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<p><b>OBJECTIVE</b>To explore the value of ¹⁸F-FDG PET-CT in evaluating bronchial mucosa involvement in patients with saroidosis.</p><p><b>METHODS</b>A retrospective analysis was conducted among 6 sarcoidosis patients with and 14 patients without bronchial mucosa involvement to collect the data including the standard uptake value (SUVMax/Mean) of ¹⁸F-FDG, serum angiotensin converting enzyme (sACE), and proportion of lymphocytes and CD4⁺/CD8 ⁺ T lymphocyte ratio in bronchoalveolar lavage fluid (BALF).</p><p><b>RESULTS</b>The lung focal SUV(Max/Mean) was higher in patients with bronchial mucosa involvement than those without (7.04 ± 5.83/5.00 ± 4.69 vs 5.68 ± 3.66/3.82 ± 2.39), but such differences were not statistically significant (P=0.565/0.495). The SUV(Max/Mean) of the hilum of the lung and the mediastina lymph nodes were significantly higher in patients with bronchial mucosa involvement (13.28 ± 5.57/10.48 ± 4.43 vs 6.20 ± 1.77/4.52 ± 1.43, P=0.0003/0.0002; 13.84 ± 4.35/9.69 ± 2.74 vs 7.16 ± 2.52/5.28 ± 1.77, P=0.0004/0.0004). The level of sACE and CD4⁺/CD8 ⁺ T lymphocyte ratio in BALF were also significantly higher in patients with bronchial mucosa involvement (60.58 ± 16.3 vs 49.16 ± 13.3 IU/L, P=0.045; 7.30 ± 5.0 vs 2.90 ± 3.1, P=0.026). The proportion of lymphocytes in BALF was comparable between the patients with and without bronchial mucosa involvement (44.10 ± 10.3% vs 35.30 ± 12.5%, P=0.148).</p><p><b>CONCLUSIONS</b>For patients with saroidosis, ¹⁸F-FDG PET-CT is useful in evaluating bronchial mucosa involvement, which is one of the key features of active sarcoidosis.</p>
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Humans , Bronchi , Pathology , Bronchoalveolar Lavage Fluid , CD4-CD8 Ratio , Fluorodeoxyglucose F18 , Lymph Nodes , Pathology , Peptidyl-Dipeptidase A , Blood , Positron-Emission Tomography , Respiratory Mucosa , Pathology , Retrospective Studies , Sarcoidosis , DiagnosisABSTRACT
Objective To construct the bait plasmid of pSos-single immunoglobin IL-1 receptor related protein (SIGIRR) in Cy-toTrap yeast two hybrid system ,and to test its self-activation .Methods The cDNA fragments of SIGIRR(480 -1 230 bp) were amplified from pReceiver-LV19-SIGIRR and ligated into the bait plasmid pSos to generate the plasmid pSos-SIGIRR .The pSos-SI-GIRR was identified by DNA sequencing and dual-site endonuclease digestion .Then the recombinant plasmid and control plasmid were introduced into the yeast cell cdc25H .The transformants were inoculated on plates of 25 ℃ /SD/Glucose(-UL) ,25 ℃/SD/Ga-lactose(-UL) ,37 ℃ /SD/Glucose(-UL) and 37 ℃ /SD/Galactose ,respectively and the proliferation ability of transformant was ob-served for 6 d .The Western blot was adopted to detect the expression of target protein .Results The pSos-SIGIRR vector was cor-rectly constructed and proved of no self-activation and toxic action .The Western blot showed that the target protein was expressed in a form of fusion protein of 170KD .Conclusion The bait plasmid containing SIGIRR cytoplasmic tail can be applied to the yeast two-hybrid system and lays the important foundation for seeking the interacting protein with SIGRR from the human lung cDNA li-brary in .
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Objective To evaluate the efficacy of noninvasive positive-pressure ventilation (NPPV) on acute respiratory failure (ARF) in elderly patients with severe community-acquired pneumonia (CAP).Methods 321 CAP patients with ARF aged over 65 years [(75.6±12.2) years old in averag] were randomly treated with NPPV (n=162) and the standard oxygen therapy (n=159).Intubation rate,ARF control rate and total mortality were compared between the two groups,and the risk factors were analyzed.Results 90％ of 321 patients presented with hypoxemic respiratory failure.Compared with standard therapy group,the intubation rate was lower in NPPV group (46.9％ vs.64.2％,x2=9.652,P＜0.01).However,there were no differences in ARF control rate(77.9％ vs.72.3％,x2 =1.274,P＞0.05),overall 30-day mortality and 90-day survival between the two groups.The overall mortality in NPPV group was higher in treatment failure cases than in treatment success cases (48.7％ vs.11.6％,x2=26.900,P＜0.01).The independent risk factors for death were treatment failure in NPPV,higher simplified acute physiology score assessment,old age and mutilobar infiltrate.Conclusions NPPV can decrease the intubation rate in CAP patients with acute hypoxemic respiratory failure,but the overall efficacy is not significant.Delayed intubation should be avoided when NPPV is to be applicated.
