目的:探究非小细胞肺癌(NSCLC)组织及其细胞系内基因长链非编码RNA00052(long intergenic non-coding RNA 00052,Linc00052)的表达水平,以及Linc00052在肺癌中的临床意义、作用机制及与患者预后的相关性.方法:利用逆转录-聚合酶链反应(qRT-PCR)检测正常肺细胞系与肺癌细胞系之间Linc00052表达水平的差异,肺癌组织与癌旁组织之间Linc00052表达水平的差异,并分析Linc00052与肺癌临床病理特征的相关性,Kaplan-Meier生存曲线分析Linc00052与肺癌预后之间的相关性.在A549细胞系中过表达Linc00052,采用MTT实验检测过表达Linc00052前后细胞增殖变化,并采用qRT-PCR检测miR-330-3p表达变化.结果:肺癌细胞系较正常肺细胞系中Linc00052明显低表达,同时肺癌组织比癌旁组织中Linc00052明显低表达(P<0.01);Linc00052的表达与肿瘤的分化程度(P=0.02)、淋巴结转移(P=0.002)、远处转移(P=0.005)和临床分期(P=0.001)有关.肺癌的Linc00052表达水平减低与肺癌患者的预后不良有关(P<0.05).过表达Linc00052后可显著抑制细胞增殖(P<0.05),qRT-PCR结果证实,过表达Linc00052可显著下调miR-330-3p mRNA的表达水平(P<0.05).结论:Linc00052在肺癌组织中表达下调,并与肺癌的发生发展及预后密切相关,Linc00052有可能通过负调控miR-330-3p在肺癌中发挥抑癌作用.

目的 探讨慢性阻塞性肺疾病患者血清半乳糖凝集素-3(Galectin-3)、白介素-38(IL-38)水平变化及与肺功能的相关性.方法 选取本院2016年1月～2018年4月诊治的258例慢性阻塞性肺疾病患者为观察组,其中急性加重期患者(急性组)151例,稳定期患者(稳定组)107例;选取同期129例健康体检者为对照组.入组时检测研究对象血清Galectin-3、IL-38、CRP、PCT水平及肺功能,分析血清Galectin-3、IL-38、CRP、PCT水平与肺功能的相关性.应用ROC曲线分析血清Galectin-3、IL-38、PCT水平对慢性阻塞性肺疾病急性加重期的诊断价值.结果 急性组和稳定组患者血清Galectin-3、IL-38、CRP、PCT水平均高于对照组(P<0.05),且急性组高于稳定组(P<0.05);急性组和稳定组患者PEF％pred、FEV1％pred及FEV1/FVC水平均低于对照组(P<0.05),且急性组低于稳定组(P<0.05).血清Galectin-3、IL-38、CRP、PCT水平与肺功能指标(PEF％perd、FEV1％pred、FEV1/FVC)呈负相关.ROC曲线分析显示,血清Galectin-3、IL-38诊断COPD急性加重期的曲线下面积(AUC)分别为0.839、0.893,敏感度分别为0.808、0.781,特异度分别为0.841、0.748.血清Galectin-3、IL-38诊断COPD急性加重期的AUC、灵敏度和特异度均高于CRP(AUC:0.735,灵敏度:0722,特异度:0.710)和PCT(AUC:0.760,灵敏度:0.702,特异度:0.682).结论 COPD患者血清Galectin-3、IL-38、CRP、PCT水平显著上升,并且与肺功能存在一定的关系,可作为COPD患者病情判断的标志物;但血清Galectin-3、IL-38在COPD急性加重期的诊断价值优于CRP和PCT.

目的 探讨血清诱骗受体3(decoy receptor 3,DcR3)和白细胞介素9(interleukin-9,IL-9)在急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者中表达情况及临床意义.方法 86例ARDS为ARDS组,43例体检健康者为对照组.ARDS组根据氧合指数(oxygenation index,OI)分为轻度组(OI＞26.6～39.9 kPa)22例、中度组(OI＞13.3～26.6 kPa)45例和重度组(OI≤13.3 kPa)19例,根据患者28 d生存情况分为生存组40例和死亡组46例.检测各组血清DcR3、IL-9和降钙素原(procalcitonin,PCT)水平,绘制ROC曲线,评估血清DcR3、IL-9和PCT水平预测ARDS患者预后的临床价值;采用Kaplan-Meier法绘制生存曲线,采用log-rank检验比较不同DcR3、IL-9和PCT水平ARDS患者28 d的存活率.结果 ARDS组血清DcR3[(2.93±1.01)μg/L]、IL-9[(4.36±1.17)ng/L]和PCT[(1.62±0.53)μg/L]水平明显高于对照组[(0.49±0.18)μg/L、(2.01±0.73) ng/L、(0.38±0.12)μg/L](P＜0.05);轻度组、中度组和重度组血清DcR3、IL-9和PCT水平均依次升高(P＜0.05);生存组血清DcR3 [(2.11±1.13)μg/L]、IL-9[(3.81±1.20)ng/L]和PCT[(1.41±0.49) μg/L]水平明显低于死亡组[(3.64±1.62)μg/L、(4.84±1.33)ng/L、(1.80±0.57)μg/L] (P＜0.05);DcR3、IL-9和PCT的最佳截断值分别为2.98 μg/L、4.02 ng/L、1.59μg/L时,预测ARDS患者预后的AUC分别为0.845(95 ％CI:0.760～0.929)、0.821(95％CI:0.735～0.906)、0.763(95％CI:0.661～0.864),灵敏度分别为0.761、0.739、0.713,特异度分别为0.856、0.807、0.725;DcR3≥2.98 μg/L、IL-9≥4.02 ng/L和PCT≥1.59 μg/L时,ARDS患者28 d存活率(34.00％、37.25％、38.78％)较DcR3＜2.98,μg/L、IL-9＜4.02 ng/L和PCT＜1.59 μg/L者(63.89％、60.00％、56.76％)明显降低(P＜0.001).结论 ARDS患者血清DcR3、IL-9和PCT水平明显上升,可作为评价ADRS患者病情严重程度和预后的指标,DcR3和IL-9的临床价值优于PCT.

