Serum miR-146a and miR-223 as potential new biomarkers for sepsis

Objective

Current biomarkers cannot completely distinguish sepsis from systemic inflammatory response syndrome (SIRS) caused by other non-infectious diseases. Circulating microRNAs (miRNAs) are promising biomarkers for several diseases, but their correlation with sepsis is not totally clarified.

Methods

Seven miRNAs related to inflammation or infection were included in the present study. Serum miRNA expression was investigated in 50 patients diagnosed with sepsis, 30 patients with SIRS and 20 healthy controls to evaluate the diagnostic and prognostic value. Expression levels of serum miRNAs were determined by quantitative PCR using the Qiagen miScript system. Serum CRP and IL-6 levels were determined by enzyme linked immunosorbent assay.

Results

Serum miR-146a and miR-223 were significantly reduced in septic patients compared with SIRS patients and healthy controls. The areas under the receiver operating characteristic curve of miR-146a, miR-223 and IL-6 were 0.858, 0.804 and 0.785, respectively.

Conclusion

Serum miR-146a and miR-223 might serve as new biomarkers for sepsis with high specificity and sensitivity. (ClinicalTrials.gov number, NCT00862290.)     

胃肠道间质瘤临床诊治-附46例临床分析

目的:探讨胃肠间质瘤(Gastrointestinal Stromal Tumor,GIST)的临床特点及诊断及治疗方法。方法:回顾性分析我院1997-2009年收治的46例有完整病历资料的GIST病例,以探讨GIST的主要发生部位、临床表现、诊断和治疗方法。结果:GIST主要发生在胃(60.87%)和小肠(26.09%);主要表现为消化道出血(71.74%),腹痛不适(19.57%),腹部包块(15.22%)等;诊断首选B超(阳性率45.65%)、CT(阳性率100%)和内窥镜检查(阳性率81.09%)。本组手术45例,根治性切除40例,姑息性切除3例,术中活检1例,局部切除1例,1例放弃治疗。所有病例均经病理证实。随访42例,复发死亡11例,带瘤生存8例,无瘤生存21例,3例术后口服格列卫(甲磺伊马替尼,ST1571)的病人已生存8月、14月、18月。结论:目前GIST的治疗仍以手术治疗为主,分子靶向制剂的应用显示了一定的治疗效果。     

磁共振成像弥散张量成像参数联合血清NSE、Lp-PLA2在脑梗死患者的诊断和预后不良风险评估中的应用价值

摘要 目的：探讨磁共振成像（MRI）弥散张量成像（DTI）参数联合血清神经元特异性烯醇化酶（NSE）、脂蛋白相关磷脂酶A2（Lp-PLA2）在脑梗死患者的诊断和预后不良风险评估中的应用价值。方法：选择2021年3月至2022年9月吉林大学中日联谊医院收治的106例脑梗死患者作为脑梗死组，另选同期62例体检健康志愿者作为对照组，比较两组DTI参数，血清NSE和Lp-PLA2水平。脑梗死组出院90d后，采用改良Rankin量表（mRS）进行预后评估，分为预后良好组与预后不良组，并比较两组上述指标水平。受试者工作特征（ROC）曲线分析DTI参数联合血清NSE、Lp-PLA2诊断脑梗死和预测脑梗死患者预后的价值。结果：脑梗死组表观弥散系数（ADC）值、部分各向异性指数（FA）值低于对照组（P＜0.05），血清NSE、Lp-PLA2水平高于对照组（P＜0.05）。预后不良组FA值、ADC值低于预后良好组（P＜0.05），血清NSE、Lp-PLA2水平高于预后良好组（P＜0.05）。联合FA值、ADC值、NSE和Lp-PLA2诊断脑梗死以及预测脑梗死患者预后不良的曲线下面积（AUC）分别为0.852、0.874，均高于各因素单独诊断和预测。结论：脑梗死DTI参数FA值、ADC值降低，血清NSE、Lp-PLA2水平增高，联合DTI参数和血清NSE、Lp-PLA2检测在脑梗死诊断和预后预测中具有较高价值。     

Quality assessed nonculture techniques for detection and typing of meningococci

PCR protocols are increasingly used in laboratories worldwide for the diagnosis and confirmation of invasive meningococcal infection. Protocols are now available for the identification of Neisseria meningitidis, for genogrouping, susceptibility to antibiotics and genotyping of the corresponding isolates. The implementation of quality assurance (QA) schemes and standardization of protocols are required. Diagnostic and confirmatory PCRs should perform consistently in clinical and reference microbiology laboratories. General QA schemes address the issues of sample preparation, PCR laboratory environment, equipment and validation of protocols. Moreover, external QA interlaboratory studies are essential. The European Monitoring Group on Meningococci has provided a good forum to conduct such studies through the development and distribution of samples and protocols for nonculture detection and typing of N. meningitidis.     

