Objective To investigate the serum total IgE(tlgE) and specific IgE(slgE) to common allergens among allergic patients in Guangzhou,China.Methods 7 085 patients were examined for tlgE and slgE to 15 allergens,based on ...Objective To investigate the serum total IgE(tlgE) and specific IgE(slgE) to common allergens among allergic patients in Guangzhou,China.Methods 7 085 patients were examined for tlgE and slgE to 15 allergens,based on the protocols of reversed enzyme allergosorbent test and the sandwich enzyme-linked immunosorbent assay.Results 3 758(53.04%) patients tested positive for tlgE,and 4 640(65.49%) for slgE.Der pteronyssinus,Der farinae,eggs,and cow's milk were the most common allergens leading to higher positive rates of slgE responses.Several peaks of sensitization were:Der pteronyssinus,Der farinae,and Blomia tropicalis at age 10-12;cow's milk at age below 3;eggs at age 4-6.The mean level and positive rate of tlgE tended to increase in subjects sensitized to more allergens.Sensitization to Der pteronyssinus(OR,1.6;P<0.05),Der farinae(OR,1.5;P<0.05),Blomia tropicalis(OR,1.4;P<0.05),Blattella germanica(OR,1.5;P<0.05),cow's milk(OR,1.3;P<0.05),and soy beans(OR,2.0;P<0.05) were independently correlated with allergy-related conditions in preliminary diagnosis.Conclusion The major allergens in Guangzhou include Der pteronyssinus,Der farinae,cow's milk,and eggs.Sensitization to these allergens appears to be predictors of allergy-related disorder.展开更多
Objective: To explore the effect of early enteral nutrition (EN) on postoperative nutritional status, intestinal permeability, and immune function in elderly patients with esophageal cancer or cardiac cancer. Methods:...Objective: To explore the effect of early enteral nutrition (EN) on postoperative nutritional status, intestinal permeability, and immune function in elderly patients with esophageal cancer or cardiac cancer. Methods: A total of 96 patients with esophageal cancer or cardiac cancer who underwent surgical treatment in our hospital from June 2007 to December 2010 were enrolled in this study. They were divided into EN group (n=50) and parenteral nutrition (PN) group (n=46) based on the nutrition support modes. The body weight, time to first flatus/defecation, average hospital stay, complications and mortality after the surgery as well as the liver function indicators were recorded and analyzed. Peripheral blood samples were collected on the days 1, 4 and 7 after surgery. The plasma diamine oxidase (DAO) activity and D-lactate level were determined to assess the intestinal permeability. The plasma endotoxin levels were determined using dynamic turbidimetric assay to assess the protective effect of EN on intestinal mucosal barrier. The postoperative blood levels of inflammatory cytokines and immunoglobulins were determined using enzyme- linked immunosorbent assay (ELISA). Results: After the surgery, the time to first flatus/defecation, average hospital stay, and complications were significantly less in the EN group than those in the PN group (P<0.05), whereas the EN group had significantly higher albumin levels than the PN group (P<0.05). On the 7th postoperative day, the DAO activity, D-lactate level and endotoxin contents were significantly lower in the EN group than those in the PN group (all P<0.05). In addition, the EN group had significantly higher IgA, IgG, IgM, and CD4 levels than the PN group (P<0.05) but significantly lower IL-2, IL-6, and TNF-α levels (P<0.05). Conclusions: In elderly patients with esophageal cancer or cardiac cancer, early EN after surgery can effectively improve the nutritional status, protect intestinal mucosal barrier (by reducing plasma endoxins), and enhance the immune展开更多
Objective To analyze the prevalence of asthma and asthma related symptoms among children aged 0-14 years in three Chinese cities and to obtain a crude estimation of the trend of childhood asthma prevalence in China. M...Objective To analyze the prevalence of asthma and asthma related symptoms among children aged 0-14 years in three Chinese cities and to obtain a crude estimation of the trend of childhood asthma prevalence in China. Methods A cross-sectional, population-based survey of prevalence of asthma was conducted in children aged from 0 to 14 years in 3 major cities of China (Beijing, Chongqing, and Guangzhou) with different geographic locations. All the subjects were randomly selected by a multi-stage sampling method. Three to five schools and kindergartens in 2 urban districts in each city were randomly selected for the survey, and a validated questionnaire that included the core questions of the International Study of Asthma and Allergies in Childhood, Phase Ⅲ questionnaire and several additional questions were used. All questionnaires were completed by parents or guardians of the selected children. Children whose parents responded affirmatively to the question" Has your child ever been diagnosed as asthma by a doctor" were recognized as victims of asthma. Results The prevalence of asthma in Beijing, Chongqing, and Guangzhou was 3.15%, 7.45%, and 2.09%, respectively. These values were significantly higher than those obtained 10 years ago in the national epidemiological survey in 2000 which used the same method of investigation and the same diagnotic criteria (χ2 =3.938, P=0.047; χ2 =73.506, P≤0.001; χ2 =11.956, P=0.001, in each city). Of the asthmatic children 57.21%, 69.91%, and 60.00% had their first attack before the age of 3 in Beijing, Chongqing, and Guangzhou, respectively. Wheezing was the primary clinical manifestation for all asthmatic children , followed by persistent cough and repeated respiratory infections. Both the prevalence of asthma and asthma-related symptoms were statistically higher in males than in females. Conclusion The prevalence of childhood asthma is statistically higher than that 10 years ago in the three Chinese cities.展开更多
