BACKGROUND The relationship between diabetes mellitus(DM)and asthma is complex and can impact disease trajectories.AIM To explore the bidirectional influences between the two conditions on clinical outcomes and diseas...BACKGROUND The relationship between diabetes mellitus(DM)and asthma is complex and can impact disease trajectories.AIM To explore the bidirectional influences between the two conditions on clinical outcomes and disease control.METHODS We systematically reviewed the literature on the relationship between DM and asthma,focusing on their impacts,mechanisms,and therapeutic implications.Various studies were assessed,which investigated the effect of glycemic control on asthma outcomes,lung function,and exacerbations.The study highlighted the role of specific diabetes medications in managing asthma.RESULTS The results showed that poor glycemic control in diabetes can exacerbate asthma,increase hospitalizations,and reduce lung function.Conversely,severe asthma,especially in obese individuals,can complicate diabetes management and make glycemic control more difficult.The diabetes-associated mechanisms,such as inflammation,microangiopathy,and oxidative stress,can exacerbate asthma and decrease lung function.Some diabetes medications exhibit anti-inflammatory effects that show promise in mitigating asthma exacerbations.CONCLUSION The complex interrelationship between diabetes and asthma suggests bidirectional influences that affect disease course and outcomes.Inflammation and microvascular complications associated with diabetes may worsen asthma outcomes,while asthma severity,especially in obese individuals,complicates diabetes control.However,the current research has limitations,and more diverse longitudinal studies are required to establish causal relationships and identify effective treatment strategies for individuals with both conditions.展开更多
Bronchial rupture from penetrating,perforating,or compressive cervical or thoracic injuries can lead to complete tracheal,mainstem bronchial,or lobar bronchial detachment.Although rare in children,bronchial rupture pr...Bronchial rupture from penetrating,perforating,or compressive cervical or thoracic injuries can lead to complete tracheal,mainstem bronchial,or lobar bronchial detachment.Although rare in children,bronchial rupture presents significant risks,including dyspnea,respiratory failure,and potentially fatal airway obstruction,and is often overlooked or diagnosed late in clinical settings.Prompt diagnosis and intervention are prognostically crucial.[1,2]Between January 2013 and December 2023,four children(two male and two female)with bronchial rupture were admitted to the Pediatric Surgical Intensive CareUnit(ICU)at Children’s Hospital,Zhejiang University School of Medicine.Here,we share our experience of patient management.展开更多
Hemoptysis is defined as bleeding originating from the respiratory tract distal to the larynx and is associated with a wide spectrum of underlying conditions,including bronchiectasis,pulmonary malignancies,tuberculosi...Hemoptysis is defined as bleeding originating from the respiratory tract distal to the larynx and is associated with a wide spectrum of underlying conditions,including bronchiectasis,pulmonary malignancies,tuberculosis,aspergillosis,and vascular malformations.^([1-3]) A metaanalysis involving patients with massive hemoptysis reported a mortality rate of 3.5%.^([4])This underscores the critical importance of prompt and eff ective embolization of the responsible artery to improve outcomes,particularly in patients presenting with life-threatening hemoptysis.展开更多
Bronchial asthma is divided into type 2 and non-type 2 asthma based on the immunopathogenesis.Type 2 inflammation is an inflammation mediated by T helper 2 cells,group 2 innate lymphoid cells and sustained by a specif...Bronchial asthma is divided into type 2 and non-type 2 asthma based on the immunopathogenesis.Type 2 inflammation is an inflammation mediated by T helper 2 cells,group 2 innate lymphoid cells and sustained by a specific subset of cytokines.In recent years,type 2 asthma has become the research hotspot in the field of asthma.For type 2 asthma,targeted therapies have become effective treatments and widely used in clinical practice.In order to further understand the progress of biologic drugs for bronchial asthma,as well as the disease outcomes in patients with type 2 asthma,and improve asthma control and remission,this article reviewed the progress and achievements of biologic drugs for asthma from May 1,2023 to April 30,2024,providing clinical perspective for the choosing appropriate targeted treatment of asthma.It also highlights selected poster pre-sentations from the ATS 2024 Annual Meeting to provide clinical insights for choosing appropriate targeted treatments for Type 2 asthma.展开更多
Objective: To evaluate three-dimensional bronchial artery imaging charactersin central lung cancer and applied values with multi-slice spiral CT (MSCT) to provide theoreticalevidence on blood supply and intervention t...Objective: To evaluate three-dimensional bronchial artery imaging charactersin central lung cancer and applied values with multi-slice spiral CT (MSCT) to provide theoreticalevidence on blood supply and intervention therapy. Methods: Eighteen patients with central lungcancer underwent MSCT with real time helical thin-slice CT scanning. Three-dimensional bronchialartery reconstruction was done at the console work-station. The space anatomical characters ofbronchial artery were observed through different rotations. Results: For 6 cases, thethree-dimensional images of bronchial artery (33.33%) could exactly show the origins, the routes(lung inner segment and mediatism segment) and the diameters of bronchial arteries. Vision rate ofbronchial arteries was the highest in pulmonary artery stricture and truncation groups, and thevessels' diameter became larger apparently. These characters demonstrated blood supply of this kindof central lung cancer come from bronchial artery. Volume rendering images were the best ones amongthree-dimensional images. Conclusion: Three-dimensional imaging with MSCT in bronchial artery canreveal the anatomical characters of bronchial artery and provide theoretical evidence on bloodsupply and intervention therapy of central lung cancer.展开更多
Objective： The purpose of this study was to assess the features of bronchial alveolar carcinoma in fluorine-18 fluorodeoxyglucose （FDG） uptake by Positron emission tomography（PET）. Methods： From December 1998 to...Objective： The purpose of this study was to assess the features of bronchial alveolar carcinoma in fluorine-18 fluorodeoxyglucose （FDG） uptake by Positron emission tomography（PET）. Methods： From December 1998 to October 2004, 35 patients with bronchial alveolar carcinoma （BAC） were imaged with FDG-PET before surgery. The PET results were interpreted using visual and semiquantitative assessment. For semiquantitative analysis, standardized uptake value （SUV） was calculated. Results： All tumors of the patients could be detected by FDG-PET and identified by visual method. By semiquantitative analysis, FDG uptake of the tumor （SUVmax and SUVmean） was higher than that of normal lung （SUVlung） （P〈0.001）, SUVmax, SUVmean of the tumor and SUVlung were 3.14±1.65, 2.40±1.34 and 0.38±0.08 respectively. Correlations were found between FDG uptake and tumor size （P〈0.05）. SUVmean in 21 tumors （21/35, 60.0%） and SUVmax in 15 tumors （15/35, 42.9%） were lower than 2.5. These 21 tumors were all considered as benign by visual method and semiquantitative analysis. Conclusion： （1） FDG uptake was higher in bronchial alveolar carcinoma than that in normal lung tissue. （2） FDG uptake and tumor size appear to be correlated with each other. （3） Bronchial alveolar carcinomas lead to many false negative cases in FDG-PET.展开更多
