Expression of Placenta growth factor (PlGF) in non-Small cell Lung cancer (NSCLC) and the clinical and prognostic significance

Background

Placenta growth factor (PlGF) is a member of the vascular endothelial growth factor (VEGF) family. Over-expression of PlGF is known to be associated with pathological angiogenesis. This study examined PlGF expression at protein and message levels in non-small cell lung cancer (NSCLC), in which no reports on the significance of PlGF expression is available to date.

Patients and methods

We used immunohistochemistry to assess the PlGF protein and correlated PlGF with microvessel density (MVD), as well as clinical outcome in patients with NSCLC tumours (n = 91). In addition, we applied a real time quantitative PCR assay using SYBR Green chemistry to measure PlGF mRNA in normal lung tissues and NSCLC tumours.

Results

PlGF was positively stained mainly in cytoplasm of lung cancer cells. High level staining of PlGF was found in 38.5% NSCLC patients. A high level of MVD in NSCLC was found in 42.9% of cases. Tumours with high level and low level PlGF staining had a significantly different MVD (26.69 vs. 20.79, respectively, p = 0.003). Using both univariate and multivariate analyses, PlGF was found to be an independent prognostic factor. Real time PCR analysis revealed that PlGF mRNA was higher in the cancer tissue than normal tissue (0.95 ± 0.19 vs. 0.57 ± 0.24; p < 0.005) and that PlGF mRNA was significant higher in III-IV stage patients than in I-II stage patients (1.03 ± 0.20 vs. 0.80 ± 0.17; p = 0.011).

Conclusion

PlGF expression is significantly more in NSCLC tumour tissues than in matched normal tissues. It has a significant positive association with MVD and is an independent factor for NSCLC patients. PlGF may have a pivotal role in NSCLC development and disease progression.     

VEGF、P-ACC、LKB1在非小细胞肺癌组织中的表达及意义

目的:探究非小细胞肺癌组织中血管内皮生长因子(VEGF)、磷酸化乙酰辅酶A羟化酶(P-ACC)、肝激酶B1(LKB1)表达及其与肿瘤血管生成的关系。方法:将我院收治的83例非小细胞肺癌(NSCLC)患者作为研究对象,取其NSCLC病理组织样本进行研究,同时取其远离肿瘤的外周正常肺组织作为对照。采用免疫组化法测定其NSCLC病理组织样本和正常组织样本VEGF、P-ACC、LKB1的表达情况,分析比较NSCLC病理组织的VEGF、P-ACC、LKB1表达情况与其病理特征及肿瘤血管生成的关系。结果:NSCLC组织样本的VEGF阳性表达率为72.29%,明显高于癌旁正常组织样本(22.89%)(P0.05);同时,其P-ACC、LKB1阳性表达率分别为31.33%、61.45%,明显低于癌旁正常组织样本(分别为75.90%、90.36%)(P0.05)。NSCLC组织VEGF阳性表达与N分期、临床分期以及肿瘤微血管密度(MVD)有关,P-ACC阳性表达与T分期、临床分期以及MVD有关,LKB1阳性表达与N分期、临床分期、分化程度以及MVD有关(P0.05)。在样本中,VEGF阳性NSCLC组织的MVD水平明显高于VEGF阴性样本,而P-ACC、LKB1阳性NSCLC组织的MVD水平明显低于阴性样本(P0.05)。结论:非小细胞肺癌组织中VEGF在呈高表达,P-ACC、LKB1呈现低表达。VEGF、P-ACC、LKB1的表达与NSCLC临床病理特征及肿瘤血管生成均存在密切联系,对于预测NSCLC癌细胞的生长、浸润和转移具有重要意义。     

Clinical value of serum trophoblast cell surface protein 2 (TROP2) antibody in non-small-cell lung cancer patients

Objective: This study was to explore the clinical role of serum trophoblast cell surface protein 2 (TROP2) antibody in patients with non-small-cell lung cancer (NSCLC).

