结节病易误诊,据王洪武等~([1])收集国内18篇关于此病误诊的文献,误诊率高达63.2%,当然有误诊就会有误治,如孙永昌等~([2])报道26例结节病在影像学检查诊断的第一印象中拟诊结核5例,其中就有2例完成规范的抗结核治疗,为此应引起临床对本病诊治的重视。

Sarcoidosis

A comprehensive review of signal peptides: Structure, roles, and applications.

METASTATIC ABSCESSES and metastatic tumors can appear in locations that do not seem to be in line of direct spread from their primary focus. There is even a regularity of distribution of these paradoxic metastases. Empirically, the roentgenologist makes a diagnosis of primary carcinoma of the prostate when he finds a certain peculiar distribution of bone lesions in the pelvis. Adequate explanation has not been forthcoming for. the typical and peculiar distribution of these metastatic lesions. The pattern, to me, is not at all that of the nerve sheaths of the area as suggested by Warren, et al.1 It is not the pattern of lymph vessel distribution. The only anatomic system into which this pattern fits is the system of veins which, in its plexiform ramifications, infiltrates and invests the sacrum, the lumbar spine, and the adjacent wings of the ilia. Several years ago, I suggested that the architecture of this plexus of veins could be explored by taking advantage of the pelvic anastomoses of the deep dorsal vein of the penis. The connections and the collateral circulations of this vein are identical with those of the prostatic plexus of veins with which it connects. Valves in the veins of this region are exceedingly variable. All valves present permit flow toward the sacral venous plexus. Injections were first made in I937. A preliminary report was read before the Conference of Eastern Radiologists, in Philadelphia, January 29, I938, under the title of \"The Veins of the Sacrum in Relation to Metastatic Carcinoma from the Prostate.\" This work has been continued and extended. Injections and corrosion preparations of the vessels of the head and neck, already completed, formed an invaluable background for this study. The dissemination of infections and tumors from organs in other regions by the veins about the spine has also been considered. This has led to a better appreciation of the role of the vertebral veins in normal physiology.

The function of the vertebral veins and their role in the spread of metastases : Skeletal cancer metastasis recent expansion of orthopaedic expertise

Ruthenium complexes are a new generation of metal antitumor drugs that are currently of great interest in multidisciplinary research. In this review article, we introduce the applications of ruthenium complexes in the diagnosis and therapy of tumors. We focus on the actions of ruthenium complexes on DNA, mitochondria, and endoplasmic reticulum of cells, as well as signaling pathways that induce tumor cell apoptosis, autophagy, and inhibition of angiogenesis. Furthermore, we highlight the use of ruthenium complexes as specific tumor cell probes to dynamically monitor the active biological component of the microenvironment and as excellent photosensitizer, catalyst, and bioimaging agents for phototherapies that significantly enhance the diagnosis and therapeutic effect on tumors. Finally, the combinational use of ruthenium complexes with existing clinical antitumor drugs to synergistically treat tumors is discussed.

Applications of Ruthenium Complex in Tumor Diagnosis and Therapy.

Silymarin (SLY) and naringin (NRG) are natural flavonoids that have been reported to have many benefits and medicinal properties. The present study was designed to investigate the protective effect of SLY and NRG against methotrexate (MTX)-induced nephrotoxicity in experimental animals. Rats were subjected to oral pretreatment of SLY (25 and 50 mg/kg body weight (b.w.)/day) and NRG (50 and 100 mg/kg b.w./day) for 7 days against renal toxicity induced by single intraperitoneal administration of MTX (20 mg/kg b.w.). MTX resulted in an increase in serum toxicity markers, lipid peroxidation, and reduction in activities of antioxidant enzymes. Additionally, MTX provoked inflammatory responses by increasing the levels of TNF-α, IL-1β, IL-6, NF-κB, and activation of COX-2 and iNOS. Furthermore, MTX administration caused apoptosis and autophagy by increasing activity of Caspase-3 and light chain 3B level. Conversely, SLY and NRG therapy significantly decreased these values in rats. This study demonstrated that SLY and NRG protect against MTX-induced nephrotoxicity.

Practical applications
Chemotherapeutic drugs have been used for cancer treatment for many years. However, in the treatment process, they may damage organs such as liver and kidney, prolong the treatment process and negatively affects patient welfare. This study revealed that silymarin and naringin exhibited potent anti-inflammatory, antiapoptotic, and antiautophagic effect in renal injury caused by methotrexate, a chemotherapeutic drug. Therefore, treatment silymarin and naringin can be used for the beneficial effect against methotrexate-induced kidney damage in cancer chemotherapy.

