Background The association of systemic inflammatory response index(SIRI)with prognosis of coronary artery disease(CAD)patients has never been investigated in a large sample with long-term follow-up.This study aimed to...Background The association of systemic inflammatory response index(SIRI)with prognosis of coronary artery disease(CAD)patients has never been investigated in a large sample with long-term follow-up.This study aimed to explore the association of SIRI with all-cause and cause-specific mortality in a nationally representative sample of CAD patients from United States.Methods A total of 3386 participants with CAD from the National Health and Nutrition Examination Survey(NHANES)1999-2018 were included in this study.Cox proportional hazards model,restricted cubic spline(RCS),and receiver operating characteristic curve(ROC)were performed to investigate the association of SIRI with all-cause and cause-specific mortality.Piecewise linear regression and sensitivity analyses were also performed.Results During a median follow-up of 7.7 years,1454 all-cause mortality occurred.After adjusting for confounding factors,higher lnSIRI was significantly associated with higher risk of all-cause(HR=1.16,95%CI:1.09-1.23)and CVD mortality(HR=1.17,95%CI:1.05-1.30)but not cancer mortality(HR=1.17,95%CI:0.99-1.38).The associations of SIRI with all-cause and CVD mortality were detected as J-shaped with threshold values of 1.05935 and 1.122946 for SIRI,respectively.ROC curves showed that lnSIRI had robust predictive effect both in short and long terms.Conclusions SIRI was independently associated with all-cause and CVD mortality,and the dose-response relationship was Jshaped.SIRI might serve as a valid predictor for all-cause and CVD mortality both in the short and long terms.展开更多
Acute cardiomyocyte necrosis in the infarcted heart generates damage-associated molecular patterns, activating complement and toll-like receptor/interleukin-1 signaling, and triggering an intense inflammatory response...Acute cardiomyocyte necrosis in the infarcted heart generates damage-associated molecular patterns, activating complement and toll-like receptor/interleukin-1 signaling, and triggering an intense inflammatory response. Iuflammasomes also recognize danger signals and mediate sterile inflammatory response following acute myocardial infarction （AMI）, Inflammatory response serves to repair the heart, but excessive inflammation leads to adverse left ventricular remodeling and heart failure. In addition to local inflammation, profound systemic inflammation response has been documented in patients with AMI, which includes elevation of circulating inflammatory cytokines, chemokines and cell adhesion molecules, and activation of peripheral leukocytes and platelets. The excessive inflammatory response could be caused by a deregulated immune system. AMI is also associated with bone marrow activation and spleen monocytopoiesis, which sustains a continuous supply of monocytes at the site of inflammation. Accumulating evidence has shown that systemic inflammation aggravates atherosclerosis and markers for systemic inflammation are predictors of adverse clinical outcomes （such as death, recurrent myocardial in- farction, and heart failure） in patients with AMI.展开更多
BACKGROUND:Periplaneta americana extract is recognized to have a positive effect on gastrointestinal mucosa.This study aimed to investigate the effects of periplaneta americana extract on immune function,nutrition sta...BACKGROUND:Periplaneta americana extract is recognized to have a positive effect on gastrointestinal mucosa.This study aimed to investigate the effects of periplaneta americana extract on immune function,nutrition status and gastrointestinal complications of early enteral nutrition patients with systemic inflammatory response syndrome(SIRS).METHODS:Patients with SIRS were randomly divided into two groups:treatment and control groups.All patients in the two groups received conventional therapy including enteral nutrition,but periplaneta americana extract,an additional Chinese medicine,was given to the patients in the treatment group.At the beginning of treatment(0 day)and 1,3,and 7 days after treatment,the levels of immunoglobulin(Ig A),total lymphocyte count(TLC),total protein(TP)and prealbumin(PA)were respectively tested in patients'venous blood.The incidences of bloating,diarrhea,aspiration pneumonia and high blood sugar at 7 days after treatment were recorded.The mortality of the patients in 28 days was recorded.RESULTS:At 3 and 7 days after treatment,the levels of Ig A and TLC in the treatment group were higher than those in the control group(P<0.05).At 7 days after treatment,the levels of TP and PA in the treatment group were higher than those in the control group(P<0.05).The incidences of bloating and diarrhea in the treatment group were lower than those in the control group,the differences were significant(P<0.05).The mortality of treatment group was lower than that of the control group(P>0.05).CONCLUSION:Periplaneta americana extract could reduce gastrointestinal complications and improve immune function and nutritional status in patients with systemic inflammatory response syndrome.展开更多
BACKGROUND： This study aimed to determine the plasma levels of urokinase-type plasminogen activator （uPA）, urokinase-type plasminogen activator receptor （uPAR）, D-dimer, IL-6 and TNF-α, and observe the relations...BACKGROUND： This study aimed to determine the plasma levels of urokinase-type plasminogen activator （uPA）, urokinase-type plasminogen activator receptor （uPAR）, D-dimer, IL-6 and TNF-α, and observe the relations among uPA, uPAR, D-dimer, IL-6 and TNF-α in patients with systemic inflammatory response syndrome （SIRS）.METHODS： A prospective, clinical case-control study was conducted in patients with SIRS at age of more than 55 years old treated during 2008-2010 at Wuhan Central Hospital. Venous blood samples were collected by routine venipuncture. Eighty-five patients were divided into two groups according to diagnostic criteria of SIRS： SIRS patients from intensive care units （n=50）, and non- SIRS patients from medical wards （n=35）. Thirty healthy blood donors who visited the General Health Check-up Division at Wuhan Central Hospital served as controls. Excluded from the study were （1） those patients with pregnancy; （2） those with cancer; （3） those died after admission into the ICU in 7 days; （4） those received cardiopulmonary resuscitation; （5） those who had previous blood system diseases; and （6） those with SIRS before admission into the ICU. The levels of uPA, uPAR, D-D, IL-6 and TNF-a in blood were detected by commercial enzyme-linked immunosorbent assay （ELISA） kit. The data were analyzed using SPSS version 17.0 and expressed as mean ＋ standard. Student＇s t test and the Mann-Whitney U test were used in the analysis. The relations of uPA, uPAR and D-dimer, IL-6 TNF-α levels were analyzed using Spearman＇s rank-order correlation coefficient test. RESULTS： The plasma levels of uPA, uPAR, D-dimer, lL-6 and TNF-α in the patients with SIRS were obviously higher than those in the non-SIRS patients and controls （P〈0.001）. Correlation analysis showed a positive correlation between uPAR and IL-6 levels （r=0.395, P=0.004） and between uPAR and TNF-a levels （r=0.606, P〈0.001）, but no correlation between uPAR and D-dimer levels （r=0.069, P=0.632）. No correlation was observed between uPA, D-dimer, IL-6 and TNF-α levels （P〉0.05）. The establishment of ROC curve was based on the levels of uPAR, D-dimer, IL-6 and TNF-α in 24 hours for the diagnosis of multiple organ dysfunction syndrome （MODS）, and the ROC areas under the curve were 0.76, 0.58, 0.86 and 0.83, respectively. CONCLUSIONS：uPA and uPAR play a major role in patients with SIRS in the process of coagulation disorder, but the mechanism of SIRS is not the same. uPAR may play a central role in the development of SIRS to MODS.展开更多
The changes of Toll-like receptor （TLR） 2, 4 of peripheral blood mononuclear cells （PBMCs） in the acute abdomen patients associated with systemic inflammatory response syndrome （SIRS） and their potential signifi...The changes of Toll-like receptor （TLR） 2, 4 of peripheral blood mononuclear cells （PBMCs） in the acute abdomen patients associated with systemic inflammatory response syndrome （SIRS） and their potential significance were explored. A clinical study was performed on 103 acute abdomen patients in whom 65 were associated with SIRS. Forty healthy individuals served as normal controls. The mRNA expression of TLR2, 4 was detected by RT-PCR, and the expression of TNF-α and IL-6 by ELISA. The level of plasma endotoxin, hospital stay and mortality were measured. It was found that the endotoxin level was increased to varying degrees in all the acute abdomen patients, and the endotoxin level was and hospital stay longer in SIRS group than in non-SIRS group （P〈0.01）. TLR2 mRNA, TLR4 mRNA, IL-6 and TNF-ct could be detected with low value in normal controls, but they were up-regulated markedly on the 1 st day after admission. Then TLR4 mRNA, IL-6 and TNF-α were decreased gradually, but TLR2 mRNA maintained at a high level till the 5th day. These indexes above in SIRS group were higher than those in non-SIRS group （P〈0.01）. The results of correlation analysis revealed the expression of TLR2, 4 mRNA was positively correlated with the levels of TNF-α and IL-6, and the hospital stay, The results of Logistic regression demonstrated that overexpression of TLR2, 4 mRNA might result in higher risk of multiple organ dysfunction syndrome （MODS）. It was concluded that in the acute abdomen patients associated with SIRS, the expression of TLR2, 4 in PBMCs was increased markedly, suggesting that TLR might play an important role in the pathogenesis of acute abdomen associated with SIRS.展开更多
