Tuberculous pleurisy is a kind of tuberculosis, it is well known that Th1 lymphocytes play a key role in the treatment of tuberculosis infection. However, latest studies show that Th17 lymphocyte may also play an important role tuberculosis infection. There is close relationship between Treg and Thl7 cells, and changes in the number or the function of the two kinds of cells may lead to diseases. The current researches on Thl7 and Treg cells maily focus on autoimmune diseases, however, reports about their role in tuberculosis are limited. In this study, we investigate the function of th17 and Treg cells and the above cytokines in the pathogenesis of tuberculosis pleurisy; by determining the expression of Th17 and Treg cells in peripheral CD4 T cells and the related cytokines in patients with tuberculous compared with healthy people. Th17 cells in patients were higher than that in the Healthy control group, expression of Treg cells in patients were lower than that in the healthy group; IL-17, IL-23 levels in peripheral blood and hydrothorax from the patients were higher than that in the healthy group; IL-17, IL-23 and IL-6 levels in hydrothorax were higher than that in peripheral blood. There was no difference in IL-6 level in peripheral blood between the patients and healthy control; TGF- β level in peripheral blood from the healthy group was higher than that in peripheral blood and hydrothorax from the patients. And there were no differences in TGF- β level between peripheral blood and hydrothorax. Th17 cells were negatively correlated with Treg cells ,but were positive correlation with IL-17, IL-23, IL-6 levels in peripheral blood; TGF- β level was positive correlation with Treg cells in the peripheral blood, but no correlation with Th17 cells. Th17 and Treg cells may be involved in the immune pathological mechanism of tuberculous pleurisy and changes of related cytokines may be involved in the differentiation of Th17 and Treg cells and inflammatory response. Thus, Th17 and Treg cells and related cytokines may be important immunopathogenesis for tuberculous pleurisy.
Objective To described methods and outcomes of a sutureless technique for partial excision of symptomatic overhanging bleb and reported the histopathological findings.Methods A retrospective case series of 10 eyes of 9 patients who underwent trabeculectomy.A sutureless partial excision procedure was offered to 10 eyes with overhanging blebs.Data on age,sex,presenting symptoms,glaucoma types,type of prior filtration surgery,pre-and post-best corrected visual acuity,pre-and post-excision intraocular pressure (IOP),bleb morphology,corneal surface,complications of excision,ultrasonic biomicroscopy images and histopathotogical imaging were collected.The length of follow up ranged from 4 months to 5 years.Data were analyzed using paired t test.Results The length of follow up was (28.8±19.8) months.Before the surgical excision,Ultrasonic biomicroscopy imagings showed that the bleb tissues were tightly attached to the cornea and some parts of the blebs were fluid-filled.Successful excision of the overhanging bleb was achieved for all the cases.There was satisfactory control of IOP and the cornea remained clear.No case of recurrent overhanging bleb was found in the period of follow-up.This surgical technique did not lead to leakage,hypotony,and endophthalmitis during the period of follow up.Histopathological examination showed that the excised tissues mainly consisted of fibrous connective tissue and corneal epithelial tissue embedded with cyst-like structures.Conclusion Sutureless partial excision of the overhanging blebs seems to be a simple and safe means that helps in revising the blebs,relieving discomfort,and ensuing IOP control.
