Respiratory infections are associated with high morbidity and mortality and are a major global health problem[1].Acute respiratory infections are caused by multiple respiratory pathogens,including viruses and bacteria...Respiratory infections are associated with high morbidity and mortality and are a major global health problem[1].Acute respiratory infections are caused by multiple respiratory pathogens,including viruses and bacteria.Viral-bacterial co-infections,which have become increasingly common and a global concern,can lead to substantial complications,causing higher morbidity and adverse prognosis[2].Previous studies have reported low positive detection rates of targeted pathogens related to acute respiratory infections,owing to the limited number of detected pathogens and variations in the sensitivity of diagnostic methods[3-4].Low positive detection rates may impede our understanding of respiratory pathogen characteristics and hamper the development of precise treatment and prevention strategies.展开更多
BACKGROUND Acute respiratory distress syndrome(ARDS)is a critical condition characterized by acute hypoxemia,non-cardiogenic pulmonary edema,and decreased lung compliance.The Berlin definition,updated in 2012,classifi...BACKGROUND Acute respiratory distress syndrome(ARDS)is a critical condition characterized by acute hypoxemia,non-cardiogenic pulmonary edema,and decreased lung compliance.The Berlin definition,updated in 2012,classifies ARDS severity based on the partial pressure of arterial oxygen/fractional inspired oxygen fraction ratio.Despite various treatment strategies,ARDS remains a significant public health concern with high mortality rates.AIM To evaluate the implications of driving pressure(DP)in ARDS management and its potential as a protective lung strategy.METHODS We conducted a systematic review using databases including EbscoHost,MEDLINE,CINAHL,PubMed,and Google Scholar.The search was limited to articles published between January 2015 and September 2024.Twenty-three peer-reviewed articles were selected based on inclusion criteria focusing on adult ARDS patients undergoing mechanical ventilation and DP strategies.The literature review was conducted and reported according to PRISMA 2020 guidelines.RESULTS DP,the difference between plateau pressure and positive end-expiratory pressure,is crucial in ARDS management.Studies indicate that lower DP levels are significantly associated with improved survival rates in ARDS patients.DP is a better predictor of mortality than tidal volume or positive end-expiratory pressure alone.Adjusting DP by optimizing lung compliance and minimizing overdistension and collapse can reduce ventilator-induced lung injury.CONCLUSION DP is a valuable parameter in ARDS management,offering a more precise measure of lung stress and strain than traditional metrics.Implementing DP as a threshold for safety can enhance protective ventilation strategies,po-tentially reducing mortality in ARDS patients.Further research is needed to refine DP measurement techniques and validate its clinical application in diverse patient populations.展开更多
Objective:To explore the obstructive factors in the behavior of medical staff during the implementation of respiratory rehabilitation process,and to provide a basis for the rehabilitation management intervention of CO...Objective:To explore the obstructive factors in the behavior of medical staff during the implementation of respiratory rehabilitation process,and to provide a basis for the rehabilitation management intervention of COPD.Methods:A descriptive nature research method was adopted.An interview outline was formulated based on the theoretical domain framework.From October to December 2024,15 medical staff from the respiratory department of a tertiary hospital in Shaanxi Province were selected for semi-structured interviews.The interview data were analyzed using the Colaizzi 7-step analysis method.Result:The analysis of this study found that the obstructive factors for medical staff to implement respiratory rehabilitation include five theoretical domains.The problems are respectively the lack of knowledge about respiratory rehabilitation and insufficient training intensity,the insufficient self-recognition of implementing respiratory rehabilitation,the low awareness rate of patients and the low cooperation degree,the insufficient provision of instruments and facilities,the lack of rehabilitation training venues and respiratory rehabilitation clinics,and the lack of scientific and standardized respiratory rehabilitation management processes.Conclusion:There are many obstructive factors affecting the implementation of respiratory rehabilitation by medical staff.Clinical managers should take corresponding measures,continuously improve the rehabilitation management strategies for COPD,and promote the clinical application of the best evidence for respiratory rehabilitation.展开更多
BACKGROUND Depression is a common psychological disorder often associated with genetic,neurobiological,and psychosocial factors.This condition is characterized by low mood and decreased conscious activity and can lead...BACKGROUND Depression is a common psychological disorder often associated with genetic,neurobiological,and psychosocial factors.This condition is characterized by low mood and decreased conscious activity and can lead to severe consequences such as suicidal thoughts.Respiratory failure,a disorder of pulmonary ventilation and gas exchange,is frequently complicated by depression,aggravating the condition and creating complications in treatment.Patients with both conditions tend to exhibit poor compliance with medical advice,resulting in adverse outcomes such as sleep disorders,arrhythmias,and electrolyte imbalances.Therefore,effective nursing interventions are crucial for improving patient outcomes.While routine nursing care can provide basic support,dedicated nursing,which involves specialized and personalized care by highly trained professionals,may offer additional benefits.AIM To examine the effect of dedicated nursing intervention on medical advice compliance and adverse event incidence in patients with depression complicated by respiratory failure.METHODS A total of 160 patients with depression complicated by respiratory failure admitted to the Second Affiliated Hospital of Soochow University from January to December 2024 were randomly categorized into a control group(n=80)receiving routine nursing care and observation group(n=80)receiving routine nursing combined with dedicated nursing care.The establishment of a specialized nursing team;the development of a personalized nursing plan;and the implementation of comprehensive care strategies targeting emotional support,sleep improvement,pulmonary function enhancement,and adherence to medical advice were included in the dedicated nursing intervention.Emotional state[evaluated using the Self-Rating Depression Scale(SDS)],sleep quality[assessed using the Pittsburgh Sleep Quality Index(PSQI)],hope level[measured using the Herth Hope Scale(HHS)],pulmonary function[comprising forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1)],exercise endurance[6-minute walk distance test(6MWD)],compliance with medical advice,and incidence of adverse events were compared between the two groups.RESULTS No significant differences were observed in SDS,PSQI,HHS,FVC,FEV1,6MWD,or compliance with medical advice between the two groups(P>0.05)before the intervention.However,after the intervention,the control group exhibited significantly lower SDS and PSQI scores;higher HHS scores;greater improvements in FVC,FEV1,and 6MWD;and higher compliance with medical advice compared with the control group(P<0.05).In addition,the incidence of adverse events was significantly lower in the control group(P<0.05).CONCLUSION Dedicated nursing intervention significantly improves emotional state,sleep quality,hope level,pulmonary function,exercise endurance,and compliance with medical advice while reducing adverse events in patients with depression complicated by respiratory failure.Therefore,dedicated nursing appears to be an effective approach to enhance patient outcomes in this population.展开更多
