The Performance of Pleural Fluid T-SPOT.TB Assay for Diagnosing Tuberculous Pleurisy in China: A Two-Center Prospective Cohort Study

The performance of T-SPOT.TB (T-SPOT) assay in diagnosing pleural tuberculosis (plTB) is inconsistent. In this study, we compared the performance of peripheral blood (PB) and pleural fluid (PF) T-SPOT assay in diagnosing plTB. Between July 2017 and March 2018, 218 and 210 suspected plTB patients were prospectively enrolled from Wuhan (training) and Guangzhou (validation) cohort, respectively. PB T-SPOT, PF T-SPOT, and other conventional tests were simultaneously performed. Our data showed the performance of PB T-SPOT in diagnosing plTB was limited, especially with low sensitivity. However, the results of early secreted antigenic target 6 (ESAT-6) and culture filtrate protein 10 (CFP-10) in PF T-SPOT were significantly increased compared with those in PB T-SPOT in plTB patients. If using 76 as the cutoff value of MAX (the larger of ESAT-6 and CFP-10) in Wuhan cohort, the sensitivity and specificity of PF T-SPOT to diagnose plTB were 89.76 and 96.70%, respectively. The diagnostic accuracy of PF T-SPOT was better than other routine tests such as pathogen detection methods and biochemical markers. The diagnostic accuracy of PF T-SPOT in Guangzhou cohort was similar to that in Wuhan cohort, with a sensitivity and specificity of 91.07 and 94.90%, respectively. Furthermore, CD4+ T cells were more activated in PF compared with PB, and the frequency of mycobacterium tuberculosis-specific CD4+ T cells in PF was significantly higher than that in PB in plTB patients. In conclusion, the performance of PF T-SPOT is obviously better than PB T-SPOT or other laboratory tests, which suggests that PF T-SPOT assay has been of great value in the diagnosis of pleural tuberculosis

Tenascin-C induces inflammatory mediators and matrix degradation in osteoarthritic cartilage

<p>Abstract</p> <p>Background</p> <p>Tenascin-C (TN-C) is an extracellular matrix glycoprotein that is involved in tissue injury and repair processes. We analyzed TN-C expression in normal and osteoarthritic (OA) human cartilage, and evaluated its capacity to induce inflammatory and catabolic mediators in chondrocytes <it>in vitro</it>. The effect of TN-C on proteoglycan loss from articular cartilage in culture was also assessed.</p> <p>Methods</p> <p>TN-C in culture media, cartilage extracts, and synovial fluid of human and animal joints was quantified using a sandwich ELISA and/or analyzed by Western immunoblotting. mRNA expression of TN-C and aggrecanases were analyzed by Taqman assays. Human and bovine primary chondrocytes and/or explant culture systems were utilized to study TN-C induced inflammatory or catabolic mediators and proteoglycan loss. Total proteoglycan and aggrecanase -generated ARG-aggrecan fragments were quantified in human and rat synovial fluids by ELISA.</p> <p>Results</p> <p>TN-C protein and mRNA expression were significantly upregulated in OA cartilage with a concomitant elevation of TN-C levels in the synovial fluid of OA patients. IL-1 enhanced TN-C expression in articular cartilage. Addition of TN-C induced IL-6, PGE₂, and nitrate release and upregulated ADAMTS4 mRNA in cultured primary human and bovine chondrocytes. TN-C treatment resulted in an increased loss of proteoglycan from cartilage explants in culture. A correlation was observed between TN-C and aggrecanase generated ARG-aggrecan fragment levels in the synovial fluid of human OA joints and in the lavage of rat joints that underwent surgical induction of OA.</p> <p>Conclusions</p> <p>TN-C expression in the knee cartilage and TN-C levels measured in the synovial fluid are significantly enhanced in OA patients. Our findings suggest that the elevated levels of TN-C could induce inflammatory mediators and promote matrix degradation in OA joints.</p

Nonoscillatory Solutions for Higher-Order Neutral Dynamic Equations on Time Scales

We study the higher-order neutral dynamic equation {a(t)[(x(t)−p(t)x(τ(t)))Δm]α}Δ+f(t,x(δ(t)))=0 for t∈[t0,∞)T and obtain some necessary and sufficient conditions for the existence of nonoscillatory bounded solutions for this equation

Oscillation for Higher Order Dynamic Equations on Time Scales

We investigate the oscillation of the following higher order dynamic equation: {an(t)[(an-1(t)(⋯(a1(t)xΔ(t))Δ⋯)Δ)Δ]α}Δ+p(t)xβ(t)=0, on some time scale T, where n≥2, ak(t)   (1≤k≤n) and p(t) are positive rd-continuous functions on T and α,β are the quotient of odd positive integers. We give sufficient conditions under which every solution of this equation is either oscillatory or tends to zero

On Boundedness of Solutions of the Difference Equation <inline-formula><graphic file="1687-1847-2009-463169-i1.gif"/></inline-formula> for <inline-formula><graphic file="1687-1847-2009-463169-i2.gif"/></inline-formula>

<p/> <p>We study the boundedness of the difference equation <inline-formula><graphic file="1687-1847-2009-463169-i3.gif"/></inline-formula>, <inline-formula><graphic file="1687-1847-2009-463169-i4.gif"/></inline-formula> where <inline-formula><graphic file="1687-1847-2009-463169-i5.gif"/></inline-formula> and the initial values <inline-formula><graphic file="1687-1847-2009-463169-i6.gif"/></inline-formula>. We show that the solution <inline-formula><graphic file="1687-1847-2009-463169-i7.gif"/></inline-formula> of this equation converges to <inline-formula><graphic file="1687-1847-2009-463169-i8.gif"/></inline-formula> if <inline-formula><graphic file="1687-1847-2009-463169-i9.gif"/></inline-formula> or <inline-formula><graphic file="1687-1847-2009-463169-i10.gif"/></inline-formula> for all <inline-formula><graphic file="1687-1847-2009-463169-i11.gif"/></inline-formula>; otherwise <inline-formula><graphic file="1687-1847-2009-463169-i12.gif"/></inline-formula> is unbounded. Besides, we obtain the set of all initial values <inline-formula><graphic file="1687-1847-2009-463169-i13.gif"/></inline-formula> such that the positive solutions <inline-formula><graphic file="1687-1847-2009-463169-i14.gif"/></inline-formula> of this equation are bounded, which answers the open problem 6.10.12 proposed by Kulenovi&#263; and Ladas (2002).</p