Materials and methods: We collected serum specimens from 117 NSCLC patients, 40 benign lung disease patients, and 60 healthy controls. TROP2 antibody concentrations were measured using enzyme-linked immunosorbent assay.

Results: Serum TROP2 antibody levels were higher in the NSCLC group compared to the control group (p?Conclusion: Measurement of TROP2 antibody might have diagnostic value for patients with NSCLC.     

Association of secreted frizzled-related protein 4 (SFRP4) with type 2 diabetes in patients with stable coronary artery disease

Background

The interplay between the novel adipokine retinol-binding protein-4 (RBP4) and coronary artery disease (CAD) is still obscure. We investigated the relationship between RBP4 levels and the presence and severity of angiographically proven CAD and determined its possible role in acute myocardial infarction (AMI).

Methods

305 individuals with angiographically proven CAD (CAD-patients), were classified into 2 subgroups: 1) acute myocardial infarction (AMI, n = 141), and 2) stable angina (SA, n = 164). Ninety-one age- and sex-matched individuals without CAD, but with at least 2 classical cardiovascular risk factors, served as controls (non-CAD group). RBP4 serum levels were measured at hospital admission and were analyzed in relation to the coronary severity stenosis, assessed by the Gensini-score and the number of coronary narrowed vessels. Other clinical parameters, including insulin levels, HOMA-IR, hsCRP, glycaemic and lipid profile, and left-ventricular ejection fraction were also assessed.

Results

Serum RBP4 levels were significantly elevated in patients with CAD compared to non-CAD patients (39.29  ± 11.72 mg/L vs. 24.83  ± 11.27 mg/L, p < 0.001). We did not observe a significant difference in RBP4 levels between AMI and SA subgroups (p = 0.734). Logistic regression analysis revealed an independent association of CAD presence with serum RBP4 (β = 0.163, p = 0.006), and hsCRP (β = 0.122, p = 0.022) levels, in the whole study group. Among variables, hsCRP (β = 0.220), HDL (β = β0.150), and RBP4 (β = 0.297), correlated in both univariate and multivariate analysis with CAD severity (R² = 0.422, p < 0.001). Similarly, RBP4 concentrations increased with the number of coronary narrowed vessels (p < 0.05).

Conclusion

Patients with CAD, both SA and AMI, showed elevated RBP4 serum levels. Notably, increased RBP4 concentration seemed to independently correlate with CAD severity, but no with AMI.

Trial registration

The ClinicalTrials.gov Identifier is: NCT00636766

     

Serum RBP4 positively correlates with triglyceride level but not with BMI,fat mass and insulin resistance in healthy obese and non-obese individuals

Abstract

Purpose: Retinol binding protein 4 (RBP4) has recently been identified as an adipokine possibly involved in the development of impaired glucose metabolism. We aimed to test serum RBP4 in healthy non-obese individuals and in patients with well-characterized phenotype: obesity without confounding effects of diabetes, metabolic syndrome or dyslipidaemia. Additionally, we examined whether serum RBP4 is associated with anthropometric parameters, insulin resistance and blood lipid parameters.

Patients and methods: Twenty-eight patients with obesity and no co-morbidities and twenty-five age-matched lean controls were recruited. Anthropometric parameters, body composition, fasting blood lipid profile, RBP4, glucose and insulin were assessed and HOMA-IR was calculated.

Results: Mean concentration of RBP4 did not differ between studied groups (in obese patients was 33.93?±?4.46?µg/ml and 32.53?±?2.53?µg/ml in non-obese controls). RBP4 positively correlated with serum triglycerides in obese and non-obese individuals (r?=?0.74, p?=?0.03 and r?=?0.62, p?=?0.02, respectively) and did not show any significant associations with HOMA-IR, anthropometric and body composition parameters.

