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 Acute right colonic diverticulitis (ARCD) is an important differential diagnosis of acute appendicitis (AA) in Asian countries because of the unusually high prevalence of right colonic diverticula. Due to q...BACKGROUND Acute right colonic diverticulitis (ARCD) is an important differential diagnosis of acute appendicitis (AA) in Asian countries because of the unusually high prevalence of right colonic diverticula. Due to qualitative improvement and the high penetration rate of computed tomography (CT) scanning in Japan, differentiation of ARCD and AA mainly depends on this modality. But cost, limited availability, and concern for radiation exposure make CT scanning problematic. Differential findings of ARCD from AA are based on several small studies that used univariate comparisons from Korea and Taiwan. Previous studies on clinical and laboratory differences between AA and ARCD are limited. AIM To determine clinical differences between AA and ARCD for differentiation of these two diagnoses by creating a logistic regression model. METHODS We performed an exploratory single-center retrospective case-control study evaluating 369 Japanese patients (age ≥ 16 years), 236 (64.0%) with AA and 133 (36.0%) with ARCD, who were hospitalized between 2012 and 2016. Diagnoses were confirmed by CT images. We compared age, sex, onset-to-visit interval, epigastric/periumbilical pain, right lower quadrant (RLQ) pain, nausea/vomiting, diarrhea, anorexia, medical history, body temperature, blood pressure, heart rate, RLQ tenderness, peritoneal signs, leukocyte count, and levels of serum creatinine, serum C-reactive protein (CRP), and serum alanine aminotrans-ferase. We subsequently performed logistic regression analysis for differentiating AA from ARCD based on the results of the univariate analyses.RESULTS In the AA and ARCD groups, median ages were 35.5 and 41.0 years, respectively (p=0.011);median onset-to-visit intervals were 1 [interquartile range (IQR): 0-1] and 2 (IQR: 1-3) days, respectively (P < 0.001);median leukocyte counts were 12600 and 11500/mm3, respectively (P = 0.002);and median CRP levels were 1.1 (IQR: 0.2-4.1) and 4.9 (IQR: 2.9-8.5) mg/dL, respectively (P < 0.001). In the logistic regression model, odds ratios (ORs) were significantly high in nausea/vomiting (OR: 3.89, 95%CI: 2.04-7.42) and anorexia (OR: 2.13, 95%CI: 1.06-4.28). ORs were significantly lower with a longer onset-to-visit interval (OR: 0.84, 95%CI: 0.72- 0.97), RLQ pain (OR: 0.28, 95%CI: 0.11-0.71), history of diverticulitis (OR: 0.034, 95%CI: 0.005-0.20), and CRP level > 3.0 mg/dL (OR: 0.25, 95%CI: 0.14-0.43). The regression model showed good calibration, discrimination, and optimism. CONCLUSION Clinical findings can differentiate AA and ARCD before imaging studies;nausea/vomiting and anorexia suggest AA, and longer onset-to-visit interval, RLQ pain, previous diverticulitis, and CRP level > 3.0 mg/dL suggest ARCD.展开更多
Background It＇s an effective treatment to achieve percutaneous coronary intervention （PCI） in acute myocardial infarction （AMI） patients for reperfusion of coronary artery. The PCI treatment can improve the blood...Background It＇s an effective treatment to achieve percutaneous coronary intervention （PCI） in acute myocardial infarction （AMI） patients for reperfusion of coronary artery. The PCI treatment can improve the blood supply of coronary artery, make some adverse effects at the same time. Studies have shown that statins have other effects in addition to lipid-lowering, such as anti-inflammatory effects. It can significantly reduce the incidence of coronary heart disease, cardiovascular disease mortality and even all-cause mortality. The aim of this study was to investigate the clinical effects and significance of intensive atorvastatin in AMI patients during perioperative period of PCI. Methods One hundred twelve AMI patients were randomly divided into three groups. The control group （n = 32） was given the routine medicine, and the two therapy groups were administered atorvastatin 80 mg or 40 mg before PCI,and then were administered atorvastati 40 mg q.d or 20 mg q.d after PCI. Levels of high-sensitive C-reactive protein （hs-CRP）, compared after PCI. Results sCD40L, myocardial enzymes and lipid was determined and Compared with the control group, the levels of serum hs-CRP, CD40L in treatment group 1 （n = 40） and treatment 2 group （n = 40） was significant difference between two treatment groups （ atorvastatin in AMI patients during PCI perioperative period i anti-inflammatory, anti-platelets, and stability of plaque and were significantly decreased （P 〈 0.05）, and there P 〈 0.01 ）. Conclusion Intensive treatment of s beneficial, possibly through Mechanisms such as coronary vascular endothelial function.