RÉSUMÉ
Objective To investigate the expression of serum Hsa_circ_0003928 in patients with diabetic foot ulcer(DFU)and its relationship with the severity and prognosis of disease.Methods 113 DFU patients were selected as the study subjects.According to the severity of infection,19 cases were classified into level 1(no infection),40 cases at level 2(mild infection),20 cases at level 3(moderate infection),and 34 cases at level 4(severe infection).According to the prognosis of DFU patients,they were divided into good prognosis group(GP,n=63)and poor prognosis group(PP,n=50).The baseline data and levels of IL-6,C-RP and Hsa_circ_0003928 were compared among the four groups.Logistic regression was used to analyze the risk factors of poor prognosis in patients with DFU.The receiver operating characteristic(ROC)curve was used to analyze the value ofHsa_circ_0003928,C-RP and IL-6 in predicting the poor prognosis in DFU patients.Results The DFU duration,infection grade 3～4,serum creatinine,uric acid,BUN,C-RP,IL-6 and Hsa_circ_0003928 levels in PP group were significantly higher than those in GP group(P＜0.05 or P＜0.01).Grade 3～4 DFU patients had higher Hsa_circ_0003928 expression than grade 1～2(P＜0.01).Logistic regression analysis showed that long duration of DFU,infection grade 3～4,higher levels of BUN,C-RP,IL-6 and Hsa_circ_0003928 were risk factors for poor prognosis in DFU patients.ROC curve showed that Hsa_circ_0003928 had the greatest AUC(0.882,95％CI 0.819～0.942)in predicting poor prognosis in DFU patients,with sensitivity 87.5％and specificity 85.6％,respectively.Conclusion Elevated Hsa_circ_0003928 is associated with DFU severity and poor prognosis,which has certain predictive value for the prognosis of DFU patients.
RÉSUMÉ
Objective:A rare case of δ-globin gene (HBD) mutation in Guangdong Province was analyzed to provide reference for avoiding misdiagnosis of δ-thalassemia in clinic.Methods:The patient was admitted to Guangdong Maternal and Child Health Hospital, and the peripheral blood sample was collected for hematological phenotypes [mean erythrocyte volume (MCV), mean erythrocyte hemoglobin content (MCH), hemoglobin (Hb)] and Hb typing analysis. The routine deletion and mutation of α-thalassemia and β-thalassemia genes were analyzed by PCR-flow fluorescence hybridization. At the same time, DNA sequencing was used to analyze the type of HBD mutation.Results:The results of hematological phenotypes analysis showed that MCV was 87.9 fl, MCH was 29.3 pg, and Hb content was 140 g/L. The results of Hb typing showed that the contents of Hb F, Hb A 2, Hb A 2 variant, and Hb A were 0.4%, 1.3%, 0.6%, and 97.7%, respectively. No abnormality was found in α-thalassemia and β-thalassemia genes by routine deletion and mutation detection. According to DNA sequencing analysis, the patient had HBD: c.349 C>G variant. Conclusion:The low Hb A 2 content (reference value is 2.5% - 3.5%) in this case is due to the mutation of HBD, HBD: c.349 C>G variant is rare in Chinese population.
RÉSUMÉ
Objective To evaluate the change and clinical significance of serum procalcitonin(PCT)and C-reactive protein(CRP)in patients with septic shock. Methods Patients with severe infection in the intensive care unit (ICU) of a hospital between January 2013 and June 2015 were selected. According to the extent of infection,patients were divided into septic shock group (n= 66,subdivided into survival group [n= 50]and death group[n= 16]according to 1-month survival)and severe sepsis group (n= 62),control group were patients without septic shock during the same hospitalization period,serum PCT,CRP,and WBC levels in each group at different times before and after treatment were compared. Results In septic shock group,serum PCT,CRP and WBC levels before treatment,after 1,3,and 7 days of treatment were all significantly higher than control group;in severe septic shock group,serum PCT and CRP levels after 1 ,3 ,and 7 days of treatment were all significantly higher than control group;in death group,serum PCT levels after 1,3,and 7 days of treatment were all significantly higher than survival group,CRP levels after 3 and 7 days of treatment were both significantly higher than survival group(all P<0.05). Receiver op-erating characteristic (ROC)curves showed that area under the curve (AUC)and 95% CI of PCT,CRP,and WBC were 0.786(0.703-0.864),0.754(0.691-0.827),and 0.603(0.542-0.679)respectively. Spearman correlation analysis showed that serum PCT and CRP in patients with septic shock before treatment,after 7 days of treatment were positively correlated([r= 0.596,P= 0.004],[r= 0.523,P= 0.012],respectively),and after 7 days of treat-ment,serum PCT was positively correlated with WBC(r= 0.604,P= 0.001 ). Conclusion PCT can be used as a indicator in early diagnosis of patients with septic shock,and dynamic observation of PCT and CRP has important significance in evaluating patients'severity and prognosis.