OBJECTIVETo evaluate the comparability and bias of the test results of two detection systems for serum procalcitonin (PCT) under the same laboratory condition.

METHODSAccording to the profile NCCLS-EP9-A, the two systems were used to detect PCT to obtain the correlation coefficient and the liner equation for evaluation of the test result bias.

RESULTS AND CONCLUSIONThe test results of PCT showed no significant difference between the two detection systems (P>005) with a kappa value greater than 0.75. The correlation coefficients of both systems were above 0.975, suggesting a consistency between them for clinical detection of PCT.

Bias ; Blood Chemical Analysis ; methods ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Humans ; Protein Precursors ; blood

OBJECTIVETo investigate the changes in the serum content of immunoreactive calcitonin (iCT) after burns or inhalation injury, and to explore its diagnostic significance.

METHODSTwenty-four dogs were randomized into 4 groups, i. e. A (n = 6, with moderate degree inhalation injury) , B ( n = 6, with severe inhalation injury), C (n = 6, with most severe inhalation injury) and D (n = 6, with severe burns) groups. The serum content of iCT and blood gas analysis before and after injury were determined at different time points. The degree of inhalation injury was determined with fibrobronchoscopic examination at 6 post-inhalation injury hour (PIH).

RESULTS(1) Fiber bronchoscopic examination showed that the degree of inhalation injury in each group was coincident with the anticipation. (2) The serum content of iCT in each group at 1 PIH was obviously higher than that before injury, and it was evidently higher in A, B and C groups than that in D group at 4 PIH. The peak value of iCT in group A at 24 PIH was (453+/-224) ng/L, and it increased gradually in B and C groups at 48 PIH. The serum content of iCT increased continually from 2 PIH on, and it reached (125+/-41) ng/L at 48 PIH. (3) Compared with PaO2 value before injury (109+/-8) mmHg, there was no obvious difference of the PaO, in A and D groups. PaO2 value in B and C group began to descend continually at 8 PIH (65+/-6) mmHg, and that in C group began to descend at 4 PIH (71+/-9) mmHg. PaCO2 value in C group began to increase at 24 PIH(52+/-11) mmHg when compared with that before injury(38+/-5 ) mmHg.

CONCLUSIONThe changes in the serum level of iCT within 8 PIH occurred much earlier than PaO2 and PaCO2, thus it has the same diagnostic significance as fibers bronchoscopic examination.

Animals ; Blood Gas Analysis ; Burns, Inhalation ; blood ; physiopathology ; Calcitonin ; blood ; Disease Models, Animal ; Dogs

OBJECTIVETo evaluate the diagnostic value of measuring serum C-reactive protein (CRP) and procalcitonin (PCT) levels, within 6 hours after admission to the pediatric intensive care unit (PICU) in children with bloodstream infection (BSI)-associated sepsis and septic infection at other sites.

METHODSA retrospective analysis was performed on 30 children with a confirmed diagnosis of systemic inflammatory response syndrome who were admitted to the Shengjing Hospital of China Medical University between January 2010 and January 2012. Clinical data on serum CRP, PCT and D-dimer levels were collected within 6 hours after admission. The diagnostic values of the indices were determined by comparative analysis.

RESULTSSerum CRP and PCT levels in children with BSI-associated sepsis were significantly higher than in children with septic infection at other sites (P<0.05), but there was no significant difference in serum D-dimer levels between the two groups (P>0.05). Serum PCT level was superior to serum CRP level in distinguishing children with BSI-associated sepsis from those with septic infection at other sites. Serum PCT level could not realistically be used for diagnosing BSI-associated sepsis when it was less than 2 ng/mL (negative predictive value: 100%), but could be reliably used when it was more than 10 ng/mL (positive predictive value: 77%).

CONCLUSIONSSerum PCT level is superior to serum CRP level in distinguishing children with BSI-associated sepsis from those with septic infection at other sites within 6 hours after admission to the PICU. Serum PCT level has a better diagnostic value for BSI-associated sepsis when it is more than 10 ng/mL.

C-Reactive Protein ; analysis ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Child ; Fibrin Fibrinogen Degradation Products ; analysis ; Humans ; Protein Precursors ; blood ; Retrospective Studies ; Sensitivity and Specificity ; Sepsis ; blood ; diagnosis

OBJECTIVETo investigate the correlation of hypoproteinemia with inflammation parameters C-reactive protein (CRP), procalcitonin (PCT) and WBC in children with sepsis.

