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Objective Study the endobronchial ultrasound features of mediastinal tubercular lymphadenopathy and sarcoidosis to probe a new method for the differential diagnosis. Methods The endobronchial ultrasound features of 74 lymph nodes in 16 mediastinal tubercular lymphadenopathy and 30 sarcoidosis patients diagnosed in our department were studied retrospectively, and the sizes, borders, fusion and echo features of mediastinal tubercular lymphadenopathy were compared to sarcoidosis. Results Both of the long size and the short size of mediastinal tubercular lymphadenopathy were smaller than sarcoidosis [(15.77 ± 4.10) vs (19.76 ± 5.83), t = 3.28, P = 0.021;(12.67 ± 4.09) vs (16.81 ± 5.54), t = 3.56, P = 0.001]. And the following features were statistically significant of tubercular lymphadenopathy as compared to sarcodosis: indistinct borders, fusion of lymph nodes, hyperechoic echotexture and patchy anechoic/hypoechoic areas [50.0% (11/22) vs 17.3% (9/52), χ2 = 8.38, P = 0.004; 18.2%(4/22) vs 0.0% (0/52), P = 0.008; 50.0% (11/22) vs 0.0% (0/52), P = 0.000; 63.6% (14/22) vs 0.0% (0/52), P = 0.000, respectively). However, there was no significant difference in the existence of central hilar structure [9.1% (2/22) vs 19.2% (10/52), P = 0.491] between mediastinal tubercular lymphadenopathy and sarcoidosis. Conclusions The endobronchial ultrasound features of mediastinal lymph nodes, including sizes, borders, fusion, hyperechoic echotexture and patchy anechoic/hypoechoic areas are helpful in the differential diagnosis of mediastinal tubercular lymphadenopathy and sarcoidosis.
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Objective: To investigate the serum levels of Interleukin [IL]-17 and eotaxin levels and the relationship between serum IL-17, eotaxin and pulmonary function in asthmatic patients with allergic rhinitis
Methods: Serum IL-17 and eotaxin levels in asthmatic patients with allergic rhinitis during attacking and remission and in healthy control subjects were measured using enzyme-linked immunosorbent assay [ELISA] kits. Then we studied the correlation between the serum IL-17, eotaxin levels and pulmonary function in patients
Results: Serum IL-17 and eotaxin levels were significantly elevated in patients during asthma attack and remission compared with healthy control subjects. These levels in patients during asthma attack were much higher than those during remission. Furthermore, serum IL-17 and eotaxin levels were negatively correlated with pulmonary function in asthmatic patients with allergic rhinitis, respectively
Conclusion: Our findings suggest that IL-17 and eotaxin are important factors in asthma with allergic rhinitis, and the correlation between serum IL-17, eotaxin and lung function possibly lead to improvements in the diagnosis and treatment of asthma with allergic rhinitis and related diseases
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Objective To provide reference for establishing diagnosis and differential diagnosis methods of rare yeast-like fungal bloodstream infection for clinical microbiology laboratory.Methods Trichosporon asahii (T.asa-hii)and Geotrichum capitatum (G.capitatum)bloodstream infection was diagnosed and differentially diagnosed through clinical data analysis,morphological examination,biochemical reactions,and molecular biology technology. Results Two types of yeast-like fungal bloodstream infections in case 1 and case 2 both occurred in leukemia agranulocytosis phase after chemotherapy,such infections were serious and highly similar.The cultivated colonies on blood agar plates of case 1 and case 2 were performed gram stain and microscopic examination.Hyphae,arthro-spores and microconidia were visible in the former,thickness of hyphae branches and length of arthrospores were different,most presented rectangular and barrel shape;the latter can be seen hyphae with transparent septum bro-ken up into arthrospores,presented rectangular shape,did not produce blastoconidia.Identification with API 20C AUX showed that they were T.asahii and G.capitatum.The PCR product sequences were compared with NCBI, suggesting that T.asahii and G.capitatum were at sexual stage.Conclusion Comprehensive application of a varie-ty of technical methods is helpful for improving the diagnosis accuracy of bloodstream infection with yeast-like fungi, identifying Trichosporon and Geotrichum to the species level may help physicians to understand such rare fungal in-fection,choose antifungal agents rationally,and improve clinical prognosis.
