Objective To explore the characteristics and the related factors of the lipid profiles in patients with ankylosing spondylitis (AS). Methods Sixty AS patients and 60 healthy controls were included retrospectively from January 2005 to January 2015. Information including general data, physical examination, and blood sample were collected; triacylglycerol (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), high-density lipoprotein cholesterol (HDL-C), and C-reactive protein (CRP) were assessed. Results TG increased in 46.7% (28/60) patients, and HDL-C decreased in 50.0% (30/60). Compared with the control group, AS patients had lower levels of HDL-C, TC and LDL-C, and higher levels of TG, VLDL-C, VLDL-C/LDL-C ratio, LDL-C/HDL-C ratio, and TC/HDL-C ratio; the differences above were all statistically significant (P<0.01). Spearman correlation test demonstrated that HDL-C level was correlated negatively with serum CRP (rs=–0.359, P=0.005). Multiple linear regression model demonstrated that CRP was associated with HDL-C in AS patients (P=0.019). Conclusions Dyslipoproteinemia is a common feature in AS patients. The main characteristic is the increase of TG and decrease of HDL-C, related with inflammation. It suggests a high risk of atherosclerosis.
Objective To investigate the effect of monocyte count to high density lipoprotein ratio (MHR) on early complications after off-pump coronary artery bypass grafting and to explore the predictive factors for early complications in patients after off-pump coronary artery bypass grafting. Methods The clinical data of patients who underwent simple off-pump coronary artery bypass grafting from October 2021 to September 2023 in our hospital were retrospectively analyzed. The patients were divided into a low value group and a high value group according to the median MHR value. The clinical data of the two groups were compared, and binary logistic regression analysis was used to explore the and predictors of atrial fibrillation (AF) and acute kidney injury (AKI) after coronary artery bypass grafting. Results A total of 220 patients were included, with a median MHR of 0.48. There were 108 patients in the low value group (MHR<0.48), including 71 males and 37 females, with an average age of 65.28±7.85 years. There were 112 patients in the high-value group (MHR≥0.48), including 84 males and 28 females, with an average age of 64.57±8.75 years. There was no statistical difference between the two groups in terms of general basic data such as gender or age (P>0.05). The incidence of postoperative AF and AKI in the high-value group was significantly higher than that in the low-value group (P<0.05), and no statistical difference in terms of other postoperative complications was observed. Binary logistic regression analysis showed that MHR was a risk factor for postoperative AKI and postoperative AF (P<0.05). Conclusion The study shows that MHR is a risk factor for new-onset AF and AKI after coronary artery bypass grafting.
Objective To identify independent risk factors for in-hospital all-cause mortality in patients with sepsis and to integrate them into the quick Sequential Organ Failure Assessment (qSOFA) score to construct modified models, thereby improving the ability of the original qSOFA to predict mortality risk. Methods This retrospective study included adult patients who met the Sepsis-3 criteria for sepsis and were admitted to the Intensive Care Unit or Emergency Intensive Care Unit of Zigong Fourth People’ s Hospital between January 2018 and December 2023. Demographic characteristics, vital signs, comorbidities, and laboratory parameters were collected, and the Sequential Organ Failure Assessment (SOFA) and qSOFA scores were calculated. Multivariable logistic regression analysis was used to identify independent predictors of in-hospital mortality. Independent predictors were dichotomized according to cut-off values derived from receiver operating characteristic (ROC) curves and combined with qSOFA to construct new models. The ROC analysis with bootstrap validation was used to assess predictive performance, and comparative performance was further evaluated using net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Results A total of 218 patients were included. Multivariable logistic regression analysis identified blood urea nitrogen (BUN) [odds ratio (OR)=1.100, 95% confidence interval (CI) (1.040, 1.170)] and qSOFA [OR=2.610, 95%CI (1.450, 4.920)] as independent risk factors for in-hospital mortality, whereas high-density lipoprotein cholesterol (HDL-C) was an independent protective factor [OR=0.250, 95%CI (0.065, 0.841)]. After dichotomization by ROC-derived cut-off values, BUN and HDL-C were incorporated into qSOFA to generate B-qSOFA, H-qSOFA, and BH-qSOFA. Bootstrap ROC analysis showed that BH-qSOFA exhibited the highest discriminatory ability compared with all combined models as well as the conventional SOFA and qSOFA scores [area under the curve=0.803, 95%CI (0.735, 0.863)]. NRI and IDI analyses demonstrated that BH-qSOFA provided incremental prognostic improvement over qSOFA (NRI=0.969, IDI=0.165), B-qSOFA (NRI=0.644, IDI=0.054), and H-qSOFA (NRI=0.804, IDI=0.091) (all P<0.05). Conclusions Elevated BUN and qSOFA and decreased HDL-C are independent predictors of in-hospital mortality in sepsis. The BH-qSOFA model is simple and clinically practical, exhibits superior predictive performance over the original qSOFA. It may serve as a useful early instrument for prognostic risk stratification in patients with sepsis.
