Humans ; Asthma/diagnosis* ; HMGB1 Protein

Tuberculous meningitis (TBM) is one of the most serious and lethal diseases in neurology. The early diagnosis and treatment of TBM still faces severe challenges. Acid-fast staining of cerebrospinal fluid and culture of Mycobacteriumtuberculosis are the "gold standard" for the diagnosis of TBM, but lack sensitivity. With the application of metagenomic next-generation sequencing technology, significant advances have been made in the early diagnosis of TBM. The optimal treatment regimen for TBM remains to be further explored and studied. This article intends to provide an overview of the pathogenesis, pathology, clinical manifestations, diagnosis and treatment advancement of TBM, and provide guidance for clinical practice.

Chronic obstructive pulmonary disease (COPD) has become the third-leading cause of death worldwide, which is a severe economic burden to the healthcare system. Chronic bronchitis is the most common condition that contributes to COPD, both locally and systemically. Neutrophilic inflammation predominates in the COPD airway wall and lumen. Logically, repression of neutrophilia is an essential fashion to COPD treatment. However, currently available anti-neutrophilic therapies provide little benefit in COPD patients and may have serious side effects. Thus, there is an urgent need to explore an effective and safe anti-neutrophilic approach that might delay progression of the disease. Sialic acid-binding immunoglobulin-like lectin (Siglec)-9 is a member of the Siglec cell surface immunoglobulin family. It is noteworthy that Siglec-9 is highly expressed on human neutrophils and monocytes. Ligation of Siglec-9 by chemical compounds or synthetic ligands induced apoptosis and autophagic-like cell death in human neutrophils. Furthermore, administration of antibody to Siglec-E, mouse functional ortholog of Siglec-9, restrained recruitment and activation of neutrophils in mouse models of airway inflammation in vivo. Given the critical role that neutrophils play in chronic bronchitis and emphysema, targeting Siglec-9 could be beneficial for the treatment of COPD, asthma, fibrosis, and related chronic inflammatory lung diseases.
Animals ; Asthma ; Humans ; Lung ; Mice ; N-Acetylneuraminic Acid ; Neutrophils ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Sialic Acid Binding Immunoglobulin-like Lectins

Artificial Intelligence ; Humans ; Pulmonary Disease, Chronic Obstructive/diagnosis*

Chronic obstructive pulmonary disease (COPD), characterized by persistent and not fully reversible airflow restrictions, is currently one of the most widespread chronic lung diseases in the world. The most common symptoms of COPD are cough, expectoration, and exertional dyspnea. Although various strategies have been developed during the last few decades, current medical treatment for COPD only focuses on the relief of symptoms, and the reversal of lung function deterioration and improvement in patient's quality of life are very limited. Consequently, development of novel effective therapeutic strategies for COPD is urgently needed. Stem cells were known to differentiate into a variety of cell types and used to regenerate lung parenchyma and airway structures. Stem cell therapy is a promising therapeutic strategy that has the potential to restore the lung function and improve the quality of life in patients with COPD. This review summarizes the current state of knowledge regarding the clinical research on the treatment of COPD with mesenchymal stem cells (MSCs) and aims to update the understanding of the role of MSCs in COPD treatment, which may be helpful for developing effective therapeutic strategies in clinical settings.
Humans ; Lung ; Mesenchymal Stem Cells ; Pulmonary Disease, Chronic Obstructive/therapy* ; Quality of Life ; Stem Cell Transplantation

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common public health problem worldwide. Recent studies have reported that socioeconomic status (SES) is related to the incidence of COPD. This study aimed to investigate the association between SES and COPD among adults in Jiangsu province, China, and to determine the possible direct and indirect effects of SES on the morbidity of COPD. METHODS: A cross-sectional study was conducted among adults aged 40 years and above between May and December of 2015 in Jiangsu province, China. Participants were selected using a multistage sampling approach. COPD, the outcome variable, was diagnosed by physicians based on spirometry, respiratory symptoms, and risk factors. Education, occupation, and monthly family average income (FAI) were used to separately indicate SES as the explanatory variable. Mixed-effects logistic regression models were introduced to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for examining the SES-COPD relationship. A pathway analysis was conducted to further explore the pulmonary function impairment of patients with different SES. RESULTS: The mean age of the 2421 participants was 56.63 ± 9.62 years. The prevalence of COPD was 11.8% (95% CI: 10.5%-13.1%) among the overall sample population. After adjustment for age, gender, residence, outdoor and indoor air pollution, body weight status, cigarette smoking, and potential study area-level clustering effects, educational attainment was negatively associated with COPD prevalence in men; white collars were at lower risk (OR: 0.60, 95% CI: 0.43-0.83) of experiencing COPD than blue collars; compared with those within the lower FAI subgroup, participants in the upper (OR: 0.68, 95% CI: 0.49-0.97) tertiles were less likely to experience COPD. Such negative associations between all these three SES indicators and COPD were significant among men only. Education, FAI, and occupation had direct or indirect effects on pulmonary function including post-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC), FEV1, FVC, and FEV1 percentage of predicted. Education, FAI, and occupation had indirect effects on pulmonary function indices of all participants mainly through smoking status, indoor air pollution, and outdoor air pollution. We also found that occupation could affect post-bronchodilator FEV1/FVC through body mass index. CONCLUSIONS Education, occupation, and FAI had an adverse relationship with COPD prevalence in Jiangsu province, China. SES has both direct and indirect associations with pulmonary function impairment. SES is of great significance for COPD morbidity. It is important that population-based COPD prevention strategies should be tailored for people with different SES.
Adult ; Aged ; China/epidemiology* ; Cross-Sectional Studies ; Forced Expiratory Volume ; Humans ; Male ; Middle Aged ; Prevalence ; Pulmonary Disease, Chronic Obstructive/epidemiology* ; Risk Factors ; Social Class ; Spirometry ; Vital Capacity

