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2.
Sci Rep ; 6: 22911, 2016 Mar 18.
Article in English | MEDLINE | ID: mdl-26987602

ABSTRACT

Aim of this study was to develop a new simpler and more effective severity score for community-acquired pneumonia (CAP) patients. A total of 1640 consecutive hospitalized CAP patients in Second Affiliated Hospital of Zhejiang University were included. The effectiveness of different pneumonia severity scores to predict mortality was compared, and the performance of the new score was validated on an external cohort of 1164 patients with pneumonia admitted to a teaching hospital in Italy. Using age ≥ 65 years, LDH > 230 u/L, albumin < 3.5 g/dL, platelet count < 100 × 10(9)/L, confusion, urea > 7 mmol/L, respiratory rate ≥ 30/min, low blood pressure, we assembled a new severity score named as expanded-CURB-65. The 30-day mortality and length of stay were increased along with increased risk score. The AUCs in the prediction of 30-day mortality in the main cohort were 0.826 (95% CI, 0.807-0.844), 0.801 (95% CI, 0.781-0.820), 0.756 (95% CI, 0.735-0.777), 0.793 (95% CI, 0.773-0.813) and 0.759 (95% CI, 0.737-0.779) for the expanded-CURB-65, PSI, CURB-65, SMART-COP and A-DROP, respectively. The performance of this bedside score was confirmed in CAP patients of the validation cohort although calibration was not successful in patients with health care-associated pneumonia (HCAP). The expanded CURB-65 is objective, simpler and more accurate scoring system for evaluation of CAP severity, and the predictive efficiency was better than other score systems.


Subject(s)
Biomarkers/analysis , Community-Acquired Infections/mortality , Pneumonia/mortality , Aged , Area Under Curve , China/epidemiology , Community-Acquired Infections/metabolism , Female , Hospitalization , Humans , Length of Stay , Male , Middle Aged , Pneumonia/metabolism , Risk Factors , Severity of Illness Index
3.
Article in Chinese | MEDLINE | ID: mdl-20387477

ABSTRACT

OBJECTIVE: To investigate the effect of proliferation and differentiation of CD8 T cells on the progression in patients co-infected with HIV and HCV. METHODS: To address this issue, the presences of CD57 and CD28 in the surface of CD8+ T-cell were monitored using flow cytometry in 20 patients co-infected with HIV and HCV and 20 patients infected with HCV alone. The proliferation and differentiations of CD8+ T cell were compared hetween patients co-infected with HIV and HCV and ones with HCV infection alone, to clarify the association hetween the function of CU and the progression of disease. RESULTS: A high presence (28.84 +/- 4.49)% of CD57 in the surface of CD8+ T-cell in the patients with HIV/HCV co-infections was found, comparing with a low presence (8.24% +/- 5.05%) of CU57 in the patients with HCV infection alone, the difference hetween these two groups is significant (P < 0.001). Moreover, A clear linear regression hetween the percentage of CD57CD8t T and HCV viral load (log) was identified (P = 0.023, R2 = 0.21). In addition, the differentiations of CD8 T cells were compared between patients with HIV/HCV co-infection and mono-HCV infection: the dominant cells in patients with mono-HCV infection were ones in intermediate stage, while, a late differentiation process of CU8 T cells might he associated with HIV/HCV co-infection. CONCLUSION: The differences of proliferation and differentiation of CTL. are significant, between HIV/HCV co- infection and mono-HCV infection. Lower proliferation and late stage of differentiations of CD8 T cell might affect the clearance of hepatitis C virus, weaken CU immunological response and induce chronic inflammation, finally will accelerate the progression of HCV infection.


Subject(s)
CD8-Positive T-Lymphocytes/cytology , Cell Differentiation , Cell Proliferation , HIV Infections/physiopathology , Hepatitis C/physiopathology , Adult , CD8-Positive T-Lymphocytes/immunology , Cells, Cultured , Disease Progression , Female , HIV Infections/complications , HIV Infections/immunology , HIV Infections/pathology , HIV-1/immunology , HIV-1/physiology , Hepacivirus/immunology , Hepacivirus/physiology , Hepatitis C/complications , Hepatitis C/immunology , Hepatitis C/pathology , Humans , Male , Middle Aged , T-Lymphocytes/immunology , Young Adult
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