The value of peripheral blood and pleural effusion T-SPOT.TB combined with pleural effusion adenosine deaminase in diagnosis of tuberculous pleurisy / 中国热带医学

@#Abstract: Objective To explore the relationship between peripheral blood and pleural effusion tuberculosis (TB) infection effector T cells, and to further evaluate the value of combined pleural effusion adenosine deaminase (ADA) for rapid diagnosis of tuberculous pleurisy. Methods The test data of 80 cases of tuberculous pleurisy and 70 cases of nontuberculous pleurisy treated in the Sixth People's Hospital of Nantong City from January 2017 to December 2020 were analyzed. The TBinfected effector T cells were also detected simultaneously in the peripheral blood and the pleural effusion by the T-SPOT technique, and the pleural effusion ADA was detected by the rate method. The subject operating characteristic curve (ROC) was applied to take the optimal pleural effusion ADA threshold to compare the sensitivity and specificity of different critical values. Person phase analysis was applied to analyze the correlation between peripheral blood and pleural effusion T-SPOT.TB. Data of peripheral blood, pleural effusion T-SPOT.TB and ADA were integrated. Results When pleural effusion ADA>45 U/L, the sensitivity and specificity for the diagnosis of tuberculous pleurisy were 50.0% and 94.3%, respectively; when ADA > 25.15 U/ L, the sensitivity and specificity were 80.0% and 72.9%. When ADA > 45 U / L, pleural/ blood T-SPOT.TB spot ratio (spot forming cells, SFCs) > 2 times, the specificity for the diagnosis of tuberculous pleurisy was 100% (highest); when 25.15 U/L< pleural effusion ADA ≤ 45 U/L, pleural/blood T-SPOT.TB spot ratio > 2 times, the specificity for the diagnosis of tuberculous pleurisy was 92.3% (second). When pleural effusion ADA ≤ 25.15 U/L, and the pleural effusion/blood T-SPOT.TB spot number ratio > 2 times, with 83.3% specificity (the lowest of the three groups). Conclusions The level of pleural effusion ADA is one of the most used methods for diagnosing tuberculous pleurisy. Further combination of pleural effusion and blood T-SPOT.TB, if the ratio of pleural effusion / blood T-SPOT. TB spots is greater than 2 times, it can further improve the diagnosis rate of tuberculous pleurisy.

Application value of bedside lung ultrasound in the diagnosis of acute dyspnea / 中国基层医药

Objective:To investigate the application value of bedside lung ultrasound in the diagnosis of acute dyspnea.Methods:Sixty-four patients with acute dyspnea who received treatment in Jincheng General Hospital from January 2020 to January 2021 were included in this study. These patients underwent bedside lung ultrasound, chest X-ray examination, and CT scan. The value of bedside lung ultrasound in the diagnosis of lung consolidation, pleurisy, pleural effusion, and pulmonary edema was analyzed.Results:The diagnostic rate of lung consolidation, pleurisy, pleural effusion, and pulmonary edema by bedside lung ultrasound was 34.4% (22/64), 64.1% (41/64), 67.2% (43/64), and 57.8% (37/64), respectively, which was slightly, but not significantly, different from that by chest CT scans [42.2% (27/64), 57.8% (37/64), 64.1% (41/64), 68.8% (44/64), all P > 0.05]. The diagnostic rate of lung consolidation, pleurisy, pleural effusion, and pulmonary edema by bedside lung ultrasound was significantly higher than that by chest X-ray examination [17.2% (11/64), 26.6% (17/64), 34.4% (22/64), 37.5% (37/64), χ2 = 4.94, 18.16, 13.78, 5.293, all P < 0.05]. Conclusion:Bedside lung ultrasound can help diagnose and screen patients with acute dyspnea quickly, accurately, and timely. Bedside lung ultrasound has a higher rate in the diagnosis of lung consolidation, pleurisy, pleural effusion, and pulmonary edema than chest X-ray examination, which is worthy of clinical application.

