Mild Moderate Group Research Articles

Relationship between platelet count and severity of neonatal respiratory distress syndrome

BackgroundNeonatal respiratory distress syndrome (NRDS) is a primary cause of morbidity and mortality in premature infants. Platelets have a unique role in lung repair and remodeling. This study aimed to determine the relationship between platelet count and NRDS severity.MethodsThe study included 234 newborns diagnosed with NRDS from January 2019 to August 2023. This study employed two methods of grouping: the first based on platelet count, dividing participants into thrombocytopenia (platelet count < 150 × 109/L, n = 50) and non-thrombocytopenia groups (platelet count ≥ 150 × 109/L, n = 184), and the second based on the severity of NRDS, categorizing them into severe (n = 24) and mild-moderate (n = 210) groups. Within the first grouping method, the thrombocytopenia group was further subdivided into moderate-severe group (platelet count < 100 × 109/L, n = 4) and mild group (platelet count was between 100.0 × 109/L and 150.0 × 109/L, n = 46). This study aimed to analyze the clinical characteristics of NRDS with thrombocytopenia, explore the correlation between platelet count and clinical indicators of NRDS. Binary Logistic regression analysis was employed to identify independent risk factors for thrombocytopenia in NRDS.ResultsA higher proportion of newborns in the severe group exhibited thrombocytopenia (severe group = 41.7%, mild-moderate group = 19.0%). Hospital stay, ventilation time, oxygen therapy duration were longer in the thrombocytopenia group compared to the non-thrombocytopenia group. Hospital stay, ventilation time, oxygen therapy duration, chest radiography score, and C-reactive protein (CRP) levels were inversely associated with platelet count. Conversely, Apgar scores at 1 and 5 min, gestational age, and birth weight showed positive correlations with platelet count. Point-biserail correlation showed that thrombocytopenia was more likely to occur in newborns whose mothers had gestational hypertension, and the lower platelet count, the more severe NRDS. Oxygen therapy duration, birth weight < 1500 g, gestational hypertension and CRP levels emerged as independent risk factors for thrombocytopenia in NRDS. All differences were statistically significant (p all < 0.05).ConclusionNRDS accompanied by thrombocytopenia indicates a more severe condition and poorer clinical outcomes. It is hypothesized that NRDS with thrombocytopenia involves a complex multifactorial etiology, including severe lung inflammation.

Dynamic Reorganization Patterns of Brain Modules after Stroke Reflecting Motor Function.

Advancements in neuroimaging technologies have significantly deepened our understanding of the neural physiopathology associated with stroke. Nevertheless, the majority of studies ignored the characteristics of dynamic changes in brain networks. The relationship between dynamic changes in brain networks and the severity of motor dysfunction after stroke needs further investigation. From the perspective of multilayer network module reconstruction, we aimed to explore the dynamic reorganization of the brain and its relationship with motor function in subcortical stroke patients. We recruited 35 healthy individuals and 50 stroke patients with unilateral limb motor dysfunction (further divided into mild-moderate group and severe group). Using dynamic multilayer network modularity analysis, we investigated changes in the dynamic modular reconfiguration of brain networks. Additionally, we assessed longitudinal clinical scale changes in stroke patients. Correlation and regression analyses were employed to explore the relationship between characteristic dynamic indicators and impairment and recovery of motor function, respectively. We observed increased temporal flexibility in the Default Mode Network (DMN) and decreased recruitment of module reconfiguration in the Attention Network (AN), Sensorimotor Network (SMN), and DMN after stroke. We also observed reduced module loyalty following stroke. Additionally, correlation analysis showed that hyper-flexibility of the DMN was associated with better lower limb motor function performance in stroke patients with mild-to-moderate impairment. Regression analysis indicated that increased flexibility within the DMN and decreased recruitment coefficient within the AN may predict good lower limb function prognosis in patients with mild to moderate motor impairment. Our study revealed more frequent modular reconfiguration and hyperactive interaction of brain networks after stroke. Notably, dynamic modular remodeling was closely related to the impairment and recovery of motor function. Understanding the temporal module reconfiguration patterns in multilayer networks after stroke can provide valuable information for more targeted treatments.

Correlation analysis of serum Rac1 level with asthma control, airway inflammatory response and lung function in asthmatic children

