Objective To verify the association between admission serum phosphate level and short-term (<30 days) mortality of severe pneumonia patients admitted to intensive care unit (ICU) / respiratory intensive care unit (RICU). Methods Severe pneumonia patients admitted to the ICU/RICU of Quanzhou First Hospital Affiliated to Fujian Medical University from November 2019 to September 2021 were included in the study. Serum phosphate was demonstrated as an independent risk factor for short-term mortality of severe pneumonia patients admitted to ICU/RICU by logical analysis and receiver operator characteristic (ROC) curve. The patients were further categorized by serum phosphate concentration to explore the relationship between serum phosphate level and short-term mortality. Results Comparison of baseline indicators at admission between the survival group (n=54) and the non survival group (n=46) revealed that there was significant difference in serum phosphate level [0.9 (0.8, 1.2) mmol/L vs. 1.2 (0.9, 1.5) mmol/L, P<0.05]. Logical analysis showed serum phosphate was an independent risk factor for short-term mortality. ROC curve showed that the prediction ability of serum phosphate was close to pneumonia severity index (PSI). After combining serum phosphate with PSI score, CURB65 score, and sequential organ failure score, the predictive ability of these scores for short-term mortality was improved. Compared with the normophosphatemia group, hyperphosphatemia was found be with significantly higher short-term mortality (85.7% vs. 47.3%, P<0.05), which is absent in hypophosphatemia (25.8%). Conclusions Serum phosphate at admission has a good predictive value on short-term mortality in severe pneumonia patients admitted to the ICU/RICU. Hyperphosphatemia at admission is associated with a higher risk of short-term death.
Objective To investigate clinical significance of serum VEGF-C level and C-erbB-2 protein expression in patients with breast cancer. Methods Sixty-two female patients with breast invasive ductal cancer and breast benign lesion were respectively selected. Serum VEGF-C level was detected by enzyme-linked immunosorbent assay (ELISA) before operation and at one month after operation, and C-erbB-2 protein expression in tissues of breast cancer was detected by immunohistochemistry. Then, the relationship between serum VEGF-C level and clinicopathologic characteristics and C-erbB-2 protein expressions wereas analyzed. Results The serum VEGF-C level before operation in breast cancer patients〔(279.65±17.34) pg/ml〕 was significantly higher than that in breast benign lesions patients 〔(167.26±12.15) pg/ml〕, P<0.01. In breast cancer patients, the serum VEGF-C level before operation was higher than that at one month after operation 〔(209.45±15.23) pg/ml〕, P<0.01. The serum VEGF level was related to tumor stage (P<0.05) but not to patient age, tumor size, menopause status , lymph node metastasis or not and ER and PR expression (Pgt;0.05). The positive expression rate of C-erbB-2 protein in breast cancer patients (54.84%, 34/62) was significantly higher than that in breast benign lesion patients (11.29%, 7/62), P<0.01. Moreover, the positive expression rate of C-erbB-2 protein in breast cancer patients with axilla lymph node metastasis (69.44%) was significantly higher than that without axilla lymph node metastases (34.62%), P<0.05. The serum VEGF level increased with increasing expression intensity of C-erbB-2 protein and there was positive correlation between them (r=0.813,P<0.05). Conclusions The serum VEGF-C level in breast cancer may be conducted as an assisted marker to differential diagnosis of breast tumor. C-erbB-2 is related to lymph node metastasis of breast cancer patients. There is synergistic effect between VEGF-C and C-erbB-2 in the lymph node metastasis way of breast cancer.
Objective To investigate the clinical significance of the level of serum amylase and serum IgA and total IgE in henoch-schonlein purpura patients with gastrointestinal involvement (also known as "Henoch purpura "). Methods Levels of serum amylase and serum IgA and total IgE in henoch-schonlein purpura patients with or without abdominal pain or patients with acute abdominal pain were compared. Results The average level (180.3 ± 15.8 IU) of serum amylase of Henoch purpura patients was significantly higher than HSP patients without abdominal pain and acute abdominal pain patients (F=32.214, P=0.009); Ratio of cases of increased level of serum IgA in henoch purpura abdomen patients was 44.2%, and there was no significant difference with HSP patients without abdominal pain. But ratio of two groups was respectively higher than the acute abdominal pain patients group (χ2=13.73, P=0.001); Ratio of cases of increased level of serum IgE in Henoch purpura abdomen patients accounted for 40.4%, but there was no significant difference among the three group (χ2=1.80,P=0.41). Conclusion Levels of serum amylase increase and serum IgA increase conduce to diagnose HSP patients with the onset of abdominal pain, and serum total IgE has little significance.
