Posterior pedicle screw fixation combined with local steroid injections for treating axial eosinophilic granulomas and atlantoaxial dislocation:A case report

BACKGROUND Eosinophilic granuloma(EG)is a proliferative condition that affects the cells of bone tissue.There are no specific clinical signs or imaging manifestations in the early stages of the disease,making it simple to overlook and misdiagnose.Because of the disease's rarity,there is presently no standardized treatment principle.There are few accounts of such occurrences affecting the axis among children.We discovered a case of a child whose EG resulted in atlantoaxial joint dislocation and destruction of the axial bone.CASE SUMMARY After having pharyngeal discomfort for more than six months without a clear explanation,a 6-year-old boy was brought to our hospital.Following a careful evaluation,the pathology indicated a strong likelihood of an axial EG.Ultimately,we decided to treat the boy with posterior pedicle screw fixation and local steroid injections.CONCLUSION EGs of the upper cervical spine are quite uncommon in children,and they are exceedingly easy to overlook or misdiagnose.Posterior pedicle screw fixation and local steroid injections are effective treatments for patients with axial EGs affecting the atlantoaxial junction.

Persicaria lanigera (Polygonaceae) leaf extract exhibits antiulcerogenic and antiproliferative activities against acetic acid-induced ulcerative colitis and cotton pellet-induced granuloma tissue in rats

Objective:To assess the effect of leaf extract of Persicaria lanigera on cotton pellet-induced granuloma tissue formation and acetic acid-induced ulcerative colitis.Methods:Rats were randomly divided into six groups:normal control,negative control,positive control(dexamethasone or sulfasalazine)as well as Persicaria lanigera(100-600 mg/kg)-treated groups.The effects of the extracts on body weight,antioxidant,and hematological parameters,as well as mast cell proliferation,were assessed.In addition,a histological evaluation was conducted.Results:Persicaria lanigera extract significantly decreased the mean exudate amount and suppressed granuloma tissue formation in a concentration-dependent manner in rats(P<0.05).Additionally,the extract significantly increased body weight,improved hematological profile,reduced the disease activity index score and malondialdehyde level,as well as enhanced catalase and superoxide dismutase activities(P<0.05).Histological evaluation showed Persicaria lanigera extract alleviated acetic acid-induced colonic damages,as evidenced by decreased cell necrosis,edema,and inflammatory cell infiltration.Conclusions:Persicaria lanigera extract possesses antiproliferative,antioxidative,and anti-colitis activities.However,its underlying mechanisms of action need further investigation.

Perifollicular granulomas with Ig G4 plasmacytosis:A case report and review of literature

Perifollicular granuloma is a unique histologic feature and whether it is associated with immunoglobulin G4(IgG 4)-related disease is controversial. We report a case of a 38-year-old man who presented with worsening left eye pain, proptosis, tearing, gritty sensation, blurred vision and multiple lymphadenopathy. An axillary lymph node resection showed reactive follicular and interfollicular lymph node hyperplasia, and increased eosinophils and plasma cells(at least 80% of Ig G+ plasma cells were positive for IgG 4). A distinct feature was the presence of multifocal, perifollicular histiocytic granulomas, which formed a wreath around the entire follicles. The human herpes virus 8 was not detected by immunohistochemistry. In addition, an extensive panel of special stains, immunohistochemistry, and flow cytometry was negative for lymphoma, fungal, or mycobacterial infection. The findings were suggestive of IgG 4-related sclerosing disease-associated lymphadenopathy. Further laboratory testing showed a significant increase of serum immunoglobulin E(> 23000 IU/mL) and slight increase of total Ig G, but normal serum Ig G4. Even though perifollicular granuloma is a nonspecific histopathologic feature and can be seen in other diseases, such as nodular lymphocyte predominant Hodgkin lymphoma, Ig G4-related lymphadenopathy should be listed in the differential diagnoses of benign reactive lymph nodes, especially when perifollicular granuloma and plasmacytosis coexist.

