FcεRI/Syk signaling pathway.
Zhibing FU ; Yajie XIE ; Liyue ZENG ; Lihua GAO ; Xiaochun YU ; Lina TAN ; Lu ZHOU ; Jinrong ZENG ; Jianyun LU
Journal of Central South University(Medical Sciences) 2023;48(1):1-14
OBJECTIVES:
Ozone is widely applied to treat allergic skin diseases such as eczema, atopic dermatitis, and contact dermatitis. However, the specific mechanism remains unclear. This study aims to investigate the effects of ozonated oil on treating 2,4-dinitrochlorobenzene (DNCB)-induced allergic contact dermatitis (ACD) and the underling mechanisms.
METHODS:
Besides the blank control (Ctrl) group, all other mice were treated with DNCB to establish an ACD-like mouse model and were randomized into following groups: a model group, a basal oil group, an ozonated oil group, a FcεRI-overexpressed plasmid (FcεRI-OE) group, and a FcεRI empty plasmid (FcεRI-NC) group. The basal oil group and the ozonated oil group were treated with basal oil and ozonated oil, respectively. The FcεRI-OE group and the FcεRI-NC group were intradermally injected 25 µg FcεRI overexpression plasmid and 25 µg FcεRI empty plasmid when treating with ozonated oil, respectively. We recorded skin lesions daily and used reflectance confocal microscope (RCM) to evaluate thickness and inflammatory changes of skin lesions. Hematoxylin-eosin (HE) staining, real-time PCR, RNA-sequencing (RNA-seq), and immunohistochemistry were performed to detct and analyze the skin lesions.
RESULTS:
Ozonated oil significantly alleviated DNCB-induced ACD-like dermatitis and reduced the expressions of IFN-γ, IL-17A, IL-1β, TNF-α, and other related inflammatory factors (all P<0.05). RNA-seq analysis revealed that ozonated oil significantly inhibited the activation of the DNCB-induced FcεRI/Syk signaling pathway, confirmed by real-time PCR and immunohistochemistry (all P<0.05). Compared with the ozonated oil group and the FcεRI-NC group, the mRNA expression levels of IFN-γ, IL-17A, IL-1β, IL-6, TNF-α, and other inflammatory genes in the FcεRI-OE group were significantly increased (all P<0.05), and the mRNA and protein expression levels of FcεRI and Syk were significantly elevated in the FcεRI-OE group as well (all P<0.05).
CONCLUSIONS
Ozonated oil significantly improves ACD-like dermatitis and alleviated DNCB-induced ACD-like dermatitis via inhibiting the FcεRI/Syk signaling pathway.
Animals
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Mice
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Dinitrochlorobenzene/metabolism*
;
Skin/metabolism*
;
Cytokines/metabolism*
;
Interleukin-17/metabolism*
;
Tumor Necrosis Factor-alpha/metabolism*
;
Dermatitis, Allergic Contact/pathology*
;
Dermatitis, Atopic/chemically induced*
;
Signal Transduction
;
RNA, Messenger/metabolism*
;
Mice, Inbred BALB C
7.Expression of circ_0006692 in Non-small Cell Lung Cancer and Its Regulatory Mechanism on Proliferation and Metastasis of Lung Cancer Cells
Zeng CHEN ; Jinrong LIAO ; Changyan ZOU ; Ying SU ; Keyu LIN ; Shanfeng JIN ; Qianlan ZHENG ; Xiandong LIN
Cancer Research on Prevention and Treatment 2021;48(9):846-852
Objective To explore the expression of circ_0006692 in NSCLC and its relation with clinicopathological characteristics and related mechanism. Methods We collected 50 pairs of NSCLC tissues and adjacent tissues. The expression of circ_0006692 was detected by qRT-PCR and its relation with clinicopathological features was analyzed. We constructed lung cancer A549 cell line with circ_0006692 overexpression and knockdown. Cell proliferation, migration and invasion were detected by MTS, colony forming, wound healing and Transwell invasion assays. qRT-PCR and Western blot were used to detect the effect of circ_0006692 expression change on EMT-related gene expression. Results The expression of circ_0006692 in NSCLC was significantly higher than that in adjacent tissues (
8.Correlation between blood pressure rhythm and left ventricular structure and function in elderly hypertension patients
Weiwei DENG ; Shuifen YE ; Meie ZENG ; Bin CHEN ; Jinrong ZHONG
Chinese Journal of Primary Medicine and Pharmacy 2019;26(8):963-967
