特发性间质性肺炎的分类和诊断

特发性间质性肺炎(idiopathicinterstitialpneumonia,IIP)是一组原因不明的肺间质性疾病。在过去30余年里,人们对这组疾病的临床、影像学和病理学的研究和认识在不断深入,其分类与命名亦有一个演变过程。一、特发性间质性肺炎的分类最早注意这组疾病的是Liebow等[1] ,他们从病理学角度将特发性间质性肺炎分为5种病理类型,即寻常型间质性肺炎(usualinterstitialpneumonia,UIP) ,脱屑性间质性肺炎(desquamativeinterstitialpneumonia ,DIP) ,闭塞性细支气管炎伴间质性肺炎(bronchioliticobliteranswithinterstitialpneumonia ,BIP) ,淋…     

非特异性间质性肺炎的诊断和治疗进展

非特异性间质性肺炎(nonspecificinterstitialpneumonia,NSIP)是近10年来提出的一种间质性肺炎;2002年有关特发性间质性肺炎多学科共识中认为,NSIP是特发性间质性肺炎(idiopathicinterstitialpneumonia,IIP)中的一种,NSIP发现率仅次于特发性肺纤维化(idiopathicpulmonaryfibrosis,IPF)。现有的研究认为,NSIP肺纤维化的机制不同于IPF;与其它IIP相比较,NSIP的临床、病理和影像学表现均有其特殊性;NSIP对糖皮质激素治疗的反应,存活率和预后明显好于IPF;NSIP应该是一个独立的疾病实体。     

TGF-β1的表达与特发性间质性肺炎关系分析

目的探讨特发性间质性肺炎患者TGF-β1的表达水平。方法对我院治疗的特发性间质性肺炎患者和健康体检人群的TGF-β1的表达水平进行检测,探讨TGF-β1在特发性间质性肺炎患者中的表达强度。结果特发性间质性肺炎患者TGF-β1水平高于健康体检人群,PaO2和SaO2均低于健康体检人群,组间资料比较,差异有统计学意义(P0.05)。特发性间质性肺炎各型患者中TGF-β1的表达水平不一,以脱屑性间质性肺炎表达强度最高,其次为普通型间质性肺炎和急性间质性肺炎。结论特发性间质性肺炎患者TGF-β1表达水平高于正常健康体检人群,TGF-β1在各个类型的特发性间质性肺炎患者中表达强度不同,在脱屑性间质性肺炎表达程度明显高于其他类型。     

特发性间质性肺炎的现代概念及研究进展

特发性间质性肺炎（idiopathic interstitial pneumonias, IIPs）是一组发生在肺实质的不同形式和程度的慢性炎症及纤维化所导致的异质性非特异性疾病,其中包括特发性肺纤维化（idiopathic pulmonary fibrosis, IPF）及其以外的其它间质性肺炎,发病原因不明,     

老年人特发性肺纤维化

特发性肺纤维化（idiopathi cpulmonary fibrosis,IPF）是组织病理学表现为普通间质性肺炎（usual interstitial pneumonia,UIP）的一种特殊的、慢性致纤维性间质性肺炎,在特发性间质性肺炎（idiopathic interstitial pneumonias，IIPs）中占47%～71%。与其他IIPs（如呼吸性细支气管炎相关间质性肺病RB-ILD、脱屑性间质性肺炎DIP、急性间质性肺炎AIP、淋巴细胞间质性肺炎LIP、     

特发性肺纤维化中TGF-β1诱导上皮细胞间质转化作用机制研究进展

正特发性肺纤维化(idiopathic pulmonary fibrosis,IPF)是一种慢性、进行性、纤维化间质性肺炎,为临床最常见的一种特发性间质性肺炎(idiopathic interstitial pneumonia,IIP),其特征性病理改变类型为普通型间质性肺炎(usual interstitial pneumonia,UIP)~([1-2])。IPF病理特点为Ⅱ型肺泡上皮细胞增     

弥漫性肺间质纤维化临床诊断思路

正弥漫性肺间质纤维化是一大类疾病,目前认为这类疾病至少具有以下四个特点:1病因繁多:据不完全统计其病因大约有180多种。已知病因包括职业性肺病(尘肺)、药物性肺病、结缔组织疾病相关性ILD(CTD-ILD)等。特发性间质性肺炎包括特发性肺纤维化(IPF)、非特异性间质性肺炎(NSIP)、隐源性机化性肺炎(COP)、急性间质性肺炎(AIP)、呼吸性细支气管炎间质性肺病(RB-ILD)、脱屑性间质性肺炎(DIP)和淋巴细胞性间质性肺炎(LIP)等。     