ObjectiveTo investigate the correlation between serum Rac1 enzyme (Rac1) level with asthma control, airway inflammatory response and lung function in asthmatic children.MethodsA retrospective analysis was performed on 79 children with asthma who were diagnosed and treated in our hospital from June 2020 to January 2023. According to the severity of the disease, the children were divided into mild group (25 cases), moderate group (30 cases) and severe group (24 cases). 36 healthy children who underwent physical examination at the same period in our hospital were selected as the control group. The state of an illness, control level, serum mRNA Rac1, inflammatory factors, and lung function of the children in two groups were compared between the control group and the observation group.ResultsThe Rac1 mRNA levels, forced vital capacity (FVC), forced expiratory volume in one second/FVC (FEV1/FVC), peak expiratory flow (PEF), and maximum mid-expiratory flow (MMEF) in the observation group were significantly lower than these in the control group (P < 0.05). The tumor necrosis factor-alpha (TNF-α), interleukin-5 (IL-5), IL-6, and IL-33 in the observation group were markedly higher than these in the control group (P < 0.05). As the state of an illness worsened, the Rac1 mRNA levels, FVC, FEV1/FVC, PEF, and MMEF gradually reduced (P < 0.05), while the levels of TNF-α, IL-5, IL-6, and IL-33 increased (P < 0.05). As the degree of disease control improved, the Rac1 mRNA levels, FVC, FEV1/FVC, PEF, and MMEF gradually elevated (P < 0.05), and the levels of TNF- α, IL-5, IL-6, and IL-33 showed the opposite trend (P < 0.05). Rac1 was negatively related to the levels of TNF-α, IL-5, IL-6 and IL-33 (P < 0.05), and positively to the levels of FVC, FEV1/FVC, PEF and MMEF (P < 0.001). Rac1 mRNA levels, FVC, FEV1/FVC, PEF and MMEF were protective factors, while TNF-α, IL-5, IL-6 and IL-33 were risk factors for the prognosis of children with asthma (P < 0.05).ConclusionChildren with asthma have obviously lower serum Rac1 mRNA levels, higher inflammatory factor levels and lower lung function. Serum Rac1 mRNA level may be associated with better asthma control, lower airway inflammatory response, better lung function and lower disease severity. It has important reference value for the evaluation of the state of an illness, efficacy and prognosis of children with bronchial asthma.

Early diagnostic and prognosis prediction of circ_0054633 for acute lung injury/acute respiratory distress syndrome in children with severe pneumonia

To explore the value of circ_0054633 in early diagnosis and prognosis prediction of acute lung injury/acute respiratory distress syndrome (ALI/ARDS) in children with severe pneumonia. A retrospective case-control study was conducted on children with diagnosed severe pneumonia admitted to Tianjin Children's Hospital from July 1, 2022, to February 29, 2024. The clinical data was collected by electronic medical record system and clinical follow-up, including gender, age, lung injury prediction score (LIPS), pediatric critical illness score (PCIS), serum circ_0054633, interleukin-6 (IL-6), the indicators of the arterial blood-gas analysis, oxygenation index (PaO2/FiO2) within 24 hours of admission and the survival status of 28 days. According to whether ALI/ARDS occurred, they were divided into the ALI/ARDS group and the non-ALI/ARDS group. The differences of clinical data between the two groups were compared, and multivariate Logistic regression was used to analyze the risk factors for ALI/ARDS in children with severe pneumonia. The receiver operator characteristic curve (ROC curve) will be used to explore the early diagnostic value of ALI/ARDS in children with severe pneumonia. The patients of ALI/ARDS were divided into mild group, moderate group and severe group according to the level of PaO2/FiO2. The levels of serum circ_0054633 and IL-6 in various severity ALI/ARDS were compared. The differences of serum circ_0054633, IL-6 levels, PCIS score and LIPS score were compared between the two groups of ALI/ARDS patients according to different prognoses in 28 days, as well as the correlation between various risk factors and circ_0054633. A total 74 children with severe pneumonia were included, with 34 cases in the ALI/ARDS group and 40 cases in the non-ALI/ARDS group. In ALI/ARDS group, there were 9 cases in the mild group, 15 cases in the moderate group and 10 cases in the severe group; while 12 cases died and 22 cases survived after 28 days. The serum circ_0054633, IL-6 level and LIPS score were higher in the ALI/ARDS group than the non-ALI/ARDS group, while the PCIS score was lower, and the two groups had significant difference. Multivariate Logistic regression analysis showed that circ_0054633 was independent predictors of ALI/ARDS in children with severe pneumonia [odds ratio (OR) = 3.853, 95% confidence interval (95%CI) was 1.912-7.805, P = 0.017]. ROC curve analysis showed that the cut-off values for circ_0054633 in the diagnosis of ALI/ARDS were 3.955, sensitivity was 79.4%, specificity was 92.5%, area under the ROC curve (AUC) was 0.892. The serum circ_0054633 and IL-6 levels were higher in the children who died in 28 days than the children who were survived, while the PCIS score was lower, and the two groups had significant difference. Spearman correlation analysis showed that the level of circ_0054633 in children with ALI/ARDS was positively correlated with 28-day mortality and IL-6 (r value was 0.675, 0.763, respectively, all P < 0.001), but negatively correlated with PCIS score (r = -0.626, P < 0.001), while no significant correlation with LIPS score (r = 0.389, P = 0.023). The level of serum circ_0054633 has a better value in early diagnosis and prognosis prediction of ALI/ARDS caused in children with severe pneumonia.

Expressions of glycemic parameters, lipid profile, and thyroid hormone in patients with type 2 diabetes mellitus and their correlation.

