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Objective To determine the prognostic indicators of severe acute respiratory distress syndrome (ARDS) by comprehensive analysis.Methods The clinical data of 71 patients with ARDS admitted from Feb.2012 to Apr.2017 were retrospectively collected and analyzed.The acute pathophysiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,occurrence of extrapulmonary organ dysfunction and mortality within 28d after final diagnosis were calculated.The risk factors were screened using the logistic regression analysis to construct the risk prediction model by dynamic recording and comparing the variation of each baseline index within 7 days,and ROC curve was used to evaluate the prediction efficiency of the model.Results Of the 71 cases analyzed,the overall mortality within 28d after final diagnosis was 57.7％(41/71).Single factor logistic regression analysis showed that the APACHE Ⅱ score,the occurrence of extrapulmonary organ dysfunction,the changing rate within 7 days of APACHE Ⅱ score,pH,CO2 partial pressure and oxygenation index were significantly related to mortality.Multiple logistic regression showed that the occurrence of extrapulmonary organ dysfunction and the changing rate within 7 days of APACHE Ⅱ score were the independent risk factors for the death of patients 28 days after admission.The prediction model of 28d mortality in ARDS patients was constructed using the single factor-and multiple logistic regression as covariant,the sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of the model were 93.9％,91.7％,93.3％ and 91.7％,respectively.Conclusions Occurrence of extrapulmonary organ dysfunction and changing rate within 7 days of APACHE Ⅱ score can be used as an indicator to evaluate the prognosis of patients with severe ARDS.
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Objective To investigate the expression and the mechanism of interleukin-1 beta (IL-1β) in human A549 cells regulated by lipopolysaccharide (LPS) combined with adenosine triphosphate (ATP). Methods The protein expressions of NLRP3, ASC and caspase-1 in A549 cell lines were firstly assessed by Western blotting, and then the effects of different concentrations (0, 1, 5, 10, 50 and 100µg/ml) of LPS on the protein expression of NLRP3 inflammasome pathway and the secretion of IL-1β in A549 cell lines were determined by Western blotting and ELISA, respectively. Secondly, the effects of co-stimulation of LPS and ATP on the activation of inflammasome and the secretion of IL-1β in A549 cell lines were detected. Finally, the effects were observed of siRNA interference to the NLRP3 gene expression in A549 cell lines on the secretion of proinflammatory cytokines-IL-1β induced by LPS+ATP. Results NLRP3, ASC and caspase-1 proteins were observed in A549 cell lines. The expressions of NLRP3, caspase- 1p45 and pro-IL-1β in A549 cell lines increased by treatment of LPS alone compared with that of control group (P<0.05) in a dosedependent manner, but no expression of caspase-1p20 protein and no secretion of cytokine IL-1β were detected. While the expression of activated caspase-1p20 protein and the secretion of cytokine IL-1β were found by co-stimulation of LPS+ATP compared with that of LPS alone stimulation group (P<0.05). After siRNA interference of the expression of NLRP3 gene, the LPS+ATP-induced release of proinflammatory cytokines-IL-1 β was inhibited significantly (P<0.05). Conclusions The NLRP3 inflammasome pathway is present in A549 cell lines. The release of cytokines-IL-1β in LPS+ATP-induced A549 cell lines decreases after down-regulation of NLRP3 genes, implying the release of cytokines-IL-1 β may be regulated by the NLRP3 inflammasome pathway.
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<p><b>OBJECTIVE</b>To detect CCL20 and CXCR4 expressions in epidermis infected with condyloma acuminatum (CA) and normal epidermis and investigate the effect of their expressions on Langerhans cells in CA epidermis.</p><p><b>METHODS</b>Gene expression of CCL20 and CXCR4 in 3 epidermal CA lesions and in 3 normal epidermis specimens were detected using Affymetrix oligonucleotide microarrays HG-U 133A 2.0, and the protein levels of CCL20 and CXCR4 in these specimens were measured by Western blotting.</p><p><b>RESULTS</b>Microarray analysis revealed markedly down-regulated mRNA expressions of CCL20 and CXCR4 in the 3 epidermal CA lesions as compared with those in the normal specimens. Western blot analysis showed that the protein expressions of CCL20 and CXCR4 in the CA lesions were significantly lower than those in normal epidermis.</p><p><b>CONCLUSION</b>The protein and mRNA expressions of CCL20 and CXCR4 are markedly down-regulated in epidermal CA lesions, which may contribute to decreased number and backflow disturbance of Langerhans cells in these lesions.</p>