High Ratio Group Research Articles

714 IL-6 and Soluble IL-6 Receptor – Two Sides of the Same Coin

Abstract Introduction Interleukin (IL)-6 is a multifunctional cytokine that has both a pro- and anti-inflammatory role. In many studies, IL-6 has been shown to increase rapidly after burn injury and is associated with poor outcomes. IL-6 can signal via its soluble IL-6 Receptor (sIL-6R) and is referred to as trans-signaling, which is regarded as the pro-inflammatory pathway. The role of sIL-6R post-burn injury has not yet been explored. We hypothesized that patients with a lower ratio of IL-6 to sIL-6R would have worse outcomes. Methods Patients admitted to our burn centre within 7 days of injury were included in this study. Patients were divided into two groups based on IL-6 and sIL-6R levels measured within the first 30 days post-burn injury. Patients were in the high ratio group if their IL-6:sIL-6R ratio was ≥ 0.185. Clinical outcomes included organ biomarkers, morbidities, and hospital length of stay. Groups were compared using Student’s t-test, Mann-Whitney U, and Fisher’s exact test as appropriate; a P value of < 0.05 was considered statistically significant. Results We studied 104 patients, mean age 51 ± 18 years and 24 ± 17% total body surface area (TBSA) burn. There were 49 patients categorized with a low IL-6:sIL-6R ratio and 55 patients with a high IL-6:sIL-6R ratio. Patients in the high IL-6:sIL-6R ratio group had a significantly greater TBSA burn and a significantly greater proportion of patients with inhalation injury (p< 0.05). Levels of sIL-6R were not significantly different among the low and high group (770 ± 264 pg/mL vs. 798 ± 268 pg/mL respectively; p=0.601). However, levels of IL-6 were significantly higher in patients with a high IL-6:sIL-6R ratio (37 IQR 19–97 pg/mL vs. 567 IQR 273–916 pg/mL; p< 0.0001). Mortality was significantly greater in the high IL-6:sIL-6R ratio group (2% vs. 27%; p< 0.001). Conclusions Interestingly, patients with a higher ratio of IL-6:sIL-6R had significantly greater mortality. Using sIL-6R as a marker for the proinflammatory immune response, we expected patients with a lower IL-6:sIL-6R ratio to have poor outcomes which are typically associated with a hyperinflammatory or exaggerated immune response. However, the absolute value of sIL-6R did not differ. This suggests that classic signaling of IL-6 via its membrane bound receptor, with an anti-inflammatory function, is an important factor. Applicability of Research to Practice The opposing pro- and anti-inflammatory function of IL-6 through trans- and classic signaling is contingent on the ratios expressed. The demonstrated increase in classic signaling highlights the importance of measuring both IL-6 and sIL-6R in future studies. Additionally, it lays the foundation for potential precision medicine approaches to selectively block specific signaling pathways.

Prognostic Values of LDH and CRP in Cervical Cancer.

PurposeCervical cancer is one of the deadliest tumors among women in China. C-reactive protein (CRP), an indicator of inflammation, and lactate dehydrogenase (LDH), an enzyme ubiquitously expressed in cells, both play important roles in tumor growth and metastasis.Patients and MethodsBased on pre-radiotherapy LDH and CRP median levels, we divided patients into four groups: high LDH and CRP group, high LDH group, high CRP group, and low LDH and CRP group. Then, based on pre-/post-radiotherapy LDH and CRP ratios, we divided patients into four groups: high LDH and CRP ratio group, high LDH ratio group, high CRP ratio group, and low LDH and CRP ratio group. Kaplan–Meier (KM) curves were constructed to show overall survival (OS). A multivariate Cox regression model was employed to identify the independent risk factors.ResultsHigh pre-radiotherapy LDH and CRP levels and increased pre-/post-radiotherapy LDH and CRP ratios were correlated with worst OS compared with the other three groups.ConclusionLDH and CRP were correlated with outcomes in patients with locally advanced cervical cancer.

Soccer Passing Accuracy Differentiates Between High and Low Digit Ratio (2D:4D) Soccer Players

