Clinical characteristics and risk factors affecting outcomes of elderly patients with non-small cell lung cancer complicated by chronic obstructive pulmonary disease / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the clinical features, treatment strategy and risk factors affecting the prognosis of elderly patients with non-small cell lung cancer (NSCLC) complicated by chronic obstructive pulmonary disease (COPD).</p><p><b>METHODS</b>We retrospectively analyzed the data of elderly patietns (>60 years) with newly diagnosed NSCLC complicated by COPD at the Geriatric Institution of General Hospital of PLA between January, 2000 and June, 2015. The clinical data collected included history of smoking, pulmonary function test results, initial treatments, TNM stage, chief complaints, comorbidities and laboratory tests. The Cox proportional hazards regression model was used to explore the prognostic factors in these patients.</p><p><b>RESULTS</b>A total of 200 NSCLC patients were reviewed, of which 107 (53.5%) patients had the co-morbidity of COPD as confirmed by spirometry using bronchodilator test. The median survival of the patients with NSCLC complicated by COPD was 45.8 months with 1-, 3-, 5-, and 10-year survival rates of 80.4%, 55.4%, 41.0% and 20.0%, respectively. Stratification analysis showed that patients with COPD Gold grades 1 and 2 had a significant longer median overall survival (51.7 and 43.1 months, respectively) than those with grade 3/4 (16.9 months; P=0.020 and 0.043, respectively). Univariate and multivariate analyses using Cox proportional hazards regression model showed that an older age, a higher Gold grade, advanced disease stage (stages III and IV), squamous cell carcinoma, nonsurgical initial treatment, coughing and an elevated serum CEA level were independent risk factors for shorter survival of the patients.</p><p><b>CONCLUSION</b>Multiple prognostic factors can affect the outcomes of elderly patients with NSCLC complicated by COPD, and a higher COPD Gold grade that fails to respond to treatment within 3 months is the independent risk factor for survival of the patients.</p>

Effect of simulated microgravity and its associated mechanism on pulmonary circulation in rats / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the effect of Simulated Microgravity and its Associated Mechanism on Pulmonary Circulation in Rats).</p><p><b>METHODS</b>Rat tail-suspension model was used to simulate the physiological effects of microgravity and changes in pulmonary blood vessel morphology, pulmonary arterial and venous blood pressure, pulmonary vascular resistance, pulmonary vasomotoricity, as well as the regulation of pulmonary circulation by cytokines produced and released by the lung of rats were measured.</p><p><b>RESULTS</b>The walls of pulmonary blood vessels of rats were thickened, and the pulmonary artery was reconstructed with increased pulmonary vascular resistance. The pulmonary blood vessels of rats became more prone to dilation as contractions increased. Rat epithelial Adrenomedulin gene transcription and protein expression were upregulated. The level of basic fibroblast growth Factor of rat was also elevated.</p><p><b>CONCLUSION</b>Findings from the present study on rats revealed that the microgravity can affect pulmonary blood vessel structure, pulmonary arterial pressure, and pulmonary blood vessel self-regulation and cytokine production.</p>

Significance of low serum vitamin D for infection risk, disease severity and mortality in critically ill patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hospitalized patients often have higher rate of vitamin D deficiency than healthy people. Vitamin D levels below normal are associated with hospital stay, increased incidence of adverse prognosis and increased mortality of a number of diseases. Whether there is a relationship between vitamin D levels and infection or sepsis in the critically ill is still unclear. This study will explore the relationship between vitamin D levels and risk of infection, assessment for disease severity, and predictor of mortality.</p><p><b>METHODS</b>To evaluate the value of vitamin D in intensive care unit (ICU) cases to sepsis, severity and prognosis assessment, high performance liquid chromatography and tandem mass spectrometry were used to measure the concentrations of vitamin D in sera of critically ill patients. The serum samples were drawn within the first 24 hours of ICU admission.</p><p><b>RESULTS</b>The study included 206 people, 50 healthy controls, 51 ICU control patients and 105 ICU diagnosed with sepsis. Critically ill ICU patients (ICU sepsis and ICU control group) had lower vitamin D concentration than normal people, but septic patients showed no significant reduction of vitamin D concentration when compared with critically ill patients with no positive etiological evidence. For assessment of disease severity, there were very low negative correlations between APACHE II, SAPS II and SOFA scores and vitamin D level. Additionally, patients of different 25-(OH)D levels showed no difference whether in terms of 28-day survival (X(2) = 1.78, P = 0.776) or 90-day survival (X(2) = 4.12, P = 0.389). Multivariate Logistic regression demonstrated that APECHE II and SAPS II scores were independent risk factors to deaths caused by sepsis.</p><p><b>CONCLUSION</b>Clinically, serum concentration of vitamin D is not an indicator for diagnosis and assessment in critically ill patients (ClinicalTrial.gov identifier NCT01636232).</p>

