哮喘模型大鼠气管的张开角及残余应变

对哮喘模型大鼠气管的无载荷状态和零应力状态进行分析。与正常组相比，模型大鼠气管软骨剪开的张开角及所对应的残余应变绝对值均较正常组显著增大（P〈0．05），而且随着x／L的增大而呈明显上升趋势。模型大鼠气管肌肉剪开的张开角及所对应的残余应变绝对值无显著变化，且沿气管轴向变化不明显。结果表明哮喘大鼠气管为了适应外在应力环境的变化，肌肉部分不断进行代偿性生长，导致哮喘大鼠气道重建。     

Effect of suplatast tosilate on goblet cell metaplasia in patients with asthma

BACKGROUND: Goblet cell metaplasia is a pathologic characteristic of asthma, associated with excess mucus secretion. Interleukin (IL)-4 and IL-13 plays an important role in mucus hypersecretion. Suplatast tosilate (suplatast), an antiallergic agent, is a Th2 cytokine inhibitor that suppresses the synthesis of IL-4, IL-5, IL-13, and eosinophilic airway inflammation. OBJECTIVE: We examined the effects of suplatast on mucus production in bronchial biopsy specimens taken from asthmatic subjects. METHODS: Oral suplatast 300 mg daily, or placebo was administered for 3 months in a double-blind, parallel-group study in 25 patients with asthma. Biopsy specimens were evaluated at before and after treatment for alcian blue/period acid-Schiff (AB/PAS), MUC5AC staining in bronchial epithelium and IL-4+, IL-13+ cells as well as inflammatory cells in lamina propria. RESULTS: There were significant decreases in the percentage of AB/PAS (P < 0.01) and MUC5AC (P < 0.01) stained area in the suplatast group. These changes were accompanied by significant decreases in IL-4+ and IL-13+ cells in suplatast-treated subjects. Additionally, we have observed that the number of infiltrating eosinophils and CD4+ T cells significantly decreased. CONCLUSIONS: These findings suggest that suplatast prevents goblet cell metaplasia through modulation of Th2 cytokine production and the recruitment of eosinophils and CD4+ T cells in the asthmatic airways.     

婴幼儿呼吸道疾病B淋巴细胞状况分析

用流式细胞术测定婴幼儿哮喘、婴幼儿肺炎、婴幼儿急性上呼吸道感染患儿外周血淋巴细胞CD19、CD19+ CD2 3+ 表达 ,用化学发光免疫法测定其血清总IgE水平 ,以探索婴幼儿呼吸道疾病时B淋巴细胞及其活化状况。结果表明 ,婴幼儿哮喘组CD19+ 、CD19+ CD2 3+ 表达、血清总IgE水平明显增高 ,婴幼儿肺炎、婴幼儿急性上呼吸道感染无升高 ;婴幼儿哮喘组CD19的表达阳性率和绝对值分别与CD19+ CD2 3+ 表达阳性率和绝对值均呈正相关。提示婴幼儿哮喘存在明显的B淋巴细胞数量增多及活化异常 ,婴幼儿肺炎和婴幼儿急性上呼吸道感染B淋巴细胞状况无明显改变     

咪喹莫特治疗支气管哮喘的动物实验研究

目的 :研究咪喹莫特治疗支气管哮喘的疗效及可能的机制。方法 :建立豚鼠哮喘模型 ,随机分为 :①对照组 (哮喘组 ) ;②咪喹莫特吸入组 ;③咪喹莫特灌胃组 ;④咪喹莫特外用组 ;⑤安慰剂组。治疗 2周后 ,支气管肺泡灌洗液 (BALF)及肺组织 ,分别测定外周血IgE ,支气管肺泡灌洗液 (BALF)细胞计数、分类 ,计数肺组织切片 0 1～ 0 3mm范围的支气管壁嗜酸性粒细胞 (EOS)、淋巴细胞 (L)数。结果 :咪喹莫特治疗组外周血IgE值 ,BALF细胞计数、EOS分类及 0 1～ 0 3mm支气管周围EOS计数、L计数与对照组间或安慰剂组间有统计学意义 (P <0 0 5 ) ,而BALFL分类百分比 ,治疗组与对照组间或安慰剂组间无统计学意义。咪喹莫特治疗组间IgE值、BALF计数、EOS分类、支气管旁EOS计数、L计数方差分析均有统计学意义。 结论 :咪喹莫特能显著减轻支气管肺周围的炎性细胞的浸润 (主要表现为下调EOS与L数、EOS百分率和IgE)。咪喹莫特吸入可能是治疗支气管哮喘的一种新方法。     

