支气管哮喘气道重塑的研究进展

支气管哮喘(bronchial astima,以下简称哮喘)是由多种细胞(如:嗜酸性粒细胞、T细胞、肥大细胞、中性粒细胞等)和细胞组分参与的气道慢性炎症性疾病[1],以气道慢性嗜酸性粒细胞炎症、气道高反应性和不可逆性气道重塑(airwayremodeling)为特点[2]。气道重塑是由Huber和Koessler在1922年首先提出的。目前认为:气道重塑是指气道在慢性炎症刺激下所发生的气道壁结构变化,包括气道平滑肌细胞增生和肥大,细胞外基质(胶原)沉积、基底膜增厚,炎症细胞浸润和腺体增生肥大,是哮喘发病机制的一个重要环节和哮喘气道病理改变的重要基础[3,4]。进一步的…     

痰嗜酸粒细胞在支气管哮喘气道炎症中作用的研究进展

痰嗜酸粒细胞(EOS)作为支气管哮喘的炎症效应细胞,与哮喘患者气道炎症、气道重构密切相关,在哮喘发病机制中起重要作用。痰EOS作为评价哮喘治疗效果的重要指标,具有评价治疗反应性、预测哮喘再次发作风险以及提示预后等作用。连续动态监测痰EOS计数,有助于评估哮喘治疗的反应性和充分性,将其作为气道炎症标志物的哮喘管理模式在哮喘临床管理中具有一定的参考价值。由于不同哮喘患者存在气道炎症表型差异,明确表型并分别给予精准治疗方案,可优化哮喘治疗的管理方法。目前,抗白细胞介素-5治疗支气管哮喘已显示出一定的功效,针对哮喘气道EOS炎症靶向药物的治疗已得到肯定,靶向药物为未来哮喘的治疗提供了更多可能性。     

肺表面活性物质对哮喘豚鼠肺血管通透性的作用

目前认为哮喘是气道慢性炎症性疾病 ,其临床特征是气道高反应。当触发因素存在时 ,可激活多种炎症细胞和释放系列炎症介质 ,引起气道平滑肌痉挛 ,致哮喘突然发作。有报道认为炎症介质或酸中毒等会引起细胞膜通透性变化。对哮喘的进一步研究发现 ,哮喘时存在肺表面活性物质 (PS)功能不良 ,并发现肺泡 型细胞中板层体空泡化 ,而外源性 PS能够预防 [1 ] 和治疗实验性哮喘 [2 ] 。本研究旨在探讨应用 PS预防和治疗哮喘时对肺血管通透性的作用。1　材料和方法1.1　动物及分组　雄性豚鼠 5 0只 ,体质量 2 5 0～ 30 0 g(上海计划生育研究所动物…     

抗哮喘气道炎症药物的研究近况

近年来 ,通过纤维支气管镜下组织活检和支气管肺泡灌洗液细胞学的研究 ,强调了由各种因素造成的气道变应性炎症 ,气道粘膜和粘膜下层炎症细胞 ,尤其是嗜酸性粒细胞为主的气道慢性炎症是支气管哮喘的病理基础[1] 。针对哮喘发病的炎症机制 ,提出了预防和控制气道炎症应是哮喘的第一线治疗措施这一全新观念 [2 ] 。这一观念的出现使临床上摒弃了已沿用多年、经典的以支气管解痉剂为主的治疗原则。目前已知的具有抗气道炎症的药物主要包括 :皮质类固醇、肥大细胞膜稳定剂、新型抗组胺药、长效β2受体激动剂、炎症介质拮抗剂以及其它一些可能有…     

支气管哮喘诊断与治疗

支气管哮喘(bronchial asthnla哮喘)是由嗜酸性粒细胞、肥大细胞和T淋巴细胞等多种炎性细胞参与的气道慢性炎症. [发病机制] 哮喘的发病与变态反应、气道炎症、气道高反应性及神经等因素及其相互作用有关.     

