Inflammatory Reaction In Patients Research Articles

Changes of urine isolates of Escherichia coli and Klebsiella pneumoniae biofilm affect monocytes\u2019 response

The Gram negative rods as Escherichia coli and Klebsiella pneumoniae belong to the most common etiology agents of urinary tract infections. The aim of our study was to assess the diversity of biofilm formed in different urinary tract diseases and their impact on monocytes’ adherence and activation. The bacteria were obtained from patients with different kidney problems. Some of the patients were after renal transplantation, some of them were not. Changes in the size and granularity of monocytes, as well as their adherence to biofilm, were assessed using FACSVerse flow cytometer after 1 h co-incubation of monocytes and bacterial biofilm in 37 °C. The obtained results were validated against monocytes incubated without bacteria. The isolates from patients with chronic kidney disease formed the most adherent biofilm regardless the presence or absence of inflammatory reaction. Adherence of monocytes also increased during therapy with immunosuppressive agents, but monocytes’ response was different when cyclosporine or tacrolimus were used. Additionally the presence of inflammatory reaction in patients with kidney disease modified the monocytes response when the immunosuppressive drugs were used. Considering the obtained results, we conclude that the changes of monocytes’ morphology in response to biofilm formed by Gram negative rods could become a tool to detect urinary tract infection, especially in those groups of patients, where the knowledge of ongoing inflammation is important and the standard tools fail to detect it.

Application of Seamless Nursing in the Treatment of Uremia with HD Combined with HP and its Effect on the Occurrence of Inflammatory Reaction in Patients

Application of Seamless Nursing in the Treatment of Uremia with HD Combined with HP and its Effect on the Occurrence of Inflammatory Reaction in Patients

Association between Inflammatory Factors in the Aqueous Humor and Hyperreflective Foci in Patients with Intractable Macular Edema Treated with Antivascular Endothelial Growth Factor

Background To evaluate the correlations between the inflammatory factors in the aqueous humor and hyperreflective foci (HRF) in patients with intractable macular edema treated with antivascular endothelial growth factor (anti-VEGF). Methods This study included 17 patients with intractable macular edema (ME) treated with anti-VEGF agents. Inflammatory factors in the aqueous humor were measured by the Cytometric Beads Array before injection, and the numbers of HRF pre- and post-anti-VEGF treatment were counted from four different directions (90 degrees, 45 degrees, 180 degrees, and 135 degrees) in the SD-OCT images, respectively, before treatment and one month after treatment. The correlations between inflammatory factors and the numbers of HRF were assessed. Results The numbers of HRF were reduced significantly after anti-VEGF treatment. The change in the HRFs at the 90-degree location was significantly positively correlated with IL-8 and VCAM-1. The change of all HRFs was significantly positively correlated with IL-8. The HRFs before the treatment also had a positive correlation with IL-8 and VCAM-1. Conclusion After anti-VEGF treatment, the numbers of HRF in intractable ME declined greatly. The higher the levels of IL-8 and VCAM-1 before treatment, the more significant the reduction of HRF after anti-VEGF treatment, which indicated that HRF could be an effective noninvasive imaging indicator for evaluating the effect of anti-VEGF on intractable macular edema. The OCT images at the 90-degree location could better show the inflammatory reaction of patients and also had better clinical significance for the prognosis evaluation of ME associated with inflammation.

Decreased angiogenesis as a possible pathomechanism in cervical degenerative myelopathy

