Publications (11)22.8 Total impact
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Article: Characterization and Identification of Novel Serum miRNAs in Sepsis Patients With Different Outcomes.
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ABSTRACT: Circulating microRNAs (miRNAs) are an emerging biomarker for sepsis patients. The purpose of this study was to identify novel miRNAs in the sera of sepsis patients and determine their prognostic value. Ninety-four serum samples were collected from sepsis patients within 24 hours of intensive care unit admission. Solexa sequencing followed by bioinformatics analysis was used to predict novel miRNAs in survivors (n=9) and nonsurvivors (n=9). A total of 650 novel miRNAs were predicted by bioinformatics analysis after Solexa sequencing, and 41 novel miRNAs were validated in 10 survivors, 10 non-survivors, and 10 healthy controls by quantitative reverse transcriptase polymerase chain reaction (qRTPCR). Among these 41 miRNAs, 18 were present in both survivors and non-survivors, and 9 were differentially expressed between the 2 groups. The expression levels of the 9 miRNAs were determined by qRT-PCR in 24 non-survivors and 32 survivors, and 6 were differentially expressed. Conjoin analysis of the 6 miRNAs and severity scores (Acute Physiology and Chronic Health Evaluation II score and Sequential Organ Failure Assessment score) showed that the area under the receiver operating characteristic curve (AUC) for the predictive value of the 6 miRNAs was 0.969 (95% CI, 0.930-1.000). When the cutoff point was set at 0.714, the 6 miRNAs and severity score provided a sensitivity of 100% and a specificity of 82.6%. In conclusion, 41 novel miRNAs were detectable in the sera of sepsis patients, and 6 of them might be related to sepsis outcome.Shock (Augusta, Ga.) 04/2013; · 2.87 Impact Factor -
Article: Diagnosing Ventilator-Associated Pneumonia in Critically Ill Patients With Sepsis.
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ABSTRACT: Background Timely diagnosis and prognostic assessment of ventilator-associated pneumonia remain major challenges in critical care. Objective To explore the value of soluble triggering receptor expressed on myeloid cells 1, procalcitonin, and the Clinical Pulmonary Infection Score in the diagnosis and prognostic assessment of ventilator-associated pneumonia. Methods For 92 patients, bronchoalveolar lavage fluid was cultured for detection of microorganisms, serum levels of the receptor and procalcitonin and levels of the receptor in exhaled ventilator condensate were measured, and the Clinical Pulmonary Infection Score was calculated. Results On the day of diagnosis, patients who had pneumonia had higher serum levels of the receptor, procalcitonin, and C-reactive protein; higher white blood cell counts; and higher pulmonary infection and Sequential Organ Failure Assessment scores than did patients without pneumonia. White blood cell count (odds ratio, 1.118; 95% CI, 1.139-1.204) and serum levels of the receptor (odds ratio, 1.002; 95% CI, 1.000-1.005) may be risk factors for VAP. Serum levels of the receptor plus the pulmonary infection score were the most reliable for diagnosis; the area under the receiver operating characteristic curve was 0.972 (95% CI, 0.945-0.999), sensitivity was 0.875, and specificity was 0.95. For 28-day survival, procalcitonin level combined with pulmonary infection score was the most reliable for prognostic assessment (area under the curve, 0.848; 95% CI, 0.672-1.025). Conclusions In patients with ventilator-associated pneumonia, serum levels of the receptor plus the pulmonary infection score are useful for diagnosis, and procalcitonin levels plus the pulmonary infection score are useful for prognostic assessment.American Journal of Critical Care 11/2012; 21(6):e110-e119. · 1.66 Impact Factor -
Article: Four serum microRNAs identified as diagnostic biomarkers of sepsis.
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ABSTRACT: BACKGROUND: Serum microRNAs (miRNAs) can be used as biomarkers for many kinds of diseases, and some are even better than current indicators. The aim of this study was to investigate a diagnostic role for serum miRNAs in sepsis patients. METHODS: We recruited 166 patients with sepsis and 24 normal controls. Blood samples for these patients were obtained upon their admission in intensive care units of the Chinese PLA General Hospital. The expression levels of miR-223, miR-15b, miR-483-5p, miR-499-5p, miR-122, and miR-193b* were determined by quantitative reverse transcriptase polymerase chain reaction assays. RESULTS: Expression levels of miR-223 were significantly higher in patients with mild sepsis (p < 0.001) and patients with severe sepsis and septic shock (p < 0.001) than in normal controls, and levels of miR-499-5p, miR-122, and miR-193b* were significantly lower than in normal controls. In addition, only miR-223 (p = 0.035) and miR-499-5p (p < 0.001) were significantly different between patients with mild sepsis and patients with severe sepsis and septic shock. miR-499-5p had the highest area under a receiver operating characteristic curve of 0.686 (95% confidence interval, 0.592-0.779). In addition, Sequential Organ Failure Assessment scores (p < 0.001), Acute Physiology and Chronic Health Evaluation II scores (p < 0.001), and procalcitonin levels (p < 0.001) also could distinguish a mild sepsis group from a severe sepsis and septic shock group. In a binary logistic regression model, only miR-499-5p and Sequential Organ Failure Assessment scores had good diagnostic values to distinguish between mild sepsis and severe sepsis and septic shock. CONCLUSION: Four serum miRNAs were identified as novel biomarkers of sepsis. LEVEL OF EVIDENCE: II, diagnostic study.The journal of trauma and acute care surgery. 10/2012; 73(4):850-854. -
Article: Clinical significance of soluble hemoglobin scavenger receptor CD163 (sCD163) in sepsis, a prospective study.
