Objective To study the responsiveness change of neutrophils when experiencing the second insult after the initial temperature activation in cardiopulmonary bypass (CPB) by using an in vitro model. Methods The neutrophils were isolated from blood which was drawn from each of 60 health volunteers. The samples were divided into 5 groups including normothermia, tepid temperature, moderate hypothermia, deep hypothermia, and rewarming hyperthermia by random digital table with 12 in each group according to the change of temperature during CPB. An in vitro model for studying neutrophil responsiveness was established by using a polymerase chain reaction thermocycler. Five time points were set for each group, including T0: starting CPB, T1: starting rewarming, T2: 0.5 h after rewarming, T3: 1 h after rewarming, and T4: 1.5 h after rewarming. Platelet activating factor (PAF) was added into each group at T2, T3, and T4, and then the value of membranebound elastase (MBE) activity was measured as responsiveness of neutrophils. Analysis of covariance was applied by using SPSS 13.0 for statistic analysis. If the [CM(159mm]covariance had significant difference between main effects, Bonferroni method would be applied for pairwise comparison. Results The main effect difference of neutrophil responsiveness among different groups was statistically different (F=4.372,P=0.002). MBE value had no statistical difference between the normothermia and tepid temperature groups (81.9±4.5 ng/10.6 cells vs. 76.5±3.6 ng/106 cells, P=0.134). while the MBE values in these two groups were higher than those in the other three groups (P=0.001). MBE value in the rewarming hyperthermia group was higher than that in the deep hypothermia group (61.2±2.7 ng/106 cells vs. 50.9±3.7 ng/106 cells, P=0.005). There was no statistical difference between the moderate hypothermia group (56.4±3.2 ng/106 cells) and the rewarming hyperthermia group (P=0.167), so was it between the moderate hypothermia group and the deep hypothermia group (P=0.107). The main effects of neutrophil responsiveness at different time points was statistically different (F=3.566, P=0.03) when PAF was added. MBE value at T4 was higher thanthat at T2 (70.9±2.5 ng/106 cells vs. 59.9±2.3 ng/106 cells, P=0.027). There was no statistical difference among T3 (65.5±1.8 ng/106 cells), T2 (P=0.168), and T4 (P=0.292) in MBE value. Conclusion Normothermia， tepid temperature， and rewarming hyperthermia during CPB can enhance neutrophil responsiveness and MBE release when neutrophils suffer the second insult. There is a time window for neutrophils to be easily activated during rewarming period.
ObjectiveTo investigate the predictive value of preoperative D-dimer, CA19-9, neutrophil-to-lymphocyte ratio (NLR) in the diagnosis of pancreatic cancer. MethodsThe clinicopathologic data of patients who underwent pancreaticoduodenectomy for pancreatic occupying lesions in the First and Fifth Affiliated Hospitals of Xinjiang Medical University from January 2016 to December 2019 were analyzed retrospectively. According to the pathological characteristics, the patients were divided into pancreatic cancer and pancreatic benign tumour. The gender, age, accompanying diseases, preoperative D-dimer, CA19-9, lymphocyte count, neutrophil count, NLR and so on were compared between them. The receiver operating characteristic (ROC) curves of preoperative D-dimer, CA19-9, and NLR for diagnosis of pancreatic cancer were draw. ResultsA total of 142 patients were collected, including 79 patients with pancreatic cancer and 63 patients with pancreatic benign tumour. Compared with the patients with pancreatic benign tumour, the age was older (P<0.05), the number of neutrophils was more (P<0.05), the number of lymphocytes was less (P<0.05), the preoperative levels of CA19-9 and D-dimer, and the preoperative NLR were higher (P<0.05) for the patients with pancreatic cancer. The multivariate analysis of logistic regression revealed that the preoperative higer CA19-9, D-dimer, and NLR increased the incidence of pancreatic cancer (P<0.05), then the optimal cut-off value of preoperative levels of CA19-9 and D-dimer, and preoperative NLR on diagnosis of pancreatic cancer was 108 U/mL, 306 μg/L and 3.2, respectively, the corresponding area under ROC curve was 0.900, 0.891, 0.768, respectively, and which of combination of preoperative CA19-9, D-dimer, and NLR was 0.931. For the pancreatic cancer patients with preoperative NLR, CA19-9, and D-dimer higher than the optimal cut-off value, the proportions of patients with pTNM stage Ⅲ and lymph node metastasis were higher than those for pancreatic cancer patients with below than optimal cut-off value (P<0.05). ConclusionFrom preliminary study results, preoperative CA19-9, D-dimer, and NLR values have certain values in diagnosis of pancreatic cancer, and diagnostic value of combined detection of 3 indexes is higher than single index.