Objective:To explore the effects of respiratory exercise rehabilitation nursing on self-care ability,lung function,and quality of life in patients with chronic obstructive pulmonary disease(COPD).Methods:A total of 88...Objective:To explore the effects of respiratory exercise rehabilitation nursing on self-care ability,lung function,and quality of life in patients with chronic obstructive pulmonary disease(COPD).Methods:A total of 88 patients with COPD admitted from February 2024 to February 2025 were selected and randomly divided into an experimental group and a control group,with 44 patients in each group.The control group received routine nursing,while the experimental group received respiratory exercise rehabilitation nursing on the basis of routine nursing.After 12 weeks of intervention,the self-care ability,lung function,and quality of life of the two groups were compared.Results:After the intervention,the scores of each dimension and the total score of self-care ability in the experimental group were significantly higher than those in the control group(p<0.001).The improvement of lung function indicators such as FEV_(1),FVC,and FEV_(1)/FVC in the experimental group was better than that in the control group(p<0.001).The scores of each dimension and the total score of quality of life in the experimental group were significantly lower than those in the control group(p<0.001).Conclusion:Respiratory exercise rehabilitation nursing can effectively improve the self-care ability,lung function,and quality of life of patients with COPD,which is worthy of clinical promotion and application.展开更多
Objective Recombination events are common and serve as the primary driving force of diverse human adenovirus(HAdV),particularly in children with acute respiratory tract infections(ARIs).Therefore,continual monitoring ...Objective Recombination events are common and serve as the primary driving force of diverse human adenovirus(HAdV),particularly in children with acute respiratory tract infections(ARIs).Therefore,continual monitoring of these events is essential for effective viral surveillance and control.Methods Respiratory specimens were collected from children with ARIs between January 2022 and December 2023.The penton base,hexon,and fiber genes were amplified from HAdV-positive specimens and sequenced to determine the virus type.In cases with inconsistent typing results,genes were cloned into the pGEM-T vector to detect recombination events.Metagenomic next-generation sequencing(mNGS)was performed to characterize the recombinant HAdV genomes.Results Among 6,771 specimens,277(4.09%,277/6,771)were positvie for HAdV,of which 157(56.68%,157/277)were successfully typed,with HAdV-B3 being the dominant type(91.08%,143/157),and 14(5.05%,14/277)exhibited inconsistent typing results,six of which belonged to species B.The penton base genes of these six specimens were classified as HAdV-B7,whereas their hexon and fiber genes were classified as HAdV-B3,resulting in a recombinant genotype designated P7H3F3,which closely resembled HAdV-B114.Additionally,a partial gene encoding L152/55 kD was identified,which originated from HAdV-B16.Conclusion A novel recombinant,P7H3F3,was identified,containing sequences derived from HAdV-B3 and HAdV-B7,which is similar to HAdV-B114,along with additional sequences from HAdV-B16.展开更多
Respiratory syncytial virus(RSV)is one of the most common viruses leading to lower respiratory tract infections(LRTIs)in children and elderly individuals worldwide.Although significant progress in the prevention and t...Respiratory syncytial virus(RSV)is one of the most common viruses leading to lower respiratory tract infections(LRTIs)in children and elderly individuals worldwide.Although significant progress in the prevention and treatment of RSV infection was made in 2023,with two anti-RSV vaccines and one monoclonal antibody approved by the FDA,there is still a lack of postinfection therapeutic drugs in clinical practice,especially for the pediatric population.In recent years,with an increasing understanding of the pathogenic mechanisms of RSV,drugs and drug candidates,have shown great potential for clinical application.In this review,we categorize and discuss promising anti-RSV drug candidates that have been in preclinical or clinical development over the last five years.展开更多
Background:The aim was to elucidate the function of IL-37 in middle east respiratory syndrome coronavirus(MERS-CoV)infection,thereby providing a novel therapeutic strategy for managing the clinical treatment of inflam...Background:The aim was to elucidate the function of IL-37 in middle east respiratory syndrome coronavirus(MERS-CoV)infection,thereby providing a novel therapeutic strategy for managing the clinical treatment of inflammatory response caused by respiratory virus infection.Methods:We investigated the development of MERS by infecting hDPP4 mice with hCoV-EMC(107 TCID50[50%tissue culture infectious dose])intranasally.We infected A549 cells with MERS-CoV,which concurrently interfered with IL-37,detecting the viral titer,viral load,and cytokine expression at certain points postinfection.Meanwhile,we administered IL-37(12.5μg/kg)intravenously to hDPP4 mice 2 h after MERS-CoV-2 infection and collected the serum and lungs 5 days after infection to investigate the efficacy of IL-37 in MERS-CoV infection.Results:The viral titer of MERS-CoV-infected A549 cells interfering with IL-37 was significantly reduced by 4.7-fold,and the viral load of MERS-CoV-infected hDPP4 mice was decreased by 59-fold in lung tissue.Furthermore,the administration of IL-37 suppressed inflammatory cytokine and chemokine(monocyte chemoattractant protein 1,interferon-γ,and IL-17A)expression and ameliorated the infiltration of inflammatory cells in hDPP4 mice.Conclusion:IL-37 exhibits protective properties in severe pneumonia induced by MERS-CoV infection.This effect is achieved through attenuation of lung viral load,suppression of inflammatory cytokine secretion,reduction in inflammatory cell infiltration,and mitigation of pulmonary injury.展开更多
BACKGROUND: Prehospital medication is a reality, and the role of these therapies must be explored to assess their validity, especially for acute respiratory diseases, which are usually associated with increased morbid...BACKGROUND: Prehospital medication is a reality, and the role of these therapies must be explored to assess their validity, especially for acute respiratory diseases, which are usually associated with increased morbidity. The aim of this study was to examine the association of prehospital medication use with mortality in patients with acute respiratory disease.METHODS: A prospective, multicenter, emergency medical service(EMS) delivery cohort study was carried out in adults with unselected respiratory diseases managed by EMS who were transferred to the emergency department. From January 1, 2019, to October 31, 2023, six advanced life support units, thirty-eight basic life support units, and four hospitals in Spain participated in the study. Demographic data, vital signs, use of mechanical ventilation, prehospital respiratory diagnosis, and prehospital medication were collected. The primary outcome was 30-day in-hospital mortality.RESULTS: A total of 961 patients were included, with a mortality rate of 17.5%(168 patients). Age, an increasing number of comorbidities, the use of invasive mechanical ventilation(IMV), the use of major analgesics, hypnotics, and bicarbonate were risk factors. In contrast, elevated systolic blood pressure and Glasgow Coma Scale scores were found to be protective factors against mortality. The predictive capacity of the model reached an area under the curve(AUC) of 0.857(95% confidence interval [95% CI] 0.827–0.888).CONCLUSION: Our data revealed that IMV, major analgesics, hypnotics and bicarbonate administration were associated with elevated mortality. Adding prehospital drug therapy information to demographic variables and vital signs could improve EMS decision-making, allowing a better characterization of patients at risk of clinical worsening.展开更多
Objective:To analyze the intervention effect of respiratory care on asthma patients.Methods:49 asthma patients admitted to the hospital between December 1,2018 and November 30,2022 were selected for this study.The pat...Objective:To analyze the intervention effect of respiratory care on asthma patients.Methods:49 asthma patients admitted to the hospital between December 1,2018 and November 30,2022 were selected for this study.The patients were divided into Group A(25 cases)and Group B(24 cases).The patients in Group A received respiratory care,while the patients in Group B received routine care,and the nursing effects of both groups were compared.Results:Group A demonstrated a better nursing effect compared to Group B;the patients in Group A were generally more satisfied with the care given compared to those of Group B.Furthermore,Group A showed better improvements in respiratory function compared to Group B(P<0.05).Before care,there was no difference in quality-of-life scores between the two groups(P>0.05).After care,Group A’s quality of life score was lower than Group B’s(P<0.05).Conclusion:Respiratory care for asthma patients can improve the quality of care and patient satisfaction.Besides,it also leads to a better improvement in respiratory function and the quality of life of the patients.展开更多
