2010年 · 第33卷第02期

We used colloidal gold immunochromatography (GICA) to detect the core antigen of influenza A virus, and verified it by virus isolation and culture, RT-PCR and control. The results are reported below.

There are many methods to treat central airway stenosis caused by malignant tumors. At present, the commonly used methods are ND: YAG laser guided by bronchoscopy, high frequency electrosurgery, argon plasma coagulation (APC), photodynamic therapy (PDT) and cryotherapy^[1,2]Its common characteristics all require multiple operations to remove tumor necrotic tissue, which cannot be immediately effective. Traditional cryotherapy uses rigid or soft probes to freeze the affected area to cause local necrosis of the tumor. About 1 week after treatment, it is necessary to freeze or remove the necrotic tissue again. Although this therapy is effective in the early stage, it cannot quickly eliminate respiratory obstruction. We explored a cryoprobe developed specifically for the treatment of endotracheal invasive tumors that can recanalize central airway stenosis in one operation.

The incidence of OSAHS in adults is 2% ~4%^[1]Destruction of sleep structure and repeated severe hypoxemia during sleep can cause multisystem damage. The results show that OSAHS is an important risk factor for coronary heart disease, hypertension, cerebrovascular disease and diabetes^[2,3]。 continuous positive airway pressure (CPAP) is currently recognized as the most effective therapy^[4]It can reduce daytime sleepiness symptoms and improve quality of life in OSAHS patients, and long-term treatment can reduce cardiovascular and cerebrovascular complications and mortality. The effectiveness of CPAP treatment is related to the treatment pressure set by it. Too low pressure is difficult to achieve curative effect, and too high pressure may affect treatment compliance. The commonly used method of pressure setting is artificial pressure regulation under polysomnography (PSG). The results obtained by this method are highly accurate, but it requires professional technicians to monitor the patient overnight and analyze the monitoring results. In recent years, Auto-CPAP technology has been adopted more and more^[5]This method is simple and convenient, does not require technicians to monitor all night, and can even be completed at the patient's home. However, because there is no nasal mask pressure and air leakage monitoring system, if air leakage occurs, the accuracy of the results may be affected. In order to further simplify the pressure adjustment method, some scholars calculated the pressure required for CPAP treatment according to the patient's neck circumference, body mass index and apnea-hypopnea index (AHI)^[6]。 Because the obesity degree and maxillofacial anatomy of Western patients and Chinese patients are different^[7], the body mass index was higher in the western population at the same AHI level^[8]。 In this study, by observing and comparing the results of automatic pressure regulation, manual pressure regulation and existing formulas, the accuracy of automatic pressure regulation is judged, and a more suitable pressure calculation formula for Chinese population is proposed.

MTB can survive in various harsh environments and infect hosts, and its strong environmental adaptability is closely related to its own complex gene expression regulation system. Initiating transcription is a crucial step in the regulation of prokaryotic expression, which requires sigma factor to recognize the transcriptional initiation point. Most of the 13 sigma factors encoded by the MTB genome are closely related to MTB pathogenicity.

Recombinant prourokinase (u-PA) is a second generation new thrombolytic drug with fibrin specificity and few adverse bleeding reactions independently developed in China. A large-scale clinical study of recombinant prourokinase for thrombolytic therapy of acute myocardial infarction has shown that its thrombolytic effect is good, and it has less effect on systemic fibrolytic system than prostreptokinase (t-PA). At present, there is still a lack of clinical or basic research reports on the effect of recombinant prourokinase on endogenous fibrinolysis of pulmonary artery endothelial cells and its application in the treatment of pulmonary embolism. The effects of recombinant prourokinase on the endogenous fibrinolytic function of human pulmonary artery endothelial cells cultured in vitro were investigated by means of cell molecular biology and immunofluorescence techniques. The results showed that recombinant prourokinase acted on human pulmonary artery endothelial cells, promoted the expression and release of urokinase-type plasminogen activator and its receptor, and inhibited the release of plasminogen activator inhibitor. This mechanism enriches the understanding of urokinase-type plasminogen activator system in pulmonary vascular endogenous fibrinolysis. Recombinant prourokinase can fully mobilize the pro-fibrinolytic potential of vascular endothelial cells, which will be beneficial to promote thrombolysis, delay the appearance of rethrombosis, and improve the thrombolytic effect of drugs, which provides a scientific basis for further application of recombinant prourokinase in clinical pulmonary vascular disease treatment.

