1.Value of combined detection of biomarkers in early diagnosis and prognosis of patients with septic myocardial injury
Zhiyu LI ; Shaohua CUI ; Lixia GENG
Chinese Critical Care Medicine 2021;33(4):443-448
Objective:To investigate the value of combined detection of biomarkers in early diagnosis and prognosis of patients with septic myocardial injury.Methods:The clinical data of 103 patients with sepsis admitted to the intensive care unit (ICU) of the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology from October 2018 to January 2021 were enrolled. According to the cardiac troponin I (cTnI) at admission of ICU, they were divided into septic myocardial injury group (cTnI ≥ 0.15 μg/L) and non-septic myocardial injury group (cTnI < 0.15 μg/L). The serum levels of heart-type fatty acid-binding protein (H-FABP), procalcitonin (PCT), C-reactive protein (CRP), MB isoenzyme of creatine kinase (CK-MB), cTnI and N-terminal pro-brain natriuretic peptide (NT-proBNP) within 6 hours after ICU admission and the worst value of acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score within 24 hours after ICU admission in 103 patients was recorded as well as the 28-day prognosis of patient with septic myocardial injury. Spearman correlation analysis was used to analyze the correlation of each index; receiver operating characteristic curve (ROC curve) was drawn, and the area under ROC curve (AUC) was calculated to analyze the early diagnosis and prognostic value of each index and APACHEⅡ score alone or combined detection in patients with septic myocardial injury.Results:① Among 103 patients with sepsis, 58 patients were complicated with myocardial injury and 45 patients were not complicated with myocardial injury. The serum levels of PCT, CRP, NT-proBNP, CK-MB, cTnI, H-FABP and APACHEⅡ score in patients with septic myocardial injury were significantly higher than those in patients without septic myocardial injury [PCT (μg/L): 3.46±1.35 vs. 1.89±0.43, CRP (mg/L): 81.1±26.8 vs. 65.3±19.1, NT-proBNP (U/L): 8 261.4±2 346.9 vs. 6 120.2±1 809.6, CK-MB (U/L): 15.89±6.25 vs. 12.14±4.24, cTnI (μg/L): 1.50 (0.91, 2.21) vs. 0.18 (0.16, 0.19), H-FABP (μg/L): 26.45±8.24 vs. 12.82±5.73, APACHEⅡ score: 24.0 (18.0, 29.0) vs. 16.0 (14.0, 18.0), all P < 0.01]. Spearman correlation analysis showed that PCT, CRP and APACHEⅡ scores were positively correlated with NT-proBNP, CK-MB, cTnI and H-FABP. ROC curve analysis showed that H-FABP in the diagnosis of septic myocardial injury (AUC = 0.916) was superior to NT-proBNP (AUC = 0.756) and CK-MB (AUC = 0.675); the AUC of NT-proBNP and CK-MB combined with H-FABP was 0.921, the sensitivity was 82.1%, and the specificity was 88.2%.② Twenty-three patients survived in 28 days, and 35 died. The levels of serum PCT, CRP, NT-proBNP, CK-MB, cTnI, H-FABP and APACHEⅡ score in death group were significantly higher than those in survival group [PCT (μg/L): 3.86±1.27 vs. 2.84±1.24, CRP (mg/L): 92.3 (65.0, 101.7) vs. 74.3 (65.7, 79.8), NT-proBNP (ng/L): 9 106.4±2 013.9 vs. 6 975.5±2 266.7, CK-MB (U/L): 17.90±6.49 vs. 12.82±4.46, cTnI (μg/L): 2.11±0.86 vs. 1.12±0.44, H-FABP (μg/L): 30.08±7.90 vs. 20.93±5.14, APACHEⅡ score: 25.0 (20.0, 30.0) vs. 19.0 (17.0, 24.0), all P < 0.01]. ROC curve analysis showed that H-FABP in evaluating 28-day death of patients with septic myocardial injury (AUC = 0.839) was superior to PCT (AUC = 0.707), CRP (AUC = 0.716), NT-proBNP (AUC = 0.761), CK-MB (AUC = 0.733), cTnI (AUC = 0.824) and APACHEⅡ score (AUC = 0.724); the AUC of NT-proBNP and cTnI combined with H-FABP was 0.888, the sensitivity was 91.4%, and the specificity was 82.6%. Conclusions:H-FABP plays an important role in the early diagnosis and prognosis of septic myocardial injury. Early combined detection of NT-proBNP, CK-MB and H-FABP can significantly improve the diagnostic ability of septic myocardial injury, and NT-proBNP and cTnI combined with H-FABP can significantly improve the ability to predict the adverse prognosis of sepsis myocardial injury.
