地塞米松和环孢菌素A对IL-4、IL-5合成的抑制作用

为研究淋巴细胞在哮喘发病中的作用及地塞米松（Ｄｅｘ）、环孢菌素Ａ（ＣｓＡ）治疗哮喘的机理,用ＥＬＩＳＡ法检测哮喘患者和对照组的外周血单个核细胞（ＰＢＭＣ）在植物血凝素刺激下合成白细胞介素４（ＩＬ－４）、白细胞介素５（ＩＬ－５）水平,以及Ｄｅｘ和ＣｓＡ对哮喘患者的ＰＢＭＣ合成ＩＬ－４、ＩＬ－５的抑制作用。结果表明,哮喘组的ＩＬ－４、ＩＬ－５水平较对照组高（Ｐ＜０．０５）;１０－６ｍｏｌ／Ｌ的Ｄｅｘ和ＣｓＡ均能抑制哮喘组ＰＢＭＣ合成ＩＬ－４、ＩＬ－５,增大药物浓度至２×１０－６、３×１０－６ｍｏｌ／Ｌ时,ＣｓＡ对ＩＬ－５合成的抑制作用逐步增强;Ｄｅｘ对ＩＬ－５合成的抑制作用较ＣｓＡ强（Ｐ＜０．０５）。提示糖皮质激素和ＣｓＡ抑制ＩＬ－４、ＩＬ－５的合成是其治疗哮喘的机理之一。     

止喘雾化液的制备及其质量标准研究

目的：为了优化止喘雾化液的制备工艺,同时建立质量控制标准。方法：采用正交试验法,优选药材浸提分离工艺、增溶剂用量及最适宜ｐＨ值,同时采用ＴＬＣ、ＴＬＣＳ法建立定性定量方法。结果：该雾化液的最佳浸提工艺为药材加１０倍量水浸泡１ｈ,煎煮３次,每次１．５ｈ,配液时加５％吐温－８０,调ｐＨ至６．０～８．０;黄芩甙的含量不低于２０ｍｇ／ｍｌ。结论：止喘雾化液工艺稳定,质量可控     

A cross-sectional study of workers in the chemical industry with occupational exposure to hexamethylenetetramine

Objectives: To assess the health effects of hexamethylenetetramine (HMT) on the airways and the skin of workers in the chemical industry. Methods: A cross-sectional study was performed with 17 employees of a HMT-producing chemical plant and 16 control subjects from the plant. In addition, we examined 4 out of 5 subjects who had left the production for medical reasons during the last 10 years. Anamnestic data, total and specific IgE to four environmental allergens, lung function and bronchial responsiveness to methacholine were assessed by standard procedures. Skin prick tests (SPT) and patch tests were performed with known sensitizing substances and HMT 100 mg/ml and 2% pet and aq. Results: A high number of exposed subjects and controls reported symptoms during the previous year (64.7% vs 68.8%), most of them were not related to work. Work-related symptoms and objective parameters did not show differences between groups. No sensitizations to HMT as assessed by SPT or patch tests were found. Among those who had left the HMT production for medical reasons, 2 former baggers showed sensitizations to HMT by patch tests. These reported eczema during exposure but lost symptoms after removal from exposure. Geometric mean HMT concentrations as assessed by personal sampling were 0.3 [95% confidence intervals (CI) 0.1; 0.9] mg/m³ in shiftleaders and 0.6 (95% CI 0.3; 1.1) mg/m³ in baggers. Conclusion: High exposures to HMT may cause allergic contact dermatitis. There was no evidence of an increased risk for occupational asthma at mean airborne HMT concentrations below 1 mg/m³. Received: 4 February 1999 / Accepted: 10 July 1999     

Prevalence of asthma and respiratory symptoms in south-central Durban, South Africa

The prevalence of asthma and respiratory symptoms in south-central Durban, one of the most heavily polluted areas of South Africa, has been determined using a cross-sectional survey of 213 households in the communities of Merewent (97% Indians) and Austerville (98% coloreds). The study population consisted of 367 children (less than 17 years old) and 693 adults. About 10% of the children and 12% of adults reported doctor diagnosed asthma. The self-reported prevalence rates for wheezing (37–40%) and attacks of shortness of breath with wheeze (16–28%) were much higher than that for doctor diagnosed asthma and common co-occurrence of the three symptoms is found. The prevalence rates for other respiratory symptoms include 33–35% for chronic cough, 31–32% for chronic phlegm, 44–50% for frequent blocked-runny nose, and 16–27% for sinusitis. Factors in the community that were associated with asthma, wheeze and shortness of breath with wheeze among the adult population included cigarette smoking, use of insecticides (coils and pump spray) and home ownership. An association between asthma among children and a number of household risk factors including dampness, carpet, pets or use of pesticides was not apparent in the community. Asthma prevalence was strongly correlated with missing of school by children (odds ratio (OR): 44; 95% confidence interval (CI): 13–141). The study serves to draw attention to a growing but neglected public health problem in urban areas of Africa.     

