Pulmonary veno-occlusive disease (PVOD) is a rare and usually survival poor disorder. We report a patient with a long history of progressive dyspnea of over 8 years, who with a diagnosis of chronic cor pulmonale confirmed elsewhere, was ultimately diagnosed as PVOD via histological analysis of a lung biopsy. After treatment with combined bosentan, diuretics and digoxin, his symptoms and function improved. This case highlights that PVOD is an under-recognised and often misdiagnosed disease, especially in its chronic form. Understanding its pathogenesis, its poor response to medical therapy and its dismal prognosis remain challenges for the treatment of PVOD.
Septic shock is one of the most significant health concerns across the world, involving hypo-perfusion and defects in tissue energy. The current study investigates the role of NLR family CARD domain containing protein 4 (
NLRC4)
in septic shock-induced inflammatory reactions, lung tissue injuries, and dendritic cell (DC) apoptosis. Septic shock mice models were established by modified cecal ligation and puncture and injected with retroviral vector expressing siRNA-
NLRC4
. DCs were then isolated and transfected with siRNA-
NLRC4
. The degree of lung tissue injury, cell cycle distribution, cell apoptosis and cell viability of DCs were assessed.
NLRC4
was found to be expressed at high levels in mice with septic shock.
NLRC4
silencing inhibited the activation of the NOD-like receptor (NLR) pathway as evidenced by the decreased levels of
NOD1
,
NOD2
,
RIP2
, and
NF-κB
. In addition,
NLRC4
silencing reduced the inflammatory reaction as attributed by reduced levels of IL-1β, TNF-α and IL-6. Suppressed
NLRC4
levels inhibited cell viability and promoted cell apoptosis evidenced by inhibited induction of DC surface markers (CD80, CD86, and MHC II), along with alleviated lung tissue injury. In conclusion,
NLRC4
silencing ameliorates lung injury and inflammation induced by septic shock by negatively regulating the NLR pathway.
OBJECTIVE To explore the clinical significance of the human telomerase reverse transcriptase (hTERT) mRNA, CEA and CA19-9 in di erential diagnosis of benign and malignant pleural e usions.
METHODSConcentrations of CEA and CA19-9 in pleural e usions were assayed using automated chemiluminescence, and expression of hTERT mRNA was detected by RT-PCR.
RESULTSThe positive rates of hTERT mRNA, CEA and CA19-9 expression in the group with malignant effusions were signifi cantly higher compared to the group with benign e usion (P < 0.05). The sensitivity (%), specificity (%) and diagnostic accordance rates (%) of the 3 tumor markers were as follows: i) hTERT mRNA: 81.8/90.5/86.1; ii) CEA: 52.3/92.9/72.1; iii) CA19-9: 34.1/90.5/61.6. The positive rates of hTERT mRNA + CEA (%) expression in the pleural e usions were 97.7. CONCLUSION All of these tumor markers can be helpful for differential diagnosis of pleural effusions. hTERT mRNA had more clinical value in differentiation of the pleural efffusions. CA19-9 is unfi t to be as an optimal index. The combined assay of hTERT mRNA and CEA in pleural e usions can further raise the positive detection rate of the tumor markers and can be helpful in producing a diagnosis.
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