Objective To study the significance of changes in the blood C-reactive protein(CRP)concentration in patients with chronic obstructive pulmonary disease(COPD)at different stages and different classification and further analyze the relationship between the degree of impairment of pulmonary function and CRP concentrations.Methods Fouty-two cases of COPD patients were enrolled,forced expiratory volume in one second(FEV1),the forced expiratory volume in one second/forced vital capacity(FEV1/FVC),a second rate were tested in these patients at admission and discharged from hospital after recovery.Arterial blood gas including PaO2,PaCO2 were analyzed.The CRP level was measured by ELISA from venous blood collected in the early morning.At the same time,10 healthy people were selected as control group.Results The CRP level in COPD group was significantly higher than that of the control group(P ＜ 0.05).It displayed highest in the Ⅳ grade of COPD patients,but there was no statistically significant differences among the levels(P ＞ 0.05).The CRP level in COPD patients at acute exacerbations was significantly higher than that in COPD patients at remission and differences was statistically significant([6.283 ± 3.168]mg/L vs[4.104 ± 1.013]mg/L,P ＜0.05).The changes of serum CRP levels was correlated negatively with FEV1(r =-0.618,P ＜ 0.05),with FEV1/FVC(r =-0.629,P ＜ 0.05)and with PaO2(r =-0.605,P ＜ 0.05).The changes of serum CRP levels was correlated positively with PaCO2(r =0.613,P ＜ 0.05).Conclusion The increase of CRP level may be associated with the damage of lung function and the degree of dyspnea in COPD patients.But CRP as a independent predictor of COPD outcomes and prognosis remains to be further studied.

Objective Non small cell lung cancer( NSCLC) is a common tumor and the blood of NSCLC patients is generally in a state of high coagulation.However, as a predictor of coagulation, few study has been done on the role of D-dimer level in lung cancer.This article aimed to analyze the prognostic value of plasma D-dimer level in patients with advanced NSCLC and its relation with pulmonary embolism Methods The study collected patients with lung cancer treated in Tianjin Chest Hospital from January 1, 2013 to October 31, 2015.The serum levels of D-dimer were measured by enzyme-linked immunosorbent assay.Based on different lev-els, the patients were divided into high expression group and normal expression group.The relationship between D-dimer level and the prognosis of lung cancer patients were analyzed by Kaplan-Meier method and Log-rank test univariate analysis.T test was used to ana-lyze the difference of D-dimer between patients with and without pulmonary embolism. Results In all the enrolled subjects,103 ca-ses (73.75%) of plasma D-dimer were normal, while 37 patients (26.25%) were elevated.Survival analysis showed that the patho-logical status, tumor size and D-dimer were independent prognostic factors; and the D-dimer in patients with pulmonary embolism was 5.37 ±1.23 μg/mL, while the patients without pulmonary embolism was 0.43 ±0.73μg/mL, D-dimer in patients with pulmonary embol-ism was high than the patients without pulmonary embolism, showing significant difference (P<0.05). Conclusion Plasma D-dimer is an independent prognostic factor for the prognosis of lung cancer, which is obviously higher in patients with lung cancer and pulmonary embolism than in patients without pulmonary embolism.

To study the variety of sIL-2R, Il-8, immunoglo bulin, T-lymphycyte subgroup in patients with COPD． 30 cases with COPD and the control group of 30 cases were d etected sIL-2R, IL-8 with ELISA; IgG, IgA with rate nephelometry; CD+3，CD+1， Cd+ 3，with immunoflu orescence． Results: Patients with CO-PD sIL-2R, Il-8, CD 8 increase and IgG, IgA, CD+3, CD+4，CD+4/CD+8　 decrease ． The difference is very significant． Conclusion: The immuni faction of patients with COPD reduce．