Objective: The current study was prospectively designed to explore the application of video-assisted thoracoscopic surgery(VATS) radical treatment for patients with stage IIIA lung cancer, with the primary endpoints b...Objective: The current study was prospectively designed to explore the application of video-assisted thoracoscopic surgery(VATS) radical treatment for patients with stage IIIA lung cancer, with the primary endpoints being the safety and feasibility of this operation and the second endpoints being the survival and complications after the surgery.Methods: A total of 51 patients with radiologically or mediastinoscopically confirmed stage IIIA lung cancer underwent VATS radical treatment, during which the standard pulmonary lobectomy and mediastinal lymph node dissection were performed after pre-operative assessment. The operative time, intraoperative blood loss/complications, postoperative recovery, postoperative complications, and lymph node dissection were recorded and analyzed. This study was regarded as successful if the surgical success rate reached 90% or higher.Results: A total of 51 patients with non-small cell lung cancer(NSCLC) were enrolled in this study from March 2009 to February 2010. The median post-operative follow-up duration was 50.5 months. Of these 51 patients, 41(80.4%) had N2 lymph node metastases. All patients underwent the thoracoscopic surgeries, among whom 50(98%) received pulmonary lobectomy and mediastinal lymph node dissection completely under the thoracoscope, 6 had their incisions extended to about 6 cm due to larger tumor sizes, and 1 had his surgery performed using a 12 cm small incision for handling the adhesions between lymph nodes and blood vessels. No patient was converted to conventional open thoracotomy. No perioperative death was noted. One patient received a second surgery on the second post-operative day due to large drainage(>1,000 mL), and the postoperative recovery was satisfactory. Up to 45 patients(88.2%) did not suffer from any perioperative complication, and 6(11.8%) experienced one or more complications.Conclusions: VATS radical treatment is a safe and feasible treatment for stage IIIA lung cancer.展开更多
Objective: The purposes of this study were to observe the effects of different treatment strategies, including third-line pemetrexed alone versus its combination with bevacizumab, in patients with advanced epidermal g...Objective: The purposes of this study were to observe the effects of different treatment strategies, including third-line pemetrexed alone versus its combination with bevacizumab, in patients with advanced epidermal growth factor receptor(EGFR) mutation-positive lung adenocarcinoma, and to analyze the effects of the different medication orders of first- and second-line drugs on third-line efficacy.Patients and methods: One hundred and sixteen cases of patients with EGFR-positive lung adenocarcinoma who had received third-line pemetrexed alone or in combination with bevacizumab between March 2010 and March 2014 at Guangzhou Institute of Respiratory Diseases, the First Affiliated Hospital of Guangzhou Medical University were analyzed retrospectively. Additionally, all the patients were treated with first-line gemcitabine and cisplatin(GP) chemotherapy and second-line EGFR tyrosine kinase inhibitor(TKI) or with first-line EGFR-TKI and second-line GP chemotherapy.Results: The median survival of 61 cases with third-line pemetrexed monotherapy was 36.22 months, the median survival time of 55 cases with third-line pemetrexed plus bevacizumab was 38.76 months, and there was a significant difference in survival time between the two groups(P=0.04). Subgroup analysis revealed that among the 55 cases with third-line bevacizumab plus pemetrexed treatment, the median survival of 29 patients with first-line GP and second-line EGFR-TKI was 42.80 months, while the median survival of 26 patients with first-line EGFR-TKI and second-line GP was only 34.46 months; additionally, there was a significant difference in the survival time between the two subgroups(P=0.001). Among 61 cases with thirdline pemetrexed treatment, the median survival of 34 patients with first-line GP and second-line EGFR-TKI was 38.72 months, while the median survival of 27 patients with first-line EGFR-TKI and second-line GP was only 32.94 months; the survival time of the two subgroups was significantly different(P=0.001).Conclusions: Regardless of the order of the first- and second-line chemotherapy and TKI therapy, the pemetrexed plus bevacizumab regimen was superior to the pemetrexed monotherapy as the third-line therapy in patients with advanced EGFR-positive lung adenocarcinoma. However, this strategy is worth further investigation in prospective studies.展开更多
Background: Video-assisted thoracic surgery(VATS) has been shown to be a safe alternative to conventional thoracotomy for patients with non-small cell lung cancer(NSCLC). However, popularization of this relatively nov...Background: Video-assisted thoracic surgery(VATS) has been shown to be a safe alternative to conventional thoracotomy for patients with non-small cell lung cancer(NSCLC). However, popularization of this relatively novel technique has been slow, partly due to concerns about its long-term outcomes. The present study aimed to evaluate the long-term survival outcomes of patients with NSCLC after VATS, and to determine the significant prognostic factors on overall survival.Methods: Consecutive patients diagnosed with NSCLC referred to one institution for VATS were identified from a central database. Patients were treated by either complete-VATS or assisted-VATS, as described in previous studies. A number of baseline patient characteristics, clinicopathologic data and treatment-related factors were analyzed as potential prognostic factors on overall survival.Results: Between January 2000 and December 2007, 1,139 patients with NSCLC who underwent VATS and fulfilled a set of predetermined inclusion criteria were included for analysis. The median age of the entire group was 60 years, with 791 male patients(69%). The median 5-year overall survival for Stage I, II, III and IV disease according to the recently updated TNM classification system were 72.2%, 47.5%, 29.8% and 28.6%, respectively. Female gender, TNM stage, pT status, and type of resection were found to be significant prognostic factors on multivariate analysis.Conclusions: VATS offers a viable alternative to conventional open thoracotomy for selected patients with clinically resectable NSCLC.展开更多
Cancers are a concerning health catastrophe worldwide that may become the end of lifetime for many of us—they overwhelmingly exhaust medical resources,lead to huge economic burdens,and separate people from their belo...Cancers are a concerning health catastrophe worldwide that may become the end of lifetime for many of us—they overwhelmingly exhaust medical resources,lead to huge economic burdens,and separate people from their beloved ones.Fewer and fewer insurance agencies are willing to include primary cancers on their general health insurance plan,just because cancers have been so flummoxingly展开更多
