Objective To investigate the effects of caveolin-1 scaffolding domain peptide ( CSD-p)on expressions of extracellular matrix and Smads in human fetal lung fibroblasts. Methods Human fetal lung fibroblasts were cultured in vitro and divided into four groups. A control group: the cells were cultured in DMEMwithout TGF-β1 or CSD-p. A CSD-p treatment group: the cells were cultured in DMEMcontaining 5 μmol /L CSD-p. A TGF-β1 treatment group: the cells were cultured in DMEMcontaining 5 μg/L TGF-β1 .A TGF-β1 + CSD-p treatment group: the cells were cultured in DMEM containing 5 μg/L TGF-β1 and 5 μmol /L CSD-p. Caveolin -1 mRNA was detected by RT-PCR. Caveolin-1, collagen-Ⅰ, α-SMA, p-Smad2,p-Smad3 and Smad7 proteins were measured by Western blot. Results Compared with the control group,the Caveolin -1 mRNA and protein expressions in the cells of TGF-β1 group significantly reduced ( mRNA:0. 404 ±0. 027 vs. 1. 540 ±0. 262; protein: 0. 278 ±0. 054 vs. 1. 279 ±0. 085; P lt; 0. 01) , and the expression levels of collagen-Ⅰ and α-SMA proteins significantly increased ( collagen-Ⅰ: 1. 127 ±0. 078 vs.0. 234 ±0. 048; α-SMA: 1. 028 ±0. 058 vs. 0. 295 ±0. 024) . Meanwhile, the expression levels of p-Smad2 ( 1. 162 ±0. 049 vs. 0. 277 ±0. 014) and p-Smad3 proteins ( 1. 135 ±0. 057 vs. 0. 261 ±0. 046) increased with statistical significance ( P lt; 0. 01) , but the expression level of Smad7 protein significantly reduced( 0. 379 ±0. 004 vs. 1. 249 ±0. 046, P lt;0. 001) . In the CSD-p group, CSD-p had no significant effects on the expressions of above proteins compared with the control group. But in the TGF-β1 +CSD-p group, the overexpressions of collagen-Ⅰ, α-SMA, p-Smad2 and p-Smad3 induced by TGF-β1 were obviously inhibited by CSD-p ( collagen-Ⅰ: 0. 384 ±0. 040 vs. 1. 127 ±0. 078; α-SMA: 0. 471 ±0. 071 vs. 1. 127 ±0. 078;p-Smad2: 0. 618 ±0. 096 vs. 1. 162 ±0. 049; p-Smad3: 0. 461 ±0. 057 vs. 1. 135 ±0. 057; P lt; 0. 01) .Otherwise, the up-regulation of Smad7 ( 0.924 ±0. 065 vs. 0.379 ±0. 004) was found. Conclusions CSD-p can reduce fibroblast collagen-I and α-SMA protein expressions stimulated by TGF-β1 , possibly through regulation of TGF-β1 /Smads signaling pathway. It is suggested that an increase in caveolin -1 function through the use of CSD-p may be an intervention role in pulmonary fibrosis.
Objective To analyze the clinical presentations and radiological characteristics of acute exacerbation of idiopathic pulmonary fibrosis ( IPF) . Methods Clinical and radiological data of 2 patients with acute exacerbation of IPF from April 2006 to July 2008 were retrospectively analyzed and literatures were reviewed. Results Both patients were senior male patients over 60 years old. Dyspnea, cough and inspiratory crackles were the major symptoms and signs. Two patients were experiencing an exacerbation of dyspnea for one week and half of month, respectively. PaO2 /FiO2 of both patients was less than225 mm Hg. In both patients, high-resolution computed tomography ( HRCT) scans at the exacerbation showed typical signs of IPF including peripheral predominant, basal predominant reticular abnormality, with honeycombing and traction bronchiectasis and bronchiolectasis, and newly developing alveolar opacity. HRCT scan showed peripheral area of ground-glass attenuation adjacent to subpleural honeycombing in one patient, and diffusely distributed ground-glass opacity in another patient. Two patients had received corticosteroid treatment. For one patient, the symptoms improved, and ground-glass attenuation adjacent to subpleural honeycombing had almostly resolved. The other patient died of respiratory failure. Conclusions Some acute exacerbation in idiopatic pulmonary fibrosis can be idiopathic. The clinical presentations mainly include the worsening of dyspnea within short time. HRCT generally demonstrates new bilateral ground-glass abnormality with or without areas of consolidation, superimposed on typical changes of IPF.
