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Objective@#To validate a nomogram model based on prostate health index (PHI) for predicting prostate cancer (PCa). @*Methods@#The pre-operation serum and clinical data were collected for suspected PCa patients (aged 34 to 90 years), who visited Peking University First Hospital from August 2015 to May 2017 and received transrectal ultrasound-guided prostate biopsy. A total of 391 suspected PCa with total prostate-specific antigen (tPSA)>4 ng/ml were selected into this study, including 235 cases with tPSA level of 4-10 ng/ml and 156 cases with tPSA>10 ng/ml. The p2PSA was tested in all cases and then PHI was calculated. The biopsy results were considered as the gold standard to diagnose PCa. The nomogram model established in Shanghai based on PHI, age and prostate volume was validated in all cases enrolled in this study. Receiver operator curves (ROC) were used to assess the ability of nomogram model to predict PCa. @*Results@#Of 391 male patients included in this study, 175(44.8%)were finally diagnosed as PCa. ROC curves indicated that, the area under the curve (AUC) of the nomogram model for predicting PCa among 391 cases was higher than that of the traditional indicator tPSA (AUC: 0.786 vs 0.578, P<0.000 1). And f/t(AUC: 0.786 vs 0.672, P=0.000 2). For those people with tPSA level of 4-10 ng/ml, the AUC of the nomogram model was also higher than that of tPSA (AUC: 0.720 vs 0.513, P=0.000 3) and f/t(AUC: 0.720 vs 0.626, P=0.042 5). @*Conclusion@#The nomogram model based prostate health index (PHI) was validated to have a good auxiliary diagnostic value for PCa in our center.(Chin J Lab Med, 2018, 41: 536-540)
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Objective To investigate the trans‐regulative effect of hepatitis B virus (HBV) preS2 on the promoter of human acyl protein thioesterase 1 (APT1) gene .Methods The promoter sequence of human APT1 gene was identified applying the soft‐ware of bioinformatics .The APT1 promoter and HBV preS2 gene were amplified with PCR and cloned into pGL3 and pcDNA3 .1 (-) plasmids to construct the luciferase reporter gene plasmid of human APT1 gene promoter pGL3‐APT1 and the preS2 eukary‐otic expression plasmid pcDNA3 .1(-)‐preS2 ,respectively .The effect of the preS2 on the human APT1 gene promoter was exam‐ined by cotransfecting hepatocellular carcinoma cell HepG2 with pGL3‐APT1 and pcDNA3 .1(-)‐preS2 and measuring luciferase activities of the HepG2 cells .The statistical data were analyzed with independent‐samples t test .Results Both plasmids of pGL3‐APT1 and pcDNA3 .1(-)‐preS2 were confirmed by DNA sequencing to be accurately constructed as design .The luciferase activity of the pGL3‐APT1 was 1 .2 times (P<0 .01) that of the positive control plasmid pGL3‐Control .And the luciferase activity of the HepG2 cells cotransfected with pcDNA3 .1(-)‐preS2 and pGL3‐APT1 was 2 .6 times (P<0 .01) that of the HepG2 cells cotrans‐fected with the plasmid without preS2 gene pcDNA3 .1(-) and pGL3‐APT1 .Conclusion The human APT1 promoter cloned in the study has high promoter activity ;HBV preS2 activates human APT1 promoter .
