1.PCT and sTREM-1 combined with APACHE Ⅱ score for assessing diagnosis of sepsis and prognostic value
Yunshan LUO ; Yilin LIU ; Xiamei DENG ; Jian ZHANG ; Li LI
The Journal of Practical Medicine 2017;33(4):586-590
Objective PCT and sTREM-1 combined with APACHE Ⅱ score for assessing diagnosis of sepsis and prognostic value.Methods The clinical data for related patients who had hospitalized between January and October 2015 were collected by prospective study methods.According to China guidelines for treatment of severe sepsis/septic shock (2014).The patients were divided into SIRS group,sepsis group,severe sepsis group,septic shock group,and control group.Results Levels of CRP and sTREM-1 were significantly higher in total sepsis group and subgroups than in SIRS group and control group,with a statistical difference (P < 0.05);but there were no significant differences among he subgroups.Lactic acid level differed statistically between both total sepsis group and its subgroups and both control group and SIRS group,so did level of lactic acid between the other groups and septic shock group (P < 0.05).PCT was significantly higher in total sepsis group and its subgroups than in the control group and SIRS group,so did it in septic shock and severe sepsis group than in sepsis group.PCT level was significantly higher in septic shock than in severe sepsis (P < 0.05).APACHE Ⅱ scores were markedly in total sepsis group and its subgroups than in SIRS group and the control group;and it differed statistically between septic shock group and sepsis group (P < 0.05).According to the ROC curve analysis,the area under the curve was 0.935,0.877,0.816,and 0.856 for PCT,sTREM-1,APACHE Ⅱ,CRP,and lactic acid,respectively.Conclusions Detection of serum PCT and sTREM-1 combined with APACHE Ⅱ score can be used to assess diagnosis of sepsis and prognostic value,which has more benefit to the diagnosis and treatment of sepsis.
2.Clinical value of inflammatory factors in sepsis
Yunshan LUO ; Yilin LIU ; Xiamei DENG ; Jian ZHANG ; Li LI
The Journal of Practical Medicine 2016;32(17):2861-2863
Objective To study the clinical value of sTREM-1, PCT, CRP in sepsis. Methods A prospective study was conducted and clinical data of related patients from January to October 2015 were collected. Thirty-nine cases of sepsis patients , 15 patients with SIRS and 12 normal controls were detected by ELISA then the prognostic value of sTREM-1, PCT, CRP was determined in sepsis. Results In sepsis and SIRS group, sTREM-1 and PCT level were significantly higher than those in control group (P < 0.05); CRP only in sepsis group and control group was statistically significant (P < 0.05). In sepsis group, sTREM-1,PCT and CRP were significantly higher than those in SIRS group (P < 0.05). The ROC curve analysis indicated that sTREM-1,PCT and CRP for SIRS and non SIRS area under the curve was 0.914,0.887 and 0.831 respectively. Conclusion sTREM-1 is a good indicator for early diagnosis of sepsis, and it has high sensitivity and specificity.
3.Value of clearance rate of sTREM-1c in assessing prognosis in patients with septic shock
Yunshan LUO ; Yilin LIU ; Xiamei DENG ; Jian ZHANG ; Li LI ; Mingqing RAO ; Jianling LUO
The Journal of Practical Medicine 2018;34(1):67-70
Objective To monitor the dynamic change of soluble myeloid cells trigger receptor 1 (sTREM-1)and the clearance rate of sTREM-1 (sTREM-1 c) in patients with sepsis shock and to explore its value in assessing the prognosis.Methods A total of 54 patients from January to December 2016 were divided into improved group and death group,sTREM-1 and sTREM-1c level at 1,5,7 and 9 d were monitored and the receiver-operating characteristic curve analysis was used to judge its value in prognosis.Results Comparison of baseline of APACHE Ⅱ score,PCT and age in 2 groups was statistically significant.After treatment,the sTREM-1 level declined,especially in improved group.Similarly,sTREM-1c in improved group at 5,7 and 9 d dropped more significantly than that in death group (P < 0.05).At different time points,sTREM-1 7 topped the predictive value of AUC on the prognosis,followed by APACHE Ⅱ and sTREM-1 5,PCT,sTREM-1 9,sTREM-1c 9 and sTREM-1 1,and sTREM-1c 5 and sTREM-1c 7 were the minimum.Conclusion Effect of dynamic monitoring of sTREM-1 and sTREM-1c analysis in clinic is better than that of simply monitoring of sTREM-1.
4.Application of DTI in sensorineural hearing loss infants induced by cytomegalovirus infection
Xiamei ZHUANG ; Ke JIN ; Junwei LI ; Hai WANG ; Guangchun WU ; Yan YIN ; Xiaoming LI ; Min DENG
Chinese Journal of Medical Imaging Technology 2017;33(10):1484-1487
Objective To investigate the application value of magnetic resonance diffusion tensor imaging (DTI) in auditory pathway of sensorineural hearing loss (SNHL) infants caused by cytomegalovirus (CMV) infection.Methods Thirtyone SNHL infants caused by CMV infections were included,and were divided into bilateral hearing loss (BPHL;n=13) group and unilateral hearing impairment (UPHL;n=18) group (including damaged side [lpsi subgroup] and the undamaged side [contrast subgroup]).Thirty-one infants without hearing loss as control group.The fractional anisotropy (FA),the mean diffusivity (MD),the axial diffusivity (AD) and the radial diffusivity (RD) of bilateral inferior colliculus (IC)and lateral lemniscus (LL) were obtained with DTI technique.The statistical analysis was performed.Results Compared with the control group,the FA value reduced and the RD value increased at LL and IC in the BPHL group (all P<0.001).Compared with the contrast subgroup,the FA value reduced and the RD value increased at IC and LL in lpsi subgroup (all P<0.001).Compared with the control group,the FA value reduced at LL in the lpsi subgroup,and FA values reduced and RD value increased at IC (all P<0.001).Compared with the contrast subgroup,the FA value reduced and RD value increased at LL,and RD value increased at IC in the BPHL group (all P<0.001).The FA value at IC was negatively correlated with auditory threshold (r=-0.966,P<0.001).No matter in IC or in LL,the MD and AD had no statistical differences (all P>0.05).Conclusion White matter of auditory pathway of SNHL infant caused by CMV infection is obviously altered,suggesting white matter myelination or myelin dysplasia.