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Objective To analyze the pathologically confirmed pulmonary Actinomycosis in the 11 patients in focusing on clinical features and mis-diagnostic reasons so as to improve physicians' awareness of this rare disease and reduce the misdiagnosis.Methods We retrospectively reviewed the medical records of 11 cases with pathologically confirmed pulmonary Actinomycosis during January 2003-August 2015.The clinical data and main causes of misdiagnosis in these cases were collected and analyzed.Results The study included 11 patients with a mean age of(53.0 ± 11.6.0)years.Among the 11 cases,8 (72.7 ％) patients had complications,6 (54.5 ％) were current or ex-smokers.Main clinical manifestations of 11 cases were cough(11/11,100.0 ％),sputum(11/11,100.0 ％),hemoptysis (7/11,63.6％),chest pain(6/11,54.5％)and fever(3/11,27.3％).Ten patients presented with one lobe of lung lesions,including 4 patients in the lower lobe and 3 in the upper lobe of the left lung,2 in the upper lobe and 1 in the lower lobe of the right lung.While,the remained one case presented with lesion locating in right main bronchus.Iconography often presented as pulmonary mass shadow,consolidation shadow,spicule sign,lobulation sign,hilar and/or mediastinal lymphadenopathy and pleural effusion.Vacuolar lesions were observed in some of the focuses.Flexible bronchoscopy was performed in 8 (72.7％)patients.Among them,7 patients showed mucosal swelling and congestion,luminal occlusion with purulence secretion,2 cases with polypoid neoplasm.Initial misdiagnosis rate were 100％ (11/11),among which 7 cases were misdiagnosed as lung cancer,2 cases as fungus infection,and 1 case as pulmonary tuberculosis and 1 case as pneumonia,respectively.All patients were definitely diagnosed by biopsy finding an evidence of hyphae of Actinomycosis in lung tissue specimens.The definitive diagnosis was made by CT-guided percutaneous lung biopsy in 4 cases,by transbronchial lung biopsy (TBLB)in 5 cases and by thoracotomy or video-assisted thoracoscopic surgery(VATS) in 1 case respectively.Actinomycosis in most patients was cured with high-dose penicillin administration over a prolonged period.Conclusions The diagnosis of pulmonary Actinomycosis remains challenging via its non-specific clinical symptoms and iconography features,and the presence of comorbidity may further increase the difficulty and complexity of diagnosis,leading to delaying-or mistaking-diagnosis.Obtaining positively pathological specimens is diagnostic key.Transbronchial lung biopsy through a bronchoscope and CT-guided percutaneous needle biopsy are the priority methods.
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AIM:To study whether the pulmonary infection of Escherichia coli (E.coli) interferes the glu-colipid metabolism in high-fat diet-induced obese mice.METHODS:High-fat diet-induced obese mice (n=48) and nor-mal chow-fed control mice ( n=48) were intranasally infused with 40 μL fluid containing 4 ×109 CFUs E.coli.The ser-um, periepididymal adipose tissue and liver were obtained at 0 d, 1 d, 2 d, 3 d and 4 d after infection.The body mass, periepididymal adipose tissue and liver were weighed , and the levels of fasting blood glucose (FBG), fasting blood insulin ( FINS) , free fatty acid ( FFA) and very-low-density lipoprotein ( VLDL) were measured by ELISA .The serum total cho-lesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol ( LDL-C) , and hepatic TG contents were detected , and the hepatic steatosis was observed under microscope with oil red O staining.RESULTS:Compared with day 0, the body mass, fat mass and fat index were decreased significantly from day 1 to day 4 after infection (P<0.05).The levels of FBG, FINS and HOMA-IR were apparently raised from day 2 to day 4 af-ter infection (P<0.05).The contents of serum FFA, TG and VLDL were increased markedly from day 1 to day 4 after in-fection (P<0.05).However, the concentrations of serum TC, LDL-C and HDL-C were decreased obviously from day 1 to day 3 ( P<0.05 ) .The liver mass , liver index and TG content were significantly increased from day 1 to day 4 ( P<0.05 ) .Consistently , the lipid droplet accumulation in the liver cells was increased obviously at day 2 and day 4 after infec-tion.Compared with control group , except the levels of serum TC , LDL-C and HDL-C in obese group substantially de-creased, the other indexes were increased by different degrees during the whole experiment period (P<0.05).CONCLU-SION:Pulmonary infection of Escherichia coli exacerbates the disorder of glucose and lipid metabolism in high-fat diet-in-duced obese mice , which contributes the development of insulin resistance and hepatic steatosis .
