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Objective@#To analyze the clinical characteristics of community-acquired pneumonia (CAP) in children under five years of age and analyze the safety and efficiency of nasal continuous positive airway pressure (NCPAP) ventilation for CAP in this population.@*Method@#This was a prospective multicenter study. Children who were admitted to these six centers with CAP and met the NCPAP ventilation indications, aged from 29 d to 5 years, were continuously included during November 2013 to October 2015. The baseline data were collected and NCPAP ventilation were then followed up by operation standards, and the vital signs and arterial blood gas change at special time points were observed and recorded. Any side effect associated with NCPAP were recorded. For categorical variables, comparisons were performed using Fisher test. Rank-sum test and t test were performed respectively for abnormal and normal distribution continuous variables. The variables pre-NCPAP and post-NCPAP were analyzed by repeated measures ANOVA analysis.@*Result@#Totally 145 children were included, and 13 children were excluded due to incomplete data. One hundred and two children(77.3%)were ≤12 months; 91 children (68.9%) were from rural area. NCPAP ventilation was effective in 123 children, with a response rate of 93.2%, were all discharged with a better condition; it was ineffective in 9 children(6.8%), and they were all intubated and went on mechanical ventilation, 5 were discharged with a better condition, and 4 died after gaving up treatment. The gender, age, body weight, residence, main symptoms, main signs, imaging diagnosis, medications, partial pressure of oxygen(PaO2), breath and heart rate before NCPAP treatment of two groups had no significant differences(allP>0.05). The rates of combining underlying diseases, trouble with feeding and cyanosis, and the partial pressure of carbon dioxide(PaCO2 ) before NCPAP ventilation were higher in NCPAP ineffective group ((59±11 )vs.( 49±11) mmHg, 1 mmHg=0.133 kPa, t=-2.597, P=0.028); while the PaO2/fraction of inspiration O2 (FiO2 ) before NCPAP was lower((150±37) vs. (207±63) mmHg, t=2.697, P=0.008). The breathing, heart rate and PaCO2 of NCPAP effective group decreased significantly, while the PaO2 and PaO2/FiO2 increased significantly after 2, 8, 24 h of NCPAP ventilation(all P=0.000). PaCO2 in children with hypercapnia before NCPAP ventilation in NCPAP effective group decreased significantly ((48±9), (47±12), (45±11)vs.(58±7)mmHg, all P=0.000). All children tolerated well to NCPAP ventilation, and there were no severe side effects or complications associated with NCPAP ventilation.@*Conclusion@#NCPAP ventilation is safe and effectively improved the oxygenation and hypercapnia in infants with CAP. But it may not work well in children with underlying diseases, manifest as difficulty in feeding/cyanosis and extremely high PaCO2 or low PaO2/FiO2, and they may need early intubation.
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Aim To explore the inhibitory effects of ophiopogonin-B (OP-B ) on cell adhesion,invasion and migration in non-small cell lung cancer (NSCLC) A549 cells in vitro and its possible mechanism.Meth-ods Cell adhesion assay and transwell chamber assay were used to detect the ability of cell adhesion,migra-tion and invasion.qRT-PCR was used to detect the mRNA levels of MMP-2 and 9 .Meanwhile ,Western blot assay was performed to determine the protein levels of MMP-2/9 and p-Akt.Results OP-B significantly inhibited the ability of cell adhesion,invasion and mi-gration in A549 cells at the concentration of 10 μmol· L-1 (P<0.01 ).Meanwhile,it inhibited the mRNA and protein levels of MMP-2 and MMP-9 and down-regulated the phosphorylation of Akt (P <0.0 1 ). Conclusion OP-B inhibits cell adhesion,invasion and migration in A549 cells through down-regulation of the mRNA and protein expression of MMP-2/9 ,and the inhibitory effect on the expression of p-Akt.