Objective
To improve the diagnosis and treatment of pulmonary infiltration with eosinophilia (PIE).
Methods
Patients who were diagnosed with PIE in the First Affiliated Hospital of Guangzhou Medical University from January 2004 to December 2013 were recruited and retrospectively analyzed. Data of etiology, clinical manifestation, imaging and pathological features were recorded.
Results
pulmonary eosinophilic granuloma (PEG) (n=2), eosinophilic granulomatosis with polyangiitis (EGPA) (n=7), L?ffler syndrome (n=4), allergic bronchopulmonary aspergillosis (ABPA) (n=16), and chronic eosinophilic pneumonia (CEP) (n=19). There were 27 males and 21 females. 47.9% of the PIE patients were diagnosed as asthma and treated with regular treatment but had not been controlled well. PEG was characterized with wheeze and anhelation in clinical manifestations, unelevated blood eosinophil counts and percentage, significant small airway abnormalities in lung function, diffuse pneumonectasis in Chest CT, and appearance of eosinophil cells in alveole. EGPA shows dyspnea and cough in clinical manifestations, as well as other organs function damaged, unelevated blood eosinophil counts and percentage, significant FEV1/FVC and small airway abnormalities in lung function, tree-in-bud in Chest CT, appearance of eosinophilic granuloma outside blood vessels. L?ffler syndrome also showed cough, shorter course of disease, normal lung function and diffusion. ABPA showed wheeze and cough, 31.3% of them with hemoptysis, normal blood eosinophil count, central bronchiectasis in Chest CT. CEP also showed dyspnea and cough. 21.1% of CEP patientshad chest pain, increasing sputum eosinophil percentage compare with blood eosinophil percentage, and small airway abnormalities in lung function.
Conclusions
Most of PIE patients are diagnosed as asthma but haven’t gotten well controlled under the regular anti-asthmatic treatment. Patients with PIE have increasing eosinophil counts and decreasing lung function. The diagnosis of PIE still depends on clinical manifestation, laboratory test, imaging and pathological examination.
Objective To evaluate the correlation between cyclin B1 (CCNB1) gene expression and the prognosis of lung adenocarcinoma. Methods Oncomine, STRING, Human Protein Atlas, The Cancer Genome Atlas and other databases as well as Kaplan-Meier method, Cox regression, receiver operating characteristic (ROC) curve and Spearman correlation analysis were used to verify the effect of CCNB1 on patients with lung adenocarcinoma. Results CCNB1 was highly expressed in lung adenocarcinoma, and the high expression was correlated with T stage (P=0.001), N stage (P<0.001), pathological stage (P<0.001) and gender (P=0.008). Univariate Cox regression analysis showed that the expression of CCNB1, T stage, N stage, M stage and pathological stage were the factors affecting the overall survival rate of patients with lung adenocarcinoma (P<0.05); multivariate Cox regression analysis showed that the expression of CCNB1 and T stage were independent risk factors for overall survival of patients with lung adenocarcinoma (P<0.05). Kaplan-Meier analysis showed that high expression of CCNB1 was associated with shorter overall survival [hazard ratio (HR)=1.60, 95% confidence interval (CI) (1.20, 2.14), P=0.002], disease-specific survival [HR=1.68, 95%CI (1.16, 2.44), P=0.006] and progression-free interval [HR=1.42, 95%CI (1.09, 1.85), P=0.009]. The ROC curve showed that CCNB1 might be a potential diagnostic molecule for lung adenocarcinoma [area under the curve=0.980, 95%CI (0.967, 0.993)]. Spearman correlation analysis showed that CCNB1 expression was positively correlated with the infiltration of T helper cells 2 (rs=0.805, P<0.001) and T helper cells (rs=0.103, P=0.017), and negatively correlated with the infiltration of natural killer cells (rs=?0.195, P<0.001), macrophages (rs=?0.134, P=0.002), and T cells (rs=?0.092, P=0.033). Conclusion CCNB1 is highly expressed in lung adenocarcinoma compared with normal tissues, which is related to poor prognosis and may provide a potential therapeutic target for patients with lung adenocarcinoma.