目的 探討膿毒癥患者的病情預后與高密度脂蛋白（HDL）之間的關聯性。 方法 2008年3月1日－2010年2月28日選擇50例嚴重膿毒癥患者（膿毒癥組）和30例非膿毒癥的健康人（對照組），比較兩組急性生理學與慢性健康狀況評分Ⅱ（APACHEⅡ）和HDL水平。 結果 膿毒癥組的HDL水平為（1.10 ± 0.39）mmol/L，對照組HDL水平為（1.61 ± 0.42） mmol/L，兩組差異有統計學意義（t=6.786，P=0.000）。多因素非條件logistic回歸分析顯示，HDL水平（OR=0.877，P=0.025）和APACHEⅡ評分（OR=15.556，P=0.009）是影響膿毒癥患者患病程度的兩個有效獨立因素。 結論 膿毒癥能夠導致患者的脂代謝出現紊亂，HDL水平是評估膿毒癥患病程度的較好指標。
Objective To study endotoxin release induced by differential antibiotics in gram negative bacterial infection. Methods Thirty critical patients accompanied with gram negative bacterial infection were divided into group A (imipenem group, n=15) and group B (ceftazidine group, n=15). Imipenem (0.5 g iv q8h) and ceftazidine (1.0 g iv q8h) were given respectively. White blood cell (WBC), systolic blood pressure (SBP), lipopoly sacchride (LPS), tumor necrosis factor alpha (TNFα) and high density lipoprotein (HDL) were determined in 0, 1, 2, 3, 5 and 7 day. Results There was no difference in the change of WBC between two groups. Group A had a more stable SBP than group B. There was lower endotoxin release in group A than in group B and so were the cytokines release. HDL level was lower in group B than in group A. Conclusion Imipenem has lower endotoxinliberating potential than ceftazidine and mediate lower cytokines release. HDL may protect the patients from LPS damage.
Ｗｅ ｄｅｔｅｒｍｉｎｅｄ ｔｈｅ ｗｈｏｌｅ ｐｒｏｃｅｓｓ ｏｆ ｌｉｐｏｐｒｏｔｅｉｎ ｍｅｔａｂｏｌｉｓｍ ｄｕｒｉｎｇ ｔｈｅ ｆｏｒｍａｔｉｏｎ ｏｆ ｇａｌｌｓｔｏｎｅ ｉｎ ｒａｂｂｉｔ ｍｏｄｅｌ ｏｆ ｃａｌｃｉｕｍ ｂｉｌｉｒｕｂｉｎａｔｅ ｃｈｏｌａｎｇｉｏｌｉｔｈｉａｓｉｓ．Ｔｈｅ ｍａｉｎ ｒｅｓｕｌｔｓ ｉｎｃｌｕｄｅｄ：ｔｈｅ ｃｏｎｃｅｎｔｒａｔｉｏｎｓ ｏｆ ｆｒｅｅ ｃｈｏｌｅｓｔｅｒｏｌ ａｎｄ ＨＤＬ３ｃｈｏｌｅｓｔｅｒｏｌ ｏｂｖｉｏｕｓｌｙ ｉｎｃｒｅａｓｅｄ ｉｎ ａｌｌ ｅｘｐｅｒｉｍｅｎｔａｌ ｇｒｏｕｐｓ ｗｈｉｌｅ ＨＤＬｃｈｏｌｅｓｔｅｒｏｌ，ＨＤＬ２ｃｈｏｌｅｓｔｅｒｏｌ ｄｅｃｒｅａｓｅｄ，ｔｈｅ ａｃｔｉｖｉｔｉｅｓ ｏｆ ｌｅｃｉｔｈｉｎｃｈｏｌｅｓｔｅｒｏｌ ａｃｙｔｒａｎｓｆｅｒａｓｅ（ＬＣＡＴ） ａｎｄ ｔｈｅ Ｂｍａｘ ｏｆ ＨＤＬｒｅｃｅｐｔｏｒ ｉｎ ｈｅｐａｔｉｃ ｃｅｌｌ ｃｅｎｔｒａｔｉｏｎｓ ｏｆ ｇｌｙｃｏｃｈｏｌｉｃ ａｃｉｄ，ｇｌｙｃｏｄｅｏｘｙｃｈｄｉｃ ａｃｉｄ ａｎｄ ｔｏｔａｌ ｂｉｌｅ ａｃｉｄ ｉｎ ｔｈｅ ｂｉｌｅ ｄｅｃｒｅａｓｅｄ ｏｂｖｉｏｕｓｌｙ ｉｎ ｅｘｐｅｒｉｍｅｎｔａｌ ｇｒｏｕｐｓ，ｔｈｅ ｌｅｖｅｌｓ ｏｆ ＬＤＬｃｈｏｌｅｓｔｅｒｏｌ，ｖＬＤＬｃｈｏｌｅｓｔｅｒｏｌ ｉｎ ｔｈｅ ｓｅｒｕｍ ａｎｄ ｔｏｔａｌ ｃｈｏｌｅｓｔｅｒｏｌ，ｔｒｉｇｌｙｃｅｒｉｄｅ ｉｎ ｔｈｅ ｈｅｐａｔｉｃ ｔｉｓｓｕｅ ｗｅｒｅ ｎｏｔ ｓｉｇｎｉｆｉｃａｎｔ ｄｉｆｆｅｒｅｎｃｅｓ ｉｎ ａｌｌ ｇｒｏｕｐｓ．