Modelling asthma epidemics on the relationship between air pollution and asthma emergency visits in Barcelona, Spain

We have investigated different methods of controlling for asthma epidemics in the time series regression of the relationship between air pollution and asthma emergency visits in Barcelona, Spain. The relationship between air pollution and asthma emergency room visits was modelled using autoregressive Poisson models. We examined the effect of using no control by epidemics, and modelling asthma epidemics with a single dummy variable, six dummy variables, and a dummy variable for each epidemic day. Air pollution coefficients increased when controlling asthma epidemics with six dummy variables instead of a single variable. They further increased when autocorrelation was allowed for. Standard errors were relatively unaffected when either the epidemics or the autocorrelation were included in the model. Black smoke, nitrogen dioxide and ozone were statistically significant associated to asthma emergency visits after using six dummy variables to control for asthma epidemics. We have shown that different models, including different confounding variables, give markedly different estimates of the effect of a pollutant on health. Care is needed in the interpretation of such models, and careful reporting so it is clear how the confounding variables have been modelled.     

Evaluation of patient's Health-Related Quality of Life using a modified and shortened version of the Living With Asthma Questionnaire (ms-LWAQ) and the medical outcomes study, Short-Form 36 (SF-36)

Objective: The specific objectives of this study were to: 1) study the effect of moderate-to-severe asthma on patient's Health-Related Quality of Life (HRQoL) as measured by the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) and 2) evaluate the construct validity of a modified and shortened version of the Living With Asthma Questionnaire (ms-LWAQ) using the SF-36 as a concomitant measure of HRQoL. Methods: Cross-sectional, telephone or mail surveys of asthmatic patients enrolled in two central Florida managed care organizations. Results: All subscales of the SF-36 and four subscales of the ms-LWAQ demonstrated adequate reliability in this population (Cronbach >0.72). The subscales of the SF-36 most affected by patient's asthma were: general health perceptions, vitality and physical role functioning. These three subscales were correlated with four subscales of the ms-LWAQ: consequences, seriousness, affect and leisure. Six of the eight SF-36 subscales and all of the ms-LWAQ subscales were associated with patient's emergency department and hospital utilization. Conclusion: The ms-LWAQ and SF-36 are valid as useful measures of asthma patient's HRQoL in this cross-sectional study. Severity of disease, as measured by health care utilization, was significantly associated with HRQoL.     

252例儿童哮喘的门诊治疗和管理

目的为探讨儿童哮喘得到长期缓解有效方法。方法我们开展前瞻性的对２５２例哮喘儿童进行了门诊治疗与管理和家庭治疗与自我管理相结合地研究,强调长期规范治疗,并对部分患儿进行了缓解期肺功能的测定,以此评价疗效。结果经半年～１年随访,系统管理治疗规范组哮喘缓解率明显高于间歇规范组及不规范组（Ｐ＜０００１）。缓解期肺功能测定也表明规范组肺功能基本正常率明显高于其他两组（Ｐ＜００５）。结论儿童哮喘要得到长期缓解及根本控制,必须要有系统的门诊治疗管理和家庭治疗与自我管理相结合。     

Verapamil in the prophylaxis of bronchial asthma

Summary A single oral dose of verapamil 80 mg was shown significantly to inhibit histamine-induced bronchoconstriction in 8 out of 16 asthmatic subjects (maximum increase in PD_20FEVHi 416%). There was still significant protection ( PD_20FEV1Hi>100%) in the responders 5 h after the oral dose. The relationship of the bronchoprotective effect to the plasma level of verapamil was also examined. Responders and non-responders did not differ significantly in the peak plasma level or the time course of the plasma verapamil concentration.The protective effect was not correlated with the peak plasma level of verapamil or with the baseline bronchial hyperreactivity.     

平喘合剂对哮喘豚鼠T淋巴细胞凋亡的影响

目的：观察平喘合剂对哮喘豚鼠T淋巴细胞凋亡的影响。方法：运用流式细胞仪测定豚鼠T淋巴细胞凋亡率。结果：正常组豚鼠BALF（支气管肺泡灌洗液），中T淋巴细胞凋亡率最高，模型组T淋巴细胞凋亡率最低，平喘合剂组，氨茶碱组，地塞米松组BALF中T淋巴细胞凋亡率比模型组显著升高，其中氨茶碱组升高最明显，结论：平喘合剂促进T淋巴细胞凋亡可能是其有效治疗哮喘的机制之一。     

丙酸氟替卡松对儿童哮喘肺功能的影响

目的：观察哮喘患儿吸入丙酸氟替卡松（辅舒酮）治疗后对肺功能的影响程度。方法：应用德国耶格公司生产的MasterScope儿童肺功能仪对儿童哮喘进行用药前后肺功能指标测定。结果：在受检45例患儿中，经丙酸氟替卡松治疗前后其肺功能主要指标（FEVI和PEF）均有显著性差异（P＜0．05），结论：丙酸氟替卡松用于儿童哮喘的治疗及预防，对缓解症状和改善肺功能均能收到良好效果。