Endogenous immune mediated reactions of inflammation and angiogenesis are components of the spinal cord injury in patients with degenerative cervical myelopathy (DCM). The aim of this study was to identify alteration of certain mediators participating in angiogenetic and inflammatory reactions in patients with DCM. A consecutive series of 42 patients with DCM and indication for surgical decompression were enrolled for the study. 28 DCM patients were included, as CSF samples were taken preoperatively. We enrolled 42 patients requiring surgery for a thoracic abdominal aortic aneurysm (TAAA) as neurologically healthy controls. In 38 TAAA patients, CSF samples were taken prior to surgery and thus included. We evaluated the neurological status of patients and controls prior to surgery including NDI and mJOA. Protein-concentrations of factors with a crucial role in inflammation and angiogenesis were measured in CSF via ELISA testing (pg/ml): Angiopoietin 2, VEGF-A and C, RANTES, IL 1 beta and IL 8. Additionally, evaluated the status of the blood-spinal cord barrier (BSCB) by Reibers´diagnostic in all participants. Groups evidently differed in their neurological status (mJOA: DCM 10.1 ± 3.3, TAAA 17.3 ± 1.2, p < .001; NDI: DCM 47.4 ± 19.7, TAAA 5.3 ± 8.6, p < .001). There were no particular differences in age and gender distribution. However, we detected statistically significant differences in concentrations of mediators between the groups: Angiopoietin 2 (DCM 267.1.4 ± 81.9, TAAA 408.6 ± 177.1, p < .001) and VEGF C (DCM 152.2 ± 96.1, TAAA 222.4 ± 140.3, p = .04). DCM patients presented a mild to moderate BSCB disruption, controls had no signs of impairment. In patients with DCM, we measured decreased concentrations of angiogenic mediators. These results correspond to findings of immune mediated secondary harm in acute spinal cord injury. Reduced angiogenic activity could be a relevant part of the pathogenesis of DCM and secondary harm to the spinal cord.

Eosinophils and childhood asthma.

Eosinophils are a type of granulocyte with eosinophilic granules in the cytoplasm that play an important role in allergic and parasitic diseases. Eosinophils are important in the pathogenesis of asthma, and many studies have examined the relationship between them. In allergic eosinophilic asthma, eosinophils act not only as important effector cells but also as antigen-presenting cells in allergic inflammatory reactions. In nonallergic eosinophilic asthma, type 2 innate lymphoid cells in the airways play an important role in eosinophil activation. Direct methods, including bronchial biopsy, bronchoalveolar lavage, and the induced sputum test, are used to evaluate eosinophilic inflammatory reactions in patients with asthma, however, because of difficulty with their implementation, they are sometimes replaced by measurements of blood eosinophils, fraction of exhaled nitric oxide, and serum periostin level. However, these tests are less accurate than direct methods. For the treatment of patients with severe eosinophilic asthma, anti-interleukin-5 preparations such as mepolizumab, reslizumab, and benralizumab have recently been introduced and broadened the scope of asthma treatment. Although eosinophils are already known to play an important role in asthma, we expect that further studies will reveal more details of their action.

Disturbances of the hemostasis system and expression of inflammatory reaction in patients with new coronaviral pneumonia.

Disorders of the hemostatic system and inflammation play a key role in the pathogenesis of new coronavirus pneumonia (NCP), determining its course and outcome. To study the dynamics of the state of the hemostasis system and the severity of the acute phase response in patients with new coronavirus pneumonia. We determined APTT, prothrombin time (PT), fibrinogen (F), D-dimers (D-d), antitrombin III (AT III), C-reactive protein (CRP), platelet count in 22 patients. In 49 patients, the viscoelastic properties of a blood clot were studied by thromboelastography (TEG) with koalin. The age of the patients ranged from 40 to 77 years. According to CT, the severity of 100% cases corresponded to CT2-CT3. Acute respiratory failure (ARF) was diagnosed in 16 patients. A control group included 25 apparently healthy subjects. During hospitalization, patients with NCP were characterized by: an increase in the concentration of D-d, CRP, Fg, lengthening of APTT and PT, ATIII activity and platelet count not differing from the normal range. 10 days after hospitalization and against the background of ongoing therapy, patients with NCP showed positive dynamics in the hemostasiological profile and the severity of the inflammatory response. Thromboelastography indices in patients with LCP did not differ from control values both at hospitalization and on day 10.Thus, in patients with novel coronavirus pneumonia, an increased prothrombotic activity and a pronounced inflammatory response are recorded. Against the background of treatment, there is a positive dynamics in both the coagulation status and the inflammatory response. Additional studies are needed to determine the diagnostic capabilities of thromboelastography in patients with NCP.

