Abstract. Current relevant research suggests there are significant differences between the expression of the urokinase plasminogen activator (uPA) system in cancer tissues and in normal tissues. However, the potential effectiveness of the uPA system as a prognostic biomarker of non-small cell lung cancer (NSCLC) remains unclear. In the present study, a systematic review and meta-analysis were performed to evaluate the relevance of the uPA system in the prognosis of patients with NSCLC. Using the PubMed, EMBASE, Web of Science and Cochrane Library databases, data from relevant academic journal articles were extracted and subjected to analysis. Associations between expression profiles pertaining to the uPA system and the overall survival (OS) of patients with NSCLC were analyzed. The study incorporated data from 11 independent journal articles and these reports included a total of 937 patients with NSCLC. The meta-analysis results revealed that increased expression of urokinase plasminogen activator (uPA) and PA inhibitor type 1 (PAI-1) exhibited no significant association with poor OS [hazard ratio (HR)-uPA=1.07 (0.87-1.31), P=0.53; HR-PAI-1=1.02 (0.63-1.65), P=0.94]. Similarly, reduced expression of PAI type 2 (PAI-2) did not significantly correlate with poor OS [HR-PAI-2=1.58 (0.64-3.90); P= 0.32]. Notably, however, a significant association was observed between increased expression levels of uPA receptor (uPAR) and poor OS for NSCLC (1.04-2.15); P=0.03]. Therefore, the expression of uPAR in the uPA system of patients with NSCLC could be used as a novel clinical biomarker to evaluate the prognosis of NSCLC. The utilization of this biomarker may provide a platform for the further development of targeted drugs for the treatment of NSCLC. IntroductionOver the past 50 years, the worldwide incidence of lung cancer has significantly increased. In developed countries and large cities, lung cancer has become the most common type of cancer among males. In many countries, the number of mortalities due to lung cancer has surpassed the combined numbers from prostate cancer, breast cancer and gastrointestinal tumors (1,2). The majority of patients with lung cancer are males over the age of 40; however, the number of female patients has also increased significantly in recent years. Typically, lung cancer is divided into two categories: Small cell lung cancer (SCLC) and non-SCLC (NSCLC). As SCLC is distinct from NSCLC with respect to its biological behavior, treatment, prognosis and other features, the present study focused on the associations between NSCLC prognosis and the uPA system. Although there has been considerable progress in the diagnosis and treatment of NSCLC in recent years, the majority of cases are diagnosed only at an advanced stage. Consequently, the 5-year survival rate for NSCLC is ~15% (3). The invasion and distant metastasis of NSCLC cells are the most important biological characteristics of malignant lung tumors; these phenomena result in the associated low survival rates of patients with NSCLC (4). Thu...

Background/Purpose Ludwig's angina (LA) still presents regularly and various characteristics are documented, but patients admitted to the Intensive Care Unit (ICU) has not been studied. The purpose of this study was to investigate the clinical characteristics and outcomes of patients with LA who were admitted to ICU. Materials and methods We retrospectively reviewed all 29 patients with LA who were admitted to the ICU of a university hospital from January 2013 to October 2018. Results were evaluated via descriptive analysis. The Log–Rank test was used to analyze the hospital/ICU length of stay (LOS). Results The male: female ratio was 2.63:1. Mean age was 53.41 ± 16.57 years (range 8–78 years). Concomitant conditions comprised diabetes mellitus in 10 patients (34.48%), and hypertension in six (20.69%). The main reason for ICU admission was surgical (44.83%). The mean Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) and the Sequential Organ Failure Assessment (SOFA) scores were 13.52 ± 3.18 and 3.83 ± 2.89, respectively. Twenty-eight patients (96.55%) received respiratory support. Sixteen patients (55.17%) had positive bacterial culture results. Fourteen bacterial strains were detected, most of which were gram-positive (72.72%). Mean LOS was 6.89 ± 14.39 days (range 0.5–73 days), and 24.79 ± 16 days in the hospital. The ICU mortality rate was 10.34%. Compared with LA patients without descending necrotizing mediastinitis (DNM), those with DNM had longer ICU and hospital LOS. The laboratory investigations were higher. Conclusion LA patients in ICU were predominantly male, with a wide range age, high incidence of complications, long hospital LOS.

Objective: This study aimed to explore the effect of ghrelin on the gastric blood flow of a rat model of sepsis, and on the expression of Bcl-2 and Bax in gastric tissues. Methods: Forty-eight male Wistar rats were randomly divided into four groups (n = 12): normal control, sham (laparotomy without model induction, and saline injection), sepsis (cecal ligation and puncture [CLP], and saline injection), and ghrelin (ghrelin was injected at 2, 4 and 8 hours after CLP) groups. Blood flow in the greater curvature of the stomach was detected at 12 hours after surgery by laser Doppler. Then, Bcl-2 and Bax in gastric tissues were detected by immunohistochemistry. Results: The blood flow in the greater curvature of the stomach was similar in the normal control and sham groups, the blood flow in the greater curvature of the stomach in the sepsis group (284.3 ± 95.7) was significantly lower than that in the sham group (317.8 ± 5.2) (P < 0.05), and the blood flow in the ghrelin group (377.8 ± 99.0) was significantly higher than that in the sham and sepsis groups (P < 0.05). In the normal control and sham groups, the expression of Bcl-2 or Bax was hardly detectable in rat gastric mucosal tissues. In the sepsis group, a moderate expression of Bcl-2 and a stronger expression of Bax were detected. In the ghrelin group, Bcl-2 expression increased and Bax expression decreased. Conclusion: These results suggest that ghrelin can promote blood flow in the stomach of septic rats, and upregulate the protein expression of Bcl-2 and downregulate the protein expression of Bax in gastric tissues.