Upper and lower airways can be considered as a unifiedmorphofunctional unit. In this paper, nasobronchial interactions are evaluated based on literature.To discuss nasobronchial interactions, literature review from Pu...Upper and lower airways can be considered as a unifiedmorphofunctional unit. In this paper, nasobronchial interactions are evaluated based on literature.To discuss nasobronchial interactions, literature review from Pub Med since 1982 is evaluated. Data base was including the terms "nasobronchial interaction, nasal and bronchial". Asthma and rhinosinusitis may be associated with environmental factors and immunological predisposition. Treatment of rhinosinusitis may decrease asthma exacerbations. It was concluded that "one airway, one disease"-concept may be accepted when considering naso-bronchial interaction. Asthma treatment should also mean treating the nose as good as treating patients with nasal symptoms. To reach the succesful results it should be associated with evaluation of lung functions.展开更多
BACKGROUND The number of patients with bronchial trauma(BT)who survived to hospital admission has increased with the improvement of prehospital care;early diagnosis and treatment should be considered,especially among ...BACKGROUND The number of patients with bronchial trauma(BT)who survived to hospital admission has increased with the improvement of prehospital care;early diagnosis and treatment should be considered,especially among blunt trauma patients,whose diagnosis is frequently delayed.AIM To describe the early recognition and surgical management considerations of blunt and penetrating BTs,and to elaborate the differences between them.METHODS All patients with BTs during the past 15 years were reviewed,and data were retrospectively analyzed regarding the mechanism of injury,diagnostic and therapeutic procedures,and outcomes.According to the injury mechanisms,the patients were divided into two groups:Blunt BT(BBT)group and penetrating BT(PBT)group.The injury severity,treatment procedures,and prognoses of the two groups were compared.RESULTS A total of 73 patients with BT were admitted during the study period.The proportion of BTs among the entire cohort with chest trauma was 2.4%(73/3018),and all 73 underwent thoracotomy.Polytrauma patients accounted for 81.6% in the BBT group and 22.9%in the PBT group,and the mean Injury Severity Score was 38.22±8.13 and 21.33±6.12,respectively.Preoperative three-dimensional spiral computed tomography(CT)and/or fiberoptic bronchoscopy(FB)were performed in 92.1% of cases in the BBT group(n=38)and 34.3% in the PBT group(n=35).In the BBT group,a delay in diagnosis for over 48 h occurred in 55.3% of patients.In the PBT group,31 patients underwent emergency thoracotomy due to massive hemothorax,and BT was confirmed during the operation.Among them,22 underwent pulmo-tractotomy for hemostasis,avoiding partial pneumonectomy.In this series,the overall mortality rate was 6.9%(5/73),and it was 7.9%(3/38)and 5.7%(2/35)in the BBT group and PBT group,respectively(P>0.05).All 68 survivors were followed for 6 to 42(23±6.4)mo,and CT,FB,and pulmonary function examinations were performed as planned.All patients exhibited normal lung function and healthy conditions except three who required reoperations.CONCLUSION The difference between blunt and penetrating BTs is obvious.In BBT,patients generally have no vessel injury,and the diagnosis is easily missed,leading to delayed treatment.The main cause of death is ventilation disturbance due to tension pneumothorax early and refractory atelectasis with pneumonia late.However,in PBT,most patients require emergency thoracotomy because of simultaneous vessel trauma and massive hemothorax,and delays in diagnosis are infrequent.The leading cause of death is hemorrhagic shock.展开更多
Objective: To study the influence of glycyrrhetinic acid(GA) on bronchial asthma(BA)smooth muscle proliferation and apoptosis as well as inflammatory factor expression and its molecular mechanism.Methods: Male SD guin...Objective: To study the influence of glycyrrhetinic acid(GA) on bronchial asthma(BA)smooth muscle proliferation and apoptosis as well as inflammatory factor expression and its molecular mechanism.Methods: Male SD guinea pigs were selected and made into asthma models, bronchial asthma smooth muscle cells were cultured and divided into BA group, GA group and GA + LM group that were treated with serum-free RPMI1640 culture medium, serumfree RPMI1640 culture medium containing 50 ng/mL glycyrrhetinic acid, serum-free RPMI1640 culture medium containing 50 ng/mL glycyrrhetinic acid and 100 ng/mL LM22B-10 respectively; normal guinea pigs were collected and bronchial smooth muscle cells were cultured as control group. The cell proliferation activity as well as the expression of proliferation and apoptosis genes, inflammatory factors and p-ERK1/2 was determined.Results: Proliferation activity value and m RNA expression of Bcl-2, TNF-α, IL-4, IL-6,YKL-40, protein expression of p-ERK1/2 of airway smooth muscle cell in BA group were significantly higher than those of control group while m RNA expression levels of Bax,caspase-9 as well as caspase-3 were significantly lower than that of control group(P < 0.05); proliferation activity value and m RNA expression of Bcl-2, TNF-α, IL-4, IL-6, YKL-40, protein expression of p-ERK1/2 of airway smooth muscle cell in GA group were significantly lower than those of BA group(P < 0.05) while the m RNA expression levels of Bax, caspase-9 as well as caspase-3 were significantly higher than those of BA group(P < 0.05); proliferation activity value and m RNA expression of Bcl-2, TNF-α, IL-4, IL-6, YKL-40 of airway smooth muscle cell in GA + LM group were significantly higher than those of GA group(P < 0.05) while m RNA expression levels of Bax, caspase-9 as well as caspase-3 were significantly lower that of GA group(P < 0.05).Conclusion: GA can inhibit the proliferation of bronchial smooth muscle cells and reduce the expression of inflammatory factors by inhibiting the phosphorylation of ERK1/2.展开更多
To investigate whether apoptosis is associated with cell adhesion in bronchial epithelium, and whether it contributes to the kinetics of injury and repair of surface epithelia, this study was performed for E-cadherin ...To investigate whether apoptosis is associated with cell adhesion in bronchial epithelium, and whether it contributes to the kinetics of injury and repair of surface epithelia, this study was performed for E-cadherin expression by using immunohistochemistry technique and for apoptosis by TUNEL method An animal model of smoking was used for this study The results showed that epithelial cells with membrane anchored E-cadherin decreased remarkably at several time points during 6 months of exposure to smoke ( P< 0 01) and then restored to normal level This fluctuation was associated exclusively with the alteration in number of apoptotic cells ( P <0 01) There was no significant difference in activation of nuclear transcription factor NF-kappa B among groups ( P> 0 05) All these suggested that apoptosis is associated with E-cadherin expression in bronchial epithelium of smoking mouse展开更多
AIM:To explore the anatomical relationships between bronchial artery and tracheal bifurcation using computed tomography angiography (CTA).METHODS:One hundred consecutive patients (84 men,16 women;aged 46-85 years) who...AIM:To explore the anatomical relationships between bronchial artery and tracheal bifurcation using computed tomography angiography (CTA).METHODS:One hundred consecutive patients (84 men,16 women;aged 46-85 years) who underwent CTA using multi-detector row CT (MDCT) were investigated retrospectively.The distance between sites of bronchial artery ostia and tracheal bifurcation,and dividing directions were explored.The directions of division from the descending aorta were described as on a clock face.RESULTS:We identified ostia of 198 bronchial arteries:95 right bronchial arteries,67 left bronchial arteries,36 common trunk arteries.Of these,172 (87%) divided from the descending aorta,25 (13%) from the aortic arch,and 1 (0.5%) from the left subclavian artery.The right,left,and common trunk bronchial arteries divided at-1 to 2 cm from tracheal bifurcation with frequencies of 77% (73/95),82% (54/66),and 70% (25/36),respectively.The dividing direction of right bronchial arteries from the descending aorta was 9 to 10 o’clock with a frequency of 81% (64/79);that of left and common tract bronchial arteries was 11 to 1 o’clock with frequencies of 70% (43/62) and 77% (24/31),respectively.CONCLUSION:CTA using MDCT provides details of the relation between bronchial artery ostia and tracheal bifurcation.展开更多