Corticosteroid therapy for the management of paradoxical inflammatory reaction in patients with pulmonary tuberculosis

Background Paradoxical reaction after the initiation of tuberculosis treatment is defined as increased inflammation following effective antimycobacterial treatment. This is a phenomenon that can severely complicate a patient’s recovery, potentially leading to further morbidity and residual deficits. Paradoxical reaction remains poorly understood regarding its pathophysiology and management. Only a limited number of reports look critically at the available therapeutic options, with evidence of the efficacy of prednisolone therapy being primarily limited to extrapulmonary PR only.CaseWe describe two HIV negative patients who were admitted to our department with pulmonary tuberculosis, presenting with inflammatory patterns attributable to PR and their response to adjunctive steroid therapy.Discussion and ConclusionsThe presented cases further highlight the need for immunological studies and randomized trials for corticosteroid therapy are needed to better understand this phenomenon as well as provide an evidence-base for anti-inflammatory treatment. Furthermore, by means of this case series, we are also able to highlight the potential variability in the symptomatology of the lesser known PR phenomenon, in which we observed a hypotensive shock-like syndrome not previously described in literature.

Drug-Eluting Stent Implantation after Percutaneous Transluminal Angioplasty decreases Restenosis Incidence and Inflammatory Reaction in Patients with Lower Extremity Arterial Disease

Drug-Eluting Stent Implantation after Percutaneous Transluminal Angioplasty decreases Restenosis Incidence and Inflammatory Reaction in Patients with Lower Extremity Arterial Disease

Value of enhanced recovery after surgery in D2 radical resection of distal gastric cancer under total laparoscopy and its effect on inflammatory factors

Objective To investigate the value of enhanced recovery after surgery (ERAS) in D2 radical resection of distal gastric cancer under total laparoscopy and its effect on inflammatory factors. Methods The clinical data of 50 patients with distal gastric cancer at Hanzhong Central Hospital from March 2016 to October 2017 were retrospectively analyzed. The patients were divided into the observation group (25 cases) and the control group (25 cases). The observation group received totally laparoscopic radical D2 gastrectomy for distal gastric cancer under the guideline of ERAS; the control group received totally laparoscopic radical D2 gastrectomy for distal gastric cancer under the guideline of the traditional method. The changes of perioperative related indexes, postoperative recovery and postoperative inflammatory indexes were compared between the two groups. Results All 50 patients successfully completed the operation. The operation time was (287.2±52.3) min and (296.8±57.9) min, respectively of the observation group and the control group; the number of lymph node dissection was (34.0±11.0) and (34.6±14.3), respectively of the observation group and the control group. There were no significant differences in the above indexes between the two groups (all P > 0.05). The hospitalization time, the hospitalization cost, the postoperative time of getting out of bed of the observation group was (22.0±2.8) d, (61 044.4±4 692.7) yuan, (12.8±1.8) h. The hospitalization time, the hospitalization cost, the postoperative time of getting out of bed of the control group was (23.9±1.9) d, (63 875.81±4 392.6) yuan, (23.7±8.2) h. And there were statistically significant differences between the two groups (all P 0.05). There were no statistically significant differences in the tumor necrosis factor α, interleukin-6 (IL-6), C-reactive protein and procalcitonin on the day before the operation of both groups (all P > 0.05); the levels of above four factors in the observation group were lower than those in the control group on the 1st, 4th and 7th day after the operation, and the differences were statistically significant (all P < 0.05). Conclusion The application of ERAS in totally laparoscopic radical resection of gastric cancer can improve the postoperative condition, significantly reduce the inflammatory reaction of patients, which has a certain value of improving the quality of life of patients. Key words: Gastric neoplasms; Laparoscopy, D2 radical resection; Inflammation; Cytokines; Enhanced recovery after surgery

