急性肺損傷/急性呼吸窘迫綜合征（ALI/ARDS）是指心源性以外的各種肺內外致病因素導致的原發或繼發的急性、進行性呼吸衰竭，其病理改變主要表現為肺上皮及內皮細胞的損傷、炎性浸潤和透明膜形成，并伴有肺間質纖維化。臨床表現為以呼吸窘迫、頑固性低氧血癥和非心源性肺水腫為特征的一種急性進行性呼吸困難。采用常規的治療難以糾正其低氧血癥，死亡率高達60%，嚴重威脅人們的生命健康[1]。自1967年Ashbaugh及其同事首次描述ALI/ARDS以來，醫學研究者進行了大量關于ALI/ARDS發病機制及病理生理學的基礎及臨床研究，但是迄今ALI/ARDS的發病機理仍未完全闡明。近年來越來越多的研究提示凋亡因子（Fas/Fas配體，即Fas/FasL）介導的細胞凋亡在ALI/ARDS的發生發展過程中有著十分重要的作用[2，3]。本文就Fas/FasL的生物學特性及其在ALI/ARDS發病機制中的作用作一綜述。
Influenza A is an acute infectious respiratory disease caused by influenza A virus, with typical signs and symptoms of upper and / or lower respiratory tract involvement, and symptoms of systemic disease such as fever, headache, myalgia and fatigue. Although it is a self-limited disease in the general population, it is associated with increased morbidity and mortality in some high-risk populations and often leads serious complications, such as severe acute lung injury, acute respiratory distress syndrome, as well as other extrapulmonary injuries. The exploration of the mechanisms of lung injury caused by influenza A infection could be helpful to understand the pathogenic mechanisms of other viral pneumonias, such as coronavirus disease 2019.
In recent years, with the wide application of metagenomics next-generation sequencing, more and more rare pathogens have been detected in our clinical work, including non-tuberculous Mycobacterium, Corynebacterium, Fusarium, Cryptococcus pneumoniae, human herpes virus, torque teno virus, parvovirus, Tropheryma whipplei, Bartonella, Chlamydia psittaci, etc. It is difficult to determine whether these rare pathogens are clinically significant and need treatment. This article puts forward some suggestions and discussions on the diagnosis and treatment of pulmonary infections with some rare pathogens.
Community-acquired pneumonia (CAP) is still a common disease that seriously affects people’s health. It is of great clinical significance for proper anti-infective therapy to identify the characteristics and changes of the pathogens. Along with the accelerated process of aging population, increased use of immunosuppression agents, and increased morbidity of malignant tumor and underlying diseases, the pathogenic spectrum of patients with CAP varies as well. This article reviews the important pathogenic changes of CAP in recent years.
Sarcoidosis is a multi-organ inflammatory disorder characterized by the presence of non-caseating granulomas primarily affecting the lungs. The pathogenesis of sarcoidosis has not been fully clarified. In recent years, studies have suggested that a variety of pathogen infections, including Mycobacterium tuberculosis, Propionibacterium acnes, fungi, viruses, may be related to the occurrence and progression of sarcoidosis. This article reviews the researches on sarcoidosis and pathogen infection, aiming to explore the potential role of pathogen infection in the pathogenesis of sarcoidosis and provide another direction for the treatment of sarcoidosis.
Objective To overview the systematic reviews about the efficacy and safety of respiratory fluoroquinolones for community-acquired pneumonia (CAP). Methods We electronically searched databases including China National Knowledge Internet, WanFang Data, VIP, PubMed, Embase and The Cochrane Library to collect systematic reviews or Meta-analyses about respiratory fluoroquinolones for CAP from inception to November 2, 2017. Two reviewers independently screened literatures, extracted data, and then AMSTAR tool was used to assess the methodological quality of included studies. Results A total of 18 systematic reviews/Meta-analyses were included. The results of quality assessment indicated the scores ranged from 5 to 10. Among the 11 items, the item 1 of " Was an ‘a priori’ design provided” and item 4 " Was the status of publication (i.e. grey literature) used as an inclusion criterion” appeared to be the most problematic. The results of overview suggested that: the efficacy of respiratory fluoroquinolones might be similar to β-lactams plus macrolides combination treatment for CAP. However, respiratory fluoroquinolones might be more safety. In addition, the efficacy of respiratory fluoroquinolones sequential therapy for CAP was similar to that of continuous intravenous therapy, but the adverse reactions of the former were fewer. Conclusions Respiratory fluoroquinolones might be similar in efficacy for CAP to other antibiotics recommended by the guidelines with less adverse reactions. However, it can increase multi-drug resistance and potential tuberculosis drug resistance, we should strictly follow the principle of rational use of antibiotics to avoid abuse.
目的：調查6個短串聯重復（short tandem repeat，STR）基因座在中國四川成都漢族人群中的基因頻率分布。方法：應用四色熒光標記引物復合擴增技術對260名成都漢族無關個體的血樣6個STR基因座進行多態性研究。結果：在四川成都漢族人群中6個STR基因座個體識別機率PD為0.796～0.913，雜合度HO為0.627～0.796，多態信息含量PIC為0.57～0.75。6個STR基因座PD總值為0.999 995 97。所有基因座經卡方檢驗符合Hard-Weinberg平衡。結論：上述6個STR基因座在成都漢族人群中等位基因分布較好，個體識別率高，適合法醫個體識別和親子鑒定。
The common cold is the most common acute respiratory infectious disease, with a high incidence and widespread susceptibility. Most common colds are self-limited but can lead to serious social and economic burdens. In recent years, the symptoms of common cold patients have been complex and diverse, and some patients can develop serious complications, even threatening their lives. The Anti-infection Committee, Emergency Doctor Branch of Chinese Medical Doctor Association has developed the Practice Guidelines for the Diagnosis and Management of Common Cold in Adults, 2023, which explored 15 important issues related to clinical practice. This article provides a detailed and comprehensive interpretation of the guideline, in order to better understand the diagnosis and treatment of adult common cold and serve clinical practice.
Bronchiectasis is a heterogeneous disease characterized by abnormal expansion of the bronchi, manifested by cough, sputum, and recurring lung infections. As one of the common fungi of lung infection, aspergillus can not only appear as the outcome of the disease in bronchiectasis, but also as an inducement to participate in the disease progression, and ultimately complicate the course of bronchiectasis. This article describes the susceptibility factors and pathogenic mechanisms of aspergillus in bronchiectasis, and further introduces the diagnosis and treatment status of bronchiectasis combined with aspergillus infection, aiming to clarify the effect of aspergillus infection on bronchiectasis and provide new thinking directions for its clinical diagnosis and treatment.
Severe pneumonia remains a critical global concern. The immune and cytokine imbalance mediated by lymphocytes are related to the severe transformation and tissue damage of pneumonia, and are expected to become potential therapeutic targets for severe pneumonia. This article elaborates on the protection and pathogenic mechanism of lymphocyte in severe pneumonia, and further introduces the clinical application and research status of host-directed immunotherapy in severe pneumonia from two aspects: enhancing host immunity and improving immunopathological damage. It also introduces the challenges faced by immunotherapy in the future clinical translational application, aiming to provide new thinking directions for its clinical diagnosis, treatment, and research.