Objective To compare the difference of IL-8 and MMP-9 levels in the serum and sputum before and after treatment in patients with acute exacerbations of COPD,and to analyze the correlation between IL-8 and MMP-9 levels and lung function.Method A total of 20 cases of AECOPD patients were randomly selected in the observation group and 15 cases of healthy people were selected in the control group.Pulmonary function was measured and the specimens of sputum and blood were collected during the admission and discharge for AECOPD patients.FEV1 and FEV1/FVC％ were recorded,and the concentration of IL-8 and MMP-9 in the sputum supernatant and serum were tested with double antibody sandwich enzyme linked immunosorbent assay before and after treatment.All the data and correlation were analyzed with t test and SPSS software.Results (1) Before the treatment,serum IL-8 concentration in COPD patients was 28.30 ± 14.39 pg/mL,higher than that in the control group [17.46 ± 3.48) pg/mL,P=0.008].After treatment,the serum IL-8 concentration was significantly decreased [(13.30 ± 6.31) pg/mL,P=0.000].IL-8 concentration of sputum significantly decreased after treatment [(501.60 ± 508.61) pg/mL,P=0.042] than one before treatment (639.40 ± 703.12) pg/mL.(2) Before treatment,serum MMP-9 concentration in patients with AECOPD was 1.12 ± 0.36 ng/mL,lower than control group [(17.89 ± 11.00) ng/mL,P=0.000)].After treatment,the serum MMP-9 concentration was significantly decreased [(0.87 ± 0.31) ng/mL,P=0.000].MMP-9 concentration of sputum before treatment (12.04 ± 12.22) ng/mL decreased significantly after treatment [(8.02 ± 7.13) ng/mL,P=0.005].(3) Before treatment,no correlation was seen between the concentration of serum IL-8 and FEV1,FEV1/FVC.Negative correlation was observed between the sputum IL-8 concentration and FEV1/FVC and no correlation was found with FEV1.After treatment,we found that no correlation showed between the concentration of IL-8 and FEV1,FEV1/FVC,and negative correlation was seen between the IL-8 concentration in sputum and FEV1,FEV1/FVC.(4) Before treatment,no correlation between the concentration of serum MMP-9 and FEV1,FEV1/FVC was observed and no correlation between the sputum MMP-9 concentration with FEV1 was seen.Negatively correlation was found between the sputum MMP-9 level wtih FEV1/FVC.After treatment,we observed no correlation between the serum concentration of MMP-9 and FEV1,FEV1/FVC,and negative correlation between the concentration of MMP-9 in sputum and FEV1,FEV1/FVC.Conclusion The concentration of IL-8 and MMP-9 in serum and sputum in patients with acute exacerbation of COPD is higher than those in the stable phase.IL-8 and MMP-9 levels in serum show no correlation with lung function.Negative correlation was observed between IL-8 and MMP-9 levels in sputum and lung function.We can test the levels of IL-8 and MMP-9 in sputum to evaluate the severity of the disease.

Objective:To investigate possible correlation between nutritional status and forced expiratory volume in 1 second expressed as percent predicted (FEV1%) and serum levels of complement components C3 and C4 in patients with chronic obstructive pulmonary disease (COPD).Method:Body weight,FEV1% and serum levels of C3 and C4 in 27 healthy subjects and 40 stable COPD patients were determined and studied the correlation between them.Results:Body weight and C4 serum level in COPD group were much lower than that health group,while C3 serum level was no significant.A significant and positive correlation was present between FEV1% and decrease of body weight and C4 level(γ=0.517 9,0.527 3,respectively).Morever,there was significant correlation between body weight and C4 level (γ=0.487 3) in patients with COPD.Conclusion:In patents with stable COPD,pulmonary funciton was associated with the decrease of nutritional depletion (ND) and serum level of complement components C4,which was an indicator of showing the severe degree of COPD and prognosis.These results suggest that nutritional supplementation and immunological supporting treatment directly influence the curative effect of COPD.

Objective To explore the clinical characteristics and risk factors of death during hospitalization in patients with community-acquired pneumonia(CAP)complicated with diabetes mellitus(DM).Methods A retrospective analysis was performed on 566 patients with CAP hospitalized in the Second Affiliated Hospital of Kunming Medical University from January 2018 to January 2022.The patients were divided into simple CAP group(n=478)and CAP combined with diabetes(CAP+DM)group(n=88)according to whether they had diabetes,and then CAP+DM group(n=88)was divided into survival group(n=69)and death group(n =19)according to whether the patients died during hospitalization.The clinical data and laboratory test indicators of patients in different groups were compared.Cox regression analysis was used to screen the risk factors of death during hospitalization in the CAP+DM group.Receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of independent risk factors on hospitalization death.Results Compared with the simple CAP group,the CAP+DM group had significant differences in age,concomitant hypertension,coronary heart disease,CURB-65 score,neutrophil to lymphocyte ratio(NLR),C-reactive protein(CRP),procalcitonin(PCT),albumin(ALB),prealbumin(PA),glucose(GLU),serum potassium(K),calcium(Ca),phosphorus(P),magnesium(Mg),lactic acid(Lac),non-invasive ventilation time,ICU occupancy rate and mortality rate(P<0.05);Compared with the survival group,there were statistically significant differences in CURB-65 score,NLR,CRP,PCT,GIU,ALB,PA,serum iron(Fe),Ca,non-invasive ventilation time,and ICU admission rate among the death group patients(P<0.05).Cox regression analysis showed that the increase of NLR level and the decrease in PA level were the risk factors for in-hospital death in patients with CAP complicated with diabetes(P<0.05).When the PA cutoff value was 91 mg/L,the AUC,sensitivity,and specificity for predicting in-hospital death of CAP patients with diabetes were 0.849,84.2%and 81.2%,respectively.Conclusion Patients with CAP combined with diabetes are more serious and have worse prognosis than those with CAP alone.PA has a good predictive value for the prognosis of these patients.Early detection and active intervention should be carried out to reduce the in-hospital mortality of patients.