[Predictive values of serum 8-hydroxydeoxyguanosine on disease progression and prognosis of patients with sepsis].

Objective: To investigate the values of serum 8-hydroxydeoxyguanosine (8-OHdG) in predicting disease progression and prognosis of patients with sepsis. Methods: The prospective observational research methods were used. A total of 124 patients with sepsis who met the inclusion criteria were admitted to the Department of Emergency of the First Affiliated Hospital of Wenzhou Medical University from April 2015 to July 2016, including 79 males and 45 females, aged (62±15) years. The sepsis-related organ failure assessment (SOFA) scores of all patients on admission and on the second day of admission and their difference (ΔSOFA) were calculated. The patients were divided into non-progression group with ΔSOFA score <2 (n=101) and progression group with ΔSOFA score ≥2 (n=23), and according to the survival during hospitalization, the patients were divided into survival group (n=85) and death group (n=39). Data of patients between non-progression group and progression group, survival group and death group were compared, including the gender, age, days in emergency intensive care unit (ICU), smoking, hypertension, diabetes mellitus, serum white blood cell count, serum C-reactive protein, and serum procalcitonin on admission, and serum 8-OHdG within 24 h of admission. The multivariate logistic regression analysis was used to screen the independent risk factors of disease progression and death during hospitalization in 124 patients with sepsis, the receiver's operating characteristic (ROC) curves were drawn according to the independent risk factors, and the area under the curve (AUC), the best threshold, and the sensitivity and specificity under the best threshold were calculated. The patients were divided into high 8-OHdG group (n=35) and low 8-OHdG group (n=89) according to the best threshold in ROC curve of death during hospitalization. The data including the gender, age, SOFA score on admission, SOFA score on the second day of admission, and ΔSOFA score of patients in the two groups were compared. The survival rates of patients within 90 d of admission in the two groups were compared by the Kaplan-Meier method. Data were statistically analyzed with independent sample t test, Mann-Whitney U test, chi-square test, and Log-rank test. Results: The gender, age, days in emergency ICU, smoking, complicated with hypertension, complicated with diabetes mellitus, serum white blood cell count, serum C-reactive protein, and serum procalcitonin on admission of patients in non-progression group and progression group were similar (P>0.05). The serum 8-OHdG within 24 h of admission of patients in progression group was significantly higher than that in non-progression group (Z=-2.31, P<0.05). Multivariate logistic regression analysis showed that the serum 8-OHdG within 24 h of admission was the independent risk factor for disease progression of 124 patients with sepsis (odds ratio=1.06, with 95% confidence interval of 1.01-1.11, P<0.05). The AUC under the ROC curve of serum 8-OHdG within 24 h of admission to predict disease progression of 124 patients with sepsis was 0.65 (with 95% confidence interval of 0.52-0.79, P<0.05), the optimal threshold was 32.88 ng/mL, and the sensitivity and specificity under the optimal threshold was 52.2% and 79.2%, respectively. The gender, age, days in emergency ICU, smoking, complicated with hypertension, complicated with diabetes mellitus, and serum white blood cell count, serum C-reactive protein, and serum procalcitonin on admission of patients in survival group and death group were similar (P>0.05). The serum 8-OHdG within 24 h of admission of patients in death group was significantly higher than that in survival group (Z=-2.37, P<0.05). Multivariate logistic regression analysis showed that the serum 8-OHdG within 24 h of admission was the independent risk factor for death of 124 patients with sepsis (odd ratio=1.04, with 95% confidence interval of 1.00-1.09, P<0.05). The AUC under the ROC curve of serum 8-OHdG within 24 h of admission to predict death of patients during hospitalization was 0.63 (with 95% confidence interval of 0.52-0.75, P<0.05), the optimal threshold was 32.43 ng/mL, the sensitivity and specificity under the optimal threshold was 51.3% and 84.7%, respectively. The gender and age of patients in high 8-OHdG group and low 8-OHdG group were similar (P>0.05). The SOFA score on admission, SOFA score on the second day of admission, and ΔSOFA score of patients in high 8-OHdG group were significantly higher than those in low 8-OHdG group (with Z values of -2.49, -3.01, and -2.64, respectively, P<0.05 or P<0.01). The survival rate within 90 d of admission of patients in low 8-OHdG group was significantly higher than that in high 8-OHdG group (χ2=14.57, P<0.01). Conclusions: Serum 8-OHdG level is an independent risk factor for disease progression and death in sepsis patients with limited ability for predicting disease progression and prognosis of sepsis of patients. The patients with higher serum 8-OHdG level have higher death risk within 90 d of admission.

Comparison of imaging features and diagnostic values of MRI, CT and contrast-enhanced ultrasonography in the diagnosis of cervical carcinoma staging.

OBJECTIVE: This study aimed at exploring and contrasting the clinical significances and values of MRI, CT and contrast-enhanced ultrasonography in FIGO staging of cervical carcinoma. PATIENTS AND METHODS: The contrast-enhanced ultrasonography, CT and MRI imaging data of 348 patients with cervical carcinoma confirmed by clinical pathology were analyzed retrospectively and contrasted with pathological findings. RESULTS: The total accuracy of MRI in cervical carcinoma staging was 79.89% (278/348), and the diagnostic accuracy of MRI in stage IB, stage II, stage III and stage IV of cervical carcinoma was 74.29% (26/35), 75.74% (153/202), 85.25% (52/61), 94.00% (47/50), respectively. The total accuracy of CT in cervical carcinoma staging was 73.28% (255/348), and the diagnostic accuracy of CT in stage IB, stage II, stage III and stage IV of cervical carcinoma was 60.00% (21/35), 69.80% (141/202), 78.69% (48/61), 94.00% (45/50), respectively. The total accuracy of contrast-enhanced ultrasonography in cervical carcinoma staging was 57.47% (200/348), and the diagnostic accuracy of contrast-enhanced ultrasonography in stage IB, stage II, stage III and stage IV of cervical carcinoma was 37.14% (13/35), 50.99% (103/202), 70.49% (43/61), 82.00% (41/50), respectively. The accuracy of MRI in the diagnosis of stage IB, stage II of cervical carcinoma was higher than that of CT and contrast-enhanced ultrasonography (p<0.05), and the diagnostic accuracy of CT was higher than that of contrast-enhanced ultrasonography (p<0.05). The differences among the three methods were statistically significant. CONCLUSIONS: According to the results of pathological sections, there were statistically significant differences among the sensitivity and specificity of MRI, CT and contrast-enhanced ultrasonography in the diagnosis of stage IB and stage II (p<0.05). MRI has high diagnostic values in the differentiation and diagnosis of cervical carcinoma staging.

Trypanosoma brucei: four tandemly linked genes for fatty acyl-CoA synthetases.

We have cloned four acyl CoA synthetase (ACS) genes from Trypanosoma brucei strain 927. Each of these genes encodes a polypeptide about 78 kDa in size and all four contain the "ACS signature motif." Sequence alignments indicate that these proteins are 46%-95% identical in amino acid sequence. Interestingly, three of them share almost identical C-termini (about 215 amino acid residues). Southern blots suggest that these genes are present in a single copy, and Northern blots reveal that all four are expressed in both bloodstream and procyclic trypanosomes.