关于特发性肺纤维化病理分类的商榷

编辑同志 :我们近日比较了美国胸科学会[1] 和贵刊发表的 3篇文章[2 4 ] ,发现前文有一些不同的提法 ,主要为 :(1)特发性肺纤维化 (ＩＰＦ) [或隐源性致纤维化性肺泡炎 (ＣＦＡ) ]的定义 :ＩＰＦ是一些特发性间质性肺炎的一种 ,是一个独特的临床疾病 ;(2 )普通型间质性肺炎 (ＵＩＰ)的病理组织学类型与ＩＰＦ是一致的 ;(3)脱屑型间质性肺炎 (ＤＩＰ)、呼吸性细支气管炎伴间质性肺病 (ＲＢＩＬＤ)、急性间质性肺炎 (ＡＩＰ)、非特异性间质性肺炎 (ＮＳＩＰ)、淋巴细胞性间质性肺炎 (ＬＩＰ)以及特发性闭塞性细支气管炎伴间质性肺炎 (特发性…     

老年人特发性肺纤维化的正确诊断寓于鉴别诊断之中

特发性肺纤维化（idiopathic pulmonary fibrosis,IPF）是一种病因未知的、局限于肺的特殊的慢性纤维化性间质性肺炎,外科肺活检证实其组织学为寻常型间质性肺炎（usual interstitial pneumonia,UIP）,它是特发性间质性肺炎（idiopathic interstitial pneumonia，IIP）中最常见的类型，占IIP的60%～70%。     

非特异性间质性肺炎

非特异性间质性肺炎，是特发性间质性肺炎中继特发性肺间质纤维化后最常见的类型，它在流行病学、发病机制、临床表现、影像学特点、病理表现及预后等方面都有其自身特点，尤其是预后远较特发性肺间质纤维化好。本文将就目前对于NSIP的认识做一综述。     

ESD衍生技术的临床应用

内镜技术的问世被誉为是医学史上的一次革命,在内镜治疗方面产生了“内镜外科”和“微创手术”的新概念,消化道疾病的治疗由此进入了一个新时代。近年随着ESD的逐渐开展和经验积累,新的内镜技术和内镜附件不断涌现,国内外学者提出了诸多ESD衍生技术用于消化道疾病的治疗。本文就ESD的衍生技术在消化道疾病治疗中的应用作一综述。     

Access to primary care for Medicare beneficiaries

OBJECTIVES: To determine the acceptance rate of new Medicare patients by all primary care physicians. Among primary care physicians accepting new patients, to determine whether demographic and geographic factors are associated with the likelihood of accepting new Medicare patients. DESIGN: Cross-sectional. SETTING: Primary care physicians drawn from a national sample. PARTICIPANTS: Eight hundred forty-eight primary care physicians. MEASUREMENTS: Percentage of physicians accepting, not accepting, or conditionally accepting new Medicare patients. RESULTS: Of the 848 primary care physicians contacted, only 58% unconditionally accepted all new Medicare patients; 20% accepted new patients but restricted new Medicare patients using policies of nonacceptance or conditional acceptance. Of the 665 physicians accepting new patients, those in the south and west were more likely not to accept new Medicare patients than those in the northeast, with multivariable odds ratios (ORs) of 2.79 (95% confidence interval (CI)=1.34-5.78) and 3.14 (95% CI=1.35-7.33), respectively. Similarly, family physicians were more likely than internists not to accept new Medicare patients (OR=2.36, 95% CI=1.39-3.99). Primary care physicians in the Midwest were more likely to conditionally accept new Medicare patients than those in the northeast (OR=4.84, 95% CI=1.32-17.76), and primary care physicians in metropolitan areas with a population less than 100,000 were more likely to conditionally accept new Medicare patients than those in areas with a population greater than 100,000 (OR=2.39, 95% CI=1.18-4.84). CONCLUSION: Medicare beneficiaries' access to primary care is limited and varies significantly by region, population size, and type of provider.     

抗结核新药早期杀菌活性研究方法专家共识

结核病疫情依然严峻,迫切需要抗结核新药。新药临床试验是新药研发的最重要阶段,早期杀菌活性(early bactericidal activity,EBA)研究是新型抗结核药物首次用于结核病患者治疗时进行的临床研究,也是单个抗结核药物和新的联合方案临床评价的关键。为了规范开展以及更好地推进我国抗结核新药研发进程,首都医科大学附属北京胸科医院和《中国防痨杂志》编辑委员会共同组织结核病临床研究和基础研究领域的专家,经反复讨论,撰写了《抗结核新药早期杀菌活性研究方法专家共识》,就抗结核新药EBA的意义、设计、实施,以及影响因素等内容进行阐述。     

New trends in the chemotherapy of tuberculosis — Current aspects

A review of new achievements in tuberculosis chemotherapy in recent years is presented; new trends and concepts of treatment of tuberculosis are discussed. Emphasized are the new classification of the tuberculous agents, the role of the new drugs rifampicin and ethambutol in the new regimens particularly in chemotherapy programs. The current aspects of intermittent chemotherapy methods are discussed; their results in original treatment and re-treatment of tuberculosis are analyzed, based on our own studies and other publications. Today new principles in the applications of various treatment models, with new drug regimens, intermittent chemotherapy, and shortening of treatment duration in tuberculosis have been developed in a background of experimental and clinical trials.     