Conclusions: Excessive adiposity without co-morbidities is not associated with higher levels of circulating RBP4. Serum RBP4 cannot be considered as a direct predictive marker for impaired glucose metabolism. RBP4 possibly contributes to lipid metabolism.     

非小细胞肺癌组织CENPF、KLF4表达与上皮-间质转化和预后的关系研究

摘要 目的：探讨非小细胞肺癌（NSCLC）组织中着丝粒蛋白F（CENPF）、Krüppel样因子4（KLF4）表达与上皮-间质转化（EMT）和预后的关系。方法：选取2017年1月至2019年12月期间于泰州市第四人民医院行手术切除的120例NSCLC患者的癌组织和距癌组织5cm癌旁组织标本,采用免疫组织化学法和免疫印迹法检测癌组织和癌旁组织中CENPF、KLF4及ETM相关标志物[E-钙粘蛋白（E-cadherin）、波形蛋白（Vimentin）]的阳性表达率和表达量。采用Pearson检验分析CENPF、KLF4与EMT相关标志物的相关性,并分析CENPF、KLF4表达与NSCLC患者预后的关系。结果：NSCLC癌组织中CENPF、Vimentin的阳性表达率显著高于癌旁组织（均P<0.05）,而KLF4、E-cadherin的阳性表达率均显著低于癌旁组织（均P<0.05）。NSCLC癌组织中CENPF与E-cadherin呈负相关,与Vimentin呈正相关（P<0.05）;而KLF4与E-cadherin呈正相关,与Vimentin呈负相关（P<0.05）。NSCLC癌组织中CENPF、KLF4的阳性表达率与TNM分期和淋巴结转移有关（均P<0.05）。入组患者3年无病生存率（DFS）为60.00%。CENPF阳性表达的NSCLC患者3年DFS显著低于CENPF阴性表达患者（56.25% vs 75.00%,P=0.014）,KLF4阳性表达的NSCLC患者3年DFS显著高于KLF4阴性表达患者（68.75% vs 54.17%, P=0.048）。结论：CENPF的高表达及KLF4的低表达可促进NSCLC的EMT发生、进展,并导致患者预后不良,CENPF和KLF4可辅助预测NSCLC患者的预后。     

非小细胞肺癌组织PAK4、PAK5蛋白表达与上皮-间质转化、临床病理特征和预后的关系分析

摘要 目的：探讨非小细胞肺癌（NSCLC）组织p21激活激酶（PAK）4、PAK5蛋白表达与上皮-间质转化（EMT）、临床病理特征和预后的关系。方法：选取2018年1月～2019年12月我院收治的100例NSCLC患者,收集手术切除的癌组织和癌旁组织标本,采用免疫组化法检测NSCLC组织和癌旁组织中PAK4、PAK5和EMT相关蛋白[E-钙粘蛋白（E-Cad）、N-钙粘蛋白（N-Cad）和波形蛋白（VIM）]表达。分析PAK4、PAK5蛋白表达与NSCLC患者病理特征的关系和与EMT相关蛋白的相关性。根据NSCLC组织中PAK4、PAK5表达分为阳性/阴性表达组,采用K-M法绘制PAK4、PAK5阳性/阴性表达NSCLC患者的生存曲线,多因素Cox回归分析NSCLC患者死亡的影响因素。结果：与癌旁组织相比,NSCLC组织中PAK4、PAK5、N-Cad、VIM蛋白阳性表达率升高,E-Cad蛋白阳性表达率降低（P＜0.05）。二列相关性分析显示,NSCLC组织PAK4、PAK5与E-Cad蛋白阳性表达率呈负相关,与N-Cad、VIM蛋白阳性表达率呈正相关（P均＜0.001）。不同分化程度、TNM分期、淋巴结转移NSCLC患者PAK4、PAK5蛋白阳性表达率比较,差异有统计学意义（P＜0.05）。100例NSCLC患者3年总生存率为56.00%（56/100）。K-M生存曲线分析显示,PAK4、PAK5阳性表达组总生存率低于阴性表达组（P＜0.05）。多因素Cox回归分析显示,低分化、TNM分期为ⅢA期、淋巴结转移和PAK4、PAK5蛋白阳性表达为NSCLC患者死亡的独立危险因素（P＜0.05）。结论：NSCLC组织PAK4、PAK5蛋白表达升高,与EMT、分化程度、TNM分期、淋巴结转移和预后有关,可能成为NSCLC诊治的新靶点。     

