• 【从患有慢性支气管炎的非分泌型(O,Le(a b-))患者的呼吸道粘蛋白中分离出的中性寡糖的结构。】 复制标题 收藏 收藏
    DOI:10.1093/glycob/1.3.277 复制DOI
    作者列表:Lhermitte M,Rahmoune H,Lamblin G,Roussel P,Strang AM,van Halbeek H
    BACKGROUND & AIMS: :Mucin glycopeptides were prepared from the respiratory mucus of a non-secretor, chronic bronchitis patient with blood group O, Le(a+b-). Oligosaccharides were released by alkaline-borohydride treatment and purified by anion-exchange chromatography, size exclusion chromatography, and HPLC on a silica-bonded alkylamine column. Structural studies employed 500-MHz 1H-NMR spectroscopy, fast-atom-bombardment mass spectrometry and methylation analysis. Twenty-four neutral oligosaccharides, ranging in size from disaccharides to hexasaccharides, were fully characterized in this study. None of the structures contained an alpha(1----2)-linked fucose residue, in keeping with the non-secretor status of the patient. Seven of the structures had fucose present in alpha(1----3)-linkage in the X-determinant, while only one oligosaccharide (compound 14b) was seen with fucose alpha(1----4)-linked in the Le(a) determinant. The following eight structures isolated from the mucins of the non-secretor patient had not been found previously in the mucins of secretor individuals: [formula: see text] This study confirms that the blood group status of an individual is reflected in the carbohydrate structures of the secreted mucins. Furthermore, it clearly illustrates the need for detailed carbohydrate structural studies of mucins from different individuals before any attempt can be made to correlate observed differences in oligosaccharide profiles to disease status.
    背景与目标: :Mucin糖肽是从非分泌型慢性支气管炎患者的O型Le(a b-)血液中提取的。通过碱性硼氢化物处理释放寡糖,并通过阴离子交换色谱法,尺寸排阻色谱法和在硅胶键合的烷基胺柱上的HPLC纯化。结构研究采用500-MHz 1H-NMR光谱,快速原子轰击质谱和甲基化分析。这项研究充分表征了二十四种中性寡糖,大小从二糖到六糖不等。与患者的非分泌者状态一致,这些结构均未包含α(1 ---- 2)-连接的岩藻糖残基。 X决定簇中有七个结构的岩藻糖以alpha(1 ---- 3)链存在,而在果糖中只有一种寡糖(化合物14b)与岩藻糖的alpha(1 ---- 4)链连接。 Le(a)行列式。从非分泌者患者的黏蛋白中分离出的以下八种结构先前在分泌者个体的粘蛋白中未发现:[分子式:见正文]这项研究证实,个体的血型状况反映在该个体的碳水化合物结构中分泌的粘蛋白。此外,它清楚地说明了对任何来自不同个体的粘蛋白进行详细的碳水化合物结构研究的必要性,然后才能尝试将寡糖谱的观察到的差异与疾病状况相关联。
  • 【慢性支气管炎中的支气管软骨萎缩:软骨溶解过程的观察。】 复制标题 收藏 收藏
    DOI:10.1159/000028072 复制DOI
    作者列表:Tetlow LC,Freemont AJ,Woolley DE
    BACKGROUND & AIMS: :The status of bronchial cartilage degeneration in chronic bronchitis is unclear, and little is known about the chondrolytic mechanisms involved. The potential contributions of various inflammatory cells, chondrocytes and cartilage-degrading enzymes to cartilage atrophy have been examined. Bronchial cartilage specimens were obtained at autopsy from lobar secondary bronchi from chronic bronchitics and age-matched controls; each was examined by light microscopy and immunohistology for the distributions of mast cells, macrophages, eosinophils, collagenase 1, collagenase 3, and degradation products of cartilage collagen. Most bronchitic specimens showed hypertrophic chondrocytes, some of which were immunostained for collagenase 3, and occasionally for collagenase 1. Evidence for collagen degradation products was demonstrated around the lacunae of a proportion of chondrocytes, and both collagenases were also observed in the soft inflammatory tissues in close association with the cartilage surface, together with variable distributions of mast cells and macrophages. Such observations were generally absent or very much reduced in the control, non-bronchitic specimens. Degenerative changes, atrophy and loss of bronchial cartilage were common features of most chronic bronchitic specimens, this usually being related to intrinsic changes in the chondrocyte phenotype, including proliferative and matrix-degrading properties. Mast cells and macrophages were often observed in close association with the bronchial cartilage, suggesting that inflammatory cells may also contribute to the mechanisms of bronchial cartilage degradation and loss. These observations of bronchial cartilage degeneration were generally lacking in age-matched non-bronchitic control specimens.
