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Progress in the treatment of Pneumocystis pneumonia 肺囊虫性肺炎的治疗进展
Pub Date : 2020-01-20 DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.02.014
Tong-Zeng Li
Pneumocystis pneumonia (PCP) is a pulmonary disease that occurs frequently in immunocompromised and acquired human immunodeficiency virus infected patients.Severe patients can be life-threatening.Trimethoprim-sulfamethoxazole is the first choice for first-line treatment, but it has potential drug resistance.Most mild patients have good prognosis after using compound sulfamethoxazole and active treatment of primary diseases.However, for severe patients, due to lack of specific diagnostic methods in the early stage, the course of disease progresses rapidly, and glucocorticoid therapy can be combined to reduce the mortality of PCP.This article reviews the progress of treatment of PCP. Key words: Pneumonia; Homones; Sulfamethoxazole; Spores
肺囊虫性肺炎(PCP)是一种常见于免疫功能低下和获得性人类免疫缺陷病毒感染患者的肺部疾病。严重的病人可能危及生命。甲氧苄啶-磺胺甲恶唑是一线治疗的首选药物,但有潜在的耐药性。多数轻症患者在应用复方磺胺甲恶唑并积极治疗原发疾病后预后良好。但对于重症患者,由于早期缺乏特异性的诊断方法,病程进展迅速,可联合糖皮质激素治疗,降低PCP的死亡率。本文就PCP的治疗进展作一综述。关键词:肺炎;性激素;磺胺甲恶唑;孢子
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引用次数: 0
Study on expression of RYR2, FKBP12.6 and CaMK-II in lung tissue of patients with chronic obstructive pulmonary disease 慢性阻塞性肺疾病患者肺组织中RYR2、FKBP12.6和CaMK-II表达的研究
Pub Date : 2020-01-20 DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.02.003
Xi Wang, Ping Li, B. Zhuan, Qun Yuan, Jun Xie, Zhao Yang
Objective To explore the significance of immunohistochemical expression of Ryanodine receptor 2 (RYR2), FK506-binding protein 12.6 (FKBP12.6) and Calcium/ calmodulin dependent protein kinaseⅡ (CaMK-Ⅱ) in lung tissues from patients with chronic obstructive pulmonary disease (COPD). Methods A retrospective analysis from November 2012 to April 2017 in People′s Hospital of Ningxia Hui Autonomous Regin, lung tissue of 30 patients after lung cancer surgery, according to the results of pulmonary function test and Cardio-Uhrasonography, the patients were divided into three groups: COPD with pulmonary hypertension (PH)(group A) and COPD group (group B), non-COPD, non-PH patients with pulmonary tumor as the negative control group (group C). Take lung tissue about 5 cm from the cancerous area was removed after surgery.The Circum-ferential area of pulmonary valve of the three groups has been observed.To observe RYR2, FKBP12.6 and CaMK-Ⅱby immunohistochemical method respectively, then make correlation analysis. Results (1)Compared with group C, wall area% (WA%), pulmonary artery systolic pressure (PASP) were higher in group A and group B (F=24.115, 9.421, both P<0.05), and WA%, PASP were higher in group A than group B. (2)Compared with group C, the immunohistochemical expressions of RYR2, FKBP12.6 and CaMK-Ⅱ in group A and group B were all increased (F=9.219, 6.143, 11.337, all P<0.05), and the immunohistochemical expressions of RYR2, FKBP12.6 and CaMK-Ⅱ in group A was higher than group B. (3)Correlation analysis indicated that the immunohistochemical