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ABSTRACT: We investigated serum soluble CD163 (sCD163) levels for use in the diagnosis, severity assessment, and prognosis of sepsis in the critical ill patients and compared sCD163 with other infection-related variables. During july 2010 and April 2011, serum was obtained from 102 sepsis patients (days 1, 3, 5, 7, and 10 after admission to an ICU) and 30 systemic inflammatory response syndrome (SIRS) patients with no sepsis diagnosed. Serum levels of sCD163, procalcitonon (PCT), and C reactive protein (CRP) were determined respectively. Sequential organ failure assessment (SOFA) scores for sepsis patients were also recorded. Then evaluated their roles in sepsis. The sCD163 levels were 0.88(0.78-1.00) ug/mL for SIRS patients, 1.50(0.92-2.00) ug/mL for moderate sepsis patients, and 2.95(2.18-5.57) ug/mL for severe sepsis patients on day 1. The areas under the ROC curves for sCD163, CRP, and PCT for the diagnosis of sepsis were, respectively, 0.856(95%CI: 0.791-0.921), 0.696(95%CI: 0.595-0.797), and 0.629(95%CI: 0.495-0.763), At the recommended cut-off 1.49 ug/mL for sCD163, the sensitivity is 74.0% with 93.3% specificity. Based on 28-day survivals, sCD163 levels in the surviving group stay constant, while they tended to gradually increase in the non-surviving group.The area under the ROC curve for sCD163 for sepsis prognosis was 0.706(95%CI 0.558-0.804). Levels of sCD163 with cut-off point >2.84 ug/mL have sensitivity of 55.8.0%, specificity 80.4%. Common risk factors for death and sCD163 were included in multivariate logistic regression analysis; the odds ratios (OR) for sCD163 and SOFA scores for sepsis prognosis were 1.173 and 1.396, respectively (P<0.05). Spearman rank correlation analysis showed that sCD163 was weakly, but positively correlated with CRP, PCT, and SOFA scores (0.2< r <0.4, P<0.0001), but not with leukocyte counts (r <0.2, P = 0.450). Serum sCD163 is superior to PCT and CRP for the diagnosis of sepsis and differentiate the severity of sepsis. sCD163 levels were more sensitive for dynamic evaluations of sepsis prognosis. Serum sCD163 and SOFA scores are prognostic factors for sepsis. www.chictr.orgChiCTR-ONC-10000812.PLoS ONE 01/2012; 7(7):e38400. · 4.09 Impact Factor -
Article: Diagnostic value of urine sTREM-1 for sepsis and relevant acute kidney injuries: a prospective study.
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ABSTRACT: We explored the diagnostic value of a urine soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) for early sepsis identification, severity and prognosis assessment, and for secondary acute kidney injury (AKI). We compared this with white blood cell (WBC) counts, serum C-reactive protein (CRP), serum procalcitonin (PCT), urine output, creatinine clearance (CCr), serum creatinine (SCr), and blood urea nitrogen (BUN). We enrolled 104 subjects admitted to the ICU: 16 cases with systemic inflammatory response syndrome (SIRS); 35 with sepsis and 53 with severe sepsis. Results for urine sTREM-1, WBC, serum CRP and serum PCT were recorded on days 1, 3, 5, 7, 10, and 14. For 17 sepsis cases diagnosed with secondary AKI, comparisons between their urine sTREM-1, urine output, CCr, SCr and BUN at diagnosis and 48 h before diagnosis were made. On the day of admission to the ICU, and compared with the SIRS group, the sepsis group exhibited higher levels of urine sTREM-1 and Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II) scores (P < 0.05). Areas under the curve (AUC) shaped by the scores were 0.797 (95% CI 0.711 to 0.884) and 0.722 (95% CI 0.586 to 0.858), respectively. On days 1, 3, 5, 7, 10, and 14, urine sTREM-1, serum PCT and WBC levels registered higher in the severe sepsis group in contrast to the sepsis group (P < 0.05). Urine sTREM-1 and serum PCT levels continuously increased among non-survivors, while WBC and serum CRP levels in both groups declined. For 17 patients with AKI, urine sTREM-1, SCr and BUN levels at 48 h before AKI diagnosis were higher, and CCr level was lower than those for non-AKI subjects (P < 0.05). AUC for urine sTREM-1 was 0.922 (95% CI 0.850 to 0.995), the sensitivity was 0.941, and the specificity was 0.76 (based on a cut-off point of 69.04 pg/ml). Logistic regression analysis showed that urine sTREM-1 and severity were risk factors related to AKI occurrence. Besides being non-invasive, urine sTREM-1 testing is more sensitive than testing WBC, serum CRP, and serum PCT for the early diagnosis of sepsis, as well as for dynamic assessments of severity and prognosis. It can also provide an early warning of possible secondary AKI in sepsis patients. ClinicalTrial.gov identifier NCT01333657.Critical care (London, England) 10/2011; 15(5):R250. · 4.61 Impact Factor -
Article: [Clinical analysis of non-invasive positive pressure ventilation in immunocompromised host with acute respiratory failure].