OBJECTIVE:To evaluate the efficacy of Qidong Huoxue decoction(芪冬活血饮,QDHX)in treating acute lung injury and acute respiratory distress syndrome(ALI/ARDS)when used as an adjunctive treatment.METHODS:ALI/ARDS patien...OBJECTIVE:To evaluate the efficacy of Qidong Huoxue decoction(芪冬活血饮,QDHX)in treating acute lung injury and acute respiratory distress syndrome(ALI/ARDS)when used as an adjunctive treatment.METHODS:ALI/ARDS patients admitted to our medical intensive care unit were randomly allocated to the control group or the QDHX group and received standard therapy.The QDHX group received QDHX(50 mL per day for 14 d)orally or via a gastric tube.The primary outcome was measured according to Traditional Chinese Medicine(TCM)syndrome scores,with partial pressure of oxygen/fraction of inspired oxygen(PaO_(2)/FiO_(2))levels as the secondary outcome.RESULTS:A total of 73 patients completed the study(36 in the TCM and 37 in the conventional group),and their records were analyzed.After 14-d treatment,the TCM group showed a significant decrease in TCM syndrome scores(P<0.05)and increased PaO_(2)/FiO_(2) levels(P<0.05).The therapeutic effect of integrated Chinese and western medicine was more significant than that of Western Medicine alone.No serious side effects were observed.CONCLUSIONS:Our study results show that QDHX in combination with conventional drug therapy can significantly reduce some clinical symptoms in patients with ALI/ARDS.展开更多
Objective:To explore the role of narrative medicine in cultivating the humanistic spirit of respiratory medicine interns.Methods:Thirty interns were selected,all of whom were received by the respiratory department of ...Objective:To explore the role of narrative medicine in cultivating the humanistic spirit of respiratory medicine interns.Methods:Thirty interns were selected,all of whom were received by the respiratory department of our hospital from September 2023 to June 2024 and underwent narrative medicine teaching.Scores on narrative medicine knowledge,empathy ability,humanistic care ability,and teaching recognition were compared before and after the internship.Results:Compared to before the internship,the interns’scores on narrative medicine knowledge were significantly higher after the internship,as were their empathy and humanistic care scores(P<0.05).Among the 30 interns,25 expressed interest in narrative medicine,and 29 were willing to continue with the narrative medicine teaching model.Conclusion:The application of narrative medicine in respiratory medicine internship teaching is highly effective.It cultivates the humanistic spirit of interns,improves their empathy and humanistic care abilities,and is worthy of wider implementation.展开更多
Immunotherapy and associated immune regulation strategies gained huge attraction in order to be utilized for treatment and prevention of respiratory diseases.Engineering specifically nanomedicines can be used to regul...Immunotherapy and associated immune regulation strategies gained huge attraction in order to be utilized for treatment and prevention of respiratory diseases.Engineering specifically nanomedicines can be used to regulate host immunity in lungs in the case of respiratory diseases including coronavirus disease 2019(COVID-19)infection.COVID-19 causes pulmonary embolisms,thus new therapeutic options are required to target thrombosis,as conventional treatment options are either not effective due to the complexity of the immunethrombosis pathophysiology.In this review,we discuss regulation of immune response in respiratory diseases especially COVID-19.We further discuss thrombosis and provide an overview of some antithrombotic nanoparticles,which can be used to develop nanomedicine against thrombo-inflammation induced by COVID-19 and other respiratory infectious diseases.We also elaborate the importance of immunomodulatory nanomedicines that can block pro-inflammatory signalling pathways,and thus can be recommended to treat respiratory infectious diseases.展开更多
Respiratory syncytial virus(RSV)is a significant cause of acute lower respiratory tract infection(ALRTI)in children underfive years of age.Between 2017 and 2021,396 complete sequences of the RSV F gene were obtained fro...Respiratory syncytial virus(RSV)is a significant cause of acute lower respiratory tract infection(ALRTI)in children underfive years of age.Between 2017 and 2021,396 complete sequences of the RSV F gene were obtained from 500 RSV-positive throat swabs collected from ten hospitals across nine provinces in China.In addition,151 sequences from China were sourced from GenBank and GISAID,making a total of 549 RSV F gene sequences subjected to analysis.Phylogenetic and genetic diversity analyses revealed that the RSV F genes circulating in China from 2017 to 2021 have remained relatively conserved,although some amino acids(AAs)have undergone changes.AA mutations with frequencies10%were identified at six sites and the p27 region:V384I(site I),N276S(site II),R213S(siteØ),and K124N(p27)for RSV A;F45L(site I),M152I/L172Q/S173 L/I185V/K191R(site V),and R202Q/I206M/Q209R(siteØ)for RSV B.Comparing mutational frequencies in RSV-F before and after 2020 revealed minor changes for RSV A,while the K191R,I206M,and Q209R frequencies increased by over 10%in RSV B.Notably,the nirsevimab-resistant mutation,S211N in RSV B,increased in frequency from 0%to 1.15%.Both representative strains aligned with the predicted RSV-F structures of their respective prototypes exhibited similar conformations,with low root-mean-square deviation values.These results could provide foundational data from China for the development of RSV mAbs and vaccines.展开更多
Respiratory syncytial virus(RSV)is the main pathogen that causes hospitalization for acute lower respiratory tract infections(ALRIs)in children.With the reopening of communities and schools,the resurgence of RSV in th...Respiratory syncytial virus(RSV)is the main pathogen that causes hospitalization for acute lower respiratory tract infections(ALRIs)in children.With the reopening of communities and schools,the resurgence of RSV in the COVID-19 post-pandemic era has become a major concern.To understand the circulation patterns and genotype variability of RSV in Tianjin before and during the COVID-19 pandemic,a total of 19,531 nasopharyngeal aspirate samples from hospitalized children in Tianjin from July 2017 to June 2022 were evaluated.Direct immunofluorescence and polymerase chain reaction(PCR)were used for screening RSV-positive samples and subtyping,respectively.Further analysis of mutations in the second hypervariable region(HVR2)of the G gene was performed through Sanger sequencing.Our results showed that 16.46%(3215/19,531)samples were RSV positive and a delayed increase in the RSV infection rates occurred in the winter season from December 2020 to February 2021,with the average RSV-positive rate of 35.77%(519/1451).The ON1,with H258Q and H266L substitutions,and the BA9,with T290I and T312I substitutions,are dominant strains that alternately circulate every 1–2 years in Tianjin,China,from July 2017 to June 2022.In addition,novel substitutions,such as N296Y,K221T,N230K,V251A in the BA9 genotype,and L226I in the ON1 genotype,emerged during the COVID-19 pandemic.Analysis of clinical characteristics indicated no significant differences between RSV-A and RSV-B groups.This study provides a theoretical basis for clinical prevention and treatment.However,further studies are needed to explore the regulatory mechanism of host immune responses to different lineages of ON1 and BA9 in the future.展开更多
BACKGROUND Electronic cigarettes(ECs)have been promoted as alternatives to traditional cigarettes.To investigate ECs’effects on respiratory system,especially in patients with respiratory diseases.METHODS We randomly ...BACKGROUND Electronic cigarettes(ECs)have been promoted as alternatives to traditional cigarettes.To investigate ECs’effects on respiratory system,especially in patients with respiratory diseases.METHODS We randomly selected 25 smokers with stable moderate asthma and matched them with 25 healthy smokers.All were subjucted to pulmonary function tests(PFTs),impulse oscillometry(IOS),fraction exhaled Nitric Oxide(FeNO),exhaled breathe condensate(EBC)and biomarker measurements before and after vaping one nicotinecontaining EC.RESULTS The increase in FeNO 30 minutes after EC,reflecting airway inflammation,significantly correlated with increase of residual volume(RV),total lung capacity,respiratory impedance at 5 Hz(Z5Hz)and respiratory resistance at 5 and 20 Hz(R5Hz and R20Hz).No significant correlations were found between EBC biomarkers'changes and respiratory mechanics.CONCLUSION This is the first study demonstrating that the changes in airway inflammation caused by EC have direct effects in respiratory mechanics of asthmatic patients.展开更多
