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Imatinib-induced severe hematological toxicity: Prolonged myelosuppression resulting from extraordinary sensitivity in an old age 伊马替尼诱导的严重血液学毒性:老年人异常敏感导致的长期骨髓抑制
IF 0.7 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-02-15 DOI: 10.1177/1721727x231158468
Jia Xu, B. Ju, X. Yang, Nuan-Nuan Xiu, Xi-Chen Zhao
The advent of tyrosine kinase inhibitors (TKIs) has profoundly changed the therapeutic landscape of chronic myeloid leukemia (CML) in the chronic phase (CML-CP). Imatinib is the first-generation, and the first and as yet the most widely used TKI, and the recommended dose is 400 mg/day for treating CML-CP. Most patients tolerate this treatment well, and prolonged hematological toxicities have rarely been reported. In this manuscript, we report a newly diagnosed CML-CP patient who developed prolonged myelosuppression (lasting for more than three months) following only one week of imatinib at 400 mg/day as the solitary treatment. Imatinib was discontinued, and pancytopenia persisted, with a continuous decrease in hemoglobulin levels. After restoration of autologous hematopoiesis, reintroduction of imatinib at 100 mg/day resulted in recurrent myelosuppression, and subsequent treatment with imatinib at 50 mg/day achieved good hematological homeostasis. We hypothesized that extraordinary sensitivity resulted in severe and prolonged myelosuppression.
酪氨酸激酶抑制剂(TKIs)的出现深刻地改变了慢性粒细胞白血病(CML)慢性期(CML-CP)的治疗格局。伊马替尼是第一代,也是第一种也是迄今为止使用最广泛的TKI,治疗CML-CP的推荐剂量为400 mg/天。大多数患者都能很好地耐受这种治疗,而且很少报道长期的血液毒性。在这份手稿中,我们报告了一名新诊断的CML-CP患者,他在单独治疗伊马替尼400 mg/天仅一周后就出现了长期骨髓抑制(持续三个月以上)。伊马替尼停用,全血细胞减少症持续存在,血球蛋白水平持续下降。自体造血恢复后,再次引入100mg/天的伊马替尼导致复发性骨髓抑制,随后用50mg/天的伊马替尼治疗实现了良好的血液稳态。我们假设异常敏感会导致严重和长期的骨髓抑制。
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引用次数: 0
The impacts of SphK1 on inflammatory response and oxidative stress in LPS-induced ALI/ARDS SphK1对LPS诱导的ALI/ARDS炎症反应和氧化应激的影响
IF 0.7 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-02-13 DOI: 10.1177/1721727x231158310
Wei Chao-shun, Wang Xiao-Li
As severe conditions, acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) threaten human health. Inflammation and oxidative stress play a vital role in the pathogenesis of ALI/ARDS. Sphingosine kinase 1 (SphK1) significantly contributes to mediating inflammatory responses. Nevertheless, the impact of SphK1 on lipopolysaccharide (LPS)-triggered ALI/ARDS remains largely undetermined. In our current work, we explored the impact of SphK1 on ALI/ARDS using a mouse model. We studied whether it could reduce LPS-triggered inflammatory response and oxidative stress by suppressing SphK1 in ALI/ARDS. The mice were treated with the inhibitor of SphK1 (N,N-dimethylsphingosine, DMS) before intraperitoneal injection of LPS. Moreover, we assessed the survival rate, and several parameters, such as the lung wet/dry (W/D) ratio, myeloperoxidase (MPO) activity, superoxide dismutase (SOD) activity, malondialdehyde (MDA) content, and the release of inflammatory cytokines. Western blotting analysis was adopted to evaluate the levels of phosphoinositide 3-kinase (PI3K)/serine/threonine kinase (AKT) pathways. We showed that the inhibitor of SphK1 not only ameliorated LPS-stimulated lung histopathological changes and W/D ratio of lung tissue but also elevated the survival rate, the SOD activity and decreased the MDA content, MPO activity, interleukin-6 (IL-6) and tumor necrosis factor-ɑ (TNF-ɑ) production by regulating the PI3K/AKT signaling pathway in lung tissue. Taken together, SphK1 played an essential role in inflammatory responses and oxidative stress. The underlying mechanism might be linked to the activation and up-regulation of the PI3K/AKT signaling pathway in LPS-triggered ALI/ARDS.
