Respiratory pathogen spectrum in adult patients with acute exacerbation of bronchiectasis and its correlation with severity of disease / 中国医师进修杂志

Objective:To analyze the characteristics of respiratory pathogen spectrum in adult patients with acute exacerbation of bronchiectasis and its correlation with the severity of disease.Methods:A total of 108 patients with stable bronchiectasis from January 2014 to May 2018 in the Third People′s Hospital of Haikou City were enrolled. Sputum bacteria were cultured and common respiratory viruses in sputum and nasal swabs were detected by fluorescence quantitative polymerase chain reaction(PCR). All bronchiectasis patients were followed up for 1 year. Sputum bacteria culture and PCR virus detection were performed again in patients with acute exacerbation, and the differences of respiratory pathogen spectrum in patients with different severity of acute exacerbation were compared.Results:During the follow-up period, there were 53 cases of acute exacerbation events and a total of 91 case-times (up to 5 times per patient). The positive rates of sputum virus and nasal swab virus in patients with acute exacerbation were significantly higher than those in patients with stable period [39.6% (36/91) vs. 15.1% (8/53) , 45.1% (41/91) vs. 9.4% (5/53) ], and there were significant differences ( χ2=8.460, 13.621, P<0.05). However, the total positive rate of sputum bacterial culture in acute exacerbation and stable period had no significant difference ( P>0.05). The positive rate of Pseudomonas aeruginosa [0, 34.6% (9/26) ,52.4% (22/42) ] and rhinovirus [8.7% (2/23) ,3.8% (1/26) ,23.8% (10/42) ] in sputum among mild patients (16 cases, 23 case-times), moderate patients (16 cases, 26 case-times) and severe patients (21 cases, 42 case-times) in acute exacerbation stage were significant differences ( P<0.05). The levels of C-reactive protein (CRP) and interleukin (IL)-8 in patients in mixed infection of bacteria and viruses group in acute exacerbation stage were significantly higher than those in negative group, bacteria group and viruses group [CRP: (45.6 ± 23.0) mg/L vs. (11.2 ± 2.7) , (32.3 ± 10.2) , (21.3 ± 8.0) mg/L; IL-8: (9.0 ± 2.5) ng/L vs. (1.5 ± 0.9) , (1.8 ± 1.1) , (2.0 ± 1.3) ng/L], and there were significant differences ( F=23.012, 9.926, P<0.05). The hospitalization rate of patients in mixed infection of bacteria and viruses group was significantly higher than that in negative group, bacteria group and viruses group [29.6% (8/27) vs. 0, 16.7% (4/24) , 1/18] , and there were significant differences ( χ2=7.691, P<0.05). Conclusions:The positive rate of respiratory viruses in acute exacerbation of bronchiectasis in adults is significantly higher than that in stable stage. Pseudomonas aeruginosa and rhinovirus are the main infections in moderate and severe patients, Haemophilus parainfluenzae and influenza A virus are the main infections in mild patients, and the patients with mixed infection of bacteria and viruses have severe systemic inflammatory reaction and high hospitalization rate.

Differential expression and prognostic value of excision repair cross-complementing gene-1 in resected gastric adenocarcinoma / 中国综合临床

Objective Excision repair cross-complementing gene-1(ERCC1) are key regulatory enzymes whose expression patterns are associated with overall survival(OS) in several malignancies.Their expression patterns and prognostic value in resected gastric adenocarcinoma(GAC) are not known and need to investigate.Methods A total of 109 patients who underwent resection for GAC in Liu′an People′s Hospital from January 2010 to June 2013 had tissue available for analysis.The primary objective was to assess for the differential expression of ERCC1 using by immunohistochemistry.The secondary objective was to assess for the association between OS and the expression of ERCC1.Results The median follow-up was 21.2 months,and the median OS was 28.8 months.Resected GAC exhibited differential expression of ERCC1(high expression,n=25(23%)).ERCC1 expression was not associated with OS(18.9 months vs.27.7 months,P=0.72).In a subset analysis of patients who received chemotherapy(n=73),high ERCC1 expression was associated with decreased OS(16.7 months vs.53.8 months,P=0.03).After controlling for known adverse pathologic features,high ERCC1 expression persisted as a negative prognostic factor in multivariate Cox regression analysis(HR=2.22,95% CI1.05-4.98,P<0.05).Conversely,in patients who underwent resection only(n=35),high ERCC1 expression demonstrated a trend toward improved OS(40.4 months vs.12.7 months,P=0.10).A positive prognostic influence also was present on multivariate analysis(HR=0.20,95% CI0.05-0.84,P=0.03).Conclusion Resected GAC exhibited differential expression of ERCC1.Among all patients,ERCC1 expression levels were not associated with OS.High ERCC1 tumor expression is associated with decreased OS in the patients who received chemotherapy but is associated with increased OS in those who underwent surgery alone.ERCC1 expression have prognostic value in resected gastric cancer,and further investigation is needed.

