Objective: To explore the predictive value of neutrophil/lymphocyte ratio (NLR) on myocardial injury in severe COVID-19 patients. Methods: In this single-center retrospective cohort study, we collected and analyzed data form 133 severe COVID-19 patients admitted to Renmin Hospital of Wuhan University (Eastern District) from January 30 to February 18, 2020. Patients were divided into myocardial injury group (n=29) and non-myocardial injury group (n=104) according the presence or absence of myocardial injury. The general information of patients was collected by electronic medical record database system. All patients were followed up for 30 days, the organ injury and/or dysfunction were monitored, the in-hospital death was compared between the two groups, and the disease progression was reevaluated and classified at 14 days after initial hospitalization. Logistic regression analysis was performed to identify risk factors of myocardial injury in severe COVID-19 patients. The ROC of NLR was calculated, and the AUC was determined to estimate the optimal cut-off value of NLR for predicting myocardial injury in severe cases of COVID-19. Results: There was statistical significance in age, respiratory frequency, systolic blood pressure, symptoms of dyspnea, previous chronic obstructive pulmonary disease, coronary heart disease history, white blood cells, neutrophils, lymphocytes, platelets, C-reactive protein, platelet counting, aspartate transaminase, albumin, total bilirubin, direct bilirubin, urea, estimated glomerular filtration rate, total cholesterol, low-density lipoprotein cholesterol, D-dimer, CD3⁺, CD4⁺, partial pressure of oxygen, partial pressure of CO₂, blood oxygen saturation, other organ injury, clinical outcome and prognosis between patients with myocardial injury and without myocardial injury (all P<0.05). Multivariate logistic regression analysis showed that NLR was a risk factor for myocardial injury (OR=1.066，95%CI 1.021-1.111，P=0.033). ROC curve showed that NLR predicting AUC of myocardial injury in severe COVID-19 patients was 0.774 (95%CI 0.694-0.842), the optimal cut-off value of NLR was 5.768, with a sensitivity of 82.8%, and specificity of 69.5%. Conclusion: NLR may be used to predict myocardial injury in severe COVID-19 patients.
Betacoronavirus ; COVID-19 ; Coronavirus Infections/pathology* ; Heart Diseases/virology* ; Humans ; Lymphocytes/cytology* ; Myocardium/pathology* ; Neutrophils/cytology* ; Pandemics ; Pneumonia, Viral/pathology* ; Prognosis ; ROC Curve ; Retrospective Studies ; SARS-CoV-2

To study the difference of changes on apoptosis, necrosis and respiratory burst of the polymorphonuclear neutrophils (PMN) in endotoxemia rat model. LPS (O(55)B(5), 5 mg/kg) was injected into abdominal cavity of 20 random normal Wistar rat. 2, 4, 8 and 12 hours after injection, the changes of apoptosis, necrosis and respiratory burst of the rats between PMN from the peripheral blood and from the bronchoalveolar lavage fluid were observed using the flow cytometer. At the same time, 5 uninjected rats were taken as control. The results demonstrated that the quantity proportions of apoptosis of PMN between the peripheral blood PMN and the bronchoalveolar lavage fluid PMN in rat's endotoxemia were similar. However, comparison with the uninjected LPS rat, the necrosis of peripheral blood PMN obviously increased and the respiratory burst capacity was clearly inhibited. Contrarily, the necrosis of bronchoalveolar lavage fluid PMN obviously decreased and the respiratory burst obviously increased in the injecting LPS rat. It was concluded that the necrosis and apoptosis displayed differently between the pulmonary and peripheral blood PMNs in endotoxemia. Under state of inflammation, the surviving PMN in tissue increased and kept the activated state due to tissue injury.
Animals ; Apoptosis ; Bronchoalveolar Lavage Fluid ; cytology ; Endotoxemia ; blood ; Necrosis ; Neutrophils ; physiology ; Pulmonary Alveoli ; pathology ; Rats ; Rats, Wistar ; Respiratory Burst

Animals ; Animals, Newborn ; Bronchoalveolar Lavage Fluid ; chemistry ; cytology ; Female ; Lipopolysaccharides ; toxicity ; Lung ; drug effects ; enzymology ; pathology ; Male ; Neutrophils ; cytology ; Peroxidase ; analysis ; Rats ; Rats, Wistar

OBJECTIVETo investigate the changes of neutrophils in airway inflammation in children with severe asthma.

METHODChildren with mild to moderate asthma (n=23), severe asthma (n=16) and healthy control subjects (n=16) underwent lung function tests and sputum induction. The sputum specimens were assayed for cellular differential count, the supernatant and peripheral blood were assayed for the concentrations of IL-8 by "sandwich" enzyme linked immunosorbent assay (ELISA). Sputum supernatant, IL-8 and mifepristone were assessed for their abilities to prolong the in vitro survival of blood-derived neutrophils.