Objective: To study the possibility of using portions of deepithelialized myocutaneous flaps to the reconstruction of thoracic tracheal defects after resection of a large tumor. Methods: From June 2007 to June 2012, f...Objective: To study the possibility of using portions of deepithelialized myocutaneous flaps to the reconstruction of thoracic tracheal defects after resection of a large tumor. Methods: From June 2007 to June 2012, five cases of defects of the thoracic trachea were reconstructed by applying portions of deepithelialized myocutaneous flaps. The patients were 27-61 years old with 4 male cases and 1 female. The cervical trachea ranged in diameter from 4-8.5 cm with circumferences of approximately 1/3-2/5 of the bronchial circumference. Results: All five patients with thoracic tracheal defects after resection of a large tumor were cured of portions of deepithelialized myocutaneous flaps, with no tracheal stricture remaining and vomica successfully eliminated. During the first 1 to 3 months after the operation, bronchoscopy showed that the tracheal lumens were smooth, and the visible skin of the musculocutaneous flaps became gray and exhibited a small amount of white discharge. Conclusions: Despite this being a small series and short follow-up, this thoracic tracheal reconstruction with portions of deepithelialized myocutaneous flaps shows encouraging preliminary results and could be an alternative to other methods for the treatment of carefully selected patients with thoracic tracheal defects.展开更多
Objective:To observe the efficacy of the inhalation of an aerosolized group A streptococcal(GAS) preparation in treating orthotopic lung cancer in mouse models and assess the feasibility,safety,and effectiveness of th...Objective:To observe the efficacy of the inhalation of an aerosolized group A streptococcal(GAS) preparation in treating orthotopic lung cancer in mouse models and assess the feasibility,safety,and effectiveness of this administration mode for lung cancer.Methods:Lewis lung carcinoma(LLC) cell strains were administered via intrathoracic injection to establish orthotopic lung cancer mouse models.After the tumor-bearing models were successfully established,as confirmed by computed tomography,the mice were administered by inhalation with an aerosolized GAS preparation(GAS group) or aerosolized normal saline(control group).The anti-tumor effect of the aerosolized GAS preparation was evaluated histologically;meanwhile,the survival and quality of life were compared between these two groups.Results:The aerosolized GAS preparation showed remarkably anti-tumor effect,causing the necrosis of the orthotopic lung cancer cells in tumor-bearing mice.Furthermore,mice in the GAS group had significantly better quality of life and longer survival than those in control group.Conclusions:The inhalation of aerosolized GAS preparation may be a feasible,safe and effective solution for lung cancer.展开更多
<正>Endoscopic techniques in gastroenterology have been developing rapidly over the past two decades.Advances in minimally invasive endoscopic techniques allow for the detection and treatment of more gastrointes...<正>Endoscopic techniques in gastroenterology have been developing rapidly over the past two decades.Advances in minimally invasive endoscopic techniques allow for the detection and treatment of more gastrointestinal(GI)diseases than ever.In a manner of speaking,the advent of miniature ultrasound device coupled with展开更多
<正>Lung cancer is one of the most common neoplasms worldwide and a major cause of cancer death.Rapid diagnosis and accurate staging for patients with suspected lung cancer are essential to appropriate treatment...<正>Lung cancer is one of the most common neoplasms worldwide and a major cause of cancer death.Rapid diagnosis and accurate staging for patients with suspected lung cancer are essential to appropriate treatment.However,many of submucosal or parabronchial intrapulmonary lesions are invisible by bronchoscopy despite their展开更多
BACKGROUND: Both hypoxia and carbon dioxide retention can damage phrenic nerve and muscle conduction, as well as diaphragm function. Diaphragm compound muscle action potential and phrenic nerve conduction time are rel...BACKGROUND: Both hypoxia and carbon dioxide retention can damage phrenic nerve and muscle conduction, as well as diaphragm function. Diaphragm compound muscle action potential and phrenic nerve conduction time are reliable indicators for measuring phrenic nerve and diaphragm function. OBJECTIVES: To verify the hypothesis that changes of phrenic nerve conduction time (PNCT) and diaphragm compound muscle action potential (CMAP) in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients might contribute to the decline of phrenic nerve and diaphragm function. PNCT and CMAP were measured with multipair esophageal electrodes combined with unilateral magnetic stimulation. DESIGN, TIME AND SETTING: Case controlled study. The experiment was carried out in Guangzhou Institute of Respiratory Disease, Guangzhou Medical College, from June 2005 to April 2006. PARTICIPANTS: Twenty seven OSAHS patients and eight primary snoring subjects from Guangzhou Institute of Respiratory Disease, Guangzhou Medical College were recruited and all subjects were diagnosed by polysomnography (PSG). Sixteen healthy, non-snoring subjects in the hospital for medical examination during the same time period were selected as the control group. METHODS: Esophageal electrodes, made by Guangzhou Institute of Respiratory Disease, combined with unilateral magnetic stimulation, were used to measure PNCT and CMAP of all subjects. PNCT was defined as the time from stimulation artifact to the onset of CMAP and diaphragm CMAP amplitude was measured from peak to peak. Oxygen desaturation index and apnea-hypopnea index were measured using PSG, and their relevance to PNCT and CMAP were analyzed. PNCT and CMAP in five OSAHS patients were repeatedly measured after effective nasal continuous positive airway pressure treatment for more than 2 months. MAIN OUTCOME MEASURES: (1) PNCT and diaphragm CMAP of subjects in each group. (2) Relevance of oxygen desaturation index and apnea-hypopnea index to PNCT and CMAP. (3) Changes of PNCT and CMAP of OSAHS patients before and after treatment. RESULTS: All subjects were included in the analyzed results. (1) PNCT of the OSAHS group was significantly longer compared to that of the control and primary snore groups, while CMAP of the OSAHS group was significantly lower (P < 0.05). (2) PNCT and CMAP recorded from both sides correlated significantly with oxygen desaturation index and with apnea-hypopnea index (P < 0.01). (3) PNCT shortened significantly after effective nasal continuous positive airway pressure treatment for more than 2 months ( P < 0.05). CONCLUSION: Prolongation of PNCT and decrease of CMAP might contribute to the decline of phrenic nerve and diaphragm function caused by repeated nocturnal hypoxia and carbon dioxide retention. The impairment of the phrenic nerve might also decrease diaphragm function.展开更多