血液流变学在临床疾病诊断、治疗中的应用

近十多年来,血液流变学在临床医学的各领域得到了广泛而深入的研究,不仅发现了许多疾病可导致血液流变学的异常,而且发现了血液流变学的变化可作为许多疾病诊断、治疗及愈后的重要指标。本文主要介绍血液流变学在这些方面的应用研究。     

长江江豚感染铜绿假单胞菌肺炎的诊治

本文记录了一例患急性铜绿假单胞菌肺炎的长江江豚诊断、治疗和预后观察过程。病原学鉴定采用鲜血琼脂平板对该江豚鼻腔拭子,在37℃下进行细菌需氧、厌氧培养和分离,并对所分离的细菌种类进行细菌学鉴定,结合血常规和血生化的检测结果,判定病原为铜绿假单胞菌（Pseudomonas aeruginosa,PA）。依据病原菌的药敏试验结果对患病江豚进行治疗,预后良好。通过对整个过程的资料分析以及预后观察,得到如下提示：1）应做好饲养环境的消毒措施,防止江豚出现获得性PA感染;2）对江豚日常呼吸道和粪便中PA的检测,有利于疾病的早期预防和控制;3）江豚呼吸系统疾病的治愈依赖于准确的病原鉴定和及时的治疗,药敏试验对于PA感染的治疗非常必要;4）行为学的改变在江豚呼吸道疾病发病初期以及预后有重要的指示作用。     

Dictyocaulus viviparus bulk tank milk seropositivity is correlated with meteorological variables

Control of infections with Dictyocaulus viviparus is difficult due to its volatile epidemiology. In the absence of predictive models, ‘vigilance and treatment’ is today’s mainstay for control. In order to evaluate the potential of predictive model development to support a more preventative approach, this longitudinal study aimed at understanding the influence of weather factors on D. viviparus bulk tank milk antibody ELISA results. Bulk tank milk samples were analysed with a Major Sperm Protein-based ELISA (expressed as an optical density ratio) twice monthly on 717 Flemish dairy farms during the grazing season (April–October) in 2018. Meteorological data of the sampled farms were obtained at 1 km spatial scale using the ALARO-SURFEX climate model. A mixed effects model showed that the bulk tank milk optical density ratio was significantly associated with the month of sampling, evapotranspiration, temperature and its quadratic term, the number of hot days and the number of rainy days in the 7–8 weeks prior to sampling. There were significant farm effects involved. The model’s accuracy to predict bulk tank milk optical density ratio infection status was 80%, while optical density ratios were generally overestimated by 38%. Inclusion of the previous (2-week-old) optical density ratio values increased accuracy to 86% and reduced the mean square error. We conclude that meteorological parameters have a predictive value for bulk tank milk optical density ratio results, while further research should evaluate model improvements through the addition of herd management factors as well as confirm the predictive power through external validation in additional farms and years.     

Associations between the masticatory system and muscle activity of other body districts. A meta-analysis of surface electromyography studies

The aim of this meta-analysis regarding the use of surface electromyography (sEMG) is to assess the scientific evidence for detectable correlations between the masticatory system and muscle activity of the other body districts, particularly those mainly responsible for body posture. A literature survey was performed using the PubMed database, covering the period from January 1966 to April 2011, and choosing medical subject headings. After selection, five articles qualified for the final analysis. One study article was judged to be of medium quality, the remaining four of low quality. No study included a control group or follow-up; in only one study, subjects with impairment of the masticatory system were enrolled. In all studies, detectable correlations between the masticatory systems and muscle activity of the other body districts, or vice versa, were found; however, after a reappraisal of the data provided in these studies, only weak correlations were found, which reached biological, but not clinical relevance. With the limitations that arise from the poor methodological quality of the published study reports discussed here, the conclusion is that a correlation between the masticatory system and muscle activity of the other body districts might be detected through sEMG under experimental conditions; however, this correlation has little clinical relevance. While more investigations with improved levels of scientific evidence are needed, the current evidence does not support clinically relevant correlations between the masticatory system and the muscle activity of other body districts, including those responsible for body posture.     

以肠道外症状为首发表现的结肠癌47例临床分析

目的:分析以肠道外症状为首发表现的结肠癌临床特征,旨在提高结肠癌诊治水平。方法:收集我院1994年1月至2008年1月间以肠道外症状为首发表现的结肠癌47例,对其临床特点进行回顾性分析。结果:47例以肠道外症状为首发表现的结肠癌中位发病年龄为65岁;贫血症状多见,占78.7%(37/47),长期低热3例,肝转移瘤4例,肺转移瘤2例,皮肌炎1例;肿瘤多发生于右半结肠,占74.5%(35/47);病理类型:乳头状腺癌为主,占61.7%(29/47);Dukes分期:B期占44.7%(21/47),C期占42.6%(20/47);结肠镜是重要诊断方法,结肠镜与钡灌肠有互补优势;手术是主要治疗手段,综合治疗可延长患者生存期。结论:以肠道外症状为首发表现的结肠癌以贫血多见,病变多位于右半结肠,结肠镜是主要确诊方法,以手术为主的综合治疗可改善患者预后。     

血清CREG蛋白在急性心肌梗死早期的表达研究

目的：探讨血清中CREG蛋白在急性心肌梗死发作早期的表达情况,尝试为临床心肌缺血的极早期诊断提供一种新的血清标志分子。方法：在2010年6月至2010年11月期间,入选在沈阳军区总医院心内科住院治疗的急性ST段抬高型心肌梗死患者50例及非AMI对照50例,于AMI组胸痛发作后的不同时间点采血测定CK、CK—MB、LDH和cTnT,同时应用Westem blot技术测定血清中CREG蛋白的含量,并与对照组比较。结果：AMI组发病72小时内的血清中CREG蛋白表达均较对照组有不同程度的增高（P〈0．05）。胸痛开始2h内,AMI组血清中CREG的含量即明显增高,其在2h、4h及6h的含量显著高于对照组（P〈0．001）。在胸痛已经发作2小时内,两组间血清cTnT、CK、CK-MB及LDH水平比较无统计学意义（P〉0．05）。结论：CREG在AMI患者血清中的表达增高．其在血清中表达时间早于cTNT及CK-MB。