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Objective:To explore the relationship between microRNA-4429 (miR-4429) derived from serum exosomes and prognosis of radical radiation and chemotherapy for non-small cell lung cancer (NSCLC).Methods:309 blood samples of NSCLC patients were collected [before chemotherapy (T0), after 1 cycle of chemotherapy (T1) and after 2 cycles of chemotherapy (T2), 103 cases at each time point], and the expression level of miR-4429 was detected by real-time fluorescent quantitative PCR method, and the relationship between it and the prognosis of radical radiation and chemotherapy in NSCLC was analyzed.Results:The 1-year, 2-year and 3-year survival rates of 103 NSCLC patients were 69.90%, 45.63% and 34.95%, respectively. The expression levels of T1-miR-4429 and T2-miR-4429 in the survival group were 0.66±0.14 and 0.77±0.11, respectively, which were higher than T1-miR-4429 (0.60±0.06) and T2-miR-4429 (0.62±0.11) in the death group, and the differences were statistically significant ( t=2.269, 6.997, P<0.05). Restricted cubic spline fitting COX regression analysis showed that T2-miR-4429 had a linear relationship with survival in NSCLC. COX regression analysis showed that TNM staging was an independent risk factor for the survival and prognosis in NSCLC ( P<0.05), and the degree of differentiation, targeted therapy and T2-miR-4429 were all independent protective factors for the survival and prognosis in NSCLC ( P<0.05). The calibration curve of the nomogram regression model constructed by TNM stage, degree of differentiation, targeted therapy and T2-miR-4429 coincided well with the ideal curve, and the C-index was 0.713. Conclusions:The high expression level of T2-miR-4429 indicates that NSCLC patients have a low risk of poor survival prognosis. The nomogram regression model constructed by TNM staging, degree of differentiation, targeted therapy and T2-miR-4429 has a certain degree of discrimination and accuracy, which can assist in evaluating the prognosis of NSCLC.
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Post-transplantation lymphoproliferative diseases (PTLD) is a kind of lymphoproliferative disease caused by immune deficiency after hematopoietic stem cell transplantation and solid organ transplantation, and characterized by poor prognosis. Its major pathogenesis is associated with EB virus (EBV), which means immune monitoring in the condition of immune deficiency generates abnormal hyperplasia and transformation of B-cell infected by EBV. The clinical manifestations include fever, pharyngitis, lymphadenopathy, hepatosplenomegaly and other nonspecific symptoms. Supplementary examination refers to EBV, and definite diagnosis requires histopathology results. Pathological classification of PTLD includes early lesion, polymorphic lesion, monomorphic lesion, and Hodgkin's lymphoma. Management of EBV infection and EBV related to PTLD after transplantation is divided into 3 levels: prevention of EBV activation, preemptive treatment and target therapy. Fortunately, rituximab being a B-cell targeted drug has gained an increasing application.
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Objective To explore the effects of psychological intervention on negative emotion and quality of life of the patients with chronic obstructive pulmonary disease (COPD). Methods A total of 80 patients with COPD were divided into the psychological intervention group and the control group. The psychological intervention group received routine treatment + psychological intervention; the control group only received routine treatment. SCL-90 symptom checklist and St George'S Respiratory Questionnaire (SGRQ) scores before and after the treatment were assessed. Results There was no significant difference in each score between the 2 groups at baseline ( P ＞ 0. 05 ). After 3 months' treatment, the scores of the 2 groups was declined; somatization, obsession, anxiety, and depression were significantly improved compared with baseline. There was no significant difference in SGRQ respiratory symptoms, disease impact and the SGRQ indicators at baseline ( P ＞ 0. 05 ). After the invention, there showed significant difference in the treatment group in SGRQ respiratory symptoms, disease impact and the SGRQ indicators compared with baseline (P ＜0. 05 ). Conclusion Psychological intervention could improve negative mood and the quality of life of patients with COPD.
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Objective To evaluate the clinical effect of ambroxol, budesonide and obstructive combinedly atomized inhalation on old patients with acute exacerbation of chronic obstructive pulmonary disease(COPD). Meth-ods 60 old patients with acute exacerbation of COPD were allocated into two groups in random, the control group(n =30) and the treated group(n =30). The control group was received conventinal theray,but the treated group re-ceived combinedly atomized inhalation on basis of conventional therapy. The two groups were treated in five-seven days, and were recorded the changes of clinical symptom, physicak sign, arterial blood gas analysis and the related side effect (for example, liver and renal function, blood sugar, etc). Results There are significant difference be-twcen the two groups in clinical effect (P < 0.05). Conclusion Ambroxol, budesonida and terbutaline combinedly atomized inhalation in the treatment of old patients with acute exacerbation of COPD was effective, little side effect and very safe.