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Objective To review the clinical features of lung nodule and the common misdiagnosed reasons and diseases. Methods A total of 44 literature on misdiagnosed lung nodule in the latest ten years were reviewed and their clinical characters, diagnosis methods were analyzed. Results Forty-four relative literatures were found, in which there were 319 misdiagnosed cases. The median of onset age was 43 years. Female patients were more than male. Cough, chest distress and fever were primary symptoms. 46. 39% of the patients were characterized with hilus of lung lymphadenectasis symmetrically. The most common misdiagnosis were tuberculosis, lung cancer and lymphadenoma ( 53.61%, 25. 71% and 10. 34% ). Majority of patients were correctly diagnosed by biopsy, especially through transbronchial lung or mucosa biopsy or lymphaden biopsy. Conclusion Clinicians should improve the understanding on lung nodule and comprehensively analyze and differentiate it with other diseases to reduce the misdiagnosis.
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Objective To explore the diagnostic value of video bronchoscope-guide transbronchial needle aspiration(TBNA) combined with transbronchial lung biopsy(TBLB) on pulmonary sarcoidosis.Methods Twenty-two patients,definitely diagnosed as stage Ⅰ pulmonary sarcoidosis,were enrolled into the study and accepted TBNA and TBLB.Results The positive diagnostic rates of TBNA and TBLB were 63.6%(14/22) and 40.9%(9/22),but the rate increased to 90.9%(20/22) when the two methods were used together,which showed significant differences(x2=12.24,4.66,P＜0.01 or ＜0.05).Conclusion TBNA combined TBLB test is a safety method with high diagnostic accuracy for pulmonary sarcoidosis.
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Objective To study the main clinical characters of recurrent sarcoidosis.Methods Sarcoidosis recurrence were defined as presenting activity through imaging or histology after having self-relief or treated relief.There were 12 patients who consistent to the standard in all sarcoidosis patients from 2004 to 2008 in our hospital.Results All patients but one were male.The time of recurrent to the remission was from 4 to 38 months.10 patients received oral steroid therapy.Recurrences often occurred in drug reducing or 6 months after drug withdrawal.There were 2 patients with recurrence time greater than 3 years after remission.Three patients presented new organ damages in recurrence.Conclusions The recurrence of sarcoidosis mostly occurred in the course of drug reduction or in the early stage of drug withdrawal and the recurrence time were hardly over 3 years after remission.The sarcoidosis patients must receive long time follow-up and the program of oral steroid therapy must be standardized.
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Objective To investigate the effects of dexamethasone on absorption of lung edema in rabbits with seawater drowning-induced acute lung injury.Methods Seawater(4 ml/kg body weight)was instilled into the lower trachea of ventilated and anesthetized rabbits.These rabbits were assigned randomly to receive intravenous injection of 1 mg/ kg body weight of dexamethasone(dexamethasone group,DG)or 2 ml of normal saline(control group,CG).Lung edema was measured by extravascular lung water index(EVLWI)using a gravimetric method.Three hours after treatment, epithelial Na~+ channel subunit-?(?-ENaC)mRNA and Na~+/K~+-adenosine triphosphatase subunit-?l(NKA-?l) protein abundances in lung tissues were respectively measured by reverse transcriptase-polymerase chain reaction and Western blotting,and NKA activity was measured by monitoring the release of inorganic phosphate(Pi)from adenosine triphosphate(ATP).Results The DG's EVLWI was significantly lower than the CG's[(0.508?0.089)vs.(0.648?0.102),P＜0.05)],but the DG's NKA activity,?-ENaC mRNA and NKA-?l protein abundances were significantly higher than the CG's,correspondingly(P＜0.05).Conclusions With up-regulation of the NKA activity and expressions of?-ENaC and NKA-?l,dexamethasone treatment could promote the absorption of lung edema in rabbits with seawater drowing-induced acute lung injury.