急性肺损伤(ALI)和急性呼吸窘迫综合征(ARDS)是危害人类健康的严重疾病。炎症和氧化应激在ALI/ARDS的发病机制中起着至关重要的作用。鞘氨醇激酶1(SphK1)显著参与介导炎症反应。然而,SphK1对脂多糖(LPS)触发的ALI/ARDS的影响在很大程度上尚未确定。在我们目前的工作中,我们使用小鼠模型探讨了SphK1对ALI/ARDS的影响。我们研究了它是否可以通过抑制ALI/ARDS中的SphK1来减少LPS引发的炎症反应和氧化应激。在腹膜内注射LPS之前,用SphK1抑制剂(N,N-二甲基鞘氨醇,DMS)处理小鼠。此外,我们评估了存活率和几个参数,如肺湿/干(W/D)比、髓过氧化物酶(MPO)活性、超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量和炎性细胞因子的释放。采用蛋白质印迹分析来评估磷酸肌醇3-激酶(PI3K)/丝氨酸/苏氨酸激酶(AKT)途径的水平。我们发现,SphK1抑制剂通过调节肺组织PI3K/AKT信号通路,不仅改善了LPS刺激的肺组织病理学变化和肺组织W/D比,而且提高了存活率、SOD活性,降低了MDA含量、MPO活性、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的产生。总之,SphK1在炎症反应和氧化应激中发挥着重要作用。其潜在机制可能与LPS触发的ALI/ARDS中PI3K/AKT信号通路的激活和上调有关。
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引用次数: 0
A cross-sectional study of systemic lupus erythematosus patients complicated with infection 系统性红斑狼疮并发感染的横断面研究
IF 0.7 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-02-12 DOI: 10.1177/1721727x231157336
Hang Yu, Qinwen Wen, Xiaolu Zhang, Xiudi Wu
The purpose of this study was to determine the prevalence and influencing factors of systemic lupus erythematosus (SLE) patients complicated with infection having multi-system involvement and to analyze the influencing factors of early CMV and fungal infection. We conducted a cross-sectional study of hospitalized SLE patients complicated with infection. Participants had an average age of 44.80 ± 17.30, with 152 being female (89.94%). Clinical data and laboratory results were collected from medical records. Receiver operating characteristic (ROC) curves were plotted, and sensitivity and specificity were calculated. Univariate analysis showed that systemic lupus erythematosus disease activity index-2000 (SLEDAI-2k), red blood cell, platelets, hemoglobin, lymphocytes, IgG, IgM, C3, C4, albumin and globulin were significantly associated with SLE patients with infection complicated with multi-system involvement. After multivariable analysis, the following variables remained significant: Hemoglobin, CD4 lymphocyte, IgM and SM ( p < 0.05). ROC curve analysis showed the areas under the curve of Hb, CD4 count, and IgM for the differential diagnosis of SLE with infection complicated with multisystem involvement being 0.646, 0.627, and 0.610. Then, the sensitivities of 73.3%, 53.3%, and 73.3% were observed with the specificities of 54.1%, 69.7%, and 48.6%, respectively. Our results demonstrated that hemoglobin, CD4 lymphocyte value, IgM and anti SM antibody had significant value in monitoring multi-system involvement in SLE patients complicated with infection. Besides, intrinsic lymphatic count disturbances associated with SLE disease can cause infections by opportunistic pathogens such as fungi.
