Diagnostic value of neutrophil gelatinase-associated lipocalin, cystatin C, and soluble triggering receptor expressed on myeloid cells-1 in critically ill patients with sepsis-associated acute kidney injury.

INTRODUCTION: Neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (Cys-C), and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) are novel diagnostic biomarkers of acute kidney injury (AKI). We aimed to determine the diagnostic properties of these biomarkers for detecting AKI in critically ill patients with sepsis. METHODS: We divided 112 patients with sepsis into non-AKI sepsis (n = 57) and AKI sepsis (n = 55) groups. Plasma and urine specimens were collected on admission and every 24 hours until 72 hours and tested for NGAL, Cys-C, and TREM-1 concentrations. Their levels were compared on admission, at diagnosis, and 24 hours before diagnosis. RESULTS: Both plasma and urine NGAL, Cys-C, and sTREM-1 were significantly associated with AKI development in patients with sepsis, even after adjustment for confounders by using generalized estimating equations. Compared with the non-AKI sepsis group, the sepsis AKI group exhibited markedly higher levels of these biomarkers at diagnosis and 24 hours before AKI diagnosis (P < 0.01). The diagnostic and predictive values of plasma and urine NGAL were good, and those of plasma and urine Cys-C and sTREM-1 were fair. CONCLUSION: Plasma and urine NGAL, Cys-C, and sTREM-1 can be used as diagnostic and predictive biomarkers for AKI in critically ill patients with sepsis.

RNA-Seq profiling of circular RNAs in human colorectal cancer 5-fluorouracil resistance and potential biomarkers.

BACKGROUND: Colorectal cancer (CRC) is a commonly diagnosed cancer of the digestive system worldwide. Although chemotherapeutic agents and targeted therapeutic drugs are currently available for CRC treatment, drug resistance is a problem that cannot be ignored and needs to be solved. AIM: To explore the relationship between circular RNA (circRNA) and CRC drug resistance. circRNA plays a key role in the occurrence and development of cancers, but its function in the process of drug resistance has not been widely revealed. METHODS: To explore the role of circRNA in 5-fluorouracil (5-Fu) resistance, we performed the circRNA expression profile in two CRC cell lines and their homologous 5-Fu resistant cells by high-throughput sequencing. RESULTS: We validated the differentially expressed circRNAs in other two paired CRC cells, confirmed that circ_0002813 and circ_0000236 could have a potential competitive endogenous RNA mechanism and be involved in the formation of 5-Fu resistance. And we combined the sequencing results of mRNA to construct the regulatory network of circRNA-miRNA-mRNA. CONCLUSION: Our study revealed that circ_0002813 and circ_0000236 may as the biomarkers to predict the occurrence of 5-Fu resistance in CRC.

[Analysis of risk factors in prognosis in patients requiring long-term mechanical ventilation].

OBJECTIVE: To analyze risk factors in patients receiving mechanical ventilation in intensive care unit (ICU). METHODS: The study group consisted of 42 patients receiving mechanical ventilation for longer than 7 days. The general condition, primary diseases, the vital signs before ventilation, accessory examination, acute physiology and chronic health evaluation II (APACHE II) score, and the time of tracheostomy were collected. The patients were divided into two groups of deceased or survived when the mechanical ventilation was weaned. Comparative analysis of all the data was made with Logistic multiple regression. RESULTS: Of the patients enrolled in the study, 22 (52.4%) survived and 20 (47.6%) died in the ICU. Difference in clinical data between death group and survival group was significant (P<0.05). In death group, the APACHE II score, the pressure adjusted heart rate (PAR), the level of blood urea nitrogen (BUN) were higher (all P<0.01), while the level of plasma albumin (ALB), the level of hematocrit (HCT) value, the amount of platelets (PLT) were lower (P<0.05 or P<0.01), and the time of tracheostomy was later compared with those of survival group (P<0.05). There were no significant differences in the time of mechanical ventilation, white blood cells (WBC) and incidence of ventilator-associated pneumonia (VAP) between two groups (all P>0.05). With Logistic multiple regression analysis, the time of tracheostomy, the levels of HCT value, the amount of PLT were correlated with requirement of long-term mechanical ventilation (LTMV) (P<0.05 or P<0.01). CONCLUSION: The time of tracheostomy, the levels of HCT value, the amount of PLT were independent risk factors associated with patients requiring LTMV.

The impact of tracheotomy on levels of procalcitonin in patients without sepsis: a prospective study.

OBJECTIVE: Procalcitonin is a reliable biomarker of infection and sepsis. We aimed to determine whether tracheotomy influences the procalcitonin concentrations in patients without sepsis and assess whether operative duration and procedure affect the peak procalcitonin level. METHODS: A total of 38 non-septic patients who required a tracheotomy underwent either a percutaneous dilatational tracheotomy (n=19) or a surgical tracheotomy (n=19). Procalcitonin levels were measured at the beginning of the tracheotomy and at 2 h, 4 h, 8 h, 24 h, 48 h and 72 h after the procedure. RESULTS: The baseline procalcitonin concentration before the tracheotomy was 0.24 ± 0.13 ng/mL. The postoperative levels increased rapidly, with a 4-fold elevation after 2 h, reaching a peak 4 h later with a 5-fold increase over baseline. Thereafter, the levels gradually returned to 2-fold greater than the baseline level within 72 h. The peak levels of procalcitonin showed a significant positive correlation with operative durations (r=0.710, p<0.001) and procedures (rho=0.670, p<0.001). CONCLUSION: In patients without sepsis, tracheotomy induces a rapid release of serum procalcitonin, and the operative duration and procedure have significant impacts on the peak procalcitonin levels. Thus, the nonspecific increase in procalcitonin levels following tracheotomy needs to be considered when this measure is used to evaluate infection.