Search

Background: The immune inflammatory reaction has vital function in pathologic mechanism of critical intracerebral hemorrhage. It recently has been reported that CD4/CD8 ratio may represent a novel composite immune inflammatory marker to predict prognosis of critical intracerebral hemorrhage (ICH). Nevertheless, as for considering the effects of surgical evacuation upon initiation of immune inflammatory reactions, the association between cerebrospinal fluid (CSF) CD4/CD8 ratio and 60-day functional outcome of patients with critical ICH after surgery has not been investigated. Present study aimed to evaluate the predictive value concerning postoperative complement system and immunoglobulin, paired cerebrospinal fluid and peripheral blood lymphocyte subsets, as well as inflammation index before and after the operations upon the 60-day prognosis of patients with ICH. Methods: In total, 69 patients with acute critical ICH admitted in First Central Hospital of Baoding City from January to July in 2022 were prospectively enrolled. We recorded and analyzed the relevant clinical data. Laboratory parameters included postoperative lymphocyte subsets in paired cerebrospinal fluid and peripheral blood, inflammation index before and after operation. The associations between 60-day outcome and laboratory biomarkers were assessed by multivariable logistic regression analysis. Comparisons of predictive value regarding independent predictors was evaluated by receiver operating characteristic (ROC) curves. Results: In total, 51 patients with critical ICH exhibited poor outcomes at 60 days, which was associated with fever after surgery, hernia before surgery, SAH and lower Glasgow Coma Scale (GCS) at admission and large hematoma volume, greater CD3T% CSF , greater CD4T% CSF , and greater CD4/CD8 ratio CSF . CD4/CD8ratio CSF showcased significant predictive power by comparing with other laboratorial variables (AUC = 0.6808; cut-off = 1.61; sensitivity = 80.39%; specificity = 61.11%; 95% CI: 0.5232-0.8385; p = .0233), which was found to correlated linearly with postoperative fever, first CSF test time, CD3T% CSF , CD4T% CSF , CD8T% CSF , NK CSF , CD3T% PB , CD8T% PB , CD4/CD8 ratio PB , and glucose CSF . Poor outcome at 60 days linearly correlated with CD4/CD8ratio CSF after adjustments. In 3-5 days after surgery tested CSF lymphocyte subsets, CD4/CD8ratio CSF ≥1.61 was associated with a higher risk for 60-day poor outcome comparing with corresponding subgroups. Conclusions: In association of critical ICH patient prognosis, CSF CD4/CD8 ratio, especially in 3-5 days after surgery, exhibited potential independent predictive ability for 60-day functional outcomes of patients with critical ICH., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

MicroRNA (miRNA) can affect tumor progression by regulating cell proliferation, apoptosis and metastasis. A significant upregulation of miR-17-5p expression was found in colorectal cancer (CRC) tissues by miRNA microarray chip analysis. However, the underlying mechanism of miR-17-5p in CRC is still unclear. The mRNA expression of miR-17-5p was significantly higher in CRC tissues than in adjacent normal tissues. In CRC group, the expression of miR-17-5p in cancer tissues with lymph node metastasis was higher compared with those without lymph node metastasis. The biological function of miR-17-5p was demonstrated through CCK-8, colony formation, flow cytometry and transwell assays. Overexpression of miR-17-5p inhibited CRC cell apoptosis, as well as promoting proliferation, migration and invasion. Transcriptome sequencing and miRNA target prediction software suggested that HSPB2 might be a target gene of miR-17-5p and luciferase reporter detection validated for the first time that miR-17-5p binds directly to the 3'-UTR of HSPB2. In the rescue experiment, the tumor suppressive effect of HSPB2 was detected and miR-17-5p could promote cell proliferation, migration and invasion by targeting HSPB2. Taken together, miR-17-5p promotes invasion and migration by inhibiting HSPB2 in CRC, thereby implicating its potential as a novel diagnostic biomarker and therapeutic target for CRC., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Objectives: To evaluate the clinical significance of individualized nutritional formulas on inflammatory factors, immune status and gastrointestinal tolerance in patients with severe head injury., Methods: A total of 80 patients with severe head injury who were hospitalized in Baoding No.1 Central Hospital from March 2017 to March 2020 were randomly divided into two groups with 40 cases in each group. Patients in both groups were given enteral nutrition (EN), the control group was given conventional enteral nutrition formula through nasointestinal tube, and the experimental group was given individualized nutrition formula. All patients were tested for tumor necrosis factor(TNF-α), C-reactive protein(CRP), interleukin 6(IL-6), IgA, IgM, IgG, serum intestinal fatty acid binding protein(I-FABP) and D-lactic acid concentration before and after enteral nutrition treatment. The incidence of adverse reactions such as abdominal distension, diarrhea, constipation, and gastric retention within seven days after treatment of two groups were compared and analyzed., Results: There was no significant difference in inflammatory factors such as TNF-a, CRP, IL-6, immunoglobulin levels, I-FABP and D-lactic acid concentration between the two groups before treatment (p>0.05). After treatment, the above indicators of the two groups of patients were better than before treatment, the difference was statistically significant (p<0.05), and the experimental group was significantly better than the control group (p<0.05). The experimental group had a gastrointestinal adverse reaction rate of 10%, and the control group had 27.5%, the difference was statistically significant (p=0.04)., Conclusions: Individualized nutritional formula has more significant advantages than conventional nutritional formula for patients with severe head injury, which can reduce inflammatory response, increase the patient's immune level, improve the intestinal mucosal barrier function, have good gastrointestinal tolerance, and have a low incidence of adverse reactions., Competing Interests: Conflicts of interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)