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Objective To discuss the clinical value of Protein induced by Vitamin K Antagonist-Ⅱ (PIVKA-Ⅱ) and alpha-Fetoproteins (AFP) in diagnosing hepatocellular carcinoma (HCC) and monitoring the treatment effects.Methods Patients were recruited by the Affiliated Hospital of Qingdao University,from August 2013 to March 2014.Serum levels of PIVKA-Ⅱ and AFP were measured by both chemiluminescence assay (CLIA) and electrochemiluminescence assay (ECLA) in patients with HCC (n =148),intrahepatic cholangiocellular carcinoma (n =37),gastric cancer and colorectal cancer (n =44),cirrhosis (n =63),chronic hepatitis B (n =38) and healthy subjects (n =57).To analyze the areas under the receiver operating characteristic curves (ROC-AUC) and to compare the sensitivity and specificity of single PIVKA-Ⅱ or AFP assay,and the combined detection.To analyze the correlation of PIVKA-Ⅱ and both tumor size and TNM staging,so do AFP,respectively.To compare the serum level changes of the two indicators in HCC patients before and after treatment.Results The serum levels of both PIVKA-Ⅱ and AFP in HCC group were higher than that in intrahepatic cholangiocellular carcinoma,gastric cancer and colorectal cancer,cirrhosis,chronic hepatitis B and healthy subjects groups (PIVKA-Ⅱ:U =866.50,424.00,958.00,292.00 and 448.00 ; AFP:U=713.00,440.50,1 182.00,614.00 and 399.00,P ＜0.001).The ROC-AUCs of the single PIVKA-Ⅱ or AFP assay and the combined detection in HCC group were not statistically different (P ＞ 0.05).The sensitivity of PIVKA-Ⅱ (87.16％) was higher than that of AFP (68.92％,x2 =4.73,P ＜ 0.05) in diagnosing HCC ; the sensitivity of the combined detection of PIVKA-Ⅱ and AFP(93.24％) was higher than that of PIVKA-Ⅱ itself (87.16％,adjusted x2 =64.70,P ＜ 0.01) ;while the specificities among them did not show statistical significance (P ＞ 0.05).Tested by Spearman rank correlation,the serum levels of PIVKA-Ⅱ and AFP were both positively related to tumor size (r =0.716,0.475 respectively,P ＜ 0.001).The serum levels of PIVKA-Ⅱ and AFP in HCC patients increased gradually correlated with tumor size (H =72.70,37.02 respectively,P ＜ 0.001) and the positive rates of PIVKA-Ⅱ and AFP were gradually improved (x2 =26.74,21.62 respectively,P ＜ 0.01),too.Based on the International TNM Staging System,the serum levels of PIVKA-Ⅱ and AFP (H =46.63,21.38 respectively,P ＜0.001) and the positive rates of PIVKA-Ⅱ and AFP (PIVKA-Ⅱ:x2 =20.40,P ＜0.01 ;AFP:x2 =8.33,P ＜0.05) in HCC patients from Ⅰ-Ⅳ stages were increased as TNM stages elevated.The serum levels of PIVKA-Ⅱ and AFP in HCC patients were both dropped sharply compared with preoperative levels (Z =-4.59,-4.22 respectively,P ＜ 0.001) and also both dropped in each of the Ⅰ-Ⅳ TNM stages (PIVKA-Ⅱ:Z =-2.85、-2.98、-2.70 respectively,P ＜ 0.05 ; AFP:Z =-2.48、-3.82、-2.50 respectively,P ＜ 0.05) compared with serum levels before treatment.Conclusion PIVKA-Ⅱ and AFP both have high clinical application values in diagnosing HCC and monitoring treatment effects.The sensitivity of PIVKA-Ⅱ in diagnosing HCC is significantly higher than AFP,and the sensitivity can be elevated by the combined detection in diagnosing HCC without reducing the specificity.