This study aimed to investigate the expressions of glycemic parameters, lipid profile, and thyroid hormone in type 2 diabetes mellitus (T2DM) patients and their correlation. Eighty-fourpatients with T2DM in our hospital were included as the observation group. The T2DM patients were divided into mild group, moderate group, and severe group according to the fasting plasma glucose (FPG) level. Another 84 healthy subjects in the same period of health examination in our hospital were included as the control group. The levels of glycemic parameters, (HbA1c and FPG), lipid profile (TC, TG, LDL-C, and HDL-C) and thyroid hormone (FT3, TSH, and FT4) were measured by automatic biochemical analyzer. The correlation between glycemic parameters, lipid profile, and thyroid hormone was analyzed by Pearson correlation analysis. The FPG, TC, TG, LDL-C, HbA1c, and TSH levels were significantly elevated, while the HDL-C and FT3 levels were significantly declined in the observation group versus to control group (p < .05). The levels of HbA1c, FPG, TC, LDL-C, and TSH were significantly increased, while the levels of HDL-C and FT3 were decreased in moderate and severe groups, when compared to mild group (p < .05). The levels of HbA1c, FPG, TC, LDL-C and TSH were higher, while the level of FT3 was lower in severe group than those in moderate group (p < .05). Pearson Correlation analysis showed that FT3 level in T2DM patients was positively correlated with FPG, HbAlc, TC, TG, and LDL-C levels (p < .05), but negatively correlated with HDL-C level (p < .05). TSH level was negatively correlated with FPG, HbAlc, TC, TG, and LDL-C levels (p < .05), while positively correlated with HDL-C level. The thyroid hormone levels were of clinical significance in evaluating glycolipid metabolism and severity of T2DM. Clinical detection of glycolipid metabolism and thyroid hormone levels in T2DM patients is of great significance for diagnosis, evaluation, and targeted treatment of the disease.

Predictive value of thrombin-antithrombin III complex and tissue plasminogen activator-inhibitor complex biomarkers in assessing the severity of early-stage acute pancreatitis.

The development of acute pancreatitis (AP) is strongly linked to blood clotting and fibrinolysis issues. Modern clinical practices now utilize advanced blood markers like thrombin-antithrombin III complex (TAT), plasmin-α2-plasmin inhibitor complex, thrombomodulin (TM), and tissue plasminogen activator-inhibitor complex (t-PAIC) to assess thrombosis risk. Our study used a highly sensitive chemiluminescence technique to measure these markers in AP patients, aiming to determine their early predictive value for AP severity. There were 173 patients with AP, all of whom developed symptoms within 72h; 102 individuals had onset symptoms within 48h. The biomarkers were measured upon admission before determining the severity of AP. The levels of TAT, plasmin-α2-plasmin inhibitor complex, TM, and t-PAIC were significantly higher in the severe acute pancreatitis (SAP) group compared with the mild acute pancreatitis and moderate severe acute pancreatitis groups. For the patients within 72h of onset, TAT, TM, and t-PAIC predicted the occurrence of SAP. For the patients within 48h of onset, TAT and t-PAIC predicted the occurrence of SAP. The area under the curve (AUC) of prediction models is similar to Bedside Index for Severity in Acute Pancreatitis (BISAP) but significantly higher than C-reactive protein (P<0.05). Notably, t-PAIC had a larger AUC than TAT, BISAP, and C-reactive protein. In the initial 48h, plasma TAT and t-PAIC levels may predict the development of SAP. Within 72h, plasma levels of TAT, TM, and t-PAIC may predict the development of SAP, and the TAT+TM+t-PAIC prediction model achieved a maximum AUC of 0.915, comparable to BISAP.

Association between the severity of hard-to-treat psoriasis and the prevalence of metabolic syndrome: A hospital-based cross-sectional study in Jakarta, Indonesia.

Psoriatic lesions on the scalp, face, intertriginous, genitals, palms/soles, and nails are often delay diagnosed, hard-to-treat, and cause disability. Metabolic syndrome (MetS) is one of the most frequent and significant comorbidities in psoriasis. Many studies have discovered a link between psoriasis and MetS, but none have specifically assessed the hard-to-treat psoriasis in Indonesian population. This is a multicenter study involving four dermatology referral hospitals to investigate the association between psoriasis severity that has hard-to-treat lesions with the prevalence of MetS in Jakarta, Indonesia. Data was collected from April to October 2022. The severity of 84 hard-to-treat psoriasis patients was measured by Psoriasis Area Severity Index (PASI) scores. The participants divided into PASI score >10 (severe) and ≤ 10 (mild-moderate) groups. MetS was identified based on the modified National Cholesterol Education Program Adult Treatment Panel III. MetS was found in 64.3% of patients. Patients with a PASI score>10 had a significantly higher risk of metabolic syndrome compared to those with a score ≤ 10 (78.6% vs 50%, OR 3.667; 95% CI 1.413-9.514; p = 0.006). The prevalence of hypertension (p = 0.028), low levels of high-density lipoprotein (HDL) cholesterol (p = 0.01), mean fasting blood sugar (p = 0.018), and triglyceride levels (p = 0.044) between the two groups differed significantly. This study found most frequent components of MetS were abdominal obesity, decreased levels of HDL cholesterol, hypertension, hyperglycemia, and hypertriglyceridemia respectively. Individuals with severe hard-to-treat psoriasis had a 3.67 times more likely to have MetS rather than the mild-moderate group.

