BACKGROUND & AIMS: :Some coronaviruses (CoVs) have an extra furin cleavage site (RRKR/S, furin-S2' site) upstream of the fusion peptide in the spike protein, which plays roles in virion adsorption and fusion. Mutation of the S2' site of QX genotype (QX-type) infectious bronchitis virus (IBV) spike protein (S) in a recombinant virus background results in higher pathogenicity, pronounced neural symptoms and neurotropism when compared with conditions in wild-type IBV (WT-IBV) infected chickens. In this study, we present evidence suggesting that recombinant IBV with a mutant S2' site (furin-S2' site) leads to higher mortality. Infection with mutant IBV induces severe encephalitis and breaks the blood-brain barrier. The results of a neutralization test and immunoprotection experiment show that an original serum and vaccine can still provide effective protection in vivo and in vitro. This is the first demonstration of IBV-induced neural symptoms in chickens with encephalitis and the furin-S2' site as a determinant of neurotropism.

背景与目标： ：某些冠状病毒（CoV）在穗蛋白中的融合肽上游具有额外的弗林蛋白酶切割位点（RRKR / S，弗林蛋白酶S2'位点），在病毒体吸附和融合中发挥作用。与野生型IBV的条件相比，重组病毒背景中QX基因型（QX型）传染性支气管炎病毒（IBV）刺突蛋白（S）的S2'位点突变导致更高的致病性，明显的神经症状和嗜神经性（ WT-IBV）感染的鸡。在这项研究中，我们提供证据表明具有突变S2'位点（弗林蛋白酶S2'位点）的重组IBV导致更高的死亡率。突变型IBV感染会引起严重的脑炎并打破血脑屏障。中和试验和免疫保护实验的结果表明，原始的血清和疫苗仍然可以在体内和体外提供有效的保护。这是IBV诱发的脑炎鸡的神经症状的首次证明，弗林蛋白酶-S2'位点是神经嗜性的决定因素。

BACKGROUND & AIMS: :The results of antibiotic therapy in 271 patients suffering from acute exacerbations of chronic bronchitis are presented. The effectiveness of the better absorbed ampicillin esters (pivampicillin and bacampicillin) is confirmed, but side-effects from the pivampicillin present problems whereas bacampicillin is excellently tolerated, even in twice daily doses of 1600 mg. Amoxycillin, if given in 750 mg doses three times daily by mouth, is also safe and effective against Haemophilus influenzae. However, if accurate MIC results are not available for both ampicillin and amoxycillin, the lesser degree of sensitivity to amoxycillin suggests that use of an ampicillin ester (such as bacampicillin) is to be preferred. Prophylactic use of antibiotics in chronic bronchitis patients does not seem logical to us.

背景与目标： ：介绍了271例慢性支气管炎急性加重患者的抗生素治疗结果。确认了吸收更好的氨苄西林酯（pivampicillin和bacampicillin）的有效性，但是来自pivampicillin的副作用存在问题，而即使每天两次服用1600 mg，也能很好地耐受bacampicillin。如果阿莫西林每天口服750毫克，每天口服3次，对付流感嗜血杆菌也是安全有效的。但是，如果氨苄西林和阿莫西林均不能获得准确的MIC结果，则对阿莫西林的敏感性较低，则建议使用氨苄西林酯（如巴坎西林）为佳。在我们看来，在慢性支气管炎患者中预防性使用抗生素似乎不合逻辑。

BACKGROUND & AIMS: :We report a case of a bronchitis caused by Bordetella holmesii in a 2-year-old girl with asthma. The patient had a moderate fever and productive cough, and her condition was initially diagnosed as mycoplasmal bronchitis on the basis of her clinical symptoms and rapid serodiagnosis of mycoplasmal infection. She was treated with a bronchodilator and clarithromycin, which resulted in complete recovery. However, after the initial diagnosis, nucleic acid amplification tests of her sputum showed the absence of both Mycoplasma pneumoniae and Bordetella pertussis infections. Sputum culture showed the presence of a slow-growing, gram-negative bacillus in pure culture on Bordetella agar plates; the bacillus was later identified as B. holmesii. B. holmesii infection is rare in immunocompetent children; however, the organism is a true pathogen that can cause bronchitis in young children with asthma.

