Exacerbation of pulmonary fibrosis following single lung transplantation

Acute exacerbations of interstitial lung disease present as clinical deteriorations, with progressive hypoxemia and parenchymal consolidation not related to infection, heart failure or thromboembolic disease. Following single lung transplantation, patients receive maintenance immunosuppression, which could mitigate the development of acute exacerbations in the native lung. A 66-year-old man with fibrotic, nonspecific interstitial pneumonitis presented with fever, hypoxemia and parenchymal consolidation limited to the native lung four years after single lung transplantation. Investigations were negative for infection, heart failure and thromboembolic disease. The patient worsened over the course of one week despite broad-spectrum antimicrobial therapy, but subsequently improved promptly with augmentation of prednisone dosed to 50 mg daily and addition of N-acetylcysteine. Hence, the patient fulfilled the criteria for a diagnosis of an acute exacerbation of pulmonary fibrosis in his native lung. Clinicians should consider acute exacerbation of parenchymal lung disease of the native lung in the differential diagnosis of progressive respiratory deterioration following single lung transplantation for pulmonary fibrosis.     

非特异性间质性肺炎相关基因筛选和生物信息学分析

目的通过生物信息学的方法筛选非特异性间质性肺炎(nonspecific interstitial pneumonia, NSIP)的致病基因,为进一步研究提供靶点。 方法从GEO数据库下载基因芯片数据集GSE110147、GSE21369、GSE40839,使用limma包分析工具筛选正常组织与NSIP的差异表达基因。通过clusterProfiler包对差异表达基因进行GO分析和KEGG通路富集分析,找到NSIP发病过程中差异表达基因主要参与的生物功能及其集中的信号通路。利用STRING数据库和CYTOSCAPE软件构建蛋白相互作用网络,使用MCODE软件提取蛋白相互作用网络中的子网络模块。 结果3个数据集的差异表达基因做韦恩图得到3个共同差异表达基因。GO富集分析表明NSIP中上调的差异表达基因主要影响RNA剪接、抗病毒感染、对肽的细胞反应等相关的生物过程,富集的分子主要参与细胞组分的囊腔合成分泌、剪接复合体,富集的分子功能主要参与ATP酶活性,受体配体活性及DNA结合转录激活因子活性。NSIP中下调的蛋白主要涉及转移酶活性调节的生物过程。KEGG通路分析表明NSIP中上调的差异表达基因主要参与PI3K-Akt、人类乳头瘤病毒感染及MAPK等信号通路。 结论利用生物信息学筛选出差异表达基因,可能是NSIP发病机制的新靶点,对诊断治疗NSIP具有临床意义。     

Effects of Qigong practice in office workers with chronic non-specific low back pain: A randomized control trial

ObjectiveTo investigate the effects of Qigong practice, Guan Yin Zi Zai Gong level 1, compared with a waiting list control group among office workers with chronic nonspecific low back pain (CNLBP).MethodsA randomized controlled trial was conducted at offices in the Bangkok Metropolitan Region. Seventy-two office workers with CNLBP were screened for inclusion/exclusion criteria (age 20–40 years; sitting period more than 4 h per day) and were allocated randomly into two groups: the Qigong and waiting list groups (n = 36 each). The participants in the Qigong group took a Qigong practice class (Guan Yin Zi Zai Gong level 1) for one hour per week for six weeks at their workstation. The participants were encouraged to conduct the Qigong exercise at home every day. The waiting list group received general advice regarding low back pain management. The primary outcomes were pain intensity, measured by the visual analog scale, and back functional disability, measured by the Roland and Morris Disability Questionnaire. The secondary outcomes were back range of motion, core stability performance index, heart rate, respiratory rate, the Srithanya Stress Scale (ST-5), and the global perceived effect (GPE) questionnaire.ResultsCompared to the baseline, participants in the Qigong group experienced significantly decreased pain intensity and back functional disability. No statistically significant difference in these parameters was found in the waiting list group. Comparing the two groups, Qigong exercise significantly improved pain intensity, back functional impairment, range of motion, core muscle strength, heart rate, respiratory rate, and mental status. The Qigong group also had a significantly higher global outcome satisfaction than the waiting list group.ConclusionQigong practice is an option for treatment of CNLBP in office workers.     

钩端螺旋体脂多糖对小鼠感染伤寒沙门氏菌O_(901)的保护作用

钩端螺旋体(钩体)属革兰氏阴性菌,可是有无内毒素尚无定论。笔者曾发现,从黄疸出血群软型钩体提取的脂多糖,在化学结构上与大肠杆菌内毒素相似,并显示出革兰氏阴性菌内毒素的生物学活性,但它能否象革兰氏阴性杆菌那样提高机体非特异性抗感染力尚不清楚。本试验结果证实,它和大肠杆菌内毒素一样,能够显著提高小鼠感染伤寒沙门氏菌后的存活率,即提高机体的非特异性抗感染力。试验结果还表明,钩体脂多糖的提高机体非特异性抗感染作用受其剂量的影响,它的作用机制尚需进一步研究。     