Objective To observe the abnormal expression of transthyretin in serum and vitreous of high myopia patients. Methods 116 patients (50 males and 66 females) with high myopia, diagnosed by retinoscopic reflex, slit-lamp microscope, indirect ophthalmoscope and Iol-Master, were enrolled. The patients had an average age of (49.7plusmn;12.3) years and average diopter of (-10plusmn;4.2) D. The control group had 86 healthy individuals (42 males and 44 females) with an average age of (48.5plusmn;10.5) years. According to the findings of indirect ophthalmoscope and optical coherence tomography (OCT) examination, the patients were classified as foveal detachment, macular hole, choroidal neovascularization, epimacular membrane, retinal scar and no significant pathological changes. 2 ml peripheral blood samples were taken from all the subjects. The vitreous samples of high myopia patients with foveal detachment and macular hole (20 patients, 20 eyes) were collected before pars plana vitrectomy. LTQ-MASS was performed on 16 serum samples of patients and 16 control serum samples. Western blot and enzyme linked immunosorbent assay (ELISA) were used to detect serum transthyretin expression in high myopia groups(n=100)and control group (n=80). Vitreous samples (n=20) and corresponding serum samples were further analyzed by ELISA. Meanwhile, the relationship between visual acuity after surgery and transthyretin expression level in vitreous were analyzed. Results LTQ-MASS detected 4 proteins differentially expressed in the serum of patients and control group, transthyretin was the most significantly increased protein in high myopia patients. Western blot validated that serum transthyretin of high myopia group was much higher than that of the control group (t=3.68, P<0.05). High myopia patients with macular hole and macular detachment had much higher serum and vitreous transthyretin than that of control group (F=9.28,P<0.01). Patients with higher vitreous transthyretin had better postoperative visual acuity. Conclusions The transthyretin level increases significantly in serum and vitreous of high myopia patients, and it correlated with ocular pathologies and visual outcomes.
Objective To evaluate the diagnostic efficiency of serum soluble CD26 (sCD26) on the diagnosis of colorectal cancer. Methods The serum sCD26 concentration of 59 colorectal cancer patients, 51 colorectal benign disease patients, and 41 healthy volunteers were detected by ELISA. The diagnostic efficiency of sCD26 and carcinoma embryonic antigen (CEA) was assessed by receiver operating characteristics (ROC) analysis. The association between sCD26 and colorectal cancer was assessed by logistic regression which included CEA in the model. Results Increased serum sCD26 was observed in colorectal cancer patients (P<0.01), but the differences of sCD26 in different Dukes stages were not statistic significance (P=0.78). The area under cure (AUC) of sCD26 confirmed by ROC analysis was 0.72 〔95% confidence interval (CI):0.63-0.82, P<0.01〕. The diagnostic sensitivity and specificity for sCD26 at 526 μg/L, the optimal diagnostic threshold, were 0.59 (95% CI: 0.48-0.72) and 0.80 (95% CI: 0.67-0.90), respectively. Positive serum sCD26 was associated with colorectal cancer after adjusted for CEA with odds ration (OR) 5.17 (95% CI:1.72-15.53, P<0.01), as confirmed by logistic regression. Increased positive rate of serum sCD26 was observed in patients at Dukes A stage (P=0.03), but not Dukes B, C, and D stage (P<0.05). Conclusions Serum sCD26 has high diagnostic performance for colorectal cancer. The association of sCD26 is independent of serum CEA. Compared to serum CEA, sCD26 has more potential to be an early biomarker for colorectal cancer diagnosis.