CXCR4 as a prognostic biomarker in gastrointestinal cancer: a meta-analysis

Background: CXCR4 is a member of the C-X-C chemokine receptor family, which is associated with multiple types of cancer. Although it has been widely reported, the prognostic value of CXCR4 expression in gastrointestinal (GI) cancer remains controversial.

Methods: A meta-analysis was conducted to investigate the relationship between CXCR4 and prognosis of patients with GI cancer. Subgroup analysis was also performed according to tumour subtypes and heterogeneity test.

Results: A total of 24 studies including 3637 cases suggested that overexpression of CXCR4 is significantly associated with overall survival (OS) for patients with GI cancer (HR = 1.71, 95% CI = 1.45–2.03, p?=?0.000). Subgroup analysis also indicated that high CXCR4 expression in oesophagus, gastric and colorectal cancer all predicted a worse prognosis (HR = 1.52, 95% CI = 1.26–1.84, p?=?0.001 for oesophagus cancer; HR = 1.59, 95% CI = 1.10–2.30, p?=?0.015 for gastric cancer; HR = 2.21, 95% CI = 1.56–3.14, p?=?0.000 for colorectal cancer).

Conclusions: CXCR4 may serve as a prognostic indicator in GI cancer patients.     

非小细胞肺癌组织PRRX1、VASH-1与微血管密度、临床病理参数和预后的关系研究

摘要 目的：探讨非小细胞肺癌（NSCLC）组织配对相关同源框蛋白1（PRRX1）、血管抑制蛋白1（VASH-1）与微血管密度（MVD）、临床病理参数和预后的关系。方法：选择2018年1月至2020年1月辽宁省金秋医院行手术切除的156例NSCLC患者的癌组织及癌旁正常组织标本。应用免疫组织化学染色法检测癌组织及癌旁组织PRRX1、VASH-1的阳性表达率,并进行MVD计数。比较PRRX1阳性表达组/阴性表达组、VASH-1阳性表达组/阴性表达组MVD计数。分析PRRX1、VASH-1与NSCLC患者病理参数的关系。随访3年,应用Kaplan-Meier生存曲线分析PRRX1、VASH-1阳性/阴性表达与NSCLC患者预后的关系。结果：与癌旁组织相比,NSCLC患者癌组织PRRX1阳性表达率降低,VASH-1阳性表达率升高（P<0.05）。与PRRX1阴性NSCLC患者相比,PRRX1阳性NSCLC患者癌组织MVD降低,与VASH-1阴性NSCLC患者相比,VASH-1阳性NSCLC患者癌组织MVD升高（P<0.05）。与TNM I~II期、无淋巴结转移NSCLC患者的癌组织相比,TNM Ⅲ A期、淋巴结转移NSCLC患者的癌组织中PRRX1阳性表达率降低,VASH-1阳性表达率升高（P<0.05）。Kaplan-Meier法分析显示,PRRX1阳性组3年总体生存率（OS）、3年无病生存率（DFS）高于PRRX1阴性组（P<0.05）,VASH-1阴性组3年OS、3年DFS高于VASH-1阳性组（P<0.05）。结论：NSCLC患者的癌组织中PRRX1阳性表达率降低,VASH-1阳性表达率升高,与淋巴结转移、TNM分期及不良预后有关。     

Stromal cell-derived factor 1 (SDF-1) and its receptor CXCR4 improves diabetic retinopathy

