Laboratory Indicators Research Articles

Effects of acute-phase COVID-19-related indicators on pulmonary fibrosis and follow-up evaluation

BackgroundPost-COVID-19 pulmonary fibrosis is a significant long-term respiratory morbidity affecting patients’ respiratory health. This exploratory study aims to investigate the incidence, clinical characteristics, and acute-phase risk factors for pulmonary fibrosis in COVID-19 patients. Additionally, it evaluates pulmonary function and chest CT outcomes to provide clinical evidence for the early identification of high-risk patients and the prevention of post-COVID-19 pulmonary fibrosis.MethodsWe retrospectively analyzed 595 patients hospitalized for COVID-19 from January 2022 to July 2023. Patients were divided into fibrosis and nonfibrosis groups on the basis of imaging changes. Baseline data, including demographics, disease severity, laboratory indicators, and chest imaging characteristics, were collected. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for pulmonary fibrosis. Pulmonary function and chest CT follow-ups were conducted for the fibrosis group. The data were processed via SPSS 26.0, with P < 0.05 considered statistically significant.ResultsThe incidence of pulmonary fibrosis was 4.37%, with 2.08% in moderate cases and 8.22% in severe cases. Significant differences were found between the fibrosis and nonfibrosis groups in sex; disease severity; NLR; ALB and LDH levels; and percentages of lung reticular lesions, consolidations, and GGOs (P < 0.05). Multivariate analysis revealed LDH (OR = 1.004, 95% CI 1.000–1.007, P = 0.035), ALB (OR = 0.871, 95% CI 0.778–0.974, P = 0.015), lung reticular lesion volume (OR = 1.116, 95% CI 1.040–1.199, P = 0.002), and lung consolidation volume (OR = 1.131, 95% CI 1.012–1.264, P = 0.030) as independent risk factors. The follow-up results revealed significant improvements in pulmonary function, specifically in the FVC%, FEV1%, and DLCO%, but not in the FEV1/FVC. Quantitative chest CT analysis revealed significant differences in lung reticular lesions, consolidation, and GGO volumes but no significant difference in honeycomb volume.ConclusionsThe incidence of pulmonary fibrosis post-COVID-19 increases with disease severity. LDH, ALB, lung reticular lesions, and consolidation volume are independent risk factors for patients with fibrosis.

Effect of SARS-CoV-2 infection on liver function in patients with hepatitis B

ObjectiveTo investigate the impact of SARS-CoV-2 infection on liver function and prognosis in patients with HBV infection.MethodsA total of 154 HBV-positive patients (HBV ( +) group) and 154 HBV-negative patients (HBV (-) group) diagnosed with COVID-19 at Taizhou Hospital between December 10, 2022, and January 31, 2023, were included in this study. Clinical characteristics, treatment, and laboratory findings were collected from patients at three time points: before (T1), during (T2), and at the time of discharge (T3) from SARS-CoV-2 infection.ResultsCompared to the HBV (-) group, the HBV ( +) group had a longer hospital stay (15 (9–22) days vs. 9 (5–16) days). Longitudinal comparisons of laboratory indicators from T1 to T3 showed a continuous decline in TP and ALB levels and a continuous increase in PT and TT levels in the HBV ( +) group. BUN levels increased during T2 and decreased thereafter. These differences were considered statistically significant (P < 0.05). Notably, the HBV ( +) group had a higher proportion of indicators elevated > 3 ULN from T1 to T2, including ALT (1.95%/5.19%), AST (3.25%/12.99%), ALP (1.95%/3.25%), GGT (4.55%/9.09%), TBIL (6.49%/9.09%), and DBIL (18.18%/22.73%). In the HBV (-) group, the elevations were mainly concentrated within 1–2 ULN, including AST (12.99%/22.08%), DBIL (10.39%/21.43%), BUN (12.99%/22.08%), CREA (20.13%/29.22%), and PLT (7.79%/14.94%). Furthermore, the incidence of liver injury from T1 to T3 was higher in the HBV ( +) group compared to the HBV (-) group (15.7% (20/127) vs. 7.2% (11/152), P < 0.05). Multivariate analysis showed that liver cirrhosis (HR = 4.847, 95% CI: 1.224–19.20, P = 0.025) and liver cancer (HR = 8.333, 95% CI: 2.156–32.209, P = 0.002) were independent risk factors for liver injury in the presence of SARS-CoV-2 infection.ConclusionSARS-CoV-2 infection has a higher proportion of liver injury in HBV-infected patients, affecting hepatic protein synthesis function. Those with cirrhosis and hepatocellular carcinoma are at higher risk of severe liver injury.