Chronic hepatitis C is a common associated with hepatic granulomas

AIM： To determine the most frequent etiologies of hepatic epithelioid granulomas, and whether there was an association with chronic hepatitis C virus （HCV）. METHODS： Both a retrospective review of the pathol- ogy database of liver biopsies at our institution from 1996 through 2006 as well as data from a prospective study of hepatic fibrosis markers and liver biopsies from 2003 to 2006 were reviewed to identify cases of hepatic epithelioid granulomas. Appropriate charts, liver biopsy slides, and laboratory data were reviewed to determine all possible associations. The diagnosis of HCV was based on a positive HCV RNA. RESULTS： There were 4578 liver biopsies and 36 （0.79%） had at least one epithelioid granuloma. HCV was the most common association. Fourteen patients had HCV, and in nine, there were no concurrent condi- tions known to be associated with hepatic granulomas. Prior interferon therapy and crystalloid substances from illicit intravenous injections did not account for the finding. There were hepatic epithelioid granulomas in 3 of 241 patients （1.24%） with known chronic HCV enrolled in the prospective study of hepatic fibrosis markers. CONCLUSION： Although uncommon, hepatic granu- Iomas may be part of the histological spectrum of chronic HCV. When epithelioid granulomas are found on the liver biopsy of someone with HCV, other clini- cally appropriate studies should be done, but if nothing else is found, the clinician can be comfortable with an HCV association.

Contrast-enhanced multidetector computed tomography features and histogram analysis can differentiate ameloblastomas from central giant cell granulomas

BACKGROUND No qualitative or quantitative analysis of contrast-enhanced computed tomography(CT)images has been reported for the differentiation between ameloblastomas and central giant cell granulomas(CGCGs).AIM To describe differentiating multidetector CT(MDCT)features in CGCGs and ameloblastomas and to compare differences in enhancement of these lesions qualitatively and using histogram analysis.METHODS MDCT of CGCGs and ameloblastomas was retrospectively reviewed to evaluate qualitative imaging descriptors.Histogram analysis was used to compare the extent of enhancement of the soft tissue.Fisher’s exact tests and Mann–Whitney U test were used for statistical analysis(P<0.05).RESULTS Twelve CGCGs and 33 ameloblastomas were reviewed.Ameloblastomas had a predilection for the posterior mandible with none of the CGCGs involving the angle.CGCGs were multilocular(58.3%),with a mixed lytic sclerotic appearance(75%).Soft tissue component was present in 91%of CGCGs,which showed hyperenhancement(compared to surrounding muscles)in 50%of cases,while the remaining showed isoenhancement.Matrix mineralization was present in 83.3%of cases.Ameloblastomas presented as a unilocular(66.7%),lytic(60.6%)masses with solid components present in 81.8%of cases.However,the solid component showed isoenhancement in 63%.No matrix mineralization was present in 69.7%of cases.Quantitatively,the enhancement of soft tissue in CGCG was significantly higher than in ameloblastoma on histogram analysis(P<0.05),with a minimum enhancement of>49.05 HU in the tumour providing 100%sensitivity and 85%specificity in identifying a CGCG.CONCLUSION A multilocular,lytic sclerotic lesion with significant hyperenhancement in soft tissue,which spares the angle of the mandible and has matrix mineralization,should indicate prospective diagnosis of CGCG.

Multi-organ failure with atypical liver granulomas following intravesical Bacillus Calmette-Guerin instillation

Bacillus Calmette-Guerin(BCG) intravesical instillation has been adopted in the treatment of patients with superficial bladder cancer.BCG-induced disseminated infection,though rare,has been associated with the histological finding of epithelioid granulomas in different organs,including the liver.We report the case of an adult patient with multi-organ failure,who developed sepsis,acute respiratory failure and acute hepatic failure with encephalopathy whose liver biopsy confirmed the presence of atypical,granulomatous-like lesions.Recovery was observed only after empirical therapy for Mycobacterium bovis with isoniazid,rifampicin,ethambutol and steroids was introduced.This case highlights the importance of a thorough patient assessment in order to exclude other more common causes of hepatic granulomas and to confirm diagnosis.Histological findings may be non-specific when the liver is involved in BCGinduced disseminated infection.

Establishment of Experimental Model of Hepatic Schistosoma Japonicum Egg Granulomas in Mice

An experimental model of hepatic Schistosoma japonicum egg granuloma was established in C57BL/6 mice sensitized with soluble egg antigen(SEA) by direct injection of vital egg suspension into the spleen. The mice infected with cercariae of Schistosoma japonicum in abdominal skin were used for comparative studies. The results showed that morbidity of hepatic Schistosoma japonicum egg granulomas in the group sensitized with SEA was 100% and that the morphology, cellular constituents, developing process and the diameter and size of the egg granulomas in the group sensitized with SEA were similar to those of the group infected with cercariae. The authors suggest that this experimental model is a useful and appropriate tool for the study on egg granulomas of Schistosoma japonicum.