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Objective:To observe the effect of partial liquid ventilation (PLV) on gas exchange,pulmonary compliance and blood dynamics in the pulmonary edema rabbits after seawater drowning(PE-SWD). Methods:Totally 42 healthy male New Zealand rabbits were randomly allocated into 3 groups (n=14);each group was treated with various methods after PE-SWD model was established:PE group with no treatment,CMV group with conventional mechanical ventilation and positive end-expiratory pressure(PEEP),PLV group with CMV,PEEP and FDC.After being treated for 3 h,blood gases,pulmonary mechanics,hemodynamics,pulmonary histopathology and survival time were observed.Results:In PLV group,PaO 2 increased obviously and reached (262.84?64.33) mmHg (1 mmHg=0.133 kPa), airway pressure decreased by 23.4%,pulmonary static compliance increased by 31.3% and TNF-? decreased by 24.9%.HR and MAP showed no significant changes after treatment compared with PE group.Conclusion: Pulmonary gas exchange and compliance are improved significantly during PLV in the PE-SWD rabbits without obvious influence on hemodynamic status, although the survival time of PLV group is less than that of CMV group.
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0.05). After ventilation with 6ml/kg tidal volumes, the TNF-? in alveolar lavage fluid (1.58?0.56pg/ml) was significantly lower in b1 group compared with that in control group (1.73?0.81pg/ml, P
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AIM To study the experimental therapeutic effects of iptakalim hydrochloride(Ipt) on hypertensive cardiac remodeling in spontaneously hypertensive rats(SHR) and stroke prone spontaneously hypertensive rats(SHRsp). METHODS SHR at the age of 12 week old were treated ig with lisinopril 12 mg?kg -1 ?d -1 or Ipt 3 mg?kg -1 ?d -1 , once a day for 30 days. Age matched Wistar rats were used as normal control. 10 week old SHRsp were treated ig with Ipt 0 25,1 0 and 4 0 mg?kg -1 , once a day for 12 weeks. Age matched Wistar rats were used as normal control. After killing animals, the effects of Ipt on hypertensive cardiac remodeling were investigated. RESULTS During the 4 week experimental period, the systolic blood pressure(SBP) and heart rates(HR) of the untreated SHR were increased progressively. Ipt 3 mg?kg -1 ?d -1 could decrease SBP effectively and inhibit the increasing tendency of HR. Ipt had no effects on hypertensive cardiac remodeling in SHR. Under the same experimental conditions, lisinopril 12 mg?kg -1 ?d -1 could decrease SBP effe-ctively and had no effects on HR. The hypertensive cardiac remodeling could be alleviated by lisinopril. During the 12 week experimental period, the SBP of the untreated SHRsp were increased progressively. Ipt 0 25,1 0 and 4 0 mg?kg -1 could decrease the SBP of SHRsp effectively. Ipt at the doses of 0 25 and 1 0 mg?kg -1 had no effects on heart rates. But in the 4th week after administration of Ipt 4 0 mg?kg -1 , significant decrease in heart rates was observed. Compared with Wistar rats, the weight of left ventricle and septum(LV+S) and the ratio of LV+S to body weight(LV+S/BW) in untreated SHRsp were elevated significantly. Ipt 0 25, 1 0 and 4 0 mg?kg -1 ?d -1 could decrease LV+S and LV+S/BW significantly. CONCLUSION Ipt could decrease SBP of SHR and SHRsp effectively. The effects of Ipt on hypertensive cardiac remodeling were related with the experimental therapeutic period. After having been treated with Ipt for 4 weeks, the hypertensive cardiac remodeling could not be reversed. But after having been treated with Ipt for 12 weeks, the hypertensive cardiac remodeling could be reversed significantly.
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Objective To study the effects of ETP-508,a novel endothelin receptor antagonist,on the proliferation of pulmonary arterial smooth muscle cells(PASMCs) of rat cultured in hypoxia environment.Methods Primary culture of rat PASMCs was prepared by the method of tissue block anchorage,and they were assigned into four groups: normoxia group(21% O2),hypoxia group(2% O2),hypoxia+BQ-485 group(10-6,10-7,10-8,10-9mol/L) and hypoxia + ETP-508 group(10-6,10-7,10-8,10-9mol/L).MTT(492nm) assay was used to detect the A value of the four groups after cells were cultured for 24,48 and 72h.Flow cytometry and radioimmunoassay were respectively used to detect the cell cycle and ET-1 content at 48h time point.Results MTT assay demonstrated that A value of each group did not significantly differ at 24h time point.At 28h time point,A value of hypoxia group was markedly increased(P