Objective To compare and analyze the predictive value of different immune-inflammatory parameters for adverse outcomes in severe community-acquired pneumonia(SCAP).Methods A total of 196 severe pneumonia patients admitted to the Second Affiliated Hospital of Zhengzhou University from May 2021 to April 2024.Patients were divided into good prognosis group(n=107)and poor prognosis group(n=89)based on the 28-day hospital outcome.Laboratory indicators were collected and inflammatory indices such as neutrophil-to-lymphocyte ratio(NLR)and NLR to hemoglobin ratio(NLR/Hb)were calculated.Logistic regression analysis was used to identify independent risk factors for poor prognosis in SCAP and to construct a regression model.The diagnostic efficacy of NLR/Hb for adverse outcomes in SCAP was evaluated using the receiver operating characteristic curve.Results NLR during hospitalization in good prognosis group was higher than that in poor prognosis group.Hemoglobin(Hb)in good prognosis group was higher than that in poor prognosis group,and Hb value of admitted patients generally showed a downward trend.platelet(PLT)count in good prognosis group showed an overall upward trend during hospitalization,while poor prognosis group showed a downward trend.NLR/Hb at day 7 showed the most stable significance in multi-model multi-factor Logistic regression analysis(P＜0.001).The indicators with differences were included in multi-factor Logistic regression model.NLR/Hb at day 7,D-dimer,and invasive mechanical ventilation were risk factors for poor prognosis,and platelet count at day 7 was a protective factor for poor prognosis(P＜0.05).Conclusion Dynamic monitoring of blood routine is very necessary in clinical practice,and NLR/Hb is expected to become an effective indicator for judging the poor prognosis of severe pneumonia patients.

Objective To compare and analyze the predictive value of different immune-inflammatory parameters for adverse outcomes in severe community-acquired pneumonia(SCAP).Methods A total of 196 severe pneumonia patients admitted to the Second Affiliated Hospital of Zhengzhou University from May 2021 to April 2024.Patients were divided into good prognosis group(n=107)and poor prognosis group(n=89)based on the 28-day hospital outcome.Laboratory indicators were collected and inflammatory indices such as neutrophil-to-lymphocyte ratio(NLR)and NLR to hemoglobin ratio(NLR/Hb)were calculated.Logistic regression analysis was used to identify independent risk factors for poor prognosis in SCAP and to construct a regression model.The diagnostic efficacy of NLR/Hb for adverse outcomes in SCAP was evaluated using the receiver operating characteristic curve.Results NLR during hospitalization in good prognosis group was higher than that in poor prognosis group.Hemoglobin(Hb)in good prognosis group was higher than that in poor prognosis group,and Hb value of admitted patients generally showed a downward trend.platelet(PLT)count in good prognosis group showed an overall upward trend during hospitalization,while poor prognosis group showed a downward trend.NLR/Hb at day 7 showed the most stable significance in multi-model multi-factor Logistic regression analysis(P＜0.001).The indicators with differences were included in multi-factor Logistic regression model.NLR/Hb at day 7,D-dimer,and invasive mechanical ventilation were risk factors for poor prognosis,and platelet count at day 7 was a protective factor for poor prognosis(P＜0.05).Conclusion Dynamic monitoring of blood routine is very necessary in clinical practice,and NLR/Hb is expected to become an effective indicator for judging the poor prognosis of severe pneumonia patients.

Objective To investigate the expression of calpains and calpastatin in diaphragm of a rat model of chronic obstructive pulmonary disease(COPD). Methods Fotry male Wistar rats were randomly divided into the control group and the COPD group. Rats in the COPD group were copied by expo -sing to cigarettes smoking and dripping lipopolysaccharide into trachea. Pathological changes of lung and diaphragm were deteted. Immunohis-tochemistry and RT-PCR were performed to determine protein and mRNA expression of calapins and calpastatin. Results Diaphragmatic atrophy was observed in rats in the COPD group instead of the control group. The protein and mRNA expression of calpains in diaphrag-m of COPD group were Increased than those in the control group(P < 0.05). On the contrary ,the expression of calpastatin was significantly reduced in rats in the COPD group(t =-9.38 and-2.97;P < 0.001 ,P = 0.005). Conclusions An imbalance in the expression of calpains/calpastatin in diaphragm was observed in COPD rats ,and this imbalance may be responsible for diaphragm atrophy.