Bilateral occurrence of sperm granulomas in the left spermatic cord and on the right epididymis:A case report

BACKGROUND Sperm granuloma is a rare disease in clinical andrology and its incidence is still unclear worldwide.According to the existing literature,sperm granuloma often occurs unilaterally.Clinical and ultrasound features are similar to epididymal tuberculosis,chronic epididymitis and other diseases.Sperm granuloma is usually diagnosed based on postoperative histopathological and immunohistochemical examination.CASE SUMMARY A 46-year-old man was admitted to the hospital due to the presence of a left scrotal mass for 3 mo and aggravation of pain for 1 wk.The lesions at both sites were surgically resected.Postoperative pathological examination showed that the left spermatic cord mass and the right epididymal mass were consistent with sperm granuloma.The sperm granulomas then recurred 3 mo after surgery.There is little change in the local mass so far.CONCLUSION The case report is helpful for our understanding of this disease.In clinical diagnosis,it should be distinguished from epididymal tuberculosis,chronic epididymitis and other diseases.Color Doppler ultrasound can be used as a preferred examination method but postoperative pathological examination is still needed for diagnosis.

Foreign body granulomas mimic peritoneal dissemination caused by incarcerated femoral hernia perforation:A case report

BACKGROUND Foreign body granuloma(FBG)is a well-known type of granulomatous formation,and intraabdominal FBG(IFBG)is primarily caused by surgical residues.Multifocal IFBGs caused by gastrointestinal perforation is an extremely rare and interesting clinicopathological condition that resembles peritoneal dissemination.Here,we present a case of IFBGs mimicking peritoneal dissemination caused by bowel perforation and describe the value of intraoperative pathological examinations for rapid IFBG diagnosis.CASE SUMMARY An 86-year-old woman with an incarcerated femoral hernia was admitted to the hospital and underwent operation.During the operation,the incarcerated ileum was perforated during repair due to hemorrhage necrosis,and a small volume of enteric fluid leaked from the perforation.The incarcerated ileum was resected,and the femoral hernia was repaired without mesh.Four months later,a second operation was performed for an umbilical incisional hernia.During the second operation,multiple small,white nodules were observed throughout the abdominal cavity,resembling peritoneal dissemination.The results of peritoneal washing cytology in Douglas’pouch and the examination of frozen nodule sections were compatible with IFBG diagnosis,and incisional hernia repair was performed.CONCLUSION IFBGs can mimic malignancy.Intraoperative pathological examinations and operation history are valuable for the rapid diagnosis to avoid excessive treatments.

Differentiation of periapical granulomas and cysts by using dental MRI: a pilot study

The purpose of this pilot study was to evaluate whether periapical granulomas can be differentiated from periapical cysts in vivo by using dental magnetic resonance imaging(MRI). Prior to apicoectomy, 11 patients with radiographically confirmed periapical lesions underwent dental MRI, including fat-saturated T2-weighted(T2 wFS) images, non-contrast-enhanced T1-weighted images with and without fat saturation(T1 w/T1 wFS), and contrast-enhanced fat-saturated T1-weighted(T1 wFS+C) images. Two independent observers performed structured image analysis of MRI datasets twice. A total of 15 diagnostic MRI criteria were evaluated, and histopathological results(6 granulomas and 5 cysts) were compared with MRI characteristics. Statistical analysis was performed using intraclass correlation coefficient(ICC), Cohen’s kappa(κ), Mann–Whitney U-test and Fisher’s exact test. Lesion identification and consecutive structured image analysis was possible on T2 wFS and T1 wFS+C MRI images. A high reproducibility was shown for MRI measurements of the maximum lesion diameter(intraobserver ICC = 0.996/0.998; interobserver ICC = 0.997), for the "peripheral rim" thickness(intraobserver ICC = 0.988/0.984; interobserver ICC = 0.970), and for all non-quantitative MRI criteria(intraobserver-κ = 0.990/0.995; interobserver-κ = 0.988). In accordance with histopathological results, six MRI criteria allowed for a clear differentiation between cysts and granulomas:(1) outer margin of lesion,(2) texture of "peripheral rim" in T1 wFS+C,(3)texture of "lesion center" in T2 wFS,(4) surrounding tissue involvement in T2 wFS,(5) surrounding tissue involvement in T1 wFS+C and(6) maximum "peripheral rim" thickness(all: P < 0.05). In conclusion, this pilot study indicates that radiation-free dental MRI enables a reliable differentiation between periapical cysts and granulomas in vivo. Thus, MRI may substantially improve treatment strategies and help to avoid unnecessary surgery in apical periodontitis.