The purpose of the present study was to know soccer passing accuracy performances between the national youth level soccer players possessing high digit ratio and low digit ratio (2D:4D). The study was carried out in 108 male soccer players of Bangladesh aged between 16 to 19 years for measured the digit ratio. To find out the high and low digit ratio groups of participant quartile deviation has been used. Participants belonged to 0.973 and above (N=28) were categorized into high digit ratio group and 0.942 and below (N=28) were categorized into low digit ratio group. Soccer passing accuracy performance was assessed (N=56) by using Loughborough Soccer Passing Test (LSPT). Digit ratio (2D:4D) was measured by digital vernier caliper, Mitutoyo Corporation, Japan measuring to 0.01 mm. The length of the index finger (2D) and ring finger (4D) measured in millimeters from the second metacarpophalangeal crease of the finger to the fingertip. The mean digit ratio was calculated as dividing the length of the 2D by the length of the 4D for the left and right hand one by one and then computes the mean of these two ratios. To find out the significance of differences of soccer passing accuracy between the high digit ratio and the low digit ratio groups independent t-test was used. It was observed that the mean score in soccer passing accuracy performance, i.e., LSPT Total performance (TP) of the lower digit ratio, group was a significantly better performer than that of the high digit ratio group. A higher level of fetal testosterone, characterized by lower values of the digit finger ratio (2D:4D), may be associated with a higher performance of soccer passing accuracy in multifaceted aspects including passing, dribbling, controlling, turning, decision-making, and cognition.

Effect of Serum Free Light Chain on Renal Function and Prognosis in Patients with Newly Diagnosed Multiple Myeloma

To analyze the effect of serum free light chain (sFLC) on renal function and prognosis in patients with newly diagnosed multiple myeloma (MM). The clinical data of 70 newly diagnosed MM patients who received sFLC examination in Fujian Medical University Union Hospital were retrospectively analyzed from April 2012 to November 2016. Univariate analysis was used to analyze the risk factors that associated with renal impairment (RI) and prognosis. Logistic regression and Kaplan-Meier analyze were used to analyze the roles of sFLC in RI and the prognosis. Out of the 70 patients, 20 patients had RI at the initial diagnosis. Compared to normal renal function group, RI group had lower level of hemoglobin, elevated levels of serum uric acid, corrected calcium, serum creatinine, serum β2 microglobulin, and involved sFLC, higher proportion of patients with ISS stage III, involved sFLC≥500 mg/L, hemodialysis (all P＜0.05). Multivariate logistic regression analysis showed that serum uric acid≥430 μmol/L, ISS stage III and a involved sFLC≥500 mg/L were all the independent risk factors for RI in patients with newly diagnosed MM patients (all P＜0.05). Receiver operating characteristic (ROC) curves analysis showed that the involved sFLC was 705.0 mg/L, which was a best cut-off value area under curve (AUC) for prediting RI in patients with MM was 0.727 (P=0.003), sensitivity was 65.0% and specificity was 82.0%). After a median follow-up period of 31 (1-84) months, the median overall survival (OS) of patients with involved sFLC≥500mg/L and involved sFLC＜500 mg/L were 52.0 and 27.0 months, respectively, there was no statistically significant difference (P=0.137). There was also no statistically significant difference in median OS between the high sFLC ratio group (κ/λ＞32 or ＜0.03) and the low sFLC ratio group (0.03≤κ/λ≤32) (27 months vs 40 months, P=0.436). The involved sFLC in the RI group is significantly higher than that in the normal renal function group in newly diagnosed MM patients. Serum uric acid≥430 μmol/L, ISS stage III and involved sFLC≥500 mg/L are the independent risk factors for RI. Monitoring sFLC in newly diagnosed MM patients is helpful to the prediction of RI, and the involved sFLC level or sFLC ratio may not affect the prognosis of newly diagnosed MM patients.

Effect of Serum Free Light Chain on Renal Function and Prognosis in Patients with Newly Diagnosed Multiple Myeloma

To analyze the effect of serum free light chain (sFLC) on renal function and prognosis in patients with newly diagnosed multiple myeloma (MM). The clinical data of 70 newly diagnosed MM patients who received sFLC examination in Fujian Medical University Union Hospital were retrospectively analyzed from April 2012 to November 2016. Univariate analysis was used to analyze the risk factors that associated with renal impairment (RI) and prognosis. Logistic regression and Kaplan-Meier analyze were used to analyze the roles of sFLC in RI and the prognosis. Out of the 70 patients, 20 patients had RI at the initial diagnosis. Compared to normal renal function group, RI group had lower level of hemoglobin, elevated levels of serum uric acid, corrected calcium, serum creatinine, serum β2 microglobulin, and involved sFLC, higher proportion of patients with ISS stage III, involved sFLC≥500 mg/L, hemodialysis (all P＜0.05). Multivariate logistic regression analysis showed that serum uric acid≥430 μmol/L, ISS stage III and a involved sFLC≥500 mg/L were all the independent risk factors for RI in patients with newly diagnosed MM patients (all P＜0.05). Receiver operating characteristic (ROC) curves analysis showed that the involved sFLC was 705.0 mg/L, which was a best cut-off value area under curve (AUC) for prediting RI in patients with MM was 0.727 (P=0.003), sensitivity was 65.0% and specificity was 82.0%). After a median follow-up period of 31 (1-84) months, the median overall survival (OS) of patients with involved sFLC≥500mg/L and involved sFLC＜500 mg/L were 52.0 and 27.0 months, respectively, there was no statistically significant difference (P=0.137). There was also no statistically significant difference in median OS between the high sFLC ratio group (κ/λ＞32 or ＜0.03) and the low sFLC ratio group (0.03≤κ/λ≤32) (27 months vs 40 months, P=0.436). The involved sFLC in the RI group is significantly higher than that in the normal renal function group in newly diagnosed MM patients. Serum uric acid≥430 μmol/L, ISS stage III and involved sFLC≥500 mg/L are the independent risk factors for RI. Monitoring sFLC in newly diagnosed MM patients is helpful to the prediction of RI, and the involved sFLC level or sFLC ratio may not affect the prognosis of newly diagnosed MM patients.

