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Objective:To evaluate the efficacy of platelet-monocyte aggregates (PMA) in the clinical diagnosis of sepsis.Methods:From January 2022 to December 2022, patients in the First Affiliated Hospital of Soochow University were recruited in this study, among which 41 were with sepsis (sepsis group), 41 patients had infection but were not diagnosed as sepsis (infection group), and 25 healthy individuals (healthy control group) were simultaneously chosen. Patients with sepsis were divided into the shock group (14 cases) and the non-shock group (27 cases). PMA of all subjects were measured by Beckman Coulter Navios Flow Cytometry and detection of procalcitonin(PCT), C-reactive protein (CRP) and platelet (PLT).The differences of the two indexes between the different groups were compared by nonparametric test. Spearman′s correlation test was used to analyze the correlation among PMA, PCT, CRP and PLT. The diagnostic value of PMA in sepsis was evaluated by drawing the receiver operating characteristic (ROC) curve. Kaplan-Meier survival curve was used to compare the survival time of patient with different PMA. Results:The PMA in the sepsis group, infection group and healthy control group were 52.66% (27.10%, 81.09%), 37.22% (26.52%, 54.56%) and 15.94% (15.10%, 17.02%), respectively. For the three groups, PCT levels were 3.10 (0.23, 15.35)μg/L, 0.15 (0.08, 0.79)μg/L and 0.02 (0.02, 0.02)μg/L, CRP levels were 106.6 (35.87, 175.60)mg/L, 76.45 (27.20, 110.10)mg/L and 1.26 (0.94, 2.42) mg/L, and the PLT counts were 116.00 (90.25, 204.30)×10 9/L, 192.00 (147.30, 333.00)×10 9/L and 199.50 (178.00, 252.80)×10 9/L. The values for PMA, PCT and CRP levels were significantly higher in the septic group compared to the healthy controls (the U values were 0.00, 5.00 and 1.00, P<0.001). But the PLT for the septic group was lower than that from the healthy control ( U=47.00, P<0.05). The differences in PCT and PLT were statistically (the U values were 84.50 and 176.50, P<0.05), but there was no significant difference between the PMA and CRP(the U values were 255.00 and 210.00, P>0.05) for the two groups. PMA was positively correlated with PCT( rs=0.562, P<0.001) and CRP( rs=0.447, P<0.001) in patients. The levels of PMA in shock and non-shock groups were 83.54% (76.51%, 86.82%) and 43.75% (21.59%, 62.83%) respectively ( U=12.00, P<0.05). The AUC of PMA in diagnostic of sepsis was 0.750(95% CI 0.657-0.843), the best cut-off value was 37.99%. Survival curve analysis showed that the survival time was significantly lower in the PMA≥37.99% group ( χ 2=4.805, P<0.05). Conclusion:PMA holds significant clinical reference for sepsis diagnosis and has the potential to serve as a biomarker in sepsis diagnostic procedures.
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Objective To explore the predictive value of neutrophil-to-lymphocyte ratio on the prognosis of H7N9 avian influenza.Methods A retrospective analysis was conducted on 28 H7N9 avian influenza patients (treatment group) at the First Affiliated Hospital of Soochow University from April 2013 to January 2016.Thirty healthy physical examiners in the same period were enrolled as the healthy control group.The 28 patients were followed up for half a year and divided into the improvement group (18 cases) and the death group (10 cases) according to the clinical prognosis.Inflammatory indicators including white blood cells (WBC),neutrophil (N),lymphocyte (L),monocytes (M),platelet (PLT),creatine kinase (CK),lactate dehydrogenase (LDH),high sensitive C reactive protein were collected at day 1,day 3 and week 1 of admission.Calculation of neutrophil-to-lymphocyte ratio (NLR),platelet-to-lymphocyte ratio (PLR),lymphocyte-to-monocyte ratio (LMR),△NLR3 (day 3 of admission NLR-on day 1 of admission NLR),△NLR7 (week 1 of admission NLR-day 3 of admission NLR) and so on calculating △PLR3,△PLR7,△LMR3,△LMR7.Differences of the above indicators between the improvement group and death group were compared.The measurement data with normal distribution were tested by t-test of two independent samples,and the count data with non-normal distribution were tested by Mann-Whitney U-test.Univariate and multivariate logistic regression analysis to explore the prognostic factors and the working characteristic curve of subjects was used to evaluate the predictive value of inflammatory response indexes for H7N9 avian influenza death.Results In the treatment group,the baseline WBC,L,N,PLT,the proportion of lymphocytes,neutrophils,monocytes,and NLR,PLR,and LMR were all statistically different compared with the healthy control group (all P ＜0.01).After treatment,day 3 NLR,△NLR3 in improvement group were both significantly decreased to 10.93 (15.71)and0.87 (-15.63),respectively when compared with death group (17.62[23.63] and 7.42[22.68],respectively) (Z =-2.16 and-2.014,respectively,both P＜0.05).Day 7 NLR,△NLR7 in improved group were 6.51 (13.23) and-0.37 (-12.38),respectively,which were both lower than those of death group (27.90 [25.64] and 11.54 [-26.22]) with statistically significant differences (Z =-2.444 and -2.111,respectively,both P ＜ 0.05).Multivariate logistic regression analysis indicates that △NLR3 is the main factor that affects the prognosis of the H7N9 infection (odds ratio [OR] =1.153,95％ confidence interval [CI]:1.052-1.263,P =0.002).Reciver operating characteristic curve analysis showed that the area under the curve was 0.733 (95 ％ CI:0.532-0.935,P =0.044).Based on the principle of Youden index,the cutoff value of △NLR3 to predict the death risk of H7N9 avian influenza was 5.453 with sensitivity of 0.700 and the specificity of 0.722.The mortality was higher when △NLR3 was higher than 5.453.Conclusions Dynamic monitoring NLR,especially △NLR3 may reflect the condition and prognosis of H7N9 infection,which is an independent predictor of death.
