ABSTRACT
Objective To systemically evaluate the the role of statins in prevention and treatment of community-acquired pneumonia (CAP). Methods A computer-based searching was conducted in PubMed,EMbase,Cochrane Library,Wanfang,and CNKI database up to October 2016. Totally 21 eligible articles were retrieved. According to the Cochrane Handbook 5.0 or Newcastle-Ottawa Scale (NOS) quality evaluation criteria,two independent reviewers carried out literature screening,data retraction,and quality evaluation. Meta-analysis was conducted with RevMan 5.3 software. Results A total 1 007 765 CAP patients from 12 studies were divided into two groups:statin group (n=118 096) and non-statin group (n=889 669). Meta-analysis suggested that statin use was associated with decreased mortality of CAP (OR=0.67,95%CI:0.57-0.79). We further divided the studies into North America group and Europe group and found the heterogenicity of North America group was lower than that of Europe group,and the Meta-analysis of both group supported the association of statin use with decreased CAP mortality (OR=0.66,95%CI:0.62-0.67;OR=0.71,95%CI:0.55-0.92). To identify the effect of statin use on mechanical ventilation,we included three articles (n=123 645) for further analysis (statin group,n=23 796;non-statin group,n=99 849),and Meta-analysis suggested that statin use was associated with decreased requirement for mechanical ventilation (OR=0.74,95%CI:0.70-0.78). Four articles (n=127 060) were enrolled (statin group,n=24 121 and non-statin group,n=102 939) to analyze the effect of statin use on ICU admission,and Meta-analysis suggested that statin use was associated with decreased requirement for ICU admission (OR=0.85,95%CI:0.82-0.88). Eleven articles (n=2 124 849) (statin group,n=306 108;non-statin group,n=1 818 741) to evaluate the effect of statin use on risk of CAP,and Meta-analysis suggested that long-term use of statins decreased the risk of CAP,although there was no statistical difference (OR=0.85,95%CI:0.85-1.07); the above studies were divided into case-control studies and cohort studies,and the case-control studies revealed statins increased the risk of CAP (OR=1.12,95%CI:1.03-1.21),while the cohort studies supported the association of statin use with decreased CAP risk (OR=0.46,95%CI:0.44-0.49). Conclusions Statin use may decrease the CAP mortality and the requirement for mechanical ventilation or ICU admission. However,whether statin use can reduce the risk of pneumonia remains unclear.
ABSTRACT
<p><b>UNLABELLED</b>OBJECTICE: To evaluate the application of high-throughput sequencing to sequence the FMS-like Tyrosine Kinase 3 internal tandem duplication (FLT3-ITD) in de novo acute myeloid leukemia (AML) patients with lower allelic ratio FLT3-ITD mutation or more than one ITD, and to analyze the feature of ITD.</p><p><b>METHODS</b>The genomic DNA of 23 AML patients with positive FLT3-ITD was amplified by PCR, capillary electrophoresis was used to detect the ITD mutation. Then, the FLT3 gene was amplified using primer with different barcode, and the product was analyzed by illumina Miseq, and the results were compared with UCSC database.</p><p><b>RESULTS</b>Out of 23 AML patients, 17 had a single ITD, and 3 had 2 ITDs, and the remaining 3 had 3 ITD detected by capillary electrophoresis. The high-throughput sequencing showed that 17 ITD were the complate duplications of wild-type FLT3, and the remaining 16 ITD were partial duplications in the all 33 ITDs. The same length ITD mutation contained 2 different ITD sequences in one patient with more than one ITD, and the other patient with 2 ITD had the same ITD insertion position. The ITD occurred in the regions from p. Y572 to p. L602 of the FLT3 protein, and all the patient ITD covered one or more amino acid between p. V592 and p. E598.</p><p><b>CONCLUSION</b>Illumina Miseq can analyze the sequence of ITDs precisely and accurately. ITD mutation varies widely, but the hotspots are concentrated.</p>