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.
输血相关性急性肺损伤（TRALI）是发生于输血期间或输血后的罕见并发症，以急性缺氧和非心源性肺水肿为特点，因死亡率高（5%~10%）而越来越受到临床关注[1]，据2004年美国食品药品管理局（FDA）的数据，TRALI为输血相关性死亡的首要因素[2]。根据文献资料，输注血制品、含血浆制品、新鲜冰冻血浆（FFP）和血小板的TRALI发生率分别约为1/5 000[3]，1/2 000[4]，1/7 900[5]和1/432[6]。据报道，所有血制品（除白蛋白外）均可引起TRALI[7]，甚至有作者怀疑大剂量给予白细胞介素-2（IL-2）也可能导致TRALI[8]。目前，我国有关TRALI的报道较少，仅有个别死亡案例报道[9，10]，而相关的研究报道很少，这可能与我们尚未认识到TRALI的危险性，以及对其的诊断率较低有关。
Objective To systematically review the efficacy of enteral nutrition with eicosapentaenoic acid ( EPA) , gamma-linolenicacid ( GLA) , and anti-oxidants for patients with sepsis. Methods We searched the PubMed, EMbase, Cochrane Library, Wanfang Database, CNKI and VIP for all randomized controlled trials about the efficacy of an enteral diet enriched with EPA, GLA, and anti-oxidants for patients with sepsis. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration’s RevMan 5.0 software.Results Three RCTs involving 350 patients were included in our systematic review. The results showed a significant reduction in the length of ICU stay ( MD =6.21, 95% CI: 4.61-8.19; P lt;0.00001) and hospital stay ( P lt;0.0001) , a fewer development of neworgan dysfunctions in the patients fed with the study diet and no more adverse events were observed. However, no significant difference in 28-day mortality of all cause was revealed( RR=0.83, 95% CI: 0.60-1.16, P = 0.27) . There were controversial results about the duration of mechanical ventilation.Conclusion A diet enriched with EPA, GLA, and elevated antioxidants is safe and beneficial for the clinical outcome in patients with sepsis.