Protective effects of hepatocyte growth factor on hypoxic human pulmonary microvascular endothelial cells / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the protective effects of hepatocyte growth factor (HGF) on hypoxic human pulmonary microvascular endothelial cells (HPMECs).</p><p><b>METHODS</b>HPMECs were cultured in vitro, and the hypoxic model was established by the physical method. Cells were divided into 4 groups: the control group, the hypoxic group, HGF group, and phytohemagglutinin (PHA) group. The 7(th) generation of HPMECs was evaluated by the method of immunocytochemistry. The persistence rate of HPMECs was measured by MTT assay and the adhesive cells were counted by the microscopy. The expression of intercellular adhesion molecule-1 (ICAM-1) protein was determined by immunofluorescence staining.</p><p><b>RESULTS</b>The adherence percentage of cells significantly decreased after hypoxia, whereas the expression of the ICAM-1 protein was significantly higher in the hypoxia group than in control group (P<0.01). Compared with the hypoxia group, the persistence and adherence percentage of cells in the HGF group significantly increased (P<0.01), whereas the expression of the ICAM-1 protein significantly dropped (P<0.01). In the PHA group, the persistence and adhesion rate were significantly different from those in the hypoxia group and HGF group (P<0.01), and the expression of the ICAM-1 protein increased significantly (P<0.01).</p><p><b>CONCLUSION</b>HGF could inhibit the hypoxic damage of HPMECs by decreasing the persistence and the adhesive capacity of these cells and inducing the expression of ICAM-1.</p>

Change in drug resistance of Staphylococcus aureus / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To analyze the change in drug resistance of Staphylococcus aureus (SAU) in the PLA general hospital from January 2008 to December 2012, and to provide solid evidence to support the rational use of antibiotics for clinical applications.</p><p><b>METHODS</b>The SAU strains isolated from clinical samples in the hospital were collected and subjected to the Kirby-Bauer disk diffusion test. The results were assessed based on the 2002 American National Committee for Clinical Laboratory Standards (NCCLS) guidelines.</p><p><b>RESULTS</b>SAU strains were mainly isolated from sputum, urine, blood and wound excreta and distributed in penology, neurology wards, orthopedics and surgery ICU wards. Except for glycopeptide drugs, methicillin-resistant Staphylococcus aureus (MRSA) had a higher drug resistance rate than those of the other drugs and had significantly more resistance than methicillin-sensitive Staphylococcus aureus (MSSA) (P < 0.05). In the dynamic observation of drug resistance, we discovered a gradual increase in drug resistance to fourteen test drugs during the last five years.</p><p><b>CONCLUSION</b>Drug resistance rate of SAU stayed at a higher level over the last five years; moreover, the detection ratio of MRSA keeps rising year by year. It is crucial for physicians to use antibiotics rationally and monitor the change in drug resistance in a dynamic way.</p>

Research advance in effects of weightlessness or simulated weightlessness on tumor cells / 中国医学科学院学报

Weightless environment is a rare phenomenon on the ground where the interactions among cells and internal cellular structures disappear or become weakened. Studies on the biological features and molecular expression of tumors cells in weightlessness condition may provide new clues to the tumor initiation, process, diagnosis, and therapy.