玉屏风散对Ⅰ型变态反应模型大鼠血清IL-4、TNF-a及皮肤肥大细胞脱颗粒的影响

目的:探讨玉屏风散对荨麻疹的治疗机制。方法:wister大鼠30只,随机均分为正常组、造模组和给药组。造模组、给药组都采用腹腔注射生理盐水混合液(含卵清蛋白和氢氧化铝)及腹部皮下注射卵清蛋白液建立Ⅰ型变态反应大鼠模型。给药组从首次致敏第6天开始灌胃,给予玉屏风颗粒1.35g/(kg·d),溶于2ml纯净水中灌服,正常组和造模组按2ml/d容积灌服生理盐水,连续7天。末次给药1小时后处死,检测各组大鼠血清中组胺、人白介素4(IL-4)和肿瘤坏死因子a(TNF-a)含量,皮肤肥大细胞脱颗粒情况。结果:与正常组相比,造模组大鼠的血清IL-4、组胺和TNF-a都有明显增加,皮肤肥大细胞脱颗粒百分率提高(P<0.01);与造模组比较,给药组血清组胺、IL-4、TNF-a含量均降低,肥大细胞脱颗粒百分率减少(P<0.05或P<0.01)。结论:玉屏风散能够调节炎症介质释放,从而抑制Ⅰ型变态反应的发生,而IL-4可能是治疗荨麻疹的一个关键基因靶点。

Xanthogranulomatous cholecystitis managed by laparotomy may go through troublesome clinical course: Reflection of severe inflammation

To the Editor: Xanthogranulomatous cholecystitis(XGC) is an uncommon inflammatory disease of the gallbladder, and its incidence is reported to be 1.3%-5.2% [1]. XGC is diagnosed by histopathological examination, characterized by severe inflammatory destruction followed by a granulomatous reaction, marked proliferative fibrosis, and infiltration of inflammatory cells [2].

Unusual clinical presentation of oral pyogenic granuloma with severe alveolar bone loss:A case report and review of literature

BACKGROUND Pyogenic granuloma(PG)is a localized,reddish and vascularized hyperplastic lesion of the connective tissue which occurs in the oral cavity.In most cases,the presence of this lesion does not show alveolar bone resorption.The pathology is diagnosed clinically with some caution.However,the diagnosis and treatment are usually corroborated with histopathological evidence.CASE SUMMARY Three clinical cases of PG associated with bone loss were described in this study.The three patients presented tumor-like growth which bled on touch,and were associated with local irritant factors.Radiographs showed bone loss.All cases were treated with conservative surgical excision.The scarring was satisfactory,and there was no case of recurrence.The diagnoses were based on clinical findings,and were confirmed histopathologically.CONCLUSION The occurrence of oral PG with bone loss is unusual.Therefore,clinical and radiographic evaluations are important for the diagnosis.

Elastic fiber degradation in the development of pediatric granuloma annulare:Report of 39 cases

BACKGROUND Granuloma annulare(GA)has diverse clinical manifestations,multiple subtypes,and unknown etiology and pathogenesis.Existing studies regarding GA in children are scarce.AIM To examine the correlation between clinical manifestation and histopathology of pediatric GA.METHODS A total of 39 patients under 18 years of age with both a clinical and pathological diagnosis of GA at Kunming Children's Hospital from 2017 to 2022 were retrieved.Their medical records were consulted,and clinical data of the children were recorded and summarized,including gender,age,disease site,etc.Existing wax blocks of skin lesion specimens of children and pathological films were retrieved for further study and relevant histology,including hematoxylin-eosin,Alcian blue,elastic fiber(Victoria blue-Lichon red method),and antacid staining.Finally,the children’s clinical manifestations,histopathological results,and special staining characteristics were analyzed.RESULTS The clinical manifestations of granuloma annulare in children were diverse:11 cases presented with a single lesion,25 with multiple lesions,and 3 with generalized lesions.The pathological typing comprised histiocytic infiltration,palisading granuloma,epithelioid nodular,and mixed types in 4,11,9,and 15 cases,respectively.Thirty-nine cases were negative for antacid staining.The positive rate of Alcian blue staining was 92.3%,and that of elastic fiber staining was 100%.The degree of elastic fiber dissolution and granuloma annulare histopathological typing were positively correlated(r=0.432,P<0.05).No correlation was found between clinical presentation and histopathological typing of the granuloma annulare in children.In the pathological diagnosis of granuloma annulare,the positive elastic fiber staining rate was higher than that of Alcian blue staining.A correlation was found between elastic fiber dissolution degree and histopathological staging.However,the differences in pathological staging may have been related to the pathological manifestation of granuloma annulare at different periods.CONCLUSION Elastic fiber degradation may be a critical step in the pathogenesis of pediatric granuloma annulare.This is also one of the first studies focused on granuloma annulare in children.

