Hui-Ping Li

Tongji Medical University, Shanghai, Shanghai Shi, China

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Publications (30)45.24 Total impact

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    ABSTRACT: Interstitial lung disease (ILD) is a clinical disorder associated with changes of lung structure. Concurrent infection is a serious complication and one of the major factors that exacerbates ILD. Pathogen screening is a critical step in early diagnosis and proper treatment of ILD with secondary infection. Here we analyzed distribution and drug susceptibility of pathogens isolated from hospitalized ILD patients from January, 2009 to December, 2010 and compared them to bacterial drug resistance data in CHINET during the same period. The main specimens were from sputum culture, lavage fluid culture, lung biopsy tissue culture, and pleural effusion culture and bacterial or fungal cultures were performed on these specimens accordingly. Drug susceptibility was tested for positive bacterial cultures using disk diffusion (Kirby-bauer method) and E Test strips in which results were determined based on the criteria of CLSI (2007). A total of 371 pathogen strains from ILD patients, including 306 bacterial strains and 65 fungal strains were isolated and cultured. Five main bacterial strains and their distribution were as follows: Klebsiella pneumoniae (31.7%), Pseudomonas aeruginosa (20.6%), Acinetobacter (12.7%), Enterobacter cloacae (8.2%), and Staphylococcus aureus (7.8%). The results showed that ILD patients who had anti-infection treatment tended to have gram-negative bacteria, whether they acquired an infection in the hospital or elsewhere. Drug resistance screening indicated that aminoglycosides and carbapenems had lower antibiotic resistance rates. In addition, we found that the usage of immunosupressants was associated with the increased infection rate and number of pathogens that were isolated. In conclusion, aminoglycosides and carbapenems may be selected as a priority for secondary infection to control ILD progression. Meanwhile, the use of anti-MRSA/MRCNS drugs may be considered for Staphylococcus infection.
    Pulmonary Pharmacology &amp Therapeutics 12/2014; 29(2). DOI:10.1016/j.pupt.2014.03.005 · 2.94 Impact Factor
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    Ping Wei · Hai-Wen Lu · Sen Jiang · Li-Chao Fan · Hui-Ping Li · Jin-Fu Xu ·
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    ABSTRACT: Pulmonary Langerhans cell histiocytosis (PLCH) is a rare disease with insidious onset and nonspecific manifestations. The objective of this article was to characterize the clinical manifestations and features of PLCH by retrospectively analyzing clinical data of patients with PLCH in addition to simultaneous review of literature.A retrospective analysis was conducted on clinical data of patients with PLCH (n = 7), whose conditions were diagnosed by biopsy from pulmonary tissue (n = 6) or enlarged lymph nodes in the neck (n = 1) and confirmed by PLCH typical radiological features on computed tomography (CT) scan, between January 2001 and September 2012 at the Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China. The review of published reports was made to further emphasize the clinical manifestation and radiological features of PLCH.Long history of cigarette smoking was found in 6 patients. Two patients had recurrent pneumothorax and the other 2 had pulmonary arterial hypertension (World Health Organization group 5 pulmonary hypertension), diagnosed through ultrasonic cardiogram. The nodular shadows were revealed by chest CT scan in 5 patients, cystic shadows in 5 patients, and reticular shadows in 2 patients, as major manifestations, respectively; most of the lesions were located in the middle or upper segments of the lung. The obvious shrank of lesion was found in 1 patient after completely quitting smoking.The pathogenesis of PLCH might be closely associated with smoking. The cystic or nodular lesion was the typical radiological features. Further prospective studies with large sample size are required to further validate the study results and understand the clinical characteristics of PLCH to avoid misdiagnosis.