本研究旨在确定系统性红斑狼疮(SLE)患者并发多系统感染的患病率和影响因素,并分析早期CMV和真菌感染的影响因素。我们对合并感染的住院SLE患者进行了横断面研究。参与者的平均年龄为44.80±17.30岁,其中152人为女性(89.94%)。临床数据和实验室结果来自医疗记录。绘制受试者操作特征(ROC)曲线,计算敏感性和特异性。单因素分析显示,系统性红斑狼疮疾病活动指数-2000(SLEDAI-2k)、红细胞、血小板、血红蛋白、淋巴细胞、IgG、IgM、C3、C4、白蛋白和球蛋白与SLE合并感染多系统受累患者显著相关。多变量分析后,血红蛋白、CD4淋巴细胞、IgM和SM等变量仍有显著性差异(p<0.05)。ROC曲线分析显示,Hb、CD4计数和IgM曲线下面积分别为0.646、0.627和0.610。然后,敏感性分别为73.3%、53.3%和73.3%,特异性分别为54.1%、69.7%和48.6%。我们的研究结果表明,血红蛋白、CD4淋巴细胞值、IgM和抗SM抗体在监测SLE合并感染患者的多系统受累方面具有重要价值。此外,与系统性红斑狼疮相关的固有淋巴计数紊乱可引起真菌等机会性病原体的感染。
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引用次数: 0
Comparative study of virulence factor genes, β-hemolysis and biofilm production in invasive and colonizing enterococci 侵袭性和定植性肠球菌毒力因子基因、β-溶血和生物膜产生的比较研究
IF 0.7 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-02-07 DOI: 10.1177/1721727x231156333
M. Jovanović, B. Velebit, T. Tošić, Gina Maki, S. Pavić, S. Jovanović, R. Stošović, M. Zervos
Objectives: In humans, enterococci are among the most important opportunistic pathogens. This study aims to compare invasive isolates obtained from blood cultures of patients with sepsis and endocarditis with colonizing isolates obtained from healthy donors’ stool samples. Methods: A case-by-case assessment was conducted on invasive infection cases to determine whether enterococci were involved in their pathogenesis. They were tested for the presence of virulence factor genes, β-hemolysis on agars supplemented with human and sheep blood, and biofilm forming capacity. Results: Three species of enterococci were identified among invasive isolates: Enterococcus faecalis, Enterococcus faecium, and Enterococcus durans. All endocarditis isolates were biofilm producers. Genes esp, gelE, asa1, ace, hyl, cylB, and cylA were present in 7 (41.2%), 11 (64.7%), 11 (64.7%), 13 (76.5%), 0, 3 (17.6%), and 1 (5.9%) invasive isolate, but none of them could be linked to a particular infection (sepsis or endocarditis). Colonizing isolates proved to have had more virulence factor genes, but the differences were not statistically significant. Members of that group produced a greater amount of biofilm when the ace gene was absent ( p = 0.047). The production of β-hemolysis by noninvasive strains was detected more frequently when agar was supplemented with human blood ( p = 0.021). In general, the presence of either cyl gene on that specific agar was in direct connection with the production of β-hemolysis: cylA ( p = 0.047) or cylB ( p = 0.020). Conclusion: We have been unable to establish any correlation between invasive isolates and any virulence gene carriage and biofilm formation. β-hemolysis was produced significantly more often by colonizing strains when agar had been supplemented with human blood.
目的:在人类中,肠球菌是最重要的机会性病原体之一。本研究旨在比较从败血症和心内膜炎患者的血液培养中获得的侵袭性分离株与从健康捐赠者粪便样本中获得的定植性分离株。方法:对侵袭性感染病例进行个案评估,以确定肠球菌是否参与了其发病机制。他们测试了毒力因子基因的存在、补充人血和羊血的琼脂的β-溶血作用以及生物膜形成能力。结果:在入侵分离株中鉴定出三种肠球菌:粪肠球菌、粪肠球菌和硬脑膜肠球菌。所有的心内膜炎分离物都是生物膜产生者。esp基因、gelE基因、asa1基因、ace基因、hyl基因、cylB基因和cylA基因分别存在于7个(41.2%)、11个(64.7%)、11(64.7%,13个(76.5%)、0个、3个(17.6%)和1个(5.9%)侵袭性分离株中,但它们都与特定感染(败血症或心内膜炎)无关。菌落分离株被证明具有更多的毒力因子基因,但差异无统计学意义。当ace基因缺失时,该组成员产生了更多的生物膜(p=0.047)。当琼脂补充人血时,非侵入性菌株产生β-溶血的频率更高(p=0.021)。一般来说,cyl基因在该特异性琼脂上的存在与β-溶血的产生直接相关:cylA(p=0.047)或cylB(p=0.020)。结论:我们无法确定侵袭性分离株与任何毒力基因携带和生物膜形成之间的任何相关性。当琼脂补充人血时,定植菌株更容易产生β溶血。
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引用次数: 0
The function and regulation of CCAAT/enhancer binding protein ε CCAAT/增强子结合蛋白ε的功能及调控
IF 0.7 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-01-30 DOI: 10.1177/1721727x231153322
Shao-yong Cheng, Jian Yang, Yudie Wang, Lina Xian, Zhihua Hu, Lingyun Zou
In recent years, studies on the structure, function, and regulation of the C/EBPε gene have become an essential topic in the field of many diseases. CCAAT/enhancer-binding protein ε (C/EBPε) is the fifth member of the transcription factor CCAAT/C/EBP family of transcription factors. It plays crucial roles in cell proliferation, differentiation, immunity, energy metabolism, and hematopoiesis. C/EBPε plays essential roles in regulating the hematopoietic system, including myeloid cell development and maturation, participation in the body’s immune responses, and prevention of infections. C/EBPε function is regulated by phosphorylation, acetylation, methylation, and other types of genes. This review related to C/EBPε structure, function and regulation provides a theoretical basis for subsequent research in this area. C/EBPε is an emerging therapeutic target and thus provides new strategies for disease prevention and control.
