Correlation analysis of serum miR-21 and miR-210 with hs-CRP, TNF-α, IL-6, and ICAM-1 in patients with sepsis after burns.

BACKGROUND: The aim of this study was to explore expression levels and clinical values of miR-21 and miR-210 in patients with sepsis after burns. METHODS: One hundred and twenty-eight burn patients who were treated in Binzhou Medical University Hospital were selected as research objects, among which 69 complicated with sepsis were in an observation group and 59 complicated with infection were in a control group. MiR-21 and miR-210 expression in the patients' serum was detected by RT-PCR. Serum inflammatory cytokines were detected by an enzyme-linked immunosorbent assay (ELISA). Correlation analysis was used for the correlations of the miR-21 and miR-210 with the cytokines. Receiver operating characteristic (ROC) curves were plotted to analyze the diagnostic values of the miR-21 and miR-210 for sepsis after burns and their predictive values for the poor prognosis of sepsis patients. RESULTS: MiR-21 expression reduced remarkably and miR-210 expression rose remarkably in the serum of patients with sepsis after burns. According to the analysis of the ROC curves, both of the miR-21 and miR-210 had relatively high diagnostic sensitivity for the disease, but the diagnostic value of their combined detection was higher. Contents of hs-CRP, TNF-α, IL-6, and ICAM-1 in serum were remarkably higher in the observation group than those in the control group. According to the correlation analysis, miR-21 was negatively correlated with the expression of the four cytokines, while miR-210 was positively correlated with that. The predictive value of miR-21 for the prognosis of sepsis patients was not high, but miR-210 had a certain predictive value, and their combined detection had a higher value. CONCLUSION: In serum of patients with sepsis after burns, miR-21 expression reduces remarkably and miR-210 expression rises. The miR-21 and miR-210 are related to the degree of inflammatory responses in septic patients, and their combined detection has a certain value for diagnosing the disease and predicting its prognosis.

The curative effect of Shenfu-injection in the treatment of burn sepsis and its effect on the patient's immune function, HMGB, and vWF.

OBJECTIVE: To investigate and analyze the immune regulatory effect of Shenfu-Injection (SFI) on patients with burn-injured sepsis by monitoring the serum level of high mobility group box 1 (HMGB1) and von Willebrand factor (vWF). METHODS: In this retrospective study, the Acute Physiology and Chronic Health Evaluation (APACHE II) score, Marshall score, peripheral blood T lymphocyte count, and NK cell concentration, levels of cytokines such as HMGB-1, and vWF in peripheral blood before and after treatment in patients from the control group (convention treatments, n=51) and the observation group (convention treatments plus SFI treatment, n=57) were analyzed. The prognosis of the two groups of patients at 28 days was analyzed and compared. RESULTS: After treatment, APACHE II score, Marshall score, IL-6, CPR, HMGB-1, and vWF in patients from the two groups decreased greatly when compared with those before the treatment (P<0.05). The APACHE II score, Marshall score, IL-6, CPR, HMGB-1, and vWF in the group for observation were significantly lower (P<0.05) than those in the control group. Concentrations of CD3+, CD4+, and NK cells in these two groups after 7 days of treatment were greatly higher than those before the treatment (P<0.05). Concentrations of CD3+, CD4+, and NK cells in the observation group were higher than those in the control group after treatment (P<0.05). There was no significant difference in terms of mortality between these two groups after 28 days (P<0.05). The average survival time of the non-survivors in the observation group was significantly longer than that in the control group (P<0.05). CONCLUSION: SFI can effectively improve the immunity of patients with burn-injured sepsis, reduce the expression of cytokines such as HMGB and vWF, and is of great help for the improvement of clinical prognosis.

Multi-modality relation attention network for breast tumor classification.

Automatic breast image classification plays an important role in breast cancer diagnosis, and multi-modality image fusion may improve classification performance. However, existing fusion methods ignore relevant multi-modality information in favor of improving the discriminative ability of single-modality features. To improve classification performance, this paper proposes a multi-modality relation attention network with consistent regularization for breast tumor classification using diffusion-weighted imaging (DWI) and apparent dispersion coefficient (ADC) images. Within the proposed network, a novel multi-modality relation attention module improves the discriminative ability of single-modality features by exploring the correlation information between two modalities. In addition, a module ensures the classification consistency of ADC and DWI modality, thus improving robustness to noise. Experimental results on our database demonstrate that the proposed method is effective for breast tumor classification, and outperforms existing multi-modality fusion methods. The AUC, accuracy, specificity, and sensitivity are 85.1%, 86.7%, 83.3%, and 88.9% respectively.

Feature enhancement network for CNV typing in optical coherence tomography images.