RESULTThe percentage of sputum neutrophils was significantly higher in severe asthmatics [59.54 (41.99-74.65)%] than mild-moderate asthmatics [30.03 (15.94-47.71)%] and healthy control subjects [29.72(16.53-45.74)%] (P < 0. 01); the level of IL-8 in sputum was significantly higher in severe asthmatics [2907.78 (331.67 - 3457.93) ng/L] than mild-moderate asthmatics [287.58 (130.75-656.84) ng/L] and healthy control subjects [179.2 (58.55-346.59) ng/L] (P < 0.01); the percentages of neutrophilic apoptosis respectively cultured with LPS [(10.57 +/- 1.97)%], severe asthmatics supernatant [(11.82 +/- 2.96)%], IL-8 [(10.47 +/- 1.93)%], dexamethasone [(9.93 +/- 1.95)%], severe asthma supernatant + mifepristone [(12.15 +/- 2.86)%] in vitro were lower than that cultured with PBS [(17.98 +/- 2.27)%], healthy control supernatant [(17.37 +/- 2.50)%], mild-moderate asthmatics supernatant [(16.35 +/- 3.26)%], mifepristone [(17.89 +/- 2.38)%], and dexamethasone + mifepristone [(17.06 +/- 2.59)%] (P < 0.01).

CONCLUSIONSuppression of neutrophilic apoptosis seems to play a potential role in airway neutrophilic inflammation in severe asthmatics, and the level of IL-8 in sputum was significantly higher in patients with severe asthmatics.

Adolescent ; Apoptosis ; Asthma ; metabolism ; pathology ; physiopathology ; Case-Control Studies ; Child ; Female ; Humans ; Inflammation ; Interleukin-8 ; metabolism ; Leukocyte Count ; Male ; Neutrophils ; cytology ; Respiratory System ; metabolism ; pathology ; Sputum ; metabolism

OBJECTIVETo explore the pathological changes of pulmonary fibrosis induced by SiO2 in rats and pigs.

METHODSThe silicosis models in rats and pigs were established by non-exposure method. The pathologic changes in lung tissues of rats and pigs were observed with HE staining under a light microscopy and under a transmission electron microscopy (TEM), the expression of cytokines was detected by immunohistochemistry.

RESULTS(1) The main pathologic changes of silicosis models in rats and pigs included: in 7 ∼ 15 days after treatment, silica dusts, dust cells, a lot of macrophages, lung epithelial cells, a few neutrophils, macrophage alveolar inflammation and nodules of stage I were found in alveolar space; in 30 ∼ 90 days after treatment, many nodules of stage I-III or IV with lymphocytes infiltration were observed in respiratory bronchioles, alveoli, interlobular septa, the subpleural and around blood vessels and bronchi. (2) The expression levels of CK protein, SP-A protein, CD68, b-FGF, TNF-α, IL-6, TGF-β1, NFKappa/P50, Kappa/P65 and VEGF reduced with exposure time, but still were higher than those of the control. (3) The shed alveolar type I cells, proliferation of alveolar type II cells or macrophages and activated cellular function induced by silica were observed under TEM.

CONCLUSIONThe development of pulmonary fibrosis in silicosis models corresponded with the process from macrophages alveolar inflammation to pulmonary fibrosis.

Animals ; Cytokines ; metabolism ; Disease Models, Animal ; Epithelial Cells ; metabolism ; Female ; Lung ; cytology ; pathology ; Macrophages, Alveolar ; metabolism ; Male ; Neutrophils ; metabolism ; Rats ; Rats, Sprague-Dawley ; Silicosis ; pathology ; Swine

OBJECTIVETo analyze the impact of neutrophil-to-lymphocyte ratio (NLR) on survival of patients with post-operative recurrence of non-small cell lung cancer (NSCLC).

METHODSThe clinicopathological characteristics and outcome data of 235 patients with post-operative recurrent NSCLC were collected and reviewed. The best cut-off value of NLR at recurrence was identified according to the receiver operating characteristic curve (ROC curve), and all 235 patients were therefore divided into two groups based on the NLR value. The prognostic impact of NLR on survival in patients with recurrent NSCLC was tested by univariate and multivariate analyses.