Inflammatory reaction in patients with acquired bronchiectasis based on the interleukin 1α and interleukin 10 levels measured using the ELISA method

Abstract The main objective of this study was to determine the relationship between the pro- and anti-inflammatory response based on the interleukin 1α and interleukin 10 levels in the serum of patients with acquired bronchiectasis and healthy controls. This study was conducted on 77 subjects, divided into two lots: one lot comprising 57 patients with the aforementioned bronchiectasis and the second one comprising 20 healthy control subjects. The enzyme-linked immunosorbent assay method was used to perform the spectrophotometry test for the serum to detect and measure interleukin 1α and interleukin 10 levels. The results were significant from a statistical point on view but only in terms of the mean value of interleukin 10 that was much higher in the anti-inflammatory cytokine. Therefore, we can assume that there is a systemic anti-inflammatory reaction to the inflammation caused by bronchiectasis. Interleukin 1α is unspecific, and the values were similar in both groups; therefore, this interleukin should not be researched further in this direction. Future research is open in this field for the analysis of interleukin levels in bronchoalveolar lavage compared to serum levels.

Systemic Inflammatory Reaction in Patients With Head and Neck Cancer-An Explorative Study.

Aim: To assess the longitudinal pattern of pro-inflammatory cytokines and growth factors in serum up to 1 year following treatment for head and neck cancer.Materials and Methods: Patients with newly diagnosed, curable head and neck cancer were included (n = 30). The most common subsite was oropharynx (n = 13) followed by oral cavity (n = 9). Blood was drawn from all patients at regular intervals (before treatment, 7 weeks after the start of the treatment, and at 3 months and 1 year after termination of treatment) and analyzed for cytokines (Il-1β, Il-2, Il-4, Il-5, Il-6, Il-8, Il-10, GM-CSF, TNF-α, and IFN-γ) and growth factors (G-CSF, FGF-2, EGF, and VEGF).Results: The time point of the peak level of pro-inflammatory cytokines was 7 weeks after start of treatment which corresponded for the majority of patients with termination of radiotherapy or chemoradiotherapy. Patients undergoing chemoradiotherapy exhibited a significant increase of IL-1β, IL-6, and IL-10 at 7 weeks as compared to pre-treatment levels. At 1 year after termination of treatment four patients experienced recurrence of disease while 26 patients were considered disease-free. The patients with recurrence had significantly higher levels of IL-1β, IL-6, IL-8, and IL-10 at 7 weeks after the start of treatment than patients without recurrence. Correlated with T stadium patients with T3-T4 had higher levels of IL-1β and IL-8 than patients with T1-T2 7 weeks after the start of treatment.Conclusions: The observed immune response in this explorative study demonstrates that chemoradiotherapy may induce not only a local treatment effect on the immune system but also effects far outside the irradiated field. The result of the study indicates that analysis of a pro-inflammatory panel of cytokines in serum at 7 weeks after the start of treatment could be of prognostic value in patients with head and neck cancer. Further study of a larger cohort could help identify patients at larger risk for recurrent disease with measurements of pro-inflammatory cytokines under and after treatment.

Clinical efficacy of acetylcysteine combined with tetrandrine tablets in the treatment of silicosis and the effect on serum IL-6 and TNF-α.