Objective. Choroidal neovascularization (CNV) is a characteristic feature of wet age-related macular degeneration, which is one of the main causes of blindness in the elderly. Automatic classification of CNV in optical coherence tomography images plays an auxiliary role in the clinical treatment of CNV.Approach. This study proposes a feature enhancement network (FE-net) to discriminate between different CNV types with high inter-class similarity. The FE-net consists of two branches: discriminative FE and diverse FE. In the discriminative FE branch, a novel class-specific feature extraction module is introduced to learn class-specific features, and the discriminative loss is introduced to make the learned features more discriminative. In the diverse FE branch, the attention region selection is used to mine the multi-attention features from feature maps in the same class, and the diverse loss is introduced to guarantee that the attention features are different, which can improve the diversity of the learned features.Main results. Experiments were conducted on our CNV dataset, with significant accuracy of 92.33%, 87.45%, 90.10%, and 91.25% on ACC, AUC, SEN, and SPE, respectively.Significance. These results demonstrate that the proposed method can effectively learn the discriminative and diverse features to discriminate subtle differences between different types of CNV. And accurate classification of CNV plays an auxiliary role in clinical treatmen.

[The effects of hepatitis E virus superinfection on patients with chronic hepatitis B: a clinico-pathological study].

OBJECTIVE: To observe the effect of hepatitis E virus (HEV) superinfection on hepatic lesion and hepatitis B virus (HBV) replication in patients with chronic hepatitis B (CHB). METHODS: Totally 122 patients with CHB were enrolled in this study. They were tested for anti-HEV IgM and IgG in serum, amount of HBV DNA in serum and liver tissue obtained by liver biopsy and HBcAg expression in liver tissue. Other parameters such as ALT, total bilirubin (TBil), albumin (A) and globulin (G), gamma-electrophoretic protein (gamma-EP), prothrombin activity (PTA) were also measured. 21 of the 122 patients (17.2%) were found to have HEV superinfection and the remaining 101 were not. Repeat liver biopsy was performed after 1 year in 7 patients with HEV superinfection and 14 patients without. Moreover, HBV DNA amount in serum from 8 HBeAg negative patients with HEV superinfection were tested dynamically in acute and recovery stage of HEV infection. RESULTS: Comparison of the data from the 21 patients with HEV superinfection and 101 without showed that there was no significant difference in the level of A/G ratio (1.74 +/- 0.50 vs. 1.83 +/- 0.37) and gamma-EP [(24.18 +/- 6.36)% vs. (22.27 +/- 4.59)%, P > 0.05]. However, the level of ALT [(244.61 +/- 81.07) U/L vs. (143.87 +/- 47.69) U/L] and TBil [(88.24 +/- 28.54) micro mol/L vs. (46.16 +/- 17.13) micro mol/L] was significantly higher (P < 0.05), but that of PTA lower in the group with HEV superinfection than in the group without superinfection [(58.57 +/- 17.44)% vs. (72.52 +/- 12.25)%, P < 0.05]. So were the amount of HBV DNA in serum [(5.45 +/- 1.86) copies/ml vs. (6.59 +/- 1.28) copies/ml, P < 0.05] and liver tissue [(6.96 +/- 2.52) copies/g vs. (8.47 +/- 1.79) copies/g, P < 0.05] as well as HBeAg and HBcAg positive rates (8/21 vs. 64/101; 9/21 vs. 67/101, P < 0.05). Pathologically, the hepatic inflammatory activity was more severer in patients with HEV superinfection, but the severity of fibrosis was not significantly different. There was no difference in the severity of inflammatory activity and stage of fibrosis between the 7 patients with HEV superinfection and the 14 patients without as well as before and after 1 year of treatment. The amount of HBV DNA and HBeAg positive rate in serum from recovery stage of HEV infection were higher than those of acute stage. CONCLUSIONS: HEV superinfection leads to activation of hepatic pathological changes and worsens the inflammatory activity. Moreover, HEV superinfection inhibits HBV replication, but it may not be long-lasting.

[Occult hepatitis B virus infection in chronic viral hepatitis patients with non-A to E hepatitis virus infection].

