Objective To investigate the plasma levels of soluble Fas receptor ( sFas) , soluble Fas ligand ( sFas-L) and matrix metalloproteinase-7 ( MMP-7) and their correlation with disease severity as well as the prognosis of septic patients.Methods The plasma levels of sFas, sFas-L, sFas / sFas-L ratio and MMP-7 were measured by enzyme-linked immunosorbent assay and compared between32 patients with sepsis and 24 age and sex matched healthy controls. Based on the 28-day outcome, the patients were divided into a survival group and a death group. The difference in sFas, sFas-L, sFas/ sFas-L ratio and MMP-7 between the survival group and the death group were compared.Results Compared with the healthy control group, the concentration of plasma sFas, sFas-L and MMP-7 were significantly increased in the septic patients ( P lt; 0. 01) . Elevated plasma sFas and sFas-L were both positive correlated with the APACHEⅡ score and SOFA score. Although a modest negative correlation was found between plasma MMP-7 and APACHEⅡ score and SOFA score, but this correlation did not reach statistical significance ( P gt;0. 05) . The septic patients who died had significantly higher sFas-L level and lower sFas / sFas-L ratio as compared with those who survived ( P lt;0. 05) . Conclusion Plasma sFas, sFas-L and MMP-7 are associated with the disease severity and can serve as potential markers for predicting the outcome in septic patients.
ObjectiveTo investigate the clinical value of serum proadrenomedullin (pro-ADM) for diagnosis of ventilator-associated pneumonia(VAP). MethodsA prospective study was carried out in eighty-nine patients with clinically suspected diagnosis of VAP who underwent invasive mechanical ventilation between June 2014 and July 2015.The patients were divided into a VAP group (n=52) and a non-VAP group (n=37) according to clinical and microbiological culture results.The levels of serum pro-ADM were measured by sandwich ELISA on 1st, 3rd and 5th day of VAP suspicion.The diagnostic value of pro-ADM for VAP was assessed by receiver operating characteristic (ROC) curve analysis. ResultsOn 1st day, 3rd day and 5th day, the pro-ADM levels [3.10(2.21, 4.61) nmol/L, 3.01(2.04, 4.75)nmol/L and 1.85(1.12, 3.54)nmol/L, respectively] in the VAP group were significantly higher than those in the non-VAP group [1.53(1.07, 2.24)nmol/L, 1.52(1.05, 2.17) nmol/L and 1.26(1.02, 2.17) nmol/L, respectively] (all P < 0.05).For diagnosis of VAP, the area under the ROC curve (AUC) for pro-ADM on 1st, 3rd and 5th were 0.896 (95%CI 0.799-0.940), 0.863(95%CI 0.791-0.935) and 0.651 (95%CI 0.538-0.765), respectively.When using 2.53 nmol/L as the best cutoff on 1st day, pro-ADM had 84.6% sensitivity and 86.5% specificity.When using 2.40 nmol/L as the best cutoff on 3rd day, pro-ADM had 82.7% sensitivity and 83.8% specificity. ConclusionSerum level of pro-ADM in the diagnosis of VAP has good sensitivity and specificity, which may be used as a marker to diagnose VAP early.
ObjectiveTo systematically review the diagnostic value of automatic breast volume scanner (ABVS) and handheld ultrasound (HHUS) for benign and malignant breast lesions.MethodsPubMed, EMbase, Web of Science, Biosis Preview, The Cochrane Library, WanFang Data, CNKI, VIP and SinoMed databases were electronically searched to collect studies on HHUS versus ABVS for benign and malignant breast lesions from inception to May 31st, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, and then, meta-analysis was performed by using Meta-Disc software.ResultsA total of 24 studies were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for HHUS were 0.83 (95%CI 0.82 to 0.85), 0.81 (95%CI 0.79 to 0.82), 19.71 (95%CI 14.93 to 26.01), 4.05 (95%CI 3.49 to 4.69), 0.22 (95%CI 0.18 to 0.26), and for ABVS were 0.90 (95%CI 0.89 to 0.92), 0.88 (95%CI 0.87 to 0.89), 76.86(95%CI 55.13 to 107.17), 7.40 (95%CI 6.07 to 9.04), 0.11 (95%CI 0.09 to 0.14), respectively. The areas under the summary receiver operating characteristic curves in the differentiation of benign and malignant breast lesions were 0.88 and 0.96 for ABVS and HHUS, respectively.ConclusionThe current evidence shows that ABVS has higher value than HHUS in the diagnosis of benign and malignant breast tumor. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.