Objective To evaluate the diagnostic value of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) for sepsis. Methods Such databases as The Cochrane Library (Issue 4, 2012), PubMed, EMbase, CBM, CNKI, VIP and WanFang Data were searched to collect the diagnostic tests on sTREM-1 for sepsis published before April 2012. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality. Then, Meta-Disc software (Version 1.5) was used to conduct analyses, draw the summary receiver operating characteristic (SROC) curve, and calculate the area under curve and Q index. Results A total of 11 studies involving 1 615 patients were included. The value of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, area under of SROC curve, and Q index were 69%, 71%, 3.7, 0.34, 14.73, 0.875, and 0.805, respectively. Conclusion This meta-analysis shows that sTREM-1 as a single indicator has moderate accuracy for early diagnosing sepsis. It should be combined with other diagnostic indicators to further improve the sensitivity and accuracy in diagnosing sepsis.
Objective To observe the changes of soluble triggering receptor expressed on myeloid cell-1 ( sTREM-1) and inflammatory mediators levels in plasma of severe pneumonia patients, and explore the significance of systemic inflammatory response state.Methods Plasma levels of sTREM-1, tumor necrosis factor-α ( TNF-α) and interleukin-10 ( IL-10) were examined in 40 patients with severe pneumonia, 25 patients with uncomplicated pneumonia, and 15 healthy volunteers. Plasma levels of TNF-α,IL-10 and sTREM-1 in survival and non-survival severe pneumoniawere observed on days 1,4, 7 and the day of discharge or death.Results Plasma levels of TNF-α, IL-10, and sTREM-1 [ ( 44. 25 ±10. 81) pg/mL,( 58. 21 ±16. 41) pg/mL, ( 51. 75 ±18. 51) pg/mL, respectively] in the patients with severe pneumonia were higher than those with uncomplicated pneumonia [ ( 24.6 ±6. 45) pg/mL, ( 24. 56 ±7. 1) pg/mL,( 25. 55 ±7. 72) pg/mL, respectively] and the normal controls [ ( 13. 82 ±4. 04) pg/mL, ( 15. 30 ±4. 45)pg/mL, ( 14. 37 ±4. 82) pg/mL, respectively] ( P lt;0. 001) . Plasma levels of TNF-α, IL-10, and sTREM-1 were gradually decreased in the survivors, while maintained at high levels or increased in the non-survivors.The levels of these mediators were all significantly higher in the non-survivors than the survivors at all time points. The ratio of TNF-α/ IL-10 level was higher in the severe pneumonia patients than the uncomplicated pneumonia patients and the control subjects ( 1. 286 ±0. 177 vs. 1. 077 ±0. 410 and 0. 932 ±0. 154) on day 1.The ratio of TNF-α/IL-10 level was higher in the non-survivors than the survivors at all time points. There was negative correlation between plasma levels of sTREM-1 and TNF-αon day 1 ( r = - 0. 479, P =0. 002) ,and positive correlation between plasma levels of sTREM-1 and IL-10 on day 1 ( r = 0. 326, P = 0. 040) .Conclusions There are excessive release of inflammatory mediators and unbalanced systemic inflammatory response in patients with severe pneumonia, especially in non-survivors. sTREM-1, TNF-α and IL-10 are involved in the inflammatory response, and their levels may reflect the prognosis.