BACKGROUND:Urokinase-type plasminogen activator(uPA) and urokinase-type plasminogen activator receptor(uPAR) are known as important factors,which mediate a variety of functions in terms of vascular homeostasis,inflamm...BACKGROUND:Urokinase-type plasminogen activator(uPA) and urokinase-type plasminogen activator receptor(uPAR) are known as important factors,which mediate a variety of functions in terms of vascular homeostasis,inflammation and tissue repair.However,their role in systemic inflammatory response syndrome(SIRS) has been less well studied.This study aimed to test the hypothesis that the abnormalities of fibrinolysis and degradation of extracellular matrix mediated by uPA and uPAR are directly related to the patients with SIRS.We therefore analyzed their role and clinicopathological significance in patients with SIRS.METHODS:A case-control study was conducted with 85 patients who were divided into two groups according to the diagnostic criteria of SIRS:SIRS group(n=50) and non-SIRS group(/7=35).The SIRS group was divided into MODS group(n=26) and non-MODS group(n=24) by their severity,and survival group(n=35) and non-survival group(n=15) by their prognosis.Another 30 healthy adults served as normal controls.uPA and uPAR in plasma were detected by commercial enzyme-linked immunosorbent assay(ELISA) kits.RESULTS:The plasma level of uPA was lower in the SIRS group than in the non-SIRS group and controls(P<0.001 and P<0.001).It was lower in sepsis patients and the MODS group than in the non-sepsis patients and the non-MODS patients(all P<0.05).However,there was no difference in uPA level between survivors and non-survivors(P>0.05).The plasma level of uPAR increased in the SIRS group compared with the non-SIRS group and controls(P<0.001 and P<0.001).There was a significant elevation of uPAR in sepsis patients,MODS patients and non-survivors as compared with non-sepsis patients,non-MODS patients and survivors respectively(all P<0.05).Plasma uPAR levels were positively correlated with APACHE Ⅱ score(r=0.575,P<0.001) and SOFA score(r=0.349,P=0.013).AUCs for the prediction of SIRS mortality were 0.67 and 0.51,respectively,for uPA and uPAR.CONCLUSION:uPAR could be a predictor of poor outcome in patients with SIRS.展开更多
Background: Pelvic fracture combined with massive bleeding(PFCMB) is a complex issue in clinical practice. Currently, the use of angiography and embolization for the treatment of PFCMB obtains good results. The aim of...Background: Pelvic fracture combined with massive bleeding(PFCMB) is a complex issue in clinical practice. Currently, the use of angiography and embolization for the treatment of PFCMB obtains good results. The aim of this study is to observe the effects of early internal iliac artery embolization on the systemic inflammatory response syndrome(SIRS) in dogs with simulated-pelvic-fracture combined with massive bleeding.Methods: Twenty adult dogs were randomly divided into an embolization group(EG) and a control group(CG). For the two groups, heart rate, respiratory rate and body temperature and other physiological variables were measured, and IL-6, TNF-α and arterial blood gas levels were monitored. These variables were assayed every 30 min until death in the CG, while dogs in the EG underwent arterial angiography after 60 min of modeling. The internal iliac artery was embolized on the injured side.Results: The average time to SIRS in the CG was 3.56 h, occurring at a rate of 90%(9/10) within 24 h, with a mortality rate of 50%(5/10); the average time to SIRS for the EG was 5.33 h, occurring at a rate of 30%(3/10) within 24 h, with a mortality rate of 10%(1/10). When SIRS occurred in the EG, the mean plasma IL-6 level was 52.66±7.38pg/ml and the TNF-ps, tα level was 11.45±2.72ng/ml, showing a significant difference with those of the CG(P<0.05). In the two grouhe respiratory rate and leukocyte levels were higher at each monitored time after modeling than those before modeling; the mean arterial pressure, levels of hemoglobin and oxygen partial pressure were significantly lower at each time point after modeling than those before modeling except for the mean arterial pressure at 0h in EG; the platelet levels at 4 and 8h were higher than those before modeling; and the differences were statistically significant(P<0.05). In the EG, the mean arterial pressure, heart rate, respiratory rate and hemoglobin levels at 2, 4 and 8h were lower than those at 0h; the levels of leukocytes, platelets and carbon dioxide partial pressure at 4 and 8h after modeling were higher than those at 0h, and the differences were statistically significant(P<0.05, P<0.01); in the CG after modeling, the mean arterial pressure, levels of hemoglobin and carbon dioxide partial pressure at 2, 4 and 8h were lower than those at 0h; the levels of heart rate and leukocytes were higher than those before modeling; the respiratory rate and platelet levels at 4 and 8h were higher than those at 0h; and the differences were statistically significant(P<0.05). The levels of the mean arterial pressure and hemoglobin at 4 and 8h and the p H values at 8h after modeling in the EG were significantly higher than those in the CG, while the heart rate and respiratory rate at 4 and 8h were significantly lower than those in the CG. The p H values at 8h after modeling were significantly lower than those of the other monitored times in the CG(P<0.05, P<0.01). The two groups had elevated levels of alkaline phosphatase after injury induction.Conclusion: Through the use of an on-spot interventional treatment cabin, early internal iliac artery embolization can control bleeding associated with pelvic fractures, delay the occurrence of SIRS, and improve the success rate of the treatment of pelvic fracture combined with bleeding.展开更多
BACKGROUND The systemic inflammatory response index(SIRI)has been demonstrated to make a significant difference in assessing the prognosis of patients with different solid neoplasms.However,research is needed to ascer...BACKGROUND The systemic inflammatory response index(SIRI)has been demonstrated to make a significant difference in assessing the prognosis of patients with different solid neoplasms.However,research is needed to ascertain the accuracy and reliability of applying the SIRI to patients who undergo robotic radical gastric cancer sur-gery.AIM To validate the applicability of the SIRI in assessing the survival of gastric cancer patients and evaluate the clinical contribution of preoperative SIRI levels to predicting long-term tumor outcomes in patients,who received robotic radical gastric cancer surgery.METHODS Initially,an exhaustive retrieval was performed in the PubMed,the Cochrane Library,EMBASE,Web of Science,and Scopus databases to identify relevant studies.Subsequently,a meta-analysis was executed on 6 cohort studies iden-tifying the value of the SIRI in assessing the survival of gastric cancer patients.Additionally,the clinical data of 161 patients undergoing robotic radical gastric cancer surgery were retrospectively analyzed to evaluate their clinicopathological characteristics and relevant laboratory indicators.The association between preoperative SIRI levels and 5-year overall survival(OS)and disease-free survival(DFS)was assessed.RESULTS The findings demonstrated an extensive connection between SIRI values and the outcome of patients with gastric cancer.Preoperative SIRI levels were identified as an independent hazard feature for both OS and DFS among those who received robotic surgery for gastric cancer.SIRI levels in gastric cancer patients were observed to be associated with the presence of comorbidities,T-stage,carcinoembryonic antigen levels,the development of early serious postoperative complications,and the rate of lymph node metastasis.CONCLUSION SIRI values are correlated with adverse in the gastric cancer population and have the potential to be utilized in predicting long-term oncological survival in patients who undergo robotic radical gastric cancer surgery.展开更多
Based on the scale-free network, an integrated systemic inflammatory response syndrome model with artificial immunity, a feedback mechanism, crowd density and the moving activities of an individual can be built. The e...Based on the scale-free network, an integrated systemic inflammatory response syndrome model with artificial immunity, a feedback mechanism, crowd density and the moving activities of an individual can be built. The effects of these factors on the spreading process are investigated through the model. The research results show that the artificial immunity can reduce the stable infection ratio and enhance the spreading threshold of the system. The feedback mechanism can only reduce the stable infection ratio of system, but cannot affect the spreading threshold of the system. The bigger the crowd density is, the higher the infection ratio of the system is and the smaller the spreading threshold is. In addition, the simulations show that the individual movement can enhance the stable infection ratio of the system only under the condition that the spreading rate is high, however, individual movement will reduce the stable infection ratio of the system.展开更多
Objective: To investigate whether bacterial DNA involving in the pathogenesis of systemic inflammatory response syndrome (SIRS) and possible mechanism. Methods: Escherichia coli DNA (EC DNA) was extracted from Escheri...Objective: To investigate whether bacterial DNA involving in the pathogenesis of systemic inflammatory response syndrome (SIRS) and possible mechanism. Methods: Escherichia coli DNA (EC DNA) was extracted from Escherichia coli 25922 with alkaline lysis method. The mice mortality was observed after EC DNA was injected into mice via caudal vein. The changes of serum TNF-α and IL-6 levels in rats were measured with ELISA after rats were given EC DNA. Calf thymus DNA and lipopolysaccharide (LPS) were used as the control, respectively. Results: EC DNA led mice to death with notable dose-effect relationship (LD50=11.51 mg/kg), but CT DNA didn't. The peak level of TNF-αwas lower in EC DNA group than in LPS group (P＜0. 05), though the former reaching the peak I h earlier than the latter. However, they had coordinate ability to induce IL-6 release in rats, and no significant difference was seen in serum IL-6 peak level between 2 groups. Conclusion: EC DNA leads mice to death, and induces the increases of serum TNF-αand IL-6 levels in rats. EC DNA has the effect equal to LPS in inducing SIRS by triggering cytokines cascade.展开更多