Recent state-of-the-art computed tomography and improved three-dimensional(3-D) postprocessing techniques have revolutionized the capability of visualizing airway pathology,offering physicians an advanced view of path...Recent state-of-the-art computed tomography and improved three-dimensional(3-D) postprocessing techniques have revolutionized the capability of visualizing airway pathology,offering physicians an advanced view of pathology and allowing for appropriate management planning.This article is a comprehensive review of trachea and main bronchi imaging,with emphasis on the dynamic airway anatomy,and a discussion of a wide variety of diseases including,but not limited to,congenital large airway abnormalities,tracheobronchial stenoses,benign and malignant neoplasms and tracheobronchomalacia.The importance of multiplanar reconstruction,3-D reconstruction and incorporation of dynamic imaging for non-invasive evaluation of the large airways is stressed.展开更多
Objective To analyze the relationship between malignant transformation and abnormal expression of eukaryotic initiation factor 3 （eIF3 p36） in human bronchial epithelial （16HBE） cells induced by cadmium chloride ...Objective To analyze the relationship between malignant transformation and abnormal expression of eukaryotic initiation factor 3 （eIF3 p36） in human bronchial epithelial （16HBE） cells induced by cadmium chloride （CdCl2）. Methods 16HBE cells were treated several times with different concentrations of CdCl2. Tumorigenic potential of transformed cells was identified by assays for anchorage-independent growth in soft agar and for tumorigenicity in nude mice after the 35th passage. Total RNA was isolated from 16HBE cells induced by CdC12, including non-transformed, Cd-transformed, and Cd-tumorigenic cell lines. Special primers for eIF3 p36 were designed and the expression of eIF3 mRNA in different cell lines was detected with fluorescent quantitative-polymerase chain reaction technique （FQ-PCR）. Results The 35th passage of 16HBE cells transformed by CdCl2 exhibited overlapping growth. Compared with the non-transformed cells, colonies of transformed cell lines in soft agar showed statistically significant increases and dose-dependent effects （P〈0.01）. All Cd-induced transformed cell lines formed rumors in nude mice within 2 weeks of inoculation, but none of the mice injected with non-transformed cells showed tumors even after 3 weeks. All tumors were pathologically identified as poorly differentiated squamous cell carcinoma. The eIF3 p36 genes in different stages of 16HBE cells transformed by CdCl2 were elevated as compared with the non-transformed control （P〈0.01）, and the eIF3 expression increased with the degree of cell malignancy. Conclusion CdCl2 is capable of inducing morphological transformation in 16HBE cells and transformed cells are potentially tumorigenic. Over-expression of eIF3 p36 is positively correlated with malignant transformation of 16HBE cells induced by CdCl2 and may be one of the molecular mechanisms potentially responsible for carcinogenesis due to Cd.展开更多
Objective： In the present study, we have examined the safety and efficacy of recombinant adenovirus encoding human p53 tumor suppressor gene （rAd-p53） injection in patients with advanced non-small-cell lung cancer ...Objective： In the present study, we have examined the safety and efficacy of recombinant adenovirus encoding human p53 tumor suppressor gene （rAd-p53） injection in patients with advanced non-small-cell lung cancer （NSCLC） in the combination with the therapy of bronchial arterial infusion （BAI）. Methods： A total of 58 patients with advanced NSCLC were enrolled in a non-randomized, two-armed clinical trial. Of which, 19 received a combination treatment of BAI and rAd-p53 （the combo group）, while the remaining 39 were treated with only BAI （the control group）. Patients were followed up for 12 months, with safety and local response evaluated by the National Cancer lnstitute＇s Common Toxicity Criteria and response evaluation criteria in solid tumor （RECIST）, respectively. Time to progression （TTP） and survival rates were also analyzed by Kaplan-Meier method. Results In the combo group, 19 patients received a total of 49 injections ofrAd-p53 and 46 times of BAI, respectively, while 39 patients in the control group received a total of 113 times of BAI. The combination treatment was found to have less adverse events such as anorexia, nausea and emesis, pain, and leucopenia （P〈0.05） but more arthralgia, fever, influenza-like symptom, and myalgia （P〈0.05）, compared with the control group. The overall response rates （complete response （CR）＋partial response （PR）） were 47.3% and 38.4% for the combo group and the control group, respectively （P〉0.05）. Patients in the combo group had a longer TTP than those in the control group （a median 7.75 vs 5.5 months, P-0.018）. However, the combination treatment did not lead to better survival, with survival rates at 3, 6, and 12 months in the combo group being 94.74%, 89.47%, and 52.63%, respectively, com- pared with 92.31%, 69.23%, and 38.83% in the control group （P=0.224）. Conclusion： Our results show that the combination of rAd-p53 and BAI was well tolerated in patients with NSCLC and may have improved the quality of life and delayed the disease progression. A further study to better determine the efficacy of this combination therapy is warranted.展开更多
BACKGROUND Esophagomediastinal fistula is a very rare complication of tuberculosis in otherwise healthy adults, and mediastinal bronchial artery aneurysm is even rarer. In this case report, we describe a rare case of ...BACKGROUND Esophagomediastinal fistula is a very rare complication of tuberculosis in otherwise healthy adults, and mediastinal bronchial artery aneurysm is even rarer. In this case report, we describe a rare case of tuberculosis complication that presented with acute upper gastrointestinal(GI) bleeding. It also highlights the benefits of chest computed tomography(CT) as an excellent adjunct diagnostic tool to endoscopy and bronchoscopy and the role of trans-arterial embolization as a minimal invasive therapy alternative to surgery.CASE SUMMARY A 19-year-old medically free male patient presented with acute multiple episodes of hematemesis for 1 d. Upper GI endoscopy, bronchoscopy, and chest CT with IV contrast confirmed esophagomediastinal fistula with mediastinal bronchial artery aneurysm. After resuscitating patient with IV fluid and blood product transfusion, trans catheter embolization was performed for mediastinal bronchial artery aneurysm.CONCLUSION We successfully treated a patient with acute upper GI bleeding due to tuberculous esophagomediastinal fistula and mediastinal bronchial artery aneurysm using transcatheter coil embolization.展开更多