Exopolysaccharides from Klebsiella oxytoca: anti-inflammatory activity

Abstract Exopolysaccharides (EPS) produced by Klebsiella oxytoca are of environmental, pharmaceutical, and medicinal interest. However, studies about the anti-inflammatory activity of EPS produced by this microorganism still remain limited. The aim of this study was to produce, characterize, and evaluate the anti-inflammatory activity of EPS from K. oxytoca in a pleurisy model. Colorimetric analysis revealed that precipitated crude exopolysaccharides (KEPSC) and deproteinated exopolysaccharides (KEPS) present high levels of total carbohydrates (65.57% and 62.82%, respectively). Analyses of uronic acid (7.90% in KEPSC and 6.21% in KEPS) and pyruvic acid (3.01% in KEPSC and 1.68% in KEPS) confirm that the EPS are acidic. Gas chromatography-mass spectrometry analyses demonstrated that the EPS consisted of rhamnose (29.83%), glucose (11.21%), galactose (52.45%), and mannose (6.50%). The treatment of an experimental pleurisy model in rats through subcutaneous administration of 50, 100, 200, and 400 mg/kg of KEPS decreased both the volume of inflammatory exudate and the number of leukocytes recruited to the pleural cavity. The present data showed that EPS production by K. oxytoca using the method described is easy to perform and results in a good yield. In addition, we show that KEPS exhibit anti-inflammatory activity when administered subcutaneously in rats.

Application value of detection of 157-114 protein level combined with ADA and CEA levels in pleural effusion in differential diagnosis of pleural effusion / 吉林大学学报(医学版)

Objective: To detect the levels of B7-H4 protein, adenosine deaminase (ADA) and carcinoembryonic antigen (CEA) in the malignant pleural effusion associated with lung cancer (LC-MPE) and tuberculous pleural effusion (TPK), and to evaluate the values of single and combined detection of B7-H4 protein, ADA and CEA in differential diagnosis of LC-MPE and TPK. Methods: A total of 202 samples of pleural effusion (PE) from 120 LC-MPE patients (LC-MPE group) and 82 TPE patients (TPE group) were collected. The levels of ADA and CEA and B7-H4 protein in PE were detected by the enzymatic, electrochemiluminescence and ELISA methods, respectively; and the receiver operating characteristic curve (ROC curve) was used to determine the diagnostic efficiencies of the above indexes alone or in combination, such as the sensitivity, the specificity, the Yoden index (YI)» and the area under ROC curve ( AUC). Results: The level of ADA in PE of the patients in TPE group was higher than that in LC-MPE group (P<0. 05); the levels of CEA and B7-H4 protein in PE of the patients in LC-MPE group were higher than those in TPE group ( P'-CO. 05). The ROC curve analysis results showed that the sensitivities of single detection of ADA, CEA and B7-H4 protein were 93.30%, 83.33% and 79.90%, respectively; the specificities were 86. 59%, 96.34% and 72. 50%, respectively; the AUC were 0. 927, 0. 925 and 0. 836, respectively. The combined detection of the three indexes had the highest diagnostic value; the sensitivity was 93. 90% , the specificity was 97. 50% , the YI was 0. 971, and the AUC was 0. 998. Conclusion: The combined detection of levels of ADA, CEA and B7-H4 protein in PE is superior to the single evaluation of each index, which can greatly improve the differential diagnosis efficiencies of LC-MPE and TPE.

Síndrome de Rosai-Dormfan associada a Lúpus eritematoso sistêmico: relato de caso / Rosai-Dorfman syndrome associated with systemic erythematous lupus: case report

Objetivo: Relatar um caso de associação de Síndrome de Rosai-Dorfman e Lúpus Eritematoso Sistêmico acompanhado no ambulatório de Clínica Médica de nosso Hospital Universitário. Metodologia: O estudo é em formato de relato de caso, realizado a partir de revisão de prontuário e exames complementares. O termo de consentimento livre e esclarecido foi assinado pela paciente. Resultados: Paciente do sexo feminino, 37 anos, com quadro de pneumonia associada a derrame pleural recorrente e linfonodomega-lia generalizada. Na investigação clínica, foi realizado diagnóstico de Lúpus Eritematoso Sistêmico. Os exames anatomopatológico e imuno-histoquímico da biópsia linfonodal foi compatível com Síndrome de Rosai-Dorfman. Conclusões: A Síndrome de Rosai-Dorfman é uma doença benigna que pode mimetizar neoplasias. A progressão da doença é variável e não há tratamento efetivo estabelecido atualmente, sen-do o seguimento regular importante para avaliar compressão de estruturas vitais. Lúpus eritematoso sistêmico é uma doença inflamatória crônica com acometimento multissistêmico. Seu tratamento adequado costuma resultar em sobrevida longa e com qualidade. Importância do problema e comentários: De acordo com nosso levantamento bibliográfico, este é o quarto artigo relatando a ocorrência concomitante de Síndrome de Rosai-Dorfman e Lúpus Eritematoso Sistêmico em um paciente (AU)