BACKGROUND The relationship between preoperative inflammation status and tumorigenesis as well as tumor progression is widely acknowledged.AIM To assess the prognostic significance of preoperative inflammatory biomark...BACKGROUND The relationship between preoperative inflammation status and tumorigenesis as well as tumor progression is widely acknowledged.AIM To assess the prognostic significance of preoperative inflammatory biomarkers in patients with distal cholangiocarcinoma(dCCA)who underwent pancreat-oduodenectomy(PD).METHODS This single-center study included 216 patients with dCCA after PD between January 1,2011,and December 31,2022.The individuals were categorized into two sets based on their systemic inflammatory response index(SIRI)levels:A low SIRI group(SIRI<1.5,n=123)and a high SIRI group(SIRI≥1.5,n=93).Inflam-matory biomarkers were evaluated for predictive accuracy using receiver operating characteristic curves.Both univariate and multivariate Cox proportional hazards analyses were performed to estimate SIRI for overall survival(OS)and recurrence-free survival(RFS).RESULTS The study included a total of 216 patients,with 58.3%being male and a mean age of 65.6±9.6 years.123 patients were in the low SIRI group and 93 were in the high SIRI group after PD for dCCA.SIRI had an area under the curve value of 0.674 for diagnosing dCCA,showing better performance than other inflammatory biomarkers.Multivariate analysis indicated that having a SIRI greater than 1.5 independently increased the risk of dCCA following PD,leading to lower OS[hazard ratios(HR)=1.868,P=0.006]and RFS(HR=0.949,P<0.001).Additionally,survival analysis indicated a significantly better prognosis for patients in the low SIRI group(P<0.001).CONCLUSION It is determined that a high SIRI before surgery is a significant risk factor for dCCA after PD.展开更多
To explore changes of toll-like receptor (TLR) 2,4 in peripheral blood mononuclear cells (PBMC) in acute abdomen patients with systemic inflammatory response syndrome (SIRS) and their significance.Methods A clinical s...To explore changes of toll-like receptor (TLR) 2,4 in peripheral blood mononuclear cells (PBMC) in acute abdomen patients with systemic inflammatory response syndrome (SIRS) and their significance.Methods A clinical study was done on 103 patients of which 65 were with SIRS.The mRNA expression of TLR2,4 were detected by RT-PCR;the expression of TNF-α and IL-6 were observed by ELISA;the correlation between TLR2,4 mRNA,the level of TNF-α and IL-6,and the clinical course was evaluated.Results TLR2 mRNA ,TNF-α and IL-6 were upregulated markedly on the first day of hospitalization,then decreased gradually;TLR2 mRNA maintained on high level till the 5th day.The expression of TLR2,4 mRNA was positive correlated with the level of TNF-α and IL-6,and the length of stay.TLR2,4 mRNA expression increased in patients with multiple organ failure.Conclusion In actue abdomen patients with SIRS,the expression of TLR2,4 of PBMC increased markedly,indicating its improtant role in the pathogenesis of SIRS.4 refs,2 figs,2 tabs.展开更多
Gastric ulcer(GU)represents a clinically significant manifestation of peptic ulcer disease,driven by a complex interplay of microbial,environmental,and immuneinflammatory factors.A recent cross-sectional study by Shen...Gastric ulcer(GU)represents a clinically significant manifestation of peptic ulcer disease,driven by a complex interplay of microbial,environmental,and immuneinflammatory factors.A recent cross-sectional study by Shen et al systematically evaluated six complete blood count-derived inflammatory indices:Neutrophil-tolymphocyte ratio,monocyte-to-lymphocyte ratio,platelet-to-lymphocyte ratio,systemic immune-inflammation index,systemic inflammatory response index(SIRI),and aggregate index of systemic inflammation and demonstrated their positive associations with GU prevalence,identifying SIRI as the strongest predictor.This editorial contextualizes these findings within the broader literature,clarifies that these indices reflect systemic rather than GU-specific inflammation,highlights methodological strengths and major limitations,and proposes a conceptual clinical algorithm for integrating SIRI into GU risk assessment.Future multicenter studies incorporating Helicobacter pylori infection,non-steroidal antiinflammatory drug exposure,and prospective design are essential to validate and translate these findings into clinical practice.展开更多
ObjectiveToinvestigatethe interactionof workplace noise,body mass index(BMI)and systemic inflammatory response on hypertension.Methods In January 2019,1124 male workers from an automobile factory in Wuhan were selecte...ObjectiveToinvestigatethe interactionof workplace noise,body mass index(BMI)and systemic inflammatory response on hypertension.Methods In January 2019,1124 male workers from an automobile factory in Wuhan were selected by cluster random sampling method.The study population was divided into normal body weight group(BMI<24 kg/m^(2))and overweight group(BMI≥24 kg/m^(2))according to BMI,and were followed up for 3 years.The occupational health examination of the workers was carried out every year,blood routine and blood biochemical indexes were collected,and the information of the workers'age,BMI,type of work and age of exposure to injury were collected through field questionnaires.The noise intensity of the workplace of theenterpriseewas measured for 3 consecutive years,and the equivalent sound level was calculated according to the working time.Normal and skewness measurements were described by Mean±SD and[M(Q_(1),Q_(3))],respectively.t-test or Wilcoxon rank sumtestwasusedfor inter-group comparisons.Categorical variables were expressed by frequency and percentage(%),and Chi-square test was used for intergroup comparisons.Mixed effects models and generalized estimationequations were fitted toanalyzethe relationshipbetween occupational noise,systemic inflammation,and their interactionterms with blood pressure and hypertensionrisk.Results Univariate analysis revealed that the white blood cell counts,neutrophil counts,lymphocyte counts and eosinophil counts were positively associated with systolic blood pressure and diastolic blood pressure in overweight group(n=467),respectively(P<0.05).The participants with white blood cell counts≥5.94×10^(9)/L,neutrophil counts≥3.31×10^(9)/L,lymphocyte counts≥2.03×10^(9)/L,and eosinophil counts≥0.12×10^(9)/L had increased risk of hypertension by 52%(RR=1.52,95%CI:1.11-2.05),37%(RR=1.37,95%CI:1.01-1.83),58%(RR=1.58,95%CI:1.18-2.09),and 52%(RR=1.52,95%CI:1.12-2.06),respectively(all P<0.05).Multivariate analysis found a positive association between BMI and the risk of hypertension in the overweight group(P<0.05),the participants with lymphocyte counts≥2.03×10^(9)/L and eosinophil counts≥0.12×10^(9)/L had increased risk of hypertension by 39%(RR=1.39,95%CI:1.01-1.89)and 46%(RR=1.46,95%CI:1.06-1.98),respectively(all P<0.05).There was no correlation between BMI and the risk of hypertension in normal weight group(P>0.05).The multiplicative interaction of occupational noise(≥80 dB)with white blood cell counts(≥5.94×10^(9)/L)and lymphocyte counts(≥2.03×10^(9)/L)increased the risk of hypertension by 100%(RR=2.00,95%CI:1.06-3.55)and 89%(RR=1.89,95%CI:1.01-3.32)(all P<0.05)in overweight group,respectively.Additionally,a significant additive interaction was observed between noise exposure(≥80 dB)and basophil counts(≥0.03×10^(9)/L)on hypertension risk in the overweight group(RERI=0.49,95%CI:0.02-0.96,P<0.05).Conclusion The combined exposure of occupational noise and systemic inflammation may increase the risk of hypertension in overweight workers in automobile manufacturing plants,and the two have additive and multiplicative interactions.展开更多
Background Some studies found that cholinesterase （ChE） can be an independent risk factor for patients with multiple organ dysfunction syndrome. To assess aged patients with systemic inflammatory response syndrome ...Background Some studies found that cholinesterase （ChE） can be an independent risk factor for patients with multiple organ dysfunction syndrome. To assess aged patients with systemic inflammatory response syndrome （SIRS） early and predict their prognosis, the predictive value of ChE for the prognosis of aged patients with SIRS was analyzed. Methods From September 2009 to September 2010, all aged patients with SIRS in the ICU of the Second Affiliated Hospital of Zhejiang University School of Medicine were retrospectively analyzed if they met inclusion criteria： patients aged 〉65 years and met American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference criteria for SIRS. Serum ChE, albumin, D-dimer, lactic acid and C-reactive protein （CRP） were measured, and the Acute Physiology and Chronic Health Evaluation （APACHE） II and Glasgow Coma Scale （GCS） scores were evaluated within the first 24 hours in the ICU. Fisher＇s exact test was used for comparison of the primary disease between the deceased group and surviving group. For comparison of study variables between the two groups, the Student＇s t test or Mann-Whitney U test was used. Multivariate significance was tested with binary Logistic regression analysis. Results The clinical data of 124 aged patients with SIRS were collected and analyzed. Sixty-six patients （46 male, 20 female, mean age （78.70±8.08） years） who died were included in the deceased group and 58 patients （34 male, 24 female, mean age （76.02±6.57） years） who survived were included in the surviving group. There were no significant differences in age, gender, APACHE II score and GCS score between the deceased group and surviving group （all P 〉0.05）, but there were significant differences in lactic acid （P=0.011）, D-dimer （P=0.011）, albumin （P=0.007）, CRP （P=0.008）, and ChE （P 〈0.0001）. The correlation analysis showed that the APACHE II score and CRP were not correlated with ChE （both P 〈0.05）. D-dimer and albumin were correlated with ChE （Spearman＇s rho correlation coefficients were -0.206 and 0.324, the corresponding P values were 0.022 and 〈0.0001）. Multiple Logistic regression analysis showed that age, gender, lactic acid, D-dimer, albumin, CRP, APACHE II score, and GCS score were not independent risk factors for prognosis of aged patients with SIRS, but that ChE was （P 〈0.0001）. The receiver operating characteristic curve of ChE had an area under the curve of 0.797 （standard error=0.04; P 〈0.0001）, and a ChE of 103.00 U/L was the cut-off value with sensitivity=0.793, specificity=0.742. Conclusion Serum ChE might be a predictive marker for the prognosis of aged patients with SIRS, with low serum ChE levels indicating poor prognosis.展开更多