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The experiment was conducted to examine the effect of copper toxicity on the peripheral blood T-lymphocyte using the flow cytometry(FCM) and ANAE.180 one-day-old Avian broilers were divided randomly into three groups,and fed diets as follows:(1)Controls(Cu 11.97 mg/kg diet) and (2)copper toxic(Cu 650 mg/kg diet,copper toxic group Ⅰ;Cu 850 mg/kg diet,copper toxic group Ⅱ) for six weeks.The ANAE positive ratios of the peripheral blood T-lymphocytes were much lower in the two copper toxic groups than in control group from 1 to 6 weeks of age(P＜0.05 or P＜0.01).Also,there was significant difference between copper toxic groups Ⅰ and Ⅱ at 1,3,5 and 6 weeks of age(P＜0.05 or P＜0.01).CD+4 T cell numbers reduced from 2 to 6 weeks of age in both copper toxic group Ⅰ and copper toxic group Ⅱ as compared with those of control group(P＜0.05 or P＜0.01).At the same time,there was significant difference between copper toxic groups Ⅰ and Ⅱ at 6 weeks of age(P＜0.05).But the numbers of CD+8 T cell were not varied from 2 to 6 weeks of age in copper toxic groups Ⅰ and Ⅱ in comparison with those of control group(P＞0.05).The CD+4/CD+8 ratio was lower from 2 to 6 weeks of age in copper toxic groups Ⅰ and Ⅱ than in control group.The results showed that copper toxicity could suppress the development of T-lymphocytes and reduce the peripheral blood T-lymphocyte populations.Potential mechanisms underlying these observations are also discussed.
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The experiment was conducted to examine the effect of zinc toxicity on the peripheral blood T-lymphocyte by the method of flow cytometry(FCM) and ANAE.200 one-day-old Avian broilers were divided into four groups,and fed with the diets as follows:①control group(Zn 100 mg/kg diet) and ② zinc toxic groups(Zn 1 500 mg/kg diet,zinc toxic group Ⅰ;Zn 2 000 mg/kg diet,zinc toxic group Ⅱ;Zn 2 500 mg/kg diet,zinc toxic group Ⅲ) for seven weeks.The ANAE positive ratios of the peripheral blood T-lymphocytes were much lower in the three zinc toxic groups than that in control group at 7 weeks of age.CD4+ T cell numbers were reduced from 2 to 7 weekds of age in zinc toxic group Ⅲ and from 6 to 7 weeks of age in zinc toxic group Ⅱ,as compared with that of control group.The numbers of CD8+ T cell decreased at 2 and 4 weeks of age in zinc toxic groups Ⅱ and Ⅲ,and at 7 weeks of age in zinc grups Ⅰ and Ⅲ.CD4+/CD8+ ratio was higher at 2 and 4 weeks age,and lower at 6 and 7 weeks of age in zinc toxic groups Ⅰ,Ⅱ and Ⅲ than in control group.The results showed that zinc toxicity would suppress the development of T-lymphocytes and reduce the peripheral blood T-lymphocyte populations.Potential mechanism underlying these observations are also discussed.
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150-day-old Tianfu ducklings were divided into three groups,and fed with diets as follows :Zn deficient (22. 9 mgZn per kg diet),controls(100 mg Zn per kg diet) and Zn toxic (1 300 mg Zn per kg diet) for seven weeks (Zn deficiency,ZD)or four weeks (Zn toxieity,ZT). The ANAE+ positive ratios of the peripheral blood T-lymphocytes were much lower (P＜0.01 ) in Zn deficient and toxic groups than in the control group. The results showed that Zn deficiency and toxicity would suppress the development of T-lymphocytes and reduce the peripheral blood T-lymphocyte populations. Potential mechanisms underlying these observations are also discussed.