Diabetes induced a serious of complications including diabetic retinopathy. Our study aimed to investigate the role of Stromal cell-derived factor 1 (SDF-1) and its receptor CXCR4 in diabetic retinopathy. A mice model of diabetic retinopathy was established, and expression of SDF-1 and CXCR4 in retina was examined by Real-time quantitative PCR (qRT-PCR). Cells of human retinal pigment epithelial cell line ARPE-19 were treated with CXCR4 siRNAs and expression vector, and cell viability was detected by MTT assay. We found that expression of SDF-1 and CXCR4 in retina was significantly downregulated in mice with diabetic retinopathy than in normal healthy mice. High glucose treatment downregulated the expression of SDF-1 and CXCR4 in ARPE-19 cells at both mRNA and protein levels. Transfection with CXCR4 siRNAs decreased, while transfection with CXCR4 expression vector increased cell viability under high glucose treatment. We concluded that SDF-1/CXCR4 pathway improved diabetic retinopathy possibly by increasing cell viability.

Abbreviations: SDF-1: Stromal cell-derived factor 1; CXCL12: C-X-C motif chemokine 12; qRT-PCR: Real-time quantitative PCR     

Effect of H4R antagonist N-(2-aminoethyl)-5-chloro-1H-indol-2-carboxamides and 5-chloro-2-(piperazin-1-ylmethyl)-1H-benzimidazole on histamine and 4-methylhistamine-induced mast cell response

Context: The histamine plays a decisive role in acute and chronic inflammatory responses and is regulated through its four types of distinct receptors designated from H1 to H4. Recently histamine 4 receptor (H4R) antagonists have been reported to possess various pharmacological effects against various allergic diseases.

Objective: To investigate the inhibitory effect of N-(2-aminoethyl)-5-chloro-1H-indol-2-carboxamide (Compound A) and 5-chloro-2-(piperazin-1-ylmethyl)-1H-benzimidazole (Compound L) on H4R-mediated calcium mobilization, cytokine IL-13 production, ERK1/2, Akt and NF-κB activation in human mastocytoma cells-1 (HMC-1).

Materials and methods: Compounds A and L were synthesized chemically and their inhibitory effect on intracellular calcium release was analyzed by Fluo-4 calcium assay, cytokine measurement through ELISA and activation of signaling molecules by western blot.

Results: Pre-treatment with compounds A and L significantly reduced the H4R-mediated intracellular calcium release. Histamine and 4-methylhistamine (4-MH) induced Th2 cytokine IL-13 production in HMC-1 cells, was inhibited by compound A (77.61%, 74.25% at 1?μM concentration) and compound L (79.63%, 81.70% at 1?μM concentration). Furthermore, histamine induced the phosphorylation of ERK1/2, Akt and NF-κB was suppressed by compounds A and L at varying levels, ERK1/2 (88%, 86%), Akt (88%, 89%) and NF-κB (89%, 87%) in HMC-1 cells.

Discussion and conclusions: Taken together these data demonstrate that compound A and compound L may block H4R-mediated downstream signaling events.     

Expression of Duffy antigen receptor for chemokines (DARC) is down-regulated in colorectal cancer