Therapeutic effects of silymarin and naringin on methotrexate‐induced nephrotoxicity in rats: Biochemical evaluation of anti‐inflammatory, antiapoptotic, and antiautophagic properties

Background: The aim of this study was to investigate oxidative stress and thiol/disulfide status with a novel automated homeostasis assay in advanced non-small cell lung cancer (NSCLC).Methods: Thirty-five patients with advanced NSCLC, who had been newly diagnosed and previously untreated, and 35 healthy subjects were chosen for the study. We measured plasma total thiol (–SH+–S–S–), native thiol (thiol) (–SH), and disulfide (–S–S–) levels in the patients with NSCLC and the healthy subjects. The thiol/disulfide (–SH/–S–S–) ratio was also calculated.Results: Statistically significant differences between the patient group and the control group were detected for the thiol/disulfide parameters. The mean native thiol, total thiol, and disulfide levels were significantly lower in the group with advanced stage NSCLC. The cut-off value was 313 and 13.8 for native thiol and disulfide, respectively. Median overall survival (OS) was significantly shorter in patients with low native thiol and disulfide levels accordin...

https://www.tandfonline.com/doi/pdf/10.1179/1351000215Y.0000000027

Thiol/disulfide homeostasis: A prognostic biomarker for patients with advanced non-small cell lung cancer?

Background

Sarcoidosis is a multisystemic inflammatory granulomatous disease of unknown etiology. No suitable biomarkers are available to evaluate the prognosis of this disease, which still has an unpredictable clinical course. The aim of this study was to evaluate the potential clinical usefulness of hematologic markers.



Materials and Methods

We investigated 172 subjects: 116 patients with sarcoidosis and 56 healthy individuals at Suleyman Demirel University and Dr. Suat Seren Chest Diseases and Thoracic Surgery Training Hospital. Complete blood count, demographics and pulmonary function test data from sarcoidosis patients between 2008 and 2013 were evaluated and collated retrospectively. The cut-off values were determined by calculating the neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV) of the patients.



Results

The cut-off values were determined as 2 and 8.95 for NLR and MPV, respectively. NLRs were significantly higher in sarcoidosis patients than in healthy controls (P < 0.001) and were directly correlated with erythrocyte sedimentation rate (ESR) levels (R = 0.183, P = 0.017). Receiver operator characteristic (ROC) curve analysis revealed a 0.83 [confidence interval (CI) 68.8%–88.4%] area under the curve, 80% sensitivity and 59% specificity at the cut-off of NLR. Higher NLRs (≥2) were detected in patients with sarcoidosis than in the control group (P < 0.001). Also, high NLRs were more frequent in patients with extrapulmonary involvement (P = 0.031). MPV values were not different between control and patient groups.



Conclusions

NLR may be a biomarker with good sensitivity that is easily detected in serum. It can be proposed in clinical practice to identify a patient's prognosis. However, large prospective studies are required to further demonstrate the prognostic significance of these values.

The clinical significance of hematologic parameters in patients with sarcoidosis

Background Studies suggest that tumour-infiltrating lymphocytes (TILs) and inflammation markers have independent roles in non-small cell lung cancer (NSCLC), but the relationship between the two pronostic factors remains unclear. In this study, we investigated TILs and inflammation markers in with patients advanced stage NSCLC and assessed the association of their levels with prognosis. Materials and methods TILs were evaluated by immunohistochemical staining for cluster of differentiation 3 (CD3) and cluster of differentiation 5 (CD5) and by hematoxylin and eosin staining for non-specific lymphocyte. We investigated the localisation pattern of TILs in advanced stage NSCLC. We divided all cases into two groups: TILs-high and TILs-low groups, by 75th percentile of the population of. In our study, inflammation markers were assessed by C-reactive protein (CRP) and the neutrophil-to-lymphocyte ratio (NLR). Results The results showed that the presence of intra-tumoral high CD3+ and low CD5+ were an independent prognostic factor for overall survival (respectively, P = 0.022 and P = 0.025). Moreover, the high NLR and serum high CRP levels were associated with poor survival (respectively, P = 0.008; P = 0.027). In multi-variate survival analysis, the high CD3+ , low CD5+ , high NLR, tumour node metastasis (TNM) stage, depth of tumour invasion and lymph node metastasis remained independent prognostic factors (respectively, P = 0.018, P = 0.020, P = 0.024, P = 0.038, P = 0.020 and P = 0.047).The high NLR was detected negative correlation with intra-tumoral CD3+ and positive correlation with intra-tumoral CD5+ (respectively, r = -0.623, P = 0.012; r = 0.628, P = 0.028). Conclusions This study is first report demonstrating the prognostic value of intra-tumoral low CD5+ with NSCLC. Increased CD3+ and low CD5+ was observed in patients with poor prognosis; the two molecules were correlated with NLR, suggesting that inflammation might be used as improve therapeutic efficacy to immunotherapy for advanced NSCLC.

