Blood Eosinophilia and Its Stability in Hospitalized COPD Exacerbations are Associated with Lower Risk of All-Cause Mortality.

Purpose: Peripheral blood eosinophilic counts are susceptible to many factors and have variability over time. There are limited studies on association of blood eosinophilia with long-term mortality of chronic obstructive pulmonary disease (COPD) patients and these results remain controversial. Our aims were to explore the association of blood eosinophilia at index hospitalization and stability of blood eosinophilia stability over 5 years with all-cause mortality of patients hospitalized for acute exacerbation of COPD (AECOPD). Patients and Methods: Eight hundred twenty-nine patients hospitalized for AECOPD between 2013 and 2014 were included in this study and grouped into two groups according to blood eosinophil with 150 cells/µL used as the cutoff value to form eosinophilic and non-eosinophilic groups. Two hundred forty-one COPD inpatients with at least three blood eosinophils measured from different hospitalizations were used for analysis of longitudinally eosinophilic stability and divided into three groups according to the same cutoff value: predominantly (PE), intermittently (IE) and rarely (RE) eosinophilic groups. Cox regression analysis was used to determine the association of blood eosinophilia and all-cause mortality. Results: In patients hospitalized for AECOPD, 261 (31.5%) at baseline and 41 (17%) based on at least three measurements of blood eosinophils had increased blood eosinophils. For all-cause mortality, eosinophilic COPD patients at index hospitalization had a lower all-cause mortality compared with non-eosinophilic COPD patients (hazard ratio 0.77, 95% confidence interval 0.6-0.99, P=0.04). In patients readmitted for AECOPD by longitudinal eosinophil stability, with the RE group used as reference, the PE group was associated with a lower all-cause mortality of AECOPD patients (hazard ratio 0.43, 95% confidence interval 0.22-0.85, P=0.016), compared to the IE group (hazard ratio 0.72, 95% confidence interval 0.47-1.11, P=0.133). Conclusion: Patients with increased eosinophils (using eosinophil 150 cells/µL as a cutoff value), especially predominantly increased eosinophil levels based on multiple measurements, had a lower risk of all-cause mortality. Blood eosinophilia can be used as a biomarker in hospitalized COPD exacerbations for predicting the risk of all-cause mortality.

Antimetastatic effects of Rheum palmatum L. extract on oral cancer cells.

Rheum palmatum L., a traditional Chinese medication, has been used for the treatment of various disorders. However, the detailed impacts and underlying mechanisms of R. palmatum L. extracts (RLEs) on human oral cancer cell metastasis are still unclear. Here, we tested the hypothesis that an RLE has antimetastatic effects on SCC-9 and SAS human oral cancer cells. Gelatin zymography, Western blot, real-time polymerase chain reaction, and luciferase assay were used to explore the underlying mechanisms involved in the antimetastatic effects on oral cancer cells. Our results revealed that the RLE (up to 20 µg/mL, without cytotoxicity) attenuated SCC-9 and SAS cell motility, invasiveness, and migration by reducing matrix metalloproteinase (MMP)-2 enzyme activities. Western blot analysis of the MAPK signaling pathway indicated that the RLE significantly decreased phosphorylated ERK1/2 levels but not p38 and JNK levels. In conclusion, RLEs exhibit antimetastatic activity against oral cancer cells through the transcriptional repression of MMP-2 via the Erk1/2 signaling pathways. Thus, RLEs may be potentially useful as antimetastatic agents for oral cancer chemotherapy.

Rubus idaeus extract suppresses migration and invasion of human oral cancer by inhibiting MMP-2 through modulation of the Erk1/2 signaling pathway.

Raspberries (Rubus idaeus L.) have been extensively studies worldwide because of their beneficial effects on health. Recently reports indicate that crude extracts of Rubus idaeus (RIE) have antioxidant and anticancer ability. The aim of this study was to evaluate the mechanism of its antimetastatic ability in oral cancer cells. In this study, SCC-9 and SAS oral cancer cells were subjected to a treatment with RIE and then analyzed the effect of RIE on migration and invasion. The addition of RIE inhibited the migration and invasion ability of oral cancer cells. Real time PCR, western blot and zymography analysis demonstrated that mRNA, protein expression and enzyme activity of matrix metalloproteinases-2 (MMP-2) were down-regulated by RIE. Moreover, the phosphorylation of Focal adhesion kinase (FAK), src, and extracellular signal-regulated kinase (ERK) were inhibited after RIE treatment. In conclusion, these results demonstrated that RIE exerted an inhibitory effect of migration and invasion in oral cancer cells and alter metastasis by suppression of MMP-2 expression through FAK/Scr/ERK signaling pathway. © 2016 Wiley Periodicals, Inc. Environ Toxicol 32: 1037-1046, 2017.

[A hospital-wide intervention program to optimize the utilization quality of carbapenems and glycopeptides].

OBJECTIVE: To investigate the impact of intervention program upon improvement of utilization quality of carbapenems and glycopeptides. METHODS: Multifaceted intervention program of carbapenems and glycopeptides was conducted at our hospital. It involved written justification forms, expert consultation committee meetings, audit, feedback and re-feedback. From November 1, 2007 until October 31, 2008, retrospective audit and feedback were performed on all patients dosed with carbapenems or glycopeptides. Case reports were reviewed and data of ratio of appropriate antibiotic use, length of hospital stay, total cost, mortality and rate of vancomycin-resistant Enterococci (VRE) were collected and compared between the first and second half year of antibiotic intervention program. RESULTS: A total of 397 cases were reviewed, 75 cases discussed at expert committee meetings and 58 feedback letters delivered to responsible doctors. The consumption of both carbapenems and glycopeptides decreased. The appropriate use of carbapenems and glycopeptides increased from 37.8% (45/119) to 53.5% (48/127, P < 0.05) and from 45.6% (36/79) to 63.9% (46/72, P < 0.05) respectively. The total cost and mortality of patients dosed with glycopeptides decreased from a median of RMB 65,700 (30,300 - 146,900) yuan to 55,700 (36,700 - 90,900) yuan, and from 39.2% to 26.4% respectively. The rate of VRE decreased from 5.63% in 2007 to 3.80% during the second half year of 2008. CONCLUSION: Antibiotic intervention program of carbapenems and glycopeptides is effective in decreasing the inappropriate antibiotic use.