ObjectiveTo compare the accuracy and safety of semirigid thoracoscopy and rigid thoracoscopy in the diagnosis of unexplained pleural effusion. MethodsA prospective randomized study was conducted, in which the patients with unexplained pleural effusion were enrolled consecutively from March 2012 to March 2014 in West China Hospital. The age of the patients ranged from 18 to 75 years. After informed consent, the subjects were randomized to a semirigid thoracoscopy group or a rigid thoracoscopy group to be examined. ResultsForty-nine patients were assigned to the semirigid thoracoscopy group, and 48 patients were assigned to the rigid thoracoscopy group. After thoracoscopy procedure, 44 patients were confirmed as malignant diseases, and 48 patients were confirmed as benign diseases. The overall diagnostic accuracy was 93.9% for the semirigid procedure and 95.8% for the rigid procedure. The diagnostic sensitivity and specificity for malignancy were 96.0% and 100.0% for the semirigid thoracoscopy, and 95.2% and 100.0% for the rigid thoracoscopy, respectively, without statistical significant differences between two groups. All the patients tolerated well with minor complications after two kinds of thoracoscopy. ConclusionsThe diagnostic accuracy of semirigid thoracoscopy and rigid thoracoscopy is comparable in the diagnosis of unexplained pleural diseases. The samples obtained by semirigid thoracoscopy are smaller, but adequate for pathological examination.
ObjectiveTo observe the effects of Th9 cell relative factors, including PU.1, interferon regulatory factor 4 (IRF4) and interleukin 4 (IL-4), in rats with pulmonary fibrosis. MethodsNinety SD rats were randomly divided into 3 groups, ie. a normal group, a pulmonary fibrosis group, and a dexamethasone treatment group, with 30 rats in each group. Ten rats in each group were sacrificed respectively on 7th, 14th, 28th days. Model rats were induced by injecting bleomycin into trachea. Real-time PCR was applied to detect mRNA expression of PU.1 and IRF4 in bronchoalveolar lavage fluid. IL-4 in the peripheral blood was measured by ELISA. ResultsIn the normal group, the lung tissue was normal without inflammatory reaction and fibrosis at any time points. In the pulmonary fibrosis group, at the early stage the lung tissue showed alveolar inflammation with a large number of macrophages and other inflammatory cells infiltratation in the pulmonary interstitial and alveolar cavity; on 14th day, part of the alveolar structure disappeared, inflammatory cells infiltrated slightly, while the alveolar septum was mildly widened and fibroblasts proliferated; on 28th day, alveolar structure was destructed, partial alveolar walls were collapsed, alveolar septuml was significantly widened, extracellular matrix was hyperplastic, a wide range of fibrosis occured. In the dexamethasone treatment group, the alveolar structure exsisted completely, and the inflammatory cell infiltration, widened alveolar septum and fibrosis were significantly lighter than those in the pulmonary fibrosis group. PU.1 mRNA was significantly lower in the pulmonary fibrosis group compared with the normal group. Compared with the pulmonary fibrosis group, PU.1 mRNA were lower on 14th day and 28th day in the dexamethasone treatment group (P < 0.05). PU.1 mRNA increased from 7th day, reached peak on 14th day, and declined on 28th day. IRF4 mRNA was significantly lower in the pulmonary fibrosis group compared with the normal group. Compared with the pulmonary fibrosis group, IRF4 mRNA was lower on 28th day in the dexamethasone treatment group (P < 0.05). There was a positive correlation between the content of IRF4 mRNA and IL-4 on 14th day in the pulmonary fibrosis group (r=0.044, P < 0.05). ConclusionPU.1 and IRF4 play a role in inflammation leading to pulmonary interstitial fibrosis, and IL-4 may regulate Th9 cells through activating IRF4.
ObjectiveTo investigate the therapeutic effects of different doses of tanshinone ⅡA microemulsion on radioactive lung injury. MethodsSeventy-two Wistar rats were randomly divided into a healthy control group,a model group,a liposome microemulsion treatment group,a tanshinone ⅡA microemulsion high-dose group,a tanshinone ⅡA microemulsion middle-dose group,and a tanshinone ⅡA microemulsion low-dose group.Radiation-induced lung injury model was established by irradiation of radiotherapy instrument.In addition to the control group,other groups received 6MV X radiation with one dosage of 22Gy.Four rats in each group were sacrificed on 7th,14th,and 28th day,respectively.Lung tissues were sampled to analyze the pathological changes by HE staining and the Smad7 mRNA expression by RT-PCR.The level of glutathione(GSH)in peripheral blood was determined by ultraviolet spectrophotometric method. ResultsIn the model group and four treatment groups,lung tissue biopsy showed the pathological changes gradually from pulmonary alveolitis to fibrosis.The level of Smad7 mRNA in lung tissue and GSH in peripheral blood were higher in the high-dose group,the middle-dose group and the low-dose group than those in the model group at all time points(P<0.05),and were highest in the high-dose group.There was no significant differences in the level of Smad7 mRNA in lung tissue and GSH in peripheral blood between the liposome microemulsion treatment group and the middle-dose group. ConclusionTanshinone ⅡA microemulsion has treatment effect on lung injury in a dose dependent manner.