近年来,对C/EBPε基因的结构、功能和调控的研究已成为许多疾病领域的重要课题。CCAAT/增强子结合蛋白ε (C/EBPε)是转录因子CCAAT/C/EBP家族的第五个成员。它在细胞增殖、分化、免疫、能量代谢和造血中起着至关重要的作用。C/EBPε在调节造血系统中发挥重要作用,包括髓细胞的发育和成熟、参与机体的免疫反应和预防感染。C/EBPε的功能受磷酸化、乙酰化、甲基化和其他类型基因的调控。本文对C/EBPε的结构、功能及调控进行综述,为该领域的后续研究提供理论基础。C/EBPε是一个新兴的治疗靶点,为疾病的预防和控制提供了新的策略。
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引用次数: 0
Pancreatic Beta-cell Dysfunction in Type 2 Diabetes 2型糖尿病胰腺β细胞功能障碍
IF 0.7 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-01-30 DOI: 10.1177/1721727x231154152
P. Khin, J. H. Lee, H. Jun
Pancreatic β-cells produce and secrete insulin to maintain blood glucose levels within a narrow range. Defects in the function and mass of β-cells play a significant role in the development and progression of diabetes. Increased β-cell deficiency and β-cell apoptosis are observed in the pancreatic islets of patients with type 2 diabetes. At an early stage, β-cells adapt to insulin resistance, and their insulin secretion increases, but they eventually become exhausted, and the β-cell mass decreases. Various causal factors, such as high glucose, free fatty acids, inflammatory cytokines, and islet amyloid polypeptides, contribute to the impairment of β-cell function. Therefore, the maintenance of β-cell function is a logical approach for the treatment and prevention of diabetes. In this review, we provide an overview of the role of these risk factors in pancreatic β-cell loss and the associated mechanisms. A better understanding of the molecular mechanisms underlying pancreatic β-cell loss will provide an opportunity to identify novel therapeutic targets for type 2 diabetes.