Sperm morphology by strict criteria does not predict clinical pregnancy rate following intra-uterine insemination

ABSTRACT Objective To determine the impact of abnormal sperm morphology of the pre-washed semen sample on the day of intrauterine insemination (IUI) on clinical pregnancy rates (CPR) Design Cross sectional retrospective chart review. Setting Academic fertility center Patient(s) Couples undergoing (IUI) from May 2014 to March 2022. Intervention(s) Sperm morphology, by strict criteria, on the pre-washed IUI sample. Main outcomes Measure(s) To determine the association of sperm morphology with CPR. Result(s) Semen analysis reports, including Kruger strict criteria for morphology from the pre-washed IUI sample, were reviewed for 1,059 cycles, comprising 825 total treated couples. Of the total 1,059 cycles,15.1% resulted in clinical pregnancy. When categorized by strict morphology ≥4% (normal morphology), (3%–2%) [mild-moderate teratozoospermia (TZS)], and ≤1% (severe TZS), the CPR was 16%, 13%, and 10%, respectively (p value 0.30). Early spontaneous miscarriage rate was 4% and when stratified by morphology ≥4% (3%–2%), and ≤1%, was 3%, 1%, and 0%, respectively (p value 0.20). In couples with isolated TZS, the pregnancy rate was 16% in the normal morphology group, 14% in the mild–moderate group, and 8% in the severe group. (p value 0.30). In the multivariate logistic regression, sperm morphology, mild/moderate TZS vs normal forms (OR = 0.99, 95% CI [0.94–1.1]), severe TZS vs normal forms (OR = 0.98, 95% CI [0.0.83–1.1]), was not a predictor of CPR. The Pre-wash TMSC (OR = 1.0, 95% CI [0.996–1.00]) was also not predictive of CPR. The only predictive factor of CPR in IUI was the PWTMSC (OR = 1.03, 95%CI [1.00–1.06). Conclusion(s) The morphology of the pre-washed sample on the day of IUI did not find a difference in CPR, neither in miscarriage rate following IUI, in couples with normal or abnormal sperm morphology, including severe TZS. Mild, moderate, or severe TZS in the semen sample should not exclude couples to attempt an IUI procedure.

Biomarkers in the Severity of Necrotizing Enterocolitis in Preterm Infants: A Pilot Study.

The occurrence of necrotizing enterocolitis (NEC) is a common and severe disease of the digestive system in neonates. This study aims to assess the value of the intestinal tissue oxygen saturation (rintSO2) combined with the levels of procalcitonin (PCT) and mean platelet volume (MPV) in predicting the severity of NEC in preterm infants. This experiment was a retrospective cohort study conducted in the Department of Pediatrics, Hongqi Hospital Affiliated to Mudanjiang Medical University between January 2017 and July 2022. Premature neonates with NEC were enrolled and divided into mild-moderate NEC group and severe NEC group according to Bell's stage. The general information data, rintSO2 and blood parameters such as the white blood cell (WBC) count, platelet count (PLT), PCT, MPV, red blood cell distribution width (RDW), hemoglobin (Hb), C-reactive protein (CRP) were compared between the two groups. A total of 122 patients were enrolled, including 79 mild-moderate NEC and 43 severe NEC. The rintSO2 was lower in severe group than in mild-moderate group (P = 0.042), the PCT and MPV were both higher in severe group than in mild-moderate group (P = 0.048, P = 0.049). The results of logistic regression suggested that the rintSO2 (OR = 1.491, P = 0.003), PCT (OR = 3.071, P = 0.001) and MPV (OR = 4.027, P = 0.015) were independent predictive factors for severity of NEC. The area under the curve (AUC) of the rintSO2 combined with PCT and MPV showed good diagnostic ability in the severity of NEC. The rintSO2 combined with PCT and MPV may be considered as the early biomarkers in the severity of NEC and could help us to diagnose the case early with early treatment with better prognosis.

The Effects of -806 T/C and -857 T/C Single Nucleotide Polymorphisms in the TNF-α Gene on Rheumatoid Arthritis Severity and Inflammatory Markers

Background: Polymorphisms in the TNF-α gene affect the development and progression of rheumatoid arthritis. Objective: To investigate the associations between (-806 T/C) and (-857 T/C) SNPs with rheumatoid arthritis severity and susceptibility in a sample of Iraqi patients. Methods: A case-control study was conducted in Baghdad, Iraq. Twenty healthy controls and 63 patients confirmed to be newly diagnosed with rheumatoid arthritis were included. Those are divided into two groups (patients and controls), and the patients were further subdivided into severe and mild-moderate groups. Samples from those participants were analyzed for clinical and inflammatory parameter measurements. Genotyping by the Sanger method was performed to study the SNPs. Results: No associations were demonstrated between rheumatoid arthritis and polymorphisms at positions -806 and -857. Additionally, there were no differences in the distribution of those SNP genotypes and alleles among the severe and mild-moderate groups. Also, the (-806 C/T) SNP was found to be correlated with DAS 28 in all patients and with hs-CRP in the mild-moderate group. Finally, the -857 C/T SNP was found to be correlated with TNF-α within the mild-moderate group. Conclusions: Polymorphisms at positions -806 and -857 were not associated with rheumatoid arthritis susceptibility, and the CT genotype of -806 C/T SNP was associated with disease activity.

