AIM:To evaluate serum complement C4a and its relation to liver fibrosis in children with chronic hepatitis C virus(HCV)infection.METHODS:The study included 30 children with chronic HCV infection before receiving antiv...AIM:To evaluate serum complement C4a and its relation to liver fibrosis in children with chronic hepatitis C virus(HCV)infection.METHODS:The study included 30 children with chronic HCV infection before receiving antiviral therapy.Chronic HCV infection was defined by positive anti-HCV,a positive polymerase chain reaction for HCV-RNA for more than 6 mo with absence of any associated liver disease.A second group of 30 age-and sex-matched healthy children served as controls.Serum C4a levels were measured by enzyme-linked immunosorbent assay.Liver fibrosis stage and inflammatory grade were assessed using Ishak scoring system.Serum C4a levels were compared according to different clinical,laboratory and histopathological parameters.Statistical significance for quantitative data was tested by MannWhitney U non-parametric tests.For qualitative data,significance between groups was tested by 2test.Correlation was tested by Spearman’s test.Results were considered significant if P value≤0.05.RESULTS:The age of the patients ranged from 3.5to 18 years and that of controls ranged from 4 to 17years.C4a mean levels were merely lower in patients(153.67±18.69 mg/L)than that in the controls(157.25±11.40 mg/L)with no statistical significance(P=0.378).It did not differ significantly in patients with elevated vs those with normal transaminases(152.25±16.62 vs 155.36±21.33;P=0.868)or with different HCV viremia(P=0.561).Furthermore,there was no statistical significant difference in serum levels between those with no/mild fibrosis and those with moderate fibrosis(154.65±20.59 vs 152.97±17.72;P=0.786)or minimal and mild activity(155.1±21.93 vs 152.99±17.43;P=0.809).Though statistically not significant,C4a was highest in fibrosis score 0(F0),decreasing in F1 and F2 to be the lowest in F3.When comparing significant fibrosis(Ishak score≥3)vs other stages,C4a was significantly lower in F3 compared to other fibrosis scores(143.55±2.33 mg/L vs 155.26±19.64 mg/L;P=0.047)and at a cutoff value of less than 144.01 mg/L,C4a could discriminate F3 with 76.9%sensitivity and75%specificity from other stages of fibrosis.CONCLUSION:Serum complement C4a did not correlate with any of transaminases,HCV viremia or with the histopathological scores.Although C4a decreased with higher stages of fibrosis,this change was not significant enough to predict individual stages of fibrosis.Yet,it could predict significant fibrosis with acceptable clinical performance.展开更多
To investigate the influence of preparation process on the properties of synthesized C4AF,the powder was prepared via the self-propagating combustion reaction（SPCR）method using urea as fuel and metal nitrates as cat...To investigate the influence of preparation process on the properties of synthesized C4AF,the powder was prepared via the self-propagating combustion reaction（SPCR）method using urea as fuel and metal nitrates as cation precursors.Synthesis mechanism of the SPCR method,calculation and adjusting principles of urea dosage were detailedly introduced.Material characterization of synthesized C4AF was performed with the aid of X-ray diffractometry,Fourier transform infrared spectrometry,scanning electron microscopy,energydispersive X-ray spectroscopy,^27Al nuclear magnetic resonance and isothermal microcalorimetric technique.Remaining content of transition phase of calcium carbonate in synthesized C4AF was determined by quantitative analysis of X-ray diffractometry.It was found that there was no difference in the hydration behavior of C4AF synthesized by the SPCR method and the traditional solid-state reaction（SSR）method.C3AH6 and amorphous iron（III）hydroxide（Fe（OH）3）would be formed during the hydration of C4AF while CH not.Crystallite size of synthesized C4AF was 16.1 A and the apparent activation energy was 36.2 kJ/mol.Coordinated condition of Al in C4AF can be detected by ^27Al NMR technique,but the peaks were broadened and the intensities were relatively low,supporting the use of ^27Al NMR for the quantitative analysis of C3A in Portland cements.展开更多