Objective: To report a case of association of Rosai-Dorfman syndrome and Systemic Lupus Erythema-tosus followed at the Internal Medicine ambulatory of our University Hospital. Methodology: This stu-dy is in a case report format, carried out from a review of medical records and complementary exams. The consent form was signed by the patient. Results: Female patient, 37 years old, with a history of pneumonia associated with recurrent pleural effusion and generalized lymphadenopathy. In the clini-cal investigation, Systemic Lupus Erythematosus was diagnosed. The anatomopathological and im-munohistochemical exams of lymph node biopsy were compatible with Rosai-Dorfman Syndrome. Conclusions: Rosai-Dorfman Syndrome is a benign disease that can mimic neoplasms. The disease progres-sion is variable and, currently, there is no effective treatment established. Regular follow-up is important to assess vital structures compression. Systemic Lupus Erythematosus is a chronic inflammatory disease with multisystem affection. The appropriate treatment usually results in long-term and high-quality survival. Pro-blem impact and comments: According to our bibliographic survey, this is the fourth article reporting the concomitant occurrence of Rosai-Dorfman Syndrome and Systemic Lupus Erythematosus in a patient (AU)

Significance of T-cell dot test and combined detection of adenosine deaminase in tuberculous pleurisy at different ages / 中国综合临床

Objective To analyze the clinical value of combined detection of tuberculous T cell enzyme-linked immuno spot assay (T-SPOT.TB) and adenosine deaminase (ADA) in tuberculous pleurisy patients of different ages.Methods From February 2014 to February 2018,three hundred and thirty-six patients with pleural effusion were admitted to Hebei Thoracic Hospital.Among them,two hundred and fifty five cases were diagnosed as tuberculous pleurisy and 81 cases were diagnosed as non-tuberculous pleurisy.The patients were divided into two groups according to their age.The younger group (214 cases) was 16-59 years old and the older group (122 cases) was over 60 years old.The sensitivity and specificity of T-SPOT.TB combined with ADA in the diagnosis of tuberculous pleurisy were compared between the two groups.Results The sensitivity and specificity of T-SPOT.TB were 85.5％ (153/179) and 71.4％ (25/35) in the young and middle-aged group,73.7％ (56/76) and 58.7％ (27/46) in the old group,respectively.The sensitivity of the young and middle-aged group was significantly higher than that of the old group (x2 =4.990,P =0.045).The sensitivity and specificity of T-SPOT.TB combined with ADA were 98.9％ (177/179) and 94.3％ (33/35) in the young and middle-aged group,96.1％ (73/76) and 89.1％ (41/46) in the elderly group,respectively.There was no significant difference in sensitivity and specificity between the two groups (x2 =0.256,P=0.393、x2=0.655,P=0.218).Conclusion The diagnostic efficacy of T-SPOT.TB combined with ADA in patients with tuberculous pleurisy at different ages has been improved,especially for those who can not tolerate pleural biopsy and elderly patients.

Detection of carcinoembryonic antigen levels in pleural effusion and serum and their ratio for differential diagnosis of pleural effusion resulting from tuberculosis and lung cancer / 南方医科大学学报

OBJECTIVE@#To study the clinical value of detecting carcinoembryonic antigen levels in pleural effusion (PCEA) and serum (SCEA) and their ratio (P/S) in the differential diagnosis of pleural effusions resulting from tuberculosis and lung cancer.@*METHODS@#This retrospectively study was conducted among 82 patients with pleural effusion caused by pulmonary tuberculous (TB; control group) and 120 patients with pleural effusion resulting from lung cancer in our hospital between April, 2016 and March, 2018. PCEA, SCEA and P/S were compared between the two groups and among the subgroups of lung cancer patients with squamous cell carcinoma (SqCa), adenocarcinoma (ACA), small cell carcinoma (SCLC). The receiveroperating characteristic curve (ROC) analysis was used to confirm the optimal critical value to evaluate the diagnostic efficiency of different combinations of PCEA, SCEA and P/S.@*RESULTS@#PCEA, SCEA and P/S were significantly higher in the overall cancer patients and in all the 3 subgroups of cancer patients than in the patients with TB ( < 0.05). The areas under the ROC curve of PCEA, SCEA and P/S were 0.925, 0.866 and 0.796, respectively; PCEA had the highest diagnostic value, whose diagnostic sensitivity, specificity, accurate rate, and diagnostic threshold were 83.33%, 96.34, 88.61%, and 3.26 ng/ml, respectively; SCEA had the lowest diagnostic performance; the diagnostic performance of P/S was between that of SCEA and PCEA, but its combination with SCEA greatly improved the diagnostic performance and reduced the rates of misdiagnosis and missed diagnosis. Parallel tests showed that the 3 indexes combined had significantly higher diagnostic sensitivity than each or any two of the single indexes ( < 0.05), but the diagnostic specificity did not differ significantly. The area under the ROC curve of combined detections of the 3 indexes was 0.941 for diagnosis of lung cancer-related pleural effusion, higher than those of any other combinations of the indexes.@*CONCLUSIONS@#The combined detection of PCEA, SCEA and P/S has a high sensitivity for diagnosis of lung cancer-related pleural effusion and provides important information for rapid and accurate diagnosis of suspected cases.