Clinical efficacy of acetylcysteine combined with tetrandrine tablets in the treatment of silicosis and the effect on serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in patients with silicosis was investigated. One hundred and ninety-six patients with silicosis admitted to Qingdao Central Hospital, aged 40 to 70 years, were collected by prospective analysis. The patients were divided into two groups according to the different methods of treatment. The 108 patients in the control group received routine treatment, including anti-inflammatory, cough and asthma relief and 88 patients in the observation group were treated with tetrandrine combined with N-acetylcysteine on the basis of routine treatment. The curative effect of the two groups was analyzed by X-ray, and the incidence of adverse reactions was compared between the two groups. There was no significant difference in the effective rate between the two groups (P>0.05). After treatment, respiratory rate (RR) decreased, and forced vital capacity (FVC), and first second forced expiratory volume (FEV1) increased in both groups (P<0.05). RR in the observation group was lower than that in the control group (P<0.05), FVC and FEV1 were higher than those in the control group (P<0.05). There was no significant difference in serum IL-6 and TNF-α levels between the two groups before treatment (P>0.05). After treatment, the levels of IL-6 and TNF-α in the two groups decreased (P<0.05), and the IL-6 and TNF-α levels in the observation group after treatment were significantly lower than those in the control group (P<0.05). According to the effect of clinical treatment, the patients were re-divided into two groups. In conclusion, tetrandrine combined with acetylcysteine can effectively improve the clinical therapeutic effect of silicosis and alleviate the degree of inflammatory reaction in patients with silicosis. The levels of IL-6 and TNF-α in peripheral blood are valuable for the clinical treatment of silicosis.

Delayed 18F FDG PET/CT Imaging in the Assessment of Residual Tumors after Transurethral Resection of Bladder Cancer.

Background Delayed fluorine 18 (18F) fluorodeoxyglucose (FDG) PET/CT is used to diagnose bladder cancer. However, it remains difficult to determine whether a lesion with abnormal 18F FDG uptake is tumor residue or recurrence or if it is an inflammatory reaction in patients with bladder cancer after oncologic treatment. Purpose To determine the diagnostic performance of delayed 18F FDG PET/CT in the differentiation of residual tumors from postoperative inflammatory reactions in patients with bladder cancer after initial transurethral resection of bladder tumor (TURBT). Materials and Methods A retrospective clinical study between January 2015 and April 2018 was performed in 79 patients with bladder cancer who had undergone 18F FDG PET/CT within 1 month after initial TURBT. After PET/CT, all patients underwent a second surgery within 2 weeks to confirm the histologic nature of the suspicious lesion and to remove residual tumors. Uni- and multivariable analysis were used to identify predictive factors for residual bladder tumors. Results A total of 79 patients (61 men, 18 women; mean age, 63 years ± 11 [standard deviation]) were enrolled in this study. A total of 98 lesions was studied, 64 (65.3%) of which were residual tumors after initial TURBT. When compared with inflammatory reactions, residual tumors had higher mean standardized uptake value (SUVmean) (mean, 5.8 ± 2.0 vs 9.3 ± 5.4; P < .001), higher maximum standardized uptake value (SUVmax) (mean, 15.5 ± 9.8 vs 22.2 ± 13.6, P = .01), and greater lesion thickness (mean, 9.6 mm ± 4.1 vs 17.9 mm ± 11.1, P < .001) at 18F FDG PET/CT. SUVmean (odds ratio [OR], 1.2; 95% confidence interval [CI]: 1.0, 1.5; P = .049) and lesion thickness (OR, 1.2; 95% CI: 1.0, 1.3; P = .006 or OR, 1.2; 95% CI: 1.1, 1.3; P = .001) were identified as independent predictors for residual tumors with multivariable logistic regression analysis. On the basis of the threshold values of SUVmean and lesion thickness, we revealed a prediction rate of 37.5% (17 of 47), 85.4% (26 of 29), and 98.3% (21 of 22) for residual tumors in low-, moderate-, and high-risk subgroups, respectively. Conclusion Use of fluorine 18 fluorodeoxyglucose PET/CT to differentiate lesions after transurethral resection of bladder tumor indicates that higher mean standardized uptake values and greater lesion thickness are predictive factors for residual tumors in patients with bladder cancer after oncologic treatment. Published under a CC BY 4.0 license.