ObjectiveTo explore the interaction between immune cell infiltration and extracellular matrix (ECM) in diffuse gastric cancer (DGC), and to identify novel diagnostic biomarkers and therapeutic targets. MethodsTranscriptomic data of DGC patients from The Cancer Genome Atlas (TCGA) database were analyzed to screen potential regulator factor of immune-related and ECM receptor-related signaling pathways. Differential expression of the identified regulator was assessed between the DGC tissues and the adjacent gastric tissues. Bioinformatics analysis was utilized to evaluate the relation between the regulator factor and immune cell infiltration and ECM, as well as prognosis. The clinical validation was performed using 90 paraffin-embedded DGC tissues and adjacent gastric tissues from the patients treated at The Lanzhou University Second Hospital (hereafter “our hospital”) from January 2017 to December 2019. The immunohistochemical staining was employed to examine the expression of regulator factor, followed by analysis of its association with immune cell infiltration, clinicopathologic features, and prognosis. Additionally, 10 paired DGC tissues and adjacent gastric tissues from the patients treated in our hospital in 2024 were collected for validation using real-time quantitative PCR to assess mRNA expression. The significance level was set at α=0.05. ResultsThe collagen type I alpha 1 chain (COL1A1), a potential regulator factor linked to immune and ECM receptor signaling pathways, was identified from the TCGA database. The COL1A1 was significantly overexpressed in the DGC tissues compared to the adjacent gastric tissues (P<0.001), and its high expression correlated with poorer prognosis [HR(95%CI)=2.98(1.21, 7.30), P=0.017]. The COL1A1 gene expression negatively correlated with CD8+ T cell enrichment score (CIBERSORT: r=?0.17, P<0.001; xCELL: r=?0.32, P<0.001) but positively correlated with M2 tumor-associated macrophage enrichment score (CIBERSORT: r=0.32, P<0.001; xCELL: r=0.24, P<0.001). The clinical validation confirmed that the COL1A1 protein and mRNA were both overexpressed in the DGC tissues (P<0.001). The patients with high COL1A1 protein expression had worse overall survival (P<0.001), and high expression (vs. low) was an independent risk factor for postoperative overall survival [HR(95%CI)=6.607(3.374, 12.940), P<0.001]. The COL1A1 protein expression positively correlated with CD163 (an M2 macrophage marker; r=0.76, P<0.001) and negatively with CD8+ (T cell marker, r=?0.84, P<0.001). ConclusionThis study demonstrates that COL1A1 is a potential therapeutic target for immune suppression and ECM interaction in DGC and a critical prognostic factor for long-term survival in patients with DGC.
Objectives
To overview the systematic reviews/meta-analyses of safety of femoral nerve block (FNB) used as a postoperative analgesic technique in patients undergoing total knee arthroplasty (TKA).
Methods
We searched databases including The Cochrane Library, PubMed, EMbase, CNKI, WanFang Data, and VIP from inception to July, 2016. Two reviewers independently screened literature, extracted data and used AMSTAR to evaluate the methodological quality of the included studies. The major indexes used to evaluate the safety of FNB were the incidence rates of symptoms including nausea, vomiting, sedation, retention of urine, dizziness, pruritus, hypotension, falls, nenous thromboembolism and deep infection.
Results
A total of 12 systematic reviews/meta-analyses were included.They assessed the safety of FNB compared with local infiltration analgesia (LIA), periarticular multimodal drug injection (PMDI), epidural analgesia (EA), patient-controlled intravenous analgesia of opioids (PCA) and adductor canal block (ACB), respectively. The methodological quality of included studies were medium, with the scores between 3 to 10. The results of overview indicated that: FNB had lower incidence rates of nausea and vomiting compared with EA and PCA, but had higher than ACB. FNB had lower incidence rates of sedation and retention of urine compared with EA and PCA. FNB had lower incidence rates of dizziness compared with EA and PCA, and lower incidence rate of hypotension compared with EA.
Conclusion
Current evidence suggests that FNB is safer than EA and PCA. Due to the limited quantity and quality of the included studies, the above conclusions are needed to be verified by more high-quality studies.