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Objective To observe the clinical effect of long-term domiciliary oxygen therapy (LTDOT) on chronic obstructive pulmonary disease(COPD).Methods COPD patients were randomly divided into LTDOT group and control group,LTDOT group received LTDOT on basis of conventional therapy,and control group only received conventional thempy.The lung function,blood gas analysis was detectedand quality of life in paracmasis before and after treatment was evaluted.Results After two years, FEV1[(1.42±0.42)L],PaO2[(80.0±2.6)mm Hg,1 mm Hg=0.133 kPa]in LTDOT group were obviously higher than those in control group[(0.72±0.38)L,(55.0±2.2)mm Hg],there were significant differences between two groups(P<0.01).FVC,PaCO2 in two groups were no significant difference(P>0.05).Quality of life in LTDOT group was better than that in control group,average emergency frequency[(2.3±1.2)times] and hospital day[(16.0±2.4)d]in LTDOT group were obviously decwatsed than those in control group [(5.2±1.3)times,(36.0±2.2)d](P<0.01).Conclusion For the patients with COPD paracmasis, LTDOT can increase FEVI,PaO2,elevate quality of life and decrease average emergency frequency and hospital day.
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Objective To evaluate the clinical effect of noninvasive positive pressure ventilation (NIPPV)on chronic obstructive pulmonary disease (COPD) with type Ⅱ respiratory failure. Methods Seventy-six cases of COPD with type Ⅱ respiratory failure were randomly divided into two groups.All patients were treated with antibiotics and other coventional therapy, 6 hours of intravenous drop infusion coramine was added to the control group (38 cases) and 6 hours of NIPPV was added to the treatment group (38 cases). Vital signs and arterial blood gas analysis were evaluated. Results After 6 hours of treatment, blood pressure, heart rate, respiratory rate and pH were significantly improved in the treatment group than those in the control group (P< 0.05 or < 0.01).Compared with the control group, there was a significant improvement of pH in the treatment group (P < 0.05). PaO2 increased [(81.7 ± 6.3) mm Hg (1 mm Hg = 0.133 kPa) vs (50.6 ± 4.3) mm Hg, (67.6 ± 7.4) mm Hg vs (50.8 ± 5.2) mm Hg] and PaCO2 decreased [(49.6 ± 4.5) mm Hg vs (78.5 ± 10.4) mm Hg, (60.8 ± 6.1)mm Hg vs (76.8 ± 8.3) mm Hg] was found in both groups, the amplitudes of PaO2 and PaCO2 before and after treatment were more singnificant in the treatment group (P < 0.01). Conclusion NIPPV on COPD with type Ⅱ respiratory failure can improve clinical symptom and arterial blood gas analysis more significantly than conventional therapy.
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Objective To observe the effects of respiratory training on pulmonary function in the patients with chronic obstructive pulmonary disease(COPD). Methods A total of 74 patients with COPD were recruited and randomly divided into a treatment group and a control group with 37 subjects in each.The treatment group re-ceived respiratory training including lip-contracting breathing,abdominal breathing and breathing exercises for 6 months in addition to routine medical treatment.The control group received only routine medical treatment.Pulmona-ry function was evaluated before and after treatment. Results After treatment,both groups improved in terms of all the pulmonary function measures,showing increased vital capacity(VC),forced expiratory volume after 1 s(FEVl),peak forced expiratory flow rate(PEFR),as well as forced expiratory flow at 25%of Vcmax(V25),de-creased residual volume and residual volume as a percentage of total lung capacity(RV/TCL).The difference be-tween the two groups was significant with regard to the extent of improvement. Conclusion Respiratory training can improve the pulmonary function of COPD patients.
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Objective To observe the effects of exercise and respiratory training on patients with chronic obstructive pulmonary disease. Methods Fifty-six patients were randomly divided into an observation group (with 30 subjects) and a control group (26 subjects). Both groups received routine medical treatment, while the observation group received movement exercise and respiratory training in addition. Results After 3 months of treatment, there were significant differences between the two groups in terms of the improvement in pulmonary function and quality of life. Conclusion Movement exercise and respiratory training can improve pulmonary function and the quality of life of patients with chronic obstructive pulmonary disease.