METHODSSeventy-three children with sepsis (including 22 severe sepsis) and 40 non-sepsis children (control group) were enrolled. Serum albumin levels were measured on admission. Based on the level of serum albumin, 73 cases of sepsis were classified into three groups: mild hypoproteinemia, severe hypoproteinemia and normal albumin. Blood CRP, PCT and WBC levels were compared in the three groups. The correlation of CRP, PCT and WBC with serum albumin level was evaluated.

RESULTSSerum albumin levels in the sepsis groups (severe or non-severe) were significantly lower than those in the control group (P<0.05), and the severe sepsis group showed more decreased albumin levels compared with the non-severe sepsis group (P<0.05). Blood CRP, PCT and WBC levels in the mild hypoproteinemia group were higher than those in the normal albumin group (P<0.05), and the severe hypoproteinemia group showed more increased blood CRP, PCT and WBC levels compared with the mild hypoproteinemia group (P<0.05). The incidence of multiple organ failure in the severe hypoproteinemia group was significantly higher than that in the normal albumin group (P<0.05). Serum albumin levels were negatively correlated with blood CRP, PCT and WBC levels.

CONCLUSIONSSerum albumin levels decrease in children with sepsis, and the more serious the illness, the lower serum albumin levels, resulting in a worse prognosis. CRP, PCT and WBC are negatively correlated to serum albumin levels in children with sepsis.

C-Reactive Protein ; analysis ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Leukocyte Count ; Male ; Protein Precursors ; blood ; Sepsis ; blood ; Serum Albumin ; analysis

OBJECTIVENeonatal septicemia is a critical disease in neonatal period. Its incidence among live births is between 1 per thousand and 8 per thousand. Mortality of neonatal septicemia may be as high as 50% for infants who are not treated. The early signs of septicemia in the newborn are generally nonspecific. Blood culture and the other clinical diagnostic measures are not sufficiently sensitive. The present study aimed at evaluating potential use of soluble intercellular adhesion molecule-1 (sICAM-1), procalcitonin (PCT) and C-reactive protein (CRP) in diagnosis of septicemia.

METHODSThe experimental group consisted of 50 newborns with septicemia who were treated in Hebei Provincial Children's Hospital from April 1, 2002 to December 30, 2002. Thirty of the 50 cases had positive blood culture. The control group included 35 healthy newborns. Fasting blood samples were taken for bacterial cultures and sICAM-1, CRP, PCT determination. PCT and CRP contents were determined immediately after the specimens were collected. Analyses of sICAM-1 were done after inclusion of the last patient. Serum was separated from each specimen and stored at -20 degrees C within 2 hours. The analyses of sICAM-1 were performed by ELISA technique. CRP was analyzed by immunoturbidimetry assay (ITA). Immunochromatographic test was performed for detection of PCT from 200 ul serum. SPSS 10.0 was used to process the data. P values < 0.05 was considered to be statistically significant. One way analysis of variance (ANOVA), multiple comparison, chi-square test, paired-samples T test, linear correlation, Spearman correlation analysis, ROC curve were used for statistical analysis. The sensitivity, specificity, positive and negative predictive values, accuracy, Youden's index for sICAM-1, PCT, CRP and WBC count were calculated. These values were compared with each other.

RESULTS(1) The content of sICAM-1 in control group varied widely from 79 to 1252 ng/ml. Comparison of the data indicated that there was significant difference among the three groups in the content of sICAM-1, CRP and PCT (P < 0.05), but not in WBC count. These markers are considered positive if sICAM-1 >or= 300 ng/ml, CRP >or= 8 mg/l, PCT >or= 2 ng/ml. Their sensitivity was higher than WBC (P < 0.05). Among these indices, PCT has the highest specificity (94.3%), positive predictive (95.6%), negative predictive (82.5%), accuracy (89.4%), and Youden's index (80.3%). (2) No significant difference was found in sICAM-1 between pre- and post-treatment (P > 0.05); however, there was significant difference in CRP and PCT. (3) sICAM-1 was in direct proportion to CRP (r = 0.339,P < 0.01). PCT is correlated with sICAM-1, CRP (the spearman correlation coefficient 0.569, 0.482, P < 0.01).