Objective： To investigate the role of Shenfu Injection （参附注射液, SFI） in rats with systemic inflammatory response syndrome （SIRS）. Methods： The SIRS rat model was induced by the intravenous injection of lipop...Objective： To investigate the role of Shenfu Injection （参附注射液, SFI） in rats with systemic inflammatory response syndrome （SIRS）. Methods： The SIRS rat model was induced by the intravenous injection of lipopolysaccharide （LPS）. Forty-five male Wistar rats were randomly divided into 3 groups, the sham operative control group （control group, n=5）, the SIRS model group （model group, n=20） and the SFI treatment group （SFI group, n=20）. LPS was injected through the external jugular vein （12 mg/kg, 6 mg/mL） to all rats except for those in the control group, and SFI （10 mL/kg） was given to those in the SF group only once through intraperitoneal injection, while the normal saline （10 mL/kg） was given to those in the model group. For those in the control group, normal saline was given through the external jugular vein （2 mL/kg） and intraperitoneal injection （10 mL/kg）. Then, rats in the model group and SFI group were divided into 4 subgroups according to the time points, i.e., 1 h, 2 h, 4 h and 6 h subgroups, 5 rats in each group. The activity of nuclear factor of κB （NF-κB） of in blood mononuclear cells and the plasma levels of tumor necrosis factor- α （TNF- α ） and interleukin 6-（IL-6） were determined using enzyme-linked immunoabsordent assay （ELISA） at 1 h, 2 h, 4 h and 6 h after modeling. Histopathologic changes of the lung and liver were observed under a light microscope. Results： Compared with the control group, the activity of NF-κB in mononuclear cells and the plasma level of TNF-α were obviously increased at each time points （all P〈0.01）, reaching the peaks at 2 h after modeling. The plasma level of IL-6 increased gradually as time went by in the model group （P〈0.01）. Pathological examination showed pulmonary alveoli hemorrhage, edema and inflammatory cell infiltration in the lung tissue, and angiotelectasis, congestion, and local necrosis in the liver tissue in the model group. Compared with the model group, the activity of NF- κB and the levels of TNF-α and IL-6 in plasma decreased significantly in the SFI group （P〈0.01）, and the pathological injury in the lungs and liver was significantly alleviated. Conclusion： SFI plays a protective role by inhibiting the activity of NF-κB, and reducing the expressions of TNF-α and IL-6 in SIRS rats.展开更多
To evaluate the efficacy of using procalcitonin (PCT) and interleukin-6 (IL-6) to differentiate sepsis from non-infectious systemic inflammatory response syndrome (SIRS) Methods We made a prospective study in a gen...To evaluate the efficacy of using procalcitonin (PCT) and interleukin-6 (IL-6) to differentiate sepsis from non-infectious systemic inflammatory response syndrome (SIRS) Methods We made a prospective study in a general intensive care unit at Peking Union Medical College Hospital Twenty patients with sepsis and 31 patients with non-infectious SIRS were enrolled in this study Serum concentrations of PCT, IL-6 and C-reactive protein (CRP) were determined within 24 h after clinical onset of sepsis or non-infectious SIRS Leukocyte count, percentage of neutrophils, and absolute neutrophil count, as well as maximal body temperature were also recorded Results Serum concentrations of PCT, IL-6, and CRP, as well as maximal body temperature, were significantly higher in septic patients [3 6 (1 8, 27 5) μg/L, 810±516 ng/L, 180±108 g/L, 38 6±1 2℃] than non-infectious SIRS patients [0 5 (0 2, 1 8) μg/L, 235±177 ng/L, 109±70 g/L, 37 9±0 9℃] IL-6 and PCT exhibited the best discriminative power between sepsis and non-infectious SIRS, with sensitivity above 80% and specificity above 70% A sepsis score with combination of IL-6 and PCT showed the best discriminative power with the area under the receiver operating characteristic curve of 0 923 Conclusions Assessing IL-6 and PCT levels are more reliable ways to differentiate sepsis from non-infectious SIRS, compared with conventional inflammatory parameters展开更多
Objective To investigate the fluctuations in arterial leukocyte phospholipase D (PLD) activity during the perioperative period of open heart surgery under cardiopulmonary bypass ( CPB), and the relationship between PL...Objective To investigate the fluctuations in arterial leukocyte phospholipase D (PLD) activity during the perioperative period of open heart surgery under cardiopulmonary bypass ( CPB), and the relationship between PLD activity and systemic inflammatory response induced by CPB.Methods Arterial blood was obtained from 26 patients undergoing open heart surgery at 8 different time points during the perioperative period, from which leukocytes were isolated for determination of PLD activity, CD11b expression and myeloperoxidase (MPO) activity. Plasma IL-6, IL-8 and C-reactive protein were also determined. The 26 cases were retrospectively divided into 3 groups according to perfusion time in order to detect the possible influences of CPB on PLD activity and IL-6 and IL-8 levels.Results When the ascending aorta was declamped, average arterial leukocyte PLD activity was 0. 305±0.132 nmol choline·min-1·mg-1, 5. 0 times higher of the pre-CPB value, and remained (5. 4 times higher of the pre-CPB level) at 72 hours after CPB. Leukocyte CD11 b expression and plasma IL-6 and IL-8 levels increased significantly at the end of CPB, while MPO activity and C-reactive protein concentration reached their peaks at 1 and 24 hours, respectively, after CPB. At the end of CPB, the arterial leukocyte PLD activity of patients whose CPB duration was longer than 90 minutes were 1. 82- and 1. 74-fold that of the other two groups with CPB lasting between 90 and 60 minutes and less than 60 minutes.Conclusions Arterial leukocyte PLD activity rises significantly in CPB and its elevation is earlier and more persistent than other inflammation-related indicators tested; longer CPB duration leads to higher leukocyte PLD activity at the end of CPB. These results imply that PLD could be a new target for prevention of systemic inflammatory response induced by CPB.展开更多
The hypersecretion of cytokines triggers life-threatening systemic inflammatory response syndrome(SIRS),leading to multiple organ dysfunction syndrome(MODS)and mortality.Although both coagulopathy and necroptosis have...The hypersecretion of cytokines triggers life-threatening systemic inflammatory response syndrome(SIRS),leading to multiple organ dysfunction syndrome(MODS)and mortality.Although both coagulopathy and necroptosis have been identified as important factors in the pathogenesis of SIRS,the specific cell types that undergo necroptosis and the interrelationships between coagulopathy and necroptosis remain unclear.In this study,we utilized visualization analysis via intravital microscopy to demonstrate that both anticoagulant heparin and nonanticoagulant heparin(NAH)pretreatment protect mice against TNF-α-induced mortality in SIRS.Moreover,the deletion of Mlkl or Ripk3 resulted in decreased coagulation and reduced mortality in TNF-α-induced SIRS.These findings suggest that necroptosis plays a key role upstream of coagulation in SIRS-related mortality.Furthermore,using a genetic lineage tracing mouse model(Tie2-Cre;Rosa26-tdT),we tracked endothelial cells(ECs)and verified that EC necroptosis is responsible for the vascular damage observed in TNF-α-treated mice.Importantly,Mlkl deletion in vascular ECs in mice had a similar protective effect against lethal SIRS by blocking EC necroptosis to protect the integrity of the endothelium.Collectively,our findings demonstrated that RIPK3–MLKL-dependent necroptosis disrupted vascular integrity,resulting in coagulopathy and multiorgan failure,eventually leading to mortality in SIRS patients.These results highlight the importance of targeting vascular EC necroptosis for the development of effective treatments for SIRS patients.展开更多
AIM: To identify a mean platelet volume(MPV) cutoff value which should be able to predict the presence of bacterial infection.METHODS: An observational, analytic, retrospective study. We evaluated medical records of c...AIM: To identify a mean platelet volume(MPV) cutoff value which should be able to predict the presence of bacterial infection.METHODS: An observational, analytic, retrospective study. We evaluated medical records of cirrhotic patients who were hospitalized from January 2012 to January 2014 at the Gastroenterology Department of "Hospital General de México Dr. Eduardo Liceaga", we included 51 cirrhotic patients with ascites fluid infection(AFI), and 50 non-infected cirrhotic patients as control group. Receiver operator characteristic curves were used to identify the best cutoff value of several parameters from hematic cytometry, including MPV, to predict the presence of ascites fluid infection.RESULTS: Of the 51 cases with AFI, 48 patients(94.1%) had culture-negative neutrocytic ascites(CNNA), 2(3.9%) had bacterial ascites, and one(2%)had spontaneous bacterial peritonitis. Infected patients had greater count of leucocytes and polymorphonuclear cells, greater levels of MPV and cardiac frequency(P < 0.0001), and lower mean arterial pressure compared with non-infected patients(P = 0.009). Leucocytes, polymorphonuclear count, MPV and cardiac frequency resulted to be good or very good predictive variables of presence of AFI in cirrhotic patients(area under the receiving operating characteristic > 0.80). A cutoff MPV value of 8.3 fl was the best to discriminate between cirrhotic patients with AFI and those without infection. CONCLUSION: Our results support that MPV can be an useful predictor of systemic inflammatory response syndrome in cirrhotic patients with AFI, particularly CNNA.展开更多
基金National Key Research and Development Program of China(2022YFC2503500 and 2022YFC2503504)。
文摘Background The association of systemic inflammatory response index(SIRI)with prognosis of coronary artery disease(CAD)patients has never been investigated in a large sample with long-term follow-up.This study aimed to explore the association of SIRI with all-cause and cause-specific mortality in a nationally representative sample of CAD patients from United States.Methods A total of 3386 participants with CAD from the National Health and Nutrition Examination Survey(NHANES)1999-2018 were included in this study.Cox proportional hazards model,restricted cubic spline(RCS),and receiver operating characteristic curve(ROC)were performed to investigate the association of SIRI with all-cause and cause-specific mortality.Piecewise linear regression and sensitivity analyses were also performed.Results During a median follow-up of 7.7 years,1454 all-cause mortality occurred.After adjusting for confounding factors,higher lnSIRI was significantly associated with higher risk of all-cause(HR=1.16,95%CI:1.09-1.23)and CVD mortality(HR=1.17,95%CI:1.05-1.30)but not cancer mortality(HR=1.17,95%CI:0.99-1.38).The associations of SIRI with all-cause and CVD mortality were detected as J-shaped with threshold values of 1.05935 and 1.122946 for SIRI,respectively.ROC curves showed that lnSIRI had robust predictive effect both in short and long terms.Conclusions SIRI was independently associated with all-cause and CVD mortality,and the dose-response relationship was Jshaped.SIRI might serve as a valid predictor for all-cause and CVD mortality both in the short and long terms.
