Extrinsic allergic alveolitis is a general term for type Ⅲ or Ⅳ allergic pneumonia caused by repeated inhalation of various antigenic organic dusts and low molecular weight chemicals in susceptible people. The lesions involve alveolar, pulmonary interstitial, and airway. The main clinical manifestations are cough, expectoration, and dyspnea. Clinically, extrinsic allergic alveolitis is classified into acute, subacute, and chronic forms. Extrinsic allergic alveolitis has a great impact on the pulmonary function of patients. Timely treatment will improve clinical symptoms and inhibit the development of disease. The current treatment plan is mainly avoiding exposure to antigen, glucocorticoid therapy, immunosuppressive therapy, anti-fibrotic therapy, and lung transplantation.
Melanoma differentiation associated gene 5 (MDA5) antibody is a kind of myositis-specific autoantibodies, which can be used as a biological marker for dermatomyositis (DM) patients. It has been shown that this antibody is closely related to the occurrence of interstilung disease (ILD) in DM patients, which may lead to rapidly progressive interstitial lung disease in DM patients with MDA5 antibody positive, leading to a higher mortality rate. Therefore, the early detection, diagnosis and treatment of this disease have attracted the attention of clinical workers. In this paper, the progress of diagnosis and treatment of MDA5 antibody-positive DM with ILD is reviewed.
發生在我國汶川的5·12特大地震為里氏8.0級，造成大量人員傷亡及財產損失。據統計，截至2008年6月2日12時，此次大地震全國共有69 107人遇難，373 577人受傷，18 230人失蹤。地震發生后，國家立即動員大量人力搜救受傷人員，使部分被掩埋人員及時從倒塌廢墟中挖掘出來。同時，全國衛生系統緊急動員，對這些被搶救出的傷員進行了救治。據衛生部統計，到目前為止，因地震傷病住院治療合計92,973人，已出院68 565人，仍有11 832人住院，共救治傷員583 891人次（http://scnews.newssc.org/system/2008/06/02/010871823.shtml）。分析既往地震及其他自然災害中病人的傷害的情況及救治經驗，總結此次地震中病人受傷情況及救治過程中的得失，對我們應對以后的地震及其他自然災害有一定幫助。
Interstitial lung disease is the most common pulmonary complication in patients with inflammatory myopathy, with a high case fatality rate, unknown pathogenesis, and complex clinical manifestations, and the treatment is difficult. Early and timely treatment can improve the patient’s clinical symptoms and inhibit the development of the disease. The present treatment protocols can be mainly summarized as the commonly used drugs (corticosteroids, azathioprine, cyclophosphamide, mycophenolate mofetil, and intravenous immunoglobulin) and new drugs (cyclosporin A, tacrolimus, biological agents, and anti-fibrosis drug), etc. In this paper, the treatment progress of inflammatory myopathy-related interstitial lung disease and different myositis antibody-related interstitial lung disease in recent years at home and abroad is reviewed, so as to provide a basis for clinical treatment.
After pirfenidone and nintedanib showed efficacy, drug treatment for idiopathic pulmonary fibrosis began to focused on anti-fibrosis. Current research on idiopathic pulmonary fibrosis mainly focus on the pathogenesis and therapeutic targets, and more targeted drugs are gradually entering clinical trials. This article summarizes the results of recent studies on the treatment of idiopathic pulmonary fibrosis with pirfenidone and nintedanib alone or in combination by searching the literature, and reviews the mechanism and test results of the new target anti-fibrosis drugs based on molecular biology that are currently undergoing clinical research in various phases, and aims to provide a basis for how to choose drugs to treat idiopathic pulmonary fibrosis.