胰腺β细胞产生并分泌胰岛素以维持血糖水平在一个狭窄的范围内。β-细胞的功能和质量缺陷在糖尿病的发生发展中起着重要作用。2型糖尿病患者胰岛β细胞缺乏和β细胞凋亡增加。在早期阶段,β细胞适应胰岛素抵抗,其胰岛素分泌增加,但最终耗尽,β细胞质量减少。高糖、游离脂肪酸、炎性细胞因子和胰岛淀粉样多肽等多种因素可导致β细胞功能受损。因此,维持β细胞功能是治疗和预防糖尿病的一种合乎逻辑的方法。在这篇综述中,我们概述了这些危险因素在胰腺β细胞损失中的作用及其相关机制。更好地了解胰腺β细胞损失的分子机制将为确定2型糖尿病的新治疗靶点提供机会。
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引用次数: 3
Clinical significance of vascular endothelial growth factor and endothelin-1 in serum levels as novel indicators for predicting the progression of diabetic nephropathy 血清血管内皮生长因子和内皮素-1作为预测糖尿病肾病进展的新指标的临床意义
IF 0.7 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-01-26 DOI: 10.1177/1721727x231151526
Wei-Ming Chu, Linlin Ma, Bin-Xian Li, Ming-Cheng Li
Objective: Early diagnosis and intervention of diabetic nephropathy (DN) is necessary to optimize therapy in order to delay the progression of diabetes. This research aimed to reveal the change of vascular endothelial growth factor (VEGF) and endothelin-1 (ET-1) in patients with DN, and to assess possible correlations with glycated hemoglobin (HbAlc) values. Methods: The present study was a retrospective, single-center study conducted at a teaching hospital in the northeast China. A total of 120 patients were divided into proteinuria-positive group ( n = 40), the microalbuminuria group ( n = 40), and the high proteinuria group ( n = 40) according to the urinary albumin excretion rate (UAER), and 40 healthy volunteers were selected as the control group. The levels of VEGF, ET-1 and HbA1c were measured in all subjects and principal component analysis (PCA) was performed to classify and reveal correlations between VEGF, ET-1 and HbA1c. Results: Compared to the control group, a significant difference in the increase of HbA1c was detected in group I, II and III. A significant increase in the concentrations of serum VEGF and ET-1 was also observed. HbA1c in DN patients had proven to be positively correlated with VEGF (r = 0.7941; p < 0. 0001) and ET-1 (r = 0.8504; p < 0.0001) respectively. Conclusion: The elevated levels of VEGF and ET-1 in serum have been proposed as being able to supplement the additional information about the progression of DN. These data suggest that the decrease in endothelial function may be related to poor glycemic control.
目的:糖尿病肾病(DN)的早期诊断和干预是优化治疗以延缓糖尿病进展的必要条件。本研究旨在揭示DN患者血管内皮生长因子(VEGF)和内皮素-1(ET-1)的变化,并评估其与糖化血红蛋白(HbAlc)值的可能相关性。方法:本研究是在中国东北某教学医院进行的单中心回顾性研究。根据尿白蛋白排泄率(UAER)将120例患者分为蛋白尿阳性组(n=40)、微量白蛋白尿组(n=40%)和高蛋白尿组(n=40),并选择40名健康志愿者作为对照组。测量所有受试者的VEGF、ET-1和HbA1c水平,并进行主成分分析(PCA)来分类和揭示VEGF、ET-1HbA1c之间的相关性。结果:与对照组相比,I、II和III组的HbA1c升高有显著差异。血清VEGF和ET-1浓度也有显著升高。DN患者HbA1c与VEGF呈正相关(r=0.7941。0001)和ET-1(r=0.8504;p<0.0001)。结论:血清中VEGF和ET-1水平的升高被认为能够补充有关DN进展的额外信息。这些数据表明,内皮功能的下降可能与血糖控制不佳有关。
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引用次数: 0
Maximum amplitude and mean platelet volume in the blood as biomarkers to detect lung adenocarcinoma cancer featured with ground-glass nodules 血液中血小板最大振幅和平均体积作为检测以磨玻璃结节为特征的肺腺癌的生物标志物
IF 0.7 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-01-17 DOI: 10.1177/1721727x231151530
Hao Feng, Gaigai Huang, Boxiong Cao, Ziliang Zan, Q. Wei
The development and progression of malignancies are closely linked to hypercoagulability. As an early type of lung adenocarcinoma, ground glass nodules (GGNs) have been detected increasingly. Blood Maximum amplitude (MA) and mean platelet volume (MPV) are related to various conditions of hypercoagulability. Therefore, the role of MA and MPV in diagnosing lung adenocarcinoma cancer featured with GGNs was investigated in this case-control study. The analyzed data of this study is derived from GGNs patients and healthy individuals in West China (Airport) Hospital Sichuan University. The differences between GGNs patients and healthy individuals were determined by one-way ANOVA, logistic regression or chi-squared test. The accuracy of diagnostic was performed by receiver operating characteristic curve (ROC). The relative mRNA expressions were studied by RT-qPCR. 470 patients diagnosed with GGNs which benign lesions (BN group) are inflammatory and malignant lesions (LC group) are adenocarcinoma in stage IA, and 235 healthy subjects (HC group) were enrolled in this study. Levels of MA and MPV were increased in LC group compared with BN and HC group ( p < 0.001, p < 0.001). When we combined MA and MPV, MA and MPV presented a sensitivity (SEN) of 0.809 and a specificity (SPE) of 0.774. And the area under the curve (AUC) increased to 0.871 (0.837–0.900) when confidence interval was 95%. This study demonstrates that there have been systemic changes in coagulation disorders in the pathogenesis of GGNs. The diagnostic ability to different lung adenocarcinoma cancer featured with GGNs from benign or healthy controls can be improved by the combination of MA and MPV. Maximum amplitude and MPV may be used as biomarkers to detect lung adenocarcinoma cancer featured with GGNs.
