Objective To explore the diagnosis and treatment of clinical possible organizing pneumonia.Methods The medical records of 31 patients with clinical probable organizing pneumonia were retrospectively analyzed.The clinical presentation,radiographic results and treatment were collected and analyzed.Results Thirty-one patients with non-response to antibiotics were preliminary diagnosed as organizing pneumonia.By percutaneous lung biopsy or transbronchial lung biopsy the tuberculosis,fungi,suppurative inflammation,lung cancer and other diseases were ruled out in 24 patients,and 7 patients were diagnosed by perfect effect of corticosteroids treatment.Twenty-one patients had typical CT findings.All the patients responded rapidly and completely to the administration of corticosteroids.Six patients relapsed after the reduction or stop of corticosteroid in a follow-up time of 6-25 months.Conclusions Non-response to antibiotics,the typical imaging findings and lung biopsy ruling out other diseases are important for diagnosing organizing pneumonia.Rapid response to administration of corticosteroids may be helpful to the diagnosis.Decreasing the dose of corticosteroid too early may cause recurrence of organizing pneumonia.

It is purposed to analyze therapeutic effectiveness at community and designated hospitals for extensive influenza A H1N1 outbreaks at five universities in Qingdao,Shandong,east China during September 1 to 30,2009,including 28 confirmed cases,182 suspected cases and 136 close contacts treated at community health-care facilities,and 56 confirmed cases treated at designated hospitals.There was no significant difference in therapeutic effectiveness between community health-care facilities and designated hospitals (P ＞ 0.05).No new cases occurred seven days after their isolation was lifted for suspected cases and close contacts at community,indicating influenza A H1N1 could be prevented,controlled and cured and its mild cases could be treated at community health-care facilities.

Objective To observe the effect of gheocorticoid by oral medication or intrathoracic iniection on the expression of IL-6,IL-8 and sIL-2R in gerum and pleural fluid in patients of tuberculous pleurisy.Methods Twenty tuberculous pleurisy patients were treated with ghcocortieoid by oral medication (oral group)and 20 cases by intrathoracic injection(injection group).ELISA wag employed to detect the levels of IL-6,IL-8 and sIL-2R in serum and pleural fluid before treatment and 3,6 and 9 days after treatment.Results The levels of serum IL-6 and IL-8 decreased and sIL-2R increased obviously in injection group at 3,6 and 9 days after treatment(P＜0.01).Meanwhile the levels of IL-6 and IL-8 in pleural fluid decreased and sIL-2R increased obviously(P＜0.01).The levels of IL-6 and IL-8 were significantly lower and the levels of aIL-2R were significantly higher in injection group than those in oral group(P＜0.01).One month after treatment,the rate of complete absorpion of pleural fluid was higher in injection group(80%)than thatin oral group(45%),the rate of pachynsis pleurae was lower in injection group(10%)than that in oral group(40%),P＜0.05.Conclusions Intrathoracic injection of ghcocorticoid shows stronger suppression of cellular immune function in cavum pleurae and weaker suppression of the general immune sysmm than oral medication.Intrathoracic injection of glucocorticoid can increase the therapeutic effect and decrease side effect in tuberculous pleurisy.

Objective To study the differential diagnostic value of interferon-γ inducible protein 10 (IP-10),macrophage inflammatory protein-1 α (MIP-1 α) and monocyte chemoattractant-1 (MCP-1) level in the tuberculous,malignant pleural effusion.Methods Enzyme-linked immunosorbent assay was used to detect the level of IP-10,MIP-1 α and MCP-1 in tuberculous pleural fluid (tuberculous pleural fluid group,43 cases) and malignant pleural fluid (malignant pleural fluid group,45 cases).The level of IP-10,MIP-1 α and MCP-1 and the significance were analyzed by ROC curve.Results The level of IP-10,MIP-1 α and MCP-1 were significantly higher in tuberculous pleural fluid group than those in malignant pleural fluid group,and there were significant differences(t =4.931,3.106,2.385 ; P =0.000,0.004,0.041).ROC curve analysis showed that the critical value of IP-10,MIP-1 α and MCP-1 in diagnosis of pleural effusion was respectively 1 589.73,213.50,1 452.63 ng/L.The sensitivity and specificity of IP-10,MIP-1 α and MCP-1 in pleural fluid were 68.8％,81.3％,87.5％ and 87.5％,68.8％,56.3％,respectively.Conclusion The level of IP-10,MIP-1 α and MCP-1 in tuberculous and malignant pleural fluid are significant for the early diagnosis and differential diagnosis.