Peculiarities of post-vaccination immunity to infections manageable by specific prevention means in schoolchildren

Introduction. Stable post-vaccination immunity and prediction of vaccination immunologic effectiveness are topical issues that require profound studies with their focus on the role in their formation that belongs to exogenous factors. The aim of this study was to establish pathogenetic peculiarities of the development of impairments of post-vaccination immunity to infections manageable by specific prevention in schoolchildren under combined exposure to chemical environmental factors as well as factors related to the educational process, lifestyle, and diet. Materials and methods. We analyzed laboratory test results and data obtained by questioning and analyzing diet records of one hundred eighty four children vaccinated against diphtheria, whooping cough, and measles. The children attended either a secondary school with standard educational programs (Reference Group) or a secondary school with profound studies of some subjects (Observation Group). Priority risk factors and etiopathogenetic peculiarities of the development of post-vaccination immunity impairments were identified by building one-factor logistic regression models and sequential modelling. Results. The schoolchildren from the School 2 had to study in an environment that did not conform to hygienic requirements to the management of the educational process; they did not consume biologically valuable foods in recommended quantities; their blood was contaminated with metals and aromatic hydrocarbons; they had high levels of digital activity but their physical activity was low. Given all this, intensity of their humoral post-vaccination immunity against diphtheria and whooping cough was 1.2–1.7 times lower than in the Reference Group. We identified determinants of advers effects produced on post-vaccination immunity development by the analyzed factors and determined their isolated and combined contributions to likelihood of a decline in intensity of humoral immunity to diphtheria (10–55% and 72%) and whooping cough (13–40% and 77%). We established pathogenetic peculiarities and marker laboratory indices of risk-associated impairments of post-vaccination immunity to diphtheria and whooping cough under combined exposure to the analyzed factors. Limitations. The study results were obtained without considering types of applied vaccines. Conclusion. The established pathogenetic aspects of risk-associated impairments of post-vaccination immunity to diphtheria and measles under combined exposure to the set of the analyzed factors are target ones for hygienic activities, prediction, and immunity correction.

Comprehensive review of patients with hypercoagulable state in rheumatoid arthritis and strategies to reduce readmission rates: A retrospective cohort study based on protective exploration of traditional Chinese medicine.

This study aimed to investigate the effect of traditional Chinese medicine (TCM) intervention on the risk of readmission and laboratory indicators in patients with rheumatoid arthritis hypercoagulable state. In the retrospective cohort design, patients with RA hospitalized between June 2013 and June 2021 at the First Affiliated Hospital of Anhui University of Chinese Medicine were followed up by telephone. Propensity score matching (PSM) was used to balance deviations in baseline information between patients in the hypercoagulable (HC) and non-hypercoagulable (Non-HC) groups, with exposure defined as receiving TCM treatment for ≥ 1 month. Cox proportional hazards model and Kaplan-Meier survival curves were employed to determine the factors influencing the readmission of RA-HC patients. Mantel test and association rule analysis was used to explore the relationship between the included factors and laboratory indicators. A total of 1169 cases were successfully followed up, including 831 RA-HC patients. 1:2 PSM yielded 311 patients in the non-HC group versus 535 patients in the HC group. We observed that the incidence of readmission and surgical treatment was significantly higher in the HC group than in the non-HC group, while the incidence of readmission, surgical treatment, and all-cause mortality was much lower in the exposed group than in the non-exposed group (all P < .05). Based on the Cox proportional risk model, we identified age above 60 years, Sjogren's syndrome, neutrophil count, and neutrophil-lymphocyte ratio (NLR) as risk factors for readmission, with TCM playing a protective role. The Kaplan-Meier survival curves further showed that the risk of readmission in the high-exposure subgroup was markedly lower than that of the low-exposure subgroup. Furthermore, the Mantel test highlights an intrinsic correlation between coagulation markers and other markers such as erythrocyte sedimentation rate (ESR) and hypersensitive c-reactive protein (hs-CRP), which are dramatically influenced by gender, age, etc. In addition, association rule analysis revealed a strong correlation between TCM and non-readmission, as well as improvement in rheumatoid factor, hs-CRP, ESR, platelet count, and NLR in RA-HC patients. As a promising therapeutic strategy, TCM with sufficient intensity and duration interventions can effectively reduce the risk of readmission and relieve laboratory indicators in RA-HC patients.

