Objective To assess the value of bedside gastrointestinal ultrasound combined with gaswater alternate injection on nasointestinal tube positioning in critically ill patients.Methods A total of 62 critically ill patients requiring post-pyloric enteral nutrition admitted to the intensive care unit in our Hospital from May 1,2017 to December 1,2017 were enrolled.Nasointestinal tubes were blindly inserted in a bedside setting.Then,we evaluated the nasointestinal tube position using both an ultrasound with gas-water alternate injection and the traditional auscultation method after gas perfusion.Abdominal X-ray imaging was also performed in all cases as the gold standard,and the sensitivities,specificities,positive predictive values,negative predictive values,and accuracies of the tested methods were obtained.Results Sixty-two patients were confirmed by X-ray,wherein 55 were successfully catheterized and 7 were ectopic.The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of ultrasound-assisted gas-water injection were 90.9％,100％,100％,58.3％,and 91.9％,respectively,which were all higher than those of traditional gas perfusion auscultation (P ＜ 0.05).Conclusion The bedside gastrointestinal ultrasound with gas-water alternate injections for nasointestinal tube positioning in critically ill patients has a certain clinical value.

Objective To evaluate the six scoring systems and four laboratory tests,including pancreatitis outcome prediction (POP),Ranson score,bedside index for severity in acute pancreatitis (BISAP),acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ),systemic inflammatory response syndrome (SIRS),and Glasgow score as well as four laboratory tests including C-reactive protein (CRP),hematocrit (HCT),blood urea nitrogen (BUN) and serum creatinine (Scr) in the prognostic assessment of severe acute pancreatitis (SAP).Methods From January 2016 to December 2017,at Sir Run Run Shaw Hospital,151 SAP patients who met the enrollment criteria were retrospectively analyzed.According to the time from onset to treatment,the patients were divided into less than three days group (n=102) and over three days group (n=49).The evaluation of six scoring systems and four laboratory tests,including CRP,HCT,BUN and Scr at 0,24 and 48 h after hospitalization in the prognostic assessment of SAP patients was measured by receiver-operating characteristic (ROC) curve.Results The Ranson score had the highest area under curve (AUC) value (0.916) in the evaluation of the prognosis of SAP patients less than three days group followed by BISAP,APACHE Ⅱ,Glasgow and POP score,and their AUC values were 0.832,0.823,0.793,and 0.787,respectively,all of them were statistically significant in the prognostic assessment of SAP patients in less than three days group (all P＜0.05).There were statistically significant of BISAP and APACHE Ⅱ scores in the prognostic evaluation of SAP patients in over three days group (both P＜0.05),and the AUC values were 0.751 and 0.735,respectively,which were less than those of SAP patients in less than three days group.There were statistical significance of BUN and Scr at 24 and 48 h after hospitalization in the prognostic assessment of SAP patients in less than three days group (all P＜0.05),and the AUC values were 0.856,0.853 and 0.793,0.874,respectively.There were statistical significance of BUN at 0,24,48 h and Scr at 48 h after hospitalization in the prognostic assessment of SAP patients in over three days group (all P＜0.05),and the AUC value was 0.709,0.754,0.742 and 0.716,respectively.Conclusions Ranson,POP and Glascow score systems are only suitable for patients with SAP less than three days.APACHE Ⅱ,BISAP score systems,BUN and Scr can be used to evaluate patients with SAP over three days,but are more suitable for patients with SAP less than three days group.

PURPOSE: Breast cancer is the most commonly occurring cancer among women worldwide, and therefore, improved approaches for its early detection are urgently needed. As microRNAs (miRNAs) are increasingly recognized as critical regulators in tumorigenesis and possess excellent stability in plasma, this study focused on using miRNAs to develop a method for identifying noninvasive biomarkers. METHODS: To discover critical candidates, differential expression analysis was performed on tissue-originated miRNA profiles of 409 early breast cancer patients and 87 healthy controls from The Cancer Genome Atlas database. We selected candidates from the differentially expressed miRNAs and then evaluated every possible molecular signature formed by the candidates. The best signature was validated in independent serum samples from 113 early breast cancer patients and 47 healthy controls using reverse transcription quantitative real-time polymerase chain reaction. RESULTS: The miRNA candidates in our method were revealed to be associated with breast cancer according to previous studies and showed potential as useful biomarkers. When validated in independent serum samples, the area under curve of the final miRNA signature (miR-21-3p, miR-21-5p, and miR-99a-5p) was 0.895. Diagnostic sensitivity and specificity were 97.9% and 73.5%, respectively. CONCLUSION: The present study established a novel and effective method to identify biomarkers for early breast cancer. And the method, is also suitable for other cancer types. Furthermore, a combination of three miRNAs was identified as a prospective biomarker for breast cancer early detection.
Area Under Curve ; Biomarkers ; Biomarkers, Tumor ; Breast Neoplasms* ; Breast* ; Carcinogenesis ; Data Mining ; Early Detection of Cancer ; Female ; Genome ; Humans ; Methods ; MicroRNAs* ; Plasma ; Prospective Studies ; Real-Time Polymerase Chain Reaction ; Reverse Transcription ; Sensitivity and Specificity