Multiplex RT-PCR assays have been widely used tools for detection and differentiation of a panel of respiratory viral pathogens. In this study, we evaluated the Qiagen ResPlex lI V2.0 kit and explored factors influenc...Multiplex RT-PCR assays have been widely used tools for detection and differentiation of a panel of respiratory viral pathogens. In this study, we evaluated the Qiagen ResPlex lI V2.0 kit and explored factors influencing its sensitivity. Nasopharyngeal swab （NPS） specimens were prospectively collected from pediatric inpatients with lower respiratory tract infections at the time of admission in the Shenzhen Children＇s Hospital from May 2009 to April 2010. Total nucleic acids were extracted using the EZ1 system （Qiagen, Germany） and 17 respiratory viruses and genotypes including influenza A virus （FluA）, FluB, parainfluenza virus 1 （PIV1）, PIV2, PIV3, PIV4, respiratory syncytial virus （RSV）, human metapneumovirus （hMPV）, rhinoviruses （RhV）, enteroviruses （EnV）, human bocaviruses （hBoV）, adenoviruses （AdV）, four coronaviruses （229E, OC43, NL63 and HKU1）, and FluA 2009 pandemic H1NI（H1NI-p） were detected and identified by the ResPlex II kit. In parallel, 16 real-time TaqMan quantitative RT-PCR assays were used to quantitatively detect each virus except for RhV. Influenza and parainfluenza viral cultures were also performed. Among the total 438 NPS specimens collected during the study period, one or more viral pathogens were detected in 274 （62.6%） and 201（45.9%） specimens by monoplex TaqMan RT-PCR and multiplex ResPlex, respectively. When results from monoplex PCR or cell culture were used as the reference standard, the multiplex PCR possessed specificities of 92.9-100.0%. The sensitivity of multiplex PCR for PIV3, hMPV, PIV1 and BoV were 73.1%, 70%, 66.7% and 55.6%, respectively, while low sensitivities （11.1%-40.0%） were observed for FluA, EnV, OC43, RSV and H1N1. Among the seven viruses/genotypes detected with higher frequencies, multiplex PCR sensitivities were correlated significantly with viral loads determined by the TaqMan RT-PCR in FluA, H 1N 1-p and RSV （p=0.011-0.000） The Qiagen ResPlex II multiplex RT-PCR kit possesses excellent specificity for simultaneous detection of 17 viral pathogens in NPS specimens in pediatric inpatients at the time of admission. The sensitivity of multiplex RT-PCR was influenced by viral loads, specimen process methods, primer and probe design and amplification condition.展开更多
Objective Lower respiratory tract infections continue to pose a significant threat to human health. It is important to accurately and rapidly detect respiratory bacteria. To compensate for the limits of current respir...Objective Lower respiratory tract infections continue to pose a significant threat to human health. It is important to accurately and rapidly detect respiratory bacteria. To compensate for the limits of current respiratory bacteria detection methods, we developed a combination of multiplex polymerase chain reaction （PCR） and capillary electrophoresis （MPCE） assay to detect thirteen bacterial pathogens responsible for lower respiratory tract infections, including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catorrholis, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, Mycoplasma pneumoniae, Legionella spp., Bordetella pertussis, Mycobacterium tuberculosis complex, Corynebactefium diphthefiae, and Streptococcus pyogenes. Methods Three multiplex PCR reactions were built, and the products were analyzed by capillary electrophoresis using the high-throughput DNA analyzer. The specificity of the MPCE assay was examined and the detection limit was evaluated using DNA samples from each bacterial strain and the simulative samples of each strain. This assay was further evaluated using 152 clinical specimens and compared with real-time PCR reactions. For this assay, three nested-multiplex-PCRs were used to detect these clinical specimens. Results The detection limits of the MPCE assay for the 13 pathogens were very low and ranged from 10-7 to 10-2 ng/μL. Furthermore, analysis of the 252 clinical specimens yielded a specificity ranging from 96.5%-100.0%, and a sensitivity of 100.0% for the 13 pathogens. Conclusion This study revealed that the MPCE with high specificity and sensitivity. This assay survey of respiratory pathogens. assay is a rapid, reliable, and high-throughput method has great potential in the molecular epidemiological.展开更多
Human respiratory syncytial virus(RSV) is a major pathogen of acute lower respiratory tract infection among young children. To investigate the prevalence and genetic characteristics of RSV in China, we performed a mol...Human respiratory syncytial virus(RSV) is a major pathogen of acute lower respiratory tract infection among young children. To investigate the prevalence and genetic characteristics of RSV in China, we performed a molecular epidemiological study during 2015–2019. A total of 964 RSV-positive specimens were identified from 5529 enrolled patients during a multi-center study. RSV subgroup A(RSV-A) was the predominant subgroup during this research period except in2016. Totally, 535 sequences of the second hypervariable region(HVR-2) of the G gene were obtained. Combined with182 Chinese sequences from GenBank, phylogenetic trees showed that 521 RSV-A sequences fell in genotypes ON1(512),NA1(6) and GA5(3), respectively;while 196 RSV-B sequences fell in BA9(193) and SAB4(3). ON1 and BA9 were the only genotypes after December 2015. Genotypes ON1 and BA9 can be separated into 10 and 7 lineages, respectively. The HVR-2 of genotype ON1 had six amino acid changes with a frequency more than 10%, while two substitutions H258 Q and H266 L were co-occurrences. The HVR-2 of genotype BA9 had nine amino acid substitutions with a frequency more than10%, while the sequences with T290 I and T312 I were all from 2018 to 2019. One N-glycosylation site at 237 was identified among ON1 sequences, while two N-glycosylation sites(296 and 310) were identified in the 60-nucleotide duplication region of BA9. To conclusion, ON1 and BA9 were the predominant genotypes in China during 2015–2019. For the genotypes ON1 and BA9, the G gene exhibited relatively high diversity and evolved continuously.展开更多
OBJECTIVE:To examine the clinical effects of a mixture of Chinese Yam and Epimedium in patients with stable moderate or severe chronic obstructive pulmonary disease(COPD).METHODS:Forty-nine patients with COPD were ran...OBJECTIVE:To examine the clinical effects of a mixture of Chinese Yam and Epimedium in patients with stable moderate or severe chronic obstructive pulmonary disease(COPD).METHODS:Forty-nine patients with COPD were randomly allocated to a group whose usual treatment was supplemented with oral Chinese Yam-Epimedium mixture,or a control group given placebo.For each patient,body mass index,airflow obstruction,dyspnea,and exercise capacity were measured and converted into the BODE index before treatment and at one and three months after initiation of treatment.Participants also completed the St George's Respiratory Questionnaire(SGRQ) at the same intervals.RESULTS:After one month,improvements were seen in the BODE index and SGRQ of participants taking Chinese Yam-Epimedium mixture compared to controls.There were statistically significant differences in the SGRQ:three of its components and the total SGRQ scores were significantly decreased(P<0.05),respiratory symptom scores had improved(P<0.01),and the dyspnea component of the BODE index had significantly decreased(P<0.05).Similar improvements were observed after three months of treatment,but exercise tolerance had also improved:the six-minute walking distance had significantly increased(P<0.05) in the treatment group when compared with controls.CONCLUSION:Chinese Yam-Epimedium mixture can significantly improve dyspnea,exercise capacity,and the quality of life of patients with stable moderate or severe COPD.展开更多
基金supported by the Beijing Science and Technology Planning Project of the Beijing Science and Technology Commission(Z241100009024047)the High-Level Public Health Technical Talent Training Plan(lingjunrencai-01-02).
