BackgroundInterleukin-17 (IL-17) plays an important role in cancer progression. Previous studies remained controversial regarding the correlation between IL-17 expression and lung cancer (LC) prognosis. To comprehensively and quantitatively summarize the prognostic value of IL-17 expression in LC patients, a systematic review and meta-analysis were performed.MethodsWe identified the relevant literatures by searching the PubMed, EMBASE, Cochrane Library, SinoMed, China National Knowledge Infrastructure (CNKI) and Wanfang Data databases, up until April 1, 2017. Overall survival (OS), disease free survival (DFS) and clinicopathological characteristics were collected from relevant studies. Pooled hazard ratios (HR) and corresponding 95% confidence intervals (CI) were calculated to estimate the effective value of IL-17 expression on clinical outcomes.ResultsSix studies containing 479 Chinese LC patients were involved in this meta-analysis. The results indicated high IL-17 expression was independently correlated with poorer OS (HR = 1.82, 95% CI 1.44–2.29, P < 0.00001) and shorter DFS (HR = 2.41, 95% CI 1.42–4.08, P = 0.001) in LC patients. Further, when stratified by LC histological type (non-small cell lung cancer and small cell lung cancer), tumor stage (Ⅰ-Ⅲ,Ⅰ-Ⅳ and Ⅳ), detection specimen (serum, intratumoral tissue and pleural effusion), test method (immunological histological chemistry and enzyme linked immunosorbent assay), and HR estimated method (reported and estimated), all of the results were statistically significant. These data indicated that elevated IL-17 expression is correlated with poor clinical outcomes in LC. The meta-analysis did not show heterogeneity or publication bias.ConclusionsThe present meta-analysis revealed that high IL-17 expression was an indicator of poor prognosis for Chinese patients with LC. It could potentially help to assess patients’ prognosis and estimate treatment efficacy in therapeutic interventions.

Accumulating studies have confirmed that mammary serine protease inhibitor (MASPIN) plays an essential role in non-small cell lung cancer (NSCLC). However, results are still controversial or inconsistent. In the present study, we attempted to identify the clinical significance of MASPIN and its potential molecular roles in NSCLC. The correlation of MASPIN with prognosis and clinicopathological characteristics was assessed by meta-analysis. Additionally, the potential molecular mechanisms of MASPIN in NSCLC was also investigated through several online databases. A total of 2220 NSCLC patients from 12 high quality studies were included and the results indicated that up-regulated MASPIN nucleus and cytoplasm expression was associated with poor overall survival (OS) (hazard ratio (HR) = 1.43, 95% confidence interval (CI) = 1.01–2.04, P&lt;0.05), elevated MASPIN cytoplasm expression was associated with poor OS (HR = 1.45, 95% CI = 1.01–2.07, P&lt;0.05), disease-free survival (DFS) (HR = 1.95, 95% CI = 1.31–2.88, P=0.001), and disease-specific survival (DSS) (HR = 2.17, 95% CI = 1.18–3.99, P=0.013). MASPIN both nucleus and cytoplasm location were associated with clinicopathological characteristics. Bioinformatics analysis validated the above results and suggested that human serpin family B member 5 (SERPINB5) hypomethylated levels were negatively correlated with its mRNA expression. Bioinformatics analysis also revealed the 85 most frequently altered neighboring genes of SERPINB5, and gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis revealed 20 GO terms and 3 KEGG pathways with statistical significance. MASPIN had a statistically negative correlation with NSCLC prognosis, functioning as an oncoprotein by hypomethylation and influencing specific pathways involving the 85 genes identified herein. MASPIN might be a promising prognostic signature in NSCLC.

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Background To promote the utilization of pulmonary function tests (PFT) through analyzing the data of PFT during the past seven years in one large teaching hospital in China.Methods Through a retrospective analysis, the allocation of full-time staff in PFT room, the demographic characteristics of patients, cost-effectiveness of PFT, positive rate and failure rate of PFT, adverse events were analyzed.Results 1) From 2012 to 2018, the numbers of PFT showed the trend of escalation year by year. The proportion of patients receiving PFT rose from 29.0/10000 in 2012 to 34.7/10000 in 2018. The best allocation of PFT room was 20-25/ person / day. 2) The number of PFT provided by Department of Pulmonary and Critical Care Medicine (PCCM) accounted for 97.2%, 97.1%, 97.3%, 97.8%, 97.8%, 98.0%, and 98.2% of the total cases of outpatient PFT in the same year. The top three departments in the inpatient department were Department of Thoracic Surgery, Department of General Surgery, and Department of Urinary Surgery, the total cases of PFT in these three departments accounted for 65.1%, 64.4%, 62.1%, 63.5%, 62.4%, 65.3% and 69.1% of the total cases of inpatient PFT in the same year. 3) Data from 2018 showed that the revenue from PFT was about 3.7 million Chinese Yuan, and that the salary of personnel and expenditure on machine maintenance and wear were about 800,000 Chinese Yuan. 4) 58.2% of the patients who had undergone PFT had ventilatory dysfunction. 5) The average failure rate of PFT in the past seven years was 1.91%. 6) The main adverse events of PFT examination were dizziness, amaurosis, limb numbness, lip numbness and falls. The incidence rates were 0.49%, 0.42%, 0.41%, 0.39%, 0.44%, 0.48%, and 0.45% respectively, with an average of 0.44%.Conclusions The number of PFT showed an upward trend in the past seven years, and the optimal staffing of PFT room was 20-25 cases per person per day. The positive rate of pulmonary dysfunction was 58.2%. The failure rate of PFT and the incidence of adverse events were very low, suggesting it is a simple and safe clinical examination. It's worthy of further popularization and promotion.

