Objective To investigate the clinical efficacy of nutritional support with different proportion of fat on the prognosis of patients with severe community-acquired pneumonia (SCAP). Methods Ninety SCAP patients with nutritional risk treated between January 2014 and July 2015 were randomized into high, normal, and low-proportion fat groups with 30 patients in each. The patients in different groups underwent nutritional support with different fat proportion besides the same medication. Data of albumin, pre-albumin and transferrin were collected and analyzed before treatment and 10 days after treatment. The mortality rates were compared between groups. Results Albumin, pre-albumin and transferrin were similar in all groups before intervention (P>0.05); albumin, pre-albumin and transferrin increased significantly 10 days after treatment in each group (P<0.05). Patients in the normal-fat group acquired significantly more obvious improvements on each index (P<0.05). A shorter length of stay in hospital was observed in the normal-proportion fat group compared with the high and low-proportion fat groups, but there was no significant differences among groups (P>0.05). On the 10th day, the normal -proportion fat proportion group had a significantly higher cure rate and a significantly lower mortality rate than the other two groups (P<0.05). The improvement rate was similar in all groups (P>0.05). Conclusion Supportive treatment with normal fat proportion has a promising value in the improvement of albumin, pre-albumin and transferrin for SCAP patients with a shorter length of stay in hospital, which is worthy of clinical promotion.
Objective To systematically evaluate the association between Caveolin-1 and gastric cancer, as well as its clinical pathologic features. Methods Databases including Wanfang, VIP, CNKI and PubMed were searched to identify case-control studies involving the association between Caveolin-1 and gastric cancer as well as its clinical pathologic features from January 2000 to May 2017. The literatures were screened and the methodological quality was assessed, then RevMan 5.3 software was used to conduct Meta-analysis. Results A total of 12 case-control studies were collected after screening, including 1 380 cases of gastric cancer, with Caveolin-1 expressed positive in 286 cases; 295 cases of non-carcinoma control, with Caveolin-1 expressed positive in 264 cases; 238 cases of precancerous lesions of gastric cancer, with Caveolin-1 expressed positive in 180 cases. Results of Meta-analysis indicated that: as for Caveolin-1 expression, significant differences were found in non-carcinoma vs. gastric cancer [odds ratio (OR)=23.74, 95% confidence interval (CI) (15.19, 37.11), P<0.000 01], precancerous lesions of gastric cancer vs. gastric cancer [OR=6.58, 95%CI (4.52, 9.58), P<0.000 01], and non-carcinoma control vs. precancerous lesions of gastric cancer [OR=2.88, 95%CI (1.58, 5.25), P=0.000 6]. Significant differences were also found between Caveolin-1 expression and gastric cancer clinical pathologic features in undifferentiated vs. differentiated tissue [OR=0.48, 95%CI (0.33, 0.70), P=0.000 1], and without vs. with lymph node metastasis [OR=3.19, 95%CI (1.77, 5.74), P=0.000 1]. Conclusions Caveolin-1 expression is lesser in most gastric cancer patients than in the controls, and is closely associated with its clinical pathologic features. Due to limited quantity and quality of included studies, more high quality studies are needed to verify the conclusion of Caveolin-1 as a tumor marker in gastric cancer.
Objective To observe the expression of S100A8 and S100A9 in alveolar macrophages (AMs) of chronic obstructive pulmonary disease (COPD) rats, and explore the effect on the release of inflammatory mediators from AMs in COPD rats. Methods Twelve adult male Wistar rats were randomly divided into a normal control group and a COPD group. The COPD model was established by exposing the rats to cigarette smoke and intratracheal injection of endotoxin for 1 month. The pathological changes of lung tissue of rats were observed under light microscope. Total cells counts and the number of AMs, lymphocytes, neutrophils in bronchoalveolar lavage fluid (BALF) of two groups were examined by Wright's staining methods. Rat AMs from the control group and the COPD group were isolated and cultured, and then treated with different doses of S100A8 and S100A9 for 6 hours and 12 hours. The levels of interleukin (IL)-8, IL-6 and tumour necrosis factor-α (TNF-α) in the AMs supernatants were measured by enzyme linked immunosorbent assay. The expression of S100A8 and S100A9 mRNA in AMs of rats were observed by in situ hybridization. The immunohistochemical method was used to observed the expression of S100A8/A9 protein of AMs. Results After cigarette smoking combined with intratracheal injection of endotoxin for 1 month, the lung tissue of rats showed typical pathological changes of COPD. Total cell counts and the number of AMs, lymphocytes, neutrophils in BALF of the COPD rats were significantly higher than those of the normal rats (P<0.05). Among them, the increase in the number of AMs was the most obvious. Compared with the control group, the expression of S100A8 mRNA, S100A9 mRNA and S100A8/A9 protein in AMs of the COPD group were up-regulated significantly (P<0.05). After the AMs of COPD rats were treated with S100A8 and S100A9, the contents of IL-8, IL-6 and TNF-α in AMs supernatants increased significantly in a time- and dose-dependent manner. When the AMs were treated with the same dose of S100A8 and S100A9 for the same time, the levels of IL-8, IL-6 and TNF-α in the AMs supernatant of the COPD group were higher than those of the normal control group. Conclusions The expression of S100A8 and S100A9 in cultured COPD rat AMs is significantly increased. S100A8 and S100A9 can promote the secretion and release of inflammatory factors IL-6, IL-8 and TNF-α from AMs of COPD rats in a time and dose-dependent manner. The effects of S100A8 and S100A9 on the secretion of IL-6, IL-8 and TNF-α in AM of COPD rats are significantly enhanced compared with those of normal rats.
Objective To investigate the incidence and management of CTEPH in the Department of Pulmonary and Critical Care Medicine in Xijing Hospital to enrich the epidemiological data of chronic thromboembolic pulmonary hypertension (CTEPH) in China.Methods We conducted a retrospective study to investigate the incidence and management of CTEPH in the Department of Pulmonary and Critical Care Medicine in Xijing Hospital from 2008 to 2012. Results The incidence of CTEPH was 5.24% . About 62.90% of venous thromboembolism/pulmonary embolism (VTE/PE) patients were unprovoked, and about 53.85% of CTEPH patients was unprovoked. About 38% of CTEPH patients had no history of VTE, and 62% of CTEPH patients had no history of acute pulmonary embolism. None of the CTEPH patients was treated by pulmonary thromboendarterctom (PTE) , and about 53.85% of patients were only given anticoagulant monotherapy. Conclusions The incidence of CTEPH is higher in our hospital than reported. This phenomenon may be related to the lack of awareness of risk factors of CTEPH and the insufficient thrombolytic and anticoagulant therapy to acute pulmonary embolism. It’s very urgent to standardize the diagnosis and management of CTEPH in pulmonologists.