RÉSUMÉ
Objective:To investigate the characteristics and relationship between the location of lower extremity deep vein thrombosis (DVT) and the site of pulmonary embolism in hospitalized patients.Methods:The data of patients with lower extremity DVT diagnosed by ultrasound examination and pulmonary embolism diagnosed by CT pulmonary angiography from December 2017 to December 2021 were analyzed retrospectively. According to the location of lower extremity DVT, the patients were divided into mixed DVT, proximal DVT, and distal DVT which was further divided into anterior/posterior tibial vein or peroneal vein thrombosis and calf muscular venous thrombosis. Mixed DVT was referred to the presence of both proximal and distal DVT. According to the involved site of pulmonary artery, pulmonary embolism was divided into three types: main pulmonary artery, left or right pulmonary artery trunk embolism, lobar pulmonary artery embolism and segmental pulmonary artery embolism. The location of lower extremity DVT, the site of pulmonary embolism, the clinical manifestation (shortness of breath, chest tightness, chest pain, hemoptysis, cough, lower limb swelling, lower limb pain, syncope, fever) and risk factors (fracture/trauma, tumor, diabetes, hypertension, atrial fibrillation, infection, surgery, autoimmune diseases, paralysis, pregnancy) of venous thromboembolism (VTE), and the level of D-dimer were analyzed.Results:A total of 209 patients were enrolled finally, including 127 patients with left lower extremity DVT (60.8%) and 82 with right lower extremity DVT (39.2%). Mixed DVT accounted for 39.2%, proximal DVT accounted for 17.3%, and distal DVT accounted for 43.5% (anterior/posterior tibial vein and peroneal vein thrombosis accounted for 14.8%, calf muscular venous thrombosis accounted for 28.7%). The incidences of main pulmonary artery embolism, left or right pulmonary artery trunk embolism in the mixed DVT and proximal DVT were significantly higher than those in the anterior/posterior tibial vein or peroneal vein thrombosis and calf muscular venous thrombosis [41.5% (34/82), 38.8% (14/36) vs. 16.2% (5/31), 10.0% (6/60)], with statistically significant differences (all P < 0.05). The incidences of pulmonary segmental artery embolism in the anterior/posterior tibial vein or peroneal vein thrombosis were higher than those in the mixed DVT and proximal DVT [41.9% (13/31) vs. 26.8% (22/82), 30.6% (11/36)], but the difference was not statistically significant (both P > 0.05). The incidences of pulmonary segmental artery embolism in the calf muscular venous thrombosis were significantly higher than those in the mixed DVT and the proximal DVT [66.7% (40/60) vs. 26.8% (22/82), 30.6% (11/36)], and the difference was statistically significant (both P < 0.05). The levels of D-dimer in patients with calf muscular venous thrombosis combined with main pulmonary artery embolism, left or right pulmonary artery trunk embolism were significantly higher than those in patients with calf muscular venous thrombosis combined pulmonary segmental artery embolism (mg/L: 6.08±3.12 vs. 3.66±2.66, P < 0.05). There were no significant differences in D-dimer levels in other patients with DVT combined with pulmonary embolism in different sites. In terms of the clinical manifestations of VTE, the incidences of lower limb swelling in the mixed DVT and proximal DVT were significantly higher than those in the anterior/posterior tibial vein or peroneal vein thrombosis and calf muscular venous thrombosis [54.9% (45/82), vs. 29.0% (9/31), 15.0% (9/60), both P < 0.05], the incidences of lower limb swelling in the proximal DVT were significantly higher than those in the calf muscular venous thrombosis [41.7% (15/63) vs. 15.0% (9/60), P < 0.05], there were no significant difference in the other clinical manifestations among the DVT groups. There was no significant difference in the incidence of VTE risk factors among the groups. Conclusions:The DVT of inpatients mostly occurred in the left lower limb, and the incidence of distal DVT was higher than that of proximal DVT. Mixed DVT and proximal DVT combined with pulmonary embolism mostly occurred in the main pulmonary artery, left or right pulmonary artery trunk, while distal DVT combined with pulmonary embolism mostly occurred in the pulmonary segmental artery. The levels of D-dimer in patients with lower extremity DVT combined with main pulmonary artery or left and right pulmonary artery trunk embolism were higher than those in patients with pulmonary lobe and segmental artery embolism. The incidence of lower extremity swelling in patients with mixed DVT and proximal DVT was higher than that in patients with distal DVT.
