RESUMEN
BACKGROUND: Since the first genome-wide association study report of an association between the ORMDL3 rs7216389 polymorphism and asthma, many studies have been carried out to establish its role in asthma susceptibility among different ethnic groups. However, results have not been consistent across all studies, compelling us to conduct the present meta-analysis. METHODS: A literature search for eligible studies published before January 20, 2014 was conducted in the MEDLINE, EMBASE, and CNKI databases. The association was assessed using pooled crude odds ratios (ORs) with their corresponding 95% confidence intervals (CIs). RESULTS: A total of 18 individual studies in 15 publications (total 7904 asthma patients and 10,874 healthy controls) were included in the meta-analysis. A meta-analysis of all included studies suggested that there was a highly significant risk effect conferred by the rs7216389*T allele on asthma susceptibility. In addition, we performed stratified analyses to evaluate ethnicity-specific and age-specific effects. Our subgroup analyses based on ethnicity and age-of-onset confirmed the role of the ORMDL3 rs7216389 polymorphism in conferring susceptibility to both childhood- and adult-onset asthma, especially in Caucasians and Asians. CONCLUSIONS: The results of this meta-analysis firmly established that genetic variation at the rs7216389 locus, which controls the expression of the ORMDL3, may be a major, independent predisposing factor for asthma in ethnically diverse populations. However, further systematic studies are needed to determine the underlying mechanisms of this association.
Asunto(s)
Asma/genética , Predisposición Genética a la Enfermedad/genética , Variación Genética , Proteínas de la Membrana/genética , Edad de Inicio , Alelos , Pueblo Asiatico/genética , Asma/epidemiología , Asma/etnología , Frecuencia de los Genes , Predisposición Genética a la Enfermedad/etnología , Genotipo , Humanos , Oportunidad Relativa , Polimorfismo de Nucleótido Simple , Factores de Riesgo , Población Blanca/genéticaRESUMEN
OBJECTIVE: To investigate the value of coexisting pneumonia and British Thoracic Society CURB-65 score in predicting early mortality in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: In this prospective study, 483 consecutive in-patients with AECOPD were recruited between January 2010 and September 2012, including 295 males and 188 females. The patients were aged 45 to 92 years. They were divided into 2 groups: non-pneumonia (npAECOPD) and with pneumonia (pAECOPD). The start point of this study was the date when the patients were admitted into the respiratory ward, and the endpoint was the 30 day mortality. Clinical and demographic data were collected for all the patients, and the value of coexisting pneumonia and CURB-65 in predicting in-hospital mortality and 30 day mortality were assessed and compared. RESULTS: According to the inclusion/exclusion criteria, eventually 457 patients were included in this research, with 278 males and 179 females, and an average age of (75 ± 9) years. Of the 457 patients, 120 (26.3%) patients were in the pAECOPD group and 337 (73.7%) patients in the npAECOPD group. The in-hospital mortality, the 30 day mortality and the assisted ventilation rate were significantly higher in the pAECOPD group as compared to the npAECOPD group 18.3% (22/120) vs 4.7% (16/337), 21.7% (26/120) vs 7.4% (25/337); 49.2% (59/120) vs 27.0% (91/337), χ(2) = 18.1 - 21.4, all P < 0.05, respectively. Furthermore, the in-hospital mortality of the pAECOPD patients with CURB-65 score < 2, = 2 and > 2 was 4.4% (2/45), 15.2% (7/46) and 44.8% (13/29), respectively, while that of the npAECOPD patients was 0.9% (1/113), 3.4% (4/119) and 10.5% (11/105), respectively. The 30 day mortality of the pAECOPD patients with CURB-65 score < 2, = 2 and > 2 was 4.4% (2/45), 19.6% (9/46) and 51.7% (15/29), respectively, while that of the npAECOPD patients was 0.9% (1/113), 5.0% (6/119) and 17.1% (18/105), respectively. Stratified by CURB-65 Score, the in-hospital and 30 day mortality were both significantly higher in the pAECOPD group than in the npAECOPD group when CURB-65 was ≥ 2 (χ(2) = 5.8 - 10.1, P < 0.05 and P < 0.01, respectively). The AUROC analysis of CURB-65 as a predictor for early mortality resulted in an area under curve of 0.744. CONCLUSIONS: In patients with AECOPD, coexisting pneumonia is not only a risk factor for in-hospital mortality, but also a predictor for the treatment of assisted ventilation. CURB-65 score may be a good predictor for early mortality in patients with AECOPD.
Asunto(s)
Neumonía/complicaciones , Neumonía/mortalidad , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/mortalidad , Índice de Severidad de la Enfermedad , Anciano , Anciano de 80 o más Años , Femenino , Mortalidad Hospitalaria , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Neumonía/diagnóstico , Neumonía/terapia , Valor Predictivo de las Pruebas , Pronóstico , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/terapia , Curva ROC , Factores de Riesgo , Sensibilidad y EspecificidadRESUMEN
OBJECTIVE: To investigate the clinical significance of perineural invasion(PNI) in rectal cancer. METHODS: Clinical data of 204 patients undergoing resection of low rectal cancer from January 2003 to January 2005 at the First People's Hospital of Chenzhou were analyzed retrospectively. Paraffin sections of surgical specimens from all the patients who underwent resection of low rectal cancer were stained with HE. PNI-positive was defined as infiltration of carcinoma cell into the perineurium or neural fascia. The association of PNI with clinicopathologic features and prognosis of rectal cancer was analyzed. RESULTS: PNI was positive in 31.9%(65/204) of the patients. The tumor size, depth of invasion, lymph node metastasis, TNM stage, tumor growth pattern, histologic grade, tumor resection were significantly associated with PNI. The overall survival time of the PNI-positive patients was shorter than that of the PNI-negative patients[(43.8±1.5) months vs.(57.2±1.5) months, P<0.01]. Furthermore, the overall survival time of the PNI-positive stage II( patients was shorter than that of the stage III( patients [(46.5±3.2) months vs. (55.7±1.2) months, P<0.05]. CONCLUSION: PNI can be used as one of the indicators to predict the prognosis of patients with rectal cancer.