ObjectiveTo systematically evaluate relationship between expression of autophagy-related protein Beclin-1 in gastric cancer and its clinicopathologic features and its clinical significances.MethodsThe researches on the expression and significance of Beclin-1 protein in the gastric tumor tissues published from the database establishment to June 1, 2018 in the Cochrane Library, Springer Link, Web of Science, Embase, PubMed, CNKI, Wanfang, VIP, and other databases were searched. Two researchers independently screened and evaluated the literatures, extracted the relevant data, and conducted the meta-analysis using the Review Manager 5.3 and Stata 15.0 software.ResultsFinally, 10 articles were included, and there were 1 402 patients with gastric cancer. The meta-analysis showed that the positive rate of Beclin1 protein expression in the gastric cancer tissues was significantly lower than that in the non-gastric cancer tissues [OR=0.30, 95% CI (0.13, 0.72), P=0.007], which in the patients with TNM stage Ⅲ/Ⅳ and distant metastatic gastric cancer were significantly lower than those in the patients with stage Ⅰ/Ⅱ [OR=1.82, 95% CI (1.03, 3.20), P=0.04] and without distant metastasis [OR=0.36, 95% CI (0.20, 0.63), P=0.000 4], which were not associated with the gender, age, tumor size, lymph node metastasis, serosa invasion, and tumor differentiation degree of gastric cancer patients (P>0.05). For the studies of existed heterogeneity, further the subgroup analysis showed that the positive expression rate of Beclin-1 protein in the gastric cancer tissues was significantly lower than that in the non-gastric cancer tissues [OR=0.19, 95% CI (0.13, 0.29), P<0.000 01], which in the patients with lymph node metastasis, invasion of serosa, and poorly differentiated gastric cancer were significantly lower than those in the non-lymph node metastasis [OR=0.35, 95% CI (0.22, 0.57), P<0.000 1], non-invasion of serosa [OR=0.56, 95% CI (0.33, 0.94), P=0.03], and moderately/highly differentiated gastric cancer tissues [OR=0.29, 95% CI (0.20, 0.43), P<0.000 01].ConclusionsLow expression of Beclin-1 in gastric cancer tissues is related to stage and distant metastasis of gastric cancer. It is suggested that it might not only be an important cause of gastric cancer, but also play a regulatory role in progress of gastric cancer.
ObjectiveTo investigate the predominant pathogen distribution in malignant pleural effusion (MPE) complicated by pleural infection and analyze the antimicrobial resistance, thereby providing data support for the empirical use of antibiotics in clinical practice. MethodsClinical data from patients with MPE at the Second Affiliated Hospital of Harbin Medical University between January 2021 and September 2024 were collected and analyzed to identify common pathogens and their antimicrobial resistance in MPE-associated infections. ResultsRetrospective analysis included 240 patients, with 120 cases being pathogen-positive and 120 pathogen-negative. Among the pathogen-positive cases, 62 were female (51.67%) and 58 were male (48.33%), with a mean age of 65.25 ± 12.23 years. A total of 138 pathogen strains were isolated, including 137 bacterial strains (99.28%) and only 1 fungal strain (0.72%). Gram-positive bacteria predominated (99 strains, 72.26%), comprising Streptococcus spp. (60 strains, 60.61%; including 20 Streptococcus mitis), Staphylococcus spp. (31 strains, 31.31%; including 20 Staphylococcus epidermidis), Enterococcus spp. (4 strains, 4.04%), and others (4 strains, 4.04%). Gram-negative bacteria accounted for 38 strains (27.74%), including Enterobacterales (16 strains, 42.11%; including 5 Enterobacter cloacae), Acinetobacter spp. (15 strains, 39.47%; including 9 Acinetobacter baumannii), Pseudomonas spp. (6 strains, 15.79%), and others (1 strain, 2.63%). Gram-positive bacteria exhibited high resistance to erythromycin and clindamycin. However, they are susceptible to vancomycin, linezolid, and tigecycline. Streptococcus demonstrated favorable antimicrobial activity against penicillin, third-generation cephalosporins (cefotaxime), and fourth-generation cephalosporins (cefepime). Gram-negative bacteria were generally more sensitive to antibiotics, though elevated resistance rates were observed for certain third-generation cephalosporins (ceftazidime) and quinolones (levofloxacin). ConclusionsBacterial pathogens, particularly Gram-positive cocci, remain the primary causative agents in MPE-associated pleural infections. For empirical treatment, third-generation cephalosporins or third-/fourth-generation quinolones are recommended. Vancomycin or linezolid may be used for penicillin-allergic patients, while carbapenems should be reserved for refractory cases.