There is no association between serum endotoxin levels and inflammation in asthma

Backround Endotoxin, in lipopolysaccharide structure (LPS), is the main component of the outer membrane of gram negative bacteria. LPS levels were associated with inflammatory disease. Asthma is a chronic inflammatory disease involving many different cell types and cellular elements. The association between LPS serum levels and the asthma is not well known. The aim of this study was to investigate the association between the LPS serum levels and the severity of asthma, demographic data and laboratory parameters. Methodology The study included 67 patients aged >18 years with a diagnosis of asthma, and 15 healthy volunteers with no history of chronic disease as a control group. The Asthma Control Test (ACT), Respiratory Function Tests (RFTs), fractional exhaled nitric oxide (FeNO), and endotoxin levels were measured and compared between the groups. The endotoxin measurements were performed using the ELISA method. Results The mild-moderate asthma group included 33 patients and the severe asthma group, 34 patients. The endotoxin level was measured as 17.78 (range 3.59 to 304.55) EU/ml in the patient group and 15 (range 4.01 to 74.06) EU/ml in the control group with no statistically significant difference determined between the groups. In the subgroups, the endotoxin level was measured as 15.21 (range 3.69 to 304.55) EU/ml in the mild-moderate group and 14.46 (range 3.59 to 278.86) EU/ml in the severe asthma group with no statistically significant difference determined between the groups. Conclusion The results of this study showed no relationship between serum endotoxin level and asthma or asthma severity.

Prevalance of impaired glucose tolerance and its association with adverse perinatal outcomes in non-gestational diabetes pregnancies

Objective: Gestational diabetes mellitus (GDM) is characterized by glucose intolerance with onset during pregnancy and is one of the most common metabolic disorders complicating pregnancy. The aim of this study was to evaluate the risk of maternal and neonatal outcomes in non-gestational diabetes pregnancies with abnormal glucose challenge test (GCT) and abnormal glucose tolerance test (GTT) results.&#x0D; &#x0D; Methods: In this retrospective cohort study of 2982 singleton pregnancies, all patients underwent a non-fasting 50 g GCT at 24 to 28 weeks of gestation. A GCT cutoff of ≥ 140 mg/dl was selected. Women with an elevated GCT underwent prompt diagnostic testing with a 3-hour GTT. Subjects were divided into four groups according to GCT and GTT results.&#x0D; &#x0D; Results: There was an impaired glucose tolerance in 19.2 % of patients and 14.7 % of them had mild glucose intolerance and 4.5 % of them had moderate glucose intolerance. As expected, there was statistically significant difference in fetal macrosomia, neonatal hypoglicemia, PE, primary CS, and preterm birth between secreening negative and GDM patients (p &lt; 0.0001). We also observed statistically significant difference in neonatal hypoglicemia (p = 0.0001) and PE (p = 0.0277) between screning negative and mild glucose intolerance group. Moreover, there was a significant difference in fetal macrosomia (p=0.0480) between mild glucose intolerance and moderate glucose intolerance groups.&#x0D; &#x0D; Conclusion: Compared with screening negative group, mild and moderate glucose intolerance are associated with increased adverse maternal and neonatal outcomes even in the absence of GDM.

The Comparison Of Chest X-Ray Changes Between Post-Covid-19-Infection Patients With Mild-Moderate Severity And Severe-Critical Severity At Ugm Academic Hospital

Introduction: Post-COVID-19 syndrome can be seen from the radiological findings on the chest X-ray (CXR). However, limited studies compared CXR changes in post-COVID-19 patients based on their severity. Methods: Thirty-three post-hospitalized COVID-19 patients who came to the Long COVID Clinic at UGM Academic Hospital were divided into mild-moderate and severe-critical groups. The CXR were taken during hospital admission, in the 4th week, and in the 8th week. CXR images were assessed with the Brixia Score method. Results: The Brixia score in the mild-moderate group (n = 17) and severe-critical (n = 16) group showed a trend of change, which increased in the 4th week and decreased in the 8th week. However, there were no significant changes between the two groups during hospital admission, in the 4th week, and in the 8th week. The Brixia score during hospital admission and in the 8th-week follow-up in the mild-moderate group was significantly lower than that of the severe-critical group. Clinically, the mean Brixia score in the mild-moderate group ranges from mild pneumonia, while the severe-critical group ranges from moderate pneumonia. Conclusion: There is no significant resolution of the CXR until the 8th-week follow-up in post-COVID-19 infection patients with mild-moderate and severe-critical severity. However, the CXR during hospital admission and the 8th week is better in post-COVID-19 infection patients with mild-moderate severity. Keywords: chest X-ray, COVID-19, infectious disease, post-COVID-19 syndrome, severity,

Serum neopterin, YKL-40, IL-6, and TNF-α in patients with obstructive sleep apnea