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Purpose To investigate relationship between PD-L1 molecule expression and Treg infiltration in non-small cell lung cancer ( NSCLC) tissue and to explore their clinical significance. Methods Immunohistochemistry was used to detect the PD-L1 molecules expression and Treg infiltration of 78 NSCLC tissues. The relationship among PD-L1 expression, Treg infiltration and clinic-pathological parameters was analyzed in the patients. Results PD-L1 molecule was highly expressed in lung cancer tissues than adjacent tissues (52. 5% vs 6. 4%), and same to Foxp3 +Treg (18. 63 ± 16. 67)/HPF vs (2. 96 ± 2. 97)/HPF. There was close relationship between PD-L1 expression and Treg infiltration with lymph node metastasis and clinical stage of patients, but was no statistical correlation with patient’ s age, gender, histological type and degree of differentiation of the tumor cells. PD-L1 expression was significantly higher in advanced stage than that in early stage (70. 0% vs 41. 7%) and same to Treg infiltration (73. 3% vs 35. 4%). There were also signif-icantly higher infiltration with lymph node metastasis than that without metastasis. In addition, PD-L1 molecule expression and Foxp3 +Treg infiltration were positively correlated (rs =0. 611, F=78. 82, P=0. 023). Conclusion There was strong relationship among PD-L1 expression, Treg infiltration and disease progress in lung cancer patients, and they possibly participate in the progression and immune escape of lung cancer.
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Objective To construct a novel M.tb DNA vaccine (p846) co-expressing mycobacterial triple antigens including Rv3615c, Mtb10.4 and Rv2660c, and evaluate its cellular immune response and protective efficacy against tuberculosis infection in BALB/c mice. Methods We constructed the p846 by using the cloning technology. The 6- to -8-week old female BALB/c mice were randomly divided into 4 groups: p846, pcDNA3.1, PBS and the BCG group. All mice were administrated intramuscularly with 50 μg recombinant plasmids at 0, 2, 4, 6 week. A single dose of BCG was injected subcutaneously in the BCG group. Two weeks after the final immunization, 10 mice in each group were used for cell proliferation, ELISPOT and FCM assay, BCG challenge experiment and HE staining of lung were performed at 4, 6 weeks later, respectively. Results The p846 vaccine could effectively induce the specific T cell proliferation(P < 0.001) and increase the numbers of IFN-γ+T cells(P <0.001), compared with those in the PBS group and the vector conreol group. The mouse lung tissue presented very mild lung inflammation in the p846 group, compared with other groups. Conclusion Vaccine p846 could not only induce strong cellular immune response, but also efficiently protect BALB/c mice against M.tb infection.
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Objective To compare the efficacy and safety of levofloxacin 750 mg for 5 days versus 500 mg for 7‐14 days intravenous (IV ) infusion in the treatment of community‐acquired pneumonia (CAP ) . Methods This study was a multi‐center , randomized , open‐label , non‐inferiority , controlled clinical trial .The CAP patients were randomized to receive levofloxacin 750 mg IV daily for 5 days or levofloxacin 500 mg IV daily for 7‐14 days .The clinical symptoms , laboratory tests , imaging results and microbiology data were collected and compared between the two treatment groups in terms of efficacy and safety .Results A total of 241 patients were enrolled in this clinical trial from 10 study centers .Among these patients ,223 were eligible for full analysis set (FAS) analysis ,including 111 in 750 mg group and 112 in 500 mg group .Of the 223 patients in FAS ,211 were eligible for per‐protocol set (PPS) analysis ,including 107 in 750 mg group and 104 in 500 mg group .Two hundred and forty‐one patients were included in safety set (SS) ,including 121 patients in 750 mg group and 120 in 500 mg group .The median treatment duration was 5 .0 days in 750 mg and 9 .0 days in 500 mg group .The median total dose was 3 750 mg in 750 mg group and 4 500 mg in 500 mg group .The overall efficacy rate was 86 .2% in 750 mg group and 84 .7% in 500 mg group in terms of FAS at visit 4 ,which suggested that the efficacy of 750 mg group was non‐inferior to 500 mg group .Of the 111 FAS patients in 750 mg group ,40 were bacteriological evaluable ,and 41 strains of pathogens were isolated .Forty‐nine of the 112 FAS patients in 500 mg group were bacteriological evaluable ,and 51 bacterial strains were obtained .The bacterial eradication rate was 100% in both groups .The clinical treatment efficacy rate for atypical pathogens was 100% in both groups .In 750 mg group ,the most common clinical adverse drug reactions (ADRs) were injection site adverse reactions including injection site pruritus ,pain and hyperemia .The other common ADRs were insomnia ,nausea ,skin rash .The most common drug‐related laboratory abnormalities were neutrophil percentage decreased , decreased white blood cell (WBC ) count , alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevation .Most of the ADRs were mild in severity and well‐tolerated .The safety profile of the two treatments was comparable in terms of the drug‐related treatment discontinuation and the incidence of ADRs .Conclusions The short‐course regimen of levofloxacin 750 mg IV for 5 days is at least as effective and well tolerated as the long‐course regimen of 500 mg IV for 7‐14 days in treatment of CAP .
