Microbiology and progress of the diagnosis and treatment of pleural infection / 中华临床感染病杂志

Pleural infection is a common disease associated with increasing morbidity and high mortality. Factors such as age, geographical area, settings of infection (hospital or community acquired)or certain underlying diseases can influence the microbiology of pleural infection. Thus, understanding the microbiology of pleural infection is of vital importance to guide therapeutic decisions. Since the positive rate of conventional cultures is low among cases of pleural infection, new diagnostic methods such as 16S ribosomal RNA (16S rRNA)and metagenomic next-generation sequencing(mNGS)have broad prospects in clinical applications. 16S rRNA and mNGS improves the etiologic diagnosis of pleural infection, facilitating the decision of appropriate anti-infection regimens. The treatment of pleural infection includes appropriate anti-infection regimen, pleural drainage, intrapleural therapy and the need for medical thoracoscopy or surgery. It is convinced that the use of intra-pleural DNase and t-PA has exhibited excellent therapeutic effects in pleural infection and reduced the need for surgery. This paper summarizes recent literatures on the microbiologic characteristics of pleural infection and progress of diagnosis and treatment, aimed to provide clinical evidence for the management of pleural infection.

Bronchial lavage P16INK4A gene promoter methylation and lung cancer diagnosis: A meta‑analysis.

OBJECTIVE: To evaluate the diagnostic value of bronchial lavage P16INK4A promoter methylation and lung cancer. MATERIALS AND METHODS: The databases of PubMed, Medline, China National Knowledge Infrastructure, and Wanfang were electronically searched by two reviewers to find the suitable studies related to the association between P16INK4A promoter methylation and lung cancer. The P16INK4A promoter methylation rate was extracted from each included individual study. The diagnostic sensitivity, specificity, and area under the receiver operating characteristic ROC curve of bronchial lavage P16INK4A as a biomarker for diagnosis of lung cancer were pooled by stata11.0 software (Stata Corporation, College Station, TX, USA). RESULTS: At last, 10 publications were included in this meta‑analysis. Of the included 10 studies, five are published in English with relatively high quality and other five papers published in Chinese have relatively low quality. The pooled sensitivity and specificity of bronchial lavage P16INK4A promoter methylation for lung cancer diagnosis were 0.61 (95% confidence interval [CI]: 0.57–0.65) and 0.81 (95% CI: 0.78–0.85), respectively, with random effect model. The ROC curve were calculated and drawn according to Bayes’ theorem by stata11.0 software. The systematic area under the ROC was 0.72 (95% CI: 0.68–0.76), which indicated that the diagnostic value of bronchial lavage P16INK4A promoter methylation for lung cancer was relatively high. Moreover, no significant publication bias was existed in this meta‑analysis (t = 0.69, P > 0.05). CONCLUSION: Bronchial lavage P16INK4A promoter methylation can be a potential biomarker for diagnosis of lung cancer.