expressions of RYR2 in group A and B was positively correlated with WA% (r=0.547, 0.771, both P<0.01), while the immunohistochemical expressions of RYR2 in group A was positively correlated with PASP (r=0.773, P<0.01). Histochemical expressions of FKBP12.6 in group A were positively correlated with WA% (r=0.796, 0.810, both P<0.01), and the immunohistochemical expressions of FKBP12.6 in group A was positively correlated with PASP (r=0.729, P<0.01). The immunohistochemical expressions of CaMK-Ⅱ in group A and B were positively correlated with WA% (r=0.879, 0.504, both P<0.01), and the immunohistochemical expressions of CaMK-Ⅱ in group A was positively correlated with PASP (r=0.748, P<0.01). Conclusions FKBP12.6 and CaMK-Ⅱ may play a role in COPD-related pulmonary artery proliferation. Key words: Pulmonary disease, chronic obstructive; Hypertension, pulmonary; Ryanodine receptor calcium release channel; Calcium-calmodulin-dependent protein kinase type 2; FK506-binding protein 12.6
目的探讨慢性阻塞性肺疾病(COPD)患者肺组织中Ryanodine受体2 (RYR2)、fk506结合蛋白12.6 (FKBP12.6)和钙/钙调素依赖性蛋白激酶Ⅱ(CaMK-Ⅱ)免疫组化表达的意义。方法回顾性分析2012年11月至2017年4月宁夏回族自治区人民医院收治的30例肺癌术后肺组织患者,根据肺功能检查及超声心动图结果,将患者分为3组:COPD合并肺动脉高压(PH)组(A组)、COPD组(B组)、非COPD、非PH合并肺肿瘤患者作为阴性对照组(C组)。术后取距癌区约5cm的肺组织切除。观察三组患者肺动脉瓣围周面积。采用免疫组化方法分别观察RYR2、FKBP12.6和CaMK-Ⅱ,并进行相关性分析。结果(1)与C组比较,A组和B组的壁面积% (WA%)、肺动脉收缩压(PASP)均高于B组(F=24.115、9.421,均P<0.05), A组的WA%、PASP均高于B组(2)与C组比较,A组和B组的RYR2、FKBP12.6、CaMK-Ⅱ免疫组化表达均升高(F=9.219、6.143、11.337,均P<0.05), RYR2、A组FKBP12.6、CaMK-Ⅱ均高于B组。(3)相关性分析显示,A组和B组RYR2免疫组化表达与WA%呈正相关(r=0.547、0.771,均P<0.01), A组RYR2免疫组化表达与PASP呈正相关(r=0.773, P<0.01)。A组FKBP12.6的组织化学表达与WA%呈正相关(r=0.796, 0.810,均P<0.01), A组FKBP12.6的免疫组织化学表达与PASP呈正相关(r=0.729, P<0.01)。A、B组CaMK-Ⅱ免疫组化表达与WA%呈正相关(r=0.879、0.504,均P<0.01), A组CaMK-Ⅱ免疫组化表达与PASP呈正相关(r=0.748, P<0.01)。结论FKBP12.6和CaMK-Ⅱ可能在copd相关肺动脉增生中起作用。关键词:肺部疾病;慢性阻塞性肺疾病;高血压、肺;赖诺定受体钙释放通道;钙钙调素依赖性蛋白激酶2型;fk506结合蛋白
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引用次数: 0
Advances in research of pulmonary micro-ecology in chronic obstructive pulmonary disease 慢性阻塞性肺疾病肺微生态研究进展
Pub Date : 2020-01-20 DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.02.011
Lin Chen
Chronic obstructive pulmonary disease (COPD) is a common and preventable disease.However, due to its high number of patients and high mortality, it is still highly valued.Although the research on the occurrence and development of COPD has gradually deepened in recent years, it still can not fully reveal the nature of its disease.Therefore, it is urgent to explore from a new perspective to develop new treatment methods.With the development of molecular biology, people gradually recognize the concept of pulmonary micro-ecology, and related research is further explored.Future research on pulmonary micro-ecology will provide new and effective treatments for the prevention and treatment of COPD. Key words: Pulmonary disease, chronic obstructive; Pathogenesis; Pulmonary micro-ecology
慢性阻塞性肺疾病(COPD)是一种常见且可预防的疾病。然而,由于患者数量多,死亡率高,它仍然受到高度重视。虽然近年来对慢阻肺发生发展的研究逐渐深入,但仍不能完全揭示其疾病的本质。因此,迫切需要从新的角度探索开发新的治疗方法。随着分子生物学的发展,人们逐渐认识到肺微生态的概念,相关研究也在进一步探索。未来肺微生态的研究将为COPD的防治提供新的有效的治疗方法。关键词:肺部疾病;慢性阻塞性肺疾病;发病机理;肺、胃肠道