Objective To analyze the clinical presentations and radiological characteristics of pathologically proved cases of cryptogenic organizing pneumonia(COP).Methods The clinical and radiological features of 8 patients with COP confirmed by open lung biopsy were analyzed.Treatment and follow-up data were also recorded.Results There were 5 male an 3 female patients aged 37 to 68 years.Dyspnea,cough and inspiratory crackles were the most common symptoms and signs.Various computed tomography findings including ground glass opacities,pathy consolidation with air bronchograms,nodules and reticulation were simultaneously observed in the same patient.The diagnostic imaging features of COP were patchy or lobar consolidation,often by a predominantly subpleural distribution,and irregular band-like opacities distributed along the bronchovascular bundle or located in the subpleural area.All patients were treated with corticosteroids and yielded significant improvement in seven cases.Conclusions COP could be diagnosed by clinical and radiological findings and histopathological examination was needed for confirmed diagnosis.In general,COP responds well to glucocorticoid therapy and has a benign prognosis.
ObjectiveTo explore the predictive value of microRNA-215 (miR-215) and microRNA-7-5p (miR-7-5p) expression levels in gastric cancer tissues for recurrence after endoscopic submucosal dissection (ESD) based on restricted cubic spline (RCS). MethodsA total of 200 patients with early gastric cancer who underwent ESD in Yibin Second People’s Hospital from August 2020 to August 2022 were prospectively selected. The patients were followed up for 2 years, and the postoperative recurrence was counted. RCS was used to analyze the predictive value of miR-215 and miR-7-5p expression levels in gastric cancer tissues for recurrence after ESD and the dose-response relationship with recurrence after ESD. Helicobacter pylori (HP) infection, tumor maximum diameter, depth of invasion, carbohydrate antigen 724 (CA724), and neutrophils to lymphocytes ratio (NLR) levels were included to construct a basic nomogram prediction model, and miR-215, miR-7-5p, HP infection, tumor maximum diameter, depth of invasion, CA724, and NLR were included to construct a new nomogram prediction model. The value of the two models in predicting recurrence after ESD was compared. The clinical data of 84 patients with early gastric cancer who underwent ESD in Deyang People’s Hospital from September 2022 to September 2023 were retrospectively collected for external validation. ResultsDuring the follow-up period, 5 of 200 patients with early gastric cancer were lost to follow-up, and 195 patients were included and analyzed. The recurrence rate after ESD was 11.28% (22/195). The expression level of miR-215 in gastric cancer tissues of recurrence group and non-recurrence group [recurrence group: (0.67±0.15) vs. (0.97±0.24); non-recurrence group: (0.84±0.19) vs. (0.98±0.26)], miR-7-5p [recurrence group: (0.45±0.12) vs. (1.59±0.36); non-recurrence group:(0.68±0.20) vs. (1.61±0.37)] were lower than those in adjacent tissues (P<0.05). The expression level of non-recurrence group: (0.68±0.20) vs. (1.61±0.37)] was lower than that of adjacent tissues (P<0.05). The expression levels of miR-215 (OR=0.850, P=0.008) and miR-7-5p (OR=0.798, P=0.005) in gastric cancer tissues were the influencing factors of recurrence after ESD. There was a linear dose-response relationship between the expression levels of miR-215 and miR-7-5p in gastric cancer tissues and the recurrence after ESD (Poverall=0.009, Poverall<0.001; Pnonlinear=0.923, Pnonlinear=0.786). The area under curve (AUC) of the new nomogram prediction model including miR-215, miR-7-5p, HP infection, tumor maximum diameter, depth of invasion, CA724 and NLR for predicting recurrence after ESD was 0.964 [95%CI (0.900, 0.981)], which was greater than 0.857 [95%CI (0.796, 0.892)] of the basic nomogram prediction model, Z=2.158, P=0.032. The new nomogram prediction model has a high degree of calibration in predicting recurrence after ESD, and the clinical effect was good. External validation showed that the AUC of the new nomogram prediction model for predicting recurrence after ESD was 0.945 [95%CI (0.886, 0.978)], and the calibration degree for predicting recurrence after ESD was high and the clinical utility was good. ConclusionsThe expression levels of miR-215 and miR-7-5p in gastric cancer tissues of patients with early gastric cancer are lower than those in adjacent tissues, and there is a linear dose-response relationship with recurrence after ESD. The nomogram prediction model based on the expression levels of miR-215 and miR-7-5p in gastric cancer tissues can provide a reliable clinical basis for clinical prediction of postoperative recurrence.
