Chronic low-grade inflammation is a major contributor to both the onset and advancement of type 2 diabetes mellitus(T2DM),and its associated microvascular complications,including diabetic nephropathy,retinopathy,and p...Chronic low-grade inflammation is a major contributor to both the onset and advancement of type 2 diabetes mellitus(T2DM),and its associated microvascular complications,including diabetic nephropathy,retinopathy,and peripheral neuropathy.This review aims to overview the roles of high sensitivity C-reactive protein(hs-CRP),C-reactive protein(CRP),CRP-to-lymphocyte count ratio(CLR),and the CRP-to-albumin ratio(CAR)as biomarkers for assessing systemic inflammation and predicting the development and severity of diabetic chronic microvascular complications.Elevated levels of CRP and hs-CRP have been consistently associated with increased risk of these complications,reflecting ongoing inflammatory processes that contribute to endothelial dysfunction and tissue damage.Furthermore,CAR and CLR,which combine CRP with albumin and lymphocyte counts respectively,offer a more nuanced understanding of the inflammatory and immune response in T2DM patients.While individual studies have demonstrated the clinical relevance of these biomarkers in predicting disease onset and progression,further investigation is needed to establish their utility in clinical practice.This review highlights the potential of these biomarkers for enhancing early detection,risk stratification,and personalized management of diabetic patients,ultimately aiming to improve outcomes and reduce the burden of diabetic chronic microvascular complications.展开更多
BACKGROUND Gastric cancer is the most common malignancy of the digestive system and surgical resection is the primary treatment.Advances in surgical technology have reduced the risk of complications after radical gast...BACKGROUND Gastric cancer is the most common malignancy of the digestive system and surgical resection is the primary treatment.Advances in surgical technology have reduced the risk of complications after radical gastrectomy;however,post-surgical pancreatic fistula remain a serious issue.These fistulas can lead to abdominal infections,anastomotic leakage,increased costs,and pain;thus,early diagnosis and prevention are crucial for a better prognosis.Currently,C-reactive protein(CRP),procalcitonin(PCT),and total bilirubin(TBil)levels are used to predict post-operative infections and anastomotic leakage.However,their predictive value for pancreatic fistula after radical gastrectomy for gastric cancer remains unclear.The present study was conducted to determine their predictive value.AIM To determine the predictive value of CRP,PCT,and TBil levels for pancreatic fistula after gastric cancer surgery.METHODS In total,158 patients who underwent radical gastrectomy for gastric cancer at our hospital between January 2019 and January 2023 were included.The patients were assigned to a pancreatic fistula group or a non-pancreatic fistula group.Multivariate logistic analysis was conducted to assess the factors influencing development of a fistula.Receiver operating characteristic(ROC)curves were used to determine the predictive value of serum CRP,PCT,and TBil levels on day 1 postsurgery.RESULTS On day 1 post-surgery,the CRP,PCT,and TBil levels were significantly higher in the pancreatic fistula group than in the non-pancreatic fistula group(P<0.05).A higher fistula grade was associated with higher levels of the indices.Univariate analysis revealed significant differences in the presence of diabetes,hyperlipidemia,pancreatic injury,splenectomy,and the biomarker levels(P<0.05).Logistic multivariate analysis identified diabetes,hyperlipidemia,pancreatic injury,CRP level,and PCT level as independent risk factors.ROC curves yielded predictive values for CRP,PCT,and TBil levels,with the PCT level having the highest area under the curve(AUC)of 0.80[95%confidence interval(CI):0.72-0.90].Combined indicators improved the predictive value,with an AUC of 0.86(95%CI:0.78-0.93).CONCLUSION Elevated CRP,PCT,and TBil levels predict risk of pancreatic fistula post-gastrectomy for gastric cancer.展开更多
BACKGROUND Inflammatory cytokines are associated with cancer prognosis,but their specific role in cholangiocarcinoma remains poorly understood.The lymphocyte to C-reactive protein ratio(LCR),a novel inflammatory-nutri...BACKGROUND Inflammatory cytokines are associated with cancer prognosis,but their specific role in cholangiocarcinoma remains poorly understood.The lymphocyte to C-reactive protein ratio(LCR),a novel inflammatory-nutritional biomarker,has demonstrated predictive value in gastrointestinal cancers;however,its clinical relevance in cholangiocarcinoma has not been investigated.AIM To validate the LCR as an independent prognostic factor for overall survival(OS),surgical site infection(SSI),and length of hospital stay in patients with resectable cholangiocarcinoma.METHODS We conducted a retrospective analysis of 76 patients with cholangiocarcinoma who underwent radical surgery between 2008 and 2013.The preoperative LCR was calculated as the lymphocyte count divided by C-reactive protein level,using a cutoff value of 180.Univariate and multivariate logistic regression analyses were performed to evaluate factors associated with SSI and hospitalization duration,while Kaplan-Meier survival curves and Cox proportional hazards models were used to assess predictors of OS.RESULTS Patients in the low LCR group was significantly associated with several adverse clinical outcomes:A shorter median OS(14.93 months vs 46.67 months;P=0.022);a 4.5-fold increased risk of prolonged hospitalization(P=0.007);and a higher incidence of SSI(odds ratio=4.41,P=0.045).Multivariate analysis confirmed that LCR was an independent predictor of OS[hazard ratio(HR)=3.204,P=0.002],SSI,and hospitalization duration.Additionally,R0 resection(HR=3.546,P=0.002)and advanced tumor-node-metastasis stage(HR=2.016,P=0.035)were identified as independent prognostic factors for OS.CONCLUSION In this retrospective study,preoperative LCR is a cost-effective and practical biomarker that independently predicts OS,postoperative complications,and hospitalization duration in patients with resectable cholangiocarcinoma,thereby facilitating more precise patient stratification.展开更多
Background:Bacterial pneumonia continues to be a significant global health concern,particularly among high-risk groups,necessitating the development of precise and early diagnostic biomarkers.While the efficacy of pro...Background:Bacterial pneumonia continues to be a significant global health concern,particularly among high-risk groups,necessitating the development of precise and early diagnostic biomarkers.While the efficacy of procalcitonin(PCT)and C-reactive protein(CRP)as inflammatory markers is widely recognized,their relative diagnostic performance across different age groups remains debate.This meta-analysis was designed to assess the diagnostic accuracy of PCT and CRP in bacterial pneumonia.Methods:In this meta-analysis adhering to PRISMA guidelines,we searched PubMed,Web of Science,and the Cochrane Library for relevant diagnostic accuracy studies.From 19 included studies(n=2,603),data were extracted to construct tables.Study quality was assessed with the QUADAS-2 tool.The bivariate random-effects model was employed to derive pooled sensitivity,specificity,positive and negative likelihood ratios,and summary AUCs.To explore the substantial heterogeneity(I^(2)>80%),we performed pre-specified subgroup analyses based on age demographics.Results:Our findings indicate superior diagnostic performance for PCT,evidenced by a pooled sensitivity of 0.8841 and specificity of 0.8499,relative to CRP’s sensitivity of 0.8371 and specificity of 0.7185.The area under the ROC curve(AUC)for PCT was 0.992,a value significantly higher than that of CRP(0.987).Intriguingly,subgroup analyses revealed age-dependent variations:CRP demonstrated enhanced diagnostic utility in minors,while PCT proved substantially more effective in non-elderly adults.Conclusion:These results reinforce the clinical relevance of PCT as a more dependable biomarker for bacterial pneumonia,particularly in informing antibiotic treatment and mitigating misuse.This study uniquely includes age-stratified analyses based on predefined groups(minors and non-elderly adults),providing refined insights for individualized diagnostic approaches.We propose further multicenter research endeavors to confirm threshold optimization and explore combined biomarker strategies.展开更多
The advancement of various types of fluorescent nanoparticles is crucial for enhancing the application of lateral flow immunoassays(LFIA)across multiple fields.Currently,the fluorescent nanoparticles utilized in LFIA ...The advancement of various types of fluorescent nanoparticles is crucial for enhancing the application of lateral flow immunoassays(LFIA)across multiple fields.Currently,the fluorescent nanoparticles utilized in LFIA predominantly consist of traditional dye-doped nanoparticles or aggregation-induced luminescence dye-doped nanoparticles.The reliance on specific types of nanoparticles limits the diversity of signal reporting groups available for LFIA.Herein,we developed a solid-state luminescent dye-doped nanoparticles(SLDNPs)-based LFIA system with exceptional stability for the detection of C-reactive protein(CRP)in serum.The synthesis of SLD_(520)NP_(S)was simplicity,efficient and eco-friendly,which was ideal for large-scale production of the LFIA test strip.And the SLD_(520)NP_(S)exhibits superior fluorescence quantum yield(49%),fully guarantees the performance of the LFIA test strip.The constructed SLD_(520)NPsm Ab1-based LFIA demonstrated a satisfactory linear relationship with CRP concentrations ranging from 0.5 ng/mL to 100 ng/mL,with limits of detection(LOD)of 0.78 ng/mL and a visible LOD of 1 ng/mL using a handheld 405 nm lamp.Furthermore,the developed LFIA exhibited excellent recoveries in serum,ranging from 94.45%to 102.5%.Overall,the outstanding performance of the SLD_(520)NPs-mAb1-based LFIA indicates that solid-state luminescent dyes have significant potential applications in the field of LFIA.展开更多