Efficacy of low molecular weight heparin in spinal trauma patients after part concentrated screw surgery and its influence on blood parameters and the incidence of deep venous thrombosis

This study was to investigate the efficacy of low molecular weight heparin (LMWH) therapy in patients with spinal trauma after part concentrated screw (PCS) pedicle screw surgery (PSS) and its influence on blood parameters and the incidence of deep venous thrombosis. Prospectively, 36 patients with spinal trauma who underwent PSS were randomly divided into an experimental group (n = 18) and a control group (n = 18). The experimental group was treated with LMWH after the operation. Changes in the vascular endothelial function, inflammatory factors and other blood indexes, and the incidence of deep venous thrombosis in lower extremities were compared between the two groups before and after the surgery. Compared to pre-surgery, the levels of endothelin (ET) and tissue plasminogen activator (tPA) in the experimental group decreased significantly after surgery (all P < 0.001), while the levels of ET increased and tPA decreased significantly in the control group (all P < 0.001). In addition, compared with pre-surgical levels, interleukin-8 (IL-8), IL-6 and procalcitonin (PCT) decreased significantly in the experimental group after surgery while there was a significant increase in these cytokines in the control group (all P < 0.001), with a significant difference in the cytokine levels between the two groups post-surgery (P < 0.01). After the surgery, plasma viscosity, erythrocyte electrophoresis time and platelet aggregation rate in the control group were significantly increased from pre-surgery levels (all P < 0.001), and these levels were also significantly higher than in the experimental group (P < 0.01). The D-dimer (D-D) level in both groups also increased significantly after surgery (all P < 0.001), and the level post-surgery was significantly higher in the experimental group as compared to the control group (P < 0.01). Finally, the incidence of deep venous thrombosis in the experimental group was significantly lower than in the control group (P < 0.05). LMWH is beneficial in reducing the degree of hypercoagulability, hyperviscosity and inflammatory reaction in patients with spinal trauma who underwent PSS. It also effectively reduced the occurrence of deep vein thrombosis in lower limbs after surgery. Thus, it is a candidate for further clinical development.

Perioperative inflammation

Surgical interventions and invasive procedures can trigger an inflammatory reaction in patients. This inflammatory reaction is an inherent response by the body and can be triggered by different stimuli, including the surgical tissue trauma itself and also by the administration of drugs commonly used for the induction and maintenance of general anesthesia. Immune system activation is mostly beneficial for the host defense against various exogenous pathogens during infectious disorders; however, if uncontrolled and overshooting or in the case of excessive immune system activation as aconsequence of sterile inflammation, the inflammatory host response may also carry the risk for tissue and organ damage, which might severely threaten the patient. The aim of this article is to identify the causal factors of a perioperative immune reaction and to present interventional options. An extensive MEDLINE search was carried out on the perioperative and postoperative inflammatory response in the field of clinical and basic research. Current publications provide essential information on how surgical patients may be affected by overshooting inflammatory responses. Thus, the choice of administered anesthetic agent and the surgical trauma itself in addition to asupportive therapy may modulate perioperative inflammation in the perioperative phase. The effects on the patient can be multifarious. This article discusses the causes and effects of inflammatory processes in the perioperative phase. Additionally, it highlights the immunomodulatory effects of perioperatively administered therapeutics and anesthetics. Knowledge of this topic enables the reader to make qualified decisions in the perioperative setting to improve the individual patient outcome.

PROSPECTIVE ANALYSIS OF LIPID SPECTRUM PARAMETERS AND VASCULAR INFLAMMATORY MARKERS AS A VARIANT OF A PERSONIFIED APPROACH TO PROGNOSIS OF UNDESIRABLE CORONARY EVENTS IN PATIENTS WITH CORONARY HEART DISEASE AFTER ANGIOPLASTY