OBJECTIVE:To preliminarily analyze key factors influencing curative effect through clinical observations of acupoint application for "treatment of win-ter disease in summer" used to prevent and treat bronchi...OBJECTIVE:To preliminarily analyze key factors influencing curative effect through clinical observations of acupoint application for "treatment of win-ter disease in summer" used to prevent and treat bronchial asthma in children.METHODS:In an observational study and prospective cohort study,we observed children in remission of asthma at three class Ⅲ grade A TCM hospitals in Liaoning,Hubei,and Chengdu.RESULTS:A total of 609 children conformed to diagnostic and inclusive standards for remission of bronchial asthma.Through follow-up visits,we observed their skin reactions and the time and chance of treatment with different therapies in the three hospitals;we also compared and analyzed different drugs,acupoints,and preparations.We found that the key Chinese drugs were Bai Jie Zi(Semen Sinapis Albae) and Yian Hu Suo(Rhizoma Corydalis);the key acupoints were Feishu(BL 13),Gaohuang(BL 43),Dingchuan(EX-B1),Tiantu(CV 22),and Shanzhong(CV 17);and the best preparation was a mixture of drugs,ginger juice,and musk.Acupoint application was practiced on the hottest days of summer and the coldest days of winter for 0.5 to 2 h with the lowest rate of asthma relapse.CONCLUSIONS:The present data analysis shows that the curative effect of acupoint application for "treatment of winter disease in summer" may be influenced by recipes of Chinese drugs,preparations,prescriptions of acupoints,chance,time,and skin reactions.A curative effect is the result of the comprehensive action of these factors.展开更多
Objective To investigate the roles of Rho/Rock signaling pathway in silica-induced Epithelial-mesenchymal transition （EMT） in human bronchial epithelial cells （BEC） in vitro. Methods Human BEC were incubated with ...Objective To investigate the roles of Rho/Rock signaling pathway in silica-induced Epithelial-mesenchymal transition （EMT） in human bronchial epithelial cells （BEC） in vitro. Methods Human BEC were incubated with silica with various concentrations for indicated times. Cell viability was assayed by MTT test. Morphologic Changes were observed by microscope. Mesenchymal marker a-smooth muscle actin （a-SMA）, vimentin （Vim）, and epithelial marker E-cadherin （E-cad） were analyzed by Western Blot. The pull-down assay was used to measure Rho activity. In the prevention experiments, the specific inhibitor for Rho effector ROCK （Y27632） was used to inhibit the activity of Rho. Results Human BEC stimulated with silica were converted from a ＂cobblestone＂ epithelial structure into an elongated fibroblast-like shape structure. Incubation of human BEC with silica induced de novo expression of a-SMA and Vim, and loss of E-cad. Also, silica treatment resulted in Rho activation in human BEC. Y27632 up-regulated the E-cad expression but attenuated a-SMA and Vim expression in silica-stimulated cells. Conclusion The activation of Rho/ROCK signaling pathways is most likely involved in Silica-induced EMT in human bronchial epithelial cells.展开更多
Today the most important challenge facing the pediatrician is the increasing prevalence of chronic diseases. With this regard, pediatricians play a key role in the management of these conditions. The closeness with th...Today the most important challenge facing the pediatrician is the increasing prevalence of chronic diseases. With this regard, pediatricians play a key role in the management of these conditions. The closeness with the family, the knowledge of the clinical case and the care continuity allow the pediatrician to acquire a position of director of every case. When pathological events have a chronic feature, suddenly the quality of life of the whole family changes. For this reason the first communication of chronic disease is very important and the task of the pediatrician should be to provide a positive message to help the family in facing the difficulty of this new challenge. The bronchial asthma is the most common chronic disease worldwide. The incidence, the prevalence, and the mortality of the disease have increased in children over the past decades. These trends are particularly marked above all in preschool children. The success reached by Pediatricians is closely related to the compliance and the implementation of the therapy followed by the little patient and his family. With this regard authors, in this review, focus on the illustration of several strategies, based on the pediatrician’ skills and medicine documents, that can be used for the improvement of communication among pedia- trician-family and child, never forgetting the hu- man aspect of the same doctor, that should con- ciliate with the scientific knowledge in the taking care of a specific chronic disease.展开更多
OBJECTIVE:To assess the effectiveness and safety of Traditional Chinese Medicine(TCM) treatment of non-acute bronchial asthma complicated by gastroesophageal reflux.METHODS:We searched databases from MEDLINE,Cochrane ...OBJECTIVE:To assess the effectiveness and safety of Traditional Chinese Medicine(TCM) treatment of non-acute bronchial asthma complicated by gastroesophageal reflux.METHODS:We searched databases from MEDLINE,Cochrane Library,CNKI,VIP,CBM,Wanfang Data,and TCM Database Systems.All randomized,controlled trials(RTCs) of TCM treatment of non-acute asthma complicated by gastroesophageal reflux were included.Data were independently collected by two reviewers.The standards for assessing quality described in the Cochrane Handbook for Systematic Reviews of Interventions were used to evaluate articles.Meta-analyses were conducted using RevMan 5.0.17 software.Heterogeneity was assessed,and a corresponding effects model was used to merge and analyze results.Indexes used to evalu-ate curative effects were:clinical efficacy,symptom scores,pulmonary function values,and adverse incidents.Effectiveness was indicated using risk ratio(RR) or mean difference(MD),and 95% confidence intervals(CIs) were calculated.RESULTS:Six RCTs were included,involving 304 patients with non-acute asthma complicated by gastroesophageal reflux.The treatment groups received Chinese drugs alone or TCM combined with standard Western medical treatment,and the control groups received standard Western medical treatment alone.Standard Western medical treatment included anti-inflammatory drugs and bronchodilators for asthma,and drugs to promote gastric peristalsis and inhibit gastric acid production for gastroesophageal reflux.Methodological quality was low in all six RCTs.Two RCTs showed that clinical efficacy was higher in the treatment group than in the control group(RR:1.43,95%CI:1.10 to 1.87 vs RR:1.51,95% CI:1.09 to 2.08).One RCT showed that the asthma score was lowered more effectively in the treatment group than in the control group(MD:-1.10,95% CI:-2.04 to-0.16).Two RCTs showed that the gastroesophageal reflux score was reduced more effectively in the treatment group than in the control group(RR:-3.70,95% CI:-4.30 to 3.10 vs RR:-5.30,95% CI:-6.32 to-4.28).One RCT showed that some pulmonary function values were improved more effectively in the treatment group than in the control group(P< 0.05).No differences were seen in the various indexes between groups in the other RCTs.No adverse reactions,dropout rates,or follow-up rates were reported in any of the RCTs.CONCLUSIONS:The clinical symptoms ofnon-acute asthma complicated by gastroesophageal reflux can be improved by some Chinese drugs.Curative effects can be increased by combining the use of TCM with Western medicine.Because of the small quantity and low quality of research reported to date,it is necessary to conduct further RCTs to confirm these results.The results of this systematic review indicate that the quality of future clinical trials should be improved by including larger patient numbers,correctly randomizing patients into study groups,using blinding methods to measure and assess outcomes,and using accepted indexes to evaluate curative effects.展开更多
