Objective: To ascertain the therapeutic effect of honey scallion white paste on umbilicus in the treatment of infant abdominal distension.
Methods: Retrospective cohort study on hospitalized children with abdominal distention. Between January 2012 and December 2021, 3120 cases of hospitalized children with abdominal distention, randomly divided into two groups, control group 1560 cases, adopt Ding Gui umbilical sticking therapy, cooperate to fight infection, digestion, protect the intestinal mucosa, maintaining the normal flora, , phlegm, oxygen, antifebrile, rehydration, anal exhaust, potassium, abdominal massage, foot three mile closed and symptomatic treatment. In the treatment group, 1560 cases were treated with the umbilical application of honey processed scallion white paste, and the treatment was the same as the control group.
Results: Before and after treatment, the clinical performance scores of the two groups were compared, P < 0.05. After treatment, the improvement of syndrome scores of the treatment group was significantly better than that of the control group, treatment was similar in two case and control groups (P < 0.05). The total effective rate of the treatment group was higher than that of the control group (P < 0.05). The average disappearance time of abdominal distension and the average length of hospital stay in the treatment group were significantly shorter than those in the control group (P < 0.05).
Conclusion: The treatment of abdominal distension in children with honey processed onion white paste is effective, and the method has the characteristics of convenient operation and low price, which is worthy of clinical application.
The current study aimed to investigate the clinical efficacy of paclitaxel combined with avastin for non-small cell lung cancer (NSCLC) patients diagnosed with malignant pleural effusion (MPE).Total of 33 patients diagnosed with NSCLC as well as malignant pleural effusion were included. All of them received paclitaxel (175 mg/m2) and avastin (5 mg/kg). Clinical efficacy was evaluated using the total response rate, overall survival, progression-free survival and changes in MPE volume. Adverse events and rates of toxicities were examined as well.The total response rate reached 77% while the overall survival and the median progression-free survival were respectively 22.2 months and 8.4 months. Toxicities of grade 3-4 consisted of neutropenia in 57% of patients, anemia in 17% of them, febrile neutropenia in 11%, as well as anorexia in 7%. No treatment-correlated deaths were found.Paclitaxel combined with avastin decreased MPE volume and increased survival rate of NSCLC patients via inhibiting vascular endothelial growth factor expression.
The concentration assay of pleural effusion interleukin-27 (IL-27) has raised concern for diagnosing tuberculous pleurisy. Compared with malignant pleural effusion (MPE), the concentration of IL-27 in tuberculous pleural effusion (TPE) increased significantly. Accurate differentiating diagnosis is essential for choosing treatment for pleural effusion.The present meta-analysis is aimed at determining the accuracy of IL-27 in the differential diagnosis between TPE and MPE.After having retrieved the published studies, we combined the sensibility (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) of IL-27 in the diagnosis of TPE compared to MPE using a fixed-effect model. The summary receiver operating characteristic curve was applied to estimate the overall test performance.In total, 550 patients (285 patients with TPE and 265 patients with MPE), included in 7 case-control studies, were enrolled. The summary assessments for IL-27 in the diagnosis between TPE and MPE were: SEN 0.93 (95% CI 0.90-0.96), SPE 0.97 (95% CI 0.94-0.98), PLR 25.88 (95% CI 13.84-48.39), NLR 0.07 (95% CI 0.05-0.11), and DOR 333.26 (95% CI 146.10-760.19), respectively. The maximal joint SEN and SPE was 0.95; the area under the curve was 0.99.IL-27 determination is a relatively accurate test for the diagnosis of TPE, which has very high SEN and SPE for discriminating TPE from MPE. The results of IL-27 assays should be interpreted in parallel with clinical findings and the results of conventional tests.
