Effect of Elephantopus scaber L.Extract on Acute Pleurisy in Rats

[Objectives]To study the anti-inflammatory effect of Elephantopus scaber L.extract on acute pleurisy induced by carrageenan in rats,and to explore its anti-inflammatory mechanism.[Methods]The active sites of E.scaber L.were extracted by ethanol reflux method.The extracts of different concentrations of E.scaber L.were used as the study object,and dexamethasone was used as the positive control drug.The anti-inflammatory effects of E.scaber L.extracts were studied by measuring the levels of malondialdehyde(MDA),prostaglandin E_(2)(PGE_(2)),tumor necrosis factor(TNF-α),interleukin-1β(IL-1β)in pleural fluid and serum nitric oxide(NO),MDA,PEG_(2),TNF-α,IL-1βin rats with acute pleurisy induced by carrageenan.[Results]E.scaber L.extracts in three doses could reduce the levels of inflammatory factors in pleural fluid and serum,and inhibit acute pleurisy in rats.It was speculated that the anti-inflammatory mechanism was related to the inhibition of the release of inflammatory factors and the antioxidant effect of extracts of three doses of E.scaber L.[Conclusions]This experiment provides a basis for the development and application of E.scaber L.

Epidemiological, Diagnostic, Therapeutic, and Prognostic Profile of Non-Tuberculous Community-Acquired Purulent Pleurisy in Children at the Bouaké University Hospital Center, 2017-2021

Introduction: In Côte d’Ivoire, there is a scarcity of data on children’s purulent pleurisies. Objective: This study aims to elucidate the epidemiological, diagnostic, therapeutic, and evolutionary facets of non-tuberculous purulent pleurisies in pediatric patients. Methods: A retrospective analysis was conducted using the medical records of children aged one month to fifteen years with purulent pleurisies at Bouaké University Hospital Center from January 2017 to December 2021. Results: The study identified 124 cases of purulent pleurisies, constituting 18% of lower respiratory tract infections and 0.8% of all hospitalizations. The majority of these cases (69%) were in children between 1 and 24 months of age. Prominent symptoms included dyspnea (85.5%), O2 saturation below 95% in room air (76.6%), respiratory distress (68.5%), cutaneous-mucosal pallor (63.7%), and fever (43.5%). Radiological findings predominantly showed right-sided pleurisy (62.1%). The pleurisy was often extensive (78.2%), accompanied by pneumothorax (37.1%), alveolo-interstitial opacities (8.1% of cases), and abscess formations (1.6%). Pleural fluid cultures were positive in 46.9% of cases, with Staphylococcus aureus (75%, methi-S) identified among 32 bacteria. Initial antibiotic treatment was empirical, favoring oxacillin (53.2%) or amoxicillin-clavulanic acid (53.2%) in dual (42%) or triple therapy (33%) with gentamicin (64.1%) and/or metronidazole (21.8%). Treatments also included pleural drainage (68.5%) or repeated evacuation punctures (33.1%), and blood transfusion (39%). The mortality rate was 18.8%. Conclusion: Non-tuberculous purulent pleurisy remains a significant concern in pediatric hospitalizations at the CHU of Bouaké, marked by high mortality rates.

Metagenomic next-generation sequencing for pleural effusions induced by viral pleurisy:A case report

BACKGROUND Viral pleurisy is a viral infected disease with exudative pleural effusions.It is one of the causes for pleural effusions.Because of the difficult etiology diagnosis,clinically pleural effusions tend to be misdiagnosed as tuberculous pleurisy or idiopathic pleural effusion.Here,we report a case of pleural effusion secondary to viral pleurisy which is driven by infection with epstein-barr virus.Viral infection was identified by metagenomic next-generation sequencing(mNGS).CASE SUMMARY A 40-year-old male with a history of dermatomyositis,rheumatoid arthritis,and secondary interstitial pneumonia was administered with long-term oral prednisone.He presented with fever and chest pain after exposure to cold,accompanied by generalized sore and weakness,night sweat,occasional cough,and few sputums.The computed tomography scan showed bilateral pleural effusions and atelectasis of the partial right lower lobe was revealed.The pleural fluids were found to be yellow and slightly turbid after pleural catheterization.Thoracoscopy showed fibrous adhesion and auto-pleurodesis.Combining the results in pleural fluid analysis and mNGS,the patient was diagnosed as viral pleuritis.After receiving Aciclovir,the symptoms and signs of the patient were relieved.CONCLUSION Viral infection should be considered in cases of idiopathic pleural effusion unexplained by routine examination.mNGS is helpful for diagnosis.