背景与目标： ：我们报告了一名2岁哮喘小女孩由霍乱博德特氏菌引起的支气管炎病例。该患者患有中度发烧和咳嗽，根据她的临床症状和支原体感染的快速血清诊断，最初被诊断为支原体支气管炎。她接受了支气管扩张药和克拉霉素治疗，从而完全康复。然而，在初步诊断后，其痰液的核酸扩增测试显示肺炎支原体和百日咳博德特氏菌均无感染。痰培养显示在博德特氏菌琼脂平板上的纯培养物中存在缓慢生长的革兰氏阴性杆菌。该杆菌后来被鉴定为霍乱芽孢杆菌。霍曼氏杆菌感染在具有免疫能力的儿童中很少见；但是，这种生物体是一种真正的病原体，可以引起哮喘小儿支气管炎。

BACKGROUND & AIMS: BACKGROUND:The optimal treatment for acute bronchitis is not clear. Because many patients with acute bronchitis have airflow limitation as well as cough, beta2-agonists may be useful. OBJECTIVES:To determine whether beta2-agonists improve the symptoms of acute bronchitis in patients who do not have underlying pulmonary disease. SEARCH STRATEGY:The Cochrane Library (through August 2000), MEDLINE (1966 to 2000), EMBASE (1974 to 2000), and Conference Proceedings using "bronchodilator (exp)", "adrenergic beta-agonist (exp)", or "sympathomimetics (exp)" and "bronchitis" or "cough"; Science Citation Index for referenced publications; and letters to manufacturers of beta2-agonists. An updated search of the Cochrane Central Register of Controlled Trials (CENTRAL) (issue 3, 2003); MEDLINE (January 2000 to July 2003); EMBASE (January 2000 to July 2003) was run in July 2003. SELECTION CRITERIA:Trials in which patients (adults or children over two years of age) without known pulmonary disease who were diagnosed with acute bronchitis or acute cough without other cause were randomized to beta2-agonist versus placebo, no treatment, or alternative treatment. DATA COLLECTION AND ANALYSIS:Three reviewers independently first selected outcomes and evaluated trial quality while blinded to study results, and then extracted data. Trials in children and in adults were analyzed separately. MAIN RESULTS:Two trials in children (n = 109) with acute cough and no evidence of airway obstruction did not find any benefits from beta2-agonists. Combined data did not show a significant difference in daily cough scores between patients given oral beta2-agonists and those in the control groups. Five trials in adults (n = 418) with acute cough or acute bronchitis had mixed results, but overall summary statistics did not reveal any significant benefits from oral (three trials) nor inhaled (two trials) beta2-agonists. There were no significant differences in daily cough scores nor in the number of patients still coughing after seven days (control rate 73%; RR = 0.77, 95% CI 0.54-1.09). Subgroups of patients with evidence of airflow limitation had lower symptom scores if given beta2-agonists in one trial; and the trials that did note quicker resolution of cough in patients given beta2-agonists were those that had a higher proportion of patients with wheezing at baseline. Patients given beta2-agonists were more likely to report tremor, shakiness, or nervousness than patients in the control groups (for trials in children control rate 0%; RR 6.76, 95% CI 0.86 to 53.12, NNH 9, 95% CI 5 to 100; for trials in adults, control rate 11%; RR 7.94, 95% CI 1.17 to 53.94, NNH 2.3, 95% CI 2 to 3). REVIEWER'S CONCLUSIONS:There is no evidence to support using beta2-agonists in children with acute cough who do not have evidence of airflow obstruction. There is also little evidence that the routine use of beta2-agonists for adults with acute cough is helpful. These agents may reduce symptoms, including cough, in patients with evidence of airflow obstruction; but this potential benefit is not well-supported by the available data and must be weighed against the adverse effects associated with beta2-agonists.