    背景与目标: :慢性支气管炎中支气管软骨退变的状态尚不清楚,所涉及的软骨分解机制知之甚少。检查了各种炎症细胞,软骨细胞和软骨降解酶对软骨萎缩的潜在作用。尸体解剖是从慢性支气管炎和年龄匹配的对照的大叶继发支气管中进行的。通过光学显微镜和免疫组织学检查每种细胞的肥大细胞,巨噬细胞,嗜酸性粒细胞,胶原酶1,胶原酶3和软骨胶原降解产物的分布。大多数支气管标本显示肥大的软骨细胞,其中一些对胶原酶3进行了免疫染色,偶而对胶原酶1进行了染色。在一定比例的软骨细胞的腔周围发现了胶原降解产物的证据,并且在软性炎症组织中也观察到了两种胶原酶。与软骨表面密切相关,以及肥大细胞和巨噬细胞的可变分布。在对照的非支气管标本中,通常没有这种观察或观察结果大大减少。退行性改变,萎缩和支气管软骨丧失是大多数慢性支气管标本的共同特征,这通常与软骨细胞表型的内在变化有关,包括增殖和基质降解特性。通常观察到肥大细胞和巨噬细胞与支气管软骨紧密相关,这表明炎症细胞也可能有助于支气管软骨的降解和丧失。在年龄匹配的非支气管对照标本中,通常缺乏这些支气管软骨变性的观察结果。
  • 【芬兰北部人群的支气管高反应性,以前没有诊断为哮喘或慢性支气管炎,可通过组胺和乙酰甲胆碱测试进行评估。】 复制标题 收藏 收藏
    DOI:10.3402/ijch.v67i4.18343 复制DOI
    作者列表:Juusela M,Poussa T,Kotaniemi J,Lundbäck B,Sovijärvi A
    BACKGROUND & AIMS: OBJECTIVES:To assess the prevalence of bronchial hyperresponsiveness (BHR) in a population of north Finland among subjects with no previous diagnosis of asthma or chronic bronchitis by using histamine and methacholine challenges. The agreement between the methods was also evaluated. STUDY DESIGN:An epidemiological study assessing the prevalence of BHR measured with 2 direct dosimetric challenge methods. METHODS; Seventy-nine randomly selected subjects (21-73 years) were studied; 67% had respiratory or allergic symptoms. The baseline spirometry was normal or showed mild obstruction. Bronchial challenges to methacholine and histamine were performed on each subject in a randomized order. Provocative doses inducing the decrease of FEV1 by 15% and 20% (PD15FEV1 and PD20FEV1) and dose response ratios (DDR) were calculated for both tests. RESULTS; BHR with the methacholine test (PD20FEV1 < or = 2.6 mg) was found in 20% and with the histamine test (PD15FEV1 < or = 1.6 mg) in 28% of subjects; the agreement was 80% (kappa 0.45; 95% CI 0.23-0.68). In staging the severity of BHR the methods had a good agreement (weighted kappa 0.64; CI 95% 0.46-0.82). Prevalence of BHR fulfilling the criteria of the both methods was 14%. CONCLUSIONS:The findings suggest that the prevalence of BHR in the population of north Finland with no previous diagnosis of asthma or chronic bronchitis is at least 14%, probably around 20%, assessed by histamine and methacholine challenge methods. The methods have a good agreement to be used for classifying the severity of BHR.
