Objective: To analyze the relationship between single nucleotide polymorphisms (SNP) of Notch signaling pathway and susceptibility to lung cancer. Methods: The present study was a hospital-based case-control study. All 1 121 patients of lung cancer diagnosed by histopathology three hospitals in Fujian and Nanjing were selected as cases from January 2006 to December 2012. At the same time, 1 121 healthy population from other departments of the hospital to visit patients or community, excluding those with tumor, chronic disease, and immediate family members of lung cancer, were enrolled in control group. A uniform questionnaire was used to collect general information. Matrix-assisted laster desorption ionization time of flight mass spectrometry (MALDI-TOF-MS) was used to identify the polymorphisms of 9 SNP (Notch3 rs3815188, Notch4 rs915894, Notch4 rs520692, DLL1 rs1033583, JAG1 rs8708, JAG2 rs9972231, HEY1 rs1046472, HEY2 rs3734637, HES2 rs11364) in 1 121 lung cancer patients and 1 121 healthy controls. The association between SNP and lung cancer was analyzed by χ² and logistic regression model. Results: The average age of cases and controls was (58.70±10.73) and (58.98±10.85) years old. The OR for genotype AC carriers of HEY1 rs1046472 was 0.80 (95%CI: 0.66-0.97) when comparing with genotype CC. The OR for genotype AC+AA carriers of HEY1 rs1046472 was 0.81 (95% CI: 0.67-0.98) when comparing with genotype CC. The OR for genotype AC carriers of HEY2 rs3734637 was 0.82 (95%CI: 0.67-0.99) when comparing with genotype AA. In the stratified analysis, Notch3 rs3815188, DLL1 rs1033583, JAG1 rs8708, JAG2 rs9972231, HEY1 rs1046472, HEY2 rs3734637, HES2 rs11364 were associatied with the risk of lung cancer, P were 0.041, 0.030, 0.043, 0.003, 0.004, 0.026 and 0.038, respectively.The interactions analysis done by logistic regression model showed JAG1 rs8708 and family history, JAG2 rs9972231 and BMI had interaction in the study, OR were 2.07 (95% CI:1.21-3.52) and 1.73 (95% CI:1.21-2.47), respectively. Conclusion Notch3 rs3815188, DLL1 rs1033583, JAG1 rs8708, JAG2 rs9972231, HEY1 rs1046472, HEY2 rs3734637 and HES2 rs11364 were significantly associated with susceptibility to lung cancer.

Objective To analyze the effect of gender on the prognosis of patients with non-small cell lung cancer (NSCLC).Methods Data of 1 195 patients with NSCLC were analyzed by Chi-square,Kaplan-Meier,log-rank tests and Cox regression models.Results Women had a longer survival than men (median overall survival 31.64 versus 22.71 months,P＜0.01) in the participants of this study.Differences seen in overall survival remained the similar,after stratified by age,pathologic types,clinical stage,sizes,pleural effusion and surgery of the patients,respectively.Data from the multivariate analysis revealed that factors as smoking,clinical stage,metastatic when diagnosis was made and surgery,but not gender,were independent prognostic factors for patients with NSCLC.After adjustment for potential confounders,we found that smoking was a major confounding factor,affecting the relationship between gender and prognosis of NSCLC.Conclusion Gender did not seem an independent prognostic factor for NSCLC patients while the survival advantages of females might be attributed to the lower prevalence of smoking in this population.