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Objective To evaluate the diagnostic value of procalcitonin (PCT) in patients with infection complicated by heart failure.Methods A total 2454 patients,which with simple heart failure,simple bacterial infection and bacterial infection complicated with heart failure,from Sun Yat-sen University affiliated zhongshan hospital were enrolled in this case-control study.244 heathly controls were aslo evaluated at the same time.The serum PCT levels in different groups were analyzed by Cobas E601.ROC curve was employed to compare the diagnostic values of PCT between simple heart failure group and infection complicated with heart failure group,and the cutoff value of PCT testing for infection complicated by different grades heart failure was determined.The difference between test groups was analyzed using Kruskal-Walis H method.Results PCT levels in simple heart failure group (3.46 ± 3.07) were significantly higher than those in control group (0.04 ± 0.03) (t =4.262,P ＜ 0.01).Besides,PCT levels in infection complicated by heart failure group(18.18 ± 10.33)were significantly higher than those in simple infection group(8.97 ± 6.20) (t =2.694,P ＜ 0.01).Although PCT could still be a biomarker for diagnosis of bacterial infection in patients with or without heart failure (areas under the ROC curve were 80％,82％,85％,88％,respectively),the positive predictive values of PCT were declined in line with the heart failure degree increasing [z(1,2) =-6.24,P＜0.01; z(l,3) =-4.35,P＜0.01; z(1,4) =-5.19,P＜0.01; z(2,3) =-5.33,P＜0.01;z(2,4) =-2.86,P＜0.05; z(3,4) =-2.46,P＜0.05].There are significant differences between areas under ROC curve [z(1,2) =-2.55,P ＜ 0.05 ; z(1,3) =-5.42,P ＜ 0.01; z(2,3) =-2.90,P ＜ 0.05],and the cutoff values of PCT to identify infection patients complicated with Ⅱ,Ⅲ,Ⅳ degrees heart failure were 0.086,0.192 and 0.657 μg/L,respectively.Conclusion PCT levels were increased in heart failure patients so we should pay more attention to the degree of heart failure and PCT level on patients which suffered both infection and heart failure.
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Objective This study assesses the influence of rizatriptan on calcitonin gene-related peptide (CGRP),proenkephalin (PENK) and cholecystokinin (CCK) mRNA expressions in the trigeminal ganglia of a rat migraine model and investigates the possible mechanisms by which triptans treat migraine.Methods A total of 24 rats were randomly divided into four groups:normal control group (A),migraine model group(B),rizatriptan control group (C) and rizatriptan treatment group(D).Groups C and D were intragastrically perfused with rizatriptan,1 mg/kg per day.After 7 days,nitroglycerin was subcutaneously injected into the buttocks of the groups B and D to induce migraine.Two hours after nitroglycerin injection,the trigeminal ganglia was isolated.CGRP,PENK and CCK mRNA expressions in the trigeminal ganglia were determined using SYBR Green Ⅰ real-time quantitative PCR.Results The copy number of CGRP mRNA (× 107) in 200 ng total RNA of each group was 0.05 ±0.01,1.30 ±0.52,0.23 ±0.12,0.43 ±0.33 ; The copy number of PENK mRNA (× 103) in 200 ng total RNA of each group was 3.30 ± 1.65,0.34 ±0.14,3.91 ± 2.44,0.71 ± 0.13.The copy number of CGRP mRNA in the trigeminal ganglia of group B was significantly higher than that of group A (q =7.854,P ＜ 0.05) ; CGRP mRNA expressions were significantly lower in the trigeminal ganglia of rats in group D compared with group B (q =5.458,P ＜0.05).Compared with group A,PENK mRNA expressions in the trigeminal ganglia of rats were significantly lower in group B (q =4.478,P ＜ 0.05).PENK mRNA expressions were significantly higher in trigeminal ganglia of rats in group C compared with group D (q =4.838,P ＜ 0.05).CCK mRNA expression in trigeminal ganglia of rats was similar among groups.Conelusions Rizatriptan can decrease the expressions of CGRP in the trigeminal ganglia of the migraine rats and exhibits neurogenic inflammation triggered by CGRP.PENK expressions decrease in the trigeminal ganglia of the migraine rats,weaken the analgesic effects of enkephalin.
