1.Diagnostic value of the combinations of bronchoalveolar lavage fluid galactomannan test and serum galactomannan test in invasive pulmonary aspergillosis.
Lihua LIU ; Jianmei LI ; Haixin DONG ; Luning JIANG ; Hui SONG ; Shuyuan ZHANG ; Yuqin ZHANG
Chinese Critical Care Medicine 2019;31(3):331-335
OBJECTIVE:
To evaluate the accuracy and diagnostic value of bronchoalveolar lavage fluid galactomannan test (BALF-GM) combined with serum GM test on invasive pulmonary aspergillosis (IPA).
METHODS:
190 cases of BALF-GM and 4 787 cases of serum GM specimens suspected of fungal infection in patients admitted to Affiliated Hospital of Jining Medical University from January 2016 to June 2018 were enrolled and analyzed. All patients were classified into clinically confirmed IPA, clinically diagnosed IPA, suspected IPA and excluded IPA according to the classification standard of Expert consensus on diagnosis and treatment of pulmonary mycosis. The coincidence rate of BALF and serum GM test results with clinical diagnosis was analyzed. Receiver operating characteristic (ROC) curve was performed, and the diagnostic value of BALF and serum GM test alone or in combination for IPA was evaluated. Subgroup analysis was performed in patients with normal or abnormal immune function, and the sensitivity and specificity of BALF and serum GM test were compared separately or jointly.
RESULTS:
The positive rate of BALF-GM was 46.8% (89/190), and 10.4% (497/4 787) on serum GM. Among them, 156 patients were both tested on BALF and serum GM. There were 44 cases with both positive in BALF and serum GM, the coincidence rate of clinical definite was 93.2% (41/44). There were 34 cases with positive BALF-GM and negative GM test in serum, and the coincidence rate of clinical definite was 64.7% (22/34). There were 56 cases positive in serum GM and negative in BALF-GM, and the coincidence rate of clinical definite was 48.2% (27/56). BALF and serum GM tests were both negative in 22 cases, and the coincidence rate of exclusion diagnosis was 90.9% (20/22). ROC curve analysis showed that the diagnostic value of BALF-GM test combined with serum GM test for IPA was better than that of BALF-GM test or serum GM test alone [area under ROC curve (AUC): 0.992 vs. 0.983, 0.976]. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 95.3%, 87.0%, 93.2% and 90.9%, respectively. Subgroup analysis showed that among 89 patients with positive BALF-GM test, 85 cases (95.5%) had normal immune function and 4 cases (4.5%) had unknown condition. Among 497 patients with positive serum GM test, 12 cases (2.4%) had normal immune function, 372 cases (74.9%) had abnormal immune function and 113 cases (22.7%) were uncertain. It was shown by ROC curve analysis that the sensitivity of positive BALF-GM test in diagnosis of IPA in patients with normal immune function was higher than that of positive serum GM test (95.6% vs. 88.9%), while the sensitivity of positive serum GM test in patients with abnormal immune function was higher than that of positive BALF-GM test (91.8% vs. 89.9%).
CONCLUSIONS
The results of BALF and serum GM tests are in good agreement with clinical diagnosis, and the combined detection of BALF and serum GM is more valuable for IPA diagnosis than single detection, especially for patients with unknown immune function.
Bronchoalveolar Lavage Fluid/chemistry*
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Galactose/analogs & derivatives*
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Humans
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Invasive Pulmonary Aspergillosis/diagnosis*
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Mannans/blood*
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Sensitivity and Specificity
2.Inhibition effect of epalrestat on rat lens osmotic expansion.
Li-Xia JI ; Ning SHEN ; Cai-Na LI ; Quan LIU ; Yi HUAN ; Zhu-Fang SHEN
Acta Pharmaceutica Sinica 2009;44(10):1107-1111
Epalrestat is the unique aldose reductase inhibitor on the market, which was mainly used for the diabetic neuropathy. Lenses osmotic expansion could be induced by galactose to mimic the pathological process of diabetic cataract in vitro. In present study, we mainly investigated whether epalrestat possesses inhibitory effect on the lens osmotic expansion. The results indicated that epalrestat could not only markedly inhibit rat lens osmotic expansion in vitro, but also significantly reduced the high expression of the osmotic expansion-related genes such as AR and AQP1 in mRNA and protein levels. The findings may provide an important reference to epalrestat in the clinical application for the treatment of diabetic cataract.
Aldehyde Reductase
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antagonists & inhibitors
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biosynthesis
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genetics
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Animals
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Aquaporin 1
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genetics
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metabolism
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Cataract
;
etiology
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metabolism
;
pathology
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Diabetes Mellitus, Experimental
;
complications
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Enzyme Inhibitors
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pharmacology
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Galactose
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antagonists & inhibitors
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Lens, Crystalline
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drug effects
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metabolism
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pathology
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Male
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Osmosis
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drug effects
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RNA, Messenger
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metabolism
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Rats
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Rats, Sprague-Dawley
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Rhodanine
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analogs & derivatives
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pharmacology
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Thiazolidines
;
pharmacology
3.Protective effect of Angelica sinensis polysaccharides on subacute renal damages induced by D-galactose in mice and its mechanism.