Background and Objective Inflammation plays a pivotal role in the progression of coronary artery disease(CAD).High-sensitivity C-reactive protein(hsCRP)serves as a well-established biomarker for assessing cardiovascul...Background and Objective Inflammation plays a pivotal role in the progression of coronary artery disease(CAD).High-sensitivity C-reactive protein(hsCRP)serves as a well-established biomarker for assessing cardiovascular inflammation risk.However,the specific intestinal microbiota alteration contributing to increased inflammation remains unclear.Therefore,the present study investigated the correlation between the intestinal microbiota and inflammation in patients with unstable angina(UA).Methods A cohort of 92 patients with UA was recruited for this study.The plasma hsCRP level was measured via a CardioPhase hsCRP assay,fecal samples were collected after admission,and 16S rRNA sequencing was conducted to identify the fecal microbial profile.The participants were classified into two groups according to the median hsCRP level(1.11 mg/L).The composition of the fecal microbiota was compared between patients with hsCRP≥1.11 mg/L and those with hsCRP<1.11 mg/L.Additionally,the correlations between the fecal microbiota and clinical characteristics were analyzed.Results A notable reduction in the relative abundance of Akkermansia was observed in patients with hsCRP≥1.11 mg/L,whereas the diversity of the fecal microbiota was not significantly different between patients with hsCRP≥1.11 mg/L and those with hsCRP<1.11 mg/L.Furthermore,the abundance of Akkermansia was negatively correlated with hsCRP levels.Conclusion This study suggested a significant association between decreased levels of Akkermansia and inflammatory risk in patients with UA.These findings underscore the potential role of the intestinal microbiota in contributing to inflammation in UA patients.Further work is needed on the mechanism by which the microbiota contributes to inflammatory risk.展开更多
BACKGROUND Gastric cancer,a globally prevalent malignant tumor,continues to exhibit high incidence and mortality rates.Although radical gastrectomy remains the primary treatment for this disease,postoperative complica...BACKGROUND Gastric cancer,a globally prevalent malignant tumor,continues to exhibit high incidence and mortality rates.Although radical gastrectomy remains the primary treatment for this disease,postoperative complications frequently arise,negatively impacting short-term recovery and significantly reducing patients’quality of life.In this context,accurately predicting the risk of postoperative recurrence and metastasis,coupled with targeted interventions,could substantially improve patient outcomes.The C-reactive protein-triglyceride-glucose index(CTI),a composite biomarker that integrates metabolic disturbances and systemic inflammation,has garnered increasing attention in oncology.The prognostic nutritional index(PNI),a composite measure based on serum albumin and peripheral blood lymphocyte count,is used to evaluate both the nutritional status and systemic immune function of patients.In recent years,both the CTI and PNI have demonstrated significant prognostic value in predicting tumor outcomes,assessing treatment responses,and formulating personalized treatment strategies.AIM To investigate whether the combined inflammation and insulin resistance marker,the CTI,can serve as a prognostic indicator for patients undergoing radical gastrectomy for gastric cancer.Additionally,it seeks to develop a predictive model by incorporating the PNI alongside CTI.METHODS This retrospective study included a total of 300 patients who underwent radical gastrectomy.The patients were classified into high and low CTI groups based on their CTI index.Cox proportional hazards regression analysis was performed to identify independent prognostic factors influencing overall survival(OS)and disease-free survival(DFS),and two nomogram models were developed.RESULTS Of the included patients,131 had a high CTI and 169 had a low CTI.The DFS period of the low CTI group was significantly longer than that of the high CTI group.The number of postoperative adjuvant treatments,T stage,N stage,CTI,and PNI were identified as independent prognostic factors for DFS.The hazard ratio for CTI was 2.07(95%confidence interval:1.36-3.17,P<0.001).In terms of OS,the OS period of the low CTI group was significantly longer than that of the high CTI group.Whether adjuvant treatment was administered,T stage,CTI,and PNI were independent prognostic factors for OS.The hazard ratio for CTI was 2.47(95%confidence interval:1.44-4.23,P=0.001).The nomogram models for OS and DFS further emphasized the importance of CTI as a key predictor of patient prognosis.CONCLUSION CTI is a long-term prognostic indicator for the outcome of radical gastrectomy for gastric cancer.Patients with lower CTI values have a better prognosis.The prediction models constructed by combining CTI with PNI has good predictive ability for DFS and OS after radical gastrectomy.展开更多
BACKGROUND Acute-on-chronic liver failure(ACLF)is a life-threatening syndrome associated with high short-term mortality.Accurate risk stratification is crucial for the mana-gement of ACLF.AIM To evaluate the prognosti...BACKGROUND Acute-on-chronic liver failure(ACLF)is a life-threatening syndrome associated with high short-term mortality.Accurate risk stratification is crucial for the mana-gement of ACLF.AIM To evaluate the prognostic value of the C-reactive protein to albumin ratio(CAR)and its dynamic changes in patients with ACLF defined by the Chinese Group on Study of Severe Hepatitis B(COSSH)criteria.METHODS A total of 126 consecutive patients diagnosed with COSSH-ACLF were pros-pectively enrolled.CAR was calculated at admission and on days 4,7,and 14.The primary and secondary outcomes were 28-day and 90-day mortality,respectively.Multivariate Cox regression analysis was conducted to identify independent predictors of mortality.A novel prognostic model(COSSH-CAR),integrating baseline and dynamic variables,was developed and compared with established prognostic scoring systems.RESULTS The 28-day and 90-day mortality rates were 27.8%and 40.5%,respectively.Baseline CAR was significantly higher in 28-day non-survivors than in survivors(2.68 vs 1.42,P<0.001).The dynamic change in CAR from baseline to day 7(ΔCAR-7)showed stronger predictive power for 28-day mortality[area under the receiver operating characteristic curve(AUC)=0.765]than baseline CAR(AUC=0.698),ΔCAR-4(AUC=0.706)orΔCAR-14(AUC=0.712).Multivariate analysis identifiedΔCAR-7(HR=1.53),baseline Model for End-Stage Liver Disease-Sodium(MELD-Na)score(HR=1.08),and hepatic encephalopathy grade(HR=1.92)as independent predictors of 28-day mortality(all P<0.05).The COSSH-CAR model,which incorporated these parameters,showed superior predictive performance(AUC=0.832)for 28-day mortality compared with established prognostic scores,including Child-Pugh(AUC=0.721),MELD-Na(AUC=0.768)and COSSH-ACLF(AUC=0.786)and effectively stratified patients into three risk categories with significantly different survival rates(P<0.001).CONCLUSION Dynamic changes in CAR during the first week provide important prognostic information in patients with COSSH-ACLF,surpassing baseline values and conventional inflammatory markers.The novel COSSH-CAR model improves risk stratification and may support clinical decision-making in the management of ACLF,pending ex-ternal validation in diverse populations.展开更多
AIM:To determine the differences in levels of systemic C-reactive protein(CRP)in patients with geographic atrophy(GA)and sex-based differences in CRP levels.METHODS:Blood samples from patients with GA and controls wer...AIM:To determine the differences in levels of systemic C-reactive protein(CRP)in patients with geographic atrophy(GA)and sex-based differences in CRP levels.METHODS:Blood samples from patients with GA and controls were collected in a prospective age-related macular degeneration(AMD)registry from August 2014 to June 2021.AMD was confirmed using multimodal imaging and the Beckman and Consensus of Atrophy Meeting criteria for GA.High-sensitivity serum CRP levels were measured using an automated nephelometer.A non-parametric(rank-based)linear regression model was fit with an interaction between sex and GA.RESULTS:There were 97 GA patients and 139 controls,with females comprising 55%and 66%of each cohort,respectively.There is no difference in CRP between cases and controls,with a median(interquartile range)of 1.2(0.6-2.6)mg/L in GA patients versus 1.3(0.8–2.9)mg/L in controls(P=0.52).Although females had higher CRP levels compared to males in both the GA and control groups,this difference did not reach statistical significance after adjustment for multiple comparisons.CONCLUSION:There is no significant difference in systemic CRP levels between GA cases and controls.展开更多
Objective:To analyze the diagnostic value of combined testing of C-reactive protein(CRP)and procalcitonin(PCT)in elderly patients with bacterial pneumonia.Methods:This study included 50 elderly patients with bacterial...Objective:To analyze the diagnostic value of combined testing of C-reactive protein(CRP)and procalcitonin(PCT)in elderly patients with bacterial pneumonia.Methods:This study included 50 elderly patients with bacterial pneumonia as the observation group and 50 patients with non-bacterial pneumonia as the control group,recruited from May 2022 to October 2023.Fasting venous blood samples were collected in the morning from all 100 participants.CRP levels were measured using a fully automated biochemical analyzer,while PCT levels were detected using the immunoturbidimetric luminescence method.Results:CRP and PCT levels were significantly higher in bacterial pneumonia patients[(98.25±11.59)mg/L and(3.57±1.35)μg/L,respectively]compared to the control group[(5.55±2.78)mg/L and(0.25±0.12)μg/L,respectively],with significant intergroup differences(P<0.05).Patients with severe bacterial pneumonia exhibited higher serum CRP and PCT levels compared to those with moderate or mild disease(P<0.05).The combined testing of CRP and PCT showed higher sensitivity and specificity than individual tests.In the observation group,CRP and PCT levels significantly decreased after treatment compared to pre-treatment levels.Conclusion:The combination of CRP and PCT testing provides high diagnostic accuracy for bacterial pneumonia in elderly patients.It effectively differentiates bacterial from non-bacterial infections,offering valuable data to guide clinical treatment.展开更多
Objectives To investigate the morphologic characteristics of intramural hematoma(IMH)on CT angiography(CTA),and evaluate the possible correlation of serum C-reactive protein(CRP)with morphologic characteristics of IMH...Objectives To investigate the morphologic characteristics of intramural hematoma(IMH)on CT angiography(CTA),and evaluate the possible correlation of serum C-reactive protein(CRP)with morphologic characteristics of IMH.Material and Methods Forty-two patients who were initially diagnosed as IMH by aortic CTA and also had serum CRP examination on the same day of CTA were enrolled in this retrospective study,including 30 males and 12 females,with the mean age of 61±14 years old.The volumetric CT data were retrospectively processed and analyzed on post-processing workstation.Based on the thickness of IMH and the length-area curve,the crosssectional area of true lumen and total vessel were measured,the hematoma-vessel ratio(HVR)was calculated.Imaging characteristics were compared between patients who had pathological elevated CRP(>0.8 mg/dl)and those did not.Spearman correlation analyses of CRP level and morphological characteristics of IMH were performed,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic validity of CRP.Results Of all 42 IMH patients,the mean serum CRP was 3.94±4.71 mg/dl,and the mean HVR was 46.7%±14.2%.HVR in patients with elevated CRP was significantly higher than those with normal CRP(49.7%±15.0%vs.40.7%±10.5%,P=0.030).HVR was mildly correlated with CRP in all patients(r=0.48,P<0.001).CRP levels differed neither between patients with Stanford type A and B(P=0.207),nor between patients with and without intimal disruption(P=0.230).To discriminate HVR>47%(the mean value),the area under curve(AUC)were 0.700(95%CI:0.535-0.865)for CRP at a cutoff point of 3.55 mg/dl,with a sensitivity of 54.5%and a specificity of 90.0%.Conclusion CRP was mildly correlated with the severity of cross-sectional hematoma area of IMH,but not with Stanford types and the presence of intimal disruption.展开更多