AIM: Metastases from lung cancer to gastrointestinal tract are not rare at postmortem studies but the development of clinically significant symptoms from the gastrointestinal metastases is very unusual. METHODS: Forma...AIM: Metastases from lung cancer to gastrointestinal tract are not rare at postmortem studies but the development of clinically significant symptoms from the gastrointestinal metastases is very unusual. METHODS: Formalin-fixed, paraffin-embedded tissues were cut into 5 urn thick sections and routinely stained with hematoxylin and eosin. Some slides were also stained with Alcian-PAS. Antibodies used were primary antibodies to pancytokeratin, cytokeratin 7, cytokeratin 20, epithelial membrane antigen, vimentin, smooth muscle actin and CD-117. RESULTS: We observed three patients who presented with multiple metastases from large cell bronchial carcinoma to small intestine. Two of them had abdominal symptoms (sudden onset of abdominal pain, constipation and vomiting) and in one case the tumor was incidentally found during autopsy. Microscopically, all tumors showed a same histological pattern and consisted almost exclusively of strands and sheets of poorly cohesive, polymorphic giant cells with scanty, delicate stromas. Few smaller polygonal anaplastic cells dispersed between polymorphic giant cells, were also observed. Immunohistochemistry showed positive staining of the tumor cells with cytokeratin and vimentin. Microscopically and immunohistochemically all metastases had a similar pattern to primary anaplastic carcinoma of the small intestine. CONCLUSION: In patients with small intestine tumors showing anaplastic features, especially with multiple tumors, metastases from large cell bronchial carcinoma should be first excluded, because it seems that they are more common than expected.展开更多
文摘BACKGROUND The relationship between diabetes mellitus(DM)and asthma is complex and can impact disease trajectories.AIM To explore the bidirectional influences between the two conditions on clinical outcomes and disease control.METHODS We systematically reviewed the literature on the relationship between DM and asthma,focusing on their impacts,mechanisms,and therapeutic implications.Various studies were assessed,which investigated the effect of glycemic control on asthma outcomes,lung function,and exacerbations.The study highlighted the role of specific diabetes medications in managing asthma.RESULTS The results showed that poor glycemic control in diabetes can exacerbate asthma,increase hospitalizations,and reduce lung function.Conversely,severe asthma,especially in obese individuals,can complicate diabetes management and make glycemic control more difficult.The diabetes-associated mechanisms,such as inflammation,microangiopathy,and oxidative stress,can exacerbate asthma and decrease lung function.Some diabetes medications exhibit anti-inflammatory effects that show promise in mitigating asthma exacerbations.CONCLUSION The complex interrelationship between diabetes and asthma suggests bidirectional influences that affect disease course and outcomes.Inflammation and microvascular complications associated with diabetes may worsen asthma outcomes,while asthma severity,especially in obese individuals,complicates diabetes control.However,the current research has limitations,and more diverse longitudinal studies are required to establish causal relationships and identify effective treatment strategies for individuals with both conditions.
文摘Bronchial rupture from penetrating,perforating,or compressive cervical or thoracic injuries can lead to complete tracheal,mainstem bronchial,or lobar bronchial detachment.Although rare in children,bronchial rupture presents significant risks,including dyspnea,respiratory failure,and potentially fatal airway obstruction,and is often overlooked or diagnosed late in clinical settings.Prompt diagnosis and intervention are prognostically crucial.[1,2]Between January 2013 and December 2023,four children(two male and two female)with bronchial rupture were admitted to the Pediatric Surgical Intensive CareUnit(ICU)at Children’s Hospital,Zhejiang University School of Medicine.Here,we share our experience of patient management.
文摘Hemoptysis is defined as bleeding originating from the respiratory tract distal to the larynx and is associated with a wide spectrum of underlying conditions,including bronchiectasis,pulmonary malignancies,tuberculosis,aspergillosis,and vascular malformations.^([1-3]) A metaanalysis involving patients with massive hemoptysis reported a mortality rate of 3.5%.^([4])This underscores the critical importance of prompt and eff ective embolization of the responsible artery to improve outcomes,particularly in patients presenting with life-threatening hemoptysis.
基金supported by Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2M-1-049)Noncommunicable Chronic Diseases-National Science and Technology Major Project(2024ZD0529800).
文摘Bronchial asthma is divided into type 2 and non-type 2 asthma based on the immunopathogenesis.Type 2 inflammation is an inflammation mediated by T helper 2 cells,group 2 innate lymphoid cells and sustained by a specific subset of cytokines.In recent years,type 2 asthma has become the research hotspot in the field of asthma.For type 2 asthma,targeted therapies have become effective treatments and widely used in clinical practice.In order to further understand the progress of biologic drugs for bronchial asthma,as well as the disease outcomes in patients with type 2 asthma,and improve asthma control and remission,this article reviewed the progress and achievements of biologic drugs for asthma from May 1,2023 to April 30,2024,providing clinical perspective for the choosing appropriate targeted treatment of asthma.It also highlights selected poster pre-sentations from the ATS 2024 Annual Meeting to provide clinical insights for choosing appropriate targeted treatments for Type 2 asthma.
文摘Objective: To evaluate three-dimensional bronchial artery imaging charactersin central lung cancer and applied values with multi-slice spiral CT (MSCT) to provide theoreticalevidence on blood supply and intervention therapy. Methods: Eighteen patients with central lungcancer underwent MSCT with real time helical thin-slice CT scanning. Three-dimensional bronchialartery reconstruction was done at the console work-station. The space anatomical characters ofbronchial artery were observed through different rotations. Results: For 6 cases, thethree-dimensional images of bronchial artery (33.33%) could exactly show the origins, the routes(lung inner segment and mediatism segment) and the diameters of bronchial arteries. Vision rate ofbronchial arteries was the highest in pulmonary artery stricture and truncation groups, and thevessels' diameter became larger apparently. These characters demonstrated blood supply of this kindof central lung cancer come from bronchial artery. Volume rendering images were the best ones amongthree-dimensional images. Conclusion: Three-dimensional imaging with MSCT in bronchial artery canreveal the anatomical characters of bronchial artery and provide theoretical evidence on bloodsupply and intervention therapy of central lung cancer.
文摘Objective： The purpose of this study was to assess the features of bronchial alveolar carcinoma in fluorine-18 fluorodeoxyglucose （FDG） uptake by Positron emission tomography（PET）. Methods： From December 1998 to October 2004, 35 patients with bronchial alveolar carcinoma （BAC） were imaged with FDG-PET before surgery. The PET results were interpreted using visual and semiquantitative assessment. For semiquantitative analysis, standardized uptake value （SUV） was calculated. Results： All tumors of the patients could be detected by FDG-PET and identified by visual method. By semiquantitative analysis, FDG uptake of the tumor （SUVmax and SUVmean） was higher than that of normal lung （SUVlung） （P〈0.001）, SUVmax, SUVmean of the tumor and SUVlung were 3.14±1.65, 2.40±1.34 and 0.38±0.08 respectively. Correlations were found between FDG uptake and tumor size （P〈0.05）. SUVmean in 21 tumors （21/35, 60.0%） and SUVmax in 15 tumors （15/35, 42.9%） were lower than 2.5. These 21 tumors were all considered as benign by visual method and semiquantitative analysis. Conclusion： （1） FDG uptake was higher in bronchial alveolar carcinoma than that in normal lung tissue. （2） FDG uptake and tumor size appear to be correlated with each other. （3） Bronchial alveolar carcinomas lead to many false negative cases in FDG-PET.