文摘Respiratory infections are associated with high morbidity and mortality and are a major global health problem[1].Acute respiratory infections are caused by multiple respiratory pathogens,including viruses and bacteria.Viral-bacterial co-infections,which have become increasingly common and a global concern,can lead to substantial complications,causing higher morbidity and adverse prognosis[2].Previous studies have reported low positive detection rates of targeted pathogens related to acute respiratory infections,owing to the limited number of detected pathogens and variations in the sensitivity of diagnostic methods[3-4].Low positive detection rates may impede our understanding of respiratory pathogen characteristics and hamper the development of precise treatment and prevention strategies.
文摘BACKGROUND Acute respiratory distress syndrome(ARDS)is a critical condition characterized by acute hypoxemia,non-cardiogenic pulmonary edema,and decreased lung compliance.The Berlin definition,updated in 2012,classifies ARDS severity based on the partial pressure of arterial oxygen/fractional inspired oxygen fraction ratio.Despite various treatment strategies,ARDS remains a significant public health concern with high mortality rates.AIM To evaluate the implications of driving pressure(DP)in ARDS management and its potential as a protective lung strategy.METHODS We conducted a systematic review using databases including EbscoHost,MEDLINE,CINAHL,PubMed,and Google Scholar.The search was limited to articles published between January 2015 and September 2024.Twenty-three peer-reviewed articles were selected based on inclusion criteria focusing on adult ARDS patients undergoing mechanical ventilation and DP strategies.The literature review was conducted and reported according to PRISMA 2020 guidelines.RESULTS DP,the difference between plateau pressure and positive end-expiratory pressure,is crucial in ARDS management.Studies indicate that lower DP levels are significantly associated with improved survival rates in ARDS patients.DP is a better predictor of mortality than tidal volume or positive end-expiratory pressure alone.Adjusting DP by optimizing lung compliance and minimizing overdistension and collapse can reduce ventilator-induced lung injury.CONCLUSION DP is a valuable parameter in ARDS management,offering a more precise measure of lung stress and strain than traditional metrics.Implementing DP as a threshold for safety can enhance protective ventilation strategies,po-tentially reducing mortality in ARDS patients.Further research is needed to refine DP measurement techniques and validate its clinical application in diverse patient populations.
基金Shaanxi Provincial People’s Hospital Science and Technology Development Incubation Fund Program 2023(Project No.:2023HL-12)。
文摘Objective:To explore the obstructive factors in the behavior of medical staff during the implementation of respiratory rehabilitation process,and to provide a basis for the rehabilitation management intervention of COPD.Methods:A descriptive nature research method was adopted.An interview outline was formulated based on the theoretical domain framework.From October to December 2024,15 medical staff from the respiratory department of a tertiary hospital in Shaanxi Province were selected for semi-structured interviews.The interview data were analyzed using the Colaizzi 7-step analysis method.Result:The analysis of this study found that the obstructive factors for medical staff to implement respiratory rehabilitation include five theoretical domains.The problems are respectively the lack of knowledge about respiratory rehabilitation and insufficient training intensity,the insufficient self-recognition of implementing respiratory rehabilitation,the low awareness rate of patients and the low cooperation degree,the insufficient provision of instruments and facilities,the lack of rehabilitation training venues and respiratory rehabilitation clinics,and the lack of scientific and standardized respiratory rehabilitation management processes.Conclusion:There are many obstructive factors affecting the implementation of respiratory rehabilitation by medical staff.Clinical managers should take corresponding measures,continuously improve the rehabilitation management strategies for COPD,and promote the clinical application of the best evidence for respiratory rehabilitation.
基金Supported by the Second Nursing Research Project of the Humanities Nursing Professional Committee,No.RW2024PY03the Open Project of Suzhou Key Laboratory of Elderly Smart Nursing and Health Care in 2024.
文摘BACKGROUND Depression is a common psychological disorder often associated with genetic,neurobiological,and psychosocial factors.This condition is characterized by low mood and decreased conscious activity and can lead to severe consequences such as suicidal thoughts.Respiratory failure,a disorder of pulmonary ventilation and gas exchange,is frequently complicated by depression,aggravating the condition and creating complications in treatment.Patients with both conditions tend to exhibit poor compliance with medical advice,resulting in adverse outcomes such as sleep disorders,arrhythmias,and electrolyte imbalances.Therefore,effective nursing interventions are crucial for improving patient outcomes.While routine nursing care can provide basic support,dedicated nursing,which involves specialized and personalized care by highly trained professionals,may offer additional benefits.AIM To examine the effect of dedicated nursing intervention on medical advice compliance and adverse event incidence in patients with depression complicated by respiratory failure.METHODS A total of 160 patients with depression complicated by respiratory failure admitted to the Second Affiliated Hospital of Soochow University from January to December 2024 were randomly categorized into a control group(n=80)receiving routine nursing care and observation group(n=80)receiving routine nursing combined with dedicated nursing care.The establishment of a specialized nursing team;the development of a personalized nursing plan;and the implementation of comprehensive care strategies targeting emotional support,sleep improvement,pulmonary function enhancement,and adherence to medical advice were included in the dedicated nursing intervention.Emotional state[evaluated using the Self-Rating Depression Scale(SDS)],sleep quality[assessed using the Pittsburgh Sleep Quality Index(PSQI)],hope level[measured using the Herth Hope Scale(HHS)],pulmonary function[comprising forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1)],exercise endurance[6-minute walk distance test(6MWD)],compliance with medical advice,and incidence of adverse events were compared between the two groups.RESULTS No significant differences were observed in SDS,PSQI,HHS,FVC,FEV1,6MWD,or compliance with medical advice between the two groups(P>0.05)before the intervention.However,after the intervention,the control group exhibited significantly lower SDS and PSQI scores;higher HHS scores;greater improvements in FVC,FEV1,and 6MWD;and higher compliance with medical advice compared with the control group(P<0.05).In addition,the incidence of adverse events was significantly lower in the control group(P<0.05).CONCLUSION Dedicated nursing intervention significantly improves emotional state,sleep quality,hope level,pulmonary function,exercise endurance,and compliance with medical advice while reducing adverse events in patients with depression complicated by respiratory failure.Therefore,dedicated nursing appears to be an effective approach to enhance patient outcomes in this population.
基金Baoding Science and Technology Plan(Project No.:2541ZF096)。
文摘Objective:To explore the effects of respiratory exercise rehabilitation nursing on self-care ability,lung function,and quality of life in patients with chronic obstructive pulmonary disease(COPD).Methods:A total of 88 patients with COPD admitted from February 2024 to February 2025 were selected and randomly divided into an experimental group and a control group,with 44 patients in each group.The control group received routine nursing,while the experimental group received respiratory exercise rehabilitation nursing on the basis of routine nursing.After 12 weeks of intervention,the self-care ability,lung function,and quality of life of the two groups were compared.Results:After the intervention,the scores of each dimension and the total score of self-care ability in the experimental group were significantly higher than those in the control group(p<0.001).The improvement of lung function indicators such as FEV_(1),FVC,and FEV_(1)/FVC in the experimental group was better than that in the control group(p<0.001).The scores of each dimension and the total score of quality of life in the experimental group were significantly lower than those in the control group(p<0.001).Conclusion:Respiratory exercise rehabilitation nursing can effectively improve the self-care ability,lung function,and quality of life of patients with COPD,which is worthy of clinical promotion and application.