Genetic Association of Interferon Gamma Induced Protein-10 (IP-10), <i>CXCL-</i>10 Gene Polymorphisms with TB Pleurisy Susceptibility in South Indian Population

CXCL-10 known as Interferon gamma-induced protein 10 (IP-10) or small-inducible cytokine 10 is a 8.7 kDa protein, which is secreted in response to IFN-γ by monocytes, endothelial cells and fi-broblasts. It has chemo-attraction for monocytes/macrophages, T cells, NK cells and dendritic cells in promotion of T cell adhesion to endothelial cells. In the present study, we investigated whether polymorphisms in CXCL-10 gene have any role in the manifestation of Tuberculous (TB) pleurisy. Two SNPs in CXCL-10 promoter region (﹣1447A > G and ﹣135G > A) were genotyped in patients with TB Pleurisy (n = 186), Pulmonary TB patients (n = 159) and healthy controls (n = 205) by PCR-RFLP. Disease associations were statistically analyzed by Fisher exact test. At the ﹣135G > A position, the frequencies of genotype GA and allele G were significantly high in TB pleurisy patients compared to healthy controls. While the frequencies of genotype AA and allele A were significantly low in TB pleurisy patients compared to healthy controls. The frequency of haplotype A-G with the combination of 1447A > G and ﹣135G > A was significantly high in TB pleurisy. Our results reveal that genotype GA and allele G at ﹣135G > A position were strongly associated with susceptibility to tuberculous pleurisy. The GA genotype may be a useful genetic marker for early detection of the disease in high risk individuals.

Evaluation of molecular and immunological methods for diagnosis of tuberculosis pleurisy

Objective:The inefficiency of conventional laboratory methods for diagnosis of Pleural tuberculosis(TBP) and the reliance on pleural biopsy have motivated the evaluation of alternative diagnostic strategies.Our goal was to evaluate different laboratory techniques Ziehl Neelsen,Mantoux skin test,determination of interferon gamma in serum and pleural fluid,polymerase chain reaction and serological study of specific IgG,IgM and IgA beside bacteriological culture by BACTEC 460 TB for rapid and accurate diagnosis of tuberculosis pleurisy. Methods:Patients presented with pleural effusions were subjected to study by ZN,PCR,serological study By specific IgG,IgM and IgA for A60 of tuberculosis compared to culture by BACTEC460 TB.Interferon gamma was determined both in serum and pleural fluid.Results:Mantoux skin test was positive in 19 TBP patients and four patients with exudative pleural effusion.Z.N staining results of pleural biopsy specimens were positive in only 1 of 23 patients(4.3%) in the tuberculous pleural effusion group.PCR was positive in 20 cases of group 1(87%).Serum and pleural fluid interferon had significantly elevated levels(P【0.000 1) in TBP and both measurements had significant correlation in TBP(P【0.000 1).The serum IgA ELISA test was positive in 7/23(30.4%),IgM was positive in 17/23(73.9%) patients and IgG was positive in 16/23(69%) patients.Non of the non TBP had either ZN,PCR or positive serum IgA,IgG,or IgM.When the positive results for IgG and IgM were combined together the serological tests correcdy identified 20/23(87%) of patients. Conclusion:We suggest that in TBP serological diagnosis by combined use of IgG and IgM for A60 antigen with serum determination of interferon gamma can provide rapid and non invasive diagnostic tool that can justify the starting of chemotherapy while awaiting the results of culture.

Effects of tetrandrine on experimental pleurisy in rats

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Treatment of Tuberculous Pleurisy with Effusion by Artificial Pneumothorax

patients were divided into two groups at random. The patients of two groups were all given standard treatments with anti-tuberculous drugs. Treatment group received artificial pneumothorax to help the cure. Results showed that the frequency and quantity of drawing liquid in the treatment group were obviously less than those in the control group and the duration of the complete liquid absorption was shortened markedly in the treatment group and that total effective rate in treatment group (92.5%) was obviously higher than that of the control group (83.33%). We found that the artificial pneumothorax could raise the intra-pleural pressure by 0.20-0.39 kpa, reduce leakage in parietal pleurae and increase the absorption in visceral layer evidently. As it can isolate the two layers of pleurae from one another by the air in thorax, the incidence of pleurae adhesion can be decreased.