文摘Upper and lower airways can be considered as a unifiedmorphofunctional unit. In this paper, nasobronchial interactions are evaluated based on literature.To discuss nasobronchial interactions, literature review from Pub Med since 1982 is evaluated. Data base was including the terms "nasobronchial interaction, nasal and bronchial". Asthma and rhinosinusitis may be associated with environmental factors and immunological predisposition. Treatment of rhinosinusitis may decrease asthma exacerbations. It was concluded that "one airway, one disease"-concept may be accepted when considering naso-bronchial interaction. Asthma treatment should also mean treating the nose as good as treating patients with nasal symptoms. To reach the succesful results it should be associated with evaluation of lung functions.
文摘BACKGROUND The number of patients with bronchial trauma(BT)who survived to hospital admission has increased with the improvement of prehospital care;early diagnosis and treatment should be considered,especially among blunt trauma patients,whose diagnosis is frequently delayed.AIM To describe the early recognition and surgical management considerations of blunt and penetrating BTs,and to elaborate the differences between them.METHODS All patients with BTs during the past 15 years were reviewed,and data were retrospectively analyzed regarding the mechanism of injury,diagnostic and therapeutic procedures,and outcomes.According to the injury mechanisms,the patients were divided into two groups:Blunt BT(BBT)group and penetrating BT(PBT)group.The injury severity,treatment procedures,and prognoses of the two groups were compared.RESULTS A total of 73 patients with BT were admitted during the study period.The proportion of BTs among the entire cohort with chest trauma was 2.4%(73/3018),and all 73 underwent thoracotomy.Polytrauma patients accounted for 81.6% in the BBT group and 22.9%in the PBT group,and the mean Injury Severity Score was 38.22±8.13 and 21.33±6.12,respectively.Preoperative three-dimensional spiral computed tomography(CT)and/or fiberoptic bronchoscopy(FB)were performed in 92.1% of cases in the BBT group(n=38)and 34.3% in the PBT group(n=35).In the BBT group,a delay in diagnosis for over 48 h occurred in 55.3% of patients.In the PBT group,31 patients underwent emergency thoracotomy due to massive hemothorax,and BT was confirmed during the operation.Among them,22 underwent pulmo-tractotomy for hemostasis,avoiding partial pneumonectomy.In this series,the overall mortality rate was 6.9%(5/73),and it was 7.9%(3/38)and 5.7%(2/35)in the BBT group and PBT group,respectively(P>0.05).All 68 survivors were followed for 6 to 42(23±6.4)mo,and CT,FB,and pulmonary function examinations were performed as planned.All patients exhibited normal lung function and healthy conditions except three who required reoperations.CONCLUSION The difference between blunt and penetrating BTs is obvious.In BBT,patients generally have no vessel injury,and the diagnosis is easily missed,leading to delayed treatment.The main cause of death is ventilation disturbance due to tension pneumothorax early and refractory atelectasis with pneumonia late.However,in PBT,most patients require emergency thoracotomy because of simultaneous vessel trauma and massive hemothorax,and delays in diagnosis are infrequent.The leading cause of death is hemorrhagic shock.
基金supported by Guangdong Medical Science and Technology Research Fund Project(No:A2017331)
文摘Objective: To study the influence of glycyrrhetinic acid(GA) on bronchial asthma(BA)smooth muscle proliferation and apoptosis as well as inflammatory factor expression and its molecular mechanism.Methods: Male SD guinea pigs were selected and made into asthma models, bronchial asthma smooth muscle cells were cultured and divided into BA group, GA group and GA + LM group that were treated with serum-free RPMI1640 culture medium, serumfree RPMI1640 culture medium containing 50 ng/mL glycyrrhetinic acid, serum-free RPMI1640 culture medium containing 50 ng/mL glycyrrhetinic acid and 100 ng/mL LM22B-10 respectively; normal guinea pigs were collected and bronchial smooth muscle cells were cultured as control group. The cell proliferation activity as well as the expression of proliferation and apoptosis genes, inflammatory factors and p-ERK1/2 was determined.Results: Proliferation activity value and m RNA expression of Bcl-2, TNF-α, IL-4, IL-6,YKL-40, protein expression of p-ERK1/2 of airway smooth muscle cell in BA group were significantly higher than those of control group while m RNA expression levels of Bax,caspase-9 as well as caspase-3 were significantly lower than that of control group(P < 0.05); proliferation activity value and m RNA expression of Bcl-2, TNF-α, IL-4, IL-6, YKL-40, protein expression of p-ERK1/2 of airway smooth muscle cell in GA group were significantly lower than those of BA group(P < 0.05) while the m RNA expression levels of Bax, caspase-9 as well as caspase-3 were significantly higher than those of BA group(P < 0.05); proliferation activity value and m RNA expression of Bcl-2, TNF-α, IL-4, IL-6, YKL-40 of airway smooth muscle cell in GA + LM group were significantly higher than those of GA group(P < 0.05) while m RNA expression levels of Bax, caspase-9 as well as caspase-3 were significantly lower that of GA group(P < 0.05).Conclusion: GA can inhibit the proliferation of bronchial smooth muscle cells and reduce the expression of inflammatory factors by inhibiting the phosphorylation of ERK1/2.
文摘To investigate whether apoptosis is associated with cell adhesion in bronchial epithelium, and whether it contributes to the kinetics of injury and repair of surface epithelia, this study was performed for E-cadherin expression by using immunohistochemistry technique and for apoptosis by TUNEL method An animal model of smoking was used for this study The results showed that epithelial cells with membrane anchored E-cadherin decreased remarkably at several time points during 6 months of exposure to smoke ( P< 0 01) and then restored to normal level This fluctuation was associated exclusively with the alteration in number of apoptotic cells ( P <0 01) There was no significant difference in activation of nuclear transcription factor NF-kappa B among groups ( P> 0 05) All these suggested that apoptosis is associated with E-cadherin expression in bronchial epithelium of smoking mouse
文摘AIM:To explore the anatomical relationships between bronchial artery and tracheal bifurcation using computed tomography angiography (CTA).METHODS:One hundred consecutive patients (84 men,16 women;aged 46-85 years) who underwent CTA using multi-detector row CT (MDCT) were investigated retrospectively.The distance between sites of bronchial artery ostia and tracheal bifurcation,and dividing directions were explored.The directions of division from the descending aorta were described as on a clock face.RESULTS:We identified ostia of 198 bronchial arteries:95 right bronchial arteries,67 left bronchial arteries,36 common trunk arteries.Of these,172 (87%) divided from the descending aorta,25 (13%) from the aortic arch,and 1 (0.5%) from the left subclavian artery.The right,left,and common trunk bronchial arteries divided at-1 to 2 cm from tracheal bifurcation with frequencies of 77% (73/95),82% (54/66),and 70% (25/36),respectively.The dividing direction of right bronchial arteries from the descending aorta was 9 to 10 o’clock with a frequency of 81% (64/79);that of left and common tract bronchial arteries was 11 to 1 o’clock with frequencies of 70% (43/62) and 77% (24/31),respectively.CONCLUSION:CTA using MDCT provides details of the relation between bronchial artery ostia and tracheal bifurcation.