Objective:To explore the epidemiological characteristics and clinical outcomes of patients diagnosed with novel coronavirus (COVID-19) pneumonia (NCP), and to provide clinical reference for subsequent epidemic prevention and control.Methods:The pathogenesis, clinical characteristics and clinical outcomes of 62 patients with imported novel coronavirus COVID-19 pneumonia in Qingdao area from January 21, 2020 to April 6, 2020 were analyzed.Results:There were 24 males and 38 females, aged from 5 to 91 (52.5±15.7)years. Among them, 31 cases (31/62, 50%) were family cluster disease, 11 cases (17.74%) were nosocomial cross infection, 14 cases (22.58%) came back from Wuhan to Qingdao and community contact infection, and 6 cases (9.68%) were imported from abroad. The longest time from fever to diagnosis was 26 days. Clinical classification: 40 cases were mild, 13 were general, 7 were severe, 2 were critically ill. 61 cases were discharged from hospital, and 1 was dead. The clinical cure rate was 98.39%. The average stay was (18.5±4.8)days. All patients were treated combined with Chinese medicine on the basis of symptomatic treatment.Conclusions:The clinical symptoms of imported NCP are relatively mild, and mild cases were more, the recovery rate was higher. The intervention strategy of traditional Chinese medicine is conducive to rehabilitation. The external input cases and symptomless infected patients are important for epidemic situation in the future.

Objective To examine the 5-year incidence of tuberculosis in different populations with strongly positive tuberculin skin test (TST) receiving preventive administration of isoniazide.Methods A total of 12 598 subjects including 8 896 college students,2 496 migrant workers and 1 206 close contacts with active pulmonary were selected from January to December 2003.Subjects with strongly positive TST but without abnormal lung findings were divided into isoniazide group (given isoniazide for 10 months) and control group (not given any drugs).The incidence of tuberculosis in year 2-5 were observed and compared usingx2 test.Results Among 12 598 subjects,897(7.12％) had strongly positive TST,including 316 college students,388 migrant workers and 193 close contacts,and the TST strongly positive rates were 3.55％ (316/8 896),15.54％ (388/2 496) and 16.00％ (193/1 206),respectively.Migrant workers and close contacts had higher TST positive rates than college students (x2 =483.51 and 344.11,P ＜ 0.01).Among 897 TST-positive individuals,37 were diagnosed as tuberculosis,including 11 college students,12 migrant workers and 14 close contacts,and the tuberculosis rates in three populations were 0.12％ (11/8 896),0.48％ (12/2 496) and 1.16％ (14/1 206),respectively.Migrant workers and close contacts also had higher tuberculosis rates than college students (x2 =12.34 and 42.18,P ＜0.01).In the second follow-up year,9 out of 429 subjects in isoniazide group quit the study due to adverse reactions,and in the rest 420 subjects,9 (2.14％) were diagnosed as tuberculosis.The incidence of tuberculosis in three populations were 1.34％ (2/149),1.60％ (3/188) and 4.82％ (4/83),and no significant difference was found (x2 =2.92,P ＞ 0.05).While in the control group,31 out of 429 (7.23％) individuals were diagnosed as tuberculosis,and the incidence was higher than that in isoniazide group (x2 =12.69,P ＜ 0.01).During the next three follow-up years,23 individuals in isoniazide group drop out of the study,and in the rest 388 subjects,8 (2.06％) were diagnosed as tuberculosis.The incidence of tuberculosis in three populations were 1.41％ (2/142),2.35％ (4/170) and 2.63％ (2/76),and no significant difference was found (x2 =3.11,P ＞ 0.05).While in the control group,17 out of 398 (4.27％) subjects were diagnosed as tuberculosis,and the incidence was not of significant difference compared with that in isoniazide group (x2 =2.47,P ＞ 0.05).Conclusion Migrant workers and close contacts are high risk populations of tuberculosis,and preventive administration of isoniazid for 10 months may reduce the incidence of tuberculosis in the following 2 years.