Background: Emerging evidence indicates that chemotherapy for lung cancer may alter EGFR mutation status. However, whether chemotherapy as a firstline treatment may increase or reduce the frequency of EGFR mutations i...Background: Emerging evidence indicates that chemotherapy for lung cancer may alter EGFR mutation status. However, whether chemotherapy as a firstline treatment may increase or reduce the frequency of EGFR mutations in NSCLC remains uncertain. Therefore, we conducted a meta-analysis to evaluate whether chemotherapy leads to altered EGFR mutation status. Methods: A systematic literature search was performed using the PubMed, OVID, Science Direct, Cochrane Library, and CNKI databases for studies on pre- and post-chemotherapy EGFR mutation status. Relevant studies documenting perichemotherapy EGFR mutation ratios were included. Analyses of pooled odds ratios (OR) were performed. Results: Six studies involving 656 patients were included in this meta-analysis. It was found that chemotherapy may alter EGFR status (OR = 1.93, 95% CI 1.05 - 3.56;p < 0.0001). No significant differences in EGFR mutation alterations were observed in terms of gender, smoking history, EGFR loci, or chemotherapy response in NSCLC patients. Conclusions: Chemotherapy may contribute to altered EGFR status. NSCLC patients with EGFR mutations might need to be considered for EGFR status redeterminations prior to second-line EGFR-TKI treatment or upon tumor recurrence after chemotherapy. Further randomized clinical trials should investigate the impact of neoadjuvant or first-line chemotherapy on EGFR mutation status in NSCLC patients.展开更多
Background Immunostimulating agents made from bacterial extracts represent a class of medications that contains antigens derived from several bacterial strains and their potential ability to prevent bacterial infectio...Background Immunostimulating agents made from bacterial extracts represent a class of medications that contains antigens derived from several bacterial strains and their potential ability to prevent bacterial infections results from the stimulation of the nonspecific component of the immune system. The present study investigated the effect of the oral immunostimulant Broncho-Vaxom,which includes material from eight different species of bacteria that are frequently present in the lower respiratory tract,on the frequency and severity of acute exacerbation in patients with chronic bronchitis accompanied by chronic obstructive pulmonary disease (COPD). Methods Ninety patients with chronic bronchitis complicated with COPD were randomly divided into groups A and B. Forty-nine subjects in group A received oral capsules containing 7mg Broncho-Vaxom,while 41 patients in group B received similar placebo capsules. Both groups took one capsule daily for the first 10 days of each month for 3 consecutive months. The frequency of acute exacerbation,symptom scores,and lung function were recorded for the following one year period.Results There was a significant decrease in the incidence,duration,and severity of acute exacerbation,as well as a reduction in the course of antibiotics administered and in the dosage of bronchodilator and mucolytic agent in group A,as compared to group B ( P <0.05,respectively). Symptom scores for cough,sputum,dyspnea,as well as symptoms observed upon auscultation of the chest also improved significantly in group A as compared to group B ( P <0.05,respectively). The bacterial clearance rate in sputum cultures from patients who received no antibiotics for the first 3 months was also significantly higher in group A compared to group B ( P <0.01).Conclusions Orally administered Broncho-Vaxom is associated with a decrease in the incidence of acute exacerbation and a decrease in the need for antibiotics and symptomatic relief medications in patients with chronic bronchitis accompanied by COPD. Broncho-Vaxom is also associated with a decrease in symptom scores. Without causing any apparent adverse effects,this drug may also help to eradicate pathogenic bacteria in the airways.展开更多
IntroductionLung cancer is the most common cancer worldwide.In the United States,it causes more cancer-related deaths than the next four causes(breast cancer,prostate cancer,colon cancer,and pancreatic cancer)of cance...IntroductionLung cancer is the most common cancer worldwide.In the United States,it causes more cancer-related deaths than the next four causes(breast cancer,prostate cancer,colon cancer,and pancreatic cancer)of cancer-related mortality combined(1).About 30% of people have already展开更多
Human adenoviruses(HAdVs) commonly cause many diseases such as respiratory diseases, gastroenteritis, cystitis worldwide. HAdV-3,-7,-4 and emergent HAdV-55 and HAdV-14 are the most important types causing severe respi...Human adenoviruses(HAdVs) commonly cause many diseases such as respiratory diseases, gastroenteritis, cystitis worldwide. HAdV-3,-7,-4 and emergent HAdV-55 and HAdV-14 are the most important types causing severe respiratory diseases. There is no effective drug available for clinical treatment, and no vaccine available for the general population.Therefore, it is important to investigate the seroprevalence against HAdV for developing novel vaccines and vectors. In this study, we investigated the seroprevalence and titer levels of neutralizing antibodies(NAb) against HAdV-3,-4,-7,-14,-55,and-11 in total 278 healthy populations between 0 months and 49 years of age(228 children and 50 adults) from Guangzhou. In children under the age of 18 years, the seropositive rates were significantly increased against HAdV-3 at12.07%, 33.96%, and 64.29% and against HAdV-7 at 0%, 18.87%, and 19.05% in age groups of 1–2, 3–5, and 6–17 years,respectively. The seroprevalence was very low(0% - 8.1%) for all other four types. In adults aged between 18 and49 years, HAdV-3,-4, and-7(> 50.00%) were the most common types, followed by HAdV-14(38.00%),-55(34.00%),and-11(24.00%). Adults tended to have high NAb titers against HAdV-4 and-55. HAdV-55-seropositive donors tended to be HAdV-11-and HAdV-14-seropositive. These results indicated the low level of herd immunity against all six HAdV types in young children, and HAdV-14,-55,-11 in adults from Guangzhou City. Our findings demonstrate the importance of monitoring HAdV types and developing vaccines against HAdV for children and adults.展开更多