Generalized granuloma annulare in an infant clinically manifested as papules and atrophic macules:A case report

BACKGROUND Granuloma annulare(GA)has diverse clinical manifestations including papules,plaques,and nodules on the extremities that are skin-colored,pink,or purple.Approximately 15%of all GA cases are considered generalized GA.CASE SUMMARY Herein,we describe the case of a pediatric patient who initially presented with papules and later developed generalized atrophic macules.Upon examination,two different morphologic lesions were histopathologically confirmed:Epithelioid nodular GA and scattered histiocytic infiltrative GA.This patient exhibited rare clinical manifestations that differed throughout the course of the disease.The varying histopathological types and clinical manifestations of GA may be linked to the different stages of the disease.CONCLUSION This rare case demonstrates the different histopathological features of different stages and clinical manifestations of granuloma annulare in an infant.

Renal granuloma misdiagnosed as renal papillary carcinoma: a case report

The imaging appearance of renal granuloma is very similar to that of a renal tumor.Granulomatous lesions usually do not require surgical treatment,while kidney tumors typically necessitate surgical removal.The diagnosis of renal granuloma typically relies on the history of bacillus Calmette-Guérin perfusion and the position of the renal pelvis in the image(malignant tumors usually destroy or compress the surrounding renal pelvis).However,in this case,the patient has no history of bacillus Calmette-Guérin perfusion,making the diagnosis more challenging.The ultrasound and enhanced CT findings were consistent with renal papillary carcinoma.Laparoscopic partial nephrectomy was performed,revealing degeneration and necrosis of the renal cortex and formation of granulomas.The imaging diagnosis of renal granuloma is difficult.Ultrasound-guided biopsy may be a preferable method to avoid unnecessary surgery.

A Giant Granuloma of the Vocal Process after Double-Lumen Bronchial Catheter Insertion: A Rare Case Report and Literature Review

Background: Double-lumen endotracheal (DLT) is commonly used for one-lung ventilation and lung separation during thoracic surgery. There are case reports of medically induced laryngeal granulomas, mainly in patients after single-lumen endotracheal (SLT) tube intubation and tracheotomy, and giant granulomas of the vocal cords due to double-lumen bronchial tube insertion have rarely been reported. Case presentation: A 49-year-old female patient underwent single-port thoracoscopy after DLT intubation as well as a wedge resection of the lower lobe of the left lung, which caused giant vocal process granulomas (VPGs) postoperatively. Based on a retrospective analysis of the general condition, current medical history, past medical history, and visual laryngoscopic observation of the vocal folds tissue, which ruled out preoperative vocal fold granuloma formation, we hypothesized that double-lumen bronchial catheter intubation may have been the primary cause of her vocal fold granuloma formation. Conclusions: Giant granuloma of the vocal folds after DLT insertion is a rare postoperative complication;therefore, if DLT intubation is to be performed, the anesthesiologist should choose an appropriate intubation plan and deal with it promptly to avoid the risk factors to ensure that the patient’s perioperative period is safe and smooth. In addition, if postoperative complications are encountered, they should be followed up and observed on time.