OBJECTIVE: To observe the status of occult hepatitis B virus infection in chronic viral hepatitis patients with non-A to E hepatitis virus infection and explore the diagnostic value of fluorescence quantitative polymerase chain reaction (FQ-PCR) technique for occult hepatitis B virus infection. METHODS: The amount of HBV-DNA in serum and liver tissue from 57 patients with non-A to E hepatitis virus infection who were diagnosed as chronic viral hepatitis by Menghini method liver biopsy were detected by using FQ-PCR technique, then the relation between the viral load of HBV DNA in liver tissue and hepatic inflammatory activity were analyzed. RESULTS: Thirteen (22.81%), 22 (38.60%) patients were positive for HBV DNA in serum and liver tissue, respectively. The positive rate and the level of HBV DNA quantity in liver tissue were significantly higher than those in serum; HBV DNA was found positive in both serum and liver tissue in 13 cases, negative in both serum and liver tissue in 35, positive in liver tissue but negative in serum in 9, and in none of the cases HBV DNA was positive in serum but negative in liver tissue (P < 0.01). The logarithmic value of HBV DNA from 13 patients in liver tissue and in serum was respectively: (6.62 +/- 1.21) copies/g vs.(4.03 +/- 1.06) copies/ml, P < 0.01. The hepatic lesions of all HBV DNA positive patients were active pathologic changes, but the level of HBV DNA in liver tissue was not significantly correlated with the grade of hepatic inflammation activity (P > 0.05). CONCLUSION: Occult HBV infection is the etiology of part of the chronic viral hepatitis patients with non-A-E hepatitis virus infection. Missed diagnosis will occur if diagnosis of hepatitis B is only based on detection of serum HBV markers. It is useful for improvement of the diagnostic level of HBV infection via detection of HBV DNA quantitatively in serum especially in liver tissue of chronic viral hepatitis patients with non-A-E hepatitis virus infection by using FQ-PCR technique. The chronic viral hepatitis patients with occult HBV infection should be also given effective anti-viral therapy.

[Role of hepatitis C virus superinfection in hepatic pathologic changes of patients with chronic hepatitis B: a retrospective short-term and long-term comparative study].

OBJECTIVE: To observe the effect of hepatitis C virus (HCV) superinfection on the short-term and long-term hepatic pathological changes in patients with chronic hepatitis B (CHB). METHODS: HCV-RNA of twice corresponding period serum samples was detected via reverse transcription polymerase chain reaction assay from 230 patients with CHB for whom liver biopsy was performed at an interval of 0.5-15 years, respectively. The hepatic pathological changes of the patients with CHB who were serum HCV-RNA positive at the beginning of observation and persistently positive between the starting and ending of observation were respectively compared with those of serum HCV-RNA negative and persistently negative patients. RESULTS: 41 patients (17.83%) were positive for serum HCV-RNA at the beginning of observation. There were significant differences in the severity of hepatic inflammatory activity grade and fibrosis stage between serum HCV-RNA positive and negative patients with CHB (P < 0.05). Twenty-nine patients were persistently positive for serum HCV-RNA in the beginning and end of observation. Compared with persistently negative patients who were 116 patients selected from the above-mentioned 230 patients and they were comparable with HCV-RNA persistently positive patients in mean follow-up time, age and sex, the long-term progression of hepatic inflammatory activity grade and fibrosis stage in persistently positive patients were more speedy (P < 0.01). CONCLUSION: HCV superinfection worsens the hepatic pathological changes of patients with CHB and speeds up its progression.

[Relationship between amount of HBV DNA in serum/liver tissue and hepatitis G virus (HGV) infection in patients with chronic hepatitis B].

OBJECTIVE: To observe the relationship between the amount of HBV DNA in serum/liver tissue and HGV infection in patients with chronic hepatitis B (CH-B) for exploring the effect of HGV infection on hepatitis B virus (HBV) replication of CH-B. METHODS: HGV RNA in serum, HGV nonstructural region 5 (NS5) antigen (HGV Ag) in liver tissue and the amount of HBV DNA in serum, liver tissue were detected for 56 patients with CH-B by reverse transcription-polymerase chain reaction (RT-PCR) assay, peroxidase antiperoxidase (PAP) immunohistochemical method and fluorescence quantitative PCR assay, respectively. Then the relationship between HGV Ag expression in liver tissue and HGV RNA expression in serum was analysed and the amount of HBV DNA in serum and liver tissues from the serum HGV RNA or liver tissue HGV Ag positive patients were compared with those of the serum HGV-RNA or liver tissue HGV Ag negative patients, respectively. RESULTS: Ten (17.9%) and eight (14.3%) patients were positive for serum and liver tissues,respectively.HGV RNA expression in serum was closely related to HGV Ag expression in liver tissues, but there was HGV RNA in serum from some of the liver tissues HGV Ag negative patients ?cases of HGV RNA and HGV Ag positive or negative,HGV RNA positive but HGV Ag negative, HGV RNA negative but HGV Ag positive, respectively: 5,43,5,3,(P<0.01). There was no significant difference in the amount of HBV DNA in serum and liver tissues between HGV RNA or HGV Ag positive and negative patients (P>0.05). CONCLUSIONS: HGV infection may not affect HBV replication. Liver is the site of HGV replication, but HGV probably also replicates in extrahepatic tissues. HGV hepatic pathogenicity is probably mild and further studies are still needed.