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Objective The aim of this study is to define if early change ofprocalcitonin (PCT) may inform about the efficacy evaluation of severe bacterial pneumonia.Methods A prospective,single-center,observational study was conducted in patients with severe bacterial pneumonia admitted to ICU in 2010 years.PCT samples were collected in baseline,72 hours,7 days and the ending in the duration of therapy.The efficacy evaluation was assessed at the end of treatment 5 days after and divided into the efficacy group and nonefficacy group according to the guiding principle of clinical research on antibacterial drugs by the Ministry of Health.Sixty-five patients with a mean age of (62.1 ± 15.9) years were evaluated.Five patients were severe community acquired pneumonia,32 patients nosocomial pneumonia and 28 patients ventilator associated pneumonia.The clinical pulmonary infection score(CPIS) was 7.9 ± 1.8 ;APACHE Ⅱ score was 14.5 ±5.3.There were 44 patients as the efficacy group and 21 patients as the nonefficacy group.SPSS13.0 was used to analyse the results.Results The PCT levels between efficacy group and nonefficacy group were (3.83 ±2.18)vs(4.23 ±2.64) μg,/L (t =1.249,P =0.387),(2.44 ± 1.05)vs(3.48 ± 1.75) μg/L(t=-1.959,P=0.045),(1.15 ±0.87) vs (3.41 ±1.58) μg/L (t=-2.904,P=0.006),and (0.51 ±0.17) vs (2.63 ±1.08) μg/L (t=-3.772,P =0.000) in baseline,72 hours,7 days and the ending in the duration of therapy.The change of PCT within the first 72 hours were (32.5 ± 12.4)％ vs (14.5 ± 7.1) ％.The area under receiver operating characteristics curve (AUC) of prediction clinical efficacy of the change of PCT within the first 72 hours was 0.823 (P =0.002),the AUC of white blood cell,the neuter granulocyte percentage,body temperature and PCT level within 72 hours were 0.575,0.543,0.521,0.597,respectively (P ＞ 0.05).In multivariate analyses,the change of PCT ＜ 30.8％ (odds ratio,15.2,95％ confidence interval,3.3-21.7,P =0.01) was independent risk factors of effect predictor.The changes of PCT within the first 72 hours (＞30.8％) combined with CPIS(＜6) were the best performance to predict clinical efficacy with a AUC of 0.910,sensitivity of 85.2％ and specificity of 92.5％.Conclusions The change of PCT within the first 72 hours can be used early to evaluate the effect in bacterial pneumonia.Especially,combined with CPIS can further improve the prediction value.
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ObjectiveTo evaluate the application value of the quantitative procalcitonin (PCT) test in bloodstream infection.Methods Of 1066 patients with blood culture and PCT detection were collected in our hospital,retrospectively,1010 were effective cases.The relationship between blood culture results and serum PCT levels was investigated.PCT levels in gram-negative bacterial infection,gram-positive bacterial infection and candidiasis were compared.The prognosis of 33 blood culture positive patients with repeated PCT detection results were analyzed.Mann-Whitney U test was used to compare the PCT value among the three groups,and Fisher' s test was used to compare the death rate among the three groups.ResultsIn the patients with negative blood culture results,the median of PCT was 0.37 (0.11 - 1.67) μg/L.But in the patients with positive blood culture results,the median of PCT were 2.24(0.57 -11.59) μg/L The positive rate of PCT in gram-negative bacteria infection,gram-positive bacterial infection and candidiasis were 86.6％,72.0％ and 75.7％,respectively.In the 33 patients subjected to repeated PCT detections,the mortality of the patients with decreasing PCT was lower than the others.The patients whose PCT levels were greater than 5 μg/L had poor prognosis.ConclusionsQuantitative PCT is proved to be an effective method for rapid diagnosis of bloodstream infection.The changing trends of PCT test results has certain reference value for the patients' prognosis.