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Objective To evaluate the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of mediastinal lymphadenopathy.Methods EBUS-TBNA were performed in 148 mediastinal lymphadenopathy previously by CT were selected,and 129 malignant tumor were confirmed by surgery.The advantages of EBUS-TBNA were evaluated,including superiority,success rate of puncture and diagnostic accurary.Results In 129 cases,mediastinal lymphadenopathy were detected clearly and were guided accurately by EBUS-TBNA.The positive results were obtained in 118 cases,and the false negative results in 11 cases.The success rate of biopsy and sensitivity of diagnosis by EBUS-TBNA in malignant tumor were 100％ and 91.47％ respectively.There were no complications in this group.Conclusions EBUS-TBNA is a safe and useful technique in diagnosis of mediastinal lymphadenopathy and evaluate the response to neoadjuvant chemotherapy.
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Objective To study the changes of subgroups of peripheral blood T lymphocytes in the patients infected with the 2009 pandemic influenza A ( H1N1 ) virus of different severity type. Method A total of 66 patients infected by H1N1 evidenced by RT-PCR admitted from September 2009 to January 2010 were divided into three groups: mild type ( B group, n = 47 ), cured patients of severe and critical severe type ( C group, n = 14) and died patients ( D group, n =5), according to the severity and prognosis. A total of 20 healthy volunteers served as control group( A group). Peripheral blood lymphocyte count, CD3+,CD4+ and CD8+ T lymphocyte count were detected by flow cytometry at the different time points. Fever duration and H1N1 virus negative time were compared. Statistical analysis were performed by using SAS version 9.13 software and the data were processed with ANOVA and SNK test. Results Lymphocyte count, CD3+,CD4+ and CD8+ T lymphocyte count declined in the early period in all the groups, and there were significant differences compared with A group (P＜0. 05), while rised with the clinical progression in group B and C,and those of C group were lower than B group ( P ＜ 0.05 ), but those of D group were always low. Fever duration and H1N1 virus negative time were (4.4 ± 1.6) days vs. (4.4 ± 1. 4) days, ( 12.9 ± 3. 1 ) days vs.( 10.2 ± 2.6) days and ( 15.2 ± 7.3 ) days vs. ( 13.3 ± 2.9 ) days respectively, and there were significant differences among the three groups ( P ＜ 0.05 ). Conclusions The cellular immune function was seriously damaged when patients were infected with H1N1. Further more, the changes of lymphocyte count, CD3+ , CD4+and CD8+ T lymphocyte count were tightly related with the degree of severity and prognosis. These findings can be used for clinical diagnosis and treatment.
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Objective To investigate the effect of comprehensive training based on work process in the teaching of Pediatric Nursing.Methods A cluster sampling of Class 1,2 enrolled in 2008 were taken as the experimental group,and Class 3,4 enrolled in 2008 were taken as the control group.The comprehensive training method WaS used in the experimental group,and the conventional practice teaching method was used in the control group.The comprehensive skills and the comprehensive ability of clinical nursing were aSsessed after experiment,questionnaires were distributed to the two groups to investigate the stimuhted learning interest of students.Results The experimental group had higher scores in comprehensire skills and comprehensive ability of clinical nursing than the control group.The teaching method of the experimental group had better effect in stimulating students learning interest than that of the control group.Conclusions The comprehensive training method based on work process used in the teaching of and comprehensive quality.
