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Objective：To investigate the changes of follicular helper T lymphocytes (Tfh) in peripheral blood of the patients with systemic lupus erythematosus (SLE) during pregnancy, and to clarify the immune effects of Tfh cells duing pregnancy. Methods：The SLE patients from Qingdao Municipal Hospital and Qingdao Women and Children Hospital were divided into SLE with pregnancy group ( n=32) and SLE without pregnancy group (n=30)；at the same time, healthy pregnancy group (healthy pregnancy women，n = 30) and healthy non-pregnancy group (healthy non-pregnancy women，n=25) were used as control. According to the changes of lupus during pregnancy and after termination of pregnancy within 3 months, the 32 cases of SLE patients in SLE with pregnancy group (2 cases were lost during follow-up) were divided into poor prognosis group (n=8) and clinical stabilization group (n=22). The clinical data and laboratory examination indexes of the patients were collected. The percentages of CD4+inducible T-cell costimulatory factor (ICOS)+ chemokine C-X-C-motif receptor 5 (CXCR5)+Tfh cells in the CD4+ T lymphocytes in peripheral blood of the patients in various groups ( percentages of Tfh cells ) were detected by flow cytometry. The relationships between the percentages of Tfh cells in peripheral blood of the patients in SLE with pregnancy group and the laboratory examination indexes were analyzed by Spearman correlation analysis. The levels of interleukin-6 (IL-6), interleukin-21 ( IL-21) and interferon-γ ( IFN- γ) in peripheral blood of the subjects in various groups were detected by enzyme linked immunosorbent assay (ELISA)method. Results：Compared with healthy pregnancy group, the percentage of Tfh cells in peripheral blood of the patients in SLE with pregnancy group was significantly increased (P<0. 01), and the percentage of Tfh cells in peripheral blood of the subjects in healthy non-pregnancy group was significantly decreased (P<0. 05). Compared with SLE without pregnancy group, the percentage of Tfh cells in peripheral blood of the patients in SLE with pregnancy group was significantly increased (P<0. 05). During the follow-up, compared with clinical stabilization group, the percentage of Tfh cells in peripheral blood of the patients in poor prognosis group was significantly increased (P<0. 05). The percentage of Tfh cells in peripheral blood of the patients in SLE with pregnancy group was positively correlated with the levels of anticardiolipin antibody ( ACA) and anti-β2 glycoprotein Ⅰ (β2GPⅠ) antibody (r=0. 743 1，P<0. 05； r= 0. 830 7，P<0. 01). Compared with healthy pregnancy group, the levels of IL-6 and IL-21 in peripheral blood of the patients in SLE with pregnancy group were significantly increased (P<0. 05)；compared with SLE without pregnancy group，the level of IL-21 in peripheral blood of the patients in SLE with pregnancy group was significantly increased (P<0. 05). Conclusion：The increase of the percentage of Tfh cells in peripheral blood of the patients with SLE in early pregnancy may be related to the poor pregnancy prognosis in the patients with SLE. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between serum N-terminal brain natriuretic peptide precursor (NT-proBNP), human epididymal protein 4(HE4), β2 microglobulin(β2-MG), soluble ST2 (sST2) and ventricular remodeling in patients with dilated cardiomyopathy (DCM) and the predictive value of short-term prognosis after discharge. Methods: 74 patients with DCM who were admitted to Tongji Hospital Affiliated to Tongji Medical College of HUST from March 2019 to December 2020 were selected, and were recorded as DCM group. Another 80 healthy subjects in the same period were taken as the control group. The levels of serum NT-proBNP, HE4, β2-MG and sST2 and related indexes of ventricular remodeling were detected and compared between the two groups. Pearson correlation was used to analyze the correlation between serum NT-proBNP, HE4, β2-MG, sST2 levels and various ventricular remodeling parameters. In addition, all patients with DCM were divided into the poor prognosis group with 33 cases and the good prognosis group with 41 cases according to whether rehospitalization for heart failure and cardiovascular death events had occurred after discharge. The baseline data and the levels of serum NT-proBNP, HE4, β2-MG and sST2 were compared between the two groups. Multivariate Logistic regression was used to analyze the risk factors for short-term prognosis in patients with DCM after discharge. The efficacy of serum NT-proBNP, HE4, β2-MG and sST2 in predicting short-term prognosis of patients with DCM after discharge was analyzed by receiver operating characteristic (ROC) curve. Results: The levels of serum NT-proBNP, HE4, β2-MG and sST2 in DCM group were higher than those in control group (P<0. 05). The levels of left ventricular mass index (LVMI), left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV) in DCM group were higher than those in control group, while the level of left ventricular ejection fraction (LVEF) was lower than that in control group (P<0. 05). Pearson correlation analysis showed that the levels of serum NT-proBNP, HE4, β2-MG and sST2 were positively correlated with LVMI, LVEDV and LVESV, while negatively correlated with LVEF (P<0. 05). The age and the levels of serum NT-proBNP, HE4, β2-MG and sST2 in the poor prognosis group were higher than those in the good prognosis group (P <0. 05). Multivariate Logistic regression analysis showed that age and the levels of serum NT-proBNP, HE4, β2-MG and sST2 were risk factors for short-term prognosis in patients with DCM after discharge (P<0. 05). ROC curve analysis showed that the area under curve, sensitivity and specificity of combined detection of serum NT-proBNP, HE4, β2-MG and sST2 in predicting short-term prognosis of patients with DCM after discharge were higher than those of the above four indicators alone. Conclusions: Serum NT-proBNP, HE4, β2-MG and sST2 are closely related to ventricular remodeling in patients with DCM, and have high value in predicting short-term prognosis after discharge. [ABSTRACT FROM AUTHOR]