ObjectiveTo investigate the association between serum thyroid hormone levels and prognosis for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) without thyroid disease, and explore the prognostic value of serum thyroid hormone levels for patients with AECOPD.MethodsThe clinical data of 239 hospitalized cases of AECOPD [149 males, 90 females, aged 42-92 (77.7±8.9) years] from January 2013 to November 2017 were retrospectively analyzed. Serum thyroid hormone levels including total tetraiodothyronin (TT4), total triiodothyronin (TT3), thyroid stimulating hormone (TSH), free tetraiodothyronin (FT4) and free triiodothyronin (FT3) were measured by chemiluminescence immunoassay. All patients were divided into a survival group and a death group according to the prognosis. Serum thyroid hormone levels were compared between two groups. Correlations of serum thyroid hormone levels with the occurrence of death in AECOPD patients were analyzed. The prognostic value of serum thyroid hormone levels for AECOPD patients was explored by receiveroperating characteristic (ROC) curve analysis. And the best cut-off value of serum thyroid hormone level in predicting the risk of death was calculated.ResultsSerum TT4, TT3, FT4 and FT3 levels in the survival group were significantly higher than those in the death group [TT4: (89.35±21.45) nmol/L vs. (76.84±21.33) nmol/L; TT3: (1.05±0.34) nmol/L vs. (0.72±0.19) nmol/L; FT4: (16.17±2.91) pmol/L vs. (14.45±2.85) pmol/L; FT3: (3.06±0.81) pmol/L vs. (2.24±0.72) pmol/L; all P<0.05]. The differences of serum TSH level between two groups were not statistically significant [0.98 (0.54-1.83)vs. 0.57 (0.31-1.84), P>0.05]. Spearman correlation analysis showed that serum TT4, TT3, FT4 and FT3 levels were significant correlated with the occurrence of death (r values were 0.226, 0.417, 0.220, 0.387, respectively, P<0.05). And there was no significant correlation between serum TSH level and the occurrence of death (P>0.05). ROC curve analysis was done between serum thyroid hormone levels (TT4, TT3, TSH, FT4 and FT3) and the occurrence of death in the AECOPD patients. The areas under ROC curve were 0.659, 0.793, 0.588, 0.655 and 0.772, respectively. Serum TT3 was the best indicator for predicting the occurrence of death. When serum TT3 level was 0.85nmol/L, the Youden index was the highest (0.486), with a sensitivity of 70.2%, and a specificity of 78.3%. It was the best cut-offl value of serum TT3 to predict the risk of death in AECOPD patients.ConculsionsSerum thyroid hormone levels are significant associated with the prognostic for AECOPD patients. There is certain value of serum thyroid hormone levels in prognostic evaluation of AECOPD patients.
Objective To explore the inducing factors, the serum total immunoglobulin E (IgE) and specific IgE of bronchial asthma in Mianyang children, for better control of childhood asthma. Methods A total of 1 288 cases of asthma who were hospitalized in pediatric respiratory ward or asthma clinic from March 2013 to February 2016 were enrolled in the study. All cases complied with the diagnostic criteria for acute episode of childhood bronchial asthma revised in 2008 by the National Children’s Asthma Cooperative Group. The causes of asthma attack were asked by doctors, and the patient’s serum total IgE and specific IgE was tested. Results Respiratory tract infections were the most common cause (1 057 cases, 82.1%), which was followed by weather changes and exposure to cold air (694 cases, 53.9%), and then food (304, 23.6%). The risk of asthma induced by respiratory infections was highest in <2-year old group (358 cases, 97.5%), and lowest in 10-14-year old group (42 cases, 33.3%), with a decreasing trend with age (χ2trend=239.865, P<0.001). Food was also an important inducing factor, and seafood was the most frequent (121 cases, 39.8%). Total serum IgE was positive in 868 cases (67.4%). The positive rate in <2-year old group (52.6%) was the lowest, and the positive rate in 10-14-year old group (89.7%) was the highest, with an increasing trend with age (χ2trend=88.055, P<0.001). Serum specific IgE was positive in 733 cases (56.9%). The positive rate in <2-year old group (37.1%) was the lowest, and the positive rate in 10-14-year old group (92.6%) was the highest, with an increasing trend with age (χ2trend=150.361, P<0.001). The progressive rate of dust mites in inhalation and dietary allergens was highest (668 cases, 51.8%), which was followed by house dust (431 cases, 33.4%). Conclusions The most common inducing factor for bronchial asthma in Mianyang children is respiratory tract infection, followed by the weather changes and cold air exposure, and then food. Detection of serum total IgE and specific IgE is more valuable in elderly children with bronchial asthma.