川芎嗪对哮喘大鼠GATA-3及Th2型细胞因子表达的影响

目的研究腹腔注射川芎嗪对大鼠哮喘模型的防治作用及机制。方法按常用方法制作大鼠哮喘模型并分为哮喘模型组（A组），川芎嗪治疗组（L组），地塞米松治疗组（D组）和正常对照组（N组）4组，每组8只。用酶联免疫吸附实验（ELIsA）检测支气管肺泡灌洗液（BALF）中白介素-4（IL-4）和白介素-5（IL-5）的浓度。用HE染色法观察气道炎症变化。用免疫组化法研究肺组织GATA-3的表达。结果L组BALF中IL-4和IL-5的浓度以及肺组织GATA-3阳性细胞的光密度值（OD值）明显低于A组BALF的IL-4和IL-5的浓度以及肺组织GATA-3阳性细胞的OD值，差异有显著性（P〈0．01），与D组无显著差异（P〉005）。结论腹腔注射川芎嗪可以抑制哮喘大鼠IL-4和IL-5的合成，其机制可能与其降低GATA-3在肺组织的表达，从而继发抑制Th2型免疫反应有关。     

舒利迭联合孟鲁司特治疗咳嗽变异性哮喘患者气道炎症的影响分析

目的 探讨舒利迭联合孟鲁司特治疗咳嗽变异性哮喘患者气道炎症的影响.方法 选择2015年3月至2016年3月我院诊治的咳嗽变异性哮喘患者70例作为研究对象.按随机数表法分为观察组和对照组各35例.对照组采用舒利迭进行治疗,观察组在对照组的基础上联合孟鲁司特进行治疗.比较两组患者的症状改善用时情况、肺通气功能、促炎症细胞因子水平、嗜酸性粒细胞(Eosinophil,Eos)及呼出气一氧化氮(Fractional exhaled nitric oxide,FeNO)水平.结果 治疗后,观察组症状缓解和消失用时均短于对照组[(6.05±1.44)d比(7.21±1.52)d,(7.63±1.75)d比(8.74±1.58)d](P<0.05);观察组患者肺通气功能中第1秒用力呼气容积(FEV 1)、第1秒用力呼气容积占预计值百分比(FEV 1/pred)、第1秒用力呼气容积占用力肺活量比值(FEV 1/FVC)及呼气峰流速占预计值百分比(PEF/pred)均高于对照组(P<0.05);观察组的白细胞介素(interleukin,IL)-12高于对照组[(84.26±10.97)ng/L比(68.13±9.82)ng/L](P<0.05),肿瘤坏死因子 α(tumour necrosis factor-α,TNF-α)及IL-6均低于对照组[(0.65±0.13)ng/L比(0.94±0.16)ng/L,(14.11±3.78)ng/L比(20.43±4.14)ng/L](P<0.05);观察组患者的Eos及FeNO均低于对照组[(2.61±1.75)%比(5.34±2.03)%,(45.68±11.43)ppb比(78.46±18.42)ppb](P<0.05).结论 舒利迭联合孟鲁司特治疗咳嗽变异性哮喘能有效改善患者肺通气功能,缩短治疗时间,缓解患者气道炎症并改善患者的炎症反应状态,效果显著,值得推广.     

Dropouts in sublingual allergen immunotherapy trials – a systematic review

Participant dropouts can reduce the power of allergen immunotherapy clinical trials. Evaluation of the dropout rate and reasons for dropout are important not only in the planning of clinical studies but are also relevant for adherence to immunotherapy in daily clinical practice. A systematic review was carried out in order to establish the overall dropout rate among published double‐blind, placebo‐controlled randomized clinical trials of sublingual immunotherapy for respiratory allergic diseases. Dropouts were analysed in regards to allergen, formulation, treatment schedule, participant age, study size, number of centres and type of allergic disease. Relative dropout rates in placebo and active groups as well as reasons for dropout were also assessed. A total of 81 studies, comprising 9998 patients, were included. Dropout rates in sublingual immunotherapy controlled studies do not appear to be a major problem with a composite dropout percentage of 14% (95% CI:11.9–16). Furthermore, they are not different for active compared to placebo‐treated participants. This lends support to the positive clinical outcomes seen in meta‐analyses of these trials.