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引用次数: 0
Research progress of voriconazole in the treatment of cryptococcal infection 伏立康唑治疗隐球菌感染的研究进展
Pub Date : 2020-01-20 DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.02.015
Jiejun Shi, G. Qian, N. Yang
Voriconazole (C16H14N5OF3) is a novel triazole antifungal drug with broad spectrum, strong potency, good tolerance and high safety.It is a derivative of fluconazole, but it has a broader antibacterial spectrum and stronger bactericidal action than fluconazole.It can highly selectively inhibit the biosynthesis of ergosterol in various fungal cell membranes.Voriconazole has high permeability to the blood-brain barrier and blood-eye barrier, thus it can reach multiple sites of cryptococcal infection with effective drug concentration.In addition, it has a certain effect on drug-resistant fungi.What′s more, voriconazole can regulate immunity to accelerate the clearance of fungi in the lesion.Therefore, voriconazole is widely used in clinical practice.This article reviews the pharmacological effects, basic research of voriconazole and its application in cryptococcal infection. Key words: Cryptococcosis; Voriconazole
伏立康唑(Voriconazole, C16H14N5OF3)是一种广谱、强效、耐受性好、安全性高的新型三唑类抗真菌药物。它是氟康唑的衍生物,但具有比氟康唑更广泛的抗菌谱和更强的杀菌作用。它能高度选择性地抑制麦角甾醇在多种真菌细胞膜上的生物合成。伏立康唑对血脑屏障和血眼屏障具有较高的渗透性,能以有效的药物浓度到达隐球菌感染的多个部位。此外,对耐药真菌也有一定的作用。伏立康唑还能调节免疫,加速病灶内真菌的清除。因此伏立康唑被广泛应用于临床。本文综述伏立康唑的药理作用、基础研究及其在隐球菌感染中的应用。关键词:隐球菌病;伏立康唑
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引用次数: 0
Research progress of skeletal muscle dysfunction and related pulmonary rehabilitation in chronic obstructive pulmonary disease 慢性阻塞性肺疾病骨骼肌功能障碍及相关肺康复研究进展
Pub Date : 2020-01-20 DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.02.009
Tingting Zhao, Dongyan Li
As one of the common extrapulmonary effects of chronic obstructive pulmonary disease, skeletal muscle dysfunction seriously affects patients′ exercise endurance, quality of life and prognosis.The mechanism may be that under the action of multifactorial etiology, some biological events occur in skeletal muscle, such as structural abnormality, oxidative stress, muscle protein metabolism disorder (increased proteolysis/decreased protein synthesis), autophagy, epigenetic regulation, cell apoptosis, endoplasmic reticulum stress, etc.At present, exercise training, neuromuscular electrical stimulation, nutritional support and other pulmonary rehabilitation interventions have been proved to be suitable for the prevention and treatment of skeletal muscle dysfunction. Key words: Pulmonary disease, chronic obstructive; Skeletal muscle dysfunction; Biological mechanisms; Pulmonary rehabilitation
骨骼肌功能障碍是慢性阻塞性肺疾病常见的肺外效应之一,严重影响患者的运动耐力、生活质量和预后。其机制可能是在多因素病因的作用下,骨骼肌发生了一些生物学事件,如结构异常、氧化应激、肌肉蛋白质代谢紊乱(蛋白质水解增加/蛋白质合成减少)、自噬、表观遗传调控、细胞凋亡、内质网应激等。营养支持和其他肺部康复干预措施已被证明适用于预防和治疗骨骼肌功能障碍。关键词:肺部疾病;慢性阻塞性肺疾病;骨骼肌功能障碍;生物学机制;肺康复
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引用次数: 0
Prolonged stay predictors in patients admitted with chronic obstructive pulmonary disease acute exacerbation 慢性阻塞性肺疾病急性加重患者住院时间延长的预测因素