用激光薄层密度扫描仪对171份血清补体 C4的电泳色带进行扫描,并求取其 C4A:C4B 比值(R 值)。结果发现含 C4A·QO 基因者的 R 值范围0.068～0.429,平均0.228,而含 C4B·QO 基因者的 R 值范围2.197～9.334,平均3.973;在所检出的...用激光薄层密度扫描仪对171份血清补体 C4的电泳色带进行扫描,并求取其 C4A:C4B 比值(R 值)。结果发现含 C4A·QO 基因者的 R 值范围0.068～0.429,平均0.228,而含 C4B·QO 基因者的 R 值范围2.197～9.334,平均3.973;在所检出的7例具有 C4B·座位重复基因的样本中.其 R 值均很小(0.120～0.625),且其中含有 C4A·QO 者与不含 C4A·QO 者的 R 值有明显差异.结果表明根据 R 值大小来指定C4·QO 基因和重复基因是有一定道理的.在最常见的 C4表型3,3/1,1中,其 R 值呈常态分布,但表型3,3/2,1、3,3/2,2和3,2/1,1的 R 值多大于1.0,而表型4,4/2,2和4,4/2,1的 R 值多小于1.0。两组表型的 R 值之间的两两比较有显著性差异(P<0.01)。展开更多
Background: Capillary leak syndrome is a life-threatening complication after cardiopulmonary bypass (CPB), with an incidence of about 4-37%in children worldwide. On the basis of previous results, we undertook a random...Background: Capillary leak syndrome is a life-threatening complication after cardiopulmonary bypass (CPB), with an incidence of about 4-37%in children worldwide. On the basis of previous results, we undertook a randomised controlled study to investigate the priming with plasma rich in the C4A isotype of complement component 4 on the incidence of capillary leak syndrome in children with C4A deficiency. Methods: In a hospital in Wuhan, China, we randomly assigned 116 neonates, infants, and children lacking complement component C4A to receive C4A-free or C4A-rich plasma priming (n=58 each, 20 mL/kg). The primary outcome was capillary leak syndrome, identified as an increased transvascular escape rate of Evans blue dye from plasma. Concentrations of activated complement components C4 and C3, inflammatory mediators interleukin 6, interleukin 8, tumour necrosis factor (TNF)-α, plasma protein, and PaO2/FIO2 ratios (ratio of the partial arterial pressure of oxygen to the fractional concentration of oxygen in inspired air) were measured before and 4 h after CPB. Analysis was by intention to treat. Findings: Three (5%) patients given C4A-rich plasma priming had capillary leak syndrome compared with 56 (97%)-given C4A-free plasma (p < 0.0001). At 4 h after CPB, activated C4, interleukin 6, interleukin 8, and TNFαconcentrations were higher, whereas PaO2/FIO2 ratios and plasma protein concentrations were significantly lower in the C4A-free group than changes in the C4A-rich group. Activated C3 rose equally in both groups. Activated C4 significantly correlated with interleukin 6, interleukin 8, and TNFαconcentrations; PaO2/FIO2 ratios; and the escape rate of Evans blue dye at 4 h after CPB. Two patients in the C4A-free group died of respiratory and renal failure on day 3 after CPB. Interpretation: In paediatric patients with C4A deficiency, C4A-rich plasma priming reduces the incidence of CPB-related capillary leak syndrome by blocking the activated C4 increase and attenuating the systemic inflammatory response after CPB.展开更多
Background: Capillary leak syndrome is a life-threatening complication after cardiopulmonary bypass(CPB), with an incidence of about 4-37%in children worldwide. On the basis of previous results, we undertook a randomi...Background: Capillary leak syndrome is a life-threatening complication after cardiopulmonary bypass(CPB), with an incidence of about 4-37%in children worldwide. On the basis of previous results, we undertook a randomised controlled study to investigate the priming with plasma rich in the C4A isotype of complement component 4 on the incidence of capillary leak syndrome in children with C4A deficiency. Methods: In a hospital in Wuhan, China, we randomly assigned 116 neonates, infants, and children lacking complement component C4A to receive C4A-free or C4A-rich plasma priming(n=58 each, 20 mL/kg). The primary outcome was capillary leak syndrome, identified as an increased transvascular escape rate of Evans blue dye from plasma. Concentrations of activated complement components C4 and C3, inflammatory mediators interleukin 6, interleukin 8, tumour necrosis factor(TNF)-α, plasma protein, and PaO2/FIO2 ratios(ratio of the partial arterial pressure of oxygen to the fractional concentration of oxygen in inspired air) were measured before and 4 h after CPB. Analysis was by intention to treat. Findings: Three(5%) patients given C4A-rich plasma priming had capillary leak syndrome compared with 56(97%)given C4A-free plasma(p< 0.0001). At 4 h after CPB, activated C4, interleukin 6, interleukin 8, and TNFαconcentrations were higher, whereas PaO2/F IO2 ratios and plasma protein concentrations were significantly lower in the C4A-free group than changes in the C4A-rich group. Activated C3 rose equally in both groups. Activated C4 significantly correlated with interleukin 6, interleukin 8, and TNFαconcentrations; PaO2/FIO2 ratios; and the escape rate of Evans blue dye at 4 h after CPB. Two patients in the C4A-free group died of respiratory and renal failure on day 3 after CPB. Interpretation: In paediatric patients with C4A deficiency, C4A-rich plasma priming reduces the incidence of CPB-related capillary leak syndrome by blocking the activated C4 increase and attenuating the systemic inflammatory response after CPB.展开更多