Characteristics of the pregnancy and labour course in women who underwent COVID-19 during pregnancy.

This study aims to analyze the impact of COVID-19 on pregnancy and labor, focusing on its effects on maternal and child health. The research explores the relationships between coronavirus infection and clinical and laboratory parameters, as well as the risks of pregnancy complications and adverse birth outcomes. The study involved 60 pregnant women diagnosed with COVID-19. A comprehensive evaluation of clinical and laboratory indicators was conducted, employing correlation, regression, logistic analyses to determine risk factors. There was a strong inverse correlation between carbon dioxide levels and haematocrit (-0.76), and a direct correlation between blood pH and partial pressure of oxygen (0.73). COVID-19 was associated with increased risks of preterm labor (OR=1.82), stillbirth (OR=2.11), pre-eclampsia (OR=1.46), and foetal distress. Multivariate analysis revealed a 200 g reduction in neonatal birth weight and higher risks of hospitalisation (OR=1.8), postpartum hemorrhage (OR=2.3), and preterm delivery (OR=2.5). Comorbid conditions such as cardiovascular abnormalities, diabetes, obesity, thrombophilias exacerbated the risks of complications, including pre-eclampsia, neonatal respiratory distress syndrome, venous thromboembolism. COVID-19 infection increases the likelihood of pregnancy complications and adverse outcomes, especially in women with comorbidities. These findings highlight the need for preventive strategies and risk management protocols for pregnant women during future outbreaks, emphasizing the importance of further research in this field.

Effects of roxadustat on thyroid profiles in patients and animals with chronic kidney disease.

Background Roxadustat, a hypoxia-inducible factor prolyl hydroxylase inhibitor used in renal anemia treatment, has been associated with thyroid hormone suppression. This study investigated the patterns of thyroid profile changes following roxadustat administration and their clinical implications. Methods In this retrospective study (2019-2023) at Shenzhen Second People's Hospital, patients were categorized based on TSH reduction during follow-up (≥50% decrease vs<50% decrease). Thyroid profiles, clinical symptoms, and laboratory indicators were analyzed. Quality of life was assessed using EQ-5D-3L and ThyPRO questionnaires. Complementary animal experiments were conducted to verify the effects of roxadustat on thyroid function. Results A total of 118 patients were finally enrolled in our study. Among patients with initially normal thyroid function, 31 developed euthyroid sick syndrome post-roxadustat treatment. Treatment significantly decreased T3, FT3, FT4, and TSH levels, with TSH showing marked reduction within the first 10 weeks. Contrastingly, animal models exhibited decreased T3 but increased TSH levels, regardless of renal status. Blood lipid levels decreased in all patients, particularly in those with substantial TSH reduction. Despite thyroid alterations, quality of life scores remained unchanged between roxadustat-treated and untreated patients, with no overt clinical symptoms in either humans or animals. Conclusions While roxadustat induces significant thyroid hormone suppression in patients, these alterations rarely manifest as clinical symptoms. Euthyroid sick syndrome is the predominant thyroid dysfunction pattern observed. Regular thyroid function monitoring is recommended during roxadustat therapy, particularly during the initial treatment phase when TSH changes are most pronounced.

Estimation of dynamic soil properties for geotechnical analysis in the Niger Delta using index testing and empirical correlations

This study investigated geotechnical properties of subsurface soils from Mbiama town in Rivers State, Niger Delta region through laboratory index testing and development of empirical correlations to estimate dynamic soil parameters. Grain size analyses revealed heterogeneous stratigraphy transitioning from upper clayey sands to lower gravelly sands deposited under changing fluvio-deltaic conditions. Atterberg limits exhibited decreasing plasticity trends with depth confirming the textural variations. Laboratory data conforms to layering architecture inferred from depositional facies analyses. Predictive models were developed relating Standard Penetration Test blow counts (SPT-N) and shear wave velocity (Vs) to depth, moisture content and percentage sand. High regression coefficients validated models' accuracy in reproducing over 90% of field measurements. Factor of safety against liquefaction was correlated to SPT-N, accounting for density-dependent properties. Index-based characterizations aligned well with trends predicted by the empirical correlations. This research demonstrated robust indirect estimation of dynamic geotechnical indices for foundation design and seismic risk analysis in data-scarce Niger Delta through standardized field and laboratory index testing integrated with depositionally-linked predictive models.