RÉSUMÉ
Objective To investigate the inhibitory effect of matrine on inflammation by regulating Th1/Th2 bal-ance in asthmatic rats and the underlying mechanism related to SOCS3.Methods Ovalbumin-sensitized rats were established as asthma model, Animals randomly divided into four groups, as follows: control ( without any treatment) , model group, treatment group A ( low-dose matrine treated asthma rats ) and treatment group B ( high-dose matrine treated asthma rats) .The eosinophil counting, goblet cells percentage, inflammatory cell in-filtration in rat lung were analyzed and scored by morphological examination .IL-4 and IFN-γlevel in BALF were determined by ELISA and IFN-γ/IL-4 ratio was further calculated.Furthermore, the expression of SOCS3 in mRNA and protein level were detected by qRT-PCR and Western blot, respectively.Results Eosinophil count and percentage, goblet cell percentage and inflammatory cell infiltration score were significantly lower than that in treatment group A and B as compare to model group ( P<0.05 ) .The group A exhibited a lower IFN-γlevel and a higher IL-4 level ( P<0.05 ) .IFN-γlevel in treatment group A and B were higher while IL-4 level were lower as compare to model group.Meanwhile, SOCS3 mRNA level in rat lung tissue was elevated in model group.Ma-trine treatment decreased SOCS3 expression in group A and B .Similar trend was found in SOCS3 protein level. Conclusions Matrine may exhibit antiinflammatory effect by inhibiting SOCS3 expression and correcting Th1/Th2 balance in asthmatic rats.
RÉSUMÉ
Objective To investigate the relationship between serum interleukin 6( IL-6 ),tumor necrosis factor α( TNF-α)and C reaction protein( CRP)levels and smoking and body mass index( BMI)in the elderly patients with stable chronic obstructive pulmonary disease( COPD ). Methods Elderly participants including 50 cases smokers with stable COPD,45 cases ex-smokers with stable COPD and 40 cases healthy ex-smokers were recruited in this study,who were hospitalized in the People's Hospital of Gansu Province from Dec. 2012 to Feb. 2014. Serum IL-6,TNF-α and CRP levels were detected. Correlation analysis was performed between serum IL-6,TNF-α,CRP levels and smoking index( SI),BMI in COPD smokers. Results The levels of serum IL-6,TNF-α and CRP in smoking group were(45. 9 ± 12. 1)mg/L,(58. 2 ± 15. 8)ng/L,(12. 2 ± 4. 1) mg/L,significantly higher than those in stop-smoking group((38. 1 ± 9. 6)mg/L,(45. 9 ± 11. 2)ng/L,(8. 6 ±3. 2)mg/L respectively),and healthy controls group((17. 0 ± 9. 9)mg/L,(27. 3 ± 13. 2)ng/L,(6. 3 ±5. 2)mg/L),and the differences were significant(F=84. 934,57. 224,23. 023;P﹤0. 01). In patients with smoking index≥400,the levels of serum IL-6,TNF-α and CRP were(50. 1 ± 12. 1)mg/L,(64. 2 ± 12. 6) ng/L,(13. 4 ± 3. 7)mg/L,significantly higher than those in patients with SI ﹤400 group((41. 0 ± 10. 2) mg/L,(47. 8 ± 14. 0)ng/L,(10. 8 ± 4. 2)mg/L respectively),and the differences were significant( t=2. 845, 4. 343,2. 347;P ﹤0. 01 or P ﹤0. 05 ). The levels of serum IL-6,TNF-α and CRP in smoking group were positively correlated with SI(r=0. 458,0. 438,0. 313;P﹤0. 01 or P﹤0. 05). The levels of serum IL-6,TNF-αwere negatively correlated with BMI,and the correlation coefficient were - 0. 358,- 0. 319( P ﹤0. 05). Conclusion The increase of serum IL-6,TNF-αand CRP caused by smoking may play an important role in the pathogenesis of COPD. And chronic smoking is the reason of the decline of BMI in COPD patients,and the decline of BMI is related to the high levels of serum IL-6 and TNF-α.