Ａｃｃｏｒｄｉｎｇ ｔｏ ｔｈｅ ａｂｏｖｅ ｒｅｓｕｌｔｓ，ｉｔ ｍａｙ ｂｅ ｃｏｎｃｌｕｄｅｄ ｔｈａｔ：ｔｈｅｒｅ ｗｅｒｅ ｄｉｓｏｒｄｅｒｓ ｏｆ ｒｅｄｕｃｅｄ ＨＤＬ ｂｉｏｓｙｎｔｈｅｓｉｓ ａｎｄ ｉｔｓ ｍａｔｕｒｅ ｐｒｏｃｅｓｓ ｃａｕｓｅｄ ｂｙ ｄｅｃｒｅａｓｉｎｇ ｏｆ ＬＣＡＴ ａｃｔｉｖｉｔｙ ｄｕｒｉｎｇ ｔｈｅ ｆｏｒｍａｔｉｏｎ ｏｆ ｔｈｅ ｇａｌｌｓｔｏｎｅｓ ｃａｕｓｅｄ ｂｙ ｔｈｅ ｂｉｌｅ ｄｕｃｔ ｏｂｓｔｒｕｃｔｉｏｎ ａｎｄ ｉｎｆｅｃｔｉｏｎ．Ｍｅａｎｗｈｉｌｅ，ｔｈｅ Ｂｍａｘ ｏｆ ｔｈｅ ＨＤＬｒｅｃｅｐｔｏｒ ｏｆ ｔｈｅ ｈｅｐａｔｉｃ ｃｅｌｌ ｍｅｍｂｒａｎｅ ｄｅｃｒｅａｓｅｄ．Ｔｈｅｒｅｆｏｒｅ，ｔｈｅｒｅ ｗｅｒｅ ｄｉｓｏｒｄｅｒｓ ｏｆ ｒｅｖｅｒｓｅ ｃｈｏｌｅｓｔｅｒｏｌ ｔｒａｎｓｐｏｒｔ ｉｎ ｍａｎｙ ａｓｐｅｃｔｓ．Ｔｈｅｓｅ ｆａｃｔｏｒｓ ｔｏｇｅｔｈｅｒ ｗｉｔｈ ｏｔｈｅｒ ｌｉｔｈｏｇｅｎｉｃ ｅｌｅｍｅｎｔｓ ｐｒｏｂａｂｌｙ ｐｒｏｍｏｔｅ ｔｈｅ ｆｏｒｍａｔｉｏｎ ｏｆ ｔｈｅ ｃａｌｃｉｕｍ ｂｉｌｉｒｕｂｉｎａｔｅ ｇａｌｌｓｔｏｎｅｓ．
Objective In order to study the mechanism of cholesterol gallstone formation through rabbit model which was induced by high cholesterol diet (HCD)Methods the activities of the high density lipoprotein receptor (HDLR) and low density lipoprotein receptor (LDLR) of hepatocytes were investigated. Results The results were as follows: The HDLR activity increased significantly after taking HCD for one week, at the same time, the LDLR activity only increased slightly. Thereafter, the activities of HDLR and LDLR all decreased markedly. As the time of animals taking HCD went on, serum total cholesterol, LDL cholesterol and hepatic cholesterol increased, but bile acids of biliary tract decreased gradually. Conclusion The results suggest that the changes of HDLR and LDLR activities of hepatocytes had no significant effect on bile cholesterol and the decreased HDLR and LDLR activities may cause the reduction some of substrate for bile acids synthesise and play an important role in the formation of gallstone.