Effect of high concentrated sucrose on the stability of OSA-starch-based beta-carotene microcapsules

Beta-carotene (BC) microcapsules based on OSA-starch emulsions with different amount of sucrose were prepared to investigate the effects of sucrose on the physicochemical stability of BC microcapsules. BC loading amount, storage retention and particle size of water reconstituted microcapsules and emulsion before spray drying were studied. With the sucrose ratio increased in the wall material, the storage retention of the microcapsules powder and reconstituted powders increased as well. The free volume of the wall material decreased with increased sucrose ratio according to the SEM. Glass transition temperatures of the wall materials, the relative distribution of OSA-group in the powder determined by confocal Raman spectra microscope and the storage retention of BC of the water reconstituted microcapsules were also determined to interpret the mechanism of sucrose acting on the oxygen barrier effects of the wall materials. Phase separation was occurred in the high sucrose ratio group which probably the reason that the chemical stability of was increased. We also found that high ratio of sucrose can help to increase both physical and chemical stability of the water reconstituted microcapsules.

Investigating the association between radiological images and the pathology of rectal cancer treated with neoadjuvant chemotherapy.

In patients with rectal cancer treated with neoadjuvant chemotherapy (NAC), differences are often observed between high and low radiological image reduction effects. It may be suggested that high radiological image reduction indicates a beneficial response to chemotherapy. However, the pathological investigation of the differences between high and low radiological cancer volume reduction cases remains limited. In the current study, a total of 50 patients with rectal cancer, treated with NAC, were examined. The approximate pathological primary cancer area and the radiological cancer volume reduction ratio were measured using CT and/or MRI imaging and the donut-shaped measurement method. Immunostaining of cytokeratin AE1/AE3 was performed to quantitatively measure the cancer cell mass in the largest section of rectal cancer. Cytokeratin AE1/AE3-stained area (P=0.04), mitosis (P=0.0027) and radiological donut-shaped images after NAC (P=0.010) were lower in the high radiological cancer volume reduction ratio group compared with the low radiological cancer volume reduction ratio group. These findings indicate that the radiological images had some ability to determine the treatment effect and clinicopathological characteristics of patients with rectal cancer treated with NAC.

P2748Lipoprotein(a) and autotaxin in patients with stenotic atherosclerosis of coronary arteries and aortic valve stenosis

Abstract Background Lipoprotein(a) [Lp(a)] is an independent risk factor of coronary heart disease (CHD) and calcific aortic valve stenosis (CAVS). It has been recently shown that autotaxin (ATX), which breaks down lysophosphatidylcholine, derived from oxidized phospholipids, to lysophosphatidic acid, was strongly associated with CAVS. Purpose The aim of the study was to investigate the role of Lp(a) and ATX in CHD patients with and without CAVS. Methods The study included 438 patients (average age 66±11 years, men 310), 332 had CHD with ≥50% stenosis in at least one coronary artery according to angiography. CAVS was diagnosed with ultrasound. The control group consisted of 106 patients without CHD and CAVS. The concentrations of Lp(a), ATX, lipids and blood cells were measured for all the patients. Results CHD without CAVS (group I) was diagnosed in 287 patients, 45 patients had CHD and CAVS (group II). Patients in both groups were older than patients in the control group (75±8, 66±10 and 61±13 years respectively). ATX level was lower in group I (median [25; 75%]: 493 [406; 583] ng/ml) than in control group (544 [412; 655] ng/ml, p=0.02) or group II (553 [475; 609] ng/ml, p=0.003). Lp(a) was lower in control group (14.5 [5.5; 36.0] mg/dl) than in group I (25.6 [9.7; 58.5] mg/dl, p=0.0004) and group II (23.8 [9.9; 79.1] mg/dl, p=0.02). Elevated level of ATX was positively associated with CAVS in CHD patients, but negatively with CHD in patients without CAVS. We have shown that age, glucose level and neutrophil-lymphocytes index (NLI) could be predictors of CAVS in patients with CHD according to results of logistic regression analysis. Odds ratio of high (QIV) vs. low (QI) Odds ratio (95% confidence interval) Groups Autotaxin Lipoprotein(a) Neutrophil-lymphocytes index I vs. control 0.5 (0.3–0.9)* 2.7 (1.3–5.2)** 2.4 (1.3–4.6)* II vs. control 8.6 (1.1–70.1)* 3.4 (1.2–9.4)* 6.2 (2.2–16.9)** II vs. I 16.6 (2.1–131.1)** 1.3 (0.5–3.2) 2.5 (1.0–6.37)* *p<0.05, **p<0.005. Conclusion Elevated Lp(a) level is a predictor of CHD regardless of calcific aortic valve stenosis, whereas elevated concentration of autotoxin in CHD patients was associated with calcific aortic valve stenosis.