Objective To summarize the clinical features of severe acute respiratory syndrome (SARS) and to discuss diagnosis and management of the disease.Methods A retrospective study was conducted on 78 cases of SARS referred ...Objective To summarize the clinical features of severe acute respiratory syndrome (SARS) and to discuss diagnosis and management of the disease.Methods A retrospective study was conducted on 78 cases of SARS referred to the Guangzhou Institute of Respiratory Diseases (GIRD) between December 22, 2002 and near the end of March 2003. Items reviewed cover all data concerning clinical manifestations, laboratory investigation and radiology.Results The patients in the study consisted of 42 males and 36 females, aged 20 -75 yrs (mean age 37. 5 +11.6 yrs), including 44 affected health-care professionals. Clinical symptoms seen in the group were fever (100. 0%), cough (88. 5%), and dyspnea (79. 5%). There were 12 cases (15. 3%) with WBCs ＜4.0×109/L, 49 cases (62. 8%) ranging between (4. 0 -10. 0) ×109/L and 17 cases (21.8%) over 10. 0 × 109/L. The average was(7. 58 ±4. 96) × 109/L, with 0.75 ±0. 14 (neutrophil) and 0.18 ±0.11 (lymphocyte). Chest films and CT scanning revealed changes related to pneumonia. The transmission of the disease was likely via close contact with contagious droplets.The prevalences of acute lung injury (ALI, in 37cases ) and acute respiratory distress syndrome (ARDS, 21 out of 37 cases ) were considerably high among the patients. Seven patients who developed ARDS complicated with multiple organs dysfunction syndrome (MODS) died.Conclusions A history of close contact, fever, sign of pneumonia by X-ray and normal-to-lowered WBC counts are favorable for the diagnosis of SARS. Recognition of All as the important index for critical SARS and comprehensive supportive management are of paramount in decreasing the mortality of the disease.展开更多
基金supported by Guangdong Industry Technology and Development Fund(No.2011B061200040)Science Foundation of Guangzhou Medical Univesity(Project No.2013A06)Guangdong Natural Science Foundation(No.S2013010014728)
文摘Objective To investigate the serum total IgE(tlgE) and specific IgE(slgE) to common allergens among allergic patients in Guangzhou,China.Methods 7 085 patients were examined for tlgE and slgE to 15 allergens,based on the protocols of reversed enzyme allergosorbent test and the sandwich enzyme-linked immunosorbent assay.Results 3 758(53.04%) patients tested positive for tlgE,and 4 640(65.49%) for slgE.Der pteronyssinus,Der farinae,eggs,and cow's milk were the most common allergens leading to higher positive rates of slgE responses.Several peaks of sensitization were:Der pteronyssinus,Der farinae,and Blomia tropicalis at age 10-12;cow's milk at age below 3;eggs at age 4-6.The mean level and positive rate of tlgE tended to increase in subjects sensitized to more allergens.Sensitization to Der pteronyssinus(OR,1.6;P<0.05),Der farinae(OR,1.5;P<0.05),Blomia tropicalis(OR,1.4;P<0.05),Blattella germanica(OR,1.5;P<0.05),cow's milk(OR,1.3;P<0.05),and soy beans(OR,2.0;P<0.05) were independently correlated with allergy-related conditions in preliminary diagnosis.Conclusion The major allergens in Guangzhou include Der pteronyssinus,Der farinae,cow's milk,and eggs.Sensitization to these allergens appears to be predictors of allergy-related disorder.
文摘Objective: To explore the effect of early enteral nutrition (EN) on postoperative nutritional status, intestinal permeability, and immune function in elderly patients with esophageal cancer or cardiac cancer. Methods: A total of 96 patients with esophageal cancer or cardiac cancer who underwent surgical treatment in our hospital from June 2007 to December 2010 were enrolled in this study. They were divided into EN group (n=50) and parenteral nutrition (PN) group (n=46) based on the nutrition support modes. The body weight, time to first flatus/defecation, average hospital stay, complications and mortality after the surgery as well as the liver function indicators were recorded and analyzed. Peripheral blood samples were collected on the days 1, 4 and 7 after surgery. The plasma diamine oxidase (DAO) activity and D-lactate level were determined to assess the intestinal permeability. The plasma endotoxin levels were determined using dynamic turbidimetric assay to assess the protective effect of EN on intestinal mucosal barrier. The postoperative blood levels of inflammatory cytokines and immunoglobulins were determined using enzyme- linked immunosorbent assay (ELISA). Results: After the surgery, the time to first flatus/defecation, average hospital stay, and complications were significantly less in the EN group than those in the PN group (P<0.05), whereas the EN group had significantly higher albumin levels than the PN group (P<0.05). On the 7th postoperative day, the DAO activity, D-lactate level and endotoxin contents were significantly lower in the EN group than those in the PN group (all P<0.05). In addition, the EN group had significantly higher IgA, IgG, IgM, and CD4 levels than the PN group (P<0.05) but significantly lower IL-2, IL-6, and TNF-α levels (P<0.05). Conclusions: In elderly patients with esophageal cancer or cardiac cancer, early EN after surgery can effectively improve the nutritional status, protect intestinal mucosal barrier (by reducing plasma endoxins), and enhance the immune
基金supported by the National Science & Technology Pillar Program under the Eleventh Five-Year Plan of China(No.2007BAI24B05)
文摘Objective To analyze the prevalence of asthma and asthma related symptoms among children aged 0-14 years in three Chinese cities and to obtain a crude estimation of the trend of childhood asthma prevalence in China. Methods A cross-sectional, population-based survey of prevalence of asthma was conducted in children aged from 0 to 14 years in 3 major cities of China (Beijing, Chongqing, and Guangzhou) with different geographic locations. All the subjects were randomly selected by a multi-stage sampling method. Three to five schools and kindergartens in 2 urban districts in each city were randomly selected for the survey, and a validated questionnaire that included the core questions of the International Study of Asthma and Allergies in Childhood, Phase Ⅲ questionnaire and several additional questions were used. All questionnaires were completed by parents or guardians of the selected children. Children whose parents responded affirmatively to the question" Has your child ever been diagnosed as asthma by a doctor" were recognized as victims of asthma. Results The prevalence of asthma in Beijing, Chongqing, and Guangzhou was 3.15%, 7.45%, and 2.09%, respectively. These values were significantly higher than those obtained 10 years ago in the national epidemiological survey in 2000 which used the same method of investigation and the same diagnotic criteria (χ2 =3.938, P=0.047; χ2 =73.506, P≤0.001; χ2 =11.956, P=0.001, in each city). Of the asthmatic children 57.21%, 69.91%, and 60.00% had their first attack before the age of 3 in Beijing, Chongqing, and Guangzhou, respectively. Wheezing was the primary clinical manifestation for all asthmatic children , followed by persistent cough and repeated respiratory infections. Both the prevalence of asthma and asthma-related symptoms were statistically higher in males than in females. Conclusion The prevalence of childhood asthma is statistically higher than that 10 years ago in the three Chinese cities.
