MedNexus
2022年 · 第45卷第11期
MedNexus
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Pleural effusion is a common complication of many diseases, and its etiological diagnosis is challenging. The Pleural and Mediastinal Diseases Group (in preparation) of the Respiratory Diseases Branch of the Chinese Medical Association organized experts to fully evaluate the latest research results in the field of pleural effusion diagnosis. Based on the principle of GRADE evidence grading, it lasted for one and a half years. After many meetings of discussion and revision, the "Chinese Expert Consensus on the Diagnosis of Pleural Effusion" was finally formed, which was published in the column of "Diagnosis and Treatment Plan". This consensus is divided into three chapters: evaluation and detection of pleural effusion, diagnosis of pleural effusion of common etiologies, diagnosis of other types of pleural effusion, and recommendations are listed in each chapter, which deserve special attention. Professor Li Weimin, deputy editor-in-chief of this journal and West China Hospital of Sichuan University, introduced the process and thinking of consensus writing in his review of the process and thinking of Chinese expert consensus on pleural effusion diagnosis, hoping to provide a reference for readers to understand the content of this consensus and choose and apply it reasonably.
The 2022 National Tuberculosis Academic Conference was held on August 18-22, 2022. This conference was sponsored by Chinese Medical Association and Tuberculosis Branch of Chinese Medical Association, undertaken by Shanghai Medical Association, Shanghai Pulmonary Hospital affiliated to Tongji University, Shanghai Public Health Clinical Center and Beijing Chest Hospital affiliated to Capital Medical University, and co-organized by Tuberculosis Prevention and Control Clinical Center of China Center for Disease Control and Prevention, Tuberculosis Branch of Shanghai Medical Association, Beijing Tuberculosis Diagnosis and Treatment Technology Innovation Alliance, and Tuberculosis Research and Training Cooperation Center of World Health Organization. In response to the needs of COVID-19 epidemic prevention and control, the conference was held online, and the live broadcast room of the main venue of the opening ceremony was set up in Shanghai Pulmonary Hospital. Nearly 100 designated medical institutions, prevention and control institutions and research institutions for tuberculosis from 31 provinces, autonomous regions and municipalities directly under the Central Government have set up sub-venues, and nearly 10,000 experts and colleagues in tuberculosis and related fields have participated online. The theme of this conference is: "Seeking common ground through harmony, integrating nuclear development", which aims to integrate the advantages of various fields, work together to promote the development of tuberculosis discipline, improve China's tuberculosis prevention and control ability, and make unremitting efforts to end the tuberculosis epidemic and achieve the goal of a healthy China.
BACKGROUND AND OBJECTIVE Autoimmunity is believed to play an important role in idiopathic pulmonary hypertension (IPAH). It is unclear whether autoimmunity is a cause or complication of IPAH, whether it has therapeutic implications and its correlation with disease prognosis. The study explores autoimmunity in IPAH using large cross-sectional cohort studies. Methods Circulating immune cell phenotypes of subjects were evaluated using flow cytometry and serum immunoglobulin profiles were generated using a standardized multiplex array consisting of 19 clinically validated autoantibodies in 473 patients with IPAH and 946 controls. GST fusion array and ELISA data were used to detect serum autoantibodies against BMPR2. Cluster analysis and clinical correlation were used to determine the association between immunogenicity and clinical prognosis. Results Flow cytometric immunoassay showed that IPAH was associated with changes in humoral immune response in addition to elevated IgG3. Multiple autoantibodies were significantly elevated in IPAH and the clustering showed 3 distinct clusters: "high autoantibodies""low autoantibodies" and one "intermediate" cluster exhibiting high levels of RNP complexes. Patients with high autoantibody clusters had poorer hemodynamics but higher survival rates. A small percentage of patients exhibited immunoglobulin reactivity to BMPR2. Conclusion This study identifies immunomodulation abnormalities and the presence of autoantibodies as key characteristics of most patients with IPAH, and they are related to clinical prognosis, which deserves further research and exploration, which may be a new hope for targeted biological immunotherapy to treat IPAH.
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