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ObjectiveTo investigate the value of serum procalcitonin (PCT) in diagnosing lower respiratory tract infection (LRTI) in adult.MethodsIn a retrospective study,97 patients were enrolled,who admitted into Peking University People's Hospital with suspected LRTI from July to December 2008.During analysis,the subjects are categorized into groups of LRTI with sepsis,hospital-acquired pneumonia(HAP),community-acquired pneumonia(CAP),acute exacerbation of chronic obstructive lung disease (AECOPD),other LRTI and non-infectious diseases.In these cases,the following parameters were assessed regularly,such as white blood cell count,erythrocyte sedimentation rate( ESR),C-reactive protein (CRP),PCT,bacterial culture of both sputum and blood,and Acute Physiology and Chronic Health Evaluation (APACHE)Ⅱ score.PCT levels were determined using antibody-coated tubes as a complete diagnostic-kit (LUMI test Pro-Calcitonin) in a Luminometer.ResultsMean PCT levels in groups of LRTI with sepsis, hospital-acquired pneumonia ( HAP ), community-acquired pneumonia ( CAP ), acute exacerbation of chronic obstructive lung disease( AECOPD),other LRTI,non-infectious diseases were 10.1 (0.7 -37.0),0.3(0.1 -0.8),0.2(0.1 -0.9),0.2(0.1 -0.4),0.3(0.1 -0.5),0.1 (0.1 -0.2) mg/L,respectively.There were statistical differences between these groups (H =19.898,P ＜ 0.01 ).And the PCT levels in groups of LRTI with sepsis,HAP,CAP,AECOPD,other LRTI were higher than group of non-infectious diseases ( U values were 0,18.000,81.000,20.000,all P ＜ 0.01 ).Patients with sepsis exhibited strongly higher PCT levels than patients with other lung diseases ( U values were 11.000,45.000,3.000,4.500,all P ＜ 0.01 ).Pearson correlation analysis of PCT levels with positive bacterial cultures and APACHE Ⅱ score was performed ( r =0.449).ROC analysis revealed that optimal discrimination between LRTI and non-infectious diseases could be performed at the cut-off point of 0.5 mg/L with a sensitivity of 32.6％ and specificity of 100％,while at a suggested cut-off point of 0.235 mg/L with a sensitivity of 53.9％ and specificity of 100％.Conclusions PCT is a more useful parameter for diagnosing lower respiratory tract infections( especially for those with sepsis) than other infectious markers such as CRP,ESR and white blood cell count.The sensitivity of PCT could be elevated with a reduction of the cut-off level.
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Objective To investigate human plasma glycoproteomie changes related to human immunodeficiency virus (HIV) infection,and to identify glycoproteins with potential anti-HIV activity or anti-HIV drug targets. Methods Plasma proteins with lower abundance were enriched through affinity purification to remove albumin and IgG in clinical samples (HIV-positive patient, n= 10, and healthy controls, n= 20). Proteins were separated by two-dimensional electrophoresis (2-DE) and stained by Pro-Q emerald glycoprotein stain kits. The 2-DE image was analyzed by ImageMaster software to find differential glycoproteins. Furthermore, the depleted HIV-positive and healthy control plasma proteins were digested by PNGase F. Glycoproteins were deglycoliszed, separated by 2-DE and analyzed by ImageMaster software. Differential glycoproteins were identified by liquid chromatography combined with high capacity ion trap mass spectrometry (HCT). Results The pretreatment of HIV-positive plasma prior to 2-DE could efficiently remove the high aboundant albumin and IgG in plasma and improve the detection of proteins with low-abundance. High revolution 2-DE gel images of glycoproteins from HIV positive and healthy control plasma samples were obtained. Glycoproteins were successfully deglycolized through PNGase F treatment. Thirteen differential glycoproteins were identified by liquid chromatography combined with mass spectrometry. These proteins included alphalantitrypsin precursor and serine/threonine-protein kinase N1. Conclusions Potential HIV infection related proteins,such as alphal-antitrypsin precursor are successfully identified. Our study may offer some help to understand the molecular mechanism of HIV infection and select new drug targets for preventing HIV infection.
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Objective To study the diagnostic value of common inflammatory markers in patients with infectious diseases. Methods One hundred sepsis patients, 100 viral infection patients,100 pulmonary tuberculosis patients and 100 gonorrhea patients were analyzed retrospectively. The contents of procalcitonin (PCT), C-reactive protein (CRP), haptoglobin (HP), ceruloplasmin (CER), α1-acid glycoprotein (α1-AAG), α1-antitrypsin (α1-AAT), white blood cell count (WBC) and erythrocyte sedimetation rate (ESR) were measured. The receiver operating characteristic curve (ROC curve), sensitivity, specificity, positive predictive value, negative predictive value, Youden's index,positive and negative likelihood ratios and total coincidence rate were calculated respectively. Results The area under the ROC curve, sensitivity, specificity, Youden's index and positive likelihood ratios,positive predictive value and total coincidence rate of PCT in sepsis patients were 0. 895, 0.84, 0.92,0.76, 10.50, 0.91 and 0.88, respectively, which were superior to CRP, HP, CER, α1-AAG, α1-AAT, WBC and ESR. Conclusions PCT is a better inflammatory reactive parameter than other parameters currently applied in practice and may serve as a rapid and sensitive test in the early stage of severe bacterial infections.