基金Supported by National Liver Institute,Menofiya University,Egypt
文摘AIM:To evaluate serum complement C4a and its relation to liver fibrosis in children with chronic hepatitis C virus(HCV)infection.METHODS:The study included 30 children with chronic HCV infection before receiving antiviral therapy.Chronic HCV infection was defined by positive anti-HCV,a positive polymerase chain reaction for HCV-RNA for more than 6 mo with absence of any associated liver disease.A second group of 30 age-and sex-matched healthy children served as controls.Serum C4a levels were measured by enzyme-linked immunosorbent assay.Liver fibrosis stage and inflammatory grade were assessed using Ishak scoring system.Serum C4a levels were compared according to different clinical,laboratory and histopathological parameters.Statistical significance for quantitative data was tested by MannWhitney U non-parametric tests.For qualitative data,significance between groups was tested by 2test.Correlation was tested by Spearman’s test.Results were considered significant if P value≤0.05.RESULTS:The age of the patients ranged from 3.5to 18 years and that of controls ranged from 4 to 17years.C4a mean levels were merely lower in patients(153.67±18.69 mg/L)than that in the controls(157.25±11.40 mg/L)with no statistical significance(P=0.378).It did not differ significantly in patients with elevated vs those with normal transaminases(152.25±16.62 vs 155.36±21.33;P=0.868)or with different HCV viremia(P=0.561).Furthermore,there was no statistical significant difference in serum levels between those with no/mild fibrosis and those with moderate fibrosis(154.65±20.59 vs 152.97±17.72;P=0.786)or minimal and mild activity(155.1±21.93 vs 152.99±17.43;P=0.809).Though statistically not significant,C4a was highest in fibrosis score 0(F0),decreasing in F1 and F2 to be the lowest in F3.When comparing significant fibrosis(Ishak score≥3)vs other stages,C4a was significantly lower in F3 compared to other fibrosis scores(143.55±2.33 mg/L vs 155.26±19.64 mg/L;P=0.047)and at a cutoff value of less than 144.01 mg/L,C4a could discriminate F3 with 76.9%sensitivity and75%specificity from other stages of fibrosis.CONCLUSION:Serum complement C4a did not correlate with any of transaminases,HCV viremia or with the histopathological scores.Although C4a decreased with higher stages of fibrosis,this change was not significant enough to predict individual stages of fibrosis.Yet,it could predict significant fibrosis with acceptable clinical performance.
基金Funded partly by the National“973”Program of China(No.2015CB655101)National Natural Science Foundation of China(No.51379163)
文摘To investigate the influence of preparation process on the properties of synthesized C4AF,the powder was prepared via the self-propagating combustion reaction（SPCR）method using urea as fuel and metal nitrates as cation precursors.Synthesis mechanism of the SPCR method,calculation and adjusting principles of urea dosage were detailedly introduced.Material characterization of synthesized C4AF was performed with the aid of X-ray diffractometry,Fourier transform infrared spectrometry,scanning electron microscopy,energydispersive X-ray spectroscopy,^27Al nuclear magnetic resonance and isothermal microcalorimetric technique.Remaining content of transition phase of calcium carbonate in synthesized C4AF was determined by quantitative analysis of X-ray diffractometry.It was found that there was no difference in the hydration behavior of C4AF synthesized by the SPCR method and the traditional solid-state reaction（SSR）method.C3AH6 and amorphous iron（III）hydroxide（Fe（OH）3）would be formed during the hydration of C4AF while CH not.Crystallite size of synthesized C4AF was 16.1 A and the apparent activation energy was 36.2 kJ/mol.Coordinated condition of Al in C4AF can be detected by ^27Al NMR technique,but the peaks were broadened and the intensities were relatively low,supporting the use of ^27Al NMR for the quantitative analysis of C3A in Portland cements.