Background Although voriconazole is a widely used azole antifungal agent in clinical practice, its side effect of muscle toxicity is extremely rare. The present study demonstrates an adverse effect of progressive myotoxicity induced by intravenous voriconazole in a cryptogenic organizing pneumonia patient misdiagnosed as suspected pulmonary fungal infection.Case presentation A 78-year-old male was admitted to our hospital due to recurrent cough and expectoration for four months. His previous chest CT scan indicated alveolar opacities and multiple cavitary nodules in the right lower lobe. Pulmonary fungal infection was considered due to weakly positive results of serum galactomannan and 1,3 β-D-glucan test,with no evidence of malignant tumor, tuberculosis, or Wegener's granulomatosis. The patient experienced diffuse myalgia with significantly elevated muscle enzymes after voriconazole administration for 13 days, and recovered uneventfully due to immediate voriconazole cessation and enhanced intravenous fluid infusion. Furthermore, the pulmonary cavitary nodules were consistent with the pathological findings of cryptogenic organizing pneumonia.Conclusions Voriconazole-associated myotoxicity should be considered when a patient presents with evidence of muscle injury during voriconazole administration. Morever, although invasive pulmonary fungal infection can often show multiple nodules with cavities in CT scan, the initiation of anti-fungal agents should be cautious before the pathological features of multiple cavitary nodules are identified, in order to avoid potential serious adverse events.

Background Left atrial diameter (LAD) has been confirmed to predict recurrence of atrial fibrillation (AF) after catheter ablation (CA). The influence of right atrium (RA) size on the prognosis after CA was relatively unclear and lack of research. The objective of the present study was to investigate the relationship between right atrial diameter (RAD) and the mid-term outcome of AF after CA. Methods This study retrospectively examined 121 patients who underwent initial CA for symptomatic AF. Cox regression model was used to find risk factors of recurrence. Receiver operating characteristic (ROC) curve was used to evaluate predictive power and determine clinic cutoff value. Kaplan-Meier survival curve and log-rank test were used to analyze success rate. Results There were 94 (77.7%) patients of freedom from AF after 24.2 ± 4.5 months’ follow-up. Multivariate Cox regression analysis showed both hypertension and RAD were independent risk factors of arrhythmia recurrence after ablation regardless of AF type (HR: 4.915; 95% CI: 1.370-17.635; P = 0.015 and HR: 1.059; 95% CI: 1.001–1.120; P = 0.045, respectively). However, in patients with paroxysmal AF (par-AF), Multivariate analysis showed RAD become the only independent risk factor (HR: 1.031; 95% CI: 1.016–1.340; P = 0.029). ROC curve demonstrated the cutoff value of RAD was 35.5 mm with an area under the curve (AUC) of 0.715 (95% CI: 0.586–0.843, P = 0.009), sensitivity of 81.3% and specificity of 54.2%. Kaplan-Meier survival curve showed significant difference of freedom from par-AF (67.5 vs. 91.4%, log-rank, P = 0.015) between patients with RAD ≥ 35.5 mm and < 35.5 mm in this subgroup. Nevertheless, in patients with persistent AF (per-AF), no risk factor of arrhythmia recurrence was found. In addition, Kaplan-Meier survival curve showed no significant difference of freedom from per-AF (69.7 vs. 87.5%, log-rank, P = 0.31) between patients with RAD ≥ 35.5 mm and < 35.5 mm. Conclusions RAD was the independent risk factor predicting recurrence of AF after CA only in patients with par-AF. In patients with RAD < 35.5 mm, there was a significantly higher freedom from par-AF recurrence compared with RAD ≥ 35.5 mm after a mid-term follow-up.

Background To promote the utilization of pulmonary function tests (PFT) through analyzing the data of PFT during the past seven years in one large teaching hospital in China.Methods Through a retrospective analysis, the allocation of full-time staff in PFT room, the demographic characteristics of patients, cost-effectiveness of PFT, positive rate and failure rate of PFT, adverse events were analyzed.Results 1) From 2012 to 2018, the numbers of PFT showed the trend of escalation year by year. The proportion of patients receiving PFT rose from 29.0/10000 in 2012 to 34.7/10000 in 2018. The best allocation of PFT room was 20-25/ person / day. 2) The number of PFT provided by Department of Pulmonary and Critical Care Medicine (PCCM) accounted for 97.2%, 97.1%, 97.3%, 97.8%, 97.8%, 98.0%, and 98.2% of the total cases of outpatient PFT in the same year. The top three departments in the inpatient department were Department of Thoracic Surgery, Department of General Surgery, and Department of Urinary Surgery, the total cases of PFT in these three departments accounted for 65.1%, 64.4%, 62.1%, 63.5%, 62.4%, 65.3% and 69.1% of the total cases of inpatient PFT in the same year. 3) Data from 2018 showed that the revenue from PFT was about 3.7 million Chinese Yuan, and that the salary of personnel and expenditure on machine maintenance and wear were about 800,000 Chinese Yuan. 4) 58.2% of the patients who had undergone PFT had ventilatory dysfunction. 5) The average failure rate of PFT in the past seven years was 1.91%. 6) The main adverse events of PFT examination were dizziness, amaurosis, limb numbness, lip numbness and falls. The incidence rates were 0.49%, 0.42%, 0.41%, 0.39%, 0.44%, 0.48%, and 0.45% respectively, with an average of 0.44%.Conclusions The number of PFT showed an upward trend in the past seven years, and the optimal staffing of PFT room was 20-25 cases per person per day. The positive rate of pulmonary dysfunction was 58.2%. The failure rate of PFT and the incidence of adverse events were very low, suggesting it is a simple and safe clinical examination. It's worthy of further popularization and promotion.