What Clinicians Think About When They Think About Sepsis: Results From a Survey Across the University of Maryland Medical System.

Sepsis, a leading cause of death in the hospital, is a heterogeneous syndrome without a defined or specific set of symptoms. We conducted a survey of clinicians in practice to understand which clinical findings they tend to associate with sepsis. A survey was distributed to physicians and advanced practice providers across a multihospital health system during April 2022 and May 2022 querying likelihood of suspecting sepsis and initiating sepsis care in response to various normal and abnormal clinical findings. Strength of association between clinical findings and suspicion of sepsis were based on median and interquartile range of complete responses. Comparisons between individual questions were performed using Wilcoxon rank-sum testing. Among 179 clinicians who opened the survey, 68 (38%) completed all questions, including 53 (78%) attending physicians representing six different hospitals. Twenty-nine respondents (43%) worked primarily in the ICU, and 16 (24%) worked in the emergency department. The clinical findings most strongly associated with suspicion of sepsis were hypotension, tachypnea, coagulopathy, leukocytosis, respiratory distress, and fever. The abnormal clinical findings least likely to prompt suspicion for sepsis were elevated bilirubin, elevated troponin, and abdominal examination suggesting ileus. On average, respondents were more likely to suspect sepsis with high temperature than with low temperature (p = 0.008) and with high WBC count than with low WBC count (p = 0.003). Clinicians in practice tend to associate the diagnosis of sepsis with signs of severe illness, such as hypotension or respiratory distress, and systemic inflammation, such as fever and leukocytosis. Except for coagulopathy, nonspecific laboratory indicators of organ dysfunction have less influence on decision-making.

Analysis of the diagnostic effect of 18F-FDG PET/CT in IIM patients and its relationship with disease severity.

To analyze the diagnostic effect of fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in patients with idiopathic inflammatory myopathies (IIM) and its relationship with disease severity. A retrospective analysis was conducted on the clinical and imaging data of 31 IIM patients treated in our hospital from April 2020 to April 2024, who were included in the lesion group. Additionally, 30 patients without muscle disease during the same period were selected as the control group. The maximum standardized uptake value (SUVmax) of the proximal limb girdle muscles was measured in both groups and compared. A receiver operating characteristic (ROC) curve was plotted to analyze the diagnostic value of SUVmax for IIM using 18F-FDG PET/CT. Spearman rank correlation was used to analyze the relationship between muscle SUVmax in IIM patients and relevant laboratory indicators, including creatine kinase (CK), creatine kinase-MB (CK-MB), C-reactive protein (CRP), serum ferritin (SF), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). The SUVmax level of the lesion group (2.94±0.58) was significantly higher than that of the control group (1.17±0.23) (t=15.568, P<0.05). A receiver operating characteristic curve analysis indicated that the optimal cut-off value of SUVmax for distinguishing the lesion group from the control group was 2.16g/mL, with a diagnostic sensitivity of 100%, specificity of 91.8%, and an area under the curve (AUC) of 0.952. Correlation analysis showed a positive correlation between SUVmax and CK (r=0.659), CK-MB (r=0.523), AST (r=0.458), and LDH (r=0.437) (P<0.05), but no significant correlation with CRP (r=0.219), SF (r=0.348), or ALT (r=0.237). Fluorine-18-FDG PET/CT demonstrates an ideal diagnostic effect for IIM patients, and its semi-quantitative parameter, SUVmax, holds good auxiliary diagnostic value for IIM. It can reflect the activity and severity of the disease to a certain extent.

Changes in the Structure, Function, and Fat Content of the Heart in Patients with Obesity After Bariatric Surgery-A Prospective Magnetic Resonance Imaging Study.