Pleurisy in Hemodialysis Patients: Epidemiological and Etiological Aspects at Donka National Hemodialysis Center

Introduction: Pleural effusion being a frequent complication in hemodialysis patients, its etiologies are diverse and the diagnosis is easy, based on clinical and radiological proofs. The main objective of this study was to describe the epidemiological and etiological profiles of pleurisy in hemodialysis patients at the National Hemodialysis Center of Donka National Hospital. Patients and methods: it was a retrospective, descriptive and analytical study that extended over a period of three years from January 1, 2017 to December 31, 2019. It concerned, among hemodialysis patients in the center during the study period, all those who had a confirmed pleurisy on chest x-ray. The variables were epidemiological (based on frequency, sex and age), clinical (based on history of the disease, physical examination looking for a reduction or elimination of vesicular murmur) and paraclinical (mainly radiological). Results: Among 286 patients undergoing hemodialysis in our center, pleural effusion was diagnosed in 35 or 12.24%. The average age of our patients was 52.22 years with ranges of 18 and 78 years. The sex ratio M/F was 2.5. Bilateral pleurisy was found in 51.43% of patients;unilateral right in 40% of cases and unilateral left in 8.57%. We observed 68.57% citrus yellow fluid and 31.43% sero haematic fluid. The bacteriology of the pleural fluid was positive in 62.86% against 37.14% negative. Tumor, tuberculosis and non-specific bacterial etiologies have been encountered. Conclusion: Pleurisy is therefore a frequent complication in hemodialysis patients at Donka National Hemodialysis Center. Etiological research is a major step for better management of these patients. Improving the technical platform of the laboratories should be an important contribution to this stage.

The Level of Expression and Diagnostic Value of Biomarkers in Tuberculous Pleurisy

Objective:Observe and analyze the clinical significance of the differences in the expression levels of sCD163,haptoglobin and cytokines.Methods:120 patients with tuberculous pleural effusion diagnosed in our hospital from January 2019 to December 2021 were randomly selected as the experimental group.On the other hand,40 patients with non-tuberculous pleural effusion admitted in the same period were selected as the control group.The expression levels of sCD163,haptoglobin and cytokines were observed and analyzed.Results:The expression levels of sCD163(μg/mL),haptoglobin(g/L),IL-6(pg/mL)and IL-12(pg/mL)of the control group were 31.26±14.12,32.14±18.79,401.23±24.36 and 1.32±0.14,respectively.As for the experimental group,the expression levels of sCD163(μg/mL),haptoglobin(g/L),IL-6(pg/mL)and IL-12(pg/mL)were 74.12±14.78,113.25±19.45,612.12±36.98 and 4.12±0.56 respectively,and p<0.05 which shows that the data was statistically significant.Conclusion:The level of inflammatory cytokines in the pleural fluid of tuberculous pleural effusion patients are higher,which can be used for the diagnosis of auxiliary tuberculous pleurisy.Tuberculous pleural effusion patients has a significantly increased expression levels of sCD163 and haptoglobin in the pleural fluid.The combination of sCD163 and haptoglobin in the diagnosis of tuberculous pleural effusion has higher clinical diagnostic value,and sCD163 and haptoglobin are not interfered by inflammatory factors in the diagnosis of tuberculous pleural effusion。

Combined detections of interleukin 27, interferon-γ, and adenosine deaminase in pleural effusion for diagnosis of tuberculous pleurisy

Background Previous studies reported interleukin-27 （IL-27）, interferon-y （IFN-γ）, or adenosine deaminase （ADA） alone plays a helpful role in diagnosing tuberculous pleural effusion （TPE）. The present study aims at comparing the diagnostic accuracy of pleural IL-27, IFN-γ, and ADA, and investigate the diagnostic accuracy of the combination of IL-27, IFN-γ, or/ and ADA for differentiating TPE from pleural effusions with the other etiologies. Methods The concentrations of IL-27, IFN-γ and ADA were simultaneously determined in pleural fluids and sera from 40 patients with TPE; 26 with malignant pleural effusion, seven with infectious pleural effusion, and eight with transudative pleural effusion by enzyme linked immunosorbent assay and colorimetric method. The corresponding biochemical indexs were also simultaneously determined. Results The concentrations of pleural IL-27 and IFN-γ in the tuberculous group were significantly higher than those in the malignant, infectious, and transudative groups. The concentrations of ADA in TPE were significantly higher than those in MPE or transudative effusions, while much lower than those in infectious effusions. Among these three biomarkers, IL- 27 was the most effective for TPE diagnosis, with the cut off value of 900.8 ng/L. IL-27 had a high sensitivity of 95% and specificity of 97.6% for differential diagnosis of TPE from non-TPEs. Combinations of IL-27, IFN-γ and ADA measurements further increased the sensitivity or specificity up to 100%. Conclusions Compared to non-TPEs, IL-27, IFN-γ and ADA all simultaneously increased in TPE; and among these three rapid detection methods, IL-27 appeared to be the best for distinguishing tuberculous from non-TPEs, especially from MPE. Combinations of the three markers （IL-27, IFN-γ and ADA） yielded the highest sensitivity and specificity. These findings suggest that the applications of a new biomarker, IL-27, alone or with IFN-γ and ADA, may contribute to more efficient diagnosis strategies in the management of tuberculous pleurisy.