Objective: Obstructive Sleep Apnea (OSA) is characterized by recurrent episodes of complete or partial upper airway obstruction during sleep. The role of locally increased inflammation in the upper respiratory tract is known in the pathogenesis of OSA. This study aimed to examine the role of some inflammatory markers in OSA. Materials and Methods: Adult patients who underwent diagnostic polysomnography (PSG) for the first time, were evaluated in this prospective study. Serum levels of neopterin, human cartilage glycoprotein 39 (YKL-40), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) were examined in the study group. Results: The study included 165 adult patients. Individuals of 56 who were did not have OSA were taken as the control group. Patients diagnosed with OSA (n=109) were included in the study and divided into two groups mild-moderate and severe based on the OSA apnea-hypopnea index (AHI). The study groups were divided into 3 cathegories: AHI &lt;5 (control) Group 1, AHI 5-15 (mild), and AHI 15-30 (moderate) Group 2, AHI&gt;30 (severe) Group 3. Individuals of 165 who completed the study [Group 1 (n=56), Group 2 (n=69), Group 3 (n=40)] were included in the statistical evaluation. There was a significant difference between the groups in terms of neopterin, YKL-40, and IL-6 values (p&lt;0.05). The median value of IL-6 and neopterin measured in the severe group was significantly higher than the value measured in the control and mild-moderate groups (p&lt;0.001). The mean value of YKL-40 measured in the severe group was significantly higher than the value measured in the control group (p=0.012). No significant difference was observed in TNF-α serum levels of groups. Conclusion: Serum levels of neopterin, YKL-40, and IL-6 were found to be elevated in OSA patients (especially in the severe group).

Correlation of expression of silencing information regulator 2 related enzyme 1 and tumor necrosis factor-like weak inducer of apoptosis in articular effusion and knee osteoarthritis

To analyze the correlation between the expression of silencing information regulator 2 related enzyme 1 (SIRT1), tumor necrosis factor like weak inducer of apoptosis (TWEAK) and knee osteoarthritis. Total of 103 patients with knee joint (knee osteoarthritis group) from February 2019 to August 2021 were selected including 40 males and 63 females with an average age of (62.02±6.09) years;according to the modified Mankin score, 103 patients were divided into mild group (Mankin score 1-4 points, 31 cases) and moderate group (Mankin score 5-8 points, 40 cases) and severe group (Mankin score ≥9, 32 cases). Another 105 physical examination volunteers were selected as the control group including 46 males and 59 females with an average age of (62.11±6.34) years old. The levels of SIRT1 and TWEAK in articular effusion and serum were detected in the knee osteoarthritis group, while serum SIRT1 and TWEAK were detected in the control group only. The relationship between SIRT1, TWEAK and the occurrence and disease of knee osteoarthritis were analyzed. Articular cavity fluid TWEAK, serum TWEAK, CRP, IL-6, IL-1β, white blood cell count and ESR were higher than those in the control group(P<0.05), articular cavity fluid SIRT1 and serum SIRT1 were lower than those in the control group(P<0.05). TWEAK level in the severe group was higher than that in the moderate and mild groups(P<0.05), SIRT1 was lower than that in the moderate and mild groups (P<0.05). The level of SIRT1 in articular cavity effusion was positively correlated with the serum level of SIRT1 (P<0.05), and negatively correlated with CRP, IL-6, IL-1β, white blood cell count, modified Mankin score and ESR (P<0.05). TWEAK level in articular cavity fluid was positively correlated with serum TWEAK level (P<0.05), C-reactive protein(CRP), interleukin(IL)-6, IL-1β, white blood cell count, modified Mankin score and erythrocyte sedimentation rate(ESR) (P<0.05). Body mass index, undertaking heavy physical work, and articular cavity fluid TWEAK were risk factors for the occurrence of knee osteoarthritis(P<0.05), and articular cavity fluid SIRT1 was a protective factor for the occurrence of knee arthritis (P<0.05). The area under curve(AUC) of SIRT1 and TWEAK for knee osteoarthritis was 0.641 and 0.653, and the AUC of SIRT1 and TWEAK for knee osteoarthritis was 0.879, which was higher than SIRT1 and TWEAK alone (z=6.105 and 6.225, P<0.05). The level of SIRT1 in articular fluid in patients with knee arthritis is decreased and the level of TWEAK is increased. Low SIRT1 and high TWEAK are associated with the onset and exacerbation of knee osteoarthritis.

The Relationship Between the Expression of CRBN in Peripheral Blood and the Severity and Prognosis of Adult Sepsis.

To investigate the correlation between the expression of cereblon (CRBN) protein in peripheral blood and the severity and prognosis of sepsis. A total of 130 patients with sepsis admitted to our hospital were selected as the observation subjects (sepsis group). The patients were divided into mild group, moderate group and severe group according to their conditions. The patients were divided into survival group and death group according to their living conditions within 28 days after admission. 130 health individuals were selected as the control group. The levels of CRBN mRNA, CRP and PCT in peripheral blood were detected. The levels of serum CRBN mRNA, CRP, and PCT in patients with sepsis were higher than those in the control group (P<0.05); As the condition worsens, the levels of CRBN mRNA, CRP, and PCT gradually increase, and there are statistically significant differences among patients with mild, moderate, and severe sepsis; Correlation analysis showed that the expression of CRBN mRNA in sepsis patients was positively correlated with CRP, PCT levels, APACHE II score and SOFA score (P<0.05); the 28-day cumulative survival rate of patients with high CRBN mRNA expression was significantly lower than that of patients with low CRBN mRNA expression (P<0.05); compared with the survival group, the levels of serum CRBN mRNA, CRP and PCT in the death group were significantly higher (P<0.05); the AUC of death in sepsis patients diagnosed by CRBN mRNA, CRP and PCT was 0.961, the combined diagnostic efficacy was higher than that of single detection (P<0.05). The expression level of CRBN in the peripheral blood of patients with sepsis is increased, which is related to the severity and prognosis of the patients. The combination of CRP and PCT has certain diagnostic value for the death of sepsis patients.