2.The thymic recent output function in patients with acute promyelocytic leukemia
Shaohua CHEN ; Yangqiu LI ; Lijian YANG ; Suxia GENG
Cancer Research and Clinic 1997;0(03):-
Objective To analyze the T- cell receptor excision DNA circles (TRECs) level and evaluate the thymic recent output nave T cells function in patients with acute promyelocytic leukemia (APL). Methods Quantitative detection of TRECs in DNA of peripheral blood mononuclear cells (PBMC) from 9 cases with APL were preformed by real- time PCR (TaqMan) analysis. The TRECs- number was related to the number of T- cells by determination of the number of CD-3 positive cells. 14 normal individuals served as controls. Results In comparison with normal individuals [ (4.10?3.65) copies/1000 PBMC and (6.36?5.28) copies/1000 CD+3 cells], a dramatic reduction of TRECs values in patients with APL [ (0.13?0.22) copies/1000 PBMC and (0.77?1.60) copies/1000 CD+3 cells] could be found (P =0.0004, P =0.0005). Conclusions This is, to our knowledge, the first description of TRECs level which was markedly reduced in APL patients.
3.Correlation of polyphenol oxidase activity and baicalin synthesis in callus of Scutellaria baicalensisi
Zhenxing REN ; Shaohua GENG ; Mengliang WANG ; Diansheng LIU
Chinese Traditional and Herbal Drugs 1994;0(11):-
Objective To study the correlation of polyphenol oxidase(PPO) activity and baicalin synthesis in callus of Scutellaria baicalensisi.Methods PPO Activity was determined by ultraviolet spectrophotometry and the content of baicalin was detected by HPLC.The effects of various substances(ascorbic acid,sodium chloride,benzoic acid,polyvinylpyrrolidone,and copper sulfate) on PPO activity and the content of baicalin were studied.Results There was no baicalin accumulation in the first 20 d of growth period, while PPO activity was expressed slowly during this period.From 20 d to 35 d,PPO activity increased significantly and the baicalin secondary synthesis was restrained.Conclusion The high-level expression of PPO activity do harm the baicalin secondary synthesis.These chemical substances,such as ascorbic acid, sodium chloride,and benzoic acid could inhibit the PPO activity and improve the content of baicalin;It is obvious for ascorbic acid(0.02%) to improve the content of baicalin with 17.6%(82.3 mg/g) compared with the control.However,polyvinylpyrrolidone and copper sulfate could increase the PPO activity and greatly inhibit the baicalin accumulation.
4.Analysis of TCR V? repertoire and clonality of CD4~+ and CD8~+ T cells in patients with CML
Suxia GENG ; Yangqiu LI ; Shaohua CHEN ; Lijian YANG ; Qingsong YIN ; Ji TANG
Chinese Journal of Immunology 1985;0(02):-
Objective:To investigate the gene expression of TCR V? subfamily T cells and clonality in peripheral blood CD4+ and CD8+ cells from patients with chronic myelogenous leukemia-chronic phase(CML-CP).Methods:The complementarity determining region 3(CDR3)of TCR V? subfamily genes in peripheral blood mononuclear cells(PBMCs),sorted CD4+ and CD8+ cells from 19 CML-CP patients were amplified using RT-PCR,the products were further by genescan analysis to identify the clonality of T cells.Results:Only 1 to 21 V? subfamilies were detected in peripheral blood CD4+ and CD8+ cells from patients with CML.The most frequent expression of V? subfamily was V?13 followed by V?9.Clonal expanded T cells in some V? subfamilies could be identified in both CD4+ and CD8+ cells,especially in CD8+ cells.The clonal expanded of V?21 subfamily in CD4+ cells and V?11 subfamily in CD8+ cells were identified most frequently.Conclusion:The restricted distribution of TCR V? repertoire has been found in CD4+ and CD8+ cells in patients with CML.Clonal expanded CD4+ cells and CD8+ cells have been identified which may relate to host immune response to CML antigen and may play a important role in anti-CML effect.