Clinical characteristics of patients with human immunodeficiency virus and immune-mediated photodermatoses: A retrospective study of 39 patients.

BACKGROUND: HIV/AIDS patients are susceptible to various infectious and inflammatory dermatoses. No systemic work has been done on HIV/AIDS patients with immune-mediated photodermatoses in China. Here, we aim to determine the clinical features of immune-mediated photodermatoses in HIV/AIDS patients. METHODS: A retrospective analysis of HIV/AIDS patients with immune-mediated photodermatoses was carried out with demographic data, clinical characteristics, laboratory data, and follow-up data at the First Affiliated Hospital of Kunming Medical University between 2012 and 2019. The data were subjected to statistical analysis. RESULTS: A total of 39 HIV/AIDS patients with immune-mediated photodermatoses were enrolled, including 22 cases of polymorphic light eruption (PLE), 16 cases of chronic actinic dermatitis (CAD), and one actinic reticuloid. The CD4 count at the visit of the HIV-positive CAD group was lower than the PLE group (p = .049). The HIV-positive CAD group was more sensitive toward UVB than the PLE group (p = .020) and had a lower MED-UVB value (p = .044). There was no significant difference in UV tests among different categories of skin types. CONCLUSION: Immune-mediated photodermatoses are a manifestation of the advanced symptom of HIV infection, and sometimes also the presenting feature of HIV infection. Compared with HIV-positive PLE patients, CAD patients showed higher sensitivity to UVB radiation and had a lower MED-UVB value. The primary treatment for immune-mediated photodermatoses in HIV/AIDS patients is HAART and sun avoidance.

Identification of the molecular subgroups in asthma by gene expression profiles: airway inflammation implications.

BACKGROUND: Asthma is a heterogeneous disease and different phenotypes based on clinical parameters have been identified. However, the molecular subgroups of asthma defined by gene expression profiles of induced sputum have been rarely reported. METHODS: We re-analyzed the asthma transcriptional profiles of the dataset of GSE45111. A deep bioinformatics analysis was performed. We classified 47 asthma cases into different subgroups using unsupervised consensus clustering analysis. Clinical features of the subgroups were characterized, and their biological function and immune status were analyzed using Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and single sample Gene Set Enrichment Analysis (ssGSEA). Weighted gene co-expression network analysis (WGCNA) and protein-protein interaction (PPI) network were performed to identify key gene modules and hub genes. RESULTS: Unsupervised consensus clustering of gene expression profiles in asthma identified two distinct subgroups (Cluster I/II), which were significantly associated with eosinophilic asthma (EA) and paucigranulocytic asthma (PGA). The differentially expressed genes (DEGs) between the two subgroups were primarily enriched in immune response regulation and signal transduction. The ssGSEA suggested the different immune infiltration and function scores between the two clusters. The WGCNA and PPI analysis identified three hub genes: THBS1, CCL22 and CCR7. ROC analysis further suggested that the three hub genes had a good ability to differentiate the Cluster I from the Cluster II. CONCLUSIONS: Based on the gene expression profiles of the induced sputum, we identified two asthma subgroups, which revealed different clinical characteristics, gene expression patterns, biological functions and immune status. The transcriptional classification confirms the molecular heterogeneity of asthma and provides a framework for more in-depth research on the mechanisms of asthma.

Primary clear cell carcinoma of the trachea: A CARE-compliant case report.

RATIONALE: Primary clear cell carcinoma of the lung is a rare condition, and presentation as an endotracheal lesion is even more unusual. In this report, we present a patient with clear cell carcinoma occurring in the trachea, which obstructed the tracheal lumen and lead to the respiratory distress. PATIENT CONCERNS: A 60-year old female patient was admitted due to a 6-month history of dyspnea with worsening symptoms for 1 month. Chest CT scan revealed a smooth nodular shadow with homogeneous density on the wall of upper trachea. DIAGNOSIS: Bronchoscopy therapy and surgical removal of the tumor were performed. The histopathological diagnosis revealed clear cell carcinoma. INTERVENTION: Surgical removal of the clear cell carcinoma was performed. OUTCOMES: The patient recovered well after the surgery and is now being followed-up after hospital discharge. LESSONS: Bronchoscopy is an essential tool for diagnosis of tracheal clear cell carcinoma. Surgical removal should be performed if possible.

Accuracy of interleukin-27 assay for the diagnosis of tuberculous pleurisy: A PRISMA-compliant meta-analysis.

BACKGROUND: The concentration of interleukin-27 (IL-27) in pleural effusions was found to be increased in tuberculous pleurisy and several studies have investigated the diagnostic value of IL-27 for tuberculous pleural effusions (TPEs), but the results varied a lot. We conducted the present study to comprehensively evaluate the diagnostic value of IL-27 for TPE. METHODS: Primary diagnostic test studies of IL-27 for TPE was searched and identified from databases. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ration, diagnostic odds ratio, and receiver operating characteristic curves (SROCs) were computed or pooled to summarize the overall test performance. RESULTS: Nine studies with a total number of 1226 patients were identified in our research. The main pooled estimates were as follows: sensitivity 0.92 [95% confidence interval (CI), 0.90-0.95], specificity 0.90 (95% CI, 088-0.92), and area under the SROC 0.97. No evidence of publication bias was detected. CONCLUSION: Our research suggested the good diagnostic value of IL-27 for TPE and it could be used as a diagnostic biomarker.