Clinical features fail to distinguish respiratory infections caused by Branhamella catarrhalis from those caused by Haemophilus influenzae

Branhamella catarrhalis is being isolated with increasing frequency from patients with symptoms and signs of respiratory tract infection. Records of 77 patients were reviewed to define the spectrum of respiratory illness and to compare clinical and laboratory features with those of respiratory infection due to Haemophilus influenzae. Both B catarrhalis and H influenzae caused respiratory infection predominantly in elderly males with underlying heart or lung disease. There were no clinical or laboratory features aside from sputum Gram stain and culture which differentiated the two groups. Although fewer than one-half of each group received antibiotics, no patient developed progressive respiratory disease.     

三氮唑核苷不同途径给药治疗喘憋性肺炎疗效评价

本文采用三氮唑核苷超声雾化吸入治疗喘憋性肺炎，并与静脉用药比较，结果表明：用药前及用药后末梢血象变化，雾化给药不影响血液系统，而且有助于红细胞、血红蛋白恢复正常，无论在止咳、平喘、肺部罗音及Ｘ线炎症吸收效果均明显优于静脉给药组（Ｐ＜０．０１），提示超声雾化吸入用于治疗呼吸道感染（ＡＲＩ），可以取代静脉途经用药，其疗效快，安全方便，避免静脉用药所引起的不良反应。     

嗜酸粒细胞性支气管炎气道炎症病理特征的探讨

目的： 观察嗜酸粒细胞性支气管炎（EB）气道粘膜炎症的病理特征，并与咳嗽变异型哮喘（CVA）进行比较。 方法： 对11例EB患者行纤支镜支气管粘膜活检，并以10例正常对照、10例CVA和14例典型支气管哮喘的支气管粘膜标本作对照。光镜下测量各组气道粘膜上皮的基底膜厚度，并通过免疫组化和特殊染色技术，计算EB和CVA组气道粘膜固有层中炎症细胞（嗜酸粒细胞、肥大细胞、T淋巴细胞）的浸润密度。 结果： EB组支气管粘膜基底膜厚度［2.92 μm(2.10-6.50)μm］显著高于对照组［2.08 μm(1.62-3.40 μm)］, P<0.05，同时显著低于CVA组［5.64 μm (3.23-8.48 μm)］, P<0.05，而CVA组的基底膜厚度又显著低于典型哮喘组［9.08 μm (6.61-11.99 μm)］, P<0.01；EB组气道粘膜固有层可见肥大细胞和嗜酸粒细胞散在分布，浸润密度分别为［75 cells/mm2(35-112 cells/mm2)］和［7 cells/mm2(0-31 cells/mm2)］，显著低于CVA组［148 cells/mm2(34-200 cells/mm2)，114 cells/mm2(1-768 cells/mm2)］, P<0.05，淋巴细胞浸润密度无显著差异。 结论： EB是以嗜酸细胞浸润为特征，涉及多种炎症细胞的慢性气道炎症性疾病，但气道粘膜基底膜厚度显著低于CVA和典型哮喘，炎症细胞浸润程度低于CVA，均可能是EB缺乏气道高反应性的重要机制。     

慢性支气管炎性急性发作期危重病人外周血B和T细胞CD分子的检测

目的 对慢性支气管炎急性期和缓解期患者外周血B细胞和T细胞CD分子检测并了解其变化。方法 用荧光单抗CD19^ 、CD4^ 、CD8^ ／CD28^ 对B细胞和T细胞亚群进行标记和记数。结果 慢性支气管炎急性发作期患者与缓解期患者相比,体内辅助性T淋巴细胞无明显变化,抑制性T淋巴细胞增加,细胞毒性T淋巴细胞减少,B淋巴细胞二者间无差异。结论 因慢性支气管炎急性期危重病人T淋巴细胞亚群变化,造成免疫功能紊乱。因此,在治疗疾病过程中,除对症处理外,另须配合使用提高免疫功能的药物,改善免疫功能。     

卡介菌多糖核酸治疗慢性支气管炎的疗效评价

为了评价卡介菌多糖核酸对慢性咳嗽咳痰病人的疗效,随机双盲地将慢性咳嗽咳痰病人136例分为卡组72例,对照组64例。两组病人严格按照慢性单纯性支气管炎和慢性喘息性支气管炎的诊断规范再分为2个亚组。在卡组病人中用卡介菌多糖核酸0.5mg/d×36d治疗后和对照组对比,结果显示:①卡组:慢单支组总有效率100％,慢喘支组92.68％;对照组:慢单支组91.67％,慢喘支组75％。②慢单支组:明显显效率卡组明显高于对照组(P=0.0001)。③慢喘支组:卡组中明显显效率和显效率均高于对照组(分别为P=0.0226;P=0.0012)。由此可见,卡介菌多糖核酸是治疗慢单支、慢喘支的有效药物,且疗效好,副作用少。     