Objective C-reactive protein(CRP)/albumin ratio(CAR)is a new inflammation-based index for predicting the prognosis of various diseases.The CAR determined on admission may help to predict the prognostic value of multip...Objective C-reactive protein(CRP)/albumin ratio(CAR)is a new inflammation-based index for predicting the prognosis of various diseases.The CAR determined on admission may help to predict the prognostic value of multiple trauma patients.Methods A total of 264 adult patients with severe multiple trauma were included for the present retrospective study,together with the collection of relevant clinical and laboratory data.CAR,CRP,albumin,shock index and ISS were incorporated into the prognostic model,and the receiver operating characteristic(ROC)curve was drawn.Then,the shock index for patients with different levels of CAR was analyzed.Finally,univariate and multivariate logistic regression analyses were performed to identify the independent risk factors for the 28-day mortality of multiple trauma patients.Results A total of 36 patients had poor survival outcomes,and the mortality rate reached 13.6%.Furthermore,after analyzing the shock index for patients with different levels of CAR,it was revealed that the shock index was significantly higher when CAR was≥4,when compared to CAR<2 and 2≤CAR<4,in multiple trauma patients.The multivariate logistic analysis helped to identify the independent association between the variables CAR(P=0.029)and shock index(P=0.019),and the 28-day mortality of multiple trauma patients.Conclusion CAR is higher in patients with severe multiple trauma.Furthermore,CAR serves as a risk factor for independently predicting the 28-day mortality of multiple trauma patients.The shock index was significantly higher when CAR was≥4 in multiple trauma patients.展开更多
Background Increased levels of inflammatory markers have been documented in various settings of coronary artery disease. The vulnerability of coronary lesions in acute myocardial infarction(AMI) at the time of onset m...Background Increased levels of inflammatory markers have been documented in various settings of coronary artery disease. The vulnerability of coronary lesions in acute myocardial infarction(AMI) at the time of onset may be related to serum levels of C reactive protein(CRP) on admission, before CRP levels are affected by myocardial damage.Objective This study assessed the predictive value of CRP levels within six hours after the onset of acute anterior myocardial infarction with primary percutaneous coronary intervention(PCI).Methods The plasma CRP of 76 patients with first acute anterior myocardial infarction was measured within 6 hours after onset. They were divided into 2 groups: group 1( n =20) with elevated CRP( ≥0.3mg/dl ) on admission within 6 hours after onset and group 2( n =56) with normal CRP( <0.3mg/dl ) within 6 hours after onset. All patients were treated by primary PCI. The primary combined end points, including death due to cardiac causes, re MI related to the infarction artery(RIA) and repeat intervention of the RIA, and the restenosis rate were assessed in relation to CRP levels within 6 hours after onset. Left ventricular end diastolic volume index(EDVI),end systolic volume index(ESVI),and ejection fraction(EF) on admission and 6 month after the onset were assessed by left ventriculography. Changes in EDVI(ΔEDVI),ESVI(ΔESVI), and EF(ΔEF) were obtained by subtracting respective on admission values from corresponding 6 month follow up values. Results There were no significant differences in baseline characteristics between the two groups. The primary combined end points were significantly more frequent in group 1(20%) than those in group 2( 1.79% , P <0.01 ).In addition, restenosis rates were significantly higher in group 1 than in group 2(41.18% vs 16.07%, P<0.05). Group 1 showed greater increases in left ventricular volume and less improvement in EF compared with group 2(ΔEDVI 6.31 ±2.17 vs 3.29 ±9.46ml/m 2 , ΔESVI 5.92 ±2.31 vs 3.86 ±1.08ml/m 2 , ΔEF 1.92 ±0.47 vs 4.79 ±1.73% , P <0.05 , respectively).Conclusions CRP levels within 6 hours after the onset of AMI might predict adverse outcome after primary PCI and progressive ventricular remodeling within 6 month of AMI.展开更多
BACKGROUND:Serum C-reactive protein(CRP) increases and albumin decreases in patients with inflammation and infection.However,their role in patients with acute pancreatitis is not clear.The present study was to investi...BACKGROUND:Serum C-reactive protein(CRP) increases and albumin decreases in patients with inflammation and infection.However,their role in patients with acute pancreatitis is not clear.The present study was to investigate the predictive significance of the CRP/albumin ratio for the prognosis and mortality in acute pancreatitis patients.METHODS:This study was performed retrospectively with 192 acute pancreatitis patients between January 2002 and June 2015.Ranson scores,Atlanta classification and CRP/albumin ratios of the patients were calculated.RESULTS:The CRP/albumin ratio was higher in deceased patients compared to survivors.The CRP/albumin ratio was positively correlated with Ranson score and Atlanta classification in particular and with important prognostic markers such as hospitalization time,CRP and erythrocyte sedimentation rate.In addition to the CRP/albumin ratio,necrotizing pancreatitis type,moderately severe and severe Atlanta classification,and total Ranson score were independent risk factors of mortality.It was found that an increase of 1 unit in the CRP/albumin ratio resulted in an increase of 1.52 times in mortality risk.A prediction value about CRP/albumin ratio >16.28 was found to be a significant marker in predicting mortality with 92.1% sensitivity and 58.0% specificity.It was seen that Ranson and Atlanta classification were higher in patients with CRP/albumin ratio >16.28 compared with those with CRP/albumin ratio ≤16.28.Patients with CRP/albumin ratio >16.28 had a 19.3 times higher chance of death.CONCLUSION:The CRP/albumin ratio is a novel but promising,easy-to-measure,repeatable,non-invasive inflammationbased prognostic score in acute pancreatitis.展开更多
AIM:To find a possible relationship between inflammation and CA19-9 tumor marker by analyzing data from patients with benign jaundice(BJ) and malignant jaundice(MJ).METHODS:All patients admitted for obstructive jaundi...AIM:To find a possible relationship between inflammation and CA19-9 tumor marker by analyzing data from patients with benign jaundice(BJ) and malignant jaundice(MJ).METHODS:All patients admitted for obstructive jaundice,in the period 2005-2009,were prospectively enrolled in the study,obtaining a total of 102 patients.On admission,all patients underwent complete standard blood test examinations including C-reactive protein(CRP),bilirubin,CA19-9.Patients were considered eligible for the study when they presented obstructive jaundice confirmed by instrumental examinations and increased serum bilirubin levels(total bilirubin > 2.0 mg/dL).The standard cut-off level for CA19-9 was 32 U/mL,whereas for CRP this was 1.5 mg/L.The CA19-9 level was adjusted by dividing it by the value of serum bilirubin or by the CRP value.The patients were divided into 2 groups,MJ and BJ,and after the adjustment a comparison between the 2 groups of patients was performed.Sensitivity,specificity and positive predictive values were calculated before and after the adjustment.RESULTS:Of the 102 patients,51 were affected by BJ and 51 by MJ.Pathologic CA19-9 levels were found in 71.7% of the patients.In the group of 51 BJ patients there were 29(56.9%) males and 22(43.1%) females with a median age of 66 years(range 24-96 years),whereas in the MJ group there were 24(47%) males and 27(53%) females,with a mean age of 70 years(range 30-92 years).Pathologic CA19-9 serum level was found in 82.3% of MJ.CRP levels were pathologic in 66.6% of the patients with BJ and in 49% with MJ.Bilirubin and CA19-9 average levels were significantly higher in MJ compared with BJ(P = 0.000 and P = 0.02),while the CRP level was significantly higher in BJ(P = 0.000).Considering a CA19-9 cut-off level of 32 U/mL,82.3% in the MJ group and 54.9% in the BJ group were positive for CA19-9(P = 0.002).A CA19-9 cut-off of 100 U/mL increases the difference between the two groups:35.3% in BJ and 68.6% in MJ(P = 0.0007).Adjusting the CA19-9 value by dividing it by serum bilirubin level meant that 21.5% in the BJ and 49% in the MJ group remained with a positive CA19-9 value(P = 0.003),while adjusting the CA19-9 value by dividing it by serum CRP value meant that 31.4% in the BJ group and 76.5% in the MJ group still had a positive CA19-9 value(P = 0.000004).Sensitivity,specificity,positive predictive values of CA19-9 > 32 U/mL were 82.3%,45% and 59.1%;when the cutoff was CA19-9 > 100 U/mL they were,respectively,68.6%,64.7% and 66%.When the CA19-9 value was adjusted by dividing it by the bilirubin or CRP values,these became 49%,78.4%,69.4% and 76.5%,68.6%,70.9%,respectively.CONCLUSION:The present study proposes CRP as a new and useful correction factor to improve the diag-nostic value of the CA19-9 tumor marker in patients with cholestatic jaundice.展开更多
AIM:To investigate the clinical signifi cance of C-reactive protein (CRP) values in determining the endpoint of antibiotic treatment for liver abscess after drainage. METHODS: The endpoints of antibiotic treatment in ...AIM:To investigate the clinical signifi cance of C-reactive protein (CRP) values in determining the endpoint of antibiotic treatment for liver abscess after drainage. METHODS: The endpoints of antibiotic treatment in 46 patients with pyogenic liver abscess after complete percutaneous drainage were assessed by performing a retrospective study. After complete percutaneous drainage, normal CRP values were considered as the endpoint in 18 patients (experimental group), and normal body temperature for at least 2 wk were considered as the endpoints in the other 28 patients (control group). RESULTS:The duration of antibiotic treatment after complete percutaneous drainage was 15.83 ± 6.45 d and 24.25 ± 8.18 d for the experimental and the control groups, respectively (P=0.001), being significantly shorter in the experimental group than in the control group. The recurrence rate was 0% for both groups.However, we could not obtain the follow-up data about 3 patients in the control group. CONCLUSION: CRP values can be considered as an independent factor to determine the duration of the antibiotic treatment for pyogenic liver abscess after complete percutaneous drainage.展开更多