Clinical study on central venous catheter drainage and intrapleural injection of urokinase in the treatment of tuberculous pleurisy / 中国基层医药

Objective To observe the therapeutic effect of central venous catheter drainage and intrapleural injection of urokinase on tuberculous pleurisy patients.Methods 60 hospitalized patients with tuberculous pleurisy were selected,and they were divided into two groupsby simple random grouping method.Both two groups received 3HRZE/6HR anti-tuberculosis treatment.30 patients in the observation group were treated with central venous catheter drainage and intrapleural injection of urokinase.30 patients in the control group were treated with conventional pleurocentesis.The duration of pleural effussion drainage,incidence of pleural thickening,hospitalization time and expense,and the adverse reaction rate were observed during treatment.Results In the observation group,the curative effect at 1 week was 46.7％,the duration of pleural effussion drainage was (20.5 ± 6.7)days,the incidence rate of pleural thickening was 26.7％,the hospitalization time was (9.4 ± 2.7) days,the hospitalization expense was (6 675.4 ± 1 818.4) RMB,the incidence rate of adverse reaction was 3.3％.In the control group,the curative effect at 1 week was 20.0％,the duration of pleural effussion drainage was (25.1 ± 7.7) days,the incidence rate of pleural thickening was 46.7％,the hospitalization time was (10.3 ± 2.8)days,the hospitalization expense was (7 508.9 ± 1 692.1) RMB,the incidence rate of adverse reaction was 20..0％.There were statistically significant differences between the two groups in the curative effect at 1 week (x2 =4.800,P =0.028),duration of pleural effussion drainage (t =2.484,P =0.016),incidence of pleural thickening (t =4.444,P =0.035) and incidence rate of adverse reaction (x2 =4.043,P =0.044).No statistically significant differences were observed between the two groups in hospitalization time(t =1.270,P =0.209) and expense (t =1.838,P =0.071).Conclusion In comparison to conventional pleurocentesis,the treatment of central venous catheter drainage and intrapleural injection of urokinase for tuberculous pleurisy is markedly efective,it is safe and Worthy of popularizing in clinical application.

Study on relationship between Th1/Th2 cells/cell cytokines and tuberculosis pleural effusion adhesion / 实用医学杂志

Objective To investigate the relationship between cellular immune response which is related with Th1/Th2 cells and the different severities of tuberculosis pleural effusion adhesion.Methods A total of 66 in-patients diagnosed with different severities of tuberculosis pleural effusion adhesion by internal thoracoscope were enrolled from August 2014 to December 2016.ELISA was used to determine levels of INF-γ,TNF-α,IL-2 and IL-4. The ratio of Th1 and Th2 cells was detected by flow cytometry. Results All the patients were divided into 3 groups:9 cases without pleural adhesion,32 cases with mild pleural adhesion,25 cases with severe pleural adhe-sion. The levels of 4 cytokines in pleural fluid were significantly higher than those in serum in each group(P <0.05,respectively).The concentrations of INF-γ and TNF-α were increased with the severity of tuberculosis pleu-ral effusion adhesion. The levels of INF-γ and TNF-α in the severe pleural adhesion group were markedly higher than those in the other two groups(P<0.05,respectively).The proportion of Th1 cells in the severe pleural adhe-sion group was significantly higher than that in the none pleural adhesion group and in the mild pleural adhesion group(P<0.05,respectively).Conclusions The proportion of Th1 cells and levels of INF-γ and TNF-α are pos-itively related with pleural adhesion severity. Cellular immune response which is related with Th1 cells contributes to pathological immune pleural damage and intensify the severity of pleural adhesions.