恶性肿瘤的发生和发展与高凝性密切相关。作为肺腺癌的早期类型,磨玻璃结节(ggn)越来越多地被发现。血液最大振幅(MA)和平均血小板体积(MPV)与各种高凝状态有关。因此,本病例对照研究探讨了MA和MPV在诊断以ggn为特征的肺腺癌中的作用。本研究的分析数据来源于四川大学华西(机场)医院的ggn患者和健康人群。ggn患者与健康个体的差异采用单因素方差分析、logistic回归或卡方检验。采用受试者工作特征曲线(ROC)评价诊断的准确性。RT-qPCR检测相对mRNA表达量。本研究纳入470例诊断为ggn的患者,其中良性病变(BN组)为炎症,恶性病变(LC组)为IA期腺癌,健康受试者(HC组)235例。LC组MA、MPV水平较BN、HC组升高(p < 0.001, p < 0.001)。当我们将MA和MPV结合使用时,MA和MPV的敏感性(SEN)为0.809,特异性(SPE)为0.774。当置信区间为95%时,曲线下面积(AUC)增加至0.871(0.837 ~ 0.900)。本研究表明,凝血功能障碍在ggn发病机制中发生了全身性变化。MA和MPV联合检测可提高对不同类型肺腺癌的诊断能力。最大振幅和MPV可作为检测以ggn为特征的肺腺癌的生物标志物。
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引用次数: 0
Effects of statin on hypertension patients: A systematic review and meta-analysis 他汀类药物对高血压患者的影响:系统综述和荟萃分析
IF 0.7 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-01-11 DOI: 10.1177/1721727x221144454
J. Wan, Min Chen
To conduct a systematic review and meta-analysis to compare the effects of statins and placebo on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients with hypertension. We used different databases such as MEDLINE and the Cochrane Library Central Register of Controlled Trials (CENTRAL) to search for randomized controlled trials published from 1 January 2000 to 1 January 2022 to retrieve relevant studies and full-text articles evaluating statins versus placebo in patients with hypertension. Data were taken from eligible studies. The included articles also performed Cochran’s Q statistics, forest plots, funnel plots, Egger’s test, and sensitivity analyses. This study included 8 studies with a total of 3086 patients. We sought to assess patients' SBP and DBP. The results were expressed as mean differences (MD) with 95% confidence intervals. There was no difference in DBP between the statin and placebo groups (MD = 2.48, 95% CI [−2.00, 6.96], p = .28, random effects model). In terms of SBP, the statin group was superior to the placebo group (MD = 4.37, 95% CI [0.72, 8.02], p = .02, random-effects model). Sensitivity analyses and funnel plots showed that our study was robust, with low publication bias. The results show that statins could be clinically more effective than placebo in patients with hypertension.