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease characteristic of small airway inflammation, obstruction, and emphysema. It is well known that spirometry alone cannot differentiate each separate component. Computed tomography (CT) is widely used to determine the extent of emphysema and small airway involvement in COPD. Compared with the pulmonary function test, small airway CT phenotypes can accurately reflect disease severity in patients with COPD, which is conducive to improving the prognosis of this disease. CT measurement of central airway morphology has been applied in clinical, epidemiologic, and genetic investigations as an inference of the presence and severity of small airway disease. This review will focus on presenting the current knowledge and methodologies in chest CT that aid in identifying discrete COPD phenotypes.
Airway Obstruction ; Humans ; Phenotype ; Pulmonary Disease, Chronic Obstructive/diagnostic imaging* ; Pulmonary Emphysema/diagnostic imaging* ; Tomography, X-Ray Computed

Respiratory viruses are major human pathogens that cause approximately 200 million pneumonia cases annually and induce various comorbidities with chronic obstructive pulmonary disease (COPD), resulting in significant health concerns and economic burdens. Clinical manifestations in respiratory viral infections and inflammations vary from asymptomatic, mild, to severe, depending on host immune cell responses to pathogens and interactions with airway epithelia. We critically review the activation, effector, and regulation of T cells in respiratory virus infections and chronic inflammations associated with COPD. Crosstalk among T cells, innate immune cells, and airway epithelial cells is discussed as essential parts of pathogenesis and protection in viral infections and COPD. We emphasize the specificity of peptide antigens and the functional heterogeneity of conventional CD4 + and CD8 + T cells to shed some light on potential cellular and molecular candidates for the future development of therapeutics and intervention against respiratory viral infections and inflammations.

Objective To investigate the clinical features,diagnosis,treatment and prognosis of Dementia with Lewy Body (DLB) in order to improve doctors' understanding and experience.Methods Thirteen cases of clinicall diagnosed DLB were analyzed.The clinical manifestations,neurological examination,laboratory tests,treatment and prognosis were analyzed.Results All of 13 patients had fluctuating dementia.Among them,11 were diagnosed with probable DLB,and 2 were diagnosed with possible DLB.There were 8 cases (8/13) with volatility cognitive impairment,8 cases (8/13) with Parkinson's syndrome,8 casess (8/13) with visual hallucinations,13 cases (13/13) with memory loss,4 patients with limb tremor (4/13),5 cases with delirium (5/13),3 cases with increased sleep (3/ 13),1 case with silence (1/13),9 cases with anxiety and depression (9/13),one case with dizziness (1/13),6 cases with abnormal dysplasia (6/13),and one case with abnormal sensitive to diazepam (1/13).The cognitive function fluctuated,the condition deteriorated and two patients died during the follow-up from 6 months and 5 years.Conclusions Lewy body dementia is an irreversible and progressive neurodegenerative disease.Comprehensive understanding of its clinical features is helpful for the early diagnosis and treatment,which may in turn improve the prognosis.

Objective To evaluate the significance of combined detection of leptin (LEP),tumor necrosis factor-α (TNF-α),carcino-embryonic antigen (CEA),C-reactive protein (CRP) and interleukin-6 (IL-6) in both serum and pleural effusion in differential diagnosis of tuberculosis and malignant tumor.Methods LEP,TNF-α,CEA,CRP and IL-6 levels in both pleural fluid and serum samples from 95 cases of pleural effusion (including 54 cases of malignant pleural effusion and 41 cases of tuberculous pleural effusion) were detected by immunoturbidimetry and enzyme linked immunosorbent assay (ELISA),respectively.The data with normal distribution and skewed distribution were analyzed by t test and rank sum test,respectively.Results In patients with tuberculosis and malignant tumor,significant difference was observed in serum LEP [(0.42±0.47) ng/ mL vs (1.80±0.91) ng/mL,t=9.666,P=0.0001],TNF-α [(30.88±24.72) pg/mL vs (59.83±30.93) pg/mL,t=4.917,P=0.0001],CEA [(0.22±0.30) ng/mL vs (5.67±3.60) ng/mL,t=ll.074,P=0.0001] and IL-6 [(146.48±54.90) pg/mL vs (20.51±11.62) pg mL,t=-14.449,P 0.0001] levels.Serum CRP levels of patients with tuberculosis and malignant tumor were comparable [(32.78±22.43) mg/mL vs (37.80±16.74) mg/mL,t =1.249,P=0.215].In pleural effusion of the two groups (tuberculous pleural effusion vs malignant pleural effusion),LEP [(0.69±0.65) ng mL vs (4.33±2.16) ng mL,t 11.711,P 0.0001],TNFα [(20.60±17.80) pg/ mL vs (40.40±20.60) pg/mL,t=4.926,P=0.0001],CEA [(0.10±0.17) ng/mL vs (4.02±2.49) ng/ mL,t=11.537,P=0.0001] and IL-6 [(87.80±48.40) pg/mL vs (9.30±5.50) pg/mL,t =-10.333,P=0.0001] levels were significantly different,while CRP levels [(27.34±17.93) mg mL vs (29.60± 13.40) mg mL,t =0.709,P =0.102] were comparable.Conclusion LEP,TNF-α,and CEA levels in both pleural effusion and serum samples from patients with malignant tumor are higher than those with tuberculosis,while IL 6 levels are quite opposite.Combined detection of these parameters can help the differential diagnosis of tuberculous and malignant pleural effusion.