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Diagnostic performance of serum interferon gamma, matrix metalloproteinases, and periostin measurements for pulmonary tuberculosis in Japanese patients with pneumonia.
日本肺炎患者血清干扰素 γ 、基质金属蛋白酶和骨膜蛋白测定对肺结核的诊断性能。
- 影响因子:3.02
- DOI:10.1371/journal.pone.0227636
- 作者列表:"Yamauchi M","Kinjo T","Parrott G","Miyagi K","Haranaga S","Nakayama Y","Chibana K","Fujita K","Nakamoto A","Higa F","Owan I","Yonemoto K","Fujita J
- 发表时间:2020-01-09
Abstract
:Serum markers that differentiate between tuberculous and non-tuberculous pneumonia would be clinically useful. However, few serum markers have been investigated for their association with either disease. In this study, serum levels of interferon gamma (IFN-γ), matrix metalloproteinases 1 and 9 (MMP-1 and MMP-9, respectively), and periostin were compared between 40 pulmonary tuberculosis (PTB) and 28 non-tuberculous pneumonia (non-PTB) patients. Diagnostic performance was assessed by analysis of receiver-operating characteristic (ROC) curves and classification trees. Serum IFN-γ and MMP-1 levels were significantly higher and serum MMP-9 levels significantly lower in PTB than in non-PTB patients (p < 0.001, p = 0.002, p < 0.001, respectively). No significant difference was observed in serum periostin levels between groups. ROC curve analysis could not determine the appropriate cut-off value with high sensitivity and specificity; therefore, a classification tree method was applied. This method identified patients with limited infiltration into three groups with statistical significance (p = 0.01), and those with MMP-1 levels < 0.01 ng/mL and periostin levels ≥ 118.8 ng/mL included only non-PTB patients (95% confidence interval 0.0-41.0). Patients with extensive infiltration were also divided into three groups with statistical significance (p < 0.001), and those with MMP-9 levels < 3.009 ng/mL included only PTB patients (95% confidence interval 76.8-100.0). In conclusion, the novel classification tree developed using MMP-1, MMP-9, and periostin data distinguished PTB from non-PTB patients. Further studies are needed to validate our cut-off values and the overall clinical usefulness of these markers.
摘要
: 区分结核性和非结核性肺炎的血清标志物将在临床上有用。然而,很少有血清标志物被研究其与任一疾病的相关性。在本研究中,血清干扰素 γ (IFN-γ),基质金属蛋白酶 1 和 9 (分别为mmp1 和MMP-9),比较 40 例肺结核 (PTB) 和 28 例非结核性肺炎 (non-PTB) 患者的periostin。通过受试者工作特征 (ROC) 曲线和分类树分析评估诊断性能。PTB患者血清IFN-γ 和MMP-1 水平显著高于非PTB患者,血清MMP-9 水平显著低于非PTB患者 (p <0.001,p = 0.002,p <0.001)。组间血清骨膜蛋白水平无显著差异。ROC曲线分析不能确定合适的临界值,具有较高的敏感性和特异性; 因此,应用分类树方法。该方法将有限浸润患者分为三组,具有统计学意义 (p = 0.01),MMP-1 <0.01 ng/mL且骨膜蛋白水平 ≥ 118.8 ng/mL的患者仅包括非PTB患者 (95% 置信区间 0.0-41.0)。广泛浸润的患者也分为三组有统计学意义 (p <0.001),MMP-9 <3.009 ng/mL者仅包括PTB患者 (95% 置信区间 76.8-100.0)。总之,使用MMP-1 、MMP-9 和periostin数据开发的新分类树区分了PTB和非PTB患者。需要进一步的研究来验证我们的临界值和这些标志物的整体临床有用性。
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METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.
呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。