Elevated PCT at ICU discharge predicts poor prognosis in patients with severe traumatic brain injury: a retrospective cohort study.

PURPOSE: Disease severity and inflammatory response status are closely related to a poor prognosis and must be assessed in patients with severe traumatic brain injury (STBI) before intensive care unit (ICU) discharge. Whether elevated serum procalcitonin (PCT) levels can predict a poor prognosis in STBI patients before ICU discharge is unclear. METHODS: This retrospective observational cohort study enrolled 199 STBI patients who were in the ICU for at least 48 hours and survived after discharge. Based on serum PCT levels at discharge, patients were divided into the high-PCT group (PCT ≥ 0.25 ng/mL) and the low-PCT group (PCT < 0.25 ng/mL). We assessed the relationship between serum PCT levels and a poor prognosis. RESULTS: The high-PCT group had a higher rate of adverse outcomes compared with the low-PCT group. Multivariate logistic regression analysis showed that the Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, white blood cell (WBC) count, C-reactive protein (CRP) level, and PCT level at discharge were significantly associated with adverse outcomes. CONCLUSIONS: Elevated PCT levels at ICU discharge were associated with a poor prognosis in STBI patients. The serum PCT level as a single indicator has limited value for clinical decision-making.

Effect of expressions of tumor necrosis factor α and interleukin 1B on peritoneal metastasis of gastric cancer.

Our study aimed to investigate effect of expressions of tumor necrosis factor α (TNF-α) and interleukin 1B (IL-1B) on peritoneal metastasis of gastric cancer (GC). From June 2012 to June 2014, a total of 60 patients with advanced peritoneal metastasis from GC were collected from Department of Gastrointestinal and Nutriology Surgery at Shengjing Hospital of China Medical University. Furthermore, 60 GC patients without peritoneal metastasis were enrolled as controls. Immunohistochemistry was performed to test TNF-α and IL-1B expression, and logistic regression analysis was employed for evaluating risk factors for peritoneal metastasis of GC. Our results showed that TNF-α expression in metastatic group and non-metastatic group was significantly different (P = 0.043), but no significant difference was found in IL-1B expression between two groups (P = 0.261). In addition, TNF-α expression in metastatic group and non-metastatic group was associated with tumor size, depth of invasion, the degree of differentiation (all P < 0.05). Logistic regression analysis indicated that tumor size, depth of invasion, the degree of differentiation and TNF-α expression were risk factors for peritoneal metastasis of GC (all P < 0.05). Our study found that TNF-α expression may play a vital role in peritoneal metastasis of GC, while IL-1B expression might not be correlated with peritoneal metastasis.