ObjectiveTo improve the knowledge of pulmonary actinomycosis.MethodsThree cases of pulmonary actinomycosis in this hospital and 65 cases reported in China were analyzed retrospectively.ResultsAmong the 68 patients 49 were male and 19 were female aged 6 to 77 years old. The most common clinical manifestations were cough, sputum and fever. Inflammatory indicators was slightly elevated. The most common site was on the right upper lung. The typical CT manifestations were the low-density liquefaction necrotic zone in the center of the mass with vacuoles of different sizes, namely, "air-space consolidation". Positron emission computed tomography showed a mild metabolic increase in lesions. The 68 patients were confirmed by surgery, CT guided percutaneous lung puncture or bronchoscopic biopsy. The average time of the diagnosis was 10 months while the longest time was 6.4 years. The rate of first diagnosis was 5.9%. Forty-one cases were treated with antibiotics alone and 12 cases were treated with simple operation, the rest were treated by antibiotics combined with surgical treatment. The cure rate was 88.7%. Although active treatment was conducted 3 patients in this hospital were not cured.ConclusionsThe clinical features of pulmonary actinomycosis are atypical and the misdiagnosis rate is high. When pulmonary actinomycosis is suspected, it should be fully communicated with the microbiologist to ensure the cultivation in anaerobic environment and extension of the incubation cycle. Tissue culture and pathological biopsy should be actively performed. Treatment depends on antibiotics or surgery with good prognosis, but for some cases the prognosis is not optimistic.
Acute pancreatitis (AP) is an acute abdominal disease characterised by inflammation of the pancreas. Acute severe upper abdominal pain is the leading symptom and primary reason for emergence hospital admission of AP patients. Nowadays, more and more research has focused on the cross-talk between the exocrine pancreas and pancreatic projecting neurons (neurogenic inflammation) for pain in AP. Elucidating the molecular mechanisms of neurogenic inflammation for pain in AP will provide insights into targeted analgesics development in this setting.
Objective To investigate the effect of chaiqin chengqi decoction (CQCQD) on serum lipid metabolism in experimental acute pancreatitis. Methods A total of 27 C57BL/6 mice were randomly divided into three groups (n=9 for each group). The mice in the acute pancreatitis model group (AP group) and the acute pancreatitis model + CQCQD treatment group (APQ group) received seven intraperitoneal injections of cerulein (50 µg/kg) at hourly intervals, while the mice in the control group (CON group) received phosphate-buffered saline injections at the same regimen of cerulein. Oral gavage of CQCQD (5.5 g/kg) or same volume of distilled water was commenced 1 h after the first cerulein injection for three times at intervals of 4 h for the APQ group and AP group, respectively. Animals were sacrificed 12 h after the first cerulein / phosphate-buffered saline injection for collecting serum and tissue samples. The levels of serum lipase and amylase, pancreatic histopathology assessment, as well as pancreatic myeloperoxidase activity, were used to assess the severity of acute pancreatitis and the efficacy of CQCQD. Additionally, serum lipid metabolites were analyzed in all groups. Results In comparison to the CON group, the mice in the AP group exhibited significant edema, inflammatory cell infiltration, necrosis of pancreatic tissues, as well as elevated levels of serum amylase, lipase, and pancreatic myeloperoxidase activity (P<0.05); in comparison to the AP group, inflammatory cell infiltration and necrosis of pancreatic tissue, as well as elevated level of serum amylase significantly reduced in the APQ group (P<0.05). A total of 319 lipid molecules were identified in serum, and 13 lipid metabolites were significantly increased in the AP group and successfully decreased in the APQ group, of which 9 were lyso-phosphatidylethanolamine (LPE) molecules involved in the glycerol phospholipid metabolic pathway. Further statistical analysis revealed that six of these LPE molecules could serve as potential biomarkers. Conclusions CQCQD ameliorated pancreatic injury and serum lipid metabolism disorder of acute pancreatitis model induced by cerulein and significantly improved the abnormal increase of serum LPE level. However, the role of LPE in acute pancreatitis and the underlying mechanisms of CQCQD on LPE metabolic pathways still need further study.
ObjectiveTo investigate the effects of generic interleukin (IL)-17A gene knockout (IL-17AKO) on pancreatic and intestinal barrier on acute pancreatitis (AP) in mice. MethodsIL-17AKO mice and their wild type (WT) littermates were employed to induce AP using cerulein (CER) and sodium taurocholate (NaTC). In the CER-AP experiment, mice were randomly divided into three groups: WT control group, WT model group, and IL-17AKO model group (n=5). Mice in the model group were intraperitoneally injected with CER [50 μg/(kg·h), 7 injections], and control group received intraperitoneal injection the same amount of 0.9% NaCl. The mice were sacrificed at 12 hours after the first injection of CER. The levels of serum amylase, lipase and IL-6 were detected, and the pancreas was stained with hematoxylin-eosin (HE). In the NaTC-AP experiment, WT mice were randomly divided into sham group (n=3) and operation model group (n=6). Similarly, IL-17AKO mice were also randomly allocated to sham group (n=3) and operation model group (n=6). The mice in the sham group underwent a surgical procedure on the abdomen only, whereas in the model group, 50 μL 3.5% NaTC dissolved in saline solution was pumped into the pancreatobiliary duct. Serum amylase, lipase, and IL-6 levels were detected. Pancreas was stained with HE, and intestine was stained with Alcian blue-periodic acid-Schiff, Dolichos Biflorus Agglutinin and bacteria fluorescence in situ hybridization. ResultsIn the CER-AP experiment, there were no significant differences in serum amylase, lipase, IL-6, and pathological changes including edema, inflammation, necrosis, and total pathological score of the pancreas between IL-17AKO and WT mice (P>0.05). In the NaTC-AP experiment, compared to the WT model group, IL-17AKO did not significantly impact serum amylase, lipase, and pancreatic pathological changes (P>0.05). However, it did lead to an increased level of IL-6 (P<0.05), and showed no significant protective effect on intestinal injury in NaTC-AP. Compared to WT mice of sham group, IL-17AKO mice of sham group exhibited decreased expressions of glycosylated mucin in ileum and colon, disordered mucus layer structure, and increased bacterial invasion. ConclusionsIL-17AKO has no significant protective effect on pancreatic and intestinal barrier damage in AP mice. Furthermore, it was discovered that prior to modeling, IL-17AKO mice exhibited higher bacterial invasion, intestinal barrier disruption, and a systemic inflammatory response. These findings imply that IL-17A plays a crucial role in immune responses and the maintenance of physiological intestinal barrier function in mice.
For patients with suspected or confirmed coronavirus disease 2019, how to take lavage fluid specimens correctly is the current clinical focus during the epidemic. At the same time, since alveolar lavage is an invasive operation of the airway, it is necessary to follow standard procedures for protection and operation to prevent occupational exposure risks of medical staff. The Department of Intensive Care Unit of West China Hospital of Sichuan University formulated the operation procedure of alveolar lavage for patients with coronavirus disease 2019 based on the original operation procedure of alveolar lavage. This article introduces the indications and contraindications of the operation procedure, preparation before operation, operation procedure and precautions, post-operation processing and operation protection for clinical reference and implementation.