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ObjectiveTo explore the expression of Glut1, HIF-1α and Ki-67 in hepatocellular carcinoma (HCC) and their relationship between their expression and clinicopathological features.MethodsImmunohistochemical study (EnVision method) for Glut1, HIF-1a and Ki-67 were performed on tissue microarray which consisted of 171 cases of HCC, 55 cases of adjacent non-neoplastic liver tissues, and 22cases of normal liver tissues.ResultsThe expression rate of Glut1 ,HIF-1α and ki-67 in 171 cases of HCC was 15.2％, 19.9％ and 66.1％, respectively, which was much higher than that in the adjacent non-neoplastic liver tissues (1.8％ ,1.8％and 5.5％) and normal liver tissues(all negative).The expressions of Glut1 and HIF-1α were positively correlated with the differentiation degree of HCC and TNM stage(P ＜0.01, P ＜0.05).The expression of ki-67 was positively correlated with the differentiation degree of HCC.There was a significant positive correlation between the expressions of Glut1 and HIF-1α in HCC (r1 =0.553, P ＜0.05), the expressions of Glut1 and HIF-1α were positively correlated with ki-67(r2 =0.560,r3 =0.613, P ＜0.05).ConclusionsGlut1, HIF-1α and ki-67 may play a role in the tumorigenesis and progression of HCC in some degree.Combined detection of Glut1, HIF-1α and Ki-67 may be helpful to judge the degree of malignancy and potential metastasis and evaluate the prognosis.
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Objective To study the signification of p57kip2 immunostaining to distinguish molar gestations from hydropic abortions.Methods To observe the p57kip2 immunohistochemical expression in 58 cases of histological hydropic villi which were divided into complete mole(18 cases) ,partial mole(19 cases),hydropic abortion(11 cases)and undetermined hydropic abortion or molar gestations(10 cases) and in 3 normal placentas.Results Normal villi,partial mole and hydropic abortions show positive staining for p57kip2, which expressed in the nuclei of cytotrophoblast and villous mesenchyme,and complete moles show complete absence of staining in the cytotrophoblast and villous mesenchyme.According to the comparison of the diagnosis based on morphology and the one based on p57kip2 stai-ning,the later whose sensitivity is 96% (46/48) confirmed the earlier diagnosis in 58 cases studied and the later conformed to the earlier very well.Conclusion The immunohistochemical staining for p57kip2 is a valuable diagnostic mean to distinguish molar gestations from hydropic abortions and is a sensitive and specific marker for the diagnosis of complete mole.
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Objective To investigate the expression and clinical significance of CDx2 and hepatocyte antigen(Hep) in gastric carcinoma.Methods The expression of CDx2 and Hep in 9 cases of nomal gastric mucosa,15 cases of small intestinal mucosa,8 cases of colon mucosa,15 cases of intestinal metaplasia of the stomach and 130 cases of gastric carcinoma were detected with immuohistochemical EnVisionTM Systems measures.Results The positive rates of CDx2 expressed in the nomal gastric mucosa were 0,small intestinal mucosa 80%(12/15),colon mucosa 87.5%(7/8),intestinal metaplasia of the stomach 86.7%(13/15),gastric carcinoma 37.7%(49/130);The positive rate of Hep was 11.1%(1/9),86.7%(13/15),12.5%(1/8),100%(15/15),55.4%(72/130) respectively.There was much higher positive expression of CDx2 in intestinal-type carcinoma than in diffuse-type gastric carcinoma(P