文摘Recent state-of-the-art computed tomography and improved three-dimensional(3-D) postprocessing techniques have revolutionized the capability of visualizing airway pathology,offering physicians an advanced view of pathology and allowing for appropriate management planning.This article is a comprehensive review of trachea and main bronchi imaging,with emphasis on the dynamic airway anatomy,and a discussion of a wide variety of diseases including,but not limited to,congenital large airway abnormalities,tracheobronchial stenoses,benign and malignant neoplasms and tracheobronchomalacia.The importance of multiplanar reconstruction,3-D reconstruction and incorporation of dynamic imaging for non-invasive evaluation of the large airways is stressed.
基金the National Natural Science Foundation of China (No. 30371195)Guangdong NaturalScience Foundation (No. 06022672)+1 种基金Guangzhou Science and Technology Foundation (No. 2003Z2-E0191/E0192)Guangzhou Municipal Department of Education (No. 1002)
文摘Objective To analyze the relationship between malignant transformation and abnormal expression of eukaryotic initiation factor 3 （eIF3 p36） in human bronchial epithelial （16HBE） cells induced by cadmium chloride （CdCl2）. Methods 16HBE cells were treated several times with different concentrations of CdCl2. Tumorigenic potential of transformed cells was identified by assays for anchorage-independent growth in soft agar and for tumorigenicity in nude mice after the 35th passage. Total RNA was isolated from 16HBE cells induced by CdC12, including non-transformed, Cd-transformed, and Cd-tumorigenic cell lines. Special primers for eIF3 p36 were designed and the expression of eIF3 mRNA in different cell lines was detected with fluorescent quantitative-polymerase chain reaction technique （FQ-PCR）. Results The 35th passage of 16HBE cells transformed by CdCl2 exhibited overlapping growth. Compared with the non-transformed cells, colonies of transformed cell lines in soft agar showed statistically significant increases and dose-dependent effects （P〈0.01）. All Cd-induced transformed cell lines formed rumors in nude mice within 2 weeks of inoculation, but none of the mice injected with non-transformed cells showed tumors even after 3 weeks. All tumors were pathologically identified as poorly differentiated squamous cell carcinoma. The eIF3 p36 genes in different stages of 16HBE cells transformed by CdCl2 were elevated as compared with the non-transformed control （P〈0.01）, and the eIF3 expression increased with the degree of cell malignancy. Conclusion CdCl2 is capable of inducing morphological transformation in 16HBE cells and transformed cells are potentially tumorigenic. Over-expression of eIF3 p36 is positively correlated with malignant transformation of 16HBE cells induced by CdCl2 and may be one of the molecular mechanisms potentially responsible for carcinogenesis due to Cd.
文摘Objective： In the present study, we have examined the safety and efficacy of recombinant adenovirus encoding human p53 tumor suppressor gene （rAd-p53） injection in patients with advanced non-small-cell lung cancer （NSCLC） in the combination with the therapy of bronchial arterial infusion （BAI）. Methods： A total of 58 patients with advanced NSCLC were enrolled in a non-randomized, two-armed clinical trial. Of which, 19 received a combination treatment of BAI and rAd-p53 （the combo group）, while the remaining 39 were treated with only BAI （the control group）. Patients were followed up for 12 months, with safety and local response evaluated by the National Cancer lnstitute＇s Common Toxicity Criteria and response evaluation criteria in solid tumor （RECIST）, respectively. Time to progression （TTP） and survival rates were also analyzed by Kaplan-Meier method. Results In the combo group, 19 patients received a total of 49 injections ofrAd-p53 and 46 times of BAI, respectively, while 39 patients in the control group received a total of 113 times of BAI. The combination treatment was found to have less adverse events such as anorexia, nausea and emesis, pain, and leucopenia （P〈0.05） but more arthralgia, fever, influenza-like symptom, and myalgia （P〈0.05）, compared with the control group. The overall response rates （complete response （CR）＋partial response （PR）） were 47.3% and 38.4% for the combo group and the control group, respectively （P〉0.05）. Patients in the combo group had a longer TTP than those in the control group （a median 7.75 vs 5.5 months, P-0.018）. However, the combination treatment did not lead to better survival, with survival rates at 3, 6, and 12 months in the combo group being 94.74%, 89.47%, and 52.63%, respectively, com- pared with 92.31%, 69.23%, and 38.83% in the control group （P=0.224）. Conclusion： Our results show that the combination of rAd-p53 and BAI was well tolerated in patients with NSCLC and may have improved the quality of life and delayed the disease progression. A further study to better determine the efficacy of this combination therapy is warranted.
文摘BACKGROUND Esophagomediastinal fistula is a very rare complication of tuberculosis in otherwise healthy adults, and mediastinal bronchial artery aneurysm is even rarer. In this case report, we describe a rare case of tuberculosis complication that presented with acute upper gastrointestinal(GI) bleeding. It also highlights the benefits of chest computed tomography(CT) as an excellent adjunct diagnostic tool to endoscopy and bronchoscopy and the role of trans-arterial embolization as a minimal invasive therapy alternative to surgery.CASE SUMMARY A 19-year-old medically free male patient presented with acute multiple episodes of hematemesis for 1 d. Upper GI endoscopy, bronchoscopy, and chest CT with IV contrast confirmed esophagomediastinal fistula with mediastinal bronchial artery aneurysm. After resuscitating patient with IV fluid and blood product transfusion, trans catheter embolization was performed for mediastinal bronchial artery aneurysm.CONCLUSION We successfully treated a patient with acute upper GI bleeding due to tuberculous esophagomediastinal fistula and mediastinal bronchial artery aneurysm using transcatheter coil embolization.
基金Supported by a grant from the National Science and Technology Supporting Project in the 11th Five-year Plan(2008BAI53B061)
文摘OBJECTIVE:To preliminarily analyze key factors influencing curative effect through clinical observations of acupoint application for "treatment of win-ter disease in summer" used to prevent and treat bronchial asthma in children.METHODS:In an observational study and prospective cohort study,we observed children in remission of asthma at three class Ⅲ grade A TCM hospitals in Liaoning,Hubei,and Chengdu.RESULTS:A total of 609 children conformed to diagnostic and inclusive standards for remission of bronchial asthma.Through follow-up visits,we observed their skin reactions and the time and chance of treatment with different therapies in the three hospitals;we also compared and analyzed different drugs,acupoints,and preparations.We found that the key Chinese drugs were Bai Jie Zi(Semen Sinapis Albae) and Yian Hu Suo(Rhizoma Corydalis);the key acupoints were Feishu(BL 13),Gaohuang(BL 43),Dingchuan(EX-B1),Tiantu(CV 22),and Shanzhong(CV 17);and the best preparation was a mixture of drugs,ginger juice,and musk.Acupoint application was practiced on the hottest days of summer and the coldest days of winter for 0.5 to 2 h with the lowest rate of asthma relapse.CONCLUSIONS:The present data analysis shows that the curative effect of acupoint application for "treatment of winter disease in summer" may be influenced by recipes of Chinese drugs,preparations,prescriptions of acupoints,chance,time,and skin reactions.A curative effect is the result of the comprehensive action of these factors.