Genetic Polymorphism in TNF-α Promoter Region: Its Association with Severity and Susceptibility to Rheumatoid Arthritis in Iraqi Patients with Active Disease

Objectives: To study the prevalence of rs1799964 (-1031 T/C) and rs361525 (- 238 G/A) SNPs and their effect on the disease activity, severity, and cytokines production in newly diagnosed Iraqi rheumatoid arthritis patients.&#x0D; Patients and Methods: sixty-three patients were diagnosed by a specialist physician while attending the rheumatology unit and twenty control participated. The inflammatory markers were measured and PCR amplification and sequencing were performed to demonstrate TNF-α SNPs.&#x0D; Results: Regarding (-1031 C/T) SNP, the TT genotype and allele C were significantly present in the controls, and the CT genotype was distributed significantly in the patients. The TT genotype was mostly distributed in the mild-moderate group, while the CT genotype and allele C were significantly distributed in the severe group. DAS28, TNF-α, IL-1, and ACPA were significantly associated with this SNP. While non-significant differences appeared in the analysis of -238 G/A SNP.&#x0D; Conclusion: The presence of the CT genotype and C allele of) -1031 C/T( was associated with susceptibility to RA. While the CT genotype and C allele were associated with more severe disease. Also, TT genotype was associated with less severe disease. Furthermore, an association between -1031 C/T and the inflammatory markers and DAS28 was reported.

Retrospective study on the correlation between serum MIF level and the condition and prognosis of patients with traumatic head injury.

This study aimed to investigate the correlation between serum levels of macrophage migration inhibitory factor (MIF) and the condition and prognosis of patients with traumatic brain injury (TBI). A retrospective study design was used, and the clinical data of 131 TBI patients from February 2019 to January 2022 were analyzed. Patients were divided into mild (13-15 points), moderate (9-12 points), or severe (3-8 points) groups according to their Glasgow Coma Scale (GCS) score after admission. The serum levels of BDNF, MIF, and MBP in the three groups were compared, and their correlation with the severity of TBI was analyzed. Patients were then separated into a good prognosis group (4-5 points) and a poor prognosis group (≤3 points) based on their Glasgow Prognostic Score (GOS) after 6 months of follow-up. The predictive power of serum indexes and combined detection on prognosis was analyzed. Patients were classified into a mild group (n = 63), moderate group (n = 47), and severe group (n = 21) based on their GCS, with a significant difference noted in serum levels of MIF, MBP, and BDNF among patients with different degrees of severity (all P < 0.001). The MIF, MBP, and BDNF levels were lower in the mild group compared to the moderate (all P < 0.001) and severe group (all P < 0.001). Additionally, the MIF and BDNF levels in the moderate group were lower compared to the severe group (P = 0.011, P = 0.002). Patients with mild severity had lower serum MIF, MBP, and BDNF levels than those with other degrees, and these indexes were positively correlated with the severity of TBI (all P < 0.001, r = 0.62, r = 0.48, r = 0.58). Based on the GOS, patients were divided into a good prognosis group (n = 107) and a poor prognosis group (n = 24), with the levels of MIF, MBP, and BDNF in the good prognosis group being significantly lower than those in the poor prognosis group (P < 0.001, P = 0.007, P = 0.003). The area under the curve (AUC) of MIF was higher than that of MBP and BDNF in predicting the prognosis of TBI patients; however, the statistical differences were not significant (MIF vs. MBP, P = 0.239; MIF vs. BDNF, P = 0.211; BDNF vs. MBP, P = 0.899). The center line has a large displacement, CT annular cisterna compression, increased white blood cell count, MBP and BDNF were risk factors for prognosis in TBI patients (P = 0.005, P = 0.001, P = 0.005, P = 0.033, P = 0.044). The serum levels of MIF, MBP, and BDNF in TBI patients were positively correlated with the severity of the disease, and MBP, BDNF levels had predictive value in determining patient prognosis.