文摘Acute cardiomyocyte necrosis in the infarcted heart generates damage-associated molecular patterns, activating complement and toll-like receptor/interleukin-1 signaling, and triggering an intense inflammatory response. Iuflammasomes also recognize danger signals and mediate sterile inflammatory response following acute myocardial infarction （AMI）, Inflammatory response serves to repair the heart, but excessive inflammation leads to adverse left ventricular remodeling and heart failure. In addition to local inflammation, profound systemic inflammation response has been documented in patients with AMI, which includes elevation of circulating inflammatory cytokines, chemokines and cell adhesion molecules, and activation of peripheral leukocytes and platelets. The excessive inflammatory response could be caused by a deregulated immune system. AMI is also associated with bone marrow activation and spleen monocytopoiesis, which sustains a continuous supply of monocytes at the site of inflammation. Accumulating evidence has shown that systemic inflammation aggravates atherosclerosis and markers for systemic inflammation are predictors of adverse clinical outcomes （such as death, recurrent myocardial in- farction, and heart failure） in patients with AMI.
基金supported by Tangshan City Science and Technology Development Project(No.15130219a)
文摘BACKGROUND:Periplaneta americana extract is recognized to have a positive effect on gastrointestinal mucosa.This study aimed to investigate the effects of periplaneta americana extract on immune function,nutrition status and gastrointestinal complications of early enteral nutrition patients with systemic inflammatory response syndrome(SIRS).METHODS:Patients with SIRS were randomly divided into two groups:treatment and control groups.All patients in the two groups received conventional therapy including enteral nutrition,but periplaneta americana extract,an additional Chinese medicine,was given to the patients in the treatment group.At the beginning of treatment(0 day)and 1,3,and 7 days after treatment,the levels of immunoglobulin(Ig A),total lymphocyte count(TLC),total protein(TP)and prealbumin(PA)were respectively tested in patients'venous blood.The incidences of bloating,diarrhea,aspiration pneumonia and high blood sugar at 7 days after treatment were recorded.The mortality of the patients in 28 days was recorded.RESULTS:At 3 and 7 days after treatment,the levels of Ig A and TLC in the treatment group were higher than those in the control group(P<0.05).At 7 days after treatment,the levels of TP and PA in the treatment group were higher than those in the control group(P<0.05).The incidences of bloating and diarrhea in the treatment group were lower than those in the control group,the differences were significant(P<0.05).The mortality of treatment group was lower than that of the control group(P>0.05).CONCLUSION:Periplaneta americana extract could reduce gastrointestinal complications and improve immune function and nutritional status in patients with systemic inflammatory response syndrome.
文摘BACKGROUND： This study aimed to determine the plasma levels of urokinase-type plasminogen activator （uPA）, urokinase-type plasminogen activator receptor （uPAR）, D-dimer, IL-6 and TNF-α, and observe the relations among uPA, uPAR, D-dimer, IL-6 and TNF-α in patients with systemic inflammatory response syndrome （SIRS）.METHODS： A prospective, clinical case-control study was conducted in patients with SIRS at age of more than 55 years old treated during 2008-2010 at Wuhan Central Hospital. Venous blood samples were collected by routine venipuncture. Eighty-five patients were divided into two groups according to diagnostic criteria of SIRS： SIRS patients from intensive care units （n=50）, and non- SIRS patients from medical wards （n=35）. Thirty healthy blood donors who visited the General Health Check-up Division at Wuhan Central Hospital served as controls. Excluded from the study were （1） those patients with pregnancy; （2） those with cancer; （3） those died after admission into the ICU in 7 days; （4） those received cardiopulmonary resuscitation; （5） those who had previous blood system diseases; and （6） those with SIRS before admission into the ICU. The levels of uPA, uPAR, D-D, IL-6 and TNF-a in blood were detected by commercial enzyme-linked immunosorbent assay （ELISA） kit. The data were analyzed using SPSS version 17.0 and expressed as mean ＋ standard. Student＇s t test and the Mann-Whitney U test were used in the analysis. The relations of uPA, uPAR and D-dimer, IL-6 TNF-α levels were analyzed using Spearman＇s rank-order correlation coefficient test. RESULTS： The plasma levels of uPA, uPAR, D-dimer, lL-6 and TNF-α in the patients with SIRS were obviously higher than those in the non-SIRS patients and controls （P〈0.001）. Correlation analysis showed a positive correlation between uPAR and IL-6 levels （r=0.395, P=0.004） and between uPAR and TNF-a levels （r=0.606, P〈0.001）, but no correlation between uPAR and D-dimer levels （r=0.069, P=0.632）. No correlation was observed between uPA, D-dimer, IL-6 and TNF-α levels （P〉0.05）. The establishment of ROC curve was based on the levels of uPAR, D-dimer, IL-6 and TNF-α in 24 hours for the diagnosis of multiple organ dysfunction syndrome （MODS）, and the ROC areas under the curve were 0.76, 0.58, 0.86 and 0.83, respectively. CONCLUSIONS：uPA and uPAR play a major role in patients with SIRS in the process of coagulation disorder, but the mechanism of SIRS is not the same. uPAR may play a central role in the development of SIRS to MODS.
基金This project was supported by a grant from National Natural Sciences Foundation of China (No. 30200272).
文摘The changes of Toll-like receptor （TLR） 2, 4 of peripheral blood mononuclear cells （PBMCs） in the acute abdomen patients associated with systemic inflammatory response syndrome （SIRS） and their potential significance were explored. A clinical study was performed on 103 acute abdomen patients in whom 65 were associated with SIRS. Forty healthy individuals served as normal controls. The mRNA expression of TLR2, 4 was detected by RT-PCR, and the expression of TNF-α and IL-6 by ELISA. The level of plasma endotoxin, hospital stay and mortality were measured. It was found that the endotoxin level was increased to varying degrees in all the acute abdomen patients, and the endotoxin level was and hospital stay longer in SIRS group than in non-SIRS group （P〈0.01）. TLR2 mRNA, TLR4 mRNA, IL-6 and TNF-ct could be detected with low value in normal controls, but they were up-regulated markedly on the 1 st day after admission. Then TLR4 mRNA, IL-6 and TNF-α were decreased gradually, but TLR2 mRNA maintained at a high level till the 5th day. These indexes above in SIRS group were higher than those in non-SIRS group （P〈0.01）. The results of correlation analysis revealed the expression of TLR2, 4 mRNA was positively correlated with the levels of TNF-α and IL-6, and the hospital stay, The results of Logistic regression demonstrated that overexpression of TLR2, 4 mRNA might result in higher risk of multiple organ dysfunction syndrome （MODS）. It was concluded that in the acute abdomen patients associated with SIRS, the expression of TLR2, 4 in PBMCs was increased markedly, suggesting that TLR might play an important role in the pathogenesis of acute abdomen associated with SIRS.
