变应性肉芽肿性血管炎相关性哮喘二例

例1 男，74岁，因反复喘息伴咳嗽29年，症状加重伴发热2周，于2001年3月24日入我院。患者息1972年起反复出现喘息和咳嗽，受凉或接触敌敌畏等可诱发，一直按支气管哮喘（简称哮喘）或肺炎治疗，给予抗感染、糖皮质激素（简称激素）和氨茶碱等治疗可缓解。     

支气管哮喘气道重构的机制及对气道生理功能的影响

支气管哮喘的三大特征包括慢性气道炎症，可逆性气流阻塞及气道高反应性。近年来，气道重构在哮喘中的作用越来越受到重视，它对哮喘的气道功能，自然病程，药物疗效及预后等多方面都有明显的影响，随着气重柢的组织病理学特征被逐渐揭示出来，这种病理学改变的学生机制及其与气道生理功能的关系更为引人注目。     

肺癌合并结核感染1例临床分析

1 病例 患者,男性,51岁,主因"喘憋、咳嗽半月"于2007年8月20日入院. 现病史:患者入院前半个月(2007年8月5日)无明显诱因出现憋气,坐位及活动时明显,平卧可减轻;伴咳嗽,咯少量白色黏痰.     

支气管哮喘气道重构的机制及对气道生理功能的影响

支气管哮喘的三大特征包括慢性气道炎症、可逆性气流阻塞及气道高反应性。近年来,气道重构在哮喘中的作用越来越受到重视。它对哮喘的气道功能、自然病程、药物疗效及预后等多方面都有明显的影响。随着气道重构的组织病理学特征被逐渐揭示出来,这种病理学改变的发生机制及其与气道生理功能的关系更为引人注目。     

禽流感的历史和现状

20世纪，人类经历了3次流感的暴发流行；进入21世纪，人类比任何时候都更接近流感的再次暴发。高致病性禽流感病毒（H5N1亚型）这种在禽类传播的病毒正在跨越种属的界限，也许在不远的将来，它改头换面成为人类流感暴发流行的元凶。     

小梁切除联合前房注入肾上腺素治疗新生血管性青光眼

新生血管性青光眼 (NVG)常继发于糖尿病性视网膜病变、视网膜中央静脉阻塞等视网膜缺氧性病变 ,药物治疗很难控制病情发展 ,手术治疗方法及疗效报道差异很大。本文总结奉化市人民医院 6例NVG患者给予小梁切除联合前房注入肾上腺素手术 ,进行局部治疗 ,追踪随访疗效 ,分析总结如下。1　资料与方法1 1　一般资料　 6例NVG中 ,男 5例 ,女 1例 ,年龄4 2～ 74岁 ,平均 6 4岁 ,均为单眼发病。糖尿病引起视网膜病变 3例 ,眼外伤 2例 ,视盘血管炎 1例 ,其中 1例做过滤过性手术 ,2例做过睫状体冷冻 ,均不能控制眼压。 6例NVG病人临床资料详见表 …     

高危后循环短暂性脑缺血发作患者CD4＋CD25＋调节性T细胞检测及意义

目的 探讨高危后循环短暂性脑缺血发作患者外周血CD4+ CD25+调节性T细胞(Treg)水平及意义.方法 采用流式细胞分析法,检测21例高危后循环短暂性脑缺血发作患者、19例眩晕综合征患者及20例健康成人外周血Treg占CD4+T细胞比例.结果 高危后循环短暂性脑缺血发作组外周血Treg/CD4+T细胞比例(5.66％±1.91％)显著低于眩晕综合征组(9.18％±2.26％)和健康成人组(9.21％±2.71％).结论 高危后循环短暂性脑缺血发作患者外周血Treg比例下降.Treg比例降低可能破坏了外周自身免疫耐受并参与了动脉粥样硬化的发生发展,可能是高危后循环短暂性脑缺血发作的发病机制之一.     

天麻素缓释片对高危后循环短暂脑缺血发作患者外周Treg和IL-17的影响

目的 探讨天麻素缓释片对高危后循环短暂脑缺血发作(TIA)患者外周CD＋4CD＋25调节性T细胞(Treg)比例及白细胞介素-17(IL-17)浓度的影响.方法 将63例患者随机分为对照组(31例)和治疗组(32例),对照组采用拜阿司匹林肠溶片、阿托伐他汀钙片、注射用丹参多酚酸盐等常规治疗.治疗组在上述常规治疗的基础上加用天麻素缓释片,疗程均为28 d.应用流式细胞分析法及酶联免疫吸附法检测治疗前后患者外周Treg/(CD＋4T)细胞比例及IL-17浓度的变化.结果 治疗前,两组患者Treg/(CD＋4T)细胞比例及IL-17浓度差异无统计学意义(P＞0.05);治疗后,治疗组Treg/(CD＋4T)细胞比例(15.30±2.97)高于对照组(13.48±2.58),差异有统计学意义(P＜0.05),治疗组IL-17浓度(184.63±65.76)低于对照组(231.91±68.30),差异有统计学意义(P＜0.05).结论 天麻素缓释片可能有助于改善高危后循环TIA患者的自身免疫炎症反应失衡.     