Objective To study the analgesic effect of a new “cocktail” of local infiltration analgesia (LIA) with Deprosone after total hip arthroplasty (THA). Methods In a prospective randomized controlled study, 100 patients with hip joint disease requiring unilateral primary THA in West China Hospital of Sichuan University between January 2018 and December 2018 were enrolled and randomly divided into observation group and control group, with 50 cases in each group. There was no significant difference in age, gender, operative side, disease type, body mass index, American Society of Anesthesiologists (ASA) classification, preoperative rest and activity visual analogue scale (VAS) score, hip Harris score (HHS), quality of life scale (SF-12) score, and other general data between the two groups (P>0.05). The patients in the observation group were treated with a new “cocktail” LIA around the hip joint before suturing the incision, and the drug formula was ropivacaine 200 mg, Diprospan 1 mL, morphine 10 mg, and added normal saline to 80 mL; the patients in the control group were not treated with LIA. The operation time, postoperative hospital stay, the amount of morphine used during hospitalization, and the range of motion of hip joint at discharge were recorded, and the complications were counted. The VAS score at rest and activity, HHS score, and SF-12 score [physiological score (PCS) and psychological score (MCS)] of the hip joint were recorded before and after operation, and the postoperative analgesic effect and the recovery of hip joint function were evaluated. Results There was no significant difference in the operation time between the two groups (P>0.05), and the postoperative hospital stay in the observation group was significantly shorter than that in the control group (P<0.05). The postoperative morphine consumption in the observation group was significantly less than that in the control group (P<0.05), and the total morphine consumption in the observation group was less than that in the control group during hospitalization, but the difference was not significant (P>0.05). Patients in both groups were followed up to 6 months after operation. The resting VAS scores of the observation group were significantly lower than those of the control group at 2, 6, 12 hours after operation and in the morning and afternoon of the first day after operation, and the active VAS scores of the observation group were significantly lower than those of the control group at 6, 12 hours after operation and in the morning of the first day after operation, and the differences were significant (P<0.05). There was no significant difference in the resting and active VAS scores between the two groups on the day of discharge and at 3 and 6 months after operation (P>0.05). At discharge, the flexion range of motion of hip joint in the observation group was significantly greater than that in the control group (P<0.05), but there was no significant difference in the abduction range of motion of hip joint between the two groups (P>0.05). There was no significant difference in HHS score and SF-12 score between the two groups at 3 and 6 months after operation (P>0.05). There was no significant difference in analgesic satisfaction and functional satisfaction between the two groups at last follow-up (P>0.05). There was no complication such as skin pruritus, superficial and deep infection of incision, skin necrosis, deep venous thrombosis of lower extremity, and pulmonary embolism in both groups. There was no significant difference in the incidence of complications such as nausea and vomiting, urine retention, fat liquefaction of incision, local hematoma, and large fluctuation of blood sugar between the two groups (P>0.05). ConclusionThe new “cocktail” LIA with Diprospan can effectively reduce the early postoperative pain of THA, reduce the dosage of opioids, shorten the length of hospital stay, and is conducive to the early functional rehabilitation of patients.
Objective To review the research progress of injection sites of local infiltration analgesia (LIA) in total knee arthroplasty (TKA). MethodsThe relevant domestic and foreign literature in recent years was extensively reviewed. The neuroanatomy of the knee, and the research progress of the selection and the difference of effectiveness between different injection sites of LIA in clinical studies were summarized. ResultsLarge concentrations of nociceptors are present throughout the various tissues of the knee joint. Patellar tendon, subpatellar fat pad, lateral collateral ligament insertions, iliotibial band insertions, suprapatellar capsule, and posterior capsule were more sensitive to pain. Most current studies support injections into the lateral capsule, collateral ligament, retinaculum, quadriceps tendon, fat pad, and subcutaneous tissue. Whether to inject into the back of the knee and subperiosteum is controversial. ConclusionThe relative difference of knee tissue sensitivity to pain has guiding significance for the selection of LIA injection site after TKA. Although researchers have conducted clinical trials on injection site and technique of LIA in TKA, there are certain limitations. The optimal scheme has not been determined yet, and further studies are needed.
ObjectiveTo study the infiltration situation of breast cancer surface skin, and explore the characteristics of infiltration of breast cancer surface skin at the molecular level.
MethodsNested reverse transcription-polymerase chain reaction technique was used to detect the expressions of human mammaglobin(hMAM)mRNA in 15 cases of hyperplasia of mammary gland tissues, 15 cases of breast fibroadenoma tissues, and 60 cases of breast cancer tissues and their corresponding tumor surface skins. The relationship of the hMAM mRNA expression in the surface skins of breast cancer tissue to its clinicopathologic characteristics was analyzed.
ResultsThe hMAM mRNA positive expressions in the breast fibroadenoma tissues, hyperplasia of mammary gland tissues, and breast cancer tissues were 40.00%(6/15), 53.33%(8/15), and 83.33%(50/60), respectively, which in the breast cancer tissues was significantly higher than that in the breast fibroadenoma tissues or hyperplasia of mammary gland tissues(P < 0.05). There was no hMAM mRNA positive expression in the surface skin of fibroadenoma or hyperplasia of mammary gland tissues, but there was 3(5.00%)cases of the hMAM mRNA positive expressions in the breast cancer surface skin. The hMAM mRNA positive expression in the breast cancer surface skin was not related with the patient age, tumor diameter, and tumor staging(P > 0.05), but was related with axillary lymph nodes metastasis and distance from tumor to nipple less than 4 cm(P < 0.05).