文摘BACKGROUND:Urokinase-type plasminogen activator(uPA) and urokinase-type plasminogen activator receptor(uPAR) are known as important factors,which mediate a variety of functions in terms of vascular homeostasis,inflammation and tissue repair.However,their role in systemic inflammatory response syndrome(SIRS) has been less well studied.This study aimed to test the hypothesis that the abnormalities of fibrinolysis and degradation of extracellular matrix mediated by uPA and uPAR are directly related to the patients with SIRS.We therefore analyzed their role and clinicopathological significance in patients with SIRS.METHODS:A case-control study was conducted with 85 patients who were divided into two groups according to the diagnostic criteria of SIRS:SIRS group(n=50) and non-SIRS group(/7=35).The SIRS group was divided into MODS group(n=26) and non-MODS group(n=24) by their severity,and survival group(n=35) and non-survival group(n=15) by their prognosis.Another 30 healthy adults served as normal controls.uPA and uPAR in plasma were detected by commercial enzyme-linked immunosorbent assay(ELISA) kits.RESULTS:The plasma level of uPA was lower in the SIRS group than in the non-SIRS group and controls(P<0.001 and P<0.001).It was lower in sepsis patients and the MODS group than in the non-sepsis patients and the non-MODS patients(all P<0.05).However,there was no difference in uPA level between survivors and non-survivors(P>0.05).The plasma level of uPAR increased in the SIRS group compared with the non-SIRS group and controls(P<0.001 and P<0.001).There was a significant elevation of uPAR in sepsis patients,MODS patients and non-survivors as compared with non-sepsis patients,non-MODS patients and survivors respectively(all P<0.05).Plasma uPAR levels were positively correlated with APACHE Ⅱ score(r=0.575,P<0.001) and SOFA score(r=0.349,P=0.013).AUCs for the prediction of SIRS mortality were 0.67 and 0.51,respectively,for uPA and uPAR.CONCLUSION:uPAR could be a predictor of poor outcome in patients with SIRS.
基金supported by the Key Project of the"Twelfth FiveYear Plan"for Medical Science and Technology Research of People’s Liberation Army(BWS12J006)the Scientific Key Project of Liaoning Province(2011225006)
文摘Background: Pelvic fracture combined with massive bleeding(PFCMB) is a complex issue in clinical practice. Currently, the use of angiography and embolization for the treatment of PFCMB obtains good results. The aim of this study is to observe the effects of early internal iliac artery embolization on the systemic inflammatory response syndrome(SIRS) in dogs with simulated-pelvic-fracture combined with massive bleeding.Methods: Twenty adult dogs were randomly divided into an embolization group(EG) and a control group(CG). For the two groups, heart rate, respiratory rate and body temperature and other physiological variables were measured, and IL-6, TNF-α and arterial blood gas levels were monitored. These variables were assayed every 30 min until death in the CG, while dogs in the EG underwent arterial angiography after 60 min of modeling. The internal iliac artery was embolized on the injured side.Results: The average time to SIRS in the CG was 3.56 h, occurring at a rate of 90%(9/10) within 24 h, with a mortality rate of 50%(5/10); the average time to SIRS for the EG was 5.33 h, occurring at a rate of 30%(3/10) within 24 h, with a mortality rate of 10%(1/10). When SIRS occurred in the EG, the mean plasma IL-6 level was 52.66±7.38pg/ml and the TNF-ps, tα level was 11.45±2.72ng/ml, showing a significant difference with those of the CG(P<0.05). In the two grouhe respiratory rate and leukocyte levels were higher at each monitored time after modeling than those before modeling; the mean arterial pressure, levels of hemoglobin and oxygen partial pressure were significantly lower at each time point after modeling than those before modeling except for the mean arterial pressure at 0h in EG; the platelet levels at 4 and 8h were higher than those before modeling; and the differences were statistically significant(P<0.05). In the EG, the mean arterial pressure, heart rate, respiratory rate and hemoglobin levels at 2, 4 and 8h were lower than those at 0h; the levels of leukocytes, platelets and carbon dioxide partial pressure at 4 and 8h after modeling were higher than those at 0h, and the differences were statistically significant(P<0.05, P<0.01); in the CG after modeling, the mean arterial pressure, levels of hemoglobin and carbon dioxide partial pressure at 2, 4 and 8h were lower than those at 0h; the levels of heart rate and leukocytes were higher than those before modeling; the respiratory rate and platelet levels at 4 and 8h were higher than those at 0h; and the differences were statistically significant(P<0.05). The levels of the mean arterial pressure and hemoglobin at 4 and 8h and the p H values at 8h after modeling in the EG were significantly higher than those in the CG, while the heart rate and respiratory rate at 4 and 8h were significantly lower than those in the CG. The p H values at 8h after modeling were significantly lower than those of the other monitored times in the CG(P<0.05, P<0.01). The two groups had elevated levels of alkaline phosphatase after injury induction.Conclusion: Through the use of an on-spot interventional treatment cabin, early internal iliac artery embolization can control bleeding associated with pelvic fractures, delay the occurrence of SIRS, and improve the success rate of the treatment of pelvic fracture combined with bleeding.
基金Supported by National Natural Science Foundation of China,No.8236110677Natural Science Foundation of Gansu Province,No.18JR2RA033Gansu Da Vinci Robot High-End Diagnosis and Treatment Team Construction Project,National Key Research and Development Program,No.2020RCXM076.
文摘BACKGROUND The systemic inflammatory response index(SIRI)has been demonstrated to make a significant difference in assessing the prognosis of patients with different solid neoplasms.However,research is needed to ascertain the accuracy and reliability of applying the SIRI to patients who undergo robotic radical gastric cancer sur-gery.AIM To validate the applicability of the SIRI in assessing the survival of gastric cancer patients and evaluate the clinical contribution of preoperative SIRI levels to predicting long-term tumor outcomes in patients,who received robotic radical gastric cancer surgery.METHODS Initially,an exhaustive retrieval was performed in the PubMed,the Cochrane Library,EMBASE,Web of Science,and Scopus databases to identify relevant studies.Subsequently,a meta-analysis was executed on 6 cohort studies iden-tifying the value of the SIRI in assessing the survival of gastric cancer patients.Additionally,the clinical data of 161 patients undergoing robotic radical gastric cancer surgery were retrospectively analyzed to evaluate their clinicopathological characteristics and relevant laboratory indicators.The association between preoperative SIRI levels and 5-year overall survival(OS)and disease-free survival(DFS)was assessed.RESULTS The findings demonstrated an extensive connection between SIRI values and the outcome of patients with gastric cancer.Preoperative SIRI levels were identified as an independent hazard feature for both OS and DFS among those who received robotic surgery for gastric cancer.SIRI levels in gastric cancer patients were observed to be associated with the presence of comorbidities,T-stage,carcinoembryonic antigen levels,the development of early serious postoperative complications,and the rate of lymph node metastasis.CONCLUSION SIRI values are correlated with adverse in the gastric cancer population and have the potential to be utilized in predicting long-term oncological survival in patients who undergo robotic radical gastric cancer surgery.
基金Project supported by the Natural Science Foundation of the Education Department of Guizhou Province,China (Grant No.20090133)International Cooperative Foundation of Guizhou Province,China (Grant No.20117007)
文摘Based on the scale-free network, an integrated systemic inflammatory response syndrome model with artificial immunity, a feedback mechanism, crowd density and the moving activities of an individual can be built. The effects of these factors on the spreading process are investigated through the model. The research results show that the artificial immunity can reduce the stable infection ratio and enhance the spreading threshold of the system. The feedback mechanism can only reduce the stable infection ratio of system, but cannot affect the spreading threshold of the system. The bigger the crowd density is, the higher the infection ratio of the system is and the smaller the spreading threshold is. In addition, the simulations show that the individual movement can enhance the stable infection ratio of the system only under the condition that the spreading rate is high, however, individual movement will reduce the stable infection ratio of the system.
基金National Natural Science Foundation of China (No. 30070299)
文摘Objective: To investigate whether bacterial DNA involving in the pathogenesis of systemic inflammatory response syndrome (SIRS) and possible mechanism. Methods: Escherichia coli DNA (EC DNA) was extracted from Escherichia coli 25922 with alkaline lysis method. The mice mortality was observed after EC DNA was injected into mice via caudal vein. The changes of serum TNF-α and IL-6 levels in rats were measured with ELISA after rats were given EC DNA. Calf thymus DNA and lipopolysaccharide (LPS) were used as the control, respectively. Results: EC DNA led mice to death with notable dose-effect relationship (LD50=11.51 mg/kg), but CT DNA didn't. The peak level of TNF-αwas lower in EC DNA group than in LPS group (P＜0. 05), though the former reaching the peak I h earlier than the latter. However, they had coordinate ability to induce IL-6 release in rats, and no significant difference was seen in serum IL-6 peak level between 2 groups. Conclusion: EC DNA leads mice to death, and induces the increases of serum TNF-αand IL-6 levels in rats. EC DNA has the effect equal to LPS in inducing SIRS by triggering cytokines cascade.