Key words:
Glaucoma; Overhanging filtering blebs; Complications; Ophthalmologic surgical procedures
Abstract Background: Cilia loss and dysfunction is one of the typical pathological features of chronic rhinosinusitis. Tryptophan-aspartic acid (W-D) repeat containing planar cell polarity effector (WDPCP) has been proven to be an essential element for ciliogenesis in human nasal epithelium, but its role in the beating of cilia remains unclear. Cilia beating requires energy from the mitochondria, which is regulated by the MAPK/ERK pathway. In this study, we sought to investigate the role of WDPCP and its underlying mechanism behind the dysfunction in the beating of cilia in chronic rhinosinusitis.Methods: We demonstrated WDPCP expression in the epithelium of nasal polyps. We also investigated the MAPK/ERK pathway in primary human sinonasal epithelial cells to explore the function of WDPCP. The air-liquid interface culture system was used as a model to verify the role of WDPCP and the MAPK/ERK pathway in the beating of cilia.Results: With the dysfunction of cilia beating, we observed a low expression of WDPCP in the epithelium of nasal polyps. Within the in vitro study, we found that WDPCP was critical for mitochondrial biogenesis and mitochondrial function in human sinonasal epithelial cells, possibly due to the activation of the MAPK/ERK pathway. The mitochondrial dysfunction caused by U0126 or lacking WDPCP could be partially recovered by dexamethasone.Conclusion: The low expression of WDPCP in nasal epithelium could affect mitochondria via the MAPK/ERK pathway, which may contribute to the dysfunction in the beating of cilia in chronic rhinosinusitis.
ABSTRACT Objective To assess the prevalence of depression, anxiety, insomnia and somatic symptom disorder (SSD) in chronic rhinosinusitis (CRS) patients who were waiting for surgery and to predict these psychiatric disorders using the 22‐item Sinonasal Outcome Test (SNOT‐22). Design A prospective cross‐sectional study. Setting The rhinology ward at our institution, a tertiary hospital. Participants Adult patients (> 18 years) diagnosed with CRS who were admitted to the rhinology ward for endoscopic sinus surgery and were able to understand and complete the study questionnaires. Main Outcome Measures Patient Health Questionnaire‐9 (PHQ‐9), Generalised Anxiety Disorder‐7 (GAD‐7), Insomnia Severity Index (ISI), Patient Health Questionnaire‐15 (PHQ‐15) and SNOT‐22. Results Of the 159 participants recruited, 58 were at risk of depression (defined by PHQ‐9 > 4, while 25 with PHQ‐9 > 9), 49 were at risk of anxiety (defined by GAD‐7 > 4, while 25 with GAD‐7 > 9), 81 were at risk of insomnia (defined by ISI > 7, while 51 with ISI > 14) and 69 were at risk of SSD (defined by PHQ‐15 > 4, while 24 with PHQ‐15 > 9). The SNOT‐22 score was closely correlated with the scores of psychometric tests and was an independent predictor of these psychiatric disorders. Patients with a high SNOT‐22 score (> 30) are likely to be affected by comorbid psychiatric disorders and should be further evaluated by otolaryngologists. Conclusion Depression, anxiety, insomnia and SSD are prevalent in CRS patients. Otolaryngologists should have a low threshold to ask the patient about psychiatric symptoms, especially for patients with an SNOT‐22 score > 30.
To observe the effect of hydrogen sulfide on Bsep and Mdr2 in acute liver failure induced by thioacetamide.Twenty-four male SD rats were randomly divided into thioacetamide (TAA) induced model group (n=6), control group (n=6), TAA+sodium hydrosulfide group (n=6), and TAA+ propargylglycine group (n=6). TAA was given to enterocoelia at the dose of 600 mg/kg for the model group, sodium hydrosulfide group and propargylglycine group rats.Sodium hydrosulfide with the dose of 0.15 mmol/kg and propargylglycine of 30 mg/kg was injected into enterocoelia one hour before the TAA used. All rats were sacrificed and serum specimen was collected to test hydrogen sulfide and hepatic function. The method of Western blot and Immunohistochemistry were used to measure the expression of Bsep and Mdr2 in the liver.The Liver function of TAA group rats was severely injured [ALT(524.0±32.0) vs (28.3±8.4) U/L]. It was worsen by application of sodium hydrosulfide [ALT(861.9±55.1) U/L] while recovered [ALT(59.5±10.2) U/L)] by propargylglycine. The level of bilirubin and bile acid was significantly higher in the TAA group rats than in the normal control group, and the application of sodium hydrosulfide caused bile acids increased further besides of bilirubin. On the contrary, the levels of bile acids and bilirubin were significantly decreased with PPG application. The level of hydrogen sulfide in the serum of the TAA group rats was higher than normal group rats'. That was elevated by sodium hydrosulfide and decreased by propargylglycine.Severely edema, necrosis and inflammatory cell infiltration were observed in TAA group rats, which worse by sodium hydrosulfide and released by propargylglycine. The expression of Bsep and Mdr2 down regulated in TAA and deteriorated by sodium hydrosulfide application and relieved by propargylglycine application.Hydrogen sulfide exacerbated the Bsep and Mdr2 loss in the liver failure and contributed to high serum concentration of bile acids.
