ObjectiveTo investigate the role of acetyl CoA carboxylase (ACC)-induced Th17 development in the pathogenesis of asthma.MethodsA total of 24 C57BL/6 mice were randomly assigned to 4 groups (6 in each group), namely a normal group, an asthma group, a DMSO control group and an ACC inhibitor group. The mice in the asthma group, the DMSO control group and the ACC inhibitor group were sensitized and challenged with ovalbumin (OVA) to establish a model of acute asthma, the mice in the normal group were administrated with equal volume of phosphate buffered saline (PBS). The mice in the ACC inhibitor group were intraperitoneally administrated with TOFA, an ACC inhibitor (dissolved in DMSO firstly, then diluted with PBS solution) twice a week, while the DMSO control group were intraperitoneally administrated with equal concentration of DMSO. All mice were sacrificed 24 days later, then lung tissue and serum were collected. The inflammatory cells infiltrated in lung tissue were assessed by the means of HE staining under light microscope. The total level of IgE in serum was detected by ELISA. The percentage of Th17 cells in CD4+ T cells in lung tissue was evaluated by flow cytometry.ResultsThe inflammatory cells infiltration in the asthma group, the DMSO control group and the ACC inhibitor group increased significantly compared with that of the normal group (3.50±0.14, 3.47±0.08, 2.07±0.20vs. 0.50±0.17, allP<0.001), but there were no significant differences between the DMSO control group group and the asthma group (P>0.05), while administration of TOFA could significantly decrease the inflammatory cells infiltration (P<0.001). The total level of serum IgE in the asthma group, the DMSO control group and the ACC inhibitor group was significantly higher than that in the normal group [(5 680.40±831.40) ng/ml, (5 624.79±365.50) ng/ml, (2 028.95±134.60) g/mlvs. (400.52±57.13) ng/ml, allP<0.008], but there were no significant differences between the DMSO control group and the asthma group (P>0.05), while the total level of serum IgE in the ACC inhibitor group was significantly lower than that in the asthma group (P<0.008). The percentage of Th17 cells in CD4+ T cells in lung tissue increased markedly in the asthma group, the DMSO control group and the ACC inhibitor group compared with the normal group [(2.01±0.12)%, (1.95±0.16)%, (0.82±0.04)%vs. (0.59±0.03)%, bothP<0.008], and also there were no significant differences between the DMSO control group and the asthma group (P>0.05), while administration of TOFA could notably reduce the percentage of Th17 cells (P<0.008).ConclusionInhibition of ACC significantly alleviates the airway inflammation of OVA-induced asthma, and reduces the percentage of Th17 cells in lung tissue and the total level of serum IgE. ACC may participate in the pathogenesis of asthma by inducing Th17 development.
ObjectiveTo explore the correlation of BMI and 25 hydroxyvitamin D3 level with colon cancer.MethodsA total of 100 cases who underwent colonoscopy and were excluded from bowel diseases at the physical examination center of the First Hospital of Qinhuangdao from March 2017 to October 2017 were retrospectively selected as the control group. A total of 100 patients who underwent colonoscopy at general surgery or physical examination center and were confirmed to have colon cancer by pathological examination were included in the colon cancer group. The height, weight and body mass index (BMI) were measured in the morning, and the level of 25 hydroxyvitamin D3 (25(OH)D3) was determined by fasting blood sampling.Results① There was no statistical significance in age and 25(OH)D3 level between the two groups (P>0.05), and BMI of the colon cancer group was significantly higher than that of the control group (P<0.05). ② The proportion of overweight and obesity in the colon cancer group was significantly higher than that in the control group (P<0.05), and the proportion of vitamin D deficiency was significantly higher as well (P<0.05). ③ Logistic regression analysis showed that the incidence of colon cancer in patients with vitamin D deficiency was 12.263 times higher than that in patients without vitamin D deficiency, and the incidence of colon cancer in patients with overweight and obesity was 2.215 times higher than that in patients with normal BMI, with statistically significant differences (P<0.05).ConclusionThe incidence of colon cancer in patients with vitamin D deficiency and those with BMI of overweight or obesity is significantly increased.
ObjectiveTo investigate the diagnostic performance of parameters of arterial enhancement fraction (AEF) based on enhanced CT with histogram analysis in the severity of liver cirrhosis.MethodsThe patients with liver cirrhosis clinically confirmed and met the inclusion criteria were included from January 2016 to December 2018 in the First Affiliated Hospital of Chengdu Medical College, then them were divided into grade A, B, and C according to the Child-Pugh score. Meanwhile, the patients without liver disease were selected as the control group. All patients underwent the upper abdomen enhanced CT scan with three-phase and the biochemical examination of liver function. The parameters of AEF histogram were obtained by using the CT Kinetics software, and the aspartic aminotransferase and platelet ratio index (APRI) was calculated. The differences of parameters of AEF histogram and APRI among these patients with liver cirrhosis and without liver disease were analyzed. The diagnostic performance was evaluated by using the area under curve (AUC) of receivers operating characteristic curve.ResultsEighty-five patients with liver cirrhosis were included in this study, including 25, 41, and 19 patients with grade A, B, and C of Child-Pugh score, respectively, and there were 20 patients in the control group. The consistencies in measuring the parameters of AEF histogram twice for the same observer and between the two observers were good (intraclass correlation coefficient was 0.938 and 0.907, respectively). The mean, median, and kurtosis of AEF histogram and the APRI among the grade A, B, C of Child-Pugh score, and control group had significant differences (all P<0.001) and these indexes were positively correlated with the severity of liver cirrhosis (rs=0.811, P<0.001; rs=0.827, P<0.001; rs=0.731, P<0.001; rs=0.711, P<0.001). The AUC of the mean, median, kurtosis, and APRI in diagnosing grade A of liver cirrhosis was 0.829, 0.841, 0.747, and 0.718, respectively; which in diagnosing grade B of liver cirrhosis was 0.847, 0.734, 0.704, and 0.736, respectively; in diagnosing grade C of liver cirrhosis was 0.646, 0.825, 0.782, and 0.853, respectively.ConclusionThe mean and median of AEF histogram parameters based on enhanced CT with three-phase and serological APRI are useful in diagnosis of grage A, B, and C of liver cirrhosis, respectively.
ObjectiveTo explore the clinical features, etiological characteristics of co-infections in adult patients with rhinovirus pneumonia.MethodsFourty-nine patients admitted to hospitals for rhinovirus pneumonia were enrolled from 8 medical centers in mainland China between August 2016 and August 2018. Multiplex real-time polymerase chain reaction assays for viral detection were implemented to all bronchoalveolar lavage fluid specimens obtained from the patients. The patients were divided into two groups depending on the status of other etiology co-infection (simple rhinovirus pneumonia group, n=24; coinfections group, n=25). The general data were collected, age, gender, underlying diseases, corticosteroids, symptoms, disease severity, imaging manifestations, etiology, whether patients with respiratory failure, mechanical ventilation, whether the application of vasoactive drugs, antibiotics application, hospital mortality rate of the two groups were reviewed and compared in detail.ResultsThirteen patients (26.5%) with rhinovirus pneumonia had no underlying diseases, 8 patients (16.3%) with chronic underlying lung diseases, 6 patients (12.2%) with diabetes mellitus, 10 patients (20.4%) were immunocompromised patients, 16 patients (32.7%) with respiratory failure, and the hospital mortality rate was 8.2% (4/49). Cases with coinfection were remarkably correlated with more cerebrovascular diseases and disturbance of consciousness, higher PSI score and higher ratio of CURB-65 score >1, more respiratory failure and hospital mortality than those of simple rhinovirus pneumonia group (P< 0.05). There were 25 cases (51.0%) with mixed infection, including 18 bacteria (36.7%), 12 viruses (24.5%), 12 (24.5%) fungi (pneumocystis, aspergillus). Enterobacter and Pseudomonas aeruginosa were most frequently identified bacteria in the viral-bacterial group. Four patients with coinfections died.ConclusionsRhinovirus pneumonia in adult patients often has underlying diseases, and is prone to coinfections (bacteria, fungi, and other viruses). The outcome of these patients is always poor.
ObjectivesTo analyze the effect of bronchiectasis (BE) on the clinical characteristics and prognosis of hospitalized patients with community acquired pneumonia (CAP), and to explore the independent risk factors affecting the 30-day mortality. MethodsA national multi-center retrospective study based on the CAP-China network platform. The clinical data of 6056 patients with CAP who were hospitalized in 13 tertiary teaching hospitals in Beijing, Shandong and Yunnan from January 1, 2014 to December 31, 2014 were collected. To compare the differences in clinical characteristics, etiological distribution and treatment prognosis of patients with CAP with bronchiectasis (BE-CAP) and patients without bronchiectasis (non-BE-CAP). Logistic regression analysis was performed to analyze independent risk factors affecting 30-day mortality in hospitalized patients with BE-CAP. ResultsIn the final analysis, 5880 CAP patients were included, and BE-CAP patients accounted for 10.8% (637/5880). Compared with non-BE-CAP patients, more BE-CAP patients were women, and a higher proportion of patients had chronic obstructive pulmonary disease, bronchial asthma, previous history of glucocorticoid inhalation, and a history of CAP within 1 year. BE-CAP patients had more dyspnea and cyanosis, lower arterial partial pressure of oxygen, longer median time to clinical stability (6 d vs. 4 d, P<0.001), and the incidence of respiratory failure was significantly higher than that of non-BE-CAP patients (27.8% vs. 19.7%, P<0.001). Pseudomonas aeruginosa is the most common bacterial infection in BE-CAP patients. Comorbid bronchiectasis has no significant effect on disease severity, total length of hospital stay, and mortality in CAP patients. The 30-day mortality rate of BE-CAP patients was 2.2%. Logistic regression analysis showed that initial treatment failure [odds ratio (OR) 6.675, 95% confidence interval (CI) 4.235-10.523, P<0.001], respiratory failure (OR 5.548, 95%CI 3.681-8.363, P<0.001), blood urea nitrogen>7.0 mmol/L (OR 2.490, 95%CI 1.625-3.815, P<0.001), albumin<35.0 g/L (OR 1.647, 95%CI 1.073-2.529, P=0.022) and CURB-65 score (OR 1.691, 95%CI 1.341-2.133, P<0.001) were independent risk factors for 30-day mortality in BE-CAP patients. ConclusionsBE-CAP patients have more serious hypoxia symptoms and higher incidence of respiratory failure. For BE-CAP patients with failure of initial treatment, complicated with respiratory failure, blood urea nitrogen>7.0 mmol/L, and albumin<35.0 g/L, treatment evaluation should be performed in time to reduce the mortality rate.