基金supported by the Capital’s Funds for Health Improvement and Research(CFH,shoufa-2022-1G-1131 and shoufa 2022-4G-1133)the High Level Technical Talent Construction Project of Beijing Municipal Health Commission(Discipline Leader-02-20)+1 种基金Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(JYY2023-10)the Pathogen Spectrum and Host Marker Analysis in Children with Respiratory Tract Infections of Children(Grant 2024-0040).
文摘Objective Recombination events are common and serve as the primary driving force of diverse human adenovirus(HAdV),particularly in children with acute respiratory tract infections(ARIs).Therefore,continual monitoring of these events is essential for effective viral surveillance and control.Methods Respiratory specimens were collected from children with ARIs between January 2022 and December 2023.The penton base,hexon,and fiber genes were amplified from HAdV-positive specimens and sequenced to determine the virus type.In cases with inconsistent typing results,genes were cloned into the pGEM-T vector to detect recombination events.Metagenomic next-generation sequencing(mNGS)was performed to characterize the recombinant HAdV genomes.Results Among 6,771 specimens,277(4.09%,277/6,771)were positvie for HAdV,of which 157(56.68%,157/277)were successfully typed,with HAdV-B3 being the dominant type(91.08%,143/157),and 14(5.05%,14/277)exhibited inconsistent typing results,six of which belonged to species B.The penton base genes of these six specimens were classified as HAdV-B7,whereas their hexon and fiber genes were classified as HAdV-B3,resulting in a recombinant genotype designated P7H3F3,which closely resembled HAdV-B114.Additionally,a partial gene encoding L152/55 kD was identified,which originated from HAdV-B16.Conclusion A novel recombinant,P7H3F3,was identified,containing sequences derived from HAdV-B3 and HAdV-B7,which is similar to HAdV-B114,along with additional sequences from HAdV-B16.
基金funded by the Beijing Natural Science Foundation(5242007,L222076,L246011)the High-level Public Health Technical Talents Project by the Beijing Municipal Commission of Health(Key discipline personnel-02-05)+1 种基金the CAMS Innovation Fund for Medical Sciences(CIFMS,2019-12M-5-026,2022-I2M-CoV19-006)the Reform and Development of the Beijing Municipal Health Commission,and the Respiratory Research Project of the National Clinical Research Center for Respiratory Diseases(HXZX-202106).
文摘Respiratory syncytial virus(RSV)is one of the most common viruses leading to lower respiratory tract infections(LRTIs)in children and elderly individuals worldwide.Although significant progress in the prevention and treatment of RSV infection was made in 2023,with two anti-RSV vaccines and one monoclonal antibody approved by the FDA,there is still a lack of postinfection therapeutic drugs in clinical practice,especially for the pediatric population.In recent years,with an increasing understanding of the pathogenic mechanisms of RSV,drugs and drug candidates,have shown great potential for clinical application.In this review,we categorize and discuss promising anti-RSV drug candidates that have been in preclinical or clinical development over the last five years.
基金the National Natural Science Foundation of China,Grant/Award Number:32000358the CAMS initiative for Innovative Medicine of China,Grant/Award Number:2021-I2M-1-035Young Elite Scientists Sponsorship Program by CAST(YESS),Grant/Award Number:2020QNRC001。
文摘Background:The aim was to elucidate the function of IL-37 in middle east respiratory syndrome coronavirus(MERS-CoV)infection,thereby providing a novel therapeutic strategy for managing the clinical treatment of inflammatory response caused by respiratory virus infection.Methods:We investigated the development of MERS by infecting hDPP4 mice with hCoV-EMC(107 TCID50[50%tissue culture infectious dose])intranasally.We infected A549 cells with MERS-CoV,which concurrently interfered with IL-37,detecting the viral titer,viral load,and cytokine expression at certain points postinfection.Meanwhile,we administered IL-37(12.5μg/kg)intravenously to hDPP4 mice 2 h after MERS-CoV-2 infection and collected the serum and lungs 5 days after infection to investigate the efficacy of IL-37 in MERS-CoV infection.Results:The viral titer of MERS-CoV-infected A549 cells interfering with IL-37 was significantly reduced by 4.7-fold,and the viral load of MERS-CoV-infected hDPP4 mice was decreased by 59-fold in lung tissue.Furthermore,the administration of IL-37 suppressed inflammatory cytokine and chemokine(monocyte chemoattractant protein 1,interferon-γ,and IL-17A)expression and ameliorated the infiltration of inflammatory cells in hDPP4 mice.Conclusion:IL-37 exhibits protective properties in severe pneumonia induced by MERS-CoV infection.This effect is achieved through attenuation of lung viral load,suppression of inflammatory cytokine secretion,reduction in inflammatory cell infiltration,and mitigation of pulmonary injury.
基金supported by the Institute of Health Carlos Ⅲ (Spain)co-financed by the European Union (DTS23/00010) for FMR。
文摘BACKGROUND: Prehospital medication is a reality, and the role of these therapies must be explored to assess their validity, especially for acute respiratory diseases, which are usually associated with increased morbidity. The aim of this study was to examine the association of prehospital medication use with mortality in patients with acute respiratory disease.METHODS: A prospective, multicenter, emergency medical service(EMS) delivery cohort study was carried out in adults with unselected respiratory diseases managed by EMS who were transferred to the emergency department. From January 1, 2019, to October 31, 2023, six advanced life support units, thirty-eight basic life support units, and four hospitals in Spain participated in the study. Demographic data, vital signs, use of mechanical ventilation, prehospital respiratory diagnosis, and prehospital medication were collected. The primary outcome was 30-day in-hospital mortality.RESULTS: A total of 961 patients were included, with a mortality rate of 17.5%(168 patients). Age, an increasing number of comorbidities, the use of invasive mechanical ventilation(IMV), the use of major analgesics, hypnotics, and bicarbonate were risk factors. In contrast, elevated systolic blood pressure and Glasgow Coma Scale scores were found to be protective factors against mortality. The predictive capacity of the model reached an area under the curve(AUC) of 0.857(95% confidence interval [95% CI] 0.827–0.888).CONCLUSION: Our data revealed that IMV, major analgesics, hypnotics and bicarbonate administration were associated with elevated mortality. Adding prehospital drug therapy information to demographic variables and vital signs could improve EMS decision-making, allowing a better characterization of patients at risk of clinical worsening.
文摘Objective:To analyze the intervention effect of respiratory care on asthma patients.Methods:49 asthma patients admitted to the hospital between December 1,2018 and November 30,2022 were selected for this study.The patients were divided into Group A(25 cases)and Group B(24 cases).The patients in Group A received respiratory care,while the patients in Group B received routine care,and the nursing effects of both groups were compared.Results:Group A demonstrated a better nursing effect compared to Group B;the patients in Group A were generally more satisfied with the care given compared to those of Group B.Furthermore,Group A showed better improvements in respiratory function compared to Group B(P<0.05).Before care,there was no difference in quality-of-life scores between the two groups(P>0.05).After care,Group A’s quality of life score was lower than Group B’s(P<0.05).Conclusion:Respiratory care for asthma patients can improve the quality of care and patient satisfaction.Besides,it also leads to a better improvement in respiratory function and the quality of life of the patients.