Objective To analyze the value of serum microRNAs (miR-218, miR-329, and miR-567) in predicting the clinical efficacy of programmed death-1 (PD-1) inhibitor combined with synchronous chemotherapy in patients with non-small cell lung cancer (NSCLC). Methods A total of 160 patients with NSCLC treated with PD-1 inhibitor combined with synchronous chemotherapy in Taiyuan Hospital, Peking University First Hospital between January 2021 and January 2023 were prospectively selected as the study objects by convenience sampling, and the serum levels of miR-218, miR-329, and miR-567 and the clinical efficacy of the patients were collected. According to the clinical efficacy, the patients were divided into remission group (partial remission and complete remission) and non-remission group (stable disease and disease progression). Receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum miR-218, miR-329 and miR-567 levels in the clinical efficacy of PD-1 inhibitor combined with synchronous chemotherapy in patients with NSCLC. Results Of the 160 patients, 34 (21.2%) had disease progression, 85 (53.1%) had stable disease, 39 (24.4%) had partial remission, and 2 (1.2%) had complete remission. They were divided into remission group (41 cases) and non-remission group (119 cases). Multiple logistic regression analysis showed that high levels of serum miR-218, miR-329, and miR-567 could promote the clinical efficacy of PD-1 inhibitor combined with synchronous chemotherapy in patients with NSCLC (all P<0.05). ROC curve analysis showed that, for predicting the clinical efficacy of PD-1 inhibitor combined with synchronous chemotherapy in patients with NSCLC according to the cut-off value of the joint prediction probability of serum miR-218, miR-329, and miR-567, the area under the ROC curve was 0.938 [95% confidence interval (0.855, 0.964)], and the sensitivity, specificity, positive predictive value, and negative predictive value were 82.9%, 92.4%, 79.1%, and 94.0%, respectively. Conclusion The combined detection of serum miR-218, miR-329 and miR-567 levels has a high predictive value for the therapeutic effect of PD-1 inhibitor combined with synchronous chemotherapy in patients with NSCLC.
【Abstract】Objective To search for valuable serum tumor markers in diagnosis and prognosis of pancreatic carcinoma. Methods Seven kinds of serum tumor markers including AFP,CEA,CA50, CA15-3,CA19-9,CA72-4 and CA125 were detected in 62 patients with pancreatic carcinoma by Auto DELFIA and IRMA, 16 patients with other gastrointestinal tumors and 16 patients with benign diseases served as control. And 19 patients after pancreatectomy were followed up. Results Among these 7 kinds of tumor markers, CA19-9,CA50 and CA125 were valuable in diagnosis of pancreatic carcinoma. CA19-9 was the most valuable one, whose sensitivity and specificity were 90.6% and 86.7% respectively. After resection of the tumor, the 3 markers tended to decrease significantly. Conclusion Serum CA19-9,CA50 and CA125 were valuable in diagnosis and following up of pancreatic carcinoma.
Objective To investigate the serum level of surfactant protein D ( SP-D) in patients with chronic obstructive pulmonary disease ( COPD) and its clinical significance. Methods Serumlevels of SP-D in patients with acute exacerbations of COPD ( n = 29) , stable COPD ( n = 26) , and control subjects ( n = 19 ) were measured by ELISA. Multiple regression modeling was performed to determine the independent relationship between SP-D and lung function variables. Results The serum SP-D levels were significantly increased in the patients who experienced an acute exacerbation [ ( 70. 6 ±20. 7) ng/mL] compared with the patients with stable COPD and the control subjects [ ( 47. 9 ±13. 3) ng/mL and ( 31. 2 ±11. 4) ng/mL] ( both P lt; 0. 01) . The serum SP-D levels in the patients with stable COPD increased significantly than the control subjects ( P lt; 0. 01) . Smoking index and staging of COPD were positively related to SP-D level. Serum SP-D levels were also found to be inversely related to FEV1% pred in stable COPD. Conclusion Serum SP-D may be a potential diagnostic and staging biomarker for COPD.