Objective To analyze the results of screening for tuberculosis (TB) in health examination participants and study the spontaneous occurrence of TB in the subjects with strong positive reaction to tuberculin skin test (TST) in ten years. Method Totally 12 598 health examination participants without past TB history were selected, of whom 8 896 were college students, 2 496 migrant workers and 1 206 had close contacts with active TB patients. They were screened by TST with strong positive reaction. All of subjects with TST strong positive results received chest X-ray examination and sputum acid-fast bacteria detection. The subjects diagnosed to have TB were given regularly anti-tuberculosis drugs treatment and followed up for ten years. The 429 subjects without TB and no isoniazid preventive treatment were chosen to be followed up for ten years and spontaneous occurrence of TB in first three years and the fourth to tenth years respectively, as well as the recurrence of TB for the patients who received anti-tuberculosis regimen were recorded. Result Thirty-seven cases were diagnosed as TB by TST screening, and the total detection rate was 0.29% (37/12 598). Among them 11 were college students (0.12%, 11/8 896), 12 were migrant workers (0.48%, 12/2 496) and 14 were close contacts (1.16%, 14/1 206) respectively. The detection rates were different among the three groups (χ2=31.40, P=0.000). Among 897 strong positive subjects, the strong positive rate was 7.12%(897/12 598), 316 were college students (3.55%, 316/8 896), 388 migrants workers (15.54%, 388/2 496), and 193 close contacts (16.00%, 193/1 206) respectively. There was significant difference in strong positive rate among the three groups (χ2=583.04, P=0.000), and the strong positive rate of college students was lower compared with that of the migrant workers and the close contacts (χ2=483.51 and 344.11, P<0.01). In ten years, 54 subjects were diagnosed as TB in 429 subjects with strong positive reaction to TST, the spontaneous cumulative incidence rate was 12.58% (54/429). Among them, the cumulative morbidity rate was 9.21%(14/152) in college students, 9.58%(18/188) in migrant workers and 24.72%(22/89) in close contacts respectively. The spontaneous morbidity rate of close contacts was higher than that of college students and migrant workers(χ2=10.63 and 11.21, P<0.001); 75 were lost in 398 participants, the dropout rate was 18.84%(75/398). In first three years of follow-up, 31 were diagnosed TB in 429 participants, the cumulative incidence rate was 7.23% (31/429). Of them 9 were college students (5.92%, 9/152), 10 migrant workers (5.32%, 10/188) and 12 close contacts (13.48%, 12/89) respectively (χ2=6.60, P=0.037). In the fourth to tenth years of follow-up, 23 were diagnosed TB in 398 participants, the cumulative incidence rate was 5.78% (23/398), which was not significantly different compared with the cumulative incidence rate of the first three years (χ2=2.50, P=0.37). Tirty-seven patients received standard anti-tuberculosis drug therapy for one year, no one of them had recurrence at ten-year follow-up. Conclusion The migrant workers and close contacts are the high-risk populations for TB. All of them with strong positive response to TST results are susceptible to TB. So regular physical examination is recommended for them and health management should be strengthened.

Objective To explore the relationship between osteoporosis and serum total type Ⅰ amino terminal extension of the peptide,vitamin D3 and smoking index in the patients with chronic obstructive pulmonary disease (COPD).Methods One hundred and fifty patients with COPD (test group) and 150 healthy people (control group) were selected.The total type Ⅰ amino terminal extension of the peptide was measured by electrochemical luminescence,and enzyme-linked immunoassay was adopted to determine the vitamin D3.The 150 patients with COPD were divided into slight group (45 cases),moderate group (52 cases) and severe group (53 cases) according to the severity of COPD.In 150 patients with COPD,120 patients with smoking were divided into 3 groups according to smoking index:A group smoking index ＜ 360,36 cases;B group smoking index 360-400,34 cases;and C group smoking index 401-560,50 cases.The levels of serum total type Ⅰ amino terminal extension of the peptide and vitamin D3 were compared and correlation was analyzed.Results The vitamin D3 and the total type Ⅰ amino terminal extension of the peptide levels in test group were significandy lower than those in control group:(35.37 ± 12.11) mg/L vs.(45.88 ± 12.55) mg/L and (38.16 ± 11.12) mg/L vs.(45.23 ± 12.33) mg/L,and there were statistical differences (t =2.74 and 4.64,P＜ 0.01).The levels of vitamin D3 and the total type Ⅰ amino terminal extension of the peptide in slight,moderate and severe group were decreased in turn,and the levels of total type Ⅰ amino terminal extension of the peptide and the vitamin D3 were positively associated with the severity of COPD (r =0.185 and 0.257,P ＜ 0.05).The levels of vitamin D3 and total type Ⅰ amino terminal extension of the peptide in A,B and C group were decreased in turn,and the levels of total type Ⅰ amino terminal extension of the peptide and the vitamin D3 were positively associated with smoking index (r =0.159 and 0.172,P ＜ 0.05).Conclusion COPD patients are easier to suffer from osteoporosis compared with healthy population,and the serum vitamin D3 and total type Ⅰ amino terminal extension of the peptide can forecast the osteoporosis in COPD patients.