Thoracoscopy is highly sensitive and accurate for detecting pleural effusions. However, most respiratory physicians are not familiar with the use of the more common rigid thoracoscope or the flexible bronchoscope, which is difficult to manipulate within the pleural cavity. The semi-rigid thoracoscope combines the best features of the flexible and rigid instruments. Since the practice with this instrument is limited in China, the diagnostic utility of semi-rigid thoracoscopy (namely medical thoracoscopy) under local anesthesia for undiagnosed exudative pleural effusions was evaluated.In 50 patients with undiagnosed pleural effusions who were studied retrospectively, 23 received routine examinations between July 2004 and June 2005 and the rest 27 patients underwent medical thoracoscopy during July 2005 and June 2006. Routine examinations of the pleural effusions involved biochemistry and cytology, sputum cytology, and thoracentesis. The difference in diagnostic sensitivity, costs related to pleural fluid examination and complications were compared directly between the two groups.Medical thoracoscopy revealed tuberculous pleurisy in 6 patients, adenocarcinoma in 7, squamous-cell carcinoma in 2, metastatic carcinoma in 3, mesothelioma in 2, non-Hodgkin's lymphoma in 1, and others in 4. Only 2 patients could not get definite diagnoses. Diagnostic efficiency of medical thoracoscopy was 93% (25/27). Only 21% patients were diagnosed after routine examinations, including parapneumonic effusion in 2 patients, lung cancer in 2 and undetermined metastatic malignancy in 1. Twelve patients with tuberculous pleurisy were suspected by routine examination. Costs related to pleural effusion testing showed no difference between the two groups (P=0.114). Twenty-three patients in the routine examination group underwent 97 times of thoracentesis. Two pleural infection patients and 2 pneumothorax patients were identified and received antibiotic treatment and drainage. Medical thoracoscopy could be well tolerated by all the patients. The semi-rigid thoracoscope could be easily controlled by chest physicians. The most common complication was transient chest pain (20 of 27 patients) from the indwelling chest tube, which would be managed with conventional analgesics. One case of subcutaneous emphysema and 2 cases of postoperative fever were self-limiting. No severe complications occurred.Medical thoracoscopy is a simple, safe, and cost-effective tool, with a high positive rate. Physicians should extend its access to proper patients if the facilities for medical thoracoscopy are available.
Abstract Background Accurately diagnosing pleural effusion is a frequent and significant problem in clinical practice. Combining pleural biomarkers with patients’ age may be a valuable method for diagnosing TPE. We sought to evaluate the influence of age on diagnostic values of pleural adenosine deaminase (ADA), interferon-gamma (IFN-γ), and interleukin 27 (IL-27) for tuberculous pleural effusion (TPE). Methods Two hundred seventy-four consecutive adult patients with pleural effusion were selected from Beijing and Wuhan between January 1, 2014 and June 30, 2015, and their pleural fluid concentrations of ADA, IFN-γ, and IL-27 were tested. Biomarker performance was analyzed by standard receiver operating characteristic (ROC) curves according to different ages. Results Data from the Beijing cohort showed that ADA, IFN-γ, and IL-27 could all accurately diagnose TPE in young patients (≤ 40 years of age). With a cutoff of 21.4 U/L, the area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ADA for diagnosing TPE were 1.000 (95% confidence interval: 0.884–1.000), 100.0, 100.0%, 100.0, and 100.0, respectively. In older patients (> 40 years of age), IL-27 and IFN-γ were excellent biomarkers for discriminating TPE versus non-TPE cases. With a cutoff of 591.4 ng/L, the AUC, sensitivity, specificity, PPV, and NPV of IL-27 for diagnosing TPE were 0.976 (95% confidence interval: 0.932–0.995), 96.3, 99.0%, 96.3, and 99.0, respectively. Similar diagnostic accuracy among the three pleural biomarkers was validated in the Wuhan cohort. Conclusions Among young patients, ADA is reliable for diagnosing TPE. Conversely, in older patients, IL-27 and IFN-γ are excellent biomarkers to differentiate TPE versus non-TPE cases.
e21059 Background: Biomarkers of combination with immunotherapy therapy remains unknown. To explore prediction of efficacy in patients(pts) with non small cell lung cancer (NSCLC) without driver genes mutations which received Camrelizumab combined with chemotherapy. Methods: From Jan, 2020 to Dec, 2021, 28 pts with NSCLC without driver genes mutations who received Camrelizumab combined with chemotherapy for 4 cycles. According to RECIST1.1, all of these patients were assessed with benefit. IFN, TNF-α, IL (IL-1B、IL-2、IL-4、IL5、IL-6、IL-8、IL-10、IL-12P70、IL-17)in peripheral blood of all pts were measured using flow cytometry. Statistical analyses were performed with SPSS 23.0 software (Pearson’s correlation). Results: Before treatment, the mean values of IFN-α, IFN-γ, TNF-α and IL in pts with partial response (PR) were higher than in pts with stable disease (SD). There was no correlation with age, sex, stage and pathological type of pts ( P > 0.05). There was significant difference of IFN- α, IL-1B, IL-5 and IL-6 increased compared with the level before treatment in 28 pts ( P＜0.05). However, pts with PR compared with pts with SD, There were no significant differences of IFN-α, IFN-γ, TNF-α, IL compared with the level before treatment (P > 0.05). The IFN-α, IL-1B, IL-5, IL-6 Spearman correlation showed that before treatment, there was a correlation between INF-α and IL-5, INF-α and IL-1B, INF- α and IL-6, IL-1B and IL-6, respectively (r = 0.786, P = 0.036 < 0.05; r = 0.889, P = 0.007 < 0.05; r = 0.929, P = 0.003 < 0.05; r = 0.778, P = 0.039 < 0.05). In self-control before and after treatment, there was a correlation between INF-α and IL-1B, INF- α and IL-6, IL-1B and IL-6, respectively (r = 0.880, P = 0.009 ＜05; r = 0.936, P = 0.002＜ 0.05; r = 0.882, P = 0.023＜ 0.05). Conclusions: First-line chemotherapy combined with Camrelizumab in NSCLC without driver genes mutations can effectively improve the levels of IFN-α, IL-1B, IL-5, and IL-6, and the combined detection has certain predictive significance for the efficacy evaluation of patients. Further study is needed.