Objective To investigate the expression and clinical significance of soluble triggering receptor expression on myeloid cells-1（sTREM-1） in sepsis patients.Methods Serum concentrations of sTREM-1，procalcitonin（PCT），tumor necrosis factor alpha（TNF-α） and interleukin-10（IL-10） were measured by enzyme-linked immunosorbent assay，while high sensitivity C-reactive protein （hsCRP） level was detected by immunoturbidimetry in 68 patients with sepsis，40 patients with no-infective SIRS，and 20 normal individuals. The diagnostic and prognostic value of sTREM-1 and its comparison with PCT and hsCRP were analyzed. The sequential organ failure assessment （SOFA） score system was used to evaluate the severity of sepsis. The relationship between sTREM-1, PCT , hsCRP , SOFA score，TNF-α ,and IL-10 of the sepsis patients was analyzed，respectively. Results The differences in the serum concentrations of sTREM-1，PCT，hsCRP，IL-10 and IL-10/TNF-α ratio had statistical significance among three groups（Plt;0.05）. The differences in the serum concentration of TNF-α had no statistical significance among three groups （Pgt;0.05）. However，the serum levels of sTREM-1，PCT and hsCRP in the sepsis group were significantly higher than those in the SIRS group （Plt;0.05）. The receiver operating characteristic curve （ROC） analysis showed the area under the curve （AUC） for sTREM-1，PCT and hsCRP were 0.772 （95%CI 0.674-0.871），0.718 （95%CI 0.601-0.835） and 0.664 （95%CI 0.532-0.797），respectively. The serum levels of sTREM-1 and PCT in the non-survivors were significantly higher than the survivors in the sepsis group （Plt;0.01），but the differences in the serum concentration of hsCRP had no statistical significance between the non-survivors and the survivors in the sepsis group （Pgt;0.05）. There were significantly positive correlations between sTREM-1 and SOFA score，IL-10 or IL-10/TNF-α ratio（r value of 0.453，0.301，0.417，Plt;0.05），but no correlation between sTREM-1 and TNF-α（Pgt;0.05）. There was significantly positive correlation between PCT and SOFA score （r=0.436，Plt;0.05），while no relationship between hsCRP and SOFA score（Pgt;0.05）. Conclusions The serum level of sTREM-1 not only be valuable in the diagnosis of sepsis，but also may be used as a prognostic marker in sepsis，as it can reflect the severity of sepsis in certain degree. Furthermore，sTREM-1 or PCT may be superior to hsCRP in diagnosis，prognostic judgment and severity assessment of sepsis.
Objective To evaluate the diagnostic value of soluble triggering receptor expressed on myeloid cells-1 ( sTREM-1 ) in endotracheal aspirate and plasma of patients with ventilator-associated pneumonia ( VAP) . Methods The consentration of sTREM-1 in plasma and endotracheal aspirate, and serum high-sensitivity C-reactive protein ( hs-CRP) were measured by enzyme-linked immunosorbent assay ( ELISA) in 68 patients with VAP ( VAP group) , 50 patients underwent ventilation without VAP ( non-VAP group) , and 50 healthy individuals ( control group) . The sensitivity and specificity of each parameter were calculated. Results In the patients with VAP, sTREM-1 in plasma and endotracheal aspirate before treatment were significantly higher than that in the non-VAP group [ ( 143.62 ±46.82) pg/mL vs. ( 68.56 ±16.24) pg/mL, ( 352.86 ±92.57) pg/mL vs. ( 126.21 ±42.28) pg/mL, Plt;0.05] ; sTREM-1 in plasma and endotracheal aspirate on the 3rd and the 7th day during treatment were significantly decreased ( Plt;0. 05) . By ROC analysis, the cut-off value of sTREM-1 in endotracheal aspirate were 193.64 pg/mL, with sensitivity and specificity of 93.84% and 89.51% respectively. The areas under ROC curve of sTREM-1 in endotracheal aspirate were 0.912. Clinical diagnostic value of sTREM-1 in endotracheal aspirate was better than plasma sTREM-1 and serum hs-CRP ( areas under ROC curve were 0. 768 and 0. 704 respectively) . Conclusions sTREM-1 may be helpful for evaluating the therapeutic effect in patients with VAP. The diagnostic value of sTREM-1 in endotracheal aspirate may be superior to plasma sTREM-1 and serum hs-CRP.
目的 对16层螺旋CT血管造影（CTA）在诊断主动脉夹层（AD）时应用智能追踪触发CTA扫描和延时扫描两期不同扫描方式所得的影像进行对比分析，探讨主动脉CTA对诊断AD的临床价值和几个技术要点。 方法 2009年3月－2012年5月对28例疑似AD患者均采用扫描范围从胸廓入口到耻骨联合上缘水平CT平扫后，再行扫描范围相同的智能追踪触发CTA扫描和延时扫描两期不同的扫描，对两期不同扫描方式所得的影像结果进行对比。 结果 智能追踪触发CTA扫描进行后处理所得图像质量明显高于延时扫描，两期不同扫描对于内膜瓣、破口位置及真腔的显示差别不明显，延时扫描对某些慢性AD患者的假腔及血栓的显示能力优于智能追踪触发扫描，所以延时扫描对假腔的显示是对智能追踪触发扫描的重要补充。 结论 智能追踪触发扫描和延时扫描可以取长补短，两者结合可为临床提供更多信息。
ObjectiveTo summarize the advance of triggering receptor expressed on myeloid cells-1 (TREM-1). MethodsLiteratures about the recent studies on the TREM-1 were reviewed. ResultsTREM1 was a mediator of inflammation. It could amplify the inflammation and lead to overexpression of inflammation in final. ConclusionTREM-1 is very important in development of many diseases and provide a new molecule target to cure.