蕈样肉芽肿误诊为寻常型银屑病临床分析

目的探讨蕈样肉芽肿的临床特点及误诊为银屑病原因、防范措施。方法对误诊40年蕈样肉芽肿1例的临床资料进行回顾性分析,并复习相关文献。结果患者主因全身红斑鳞屑40年,躯干红色丘疹伴瘙痒4年就诊。40年前双下肢出现皮疹,逐渐增大为斑块,长期诊断为银屑病,治疗效果差。4年前躯干出现粟粒样丘疹伴瘙痒,外院经病理检查考虑蕈样肉芽肿,后因皮疹反复,更换部位病理检查再次诊断为寻常型银屑病,对症治疗效果差。入院后完善相关检查,明确诊断为蕈样肉芽肿(ⅣB期),调整治疗方案,目前病情稳定。结论蕈样肉芽肿早期临床及病理表现不典型,易误诊。对于非典型的或常规治疗无反应的银屑病患者,特别是在开始使用免疫抑制剂之前,建议进行组织病理及其他特异性检查以明确诊断并排除蕈样肉芽肿,降低误诊率,改善患者预后。

结核性肉芽肿的代谢免疫调控机制研究进展

结核病仍然严重威胁人类健康。结核性肉芽肿是结核病的典型病理特征,也是结核分枝杆菌Mtb逃避宿主免疫杀伤实现长期存活及潜伏感染的“避难所”。结核分枝杆菌还利用肉芽肿促进其在体内扩散和传播,导致疾病迁延不愈,难以根除。肉芽肿环境中的代谢级联反应和免疫细胞产生的相关代谢物在疾病进展和诱导抗结核保护性免疫中发挥关键作用。而Mtb可以通过自身毒力因子,靶向宿主关键代谢通路抵抗免疫防御,实现长期存活并伺机增殖促进肉芽肿进展。本文对结核性肉芽肿中Mtb与宿主相互作用的关键代谢免疫通路及其调控机制展开论述,为后续靶向肉芽肿发病进程开发新的结核病防治策略提供参考。

紫草素调节Nrf2/HO-1信号通路对实验性大鼠肉芽肿性小叶性乳腺炎的治疗作用研究

目的探究紫草素(Shikonin,SHI)通过调节核因子-红细胞2型相关因子2/血红素加氧酶(Nrf2/HO-1)信号通路对肉芽肿性小叶性乳腺炎模型大鼠的影响及作用机制。方法建立肉芽肿性小叶性乳腺炎(GLM)大鼠模型,将大鼠分为对照组(Control组)、模型组(GLM组)、紫草素低剂量组(SHI-L组,17.5 mg·kg^(-1)·d^(-1)SHI)、紫草素中剂量组(SHI-M组,35 mg·kg^(-1)·d^(-1)SHI)、紫草素高剂量组(SHI-H组,70mg·kg^(-1)·d^(-1)SHI)和紫草素高剂量+Nrf2抑制剂ML385组(SHI-H+ML385组,70 mg·kg^(-1)·d^(-1)SHI+14 mg·kg^(-1)·d^(-1)ML385)。HE染色观察乳腺组织病理变化情况;ELISA检测乳腺组织中IL-1β、TNF-α、IL-8、T-AOC、SOD、GSH、MPO、NAGase和ROS水平;免疫荧光检测NLRP3表达;Western blotting检测Nrf2和HO-1蛋白表达。结果与Control组相比,GLM组大鼠乳腺小叶完全被破坏、大片结节样慢性肉芽肿炎性病灶生成,乳腺小叶组织边界不清,腺叶内出现空泡,伴有大量淋巴细胞及中性粒细胞浸润;IL-8、IL-1β、TNF-α、ROS、MPO和NAGase水平、NLRP3阳性表达率显著增加(P<0.05),T-AOC、SOD和GSH水平、Nrf2和HO-1蛋白表达显著降低(P<0.05)。与GLM组相比,SHI-L组、SHI-M组和SHI-H组乳腺组织病变逐渐减轻;IL-8、IL-1β、TNF-α、ROS、MPO和NAGase水平、NLRP3阳性表达率依次降低(P<0.05),T-AOC、SOD和GSH水平、Nrf2和HO-1蛋白表达依次升高(P<0.05)。与SHI-H组相比,SHI-H+ML385组乳腺组织病变加重;IL-8、IL-1β、TNF-α、ROS、MPO和NAGase水平、NLRP3阳性表达率显著增加(P<0.05),T-AOC、SOD和GSH水平、Nrf2和HO-1蛋白表达显著降低(P<0.05)。结论紫草素发挥抗炎抗氧化作用改善大鼠肉芽肿性小叶性乳腺炎,其机制可能与激活Nrf2信号通路,上调HO-1表达有关。