AIM:The current study was to determine the serum/pLasma levels of VEGF,IL-6,malondialdehyde (MDA),nitric oxide (NO),PCT and CRP in gastric carcinoma and correlation with the stages of the disease and accompanying infe...AIM:The current study was to determine the serum/pLasma levels of VEGF,IL-6,malondialdehyde (MDA),nitric oxide (NO),PCT and CRP in gastric carcinoma and correlation with the stages of the disease and accompanying infection. METHODS:We examined the levels of serum VEGF,IL-6, PCT,CRP and plasma MDA,NO in 42 preoperative gastric cancer patients and 23 healthy subjects.There were infection anamneses that had no definite origin in 19 cancer patients. RESULTS:The VEGF levels (mean±SD; pg/mL) were 478.05±178.29 and 473.85±131.24 in gastric cancer patients with and without infection,respectively,and these values were not significantly different (P>0.05).The levels of VEGF, CRP,PCT,It-6,MDA and NO in cancer patients were significantly higher than those in healthy controls and the levels of CRP,PCT,It-6,MDA and NO were statistically increased in infection group when compared with non- infection group (P<0.001). CONCLUSION:Although serum VEGF concentrations were increased in gastric cancer,this increase might not be related to infection.CRP,PCT,IL-6,MDA and NO have obvious drawbacks in the diagnosis of infections in cancer patients. These markers may not help to identify infections in the primary evaluation of cancer patients and hence to avoid unnecessary antibiotic treatments as well as hospitalization. According to the results of this study,IL-6,MDA,NO and especially VEGF can be used as useful parameters to diagnose and grade gastric cancer.展开更多
AIM： C-reactive protein （CRP） is an acute-phase reactant and a known indicator of the malignant potential of the tumour. The aim of this study was to investigate the significance of preoperative CRP as a parameter ...AIM： C-reactive protein （CRP） is an acute-phase reactant and a known indicator of the malignant potential of the tumour. The aim of this study was to investigate the significance of preoperative CRP as a parameter of the perioperative course and long-term prognosis in patients with squamous cell carcinoma and aclenocarcinoma of the oesophagus. METHODS： Serum CRP was determined preoperatively in 291 of 371 patients undergoing oesophagectomy for cancer from December 1989 to March 2004. Median patient age was 59 （28-79） year, 82.5% of patients were males. Squamous cell carcinoma was diagnosed in 151 （51.9%） and aclenocarcinoma in 122 patients. Transhiatal oesophagectomy was clone in 151 （51.9%） patients and 134 （46.0%） patients underwent the abclominothoracic procedure. RESULTS： In 127 （43.6%） patients the preoperative serum CRP concentration was within the normal range （〈 5 mg/clL）, elevated CRP levels were measured in 164 （56.4%） patients. Tumour extension （P 〈 0.0005） and the number of lymph nodes affected by metastatic spread （P = 0.015） were significantly increased in the group with elevated CRP levels. Among the perioperative parameters both the number of blood transfusions （P = 0.006） and the general complication rate （P = 0.002） were higher in patients with elevated preoperative CRP levels. The long-term survival rate of 13.6 （0-109.8） mo was poorer in the group with elevated CRP levels compared to 18.9 （0-155.4） mo in the group with normal CRP levels （log-rank test： P = 0.107）. Multivariateanalysis with backward variables selection identified preoperative CRP as an independent prognostic factor of the long-term prognosis in patients with oesophageal carcinoma, with a hazard ratio of 1.182 （95% confidence interval： 1.030-1.356）. CONCLUSION： The preoperative serum CRP-level is an easily determined independent prognostic marker in patients with squamous cell carcinoma and adenocarcinoma of the oesophagus.展开更多
Increased plasma total homocysteine (tHcy) and high sensitivity C-reactive protein (hsCRP) levels are independent risk factors for cardiovascular disease.However, the predictive value of tHcy in combination with hsCRP...Increased plasma total homocysteine (tHcy) and high sensitivity C-reactive protein (hsCRP) levels are independent risk factors for cardiovascular disease.However, the predictive value of tHcy in combination with hsCRP in patients with stroke is not known.To determine the relationship between tHcy and hsCRP, we enrolled 291 patients with first-onset stroke (196 ischemic and 95 hemorrhagic).Plasma tHcy and hsCRP levels were measured and subsequent vascular events and deaths were determined over a 5-year period.Using the arbitrary cutoff for tHcy (【18 μmol/L and ≥18 μmol/L) and hsCRP (【1 mg/L, 1-3 mg/L and 】3 mg/L), the patients were divided into 6 groups.Survival analysis showed that the probability of death or new vascular events during a 5-year follow-up increased according to tHcy and hsCRP levels (P【0.01).The relative risk (RR) of death or new vascular events was 4.67 (95% CI, 1.96 to 11.14, P=0.001) in patients with high tHcy (≥18 μmol/L) and hsCRP (】3 mg/L) compared with those with low tHcy (【18 μmol/L) and hsCRP (【1 mg/L).The increased tHcy level (≥18 μmol/L) combined with increased hsCRP level (】3 mg/L) was still significantly associated with the risk of death or new vascular events (RR, 4.10, 95% CI, 1.61 to 10.45, P=0.003) even when adjusted for other risk factors at inclusion.The combination of increased tHcy and hsCRP levels had a stronger predictive value than increased hsCRP alone or increased tHcy level alone.Further studies are required to evaluate the potential decrease in risks associated with lowering both Hcy and hsCRP levels in patients that present with both increased tHcy and hsCRP.展开更多
Changes of plasma C-reactive protein in patients with craniocerebral injury before and after hyperbaric oxygenation： A randomly controlled study BACKGROUND： Plasma inflammatory factor, such as C-reactive prot...Changes of plasma C-reactive protein in patients with craniocerebral injury before and after hyperbaric oxygenation： A randomly controlled study BACKGROUND： Plasma inflammatory factor, such as C-reactive protein, whose content is regarded as a sensitively pathological marked protein and quantitative indexes of central nervous system injury, has been paid more and more attention in clinic. OBJECTIVE： To observe the effects and clinical significance of C-reactive protein in patients with craniocerebral injury after hyperbaric oxygenation. DESIGN： Randomized controlled study. SETTING： Departments of Neurosurgery, Laboratory and Hyperbaric Oxygen, the Second Affiliated Hospital, Medical College of Shantou University. PARTICIPANTS： A total of 60 patients with craniocerebral injury were selected from Department of Neurosurgery, the Second Affiliated Hospital, Medical College of Shantou University from October 2006 to April 2007. There were 37 males and 23 females and the mean age was 26 years. All subjects were certainly diagnosed as history of craniocerebral injury. Patients hospitalized at 24 hours after injury, Glasgow Coma Score ranged from 3 to 12 points, and all patients were certainly diagnosed with CT or MR scanning. Patients and their relatives provided confirmed consent. All the subjects were randomly divided into hyperbaric oxygenation group and control group with 30 in each group. METHODS： Patients in the control group were treated with routinely neurosurgical therapy after hospitalization; however, based the same basic treatment in the control group, patients in the hyperbaric oxygenation group received hyperbaric oxygenation by using iced-wheel four-door 2-cabin air-compression chamber （made in Yantai） from 24 hours to 10 days after operation or injury. After entering the cabin, patients who had a clear consciousness breathed the oxygen by using face mask; contrarily, patients directly breathed the oxygen. Therapeutic project： Expression was increased for about 15–20 minutes, maintained for about 70–80 minutes, and decreased for 20 minutes. Otherwise, pressure was maintained from 0.2 to 0.25 MPa. Hyperbaric oxygenation took an hour for once a day and 10 times were regarded as a course. Venous blood was collected before treatment and on the next day of the first course end. Content of C-reactive protein in plasma was measured with immune turbidimetry in hyperbaric oxygenation group; in addition, content of C-reactive protein in plasma was directly measured with the same method at the corresponding time in the control group. If the content was less or equal to 8 mg/L, it was regarded as normal value. Effects of the two groups were evaluated based on Glasgow Coma Score before and after treatment. MAIN OUTCOME MEASURES： Content of plasma C-reactive protein and Glasgow Coma Score in the two groups before and after treatment. RESULTS： All 60 patients were involved in the final analysis. ① Content of plasma C-reactive protein： The two contents were obviously higher than normal value after craniocerebral injury. There was no significant difference in the two groups before treatment （P 〉 0.05）, but both contents were decreased after treatment, and there was significant difference between HBOT group and control group after treatment （t =4.756, P 〈 0.01）. In addition, there was significant difference in hyperbaric oxygen therapy group before and after treatment （t =5.236, P 〈 0.01）. ② Glasgow Coma Score： There was no significant difference in the two groups before treatment （P 〉 0.05）, but scores were increased in both groups after treatment （t =9.92, 2.51, P 〈 0.01, 0.05）; on the other hand, therefore, there was significant difference between the two groupsafter treatment （t =9.21, P 〈 0.01）. CONCLUSION： Hyperbaric oxygenation can remarkably decrease content of plasma C-reactive protein in patients with craniocerebral injury at the phase of stress.展开更多
文摘Chronic low-grade inflammation is a major contributor to both the onset and advancement of type 2 diabetes mellitus(T2DM),and its associated microvascular complications,including diabetic nephropathy,retinopathy,and peripheral neuropathy.This review aims to overview the roles of high sensitivity C-reactive protein(hs-CRP),C-reactive protein(CRP),CRP-to-lymphocyte count ratio(CLR),and the CRP-to-albumin ratio(CAR)as biomarkers for assessing systemic inflammation and predicting the development and severity of diabetic chronic microvascular complications.Elevated levels of CRP and hs-CRP have been consistently associated with increased risk of these complications,reflecting ongoing inflammatory processes that contribute to endothelial dysfunction and tissue damage.Furthermore,CAR and CLR,which combine CRP with albumin and lymphocyte counts respectively,offer a more nuanced understanding of the inflammatory and immune response in T2DM patients.While individual studies have demonstrated the clinical relevance of these biomarkers in predicting disease onset and progression,further investigation is needed to establish their utility in clinical practice.This review highlights the potential of these biomarkers for enhancing early detection,risk stratification,and personalized management of diabetic patients,ultimately aiming to improve outcomes and reduce the burden of diabetic chronic microvascular complications.
