ObjectiveTo systematically evaluate the efficacy and safety of procalcitonin guided algorithms of antibiotic therapy in acute exacerbation chronic obstructive pulmonary disease (AECOPD). MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 6, 2016), CBM, CNKI, VIP, and WanFang Data from the date of their establishment to July 2016, to collect randomized controlled trials (RCTs) about procalcitonin guided antibiotics therapy in patients with AECOPD. References of the included literature were also searched manually for additional studies. The literature screening, data extraction and bias risk assessment of the included studies were completed by two reviewers independently. Statistical analysis was conducted using RevMan 5.2 software. ResultsA total of ten RCTs involving 1 071 patients were included. The results of meta-analysis indicated that compared with the standard treatment group, the antibiotic prescription rate (RR=0.70, 95% CI 0.55 to 0.89, P=0.004), the rate of duration of antibiotic >10 days (RR=0.38, 95% CI 0.26 to 0.56, P<0.000 01) and the superinfection rate (RR=0.23, 95% CI 0.09 to 0.58, P=0.002) were significantly lower in the procalcitonin-guided treatment group. There were no statistical differences in clinical effective rate (RR=0.98, 95% CI 0.91 to 1.06, P=0.61), hospital mortality (RR=0.84, 95% CI 0.52 to 1.73, P=0.43), and the rate of need for intensive care (RR=0.77, 95% CI 0.40 to 1.47, P=0.43). ConclusionProcalcitonin guided antibiotics therapy may reduce antibiotic exposure and superinfection rate in patients with AECOPD. In addition, due to the low methodological quality and limited quantity of the included studies, larger sample-size, and high quality RCTs are needed to verify the above conclusion.
ObjectiveTo explore the correlation of clinicopathologic factors with the expression of estrogen receptor (ER) and progesterone receptor (PR) in patients with primary breast cancer. MethodsThe data of 105 patients with primary breast cancer were collected from September 2011 to September 2012. The expression of ER, PR and C-erbB-2 in breast cancer tissues was detected by immunohistochemistry. The correlation between the expression of ER, PR and C-erbB-2 and the clinicopathologic factors was evaluated. ResultsThe positive rates of expression of ER, PR and C-erbB-2 in breast cancer tissues reached 58.1%, 49.5% and 59.0%, respectively. The expression of ER had a positive correlation with the expression of PR. The concordance expression of ER and PR had a negative correlation with the expression of C-erbB-2. The positive rate of expression of ER had a correlation with the lymph node metastasis and histological grading, while it was not correlated with patients' age, the age of menarche, tumor size, tumor position, clinical stages, pathological type, or pathologic morphology of tissue adjacent to cancer (P>0.05). The positive rate of expression of PR and the different positive strength rate of expression of ER were not correlated with clinical and pathological factors (P>0.05). The positive rate of expression of C-erbB-2 in the group with lymph node metastasis was higher than that in non-lymph node metastasis group (P<0.05). ConclusionThe expression of ER and PR plays an important role in the occurrence and development of the breast cancer. Joint detection of ER and PR is very important for the evaluation of endocrine therapy effect and prognosis.