文摘BACKGROUND The relationship between preoperative inflammation status and tumorigenesis as well as tumor progression is widely acknowledged.AIM To assess the prognostic significance of preoperative inflammatory biomarkers in patients with distal cholangiocarcinoma(dCCA)who underwent pancreat-oduodenectomy(PD).METHODS This single-center study included 216 patients with dCCA after PD between January 1,2011,and December 31,2022.The individuals were categorized into two sets based on their systemic inflammatory response index(SIRI)levels:A low SIRI group(SIRI<1.5,n=123)and a high SIRI group(SIRI≥1.5,n=93).Inflam-matory biomarkers were evaluated for predictive accuracy using receiver operating characteristic curves.Both univariate and multivariate Cox proportional hazards analyses were performed to estimate SIRI for overall survival(OS)and recurrence-free survival(RFS).RESULTS The study included a total of 216 patients,with 58.3%being male and a mean age of 65.6±9.6 years.123 patients were in the low SIRI group and 93 were in the high SIRI group after PD for dCCA.SIRI had an area under the curve value of 0.674 for diagnosing dCCA,showing better performance than other inflammatory biomarkers.Multivariate analysis indicated that having a SIRI greater than 1.5 independently increased the risk of dCCA following PD,leading to lower OS[hazard ratios(HR)=1.868,P=0.006]and RFS(HR=0.949,P<0.001).Additionally,survival analysis indicated a significantly better prognosis for patients in the low SIRI group(P<0.001).CONCLUSION It is determined that a high SIRI before surgery is a significant risk factor for dCCA after PD.
文摘To explore changes of toll-like receptor (TLR) 2,4 in peripheral blood mononuclear cells (PBMC) in acute abdomen patients with systemic inflammatory response syndrome (SIRS) and their significance.Methods A clinical study was done on 103 patients of which 65 were with SIRS.The mRNA expression of TLR2,4 were detected by RT-PCR;the expression of TNF-α and IL-6 were observed by ELISA;the correlation between TLR2,4 mRNA,the level of TNF-α and IL-6,and the clinical course was evaluated.Results TLR2 mRNA ,TNF-α and IL-6 were upregulated markedly on the first day of hospitalization,then decreased gradually;TLR2 mRNA maintained on high level till the 5th day.The expression of TLR2,4 mRNA was positive correlated with the level of TNF-α and IL-6,and the length of stay.TLR2,4 mRNA expression increased in patients with multiple organ failure.Conclusion In actue abdomen patients with SIRS,the expression of TLR2,4 of PBMC increased markedly,indicating its improtant role in the pathogenesis of SIRS.4 refs,2 figs,2 tabs.
基金Supported by the National Natural Science Foundation of China,No.82170406 and No.81970238.
文摘Gastric ulcer(GU)represents a clinically significant manifestation of peptic ulcer disease,driven by a complex interplay of microbial,environmental,and immuneinflammatory factors.A recent cross-sectional study by Shen et al systematically evaluated six complete blood count-derived inflammatory indices:Neutrophil-tolymphocyte ratio,monocyte-to-lymphocyte ratio,platelet-to-lymphocyte ratio,systemic immune-inflammation index,systemic inflammatory response index(SIRI),and aggregate index of systemic inflammation and demonstrated their positive associations with GU prevalence,identifying SIRI as the strongest predictor.This editorial contextualizes these findings within the broader literature,clarifies that these indices reflect systemic rather than GU-specific inflammation,highlights methodological strengths and major limitations,and proposes a conceptual clinical algorithm for integrating SIRI into GU risk assessment.Future multicenter studies incorporating Helicobacter pylori infection,non-steroidal antiinflammatory drug exposure,and prospective design are essential to validate and translate these findings into clinical practice.
文摘ObjectiveToinvestigatethe interactionof workplace noise,body mass index(BMI)and systemic inflammatory response on hypertension.Methods In January 2019,1124 male workers from an automobile factory in Wuhan were selected by cluster random sampling method.The study population was divided into normal body weight group(BMI<24 kg/m^(2))and overweight group(BMI≥24 kg/m^(2))according to BMI,and were followed up for 3 years.The occupational health examination of the workers was carried out every year,blood routine and blood biochemical indexes were collected,and the information of the workers'age,BMI,type of work and age of exposure to injury were collected through field questionnaires.The noise intensity of the workplace of theenterpriseewas measured for 3 consecutive years,and the equivalent sound level was calculated according to the working time.Normal and skewness measurements were described by Mean±SD and[M(Q_(1),Q_(3))],respectively.t-test or Wilcoxon rank sumtestwasusedfor inter-group comparisons.Categorical variables were expressed by frequency and percentage(%),and Chi-square test was used for intergroup comparisons.Mixed effects models and generalized estimationequations were fitted toanalyzethe relationshipbetween occupational noise,systemic inflammation,and their interactionterms with blood pressure and hypertensionrisk.Results Univariate analysis revealed that the white blood cell counts,neutrophil counts,lymphocyte counts and eosinophil counts were positively associated with systolic blood pressure and diastolic blood pressure in overweight group(n=467),respectively(P<0.05).The participants with white blood cell counts≥5.94×10^(9)/L,neutrophil counts≥3.31×10^(9)/L,lymphocyte counts≥2.03×10^(9)/L,and eosinophil counts≥0.12×10^(9)/L had increased risk of hypertension by 52%(RR=1.52,95%CI:1.11-2.05),37%(RR=1.37,95%CI:1.01-1.83),58%(RR=1.58,95%CI:1.18-2.09),and 52%(RR=1.52,95%CI:1.12-2.06),respectively(all P<0.05).Multivariate analysis found a positive association between BMI and the risk of hypertension in the overweight group(P<0.05),the participants with lymphocyte counts≥2.03×10^(9)/L and eosinophil counts≥0.12×10^(9)/L had increased risk of hypertension by 39%(RR=1.39,95%CI:1.01-1.89)and 46%(RR=1.46,95%CI:1.06-1.98),respectively(all P<0.05).There was no correlation between BMI and the risk of hypertension in normal weight group(P>0.05).The multiplicative interaction of occupational noise(≥80 dB)with white blood cell counts(≥5.94×10^(9)/L)and lymphocyte counts(≥2.03×10^(9)/L)increased the risk of hypertension by 100%(RR=2.00,95%CI:1.06-3.55)and 89%(RR=1.89,95%CI:1.01-3.32)(all P<0.05)in overweight group,respectively.Additionally,a significant additive interaction was observed between noise exposure(≥80 dB)and basophil counts(≥0.03×10^(9)/L)on hypertension risk in the overweight group(RERI=0.49,95%CI:0.02-0.96,P<0.05).Conclusion The combined exposure of occupational noise and systemic inflammation may increase the risk of hypertension in overweight workers in automobile manufacturing plants,and the two have additive and multiplicative interactions.
文摘Background Some studies found that cholinesterase （ChE） can be an independent risk factor for patients with multiple organ dysfunction syndrome. To assess aged patients with systemic inflammatory response syndrome （SIRS） early and predict their prognosis, the predictive value of ChE for the prognosis of aged patients with SIRS was analyzed. Methods From September 2009 to September 2010, all aged patients with SIRS in the ICU of the Second Affiliated Hospital of Zhejiang University School of Medicine were retrospectively analyzed if they met inclusion criteria： patients aged 〉65 years and met American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference criteria for SIRS. Serum ChE, albumin, D-dimer, lactic acid and C-reactive protein （CRP） were measured, and the Acute Physiology and Chronic Health Evaluation （APACHE） II and Glasgow Coma Scale （GCS） scores were evaluated within the first 24 hours in the ICU. Fisher＇s exact test was used for comparison of the primary disease between the deceased group and surviving group. For comparison of study variables between the two groups, the Student＇s t test or Mann-Whitney U test was used. Multivariate significance was tested with binary Logistic regression analysis. Results The clinical data of 124 aged patients with SIRS were collected and analyzed. Sixty-six patients （46 male, 20 female, mean age （78.70±8.08） years） who died were included in the deceased group and 58 patients （34 male, 24 female, mean age （76.02±6.57） years） who survived were included in the surviving group. There were no significant differences in age, gender, APACHE II score and GCS score between the deceased group and surviving group （all P 〉0.05）, but there were significant differences in lactic acid （P=0.011）, D-dimer （P=0.011）, albumin （P=0.007）, CRP （P=0.008）, and ChE （P 〈0.0001）. The correlation analysis showed that the APACHE II score and CRP were not correlated with ChE （both P 〈0.05）. D-dimer and albumin were correlated with ChE （Spearman＇s rho correlation coefficients were -0.206 and 0.324, the corresponding P values were 0.022 and 〈0.0001）. Multiple Logistic regression analysis showed that age, gender, lactic acid, D-dimer, albumin, CRP, APACHE II score, and GCS score were not independent risk factors for prognosis of aged patients with SIRS, but that ChE was （P 〈0.0001）. The receiver operating characteristic curve of ChE had an area under the curve of 0.797 （standard error=0.04; P 〈0.0001）, and a ChE of 103.00 U/L was the cut-off value with sensitivity=0.793, specificity=0.742. Conclusion Serum ChE might be a predictive marker for the prognosis of aged patients with SIRS, with low serum ChE levels indicating poor prognosis.