Changes in myocardial fat in addition to changes in cardiac structure and function have not been accurately evaluated in obese patients following surgery. Forty-four obese patients who underwent sleeve gastrectomy and completed preoperative and postoperative cardiac magnetic resonance imaging (CMR) before surgery and at 1, 3, and 6 months after surgery were enrolled, and their clinical and laboratory data were collected. The differences and correlations between clinical, laboratory, and CMR parameters between the preoperative and postoperative groups were analysed. The left ventricular mass (LVM), left ventricle cardiac output (LVCO), pericardial adipose tissue volume (PATV), and myocardial proton density fat fraction (M-PDFF) decreased after surgery (all P < 0.05). The left ventricle global longitudinal strain increased at 6 months after surgery (P = 0.004). A decrease in BMI was positively correlated with the LVCO (r = 0.58, P < 0.001) at 3months after surgery and was positively correlated with the LVM and PATV (r = 0.54, P < 0.05) at 6months after surgery. Six months after surgery, the changes in PATV were positively correlated with the changes in triglycerides (r = 0.61, P < 0.01). There was a moderately positive correlation between the decrease in the LVM and PATV (r = 0.54 ~ 0.71, P < 0.02) after surgery. After surgery, the cardiac structure and function of obese patients significantly improved, the PATV and M-PDFF decreased, and there was a correlation between the structure and function of the heart and several clinical and laboratory indicators.

Predictive Factors for Primary and Secondary Nonresponders to Upadacitinib in Patients with Moderate-to-Severe Atopic Dermatitis: A Real-World Study.

Background: Some patients with atopic dermatitis (AD) do not sufficiently respond to upadacitinib, a Janus kinase 1 inhibitor. However, predictive factors for nonresponders remain unclear in real-world practice. Objective: To identify predictive factors for primary and secondary nonresponders to upadacitinib 15 mg; primary nonresponders are defined as patients with investigator's global assessment (IGA) >2 at week 12, while secondary nonresponders are defined as patients with IGA ≤2 at week 12 and IGA >2 at week 24. Methods: A prospective study was conducted from August 2021 to March 2024, involving 204 Japanese AD patients treated with upadacitinib 15 mg. Baseline clinical and laboratory indexes were compared between nonresponders and responders. Results: Primary nonresponders showed higher baseline eczema area and severity index (EASI), immunoglobulin E (IgE), thymus and activation-regulated chemokine (TARC), lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) compared with responders. Secondary nonresponders had a higher proportion of previous systemic therapies, dupilumab, and corticosteroids. Conclusions: Higher baseline EASI, IgE, TARC, LDH, NLR, CRP, SII, and SIRI may predict primary nonresponders to upadacitinib 15 mg, while previous systemic dupilumab or corticosteroids may predict secondary nonresponders.

Studying the impact of probiotic agents on the pathogenetic and clinical features of generalized periodontitis

Generalized periodontitis remains one of the most prevalent dental diseases, complications of which significantly deteriorate patients’ quality of life. Currently, the use of probiotic agents is considered a promising direction to enhance the effectiveness of non-surgical treatment of this pathology. Studying the impact of different probiotics on the pathogenetic and clinical features of generalized periodontitis will allow proposing optimized protocols for comprehensive treatment, reducing patient rehabilitation periods and improving the overall dental health of the population. The aim of this study is to examine the influence of various probiotic agents on the pathogenetic and clinical characteristics, treatment effectiveness of generalized periodontitis in adult patients by analyzing professional scientific literature. The literature review provides a brief overview of various probiotic groups and discusses pathogenetic mechanisms of their interaction with the microbiota of oral biofilms. The immunomodulatory mechanisms of probiotics on local and systemic immune responses in patients with generalized periodontitis, inhibition of enzymes responsible for bone tissue resorption, are presented. The analysis results of scientific sources regarding the dynamics of changes in clinical symptoms, microbiological, immunological, and biochemical parameters of saliva and blood serum in individuals with generalized periodontitis receiving comprehensive rehabilitation using probiotic agents compared to patients treated with traditional protocols are provided. The study highlights statistical differences in clinical and laboratory indicators of periodontitis progression at different treatment intervals. Conclusions. The use of probiotic agents for treating patients with generalized periodontitis significantly influences the clinical course of the disease by altering the species composition of dental biofilms and modulating local immune and inflammatory reactions. However, the known results of experimental and clinical studies often have conflicting findings regarding the efficacy of specific probiotic strains and the duration of inflammatory process stabilization over extended periods after treatment, which means a further study is required.

The Association of β2-Microglobulin with Physical Performance in Chinese Hemodialysis Patients with and without Diabetes.

