ABSTRACT
Descending necrotizing mediastinitis is a severe infection of the mediastinum. This syndrome manifests as fever and chest pain following cough and sputum production. A 49-year-old woman presented with fever and a 14-day history of pneumonia. CT showed mediastinal abscesses with a giant calcified mediastinal lymph node (21 × 18 mm) and pneumonia. Bronchoscopy by EBUS-TBNA under general anesthesia was performed. The pathogen found in the puncture culture was Streptococcus constellatus, and antibiotics (mezlocillin/sulbactam 3.375 IVGTT q8h) was administered. A proximal right main bronchial neoplasm, suspected lung cancer, was found and conformed to inflammatory granuloma. A total of 22 months post-discharge the patient was clinically stable. We also conducted a review of the literature for all Streptococcus constellatus descending necrotizing mediastinitis infections between 2011 and 2017.
Subject(s)
Bronchoscopy , Mediastinitis/microbiology , Pneumonia/complications , Streptococcal Infections/microbiology , Streptococcus constellatus/isolation & purification , Anti-Bacterial Agents/therapeutic use , Drainage/methods , Female , Humans , Immunocompetence , Lymph Nodes/pathology , Mediastinitis/diagnosis , Mediastinitis/therapy , Middle Aged , Pneumonia/diagnosis , Streptococcal Infections/diagnosis , Streptococcal Infections/therapy , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: To explore the effect of qidong huoxue decoction (QHD) on inflammatory factors and Toll-like receptor (TLR4) mRNA expressions in acute lung injury (ALI) rats. METHODS: Totally 50 healthy male SD rats were randomly divided into the blank control group, the lipopolysaccharide (LPS) model group, low, middle, high dose QHD groups according to body weight, 10 rats in each group. Rats in low, middle, high dose QHD groups were intragastrically administered with QHD at 4, 8, and 16 mL/kg 24, 12 h before modeling and 12 h after modeling, respectively. Normal saline was intragastrically administered to rats in the blank control group and the LPS model group. An ALI rat model was established using intratracheal instillation of LPS. Rats were killed after 24-h modeling. Then the bronchoalveolar lavage fluid was prepared. Contents of TNF-α, IL-1ß, and L-10 were detected using ELISA. TLR4 mRNA expressions were determined byreal time PCR. RESULTS: Compared with the blank control group, contents of TNF-α, IL-1ß , and IL-10 increased (P <0. 01), TLR4 mRNA expressions also increased in the LPS model group (all P <0. 01). Compared with the LPS model group, contents of TNF-α and IL-1ß decreased (P <0. 05, P <0. 01), IL-10 levels increased (P <0. 01) , TLR4 mRNA expressions were also reduced (P <0. 01), in high and middle dose QHD groups. Compared with the high dose QHD group, con- tents of TNF-α and IL-1ß increased in middle and low dose QHD groups (P <0. 05); IL-10 levels decreased (P <0. 05) in the low dose QHD group(P <0. 05), TLR4 mRNA expressions also increased in the low dose QHD group (P <0. 05). Compared with the middle dose QHD group, IL-10 levels was reduced, but TLR4 mRNA expressions increased in the low dose QHD group (P <0. 05). CONCLUSIONS: QHD had the protective effect on LPS induced ALI rats. Its mechanism might be associated with inhibiting TLR4 mRNA expressions, leading to decreased pro-inflammatory cytokines such as TNF-α and IL-ß, elevated anti-inflammatory cytokine IL-10, and thereby, correcting unbalanced inflammation.
Subject(s)
Acute Lung Injury/metabolism , Drugs, Chinese Herbal/pharmacology , Toll-Like Receptor 4/metabolism , Acute Lung Injury/genetics , Animals , Anti-Inflammatory Agents , Bronchoalveolar Lavage Fluid , Inflammation , Interleukin-10/metabolism , Interleukin-1beta/metabolism , Lipopolysaccharides , Male , RNA, Messenger/metabolism , Rats , Rats, Sprague-Dawley , Tumor Necrosis Factor-alpha/metabolismABSTRACT
OBJECTIVE: To investigate the amounts of extractable organic nitrogen (EON), and the relationships between EON and total extractable nitrogen (TEN), especially the amino acids (AAs) adsorbed by soils, and a series of other hydrolyzed soil nitrogen indices in typical land use soil types from southeast China. Under traditional agricultural planting conditions, the functions of EON, especially AAs in the rhizosphere and in bulk soil zones were also investigated. METHODS: Pot experiments were conducted using plants of pakchoi (Brassica chinensis L.) and rice (Oryza sativa L.). In the rhizosphere and bulk soil zone studies, organic nitrogen components were extracted with either distilled water, 0.5 mol/L K2SO4 or acid hydrolysis. RESULTS: K2SO4-EON constituted more than 30% of TEN pools. K2SO4-extractable AAs accounted for 25% of EON pools and nearly 10% of TEN pools in rhizosphere soils. Overall, both K2SO4-EON and extractable AAs contents had positive correlations with TEN pools. CONCLUSIONS: EON represented a major component of TEN pools in garden and paddy soils under traditional planting conditions. Although only a small proportion of the EON was present in the form of water-extractable and K2SO4-extractable AAs, the release of AAs from soil exchangeable sites might be an important source of organic nitrogen (N) for plant growth. Our findings suggest that the content of most organic forms of N was significantly greater in rhizosphere than in bulk soil zone samples. However, it was also apparent that the TEN pool content was lower in rhizosphere than in bulk soil samples without added N.