叶望云教授治疗小儿咳嗽变异性哮喘经验

咳嗽变异性哮喘(coughvariantasthma,CVA)是慢性咳嗽的首要病因。2015年《咳嗽的诊断与治疗指南》指出,如咳嗽持续时间>8周应首先考虑CVA [1]。 CVA在儿童中特别常见[2],其主要表现为刺激性干咳,通常咳嗽比较剧烈,夜间咳嗽为其重要特征;感冒、冷空气、灰尘、油烟等容易诱发或加重咳嗽。CVA 的本质是特殊类型的哮喘,咳嗽是其唯一或主要临床 表现,无明显喘息、气促等症状或体征,有气道高反应性[1]。CVA具有与典型哮喘类似的病理生理特性:气道高反应性,气道嗜酸性粒细胞炎症和气道炎症[3-4]。30%未治疗的CVA可在数年内进展为典型哮喘[5]。     

支气管哮喘的药物治疗进展

支气管哮喘 (简称哮喘 )是由多种细胞 (如嗜酸性粒细胞、肥大细胞、T淋巴细胞、中性粒细胞、气道上皮细胞等 )和细胞组份参与的气道慢性炎症性疾病[1] 。其症状为反复发作性的喘息、气急、胸闷或咳嗽等 ,常在夜间和 (或 )清晨发作、加剧 ,多数患者可自行缓解或经治疗缓解。但其     

联合吸入治疗在哮喘患者中的应用

支气管哮喘是由多种细胞和细胞组分共同参与的气道慢性变态反应性炎症。哮喘以气道慢性炎症、气道高反应性和可逆性气道阻塞为主要特征。主要炎症细胞为嗜酸性粒细胞,通常它对吸入激素治疗有反应。对中重度哮喘患者而言,吸入型皮质激素已经被推荐作为一线用药并于临床广泛应用。尽管吸入激素对缓解哮喘患者临床症状确有疗效,但我们也逐渐认识到吸入激素治疗产生的剂量相关的全身不良反应[1,2]。GINA方案也指出,应当尽可能减低吸入激素的剂量来维持对哮喘的长期控制,并推荐加用长效β2受体激动剂来改善单纯吸入皮质激素症状控制困难的中重…     

温肺健脾汤治疗支气管哮喘慢性持续期临床疗效及对细胞因子、TGF-β1和VEGF水平的影响

支气管哮喘主要是由肥大细胞、T淋巴细胞及嗜酸性粒细胞等多种细胞参与,以气道炎症为特征的慢性气道疾病,表现主要为胸闷、喘息、咳嗽及气急等。而慢性持续期具有病情迁延不愈、容易发作等特点[1-2]。目前,针对哮喘慢性持续期患者的治疗,西医治疗多以阻止疾病进展、缓解症状为主,但疗效并不十分满意[3]。哮喘慢性持续期属中医“哮病”范畴,中医药可延缓气道重建、控制气道炎症及调节免疫与神经内分泌等,以此可控制哮喘,且安全性良好[4-6]。本研究探讨温肺健脾汤治疗支气管哮喘慢性持续期患者临床疗效及对细胞因子的影响,现报道如下。     

孟鲁司特钠对多种儿童哮喘的临床应用进展研究

<正>支气管哮喘是由炎性介质、气道结构细胞和细胞因子等介导的气道慢性炎症性疾病,气道炎症细胞积聚、气道高反应性和慢性炎症是哮喘的主要特征,有着多种的临床表现,患儿易受物理、化学、生物等外界环境刺激而出现反复发作的喘气、胸闷、心率不齐、咳嗽、气短等症状[1]。儿童的呼吸系统娇嫩且发育不全更易发生哮喘,影响大约7%的儿童和青少年[2]。白三烯类抗炎拮抗剂药物具有辅助提升儿童呼吸道黏液分泌、促进气道平滑肌收缩、强化血管通透性和呼吸道白细     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.