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 Acute right colonic diverticulitis (ARCD) is an important differential diagnosis of acute appendicitis (AA) in Asian countries because of the unusually high prevalence of right colonic diverticula. Due to qualitative improvement and the high penetration rate of computed tomography (CT) scanning in Japan, differentiation of ARCD and AA mainly depends on this modality. But cost, limited availability, and concern for radiation exposure make CT scanning problematic. Differential findings of ARCD from AA are based on several small studies that used univariate comparisons from Korea and Taiwan. Previous studies on clinical and laboratory differences between AA and ARCD are limited. AIM To determine clinical differences between AA and ARCD for differentiation of these two diagnoses by creating a logistic regression model. METHODS We performed an exploratory single-center retrospective case-control study evaluating 369 Japanese patients (age ≥ 16 years), 236 (64.0%) with AA and 133 (36.0%) with ARCD, who were hospitalized between 2012 and 2016. Diagnoses were confirmed by CT images. We compared age, sex, onset-to-visit interval, epigastric/periumbilical pain, right lower quadrant (RLQ) pain, nausea/vomiting, diarrhea, anorexia, medical history, body temperature, blood pressure, heart rate, RLQ tenderness, peritoneal signs, leukocyte count, and levels of serum creatinine, serum C-reactive protein (CRP), and serum alanine aminotrans-ferase. We subsequently performed logistic regression analysis for differentiating AA from ARCD based on the results of the univariate analyses.RESULTS In the AA and ARCD groups, median ages were 35.5 and 41.0 years, respectively (p=0.011);median onset-to-visit intervals were 1 [interquartile range (IQR): 0-1] and 2 (IQR: 1-3) days, respectively (P < 0.001);median leukocyte counts were 12600 and 11500/mm3, respectively (P = 0.002);and median CRP levels were 1.1 (IQR: 0.2-4.1) and 4.9 (IQR: 2.9-8.5) mg/dL, respectively (P < 0.001). In the logistic regression model, odds ratios (ORs) were significantly high in nausea/vomiting (OR: 3.89, 95%CI: 2.04-7.42) and anorexia (OR: 2.13, 95%CI: 1.06-4.28). ORs were significantly lower with a longer onset-to-visit interval (OR: 0.84, 95%CI: 0.72- 0.97), RLQ pain (OR: 0.28, 95%CI: 0.11-0.71), history of diverticulitis (OR: 0.034, 95%CI: 0.005-0.20), and CRP level > 3.0 mg/dL (OR: 0.25, 95%CI: 0.14-0.43). The regression model showed good calibration, discrimination, and optimism. CONCLUSION Clinical findings can differentiate AA and ARCD before imaging studies;nausea/vomiting and anorexia suggest AA, and longer onset-to-visit interval, RLQ pain, previous diverticulitis, and CRP level > 3.0 mg/dL suggest ARCD.
文摘Background It＇s an effective treatment to achieve percutaneous coronary intervention （PCI） in acute myocardial infarction （AMI） patients for reperfusion of coronary artery. The PCI treatment can improve the blood supply of coronary artery, make some adverse effects at the same time. Studies have shown that statins have other effects in addition to lipid-lowering, such as anti-inflammatory effects. It can significantly reduce the incidence of coronary heart disease, cardiovascular disease mortality and even all-cause mortality. The aim of this study was to investigate the clinical effects and significance of intensive atorvastatin in AMI patients during perioperative period of PCI. Methods One hundred twelve AMI patients were randomly divided into three groups. The control group （n = 32） was given the routine medicine, and the two therapy groups were administered atorvastatin 80 mg or 40 mg before PCI,and then were administered atorvastati 40 mg q.d or 20 mg q.d after PCI. Levels of high-sensitive C-reactive protein （hs-CRP）, compared after PCI. Results sCD40L, myocardial enzymes and lipid was determined and Compared with the control group, the levels of serum hs-CRP, CD40L in treatment group 1 （n = 40） and treatment 2 group （n = 40） was significant difference between two treatment groups （ atorvastatin in AMI patients during PCI perioperative period i anti-inflammatory, anti-platelets, and stability of plaque and were significantly decreased （P 〈 0.05）, and there P 〈 0.01 ）. Conclusion Intensive treatment of s beneficial, possibly through Mechanisms such as coronary vascular endothelial function.