Objective To investigate the correlation between blood pressure rhythm and left ventricular structure and function in elderly hypertensive patients. Methods A total of 147 elderly patients with high blood pressure in the First Hospital of Longyan Affiliated to Fujian Medical University were selected. All the patients received 24h ambulatory blood pressure examination. According to the rhythm of blood pressure, the patients were divided into the dipper blood pressure group,the-non dipper type blood pressure group and the anti-dipper type blood pressure group. All patients were examined by echocardiography. Results According to the results of 24h dynamic blood pressure,the type of dipper blood pressure accounted for 11.56% (17 cases) in 147 elderly patients, non-dipper type blood pressure type accounted for 51.02% (75 cases),and the anti-dipper type of blood pressure type accounted for 37.41% (55 cases).The ventricular septal thickness(IVST),left ventricular diastolic inner diameter (LVEDD),left atrium inner diameter(LAD),left ventricle posterior wall thickness( LVPWT) and left ventricle mass index(LVMI) of the non-dipper blood pressure group were (10.56 ± 1.51)mm,(50.17 ± 4.31) mm,(34.65 ± 5.78)mm,(9.26 ± 0.98)mm,(102.31 ± 23.23)g/m2 ,respectively.The IVST,LVEDD,LAD,LVPWT and LVMI of the anti-dipper blood pressure group were (10.51 ± 1.86)mm,(50.20 ± 3.66)mm,(36.96 ± 4.22)mm,(9.42 ± 0.99)mm,(110.47 ± 31.96) g/m2 ,respectively.The IVST,LVEDD,LAD,LVPWT and LVMI of the dipper blood pressure group were (9.53 ± 1.53) mm,(47.59 ± 2.27) mm,(30.47 ± 4.17) mm,(8.88 ± 1.12) mm,(84.98 ± 15.48) g/m2 , respectively. The differences of IVST, LVEDD, LAD, LVPWT and LVMI in the three groups were statistically significant(F=1.172,3.428,1.006,0.135,all P<0.05).The maximum blood flow velocity in early diastolic period of mitral valve blood flow spectrum(E peak)/maximum blood flow velocity in late diastolic period(A peak)(E/A)of the non-dipper blood pressure group and anti-dipper blood pressure group were (0.89 ± 0.30), (0.80 ± 0.28),respectively,which was significantly lower than that of dipper blood pressure group [(1.35 ± 0.63)] (t= -2.890,-3.440,all P<0.05).The left ventricular ejection score(LVEF) of the anti-dipper blood pressure group was (65.31 ± 6.74)% ,which was significantly lower than that of the dipper blood pressure group[(70.12 ± 10.76)% ],the difference was statistically significant(t= -2.209,P<0.05).The 24 h mean systolic pressure,24 h mean diastolic pressure and daytime mean diastolic pressure in the three groups of dynamic blood pressure parameters had no statistically significant differences (all P>0.05).The average daytime systolic pressure in the dipper blood pressure group was (143.06 ± 13.70) mmHg,which was higher than that in the non-dipper blood pressure group [(133.25 ± 13.28)mmHg] and anti-dipper blood pressure group[(131.16 ± 12.26)mmHg],the differences were statistically significant(t= -2.734,-3.401,all P <0.05).The mean evening systolic pressure and the average nocturnal diastolic pressure of anti -dipper blood pressure group were ( 139.04 ± 15.01 ) mmHg and ( 80.18 ± 10.29) mmHg, respectively, which were higher than those of the dipper and non - dipper blood pressure group [(123.24 ± 14.49)mmHg and (72.24 ± 7.97) mmHg,(127.40 ± 13.30) mmHg,(73.45 ± 11.43) mmHg],the differences were statistically significant ( t =3. 822, 4. 666, 2. 919, 3. 456, all P <0. 05 ). LVMI was positively correlated with age,body mass index(BMI),low density lipoprotein( LDL-C),daytime average systolic pressure, night average systolic pressure,night average diastolic pressure,and 24h average systolic pressure(r=0.256,0.241, 0.687,0.251,0.380,0.203,0.243,all P <0.05). Conclusion Anti -dipper blood pressure and non -dipper blood pressure have more significant damage to cardiac function and structure than dipper blood pressure in elderly patients with hypertension,and the elevation of nocturnal blood pressure is closely related to left heart structure and function damage.There is a high correlation between abnormal circadian rhythm of blood pressure and left ventricular hypertrophy in elderly hypertensive patients.