Diagnostic value of interferon-γ release assay of peripheral blood and pleural effusion for tuberculous pleurisy / 解放军医学杂志

Objective To evaluate the diagnostic value of interferon-γ release assay of blood and pleural effusion for tuberculous pleurisy.Methods Fifty-six adult patients with suspected tuberculous pleurisy were enrolled in our study.The blood and pleural effusion interferon-γ release assay were measured by T-SPOT.TB test in 38 pleural tuberculosis patients and 18 nontuberculous pleurisy controls.The diagnostic sensitivity,specificity,predictive value of T-SPOT.TB in pleural effusion mononuclear cells (PE-MC) and peripheral mononuclear cells (PBMC) were analyzed.Results The sensitivities and specificities,positive predictive values and negative predictive values,respectively,of the PE-MC and PBMC for diagnosing were as follows:86.5％(95％ confidence interval[CI] 71.2％-95.5％) and 100％(95％CI 90.5％-100％);52.9％(95％CI 27.8％-77.0％) and 35.3％(95％CI 14.2％-61.7％);80.0％(95％CI 64.4％-90.9％) and 77.1％(95％CI 62.7％-88.0％);64.3％(95％CI 35.1％-87.2％) and 100％(95％CI 54.1％-100％).By ROC curve analysis,a cut-off value of 47SFC/2.5 × 105 cells in PE-MC showed a sensitivity of 89.2％ and a specificity of 88.2％.Conclusion T-SPOT.TB in PE-MC could be an accurate diagnostic method for tuberculous pleurisy in TB endemic settings.Moreover,47SFC/2.5 × 105 cells might be the optimal cut-off value for diagnosing tuberculous pleurisy.

Clinical value of IGRA for pleural effusion in the diagnosis of tuberculous pleurisy / 国际检验医学杂志

Objective To investigate the clinical diagnosis value of interferon gamma release assay (IGRA ) for pleural effusion in patients with tuberculous pleurisy .Methods 68 patients with tuberculous pleurisy (tu-berculous group) were included as object of study in Ganzi state people′s hospital ,and selected 70 patients with pneumonic pleurisy(pneumonia group) and 70 patients with malignancy (malignant group) as controls . Enzyme linked immunosorbent assay (ELISA) was used to detect interferon gamma release assay for tubercu-losis infected T cells (TB-IGRA ) in pleural effusion ,and were in progress blood TB-IGRA for tuberculous group .Results The IFN-γ level of patients in tuberculous group[179 .3(158 .1 -276 .2)ng/L] was higher than that those in pneumonia group[86 .7(55 .1 -162 .2)ng/L] and malignant group[92 .7(48 .1 -178 .3) ng/L] ,the difference was statistically significant (P＜0 .05) .The IFN-γ level of TB-IGRA for blood was low-er than that TB-IGRA for pleural effusion ,the difference was statistically significant (P＝0 .012) .The sensi-tivity ,specificity ,positive predictive value ,and negative predictive value of TB-IGRA for pleural effusion high-er than that blood TB-IGRA ,the difference was statistically significant (P＜0 .05) .The AUC of TB-IGRA for pleural effusion was higher than that blood TB-IGRA .Conclusion TB-IGRA for pleural effusion is an impor-tant laboratory index for the diagnosis of tuberculous pleurisy ,and its diagnostic efficiency is higher than that of blood TB-IGRA .

Study on the detection value of serum Treg cell related factors and chemokines in patients with tuberculous pleurisy / 国际检验医学杂志

Objective To analyze the value of serum Treg cell related factors and chemokines in patients with tuberculous pleurisy .Methods From July 2015 to December 2016 ,92 cases of tuberculous pleurisy in our hospital were selected as the observation group ,and 92 healthy persons at the same time were selected as the control group .The levels of Treg cell related factors[monocyte chemoattractant protein (MCP)-1 ,IP-10 ,CCL-3 and CCL-16] and IL-10 ,TGF-βand IL-35] were detected and compared in the two groups ,and the levels of these indexes were compared in different classifications and stages of tuberculous pleuritis .Results The ser-um Treg cell related factors and chemokine levels in the observation group were significantly higher than those in the control group (P<0 .05) .The expression level of tuberculous empyema was higher than that of dry pleuritis and exudative pleuritis ,the patients with exudative pleuritis were higher than those of dry pleuritis , and the patients with multiple pleuritis were higher than those with idiopathic and concomitant pleuritis ,the difference was statistically significant (P<0 .05) .Conclusion The serum Treg cell related factors and chemo-kines in patients with tuberculous pleurisy are highly expressed ,and the classification and staging of the dis-ease have great influence on the expression ,and the above indexes have high detection value in the patients with tuberculous pleurisy .