    Medicine 11/2014; 93(23):e141. DOI:10.1097/MD.0000000000000141 · 5.72 Impact Factor
  • Shuo Liang · Jin-Fu Xu · Wei-Jun Cao · Hui-Ping Li · Cheng-Ping Hu ·
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    ABSTRACT: Decorin is a small leucine-rich proteoglycan and it plays an important role in regulation of cell growth and migration in various tumor cell lines. Decorin was found down-regulated in non-small cell lung cancer tissue and may be involved in regulation of lung cancer development. In this study, lentivirus-mediated RNA interference and over expression were employed to change the expression levels of decorin in lung cancer A549 cells. We tested the cell cycle of A549 cells and the expression of transforming growth factor (TGF)-β, cyclin D1, epidermal growth factor receptor (EGFR), P53, and P21. We found that up-regulation of decorin could inhibit proliferation, block cell cycle at G1 and decrease invasive activity of A549 cells. Moreover, we also show that up-regulation of decorin induced significant decreases of TGF-β1, cyclin D1 expression, phosphorylation of EGFR, and increases of P53 and P21 expression. Opposite results were observed in A549 cells with down-regulation of decorin. Our results suggest that decorin is a key regulator involved in proliferation and migration of A549 cells.
    Chinese medical journal 12/2013; 126(24):4736-41. DOI:10.3760/cma.j.issn.0366-6999.20130207 · 1.05 Impact Factor
  • Jin-Fu Xu · Li Shen · Yuan Zhang · Peng Zhang · Jie-Ming Qu · Hui-Ping Li ·
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    ABSTRACT: Hypersensitivity pneumonitis (HP) without known offending antigen is hard to diagnosis. The purpose of this study was to identify and analyze the clinical features of lung biopsy proved HP. A retrospective cohort study was performed using a database from a 900-bed specialty hospital. 28 patients with the diagnosis of HP through lung biopsy were enrolled. Demographic data and clinical characteristics, radiologic characteristics serologic and, pulmonary function results, histopathologic changes, treatment and follow-up were analyzed. Of all the patients, serum IL-1beta, CRP, ESR, ECP and IgE were increased in over 50% patients, but decreased significantly after corticosteroid therapy (P<0.05). An initially reduced DLco was noted in 92.9% patients, while 39.3% patients had hypoxemia. Ground-glass opacities appear on the basis of interlobular septa thickening were observed in 71.4% cases. Histopathological findings demonstrated peribronchiolar lymphocytic infiltrates, poorly formed non-caseating granulomas fibrosis in all acute and subacute HP patients' lungs. 92% patients got improvement after corticosteroid therapy when assessed by CT scans and pulmonary function tests. For suspected HP patients who without known offending antigens, earlier diagnosed by lung biopsy followed by corticosteroid therapy showed promise and might prevent the disease progression to lung fibrosis.
    The Clinical Respiratory Journal 11/2013; 8(3). DOI:10.1111/crj.12071 · 1.51 Impact Factor
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    Li-Chao Fan · Hai-Wen Lu · Ke-Bin Cheng · Hui-Ping Li · Jin-Fu Xu ·
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    ABSTRACT: As a promising tool, PCR in bronchoalveolar lavage fluid (BALF) has not been accepted as a diagnostic criterion for PJP. We undertook a systematic review of published studies to evaluate the diagnostic accuracy of PCR assays in BALF for PJP. Eligible studies from PubMed, Embase and Web of Science reporting PCR assays in BALF for diagnosing PJP were identified. A bivariate meta-analysis of the method's sensitivity, specificity, and positive and negative likelihood ratios with a 95% confidence interval (CI) were analyzed. The post-test probability was performed to evaluate clinical usefulness. A summary receiver operating characteristics (SROC) curve was used to evaluate overall performance. Subgroup analyses were carried out to analysis the potential heterogeneity. Sixteen studies published between 1994 and 2012 were included. The summary sensitivity and specificity values (95% CI) of PCR in BALF for diagnosis of PJP were 98.3% (91.3%-99.7%) and 91.0% (82.7%-95.5%), respectively. The positive and negative likelihood ratios were 10.894 (5.569-21.309) and 0.018 (0.003-0.099), respectively. In a setting of 20% prevalence of PJP, the probability of PJP would be over 3-fold if the BALF-PCR test was positive, and the probability of PJP would be less than 0.5% if it was negative. The area under the SROC curve was 0.98 (0.97-0.99). The method of PCR in BALF shows high sensitivity and good specificity for the diagnosis of PJP. However, clinical practice for the diagnosis of PJP should consider the consistent respiratory symptoms, radiographic changes and laboratory findings of the suspected patients.