New trends in the chemotherapy of tuberculosis — Current aspects

A review of new achievements in tuberculosis chemotherapy in recent years is presented; new trends and concepts of treatment of tuberculosis are discussed. Emphasized are the new classification of the tuberculous agents, the role of the new drugs rifampicin and ethambutol in the new regimens particularly in chemotherapy programs. The current aspects of intermittent chemotherapy methods are discussed; their results in original treatment and re-treatment of tuberculosis are analyzed, based on our own studies and other publications. Today new principles in the applications of various treatment models, with new drug regimens, intermittent chemotherapy, and shortening of treatment duration in tuberculosis have been developed in a background of experimental and clinical trials.     

The COPD Biomarker Qualification Consortium (CBQC)

Abstract

Knowledge about the pathogenesis and pathophysiology of chronic obstructive pulmonary disease (COPD) has advanced dramatically over the last 30 years. Unfortunately, this has had little impact in terms of new treatments. Over the same time frame, only one new class of medication for COPD has been introduced. Even worse, the rate at which new treatments are being developed is slowing. The development of new tools for the assessment of new treatments has not kept pace with understanding of the disease. In part, this is because drug development tools require a regulatory review, and no interested party has been in a position to undertake such a process. In order to facilitate the development of novel tools to assess new treatments, the Food and Drug Administration, in collaboration with the COPD Foundation, the National Heart Lung and Blood Institute and scientists from the pharmaceutical industry and academia conducted a workshop to survey the available information that could contribute to new tools. Based on this, a collaborative project, the COPD Biomarkers Qualification Consortium, was initiated. The Consortium in now actively preparing integrated data sets from existing resources that can address the problem of drug development tools for COPD.     

蛋白质糖基化修饰：新一代肝病靶标的分子基础

肝病糖生物学研究是新一代肝病分子诊断标志物及肝癌治疗分子靶点研究的热点领域。不同肝病过程中伴随着复杂的蛋白质N-糖基化和O-糖基化修饰,这些糖基化修饰的变化导致了一些蛋白质翻译后修饰的改变,因而有可能成为未来新的肝病诊断标志物。这些修饰聚糖改变的基础在于肝细胞内部糖基转移酶和糖苷酶活性的变化,因而,对糖基转移酶和糖苷酶活性调控也有可能成为新一代抗癌药物研发的靶点。针对血清蛋白N-糖组分析也已经成为肝癌、肝硬化诊断的新方法。这些进展预示着肝病糖生物学研究将迎来一个新的时代。     

Medial temporal lobe activity can distinguish between old and new stimuli independently of overt behavioral choice

We collected fMRI data and confidence ratings as participants performed a recognition memory task that intermixed recently studied words and new (non-studied) words. We first replicated a typical finding from such studies; namely, increasing activity in medial temporal lobe structures with increasing confidence in the old/new decision. Because there are greater proportions of old items at higher confidence levels, such activity could be related to the confidence ratings or to whether items are old or new. When activity associated with old and new items was analyzed separately, we found that activity in the hippocampus bilaterally, as well as in anterior parahippocampal gyrus, was associated with the actual old/new status of the items rather than to which items participants believed to be old. Accordingly, activity in the medial temporal lobe can be modulated by the old/new status of stimuli and does not always track the behavioral response.     

New Injectable Agents for the Treatment of Type 2 Diabetes Part 1 – Injectable Insulins

The United States Food and Drug Administration has recently approved several new insulin products and new formulations of existing insulin products. These new products may provide advantages over older products, such as a lower risk of nocturnal hypoglycemia and ease of dosing; however, they are costly. The first of 2 articles in a series, this review will describe the potential advantages and disadvantages of these new insulin products.     

两种方法清理新生儿呼吸道黏液600例研究

目的研究有效清理新生儿呼吸道黏液的方法。方法我院产科足月阴道分娩并且阿氏评分8分以上的新生儿600例,随机分为试验组和对照组各300例,对照组用传统法清理呼吸道黏液,试验组在对照组的基础上增加对胃、食管的清理后转入母婴同室继续观察,实施母乳喂养,对两组新生儿发生的呕吐、吸入综合征等进行对照观察。结果试验组应用改良的呼吸道清理方法明显减少了新生儿呕吐的发生,呕吐的次数和量也明显减少,并且新生儿吸入综合征的发生率也比传统方法显著降低。结论改良法能更有效地清理新生儿呼吸道黏液。