背景与目标： 背景：急性支气管炎的最佳治疗方法尚不清楚。由于许多急性支气管炎患者都有气流受限和咳嗽，因此β2-激动剂可能会有用。
目的：确定β2-激动剂是否可改善无基础肺部疾病的患者的急性支气管炎症状。
搜索策略：Cochrane库（到2000年8月），MEDLINE（1966年到2000年），EMBASE（1974年到2000年）和使用“支气管扩张剂（exp）”，“肾上腺素β激动剂（exp）”或“拟交感神经药”的会议录（exp）”和“支气管炎”或“咳嗽”；参考出版物的《科学引文索引》；以及给beta2激动剂制造商的信。对“ Cochrane对照试验中央注册簿”（CENTRAL）的最新搜索（2003年第3期）； MEDLINE（2000年1月至2003年7月）； EMBASE（2000年1月至2003年7月）于2003年7月运行。
选择标准：将没有已知肺部疾病的被诊断患有急性支气管炎或无其他原因的急性咳嗽的患者（成人或两岁以上的儿童）随机分配给β2受体激动剂和安慰剂，不予治疗或替代治疗。
数据收集与分析：三名审阅者在不了解研究结果的情况下，首先独立选择结果并评估了试验质量，然后提取了数据。对儿童和成人的试验分别进行了分析。
主要结果：两项针对急性咳嗽且无气道阻塞证据的儿童（n = 109）的试验均未发现beta2激动剂有任何益处。组合数据未显示口服β2受体激动剂的患者与对照组的每日咳嗽评分有显着差异。在成人（418例）患有急性咳嗽或急性支气管炎的试验中，有五项结果好坏参半，但是总体统计数据并未显示口服（三项试验）或吸入（两项试验）β2-激动剂有任何明显的益处。每天的咳嗽评分和7天后仍咳嗽的患者人数均无显着差异（控制率73％； RR = 0.77，95％CI 0.54-1.09）。如果在一项试验中给予β2-激动剂，则有气流受限证据的患者亚组的症状评分较低。确实注意到在使用β2受体激动剂的患者中咳嗽得到更快缓解的试验是那些基线时出现喘息的患者比例更高的试验。与对照组相比，接受过β2受体激动剂治疗的患者更有可能出现震颤，颤抖或神经过敏（儿童试验中，对照组的控制率为0％； RR为6.76，95％CI为0.86至53.12，NNH为9，95％CI为5至100；对于成人试验，控制率11％； RR 7.94，95％CI 1.17至53.94，NHN 2.3，95％CI 2至3）。
审查者的结论：没有证据支持在没有气流阻塞迹象的急性咳嗽儿童中使用β2激动剂。也几乎没有证据表明，对患有急性咳嗽的成人常规使用β2受体激动剂是有帮助的。这些药物可以减轻有气流阻塞迹象的症状，包括咳嗽。但是现有的数据并不能很好地支持这种潜在的好处，因此必须权衡与beta2-激动剂相关的不利影响。

BACKGROUND & AIMS: BACKGROUND:In some parts of the northwest Russia, Murmansk region, high exposures to heavy mining and refining industrial air pollution, especially sulphur dioxide, have been documented. OBJECTIVE:Our aim was to evaluate whether living in the mining area would be an independent risk factor of the respiratory symptoms. DESIGN:A cross-sectional survey of 200 Murmansk region adult citizens was performed. The main outcome variable was prolonged cough with sputum production that fulfilled the criteria of chronic bronchitis. RESULTS:Of the 200 participants, 53 (26.5%) stated that they had experienced chronic cough with phlegm during the last 2 years. The prevalence was higher among those subjects living in the mining area with its high pollution compared to those living outside this region (35% vs. 18%). Multivariable regression model confirmed that the risk for the chronic cough with sputum production was elevated in a statistical significant manner in the mining and refining area (adjusted OR 2.16, 95% CI 1.07-4.35) after adjustment for smoking status, age and sex. CONCLUSIONS:The increased level of sulphur dioxide emitted during nickel mining and refining may explain these adverse health effects. This information is important for medical authorities when they make recommendations and issue guidelines regarding the relationship between environmental pollution and health outcomes.

背景与目标： 背景：在俄罗斯西北部的摩尔曼斯克地区，已经有大量采矿和精炼工业空气污染（特别是二氧化硫）的高暴露量记录在案。
目的：我们的目的是评估在矿区生活是否会成为呼吸系统症状的独立危险因素。
设计：对200名摩尔曼斯克州成年公民进行了横断面调查。主要结局变量是咳嗽时间延长，痰液产生符合慢性支气管炎的标准。
结果：在200名参与者中，有53名（26.5％）表示他们在过去2年中经历了慢性咳嗽并伴有痰。与生活在该地区以外的人相比，生活在高污染地区的那些人的患病率更高（35％对18％）。多变量回归模型证实，在对吸烟状况，年龄和性别进行调整后，采矿和精炼区（经调整的OR 2.16，95％CI 1.07-4.35）以统计学显着的方式升高了发生咳嗽的慢性咳嗽风险。
结论：镍开采和精炼过程中排放的二氧化硫水平增加可能解释了这些不利的健康影响。当医疗机构提出建议并发布有关环境污染与健康结果之间关系的指导时，这些信息对于医疗机构而言非常重要。