慢性支气管炎大鼠内皮素和肾上腺髓质素水平的变化及牛磺酸的作用

目的:探讨内皮素(endothelin,ET)和肾上腺髓质素(adrenomedullin,AdM)在慢性支气管炎大鼠血浆、支气管肺泡灌洗液(bronchoalveolarlavagefluid,BALF)和肺组织中含量的变化及牛磺酸的影响。方法:实验分为慢支组、牛磺酸组和对照组,每组6只大鼠。大鼠吸入含10-6(体积分数)二氧化硫的混合空气建立慢性支气管炎模型。放免法测定ET1和AdM含量。结果:血浆、BALF和肺组织ET1含量,慢性支气管炎动物比对照动物分别增加239%、243%和367%(P<0.01),牛磺酸组比慢支组分别降低31.7%、36.7%和62.6%(P值分别小于0.05、0.01和0.01)。血浆、BALF和肺组织AdM含量,慢支组大鼠比正常对照大鼠分别增加40%、100%和138%(P<0.01),牛磺酸组大鼠比慢支组分别减少18.6%、28.5%和29.5%(P值分别小于0.05、0.01和0.01)。结论:慢性支气管炎病程中ET1和AdM可能发挥一定作用;牛磺酸可能通过阻止ET1和AdM调节紊乱的发生发挥保护作用。     

金水六君煎治疗慢性支气管炎喘息型急性发作期56例疗效观察

目的　观察金水六君煎治疗慢性支气管炎喘息型急性发作期的临床疗效。方法　 10 2例慢性支气管炎喘息型急性发作期患者随机分为 2组 ,治疗组 5 6例给予金水六君煎 ,每日 1剂 ,水煎服 ;对照组 5 0例 ,采用常规持续低流量吸氧、静脉滴注抗生素、纠正水电解质平衡失调的基础上 ,静脉滴注氨茶碱、地塞米松治疗。 2组均 2周为 1个疗程 ,1个疗程后观察疗效。结果　治疗组总有效率为 92 .86 %,对照组为 78.0 0 %,2组比较有显著性差异 (P <0 .0 5 )。结论　金水六君煎治疗慢性支气管炎喘息型急性发作期能迅速改善症状 ,缩短疗程 ,无毒副作用 ,提高临床疗效。     

三伏天穴位拔罐敷贴治疗支气管炎、哮喘112例临床观察

目的 观察三伏天穴位拔罐贴敷对支气管炎、哮喘的临床疗效。方法 对112例患者，采用本院自制”伏贴膏”．在背部钉穴拔罐后，将药饼用胶布贴于穴位上，4-6h后患者自行去掉。结果 显效63例，有效45例．无效4例．总有效率为96．43%。结论 三伏天穴位拔罐、药物贴敷对防治支气管炎、哮喘有较好的疗效。     

Add-on treatment with nebulized hypertonic saline in a child with plastic bronchitis after the Glenn procedure,

Plastic bronchitis (PB), although a rare cause of airway obstruction, has mortality rates up to 50% in children after Fontan-type cardiac surgery. We present the case of an 18-month-old female patient with PB following pneumonia. At 6 months of age, the patient underwent the Glenn procedure due to functionally univentricular heart. Fiberoptic bronchoscopy revealed complete blockage of the left bronchus by mucoid casts. Pharmacotherapy consisted of glucocorticosteroids, azithromycin, and enalapril maleate. The child also received nebulized 3% NaCl solution, which proved to be beneficial. In children submitted to Fontan-type procedures, physicians must be alert for PB, which can be triggered by respiratory tract infection.     

Poly-Ingredient Formulation Bresol? Ameliorates Experimental Chronic Obstructive Pulmonary Disease (COPD) in Rats

In the present study, the protective effect of Bresol^® – a polyherbal formulation – was evaluated in an experimental model of cigarette smoke (CS)-induced COPD in rats. Ten minutes daily exposure to CS for 7 weeks caused significant elevation of TNF-α (p<0.01) and total protein (p<0.01) in the bronchoalveolar lavage fluid (BALF) of positive untreated control animals, indicating ongoing inflammatory process in the lungs. Further, histopathological findings have confirmed the presence of pathological lesions in the trachea and lungs. Five weeks of post-treatment with Bresol^® (250 and 500 mg/kg, p.o.) showed significant and dose-dependent anti-inflammatory effects against CS-induced lung abnormalities by maintaining the TNF-α and total protein levels within the normal range. Additionally, Bresol^®-treated animals showed normal cyto-architecture of the trachea and lungs. In conclusion, Bresol^® showed dose-dependent protection against CS-induced lung and tracheal injury in rats, which further indicates, Bresol^® is a useful healing agent, may help to decelerate the progression of COPD, and reduce the exacerbations in patients.