Pub Date : 2020-01-20 DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.02.006
Xian-kang Zhu, Chunyan Xu, Shu-zhen Guo
Objective To identify the factors related to prolonged stay in those patients admitted with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) to hospital. Methods Anumber of 661 patients were selected, all the patients admitted with AECOPD to Shanghai Pudong Hospital, either in the internal medical unit or pneumology department, from 2017 to 2018.The baseline characteristics, AECOPD characteristics and comorbidities were recorded. Results A number of 661 patients were assessed, 76.6% were male, and the mean age were 74.5 years.The mean stay were 11.9 days.24% of all patients required prolonged stay, 2.57% of all patients needed admission to intensive care unit (ICU), 14.67% of all patients were treated with noninvasive mechanical ventilation (NIV). The following factors were significantly associated with length of stay: age, lower hemoglobin count, chronic kidney disease, inpatient department, AECOPD characteristics, need for admission to ICU and the need for NIV, the differences were statistically significant (all P<0.05). Conclusions Prolonged stay in AECOPD primarily related to the unit patients are admitted to, and the need for ICU and NIV. Key words: Length of stay; Intensive care units; Acute exacerbation of chronic obstructive pulmonary disease; Noninvasive mechanical ventilation
目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者住院时间延长的相关因素。方法选取2017 - 2018年上海浦东医院内科或内科住院的AECOPD患者661例。记录基线特征、AECOPD特征及合并症。结果共纳入661例患者,男性占76.6%,平均年龄74.5岁。平均住院时间为11.9天。24%的患者需要延长住院时间,2.57%的患者需要进入重症监护病房(ICU), 14.67%的患者采用无创机械通气(NIV)治疗。年龄、血红蛋白较低、慢性肾病、住院科室、AECOPD特征、是否需要入住ICU、是否需要使用NIV与住院时间有显著相关,差异均有统计学意义(P<0.05)。结论AECOPD住院时间延长主要与患者入住的单位、ICU和NIV的需要有关。关键词:停留时间;重症监护病房;慢性阻塞性肺疾病急性加重期;无创机械通气
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引用次数: 0
Progress of endoplasmic reticulum stress in chronic obstructive pulmonary disease 慢性阻塞性肺疾病内质网应激的研究进展
Pub Date : 2020-01-20 DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.02.008
He Hao, A. Meng
Endoplasmic reticulum stress (ERS) is an important self-defense mechanism of cells, and strong persistent ERS can induce apoptosis.Unfolded protein reaction is an important signal pathway of ERS.There are many kinds of cell types with high protein synthesis and secretion in lung.It is easy to appear ERS.At present, it is believed that ERS is related to the pathogenesis of chronic obstructive pulmonary disease (COPD). This review focus on the relationship between ERS and COPD, to provide a new direction for the treatment of COPD. Key words: Pulmonary disease, chronic obstructive; Unfolded protein response; Endoplasmic reticulum stress
内质网应激(Endoplasmic reticulum stress, ERS)是细胞的一种重要的自我防御机制,强持续性内质网应激可诱导细胞凋亡。未折叠蛋白反应是ERS的重要信号通路。肺中有多种高蛋白合成和分泌的细胞。容易出现ERS。目前认为,ERS与慢性阻塞性肺疾病(COPD)的发病机制有关。本文就ERS与COPD的关系进行综述,以期为COPD的治疗提供新的方向。关键词:肺部疾病;慢性阻塞性肺疾病;未折叠蛋白反应;内质网应激
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引用次数: 0