Difference of urinary protein components and the correlation between urinary protein quantification and glomerular filtration rate in pregnant women with pre-eclampsia

Objective: To investigate the difference of urinary protein components in pregnant women with pre-eclampsia (PE) with different degrees of proteinuria and the correlation between 24-hour urinary protein quantification and estimated glomerular filtration rate (eGFR). Methods: Clinical data of 101 PE pregnant women who were delivered in Renji Hospital, Shanghai Jiao Tong University School of Medicine from July 2018 to June 2022 were retrospectively analyzed. According to 24-hour urinary protein quantification, they were divided into 3 groups, including 40 cases of mild proteinuria group (24-hour urinary protein quantification ≤2.0 g), 21 cases of moderate proteinuria group (2.0 g<24-hour urinary protein quantification ≤5.0 g), 40 cases of severe proteinuria group (24-hour urinary protein quantification >5.0 g). The general clinical data, urinary protein index and renal function index of PE pregnant women in 3 groups were compared. The eGFR was calculated based on age, serum creatinine (sCr), blood urea nitrogen (BUN) and serum albumin (sAlb). Correlation analysis was conducted between 24-hour urinary protein quantification and each index of eGFR. Results: (1) General clinical data: the median PE onset week (31 weeks) and delivery gestational week [(36.4±3.6) weeks] of PE pregnant women in the mild proteinuria group were later than those in the moderate proteinuria group [median PE onset: 22 weeks, delivery: (32.2±4.2) weeks] and severe proteinuria group [median PE onset: 25 weeks, delivery: (29.6±3.4) weeks]; systolic blood pressure, diastolic blood pressure, alanine aminotransferase, aspartate aminotransferase levels and the incidence of fetal growth restriction were lower than those in the moderate and severe proteinuria groups; median newborn birth weight (3 150 g) was higher than those in the moderate proteinuria group (1 305 g) and the severe proteinuria group (1 042 g), respectively. The differences were statistically significant (all P<0.05). (2) Urinary protein index: the 24-hour urinary protein quantification, urinary microalbumin (mAlb) and urinary transferrin (TRF) levels of PE pregnant women in the mild proteinuria group, moderate proteinuria group and severe proteinuria group were increased successively, and the differences were statistically significant (all P<0.05). The median urinary α1-microglobulin (α1-MG) level of PE pregnant women in the severe proteinuria group (50 mg/L) was significantly higher than those in the mild proteinuria group (17 mg/L) and moderate proteinuria group (22 mg/L; all P<0.05), but there was no significant difference between the mild proteinuria group and the moderate proteinuria group (P>0.05). There was no significant difference in the median urinary β2-microglobulin (β2-MG) level among the 3 groups (P=0.632). (3) Renal function index: sAlb and eGFR of PE pregnant women in the mild proteinuria group, moderate proteinuria group and severe proteinuria group were successively decreased, and BUN was successively increased, respectively, and the differences were statistically significant (all P<0.05). The sCr level of PE pregnant women in the severe proteinuria group was significantly higher than those in the mild proteinuria group and the moderate proteinuria group (all P<0.05), but there was no significant difference between the mild proteinuria group and the moderate proteinuria group (P>0.05). (4) Correlation analysis: the 24-hour urinary protein quantification of PE pregnant women was significantly negatively correlated with eGFR (r=-0.645, P<0.001), and was correlated with the variables sAlb (r=-0.549, P<0.001), sCr (r=0.582, P<0.001) and BUN (r=-0.657, P<0.001) in the eGFR calculation formula. The 24-hour urinary protein quantification were significantly negatively correlated with the gestational weeks of PE onset, gestational weeks of termination of pregnancy and newborn birth weight (all P<0.05). Conclusions: The protein composition in the urine of PE pregnant women with different degrees of proteinuria is not different, but the protein level is significantly different. There is a significant negative correlation between the increase of 24-hour urinary protein quantification and the decrease of eGFR.

P300 Event-Related Potential Predicts Cognitive Dysfunction in Patients with Vestibular Disorders.

Our aim was to determine the correlation between cognitive impairment and P300 event-related potential (ERP) in older adults with vertigo and imbalance, which further provides a reference for clinical diagnosis and patients' rehabilitation. A total of 79 older adult patients with vertigo and imbalance in our outpatient department from January 2022 to December 2022 were selected and divided into the mild group (n = 20), moderate group (n = 39), and severe group (n = 20) according to the Dizziness Handicap Inventory (DHI). The auditory P300 component of event-related potentials (ERPs), Generalized Anxiety Disorder Questionnaire-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Mini-Mental State Examination (MMSE) were used to evaluate depression, anxiety, and cognitive function in these patients, respectively. The P300 latencies of the different severity groups were 292 ± 10 ms, 301 ± 8 ms, and 328 ± 5 ms, respectively, and the differences were statistically significant (p = 0.010). The P300 amplitudes of the different severity groups were 14.4 ± 2.6 μV, 3.9 ± 0.8 μV, and 5.1 ± 1.4 μV, respectively, and the differences were also statistically significant (p = 0.004). There was no statistically significant difference in the DHI evaluation or VAS visual simulation scoring between the two groups (p = 0.625, and 0.878, respectively). Compared with the short-course group, the long-course group showed prolonged P300 latency and decreased amplitude, higher scores in PHQ-9 and GAD-7, and lower scores in MMSE, and all the differences were statistically significant (p = 0.013, 0.021, 0.006, 0.004, and 0.018, respectively). Older patients with more severe symptoms of vertigo and imbalance are at higher risk of developing abnormal cognitive function. The P300 can be used as an objective neurophysiological test for the assessment of cognitive function relevant to elderly patients with vertigo and imbalance.