RESULTSThe NLR of 2.97 was identified as the optimal cut-off value. There was no statistically significant difference in the clinicopathological characteristics between the low NLR (NLR ≤ 2.97) and high NLR (NLR>2.97) groups at recurrence. The median post-recurrence survival of 235 patients was 13 months (range, 1-81 months). The post-recurrence 1-, 2-year survival rates were 58.4% and 32.6%, respectively. Univariate analysis showed that age at the time of operation >65 years (P = 0.009), a histological type of large cell lung cancer or sarcoma (P < 0.001), TNM stage III of the primary tumor (P = 0.043) and NLR>2.97 at recurrence (P < 0.001) were prognostic risk factors for post-recurrence survival, while preoperative NLR>2.97 was not (P = 0.104). The post-recurrence 1- and 2-year survival rates of the low recurrence NLR group were 74.7% and 43.1%, respectively, significantly higher than that of the high recurrence NLR group (35.4% and 17.2%, respectively) (P < 0.001). Cox multivariate analysis showed that age >65 (HR = 1.707, P = 0.001), TNM stage III of primary tumor (HR = 1.654, P = 0.001) and NLR>2.97 (HR = 2.859, P < 0.001) at recurrence were independent prognostic factors (P < 0.05 for all).

CONCLUSIONSAn elevated NLR at recurrence indicates poor prognosis of NSCLC patients. NLR at recurrence may be an important independent prognostic factor of patients with recurrent NSCLC after curative resection.

Aged ; Carcinoma, Non-Small-Cell Lung ; pathology ; surgery ; Female ; Humans ; Leukocyte Count ; Lung Neoplasms ; pathology ; surgery ; Lymphocytes ; cytology ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; pathology ; Neoplasm Staging ; Neutrophils ; cytology ; Postoperative Period ; Retrospective Studies ; Survival Rate

The aim of this study was to evaluate the relation between neutrophil-to-lymphocyte ratio (NLR) and plaque components assessed by virtual histology-intravascular ultrasound in 399 coronary artery disease (CAD) patients with 471 coronary lesions. We classified the lesions into two groups according to the NLR on admission {low NLR group (NLR< or =2.73 [n=370]) vs. high NLR group (NLR>2.73 [n=101])}. By volumetric analysis, total atheroma and the absolute necrotic core (NC) volumes were significantly greater in high NLR group (249.9+/-149.7 microL vs. 192.5+/-127.7 microL, P=0.001, and 32.7+/-26.8 microL vs. 22.8+/-19.4 microL, P=0.001, respectively) and thin-cap fibroatheroma (TCFA) was observed more frequently in high NLR group (33% vs. 18%, P=0.001). ST segment elevation myocardial infarction (odds ratio [OR], 2.159; 95% CI, 1.000-4.660, P=0.050) and NLR>2.73 (OR, 1.848; 95% CI, 1.016-3.360, P=0.044) and total atheroma volume (OR, 1.003; 95% CI, 1.001-1.004, P=0.004) were the independent predictors of TCFA. CAD patients with high NLR had more vulnerable plaque components (greater NC-containing plaques) than those with low NLR.
Aged ; C-Reactive Protein/analysis ; Coronary Angiography ; Coronary Artery Disease/*diagnosis/pathology ; Female ; Hospitals, University ; Humans ; Lymphocytes/*cytology ; Male ; Middle Aged ; Neutrophils/*cytology ; Odds Ratio ; Patients ; Plaque, Atherosclerotic/metabolism/*pathology ; Retrospective Studies ; Ultrasonography, Interventional

BACKGROUND: Previous studies have shown that the neutrophil-to-lymphocyte ratio (NLR) has a significant impact on the prognosis of many malignant tumors such as gastric cancer, colorectal cancer and pancreatic cancer, but the study on the prognosis of patients with resectable lung adenocarcinoma is less. The aim of this study is to investigate the correlation between the NLR and the clinicopathologic features of adenocarcinoma of lung patients who underwent radical pneumonectomy. Furthermore, this study aimed to clarify the predictive and prognostic significance of NLR in patients who underwent pneumonectomy for lung adenocarcinoma. METHODS: This study reviewed the medical records of 163 patients with lung adenocarcinoma who underwent pneumonectomy. The receiver operating characteristic (ROC) curve and Youden index were used to determine the cut-off value of the NLR. Survival curves were described by Kaplan-Meier method and compared by Log-rank test. The univariate and multivariate analyses were performed with the Cox proportional hazard model to identify the prognostic factors. RESULTS: When the NLR value was 2.96, the Youden index was maximal, with a sensitivity of 77.5% and a specificity of 75.9%. The 5-year survival rate in the low NLR group was higher than that in the high NLR group (P<0.05). The univariate and multivariate analyses showed that TNM staging and NLR were independent factors in predicting survival rate. CONCLUSIONS The NLR value was a simple and useful tool to predict the prognosis of lung adenocarcinoma after radical pneumonectomy.
Adenocarcinoma ; diagnosis ; immunology ; pathology ; surgery ; Adenocarcinoma of Lung ; Aged ; Cell Count ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Lung Neoplasms ; diagnosis ; immunology ; pathology ; surgery ; Lymphocytes ; cytology ; Male ; Middle Aged ; Neoplasm Staging ; Neutrophils ; cytology ; Pneumonectomy ; Prognosis ; ROC Curve ; Retrospective Studies