ConclusionsThe hMAM mRNA highly expresses in breast cancer tissue and it has a certain value in the diagnosis of infiltration of breast cancer surface skin. The patients with axillary lymph node metastasis and distance from tumor to nipple less than 4 cm are more susceptible to infiltration of breast cancer surface skin.
ObjectiveTo evaluate the impact of local infiltration analgesia on postoperative pain after hip arthroplasty.
MethodsRelevant randomized controlled trials comparing the analgesia effect and adverse effects between local infiltration analgesia group and non-local infiltration analgesia group (control group) were identified from Cochrane Library, Embase, PubMed, China National Knowledge Infrastructure, VIP database and Wanfang database from their establishment until May 2016. A systematic review was performed to compare the pain scores and adverse events between those two groups. Effective data were pooled for Meta-analysis with software RevMan 5.2.0.
ResultsTwelve eligible trials were identified in this study. The pain scores of the two groups of patients during rest time after surgery were significantly different[WMD=-19.06, 95%CI (-21.51, -16.62), P<0.000 01]; the pain scores were also significantly different during activity time[WMD=-11.45, 95%CI (-15.56, -7.34), P<0.000 01]. There was significant difference in postoperative nausea and vomiting between the two groups[RR=0.59, 95%CI (0.42, 0.84), P=0.003]. The pain degree and incidence of nausea and vomiting in the local infiltration analgesia group were lower than the control group, but there was no significant difference between the two groups in terms of urinary retention, itch and hypotension (P>0.05).
ConclusionLocal infiltration analgesia is effective in reducing postoperative pain without any additional adverse reactions.
Objective To investigate the expression levels of fatty acid metabolism-related genes in acute myeloid leukemia (AML) and construct a prognostic risk regression model for AML. Methods Gene expression data from control groups and AML patients were downloaded from the GTEx database and The Cancer Genome Atlas (TCGA) database, followed by screening for differentially expressed genes (DEGs) between AML patients and controls. Fatty acid metabolism-related genes were obtained from the MSigDB database. The intersection of DEGs and fatty acid metabolism-related genes yielded fatty acid metabolism-associated DEGs. A protein-protein interaction network was constructed using the STRING database. Hub genes were analyzed via random forest, Kaplan-Meier survival, and Cox proportional hazards regression based on TCGA clinical data to establish a prognostic model and evaluate their diagnostic and prognostic significance. Immune cell infiltration differences between high- and low-risk groups were assessed using CIBERSORT algorithms to explore immune microenvironment variations and correlations with risk scores. Results A total of 60 fatty acid metabolism-related DEGs were identified. Further screening revealed 15 hub genes, among which four genes (HPGDS, CYP4F2, ACSL1, and EHHADH) were selected via integrated random forest, Cox regression, and Kaplan-Meier analyses to construct an AML prognostic lipid metabolism gene signature. Heatmaps demonstrated statistically significant differences in tumor-infiltrating immune cell proportions between risk groups (P<0.05). Conclusion The constructed lipid metabolism gene prognostic model may serve as a biomarker for overall survival in AML patients and provide new insights for immunotherapy drug development.
Objective To identify genes of lipopolysaccharide (LPS) -induced acute lung injury (ALI) in mice base on bioinformatics and machine learning. Methods The acute lung injury dataset (GSE2411, GSE111241 and GSE18341) were download from the Gene Expression Database (GEO). Differential gene expression analysis was conducted. Gene ontology (GO) analysis, KEGG pathway analysis, GSEA enrichment analysis and protein-protein interaction analysis (PPI) network analysis were performed. LASSO-COX regression analysis and Support Vector Machine Expression Elimination (SVM-RFE) was utilized to identify key biomarkers. Receiver operator characteristic curve was used to evaluate the diagnostic ability. Validation was performed in GSE18341. Finally, CIBERSORT was used to analyze the composition of immune cells, and immunocorrelation analysis of biomarkers was performed. Results A total of 29 intersection DEGs were obtained after the intersection of GSE2411 and GSE111241 differentially expressed genes. Enrichment analysis showed that differential genes were mainly involved in interleukin-17, cytokine - cytokine receptor interaction, tumor necrosis factor and NOD-like receptor signaling pathways. Machine learning combined with PPI identified Gpx2 and Ifi44 were key biomarkers. Gpx2 is a marker of ferroptosis and Ifi44 is an type I interferon-induced protein, both of which are involved in immune regulation. Immunocorrelation analysis showed that Gpx2 and Ifi44 were highly correlated with Neutrophils, TH17 and M1 macrophage cells. Conclusion Gpx2 and Ifi44 have potential immunomodulatory abilities, and may be potential biomarkers for predicting and treating ALI in mince.