Objective To investigate the effect and underlying mechanism of radioactive 125I seed implantation on the angiogenesis of transplanted human lung adenocarcinoma in nude mice.Methods An animal model of transplantd human lung adenocarcinoma was established by subcutaneous implanting A549 cells into nude mice.Twenty four tumor-bearing nude mice were randomly divided into 4 groups with different irradiation doses of blank control (without any treatment) and 0 MBq,22.2 MBq,29.6 MBq and by embedding radioactive 125I seeds with an 18 G implant needle.Tumor volumes were measured every 4 days until all mice were terminated 30 d later and the tumor growth curve was drawn.The microvessel density (MVD) in the tumor tissue was detected by immunohistochemistry S-P assay.The mRNA and protein levels of VEGF and HIF-1α of each group were detected by RT-PCR and Western blot,respectively.Results After embedding of 125I seeds,the tumor volumes of 22.2 MBq group (886 ± 97) and 29.6 MBq group (590 ± 107) were significantly smaller than those of control group (2 297 ± 149) at 54 d after administration (q =14.117,17.075,P ＜ 0.05),but there were no significant differences among 0 MBq group and control group,22.2 MBq and 29.6 MBq groups (P ＞ 0.05).The immunohistochemical CD34-positive staining demonstrated that MVD in 22.2 MBq group (522 ± 119) and 29.6 MBq group (491 ± 121) were decreased significantly compared with control group (922 ± 260) (q =4.826,5.197,P ＜0.05),but there were no significant differences among 0 MBq and control groups,22.2 MBq and 29.6 MBq groups(P ＞0.05).The mRNA expressions of VEGF and HIF-1α in 22.2 MBq group (0.279±0.0659,0.370 ±0.0857) and 29.6 MBq group (0.215 ±0.0620,0.278 ±0.0651) were significantly lower than those in the control group (q VEGFmRNA =18.881,17.211,q HIF-1αmRNA =15.376,14.733,P ＜0.05),but there were no significant differences among 0 MBq and control groups,22.2 MBq and 29.6 MBq groups(P ＞0.05).At the same time,the expression levels of VEGF and HIF-1α protein after 125I seed implantation were also obviously decreased in 22.2 MBq and 29.6 MBq groups (qvEGr =5.848,6.263,q HIF-1α =6.560,7.576,P ＜ 0.05),and no significant difference between 0 MBq and control groups(P ＞ 0.05) and between 22.2 MBq and 29.6 MBq groups (P ＞ 0.05).Conclusions Interstitial implantation with 125I seeds may potently inhibit angiogenesis in human lung adenocarcinoma xenografts of nude mice.

Objective To investigate the effects of glycosaminoglycans (HGAG) on the immune function of peripheral blood cells from patients with pulmonary tuberculosis.Methods Peripheral blood monouclear cells (PBMC) were isolated from peripheral blood of 40 healthy people (healthy group) and 30 tuberculosis patients (tuberculosis group) and cocultured with HGAG in vitro for 24 hours.Flow cytometry was used to detect the expression of CD45RA and CD45RO,as well as the expression of CD1a and CD83.Results The results showed that the expression of CD45RA and CD45RO in the tuberculosis group was the most significant (P ＜ 0.05) at the concentration of 50 μg/m coculturing with HGAG.The expression of CD45RA and CD45RO were most obvious in the healthy group at the concentration of 10 μg/ml and 50 μg/ml respectively (P ＜0.001).The difference of CD45RA between the two groups was no significant (P ＞0.05),while the difference of CD45RO was statistically significant (P ＜ 0.01) before co-culturing.The expression of CD45RA and CD45RO at 10 μg/ml and 50 μg/ml after co-culturing with HGAG were statistically significant (P ＜ 0.05).There was no statistical difference in CD1a and CD83 in healthy group before and after co-culturing (P ＞ 0.05),while there was statistically difference (P ＜ 0.05) before and after culturing in tuberculosis group.Before co-culturing,there was no significant difference in the expression of CD1a between the healthy group and the tuberculosis group (P ＞ 0.05),but CD83 expression was statistically different (P ＜ 0.001).After co-culturing,there were no significant differences in CD1a and CD83 expression between healthy and healthy groups (P ＞ 0.05).Conclusions HGAG can down-regulate the expression of CD45RA and up-regulate the expression of CD45RO in a certain concentration range,and promote the maturation of dendritic cells (DC) in tuberculosis patients and regulate the cellular immunity of patients with pulmonary tuberculosis in vitro.