OBJECTIVETo investigate the clinical implication of preoperative neutrophil-to-lymphocyte ratio (NLR), and association of NLR with the prognosis of the elderly patients over 75 years old with primary gastric cancer.

METHODSClinical data of 160 patients (≥75 years) with gastric cancer undergoing gastrectomy in Department of Gastrointestinal Surgery, the Tumour Hsopital of Harbin Medical University form January 2007 to December 2010 were retrospectively analyzed. Preoperative neutrophil and lymphocyte count was measured and NLR was calculated. The cut-off value of NLR to predict the survival was obtained from the receiver operating characteristic(ROC) curve. Patients were divided into two groups based on cut-off value. Clinicopathological features were compared between two groups using Chi-square test or Fisher exact test. Cox proportional hazard model was used to analyze risk factors associated with survival.

RESULTSThe cut-off value of NLR was 1.83 with 0.709 of sensitivity and 0.562 of specificity. A total of 54 patients with NLR<1.83 belonged to NLR-0 group, and 106 patients with NLR≥1.83 belonged to NLR-1 group. As compared to NLR-0 group, patients in NLR-1 group had significantly higher proportion in maximum tumor size ≥ 50 mm [66.0%(70/106) vs. 42.6%(23/54), P=0.004], serosal invasion [75.5%(80/106) vs. 57.4%(31/54), P=0.029], positive lymph node metastasis [83.0% (88/106) vs. 55.6%(30/54), P=0.001] and TNM stage III( [79.2%(84/106) vs. 61.1%(33/54), P=0.013]. The median survival of NLR-0 and NLR-1 group was 1 209 days and 587 days respectively, with significant difference(P=0.001). Multivariate analysis showed that NLR≥1.83(HR=0.530, 95% CI: 0.332 to 0.846, P=0.008), serosal invasion (HR=0.570, 95% CI: 0.332 to 0.979, P=0.042), and lymph node metastasis(HR=0.475, 95% CI: 0.462 to 1.685, P=0.033) were independent risk factors of poor prognosis(all P<0.05).

CONCLUSIONPreoperative higher NLR value in the elderly patients over 75 years old with primary gastric cancer indicates larger tumor size, severe serous invasion, more lymph node metastasis, later TNM staging, and poorer prognosis.

Aged ; Chi-Square Distribution ; Gastrectomy ; Humans ; Lymphatic Metastasis ; Lymphocyte Count ; Lymphocytes ; cytology ; Neoplasm Staging ; Neutrophils ; cytology ; Prognosis ; Proportional Hazards Models ; ROC Curve ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; diagnosis ; pathology

OBJECTIVETo explore the effect and the mechanism of yifei jianpi recipe (YFJPR) on patients with chronic obstructive pulmonary disease (COPD).

METHODSForty patients with COPD in stable phase were randomly divided into two groups, the treated group and the control group. Indexes including the total and differential count of inflammatory cell in sputum, levels of interleukin-8 (IL-8) and tumor necrosis factor-alpha (TNF-alpha), as well as the percentage of forced expiratory volume in one second in its predicted value (FEV1%) and ratio of FEV1/forced vital capacity (FVC) in patients were measured before and after treatment, and compared with those in 20 healthy subjects.

RESULTSAll the indexes measured in patients before and after treatment were significantly different from those in healthy subjects (P < 0.01). Differential count of polymorphonuclear neutrophil (PMN) and levels of IL-8 and TNF-alpha in sputum in the treated group significantly decreased after treatment (P < 0.01), while the non-PMN differential count and levels of FEV1% and FEV1/FVC significantly increased (P < 0.01). But in the control group, changes only showed in increasing of FEV1% and FEV1/FVC (P < 0.05 or P < 0.01). And the effects in the treated group were better than those in the control group (P < 0.01).

CONCLUSIONYFJPR can play a therapeutic role on patients with COPD by way of reducing the airway inflammatory reaction.

Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Interleukin-8 ; metabolism ; Leukocyte Count ; Male ; Middle Aged ; Neutrophils ; pathology ; Phytotherapy ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; metabolism ; pathology ; Respiratory Function Tests ; Sputum ; cytology ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism