Objective To study the expressions of Livin, Caspase-3 and Bcl-2 in lung tissue of nonsmall cell lung cancer ( NSCLC) , and their relationship with the clinicopathological features and prognosis of NSCLC. Methods The expressions of Livin, Caspase-3 and Bcl-2 proteins were evaluated by immunohistochemical method in 87 NSCLC samples and 40 lung benign tissues. The relationship of their expressions with the clinicopathological features and prognosis of NSCLC were analyzed by Spearman’s Rank correlation and COX Regression. Results More NSCLC tissues showed expression of Livin than lung benign tissues( 72. 41% vs 0. 0% , P = 0. 000 ) , and the expression of Caspase-3 was significantly decreased ( 67. 82% vs 87. 5%, P lt; 0. 05 ) . The proteins of Livin, Caspase-3 and Bcl-2 were detected in the endochylema but none was detected in nucelus. There was no relationship between the expression of each of these proteins and the clinicopathological features of NSCLC such as histologic type, tumor differentiation,lymph node metastasis, TNM stage, the size of tumor, and tumor site. The expression of Livin was correlated with Caspase-3 and Bcl-2 expressions ( r1 = - 0. 260, P = 0. 015; r2 = 0. 351, P = 0. 001) . Livin, Caspase-3 and Bcl-2 were not independent prognostic factors of NSCLC. Conclusions The expression of Livin and Bcl-2 are up-regulated in NSCLC. The expression of Livin is positively correlated with that of Caspase-3 and Bcl-2, they might interact with each other in the carcinogenesis and development of NSCLC. The levels of Livin, BCl-2 and Caspase-3 proteins are not independent factors affecting the prognosis of lung cancer patients.
Objective To analyze the clinical features and etiologic of community-acquired pneumonia (CAP) among the elderly aged 80 and over, and provide evidence for clinical diagnosis and treatment. Methods The clinical characteristics and etiology of the elderly CAP (≥80 years old) were analyzed by collecting and comparing the clinical characteristics and etiology between the very elderly CAP group (≥80 years old, 94 cases) and control group (65 to 79 years old, 100 cases). Results On clinical symptoms, there were statistical differences in dyspnea and gastrointestinal symptoms, systemic symptoms, and mental status (P<0.05) between the two groups. There was no statistically significant difference in upper respiratory tract symptoms, fever, cough, sputum, hemoptysis and chest pain between the two groups (P>0.05). On the complications, the very elderly CAP group was more prone to respiratory failure, sepsis, urinary tract infection and electrolyte metabolism than the control group (P<0.05). On the experimental indicators, anemia and abnormal renal function in the elderly CAP group were high (P<0.05). There was no statistical difference between the two groups of inflammation indicators (white blood count, procalcitonin, C-reactive protein, erythrocyte sedimentation rate, neutrophil alkaline phosphatase score). The pneumonia severity index score and CURB-65 score of the very elderly CAP group were significantly higher than those of the control group (P<0.001). On pathogen analysis, in the very elderly CAP group the number of bacterial infections (23/94), viral infections (21/94) and bacterial mixed virus infections (21/94) were probably equivalent, and the proportion of bacterial infections of two or more types accounted for 17.0% (16/94); The bacteria detection rate was Streptococcus pneumoniae (22.4%), Pseudomonas aeruginosa (19.4%), Stenotrophomonas maltophilia (16.4%), Staphylococcus aureus (14.9%). Viral infection mainly focused on influenza A virus (23/94) and human cytomegalovirus (21/94). Bacterial mixed virus infection was mainly caused by Streptococcus pneumoniae and influenza A virus infection. Comparing the two groups, the most common bacterial pathogen both of them was Streptococcus pneumoniae, but the overall proportion was dominated by gram-negative bacteria, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Acinetobacter baumannii and Klebsiella pneumoniae were more common; the gram-positive bacteria in the two groups were mainly Streptococcus pneumoniae and Staphylococcus aureus. There was no significant difference in the detection rate of above Gram-positive bacteria between the two groups (P>0.05). The two groups of virus infections were mainly influenza A virus, and the difference was not statistically significant (P>0.05). The two groups of single bacteria rate, single virus infection rate, double virus infection rate and bacterial mixed virus infection rate were similar, the difference had not been found (P>0.05). Conclusions The elderly (aged 80 and over) CAP group is prone to dyspnea, often presents with extrapulmonary atypical symptoms such as digestive tract symptoms, systemic symptoms and psychiatric symptoms, and usually accompanied with many complications. The etiological treatment mainly covers gram-negative bacteria, and we must pay attention to the possibility of combined virus infection.
Objective To detect the levels and study the significance of serum soluble intercellular adhension molecule-1(sVCAM-1),soluble vascular cell adhension molecule-1 (sVCAM-1) in patients with community-acquired pneumonia(CAP).Methods sICAM-1 and sVCAM-1 were detected by enzymelinked immunosorbent assy（ELISA）in 25 patients with CAP before and after treatment as well as in 10 healthy controls.Results Before treatment, the levels of serum sICAM-1 and sVCAM-1 in the patients with CAP[（2.658 4±0.259 7）ng/mL,(2.680 9±0.255 4）ng/mL)] were significantly higher than those in controls[(2.472 8±0.077 6)ng/mL,（2.426 3±0.307 2)ng/mL](Plt;0.01,Plt;0.05). After treatment, the levels of serum sICAM-1, sVCAM-1 significantly decreased [(2.518 3±0.205 2)ng/mL,(2.523 0±0.279 4)ng/mL](Plt;0.01,Plt;0.01) and were not different from those in controls（Pgt;0.05）.The levels of sICAM-1 were positively associated with neutrophil counts（r=0.602，Plt;0.001）rather than the levels of sVCAM-1（r＝0.036，Pgt;0.05）.Conclusion The changes of sICAM-1 and sVCAM-1 before and after treatment are predictive to the prognosis in patients with CAP.
ObjectiveTo investigate and compare the clinical characteristics of chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome (ACOS). MethodsA case-control study was conducted in 139 patients with COPD who admitted between March 2013 and September 2013. The patients were divided into a COPD-only group and an ACOS group. Clinical data were collected and compared between two groups. ResultsOf all 139 patients, 93 patients were diagnosed with COPD only (66.9%) and 46 patients were diagnosed with ACOS (33.1%). Compared with the COPD-only group, the ACOS group had a lower ratio of exposure to cigarette smoking (80.4% vs. 93.5%), but high possibility of a history of asthma (89.1% vs. 4.3%), allergies (60.9% vs. 9.6%) and airway hyperreactivity (80.4% vs. 6.5%) (P < 0.05). In clinical symptoms, the ACOS group had a higher ratio of breathless as the first complaint of symptom (26.1% vs. 8.6%) and dry and moist rales in lung by auscultation (67.4% vs. 31.2%) (P < 0.05). In laboratory examination, the ACOS group had increased levels of peripheral blood eosinophils and IgE than those of the COPD-only group (21.7% vs. 5.4%, 18.3% vs. 4.3%, P < 0.05). In treatment, the ACOS group was more likely to use systemic glucocorticoid (58.7% vs. 24.7%) and be treated with higher dosage of glucocorticoid (80 mg, P < 0.05). ConclusionsACOS and COPD-only are two subtypes of COPD. Compared with COPD-only patients, ACOS patients might be more likely to be breathless and have dry and moist rales in clinical symptoms, more likely to have increased levels of peripheral blood eosinophils and IgE in blood test, and more inclined to receive systemic glucocorticoid treatment.
Objective To establish a model for prognosis analysis of severe community-acquired pneumonia in order to find the independent risk factors for mortality. Methods The data of 88 patients with severe community-acquired pneumonia enrolled from 533 community-acquired pneumonia patients in Fujian Provincial Hospital from April 2012 to December 2015 were analyzed, they were divided into a survival group and a death group according to prognosis. The clinical materials of basic data of the population, clinical manifestation, treatment and prognosis and pulmonary severity indexes were collected. Then univariate analysis was used to screen risk factors of death before logistic multivaritae regression was applied to explore independent risk factors. Results The different pathogen groups including viral, bacterial, mixed infection, negative and other groups were compared and no differences were found in mortality (all P>0.05). Univariate analysis revealed antibiotics treatment before admission, higher APACHEⅡ score, higher Chalison's score, septicopyemia, and higher level of procalcitonin, blood urea nitrogen (BUN), blood glucose, lactate could increase death risk for the patients. While antiviral treatment and no invasive mechanical ventilation were determined as protective factors. Logistic multivaritae regression showed three factors including higher lactate and higher serum BUN and higher heart rates were independent death risk factors [OR values were 4.704 (95%CI 0.966-22.907), 1.264 (95%CI 0.994-1.606), and 1.081 (95%CI 1.003-1.165), respectively]. Whereas no invasive mechanical ventilation was protective factor (OR=0.033, 95%CI 0.001-0.764). Conclusion The patients with higher lactate and BUN, higher heart rate and accepting invasive mechanical ventilation have poor prognosis.