Objective To investigate the effects of simvastatin on pulmonary function and vascular endothelial growth factor ( VEGF) levels in induced sputumof patients with COPD exacerbation( AECOPD) .Methods Thirty-eight patients with AECOPD were divided into two groups randomly, ie. a routine medical treatment( RT) group( n =30) and a routine + statin medical treatment( RST) group( n =28) . The VEGF levels in serumand induced sputum were detected by ELISA on the first day and after a week treatment in hospital, respectively. Meanwhile, the pulmonary function measurements were performed. Results There were no significant differences in the pulmonary function ( FEV1% pred and FEV1 /FVC) and VEGF levels in induced sputumbetween the two groups before treatment( P gt;0. 05) . The RT group showed no significantchanges in any parameters before and after a week treatment( P gt; 0. 05) . FEV1% pread, FEV1 /FVC and VEGF levels in induced sputum in the RST group after a week treatment significantly increased compared with those before treatment and the RT group( P lt;0. 01, P lt;0. 01, P lt;0. 05) . But There were no significant differences in serumVEGF levels between the two groups before and after a week treatment. The VEGF levels in induced sputum were positively correlated to FEV1% pread and FEV1 /FVC after a week treatment( r =0. 430, P lt;0. 05; r = 0. 388, P lt; 0. 05) . Conclusions Simvastatin may reduce the decline in pulmonary function and decrease the levels of VEGF in induced sputum of patients with AECOPD. Improvement in pulmonary function may be related to down-expression of lung VEGF
Objective To investigate the effects of smoking on β-defensin-2 ( BD-2) expression in induced sputumand lung tissue, and its role in chronic obstructive pulmonary disease ( COPD) . Methods Patients suffering with early peripheral squamous celled lung cancer and underwent lobectomy were divided into a smoking COPD group ( COPD group) , a non-COPD smoking group ( smoker group) , and a nonsmoking group ( control group) . Preoperative induced sputumsamples were collected after hypertonic saline induction. Lung tissue samples were intraoperatively collected far from the tumor site. The sputum samples were prepared for total and differential cell count, while the lung tissue samples for pathology examination. The BD-2 concentration in sputumand lung homogenate were measured by ELISA. Correlation were analyzed between BD-2 concentration and smoking index, airway inflammation, and lung function. Results The lung pathology were highly consistent with the experimental grouping. The total cell count and neutrophils proportion in sputum and BD-2 concentration in lung homogenate were ( 2. 32 ±0. 51) ×106 / g, ( 35. 7 ±9. 8) % , and ( 14. 5 ±5. 7) ng/L in the control group respectively, while increased in the smoker group [ ( 4. 57 ±0. 87) ×106 / g, ( 52. 5 ±10. 9) % , and ( 78. 3 ±13. 1) ng/L, P lt;0. 05] , and further increased in the COPD group [ ( 6. 61 ±1. 03) ×106 / g, ( 65. 5 ±12. 3) % , and ( 127. 0 ±35. 0) ng/L, P lt; 0. 05] . The lymphocytes proportion and BD-2 concentration in sputum increased in the COPD group [ ( 3. 2 ±1. 7) % and ( 298. 0 ±135. 0) ng/L] as well as in the smoker group [ ( 2. 5 ±1. 2) % and ( 315. 0 ±124. 0) ng/L] ,as compared with the control group [ ( 1. 1 ±0. 3) % and ( 132. 0 ±48. 0) ng/L] ( P lt; 0. 05) . Linear correlation analysis revealed that BD-2 concentration in sputumwas positively correlated with smoking index,sputum total cell count and neutrophils proportion, whereas BD-2 concentration in lung homogenate wasreversely correlated with pulmonary ventilation function ( P lt; 0. 05) . Conclusions Smoking up-regulates the BD-2 level in sputum and lung tissues. Further more, the BD-2 expression status in lung tissue of smoking individuals might be associated with COPD susceptibility.
Lung cancer is the leading cause of death among the tumors in the whole world. Although new diagnostic techniques have been developed for nearly 20 years, the mortality is still high. Until now, no randomized controlled trial of chest x-ray and sputum cytology showed the improvement of the survival rate of lung cancer. Low-dose CT can screen more patients in early stage, however, overdiagnosis, cost and the quality of studies should be considered. Further studies of RCTs should be done to clarify these questions.
ObjectiveTo understand the clinical distribution and drug resistance of Klebsiella pneumoniae in Yibin during 2011 to 2014 so as to provide evidence for clinical rational use of antimicrobial drugs. MethodsKlebsiella pneumoniae isolated from all types of clinical specimens were collected from the First People's Hospital and the Second People's Hospital of Yibin during 2011 to 2014. VITEK2 Compact and its supporting identification card GP and drug sensitivity test card AST-GP67 were used for detection, and the results were analyzed and summarized. ResultsMost Klebsiella pneumoniae were detected from the Department of Respiratory Medicine, the proportion for each year was 48.15%, 46.24%, 45.44%, and 44.97% during 2011 to 2014. Klebsiella pneumoniae isolated were mainly from sputum samples, the proportion for each year was 81.01%, 89.18%, 87.80%, and 83.52% between 2011 and 2014. Imipenem and piperacillin/tazobactam resistance rates were lower, but the overall trend was rising. Ampicillin/sulbactam, and sulfamethoxazole resistance rates were higher. Levofloxacin, ciprofloxacin increased year by year. Aztreonam, cefepime, and amikacin rate declined. ConclusionKlebsiella pneumoniae is one of the main infection pathogen in the Department of Respiratory Medicine. Klebsiella pneumoniae resistance rates are higher. Klebsiella pneumoniae were sensitive to enzyme inhibitors β-lactam antimicrobial agents and carbapenem antibiotics.