Objective To investigate the effect of non-invasive ventilation in treatment of type II respiratory failure in patients with AECOPD and its influencing factors. Methods From January 2015 to August 2017 in our hospital, 237 AECOPD patients with type II respiratory failure who had been treated with non-invasive ventilation were selected as the research objects. Their data were collected, including gender, age, body mass index, COPD duration, onset time, AECOPD ventilation time, complications, APACHE score, GCS score, blood glucose, albumin, hemoglobin, white blood cells, and blood gas analysis. The correlation between the indexes and the treatment effect of noninvasive ventilation were analyzed. Results Univariate analysis showed that the influencing factors of curetive effect included gender, age, BMI, duration of COPD, the onset of AECOPD, noninvasive ventilation time, cardiovascular disease, APACHE Ⅱ score, GCS score, blood glucose, albumin, hemoglobin, white blood cells, procalcitonin, C-reactive protein, serum creatinine, urea nitrogen, PaO2, PaCO2 and p H value (P ＜ 0.05). Multivariate logistic analysis showed that high APACHE Ⅱ score, high procalcitonin intake, and longer ventilation time were independent risk factors for non-invasive ventilation (P ＜ 0.05), and high albumin was a protective factor for successful treatment (P ＜ 0.05). Conclusion Higher APACHE Ⅱ scores, higher engraftment of procalcitonin, longer ventilation time, and higher albumin intake may affect the efficacy of noninvasive ventilation in treatment of AECOPD patients with type Ⅱ respiratory failure. In clinic, comprehensive evaluation and targeted treatment should be based on relevant risk factors to improve the success rate of non-invasive ventilation.

Objective To investigate the effect of high mobility group box-1 protein on prognosis of venti-lator associated pneumonia in patients in ICU.Methods From January 2016 to January 2017,143 Continuous patients in ICU with ventilator respirator were collected.Multiple regression analysis was used to explore the risk factors of ventilator associated pneumonia in patients in ICU.High mobility group box-1 protein at 1,3,5 and 7 d were detected.Moreover,the association between in-hospital mortality and high mobility group box-1 protein of different times were analyzed.Results Logistic regression analysis showed that the duration of me-chanical ventilation ≥14 d and High mobility group box-1 protein ≥50 pg/mL were risk factors of ventilator-associated pneumonia in patients in ICU(P<0.05).A total of 19 patients died during hospitalization.When compared with the survivals,patients suffered from mortality at 1,3,5 and 7 d got elevated levels of high mob-ility group box-1 protein[(66.68 ± 18.69)vs.(53.37 ± 17.57)pg/mL,P= 0.003,(82.21 ± 15.68)vs. (50.65 ± 15.59)pg/mL,P=0.000,(86.53 ± 22.14)vs.(53.06 ± 14.28)pg/mL,P=0.000]and[(86.37 ± 25.02)vs.(51.38 ± 14.84)pg/mL,P=0.000].Conclusion The duration of mechanical ventilation≥14 d and high mobility group box-1 protein ≥50 pg/mL were risk factors of ventilator-associated pneumonia in patients in ICU,an elevated level of high mobility box-1 protein may be related to poor prognosis.

目的 探讨血清D二聚体(D-D)、血小板平均体积(MPV)和同型半胱氨酸(Hcy)联合检测对老年肺栓塞(PE)患者的临床价值.方法 选择2015年2月至2017年5月在航天中心医院确诊的116例PE患者作为研究组,同期100例健康体检者作为对照组,两组对象均进行血清D-D、MPV和Hcy检测,记录检测结果,并进行统计学分析.结果 研究组患者D-D、MPV和Hcy水平显著高于对照组(P＜0.05);且重度患者的D-D、MPV和Hcy水平显著高于轻度患者(P＜o.05);两组单独检测D-D、MPV和Hcy检出率有显著差异,三组指标联合检测使PE诊断率提高达91.38％(P＜0.05).结论 PE患者血清D-D、MPV和Hcy水平显著高于健康人群,且与PE严重程度有关,三者联合检测对老年PE有较高的诊断价值.

Objective To explore the effect of cardic troponin I (cTnⅠ) and B type natriuretic peptide (BNP) on the severity of senile sepsis and the value of cTnⅠ and BNP detection in prognosis evaluation.Methods 95 elderly patients with sepsis were selected;80 normal physical examination people at the same time were chosen as the control.The detection of cTnⅠ and BNP was performed within 24 hours after admission;according to APACHE Ⅱ scores,the patients were divided into 3 subgroups:group A (＜ 15 points),group B (from 15 to 25 points) and group C (＞ 25 points),the levels of cTnⅠ and BNP of the 3 subgroups were compared and the difference among the 3 was analyzed;according to the prognosis,the patients were divided into 2 groups:sepsis death group and sepsis survival group and the difference in cTnⅠ and BNP between the 2 groups was analyzed.Results The levels of cTnⅠ,BNP and the APACHE Ⅱ scores in sepsis groups were higher than those in control group (P＜0.05);the levels of cTnⅠ,BNP and the APACHEⅡ scores in sepsis survival group were lower than those in sepsis death group (P ＜ 0.05);there existed an obvious difference in the levels of cTnⅠ and BNP among the 3 subgroups (P＜0.05).Conclusions The levels of cTnⅠ and BNP may be of certain clinical value in the evaluation of the disease severity of critical patients and in prognosis prediction.