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Objective To investigate the clinical significance of protoporphyrin Ⅸ (PPⅨ) in different stages of liver disease development, including hepatitis, cirrhosis, and liver cancer. Methods A total of 41 patients with chronic hepatitis (hepatitis group), 33 patients with liver cirrhosis (cirrhosis group), and 19 patients with liver cancer (liver cancer group) who visited the First Affiliated Hospital of Xi'an Medical University from January 2022 to December 2022 were selected as study object. Additionally, 40 healthy examinees during the same period were selected as the health control group. The basic information, blood routine, liver function, coagulation function, alpha fetoprotein (AFP)，controlled attenuation parameter (CAP)，liver stiffness measurement (LSM)，γ-glutamyl transpeptidase to platelet ratio (GPR) from each group were collected and compared. The correlation between various indicators and PPⅨ was analyzed. And the predictive value of PPⅨ and liver function related indicators on liver stiffness was analyzed. Results There were significant differences in gender, age, and PPⅨ between the hepatitis group, liver cirrhosis group, and liver cancer group compared to the control group (P

This expert consensus uses clinical research evidence to explain the mechanism, monitoring and evaluation of sepsis-induced immunosuppression, and treatment with immune stimulation from two aspects: innate immunity and acquired immunity, aiming to help clinicians better understand sepsis-induced immune depression and its clinical significance. Clinical data suggest that the immune dysfunction is critically involved in the occurrence and development of sepsis. Quantitative detection of monocyte human leukocyte antigen DR and lymphocyte count can be used as important indicators to reflect the innate immune and acquired immune dysfunction in patients with sepsis. Immunomodulation therapy includes medication to improve innate immunity and acquired immunity, and immune stimulation combined with anti-inflammatory response.

The coronavirus disease 2019 (COVID-19) has outbroken globally. As an acute infectious disease, COVID-19 has significant impacts on multiple organs and systems throughout the body. Among patients with COVID-19, especially severe and critical cases, a variety of potential risk factors for coagulation dysfunction exist. Furthermore, the coagulation dysfunction of COVID-19 patients was mainly characterized by elevated D-dimer levels. The coagulation dysfunction could directly affect the prognosis of COVID-19 patients and is a major cause of death in patients with severe COVID-19. In this article, the literatures on the basic clinical manifestations, clinical risk factor, mechanism of coagulation dysfunction and evaluation of coagulation function in COVID-19 were reviewed.

Objective: To explore the changes of serum 25-hydroxyvitamin D3 [25-(OH)D3] and interleukin-6 (IL-6) in children with Kawasaki disease (KD) after treatment with intravenous immunoglobulins (IVIG) and analyze their clinical implications., Methods: Thirty-five children with KD (26 boys and 9 girls) were examined for serum 25-(OH)D3 and IL-6 levels before and after IVIG treatment using enzyme linked immunosorbent assay (ELISA), with 25 febrile children with respiratory tract infections and 25 healthy children as controls., Results: Serum 25-(OH)D3 levels were significantly higher in healthy children than in febrile children (P=0.025), and was even higher in children with KD before IVIG treatment (P=0.023). Serum IL-6 levels were similar between healthy and febrile children (P=0.4), but significantly elevated in KD children (P=0.000). Serum 25-(OH)D3 level was positive correlated with serum IL-6 level in KD children before treatment (r=0.9, P=0.000). In KD children after IVIG treatment, serum 25-(OH)D3 level was significantly increased (P=0.012) and serum IL-6 levels slightly decreased (P=0.325) without showing any correlations (r=0.18, P=0.4)., Conclusion: Serum 25-(OH)D3 level is positively correlated with serum IL-6 level in KD children before IVIG treatment but not after the treatment,. 25(OH)D3 may participate in the pathogenesis of KD and potentially serves as the therapeutic target for KD.

Objective: To investigate the mechanism of growth hormone insensitivity of rats under the endotoxemic condition., Methods: Sprague Dawley rats (n = 180) were injected endotoxin, TNF-alpha, and IL-6 respectively. Part of endotoxin injected rats were treated with exogenous somatotropin simultaneously, and all rats were killed at different time points. Liver expression of IGF I, GHR and SOCS-3 mRNA was detected by RT-PCR, the levels of growth hormone (GH) were measured by radioimmunoassay, and the levels of TNF-alpha and IL-6 were detected by ELISA., Results: Serum GH levels showed no significant change after endotoxin injection; however, liver IGF I and GHR mRNA expressions were obviously down-regulated in endotoxemic rats, with the lowest decrease of 53% and 89% respectively. Although SOCS-3 mRNA was weakly expressed in control rats, it was strongly up-regulated in endotoxemic rats and the marked increase was 7.84 folds. The higher LPS dosage induced marked GHR mRNA down-regulation and marked SOCS-3 mRNA up-regulation. Exogenous GH made IGFI mRNA expression increase 25% in the control rats, but it did fail to prevent the decline in IGFI mRNA expression in endotoxemic rats. Endotoxin stimulated the production of TNF-alpha and IL-6, and the elevated IL-6 levels showed a positive correlation with increased SOCS-3 mRNA expression. Liver GHR mRNA expression was obviously down-regulated after TNF-alpha i.v. injection, but for IL-6, it mainly up-regulated the liver SOCS-3 mRNA expression., Conclusion: The growth hormone insensitivity could be induced by LPS injection, which might be associated with down-regulated GHR mRNA expression and up-regulated SOCS-3 mRNA expression. The in vivo biological activities of LPS may be partially mediated by TNF-alpha and IL-6 at different aspects.