2014-2015年中国40岁及以上慢性阻塞性肺疾病患者肺炎疫苗接种状况

目的 了解我国≥40岁慢性阻塞性肺疾病（慢阻肺）患者的肺炎疫苗接种状况,为慢阻肺的防控提供科学依据。方法 将2014-2015年中国居民慢性阻塞性肺疾病监测中支气管舒张试验后测试FEV₁/FVC<70%的调查对象作为慢阻肺患者,其中9 067名通过询问调查明确肺炎疫苗接种情况的患者被纳入本研究分析。应用复杂抽样调整方法,估计慢阻肺患者中的肺炎疫苗接种率及其95% CI,并对其影响因素进行分析。结果 我国≥40岁慢阻肺患者的5年内肺炎疫苗接种率是0.8%（95% CI：0.3%～1.4%）。40～岁组患者的肺炎疫苗接种率是0.3%（95% CI：0.2%～0.5%）,≥60岁组患者的接种率为1.2%（95% CI：0.3%～2.1%）（P<0.05）;城镇患者的接种率（1.5%）高于乡村患者（0.4%）（P<0.05）;慢阻肺患者的气流受限程度越严重,其肺炎疫苗接种率越高（P<0.05）;合并其他慢性肺部疾病或糖尿病的患者接种率为1.7%、2.1%,高于未合并的患者（P<0.05）;曾经吸烟的慢阻肺患者肺炎疫苗接种率为1.4%,现在吸烟的患者接种率为0.6%。慢阻肺患者的肺炎疫苗接种与年龄、文化程度、职业、气流受限严重程度分级、流感疫苗接种史有关。结论 我国≥40岁慢阻肺患者的肺炎疫苗接种率非常低,需要采取多种措施加强对慢阻肺患者的健康教育与肺炎疫苗接种推荐。     

Chinese adults′ cognition of respiratory diseases in Healthy China Initiative (2019—2030)CSCD

Objective To investigate the cognition of Chinese adults on respiratory health in the Healthy China Initiative (2019—2030). Methods From January 2022 to February 2022, the electronic questionnaire was distributed by using the two‑dimensional code on the Wechat platform. The questionnaire involving the respiratory health part of the Healthy China Initiative (2019—2030) was conducted among people aged ≥18 years (except pregnant and postpartum women) in 32 provincial administrative regions in China. A total of 5 892 questionnaires were distributed, 4 754 valid questionnaires were recovered. Chi square test was used to analyze the basic situation of the survey subjects, the cognition of people in different regions to the content, the correlation between physical activity and age stratification, the correlation between smoking cessation and disease, and the common cognitive misunderstanding of chronic obstructive pulmonary disease. Results Of the 4 754 subjects in this study, 3 462 were from urban area and 1 292 were from rural area. In terms of active participation in lung cancer screening, regular physical examination, no awareness of reducing risk factors exposure, isolation of pulmonary tuberculosis patients, reduction of travel of pulmonary tuberculosis patients, wearing masks when contact with pulmonary tuberculosis patients, active learning of medical and health care knowledge, and timely medical treatment in case of health problems, the cognition status of people in the city was better than people in the rural areas (all P< 0.05). The compliance rates of moderate intensity physical activity and high intensity physical activity were 72.7% and 83.8%, respectively, among the population aged 18—64 years old; the compliance rates of moderate intensity physical activity and high intensity physical activity were 82.3% and 85.7%, respectively, among the population aged≥65 years old; the proportions of light intensity physical activity in people aged 18—64 and ≥65 years old were 65.2% and 87.6%, respectively. There was a correlation between whether the patients had respiratory diseases and whether they were troubled by respiratory diseases for a long time and their determination to quit smoking (all P<0.05); the rate of common misconceptions about chronic obstructive pulmonary disease among Chinese adults was between 13.0% and 38.0%, and the rate of misconceptions among people with college education or above who believed that even if the cognition of chronic obstructive pulmonary disease was improved and the diagnosis and treatment were standardized, the treatment of the disease was still ineffective was as high as 30.3%; in addition, the rate of two cognitive misunderstandings (when the symptoms of chronic obstructive pulmonary disease were mild, no intervention was needed; the medication can be discontinued when the symptoms were relieved) of people with college education or above were 24.2% and 25.8%, respectively, which were higher than those with primary school education and junior high school education (all P<0.05). Conclusions The cognition of Chinese adults on early screening of respiratory diseases, reduction of exposure to risk factors, prevention and control of tuberculosis, and acquisition of scientific knowledge in the Healthy China Initiative (2019—2030) is generally poor. The participation of people <65 years old in high‑intensity physical activities is insufficient, and the cognition of people with high education level does not show advantages. © 2021 Journal of Clinical Otorhinolaryngology Head and Neck Surgery. All rights reserved.