Clinical investigation on diagnostic value of interferon-γ, interleukin-12 and adenosine deaminase isoenzyme for tuberculous pleurisy

The proportion of tuberculous pleurisy among all pleurisy cases is 49.6% andis obviously increasing. However, malignant pleural effusion (29.6% of cases) also accounts for asignificant percentage of pleural diseases. Therefore, tuberculous pleurisy and malignant pleurisyare two main causes for pleural effusion. Because of their quite different prognosis and therapy, itis very important to differentiate them clearly. However, occasionally it is difficult to confirmthe diagnosis. Determination of adenosine deaminase (ADA) in pleural effusion has been confirmed asa useful supplemental diagnostic index for tuberculous pleurisy. However, ADA_2 as a major isoenzymeincreasing in tuberculous pleurisy has not been well investigated in China so far. On the otherhand, interferon- γ (IFN-γ) in tuberculous pleural effusion had been considered as a diagnosticmarker of tuberculous pleurisy. In this study, the concentration of IFN- γ and interlukin-12(IL-12), as well as the activity of ADA and ADA_2 in pleural effusion were measured in order toinvestigate their changes in tuberculous and malignant effusion, and find out the best marker fordiagnosis of tuberculous pleurisy.

Pleural fluid from tuberculous pleurisy inhibits the functions of T cells and the differentiation of Th1 cells via immunosuppressive factors

Immunosuppressive mediators in tuberculosis pleurisy(pleural fluid(PF))are associated with the course of disease,but they remain poorly defined.To study the local immune status of patients with tuberculosis pleurisy,we examined the effect of PF on the functions of T cells and the differentiation of Th1 cells.PF could inhibit the ability of T cells to produce cytokines.However,tumor-necrosis factor(TNF)-a derived from non-T cells was not impaired.Further analysis indicated that cell activation and cell cycle progression were also suppressed.Moreover,PF could inhibit Th1 cell differentiation.Importantly,we found that inhibitors of indoleamine 2,3-dioxygenase(IDO)and adenosine and neutralizing antibodies against IL-10 and transforming growth factor(TGF)-b could reverse cytokine production,suggesting that IDO,adenosine,IL-10 and Transforming growth factor–b1 in PF might take part in impairing T-cell functions.Taken together,our data demonstrate for the first time that several immunopathological factors participate in the downregulation of T-cell functions in local PF.

Diagnostic Value of tb-RNA in Pleural Effusion in Tuberculous Pleurisy

Objective:To explore the diagnostic value of tb-RNA in pleural effusion in tuberculous pleurisy.Methods:60 patients with tuberculous pleurisy treated from March 2018 to September 2019 were selected as the research object,and 60patients with non-tuberculous pleurisy treated at the same time were selected as the control group to analyze the diagnostic consistency of tuberculous pleurisy.Results:Through the consistency analysis of the gold standard and tb-RNA diagnosis,the diagnosis consistency of the two methods was strong.By comparing the tb-RNA level of the two groups,the tb-RNA level of the observation group was significantly higher than that of the control group(P<0.05);Through the analysis of diagnostic efficacy of tb-RNA,the diagnostic sensitivity and specificity of tb-RNA were 58.33%and 97.50%,respectively.Conclusion:tb-RNA detection of pleural effusion has a high positive diagnostic value and short detection cycle,which is of positive significance for the diagnosis of tuberculous pleural effusion.

Lung squamous cell carcinoma combined with tuberculous pleurisy

A58-year old male patient was admitted to our .hospital with repeated coughing, expectoration withblood in the sputum for more than 10 months, bilateral wrists and ankles with pain and afternoon low fever, chest tightness and shortness of breath in the latest one month. The patient had a history of joint pain for more than 3 years without special treatment. He had a smoking history for more than 30 years with 10 cigarettes a day. He had no family tumor history. Physical examination： T 38.5℃, P 100/min, R 22/min, blood pressure （BP） 107/77 mmHg; the double upper fingers visible clubbing, bilateral supraclavicular lymph node not feelable, left inferior pulmonary respiratory sounds disappeared, and wet and dry sounds not heard.