文摘BACKGROUND Gastric cancer is the most common malignancy of the digestive system and surgical resection is the primary treatment.Advances in surgical technology have reduced the risk of complications after radical gastrectomy;however,post-surgical pancreatic fistula remain a serious issue.These fistulas can lead to abdominal infections,anastomotic leakage,increased costs,and pain;thus,early diagnosis and prevention are crucial for a better prognosis.Currently,C-reactive protein(CRP),procalcitonin(PCT),and total bilirubin(TBil)levels are used to predict post-operative infections and anastomotic leakage.However,their predictive value for pancreatic fistula after radical gastrectomy for gastric cancer remains unclear.The present study was conducted to determine their predictive value.AIM To determine the predictive value of CRP,PCT,and TBil levels for pancreatic fistula after gastric cancer surgery.METHODS In total,158 patients who underwent radical gastrectomy for gastric cancer at our hospital between January 2019 and January 2023 were included.The patients were assigned to a pancreatic fistula group or a non-pancreatic fistula group.Multivariate logistic analysis was conducted to assess the factors influencing development of a fistula.Receiver operating characteristic(ROC)curves were used to determine the predictive value of serum CRP,PCT,and TBil levels on day 1 postsurgery.RESULTS On day 1 post-surgery,the CRP,PCT,and TBil levels were significantly higher in the pancreatic fistula group than in the non-pancreatic fistula group(P<0.05).A higher fistula grade was associated with higher levels of the indices.Univariate analysis revealed significant differences in the presence of diabetes,hyperlipidemia,pancreatic injury,splenectomy,and the biomarker levels(P<0.05).Logistic multivariate analysis identified diabetes,hyperlipidemia,pancreatic injury,CRP level,and PCT level as independent risk factors.ROC curves yielded predictive values for CRP,PCT,and TBil levels,with the PCT level having the highest area under the curve(AUC)of 0.80[95%confidence interval(CI):0.72-0.90].Combined indicators improved the predictive value,with an AUC of 0.86(95%CI:0.78-0.93).CONCLUSION Elevated CRP,PCT,and TBil levels predict risk of pancreatic fistula post-gastrectomy for gastric cancer.
基金Supported by National Natural Science Foundation of China,No.82170412.
文摘BACKGROUND Inflammatory cytokines are associated with cancer prognosis,but their specific role in cholangiocarcinoma remains poorly understood.The lymphocyte to C-reactive protein ratio(LCR),a novel inflammatory-nutritional biomarker,has demonstrated predictive value in gastrointestinal cancers;however,its clinical relevance in cholangiocarcinoma has not been investigated.AIM To validate the LCR as an independent prognostic factor for overall survival(OS),surgical site infection(SSI),and length of hospital stay in patients with resectable cholangiocarcinoma.METHODS We conducted a retrospective analysis of 76 patients with cholangiocarcinoma who underwent radical surgery between 2008 and 2013.The preoperative LCR was calculated as the lymphocyte count divided by C-reactive protein level,using a cutoff value of 180.Univariate and multivariate logistic regression analyses were performed to evaluate factors associated with SSI and hospitalization duration,while Kaplan-Meier survival curves and Cox proportional hazards models were used to assess predictors of OS.RESULTS Patients in the low LCR group was significantly associated with several adverse clinical outcomes:A shorter median OS(14.93 months vs 46.67 months;P=0.022);a 4.5-fold increased risk of prolonged hospitalization(P=0.007);and a higher incidence of SSI(odds ratio=4.41,P=0.045).Multivariate analysis confirmed that LCR was an independent predictor of OS[hazard ratio(HR)=3.204,P=0.002],SSI,and hospitalization duration.Additionally,R0 resection(HR=3.546,P=0.002)and advanced tumor-node-metastasis stage(HR=2.016,P=0.035)were identified as independent prognostic factors for OS.CONCLUSION In this retrospective study,preoperative LCR is a cost-effective and practical biomarker that independently predicts OS,postoperative complications,and hospitalization duration in patients with resectable cholangiocarcinoma,thereby facilitating more precise patient stratification.
基金supported by the National Natural Science Foundation of China(82360801,82460822)Natural Science Foundation of Inner Mongolia Autonomous Region(2022LHQN08001,2023QN08050,2025LHMS08061)+4 种基金the Scientific Research Project of Higher Education Institutions in Inner Mongolia Autonomous Region(NJZY23135)the Laboratory Open Fund of Inner Mongolia Medical University(2024ZN23)and the General Project of Inner Mongolia Medical University(YKD2025MS047Inner Mongolia Medical University Undergraduate Science and Technology Innovation"Talent Cultivation"Project(YCPY2025028,YCPY2025024)Inner Mongolia Medical University Undergraduate Innovation and Entrepreneurship Training Program Project(101322025034).
文摘Background:Bacterial pneumonia continues to be a significant global health concern,particularly among high-risk groups,necessitating the development of precise and early diagnostic biomarkers.While the efficacy of procalcitonin(PCT)and C-reactive protein(CRP)as inflammatory markers is widely recognized,their relative diagnostic performance across different age groups remains debate.This meta-analysis was designed to assess the diagnostic accuracy of PCT and CRP in bacterial pneumonia.Methods:In this meta-analysis adhering to PRISMA guidelines,we searched PubMed,Web of Science,and the Cochrane Library for relevant diagnostic accuracy studies.From 19 included studies(n=2,603),data were extracted to construct tables.Study quality was assessed with the QUADAS-2 tool.The bivariate random-effects model was employed to derive pooled sensitivity,specificity,positive and negative likelihood ratios,and summary AUCs.To explore the substantial heterogeneity(I^(2)>80%),we performed pre-specified subgroup analyses based on age demographics.Results:Our findings indicate superior diagnostic performance for PCT,evidenced by a pooled sensitivity of 0.8841 and specificity of 0.8499,relative to CRP’s sensitivity of 0.8371 and specificity of 0.7185.The area under the ROC curve(AUC)for PCT was 0.992,a value significantly higher than that of CRP(0.987).Intriguingly,subgroup analyses revealed age-dependent variations:CRP demonstrated enhanced diagnostic utility in minors,while PCT proved substantially more effective in non-elderly adults.Conclusion:These results reinforce the clinical relevance of PCT as a more dependable biomarker for bacterial pneumonia,particularly in informing antibiotic treatment and mitigating misuse.This study uniquely includes age-stratified analyses based on predefined groups(minors and non-elderly adults),providing refined insights for individualized diagnostic approaches.We propose further multicenter research endeavors to confirm threshold optimization and explore combined biomarker strategies.
基金supported by the National Natural Science Foundation of China(Nos.22064014,21765013)the Science and Technology Development Plan Project of Lanzhou(No.20211-146)+3 种基金the Science and Technology Project of Gansu Province(Nos.21YF5FA071,21JR7RA538)the Industrial Support Programme for Higher Education Institutions Project(Nos.2023CYZC-69,2024CYCZ-05)the 2023 Gansu Provincial Key Talent Project(No.2023RCXM26)a Gansu province postdoctoral grant(No.00247)。
文摘The advancement of various types of fluorescent nanoparticles is crucial for enhancing the application of lateral flow immunoassays(LFIA)across multiple fields.Currently,the fluorescent nanoparticles utilized in LFIA predominantly consist of traditional dye-doped nanoparticles or aggregation-induced luminescence dye-doped nanoparticles.The reliance on specific types of nanoparticles limits the diversity of signal reporting groups available for LFIA.Herein,we developed a solid-state luminescent dye-doped nanoparticles(SLDNPs)-based LFIA system with exceptional stability for the detection of C-reactive protein(CRP)in serum.The synthesis of SLD_(520)NP_(S)was simplicity,efficient and eco-friendly,which was ideal for large-scale production of the LFIA test strip.And the SLD_(520)NP_(S)exhibits superior fluorescence quantum yield(49%),fully guarantees the performance of the LFIA test strip.The constructed SLD_(520)NPsm Ab1-based LFIA demonstrated a satisfactory linear relationship with CRP concentrations ranging from 0.5 ng/mL to 100 ng/mL,with limits of detection(LOD)of 0.78 ng/mL and a visible LOD of 1 ng/mL using a handheld 405 nm lamp.Furthermore,the developed LFIA exhibited excellent recoveries in serum,ranging from 94.45%to 102.5%.Overall,the outstanding performance of the SLD_(520)NPs-mAb1-based LFIA indicates that solid-state luminescent dyes have significant potential applications in the field of LFIA.