Salidroside inhibits clinorotation-induced apoptosis in pulmonary microvascular endothelial cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the inhibitory effect of salidroside (Sal) on pulmonary microvascular endothelial cell (HPMEC) apoptosis induced by simulated microgravity and its mechanism.</p><p><b>METHODS</b>Human pulmonary microvascular endothelial cells cultured in vitro were divided into control group, clinorotation group and clinorotation+Sal pretreatment groups. Microgravity was simulated by clinorotation. The apoptotic rate of HPMECs was detected by flow cytometry using Annexin V-FITC staining, and the expressions of bcl-2, bax, and caspase-3 at the mRNA and protein levels were determined by real-time PCR and Western blotting, respectively.</p><p><b>RESULTS</b>A 72-h clinorotation significantly induced apoptosis in HPMECs. Real-time PCR results demonstrated a significantly lowered bcl-2 but increased bax and caspase-3 mRNA expressions in clinorotation group as compared with those in the control group. Western blotting showed that clinorotation inhibited the protein expressions of PI3K and p-AKT and increased caspase-3 protein expression. Salidroside significantly inhibited the cell apoptosis, reversed the expressions of Bcl-2 and Bax, and attenuated the decrease in the protein expression of PI3K and phosphorylation level of AKT. Salidroside also antagonized the activation of caspase-3.</p><p><b>CONCLUSION</b>PI3K/AKT pathway and caspase 3 are involved in the apoptosis of HPMVECs induced by clinorotation, and the effect of clinorotation can be reversed by salidroside, suggesting the potential value of salidroside for application in spaceflight.</p>

Effects of trichostatin A on human lung cancer cell strains A549 / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the effect of trichostatin A (TSA) on human lung cancer cell strains A549.</p><p><b>METHODS</b>A549 cells were exposed to TSA at different concentrations, then the growth-inhibiting effects of the cell line were detected with 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay; After the cells were exposed to TSA for 48 and 96 hours at 300 nmol/L, the change of the cell cycle and apoptosis of A549 were analyzed with flow cytometry. p21 protein and extracellular signal regulated kinase (ERK) expression were detected by Western blot.</p><p><b>RESULTS</b>TSA inhibited the growth of A549 cells in time- and concentration-dependent manners. The proportion of apoptosis, G0/G1 and G2/M phase increased in accordance with raising of the TSA concentration. The expression of p21 protein was significantly up-regulated and the expression of phosphorylation ERK was significantly down-regulated after A549 cells were treated with TSA.</p><p><b>CONCLUSIONS</b>Histone deacetylase inhibitor TSA can inhibit the proliferation of human lung cancer cell strains A549 and induce the cell cycle arrest and apoptosis in the A549 cells. This may be related to up-regulation of p21 protein expression and the down-regulation of phosphorylation ERK.</p>

Geriatric respiratory medicine: a field needs be furthered strengthened / 中国医学科学院学报

Respiratory diseases are common in the elderly and often the main causes of death among this population. In addition, it is expected that chronic obstructive pulmonary disease, lower respiratory tract infections, lung cancer, and pulmonary tuberculosis will be listed in the top ten diseases in 2020. Therefore, screening, diagnosis and management of respiratory diseases should be strengthened among the elderly; meanwhile, studies on geriatric respiratory medicine should be further enhanced.

Clinical data analysis and chest radiographic features of Wegener's granulomatosis with pulmonary involvement / 南方医科大学学报

<p><b>OBJECTIVE</b>To improve the diagnostic accuracy of Wegener's granulomatosis (WG) with pulmonary involvement by analyzing the clinical data and chest radiographic features.</p><p><b>METHODS</b>The clinical data and chest radiographic features of 43 WG cases with pulmonary involvement were retrospectively analyzed.</p><p><b>RESULTS</b>Clinically, the patients frequently presented with multi-system involvement, with the incidence of pulmonary involvement of 72.8%. The patients with WG presented with such symptoms in the respiratory system as coughing, expectoration, hemoptysis, and dyspnea. The radiographic manifestations varied among the cases. Nodules and cavitations in the lungs were the signs most frequently found, and patchy infiltration and bronchial narrowing were also observed, which often led to misdiagnosis of WG as other pulmonary diseases.</p><p><b>CONCLUSION</b>WG often has multi-organ involvement, and the lung is one of the most commonly involved organs. The clinical symptoms and radiographic manifestations of WG have no specificity, and the disease can be easily misdiagnosed. Biopsy and ANCA assay can be important means for WG diagnosis.</p>