The relevance of the study is due to the fact that the ambiguous role of biochemical mediators in the development of angioplasty complications with stenting and the lack of consensus on the timing of laboratory indicators determine to specify the approaches to the study of biochemical parameters that indicate the nature of the course of coronary heart disease (CHD) and the development of possible undesirable complications after percutaneous coronary intervention. This article aims to analyze the parameters of lipid spectrum and markers of vascular inflammatory reaction in patients with CHD, in groups with stable angina and unstable angina episode after angioplasty with stenting, to trace the dynamics of biochemical parameters and to reveal the predictors of undesirable coronary events. Patients with CHD with significant coronary artery stenosis (CKS, n=95) revealed after coronary angiography (CAG) at the point of maximum increase in the markers of the inflammatory response (3 months after angioplasty) are divided into 2 groups – patients with stable angina pectoris (AP, n=77) until the end of the study and patients with a developed post-revascularization episode of unstable angina (UA, n=18) after angioplasty with stenting. It was established that patients with UA at the initial stage have a significantly higher risk of developing coronary blood flow instability in the post-revascularization period due to initially elevated levels of homocysteine and rf-CRP. The results obtained are very important for the implementation of an optimal program for monitoring patients with coronary artery disease, improving measures to increase adherence to therapy at the outpatient stage of treatment.

Effect of tirofiban on cardiac function, cardiomyocytes and inflammatory reaction in patients with acute myocardial infarction during emergency percutaneous coronary intervention

Purpose : To investigate the effect of tirofiban on cardiac function, cardiomyocytes and inflammatory reaction in acute myocardial infarction (AMI) patients during emergency percutaneous coronary intervention (PCI). Methods : Ninety AMI patients who underwent PCI for two years in Hanchuan Hospital, Hanchuan People's Hospital/Wuhan University People's Hospital, Hanchuan, China, were involved in this retrospective studies. Two groups were used (46 patients per group). The study group was treated with tirofiban, while the control group was without tirofiban exposure. Changes in brain natriuretic peptide (BNP), left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDD) were determined using a biochemical analyzer, while the inflammatory cytokines i.e. interleukin -6 (IL-6), tumor necrosis factor (TNF-) and high sensitive C reactive protein (hs-CRP) were assayed with ELISA kits. Results : One week after operation, a significantly lower level of BNP and a significantly higher level of LVEF were seen in the study group than in controls (p 0.05), but their post-operative values were significantly lower in the study group than in the control group (p < 0.01). Conclusion : The use of tirofiban for AMI patients undergoing PCI significantly reduces BNP, increases LVEF, improves cardiac function, protects myocardial cells, reduces the level of inflammatory cytokines, and inhibits inflammatory reactions. Keywords : Percutaneous coronary intervention, Acute myocardial infarction, Tirofiban, Cardiac function

FEATURES OF THE PHENOTYPE AND NAD(P)-DEPENDENT DEHYDROGENASES ACTIVITY IN NEUTROPHIL BY PATIENTS WITH WIDESPREAD PURULENT PERITONITIS IN PROGNOSIS FOR SEPSIS DEVELOPMENT

The aim of the study was to examine the features of phenotype and the levels of NAD(P)-dependent dehydrogenases activity of blood neutrophils in the prognosis of abdominal sepsis development in patients with widespread purulent peritonitis (WPP). 50 patients with WPP of community and hospital origin in the pre-operative period were examined. From the 5th to the 10th day of the postoperative period 35 patients (70%) had developed abdominal sepsis, 15 patients (30%) had absence of complications. As controls 67 respect healthy people were examined. The research blood neutrophils phenotype was performed by f low cytometry using a direct immunofluorescence whole peripheral blood. The levels of surface receptor expression was assessed by the mean fluorescence intensity. The NAD(P)-dependent dehydrogenases activity in the blood neutrophils studied using bioluminescence method. It was established that the inflammatory reaction in patients with WPP is characterized by neutrophilia and changes in the phenotype of blood neutrophils. The markers of the subsequent development of sepsis in WPP are less pronounced (in comparison with the indices of uncomplicated patients), an increase in the number of neutrophils, a decrease in the HLA-DR + -cell count against the background of a high level of neutrophils expressing a high affinity receptor for IgG. The patients without subsequent complications had the number of neutrophils with CD23 receptor expression is increased. Metabolism of neutrophils in patients with WPP is characterized by a decrease in the intensity of plastic processes due to low activity of glucose-6-phosphate dehydrogenase and an imbalance in the activity of the enzymes of the mitochondrial compartment. A feature of the neutrophil metabolism in patients with WPP without subsequent development of sepsis is a high activity of anaerobic lactate dehydrogenase reaction and a decrease in the activity of NADP-dependent decarboxylating malate dehydrogenase. The patients with WPP with subsequent development of sepsis had a high level of NAD-dependent out flow of substrates from the tricarboxylic acid cycle on the amino acid exchange reaction via glutamate dehydrogenase which can affect the activity of aerobic respiration of blood neutrophils. The established differences in the phenotype and activity of enzymes in the blood neutrophils in patients with WPP depending on the subsequent development of sepsis determine the possibility of creating a method for predicting the development of complications and developing immunoactive therapy in the postoperative period of WPP.