    PLoS ONE 09/2013; 8(9):e73099. DOI:10.1371/journal.pone.0073099 · 3.23 Impact Factor
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    ABSTRACT: Acute lung injury (ALI), is a major cause of morbidity and mortality, which is routinely treated with the administration of systemic glucocorticoids. The current study investigated the distribution and therapeutic effect of a dexamethasone(DXM)-loaded immunoliposome (NLP) functionalized with pulmonary surfactant protein A (SP-A) antibody (SPA-DXM-NLP) in an animal model. DXM-NLP was prepared using film dispersion combined with extrusion techniques. SP-A antibody was used as the lung targeting agent. Tissue distribution of SPA-DXM-NLP was investigated in liver, spleen, kidney and lung tissue. The efficacy of SPA-DXM-NLP against lung injury was assessed in a rat model of bleomycin-induced acute lung injury. The SPA-DXM-NLP complex was successfully synthesized and the particles were stable at 4°C. Pulmonary dexamethasone levels were 40 times higher with SPA-DXM-NLP than conventional dexamethasone injection. Administration of SPA-DXM-NLP significantly attenuated lung injury and inflammation, decreased incidence of infection, and increased survival in animal models. The administration of SPA-DXM-NLP to animal models resulted in increased levels of DXM in the lungs, indicating active targeting. The efficacy against ALI of the immunoliposomes was shown to be superior to conventional dexamethasone administration. These results demonstrate the potential of actively targeted glucocorticoid therapy in the treatment of lung disease in clinical practice.
    PLoS ONE 03/2013; 8(3):e58275. DOI:10.1371/journal.pone.0058275 · 3.23 Impact Factor

  • Academic Journal of Second Military Medical University 02/2013; 33(2):223-226. DOI:10.3724/SP.J.1008.2013.00223
  • Shuo Liang · Wei-Jun Cao · Jin-Ming Liu · Hui-Ping Li ·

    Academic Journal of Second Military Medical University 01/2013; 33(1):114-116. DOI:10.3724/SP.J.1008.2013.00114
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    ABSTRACT: Objective: To investigate the ultrastructural features of sputum deposition (SD) and its value in the diagnosis of pulmonary alveolar proteinosis (PAP). Methods: Seven patients with PAP diagnosed by lung biopsy and cytology were enrolled in this study. The patients consisted of 5 men and 2 women, whose median age was 48 years (range 36 to 73). SD and bronchoalveolar lavage fluid (BALF) sediment were made into ultrathin sections and observed under transmission electron microscope (TEM), respectively. Seven cases of control group composed of 4 men and 3 women whose median age was 49 years (range 39 to 68) including 3 cases of bacterial pneumonia, two cases of COPD and 2 cases of exudative pulmonary tuberculosis. Each SD was made into ultrathin section, and compared with the experimental group. Results: In PAP group, Periodic acid-schiff (PAS) staining was performed on 7 sputum smears and none of them was tested positive for any components with diagnostic interest. Four cases from the 7 paraffin-embed sections of BALF sediment by microscopic examination suggested PAP. Under TEM, BALF sediment showed that many lamellar bodies existed in and outside alveolar epithelial cells, and 5 specimens were consistent with PAP diagnosis. Compared with BALF sediment, SD had apparent degeneration with more myelin phagosomes in the cytoplasm of macrophages, more lamellar bodies in alveolar epithelial cells, and lots of lamellar bodies in the shape of concentric circle in the extracellular spaces. Four from the 7 SD samples were consistent with the diagnosis of PAP. No significant difference was found between SD and BALF in the diagnosis of PAP by electronic examination (P > 0.05). In the 7 cases of control group no drifting osmiophilic lamellar bodies in extracellular space were detected. Conclusions: The osmiophilic lamellar bodies with diagnostic value were found in SD and BALF of patients with PAP. TEM of SD in combination with clinical manifestations and radiologic findings can make a definitive diagnosis of PAP, especially for those patients who have contraindications to lung biopsy and lung lavage.
    Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases 12/2012; 35(12):887-891.