Objective To evaluate the accuracy of soluble triggering receptor expressed on myeloid cells-1 ( sTREM-1) as a diagnostic index for ventilator-associated pneumonia ( VAP) . Methods We searched the PubMed, EMBase, Cochrane Library,Wanfang Database, CNKI and VIP for clinical trials which assessed the diagnosis accuracy of sTREM-1 for VAP. The methodological quality of each study was assessed by the quality assessment for studies of diagnostic accuracy ( QUADAS) tool. The Meta-disc software was used to conduct merger analyses on sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio. The heterogeneity test was performed and summary receiver operating characteristic ( SROC) curve was completed. Results 8 studies were included ( 180 VAP patients and 224 non-VAP patients) . The value of merger sensitivity, specificity, and diagnostic odds ratio were 0. 80, 0. 74, and 13. 89, respectively. The area under of SROC curve was 0. 857, with Q point at 0. 788. Conclusion sTREM-1 showed moderate accuracy for VAP diagnosis in adult mechanically ventilated patients, which should be combined with other diagnostic markers to further improve the sensitivity and specificity.
Objective To investigate the transduction pathway of TREM-1 during endotoxininduced acute lung injury ( ALI) in mice through the specific activating or blocking TREM-1.Methods 40 mice were randomly divided into a saline control group, an ALI group, an antibody group, and a LP17 group ( 3.5 mg/kg) . All mice except the control group were intraperitoneally injected with lipopolysaccharide ( LPS) to establish mouse model of ALI. Two hours after LPS injection, anti-TREM-1mAb ( 250 μg/kg) was intraperitoneally injected in the antibody group to activation TREM-1, and synthetic peptide LP17 was injected via tail vein in the LP17 group to blocking TREM-1. After 6,12,24, 48 hours, 3 mice in each group were sacrificed for sampling. The expression of NF-κB in lung tissue was determined by immunohistochemistry. The levels of TNF-α, IL-10, TREM-1, and soluble TREM-1 ( sTREM-1) in lung tissue and serumwere measured by ELISA. Pathology changes of lung were observed under light microscope, and Smith’s score of pathology was compared. Results Administration of anti-TREM-1mAb after ALI modeling significantly increased the NF-κB expression in lung tissue at 48h, resulting in a large number of pro-inflammatory cytokines releasing in the lung tissue and serumand lung pathology Smith score increasing. Administration of LP17 after modeling significantly down-regulated the expressions of NF-κB and pro-inflammatory cytokines, while led to a slight increase of anti-inflammatory cytokines and a decline of lung pathology Smith’s score.Conclusion TREM-1 may involve in inflammatory response by promoting the generation of inflammatory factors via NF-κB pathway, thus lead to lung pathological changes in ALI.
The phase-locking relationship between the firings of neuronal action potentials (i.e., spikes) and the oscillations of local field potentials (LFP) reflects important neural coding information. However, the present analysis methods can only determine whether there has phase-locking, but not the different strengths among various types of phase-locking. In the present paper, we used spike-triggered average (STA) signals and the percentage ratio (named φ) of the STA power to the power of original LFP as an index to evaluate the strengths of phase-locking. Experimental recordings obtained from rat hippocampal CA1 region as well as simulation data were used to evaluate the method. The results showed that the index φ changed monotonically as a function of the strength of phase-locking, and it could provide an effective critical value to divide phase-locking from non-phase-locking. Because the calculation of the index does not need pre-filtering, it can avoid the unwanted influences caused by intentionally limiting the frequencies of LFP oscillations such as in the traditional bin statistical method. Therefore, the index φ provides a novel method to investigate the mechanisms underlying neuronal coding in brain.