Association of intra-tumoral tumour-infiltrating lymphocytes and neutrophil-to-lymphocyte ratio is an independent prognostic factor in non-small cell lung cancer.

Purpose: We aimed to establish an inflammatory prognostic index (IPI) in early and advanced non-small cell lung cancer (NSCLC) patients based on hematologic and biochemical parameters and to analyze its predictive value for NSCLC survival. Materials and Methods: A retrospective review of 685 patients with early and advanced NSCLC diagnosed between 2009 and 2014 was conducted with collection of clinical, and laboratory data. The IPI was calculated as C-reactive protein × NLR (neutrophil/ lymphocyte ratio)/serum albumin. Univariate and multivariate analyses were performed to assess the prognostic value of relevant factors. Results: The optimal cut-off value of IPI for overall survival (OS) stratification was determined to be 15. Totals of 334 (48.8%) and 351 (51.2%) patients were assigned to high and low IPI groups, respectively. Compared with low IPI, high IPI was associated with older age, greater tumor size, high lymph node involvement, distant metastases, advanced stage and poor performance status. Median OS was worse in the high IPI group (low vs high, 8.0 vs 34.0 months; HR, 3.5; p<0.001). Progression free survival values of the patients who had high vs low IPI were determined 6 months (95% CI:5.3-6.6) and 14 months (95% CI:12.1-15.8), respectively (HR; 2.4, P<0.001). On multivariate analysis, stage, performance status, lactate dehydrogenase and IPI were independent prognostic factors for OS. Subgroup analysis showed IPI was generally a significant prognostic factor in all clinical variables. Conclusion: The described IPI may be an inexpensive, easily accessible and independent prognostic index for NSCLC patients, useful for clinical practice.

http://journal.waocp.org/article_42011_ef225456e790e865cb125e168941610b.pdf

A New Inflammatory Prognostic Index, Based on C-reactive Protein, the Neutrophil to Lymphocyte Ratio and Serum Albumin is Useful for Predicting Prognosis in Non-Small Cell Lung Cancer Cases

The aim of the present study was to assess the protective effect of silibinin against methotrexate (MTX)-induced pulmonary toxicity. Rats were divided into four groups (MTX, MTX + silibinin, silibinin and control. MTX was injected intraperitoneally (i.p) into female Wistar rats (10 mg/kg/day for 3 days), which resulted in significant increases in the serum levels of alanine aminotransferase, aspartate aminotransferase and oxidant enzymes, including nitric oxide and myeloperoxidase. Furthermore, significant reductions were detected in the serum activity levels of the antioxidative enzymes, glutathione peroxidase and superoxide dismutase, when compared with the control group. However, administration of silibinin (100 mg/kg/day for 10 days, i.p.) was shown to ameliorate the MTX-induced pulmonary toxicity, as indicated by the normalization of the oxidative stress parameters. Furthermore, silibinin treatment was demonstrated to reduce the histopathological changes associated with MTX. In conclusion, silibinin exhibited protective effects against MTX-induced pulmonary toxicity, which may be attributed to its antioxidant activity.

/pdf/silibinin-attenuates-methotrexate-induced-pulmonary-injury-55enjugzm9.pdf

Nigar Dirican

Papers

Thiol/disulfide homeostasis: A prognostic biomarker for patients with advanced non-small cell lung cancer?

The clinical significance of hematologic parameters in patients with sarcoidosis

Association of intra-tumoral tumour-infiltrating lymphocytes and neutrophil-to-lymphocyte ratio is an independent prognostic factor in non-small cell lung cancer.

A New Inflammatory Prognostic Index, Based on C-reactive Protein, the Neutrophil to Lymphocyte Ratio and Serum Albumin is Useful for Predicting Prognosis in Non-Small Cell Lung Cancer Cases

Silibinin attenuates methotrexate-induced pulmonary injury by targeting oxidative stress.