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    ABSTRACT: The role of 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) in the development or progression of interstitial lung disease (ILD) is controversial. To evaluate the association between statin use and ILD. We used regression analyses to evaluate the association between statin use and interstitial lung abnormalities (ILA) in a large cohort of smokers from COPDGene. Next, we evaluated the effect of statin pretreatment on bleomycin-induced fibrosis in mice and explored the mechanism behind these observations in vitro. In COPDGene, 38% of subjects with ILA were taking statins compared with 27% of subjects without ILA. Statin use was positively associated in ILA (odds ratio, 1.60; 95% confidence interval, 1.03-2.50; P = 0.04) after adjustment for covariates including a history of high cholesterol or coronary artery disease. This association was modified by the hydrophilicity of statin and the age of the subject. Next, we demonstrate that statin administration aggravates lung injury and fibrosis in bleomycin-treated mice. Statin pretreatment enhances caspase-1-mediated immune responses in vivo and in vitro; the latter responses were abolished in bone marrow-derived macrophages isolated from Nlrp3(-/-) and Casp1(-/-) mice. Finally, we provide further insights by demonstrating that statins enhance NLRP3-inflammasome activation by increasing mitochondrial reactive oxygen species generation in macrophages. Statin use is associated with ILA among smokers in the COPDGene study and enhances bleomycin-induced lung inflammation and fibrosis in the mouse through a mechanism involving enhanced NLRP3-inflammasome activation. Our findings suggest that statins may influence the susceptibility to, or progression of, ILD. Clinical trial registered with (NCT 00608764).
    American Journal of Respiratory and Critical Care Medicine 03/2012; 185(5):547-56. DOI:10.1164/rccm.201108-1574OC · 13.00 Impact Factor
  • Jin-Fu Xu · Hui-Ping Li ·

    01/2012; 02(03). DOI:10.4172/2161-105X.1000123
  • Xue-yuan Chen · Hui-ping Li · Rong-xuan Zhang · Shui-hua Lu ·
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    ABSTRACT: This is a case report of mediastinal fungal granuloma in an immunocompetent host. The definite diagnosis was made by pathological biopsy via video-assisted thoracoscopy and silver methenamine staining showed aspergillus hyphae and spores in the epithelioid granuloma. In conclusion, opportunistic pathogenic fungi can cause granulomatous inflammation in mediastinal lymph nodes in an immunocompetent host, as it can do in an immunocompromised host. More attention should be paid on tissue biopsy and pathological examination to ensure a correct diagnosis for these kinds of cases.
    Chinese medical journal 08/2011; 124(15):2396-9. DOI:10.3760/cma.j.issn.0366-6999.2011.15.027 · 1.05 Impact Factor
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    ABSTRACT: Bone marrow-derived cells may play a role in tissue injury and repair. Growth factors facilitate the mobilization of bone marrow-derived cells to the site of injury. The aim of this study was to determine the effect of the mobilization of autologous bone marrow-derived cells by granulocyte colony-stimulating factor (CSF3) on bleomycin-induced lung injury in mice. The bone marrow from male green fluorescent protein transgenic (C57Bl/6J) mice was transplanted into irradiated female C57Bl/6J mice. Bleomycin lung injury was induced in these bone marrow-reconstituted mice and unreconstituted C57Bl/6J mice, and some mice were treated with recombinant CSF3. Lung histology, survival, cytokine expression and matrix metalloproteinase (MMP) expression were evaluated to determine the effect of CSF3 after bleomycin-induced lung injury. Histology and flow cytometry analysis showed successful mobilization of bone marrow-derived cells by CSF3 treatment in the recipient lungs. Importantly, CSF3 attenuated bleomycin-induced lung injury and improved survival. Furthermore, CSF3 administration regulated transforming growth factor-β, interferon-γ, MMP9 and tissue inhibitors of MMP1 expression during bleomycin injury. These data demonstrated that the mobilization of bone marrow-derived cells by CSF3 has a protective effect against bleomycin-induced lung injury and fibrosis.