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ABSTRACT: To evaluate the value of non-invasive positive pressure ventilation (NPPV) in immunocompromised host (ICH) complicated by acute respiratory failure (ARF), and to investigate predictive variables of success with NPPV in ICH with ARF. A retrospective study of immunocompromised patients with ARF, who were admitted to respiratory intensive care unit (RICU) from March 2008 to March 2011, was performed. Based on clinical data, univariate Logistic regression was done for prediction for independent factors affecting the success of NPPV treatment. Immunization status was assessed according to clinical outcome. NPPV was instituted in all 33 cases with ARF initially. Among these patients, 9 patients (27.3%) received sequential invasive mechanical ventilation (IMV, failure group) and all of them died finally; among 24 cases (72.7%) who only received NPPV (success group), 7 patients died (29.2%). There was significant difference between the two groups in mortality (P<0.01). The simplified acute physiology scoreII (SAPSII) in the success group was lower than that in the failure group (33±9 vs. 43±5, P<0.01). However, other clinical data showed no statistical significance between two groups. Univariate Logistic regression analysis identified SAPSII was the independent factor associated with the success of NPPV treatment [odds ratio (OR) =0.83, 95% confidence interval (95% CI) 0.709-0.964, P<0.05]. And SAPSII≥38 was a risk factor for the failure of NPPV [area under receiver operating characteristic (ROC) curve 0.73]. In addition, the lung injury scores (LIS) in the survival group was significantly lower than that of the death group (1.95±0.48 vs. 2.57±0.52, P<0.01), the difference was statistically significant. CD3(+) and CD8(+) T counts in the survivors were higher than that of non-survivors (CD3(+):0.73±0.16 vs. 0.41±0.20; CD8(+): 0.51±0.18 vs. 0.21±0.15, both P<0.01), and the difference was statistically significant. As an early treatment for ICH with pulmonary infections suffering from ARF, NPPV can be effective for the ICH patients suffering from severe pulmonary infection through improving hypoxemia, ameliorating respiratory distress symptoms, and avoiding complications associated with IMV when SAPSIIis less than 38. CD3(+), CD8(+), and the LIS can be used to evaluate the prognosis of those patients.Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue 09/2011; 23(9):530-3. -
Article: Tri-phasic modulation of ACh- and NA-maintained calcium plateau by high potassium in isolated mouse submandibular granular convoluted tubular cells.
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ABSTRACT: The fact that submandibular glands secrete a large amount of potassium ion upon nerve stimulation has long been recognized, but a physiological role for such high potassium in the saliva has never been systematically investigated. In the present work, high potassium effect has been investigated in the freshly isolated mouse submandibular granular convoluted tubules. Isolated intact mouse submandibular granular convoluted tubules were loaded with Fura-2, and cytosolic calcium concentration in individual tubular cells was measured by microscopic fluorospectrometry. It was found that high potassium had no effect on basal cytosolic calcium concentration, but had a tri-phasic modulation of the calcium plateau maintained by continued stimulation by acetylcholine (ACh) or noradrenaline (NA): a minor initial transient depression, followed by steady increase, completed by a robust calcium rebound spike upon removal of high potassium. The phase of steady increase was blocked without major effect on the plateau by KB-R 7943, a sodium/calcium exchange (NCX) inhibitor. These data together suggest that high potassium in saliva bathing the mouse submandibular granular convoluted tubular cells has a potent feedback effect on ACh and NA stimulation, and sodium/calcium exchange is likely to play a major role in this process. Such positive feedback actions of high potassium may suggest a role for enhancing ACh- or NA-stimulated protein factor secretion from the granulated convoluted tubular cells.Archives of oral biology 06/2011; 56(11):1347-55. · 1.65 Impact Factor -
Article: Surgical resection and liposomal amphotericin B to treat cavitary pulmonary zygomycosis in a patient with diabetes.