基金supported by the National Natural Science Foundation of China(No30700661)
文摘Objective To investigate the roles of Rho/Rock signaling pathway in silica-induced Epithelial-mesenchymal transition （EMT） in human bronchial epithelial cells （BEC） in vitro. Methods Human BEC were incubated with silica with various concentrations for indicated times. Cell viability was assayed by MTT test. Morphologic Changes were observed by microscope. Mesenchymal marker a-smooth muscle actin （a-SMA）, vimentin （Vim）, and epithelial marker E-cadherin （E-cad） were analyzed by Western Blot. The pull-down assay was used to measure Rho activity. In the prevention experiments, the specific inhibitor for Rho effector ROCK （Y27632） was used to inhibit the activity of Rho. Results Human BEC stimulated with silica were converted from a ＂cobblestone＂ epithelial structure into an elongated fibroblast-like shape structure. Incubation of human BEC with silica induced de novo expression of a-SMA and Vim, and loss of E-cad. Also, silica treatment resulted in Rho activation in human BEC. Y27632 up-regulated the E-cad expression but attenuated a-SMA and Vim expression in silica-stimulated cells. Conclusion The activation of Rho/ROCK signaling pathways is most likely involved in Silica-induced EMT in human bronchial epithelial cells.
文摘Today the most important challenge facing the pediatrician is the increasing prevalence of chronic diseases. With this regard, pediatricians play a key role in the management of these conditions. The closeness with the family, the knowledge of the clinical case and the care continuity allow the pediatrician to acquire a position of director of every case. When pathological events have a chronic feature, suddenly the quality of life of the whole family changes. For this reason the first communication of chronic disease is very important and the task of the pediatrician should be to provide a positive message to help the family in facing the difficulty of this new challenge. The bronchial asthma is the most common chronic disease worldwide. The incidence, the prevalence, and the mortality of the disease have increased in children over the past decades. These trends are particularly marked above all in preschool children. The success reached by Pediatricians is closely related to the compliance and the implementation of the therapy followed by the little patient and his family. With this regard authors, in this review, focus on the illustration of several strategies, based on the pediatrician’ skills and medicine documents, that can be used for the improvement of communication among pedia- trician-family and child, never forgetting the hu- man aspect of the same doctor, that should con- ciliate with the scientific knowledge in the taking care of a specific chronic disease.
基金Supported by a Capital Special Project Grant for Traditional Chinese Medicine and Nursing Research (No. ZM01)
文摘OBJECTIVE:To assess the effectiveness and safety of Traditional Chinese Medicine(TCM) treatment of non-acute bronchial asthma complicated by gastroesophageal reflux.METHODS:We searched databases from MEDLINE,Cochrane Library,CNKI,VIP,CBM,Wanfang Data,and TCM Database Systems.All randomized,controlled trials(RTCs) of TCM treatment of non-acute asthma complicated by gastroesophageal reflux were included.Data were independently collected by two reviewers.The standards for assessing quality described in the Cochrane Handbook for Systematic Reviews of Interventions were used to evaluate articles.Meta-analyses were conducted using RevMan 5.0.17 software.Heterogeneity was assessed,and a corresponding effects model was used to merge and analyze results.Indexes used to evalu-ate curative effects were:clinical efficacy,symptom scores,pulmonary function values,and adverse incidents.Effectiveness was indicated using risk ratio(RR) or mean difference(MD),and 95% confidence intervals(CIs) were calculated.RESULTS:Six RCTs were included,involving 304 patients with non-acute asthma complicated by gastroesophageal reflux.The treatment groups received Chinese drugs alone or TCM combined with standard Western medical treatment,and the control groups received standard Western medical treatment alone.Standard Western medical treatment included anti-inflammatory drugs and bronchodilators for asthma,and drugs to promote gastric peristalsis and inhibit gastric acid production for gastroesophageal reflux.Methodological quality was low in all six RCTs.Two RCTs showed that clinical efficacy was higher in the treatment group than in the control group(RR:1.43,95%CI:1.10 to 1.87 vs RR:1.51,95% CI:1.09 to 2.08).One RCT showed that the asthma score was lowered more effectively in the treatment group than in the control group(MD:-1.10,95% CI:-2.04 to-0.16).Two RCTs showed that the gastroesophageal reflux score was reduced more effectively in the treatment group than in the control group(RR:-3.70,95% CI:-4.30 to 3.10 vs RR:-5.30,95% CI:-6.32 to-4.28).One RCT showed that some pulmonary function values were improved more effectively in the treatment group than in the control group(P< 0.05).No differences were seen in the various indexes between groups in the other RCTs.No adverse reactions,dropout rates,or follow-up rates were reported in any of the RCTs.CONCLUSIONS:The clinical symptoms ofnon-acute asthma complicated by gastroesophageal reflux can be improved by some Chinese drugs.Curative effects can be increased by combining the use of TCM with Western medicine.Because of the small quantity and low quality of research reported to date,it is necessary to conduct further RCTs to confirm these results.The results of this systematic review indicate that the quality of future clinical trials should be improved by including larger patient numbers,correctly randomizing patients into study groups,using blinding methods to measure and assess outcomes,and using accepted indexes to evaluate curative effects.
文摘AIM: Metastases from lung cancer to gastrointestinal tract are not rare at postmortem studies but the development of clinically significant symptoms from the gastrointestinal metastases is very unusual. METHODS: Formalin-fixed, paraffin-embedded tissues were cut into 5 urn thick sections and routinely stained with hematoxylin and eosin. Some slides were also stained with Alcian-PAS. Antibodies used were primary antibodies to pancytokeratin, cytokeratin 7, cytokeratin 20, epithelial membrane antigen, vimentin, smooth muscle actin and CD-117. RESULTS: We observed three patients who presented with multiple metastases from large cell bronchial carcinoma to small intestine. Two of them had abdominal symptoms (sudden onset of abdominal pain, constipation and vomiting) and in one case the tumor was incidentally found during autopsy. Microscopically, all tumors showed a same histological pattern and consisted almost exclusively of strands and sheets of poorly cohesive, polymorphic giant cells with scanty, delicate stromas. Few smaller polygonal anaplastic cells dispersed between polymorphic giant cells, were also observed. Immunohistochemistry showed positive staining of the tumor cells with cytokeratin and vimentin. Microscopically and immunohistochemically all metastases had a similar pattern to primary anaplastic carcinoma of the small intestine. CONCLUSION: In patients with small intestine tumors showing anaplastic features, especially with multiple tumors, metastases from large cell bronchial carcinoma should be first excluded, because it seems that they are more common than expected.