Objective To investigate the antitumor effects and the possible mechanisms of dendrit-ic cells co-cultured with cytokine-induced killer cells(DC-CIK)in combination with sorafenib on two lung adenocarcinoma cell lines,A549 cells(harboring KRAS gene mutation)and PC-9 cells(harboring EGFR gene mutation). Methods DC and CIK cells were routinely generated in vitro by stimulating PBMCs isola-ted from lung cancer patients with different cytokines and then co-cultured after a week of culturing. Flow cy-tometry analysis(FCM)was used to analyze the phenotype of DC-CIK cells after 7 days of co-culturing. The 50% inhibitory concentration(IC50 )of sorafenib against tumor cells was detected by MTT assay. The tumor cells were treated with DC-CIK cells alone or in combination with sorafenib. The proliferation of tumor cells was tested by CCK-8 kit and dynamically monitored by real-time cellular analysis(RTCA). Annexin-V/ PI staining was used to examine the apoptosis rates in each group. Real-time fluorescent quantitative PCR and FCM were respectively performed to detect the expression of natural killer group 2 member D ligands (NKG2DLs)at mRNA and protein levels after the treatment with sorafenib for 24 h. Results There was no significant difference between the IC50 of sorafenib against A549 and PC-9 cells after a 24-hour exposure(P﹥0. 05). Compared with the DC-CIK biotherapy,treating the tumor cells with DC-CIK cells in combination with sorafenib significantly inhibited the cell proliferation and increased the total apoptosis rates of tumor cells(P﹤0. 05). Moreover,the inhibition rates to tumor cell proliferation were enhanced along with the in-crease of effect-to-target ratio(E/ T). Compared with the single-factor treatment groups,the normalized cell index(NCI)in the combined treatment group was significantly decreased. Blocking NKG2D could abate the inhibitory effect of DC-CIK cells on tumor cell proliferation(P﹤0. 05). The expression of NKG2DLs(inclu-ding ULBP1,UBLP2 and ULBP3)on tumor cells at mRNA and protein levels were increased to different ex-tent after treating with 5 μmol/ L of sorafenib for 24 h. Conclusion There was no significant different be-tween the inhibitory effects of sorafenib on the proliferation of lung adenocarcinoma cancer cells harboring KRAS or EGFR gene mutation. The antitumor effects of DC-CIK cells combined with sorafenib on lung ade-nocarcinoma cells might be induced by regulating the NKG2D-NKG2DLs pathway and enhancing apoptosis. Moreover,the antitumor effects of the combined treatment were better than those of single-factor treatments.

OBJECTIVE To observe the effect of administration intranasal corticosteroids on small airway disfunction for allergic rhinitis (AR) patients. METHODS AR patients with small airway disfunction were administrated intranasal corticosteroids for twelve weeks. Before treatment, nasal VAS, RQLQ were recorded, pulmonary function test were given. After therapy, VAS, RQLQ were obtained again at the 4th, 8th and 12th week. Pulmonary function test were performed at the 4th and 12th week. RESULTS VAS, RQLQ were all improved after therapy (P <0.01). The indices of FEV1/FVC%, MMEF pred%, MEF75pred%, MEF50pred%, MEF25pred%were also improved significantly (P<0.05), especially for MMEFpred%, MEF75pred%, MEF50pred% (P<0.01). CONCLUSION Small airway lesions can be obviously improved by the intranasal corticosteroids applied for AR. It has positive significance for preventing AR from developing into asthma.

Objective Small airway hypofunction is an early manifestation of asthmatic airway injury and is found in patients with non-asthma allergic rhinitis.However, no report has been seen on the changes of small airway function in patients with non-aller-gic rhinitis ( NAR) .This study was to investigate the possibility of small airway lesion in NAR patients and its relationship with airway responsiveness by observing the changes of small airway function in NAR patients without asthma and/or lower airway symptoms. Methods We recruited 324 subjects for this study, including 262 NAR patients and 62 healthy controls, and assigned them to an air-way hyperresponsiveness (AHR) and a non-airway hyperresponsiveness (nAHR) group.All the subjects underwent medical history collection, nasal examination, allergen skin prick test, blood routine test, serum total immunoglobin E assay, pulmonary function test, and bronchial challenge test. Results Compared with the healthy con-trols, the NAR patients showed remarkably lower predicted percenta-ges of maximal mid-expiratory flow ([85.6 ±17.1] vs [81.3 ± 19.9]%), mid-expiratory flow (MEF) with 75% of forced vital ca-pacity (FVC) expired ([96.1 ±16.1] vs [88.8 ±23.1]%), MEF with 50%of FVC expired ([88.4 ±17.8] vs [84.8 ±20.8]%), and MEF with 25%of FVC expired ([92.7 ±25.9] vs [82.9 ± 28.7]%) (P<0.05), but had no statistically significant differences in the predicted percentages of FVC, forced expiratory volume in 1 second (FEV1), and the ratio of FEV1 to FVC (P>0.05).The positive rate of AHR was 6.1% (16/246) in the NAR group.All the indices of small airway function were significantly lower in the AHR than in the nAHR group (P <0.01). Conclusion NAR patients are apt to undergo obvious changes in small airway function, some with AHR, which is associated with lower airway function changes.