Bee venom stimulation of a lung meridian acupoint reduces inflammation in carrageenan-induced pleurisy: an alternative therapeutic approach for respiratory inflammation

Respiratory inflammation is a frequent and fatal pathologic state encountered in veterinary medicine. Although diluted bee venom (dBV) has potent anti-inflammatory effects, the clinical use of dBV is limited to several chronic inflammatory diseases. The present study was designed to propose an acupoint dBV treatment as a novel therapeutic strategy for respiratory inflammatory disease. Experimental pleurisy was induced by injection of carrageenan into the left pleural space in mouse. The dBV was injected into a specific lung meridian acupoint (LU-5) or into an arbitrary non-acupoint located near the midline of the back in mouse. The inflammatory responses were evaluated by analyzing inflammatory indicators in pleural exudate. The dBV injection into the LU-5 acupoint significantly suppressed the carrageenan-induced increase of pleural exudate volume, leukocyte accumulation, and myeloperoxidase activity. Moreover, dBV acupoint treatment effectively inhibited the production of interleukin 1 beta, but not tumor necrosis factor alpha in the pleural exudate. On the other hand, dBV treatment at non-acupoint did not inhibit the inflammatory responses in carrageenan-induced pleurisy. The present results demonstrate that dBV stimulation in the LU-5 lung meridian acupoint can produce significant anti-inflammatory effects on carrageenan-induced pleurisy suggesting that dBV acupuncture may be a promising alternative medicine therapy for respiratory inflammatory diseases.

Determination of phenolic profile by HPLC-ESI-MS/MS and anti-inflammatory activity of crude hydroalcoholic extract and ethyl acetate fraction from leaves of Eugenia brasiliensis

ABSTRACT Eugenia brasiliensis Lam., Myrtaceae, is used in folk medicine for anti-inflammatory diseases such as arthritis and rheumatism. This study investigated the anti-inflammatory activity and phenolic profile of the crude hydroalcoholic extract and ethyl acetate fraction from E. brasiliensis leaves. Crude hydroalcoholic extract and the ethyl acetate fraction were analyzed by HPLC-ESI-MS/MS in comparison to standard phenolic compounds. The anti-inflammatory activity of the crude hydroalcoholic extract (1, 10 and 25 mg kg-1) and the ethyl acetate fraction (10, 25 and 50 mg kg-1) was evaluated in a swiss mouse model of acute pleurisy induced by carrageenan, being the total cell count, exudation and analysis of nitrite/nitrate the inflammation parameters. HPLC-ESI-MS/MS analysis revealed apigenin, catechin, galangin, isoquercetin, myricetin, quercetin and rutin. Crude hydroalcoholic extract and ethyl acetate fraction were effective in inhibiting cell migration in all tested doses. Crude hydroalcoholic extract was effective in inhibiting exudation only at the 10 mg kg-1 dose; ethyl acetate fraction was effective in all tested doses. Results for nitrite/nitrate levels reveals that only the ethyl acetate fraction was effective at the tested doses. This is the first report of the presence of isoquercetin, galangin and apigenin in this species. Results from the phytochemical analysis enhance the chemical knowledge of this species. In the future, together with more studies, validation of its popular use in inflammatory diseases is possible.

A single administration of fish oil inhibits the acute inflammatory response in rats

Objective To investigate the antiinflammatory effects of a single administration of fish oil (FO) on the acute inflammatory response. Methods The paw edema and pleurisy models were used to evaluate the effects of FO dissolved in olive oil (FOP) orally administered in a single dose in rats. Nitric oxide (NO) concentrations in the pleural exudate were performed according to the Griess method and the cytokine concentrations were determined by Luminex bead-based multiplex assay. Results FOP treatment (30 and 300 mg/kg) significantly reduced paw edema. FOP treatment at 18.75, 37.5, 75.0, 150.0, and 300 mg/kg decreased both the volume of pleural exudate and cellular migration into the pleural cavity and each of these doses presented the same effectiveness. Treatment with FOP (300 mg/kg) reduced NO, TNF-α IL-1β and IL-6 concentrations in the pleural exudate. Conclusions The present data provide evidence that FO has inhibitory effects on the acute inflammatory response when administered in a single dose in rats. This effect might be attributable to a direct inhibitory effect of FO on the production or release of inflammatory mediators that are involved in the pathological processes evaluated herein.