    背景与目标: 目的:通过使用组胺和乙酰甲胆碱攻击,评估先前未诊断出哮喘或慢性支气管炎的芬兰北部人群中支气管高反应性(BHR)的患病率。还评估了方法之间的一致性。
    研究设计:一项流行病学研究,评估通过2种直接剂量挑战方法测量的BHR患病率。方法;研究了79名随机选择的受试者(21-73岁); 67%有呼吸道或过敏性症状。基线肺活量测定正常或显示轻度阻塞。以随机顺序对每个受试者进行了对乙酰甲胆碱和组胺的支气管激发。两种测试均计算了引起FEV1降低15%和20%的激发剂量(PD15FEV1和PD20FEV1)和剂量反应比(DDR)。结果;在28%的受试者中发现有甲胆碱测试(PD20FEV1 <或= 2.6 mg)的BHR和组胺测试(PD15FEV1 <或= 1.6 mg)的BHR。一致性为80%(kappa 0.45; 95%CI 0.23-0.68)。在评估BHR的严重程度时,这些方法具有很好的一致性(加权Kappa为0.64; CI为95%0.46-0.82)。符合两种方法标准的BHR患病率为14%。
    结论:研究结果表明,通过组胺和乙酰甲胆碱激发方法评估,在先前未诊断出哮喘或慢性支气管炎的芬兰北部人群中,BHR的患病率至少为14%,可能约为20%。该方法具有良好的一致性,可用于对BHR的严重程度进行分类。
  • 【慢性支气管炎急性加重对工作场所的影响(AECB);文献综述。】 复制标题 收藏 收藏
    影响因子 :
    发表时间:2004-01-01
    来源期刊:COPD
    DOI:10.1081/copd-120039211 复制DOI
    作者列表:Halpern MT,Polzin J,Higashi MK,Bakst A
    BACKGROUND & AIMS: :Acute exacerbations of chronic bronchitis (AECB) are known to have a substantial economic burden in terms of medical care costs. The objective of this study was to assess workplace-based costs associated with AECB, including absenteeism and decreased productivity, based on a review of published literature. A secondary goal was to identify factors related to workplace-based costs in AECB. A literature search was conducted to identify relevant articles assessing one or more aspects of work loss or workplace costs among patients with chronic bronchitis. A review of the identified literature indicates that patients with chronic bronchitis had more days off work; patients whose exacerbations were treated were less likely to have additional exacerbations and had comparatively less work loss. Findings suggest that clinical outcomes and workplace costs are related. While this relationship is clearer in terms of work loss, further exploration is needed to assess decreased productivity and to evaluate this relationship using objective indicators of absenteeism and productivity rather than recall.
    背景与目标: :就医疗费用而言,慢性支气管炎(AECB)的急性加重具有巨大的经济负担。这项研究的目的是根据公开的文献评估与AECB相关的工作场所成本,包括旷工和生产率下降。次要目标是确定与AECB中基于工作场所的成本相关的因素。进行文献检索以鉴定相关文章,以评估慢性支气管炎患者的工作损失或工作场所成本的一个或多个方面。对已鉴定文​​献的回顾表明,慢性支气管炎患者有更多的休息日。病情加重的患者不太可能再加重病情,并且工作损失也相对较少。研究结果表明,临床结果和工作场所成本是相关的。虽然这种关系在工作损失方面更为清楚,但仍需要进一步探索以评估生产率下降,并使用缺勤率和生产率的客观指标而不是召回率来评估这种关系。
  • 【小儿持续性腺病毒感染和慢性阻塞性支气管炎:有联系吗?】 复制标题 收藏 收藏
    DOI:10.1002/ppul.1145 复制DOI
    作者列表:Pichler M,Herrmann G,Schmidt H,Ahrens P,Zielen S
    BACKGROUND & AIMS: Chronic obstructive bronchitis with inadequate response to inhaled steroid and bronchodilator therapy is a rather rare disorder in children. Persistence of an adenoviral infection has been described as a possible cause of unremitting airway obstruction. We studied a group of 11 children with the clinical feature of chronic bronchial obstruction. A high-resolution computed tomography (HR-CT) scan was performed and typically showed hyperinflation and ground-glass-like opacities. All children underwent either bronchoscopic transbronchial or open lung biopsy. Biopsy specimens were stained with monoclonal antibodies detecting adenoviral antigen and analyzed by light-microscopy. Bronchoalveolar lavage (BAL) fluid was cultured for adenovirus, and antigen detection tests were performed. While some children had a history of proven adenoviral infection at the onset of their disease, in none of the cases could a persistence of adenovirus be shown. We conclude that adenoviral infection might act as a starter of chronic obstructive bronchitis in children, but that pathogenetic mechanisms other than persistent infection must be responsible for the chronicity of the disease.