经直肠超声引导下穿刺活检在诊断非特异性肉芽肿性前列腺炎中的价值分析

目的:探讨经直肠超声引导下穿刺活检诊断非特异性肉芽肿性前列腺炎(NSGP)的方法和使用价值。方法:回顾分析96例疑有前列腺癌经直肠超声引导下穿刺活检证实的3例NSGP的声像图表现。结果:2例NSGP病灶位于前列腺周缘区,1例为弥漫型,病灶呈低回声,难以同前列腺癌鉴别。结论:经直肠超声引导下前列腺穿刺活检具有准确、安全等优点,是诊断NSGP的有效手段之一。     

膏药刮疗联合摩法治疗非特异性下腰痛

目的:研究膏药刮疗联合摩法治疗非特异性下腰痛的临床疗效。方法:选取2018年1月—2019年1月,符合标准的非特异性下腰痛患者35例,采用铁包金按摩膏刮疗并联合摩法治疗,隔日治疗1次,共治疗10次,所有患者获3个月的随访。分别在疗程开始前、疗程结束后及随访3月后测定患者的疼痛视觉模拟评分(Visual analogy scale,VAS)、健康状况调查简表评分(the medical outcomes study 36-item short-form,SF-36)。末次随访时采用《中医病症诊断疗效标准》中非特异性下腰痛的疗效标准评定综合疗效。结果:患者的VAS评分,疗程开始前为(7.02±0.89)分,疗程结束后为(2.61±0.48)分,随访3月后为(2.55±0.53)分。患者的SF-36评分,疗程开始前为(33.62±7.24)分,疗程结束后为(62.71±3.42)分,随访3月后为(63.95±4.11)分。末次随访时,按疗效标准评定,有效率97.14%。结论:膏药刮疗联合摩法治疗非特异性下腰痛能够有效缓解患者疼痛,改善患者健康状况。     

Effects of smoking on the lung accumulation of [<Superscript>11</Superscript>C]McN5652

Objective The lung is one of the key organs for determining the distribution of drugs in the human body. Various factors influence the accumulation of drugs. In this study, we investigated the effects of smoking on drug distribution to the lung using radiolabeled drugs. Methods We measured the lung uptake of [¹¹C](+)McN5652, a radioligand for serotonin transporter (5-HTT), and inactive enantiomer [¹¹C](−)McN5652 in 19 healthy men (12 nonsmokers and 7 smokers) using positron emission tomography. Pretreatment study was performed by the administration of clomipramine (50 mg), a potent 5-HTT inhibitor. Results The mean lung uptake of [¹¹C](+)McN5652 and [¹¹C](−)McN5652 was significantly higher in smokers than in nonsmokers. The lung uptake of [¹¹C](+)McN5652 decreased after pretreatment with clomipramine, whereas that of [¹¹C](−)McN5652 was not affected by clomipramine. Conclusions Lung uptake of [¹¹C](−)McN5652 was influenced by smoking, possibly because the probable nonspecific binding accumulation was changed as [¹¹C](−)McN5652 was reported to have negligible affinity to 5-HTT. Smoking might be one of the important factors when distribution of radioligands is considered.     

非特异性间质性肺炎患者的高分辨率CT表现及其病理学特点

目的探讨非特异性间质性肺炎（NSIP）的高分辨率CT（HRCT）影像学特点及其病理学改变。方法对9例经开胸肺活组织检查（简称肺活检）证实为NSIP患者的HRCT与病理表现进行回顾性分析。结果9例NSIP患者HRCT主要表现为两侧斑片状磨玻璃影、实变影、伴或不伴不规则线影和牵拉性支气管和细支气管扩张，分布在中、下肺的外周，但未见蜂窝影。HRCT表现为磨玻璃影伴或不伴不规则线影和牵拉性支气管和细支气管扩张的区域，其相应的病理改变为不同程度的炎性细胞浸润和纤维化引起的肺间质增厚，病变时相基本一致；在HRCT表现为实变影的区域，其病理改变表现为间质纤维化病变程度重于间质炎症；也可表现为闭塞性细支气管炎伴机化性肺炎样改变，肺泡腔内泡沫状细胞聚集，镜下可见蜂窝肺内有黏液潴留等病理改变。结论NSIP患者的HRCT表现有一定的特征性；根据病理特点并结合临床资料及HRCT表现可初步诊断为NSIP。     

Nonspecific interstitial pneumonia pattern as pulmonary involvement of rheumatoid arthritis

The pathologic patterns of lung involvement were evaluated in 16 patients with rheumatoid arthritis (RA). They consisted of six females and ten males, with a median age of 67.5 years and diagnosed according to the American Rheumatism Association revised criteria. High-resolution computed tomography (HRCT) of the lungs was performed in all patients, and honeycomb formation was apparent in seven. Histopathologically, seven patients were diagnosed with usual interstitial pneumonia (UIP) pattern, seven with nonspecific interstitial pneumonia/fibrosis (NSIP) pattern, and two with UIP/NSIP hybrid pattern. There were no apparent honeycomb formations on HRCT in patients diagnosed with NSIP pattern. In conclusion, the present study demonstrates that NSIP pattern is also a significant histologic classification of interstitial pneumonia associated with RA.