Higher β2-Microglobulin (β2-MG) is associated with aging, stroke and cognitive impairment, which are all connected with poor physical fitness. Poor physical function is ascribed to increasing mortality. However, there has been an academic dispute over the association of serum β2-MG with survival rate. Furthermore, diabetes mellitus (DM) has been well linked to poor physical function and a high level of β2-MG. We hypothesized that higher β2-MG could be associated with worse physical performance in hemodialysis (HD) patients, and that association could vary with diabetes. We conducted a multicenter cross-sectional study at seven HD centers in Shanghai and Suzhou, respectively, in China, where a collection was made of the clinical characteristics, laboratory indicator, physical performance and DM assessment. The physical function was measured by the Short Physical Performance Battery (SPPB), and SPPB score ≤9 as the cutoff for low physical performance.The patients were divided into two groups of low and high physical performance, before categorized into four subgroups based on the absence of diabetes and SPPB scores. Logistic regression analyses were conducted to explore the association of β2-MG with physical performance. The final analysis involved a total of 780 patients, 251(32.2%) having diabetes. In the total population, β2-MG was lower in those with low SPPB than in those with high SPPB. Only in non-diabetic patients, β2-MG was lower in the low SPPB group, and positively associated with SPPB and its three compenents scores. Regardless of diabetes status, those who had low SPPB were prone to be older, accompanied by the poor nutritional status. Addtionally, the diabetes patients tended to have shorter HD duration and higher body mass index than the non-diabetic patients. Both before and after the covariates adjusted, β2-MG was significantly associated with physical performance in HD patients without diabetes. Low level of β2-MG was significantly associated with poor physical performance in Chinese HD patients without DM.

Deciphering the causal landscape: genetic insights into sporadic vestibular schwannoma risk factors through Mendelian Randomization

BackgroundSporadic vestibular schwannoma, a benign tumor affecting the vestibulocochlear nerve, poses significant health challenges due to its impact on hearing, balance, and facial nerve function. Despite known associations with genetic mutations and environmental factors, the causality between potential risk factors and sporadic vestibular schwannoma remains underexplored.ObjectiveThis study aims to investigate the causal effects of various genetically predicted risk factors on sporadic vestibular schwannoma utilizing a Two-Sample Mendelian Randomization (MR) approach to enhance understanding of its etiology and inform prevention strategies.MethodsLeveraging data from genome-wide association studies (GWAS), we analyzed 29 risk factors across five categories: related diseases, lifestyle habits, nutritional status, learning ability, and laboratory indicators. The MR analysis employed instrumental variables (IVs) derived from single nucleotide polymorphisms (SNPs) to assess causal relationships, overcoming traditional observational study limitations.ResultsOur findings highlight significant associations between sporadic vestibular schwannoma and factors such as ovarian cancer, uterine fibroids and lifestyle habits including dietary intake and alcohol consumption. Notably, higher educational attainment and specific laboratory indicators like high-density lipoprotein (HDL) cholesterol levels were linked to altered disease risk. These results suggest a multifaceted etiology involving hormonal, cardiovascular, gastrointestinal, immune, and metabolic pathways.ConclusionThis comprehensive MR study provides novel insights into the diverse risk factors contributing to sporadic vestibular schwannoma, emphasizing the role of genetic predispositions, hormonal influences, and lifestyle choices in its development. The associations identified underscore the need for a multidisciplinary research approach and targeted public health strategies to mitigate sporadic vestibular schwannoma risk. Further research into the underlying mechanisms of these associations is crucial for developing effective interventions and improving patient outcomes.

Основные противовоспалительные цитокины и интерлейкин 6 у больных ревматоидным артритом: взаимосвязи и клиническое значение