进行系统综述和荟萃分析,比较他汀类药物和安慰剂对高血压患者收缩压(SBP)和舒张压(DBP)的影响。我们使用MEDLINE和Cochrane Library Central Register of Controlled Trials(Central)等不同数据库搜索2000年1月1日至2022年1月31日发表的随机对照试验,以检索评估高血压患者他汀类药物与安慰剂的相关研究和全文文章。数据取自符合条件的研究。纳入的文章还进行了Cochran的Q统计、森林图、漏斗图、Egger检验和敏感性分析。本研究包括8项研究,共3086名患者。我们试图评估患者的收缩压和舒张压。结果用95%置信区间的平均差(MD)表示。他汀类药物组和安慰剂组之间的DBP没有差异(MD=2.48,95%CI[-2.00,6.96],p=.28,随机效应模型)。就SBP而言,他汀类药物组优于安慰剂组(MD=4.37,95%CI[0.72,8.02],p=0.02,随机效应模型)。敏感性分析和漏斗图显示,我们的研究是稳健的,发表偏倚低。研究结果表明,他汀类药物在高血压患者中的临床疗效可能比安慰剂更高。
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引用次数: 0
Neutrophilia and its correlation with increased inflammatory response in COVID-19 in diabetic and pre-diabetic patients 糖尿病和糖尿病前期患者新冠肺炎中性粒细胞增多及其与炎症反应增加的相关性
IF 0.7 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-01-09 DOI: 10.1177/1721727X221150338
Hayaa M. Alhuthali, M. Almehmadi, E. F. Ataya, Hind A. Alzahrani, Amani A. Alrehaili, Maha M. Bakhuraysah, F. Alsaeedi, A. Alsaiari, M. M. Khalifa, A. Gharib
Background: Hyperglycemic patients are at a high risk of COVID-19 severity. Neutrophils have been considered critical effector cells in COVID-19 development. Vitamin D deficiency is prevalent in hyperglycemic patients and was found to adversely associate with the neutrophil count. Aim: The goal of this work was to evaluate the characteristics of diabetic and pre-diabetic COVID-19 patients and discovered changes in neutrophils and their correlation, if any, with disease clinical presentation. Patients and Methods: The study included total of (514) Covid-19 positive patients confirmed by PCR and recruited from the Prince Mohammad Bin Abdulaziz Hospital in Riyadh, Saudi Arabia. Patient’s clinical characteristics were collected for all patients. Laboratory tests include HbA1c, neutrophil count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), ferritin, D- dimer, 25 hydroxy vitamin D (25(OH)D), and folate. Results: The results found that 286 patients (55.6%) were diabetic, 77 patients (15%) were pre-diabetic and 151 (29.4%) were normoglycaemic. A significant difference was exhibited regarding the neutrophil count and inflammatory factors of COVID-19 severity. Furthermore, the neutrophil count was found to be directly correlated with the severity monitoring biochemical markers for Covid-19: CRP, ESR, ferritin, and D-dimer and inversely associated with vitamin D levels in diabetic and pre-diabetic patients. Conclusion: Our findings highlight the change of neutrophils in COVID-19 diabetic and pre-diabetic patients that was found to correlate positively with CRP, ESR, ferritin, and D-dimer, and negatively with 25(OH)D, but their correlation with the clinical presentation of the disease need further large investigations.
背景:高血糖患者是新冠肺炎严重程度的高危人群。中性粒细胞被认为是新冠肺炎发展中的关键效应细胞。维生素D缺乏症在高血糖患者中普遍存在,并被发现与中性粒细胞计数有关。目的:这项工作的目的是评估糖尿病和糖尿病前期新冠肺炎患者的特征,并发现中性粒细胞的变化及其与疾病临床表现的相关性(如果有的话)。患者和方法:该研究共包括(514)名经PCR确诊的新冠肺炎阳性患者,这些患者来自沙特阿拉伯利雅得的穆罕默德·本·阿卜杜勒阿齐兹亲王医院。收集所有患者的临床特征。实验室测试包括HbA1c、中性粒细胞计数、C反应蛋白(CRP)、红细胞沉降率(ESR)、铁蛋白、D-二聚体、25-羟基维生素D(25(OH)D)和叶酸。结果:糖尿病286例(55.6%),糖尿病前期77例(15%),血糖正常151例(29.4%)。中性粒细胞计数和新冠肺炎严重程度的炎症因子存在显著差异。此外,发现中性粒细胞计数与新冠肺炎严重程度监测生化标志物:CRP、ESR、铁蛋白和D-二聚体直接相关,与糖尿病和糖尿病前期患者的维生素D水平呈负相关。结论:我们的研究结果突出了新冠肺炎糖尿病患者和糖尿病前期患者中性粒细胞的变化,发现中性粒细胞与CRP、ESR、铁蛋白和D-二聚体呈正相关,与25(OH)D呈负相关,但其与疾病临床表现的相关性需要进一步深入研究。
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引用次数: 0
期刊
European Journal of Inflammation
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