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ABSTRACT: We describe a 24-year-old man with type 1 diabetes mellitus and a cavitary lesion in the right upper lobe, caused by a zygomycete. Surgical resection plus liposomal amphotericin B therapy was successful. We discuss predisposing condition, clinical findings, diagnosis, and treatment of pulmonary zygomycosis.Respiratory care 05/2011; 56(11):1837-9. · 2.01 Impact Factor -
Article: Cytosolic calcium oscillations in submandibular gland cells.
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ABSTRACT: Calcium oscillations can, by default, encode diverse and specific signals by different modes of modulation. Frequency modulation is illustrated by the activation of calcium/calmodulin-dependent protein kinase II at unit Hz, and of calcineurin at 10 mHz frequencies, respectively. The submandibular gland secretory axis is characterized by both potassium and osmolarity gradients from the luminal side of the secretory cells. Such gradients may play significant physiological roles through the feedback modulation of cholinergic stimulation. High potassium transforms plateau calcium increases induced by cholinergic stimulation of the submandibular acinar cells into oscillatory calcium increases. The ductal cells may have similar mechanisms of feedback modulation both by high potassium and by hypoosmolarity. Such feedback mechanisms could modulate the decision-making process for determining which secretory products are selectively released after nerve stimulation.Acta Pharmacologica Sinica 08/2006; 27(7):843-7. · 1.95 Impact Factor -
Article: Cytosolic calcium oscillations in submandibular gland cells1
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ABSTRACT: Calcium oscillations can, by default, encode diverse and specific signals by different modes of modulation. Frequency modulation is illustrated by the activation of calcium/calmodulin-dependent protein kinase II at unit Hz, and of calcineurin at 10 mHz frequencies, respectively. The submandibular gland secretory axis is characterized by both potassium and osmolarity gradients from the luminal side of the secretory cells. Such gradients may play significant physiological roles through the feedback modulation of cholinergic stimulation. High potassium transforms plateau calcium increases induced by cholinergic stimulation of the submandibular acinar cells into oscillatory calcium increases. The ductal cells may have similar mechanisms of feedback modulation both by high potassium and by hypoosmolarity. Such feedback mechanisms could modulate the decision-making process for determining which secretory products are selectively released after nerve stimulat ion.Acta Pharmacologica Sinica 06/2006; 27(7):843 - 847. · 1.95 Impact Factor -
Article: Aspiration of dead space in the management of chronic obstructive pulmonary disease patients with respiratory failure.
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ABSTRACT: Carbon dioxide clearance can be improved by reducing respiratory dead space or by increasing the clearance of carbon-dioxide-laden expiratory gas from the dead space. Aspiration of dead space (ASPIDS) improves carbon dioxide clearance by suctioning out (during expiration) the carbon-dioxide-rich expiratory gas while replacing the suctioned-out gas with oxygenated gas. We hypothesized that ASPIDS would allow lower tidal volume and thus reduce exposure to potentially injurious airway pressures. With 8 hemodynamically stable, normothermic, ventilated patients suffering severe chronic obstructive pulmonary disease we tested the dead-space-clearance effects of ASPIDS. We compared ASPIDS to phasic tracheal gas insufflation (PTGI) during conventional mechanical ventilation and during permissive hypercapnia, which was induced by decreasing tidal volume by 30%. The mean P(aCO(2)) reductions with PTGI flows of 4.0 and 6.0 L/min and during ASPIDS (at 4.0 L/min) were 32.7%, 51.8%, and 53.5%, respectively. Peak, plateau, and mean airway pressure during permissive hypercapnia were significantly lower than during conventional mechanical ventilation but PTGI increased peak, plateau, and mean airway pressure. However, pressures were decreased during permissive hypercapnia while applying ASPIDS. Intrinsic positive end-expiratory pressure also increased with PTGI, but ASPIDS had no obvious influence on intrinsic positive end-expiratory pressure. ASPIDS had no effect on cardiovascular status. ASPIDS is a simple adjunct to mechanical ventilation that can decrease P(aCO(2)) during conventional mechanical ventilation and permissive hypercapnia.Respiratory care 04/2004; 49(3):257-62. · 2.01 Impact Factor
Top co-authors
Top Journals
Institutions
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2011–2012
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Chinese PLA General Hospital
Beijing, Beijing Shi, China -
301 Military Hospital
Beijing, Beijing Shi, China
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2006–2011
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Beijing Normal University
Beijing, Beijing Shi, China
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2004
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307 Hospital of the Chinese People's Liberation Army
Beijing, Beijing Shi, China
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