The correlation of HIF-1α,MACC1 and FOXO4 in gastric carcinoma pathology and prognosis / 重庆医学

Objective To explore significance and impact of hypoxia inducible factor 1α,metastasis associated with colon cancer 1 and transcription factor FOXO4 in gastric carcinoma and clinical pathological characteristics and prognosis .Methods 110 samples diagnosed as gastric carcinoma and 46 samples diagnosed as pericarcinomatous tissue which was 5 cm far away from cancer were collected in first affiliated hospital of Anhui medical university from December 2006 to May 2008 .Immunohistochemical stai-ning was performed in these samples to detect the expressions of HIF-1α,MACC1 and FOXO4 .And the correlation between devel-opment of gastric carcinoma and expressions of HIF-1α,MACC1 and FOXO4 was analyzed with the help of patients′messages .Ka-plan-Meier method and Cox regression were used to analyze patients′5 years survival rate and the factors .Results The expression levels of HIF-1α(P<0 .001) and MACC1(P<0 .001) in gastric carcinoma tissues were significantly higher than pericarcinomatous tissues ,however the expression levels of FOXO4(P<0 .001) was significantly decreased in gastric carcinoma tissues .Statistical a-nalysis revealed that the expressions of HIF-1αand MACC1 were apparently increased with the lower degree of cell differentiation , the greater degree of tumor infiltration ,accompanied with lymph node metastasis and higher TNM scores ,but lowered the expres-sion of FOXO4 factor .There were significant correlations between expressions of the three factors in gastric carcinoma .The expres-sions of HIF-1α,MACC1 and FOXO4 had an apparent influence on the patients′5 years survival rate .And they were independent factors on the prognosis of gastric carcinoma .Conclusion HIF-1α,M ACC1and FOXO4 are abnormal expression in gastric cancer tissue ,and the clinical pathological features of gastric cancer and the prognosis of patients with gastric cancer are closely related .

Estrogen receptor expression in adrenocortical carcinoma / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>Adrenocortical carcinoma (ACC) is a rare but highly malignant tumor, and its diagnosis is mostly delayed and prognosis is poor. We report estrogen receptor (ER) expression in this tumor and our clinical experiences with 17 ACC cases.</p><p><b>METHODS</b>The data of the 17 patients (9 females and 8 males, age range from 16 to 69 years, mean age of 42.6 years) with ACC were reviewed, and symptoms, diagnostic procedures, treatment, and results of follow-up were evaluated. Immunohistochemistry was used to detect ER expression in tumor samples from the 17 patients.</p><p><b>RESULTS</b>At the time of diagnosis, 4 tumors were classified as Stage I, 4 as Stage II, 3 as Stage III, and 6 as Stage IV. Eight patients demonstrated positive nuclear immunostaining of ER. The prognosis of patients with ER positive was significantly better (P<0.05) than that of patients with ER negative, with 1- and 5-year survival rates at 86% and 60% for ER-positive patients, and 38% and 0% for ER-negative patients, respectively.</p><p><b>CONCLUSION</b>ER-positivity may be one of the factors associated with a worse prognosis of ACC.</p>

Ascorbic Acid Alleviates Pancreatic Damage Induced by Dibutyltin Dichloride (DBTC) in Rats

PURPOSE: Because previous studies have reported depleted antioxidant capacity in patients with chronic pancreatitis (CP), prevention of free radical production has gained importance in antifibrotic treatment strategies for CP. The aim of this study was to investigate the effects of ascorbic acid on oxidative capacity and pancreatic damage in experimental CP. MATERIALS AND METHODS: CP was induced in male Sprague-Dawley rats by infusion of dibutyltin dichloride (DBTC) into the tail vein. Ascorbic acid was given intraperitoneally at a daily dose of 10mg/kg body weight. The treatment groups were as follows: group 1, DBTC plus intraperitoneal physiologic saline; group 2, DBTC plus intraperitoneal ascorbic acid; group 3, solvent plus intraperitoneal physiologic saline; group 4, no operation plus intraperitoneal physiologic saline. Each group contained 15 animals. Treatment was started after CP was established. After 4 weeks of treatment, serum hyaluronic acid and laminin levels were determined by radioimmunoassay, pancreatic tissue oxidative stress was analyzed, and the degree of pancreatic damage was determined. RESULTS: Ascorbic acid treatment markedly increased superoxide dismutase (SOD) activity and decreased malondialdehyde (MDA) concentrations in pancreatic tissue (p < 0.01 for both). Significant serum hyaluronic acid and laminin reductions were observed in group 2 as compared with group 1 (p < 0.05). However, the serum hyaluronic acid and laminin levels remained elevated when compared with those of groups 3 and 4 (p < 0.05). Histopathologic scores were also lower in animals with CP that underwent ascorbic acid-treatment (p < 0.05). CONCLUSION: Ascorbic acid treatment alleviated the degree of oxidative stress and pancreatic damage in rat CP. Antioxidant treatment might be considered a potential option to improve the pathologic process in CP.