In the pathogenesis of rheumatoid arthritis (RA), an important role is played by dysfunction between the production of the main anti-inflammatory interleukins (IL) IL-4, IL-10 and proinflammatory (IL-6) cytokines. Objective. Determination of IL-4, IL-6 and IL-10 concentrations in RA patients with advanced stage of the disease, assessment of the relationship between them, clinical indices of disease activity, the presence of rheumatoid factor (RF) and antibodies to cyclic citrullinated peptide (CCP). Material and methods. The study included 154 RA patients (41 males and 113 females) of middle age (56.0 (50.0; 64.0) years), disease duration (9.4 (3.0; 13.0) years), seropositive 129 (83.8 %) for IgM RF and/or 106 (68.8 %) ACPP with moderate or high (DAS28-ESR – 5.40 (4.65; 6.00)) disease activity. The concentration of IL-4, IL-6, IL-10 in the blood serum was determined by multiplex technology. Results. In patients with RA, the concentration of IL-4 did not differ significantly from the control, and for IL-6 and IL-10 it was significantly higher than in donors. High values of IL-6 were significantly more common (51.6 %) than IL-4 (12.33 %, p = 0.001) and IL- 10 (16.23%, p = 0.001). Reliable correlations were found between the hyperproduction of IL-4 and IL-6, IL-6 and IL-4, IL-10. For IL-4 and IL-10, such an association was not found. The concentration and frequency of increased IL-4, IL-6, IL-10 did not differ in patients positive or negative for IgM RF. The concentration of IL-4 was significantly higher in the group of patients seronegative for ACPA compared to seropositive ones, and the prevalence of high IL-4 values was also noted in this group. No such association was found for IL-6 and IL-10. The concentration of IL-6 significantly positively correlated with the indices (DAS28-ESR, CDAI, SDAI) of clinical activity of RA, and the level of IL-4 was positively associated with CDAI, SDAI, IgM RF and inversely with ACPA values. The concentration of IL-10 was associated with CDAI, SDAI, IgM RF. Conclusion. In patients with RA in the advanced stage of the disease, the production of IL-6 predominates over the production of IL-4 and IL-10. In the presence of interrelations between these cytokines, there are certain differences in the associations with clinical indices and laboratory indicators of disease activity, IgM RF and ACPA.

Construction of a Clinical Prediction Model for Complications After Femoral Head Replacement Surgery.

While femoral head replacement is widely used with remarkable efficacy, the complexity and diversity of postoperative complications pose a serious prognostic challenge. There is an urgent need to develop a clinical prediction model that can integrate multiple factors and accurately predict the risk of postoperative complications to guide clinical practice and optimize patient management strategies. This study is dedicated to constructing a postoperative complication prediction model based on statistics and machine learning techniques, in order to provide patients with a safer and more effective treatment experience. A total of 186 patients who underwent femoral head replacement in the Orthopedic Department of our hospital were collected in this study. Forty-two of the patients had at least one postoperative complication, and 144 had no complications. The preoperative and postoperative data of patients were collected separately and medical history was collected to study the correlation factors affecting the occurrence of postoperative complications in patients and to establish a prediction model. Possibly relevant factors were included in a one-way logistic regression, which included the patient's gender, age, body mass index, preoperative diagnosis of the mode of injury, osteoporosis or lack thereof, as well as medical history, surgical-related information, and laboratory indices. After analyzing the results, it was concluded that operation time, alanine transaminase (ALT), aspartate aminotransferase (AST), white blood cell count, serum albumin, and osteoporosis, were the risk factors affecting the development of complications after femoral head replacement in patients (P < 0.2). The data obtained were further included in a multifactorial regression, and the results showed that operation time, AST, white blood cell count, serum albumin, and osteoporosis were independent risk factors for complications after the patients underwent femoral head replacement (P < 0.05). Based on the results of this study, five factors, including duration of surgery, AST, white blood cell count, serum albumin, and osteoporosis, were identified as independent risk factors for complications after patients underwent femoral head replacement. In addition, the prediction model developed in this study has a high scientific and clinical application value, providing clinicians and patients with an important tool for assessing the risk of complications after affected femoral head replacement.

Derivation and external validation of prediction model for hypertensive disorders of pregnancy in twin pregnancies: a retrospective cohort study in southeastern China

ObjectiveWe aimed to develop and validate an effective prediction model for hypertensive disorder of pregnancy (HDP) in twin pregnancies after 28 weeks of gestation.DesignRetrospective cohort study.SettingMaternity hospital.ParticipantsWe recruited twin pregnancies...

Chest CT assess the impact of omalizumab treatment on airway remodeling in refractory asthma.