OBJECTIVE: Observe the changes of small airway function in patients with rhinitis but without asthma and/or lower airway symptoms. METHOD: Between June 2008 and December 2012, we recruited 903 subjects, including 377 with allergic rhinitis (AR), 262 with non-allergic rhinitis (NAR) and 264 healthy subjects. All subjects underwent meticulous history taking, nasal examination, allergen skin prick test, blood routine test, serum total immunoglobin E assay, pulmonary ventilation function test and bronchial challenge test. RESULT: The indices of FEV1/FVC%, MEF25pred% and MMEFpred% were lower in AR group than in the control group (P < 0.05). The indices of FEV1/FVC, MMEFpred%, MEF25pred% and MEF50pred% were also lower in NAR group than in the control group (P < 0.05). According to the FVCpred% and FEV1pred%, there were no differences between rhinitis group and the control group (P > 0.05). The positive rate of airway hyperresponsiveness(AHR) in AR group and in NAR group was 12.2%, 6.1% respectively. Indices of small airway function were all lower in the AHR group than NAHR group in rhinitis. CONCLUSION Compared with healthy controls, small airway function in patients with rhinitis has apparent changes, part of rhinitis patients has AHR, and is associated with small airway function changes.
Asthma ; Case-Control Studies ; Humans ; Respiratory Function Tests ; Respiratory System ; physiopathology ; Rhinitis ; physiopathology ; Rhinitis, Allergic ; physiopathology ; Skin Tests

Objective To study the clinical significance of nursing intervention in the treatment of diabetes patients with Alzheimer disease .Methods We screened 138 patients, who were randomly divided into intervention group and control group .Therapeutic counseling , diet control , psychological counseling and basic lifestyle guidance and other nursing interventions were applied in treatment of intervention group patients . Results After half and one month of intervention , the two hours postprandial blood glucose and fasting blood glucose in the intervention group were significantly decreased , compared with the control group ( t=-2.890,-2.971, -2.822, -2.819, respectively;P<0.05).Meanwhile, the nursing satisfaction in the intervention group was significantly higher than that in the control group (69.57% vs 46.38%;Z=-2.966,P<0.05). Conclusions Nursing intervention for diabetes patients with Alzheimer disease can promote patients ’ condition and increase their compliance .

Objective To investigate the relationship between the expression of the survivin gene and CpC methylation in exon 1 of the survivin gene in CA tissue, and to study the expression of survivin protein in CA tissue and its modulation mechanism. Methods Tissue samples were obtained from the CA lesions of 30 patients, normal cervix of 10 female controls, and normal foreskin of 10 male controls. Immunohistochemistry was carried out to detect the expression of survivin protein in these specimens, RT-PCR to measure the mRNA expression of survivin, and methylation specific PCR (MSP) to analyze the methylation status of CpG island in the survivin gene exon 1. Results The positivity rate of survivin protein and mRNA was 90% (27/30) and 93.3% (28/30) in CA tissue specimens, respectively, 5% (1/20) and 5% (1/20) in control tissue specimens, respectively; there was a significant difference between the two groups of specimens in both the parameters (x2 = 35.187, 38.437, both P < 0.01). The demethylation of CpG island in the survivin gene exon 1 was observed in 86.7% (26/30) of the CA tissue specimens and in 15% (3/20) of the control tissue specimens (x2 = 10.865, P < 0.01). There was a positive correlation between the demethylation status of CpG island in exon 1 and the mRNA expression of survivin gene (x2 = 13.929, P = 0.014). Conclusions The expression of survivin protein in CA tissues might be associated with the demethylation of CpG island in exon 1 of the survivin gene, and may play a certain role in the development of CA.