BACKGROUND & AIMS: :Eosinophilic airway inflammation is commonly observed in chronic cough in patients with asthma and non-asthmatic eosinophilic bronchitis. Indeed asthma and non-asthmatic eosinophilic bronchitis are amongst the commonest causes of chronic cough accounting for about 25 and 10% of cases respectively. In most cases the trigger that causes the cough is uncertain; however removal of potential triggers is important to consider in particular with respect to occupational exposure to known sensitizers. In both conditions the cough improves subjectively and objectively following treatment with corticosteroids. This improvement is associated with the presence of an airway eosinophilia, but whether eosinophilic inflammation is the cause of cough or an epiphenomenon is uncertain. The success of anti-IL5 to reduce eosinophilic inflammation and asthma exacerbations contrasts with the lack of efficacy to modify cough in asthma and therefore challenges a causal association. Both asthma and non-asthmatic eosinophilic bronchitis can lead onto airway remodeling and result in persistent airflow obstruction. However, response to corticosteroid therapy in both conditions is generally very good and the limited long term data available suggests that both usually have a benign course. Interestingly, improvement in airway remodeling in response to anti-IL5 observed using CT imaging and analysis of sub-epithelial matrix deposition does suggest that the eosinophil may play a causal role in airway remodeling.

背景与目标： ：哮喘和非哮喘性嗜酸性支气管炎患者在慢性咳嗽中通常观察到嗜酸性气道炎症。实际上，哮喘和非哮喘性嗜酸性支气管炎是慢性咳嗽的最常见原因，分别占病例的约25％和10％。在大多数情况下，引起咳嗽的诱因是不确定的。然而，特别是在职业上接触已知的敏化剂时，考虑潜在的诱因是很重要的。在这两种情况下，使用皮质类固醇激素治疗后，主观和客观上的咳嗽都会得到改善。这种改善与气道嗜酸性粒细胞增多的存在有关，但是尚不确定嗜酸性粒细胞炎症是咳嗽的原因还是表观现象。抗IL5减轻嗜酸性粒细胞炎症和哮喘加重的成功与缺乏改善哮喘咳嗽的功效形成鲜明对比，因此对因果关系提出了挑战。哮喘和非哮喘性嗜酸性支气管炎均可导致气道重塑，并导致持续的气流阻塞。但是，在两种情况下对皮质类固醇治疗的反应通常都非常好，并且可获得的有限长期数据表明，两者通常都具有良性病程。有趣的是，响应于抗IL5的气道重塑的改善使用CT成像和上皮下基质沉积的分析确实表明，嗜酸性粒细胞可能在气道重塑中起因果作用。

BACKGROUND & AIMS: :Infectious bronchitis (IB), caused by infectious bronchitis virus (IBV), is a highly contagious chicken disease, and can lead to serious economic losses in poultry enterprises. The continual introduction of new IBV serotypes requires alternative strategies for the production of timely and safe vaccines against the emergence of variants. Modification of the IBV genome using reverse genetics is one way to generate recombinant IBVs as the candidates of new IBV vaccines. In this study, the recombinant IBV is developed by replacing the ectodomain region of the S1 gene of the IBV Beaudette strain with the corresponding fragment from H120 strain, designated as rBeau-H120(S1e). In Vero cells, the virus proliferates as its parental virus and can cause syncytium formation. The peak titer would reach 10(5.9) 50% (median) tissue culture infective dose/mL at 24 h post-infection. After inoculation of chickens with the recombinant virus, it demonstrated that rBeau-H120(S1e) remained nonpathogenic and was restricted in its replication in vivo. Protection studies showed that vaccination with rBeau-H120 (S1e) at 7-day after hatch provided 80% rate of immune protection against challenge with 10(3) 50% embryos infection dose of the virulent IBV M41 strain. These results indicate that rBeau-H120 (S1e) has the potential to be an alternative vaccine against IBV based on excellent propagation property and immunogenicity. This finding might help in providing further information that replacement of the ectodomain fragment of the IBV Beaudette S1 gene with that from a present field strain is promising for IBV vaccine development.

