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.

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.

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.