严重多发伤早期感染患者血清降钙素原与C-反应蛋白水平检测意义研究

目的：探讨严重多发伤早期感染患者血清降钙素原(PCT)与C-反应蛋白(CRP)水平的检测意义。方法回顾性分析2013年6月至2015年6月于我院救治的64例严重多发伤患者的临床资料,依据患者是否出现感染分为观察组(有感染,32例)和对照组(未感染,32例)。检测两组患者入院后不同时间点的血清PCT及CRP水平,通过比较血清PCT及CRP水平变化及患者PCT与CRP阳性率来评估其对检测严重多发伤患者是否出现感染的临床价值。结果入院5d、7d后观察组CRP水平(157.82±42.38)mg/L、(167.82±40.23)mg/L均较对照组(108.64±32.11)mg/L、(112.30±28.93)mg/L显著较高(P＜0.05)。随着入院时间的推移,两组患者血清PCT水平均呈上升的趋势,观察组入院5d、7d后PCT水平为(29.73±17.64)ng/mL、(36.58±12.64)ng/mL较对照组(1.55±0.27)ng/mL、(1.63±0.37)ng/mL显著较高,组间差异有统计学意义(P＜0.05)。观察组患者入院1周PCT及CRP阳性率为93.75%、90.63%均较对照组12.50%、18.75%显著较高(P＜0.05)。结论严重多发伤早期感染患者会出现血清降钙素原与C-反应蛋白水平的异常增高;因而,测定血清降钙素原与C-反应蛋白水平对临床上判断严重多发伤患者是否并发早期感染具有一定的检测价值。     

High throughput ranking of recombinant avian scFv antibody fragments from crude lysates using the Biacore A100

Advances in molecular evolution strategies have made it possible to identify antibodies with exquisite specificities and also to fine-tune their biophysical properties for practically any specified application. Depending on the desired function, antibody/antigen interactions can be long-lived or short-lived and, therefore, particular attention is needed when seeking to identify antibodies with specific reaction-rate and affinity properties. Surface plasmon resonance (SPR) biosensors routinely generate sensitive and reliable kinetic data from antibody/antigen interactions for both therapeutic and diagnostic applications. However, many kinetic-based screening assays require rigorous sample preparation and purification prior to analysis. To ameliorate this problem, we developed a rapid and reliable assay for characterising recombinant scFv antibody fragments, directly from crude bacterial lysates. Ninety-six scFv antibodies derived from chickens immunised with C-reactive protein (CRP) were selected by phage display and evaluated using the Biacore A100 protein interaction array system. Antibodies were captured from crude bacterial extracts on the sensor chip surface and ranked based on the percentage of the complex left (% left) after dissociation in buffer. Kinetic rate constants (k(a) and k(d)) and affinity (K(D)) data were obtained for six clones that bound monomeric CRP across a broad affinity range (2.54 x 10(-8) to 3.53 x 10(-10) M). Using this assay format the A100 biosensor yielded high quality kinetic data, permitting the screening of nearly 400 antibody clones per day.     

Effect of calorie restriction diet on levels of C reactive protein (CRP) in obesity: A systematic review and meta-analysis of randomized controlled trials

Background and aimsChronic inflammation in obese patients can be managed through a calorie-restricted diet, characterized by reduced C - reactive protein (CRP). This study aims to assess the role of such diet on CRP.MethodsLiterature searches were performed using search engines. Randomized controlled trials were included. Calorie-restricted diets in combination with non-diet interventions were excluded.ResultsCalorie restriction decreased CRP in obese patients with a mean difference of ?0.22 (95% CI -0.40 to ?0.04, p 0.006).ConclusionsCalorie-restricted diet reduces CRP. Diet administration >12 weeks had a beneficial effect.     

Single-centre retrospective observational study comparing trough blood concentration and safety of teicoplanin formulations

Teicoplanin formulations are marketed as antibiotic mixtures with several compounds that share the same core structure. Recent studies conducted in vitro have reported differences in the composition ratio of different teicoplanin products. In this retrospective study, we examined the trough blood concentration of the originator brand and a generic teicoplanin product. Target patients were retrospectively assigned to the originator (Targocid) or generic group. The groups were matched 1:1 using propensity scores. The initial trough blood concentration analysis identified 44 matches. In both groups, the median dosing day for the first measurements was 4, respectively. The initial trough blood concentration of the originator group was significantly higher (mean ± SD, 16.3 ± 4.5 mg/L) than that of the generic group (12.8 ± 4.7 mg/L; 95% CI, ?5.4 to ?1.6). A significant difference was observed in the frequency of serum creatinine elevation in the study of the frequency of adverse events using Common Terminology Criteria for Adverse Events (originator group, 41.9% vs generic group, 20.9%). In cases where discontinuation was necessary due to side effects, there were three patients in the originator group and one patient in the generic group. This study found that trough blood concentration differed between formulations. Therefore, correction might be necessary while monitoring drug concentration in the blood. Trough blood concentrations are used as surrogate markers for efficacy and safety, so further studies on differences in efficacy and safety between formulations are required.     

Usefulness of underwater endoscopic submucosal dissection in saline solution with a monopolar knife for colorectal tumors (with videos)

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Plasma antigen levels of thrombin-activatable fibrinolysis inhibitor did not differ in patients with or without disseminated intravascular coagulation

Thrombin-activatable fibrinolysis inhibitor (TAFI) is a carboxypeptidase that downregulates fibrinolysis and might play some roles in the pathogenesis of disseminated intravascular coagulation (DIC). We prospectively examined the plasma TAFI antigen levels in patients highly suspected to be suffering from DIC. Patients were subdivided into overt DIC and non-DIC groups according to a DIC scoring system. The Sepsis-related Organ Failure Assessment (SOFA) scores were concurrently calculated on patients with sepsis. Overall, there were 23 non-DIC patients and 20 patients with overt DIC. Their baseline characteristics were similar, but patients with overt DIC had much more aberrant coagulation tests and higher lactate dehydrogenase levels. However, there was no significant difference between overt DIC and non-DIC patients regarding their TAFI antigen levels [median/interquartile range (IQR) 74.41/13.98 and 75.29/15.16, respectively, p=0.543]. On regression analysis, TAFI antigen levels were not correlated with either C-reactive protein levels or various coagulation test results. In patients with sepsis (n=31), TAFI levels among three risk groups stratified by low (5), intermediate (6–10), and high (11) SOFA scores were not statistically disparate (median/IQR 65.24/15.14, 74.63/13.79, and 75.29/21.51, respectively, p=0.684), either. Our result indicated that plasma TAFI antigen levels did not vary significantly between patients with or without DIC. Further, they did not possess any correlation with the severity of organ injury in patients with sepsis. The role of TAFI antigen in the pathogenesis of DIC needs further elucidation by future studies.