基金supported by the National Natural Science Foundation of China(No.82030016,No 82230011 and No.82200533).
文摘Background and Objective Inflammation plays a pivotal role in the progression of coronary artery disease(CAD).High-sensitivity C-reactive protein(hsCRP)serves as a well-established biomarker for assessing cardiovascular inflammation risk.However,the specific intestinal microbiota alteration contributing to increased inflammation remains unclear.Therefore,the present study investigated the correlation between the intestinal microbiota and inflammation in patients with unstable angina(UA).Methods A cohort of 92 patients with UA was recruited for this study.The plasma hsCRP level was measured via a CardioPhase hsCRP assay,fecal samples were collected after admission,and 16S rRNA sequencing was conducted to identify the fecal microbial profile.The participants were classified into two groups according to the median hsCRP level(1.11 mg/L).The composition of the fecal microbiota was compared between patients with hsCRP≥1.11 mg/L and those with hsCRP<1.11 mg/L.Additionally,the correlations between the fecal microbiota and clinical characteristics were analyzed.Results A notable reduction in the relative abundance of Akkermansia was observed in patients with hsCRP≥1.11 mg/L,whereas the diversity of the fecal microbiota was not significantly different between patients with hsCRP≥1.11 mg/L and those with hsCRP<1.11 mg/L.Furthermore,the abundance of Akkermansia was negatively correlated with hsCRP levels.Conclusion This study suggested a significant association between decreased levels of Akkermansia and inflammatory risk in patients with UA.These findings underscore the potential role of the intestinal microbiota in contributing to inflammation in UA patients.Further work is needed on the mechanism by which the microbiota contributes to inflammatory risk.
文摘BACKGROUND Gastric cancer,a globally prevalent malignant tumor,continues to exhibit high incidence and mortality rates.Although radical gastrectomy remains the primary treatment for this disease,postoperative complications frequently arise,negatively impacting short-term recovery and significantly reducing patients’quality of life.In this context,accurately predicting the risk of postoperative recurrence and metastasis,coupled with targeted interventions,could substantially improve patient outcomes.The C-reactive protein-triglyceride-glucose index(CTI),a composite biomarker that integrates metabolic disturbances and systemic inflammation,has garnered increasing attention in oncology.The prognostic nutritional index(PNI),a composite measure based on serum albumin and peripheral blood lymphocyte count,is used to evaluate both the nutritional status and systemic immune function of patients.In recent years,both the CTI and PNI have demonstrated significant prognostic value in predicting tumor outcomes,assessing treatment responses,and formulating personalized treatment strategies.AIM To investigate whether the combined inflammation and insulin resistance marker,the CTI,can serve as a prognostic indicator for patients undergoing radical gastrectomy for gastric cancer.Additionally,it seeks to develop a predictive model by incorporating the PNI alongside CTI.METHODS This retrospective study included a total of 300 patients who underwent radical gastrectomy.The patients were classified into high and low CTI groups based on their CTI index.Cox proportional hazards regression analysis was performed to identify independent prognostic factors influencing overall survival(OS)and disease-free survival(DFS),and two nomogram models were developed.RESULTS Of the included patients,131 had a high CTI and 169 had a low CTI.The DFS period of the low CTI group was significantly longer than that of the high CTI group.The number of postoperative adjuvant treatments,T stage,N stage,CTI,and PNI were identified as independent prognostic factors for DFS.The hazard ratio for CTI was 2.07(95%confidence interval:1.36-3.17,P<0.001).In terms of OS,the OS period of the low CTI group was significantly longer than that of the high CTI group.Whether adjuvant treatment was administered,T stage,CTI,and PNI were independent prognostic factors for OS.The hazard ratio for CTI was 2.47(95%confidence interval:1.44-4.23,P=0.001).The nomogram models for OS and DFS further emphasized the importance of CTI as a key predictor of patient prognosis.CONCLUSION CTI is a long-term prognostic indicator for the outcome of radical gastrectomy for gastric cancer.Patients with lower CTI values have a better prognosis.The prediction models constructed by combining CTI with PNI has good predictive ability for DFS and OS after radical gastrectomy.
文摘BACKGROUND Acute-on-chronic liver failure(ACLF)is a life-threatening syndrome associated with high short-term mortality.Accurate risk stratification is crucial for the mana-gement of ACLF.AIM To evaluate the prognostic value of the C-reactive protein to albumin ratio(CAR)and its dynamic changes in patients with ACLF defined by the Chinese Group on Study of Severe Hepatitis B(COSSH)criteria.METHODS A total of 126 consecutive patients diagnosed with COSSH-ACLF were pros-pectively enrolled.CAR was calculated at admission and on days 4,7,and 14.The primary and secondary outcomes were 28-day and 90-day mortality,respectively.Multivariate Cox regression analysis was conducted to identify independent predictors of mortality.A novel prognostic model(COSSH-CAR),integrating baseline and dynamic variables,was developed and compared with established prognostic scoring systems.RESULTS The 28-day and 90-day mortality rates were 27.8%and 40.5%,respectively.Baseline CAR was significantly higher in 28-day non-survivors than in survivors(2.68 vs 1.42,P<0.001).The dynamic change in CAR from baseline to day 7(ΔCAR-7)showed stronger predictive power for 28-day mortality[area under the receiver operating characteristic curve(AUC)=0.765]than baseline CAR(AUC=0.698),ΔCAR-4(AUC=0.706)orΔCAR-14(AUC=0.712).Multivariate analysis identifiedΔCAR-7(HR=1.53),baseline Model for End-Stage Liver Disease-Sodium(MELD-Na)score(HR=1.08),and hepatic encephalopathy grade(HR=1.92)as independent predictors of 28-day mortality(all P<0.05).The COSSH-CAR model,which incorporated these parameters,showed superior predictive performance(AUC=0.832)for 28-day mortality compared with established prognostic scores,including Child-Pugh(AUC=0.721),MELD-Na(AUC=0.768)and COSSH-ACLF(AUC=0.786)and effectively stratified patients into three risk categories with significantly different survival rates(P<0.001).CONCLUSION Dynamic changes in CAR during the first week provide important prognostic information in patients with COSSH-ACLF,surpassing baseline values and conventional inflammatory markers.The novel COSSH-CAR model improves risk stratification and may support clinical decision-making in the management of ACLF,pending ex-ternal validation in diverse populations.
基金Supported by the Greenwald Family Research Fund,a Research to Prevent Blindness grant to the Department of Ophthalmology,University of Colorado,the Frederic C.Hamilton Macular Degeneration Center,Sue Anschutz-Rodgers Eye Center Research Fund,NIH/NCATS Colorado CTSA(No.UL1 TR002535)in part by the National Eye Institute of the National Institutes of Health[No.R01EY032456(AML)].
文摘AIM:To determine the differences in levels of systemic C-reactive protein(CRP)in patients with geographic atrophy(GA)and sex-based differences in CRP levels.METHODS:Blood samples from patients with GA and controls were collected in a prospective age-related macular degeneration(AMD)registry from August 2014 to June 2021.AMD was confirmed using multimodal imaging and the Beckman and Consensus of Atrophy Meeting criteria for GA.High-sensitivity serum CRP levels were measured using an automated nephelometer.A non-parametric(rank-based)linear regression model was fit with an interaction between sex and GA.RESULTS:There were 97 GA patients and 139 controls,with females comprising 55%and 66%of each cohort,respectively.There is no difference in CRP between cases and controls,with a median(interquartile range)of 1.2(0.6-2.6)mg/L in GA patients versus 1.3(0.8–2.9)mg/L in controls(P=0.52).Although females had higher CRP levels compared to males in both the GA and control groups,this difference did not reach statistical significance after adjustment for multiple comparisons.CONCLUSION:There is no significant difference in systemic CRP levels between GA cases and controls.
文摘Objective:To analyze the diagnostic value of combined testing of C-reactive protein(CRP)and procalcitonin(PCT)in elderly patients with bacterial pneumonia.Methods:This study included 50 elderly patients with bacterial pneumonia as the observation group and 50 patients with non-bacterial pneumonia as the control group,recruited from May 2022 to October 2023.Fasting venous blood samples were collected in the morning from all 100 participants.CRP levels were measured using a fully automated biochemical analyzer,while PCT levels were detected using the immunoturbidimetric luminescence method.Results:CRP and PCT levels were significantly higher in bacterial pneumonia patients[(98.25±11.59)mg/L and(3.57±1.35)μg/L,respectively]compared to the control group[(5.55±2.78)mg/L and(0.25±0.12)μg/L,respectively],with significant intergroup differences(P<0.05).Patients with severe bacterial pneumonia exhibited higher serum CRP and PCT levels compared to those with moderate or mild disease(P<0.05).The combined testing of CRP and PCT showed higher sensitivity and specificity than individual tests.In the observation group,CRP and PCT levels significantly decreased after treatment compared to pre-treatment levels.Conclusion:The combination of CRP and PCT testing provides high diagnostic accuracy for bacterial pneumonia in elderly patients.It effectively differentiates bacterial from non-bacterial infections,offering valuable data to guide clinical treatment.