Association of Early, High Plasma-to–Red Blood Cell Transfusion Ratio With Mortality in Adults With Severe Bleeding After Trauma

Optimal transfusion management is crucial when treating patients with trauma. However, the association of an early, high transfusion ratio of fresh frozen plasma (FFP) to packed red blood cells (PRBC) with survival remains uncertain. To study the association of an early, high FFP-to-PRBC ratio with all-cause 30-day mortality in patients with severe bleeding after trauma. This cohort study analyzes the data included in a multicenter national French trauma registry, Traumabase, from January 2012 to July 2017. Traumabase is a prospective, active, multicenter adult trauma registry that includes all consecutive patients with trauma treated at 15 trauma centers in France. Overall, 897 patients with severe bleeding after trauma were identified using the following criteria: (1) received 4 or more units of PRBC during the first 6 hours or (2) died from hemorrhagic shock before receiving 4 units of PRBC. Eligible patients were divided into a high-ratio group, defined as an FFP-to-PRBC ratio more than 1:1.5, and a low-ratio group, defined as an FFP-to-PRBC ratio of 1:1.5 or less. The ratio was calculated using the cumulative units of FFP and PRBC received during the first 6 hours of management. A Cox regression model was used to analyze 30-day survival with the transfusion ratio as a time-dependent variable to account for survivorship bias. Of the 12 217 patients included in the registry, 897 (7.3%) were analyzed (median [interquartile range] age, 38 (29-54) years; 639 [71.2%] men). The median (interquartile range) injury severity score was 34 (22-48), and the overall 30-day mortality rate was 33.6% (301 patients). A total of 506 patients (56.4%) underwent transfusion with a high ratio and 391 (43.6%) with a low ratio. A high transfusion ratio was associated with a significant reduction in 30-day mortality (hazard ratio, 0.74; 95% CI, 0.58-0.94; P = .01). When only analyzing patients who had complete data, a high transfusion ratio continued to be associated with a reduction in 30-day mortality (hazard ratio, 0.57; 95% CI, 0.33-0.97; P = .04). In this analysis of the Traumabase registry, an early FFP-to-PRBC ratio of more than 1:1.5 was associated with increased 30-day survival among patients with severe bleeding after trauma. This result supports the use of early, high FFP-to-PRBC transfusion ratios in patients with severe trauma.

Peripheral Vasoconstriction During Mental Stress and Adverse Cardiovascular Outcomes in Patients With Coronary Artery Disease.

Excessive vasoconstriction in response to mental stress may be a potential mechanism by which acute psychological stress leads to adverse cardiac events. We investigated whether excessive digital vasoconstriction during acute mental stress predicts adverse cardiovascular outcomes among patients with coronary artery disease. Five hundred forty-nine patients with stable coronary artery disease (age 63±9, 76% male, 29% black) underwent mental stress testing with a standardized public speaking stressor and followed prospectively for cardiovascular end points. Digital pulse wave amplitude was continuously measured using peripheral artery tonometry (PAT, Itamar Inc). Stress/rest PAT ratio (sPAT) of pulse wave amplitude during mental stress/baseline was calculated and dichotomized by the median value into low and high sPAT ratio groups. Upon 3-year follow-up, Fine and Gray's subdistribution hazard ratios were used to examine the association between sPAT ratio and the composite end point of cardiovascular death, myocardial infarction, revascularization, and hospitalization for heart failure. The median sPAT ratio was 0.68 (interquartile range, 0.48-0.88), indicating 32% vasoconstriction with mental stress. Men were more likely to have low sPAT ratio than women (odds ratio, 1.79; P=0.007) while those on β-blockers were less likely to have low sPAT ratio (odds ratio, 0.52; P=0.003). After adjusting for demographic and cardiovascular risk factors, medications, and rate-pressure product change during mental stress, those with low sPAT ratio were at significantly higher risk of adverse outcomes (subdistribution hazard ratio, 1.77 [95% CI, 1.12-2.80]). Greater peripheral vasoconstriction with mental stress, denoted by a low sPAT ratio, is associated with a higher risk of adverse cardiovascular outcomes in patients with coronary artery disease.

