ObjectiveTo analyze hospitalized patients of respiratory diseases with mechanical ventilation (MV). MethodsHospitalized patients with or without MV were enrolled into the current study from January 2010 to December 2014. Patients' characteristics including age and sex, type of illness and costs of hospital treatment were retrospectively analyzed. ResultsA total of 9,539 patients were hospitalized into Department of Respiratory Medicine, The General Hospital of Shenyang Military Area Command in the past 5 years. Of them, 1,531 (16.0%) patients were treated with MV, 764 of the 1,531 (49.9%) patients received non-invasive mechanical ventilation (NIMV), 135 of the 1,531 (8.8%) received invasive mechanical ventilation (IMV), and 632 of the 1,531 (41.3%) received NIMV plus IMV. The percentage of patients older than 65 years in the three groups as above were 71.3%, 63.0% and 72.2%, significantly higher than the Non-MV group's 47.7% (P<0.05); the percentage of males were 52.7%, 82.2% and 63.3% respectively, the later two groups was significantly higher than the Non-MV group's 59.2% (P<0.05); the percentage of ICU admission were 67.0%, 70.4% and 82.8%, significantly higher than the Non-MV group's 24.0% (P<0.05); the percentage of type Ⅰ respiratory failure were 12.4%, 29.6% and 12.4%, the later two groups was significantly higher than the Non-MV group's 13.2% (P<0.05); the percentage of type Ⅱ respiratory failure were 76.6%, 17.8% and 47.0%, all were significantly higher than the Non-MV group's 7.6% (P<0.05). Twenty-one kinds of common co-morbidities for respiratory hospitalized patients were analyzed and it was found that MV patients were likely to have more co-morbidities. Compared to Non-MV group, IMV group had more co-morbidities of type Ⅰ or type Ⅱ respiratory failure caused by pneumonia, bronchiectasis and other infectious diseases and concomitant with hypoalbuminemia, gastrointestinal bleeding and liver and kidney dysfunction and cerebrovascular disease, with statistically significant differences (P<0.05); NIMV group had more co-morbidities of type Ⅱ respiratory failure caused by chronic bronchitis, emphysema, pulmonary heart disease and other chronic airway diseases, and concomitant with coronary heart disease, heart failure, cerebrovascular disease and renal dysfunction, with statistically significant differences (P<0.05); the co-morbidity spectrum of NIMV plus IMV group was between those of IMV and NIMV groups, but more similar to that of IMV group. The high risk factors for IMV were pneumonia, hypoalbuminemia, gastrointestinal bleeding, and cerebrovascular disease; for NIMV were chronic bronchitis, emphysema, pulmonary heart disease, type Ⅱ respiratory failure and cardiac dysfunction. Cost analysis showed that average cost of Non-MV, NIMV, IMV, and NIMV plus IMV patients were 16 359 yuan, 31 872 yuan, 66 924 yuan, and 98 648 yuan respectively, in which the expense of NIMV plus IMV patients was vastest. ConclusionsHospitalized patients receiving MV therapy tend to be older, stay in ICU, complicated with respiratory failure and multiple co-morbidities. Respiratory failure by chronic obstructive airways disease is more often treated with NIMV, but respiratory failure by lung infection often need IMV.
ObjectiveTo study the expression of cytokine-induced neutrophil chemoattractant-1(CINC-1)in rats with transfusion-related acute lung injury(TRALI),explore its possible role in the pathogenesis of TRALI. MethodsSixty Sprague-Dawley rats were randomly divided into a normal control group with sham operation,a positive control group with ALI induced by intravenous infusion of lipopolysaccharide(5 mg/kg),and a TRALI group treated by intraperitoneal injection of LPS 2h before the transfusion of human plasma (1mL),a LPS control group treated by intraperitoneal injection of LPS 2h before the transfusion of normal saline(1mL).The reverse transcription-polymerase chain (RT-PCR)was used to detect CINC-1 mRNA.The level of CINC-1 in lung tissue homogenate was measured by ELISA.Morphological changes of the lung tissue were observed under light microscope.Myeloperoxidase (MPO)in lung homogenate and wet lung weight to dry lung weight ratio (W/D)were observed.The number of cells and the percentage of polymorphonuclear neutrophil (PMN)in Bronchoalveolar lavage fluid (BALF)were also compared. ResultsCompared with the normal control group and the LPS control group,the expression of CINC-1 protein and CINC-1 mRNA were increased significantly in lung of the positive control group and the TRALI group(P<0.05).The number of cells and the percentage of PMN in BALF of the TRALI group [(310.63±76.67)×106/L and (33.57±11.51)%] were significantly higher than those in BALF of the normal control group [(101.36±63.83)×106/L and (9.87±3.56)%](P<0.05).Tissue water content and MPO activity in the TRALI group were significantly higher than those in the normal control group (P<0.05). ConclusionExpression of CINC-1 protein and CINC-1 mRNA are increased in the rat lung with TRALI and PMN infiltration in lung tissue,which suggests CINC-1 participate in the process of the PMN and endothelial cell adhesion and may play an important role in the pathogeneses of TRALI.