基金Supported by a Grant from Hubei Province Science and Technique Foundation(No.2003AA301C51)
文摘Objective： To investigate the role of Shenfu Injection （参附注射液, SFI） in rats with systemic inflammatory response syndrome （SIRS）. Methods： The SIRS rat model was induced by the intravenous injection of lipopolysaccharide （LPS）. Forty-five male Wistar rats were randomly divided into 3 groups, the sham operative control group （control group, n=5）, the SIRS model group （model group, n=20） and the SFI treatment group （SFI group, n=20）. LPS was injected through the external jugular vein （12 mg/kg, 6 mg/mL） to all rats except for those in the control group, and SFI （10 mL/kg） was given to those in the SF group only once through intraperitoneal injection, while the normal saline （10 mL/kg） was given to those in the model group. For those in the control group, normal saline was given through the external jugular vein （2 mL/kg） and intraperitoneal injection （10 mL/kg）. Then, rats in the model group and SFI group were divided into 4 subgroups according to the time points, i.e., 1 h, 2 h, 4 h and 6 h subgroups, 5 rats in each group. The activity of nuclear factor of κB （NF-κB） of in blood mononuclear cells and the plasma levels of tumor necrosis factor- α （TNF- α ） and interleukin 6-（IL-6） were determined using enzyme-linked immunoabsordent assay （ELISA） at 1 h, 2 h, 4 h and 6 h after modeling. Histopathologic changes of the lung and liver were observed under a light microscope. Results： Compared with the control group, the activity of NF-κB in mononuclear cells and the plasma level of TNF-α were obviously increased at each time points （all P〈0.01）, reaching the peaks at 2 h after modeling. The plasma level of IL-6 increased gradually as time went by in the model group （P〈0.01）. Pathological examination showed pulmonary alveoli hemorrhage, edema and inflammatory cell infiltration in the lung tissue, and angiotelectasis, congestion, and local necrosis in the liver tissue in the model group. Compared with the model group, the activity of NF- κB and the levels of TNF-α and IL-6 in plasma decreased significantly in the SFI group （P〈0.01）, and the pathological injury in the lungs and liver was significantly alleviated. Conclusion： SFI plays a protective role by inhibiting the activity of NF-κB, and reducing the expressions of TNF-α and IL-6 in SIRS rats.
文摘To evaluate the efficacy of using procalcitonin (PCT) and interleukin-6 (IL-6) to differentiate sepsis from non-infectious systemic inflammatory response syndrome (SIRS) Methods We made a prospective study in a general intensive care unit at Peking Union Medical College Hospital Twenty patients with sepsis and 31 patients with non-infectious SIRS were enrolled in this study Serum concentrations of PCT, IL-6 and C-reactive protein (CRP) were determined within 24 h after clinical onset of sepsis or non-infectious SIRS Leukocyte count, percentage of neutrophils, and absolute neutrophil count, as well as maximal body temperature were also recorded Results Serum concentrations of PCT, IL-6, and CRP, as well as maximal body temperature, were significantly higher in septic patients [3 6 (1 8, 27 5) μg/L, 810±516 ng/L, 180±108 g/L, 38 6±1 2℃] than non-infectious SIRS patients [0 5 (0 2, 1 8) μg/L, 235±177 ng/L, 109±70 g/L, 37 9±0 9℃] IL-6 and PCT exhibited the best discriminative power between sepsis and non-infectious SIRS, with sensitivity above 80% and specificity above 70% A sepsis score with combination of IL-6 and PCT showed the best discriminative power with the area under the receiver operating characteristic curve of 0 923 Conclusions Assessing IL-6 and PCT levels are more reliable ways to differentiate sepsis from non-infectious SIRS, compared with conventional inflammatory parameters
基金This work was supported by the National Natural Science Foundation of China(No.39670836)and the Science Foundation of Zhejiang Provincial Health Department(NO,222ZX033).
文摘Objective To investigate the fluctuations in arterial leukocyte phospholipase D (PLD) activity during the perioperative period of open heart surgery under cardiopulmonary bypass ( CPB), and the relationship between PLD activity and systemic inflammatory response induced by CPB.Methods Arterial blood was obtained from 26 patients undergoing open heart surgery at 8 different time points during the perioperative period, from which leukocytes were isolated for determination of PLD activity, CD11b expression and myeloperoxidase (MPO) activity. Plasma IL-6, IL-8 and C-reactive protein were also determined. The 26 cases were retrospectively divided into 3 groups according to perfusion time in order to detect the possible influences of CPB on PLD activity and IL-6 and IL-8 levels.Results When the ascending aorta was declamped, average arterial leukocyte PLD activity was 0. 305±0.132 nmol choline·min-1·mg-1, 5. 0 times higher of the pre-CPB value, and remained (5. 4 times higher of the pre-CPB level) at 72 hours after CPB. Leukocyte CD11 b expression and plasma IL-6 and IL-8 levels increased significantly at the end of CPB, while MPO activity and C-reactive protein concentration reached their peaks at 1 and 24 hours, respectively, after CPB. At the end of CPB, the arterial leukocyte PLD activity of patients whose CPB duration was longer than 90 minutes were 1. 82- and 1. 74-fold that of the other two groups with CPB lasting between 90 and 60 minutes and less than 60 minutes.Conclusions Arterial leukocyte PLD activity rises significantly in CPB and its elevation is earlier and more persistent than other inflammation-related indicators tested; longer CPB duration leads to higher leukocyte PLD activity at the end of CPB. These results imply that PLD could be a new target for prevention of systemic inflammatory response induced by CPB.
基金supported by grants from the National Key Research and Development Program of China(2022YFA0807300)the National Natural Science Foundation of China(32270803,32300630,82272181,T2293734)+2 种基金the Shanghai Excellent Academic/Technical Leader Program(22XD1404500)the Shanghai Science and Technology Commission(23141902800)the China Postdoctoral Science Foundation(2020M671261).
文摘The hypersecretion of cytokines triggers life-threatening systemic inflammatory response syndrome(SIRS),leading to multiple organ dysfunction syndrome(MODS)and mortality.Although both coagulopathy and necroptosis have been identified as important factors in the pathogenesis of SIRS,the specific cell types that undergo necroptosis and the interrelationships between coagulopathy and necroptosis remain unclear.In this study,we utilized visualization analysis via intravital microscopy to demonstrate that both anticoagulant heparin and nonanticoagulant heparin(NAH)pretreatment protect mice against TNF-α-induced mortality in SIRS.Moreover,the deletion of Mlkl or Ripk3 resulted in decreased coagulation and reduced mortality in TNF-α-induced SIRS.These findings suggest that necroptosis plays a key role upstream of coagulation in SIRS-related mortality.Furthermore,using a genetic lineage tracing mouse model(Tie2-Cre;Rosa26-tdT),we tracked endothelial cells(ECs)and verified that EC necroptosis is responsible for the vascular damage observed in TNF-α-treated mice.Importantly,Mlkl deletion in vascular ECs in mice had a similar protective effect against lethal SIRS by blocking EC necroptosis to protect the integrity of the endothelium.Collectively,our findings demonstrated that RIPK3–MLKL-dependent necroptosis disrupted vascular integrity,resulting in coagulopathy and multiorgan failure,eventually leading to mortality in SIRS patients.These results highlight the importance of targeting vascular EC necroptosis for the development of effective treatments for SIRS patients.
文摘AIM: To identify a mean platelet volume(MPV) cutoff value which should be able to predict the presence of bacterial infection.METHODS: An observational, analytic, retrospective study. We evaluated medical records of cirrhotic patients who were hospitalized from January 2012 to January 2014 at the Gastroenterology Department of "Hospital General de México Dr. Eduardo Liceaga", we included 51 cirrhotic patients with ascites fluid infection(AFI), and 50 non-infected cirrhotic patients as control group. Receiver operator characteristic curves were used to identify the best cutoff value of several parameters from hematic cytometry, including MPV, to predict the presence of ascites fluid infection.RESULTS: Of the 51 cases with AFI, 48 patients(94.1%) had culture-negative neutrocytic ascites(CNNA), 2(3.9%) had bacterial ascites, and one(2%)had spontaneous bacterial peritonitis. Infected patients had greater count of leucocytes and polymorphonuclear cells, greater levels of MPV and cardiac frequency(P < 0.0001), and lower mean arterial pressure compared with non-infected patients(P = 0.009). Leucocytes, polymorphonuclear count, MPV and cardiac frequency resulted to be good or very good predictive variables of presence of AFI in cirrhotic patients(area under the receiving operating characteristic > 0.80). A cutoff MPV value of 8.3 fl was the best to discriminate between cirrhotic patients with AFI and those without infection. CONCLUSION: Our results support that MPV can be an useful predictor of systemic inflammatory response syndrome in cirrhotic patients with AFI, particularly CNNA.