Abstract

Duffy antigen receptor for chemokines (DARC) is a silent chemokine receptor which selectively binds angiogenic chemokines without inducing conventional signaling responses. DARC has been reported to inhibit the development of multiple cancers through clearance of angiogenic chemokines. However, its role in colorectal cancer (CRC) remains unclear. We investigated the expression of DARC in CRC and explored correlation of DARC expression with clinical pathological features and microvessel density (MVD). The protein expression levels of DARC were detected by immunohistochemistry in 90 CRC and 64 paired unaffected tissues. The mRNA levels of DARC were detected by quantitative real-time PCR in 15 CRC and paired unaffected tissues. MVD in CRC was also assessed by immunohistochemistry of CD34. We found that the mRNA and protein expression levels of DARC were significantly lower in CRC than in the unaffected tissues (p?<?0.05). The DARC protein expression levels were positively correlated with DARC mRNA expression levels in both CRC (p?<?0.001) and unaffected tissues (p?<?0.001). We also found that DARC expression was significantly correlated with tumor differentiation (p?<?0.001), lymph node metastasis (p?<?0.01) and TNM stage (p?<?0.05). Moreover, we observed a strong negative relationship between DARC expression and MVD in CRC (p?<?0.001). We showed that DARC expression is down-regulated in CRC and associated with clinical pathological features and MVD of CRC. DARC might be involved in tumorigenesis, progression, angiogenesis, and metastasis of CRC.     

CXCL4 Plasma Levels Are Not Associated with the Extent of Coronary Artery Disease or with Coronary Plaque Morphology

Background

CXCL4 is a platelet chemokine released at micromolar concentrations upon platelet activation. CXCL4 has been shown to promote atherogenesis by various mechanisms. However, data on CXCL4 plasma levels in patients with coronary artery disease are largely inconclusive. Computed coronary artery angiography (CCTA) represents an excellent tool to quantify and characterize coronary atherosclerotic plaques. We hypothesized that increased CXCL4 plasma levels may be associated with features of plaque instability resulting in adverse cardiovascular events. Specifically, we sought to determine whether CXCL4 levels are correlated with specific features of coronary artery disease including (1) plaque volume, (2) calcium score, (3) degree of stenosis, or (4) vascular remodeling.

Methods and Results

CXCL4 plasma levels were measured by ELISA in 217 patients undergoing CCTA for suspected CAD (mean age 64.2 ± 9.4 years, 107 (49.3%) male). Mean CXCL4 plasma levels were 12.5 ± 4.6 ng/mL. There was no significant correlation between CXCL4 levels and any clinical or demographic parameters including cardiovascular risk factors. CXCL4 plasma levels did not differ between patient with or without coronary artery disease (CAD: 12.5 ± 4.5 ng/ml, no CAD: 12.5 ± 4.8 ng/ml). Neither univariate nor multivariate analysis showed an association between CXCL4 levels and plaque volume, total calcium score, degree of stenosis, or vascular remodeling. Subgroup analysis of patients with CAD as confirmed by CCTA did not show any association of CXCL4 levels with the extent of CAD.

Conclusions

While CXCL4 may be present and active within the arterial wall, local increase of CXCL4 may not translate into systemically elevated CXCL4 levels. Further studies will have to test whether CXCL4 may still represent a suitable therapeutic target in human atherosclerosis.     

血浆循环游离DNA(cf DNA)联合癌胚抗原(CEA)在评估晚期非小细胞肺癌治疗疗效的临床价值

摘要 目的：研究血浆循环游离DNA（cf DNA）联合癌胚抗原（CEA）在评估晚期非小细胞肺癌（NSCLC）治疗疗效中的临床价值。方法：选取我院2019年1月~2022年1月收治的96例晚期NSCLC患者作为研究对象,所有患者均接受含铂双药化疗方案或放疗,评估治疗6个月后的临床疗效,根据疗效分为有效组与无效组,检测所有患者cf DNA及CEA水平并进行比较,单因素、多因素分析患者疗效的影响因素,并通过受试者工作特征曲线图（ROC）分析cf DNA及CEA对晚期NSCLC患者治疗疗效的评估价值。结果：本研究中96例患者均顺利完成化疗治疗,疗程结束后,有54例（56.25%）治疗有效,42例（43.75%）治疗无效;无效组肿瘤TNM分期Ⅳ期、体力状况（PS）评分2~4分占比大于有效组（P＜0.05）;无效组患者cf DNA及CEA水平明显高于有效组（P＜0.05）;多因素Logistic回归分析显示,肿瘤分期Ⅳ期、PS评分2~4分、cf DNA及CEA高水平均为影响晚期NSCLC患者疗效的相关因素（P＜0.05）;ROC曲线分析显示,cf DNA、CEA对晚期NSCLC患者治疗后无效均有预测效能（P＜0.05）,其中两指标联合预测的曲线下面积（AUC）最大,为0.794,特异度、敏感度分别为85.19%、78.57%。结论：治疗无效晚期非小细胞肺癌患者cf DNA及CEA水平更高,肿瘤分期Ⅳ期、PS评分2~4分、cf DNA及CEA高水平均为晚期NSCLC患者疗效的影响因素,联合cf DNA及CEA检测有利于对晚期NSCLC患者治疗疗效进行评估。     