In Vitro Fermentation Characteristics for Different Ratios of Soluble to Insoluble Dietary Fiber by Fresh Fecal Microbiota from Growing Pigs.

This study was conducted to explore the in vitro fermentation characteristics for different ratios of soluble to insoluble dietary fiber in pig fecal microbiota. The fermentation substrates consisted of inulin and a non-starch polysaccharide mixture and were divided into five groups according to different soluble dietary fiber (SDF) to insoluble dietary fiber (IDF) ratios (SDF 25, 50, 75, and 100%). With the increased SDF ratio, the total gas production increased, and the pH in the substrate decreased as the fermentation proceeded. The concentrations of lactic acid, formic acid, and acetic acid increased in the high SDF ratio group, whereas the concentrations of propionic acid and butyric acid increased in the low SDF ratio group. The genera Clostridium_sensu_stricto_1, Ruminococcaceae_NK4A214_group, Christensenellaceae_R-7_group, and Rikenellaceae_RC9_gut_group were enriched in the high SDF ratio group. Correlation analysis indicated that these differential bacteria had the potential to degrade polysaccharides. These results revealed that high SDF ratios could stimulate the proliferation of fibrolytic bacteria, which in turn degrade fibers to produce organic acids and monosaccharides. Collectively, these findings add to our understanding of the mechanisms responsible for interaction between SDF and intestinal microbiota and provide new ideas for the rational use of dietary fiber.

Mechanical properties and frictional resistance of Al composites reinforced with Ti3C2Tx MXene

Two-dimensional (2D) Ti3C2Tx MXene is an attractive additive not only used in base oil due to its low friction coefficient, but also used in composites due to its high aspect ratio and rich surface functional groups. So far there has been intense research into polymer matrix composites reinforced with Ti3C2Tx. Here we report on the use of 2D Ti3C2Tx to enhance the mechanical and frictional properties of Al matrix composites. Ti3C2Tx/Al composites were designed and prepared by pressureless sintering followed by hot extrusion technique. The prepared composites exhibit a homogeneous distribution of Ti3C2Tx. The Vickers hardness and the tensile strength continuously increase with increasing Ti3C2Tx content. A hardness of 0.52 GPa and a tensile strength of 148 MPa were achieved in the 3 wt% Ti3C2Tx/Al composite. The frictional properties of pure Al and the Ti3C2Tx/Al composite were comparably studied under dry sliding. A low friction coefficient of 0.2, twice lower than that of pure Al, was achieved in the 3 wt% Ti3C2Tx/Al composite. Ti3C2Tx acting as a solid lubricant reduces the abrasive wear in the composite, improving the frictional properties of Al matrix composites.

Protamine/heparin 0.6 ratio in cardiac surgery

Introduction In cardiac surgery, haemostasis is key.¹ Adequate heparinization is necessary to attain perioperative prevention of thrombus formation during cardio-pulmonary bypass (CPB).² To counteract the heparin effect, protamine hydrochloride is administered.³ The main objective of this retrospective study was to analyse the effect of a protamine/heparin 0.5-0.7/1 ratio, which was implemented in our hospital as of May 2017, versus a ratio > 0.7-1.0/1 on postoperative blood loss and transfusion rate after cardiac surgery. Methods This retrospective study was conducted at a non-academic teaching hospital and based on a prospectively collected database. All patients that underwent cardiac surgery requiring CPB between May 2016 and May 2018 were included. The main outcome variables 12h postoperative total chest tube production and the total amount of blood and blood component transfusions were compared between groups by the use of the Chi-square and Mann-Whitney U test. Results A total of 1939 patients were included. We compared 1150 patients with a 0.5-0.7/1-protamine/heparin ratio versus 789 patients with > 0.7/1-protamine/heparin ratio (Table 1). Pre-operative coagulation values were within the normal range. The median 12h postoperative blood loss was 230 mL in the 0.5-0.7-ratio group versus 260 mL in the >0.7 ratio group (p The amount of patients that received blood component transfusion (composite endpoint of fresh frozen plasma (FFP), packed red blood cells (PRBC), fibrinogen concentrate (FC), platelet concentrate (PC) and prothrombin complex (PCC)) was significantly different. In the 0.5-0.7-protamine/heparin-ratio group 71.3% of the patients were transfusion free, compared to 62,5% of transfusion free patients in the high ratio group (p Discussion A average 0.6-protamine/heparin-ratio after CPB in cardiac surgery is associated with a reduced 12h postoperative blood loss and a reduced amount of patients that received blood or blood components transfusion, compared to > 0.7-protamine/heparin ratio.