Objective To assess the prevalence of depression, anxiety, insomnia, and somatic symptom disorder (SSD) in patients with benign and malignant sinonasal tumors. Materials and methods Pretreatment patients with sinonasal tumors were prospectively recruited on the rhinology ward of a tertiary hospital from July 2021 to March 2022. The electronic questionnaire which contains the rhinological symptom scale, the 22-item Sinonasal Outcome Test (SNOT-22) Scale, the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Insomnia Severity Index (ISI), and the Patient Health Questionnaire-15 (PHQ-15) was filled out by patients at admission. The associations between the scores of symptom/SNOT-22 and psychometric tests were assessed by the Pearson correlation coefficient ( r ) and simple linear regression. The receiver operating characteristic (ROC) analysis was used to evaluate the performance of the SNOT-22 score in predicting psychiatric disorders. Results Thirteen patients with benign sinonasal tumors and 15 patients with malignant sinonasal tumors were recruited. The benign and malignant groups did not differ significantly regarding symptomatology and mental wellbeing. Of the total patients, 9 were at risk of depression (PHQ-9 > 4), 10 were at risk of anxiety (GAD-7 > 4), 11 were at risk of insomnia (ISI > 7), and 11 were at risk of SSD (PHQ-15 > 4). The overall symptom, facial pain/pressure, postnasal drip, and SNOT-22 scores were positively associated with scores of psychometric tests. Patients with a high SNOT-22 score (>18) are likely to be affected by comorbid psychiatric disorders. When interpreting the results of this study, it should be noted that screening tools, not diagnostic tools, were used to identify psychiatric risk. Conclusion Depression, anxiety, insomnia, and SSD are prevalent in patients with sinonasal tumors. Otolaryngologists should have a low threshold to ask the patient about psychiatric symptoms, especially for patients with an SNOT-22 score > 18.
Objective To investigate the relationship among antigangliosides antibody (anti GS Ab)and metabolism,immunity in diabetic polyneuropathy (DPN).Methods The subjects were divided into three groups:diabetes with non peripheral neuropathy (DM group),DPN group and healthy controls (N group),each group having 30 individuals.The anti GS Ab was detected by solid enzyme immunoassay.Glycosylated hemoglobin(HbA1c),interleukin 1 (IL 1),tumor necrosis factor (TNF α),NO and the speed of nervous conduction were determined accordingly.Results The positive results of anti GS IgM Ab and anti GS IgG Ab were respectively 46 47% and 20% of the DPN group,which were much higher than those of N and DM groups.The anti GS Ab results of DPN group were also seen a significant positive correlation with DPNC,IL 1,TNF α,HbA 1C and NO,but negatively correlated with SOD.The multiple regression analysis showed that the influencing factors of anti GS Ab were DPNC,and IL 1β sequentially,while the significant influencing factors of HbA1c were IL 1β,anti GS Ab,TNF α,and NO sequentially.But TNF α has only one influencing factor of HbA1c.Conclusion The presence of metabolic disturbance,failure of secretion of cell gene factors and impairment of removal of free radicals in DPN might greatly influence the level of anti GS Ab,suggesting that anti GS Ab may serve as an index to the autoimmunity of DPN patients,and be clinically valuable in the diagnosis of DPN.
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