The prognostic impact of tumour NSD2 expression in advanced prostate cancer

Abstract

Purpose: To assess the prognostic significance of the nuclear receptor binding SET protein 2 (NSD2), a co-activator of the NFkB-pathway, on tumour progression in patients with advanced prostate cancer (PCa).

Methods: We retrospectively assessed NSD2 expression in 53 patients with metastatic and castration-resistant PCa. Immunohistochemical staining for NSD2 was carried out on specimen obtained from palliative resection of the prostate. Univariable and multivariable analyses were performed to assess the association between NSD2 expression and PCa progression.

Results: Of the 53 patients, 41 had castration-resistant PCa and 48 men had metastases at time of tissue acquisition. NSD2 expression was increased in tumour specimen from 42 patients (79.2%). In univariable Cox regression analyses, NSD2 expression was associated with PSA progression, progression on imaging and overall survival (p?=?0.04, respectively). In multivariable analyses, NSD2 expression did not retain its association with these endpoints.

Conclusions: NSD2 expression is abnormal in almost 80% of patients with advanced PCa. Expression levels of this epigenetic regulator are easily detected by immunohistochemistry while this biomarker exhibited prognostic value for PCa progression and death in univariable analysis. Further studies on NSD2 involvement in PCa proliferation, progression, metastasis and resistance mechanisms are needed.     

F-Actin is associated with a worsening qSOFA score and intensive care unit admission in emergency department patients at risk for sepsis

Abstract

Objective: We previously demonstrated that plasma levels of F-actin and Thymosin Beta 4 differs among patients with septic shock, non-infectious systemic inflammatory syndrome and healthy controls and may serve as biomarkers for the diagnosis of sepsis. The current study aims to determine if these proteins are associated with or predictive of illness severity in patients at risk for sepsis in the Emergency Department (ED).

Methods: Prospective, biomarker study enrolling patients (>18?years) who met the Shock Precautions on Triage Sepsis rule placing them at-risk for sepsis.

Results: In this study of 203 ED patients, F-actin plasma levels had a linear trend of increase when the quick Sequential Organ Failure Assessment (qSOFA) score increased. F-actin was also increased in patients who were admitted to the Intensive Care Unit (ICU) from the ED, and in those with positive urine cultures. Thymosin Beta 4 was not associated with or predictive of any significant outcome measures.

Conclusion: Increased levels of plasma F-actin measured in the ED were associated with incremental illness severity as measured by the qSOFA score and need for ICU admission. F-actin may have utility in risk stratification of undifferentiated patients in the ED presenting with signs and symptoms of sepsis.     