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Objective To explore the expressions of apoptosis gene Bcl-2 (B-cell leukemia-2) and Bad (bcl-xl/bcl-2-associated death promoter) in lung tissue of mice with acute lung injury (ALI). Method Twenty-four BALB/C female mice were randomly divided into control saline group (n = 6) and ALI group (n = 18). The ALI Group was further divided into 3 subgroups with 6 mice in each subgroup: ALI (4 h) ,ALI (6h) ,and ALI (8h) subgroups. Rats in the normal control group received injection of saline. The ALI models were produced by in-jection of oleic acid (0.9 mL/kg) via vena caudalis, and the criteria were met with the characteristically pathologi-cal changes in the lung tissue. Pathological changes of the lung tissue were examined and scored under light mi-croscopy 4 h,6 h and 8 hours after injury. The expressions of gene Bcl-2 and gene Bad were detected in lung tissue at above set intervals by using RT-PCR. Data of these assays were analyzed by using one-way ANOVA with SPSS version 13.0 software. Statistical significance was established at a P value of less than 0.05. Results The rela-tive magnitude of Bel-2 expression in ALI (4 h), ALI (6 h) and ALI (8 h) subgroups were significantly higher (58.00±5.31), (42.00±4.30), (32.51±10.40) as compared with the control group (24.30±1.00) (F =68.581, P < 0.05). The relative magnitude of Bad expressions in ALI (4 h), ALI(6 h) and ALI (8 h) sub-groups were signiticantly higher (29.32±1.19), (58.64±4.45), (95.12±4.34)as compared with control group (4.01±0.34) (F = 386.902,P < 0.05). The pathological scores ofhmg injury in ALI(4h), ALI (6 h) and ALI (8 h) subgroups were significantly higher (1.82±0.14), (2.52±0.25), (3.45±0.29) as compared with control group (0.27±0.03) (F = 260. 512, P <0.05). Comparisons between groups showed statistical signifi-cances (P < 0.05). Conclusions The aggravation of lung injury induced by oleic acid in mice related to the down-regulation of apoptosis gene Bcl-2 expression and up-regulating apoptosis gene Bad expression in lung tissue.
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Objective To detect the levels of plasminogen activator inhibitor(PAI)-1,tissue plasminogen activator(t-PA),urokinase-type plasminogen activator(u-PA)and urokinase-type plasminogen activator receptor(u-PAR)in induced sputum in patients with asthma and analyze their clinical significances in pathogenesis of asthlna.Methods The induced sputum was isolated from 15 normal subjects(control group),29 patients with acute attack of asthma(attack group)and 26 stable asthma patients(stable group).The levels of PAl-1,t-PA,u-PA and u-PAR were measured by ELISA.Meanwhile FEV1%pred of all groups were evaluated.Results The levels of PAI-1 and u-PAR of induced sputum were significandy higher in at-tack group[(23.32±21.64),(0.766±0.272)μg/L]and stable group[(17.23±9.40),(0.700±0.271)μg/L]than those in control group[(5.99±5.04),(0.516±0.197)μg/L](P＜0.05).As for the induced sputum concentrations of u-PA and t-PA,there were no significant differences among the attack group[(0.287±0.235),(7.68±3.46)μg/L],stable group[(0.251±0.276),(9.88±4.68)μg/L]and control group[(0.239±0.322),(10.35±7.47)μg/L].In stable group,the level of PAI-1 had a negative correlation with the FEV1%pred(r=-0.756,P＜0.01).In stable group,the level of PAI-1 had a positive correlation with the length of disease course(r=0.454,P＜0.05).Conclusion PAI-1 and u-PAR maybe involved in pathophysiologic change of asthma.
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Objective To evaluate the efficacy of Budesonide/formoterol to control asthma under real-life conditions.Methods A muhi-center, open label, non-interventional study was conducted.Asthma control after 12 week therapy with Budesonide/formoterol was assessed by Asthma Control Questionnaire (ACQ) and modified Asthma Control Questionnaire (ACQ5).Results A total of 360 asthma patients were recruited,including 228 adult patients and 132 child patients.After 12 weeks' therapy,all the patients' medium value of ACQ was decreased significantly from 2.03 (adults 2.20, children 1.74) at baseline to 0.60 (adults 0.78, children 0.29) (P < 0.0001), and the medium value of ACQ5 was also decreased significantly from 2.4 (adults 2.24, children 1.76) at baseline to 0.47 (adults 0.62, children 0.20) (P < 0.0001).Conclusion Budesonide/formoterol is effective in asthma treatment, by which most asthma patients obtain and maintain clineal control.
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Objective:To observe the hypoglycemic effects of Cortex Lycii Radicis (CLR) on alloxan induced diabetic mice.Methods:The alloxan induced diabetic mice were given drug decoction of CLR[2.5g/(kg?d) -1 , or 5.0g/(kg?d) -1 )] for successive 2 weeks, The blood sugar level was determined with GOD method.Results:There were remarkedly differences in the levels of blood sugar between before and after treatment of various groups. ( P