ABSTRACT
Objective@#To screen the risk factors of patients with frequent acute exacerbation of chronic obstructive pulmonary disease (COPD) by detecting the clinical indicators of periodontitis and the level of bacterial and inflammatory markers in saliva.@*Methods@#Thirty-eight COPD patients in their stable period were recruited and detected from Beijing Chao-Yang Hospital,Capital Medical University during December 2016 to May 2017. The periodontal index were recorded. The levels of inflammatory factors in saliva samples were examined by using enzyme linked immunosorbent assay (ELISA). The bacteria composition in the saliva samples were identified by using 16SrRNA gene pyrosequencing. All patients were followed up and monitored for acute exacerbation of COPD for 12 months. The patients were divided into frequent acute exacerbation group (≥2 times/year, n=10) and non frequent acute exacerbation group (<2 times/year, n=28).@*Results@#In univariate analysis, the patients′ average age of frequent acute exacerbation group (69.0±7.3) was significantly older than that of non-frequent acute exacerbation group (61.8±8.3) (P=0.02). The numbers of remaining teeth ≤26 [100% (10/10)] was significantly higher and plaque index ≤2.5 (2/10) in frequent acute exacerbation group was significantly lower compared with the remaining teeth ≤26 [43% (12/28)] and the plaque index ≤2.5 [71% (21/28)] in non-frequent acute exacerbation group (P=0.02, P=0.01). The proportions of salivary inflammatory factors interleukin-6 (IL-6) level ≤60 ng/L (10%),C-reactive protein (CRP) level ≤1 550 μg/L (30%), matrix metalloproteinase-8 (MMP-8) level ≤140 μg/L (30%) and fibrinogen level ≤90 mg/L (30%) in frequent acute exacerbation group were significantly lower compared with salivary inflammatory factors IL-6 level ≤60 ng/L (71%),CRP level ≤1 550 μg/L (71%), MMP-8 level ≤140 μg/L (86%) and fibrinogen level ≤90 mg/L (71%) in non-frequent acute exacerbation group (P<0.05). The differences of relative abundances of salivary bacteria,such as species of Chloroflexi, Anaerolineae, Anaeroales, Corynebacteriales, Anaerolineaceae, Tissierellaceae, Leptotrichiaceae, Corynebacteriaceae, Leptotrichia, Moryella, Lachnoanaerobaculum and Corynebacterium between frequent acute exacerbation group and non-frequent acute exacerbation group were significantly different (P<0.05). In multivariate logistics regression analysis,the level of IL-6 >60 ng/L and the relative abundance of Corynebacteriales >0.2 had significant difference (P<0.05).@*Conclusions@#The level of IL-6 and the relative abundance of Corynebacteriales might be the markers of frequent acute exacerbation in COPD patients.
ABSTRACT
Objective To investigate the clinical efficacy of shenfu injection combined with chemotherapy in the treatment of small cell lung cancer .Methods 100 cases of patients with small cell lung cancer were randomly di-vided into control group and observation group using the number table ,each group was 50 cases.The control group was given only gemcitabine +carboplatin treatment,and the observation group was given 60ml shenfu injection twice per day on the basis of the control group ,and it continued 10d.Two groups of a course of treatment was three weeks . Changes in lymphocyte subsets , the incidence of postoperative complications , quality of life and lung function were compared before and after treatment .Results The clinical total effective rate of control group was 54.0%,which was significantly lower than that of the observation group (86.0%),the difference existed a statistical significant difference (χ2 =8.36,P0.05).According to the SGQR scoring standads ,there was a statistical difference between the two groups ( t=4.29,5.34,4.93,6.22,all P<0.05).There was a statistical difference of pulmonary function (FEV1,FEV1%,FVC and 6MWD) between the two groups(t=4.19,5.23,4.52,4.39,all P<0.05).Conclusion Shenfu injection combined with chemotherapy is applied in the treatment of small cell lung cancer ,which has a significant effect ,it can obviously improve the patient′s quality of life and lung function ,and it should be promoted and applied in clinical practice .