A single administration of fish oil inhibits the acute inflammatory response in rats

OBJECTIVE@#To investigate the antiinflammatory effects of a single administration of fish oil (FO) on the acute inflammatory response.@*METHODS@#The paw edema and pleurisy models were used to evaluate the effects of FO dissolved in olive oil (FOP) orally administered in a single dose in rats. Nitric oxide (NO) concentrations in the pleural exudate were performed according to the Griess method and the cytokine concentrations were determined by Luminex bead-based multiplex assay.@*RESULTS@#FOP treatment (30 and 300 mg/kg) significantly reduced paw edema. FOP treatment at 18.75, 37.5, 75.0, 150.0, and 300 mg/kg decreased both the volume of pleural exudate and cellular migration into the pleural cavity and each of these doses presented the same effectiveness. Treatment with FOP (300 mg/kg) reduced NO, TNF-α, IL-1β, and IL-6 concentrations in the pleural exudate.@*CONCLUSIONS@#The present data provide evidence that FO has inhibitory effects on the acute inflammatory response when administered in a single dose in rats. This effect might be attributable to a direct inhibitory effect of FO on the production or release of inflammatory mediators that are involved in the pathological processes evaluated herein.

Secondary infection of traumatic pulmonary cyst misdiagnosed as cholesterol encapsulated pleural effusion:a rare case and review of literature / 中南大学学报(医学版)

Pulmonary cyst is a relatively common benign lesion.It is easy to be misdiagnosed when the cyst complicated with infection.Tnis paper reported a case of a giant traumatic pulmonary cyst (diameter 10 cm) combined with chronic infection.Firstly,the patient was diagnosed as cholesterol pleurisy after undergoing thoracoscopic biopsy.With repeated pleural effusion,the patient was scheduled for right anterolateral thoracotomy,which showed a thin-walled cyst (10 cm in diameter) attached to parietal and diaphragm,with the stem of cavity originated from the right lower lobe after the cyst cavity was dissociated.Pathological examination revealed that it was apseudocyst,which could be diagnosed as traumatic pulmonary cyst combined with chronic infection according to history of trauma.After undergoing right lower lobectomy and stripping of fiberboard,the prognosis was good.Traumatic pulmonary cyst,which was discovered interval 10 years after chest trauma,was rare.Traumatic pulmonary cyst combined with cholesterol cystic fluid was very rare.Huge pulmonary cyst complicated with infection was easily misdiagnosed as loculated pleural effusion.Therefore,to be correct diagnosis and treatment,clinician must carefully ask medical history.In addition,early image examination should be considered in those patients with chest trauma whether there are clinical symptoms or not.

Analysis of the Clinical Effect of Dexamethasone Combined with Urokinase on the Tuberculous Pleurisy / 现代生物医学进展

Objective:To investigate the clinical effect of dexamethasone combined with urokinase on the tuberculous pleurisy.Methods:From August 2013 to May 2016,190 cases of tuberculous pleurisy patients in our hospital were selected.All the patients were randomly divided into the observation group and control group with of 95 patients in each group,both groups were treated with anti tuberculosis treatment,the control group was given urokinase treatment,the observation group was given dexamethasone combined with urokinase treatment,both groups were treated for 1 month.After treatment,the total effective rate,incidence of adverse reactions,total drainage time of pleural effusion,total amount of pleural effusion,thrombin time and prothrombin time of two groups were compared.Results:All patients were well tolerated with injection during the treatment and there was no severe complication after treatment;the total effective rates in the observation group and the control group were 88.4％ and 72.6％,which was significantly higher in the observation group than that of the control group (P＜0.05).The total drainage time and total amount of pleural effusion in pleural effusion in the observation group were 7.56± 2.44 d and 2867.33± 456.10 mL,the control group were 9.44± 2.89 d and 1989.92± 444.20 mL,the total drainage time in the observation group was significantly shorter than that of the control group,and the total amount of pleural effusion was significantly higher than that of the control group(P＜0.05).After treatment,the pleural effusion thrombin time and prothrombin time in both groups were significantly higher than those before treatment (P＜0.05),which were higher in the observation group than those of the control group (P＜0.05).Conclusion:Dexamethasone combined with urokinase could prolong the thrombin time and prothrombin time,shorten the time of drainage of pleural effusion,increase the pleural effusion amount,with good safety and clinical effect in the treatment of tuberculous pleurisy.