    背景与目标: 对于吸入性类固醇和支气管扩张剂治疗反应不足的慢性阻塞性支气管炎是儿童中相当罕见的疾病。腺病毒感染的持续存在已被描述为不间断气道阻塞的可能原因。我们研究了一组11例具有慢性支气管阻塞临床特征的儿童。进行了高分辨率计算机断层扫描(HR-CT)扫描,通常显示出恶性通货膨胀和类似毛玻璃的混浊。所有儿童均行支气管镜经支气管或肺活检。活检标本用检测腺病毒抗原的单克隆抗体染色,并通过光学显微镜进行分析。培养支气管肺泡灌洗液(BAL)的腺病毒,并进行抗原检测测试。尽管有些儿童在病发时有被证实的腺病毒感染史,但在任何情况下都无法显示出持续存在的腺病毒。我们得出的结论是,腺病毒感染可能是儿童慢性阻塞性支气管炎的起因,但​​持续感染以外的其他致病机制必须与疾病的慢性性有关。

  • 【慢性支气管炎和慢性阻塞性肺疾病中的浆细胞和IL-4。】 复制标题 收藏 收藏
    DOI:10.1164/rccm.200602-161OC 复制DOI
    作者列表:Zhu J,Qiu Y,Valobra M,Qiu S,Majumdar S,Matin D,De Rose V,Jeffery PK
    BACKGROUND & AIMS: RATIONALE:Airway wall inflammation, IL-4, and mucus hypersecretion are thought to be associated. OBJECTIVES:To quantify bronchial inflammatory cells in smokers with chronic bronchitis (CB) with and without airflow obstruction (AO), determining the cells expressing IL-4 and IL-5 and their association with submucosal gland mucin. METHODS:We applied immunohistochemistry to identify, and double-labeling to colocalize, IL-4 and IL-5 to distinct inflammatory cells in resected bronchi from (1) 11 asymptomatic smokers (AS), (2) 11 smokers with CB, and (3) 10 smokers with CB and AO. MEASUREMENTS AND MAIN RESULTS:There were greater numbers of mucosal and gland CD45(+) leukocytes in CB (epithelium, 673/mm(2); subepithelium, 698/mm(2); gland, 517/mm(2)) than in AS (331, 237, and 178/mm(2), respectively; p < 0.01 for all) or CB + AO (375, 243, and 215/mm(2), respectively; p < 0.05 for all). There were greater numbers of subepithelial and submucosal gland plasma cells in CB (subepithelium, 110/mm(2); gland, 213/mm(2)) compared with AS (38 and 41/mm(2), respectively; p < 0.01 for both), and more subepithelial mast cells in CB (204/mm(2)) than in AS (65/mm(2); p < 0.01) or CB + AO (115/mm(2); p < 0.01). In CB, the percentage of gland occupied by mucin was positively correlated with the numbers of interstitial CD45(+) cells, plasma cells, and IL-4 protein(+) cells. In CB, 69 and 62% of gland-associated plasma cells expressed IL-4 and IL-5, respectively. CONCLUSIONS:Inflammatory cells are increased in bronchial submucosal glands and mucosa of large airways in smokers with CB. Gland-associated plasma cells express IL-4, and these likely promote mucus hypersecretion.