背景与目标： ：由传染性支气管炎病毒（IBV）引起的传染性支气管炎（IBV）是一种高度传染性的鸡疾病，可能导致家禽企业遭受严重的经济损失。不断引入新的IBV血清型需要替代策略，以生产及时，安全的疫苗，以防出现变异。使用反向遗传学对IBV基因组进行修饰是产生重组IBV作为新IBV疫苗候选者的一种方法。在这项研究中，重组IBV是通过用H120菌株的相应片段（称为rBeau-H120（S1e））取代IBV Beaudette菌株S1基因的胞外域区域开发的。在Vero细胞中，该病毒以其亲代病毒的形式增殖，并可能导致合胞体形成。感染后24小时，最高滴度达到组织培养感染剂量/ mL的10（5.9）50％（中值）。用重组病毒接种鸡后，证明rBeau-H120（S1e）保持非致病性，并在体内复制受到限制。保护研究表明，在孵化后第7天接种rBeau-H120（S1e）可提供80％的免疫保护，以抵抗10（3）50％的强毒IBV M41菌株感染剂量的攻击。这些结果表明，基于优良的繁殖特性和免疫原性，rBeau-H120（S1e）有望成为针对IBV的替代疫苗。这一发现可能有助于提供进一步的信息，即用来自目前的田间菌株的IBV Beaudette S1基因的胞外域片段替代有望用于IBV疫苗开发。

BACKGROUND & AIMS: :General theories on the inactivation of viruses in the presence of a concentrated protein, such as the allantoic fluid of chicken eggs, are not useful. That is, although sodium hypochlorite and sodium hydroxide are generally known as strong virucidal agents, they do not sufficiently inactivate viruses in allantoic fluid. We found that benzalkonium chloride (BC) is an effective virucidal agent against influenza, Newcastle disease, and avian infectious bronchitis viruses even in the presence of a concentrated protein. BC is easily biodegradable by activated sludge and is not very harmful to humans. We strongly recommend BC as a useful virucidal agent, especially in the manufacture of vaccines for these viruses.

背景与目标： ：关于在浓缩蛋白（例如鸡蛋的尿囊液）存在下使病毒失活的一般理论没有用。即，尽管次氯酸钠和氢氧化钠通常被称为强杀病毒剂，但是它们不能充分灭活尿囊液中的病毒。我们发现，即使存在浓缩的蛋白质，苯扎氯铵（BC）是一种抗流感，新城疫和禽类传染性支气管炎病毒的有效杀病毒剂。 BC易于被活性污泥生物降解，对人体危害不大。我们强烈建议BC作为有用的杀病毒剂，尤其是在制造这些病毒的疫苗时。

BACKGROUND & AIMS: :Moxifloxacin, a new respiratory quinolone, was compared with the macrolides azithromycin, clarithromycin and roxithromycin in a cohort study to assess clinical, safety and health-related outcomes of these antimicrobials in general practice settings. In total 332 patients with acute exacerbations of chronic bronchitis (AECB) each received one of the antimicrobial agents for a standard short course of therapy. Random allocation of therapeutic agents occurred by centre, not individuals, and the drugs were prescribed in an open manner. In addition to clinical evaluation by their physicians, all patients kept daily diaries to assess AECB symptoms over the study period, therapy received and quality of life. The overall clinical response rate was 96% and all four regimens were well tolerated. After 14 days there were no significant differences between the study groups, but analyses of patients' daily evaluations of certain AECB specific symptoms showed a faster response rate in the moxifloxacin group.

背景与目标： 在一项队列研究中，将一种新型呼吸道喹诺酮莫西沙星与大环内酯类阿奇霉素，克拉霉素和罗红霉素进行了比较，以评估这些抗生素在一般实践环境中的临床，安全性和健康相关结果。在总共332例慢性支气管炎急性加重患者中，每人均接受一种标准短期疗程的抗菌药物。治疗药物的分配是由中心而不是个人进行的，药物是公开处方的。除了由医生进行临床评估外，所有患者还保留每日日记，以评估研究期间的AECB症状，所接受的治疗和生活质量。总体临床反应率为96％，所有四种方案均耐受良好。 14天后，研究组之间无显着差异，但对患者对某些AECB特定症状的每日评估分析表明，莫西沙星组的响应速度更快。

BACKGROUND & AIMS: :We herein report a case of cytomegalovirus (CMV) bronchitis in a 62-year-old woman with polymyositis. She presented with respiratory symptoms and CMV antigenemia while undergoing immunosuppressive therapy with methotrexate (MTX) and prednisolone (PSL). Bronchoscopy was performed, which revealed an ulceration of the left main bronchus. A mucosal biopsy confirmed CMV infection, and the patient was diagnosed with CMV ulcerating bronchitis. The administration of ganciclovir improved the lesion, and the CMV antigenemia disappeared. Endobronchial ulceration should be considered in the differential diagnosis of CMV disease.