High ω-3/ω-6 ratio fatty acids alleviate inflammation and neuronal apoptosis in a rat model of traumatic brain injury

Objective To investigate the effects of high ω-3/ω-6 ratio fatty acids on inflammatory response and neuronal apoptosis after traumatic brain injury (TBI). Methods 33 male Sprague-Dawley rats were randomly divided into three groups: sham surgery group, low ratio group and high ratio group. TBI was induced by weigh-dropping method. In addition to a fat-free diet, rats were treated with corresponding ω-3/ω-6 ratio oil mixtures by gavage. Microglia/macrophage polarization, nuclear factor kappa B (NF-κB) activation, neuronal apoptosis and the expression of B-cell lymphoma-2 (bcl-2) and bcl-2 associated X protein (bax) were observed by immunofluorescence, TdT-mediated dUTP nick-end labeling (TUNEL) and Western blotting at day 5 after TBI. The experimental data were expressed as mean±standard deviation(Mean±SD), and two independent-samples t-test or one way ANOVA was used for comparison among groups. Results The percentage of CD16/32+ /Ionized calcium binding adapter molecule-1 (Iba-1)+ cells significantly decreased in high ratio group [(9.1±0.8)%] compared to low ratio group [(31.8±8.5)%, t=4.720, P<0.01], and the percentage of Arginase-1(Arg-1)+ /Iba-1+ cells significantly increased in high ratio group [(28.7±4.9)%] compared to low ratio group [(6.4±2.4)%, t=6.969, P<0.01]. The nuclear expression of NF-κB p65 in high ratio group was significantly lower than that in low ratio group (t=3.010, P<0.05). Meanwhile, the number of TUNEL-positive cells in the peri-lesion and hippocampus CA1 region decreased in high ratio group (49.7±6.8, 6.3±2.5) compared with low ratio group (197.7±43.7, 54.3±14.7) (t=5.801, P<0.01; t=5.559, P<0.01), which was accompanied by enhanced expression of bcl-2 (t=2.750, P<0.05; t=5.916, P<0.01) and reduced expression of bax protein (t=3.754, P<0.01; t=4.238, P<0.01). Conclusion High ω-3/ω-6 ratio fatty acids could help to decrease M1 and increase M2 type microglia/macrophage cells after TBI, which might be related to the inhibition of NF-κB pathway. High ω-3/ω-6 ratio fatty acids could inhibit posttraumatic neuronal apoptosis. Key words: Omega-3 fatty acids; Traumatic brain injury; Inflammatory response; Apoptosis

Clinical Significance of Serum Free Light Chain and Its κ/λ Ratio in Patients with Multiple Myeloma

To analyze the clinical significance of serum free light chain (sFLC) and sFLC-κ/λ ratio in patients with newly diagnosed multiple myeloma (MM), so as to provide the theoretical basis for the diagnosis, treatment and prognosis of MM patients. A total of 43 patients newly diagnosed as MM in our hospital and 40 cases of other diseases that could cause sFLC increase were selcted. The clinical features of newly diagnosed MM patients were analyzed. On the basis of the type of sFLC, MM patients were divided into sFLC-κ and sFLC-λ group. The correlation of sFLC with clinical index in two groups was analyzed. The difference of sFLC-κ/λ ratio between MM and non-MM patients was analyzed. According to whether the involved/uninvolved sFLC ratio was greater than 100, the MM patients were divided into the low ratio and the high ratio group. The clinical index of these 2 groups were analyzed. Among MM patients, IgG type was the most. In sFLC-κ and -λ groups, the hemoglobin level negatively correlated with sFLC (r=-0.307, r=-0.494, P＜0.05), and the serum β2 microglobulin level positively correlated with sFLC (r=0.453, r=0.689, P＜0.05), and myeloma cells ratio also positively correlated with sFLC (r=0.307, r=0.309, P＜0.05). The concentration of albumin, lactate dehydrogenase and serum calcium did not correlate with sFLC (P＞0.05). The serum creatinine level also did not correlate with sFLC in the sFLC-κ group (P＞0.05), but in the sFLC-λ group they were obviously positive (r=0.697, P＜0.01). The ratio of sFLC-κ/λ ＜0.26 or ＞1.65 in MM patients was higher than that of non-MM patients, and the ratio of involved/uninvolved sFLC≥100 in MM patients was also higher than that of non-MM patients with statistically significant differences (P＜0.01). The levels of serum albumin, creatinine and β2 microglobulin, as well as myeloma cell ratio and ISS international staging of the patients between 2 groups were significantly different (P＜0.05), while the differences in sex, age and levels of hemoglobin, lactate dehydrogenase and blood calcium were not significant between the 2 groups (P＞0.05). The light chain type λ in MM patients correlates with renal damage. The abnormalities of sFLC-κ/λ ratio occur mostly in MM patients. The MM patients with involved/uninvolosed sFLC ratio ≥100 show the severe symptoms and poor prognosis.