Clinical features of pediatric tuberculous pleurisy / 中华实用儿科临床杂志

Objective To sum up the clinical manifestations and laboratory features for the diagnosis of pediatric tuberculous pleurisy,and to improve the recognition of this disease in early stage.Methods A retrospective study of 113 children diagnosed as tuberculous pleurisy from August 2006 to September 2014 in the Second Department of Respiratory Medicine,Beijing Children's Hospital Affiliated to Capital Medical University was conducted.Meanwhile,another 113 cases of children with mycoplasma pneumoniae pneumonia complicated with pleurisy were selected as control group.The general information,clinical symptoms,pleural effusion and imaging features between 2 groups were analyzed and compared by using SPSS 16.0 statistical software.Results The proportion of patients with cough in tuberculous pleurisy group and control group was 47.79％ (54/113 cases) and 99.12％ (112/113 cases) (x2 =76.33,P ＜ 0.01) respectively,and the proportion with severe cough was 3.70％ (2/54 cases) and 97.32％ (109/112 cases) (x2 =144.10,P ＜0.01),while the disease duration was 15.00 (10.00,30.00) days and 10.00 (8.00,14.50) days (W =8 668.00,P ＜ 0.01),respectively,and all the differences between 2 groups were significant.The proportion of patients with low fever,moderate fever,high fever and hyper fever was 8.65％ (9/104 cases),47.12％ (49/104 cases),44.23 ％ (46/104 cases) and 0,respectively in tuberculous pleurisy group,while the proportion was 0.90％ (1/111 cases),18.92％ (21/111 cases),79.28％ (88/111 cases) and0.90％ (1/111 cases) respectively in control group,and the difference between 2 groups was significant(W =9 064.00,P ＜ 0.01).The unilateral effusion ratio in tuberculous pleurisy group and the control group was 94.69％ (107/113 cases) and 71.68％ (81/113 cases),respectively (x2 =21.39,P ＜ 0.01).The monocyte ratio was higher in tuberculous pleurisy group [0.89 (0.76,0.93)] than that in the controlgroup [0.60 (0.30,0.78)] (W =888.50,P ＜ 0.01) and the level of protein in 2 groups was [51.00 (47.35,54.20) g/L] and [42.10 (37.85,46.15) g/L],respectively (W =842.50,P ＜ 0.01).The level of lactate dehydrogenase (LDH) in tuberculous pleurisy group[553.50 (358.00,749.25) U/L] was lower than that in the control group[1 189.10 (670.95,1 820.00) U/L] (W =2 186.00,P ＜ 0.01),and the differences were significant between 2 groups.In addition to pleural effusion,the high density was the main feature of imaging examination in 2 groups.The proportion of patients with atelectasis was 77.88％ (88/113 cases) and 4.42％ (5/113 cases) (x2 =125.90,P ＜ 0.01),while the proportion of patients with consolidation was 4.42％ (5/113 cases) and 72.57 ％ (82/113 cases),respectively (x2=110.80,P ＜ 0.01).All the differences between 2 groups were significant.The sputum culture-positive rate of mycobacterium tuberculosis was only 1.77％ (2/113 cases) and the other pathogen examinations were negative in tuberculous pleurisy group.Conclusions For patients with unilateral pleural effusion,when the onset only has fever (moderate-high fever),and respiratory symptoms are not clear or symptoms are not proportional to radiographic severity,or when high monocytes proportion (＞ 0.70) in pleural effusion and radiographic evidence of compression atelectasis are observed,tuberculous pleurisy should be considered and further questioning of the predisposing factors,purified protein derivative test should be taken so as to diagnose the tuberculous pleurisy at early stage.

Diagnostic value of T-SPOT.TB for tuberculous pleural effusion / 实用医学杂志

Objective To evaluate the clinical value of T-SPOT.TB in the diagnosis of tuberculous pleu-risy. Methods A total of 180 cases of hospitalized patients with pleural effusion ( hospitalized between January 2013 to January 2015)were enrolled. Efficiency of T-SPOT.TB in the diagnosis of tuberculosis was evaluated and the effects of immune state on the number of spot forming cells were analyzed. Results The sensitivity and speci-ficity of the T-SPOT.TB in diagnosis of tuberculous pleural effusion were 82.24％(88/107)and 72.60％(53/73). The sensitivity and specificity of the T-SPOT.TB in immunocompromised patients were72.73％(40/55) and 52.63％(20/38).The sensitivity and specificity of the T-SPOT.TB in non-immunocompromised were 92.31％(48/52) and 94.29％(33/35).The sensitivity and specificity of those in non-immunocompromised were significantly higher than those in immunocompromised. ESAT-6 and CFP-10 specific SFCs of immunocompromised patients de-creased significantly compared with non-immunocompromised(Z is -26.817 and-43.756,P<0.05 ). Conclusion T-SPOT.TB has high sensitivity ,specificity in the diagnosis of tuberculous pleurisy.T-SPOT.TB and is a promising clinical test in the diagnosis of non-immunocompromised with suspected TB ,but its diagnostic performance in im-munocompromised patients is reduced compared with in non-immunocompromised patients.