基金Zhejiang Province Traditional Chinese Medicine Science and Technology Plan:the Study on Clinical Effects of Qidong Huoxue decoction in the Treatment of Acute Lung Injury(No.2017ZZ008)。
文摘OBJECTIVE:To evaluate the efficacy of Qidong Huoxue decoction(芪冬活血饮,QDHX)in treating acute lung injury and acute respiratory distress syndrome(ALI/ARDS)when used as an adjunctive treatment.METHODS:ALI/ARDS patients admitted to our medical intensive care unit were randomly allocated to the control group or the QDHX group and received standard therapy.The QDHX group received QDHX(50 mL per day for 14 d)orally or via a gastric tube.The primary outcome was measured according to Traditional Chinese Medicine(TCM)syndrome scores,with partial pressure of oxygen/fraction of inspired oxygen(PaO_(2)/FiO_(2))levels as the secondary outcome.RESULTS:A total of 73 patients completed the study(36 in the TCM and 37 in the conventional group),and their records were analyzed.After 14-d treatment,the TCM group showed a significant decrease in TCM syndrome scores(P<0.05)and increased PaO_(2)/FiO_(2) levels(P<0.05).The therapeutic effect of integrated Chinese and western medicine was more significant than that of Western Medicine alone.No serious side effects were observed.CONCLUSIONS:Our study results show that QDHX in combination with conventional drug therapy can significantly reduce some clinical symptoms in patients with ALI/ARDS.
文摘Objective:To explore the role of narrative medicine in cultivating the humanistic spirit of respiratory medicine interns.Methods:Thirty interns were selected,all of whom were received by the respiratory department of our hospital from September 2023 to June 2024 and underwent narrative medicine teaching.Scores on narrative medicine knowledge,empathy ability,humanistic care ability,and teaching recognition were compared before and after the internship.Results:Compared to before the internship,the interns’scores on narrative medicine knowledge were significantly higher after the internship,as were their empathy and humanistic care scores(P<0.05).Among the 30 interns,25 expressed interest in narrative medicine,and 29 were willing to continue with the narrative medicine teaching model.Conclusion:The application of narrative medicine in respiratory medicine internship teaching is highly effective.It cultivates the humanistic spirit of interns,improves their empathy and humanistic care abilities,and is worthy of wider implementation.
文摘Immunotherapy and associated immune regulation strategies gained huge attraction in order to be utilized for treatment and prevention of respiratory diseases.Engineering specifically nanomedicines can be used to regulate host immunity in lungs in the case of respiratory diseases including coronavirus disease 2019(COVID-19)infection.COVID-19 causes pulmonary embolisms,thus new therapeutic options are required to target thrombosis,as conventional treatment options are either not effective due to the complexity of the immunethrombosis pathophysiology.In this review,we discuss regulation of immune response in respiratory diseases especially COVID-19.We further discuss thrombosis and provide an overview of some antithrombotic nanoparticles,which can be used to develop nanomedicine against thrombo-inflammation induced by COVID-19 and other respiratory infectious diseases.We also elaborate the importance of immunomodulatory nanomedicines that can block pro-inflammatory signalling pathways,and thus can be recommended to treat respiratory infectious diseases.
基金supported by the National Key Research and Development Program of China(grant number 2023YFC2306002)National Science and Technology Major Projects(grant number 2017ZX10104001-005-010)+1 种基金CAMS Innovation Fund for Medical Sciences(CIFMS)(Grant Number 2019-I2M-5-026)Funding for Reform and Development of Beijing Municipal Health Commission.
文摘Respiratory syncytial virus(RSV)is a significant cause of acute lower respiratory tract infection(ALRTI)in children underfive years of age.Between 2017 and 2021,396 complete sequences of the RSV F gene were obtained from 500 RSV-positive throat swabs collected from ten hospitals across nine provinces in China.In addition,151 sequences from China were sourced from GenBank and GISAID,making a total of 549 RSV F gene sequences subjected to analysis.Phylogenetic and genetic diversity analyses revealed that the RSV F genes circulating in China from 2017 to 2021 have remained relatively conserved,although some amino acids(AAs)have undergone changes.AA mutations with frequencies10%were identified at six sites and the p27 region:V384I(site I),N276S(site II),R213S(siteØ),and K124N(p27)for RSV A;F45L(site I),M152I/L172Q/S173 L/I185V/K191R(site V),and R202Q/I206M/Q209R(siteØ)for RSV B.Comparing mutational frequencies in RSV-F before and after 2020 revealed minor changes for RSV A,while the K191R,I206M,and Q209R frequencies increased by over 10%in RSV B.Notably,the nirsevimab-resistant mutation,S211N in RSV B,increased in frequency from 0%to 1.15%.Both representative strains aligned with the predicted RSV-F structures of their respective prototypes exhibited similar conformations,with low root-mean-square deviation values.These results could provide foundational data from China for the development of RSV mAbs and vaccines.
基金funded by the Tianjin Key Medical Discipline(Specialty)Construction Project(Grant number TJYXZDXK-040A)the Public Health and Technology Project of Tianjin(Grant number TJWJ2021QN050).
文摘Respiratory syncytial virus(RSV)is the main pathogen that causes hospitalization for acute lower respiratory tract infections(ALRIs)in children.With the reopening of communities and schools,the resurgence of RSV in the COVID-19 post-pandemic era has become a major concern.To understand the circulation patterns and genotype variability of RSV in Tianjin before and during the COVID-19 pandemic,a total of 19,531 nasopharyngeal aspirate samples from hospitalized children in Tianjin from July 2017 to June 2022 were evaluated.Direct immunofluorescence and polymerase chain reaction(PCR)were used for screening RSV-positive samples and subtyping,respectively.Further analysis of mutations in the second hypervariable region(HVR2)of the G gene was performed through Sanger sequencing.Our results showed that 16.46%(3215/19,531)samples were RSV positive and a delayed increase in the RSV infection rates occurred in the winter season from December 2020 to February 2021,with the average RSV-positive rate of 35.77%(519/1451).The ON1,with H258Q and H266L substitutions,and the BA9,with T290I and T312I substitutions,are dominant strains that alternately circulate every 1–2 years in Tianjin,China,from July 2017 to June 2022.In addition,novel substitutions,such as N296Y,K221T,N230K,V251A in the BA9 genotype,and L226I in the ON1 genotype,emerged during the COVID-19 pandemic.Analysis of clinical characteristics indicated no significant differences between RSV-A and RSV-B groups.This study provides a theoretical basis for clinical prevention and treatment.However,further studies are needed to explore the regulatory mechanism of host immune responses to different lineages of ON1 and BA9 in the future.
文摘BACKGROUND Electronic cigarettes(ECs)have been promoted as alternatives to traditional cigarettes.To investigate ECs’effects on respiratory system,especially in patients with respiratory diseases.METHODS We randomly selected 25 smokers with stable moderate asthma and matched them with 25 healthy smokers.All were subjucted to pulmonary function tests(PFTs),impulse oscillometry(IOS),fraction exhaled Nitric Oxide(FeNO),exhaled breathe condensate(EBC)and biomarker measurements before and after vaping one nicotinecontaining EC.RESULTS The increase in FeNO 30 minutes after EC,reflecting airway inflammation,significantly correlated with increase of residual volume(RV),total lung capacity,respiratory impedance at 5 Hz(Z5Hz)and respiratory resistance at 5 and 20 Hz(R5Hz and R20Hz).No significant correlations were found between EBC biomarkers'changes and respiratory mechanics.CONCLUSION This is the first study demonstrating that the changes in airway inflammation caused by EC have direct effects in respiratory mechanics of asthmatic patients.