文摘Objective: The current study was prospectively designed to explore the application of video-assisted thoracoscopic surgery(VATS) radical treatment for patients with stage IIIA lung cancer, with the primary endpoints being the safety and feasibility of this operation and the second endpoints being the survival and complications after the surgery.Methods: A total of 51 patients with radiologically or mediastinoscopically confirmed stage IIIA lung cancer underwent VATS radical treatment, during which the standard pulmonary lobectomy and mediastinal lymph node dissection were performed after pre-operative assessment. The operative time, intraoperative blood loss/complications, postoperative recovery, postoperative complications, and lymph node dissection were recorded and analyzed. This study was regarded as successful if the surgical success rate reached 90% or higher.Results: A total of 51 patients with non-small cell lung cancer(NSCLC) were enrolled in this study from March 2009 to February 2010. The median post-operative follow-up duration was 50.5 months. Of these 51 patients, 41(80.4%) had N2 lymph node metastases. All patients underwent the thoracoscopic surgeries, among whom 50(98%) received pulmonary lobectomy and mediastinal lymph node dissection completely under the thoracoscope, 6 had their incisions extended to about 6 cm due to larger tumor sizes, and 1 had his surgery performed using a 12 cm small incision for handling the adhesions between lymph nodes and blood vessels. No patient was converted to conventional open thoracotomy. No perioperative death was noted. One patient received a second surgery on the second post-operative day due to large drainage(>1,000 mL), and the postoperative recovery was satisfactory. Up to 45 patients(88.2%) did not suffer from any perioperative complication, and 6(11.8%) experienced one or more complications.Conclusions: VATS radical treatment is a safe and feasible treatment for stage IIIA lung cancer.
基金funded by National Key Scientific & Technology Support Program: Collaborative innovation of Clinical Research for chronic obstructive pulmonary disease and lung cancer (NO. 2013BAI09B09)
文摘Objective: The purposes of this study were to observe the effects of different treatment strategies, including third-line pemetrexed alone versus its combination with bevacizumab, in patients with advanced epidermal growth factor receptor(EGFR) mutation-positive lung adenocarcinoma, and to analyze the effects of the different medication orders of first- and second-line drugs on third-line efficacy.Patients and methods: One hundred and sixteen cases of patients with EGFR-positive lung adenocarcinoma who had received third-line pemetrexed alone or in combination with bevacizumab between March 2010 and March 2014 at Guangzhou Institute of Respiratory Diseases, the First Affiliated Hospital of Guangzhou Medical University were analyzed retrospectively. Additionally, all the patients were treated with first-line gemcitabine and cisplatin(GP) chemotherapy and second-line EGFR tyrosine kinase inhibitor(TKI) or with first-line EGFR-TKI and second-line GP chemotherapy.Results: The median survival of 61 cases with third-line pemetrexed monotherapy was 36.22 months, the median survival time of 55 cases with third-line pemetrexed plus bevacizumab was 38.76 months, and there was a significant difference in survival time between the two groups(P=0.04). Subgroup analysis revealed that among the 55 cases with third-line bevacizumab plus pemetrexed treatment, the median survival of 29 patients with first-line GP and second-line EGFR-TKI was 42.80 months, while the median survival of 26 patients with first-line EGFR-TKI and second-line GP was only 34.46 months; additionally, there was a significant difference in the survival time between the two subgroups(P=0.001). Among 61 cases with thirdline pemetrexed treatment, the median survival of 34 patients with first-line GP and second-line EGFR-TKI was 38.72 months, while the median survival of 27 patients with first-line EGFR-TKI and second-line GP was only 32.94 months; the survival time of the two subgroups was significantly different(P=0.001).Conclusions: Regardless of the order of the first- and second-line chemotherapy and TKI therapy, the pemetrexed plus bevacizumab regimen was superior to the pemetrexed monotherapy as the third-line therapy in patients with advanced EGFR-positive lung adenocarcinoma. However, this strategy is worth further investigation in prospective studies.
文摘Background: Video-assisted thoracic surgery(VATS) has been shown to be a safe alternative to conventional thoracotomy for patients with non-small cell lung cancer(NSCLC). However, popularization of this relatively novel technique has been slow, partly due to concerns about its long-term outcomes. The present study aimed to evaluate the long-term survival outcomes of patients with NSCLC after VATS, and to determine the significant prognostic factors on overall survival.Methods: Consecutive patients diagnosed with NSCLC referred to one institution for VATS were identified from a central database. Patients were treated by either complete-VATS or assisted-VATS, as described in previous studies. A number of baseline patient characteristics, clinicopathologic data and treatment-related factors were analyzed as potential prognostic factors on overall survival.Results: Between January 2000 and December 2007, 1,139 patients with NSCLC who underwent VATS and fulfilled a set of predetermined inclusion criteria were included for analysis. The median age of the entire group was 60 years, with 791 male patients(69%). The median 5-year overall survival for Stage I, II, III and IV disease according to the recently updated TNM classification system were 72.2%, 47.5%, 29.8% and 28.6%, respectively. Female gender, TNM stage, pT status, and type of resection were found to be significant prognostic factors on multivariate analysis.Conclusions: VATS offers a viable alternative to conventional open thoracotomy for selected patients with clinically resectable NSCLC.