背景与目标： ：我们在此报告了一名62岁多发性肌炎妇女的巨细胞病毒（CMV）支气管炎病例。在接受甲氨蝶呤（MTX）和泼尼松龙（PSL）的免疫抑制治疗时，她表现出呼吸道症状和CMV抗原血症。进行了支气管镜检查，发现左主支气管溃疡。粘膜活检证实了CMV感染，并且该患者被诊断出患有CMV溃疡性支气管炎。更昔洛韦的使用改善了病变，并且CMV抗原血症消失了。在CMV疾病的鉴别诊断中应考虑支气管内溃疡。

BACKGROUND & AIMS: :Amiloride (1), the prototypical epithelial sodium channel (ENaC) blocker, has been administered with limited success as aerosol therapy for improving pulmonary function in patients with the genetic disorder cystic fibrosis. This study was conducted to synthesize and identify more potent, less reversible ENaC blockers, targeted for aerosol therapy and possessing minimal systemic renal activity. A series of novel 2-substituted acylguanidine analogues of amiloride were synthesized and evaluated for potency and reversibility on bronchial ENaC. All compounds tested were more potent and less reversible at blocking sodium-dependent short-circuit current than amiloride. Compounds 30-34 showed the greatest potency on ENaC with IC(50) values below 10 nM. A regioselective difference in potency was found (compounds 30, 39, and 40), whereas no stereospecific (compounds 33, 34) difference in potency on ENaC was displayed. Lead compound 32 was 102-fold more potent and 5-fold less reversible than amiloride and displayed the lowest IC(50) value ever reported for an ENaC blocker.

背景与目标： ：Amiloride（1）是一种典型的上皮钠通道（ENaC）阻滞剂，已被成功地用作改善遗传性囊性纤维化患者肺功能的气雾剂疗法。进行这项研究的目的是合成和确定更有效，更不可逆的ENaC阻滞剂，这些阻滞剂以气雾剂治疗为目标，并且具有最小的全身肾活性。合成了一系列新的阿米洛利的2-取代的酰基胍类似物，并评估了其对支气管ENaC的效力和可逆性。与阿米洛利相比，所有测试的化合物在阻断钠依赖性短路电流方面均更有效，且可逆性更低。化合物30-34在ENaC上显示出最大的效力，IC（50）值低于10 nM。发现效力的区域选择性差异（化合物30、39和40），而在ENaC上未显示立体特异性（化合物33、34）效力的差异。铅化合物32的效力比阿米洛利高102倍，可逆性低5倍，并且显示出有史以来针对ENaC阻滞剂报道的最低IC（50）值。

BACKGROUND & AIMS: :In this study, multiplex nested RT-PCR (mnRT-PCR) was applied to simultaneous detect multiplex PCR with the higher sensitivity of nested PCR that is required for avian influenza, infectious bronchitis and Newcastle disease virus using two steps of amplification. For the first PCR, primers that were specific for each virus were newly designed from the nucleoprotein gene of AIV, the nucleocapsid protein gene of IBV and the fusion protein gene of NDV to amplify products of 665, 386 and 236 nucleotides, respectively. The multiplex PCR step provides mass amplification using common primers, which increased markedly the sensitivity of the test. Non-specific reactions were not observed when other viruses and bacteria were used for evaluating the mnRT-PCR. As a field application, 172 samples were tested by RT-PCR and mnRT-PCR. Among these samples, the concordance rates for mnRT-PCR and the single conventional RT-PCR showed 98.9% (kappa=0.98) and 98.8% (kappa=0.96) similarity for IBV and AIV, respectively. As a result, it is recommended the multiplex nested PCR as an effective tool for detecting and studying the molecular epidemiology of various mixed infections of one or more of these viruses in poultry.

