Background: Soluble urokinase-type plasminogen activator receptor (suPAR) has the potential to diagnose infectious diseases. Due to the lack of reliable biomarkers and the importance of timely diagnosis for sepsis treatment, we conducted this systematic review and meta-analysis to evaluate the value of suPAR diagnosis and prognosis for sepsis. Methods: PubMed, Embase, Web of Science, and Cochrane Library databases were searched for studies, which reported the value of suPAR diagnosis and/or prognosis in patients with sepsis. Results: A total of 30 studies involving 6,906 patients were included. Sensitivity and specificity of suPAR for diagnosing sepsis were 0.76 [95% confidence interval (CI), 0.63–0.86] and 0.78 (95% CI, 0.72–0.83), respectively. The area under the summary receiver-operating characteristic curve (AUC) was 0.83 (95% CI, 0.80–0.86). Pooled sensitivity and specificity for predicting mortality were 0.74 (95% CI, 0.67–0.80) and 0.70 (95% CI, 0.63–0.76), respectively, with AUC of 0.78 (95% CI, 0.74–0.82). In addition, AUC for differentiating sepsis from systemic inflammatory response syndrome (SIRS) was 0.81 (95% CI, 0.77–0.84), and the sensitivity and specificity were 0.67 (95% CI, 0.58–0.76) and 0.82 (95% CI, 0.73–0.88), respectively. Conclusion: suPAR is a feasible biomarker for timely diagnosis and prognosis of sepsis. Compared with effective value of procalcitonin (PCT) identified by previous meta-analysis, suPAR has similar clinical guiding value, whereas suPAR exhibits higher specificity, which can facilitate the deficiencies of PCT. suPAR also shows a diagnostic value in differentiating sepsis from SIRS. Considering the lack of biomarkers for sepsis and the similar clinical value of suPAR and PCT, suPAR should be considered as a biomarker in clinical practice for sepsis.

AIMTo detect the mechanisms of Helicobacter pylori (H. pylori) infection in the invasion and metastasis of gastric cancer (GC).METHODSSpecimens from 99 patients with GC were collected. The correlation among H. pylori infection, heparanase (HPA) and mitogen-activated protein kinase (MAPK) expression, which was determined by immunohistochemistry, and the clinical features of GC was analysed using SPSS 22.0. Overall survival (OS) and relapse-free survival (RFS) of GC patients were estimated by the Kaplan-Meier method. Independent and multiple factors of HPA and MAPK with prognosis were determined with COX proportional hazards models. HPA and MAPK expression in MKN-45 cells infected with H. pylori was analysed using Western blot.RESULTSH. pylori infection was observed in 70 of 99 patients with GC (70.7%), which was significantly higher than that in healthy controls. H. pylori infection was related to lymph metastasis and expression of HPA and MAPK (P < 0.05); HPA expression was relevant to MAPK expression (P = 0.024). HPA and MAPK expression in MKN-45 cells was significantly upregulated following H. pylori infection and peaked at 24 h and 60 min, before decreasing (P < 0.05). SB203580, an inhibitor of MAPK, significantly decreased HPA expression. HPA was related to lymph metastasis and invasive depth. HPA positive GC cases and H. pylori positive GC cases showed poorer prognosis than HPA negative cases (P < 0.05). COX models showed that the prognosis of GC was connected with HPA expression, lymph metastasis, tissue differentiation, and invasive depth.CONCLUSIONH. pylori may promote the invasion and metastasis of GC by increasing HPA expression that may associate with MAPK activation, thus causing a poorer prognosis of GC.

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The aim of the present study was to investigate the effect of long non‑coding (lnc)‑G protein subunit α transducin 1 (GNAT1)‑1 in gastric cancer cells infected with Helicobacter (H.) pylori. Reverse transcription‑quantitative polymerase chain reaction was used to assess lnc‑GNAT1‑1 expression in normal gastric and gastric cancer cells infected with H. pylori. The overexpression of lnc‑GNAT1‑1 in SGC‑7901 and MNK45 cells was induced by transfection. Migration and invasion assays were performed in transfected gastric cancer cells to evaluate the effect of lnc‑GNAT1‑1. Histological and western blot analyses were used to determine the alterations in the Wnt/β‑catenin signaling pathway protein expression. Cells transfected with lnc‑GNAT1‑1 were used to initiate gastric cancer tumor xenografts to compare tumor growth in mice inoculated with untransfected cells. The results revealed that H. pylori infection significantly downregulated lnc‑GNAT‑1 expression. Lnc‑GNAT1‑1 overexpression inhibited gastric cancer cell migration and invasion. Wnt/β‑catenin pathway protein expression was decreased by lnc‑GNAT1‑1 overexpression. In addition, lnc‑GNAT1‑1 overexpression reduced tumor growth. Thus, lnc‑GNAT1‑1 is downregulated in gastric cancer infected with H. pylori and lnc‑GNAT1‑1 overexpression inhibited gastric cancer growth through the Wnt/β‑catenin signaling pathway.

ObjectivesThis study was conducted to assess the association between the Dyspnea, Eosinopenia, Consolidation, Acidemia and Atrial Fibrillation (DECAF) scores and the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), to evaluate the specific predictive and prognostic value of DECAF scores and to explore the effectiveness of different cut-off values in risk stratification of patients with AECOPD.DesignSystematic review and meta-analysis.ParticipantsAdult patients diagnosed with AECOPD (over 18 years of age).Primary and secondary outcome measuresElectronic databases, including the Cochrane Library, PubMed, the Embase and the WOS, and the reference lists in related articles were searched for studies published up to September 2019. The identified studies reported the prognostic value of DECAF scores in patients with AECOPD.ResultsSeventeen studies involving 8329 participants were included in the study. Quantitative analysis demonstrated that elevated DECAF scores were associated with high mortality risk (weighted mean difference=1.87; 95% CI 1.19 to 2.56). In the accuracy analysis, DECAF scores showed good prognostic accuracy for both in-hospital and 30-day mortality (area under the receiver operating characteristic curve: 0.83 (0.79–0.86) and 0.79 (0.76–0.83), respectively). When the prognostic value was compared with that of other scoring systems, DECAF scores showed better prognostic accuracy and stable clinical values than the modified DECAF; COPD and Asthma Physiology Score; BUN, Altered mental status, Pulse and age >65; Confusion, Urea, Respiratory Rate, Blood pressure and age >65; or Acute Physiology and Chronic Health Evaluation II scores.ConclusionThe DECAF score is an effective and feasible predictor for short-term mortality. As a specific and easily scored predictor for patients with AECOPD, DECAF score is superior to other prognostic scores. The DECAF score can correctly identify most patients with AECOPD as low risk, and with the increase of cut-off value, the risk stratification of DECAF score in high-risk population increases significantly.