    Respiration 07/2011; 82(4):358-68. DOI:10.1159/000328762 · 2.59 Impact Factor
  • Jin-Fu Xu · Jie-Ming Qu · Hui-Ping Li ·
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    ABSTRACT: 1. In critically ill patients, Pseudomonas aeruginosa-induced pneumonia and the lung injury associated with infection are major causes of mortality. The aim of the present study was to evaluate the protective properties of N-acetylcysteine (NAC) in rats infected with P. aeruginosa and the role of nitric oxide synthases (NOS) protein in this process. 2. Pneumonia was induced in rats by infecting them with P. aeruginosa intratracheally. One group of rats was treated with NAC (150 mg/kg per day, i.p., for 7 days). An untreated group served as the control. Samples were collected both before (0 h) and after infection (24 h). Bacterial loads in lung tissue, the lung wet : dry (W/D) ratio and pulmonary vascular permeability were assessed. Total cell and polymorphonuclear leucocyte cell counts in bronchoalveolar lavage fluid were determined. The expression of inducible (i) NOS and endothelial (e) NOS protein was analysed and correlated with indices of lung injury using Pearson's correlation analysis. 3. Bacterial load, lung injury indices and NOS expression increased after infection. Pretreatment with NAC mitigated lung injury although it did not significantly change bacterial loads. Furthermore, NAC treatment increased eNOS protein expression, but decreased iNOS expression, in lung tissues after infection. The expression of iNOS protein was positively correlated with indices of lung injury, whereas there was a negative correlation between eNOS expression and lung injury indices. 4. N-Acetylcysteine modulated P. aeruginosa-induced lung injury in rats. The results suggest that this effect maybe due to regulation of iNOS and eNOS protein expression by NAC.
    Clinical and Experimental Pharmacology and Physiology 03/2011; 38(5):345-51. DOI:10.1111/j.1440-1681.2011.05515.x · 2.37 Impact Factor
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    ABSTRACT: To investigate the efficacy of glucocorticoid therapy in idiopathic nonspecific interstitial pneumonia (INSIP). Twenty-nine cases of INSIP confirmed by clinical- radiological-pathological (CRP) diagnosis were collected and classified into 2 groups according to the degree of fibrosis: INSIP-1 (including 9 cases of cellular type) and INSIP-2 (20 cases of mixed and fibrotic type). Thirty cases of usual interstitial pneumonia (UIP) confirmed by CRP diagnosis served as the control. Clinical and pathological features, therapeutic effects of glucocorticoids and the follow-up results were retrospectively analyzed and the survival curves were evaluated by Kaplan-Meier method. The mean age at onset of INSIP-1 group [(48 ± 5) years] was significantly younger than INSIP-2 group [(52 ± 11) years] and the UIP group [(57 ± 14) years]. The course of disease in INSIP-1 group [(60 ± 28) months] was longer than that in INSIP-2 group [(48 ± 33) months] and that in the UIP group [(44 ± 23) months], but the differences were not statistically significant (F = 1.22, all P > 0.05). The efficacy rate of glucocorticoid treatment in INSIP-1 group (9/9) was higher than that in INSIP-2 group (11/20) and that in the UIP group (2/30), the differences being statistically significant (all P < 0.05). The follow-up period for INSIP-1 group [(56 ± 27) months] was significantly longer than for INSIP-2 group [(23 ± 18) months] and for the UIP group [(25 ± 17) months], and the rate of significant improvement (6/9) was higher than that of the INSIP-2 group (9/20) and the UIP group (0/30), the differences being statistically significant (F = 9.224, all P < 0.05). The mortality of INSIP-1 group (0/9) was lower than that in INSIP-2 group (4/20) and the UIP group (16/30), the difference being statistically significant (exact probability value 0.000 - 0.005, P < 0.05). The degree of fibrosis of INSIP is closely correlated with the effect of glucocorticoid therapy and prognosis. The cellular type has a favorable reaction to glucocorticoid therapy and a better prognosis as compared to the fibrotic type.
    Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases 08/2010; 33(8):593-6.