9.Infradiaphragmatic Stasis-Expelling Decoction reduce the expression of TIMP-1 contributing to inhibition of rat liver fibrosis
Peng ZHANG ; Yurong MIAO ; Jinrong ZENG ; Zhengping WU
The Journal of Practical Medicine 2018;34(9):1445-1449
Objective To investigate the protective effect and its mechanism of infradiaphragmatic stasis-expelling decoction on hepatic fibrosis in rats. Method One hundred and ten SD rats were divided into four groups:the normal control group ,model group ,low dose group and high dose group of infradiaphragmatic stasis-expelling decoction. In addition to the normal control group,rats in other groups were subcutaneously given pure CCl4 to set up the liver fibrosis model. Twelve weeks later,the serum liver biochemical indexes,including ALT,AST, ALB,TP and T-bil,the Ishak score about liver fibrosis ,the positive expression of TIMP-1 were compared among groups. Results Compared with the fibrotic group,the levels of serum ALT,AST and T-bil were lower in low dose group,the level of serum TP and ALB were increased in high dose group Levels of serum ALT,AST and T-bil were significantly lowered in high dose group,the levels of serum of TP and ALB were significantly increased in high dose group. Compared with model group,the Ishak score about liver fibrosis was significantly lowered(P<0.05). Numbers of cells with positive expression of TIMP-1 in liver tissue was reduced. Conclusion Infradiaphragmatic stasis-expelling decoction could inhibit the expression and activity of TIMP-1 contributing to the effect of antiliver fibrosis.
10.Correlation among ST-2,adiponectin,growth differentiation factor-15 and senile heart failure
Jian ZENG ; Jinrong XU ; Ling CHEN ; Chengbiao SU ; Ming LI ; Shian HUANG
The Journal of Practical Medicine 2017;33(23):3891-3894
Objective To explore the correlation among ST-2,adiponectin(APN),positive growth dif-ferentiation factor -15(GDF-15)and senile heart failure,and to investigate the diagnostic values of these indica-tors. Methods Totally 129 patients(15 patients of NYHA Ⅰ,60 of NYHA Ⅱ,28 of NYHA Ⅲ and 26 of NYHAⅣin study group)with heart failure and 30 control subjects(control group)were enrolled in the study.Se-rum levels of ST-2,APN and GDF-15 were determined by ELISA,and their correlation with senile heart failure was analyzed.Results Compared with those in control group,serum levels of ST-2,APN and GDF-15 in study group were significantly increased(P<0.05).There were significant differences in serum levels of ST-2,APN and GDF-15 among patients of different classifications in study group(P<0.05)and the higher level of cardiac func-tion,the higher serum ST-2,APN and GDF-15. There was a positive correlation among serum ST-2,APN and GDF-1. Conclusions The serum levels of ST-2,APN and GDF-1 are positively related to the severity of senile heart failure,thus it could be served as the index of diagnosis,curative effect monitoring and prognosis of patients with heart failure.

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