OBJECTIVE: To evaluate the diagnostic significance of multiple detector-row spiral CT(MSCT) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). METHOD: Sixty-seven patients with OSAHS and 40 volunteers were scanned. The CT imagings from the nasopharyngeal floor to the glottis obtained. The relevant dimensions of area, diameter, thickness of retropharyngeal tissue were measured in some regions in imagings including nasopharynx, oral pharynx and hypopharynx, as well as the narrowest region in pharynx. RESULT: 1) The values of area, left-right diameter and front-back diameter of oral pharyngeal imagings of patients with OSAHS were narrowest regions which were (133.5 +/- 32. 9) mm2, (12.5 +/- 2.0) mm, (10.4 +/- 1.8) mm respectively. The value of above parameters of oral pharyngeal imagings of volunteers were (238.5 +/- 46.5) mm2, (20.4 +/- 3.1) mm, (21.1 +/- 4.0) mm respectively. The values of two groups had marked difference by statistics (P< 0.01). 2) The narrowest regions were located in oral pharynx in the imagings of 58 patients with OSAHS, which located in soft palate site in 19 patients, in oral pharynx site in 11 patients and in retro-lingua site in 28 patients. The narrowest regions were located in nasopharynx in the imagings of 3 patients. None of the narrowest region was found in hypopharynx. The narrowest regions, which all located in oral pharynx, were measured in the imagings of 24 volunteers. 3) The values of area, left-right and front-back diameter of the narrowest regions of imaging of 58 patients with OSAHS among 67 patients were (75.6 +/- 17.9) mm2, (10.6 +/- 2.1) mm, (6.9 +/- 1.0) mm respectively. The values of bove parameter of the most narrowest regions of imagings of volunteer were (187.3 +/- 35.6) mm2, (21.4 +/- 4.3) mm, (15.6 +/- 2.7) mm respectively. There were significant difference in statistics among the data of these groups (P < 0.01). CONCLUSION The imagings of MSCT may provide accurate diagnosis in OSAHS. Patients with OSAHS always had anatomically narrow in pharynx, especially in oral pharynx.
Adult ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Pharynx ; diagnostic imaging ; Sleep Apnea, Obstructive ; diagnostic imaging ; Tomography, Spiral Computed

BACKGROUND: Both Allergic rhinitis and bronchial asthma are allergic diseases of respiratory tract. They frequently coexist in the same patients.OBJECTIVE: To study the incidence of allergic rhinitis in patients with bronchial asthma in Nanjing, and to analyze the correlation of clinical characteristic between allergic rhinitis and bronchial asthma.DESIGN: The questionnaire survey.SETTING: Department of Otorhinolaryngology-Head and Neck Surgery and Department of Respiratory, Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA.PARTICIPANTS: A total of 134 patients with bronchial asthma including 73 males and 61 females were selected form Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA from February 2001 to April 2005. Their ages ranged from 3 to 72 years. Severity of asthma of all patients was classified based on Global Initiative for Asthma (GINA). The diagnostic criteria of allergic rhinitis were established referred to the guideline of Haikou Meeting (November, 1997). All patients provided the confirmed consent.METHODS: The questionnaire survey of 134 bronchial asthma patients from the city of Nanjing was conducted. Their age, classification, severity, treatment status, and the family history of all 134 patients were investigated in details. Differences of age, age at onset, and course of disease between rhinitis and asthma of all patients were examined by two independent t tests. The correlation between clinical characteristics of allergic rhinitis and bronchial asthma was analyzed by Spearman rank correlation.MAIN OUTCOME MEASURES : Incidence of allergic rhinitis in patients with bronchial asthma and the correlation of clinical characteristic between allergic rhinitis and bronchial asthma.RESULTS：Of all 134 bronchial asthma patients，82(61．2％,82/134)were accompanied with allergic rhinitis．There were 45 males and 37 females．Of 82 patients with allergic rhinitis accompanying with bronchial asthma，severity was classified into grade Ⅰ (mild pause,n=56)，grade Ⅱ (mild persistence，n=21)，grade Ⅲ (moderate persistence，n=4)，and grade Ⅳ (severe persistence，n=1)．In addition,allergic rhinitis was classified into periodicity (n=65) and persistence(n=17)．According to the classification and seventy system recommended in ARIA,63 patients had mild symptoms and 19 had moderate and severe symptoms．Severity of allergic rhinitis was positively related to that of bronchial asthma(r=0.689,P＜0．01)．CONCLUSION: The morbidity of allergic rhinitis combining with bronchial asthma is high in Nanjing, China. While, their classification and severity are highly coherent.