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Chronic pulmonary aspergillosis (CPA) is a serious fungal infection, which complicates pulmonary tuberculosis, chronic obstructive pulmonary disease and sarcoidosis with high mortality. At present, the treatment of CPA include drug treatment and surgical treatment. The treatment plan should be determined by the type, clinical manifestations and surgical indications of the patients. Nevertheless, there is no standard plan, and more research is needed to improve it. Combined with the current literature reports, this article reviews the current and progress in the treatment of CPA.
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BackgroundCoronavirus disease 19 (COVID-19) has become a global unprecedented pandemic infecting more than one millon people, which is declared by WHO as a international public health emergency. Eosinopenia may predict a poor prognosis of COVID-19. However, to date, there is no detailed analysis of the clinical characteristics of COVID-19 patients with eosinopenia. Research questionThe aim of this study was to describe clinical characteristics of COVID-19 patients with eosinopenia. Study Design and MethodsThis was a multi-center retrospective study conducted in three tertiary hospitals. A total of 59 patients with COVID-19 were reviewed from January 23, 2020 to March 10, 2020. We described clincial characteristics of patients with COIVD-19 and eosinopenia phenotype. ResultsThe median age of patients with COVID-19 was 39 years old, and 32 (54,2%) were male. Patients with severe type had higher proportions of dyspnea (50%) and gastrointestinal symptoms (50%) compared with mild or moderate patients. Laboratory findings indicated that lower counts of lymphocyte and eosnophils were observed in patients with severe type. Cough, sputum, and fatigue were more common symptoms in eosinopenia patients compared with non-eosinopenia patients. High proportion of comorbidities was observed in eosinopenia patients. Laboratory findings indicated that lymphocyte counts (median: 101 cells/l) in eosinopenia patients were significantly less than those of non-eosinopenia patients (median: 167 cells/l, p<0.001). The use of corticosteroids therapy in COVID-19 patients with eosinopenia were notably higher than those in patients with non-eosinopenia (50% vs 13.8%, respectively, p=0.005). Compared with parameters in non-eosinopenia patients, eosinopenia patients were more inclined to have less lymphocyte counts (OR value 6.566, 95%CI[1.101-39.173], p=0.039). InterpretationEosinopenia are very common in COVID-19 patient, particularly in severe patients. Common symptoms included fever, cough, sputum, and fatigue are frequent in eosinopenia patients. Eosinopenia may represent a novel phenotype in COVID-19, which needs further investigation.
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PURPOSE: Intestinal dysfunction is one of the most common complications in patients after abdominal surgery. Daikenchuto (DKT), a traditional herbal medicine, is recently employed to improve postoperative intestinal dysfunction. The aim of this meta-analysis was to assess the efficacy of DKT in improving intestinal dysfunction after abdominal surgery. METHODS: PubMed, Embase, and the Cochrane library were systematically searched to identify randomized controlled trails (RCTs) in adult patients undergoing abdominal surgery, who were randomly distributed to administrate DKT and placebo. The primary outcomes included the time to first postoperative flatus or bowel movement. We used random-effects models to calculate summary mean differences (MDs) with 95% confidence intervals (CIs). RESULTS: Nine RCTs totaling 1,212 patients (618 in DKT, 594 in control group) were included in our study. Compared with control group, DKT can effectively improve postoperative intestinal dysfunction by shortening the time to first postoperative flatus (MD, −0.41; 95% confidence interval [CI], −0.66 to −0.16; P = 0.001) with significant heterogeneity (I2 = 71%, P = 0.004), and bowel movement (MD, −0.65; 95% CI, −0.97 to −0.32; P < 0.001) without significant heterogeneity (I2 = 40%, P = 0.14). Sensitivity analyses by indication of surgery and type of surgery yielded similar results. CONCLUSION: These data provide limited evidence that DKT shows efficacy on improving intestinal dysfunction after abdominal surgery. However, the results should be interpreted cautiously, due to the heterogeneity of the studies included. Thus, the efficacy of DKT on improving postoperative intestinal dysfunction warrants further investigation.