Research progress of heme oxygenase-1 and chronic obstructive pulmonary disease 血红素加氧酶-1与慢性阻塞性肺疾病的研究进展
Pub Date : 2020-01-20 DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.02.007
Weixia Li, Jiaqiang Zhang
Chronic obstructive pulmonary disease (COPD) is a preventable and treatable respiratory disease characterized by persistent airflow limitation.Its mechanism has not yet been fully clarified.In recent years, many studies have shown that oxidative stress and gene polymorphism play a very important role in its development.Heme oxygenase-1 (HO-1) is an important oxygen reductase in the body and is closely related to COPD.This article reviews the relationship between the occurrence, development, treatment and prognosis of HO-1 and COPD, in order to provide new ideas for the diagnosis, treatment and management of COPD. Key words: Pulmonary disease, chronic obstructive; Genes, duplicate; Heme oxygenase-1
慢性阻塞性肺疾病(COPD)是一种以持续气流受限为特征的可预防和可治疗的呼吸系统疾病。其机制尚未完全阐明。近年来,许多研究表明,氧化应激和基因多态性在其发展中起着非常重要的作用。血红素加氧酶-1 (HO-1)是机体中一种重要的氧还原酶,与COPD密切相关。本文就HO-1与慢性阻塞性肺病的发生、发展、治疗及预后的关系进行综述,以期为慢性阻塞性肺病的诊断、治疗和管理提供新的思路。关键词:肺部疾病;慢性阻塞性肺疾病;基因,复制;血红素oxygenase-1
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引用次数: 0
Regulation of Foxp3-mRNA expression and Th1/Th2 immune response in patients with chronic obstructive pulmonary disease 慢性阻塞性肺疾病患者Foxp3-mRNA表达及Th1/Th2免疫应答的调控
Pub Date : 2020-01-20 DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.02.004
Lillian Du, Liang Chen, Yue Zhuo, Bi-ying Wang
Objective To analyze the expression of Foxp3-mRNA and the regulation of Th1/Th2 immune response in patients with chronic obstructive pulmonary disease (COPD), and to provide a theoretical basis for the monitoring of immune status and its related mechanisms in patients with COPD. Methods A group sampling method was used to select 95 cases of patients with COPD who received a follow-up treatment in a third-grade hospital in the same hospital and 85 controls were conducted at the same time, from March 2016 to December 2017.The Foxp3-mRNA fragment was amplified by PCR and the expression of Foxp3-mRNA in serum was detected by Western blot.The expression of Th1/Th2 immune response system expression assay (including IFN-γ, IL-2, IL-4, IL-10), the obtained data were entered into SPSS 16.0 for statistical analysis. Results The level of IFN-γ, IL-2, IL-4, IL-10 in COPD group were higher than those of in the control group and there were statistical differences(t=7.282, 5.996, 7.380, 4.835, all P<0.05). In the case group, patients of different ages in IFN-γ, IL-2, IL-4, IL-10, were statistically different (t=22.237, 16.943, 45.386, 31.831, all P<0.05). In the case group, patients of different disease durations in IFN-γ, IL-2, IL-4, IL-10 were statistically different (F=33.226, 30.096, 29.353, 34.300, all P<0.05). In the case group, clear bands were seen at about 592 bp (group 1 to group 5), while the control group (group 6) and the DNA marker group (group 7) had no bands.The levels of IL-2, IL-4 and IL-10 were positively correlated and the correlation coefficients were statistically significant (r=0.614, 0.493, 0.529, 0.501, all P<0.05). Conclusions The theoretical basis for the specific expression of Foxp3-mRNA in patients with COPD is established.There is a statistically positive correlation between the expression of Foxp3-mRNA and the characteristics of Th1/Th2 immune response, but considering the epidemic of COPD in China.Characteristics, this conclusion also needs to be combined with the environmental epidemiological factors of patients with COPD to further verify the relationship between Foxp3-mRNA expression characteristics and Th1/Th2 immune response characteristics at the mechanism level. Key words: Pulmonary disease, chronic obstructive; Foxp3-mRNA; Immune response
目的分析慢性阻塞性肺疾病(COPD)患者Foxp3-mRNA表达及对Th1/Th2免疫应答的调控,为COPD患者免疫状态监测及其相关机制提供理论依据。方法采用分组抽样的方法,选取2016年3月至2017年12月在同一医院某三甲医院随访治疗的慢性阻塞性肺病患者95例,同时选取对照组85例。PCR扩增Foxp3-mRNA片段,Western blot检测血清中Foxp3-mRNA的表达。免疫应答系统进行Th1/Th2表达测定(包括IFN-γ、IL-2、IL-4、IL-10),所得数据输入SPSS 16.0进行统计分析。结果COPD组IFN-γ、IL-2、IL-4、IL-10水平均高于对照组,差异有统计学意义(t=7.282、5.996、7.380、4.835,均P<0.05)。病例组中,不同年龄患者IFN-γ、IL-2、IL-4、IL-10水平差异有统计学意义(t=22.237、16.943、45.386、31.831,P均<0.05)。病例组中,不同病程患者IFN-γ、IL-2、IL-4、IL-10水平差异有统计学意义(F=33.226、30.096、29.353、34.300,P均<0.05)。病例组(1 ~ 5组)在592 bp左右可见清晰条带,而对照组(6组)和DNA标记组(7组)无条带。IL-2、IL-4、IL-10水平呈正相关,相关系数均有统计学意义(r=0.614、0.493、0.529、0.501,P均<0.05)。结论为Foxp3-mRNA在COPD患者中的特异性表达奠定了理论基础。Foxp3-mRNA表达与Th1/Th2免疫应答特征有统计学正相关,但考虑到中国慢性阻塞性肺病的流行。特点,这一结论还需要结合COPD患者的环境流行病学因素,在机制水平上进一步验证Foxp3-mRNA表达特征与Th1/Th2免疫应答特征之间的关系。关键词:肺部疾病;慢性阻塞性肺疾病;Foxp3-mRNA;免疫反应
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引用次数: 0
Development of the studies on relationships between acute exacerbation of chronic obstructive pulmonary disease and respiratory virus infection 慢性阻塞性肺疾病急性加重与呼吸道病毒感染关系的研究进展
Pub Date : 2020-01-20 DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.02.010
Jing-yun Fan
Chronic obstructive pulmonary disease (COPD) is a common inflammatory disease of the respiratory tract.It is one of the diseases with high morbidity and mortality in the world.Acute exacerbation of COPD(AECOPD) is an important event in the process of COPD, which often leads to the decline of patients′ quality of life and the increase of mortality.Respiratory virus infection is closely related to AECOPD.Viral infection in patients with AECOPD is characterized by diversity, seasonality and locality.Respiratory virus infection can aggravate COPD by activating inflammatory mediators and participating in immune response.The effects and mechanisms of various viral infections on AECOPD may be different and require further study. Key words: Pulmonary disease, chronic obstructive; Viruses
慢性阻塞性肺病(COPD)是一种常见的呼吸道炎症性疾病。它是世界上发病率和死亡率最高的疾病之一。慢性阻塞性肺病急性加重(Acute exacerbation of COPD, AECOPD)是慢性阻塞性肺病病程中的重要事件,常导致患者生活质量下降,死亡率升高。呼吸道病毒感染与AECOPD密切相关。AECOPD患者的病毒感染具有多样性、季节性和地域性的特点。呼吸道病毒感染可通过激活炎症介质和参与免疫应答而加重COPD。各种病毒感染对AECOPD的作用和机制可能不同,需要进一步研究。关键词:肺部疾病;慢性阻塞性肺疾病;病毒
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引用次数: 0
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Chinese Journal of Asthma
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