Frequencies of PD-1- and PD-L1- positive T CD3+CD4+, T CD3+CD8+ and B CD19+ lymphocytes and its correlations with other immune cells in patients with recurrent furunculosis

Programmed cell death receptor 1 (PD-1) is one of the major immune checkpoints. Due to the lack of reports on PD-1- and PD-L1-positive lymphocyte proportions in patients with recurrent furunculosis, we aimed to evaluate percentages of those cells in the peripheral blood and to assess their correlations with other lymphocyte subsets, and the level of cell activation measured by the expression of CD25 and CD69 molecules on T lymphocytes.We recruited 30 patients with recurrent furunculosis and 15 controls. The amount of 5 mL of peripheral blood was collected for laboratory tests.Patients with chronic furunculosis presented with the similar number of lymphocytes, CD4+ T lymphocytes, CD8+CD3+ T suppressor lymphocytes, and CD19 + B lymphocytes to controls, but significant differences were found between subpopulation of those cells. Furunculosis patients had the significantly elevated percentage of lymphocytes with PD-1 and PD-L1 on their surface. Early onset of furunculosis was correlated with a higher percentage of CD19 + PD1 B lymphocytes. Greater number of skin lesions correlated with a decrease in the CD4PDL1+ cells, which subsequently was associated with an increase in the percentage of Treg cells, NKT cells, CD8+CD3+ lymphocytes and B lymphocytes. Changes in the proportion of immune cells may lead to reduced inflammatory reactions in patients with recurrent furunculosis.In the light of mechanisms of S. aureus invasion, the degree of immune impairments in the scope of adaptive immunity seems to play a significant role in the course of furunculosis. PD-1 and PD-L1 molecules change the host response and affect the ongoing inflammatory process.

Does hyperthermic preconditioning affect the rate of surgical site infection rate and inflammatory reaction in colorectal cancer patients? A prospective randomized clinical trial.

Hyperthermic preconditioning has been shown to protect against different insults in experimental studies. However, clinical studies assessing its effects remain limited. The aim of this study was to investigate the effects of hyperthermic preconditioning on the rate of surgical site infection and inflammatory reaction in patients undergoing elective colorectal cancer surgery. Patients with colorectal cancer, scheduled to undergo elective surgery were enrolled in this prospective randomized study. Patients were randomly assigned to either the hyperthermic preconditioning group or control group. Postoperative superficial and deep surgical site infection were recorded. Blood samples were collected from all the patients in the hyperthermic preconditioning group prior to the application of hyperthermia 12 h before surgery, immediately prior to surgery, and 4 h and 24 h postoperatively. For the control group, blood samples were obtained within the same periods without the application of hyperthermia. Levels of interleukin-1, IL-6, and tumor necrosis factor-α were measured from blood samples. Twenty patients were randomized to the hyperthermic preconditioning group and 21 to the control group. No significant difference was found in deep or superficial surgical site infection between the groups. No significant difference in the tumor necrosis factor-α, interleukin-1, and IL-6 levels was found in serum samples collected before hyperthermia, during the operation, and postoperatively. This study showed that hyperthermic preconditioning has no effect on the surgical site infection and cytokine response in patients undergoing elective surgical intervention for colorectal cancer.