Yan-ling FAN ; Jie-yu XIA ; Dao-yong JIA ; Meng-si ZHANG ; Yan-yan ZHANG ; Lu WANG ; Guo-ning HUANG ; Ya-ping WANG
China Journal of Chinese Materia Medica 2015;40(21):4229-4233
To explore the protective effect of Angelica sinensis polysaccharides(ASP) on subacute renal damages induced by D-galactose in mice and its mechanism. Male C57BL/6J mice were randomly divided into 3 groups, with 10 mice in each group. The D-galactose model group was subcutaneously injected with D-galactose (120 mg x kg(-1)), qd x 42; the ASP + D-galactose model group was intraperitoneally injected with ASP since the 8th day of the replication of the D-galactose model, qd x 35; and the normal control group was subcutaneously injected with saline at the same dose and time. On the 2nd day of after the injection, the peripheral blood was collected to measure the content of BUN, Crea, UA, Cys-C; paraffin sections were made to observe the renal histomorphology by HE staining; senescence-associated β-g-alactosidase (SA-β-Gal) stain was used to observe the relative optical density (ROD) in renal tissues; transmission electron microscopy was assayed to observe the renal ultrastructure; the renal tissue homogenate was prepared to measure the content of SOD, GSH-PX, MDA; the content of AGEs and 8-OH-dG were measured by ELISA. According to the result, compared with the D-galactose model group, the ASP + D-galactose model group showed obviously decreases in the content of BUN, Crea, UA, Cysc, AGES, 8-OH-dG, the number of hardening renal corpuscle, renal capsular space and renal tubular lumen, ROD of SA-β-Gal staining positive kidney cells, mesangial cells, basement membrane thickness, podocyte secondary processes fusion and MDA and increases in the number of normal renal corpuscle, ribosome and rough endoplasmic reticulum in podocytes, the activity of SOD and GSH-PX. In Conclusion, A. sinensis polysaccharides can antagonize kidney subacute damages induced by D-galactose in mice. Its protective mechanism may be correlated with the inhibition of the oxidative stress injury.
Angelica sinensis
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chemistry
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Animals
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Deoxyguanosine
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analogs & derivatives
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metabolism
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Drugs, Chinese Herbal
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administration & dosage
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Galactose
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adverse effects
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Humans
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Kidney
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anatomy & histology
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drug effects
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injuries
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Kidney Diseases
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chemically induced
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drug therapy
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metabolism
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prevention & control
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Male
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Mice
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Mice, Inbred C57BL
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Oxidative Stress
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drug effects
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Polysaccharides
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administration & dosage
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Protective Agents
;
administration & dosage
4.Development of a new HPLC technique for analyzing monosaccharide composition and its application in the quality control of Silybum marianum polysaccharide.
Ling-Min TIAN ; Xue-Mei QIU ; Zi-Jing PAN ; You LÜ ; Xing-Bin YANG
Acta Pharmaceutica Sinica 2010;45(4):498-504
A new HPLC-UV technique for the separation and analysis of 10 monosaccharides achieved within 13.5 min using 1-phenyl-3-methyl-5-pyrazolone (PMP) as the labelling molecule of the reductive monosaccharides has been established by combining common high performance liquid chromatography-UV and C18 column. The established technique was applied to the quantification of the monosaccharide components in extract of Silybum marianum. The results showed that the tested 10 monosaccharides as PMP derivatives were baseline separated under the HPLC conditions proposed. It was confirmed that Silybum marianum extract was composed of mannose, rhamnose, glucuronic acid, galacturonic acid, glucose, xylose, galactose and arabinose with the molar ratio of 0.66:0.84:0.58:1.0:1.6:0.69:2.7:4.8. Quantitative recoveries of the compositional monosaccharides separated from the extract were in the range of 92.4%-104.0%, and the RSD values fell within 0.68%-3.81%. The results demonstrated that the proposed HPLC method was simple, rapid, convenient, and precise, and it was applicable to the analysis of the compositional monosaccharides of Silybum marianum extract.
Antipyrine
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analogs & derivatives
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chemistry
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Arabinose
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analysis
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Chromatography, High Pressure Liquid
;
methods
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Galactose
;
analysis
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Glucose
;
analysis
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Glucuronic Acid
;
analysis
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Hexuronic Acids
;
analysis
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Mannose
;
analysis
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Milk Thistle
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chemistry
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Monosaccharides
;
analysis
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Plants, Medicinal
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chemistry
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Polysaccharides
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chemistry
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isolation & purification
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Quality Control
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Rhamnose
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analysis
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Seeds
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chemistry
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Spectrophotometry, Ultraviolet
;
methods
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Xylose
;
analysis