ObjectiveTo evaluate the relationship between low density lipoprotein cholesterol (LDL-C)/high density lipoprotein cholesterol (HDL-C) of preoperation (L/H value for short) and the pathological staging of colorectal cancer. MethodsThe clinical data of 187 patients with colorectal cancer who treated in PLA General Hospital from July 2009 to June 2014 were analyzed retrospectively. ResultsThere were statistical significance in L/H value among different TNM stagings, N stagings, and M stagings (P<0.05):L/H value of TNM Ⅳ staging was higher than those of TNM Ⅰ, Ⅱ, and Ⅲ staging, L/H values of N1 staging and N0 staging were lower than that of N2 staging, L/H value of M1 staging was higher than that of M0 staging. However, there was no statistical significance in L/H value among different T stagings of colorectal cancer (P>0.05). Logistic regression results showed that L/H value were positively associated with TNM staging (OR=4.34, 95% CI:2.837-6.644, P<0.000 1), T staging (OR=1.72, 95% CI:1.175-2.512, P=0.005 3), N staging (OR=2.15, 95% CI:1.422-3.254, P=0.000 3), and M staging (OR=3.04, 95% CI:1.733-5.332, P=0.000 1) of colorectal cancer, and patient with higher L/H value took more risk of progression of tumor, lymph node metastases, and distant metastasis. ConclusionsRaise of preoperative L/H value is an independent risk factor for the progression of TNM staging, T staging, N staging, and M staging in colorectal cancer.
ObjectiveTo discuss the relationship between microalbuminuria (MAU) and antioxidant activity of plasma hyper density lipoprotein (HDL) in hypertensive patients, and investigate whether MAU could be a predictor of HDL antioxidant activity. MethodFrom December 2007 to March 2009, sixty consecutive primary hypertensive patients from the inpatient and outpatient departments of West China Hospital and Sichuan Electric Power Central Hospital were included in the study, and 30 healthy volunteers served as controls. MAU, plasma HDL and paraoxonase (PON1) activity were tested. ResultsPON1 activity was lower in hypertensive patients than the controls (P<0.05), and this degree of decline was positively related to MAU (P<0.05). ConclusionMAU reflects PON1 activity in hypertensive patients and can be a predictor to judge plasma HDL function in patients with hypertension.
Objective To investigate the correlation between the uric acid to high-density lipoprotein cholesterol ratio (UHR) and the presence of atherosclerotic stenosis in both intracranial and extracranial arteries among patients who have experienced cerebral infarction. Methods Patients with cerebral infarction admitted to the Department of Neurology of Sichuan Provincial People’s Hospital between January 2021 and June 2024 were retrospective selected. According to the digital subtraction angiography (DSA) performance, patients were divided into cerebral atherosclerotic stenosis group and no cerebral atherosclerotic stenosis group. According to the location of atherosclerotic stenosis, patients were divided into extracranial atherosclerotic stenosis group, intracranial atherosclerotic stenosis group, intracranial and extracranial atherosclerotic stenosis group. According to the severity of atherosclerotic stenosis, patients were divided into mild group, moderate group and severe group. Clinical data and laboratory indicators were collected. Multifactorial regression was used to analyze the risk factors, Spearman correlation analysis was used to evaluate the relationship between UHR and the degree of stenosis, and the predictive value of UHR for intracranial and extracranial atherosclerotic stenosis was analyzed by the receiver operating characteristic curve. Results A total of 388 patients were included. Among them, 291 cases in cerebral atherosclerotic stenosis group and 97 cases in no cerebral atherosclerotic stenosis group; 85 cases in the intracranial atherosclerotic stenosis group, 123 cases in the extracranial atherosclerotic stenosis group, and 83 cases in the intracranial and extracranial atherosclerotic stenosis group; There were 104 cases in the mild group, 81 cases in the moderate group, and 106 cases in the severe group. The results of multiple logistic regression analysis showed that age, hypertension, UHR and uric acid were independent influencing factors associated with atherosclerotic stenosis of intracranial and extracranial arteries. Furthermore, the uric acid and UHR were also risk factors for the degree of stenosis (P<0.05). Spearman correlation analysis results showed that UHR was positively correlated with the degree of stenosis (r=0.516, P < 0.001). Receiver operating characteristic curve showed that the predictive value of UHR (area under the curve was 0.724) was superior to that of uric acid (area under the curve was 0.638) or HDL-C (area under the curve was 0.709). It also showed good predictive value for stenosis in different locations of intracranial and extracranial arteries. Conclusion UHR is an independent risk factor for intracranial and extracranial atherosclerotic stenosis with notabla predictive value