基金Fund supported by the Clinical Research Supporting Fund of Chinese PLA General Hospital(2016FC-TSYS-1039)~~
文摘Objectives To investigate the morphologic characteristics of intramural hematoma(IMH)on CT angiography(CTA),and evaluate the possible correlation of serum C-reactive protein(CRP)with morphologic characteristics of IMH.Material and Methods Forty-two patients who were initially diagnosed as IMH by aortic CTA and also had serum CRP examination on the same day of CTA were enrolled in this retrospective study,including 30 males and 12 females,with the mean age of 61±14 years old.The volumetric CT data were retrospectively processed and analyzed on post-processing workstation.Based on the thickness of IMH and the length-area curve,the crosssectional area of true lumen and total vessel were measured,the hematoma-vessel ratio(HVR)was calculated.Imaging characteristics were compared between patients who had pathological elevated CRP(>0.8 mg/dl)and those did not.Spearman correlation analyses of CRP level and morphological characteristics of IMH were performed,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic validity of CRP.Results Of all 42 IMH patients,the mean serum CRP was 3.94±4.71 mg/dl,and the mean HVR was 46.7%±14.2%.HVR in patients with elevated CRP was significantly higher than those with normal CRP(49.7%±15.0%vs.40.7%±10.5%,P=0.030).HVR was mildly correlated with CRP in all patients(r=0.48,P<0.001).CRP levels differed neither between patients with Stanford type A and B(P=0.207),nor between patients with and without intimal disruption(P=0.230).To discriminate HVR>47%(the mean value),the area under curve(AUC)were 0.700(95%CI:0.535-0.865)for CRP at a cutoff point of 3.55 mg/dl,with a sensitivity of 54.5%and a specificity of 90.0%.Conclusion CRP was mildly correlated with the severity of cross-sectional hematoma area of IMH,but not with Stanford types and the presence of intimal disruption.
基金supported by Jiangsu Provincial Medical Innovation Center of Jiangsu Province Capability Improvement Project through Science,Technology and Education(No.CXZX202231)the Special Research Topic on Innovation of Hospital Management,Jiangsu Provincial Hospital Association(No.JSYGY-3-2021-JZ71).
文摘Objective C-reactive protein(CRP)/albumin ratio(CAR)is a new inflammation-based index for predicting the prognosis of various diseases.The CAR determined on admission may help to predict the prognostic value of multiple trauma patients.Methods A total of 264 adult patients with severe multiple trauma were included for the present retrospective study,together with the collection of relevant clinical and laboratory data.CAR,CRP,albumin,shock index and ISS were incorporated into the prognostic model,and the receiver operating characteristic(ROC)curve was drawn.Then,the shock index for patients with different levels of CAR was analyzed.Finally,univariate and multivariate logistic regression analyses were performed to identify the independent risk factors for the 28-day mortality of multiple trauma patients.Results A total of 36 patients had poor survival outcomes,and the mortality rate reached 13.6%.Furthermore,after analyzing the shock index for patients with different levels of CAR,it was revealed that the shock index was significantly higher when CAR was≥4,when compared to CAR<2 and 2≤CAR<4,in multiple trauma patients.The multivariate logistic analysis helped to identify the independent association between the variables CAR(P=0.029)and shock index(P=0.019),and the 28-day mortality of multiple trauma patients.Conclusion CAR is higher in patients with severe multiple trauma.Furthermore,CAR serves as a risk factor for independently predicting the 28-day mortality of multiple trauma patients.The shock index was significantly higher when CAR was≥4 in multiple trauma patients.
文摘Background Increased levels of inflammatory markers have been documented in various settings of coronary artery disease. The vulnerability of coronary lesions in acute myocardial infarction(AMI) at the time of onset may be related to serum levels of C reactive protein(CRP) on admission, before CRP levels are affected by myocardial damage.Objective This study assessed the predictive value of CRP levels within six hours after the onset of acute anterior myocardial infarction with primary percutaneous coronary intervention(PCI).Methods The plasma CRP of 76 patients with first acute anterior myocardial infarction was measured within 6 hours after onset. They were divided into 2 groups: group 1( n =20) with elevated CRP( ≥0.3mg/dl ) on admission within 6 hours after onset and group 2( n =56) with normal CRP( <0.3mg/dl ) within 6 hours after onset. All patients were treated by primary PCI. The primary combined end points, including death due to cardiac causes, re MI related to the infarction artery(RIA) and repeat intervention of the RIA, and the restenosis rate were assessed in relation to CRP levels within 6 hours after onset. Left ventricular end diastolic volume index(EDVI),end systolic volume index(ESVI),and ejection fraction(EF) on admission and 6 month after the onset were assessed by left ventriculography. Changes in EDVI(ΔEDVI),ESVI(ΔESVI), and EF(ΔEF) were obtained by subtracting respective on admission values from corresponding 6 month follow up values. Results There were no significant differences in baseline characteristics between the two groups. The primary combined end points were significantly more frequent in group 1(20%) than those in group 2( 1.79% , P <0.01 ).In addition, restenosis rates were significantly higher in group 1 than in group 2(41.18% vs 16.07%, P<0.05). Group 1 showed greater increases in left ventricular volume and less improvement in EF compared with group 2(ΔEDVI 6.31 ±2.17 vs 3.29 ±9.46ml/m 2 , ΔESVI 5.92 ±2.31 vs 3.86 ±1.08ml/m 2 , ΔEF 1.92 ±0.47 vs 4.79 ±1.73% , P <0.05 , respectively).Conclusions CRP levels within 6 hours after the onset of AMI might predict adverse outcome after primary PCI and progressive ventricular remodeling within 6 month of AMI.
文摘BACKGROUND:Serum C-reactive protein(CRP) increases and albumin decreases in patients with inflammation and infection.However,their role in patients with acute pancreatitis is not clear.The present study was to investigate the predictive significance of the CRP/albumin ratio for the prognosis and mortality in acute pancreatitis patients.METHODS:This study was performed retrospectively with 192 acute pancreatitis patients between January 2002 and June 2015.Ranson scores,Atlanta classification and CRP/albumin ratios of the patients were calculated.RESULTS:The CRP/albumin ratio was higher in deceased patients compared to survivors.The CRP/albumin ratio was positively correlated with Ranson score and Atlanta classification in particular and with important prognostic markers such as hospitalization time,CRP and erythrocyte sedimentation rate.In addition to the CRP/albumin ratio,necrotizing pancreatitis type,moderately severe and severe Atlanta classification,and total Ranson score were independent risk factors of mortality.It was found that an increase of 1 unit in the CRP/albumin ratio resulted in an increase of 1.52 times in mortality risk.A prediction value about CRP/albumin ratio >16.28 was found to be a significant marker in predicting mortality with 92.1% sensitivity and 58.0% specificity.It was seen that Ranson and Atlanta classification were higher in patients with CRP/albumin ratio >16.28 compared with those with CRP/albumin ratio ≤16.28.Patients with CRP/albumin ratio >16.28 had a 19.3 times higher chance of death.CONCLUSION:The CRP/albumin ratio is a novel but promising,easy-to-measure,repeatable,non-invasive inflammationbased prognostic score in acute pancreatitis.
文摘AIM:To find a possible relationship between inflammation and CA19-9 tumor marker by analyzing data from patients with benign jaundice(BJ) and malignant jaundice(MJ).METHODS:All patients admitted for obstructive jaundice,in the period 2005-2009,were prospectively enrolled in the study,obtaining a total of 102 patients.On admission,all patients underwent complete standard blood test examinations including C-reactive protein(CRP),bilirubin,CA19-9.Patients were considered eligible for the study when they presented obstructive jaundice confirmed by instrumental examinations and increased serum bilirubin levels(total bilirubin > 2.0 mg/dL).The standard cut-off level for CA19-9 was 32 U/mL,whereas for CRP this was 1.5 mg/L.The CA19-9 level was adjusted by dividing it by the value of serum bilirubin or by the CRP value.The patients were divided into 2 groups,MJ and BJ,and after the adjustment a comparison between the 2 groups of patients was performed.Sensitivity,specificity and positive predictive values were calculated before and after the adjustment.RESULTS:Of the 102 patients,51 were affected by BJ and 51 by MJ.Pathologic CA19-9 levels were found in 71.7% of the patients.In the group of 51 BJ patients there were 29(56.9%) males and 22(43.1%) females with a median age of 66 years(range 24-96 years),whereas in the MJ group there were 24(47%) males and 27(53%) females,with a mean age of 70 years(range 30-92 years).Pathologic CA19-9 serum level was found in 82.3% of MJ.CRP levels were pathologic in 66.6% of the patients with BJ and in 49% with MJ.Bilirubin and CA19-9 average levels were significantly higher in MJ compared with BJ(P = 0.000 and P = 0.02),while the CRP level was significantly higher in BJ(P = 0.000).Considering a CA19-9 cut-off level of 32 U/mL,82.3% in the MJ group and 54.9% in the BJ group were positive for CA19-9(P = 0.002).A CA19-9 cut-off of 100 U/mL increases the difference between the two groups:35.3% in BJ and 68.6% in MJ(P = 0.0007).Adjusting the CA19-9 value by dividing it by serum bilirubin level meant that 21.5% in the BJ and 49% in the MJ group remained with a positive CA19-9 value(P = 0.003),while adjusting the CA19-9 value by dividing it by serum CRP value meant that 31.4% in the BJ group and 76.5% in the MJ group still had a positive CA19-9 value(P = 0.000004).Sensitivity,specificity,positive predictive values of CA19-9 > 32 U/mL were 82.3%,45% and 59.1%;when the cutoff was CA19-9 > 100 U/mL they were,respectively,68.6%,64.7% and 66%.When the CA19-9 value was adjusted by dividing it by the bilirubin or CRP values,these became 49%,78.4%,69.4% and 76.5%,68.6%,70.9%,respectively.CONCLUSION:The present study proposes CRP as a new and useful correction factor to improve the diag-nostic value of the CA19-9 tumor marker in patients with cholestatic jaundice.