Objective To explore the key contents of nosocomial infection prevention and control training for medical staff in secondary and above hospitals, so as to provide scientific basis for training in the future. Methods The medical workers who participated in the training of nosocomial infection prevention and control in secondary and above hospitals of 6 prefecture-level cities in Jiangxi province in December 2020 were selected. The same questionnaire was used to test the participants before and after training, and the changes of scores before and after training were compared. Results A total of 73 medical workers were included. After training, the total scores of the questionnaire (14.13±1.95 vs. 11.27±2.76; t=11.053, P<0.001), scores of manual hygiene specifications knowledge unit (4.63±0.65 vs. 4.02±1.37; t=4.215, P<0.001), scores of hospital isolation technical specifications knowledge unit (4.28±1.05 vs. 3.47±1.29; t=4.895, P<0.001), scores of airborne disease hospital infection prevention and control norms knowledge unit (5.21±0.96 vs. 3.76±1.04; t=10.419, P<0.001) and the overall accuracy of the questionnaire (83.00% vs. 66.32%) were higher than those before training. Conclusions After the training, the accuracies of different topics are improved, but there is still room for improvement in each knowledge unit. More effective training strategies should be considered.
ObjectiveTo highlight the characteristics of pulmonary MALT lymphoma with diffuse lung disease.
MethodsThe clinical,radiological and pathological data of two patients with pulmonary MALT lymphoma were analyzed,and relevant literature was reviewed.
ResultsOne patient was a 59-year-old male with cough for five years while antibiotic treatment was ineffective. The chest CT scan demonstrated diffuse lung disease,bilateral multiple consolidation and ground-glass opacities,small nodules and bronchiectasis. Thoracoscopy biopsy was performed and the pathology study confirmed the diagnosis of MALT lymphoma. Another case was a 50-year-old female,who suffered from fever,cough and dyspnea. The chest CT scan revealed bilateral multiple patchy consolidation,with air bronchogram. The eosinophils count in blood was high. Diagnosed initially as eosinophilic pneumonia,she was treated with corticosteroids. The clinical symptoms were improved,but the CT scan revealed no change. After the computed tomography guided percutaneous lung biopsy,pathological examination confirmed the diagnosis of MALT lymphoma.
ConclusionMALT lymphoma with diffuse lung disease is rare and easy to be misdiagnosed. The positive rate of bronchoscopy is low and percutaneous lung biopsy or thoracoscopy biopsy is more useful for diagnosis.
ObjectiveTo analyze the clinical radiographic features and treatment of interstitial lung disease (ILD) inpatients infected with influenza virus. MethodsThe clinical data of ILD patients with influenza in Nanjing Drum Tower Hospital from October 2023 to January 2024 were collected. According to each patient results of influenza nucleic acid detection, they were divided into an influenza infection group and a non-infection group. ResultsA total of 73 patients received influenza nucleic acid detection were enrolled, 23 cases including 5 males and 18 females were positive. Twenty-one cases were infected with influenza A virus, 2 cases were infected with influenza B virus. The median age of influenza positive patients was 64.7±7.8 years. Cough (23 cases, 100.0%), sputum (23 cases, 100.0%), wheezing (20 cases, 87.0%) and fever (17 cases, 73.9%) were the most common symptoms of the patients infected with influenza. Compared with the non-infection patients, fever was more common in the influenza infection group (P<0.05). Laboratory examination indicated that lymphocytopenia were detected in the influenza infection patients. There was no statistical difference in the level of white blood cell count, neutrophil count, lactate dehydrogenase, creatine kinase, erythrocyte sedimentation rate, C-reactive protein, calcitonin, interleukin-6 and oxygenation index. Ground glass opacity in the influenza virus infection group was more common than that in the non-infection group (P<0.05). Ten ILD patients infected with influenza virus (43.5%) were co-infected with Aspergillus. The chest CT type of ILD patients with Aspergillus infection was usual interstitial pneumonia (UIP). Honeycombing was more common than those without Aspergillus infection group (P<0.05). Twenty-two patients (95.7%) received antiviral treatment, of which 20 patients (87.0%) were treated with oseltamivir, 5 patients (21.7%) were treated with mabaloxavir, and 4 patients (17.4%) were treated combined with paramivir. Seventeen patients (73.9%) were previously treated with glucocorticoids, and 16 patients did not adjust the glucocorticoids dosage; 9 patients (39.1%) were previously treated with immunosuppressants, and 2 patients stopped immunosuppressants. Four patients (17.4%) infected with influenza virus developed acute exacerbation of ILD. There was no statistically significant difference in acute exacerbation between the two groups (P>0.05). ConclusionsCompared with ILD patients not infected with influenza, fever, lymphocytopenia and ground-glass opacity are the common clinical and chest CT features of ILD patients infected with influenza. Patients with UIP type combined with honeycomb were prone to be co-infected with Aspergillus infection.