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Objective To study the clinical significance of HBV preS1-Ag,HBV-DNA and HBeAg in main groups of HBV infection.Methods HBV preS1-Ag and hepatitis B serum markers individually were detected by ELISA,and HBV-DNA by fluorescence quantitative PCR, then the detection results of the 308 cases were analysed.Results The serum markers of the 308 cases infected by HBV presented four modes which were "HBsAg,HBeAg,HBcAb","HBsAg,HBeAb,HBcAb","HBsAg,HBeAg","HBsAg,HBcAb".The total positive rate of preS1-Ag was 62.34%(192/308),and HBV-DNA was 78.90%(243/308).Compared HBeAg(+) groups with HBeAg(-)/anti-HBe(+) groups, the corresponding positive rates of preS1-Ag were 71.65%(139/194) and 46.49%(53/114),respectively.The difference of the two groups was significant (?~2=18.30;P
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Objective To study the relationship between hepatitis B virus(HBV)pre-S gene mutations and progression of liver disease.Methods The entire pre-S1,pre-S2 genes were amplified hy nested polymerase chain reaction(PCR)and the products were digested by NlaⅢ.The method for detecting pre-S2 start codon mutation was established based on the digested restriction fragment length polymorphism(RFLP).Pre-S gene deletion was revealed by electrophoresis on polyacrylamide gel(PAGE).Pre-C A1896 and basic core promoter T1762/A1764 mutations were identified by direct sequencing of PCR products.The 138 sera from patients with HBV-related disease,including asymp- tomatic carriers(ASC),chronic hepatitis(CH),liver cirrhosis(LC),hepatocarcinoma(HCC),were tested by these methods.Results The detection rate of pre-S deletion mutation was higher in patients with HCC(56.3%)and LC(42.9%)than those with CH(11.8%)and ASC(8.1%,P
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Objective To study the expression of prepro-orexin mRNA in circadian rhythms and sleep-deprived rats.Methods Sleep was deprived with “rotation cylinder” in rats. RT-PCR was used to determine the change of prepro-orexin mRNA expression in cortex and hypothalamus of circadian rhythms and sleep-deprived rats.Results There was a significant changes of prepro-orexin mRNA expression with circadian rhythms in hypothalamus of rats. But there was no significant change in cortex. More prepro-orexin mRNA expression was found in hypothalamus than in cortex of rats. The expression of prepro-orexin mRNA in hypothalamus and in cortex of rats was not effected by short times of sleep deprivation. However the expression was raised by a 8-hour sleep deprivation.Conclusions There should be a close relationship between orexin and sleep. The control of sleep may be dependent on regulation of orexin in hypothalamus.
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Objective To Screen out incidence of vitamin K deficiecy and complicated with hemorrhage in newborn patients, infant patients and normal neonates, and also study on the treatment of vitamin K deficiency. Methods Using emzymoimmunoelectrophoresis to test PIVKA Ⅱ in umbilical and vein blood. Results The incidence of vitamin K deficiency in normal neonates, newborn patients (≤ 5 days) and infants patients (25~60 days) are 31.2%,47.6% and 31.8%. The incidence of hemorrhage in newborn patients (≤5 days) is 26.0%, infant patients (25~60 days) is 66.6%. Intramuscular injection of vitamin K 1 1 mg is the proper dosage to prevent and treat vitamin K deficiency. Conclusion The neonates right after birth or about 25 days after birth, especially those of breast feeding and who are getting lievr and gall diseases should receive vitamin K 1 to prevent vitamin K deficiency.