Objective Sedation and/or analgesia is often applied during noninvasive positive pressure ventilation (NIPPV) to make patients comfortable, and thus improve the synchronization between patients and ventilator. Nevertheless, the effect of sedation and/or analgesia on the clinical outcome of the patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) after extubation remains controversial. Methods A retrospective study was conducted on patients with AECOPD who received NIPPV after extubation in seven intensive care units in West China Hospital, Sichuan University between December 2013 and December 2017 . A logistic regression model was used to analyze the association between the use of sedation and/or analgesia and clinical outcomes including rate of NIPPV failure (defined as the need for reintubation and mechanical ventilation), hospital mortality, and length of intensive care unit stay after extubation. Results A total of 193 patients were included in the analysis, and 62 cases of these patients received sedation and/or analgesia during NIPPV. The usage of sedation and/or analgesia could result in failure of NIPPV (adjusted odd ratio [OR] 0.10, 95% confidence interval [CI] 0.02 - 0.52, P=0.006) and death (adjusted OR=0.13, 95%CI 0.04 - 0.42, P=0.001). Additionally, intensive care unit stay after extubation was longer in the patients who did not receive sedation and/or analgesia than those who did (11.02 d vs. 6.10 d, P< 0.01). Conclusion The usage of sedation and/or analgesia during NIPPV can decrease both the rate of NIPPV failure and hospital mortality in AECOPD patients after extubation.
ObjectiveTo study the effects of visceral adipose tissue area (VTA) and subcutaneous adipose tissue area (STA) on pulmonary ventilation function (PVF), and then to evaluate the impact of abdominal fat distribution on PVF.Methods Patients who underwent both PVF examination and abdominal CT between January 1st and December 31st, 2017 were selected from the electronic medical record system of West China Hospital of Sichuan University. The demographic data and PVF indexes [vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and 1 s rate (FEV1/FVC)] were collected. VTA and STA were obtained by abdominal CT measurement. The correlations between PVF indexes and VTA or STA were compared. Results A total of 224 patients were included. According to the VTA/STA ratio, there were 92 cases (41.07%) in group VTA/STA<1 and 132 cases (58.93%) in group VTA/STA≥1. VTA was not correlated with FVC (rs=?0.078, P=0.244), but negatively correlated with VC (rs=?0.138, P=0.040), FEV1 (rs=?0.141, P=0.034) and FEV1/FVC (rs=?0.137, P=0.041); STA had no correlation with VC, FVC, FEV1 or FEV1/FVC (P>0.05). VTA/STA was negatively correlated with VC (rs=?0.220, P=0.001), FEV1 (rs=?0.273, P<0.001) and FEV1/FVC (rs=?0.380, P<0.001), but it had no correlation with FVC (rs=?0.083, P=0.214). In group VTA/STA<1, VTA/STA was negatively correlated with FEV1 (rs =?0.205, P=0.050) and FEV1/FVC (rs=?0.317, P=0.002), but it had no correlation with VC or FVC (P>0.05). In group VTA/STA≥1, VTA/STA was negatively correlated with VC, FVC, FEV1 and FEV1/FVC (P<0.05). Conclusions VTA and STA are negatively correlated with PVF. The ratio of VTA/STA can be used as an index to evaluate the effect of abdominal fat distribution on lung function.
Objective To investigate the expression of Jumonji domain-containing protein 3 ( JMJD3) in lung cancer tissue. Methods The cancer tissue slides from 53 lung cancer patients with different TNMstages were immunostained with JMJD3 antibody. The relationship between the expression of JMJD3 and type of pathology, TNM stage, survival time was analyzed. Results 94. 3% lung cancer tissue expressed JMJD3 protein. The expression of JMJD3 was negatively correlated with TNMstage( r = - 0. 347,P =0. 002) . The patients with decreased JMJD3 expression had shorter survival time than the patients with high JMJD3 expression ( X2 = 17. 83, P = 0. 001) . Conclusion Decreased expression of JMJD3 may promote the lung cancer progression.
ObjectiveTo investigate a more convenient and safe sampling method for viral nucleic acid detection of coronavirus disease 2019.MethodsAn oropharyngeal swab and nasopharyngeal swab were simultaneously taken from 100 patients with coronavirus disease 2019 in a hospital in Wuhan. Then the efficacies of two sampling methods were compared on the positive rates of viral nucleic acid detection.ResultsThe positive rate for SARS-CoV-2 was 54% in oropharyngeal swabs, while 89% positive in nasopharyngeal swabs. There was a significant difference in the detection rate between oropharyngeal swab and nasopharyngeal swab (χ2=3.850 4, P=0.049 7).ConclusionsThe positive rate for nucleic acid testing from nasopharyngeal swabs are significantly better than that from oropharyngeal swabs. Therefore, sampling by nasopharyngeal swabs, rather than oropharyngeal swabs, should be chosen as the preferred virological screening method for patients with coronavirus disease 2019.