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    ABSTRACT: To investigate the contribution of mobilized autologous bone marrow-derived cells (BMDC) to lung repair after lung injury induced by bleomycin, and the mechanisms of any protective effects conferred by BMDC. Sixty marrow-reconstructed mice were randomly divided into 2 groups: group A [bleomycin + granulocyte colony stimulating factor (G-CSF)] and group B (bleomycin + saline). Seventy-five normal mice were randomly divided into 3 groups: group C (bleomycin + G-CSF); group D (bleomycin + saline) and group N (saline only). Each group was further divided into 3 subgroups, which were sacrificed respectively on days 3, 7 and 14. Therapeutic evaluations were made by means of HE stain, Masson's trichrome stain, hydroxyproline concentration and pulmonary permeability index. The expressions of TGF-beta(1), IFN-gamma, MMP-9 and TIMP-1 in the lung tissue were detected by immunohistochemistry. Intrapulmonary BMDC was evaluated by flow cytometry and laser scanning confocal microscope. Another 20 mice were randomly divided into 2 groups including group E (bleomycin + G-CSF) and group F (bleomycin + saline). The survival time of each mouse was observed without end point. The alveolitis score (mean rank 15.3), the pulmonary fibrosis score (46 +/- 8), the hydroxyproline concentrations (0.44 +/- 0.09) microg/mg, the TGF-beta(1) level (111 +/- 23), the IFN-gamma level (250 +/- 72) and the MMP-9 level (59 +/- 19) were significantly decreased in reconstructed treatment group on day 7 as compared to reconstructed control group, which was respectively (mean rank 28.0), (73 +/- 10), (0.52 +/- 0.07) microg/mg, (161 +/- 35), (299 +/- 31) and (314 +/- 77). Likewise, the alveolitis (mean rank 22.7), the pulmonary fibrosis (27 +/- 15), the hydroxyproline concentrations (0.41 +/- 0.05) microg/mg, the pulmonary permeability index (43.8 +/- 9.9) x 10(-3), the TGF-beta(1) level (132 +/- 55), the IFN-gamma level (178 +/- 23), and the MMP-9 level (101 +/- 54) in non-reconstructed treatment group on day 7 were significantly lower than those in non-reconstructed control group, (mean rank 33.9), (56 +/- 13), (0.49 +/- 0.08) microg/mg, (54 +/- 9) x 10(-3), (320 +/- 98), (409 +/- 61), (288 +/- 75), the differences being statistically significant (P < 0.05). The intrapulmonary BMDC level of reconstructed treatment group (0.65 +/- 0.13) was significantly higher than that in reconstructed control group (0.46 +/- 0.11), P < 0.05. Mobilization of BMDC by G-CSF showed a protective effect on lung injury induced by bleomycin in mice, but did not have significant influence on survival time.
    Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases 12/2009; 32(12):902-7.
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    ABSTRACT: Although previous studies have shown that peripheral airway obstruction can occur in idiopathic PAH (IPAH), pulmonary function tests have not been well-studied in patients with PAH associated with congenital heart disease (CHD-PAH) and connective tissue disease (CTD-PAH). A multicenter prospective study was performed in PAH patients in China. Pulmonary function tests were evaluated in 190 PAH patients. Total lung capacity (TLC), residual volume (RV) and total airway resistance (Rtot) were similar in PAH patients and controls. However, measures of airflow, including vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1s (FEV(1)), FEV(1)/FVC and MEF(50) were decreased in PAH group. Single-breath diffusion capacity for carbon monoxide (DL(CO)) was also decreased in PAH patients. Expiratory flow-volume curves showed reduction and a curvilinear appearance in patients with PAH. Similar changes were observed among the various subgroups of IPAH, CHD-PAH, and CTD-PAH patients. More CTD-PAH patients had abnormal DL(CO). Airway obstruction is common in IPAH, CHD-PAH and CTD-PAH patients. CTD-PAH patients have lower DL(CO). Hemodynamics, serum markers and exercise capacity parameters did not correlate well with pulmonary function indices.