Beneficial effect of estrogen on nigrostriatal dopaminergic neurons in drug-na\xefve postmenopausal Parkinson\u2019s disease

This study aimed to investigate the potential beneficial effects of estrogen on nigrostriatal dopaminergic neuron degeneration in postmenopausal drug-naïve Parkinson’s disease (PD). Based on the ratio of lifetime estrogen exposure length to the total length of the estrogen exposure and deprivation period, postmenopausal women with drug-naïve PD were divided into low (n = 31) and high (n = 31) estrogen exposure ratio groups. We performed a comparative analysis of the striatal dopamine transporter (DAT) availability between the two groups. Additionally, we evaluated the longitudinal change in the levodopa equivalent dose per month using a linear mixed model. The motor symptoms were more severe in the low estrogen exposure ratio group than in the high estrogen exposure ratio group (P = 0.016). PD patients in the two groups had significantly lower DAT availability on all striatal sub-regions except for ventral striatum than did age- and sex-matched normal controls. When comparing the two groups, PD patients in the low estrogen exposure ratio group exhibited significantly lower DAT availability in the posterior putamen (P = 0.024) and in the ventral putamen (P = 0.036) than those in the high estrogen exposure ratio group. The estimated monthly levodopa equivalent dose changes were 10.9 in the low estrogen exposure ratio group and 7.1 in the high estrogen exposure ratio group with a significant interaction between the two groups (P = 0.001). These in vivo data provide indirect evidence showing that estrogen may elicit a beneficial effect on nigrostriatal dopamine neurons in PD.

Association of Serum Magnesium and Calcium - Magnesium Ratio with Mortality in Patients with Coronary Artery Disease (P18-090-19)

ObjectivesLow serum magnesium (Mg) and high serum calcium (Ca) levels have been linked to increased mortality and cardiovascular disease (CVD) in the general population. This prospective study assessed whether there were independent associations of serum Mg levels and Ca-Mg ratio with all-cause and CVD mortality among patients with coronary artery disease (CAD). MethodsA prospective cohort study of 3380 CAD patients was conducted. Cox regression models were used to estimate the association of serum Mg levels and Ca-Mg ratio with the risk of mortality. ResultsDuring a median follow-up of 7.59 years, there were 562 deaths recorded and 331 of them were CVD deaths. Spline plots displayed U-shaped associations between serum Mg levels and Ca-Mg ratio and all-cause as well as CVD mortality among CAD patients. Patients in the low serum Mg group had a 1.63-fold (95% confidence interval [CI] 1.32–2.00) risk of all-cause mortality and a 1.82-fold (95% CI 1.40–2.36) risk of CVD mortality compared with those in medium serum Mg group. Patients in high Ca-Mg ratio group had a 1.30-fold (95% CI 1.05–1.61) risk of all-cause mortality and a 1.50-fold (95% CI 1.13–1.98) risk of CVD mortality compared with those in medium Ca-Mg group. This inverse association between serum Mg and the risk of mortality did not change when participants were stratified by sex, age, types of CHD, history of diabetes and estimated glomerular filtration rate. ConclusionsLow serum Mg concentrations and high Ca-Mg ratio were significantly associated with an increased risk of all-cause and CVD mortality in Chinese patients with CAD, independent of traditional CVD risk factors. Funding SourcesThe National Natural Science Fund.

Supramolecular Aptamers on Graphene Oxide for Efficient Inhibition of Thrombin Activity.