CONCLUSIONDifferent individual is in different immune status; The level of sICAM-1 is related with neonatal septicemia. sICAM-1 concentration may be used as a diagnostic tool with high sensitivity (85%) and moderate specificity (54.3%) in neonates suspected of infection. The sensitivity and specificity of CRP (>or= 8 mg/l) were accordingly 87.5% and 54.3%. WBC count had low sensitivity for diagnosis (30.0%); Among these indices, PCT had the highest specificity (94.3%), positive predictive (95.6%), negative predictive (82.5%) Values, accuracy (89.4%), Youden's index (80.3%); No correlation was found between sICAM-1 concentration and their ages in day accordingly. CRP, PCT may be used to estimate the effect of therapy. The correlation of the infectious indices indicates that the body may mobilize many organs at the same time to resist the invasion of organism.

C-Reactive Protein ; analysis ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Humans ; Infant, Newborn ; Intercellular Adhesion Molecule-1 ; blood ; Protein Precursors ; blood ; Sepsis ; blood ; diagnosis

Neonatal septicemia is one of the major causes of morbidity and mortality worldwide during the neonatal period. It can be classified into two subtypes: early-onset sepsis (EOS) and late-onset sepsis (LOS) depending upon the time of onset. In the western developed countries, group B Streptococcal and Escherichia coli are leading pathogens for EOS, while the most frequent microorganism involved in LOS is coagulase negative Staphylococci, which are different from the domestic data. Clinical manifestations of neonatal septicemia are not specific, so that it is often misdiagnosed. This review describes the progress in diagnostic methods for neonatal septicemia, including blood culture, blood cell counts, cytokine profiles and umbilical cord blood examinations. It provides useful information for early diagnosis and treatment of neonatal septicemia.
Blood Cell Count ; C-Reactive Protein ; analysis ; Calcitonin ; blood ; Cytokines ; blood ; Humans ; Infant, Newborn ; Protein Precursors ; blood ; Sepsis ; blood ; diagnosis

C-Reactive Protein ; analysis ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Pneumonia ; blood ; diagnosis ; Protein Precursors ; blood

OBJECTIVETo study the role of procalcitonin (PCT) in the diagnosis of acute pyelonephritis (APN) in children.

METHODSRetrospective analysis was performed on the clinical records of children aged under 3 years who were diagnosed with primary urinary tract infection (UTI) from September 2011 to February 2012. These children were divided into those with upper UTI (UUTI) (APN) and those with lower UTI (LUTI) (non-APN) based on 99mTc-dimercaptosuccinic acid (DMSA) renal scan results as a gold standard. The UUTI and LUTI groups were compared in terms of serum levels of PCT and C-reactive protein (CRP). Receiver operating characteristic (ROC) curves were drawn to evaluate the diagnostic values of serum PCT and CRP.

RESULTSSixty-five children with UTI, including 39 cases of APN and 26 cases of LUTI, were included in this study. The APN cases had significantly higher serum levels of PCT (3.08 ng/mL vs 0.37 ng/Ml; P<0.01) and CRP (6.25 mg/L vs 3.01 mg/L; P<0.01) than the LUTI cases. The sensitivity and specificity of serum PCT level for APN were 84.6% and 88.5%, respectively, with an area under the ROC curve (AUC) of 0.873 (95%CI=0.781-0.965) and an optimal threshold point of 1.03 ng/mL. The sensitivity and specificity of serum CRP level for APN were 71.8% and 69.2%, respectively, with an AUC of 0.735 (95%CI=0.612-0.858) and an optimal threshold point of 3.91 mg/L.

CONCLUSIONSAs a result of its high sensitivity and specificity for the disease, serum PCT can be used as a marker in the early diagnosis of APN in children.

C-Reactive Protein ; analysis ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Protein Precursors ; blood ; Pyelonephritis ; blood ; diagnosis ; ROC Curve ; Sensitivity and Specificity

OBJECTIVETo investigate the correlation between serum procalcitonin (PCT) level and pediatric critical illness score (PCIS) and their prognostic values in children with sepsis.

METHODSSixty-one children with sepsis in the pediatric intensive care unit were enrolled. According to PCIS, these patients were divided into non-critical (n=18), critical (n=20), and extremely critical groups (n=23). Within 24 hours after admission, serum levels of PCT, C-reactive protein (CRP), and lactic acid (LA) and routine blood counts were measured. These parameters were compared between the three groups. The Pearson correlation analysis was performed to determine the correlation of PCT with PCIS and other serological parameters. Based on clinical outcomes, these patients were divided into survival (n=39) and death groups (n=22). The PCT, PCIS, and other serological parameters were compared between the two groups.