背景与目标： ：在这项研究中，多重巢式RT-PCR（mnRT-PCR）被用于同时检测多重PCR，其巢式PCR灵敏度更高，这是禽流感，传染性支气管炎和新城疫病毒的两步扩增。对于第一次PCR，从AIV的核蛋白基因，IBV的核衣壳蛋白基因和NDV的融合蛋白基因重新设计了每种病毒的特异性引物，分别扩增665、386和236个核苷酸的产物。多重PCR步骤使用普通引物进行质量扩增，从而显着提高了测试的灵敏度。当使用其他病毒和细菌评估mnRT-PCR时，未观察到非特异性反应。作为现场应用，通过RT-PCR和mnRT-PCR测试了172个样品。在这些样本中，mnRT-PCR和单个常规RT-PCR的一致性率分别显示IBV和AIV的相似度为98.9％（kappa = 0.98）和98.8％（kappa = 0.96）。因此，建议将多重嵌套PCR用作检测和研究禽类中一种或多种这些病毒的各种混合感染的分子流行病学的有效工具。

BACKGROUND & AIMS: :Patients with chronic bronchitis were randomly allocated to 4 weeks treatment with terbutaline 0.5 mg inhaled through a cone spacer with an expiratory resistance creating a positive expiratory pressure (+PEP group) or without (-PEP group). The patients recorded their symptoms in a diary and peak expiratory flow (PEFR) was measured before and after each inhalation. PEFR increased significantly after inhaled terbutaline both with and without PEP. The mean increase in PEFR after terbutaline inhalations was significantly greater (p less than 0.0001) in the +PEP group (24 L/min) compared to the -PEP group (17 L/min). The +PEP group had less sputum and less difficulty with coughing up sputum compared to the -PEP group. This study showed a small but significant enhancement of the bronchodilation and a beneficial effect on symptoms when inhalation of beta-2-agonist was combined with PEP in patients with chronic bronchitis.

背景与目标： ：患有慢性支气管炎的患者被随机分配到4周的治疗中，通过圆锥形间隔器吸入0.5 mg的特布他林，产生呼气阻力时产生正压（PEP组）或不呼气（-PEP组）。患者在日记中记录了他们的症状，并在每次吸入之前和之后测量了最大呼气流量（PEFR）。在有和没有PEP的情况下吸入特布他林后，PEFR均显着增加。与-PEP组（17 L / min）相比，PEP组（24 L / min）吸入特布他林后PEFR的平均增加显着更大（p小于0.0001）。与-PEP组相比，PEP组的痰少，咳嗽困难少。这项研究表明，在慢性支气管炎患者中，吸入β-2-激动剂与PEP联合使用时，支气管扩张作用小而显着增强，并且对症状有有益效果。

BACKGROUND & AIMS: AIMS:The histopathology of the Sauropus androgynus (SA)-constrictive bronchiolitis obliterans (BO) is still controversial. A recent report using pneumonectomy specimens showed that the major histopathology was obliterative arteriopathy with segmental necrosis of small bronchi instead of constrictive BO as previously described. METHODS AND RESULTS:We analysed semiquantitatively and immunohistochemically the histopathology of one pneumonectomy and four biopsies specimens of SA-associated lung disease. We found a significant number of constrictive and obliterative bronchioles 1 mm or less in diameter and segmental inflammatory destruction with complete luminal obliteration of the bronchi less than 3 mm in diameter in the pneumonectomy specimen (37% and 25%, respectively). Fibromuscular intimal sclerosis of the bronchial arteries was identified in 15% of the bronchi 4 mm or less in diameter. The inflammation in these airways was composed predominantly of T-lymphocytes, macrophages, mast cells and eosinophils. They were present throughout the evolutionary stages of the bronchiolitis ranging from early oedematous to the late fibrotic obliterative stage. Double immunohistochemical stains revealed negative proliferative cell nuclear antigen for most of the T-lymphocytes and macrophages but positive for fibroblasts. CONCLUSIONS:A more accurate histopathological designation of the SA-associated lung disease should be constrictive obliterative bronchitis/bronchiolitis, with the participation of T-lymphocytes, macrophages, mast cells, eosinophils and fibroblasts in its morphogenesis. The persistent accumulation of inflammatory cells was mediated predominantly by continued recruitment to the site of injury from the bloodstream, resulting eventually in the irreversible fibrosis of the bronchioles and the bronchi less than 3 mm in diameter. Obliterative arteriopathy is suspected of being only an indirect contributing factor.