基金supported in part by Grant Name awarded to the State Key Lab of Respiratory Diseases,Guangzhou Medical College (2007DA780154F0910)
文摘Multiplex RT-PCR assays have been widely used tools for detection and differentiation of a panel of respiratory viral pathogens. In this study, we evaluated the Qiagen ResPlex lI V2.0 kit and explored factors influencing its sensitivity. Nasopharyngeal swab （NPS） specimens were prospectively collected from pediatric inpatients with lower respiratory tract infections at the time of admission in the Shenzhen Children＇s Hospital from May 2009 to April 2010. Total nucleic acids were extracted using the EZ1 system （Qiagen, Germany） and 17 respiratory viruses and genotypes including influenza A virus （FluA）, FluB, parainfluenza virus 1 （PIV1）, PIV2, PIV3, PIV4, respiratory syncytial virus （RSV）, human metapneumovirus （hMPV）, rhinoviruses （RhV）, enteroviruses （EnV）, human bocaviruses （hBoV）, adenoviruses （AdV）, four coronaviruses （229E, OC43, NL63 and HKU1）, and FluA 2009 pandemic H1NI（H1NI-p） were detected and identified by the ResPlex II kit. In parallel, 16 real-time TaqMan quantitative RT-PCR assays were used to quantitatively detect each virus except for RhV. Influenza and parainfluenza viral cultures were also performed. Among the total 438 NPS specimens collected during the study period, one or more viral pathogens were detected in 274 （62.6%） and 201（45.9%） specimens by monoplex TaqMan RT-PCR and multiplex ResPlex, respectively. When results from monoplex PCR or cell culture were used as the reference standard, the multiplex PCR possessed specificities of 92.9-100.0%. The sensitivity of multiplex PCR for PIV3, hMPV, PIV1 and BoV were 73.1%, 70%, 66.7% and 55.6%, respectively, while low sensitivities （11.1%-40.0%） were observed for FluA, EnV, OC43, RSV and H1N1. Among the seven viruses/genotypes detected with higher frequencies, multiplex PCR sensitivities were correlated significantly with viral loads determined by the TaqMan RT-PCR in FluA, H 1N 1-p and RSV （p=0.011-0.000） The Qiagen ResPlex II multiplex RT-PCR kit possesses excellent specificity for simultaneous detection of 17 viral pathogens in NPS specimens in pediatric inpatients at the time of admission. The sensitivity of multiplex RT-PCR was influenced by viral loads, specimen process methods, primer and probe design and amplification condition.
基金supported by grants from the Priority Project on Infectious Disease Control and Prevention(2012ZX10004215,2013ZX10004610)from Ministry of Health,China,and the Science Foundation for the State Key Laboratory for Infectious Disease Prevention and Control from China(Grant No.2015SKLID508)the National Natural Science Foundation of China(Grant No.81671985)and(Grant No.81170009)
文摘Objective Lower respiratory tract infections continue to pose a significant threat to human health. It is important to accurately and rapidly detect respiratory bacteria. To compensate for the limits of current respiratory bacteria detection methods, we developed a combination of multiplex polymerase chain reaction （PCR） and capillary electrophoresis （MPCE） assay to detect thirteen bacterial pathogens responsible for lower respiratory tract infections, including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catorrholis, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, Mycoplasma pneumoniae, Legionella spp., Bordetella pertussis, Mycobacterium tuberculosis complex, Corynebactefium diphthefiae, and Streptococcus pyogenes. Methods Three multiplex PCR reactions were built, and the products were analyzed by capillary electrophoresis using the high-throughput DNA analyzer. The specificity of the MPCE assay was examined and the detection limit was evaluated using DNA samples from each bacterial strain and the simulative samples of each strain. This assay was further evaluated using 152 clinical specimens and compared with real-time PCR reactions. For this assay, three nested-multiplex-PCRs were used to detect these clinical specimens. Results The detection limits of the MPCE assay for the 13 pathogens were very low and ranged from 10-7 to 10-2 ng/μL. Furthermore, analysis of the 252 clinical specimens yielded a specificity ranging from 96.5%-100.0%, and a sensitivity of 100.0% for the 13 pathogens. Conclusion This study revealed that the MPCE with high specificity and sensitivity. This assay survey of respiratory pathogens. assay is a rapid, reliable, and high-throughput method has great potential in the molecular epidemiological.
基金This work was supported by the National Science and Technology Major Projects(Grant Number 2017ZX10104001-005-010,2017ZX10103004-004)the CAMS Innovation Fund for Medical Sciences(CIFMS)(Grant Number 2019-I2M-5-026)。
文摘Human respiratory syncytial virus(RSV) is a major pathogen of acute lower respiratory tract infection among young children. To investigate the prevalence and genetic characteristics of RSV in China, we performed a molecular epidemiological study during 2015–2019. A total of 964 RSV-positive specimens were identified from 5529 enrolled patients during a multi-center study. RSV subgroup A(RSV-A) was the predominant subgroup during this research period except in2016. Totally, 535 sequences of the second hypervariable region(HVR-2) of the G gene were obtained. Combined with182 Chinese sequences from GenBank, phylogenetic trees showed that 521 RSV-A sequences fell in genotypes ON1(512),NA1(6) and GA5(3), respectively;while 196 RSV-B sequences fell in BA9(193) and SAB4(3). ON1 and BA9 were the only genotypes after December 2015. Genotypes ON1 and BA9 can be separated into 10 and 7 lineages, respectively. The HVR-2 of genotype ON1 had six amino acid changes with a frequency more than 10%, while two substitutions H258 Q and H266 L were co-occurrences. The HVR-2 of genotype BA9 had nine amino acid substitutions with a frequency more than10%, while the sequences with T290 I and T312 I were all from 2018 to 2019. One N-glycosylation site at 237 was identified among ON1 sequences, while two N-glycosylation sites(296 and 310) were identified in the 60-nucleotide duplication region of BA9. To conclusion, ON1 and BA9 were the predominant genotypes in China during 2015–2019. For the genotypes ON1 and BA9, the G gene exhibited relatively high diversity and evolved continuously.
文摘OBJECTIVE:To examine the clinical effects of a mixture of Chinese Yam and Epimedium in patients with stable moderate or severe chronic obstructive pulmonary disease(COPD).METHODS:Forty-nine patients with COPD were randomly allocated to a group whose usual treatment was supplemented with oral Chinese Yam-Epimedium mixture,or a control group given placebo.For each patient,body mass index,airflow obstruction,dyspnea,and exercise capacity were measured and converted into the BODE index before treatment and at one and three months after initiation of treatment.Participants also completed the St George's Respiratory Questionnaire(SGRQ) at the same intervals.RESULTS:After one month,improvements were seen in the BODE index and SGRQ of participants taking Chinese Yam-Epimedium mixture compared to controls.There were statistically significant differences in the SGRQ:three of its components and the total SGRQ scores were significantly decreased(P<0.05),respiratory symptom scores had improved(P<0.01),and the dyspnea component of the BODE index had significantly decreased(P<0.05).Similar improvements were observed after three months of treatment,but exercise tolerance had also improved:the six-minute walking distance had significantly increased(P<0.05) in the treatment group when compared with controls.CONCLUSION:Chinese Yam-Epimedium mixture can significantly improve dyspnea,exercise capacity,and the quality of life of patients with stable moderate or severe COPD.