工厂化金针菇菌糠栽培平菇试验

试验以工厂化生产金针菇[Flammulina velutiper(Fr.)Sing]的菌渣为主要原料,采用5种不同的配方栽培平菇(Pleurisies ostreatus)。结果表明,以配方4(金针菇菌糠24%,新鲜棉子壳74%,石灰粉1%,石膏粉1%)栽培平菇的效果最好,平均每袋比对照降低生产成本0.61元,提高经济效益1.21元。

A single administration of fish oil inhibits the acute inflammatory response in rats

Objective: To investigate the antiinflammatory effects of a single administration of fish oil(FO) on the acute inflammatory response. Methods: The paw edema and pleurisy models were used to evaluate the effects of FO dissolved in olive oil(FOP) orally administered in a single dose in rats. Nitric oxide(NO) concentrations in the pleural exudate were performed according to the Griess method and the cytokine concentrations were determined by Luminex bead-based multiplex assay. Results: FOP treatment(30 and 300 mg/kg) significantly reduced paw edema. FOP treatment at 18.75, 37.5, 75.0, 150.0, and 300 mg/kg decreased both the volume of pleural exudate and cellular migration into the pleural cavity and each of these doses presented the same effectiveness. Treatment with FOP(300 mg/kg) reduced NO, TNF-α, IL-1β, and IL-6 concentrations in the pleural exudate. Conclusions: The present data provide evidence that FO has inhibitory effects on the acute inflammatory response when administered in a single dose in rats. This effect might be attributable to a direct inhibitory effect of FO on the production or release of inflammatory mediators that are involved in the pathological processes evaluated herein.

胸腔积液腺苷脱氨酶测定对结核性胸膜炎的诊断价值

目的探讨胸腔积液腺昔脱氨酶(ADA)活性检测对结核性胸膜炎的诊断价值。方法对96例结核性胸腔积液和32例恶性胸腔积液标本进行ADA检测,同时与本人血清ADA活性作比较。结果结核性胸腔积液ADA活性明显增高(48.8±12.8),恶性胸腔积液ADA活性无异常变化(9.23±1.6),两者相比差别有极显著意义(P<0.01),两者血清ADA活性无显著差别(P>0.05)。结核组ADA胸水/血清>1(3.96±2.15),非结核组胸水/血清<1(0.78±0.14),两者相比差别有极显著意义(p<0.01)。结论胸腔积液腺苷脱氨酶测定对结核性胸膜炎具有很高的临床诊断价值。

Prise en Charge des Pleuresies Infectieuses de L’Enfant Dans Trois Hopitaux du Sud du Benin Management of Infectious Pleurisies in Three Hospitals in the South of Benin

Objective: Infectious pleurisy is a frequent hospitalization indication in pediatrics in developing countries. This study aims to describe infectious pleurisies’ features and to identify its death factors in three teaching hospitals in Benin. Design: This was a prospective, descriptive and analytical study including children aged 01 months to 17 years who were hospitalized in pediatrics in the three hospitals for pleurisy from September to December 2019. Results: Among the 3379 children admitted, 25 presented with an infectious pleurisy, making a hospital frequency of 0.74%. The sex ratio was 0.8. The majority (19/25) of the children were less than 5 years old. The mean age was 38 ± 5.88 months. Most of the parents had a low education (42/50) and socio-economic status (18/25). The main symptoms were fever (25 cases), dyspnea (23 cases) and cough (22 cases). The majority of the children (21/25) were up-to-date in regards with the Expanded Immunization Program (EIP) vaccines and none had received non-EIP vaccines. Almost all children (24 cases) had a respiratory distress (24/25). On chest X-ray, there were abundant pleural extravasations in 12 cases. The main pathogens found were Staphylococcus aureus (16 cases), Streptococcus pneumoniae (3 cases) and Streptococcus A (1 case). All children received oxygen and antibiotic therapy;pleural drainage was performed in 22 children. The average length of stay was 14 days ± 6.4. Twenty-one children were healed without sequelae, one child had a post-drainage keloid scar, and two children died. Factors associated with the death of these children were admission delay for more than 7 days (p = 0.035) and presence of respiratory distress (p = 0.049). Conclusion: Pleurisy remains a concern for children admitted in our hospitals and early management is imperative.