文摘AIM:To investigate the clinical signifi cance of C-reactive protein (CRP) values in determining the endpoint of antibiotic treatment for liver abscess after drainage. METHODS: The endpoints of antibiotic treatment in 46 patients with pyogenic liver abscess after complete percutaneous drainage were assessed by performing a retrospective study. After complete percutaneous drainage, normal CRP values were considered as the endpoint in 18 patients (experimental group), and normal body temperature for at least 2 wk were considered as the endpoints in the other 28 patients (control group). RESULTS:The duration of antibiotic treatment after complete percutaneous drainage was 15.83 ± 6.45 d and 24.25 ± 8.18 d for the experimental and the control groups, respectively (P=0.001), being significantly shorter in the experimental group than in the control group. The recurrence rate was 0% for both groups.However, we could not obtain the follow-up data about 3 patients in the control group. CONCLUSION: CRP values can be considered as an independent factor to determine the duration of the antibiotic treatment for pyogenic liver abscess after complete percutaneous drainage.
文摘AIM:The current study was to determine the serum/pLasma levels of VEGF,IL-6,malondialdehyde (MDA),nitric oxide (NO),PCT and CRP in gastric carcinoma and correlation with the stages of the disease and accompanying infection. METHODS:We examined the levels of serum VEGF,IL-6, PCT,CRP and plasma MDA,NO in 42 preoperative gastric cancer patients and 23 healthy subjects.There were infection anamneses that had no definite origin in 19 cancer patients. RESULTS:The VEGF levels (mean±SD; pg/mL) were 478.05±178.29 and 473.85±131.24 in gastric cancer patients with and without infection,respectively,and these values were not significantly different (P>0.05).The levels of VEGF, CRP,PCT,It-6,MDA and NO in cancer patients were significantly higher than those in healthy controls and the levels of CRP,PCT,It-6,MDA and NO were statistically increased in infection group when compared with non- infection group (P<0.001). CONCLUSION:Although serum VEGF concentrations were increased in gastric cancer,this increase might not be related to infection.CRP,PCT,IL-6,MDA and NO have obvious drawbacks in the diagnosis of infections in cancer patients. These markers may not help to identify infections in the primary evaluation of cancer patients and hence to avoid unnecessary antibiotic treatments as well as hospitalization. According to the results of this study,IL-6,MDA,NO and especially VEGF can be used as useful parameters to diagnose and grade gastric cancer.
文摘AIM： C-reactive protein （CRP） is an acute-phase reactant and a known indicator of the malignant potential of the tumour. The aim of this study was to investigate the significance of preoperative CRP as a parameter of the perioperative course and long-term prognosis in patients with squamous cell carcinoma and aclenocarcinoma of the oesophagus. METHODS： Serum CRP was determined preoperatively in 291 of 371 patients undergoing oesophagectomy for cancer from December 1989 to March 2004. Median patient age was 59 （28-79） year, 82.5% of patients were males. Squamous cell carcinoma was diagnosed in 151 （51.9%） and aclenocarcinoma in 122 patients. Transhiatal oesophagectomy was clone in 151 （51.9%） patients and 134 （46.0%） patients underwent the abclominothoracic procedure. RESULTS： In 127 （43.6%） patients the preoperative serum CRP concentration was within the normal range （〈 5 mg/clL）, elevated CRP levels were measured in 164 （56.4%） patients. Tumour extension （P 〈 0.0005） and the number of lymph nodes affected by metastatic spread （P = 0.015） were significantly increased in the group with elevated CRP levels. Among the perioperative parameters both the number of blood transfusions （P = 0.006） and the general complication rate （P = 0.002） were higher in patients with elevated preoperative CRP levels. The long-term survival rate of 13.6 （0-109.8） mo was poorer in the group with elevated CRP levels compared to 18.9 （0-155.4） mo in the group with normal CRP levels （log-rank test： P = 0.107）. Multivariateanalysis with backward variables selection identified preoperative CRP as an independent prognostic factor of the long-term prognosis in patients with oesophageal carcinoma, with a hazard ratio of 1.182 （95% confidence interval： 1.030-1.356）. CONCLUSION： The preoperative serum CRP-level is an easily determined independent prognostic marker in patients with squamous cell carcinoma and adenocarcinoma of the oesophagus.
基金supported in part by funds from a national research project of China (Program 863) (No.2006-AA02A406)a project of the Ministry of Education of China+1 种基金a project of the National Natural Sciences Foundation of China (No.30540087)a national basic research program of China (Program 973) (No.2007CB512004)
文摘Increased plasma total homocysteine (tHcy) and high sensitivity C-reactive protein (hsCRP) levels are independent risk factors for cardiovascular disease.However, the predictive value of tHcy in combination with hsCRP in patients with stroke is not known.To determine the relationship between tHcy and hsCRP, we enrolled 291 patients with first-onset stroke (196 ischemic and 95 hemorrhagic).Plasma tHcy and hsCRP levels were measured and subsequent vascular events and deaths were determined over a 5-year period.Using the arbitrary cutoff for tHcy (【18 μmol/L and ≥18 μmol/L) and hsCRP (【1 mg/L, 1-3 mg/L and 】3 mg/L), the patients were divided into 6 groups.Survival analysis showed that the probability of death or new vascular events during a 5-year follow-up increased according to tHcy and hsCRP levels (P【0.01).The relative risk (RR) of death or new vascular events was 4.67 (95% CI, 1.96 to 11.14, P=0.001) in patients with high tHcy (≥18 μmol/L) and hsCRP (】3 mg/L) compared with those with low tHcy (【18 μmol/L) and hsCRP (【1 mg/L).The increased tHcy level (≥18 μmol/L) combined with increased hsCRP level (】3 mg/L) was still significantly associated with the risk of death or new vascular events (RR, 4.10, 95% CI, 1.61 to 10.45, P=0.003) even when adjusted for other risk factors at inclusion.The combination of increased tHcy and hsCRP levels had a stronger predictive value than increased hsCRP alone or increased tHcy level alone.Further studies are required to evaluate the potential decrease in risks associated with lowering both Hcy and hsCRP levels in patients that present with both increased tHcy and hsCRP.
文摘Changes of plasma C-reactive protein in patients with craniocerebral injury before and after hyperbaric oxygenation： A randomly controlled study BACKGROUND： Plasma inflammatory factor, such as C-reactive protein, whose content is regarded as a sensitively pathological marked protein and quantitative indexes of central nervous system injury, has been paid more and more attention in clinic. OBJECTIVE： To observe the effects and clinical significance of C-reactive protein in patients with craniocerebral injury after hyperbaric oxygenation. DESIGN： Randomized controlled study. SETTING： Departments of Neurosurgery, Laboratory and Hyperbaric Oxygen, the Second Affiliated Hospital, Medical College of Shantou University. PARTICIPANTS： A total of 60 patients with craniocerebral injury were selected from Department of Neurosurgery, the Second Affiliated Hospital, Medical College of Shantou University from October 2006 to April 2007. There were 37 males and 23 females and the mean age was 26 years. All subjects were certainly diagnosed as history of craniocerebral injury. Patients hospitalized at 24 hours after injury, Glasgow Coma Score ranged from 3 to 12 points, and all patients were certainly diagnosed with CT or MR scanning. Patients and their relatives provided confirmed consent. All the subjects were randomly divided into hyperbaric oxygenation group and control group with 30 in each group. METHODS： Patients in the control group were treated with routinely neurosurgical therapy after hospitalization; however, based the same basic treatment in the control group, patients in the hyperbaric oxygenation group received hyperbaric oxygenation by using iced-wheel four-door 2-cabin air-compression chamber （made in Yantai） from 24 hours to 10 days after operation or injury. After entering the cabin, patients who had a clear consciousness breathed the oxygen by using face mask; contrarily, patients directly breathed the oxygen. Therapeutic project： Expression was increased for about 15–20 minutes, maintained for about 70–80 minutes, and decreased for 20 minutes. Otherwise, pressure was maintained from 0.2 to 0.25 MPa. Hyperbaric oxygenation took an hour for once a day and 10 times were regarded as a course. Venous blood was collected before treatment and on the next day of the first course end. Content of C-reactive protein in plasma was measured with immune turbidimetry in hyperbaric oxygenation group; in addition, content of C-reactive protein in plasma was directly measured with the same method at the corresponding time in the control group. If the content was less or equal to 8 mg/L, it was regarded as normal value. Effects of the two groups were evaluated based on Glasgow Coma Score before and after treatment. MAIN OUTCOME MEASURES： Content of plasma C-reactive protein and Glasgow Coma Score in the two groups before and after treatment. RESULTS： All 60 patients were involved in the final analysis. ① Content of plasma C-reactive protein： The two contents were obviously higher than normal value after craniocerebral injury. There was no significant difference in the two groups before treatment （P 〉 0.05）, but both contents were decreased after treatment, and there was significant difference between HBOT group and control group after treatment （t =4.756, P 〈 0.01）. In addition, there was significant difference in hyperbaric oxygen therapy group before and after treatment （t =5.236, P 〈 0.01）. ② Glasgow Coma Score： There was no significant difference in the two groups before treatment （P 〉 0.05）, but scores were increased in both groups after treatment （t =9.92, 2.51, P 〈 0.01, 0.05）; on the other hand, therefore, there was significant difference between the two groupsafter treatment （t =9.21, P 〈 0.01）. CONCLUSION： Hyperbaric oxygenation can remarkably decrease content of plasma C-reactive protein in patients with craniocerebral injury at the phase of stress.
