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Objective To assess the value of joint detection of serum cysteine proteinase inhibitors C (sCys-C),urinary kidney injury molecule 1 (uKIM-1),urinary neutrophil gelatinase-associated lipocalin(uNGAL) and urinary interleukin 18 (uIL-18) for early diagnosis of acute kidney injury (AKI) in critically ill patients.Methods A total of 256 adult patients who stayed Intensive Care Unit for 24 hours in the Third People's Hospital of Liaocheng between Aug 2011 and Dec 2012 were enrolled.According to Kidney Injury Net(AKIN) work,the patients were divided into non-AKI group and AKI group (including state 1,2 and 3).The concentrations of urine NGAL,KIM-1,IL-18 and serum sCys-C were measured.The diagnosis value of four biomarkers joint detection and single detection for AKI were analyzed with the receiver operating characteristic (ROC) curve and the area under curve (AUC).Results (1) The levels of uNGAL,uKIM-1,uIL-18 and sCys-C were higher in patients with AKI than the patients with no AKI (P ＜ 0.01).(2) The area under curves of uNGAL,uKIM-1,uIL-18,sCys-C and joint detection were 0.742,0.871,0.803,0.703,0.925 respectively.(3) The sensitivity and specificity of parallel tests and serial tests of four biomarkers were 97.9％,62.8％,64.3％ and 96.2％ respectively.There were significant differences of sensitivity or specificity between single test and joint tests.Conclusions The urine NGAL,KIM-1,IL-18 and serum Cys-C are sensitive indexes for the early diagnosis of acute kidney injury.Joint detection has high value for early diagnosis of AKI.
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Hepatitis E virus (HEV) sequences including four major genotypes representative strains available in GenBank were aligned with the DNAMAN software. The highly conserved internal region of ORF2 was then subjected to design primers and a probe. Furthermore, a 0.3 kb fragment of HEV ORF2 containing the amplification region was transcribed in vitro to synthese cRNA standard and a universal real-time TaqMan PCR assay was optimized and developed to detect and quantify main genotypes RNA of HEV. The specificity and reliability of the real-time RT-PCR was confirmed by testing genotype I HEV, genotype IV HEV and clinical samples. The detection limit of real-time RT-PCR was found 2.0 x 10(1) copies per reaction using in vitro transcribed cRNA. Compared with nested RT-PCR in diagnosis of HEV, the real-time RT-PCR developed was 10 to 100-fold more sensitive than the nested RT-PCR. The detection results from 54 clinical specimens indicated real-time RT-PCR was a rapid, sensitive and reproducible diagnostic method for HEV. This assay will be useful as an early and rapid diagnostic assay for HEV.