文摘Cancers are a concerning health catastrophe worldwide that may become the end of lifetime for many of us—they overwhelmingly exhaust medical resources,lead to huge economic burdens,and separate people from their beloved ones.Fewer and fewer insurance agencies are willing to include primary cancers on their general health insurance plan,just because cancers have been so flummoxingly
文摘Objective: To study the possibility of using portions of deepithelialized myocutaneous flaps to the reconstruction of thoracic tracheal defects after resection of a large tumor. Methods: From June 2007 to June 2012, five cases of defects of the thoracic trachea were reconstructed by applying portions of deepithelialized myocutaneous flaps. The patients were 27-61 years old with 4 male cases and 1 female. The cervical trachea ranged in diameter from 4-8.5 cm with circumferences of approximately 1/3-2/5 of the bronchial circumference. Results: All five patients with thoracic tracheal defects after resection of a large tumor were cured of portions of deepithelialized myocutaneous flaps, with no tracheal stricture remaining and vomica successfully eliminated. During the first 1 to 3 months after the operation, bronchoscopy showed that the tracheal lumens were smooth, and the visible skin of the musculocutaneous flaps became gray and exhibited a small amount of white discharge. Conclusions: Despite this being a small series and short follow-up, this thoracic tracheal reconstruction with portions of deepithelialized myocutaneous flaps shows encouraging preliminary results and could be an alternative to other methods for the treatment of carefully selected patients with thoracic tracheal defects.
文摘Objective:To observe the efficacy of the inhalation of an aerosolized group A streptococcal(GAS) preparation in treating orthotopic lung cancer in mouse models and assess the feasibility,safety,and effectiveness of this administration mode for lung cancer.Methods:Lewis lung carcinoma(LLC) cell strains were administered via intrathoracic injection to establish orthotopic lung cancer mouse models.After the tumor-bearing models were successfully established,as confirmed by computed tomography,the mice were administered by inhalation with an aerosolized GAS preparation(GAS group) or aerosolized normal saline(control group).The anti-tumor effect of the aerosolized GAS preparation was evaluated histologically;meanwhile,the survival and quality of life were compared between these two groups.Results:The aerosolized GAS preparation showed remarkably anti-tumor effect,causing the necrosis of the orthotopic lung cancer cells in tumor-bearing mice.Furthermore,mice in the GAS group had significantly better quality of life and longer survival than those in control group.Conclusions:The inhalation of aerosolized GAS preparation may be a feasible,safe and effective solution for lung cancer.
文摘<正>Endoscopic techniques in gastroenterology have been developing rapidly over the past two decades.Advances in minimally invasive endoscopic techniques allow for the detection and treatment of more gastrointestinal(GI)diseases than ever.In a manner of speaking,the advent of miniature ultrasound device coupled with
文摘<正>Lung cancer is one of the most common neoplasms worldwide and a major cause of cancer death.Rapid diagnosis and accurate staging for patients with suspected lung cancer are essential to appropriate treatment.However,many of submucosal or parabronchial intrapulmonary lesions are invisible by bronchoscopy despite their
文摘BACKGROUND: Both hypoxia and carbon dioxide retention can damage phrenic nerve and muscle conduction, as well as diaphragm function. Diaphragm compound muscle action potential and phrenic nerve conduction time are reliable indicators for measuring phrenic nerve and diaphragm function. OBJECTIVES: To verify the hypothesis that changes of phrenic nerve conduction time (PNCT) and diaphragm compound muscle action potential (CMAP) in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients might contribute to the decline of phrenic nerve and diaphragm function. PNCT and CMAP were measured with multipair esophageal electrodes combined with unilateral magnetic stimulation. DESIGN, TIME AND SETTING: Case controlled study. The experiment was carried out in Guangzhou Institute of Respiratory Disease, Guangzhou Medical College, from June 2005 to April 2006. PARTICIPANTS: Twenty seven OSAHS patients and eight primary snoring subjects from Guangzhou Institute of Respiratory Disease, Guangzhou Medical College were recruited and all subjects were diagnosed by polysomnography (PSG). Sixteen healthy, non-snoring subjects in the hospital for medical examination during the same time period were selected as the control group. METHODS: Esophageal electrodes, made by Guangzhou Institute of Respiratory Disease, combined with unilateral magnetic stimulation, were used to measure PNCT and CMAP of all subjects. PNCT was defined as the time from stimulation artifact to the onset of CMAP and diaphragm CMAP amplitude was measured from peak to peak. Oxygen desaturation index and apnea-hypopnea index were measured using PSG, and their relevance to PNCT and CMAP were analyzed. PNCT and CMAP in five OSAHS patients were repeatedly measured after effective nasal continuous positive airway pressure treatment for more than 2 months. MAIN OUTCOME MEASURES: (1) PNCT and diaphragm CMAP of subjects in each group. (2) Relevance of oxygen desaturation index and apnea-hypopnea index to PNCT and CMAP. (3) Changes of PNCT and CMAP of OSAHS patients before and after treatment. RESULTS: All subjects were included in the analyzed results. (1) PNCT of the OSAHS group was significantly longer compared to that of the control and primary snore groups, while CMAP of the OSAHS group was significantly lower (P < 0.05). (2) PNCT and CMAP recorded from both sides correlated significantly with oxygen desaturation index and with apnea-hypopnea index (P < 0.01). (3) PNCT shortened significantly after effective nasal continuous positive airway pressure treatment for more than 2 months ( P < 0.05). CONCLUSION: Prolongation of PNCT and decrease of CMAP might contribute to the decline of phrenic nerve and diaphragm function caused by repeated nocturnal hypoxia and carbon dioxide retention. The impairment of the phrenic nerve might also decrease diaphragm function.
文摘Background: Emerging evidence indicates that chemotherapy for lung cancer may alter EGFR mutation status. However, whether chemotherapy as a firstline treatment may increase or reduce the frequency of EGFR mutations in NSCLC remains uncertain. Therefore, we conducted a meta-analysis to evaluate whether chemotherapy leads to altered EGFR mutation status. Methods: A systematic literature search was performed using the PubMed, OVID, Science Direct, Cochrane Library, and CNKI databases for studies on pre- and post-chemotherapy EGFR mutation status. Relevant studies documenting perichemotherapy EGFR mutation ratios were included. Analyses of pooled odds ratios (OR) were performed. Results: Six studies involving 656 patients were included in this meta-analysis. It was found that chemotherapy may alter EGFR status (OR = 1.93, 95% CI 1.05 - 3.56;p < 0.0001). No significant differences in EGFR mutation alterations were observed in terms of gender, smoking history, EGFR loci, or chemotherapy response in NSCLC patients. Conclusions: Chemotherapy may contribute to altered EGFR status. NSCLC patients with EGFR mutations might need to be considered for EGFR status redeterminations prior to second-line EGFR-TKI treatment or upon tumor recurrence after chemotherapy. Further randomized clinical trials should investigate the impact of neoadjuvant or first-line chemotherapy on EGFR mutation status in NSCLC patients.