Abstract Background: Accurately diagnosing pleural effusion is a frequent and significant problem in clinical practice. We sought to evaluate the influence of age on the diagnostic values of pleural adenosine deaminase (ADA), interferon-gamma (IFN-γ), and interleukin 27 (IL-27) for tuberculous pleural effusion (TPE). Methods: Two hundred seventy-four consecutive adult patients with pleural effusion were selected from Beijing (154 patients) and Wuhan (120 patients) during the same period and their pleural fluid concentrations of ADA, IFN-γ, and IL-27 were tested. Biomarker performance was analyzed by standard receiver operating characteristic (ROC) curves according to different ages. Results: Data from the Beijing cohort showed that ADA, IFN-γ, and IL-27 could all accurately diagnose TPE in young patients (≤ 40 years of age). With a cutoff of 21.4 U/L, the area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ADA for diagnosing TPE were 1.000 (95% confidence interval: 0.884–1.000), 100.0%, 100.0%, 100.0, and 100.0, respectively. In older patients (> 40 years of age), IL-27 and IFN-γ were excellent biomarkers for discriminating TPE versus non-TPE cases. With a cutoff of 591.4 ng/L, the AUC, sensitivity, specificity, PPV, and NPV of IL-27 for diagnosing TPE were 0.976 (95% confidence interval: 0.932–0.995), 96.3%, 99.0%, 96.3, and 99.0, respectively. Similar diagnostic accuracy among the three pleural biomarkers was validated in the Wuhan cohort. Conclusions: Among young patients, ADA is reliable for diagnosing TPE. Conversely, in older patients, IL-27 is an excellent biomarker to differentiate TPE versus non-TPE cases.
To investigate the clinical value of pleural fluid adenosine deaminase (ADA) activity in differentiating tuberculous pleural effusions (TPE) from malignant effusions.The serum and pleural adenosine deaminase activity of 91 cases confirmed by pleural biopsy through medical thoracoscopy were retrospectively analyzed. TPE was confirmed in 49 cases and malignant effusion in 42 cases. The optimal cutoff for TPE was determined by using the ROC curve.The mean pleural ADA was significantly (t = 7.383, P < 0.01) higher in PTE (46 +/- 26) U/L as compared to malignancy (16 +/- 8) U/L, so was the pleural fluid/serum ADA ratio (4.1 +/- 4.0 vs 1.76 +/- 1.2, t = 3.852, P < 0.01), but there was no statistically significant difference between malignant and tuberculous effusion in serum ADA activity [(13 +/- 5) U/L vs (12 +/- 6) U/L, t = 1.582, P > 0.05]. The cutoff value of pleural ADA for PTE was 28.7 U/L, with a sensitivity of 75.5% and a specificity of 95.2%.Pleural fluid, but not serum, ADA activity, can be used for the differentiation between tuberculous and malignant pleural effusions.
To investigate the application of Flexirigid thoracoscopy in the diagnosis of pleural effusions with unknown aetiology.Sixty patients (male 36, female 24) with pleural effusions of unknown aetiology, were examined with Flexirigid thoracoscopy from July 2005 to March 2007 in our hospital. Routine examinations of the pleural effusions, including biochemistry and cytology, as well as sputum cytology and bronchoscopy had failed to reach a definite diagnosis.Of the 60 cases, malignancy was confirmed in 32 (53%), tuberculosis in 16 (27%), negative or chronic inflammations in 5 (8%), and parapneumonic effusions in 4 (7%) cases; while in 3 cases (5%), the pleural cavity could not be examined thoroughly because of severe adherence. Pulmonary adenocarcinoma was most common in malignancy. The most common complication was pain of the wounds after operations, which was relieved by symptomatic treatment. There were no complications of pulmonary edema, infection, and delay of extubation.Flexirigid thoracoscopy is a relatively simple, safe, and effective examination for a definite diagnosis of pleural effusion of unknown aetiology.
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