    背景与目标: 理由:气道壁发炎,IL-4和粘液分泌过多被认为是相关的。
    目的:为了量化患有和不患有气流阻塞(AO)的慢性支气管炎(CB)吸烟者的支气管炎性细胞,确定表达IL-4和IL-5的细胞及其与粘膜下腺黏蛋白的关系。
    方法:我们应用免疫组化技术从(1)11名无症状吸烟者(AS),(2)11名CB吸烟者和( 3)10名吸烟者患有CB和AO。
    测量和主要结果:CB中的黏膜和腺CD45()白细胞数量较多(上皮673 / mm(2);上皮下698 / mm(2);腺上皮517 / mm(2)) (分别为331、237和178 / mm(2);对于所有部件,p <0.01)或CB AO(分别为375、243和215 / mm(2);对于所有部件,p <0.05)。与AS相比,CB中的上皮下和粘膜下腺浆细胞数量更多(分别为110 / mm(2);腺体213 / mm(2))(分别为38和41 / mm(2); p <0.01 CB(204 / mm(2))中的上皮下肥大细胞比AS(65 / mm(2); p <0.01)或CB AO(115 / mm(2); p <0.01)多。在CB中,粘蛋白占据的腺体百分比与间质CD45()细胞,浆细胞和IL-4蛋白()细胞的数量呈正相关。在CB中,分别有69%和62%的腺相关浆细胞表达IL-4和IL-5。
    结论:CB吸烟者支气管黏膜下腺和大气道黏膜炎性细胞增多。腺相关浆细胞表达IL-4,这些可能促进粘液分泌过多。
  • 【表达传染性支气管炎病毒基因的禽偏肺病毒是稳定的,并具有保护作用。】 复制标题 收藏 收藏
    DOI:10.1016/j.vaccine.2013.03.055 复制DOI
    作者列表:Falchieri M,Lupini C,Cecchinato M,Catelli E,Kontolaimou M,Naylor CJ
    BACKGROUND & AIMS: :The study investigates the ability of subtype A Avian metapneumovirus (AMPV) to accept foreign genes and be used as a vector for delivery of Infectious bronchitis virus (IBV) QX genes to chickens. Initially the GFP gene was added to AMPV at all gene junctions in conjunction with the development of cassetted full length DNA AMPV copies. After recombinant virus had been recovered by reverse genetics, GFP positions supporting gene expression while maintaining virus viability in vitro, were determined. Subsequently, either S1 or nucleocapsid (N) genes of IBV were positioned between AMPV M and F genes, while later a bivalent recombinant was prepared by inserting S1 and N at AMPV MF and GL junctions respectively. Immunofluorescent antibody staining showed that all recombinants expressed the inserted IBV genes in vitro and furthermore, all recombinant viruses were found to be highly stable during serial passage. Eyedrop inoculation of chickens with some AMPV-IBV recombinants at one-day-old induced protection against virulent IBV QX challenge 3 weeks later, as assessed by greater motility of tracheal cilia from chickens receiving the recombinants. Nonetheless evidence of AMPV/IBV seroconversion, or major recombinant tracheal replication, were largely absent.
    背景与目标: :这项研究调查了A型禽亚肺炎病毒(AMPV)接受外源基因并用作将传染性支气管炎病毒(IBV)QX基因传递给鸡的载体的能力。最初,随着盒装全长DNA AMPV拷贝的发展,将GFP基因添加到AMPV的所有基因连接处。在通过逆向遗传学回收重组病毒之后,确定了在体外维持病毒生存力的同时支持基因表达的GFP位置。随后,IBV的S1或核衣壳(N)基因位于AMPV M和F基因之间,随后通过在AMPV MF和GL连接处分别插入S1和N制备二价重组体。免疫荧光抗体染色显示,所有重组体均在体外表达了插入的IBV基因,此外,还发现所有重组体病毒在连续传代过程中均高度稳定。一天后,用一些AMPV-IBV重组体对鸡进行眼药水接种可在3周后诱导出针对强毒IBV QX攻击的保护作用,这是通过接受重组体的鸡的气管纤毛运动性增强来评估的。但是,基本上没有AMPV / IBV血清转换或主要的重组气管复制的证据。
  • 【加拿大人群中慢性支气管炎的患病率和危险因素:加拿大社区健康调查,2007年至2008年。】 复制标题 收藏 收藏
    DOI:10.1155/2013/724208 复制DOI
    作者列表:Karunanayake CP,Hagen B,Dosman JA,Pahwa P
    BACKGROUND & AIMS: BACKGROUND:Chronic bronchitis (CB) represents one of the respiratory disease phenotypes that affect the Canadian health care system significantly. Presently, almost 6.5% of total health care costs are related to respiratory diseases. OBJECTIVE:To determine the prevalence of self-reported CB and associated risk factors in the Canadian general population. METHODS:Data regarding individuals ≥12 years of age from the Canadian Community Health Survey, 2007 to 2008, were analyzed. CB was determined through self-reported health professional diagnosis. Information regarding covariates of importance, such as demographics, lifestyle variables and socioeconomic status, was obtained. A weighted logistic regression analysis was performed with appropriate technique for clustering effects. RESULTS:The prevalence of self-reported CB was 2.5%. A greater prevalence of self-reported CB associated with older age, female sex and white ethnic group was found. There were differences in the prevalence of self-reported CB among regions of Canada for household income, educational attainment and smoking status. CONCLUSION:The results suggest an association between ethnicity and the prevalence of CB. The associations between self-reported CB prevalence and household income, educational attainment and smoking status varied according to region of Canada.
