Background: Pulmonary cryptococcosis (PC) was not a rare infectious disease in non-AIDS patients. However, data on the immune status were lacking in southern China for comparative analysis of differences between immunocompromised and immunocompetent hosts. This study was to investigate the epidemiological, clinical, radiological, and treatment profiles for patients with PC. Methods: We performed a retrospective review of 88 patients diagnosed with tissue-confirmed PC who were not HIV-infected from 2003 to 2013. Results: Of 88 patients, 35(39.7%) were immunocompromised host. Fever and CNS symptom were significantly common in immunocompromised patients compared to immunocompetent patients (P=0.019 and P=0.036, respectively). The most frequent radiologic abnormalities were solitary or multiple pulmonary nodules, and masses or consolidations, and most lesions were located in the peripheral lung field. Cavitations and halo sign were significantly frequent in immunocompromised patients than in immunocompetent patients (P<0.05). The most frequently applied and reliable diagnostic procedure was CT-guided percutaneous translung biopsy. Treatment included antifungal drug alone in 20 patients, surgery alone in 20 including 3 treated by VATS, surgery plus antifungal drugs in 20 patients. Conclusions: PC was not rare in immunocompetent host in southern China. Special differences remained in clinical manifestation and radiological findings of PC between immunocompromised and immunocompetent patients. Future work on the mechanisms of possible differences is required.
Purpose Obstructive sleep apnea (OSA) is suggested as a potential risk factor of nonalcoholic fatty liver disease (NAFLD). However, the underlying mechanism is still far from clear. The aim of this observational study was to investigate the influence of OSA-related hypoxia on severity of liver injury in patients with NAFLD. Methods Consecutive patients with ultrasound-diagnosed NAFLD who underwent standard polysomnography were enrolled. Fasting blood samples were obtained from all patients for biological profile measurements, and demographic data were collected. Subjects were divided into control, moderate, and severe groups. Results A total of 85 subjects with 73 males and 12 females were included (mean age, 44.67 ± 1.28 years; mean body mass index, 27.28 ± 0.33 kg/m2). Alanine aminotransferase (ALT), aspartate aminotransferase (AST), ALT/AST, gamma glutamyltransferase, total cholesterol, low density lipoprotein-cholesterol, fasting glucose, and high-sensitivity C-reactive protein significantly increased with the aggravation of OSA. In multivariate analysis, oxygen desaturation index was the major contributing factor for elevated ALT (β = 0.435, p = 0.000), average O2 saturation was the major independent predictor of elevated AST (β = −0.269, p = 0.020). Conclusions OSA-related hypoxia was independently associated with the biochemical evidence of liver injury in the presence of NAFLD.