RESULTSThe serum levels of PCT and CRP in the non-critical group were significantly lower than those in critical group and extremely critical groups (P<0.05), and the two parameters were significantly lower in the critical group than in the extremely critical groups (P<0.05). The extremely critical group had a significantly higher mortality than the critical group non-critical groups (61% vs 35% and 6%, P<0.05). Serum PCT level had a significantly negative correlation with PCIS (r=-0.63, P<0.001) but a significantly positive correlation with serum CRP level (r=0.73, P=0.003). Compared with the death group, the survival group had significantly higher serum levels of PCT and LA (P<0.05) but a significantly lower PCIS (P<0.05).

CONCLUSIONSThere is a good correlation between serum PCT level and PCIS. For children with sepsis, the lower the PCIS, the higher the serum PCT level, resulting in a poorer prognosis. A combination of serum PCT and PCIS can be used as an early prognostic indicator in children with sepsis.

Adolescent ; C-Reactive Protein ; analysis ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Child ; Child, Preschool ; Critical Illness ; Female ; Humans ; Infant ; Male ; Prognosis ; Protein Precursors ; blood ; Sepsis ; blood ; mortality

OBJECTIVETo investigate the changes in plasma gelsolin (pGSN) levels in severe burn patients with sepsis, and to evaluate the prognosis of patients when combined with other related clinical indexes.

METHODSSixty-five severe burn patients with sepsis hospitalized from June 2013 to June 2015 conforming to the study criteria were divided into death group (n=24) and survival group (n=41) according to the clinical outcome on post sepsis diagnosis day (PSD) 28. The pGSN levels of patients were determined on PSD 1, 3, 7, and 14 with double antibody sandwich enzyme-linked immunosorbent assay. The serum level of C-reactive protein (CRP), serum level of procalcitonin, lactate level of arterial blood, Acute Physiology and Chronic Health Evaluation (APACHE) II score, and Sequential Organ Failure Assessment (SOFA) score were determined or recorded on PSD 1. Data were processed with repeated measurement analysis of variance, t test, and chi-square test. On PSD 1, the pGSN level, serum level of CRP, serum level of procalcitonin, lactate level of arterial blood, APACHE II score, and SOFA score of 65 patients were collected to screen the independent risk factors related to death with single factor and multi-factor Logistic regression analysis. Receiver operating characteristic (ROC) curves of the independent risk factors related to death were plotted to evaluate the predictive power for death in 65 patients.

RESULTS(1) The pGSN levels of patients in death group on PSD 1, 3, 7, and 14 were respectively (146±44), (85±24), (28±7), and (19±4) mg/L, obviously lower than those in survival group [(287±82), (179±51), (196±56), and (249±67) mg/L, with t values from 1.735 to 4.304, P<0.05 or P<0.01]. (2) The serum level of CRP, serum level of procalcitonin, lactate level of arterial blood, APACHE II score, and SOFA score of patients in death group on PSD 1 were respectively (56±7) mg/L, (12.54±0.82) μg/L, (2.74±0.27) mmol/L, (24.3±2.4) points, and (11.43±0.57) points, significantly higher than those in survival group [(35±4) mg/L, (2.38±0.16) μg/L, (1.83±0.12) mmol/L, (15.0±1.5) points, and (7.22±0.23) points, with t values from 1.902 to 3.883, P<0.05 or P<0.01]. (3) Multi-factor Logistic regression analysis showed that the pGSN level (odds ratio: 6.83, 95% confidence interval: 4.33-10.25, P<0.01) and APACHE II score (odds ratio: 5.27, 95% confidence interval: 2.28-9.16, P<0.01) were the independent risk factors related to death in 65 patients on PSD 1. (4) The total areas under the ROC curves of pGSN level and APACHE II score for predicting death of 65 patients on PSD 1 were respectively 0.89 and 0.86, and 142 mg/L and 21 points were respectively chosen as the optimal threshold values, with sensitivity of 87% and 83% and specificity of 86% and 89%.

CONCLUSIONSFor severe burn patients with sepsis, lowering of pGSN level and elevation of APACHE II score are obviously correlated with increase in case fatality rates. Monitoring the dynamic changes in pGSN level and APACHE II score during the early stage may be useful to predict the prognosis of severe burn patients with sepsis.

Burns ; complications ; C-Reactive Protein ; analysis ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Enzyme-Linked Immunosorbent Assay ; Gelsolin ; blood ; Hospitalization ; Humans ; Organ Dysfunction Scores ; Prognosis ; Protein Precursors ; blood ; ROC Curve ; Regression Analysis ; Risk Factors ; Sepsis ; blood ; diagnosis ; Severity of Illness Index