    Respiratory medicine 05/2009; 103(8):1136-42. DOI:10.1016/j.rmed.2009.03.009 · 3.09 Impact Factor
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    ABSTRACT: Studying the proven and probable invasive pulmonary aspergillosis (IPA) cases of some hospitals in Shanghai to provide evidence for the improvement of IPA clinical diagnosis and therapy. Forty-nine IPA cases were retrospectively analyzed for demography data, host factors, underlying conditions, chest CT, microorganism and histopathology examination, as well as therapy and clinical outcome. Of 49 subjects including 19 (38.8%) proven and 30 (61.2%) probable IPA, 3 patients (6.1%) had no host factors, 25 patients (51.0%) had IPA associated host factors and underlying conditions, while 21 patients (42.9%) had uncertain fundamental diseases. Chest CT evaluation demonstrated that radiological lesions include nodules in 29 patients, patching in 15, mass in 12, consolidation in 10, cavitation in 34, Halo sign in 19, air bronchogram in 18, crescentic sign in 6, bilateral in 33 and multifocal lesions in 38. The yielding rate of fungus culture in sputum was 26.5% (13/49), and in bronchoalveolar lavage fluid was 66.7% (10/15). Eleven of thirty-six patients (30.6%) had positive results of serum galactomannan antigen tests. Nineteen of twenty-one patients (90.5%) were proven as IPA by lung histologic examinations. Aspergillus fumigatus was the most common pathogen 81.0% (17/21). The responding rate to initial anti-fungus therapy was 50% (21/42). Our study suggests that in IPA patients, bilateral, multifocal and nodular lesion could be the most common radiological characteristic, while Halo and crescentic sign occur occasionally. Invasive technologies are more valuable to IPA diagnosis.
    Zhonghua nei ke za zhi [Chinese journal of internal medicine] 01/2009; 47(12):1017-21.
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    ABSTRACT: To analyze the clinical, radiological and pathological characteristics of idiopathic lymphoid interstitial pneumonia (idiopathic LIP) and to discuss its diagnosis, treatment and prognosis. Respiratory physicians, pathologists and radiologists together retrospectively analyzed the clinical, chest roentgenogram, computerized tomography, pathological, diagnostic and therapeutic data of 3 patients with idiopathic LIP confirmed by lung biopsy, and reviewed the relevant literatures. The major symptoms of the 3 cases of idiopathic LIP were progressive dyspnea and dry cough. Higher levels of gamma-globulins in serum were found in all the cases. The characteristic radiographic manifestations were bilateral diffuse nodules and cysts. The pathologic feature was diffuse interstitial inflammation with polyclonal lymphocytes infiltration, especially with plasma lymphocytes. Corticosteroids and cytotoxic agents were used and good response to therapy was observed in the cases. Idiopathic LIP has some characteristics on the clinical, radiological and pathological features, but the best diagnostic method depends on a clinical-radiological-pathological approach. The disease usually shows good response to combinative therapy of corticosteroids and cytotoxic agents.
    Zhonghua nei ke za zhi [Chinese journal of internal medicine] 07/2008; 47(6):486-90.
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    ABSTRACT: To evaluate the role of mycobacterial infection in the pathogenesis of sarcoidosis by examination of mycobacterial DNA in tissue samples of sarcoidosis and tuberculosis, and to examine the value of quantitative real-time polymerase chain reaction (PCR) in the differentiation of the two diseases. Mycobacterium tuberculosis DNA was measured by quantitative real-time PCR from formalin-fixed and paraffin-embedded sections of biopsy samples of lymph nodes and lung tissues from 31 patients with sarcoidosis, 30 patients with tuberculosis and 15 patients with other diseases (as the control samples) in Shanghai Pulmonary Hospital from January 1998 to December 2003. Lung tissues from 15 normal embryonic mice served as the negative control. The positive rate of mycobacterial DNA in the tuberculosis samples (30/30) was higher than that of the sarcoidosis samples (6/31) and of the control samples (2/15). The difference between sarcoidosis and normal samples showed no statistical significance. The absolute and relative copies of mycobacterial DNA in the tuberculosis samples were significantly higher than those in the sarcoidosis and the control samples; while there was no statistical difference between the sarcoidosis and the control samples. There was no positive result in the lung tissues of the embryonic mice. The results do not show any relationship between mycobacterial infection and sarcoidosis. Quantitative PCR may be a reliable method for the differentiation of sarcoidosis from tuberculosis.
    Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases 10/2007; 30(9):686-90.