文摘用激光薄层密度扫描仪对171份血清补体 C4的电泳色带进行扫描,并求取其 C4A:C4B 比值(R 值)。结果发现含 C4A·QO 基因者的 R 值范围0.068～0.429,平均0.228,而含 C4B·QO 基因者的 R 值范围2.197～9.334,平均3.973;在所检出的7例具有 C4B·座位重复基因的样本中.其 R 值均很小(0.120～0.625),且其中含有 C4A·QO 者与不含 C4A·QO 者的 R 值有明显差异.结果表明根据 R 值大小来指定C4·QO 基因和重复基因是有一定道理的.在最常见的 C4表型3,3/1,1中,其 R 值呈常态分布,但表型3,3/2,1、3,3/2,2和3,2/1,1的 R 值多大于1.0,而表型4,4/2,2和4,4/2,1的 R 值多小于1.0。两组表型的 R 值之间的两两比较有显著性差异(P<0.01)。
文摘Background: Capillary leak syndrome is a life-threatening complication after cardiopulmonary bypass (CPB), with an incidence of about 4-37%in children worldwide. On the basis of previous results, we undertook a randomised controlled study to investigate the priming with plasma rich in the C4A isotype of complement component 4 on the incidence of capillary leak syndrome in children with C4A deficiency. Methods: In a hospital in Wuhan, China, we randomly assigned 116 neonates, infants, and children lacking complement component C4A to receive C4A-free or C4A-rich plasma priming (n=58 each, 20 mL/kg). The primary outcome was capillary leak syndrome, identified as an increased transvascular escape rate of Evans blue dye from plasma. Concentrations of activated complement components C4 and C3, inflammatory mediators interleukin 6, interleukin 8, tumour necrosis factor (TNF)-α, plasma protein, and PaO2/FIO2 ratios (ratio of the partial arterial pressure of oxygen to the fractional concentration of oxygen in inspired air) were measured before and 4 h after CPB. Analysis was by intention to treat. Findings: Three (5%) patients given C4A-rich plasma priming had capillary leak syndrome compared with 56 (97%)-given C4A-free plasma (p < 0.0001). At 4 h after CPB, activated C4, interleukin 6, interleukin 8, and TNFαconcentrations were higher, whereas PaO2/FIO2 ratios and plasma protein concentrations were significantly lower in the C4A-free group than changes in the C4A-rich group. Activated C3 rose equally in both groups. Activated C4 significantly correlated with interleukin 6, interleukin 8, and TNFαconcentrations; PaO2/FIO2 ratios; and the escape rate of Evans blue dye at 4 h after CPB. Two patients in the C4A-free group died of respiratory and renal failure on day 3 after CPB. Interpretation: In paediatric patients with C4A deficiency, C4A-rich plasma priming reduces the incidence of CPB-related capillary leak syndrome by blocking the activated C4 increase and attenuating the systemic inflammatory response after CPB.
文摘Background: Capillary leak syndrome is a life-threatening complication after cardiopulmonary bypass(CPB), with an incidence of about 4-37%in children worldwide. On the basis of previous results, we undertook a randomised controlled study to investigate the priming with plasma rich in the C4A isotype of complement component 4 on the incidence of capillary leak syndrome in children with C4A deficiency. Methods: In a hospital in Wuhan, China, we randomly assigned 116 neonates, infants, and children lacking complement component C4A to receive C4A-free or C4A-rich plasma priming(n=58 each, 20 mL/kg). The primary outcome was capillary leak syndrome, identified as an increased transvascular escape rate of Evans blue dye from plasma. Concentrations of activated complement components C4 and C3, inflammatory mediators interleukin 6, interleukin 8, tumour necrosis factor(TNF)-α, plasma protein, and PaO2/FIO2 ratios(ratio of the partial arterial pressure of oxygen to the fractional concentration of oxygen in inspired air) were measured before and 4 h after CPB. Analysis was by intention to treat. Findings: Three(5%) patients given C4A-rich plasma priming had capillary leak syndrome compared with 56(97%)given C4A-free plasma(p< 0.0001). At 4 h after CPB, activated C4, interleukin 6, interleukin 8, and TNFαconcentrations were higher, whereas PaO2/F IO2 ratios and plasma protein concentrations were significantly lower in the C4A-free group than changes in the C4A-rich group. Activated C3 rose equally in both groups. Activated C4 significantly correlated with interleukin 6, interleukin 8, and TNFαconcentrations; PaO2/FIO2 ratios; and the escape rate of Evans blue dye at 4 h after CPB. Two patients in the C4A-free group died of respiratory and renal failure on day 3 after CPB. Interpretation: In paediatric patients with C4A deficiency, C4A-rich plasma priming reduces the incidence of CPB-related capillary leak syndrome by blocking the activated C4 increase and attenuating the systemic inflammatory response after CPB.