BackgroundTo evaluate the benefits of omalizumab treatment in patients through real-world follow-up and assess the impact of omalizumab treatment on airway remodeling using chest CT. MethodsThis is a single-center prospective, observational study included Chinese patients with refractory asthma who received omalizumab treatment from May 2021 to December 2022. We collected real-world clinical data, including their hospitalization information, pulmonary function, FENO, laboratory assessment, ACT scores, chest CT at baseline and every follow-up month. A comparison was made between the pre-treatment and post-treatment laboratory indicators, pulmonary function, airway parameters, and mucous plug scores under chest CT. ResultsThis study included a total of 61 patients with refractory asthma treated with omalizumab. The study found that: ①regardless of whether the treatment lasted for a full four months or not, it significantly improved patient asthma control scores and reduced hospitalization costs and length of stay (p<0.05). ②After four months of treatment, pulmonary ventilation function examination revealed significant improvements (p<0.05) in MEF75, MEF50, MEF75/25, PEF, and FEV1/FVC. ③After four months of omalizumab treatment, the ratio of wall thickness and outer radius (T/D) and wall area percentage (WA%) of the bronchial wall decreased significantly (p<0.05). ④After medication, the expression of airway mucous plugs decreased. ConclusionsOmalizumab treatment can reduce airway wall thickness, decrease the percentage of airway wall area, and the expression of airway mucous plugs, thereby improving airflow limitation. Utilizing chest CT provides a novel and intuitive assessment of the efficacy of omalizumab treatment. Trial registrationThis study was registered in Chinese Clinical Trial Registry, the number is ChiCTR2100046343.

The value of quantitative muscle ultrasound in monitoring muscle and fascia inflammatory activity in juvenile dermatomyositis patients.

Currently, the activity of juvenile dermatomyositis (JDM) is mainly assessed based on clinical manifestations, creatine kinase (CK) level, and magnetic resonance imaging (MRI), but certain limitations arise in these approaches for children. Thus, this cross-sectional study aimed to explore the value of ultrasound in evaluating muscle inflammation via the dynamic analysis of muscle ultrasound characteristics in children with active or stable JDM. The data of a group of children who were diagnosed with JDM and admitted to the Rheumatology and Immunology Department of the Capital Pediatric Research Institute Children's Hospital between June 2022 and November 2023, and a normal control group were collected. The clinical, ultrasound, and laboratory data of the children with active and stable JDM were collected and compared with those of a normal control group. Muscle thickness (MT), fascia thickness (FT), muscle echo intensity (EI), muscle microvascular flow imaging (MVFI) distribution, and the blood flow resistance index (RI) were measured via ultrasound for the comparative analysis. A Spearman correlation analysis was conducted to assess the correlation between the ultrasound parameters in the JDM patients, and muscle scores and laboratory indicators of disease activity. Receiver operating characteristic (ROC) curves were generated for the ultrasound parameters. Five active JDM children were dynamically followed up. The data of 26 children with active JDM, 29 with stable JDM, and 31 normal control children were collected. The patients with active JDM had significantly greater EI (median 68.9 vs. 47.4, P<0.01), increased FT (median 0.25 vs. 0.15, P<0.01), and an increased MVFI distribution (P<0.01). The Spearman correlation analysis revealed a negative correlation between increased EI, FT, and MVFI distribution, and the Childhood Myositis Assessment Scale (CMAS) score (R=-0.662, -0.673, -0.667, all P<0.05). There was a statistically significant difference in EI between the stable JDM children and healthy children (median 47.4 vs. 39.0, P<0.05). During the follow-up period, two children with slow fasciitis resolution developed soft tissue calcification. EI, FT, and MVFI distribution can be used to assess the activity status of individuals with JDM, and are correlated with clinical activity indices. EI may be abnormal even in children with a stable clinical condition, which suggests that ultrasound may more accurately reflect muscle status. Children with long-term unresolved fasciitis may be at risk of developing calcification.

Unexpected discovery of a thyroid hydatid cyst during pathological examination: a case report

BackgroundHydatid disease, a parasitic infection caused by the larval form of Echinococcus granulosus, infrequently involves the thyroid gland, whether through direct invasion or hematogenous spread.Case presentationWe report the case of a 62-year-old female patient from Morocco who presented with an anterior cervical mass, initially suspected to be a goiter. A histopathological evaluation of the thyroidectomy specimen identified the presence of a hydatid cyst. A comprehensive review of the literature is also included.ConclusionGiven that Morocco is an endemic region for hydatid disease, clinicians should consider this parasitic infection in the differential diagnosis of thyroid cystic lesions, recognizing the clinical and laboratory indicators of the disease.