    背景与目标: 背景:慢性支气管炎(CB)代表严重影响加拿大卫生保健系统的一种呼吸道疾病表型。目前,卫生保健总费用中几乎有6.5%与呼吸系统疾病有关。
    目的:确定加拿大人群中自我报告的CB患病率及相关危险因素。
    方法:对加拿大社区健康调查(2007年至2008年)中≥12岁的个体的数据进行了分析。通过自我报告的健康专业诊断来确定CB。获得了有关重要协变量的信息,例如人口统计学,生活方式变量和社会经济地位。使用适当的技术对聚类效果进行加权逻辑回归分析。
    结果:自我报告的CB患病率为2.5%。发现自我报告的CB的患病率与年龄,女性和白人有关。在加拿大各地区,家庭收入,教育程度和吸烟状况之间自我报告的CB患病率存在​​差异。
    结论:结果表明种族与CB患病率之间存在关联。自我报告的社区卫生服务患病率与家庭收入,受教育程度和吸烟状况之间的关联因加拿大地区而异。
  • 【QX型传染性支气管炎冠状病毒穗蛋白的S2亚基是向神经性的重要决定因素。】 复制标题 收藏 收藏
    DOI:10.3390/v11100972 复制DOI
    作者列表:Cheng J,Zhao Y,Xu G,Zhang K,Jia W,Sun Y,Zhao J,Xue J,Hu Y,Zhang G
    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。
  • 【氨苄西林,氨苄西林酯(bacampicillin和pivampicillin)和阿莫西林在慢性支气管炎急性加重中的临床比较。】 复制标题 收藏 收藏
    DOI:10.1007/BF01659778 复制DOI
    作者列表:Maesen F,Davies B
    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。
  • 【一名被误诊为支原体感染的哮喘患儿由博德特氏菌引起的支气管炎。】 复制标题 收藏 收藏
    DOI:10.1007/s10156-012-0482-8 复制DOI
    作者列表:Katsukawa C,Kushibiki C,Nishito A,Nishida R,Kuwabara N,Kawahara R,Otsuka N,Miyaji Y,Toyoizumi-Ajisaka H,Kamachi K
    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。
  • 12 Beta2-agonists for acute bronchitis. 复制标题 收藏 收藏

    【Beta2-激动剂,用于急性支气管炎。】 复制标题 收藏 收藏
    DOI:10.1002/14651858.CD001726.pub2 复制DOI
    作者列表:Smucny J,Flynn C,Becker L,Glazier R
    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。
  • 【在俄罗斯西北部,环境暴露是慢性支气管炎的独立危险因素。】 复制标题 收藏 收藏
    DOI:10.3402/ijch.v72i0.19742 复制DOI
    作者列表:Nieminen P,Panychev D,Lyalyushkin S,Komarov G,Nikanov A,Borisenko M,Kinnula VL,Toljamo T
    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。
  • 【嗜酸性粒细胞,支气管炎和哮喘:咳嗽和气流阻塞的发病机制。】 复制标题 收藏 收藏
    DOI:10.1016/j.pupt.2010.11.001 复制DOI
    作者列表:Brightling CE
    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。
  • 【表达和鉴定H120株S1基因胞外区的重组传染性支气管炎病毒。】 复制标题 收藏 收藏
    DOI:10.1007/s00253-013-5352-5 复制DOI
    作者列表:Wei YQ,Guo HC,Dong H,Wang HM,Xu J,Sun DH,Fang SG,Cai XP,Liu DX,Sun SQ
    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。

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