We report a case of acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) after pandemic influenza (H1N1) vaccination. A 57-year-old man, who had been diagnosed with IPF in September 2008, was admitted to our hospital in December 2009 because of aggravation of dyspnea and fever two days after H1N1 vaccination. Chest computed tomography showed diffuse bilateral ground-glass opacities superimposed on preceding reticular opacities. We diagnosed AE-IPF. Corticosteroid and cyclophosphamide were effective. Although the efficacy of influenza vaccination in patients with chronic lung diseases is well established, physicians should keep in mind that influenza vaccination has the potential to cause AE-IPF.

SETTING: There is sparse epidemiologic information regarding the role of dietary factors in the development of idiopathic pulmonary fibrosis (IPF).

OBJECTIVE: To examine the relationship between specific types of fatty acids and selected foods high in fat and IPF in Japan.

DESIGN: Included were 104 cases aged>or = 40 years who had been diagnosed in the last 2 years in accordance with the most recent criteria. Controls aged>or = 40 years consisted of 56 hospitalised patients diagnosed as having acute bacterial pneumonia and four out-patients with common cold.

RESULTS: Intake of saturated fatty acids, mono-unsaturated fatty acids, n-6 polyunsaturated fatty acids and meat was independently associated with an increased risk of IPF. Specifically, the multivariate OR for comparison of the highest with the lowest quartile of intake of saturated fatty acids was 6.26 (95%CI 1.79-24.96, P for trend = 0.01) and for meat it was 7.19 (95%CI 2.15-27.07, P for trend = 0.02). Intake of cholesterol, n-3 polyunsaturated fatty acids, fish, eggs and dairy products was not related to the risk.

CONCLUSION: These findings suggest that consumption of saturated fatty acids and meat may increase the risk of IPF.

OBJECTIVE: To explore the mechanism of moxibustion arresting the pulmonary fibrosis and provide experimental basis for prevention and treatment of pulmonary fibrosis with acupuncture and moxibustion. METHODS: One hundred and forty SD rats were randomly assigned to 4 groups: a blank group, a model group, a moxibustion group and a prednisone group, 35 rats in each group. The 3 groups expect the blank group were injected with bleomycin via trachea to induce experimental pulmonary fibrosis model, and 7 days after modeling, they were treated with moxibustion at bilateral Feishu (BL 13) and Gaohuang (BL 43), 3 cones each point, once each day, 10 days constituting one therapeutic course with an interval of one day between courses. After 3 courses, all rats were killed and expressions of TGF-beta1mRNA were detected with PCR method. RESULTS: The content of TGF-beta1mRNA in the pulmonary tissue in the moxibustion group and the prednisone group was significantly lower than the model group (P<0.01), and there was no significant difference between the moxibustion group and the prednisone group (P>0. 05). CONCLUSION: Both moxibustion at Feishu (BL 13) and Gaohuang (BL 43), and prednisone treatment can significantly suppress the expression of TGF-beta1mRNA in the pulmonary tissue in the rat of bleomycin-induced pulmonary fibrosis.

OBJECTIVE: To study on the effect and mechanism of curcumin on inhibiting injury induced by free radical in pulmonary fibrosis. METHOD: One hundred and forty-four male SD rats were randomly divided into 6 groups (24 rats in each group). Rats in the model control group, positive medicine group, and high, moderate and low curcumin groups were injected with a single dose of bleomycin by trachea, and rats in sham-model control group with same volume normal saline. One day after the injection, curcumin solution of different dosages (200,100,50 mg x kg(-1) x d(-1)) was respectively given to rats in the high, moderate and low curcumin group by daily gastrogavage, while equal volume of normal saline was given to those in the sham-model control group and model control group, and an equal volume of prednisone (0.56 mg x kg(-1) x d(-1)) was saline was given to those in positive medicine control group. On the 7, 14, 28 days, the contents of GSH-Px, SOD, MDA and iNOS in pulmonary tissues of different groups were measured. RESULT: Curcumin can raise the content of SOD and GSH-Px and lessen the level of MDA and iNOS. CONCLUSION: Curcumin can regulate the level of free radical in the body of rats with pulmonary fibrosis and lessen the oxidative injury of pulmonary tissues caused by free radical, in the body of rats with pulmonary fibrosis. The mechanisms of curcumin on idiopathic pulmonary fibrosis lie in adjusting the level of free radical and inhibiting the injury of lung tissue induced by free radical.

INTRODUCTION: Evaluation of effectiveness of pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis (IPF) has not yet been presented in medical literature. The objective of the study is to analyze the influence of inspiratory muscle training on dyspnea (oxygen cost diagram [OCD], baseline dyspnea index [BDI]), quality of life (SF-36), results of 6 MWT (distance, dyspnea in Borg's scale), maximal inspiratory pressure (MIP), and lung function tests (IC, TLC, VC, FEV1, DLCO(SB), DLCO/VA) in patients with IPF. MATERIAL AND METHODS: Investigations were conducted before, after 6 and 12 weeks of pulmonary rehabilitation performed in 2 groups of patients: study group (GB)--16 patients--with inspiratory muscle training added to general body conditioning and in control group (GK)--14 patients--who performed only general body conditioning. RESULTS: After 12 weeks of rehabilitation in SG we noticed the significant decrease of dyspnoea before (p = 0.028) and after (p = 0.012) 6 MWT, increase of distance in 6 MWT (p = 0.001), increase of MIP (p = 0.006), decrease of dyspnoea in BDI (p = 0.001) and improvement of quality of life (SF-36/PCS; p = 0.030) in comparison to baseline values. In the GK we observed increase of distance in 6MWT (p = 0.001) and improvement in quality of life (SF-36/PCS; p = 0.016). No improvement in sensation of dyspnea during 6MWT, BDI and MIP was noticed in the GK. CONCLUSION: Adding inspiratory muscle training increases effectiveness of pulmonary rehabilitation in IPF patients.