miR-152-3p调控Notch1/DLL4通路对家兔深II度烧伤创面血管生成的影响

摘要 目的：探究微小核糖核酸（miR）-152-3p调控果蝇Notch同源物1（Notch1）/Delta样配体4（DLL4）通路对家兔深II度烧伤创面血管生成的影响。方法：将50只新西兰家兔随机分为对照组、模型组、miR-152-3p拮抗剂（antagomir）组、miR-152-3p antagomir阴性对照+空载组、miR-152-3p antagomir+Notch1敲低组,每组10只,除对照组外其余各组家兔构建深II度烧伤模型,分组给药处理后,实时荧光定量聚合酶链式反应（qRT-PCR）检测各组家兔创面组织miR-152-3p与Notch1、DLL4 mRNA表达;检测各组家兔创面愈合率及微循环血流灌注值（MPD）;免疫组织化学染色检测各组家兔创面微血管密度（MVD）;酶联免疫吸附反应（ELISA）检测各组家兔血清血管内皮细胞生长因子（VEGF）及促血管生成素1（Ang1）水平;免疫印迹检测各组家兔创面组织VEGF、Ang1与Notch1/DLL4通路蛋白表达;双荧光素酶报告基因实验检测兔脐静脉内皮细胞中miR-152-3p对Notch1及DLL4的靶向调节。结果：与对照组相比,模型组家兔创面组织miR-152-3p与Notch1、DLL4 mRNA表达升高（P<0.05）,创面MPD及MVD、血清VEGF及Ang1水平、创面组织VEGF与Ang1蛋白表达降低（P<0.05）。与模型组相比,miR-152-3p antagomir组家兔创面组织miR-152-3p mRNA表达降低（P<0.05）,创面愈合率、创面MPD及MVD、血清VEGF及Ang1水平、创面组织Notch1、DLL4 mRNA及蛋白表达、创面组织VEGF与Ang1蛋白表达升高（P<0.05）;miR-152-3p antagomir阴性对照+空载组家兔各指标无明显差异（P＞0.05）;与miR-152-3p antagomir组相比,miR-152-3p antagomir+Notch1敲低组家兔创面组织miR-152-3p mRNA表达无明显差异（P＞0.05）,创面愈合率、创面MPD及MVD、血清VEGF及Ang1水平、创面组织Notch1、DLL4 mRNA及蛋白表达、创面组织VEGF与Ang1蛋白表达降低（P<0.05）。miR-152-3p可靶向下调兔脐静脉内皮细胞中Notch1及DLL4的表达。结论：敲低miR-152-3p可通过上调Notch1/DLL4通路而增强家兔深II度烧伤创面血管生成,进而促进其创面愈合。     

The Pan-Immune-Inflammation Value predicts the survival of patients with anaplastic lymphoma kinase-positive non-small cell lung cancer treated with first-line ALK inhibitor

BackgroundAnaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) have significantly improved the clinical outcomes of patients with ALK-positive non-small cell lung cancer (NSCLC). However, reliable biomarkers to predict the prognostic role of this treatment are lacking. The Pan-Immune-Inflammation Value (PIV) has recently been demonstrated as a novel comprehensive biomarker to predict survival of patients with solid tumors. Our study aimed to evaluate the prognostic power of PIV in this group of patients.Patients and methods94 patients with advanced ALK-positive NSCLC who received first-line ALK inhibitors were enrolled in this study. PIV was calculated as the product of peripheral blood neutrophil, monocyte, and platelet counts divided by lymphocyte count. Kaplan-Meier method and Cox hazard regression models were used for survival analyses.ResultsThe 1-year progression-free survival (PFS) was 63.5%, and the 5-year overall survival (OS) rate was 55.1%. Patients with higher PIV, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune inflammation index (SII) had worse PFS in univariate analysis, but only the PIV (hazard ratio [HR] = 2.90, 95% confidence interval [CI]: 1.79–4.70, p < 0.001) was an independent prognostic factor in multivariate analysis. Similarly, patients with higher PIV, NLR, PLR, and SII had a worse OS in the univariate analysis, but only the PIV (HR = 4.70, 95% CI: 2.00–11.02, p < 0.001) was significantly associated with worse OS in multivariate analysis.ConclusionPIV is a comprehensive and convenient predictor of both PFS and OS in patients with ALK-positive advanced NSCLC who received first-line ALK TKIs. Prospective clinical trials are required to validate the value of this new parameter.