Graphene oxide (GO), a two-dimensional material with a high aspect ratio and polar functional groups, can physically adsorb single-strand DNA through different types of interactions, such as hydrogen bonding and π-π stacking, making it an attractive nanocarrier for nucleic acids. In this work, we demonstrate a strategy to target exosites I and II of thrombin simultaneously by using programmed hybrid-aptamers for enhanced anticoagulation efficiency and stability. The targeting ligand is denoted as Supra-TBA15/29 (supramolecular TBA15/29), containing TBA15 (a 15-base nucleotide, targeting exosite I of thrombin) and TBA29 (a 29-base nucleotide, targeting exosite II of thrombin), and it is designed to allow consecutive hybridization of TBA15 and TBA29 to form a network of TBAs (i.e., supra-TBA15/29). The programmed hybrid-aptamers (Supra-TBA15/29) were self-assembled on GO to further boost anticoagulation activity by inhibiting thrombin activity, and thus suppress the thrombin-induced fibrin formation from fibrinogen. The Supra-TBA15/29-GO composite was formed mainly through multivalent interaction between poly(adenine) from Supra-TBA15/29 and GO. We controlled the assembly of Supra-TBA15/29 on GO by regulating the preparation temperature and the concentration ratio of Supra-TBA15/29 to GO to optimize the distance between TBA15 and TBA29 units, aptamer density, and aptamer orientation on the GO surfaces. The dose-dependent thrombin clotting time (TCT) delay caused by Supra-TBA15/29-GO was >10 times longer than that of common anticoagulant drugs including heparin, argatroban, hirudin, and warfarin. Supra-TBA15/29-GO exhibits high biocompatibility, which has been proved by in vitro cytotoxicity and hemolysis assays. In addition, the thromboelastography of whole-blood coagulation and rat-tail bleeding assays indicate the anticoagulation ability of Supra-TBA15/29-GO is superior to the most widely used anticoagulant (heparin). Our highly biocompatible Supra-TBA15/29-GO with strong multivalent interaction with thrombin [dissociation constant (Kd) = 1.9 × 10−11 M] shows great potential as an effective direct thrombin inhibitor for the treatment of hemostatic disorders.

Impact of peripheral blood absolute lymphocyte count at the end of induction on survival in adult patients with acute lymphoblastic leukemia

Objective To study the impact of peripheral blood absolute lymphocyte count (ALC) on survival in adult patients with acute lymphoblastic leukemia (ALL) at the end of induction chemotherapy. Methods 122 adult patients with ALL from January 2011 to December 2017 in the Second Hospital of Shanxi Medical University were retrospectively analyzed.The impact of ALC at the end of induction and ALC ratios for relapse-free(RFS) and overall survival(OS) of adult ALL were analyzed. Results The study cohort was divided into the two groups according ALC-28 values (<675cells/μL and ≥675cells/μL). The median RFS (8 months vs 12 months, P=0.001), median OS (16 months vs 23 months, P=0.010) between the two groups had statistically significant differences.ALC-28/ALC-1 was bordered by 43%.The RFS and OS in the low ratio group were significantly shorter than those in the high ratio group (P<0.05). ALC-28/ALC-8 was compared with 86% cut-off.Longer RFS and OS in the higher ALC-28/ALC-8 group (all P<0.05). Low ALC-28 was independent risk factor for RFS.Low ALC-28, and low ALC-28/ALC-1 were independent risk factors of OS. Conclusion ALC at the end of induction and ALC ratios are associated with RFS and OS of adult ALL.Higher the value, the longer the survival time. Key words: Leukemia, lymphoid; Adult; Lymphocyte count; Survival

Influence of the Ratio of C2–C7 Cobb Angle to T1 Slope on Cervical Alignment After Laminoplasty

To assess the relationship between the ratio of C2-C7 Cobb angle to T1 slope (CL/T1S) and cervical alignment changes after laminoplasty. 78 consecutive patients with cervical myelopathy who underwent laminoplasty were enrolled. All patients with preoperative and follow-up cervical spine lateral x-ray images available for review were recruited in this study. Imaging data included C2-C7 Cobb angle, T1 slope, and cervical sagittal vertical axis (cSVA). All patients were classified into low-ratio group (bottom 25% of CL/T1S), fair-ratio group (middle 50% of CL/T1S), and high ratio group (top 25% of CL/T1S) according to CL/T1S ratio. The recovery rate was calculated based on the Japanese Orthopedic Association score. The preoperative C2-C7 Cobb angle had significant correlations with the T1 slope (r= 0.528). Kyphotic alignment changes in the group with a high ratio of CL/T1S was greater than that of the other 2 groups (P < 0.001). The incidence of postoperative kyphosis in the group with a low ratio of CL/T1S was higher than that of the other 2 groups (P < 0.001). There was no postoperative kyphosis in the fair-ratio group. The surgical outcome in the low-ratio CL/T1S group and the high-ratio CL/T1S group was poorer than that in the fair-ratio CL/T1S group (P= 0.005). The cervical alignment was kept well in the mid-range CL/T1S ratio group after laminoplasty. Patients with a high CL/T1S ratio were more likely to present with kyphotic alignment changes. Patients with a low CL/T1S ratio were more likely to have postoperative kyphosis.