文摘Background Immunostimulating agents made from bacterial extracts represent a class of medications that contains antigens derived from several bacterial strains and their potential ability to prevent bacterial infections results from the stimulation of the nonspecific component of the immune system. The present study investigated the effect of the oral immunostimulant Broncho-Vaxom,which includes material from eight different species of bacteria that are frequently present in the lower respiratory tract,on the frequency and severity of acute exacerbation in patients with chronic bronchitis accompanied by chronic obstructive pulmonary disease (COPD). Methods Ninety patients with chronic bronchitis complicated with COPD were randomly divided into groups A and B. Forty-nine subjects in group A received oral capsules containing 7mg Broncho-Vaxom,while 41 patients in group B received similar placebo capsules. Both groups took one capsule daily for the first 10 days of each month for 3 consecutive months. The frequency of acute exacerbation,symptom scores,and lung function were recorded for the following one year period.Results There was a significant decrease in the incidence,duration,and severity of acute exacerbation,as well as a reduction in the course of antibiotics administered and in the dosage of bronchodilator and mucolytic agent in group A,as compared to group B ( P <0.05,respectively). Symptom scores for cough,sputum,dyspnea,as well as symptoms observed upon auscultation of the chest also improved significantly in group A as compared to group B ( P <0.05,respectively). The bacterial clearance rate in sputum cultures from patients who received no antibiotics for the first 3 months was also significantly higher in group A compared to group B ( P <0.01).Conclusions Orally administered Broncho-Vaxom is associated with a decrease in the incidence of acute exacerbation and a decrease in the need for antibiotics and symptomatic relief medications in patients with chronic bronchitis accompanied by COPD. Broncho-Vaxom is also associated with a decrease in symptom scores. Without causing any apparent adverse effects,this drug may also help to eradicate pathogenic bacteria in the airways.
文摘IntroductionLung cancer is the most common cancer worldwide.In the United States,it causes more cancer-related deaths than the next four causes(breast cancer,prostate cancer,colon cancer,and pancreatic cancer)of cancer-related mortality combined(1).About 30% of people have already
基金supported by the National Key Research and Development Program of China (2018YFC1200100)the Guangzhou Science and Technology Program Key Project, China (201803040004)+2 种基金the National Science and Technology Major Project of China (2017ZX10103011003, 2018ZX10102001)the National Natural Science Foundation of China, China (31570163)the Youth Project of State Key Laboratory of Respiratory Disease, China (SKLRD-QN-201713)。
文摘Human adenoviruses(HAdVs) commonly cause many diseases such as respiratory diseases, gastroenteritis, cystitis worldwide. HAdV-3,-7,-4 and emergent HAdV-55 and HAdV-14 are the most important types causing severe respiratory diseases. There is no effective drug available for clinical treatment, and no vaccine available for the general population.Therefore, it is important to investigate the seroprevalence against HAdV for developing novel vaccines and vectors. In this study, we investigated the seroprevalence and titer levels of neutralizing antibodies(NAb) against HAdV-3,-4,-7,-14,-55,and-11 in total 278 healthy populations between 0 months and 49 years of age(228 children and 50 adults) from Guangzhou. In children under the age of 18 years, the seropositive rates were significantly increased against HAdV-3 at12.07%, 33.96%, and 64.29% and against HAdV-7 at 0%, 18.87%, and 19.05% in age groups of 1–2, 3–5, and 6–17 years,respectively. The seroprevalence was very low(0% - 8.1%) for all other four types. In adults aged between 18 and49 years, HAdV-3,-4, and-7(> 50.00%) were the most common types, followed by HAdV-14(38.00%),-55(34.00%),and-11(24.00%). Adults tended to have high NAb titers against HAdV-4 and-55. HAdV-55-seropositive donors tended to be HAdV-11-and HAdV-14-seropositive. These results indicated the low level of herd immunity against all six HAdV types in young children, and HAdV-14,-55,-11 in adults from Guangzhou City. Our findings demonstrate the importance of monitoring HAdV types and developing vaccines against HAdV for children and adults.
文摘Objective To summarize the clinical features of severe acute respiratory syndrome (SARS) and to discuss diagnosis and management of the disease.Methods A retrospective study was conducted on 78 cases of SARS referred to the Guangzhou Institute of Respiratory Diseases (GIRD) between December 22, 2002 and near the end of March 2003. Items reviewed cover all data concerning clinical manifestations, laboratory investigation and radiology.Results The patients in the study consisted of 42 males and 36 females, aged 20 -75 yrs (mean age 37. 5 +11.6 yrs), including 44 affected health-care professionals. Clinical symptoms seen in the group were fever (100. 0%), cough (88. 5%), and dyspnea (79. 5%). There were 12 cases (15. 3%) with WBCs ＜4.0×109/L, 49 cases (62. 8%) ranging between (4. 0 -10. 0) ×109/L and 17 cases (21.8%) over 10. 0 × 109/L. The average was(7. 58 ±4. 96) × 109/L, with 0.75 ±0. 14 (neutrophil) and 0.18 ±0.11 (lymphocyte). Chest films and CT scanning revealed changes related to pneumonia. The transmission of the disease was likely via close contact with contagious droplets.The prevalences of acute lung injury (ALI, in 37cases ) and acute respiratory distress syndrome (ARDS, 21 out of 37 cases ) were considerably high among the patients. Seven patients who developed ARDS complicated with multiple organs dysfunction syndrome (MODS) died.Conclusions A history of close contact, fever, sign of pneumonia by X-ray and normal-to-lowered WBC counts are favorable for the diagnosis of SARS. Recognition of All as the important index for critical SARS and comprehensive supportive management are of paramount in decreasing the mortality of the disease.
