Objective To explore the role of CD4+CD25+ Treg cells in chronic pulmonary infection caused by Pseudomonas aeruginosa(PA).Methods Sixty SD rats were randomly divided into a PA group and a control group(n=30 in each group).Chronic lung infection model was established by implantation of silicone tube precoated with PA into the main bronchus.Twenty-eight days later Treg cells in peripheral blood were measured by fluorescence-activated cell sorting（FACS）.Levels of IL-10 and TGF-β in serum were assayed by ELISA.The expression of Foxp3 mRNA in spleen was measured by RT-PCR.Pathological changes of lung tissue were studed by HE staining.Results Treg/CD4+ T cells in the PA group were significantly more than those in the control group[（19.79±6.45）% vs （5.15±0.47）%，Plt;0.05].The levels of IL-10 and TGF-β were (231.52±54.48)pg/mL and （121.05±7.98）pg/mL in the PA group respectively，which were significantly higher than those in the control group[（35.43±23.56）pg/mL and （36.02±8.94）pg/mL].The expression of Foxp3 mRNA in the PA group was significantly higher compared with the control group(0.80±0.044 vs 0.25±0.054，Plt;0.05）.HE staining revealed that PA caused a intensive inflammatory reaction with lymphocytes infiltration.Conclusion CD4+CD25+ Treg cell is up-regulated and plays an important role in chronic lung infection caused by Pseudomonas aeruginosa.
Objective To compare the diagnostic value of sterile sputumsuction tube with protected specimen brush in mechanically ventilated patients with serious lung infection, and explore the safety and efficacy of bronchofibroscope combining mechanical ventilation in the treatment of severe lung infection.Methods Seventy-four severe lung infection patients with invasive mechanical ventilation support were recruited in the study. Based on the routine treatment, the subjects were randomly divided into a control group received only mechanical ventilation, and a treatment group received sputum aspiration and bronchial lavage by bronchofibroscope combiningmechanical ventilation. Lower respiratory tract secretion was collected to analyze the bacterial etiology with sterile sputum suction tube in the control group, and with protectedspecimen brush in the treatment group. Results The positive rate of sputum suction tube and protected specimen brush was 70. 27% and 75. 68% , respectively, with no statistical difference between the two groups ( P gt; 0. 05) . The PaO2 of the treatment group increased and PaCO2 decreased obviously after sputum aspiration and bronchial lavage by bronchofibroscope ( P lt; 0. 01) . The total effective rate was also highly increased, and the heart rate and respiration were stable in the treatment group. The time of mechanical ventilation and the length of ICU stay were all shortened in the treatment group compared with the control group. Conclusions Sterile sputum suction tube can not only acquire accurate pathogen, but also is a simple and economical method for patients with severe lung infection with mechanical ventilation. Sputum aspiration and bronchial lavage with bronchofibroscope combining mechanical ventilation are effective and safe treatment for patients with severe lung infection.
ObjectiveTo analyze and summarize the clinical characteristics, risk factors, pathogenic bacteria type, and drug tolerance of diabetes complicated with hospital-acquired pulmonary infection, in order to reduce the incidence of hospital-acquired pulmonary infection in patients with diabetes. MethodsThe clinical data of diabetic patients with hospital-acquired pulmonary infection from 2011 to 2013 were taken for retrospective clinical analysis. ResultsA total of 78 diabetic patients had hospital-acquired pulmonary infection among all the 572 hospitalized patients with diabetes. Age, complications of diabetes, chronic underlying disease, duration of hospital stay, glycated hemoglobin and invasive procedures were all correlated with the incidence of hospital-acquired infection (P<0.05). Through sputum culture and throat culture, 59 strains of pathogens were found, and they were mainly multidrug-resistant Gram-negative bacteria, accounting for 71.2%. ConclusionThe rate of acquired pulmonary infection in diabetic patients is particularly high, and the pathogens are mostly Gram-negative and multidrug-resistant. Glycemic control, rational use of antimicrobial drugs, shorter hospital stay, effective prevention and treatment of diabetes complications and chronic underlying diseases, and aseptic techniques can be effective in preventing acquired pulmonary infection for diabetic patients.
ObjectiveTo analyze the incidence of bacterial lung infection after orthotopic liver transplantation and its risk factors. MethodsNinety-six patients with end-stage liver disease who underwent liver transplantation from Jan. 2010 to Jun. 2012 in our hospital were retrospectively analyzed. The relationship of preoperative, intraoperative, and postoperative variables with early postoperative bacterial lung infection was explored by multivariate non-conditional logistic regression. ResultsTwenty-nine cases of 96 cases after liver transplantation occurred early bacterial lung infection, and the infection rate was 30.21%(29/96), in which G-aerobic bacteria infection accounted for 65.52%(19/29), and G+ aerobic bacteria accounted for 34.48%(10/29). Preoperative model for end-stage liver disease score(OR=2.165, P=0.001), intraoperative blood transfusion(OR=1.952, P=0.003), average of plasma creatinine during 3 days after operation(OR=1.913, P=0.001), liquid negative balance time during 3 days after operation(OR=0.916, P=0.023), and postoperative hospital stay(OR=1.923, P=0.003) were all associated with early postoperative bacterial lung infection. ConclusionsRetrograde reperfusion in orthotopic liver transplantation patients are susceptible to bacterial lung infections. Improving basic status before operation, controlling volume of intraoperative blood transfusion, the volume of transfusion, and postoperative hospital stay, and improving renal function can reduce incidence of early postoperative bacterial lung infection.
Objective To explore the application value of metagenomic next-generation sequencing (mNGS) based on human sequencing in the clinical early diagnosis of lung cancer. Methods Four patients hospitalized with suspected lung infection were retrospectively analyzed, and the test results of bronchoalveolar lavage fluid (BALF) on mNGS of tumor metagenome, the routine clinical test results, and their clinical diagnosis and treatment information in between August 26, 2021, and December 18, 2021. Results Patient 1 was preliminarily diagnosed with lung cancer by referring to chest computed tomography (CT) imaging. Chest radiograph or CT in the other three patients showed bilateral lung CT and lamellar hyperintensities (patient 2), bilateral lung mass-like and lamellar hyperintensities (patient 3), and lung masses (patient 4), respectively. BALF samples from all 4 patients were detected with mNGS based on human tumor sequences, indicating tumor. In addition, the result in patient 3 also indicated white pseudofilamentous yeast infection consistent with clinical culture, and the result in patient 4 also showed infection of rhinovirus type A. Conclusion The second generation genome sequencing technology based on human sequence can not only assist clinical diagnosis of infection, but also provide detection datUM support for tumor early warning.