背景与目标： 目的：雄性Sauropus androgynus（SA）收缩性毛细支气管炎（BO）的组织病理学仍存在争议。最近的一项使用肺切除术标本的报告显示，主要的组织病理学是闭塞性动脉病伴小支气管节段性坏死，而不是如前所述的狭窄性BO。
方法和结果：我们半定量和免疫组织化学分析了1例肺切除术和4例SA相关性肺疾病的活检标本的组织病理学。我们发现在肺切除术标本中，直径不超过1 mm的许多收缩性和闭塞性细支气管以及节段性炎症破坏以及支气管的完全腔内闭塞小于3 mm的直径（分别为37％和25％）。在直径4mm或更小的支气管中，有15％的支气管动脉纤维内膜硬化。这些气道中的炎症主要由T淋巴细胞，巨噬细胞，肥大细胞和嗜酸性粒细胞组成。它们存在于细支气管炎的整个进化阶段，从早期水肿到晚期纤维化闭塞阶段。双重免疫组织化学染色显示，大多数T淋巴细胞和巨噬细胞的增殖细胞核抗原为阴性，而成纤维细胞为阳性。
结论：与SA相关的肺部疾病的更准确的组织病理学指征应为缩窄性闭塞性支气管炎/细支气管炎，并在其形态发生过程中参与T淋巴细胞，巨噬细胞，肥大细胞，嗜酸性粒细胞和成纤维细胞的参与。炎症细胞的持续积累主要是通过从血液中持续募集到受伤部位来进行的，最终导致细支气管和直径小于3 mm的支气管发生不可逆的纤维化。怀疑闭塞性动脉病只是间接的促成因素。

BACKGROUND & AIMS: BACKGROUND:Acute bronchitis (AB) is a common cause of childhood morbidity. Tuina, a kind of Chinese massage, is frequently used for the treatment of AB in children by traditional Chinese medicine doctors. However, there is no relevant systematic review show its effectiveness and safety. The study aims to evaluate the effectiveness and safety of Tuina for children with AB. METHODS:The following electronic databases will be searched from the respective dates of database inception to January 1st, 2020: The Cochrane Library, Web of Science, the World Health Organization International Clinical Trials Registry Platform, Springer, EMBASE, MEDLINE, China National Knowledge Infrastructure, the Chinese Biomedical Literature Database, Wanfang database, the Chinese Scientific Journal Database, and other sources. All published randomized controlled trials and blinded researches that are relevant to the subject of interest only will be contained. Two independent researchers will operate article retrieval, duplication removing, screening, quality evaluation, and data analyses by Review Manager (V.5.3.5). Meta-analyses, subgroup analysis and/or descriptive analysis will be performed based on the included data conditions. RESULTS:High-quality synthesis and/or descriptive analysis of current evidence will be provided from the bronchitis severity score, symptom, and quality-of-life questionnaires, the questionnaire of clinical symptoms of cough and sputum, Patient Satisfaction Scale and adverse reactions. CONCLUSION:This study will provide the evidence of whether Tuina is an effective and safe intervention for children with AB. PROSPERO REGISTRATION NUMBER:CRD42019140667.

背景与目标： 背景：急性支气管炎（AB）是儿童发病的常见原因。推拿是一种中式按摩，中医医生经常将其用于治疗儿童的AB。但是，没有相关的系统评价表明其有效性和安全性。该研究旨在评估推拿对AB儿童的有效性和安全性。
方法：从数据库建立之日至2020年1月1日搜索以下电子数据库：Cochrane图书馆，Web of Science，世界卫生组织国际临床试验注册平台，Springer，EMBASE，MEDLINE，中国国家知识基础设施，中国生物医学文献数据库，万方数据库，中国科学期刊数据库等资源。将只包含所有与感兴趣的主题相关的已发表的随机对照试验和盲研究。两名独立的研究人员将由Review Manager（V.5.3.5）进行文章检索，重复删除，筛选，质量评估和数据分析。将基于所包含的数据条件进行荟萃分析，亚组分析和/或描述性分析。
结果：将通过支气管炎严重程度评分，症状和生活质量调查表，咳嗽和痰液临床症状调查表，患者满意度量表和不良反应提供高质量的综合证据和/或描述性分析。
结论：本研究将提供证据，证明推拿对AB患儿是否是有效和安全的干预措施。
订单编号：CRD42019140667。