Publications (5)4.53 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: [The diagnostic and prognostic values of serum total RNA concentration in patients with sepsis].
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ABSTRACT: To explore the diagnostic and prognostic roles of serum total RNA in patients with sepsis. Seventy-six patients with sepsis admitted to intensive care unit (ICU) of Chinese PLA General Hospital from October 2009 to November 2010 were enrolled. Blood samples were drawn from these patients and total RNAs of these blood samples were isolated. The concentration of total RNA in the samples was detected. C-reactive protein (CRP) was determined by scattering turbidimetry, and procalcitonin (PCT) was determined using enzyme-linked fluorescence analysis (ELFA). Acute physiology and chronic health evaluation II (APACHE II ) score and sequential organ failure assessment (SOFA) score were recorded. Twenty-four healthy individuals with matched age and sex were enrolled as normal controls. Receiver operating characteristic curve (ROC curve) was used to determine the optimal concentration of serum total RNA for the diagnosis of sepsis. Binary logistic regression analysis was used to analyze the risk factors of sepsis patients. The concentration of serum total RNA (ng/μl) in sepsis group was significantly higher than healthy controls [4.233 (0.204, 37.733) vs. 1.593 (0.319, 5.913), P<0.01]. The area under curve (AUC) of the diagnosis of sepsis was 0.820. When the cut-off point was set at 2.027 ng/μl, the concentration of serum total RNA yielded a sensitivity of 95.9% and a specificity of 65.2%. Total RNA concentration in the healthy controls, the survival group (n=42) and non-survival group (n=34) were stepwisely increased [1.593 (0.319, 5.913), 4.178 (0.204, 10.776), 5.006 (0.997, 37.733), respectively, F=8.061, P=0.001]. Binary multivariate logistic regression analysis showed that APACHE II score and SOFA score were independent risk factors of septic patients [APACHE II score: odds ratio (OR)=1.265, 95% confidence interval (95%CI) 1.031 to 1.553, P=0.025; SOFA score: OR=1.151, 95%CI 1.031 to 2.284, P=0.012]. But PCT was not independent risk factor of sepsis patients (OR=1.075, 95%CI 0.974 to 1.187, P=0.151). In the binary univariate logistic regression analysis model, the OR of total RNAs was 1.149, but P value was 0.061, because of the small sample size. The concentration of total RNA in sepsis patients' serum was significantly increased and correlated to the severity of sepsis, which can be used as biomarkers for sepsis patients.Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue 05/2012; 24(5):269-73. -
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.
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2011–2012
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Chinese PLA General Hospital (301 Hospital)
Beijing, Beijing Shi, China
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