The effect of neutrophil extracellular traps (NETs) on promoting intravascular microthrombi formation and exacerbating the severity of sepsis in patients has gained extensive attention. However, in sepsis, the mechanisms and key signaling molecules mediating NET formation during direct interactions of endothelial cells and neutrophils still need further explored. Herein, we utilized lipoteichoic acid (LTA), a component shared by Gram-positive bacteria, to induce NET extrusion from neutrophils firmly adhered to the glass slides coated with intercellular adhesion molecule-1(ICAM-1). We also used Sytox green to label NET-DNA and Flou-4 AM as the intracellular Ca2+ signaling indicator to observe the NET formation and fluctuation of Ca2+ signaling. Our results illustrated that LTA was able to induce NET release from neutrophils firmly attached to ICAM-1-coated glass slides, and the process was time-dependent. In addition, our study indicated that LTA-induced NET release by neutrophils stably adhered to ICAM-1 depended on Ca2+ signaling but not intracellular reactive oxygen species (ROS). This study reveals NET formation mediated by direct interactions between endothelial ICAM-1 and neutrophils under LTA stimulation and key signaling molecules involved, providing the theoretical basis for medicine development and clinical treatment for related diseases.
ObjectiveTo explore the combined application of neutrophil to lymphocyte ratio (NLR) and systemic immune inflammation index (SII) on the prognosis of hepatitis B-related hepatocellular carcinoma after resection.MethodsRetrospectively collected data of 180 patients with hepatitis B-related hepatocellular carcinoma who were hospitalized in the Department of Infectious Diseases and Hepatobiliary Surgery of the Affiliated Hospital of Southwest Medical University and received surgical treatment from January 2013 to December 2019, including general information, laboratory examination and abdominal CT or MRI results. NLR and SII values were measured at one week before operation, and their critical values of NLR and SII were determined by ROC curve analysis. Univariate and multivariate analysis were performed to determine the risk factors to predict the survival status of patients with hepatitis B-related hepatocellular carcinoma after hepatectomy.ResultsUnivariate analysis showed that AFP, platelets, TNM staging, portal vein tumor thrombus, tumor differentiation, NLR, SII, and NLR+SII combined score were significantly correlated with the prognosis of patients with hepatitis B-related hepatocellular carcinoma (P<0.05). Multivariate analysis showed that PLT [HR=1.791, 95%CI (1.124, 2.854), P=0.014], NLR [HR=4.289, 95%CI (2.571, 7.156), P<0.001], SII [HR=5.317, 95%CI (3.016, 9.374), P<0.001], and NLR+SII combined score [HR=7.901, 95%CI (4.124, 15.138), P<0.001] were independently correlated with the survival of patients with hepatitis B-related hepatocellular carcinoma.ConclusionsThe preoperative NLR+SII combined score can be used to evaluate the postoperative prognosis of patients with hepatitis B-related hepatocellular carcinoma. The higher the score, the lower the postoperative survival rate.
Objective To study the role of the complement receptor 1 and 3 ( CR1 and CR3) on neutrophils in distinguishing bacterial infection in patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD) . Methods 40 patients with AECOPD were divided into two groups according to the detection of bacteria in subairway. 20 patients with stable COPD and 20 healthy subjects with no history of smoking were also included. According to Anthonisen criteria, 40 AECOPD patients weredivided into type Ⅰ( 11 cases) , type Ⅱ ( 12 cases) , and type Ⅲ( 17 cases) . The levels of CR1 and CR3 in blood were measured by flow cytometry. Results In AECOPD patients, 25 cases were detected bacteria,and 15 cases were not detected bacteria. The level of CR1 and CR3 were highest in the bacterial infection group than other groups, and highest in type Ⅰ AECOPD patients than other types. ROC analysis showed that CR1 and CR3 had good diagnostic value in bacterial infection in AECOPD, with optimal cutoff values of 11 and 52, respectively. Conclusion CR1 and CR3 may be good index of distinguishing bacterial infection in AECOPD.
