Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases
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Zhonghua Jie He He Hu Xi Za Zhi · Apr 2019
[Respiratory pathogen spectrum in pulmonary exacerbation of bronchiectasis in adults and its association with disease severity].
Objective: To determine the pattern of respiratory pathogens at bronchiectasis exacerbation and its associations with disease severity. Methods: A total of 119 steady-state bronchiectasis patients [42 males, 77 females, age range 19 to 74 years, mean age (45±14)years], diagnosed by a compatible history combined with evidence of bronchial dilatation on high-resolution computed tomography (HRCT), were recruited prospectively from out-patient clinics in the First Affiliated Hospital of Guangzhou Medical University between September 2012 and March 2013. A comprehensive history taking, radiologic appearance, spirometry, sputum bacterial culture and 16 respiratory viruses in nasopharyngeal swabs and sputum samples by PCR assays were collected at steady-state bronchiectasis. ⋯ Conclusions: Pseudomonas aeruginosa, rhinovirus and influenza A were common causative agents of exacerbation in bronchiectasis. In patients with moderate-severe bronchiectasis, pseudomonas aeruginosa was the most common bacterium in sputum, and the most common respiratory virus was rhinovirus in nasal swab or sputum, compared to Haemophilus parainfluenzae in sputum and influenza A in nasal swab or sputum in mild bronchiectasis. Patients with co-infection had more severe systemic inflammatory response and higher risk of hospitalization during exacerbation.
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Zhonghua Jie He He Hu Xi Za Zhi · Dec 2018
[The role and mechanism of regulatory T cells in indirect acute lung injury].
Objective: To study the role and mechanism of CD(4)(+) CD(25)(+) FoxP3(+) regulatory T cells (Tregs) in the pathophysiological process of indirect acute lung injury (iALI) in mice. Methods: The iALI model was successfully induced by shock/cecal ligation and puncture method. Sham (n=8), cecal ligation and puncture (CLP, n=10), and hemorrhage (Hem, n=12) groups were established as controls. ⋯ The proliferation of activated T lymphocytes in the adoptive transfer Treg (AT-Treg) group (n=5) was significantly lower than that in the natural regulatory T cell (N-Treg) group (n=5, t=7.485, P<0.01) and the negative control group (n=5, t=16.66, P<0.01). However, iNOS enzyme inhibitor L-NMMA could significantly reduce the T cell proliferation (P<0.05). Conclusion: CD(4)(+)CD(25)(+)FoxP3(+) Tregs could reduce inflammatory reaction in mice with iALI, and the iNOS signaling pathway may be involved in this process.
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Zhonghua Jie He He Hu Xi Za Zhi · Oct 2018
[Clinical analysis of 3 cases of eosinophilic granulomatosis with polyangiitis].
Objective: To improve the clinical recognition of eosinophilic granulomatosis with polyangiitis(EGPA) in clinical manifestations, diagnosis and treatment. Methods: The clinical manifestations, pathological characteristic, imaging manifestations, diagnosis and the therapy of three patients with EGPA were presented. Results: These 3 patients had asthma-like symptoms and extrapulmonary manifestations of systemic vasculitis. ⋯ Conclusions: This disease is diverse and complex, with a lack of pathognomonic symptoms. We should highly suspect eosinophilic granulomatosis with polyangiitis, when the patients present severe asthma and eosinophilia. Early detection, early treatment, and the prognosis could be better.
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Zhonghua Jie He He Hu Xi Za Zhi · Sep 2018
Review Case Reports[The clinic experience of implantable diaphragm pacer in a patient with high cervical spinal cord injury and literature review].
Objective: To report the use of implantable diaphragm pacer (IDP) in a patient with high cervical spinal cord injury(HCSCI). Methods: A 14-year-old male patient, who suffered from a HCSCI at C2 neurological level and had been on a ventilator for 2 years, received IDP in August 2017 at China Rehabilitation Research Center. A systematic literature review was performed on IDP in patients with HCSCI in Pubmed, CNKI, and Wanfang databases, using the keywords: phrenic nerve and electrical stimulation and spinal cord injury; IDP and spinal cord injury; breathing pacemaker system and spinal cord injury. ⋯ Extensive contents, such as preoperative evaluation, preoperative preparation, surgical procedures, complications, surgical outcomes, and animal model studies of IDP were involved. The indications of IDP reported by literature were: (1) central alveolar hypoventilation; (2) Sleep apnea syndrome (Biot's respiration); (3) Respiratory failure induced by brainstem injury or disease; (4) Respiratory failure induced by spinal cord injury or disease above C3 level. Conclusion: Our case study confirmed the therapeutic effect of IDP on patients with respiratory failure caused by HCSCI.
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Zhonghua Jie He He Hu Xi Za Zhi · Sep 2018
[Clinical value of Oxford acute severity of illness score in identifying quick sequential organ failure assessment-negative patients with sepsis].
Objective: The quick sequential organ failure assessment (qSOFA) score has been proposed as part of diagnostic criteria for sepsis, but there might be an underestimation of the incidence of qSOFA-negative sepsis according to a few recent studies. The purpose of this study was to evaluate the value of Oxford acute severity of illness score (OASIS) in identifying qSOFA-negative (qSOFA<2) patients with sepsis. Methods: Sepsis patients with negative qSOFA scores were selected from the Medical Information Mart for Intensive Care Ⅲ(MIMIC-Ⅲ), a database comprising de-identified health-related data from patients staying in the critical care units of Beth Israel Deaconess Medical Center between 2001 and 2012. ⋯ Multivariate regression analysis indicated that OASIS>26 was an independent risk factor for 28-day mortality (hazard ratio 2.80, 95% CI 2.15-3.65, P<0.01), ICU mortality (odds ratio 4.69, 95% CI 2.60-8.49, P<0.01), and hospital mortality (odds ratio 4.48, 95% CI 3.13-6.42, P<0.01). Analysis of the PSM cohort presented consistent results. Conclusions: OASIS had a good discriminative value to differentiate qSOFA-negative patients with sepsis from those without sepsis.