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Adult , Humans , Flatulence , Herbal Medicine , Population CharacteristicsABSTRACT
AIM: To explore the anticancer function of Shp2 in lung adenocarcinoma A549 cells and the related molecular mechanisms.METHODS: The viability and proliferation of A549 cells treated with Shp2 specific inhibi-tor Phps-1 or cisplatin (DDP) were measured by CCK-8 assay and EdU assay.Annexin V-FITC/PI double staining was ap-plied to detect apoptotic rate of A549 cells with different interventions.The protein levels of caspase-3-17p, Bcl-2, Bax, p-STAT3 /STAT3 and p-ERK/ERK were determined by Western blot.RESULTS: Compared with control group, Phps-1 at the concentration of 20 μmol/L significantly increased the viability of A549 cells after 24 h of treatment ( P <0.05). Meanwhile, the proliferation rate of A549 cells in Phps-1 20 μmol/L group was significant increased compared with control group (P <0.05).The apoptotic rate of A549 cells in DDP treatment group decreased from 13.01% ±2.62% to 3.67%±0.93% after adding Phps-1 (P <0.05).Phps-1 down-regulated the protein levels of caspase-3-17p, Bax and p-ERK, but up-regulated p-STAT3.CONCLUSION: Shp2 is a tumor suppressor in A549 cells, which may be associated with the activation of STAT3 signal pathway.
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Polyinosinic-polycytidylic acid is a synthetic analog of double-stranded RNA,which plays a vital role in the regulation of immune system.Toll-like receptor 3 ( TLR3 ),melanoma differentiation-associated gene 5 (MAD-5) and retinoic acid inducible gene - Ⅰ ( RIG- Ⅰ ) are the main three intracellular receptors binding to polyinosinic-polycytidylic acid which activates human anti-tumor immune responses including the activation of innate immunity and acquired immunity through TIR-domain-containing adapter-inducing inter feron-β (TRIF) and interferon-β.Thus,polyinosinic-polycytidylic acid plays an important role in regulating anti-tumor immune responses.The immunoregulation mechanisms ofpolyinosinic-polycytidylic acid in melanoma,breast cancer,malignant glioma and lung cancer have been clarified,which will provide new strategies for tumor immunotherapy.
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Objective To explore if the tumor cell can up-regulate the proliferation of CD4+CD25+ Treg cells. Methods Lymphoma cell EL-4 supernatant was combined with the normal mise spleen lymphocyte. After cultured 72 hours, CD4+CD25+ subset were analyzed by flow cytometry and the gene expression level of the specific marker Foxp3 were tested by RT-PCR. The experiment repeated three times. Results The supematant derived from EL-4 can increase the proportion of CD4+CD25+ Treg cells in normal mouse spleen lymphocytes than that of the control group. Moreover, when added the CD3 McAb with EL-4 supematant together, the number of CD4+CD25+ Treg cells increased. The level of corresponding Foxp3 mRNA also increased. Conclusion These data suggested that in the supernatant may occur immune regulatory factors which up-regulated the number of CD4+CD25+ Treg cells and indicated that the tumorigenesis can facilitate proliferation of CD4+CD25+ Treg cells.
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Objective To study the etiology,prophylaxis,and management of complications after transurethral prostatectomy. Methods Clinical data of 73 patients with benigh prostatic hyperplasia(BPH) undergoing transurethral resection of prostate(TURP) or transurethral vaporization of prostate(TUVP) in this hospital from August 2002 to August 2005 were reviewed.Complications occurred in 14 patients,including severe bleeding in bladder in 2 patients,postoperative urinary retention in 5 patients,urethral stricture in 2 patients,urinary incontinence in 2 patients,TURP syndrome due to the perforation of the prostatic membrane in 2 patients,and lower-extremity deep venous thrombosis in 1 patient. Results A conversion to open surgery was required in 1 patient with severe bleeding in bladder and no re-bleeding happened.In another patient with severe bleeding in bladder,a trilumen single balloon catheter was intriduced into the bladder for continuous bladder irrigation with normal saline or iced normal saline,in association with medical therapy,to obtain a full recovery of voiding function without re-bleeding.Among 5 patients with urinary retention after operation,a re-operation of TURP was conducted in 2 patients and a dilatation of the urethra in association with oral symptomatic medication was carried out in 3 patient.No recurrence of urinary retention was noted and a re-examination of the maximum flow values(Qmax) at 1~3 months after operation revealed more than 15 ml/s.The voiding function recovered well in 2 patients with urethral stricture after periodic dilatation of the urethra.Permanent cystostomy was performed in 2 patients with urinary incontinence.In 2 patients with TURP syndrome,the operation was terminated immediately and active symptomatic treatment was conducted.The two patients experienced stable vital signs and a good recovery of voiding function.The patient with lower-extremity deep venous thrombosis was cured 2 weeks later. Conclusions Urinary retention and urethral stricture are common complications following transurethral resection of prostate.Careful selection of patients,strict adherence to technique,and timely and proper management of complications are considered essential to improve results.