ObjectiveTo summarize the blood routine indexes and predictive systems that can predict the severity of acute pancreatitis (AP). MethodThe recent domestic and foreign literatures on the predictive value of blood routine indexes for the severity of AP were reviewed.ResultsFrom the current research results at domestic and foreign, independent blood routine indexes such as red blood cell distribution width, average platelet volume, hematocrit (TCT), platelet (PLT) count, platelet distribution width, percentage of immature granulocytes (IG%), and some blood routine calculation indexes such as neutrophil to lymphocyte ratio (NLR), PLT to lymphocyte ratio (PLR), red blood cell distribution width to PLT ratio (RPR), neutrophil-monocyte product, and so on, all had different predictive value for the severity of AP. In addition, multiple prediction modes such as blood routine indexes combined with some serological indexes or other scoring systems could also be used to predict the severity of AP. In general, the predictive value of the NLR, IG%, and HCT on the severity of AP had been unanimously recognized by researchers. However, the conclusions of related studies on the predictive values of PLT, PLR, and RPR on the severity of AP were still controversial. ConclusionsAt present, there are a variety of blood routine indexes can be used to predict severity of AP, but their predictive values are different. Further researches are still needed.
Objective To explore the differences in lung function, neutrophil polarization, and serum total immunoglobulin E (IgE) levels among bronchial asthma patients, chronic obstructive pulmonary disease (COPD) patients, and asthma-COPD overlap syndrome (ACO) patients. Methods The retrospective analysis enrolled 127 patients with respiratory system diseases diagnosed and treated in Wuwei People’s Hospital between March 2016 and March 2019. Among them, 45 patients with moderate and severe bronchial asthma were in included the asthma group, 42 patients with acute exacerbations of COPD were included in the COPD group, and 40 patients with moderately persistent and severely persistent ACO were included in the ACO group. Forty-eight healthy examinees in the same period were selected as the control group. The pulmonary function [forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1 to FVC (FEV1/FVC) ratio, and percentage of FEV1 to predicted value (FEV1%pred)], neutrophil polarization, and serum total IgE levels of the four groups were compared. Results In the control group, the ACO group, the asthma group, and the COPD group, the FEV1 values were (3.65±0.79), (2.04±0.58), (1.81±0.46), and (1.59±0.43) L, respectively, the FVC values were (4.13±0.92), (3.18±0.76), (2.69±0.63), and (2.43±0.58) L, respectively, the serum total IgE levels were (92.36±12.20), (334.81±55.96), (455.61±65.59), and (142.65±28.36) U/mL, respectively, and the between-group differences were all statistically significant (P<0.05). In addition, the FEV1/FVC ratios in the asthma group, the COPD group, and the ACO group were (67.93±11.51)%, (63.81±9.22)%, and (61.28±9.23)%, respectively, the FEV1%pred levels were (74.55±11.70)%, (63.29±8.60)%, and (61.34±7.91)%, respectively, which were lower than those in the control group [(83.60±7.18)% and (94.23±8.21)%] (P<0.05). The spontaneous polarization rates in the ACO group, the asthma group, the COPD group, and the control group were (29.43±5.58)%, (25.11±4.09)%, (16.28±4.51)%, and (7.18±2.12)%, respectively, the arbitrary polarization rates in the ACO group, the asthma group, the control group, and the COPD group were (30.01±5.29)%, (25.76±5.53)%, (21.42±4.36)%, and (19.85±5.00)%, respectively, the directional polarization rates in the asthma group, the ACO group, the control group, and the COPD group were (14.67±2.30)%, (8.21±1.81)%, (5.12±1.10)%, and (2.52±0.63)%, respectively, and the between-group differences were all statistically significant (P<0.05). Conclusion There are certain differences in lung function, neutrophil polarization, and serum immunoglobulin E level among patients with bronchial asthma, COPD, and asthma-COPD overlap syndrome.