Patients with acute pulmonary thromboembolism (APE) may cause right ventricular dysfunction (RVD), and APE patients with or without RVD can be controlled with thrombolytic or anticoagulant therapy. In this study, we used transthoracic echocardiography (TTE) to evaluate the changes of right ventricular morphology (cardiac ultrasound parameters) in patients with various APE before and after receiving different treatment regimens. A prospective multicenter randomized controlled approach was used to enroll 520 APE inpatients from 41 domestic hospitals from June 2002 to November 2004. Patients were divided into 2 groups: Group A included 52 cases of large-area APE and 198 cases of sublarge-area APE; Group B included 270 cases of non-large area APE. One group of patients was randomly divided into four groups and received thrombolytic therapy with urokinase 12 h regimen, urokinase 2 h regimen, tissue plasminogen activator (rt-PA) 50 mg regimen and rt-PA 100 mg regimen respectively; Patients in group B were divided into two groups and were given anticoagulant therapy with unfractionated heparin regimen and low molecular weight heparin regimen, respectively. Echocardiography was performed before treatment, 24 h, 14 d and 3 months after treatment. The results showed that the mean age of the patients was (57 ± 14) years, including 323 males (62.1%) and 197 females. At each observation time point (before treatment, 24 h, 14 d and 3 months after treatment), the TTE right ventricular function parameters (right ventricular anteroposterior diameter/left ventricular anteroposterior diameter, calculated pulmonary artery pressure and maximum tricuspid regurgitation pressure difference, etc.) of patients in group A were significantly higher than those in group B, but there was no significant difference between the four groups. There was no significant difference in the TTE parameters between the two anticoagulant groups except SPAP. The incidence of RVD at 24 h after thrombolysis in group A patients plummeted from 100% to 34%. The results of echocardiography showed that the efficacy of urokinase 12 h, urokinase 2 h, rt-PA 50 mg and rt-PA 100 mg thrombolytic regimens were comparable, suggesting that rt-PA 50 mg can replace rt-PA 100 mg regimen in clinic, and echocardiography can be used to evaluate the efficacy and timely detect patients with persistent pulmonary hypertension.

deep venous thrombosis caused by various etiologies usually occurs in the lower limbs, and the thrombus shedding can lead to pulmonary thromboembolism. Therefore, deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE) are often referred to as venous thromboembolism (VTE). VTE is the third most common cardiovascular disease after coronary heart disease and hypertension in western countries, and its 6-month recurrence rate is 7%, among which the recurrence rate of PTE is significantly higher than that of DVT; The mortality rates of DVT and PTE within 30 days of onset were 6% and 12%, respectively, and the mortality rate of large-area PTE was as high as 30%. The number of deaths due to PTE in the United States is 50,000 to 200,000 each year, and the number of deaths due to VTE in Europe is more than the number of deaths due to breast cancer, prostate cancer, AIDS and traffic accidents combined. Effective prevention, early diagnosis and early treatment can significantly reduce the death events due to VTE^[1]Adequate and timely anticoagulant therapy can help reduce the occurrence of chronic thromboembolic pulmonary hypertension. However, there is no unified opinion on how long warfarin anticoagulation treatment needs to last, and different guidelines have different recommendations or recommendations^[2,3,4]In clinical work, the duration of individual anticoagulation therapy in VTE patients needs to weigh the risk of recurrence and the risk of warfarin-related bleeding^[5]。

Inhalation therapy is a common treatment for respiratory diseases, including aerosol inhalation, aerosol inhalation through fog storage tank, dry powder inhalation and aerosol inhalation, etc. Nebulization inhalation has the most accurate curative effect and the most extensive indications. However, the application status of aerosol inhalation in China has not been reported so far. Understanding and analyzing this situation will help to improve the rational use and popularization of aerosol inhalation in clinical practice, correct the errors in the use process in time, and establish standardized guidance and educational regulations.

In recent years, the drug resistance of pulmonary tuberculosis is not optimistic. In the TB drug resistance testing data of 38 countries and regions published by WHO, China ranks first among the countries and regions that cause special warning^[1]。 Strengthening drug resistance surveillance is the main content of tuberculosis control. Therefore, we analyzed the changes of drug resistance spectrum of 194 patients with pulmonary tuberculosis diagnosed from December 2001 to December 2006 in Nanjing Chest Hospital.

The annual incidence of pulmonary thromboembolism (PTE) in the total population is about 0.5‰, and the mortality rate ranks third among all causes of mortality, second only to tumors and myocardial infarction^[1]。 In 1998, Peking Union Medical College Hospital reported that the total mortality rate of 52 patients with PTE was 19.2%, of which 77.8% were untreated and 7.0% were treated^[2]。 In recent years, with the gradual deepening of understanding of PTE, the diagnosis rate of PTE in China has been increasing, but the number of cases misdiagnosed as PTE in other diseases has also gradually increased. Two misdiagnosed cases are reported as follows.

The 4th National Conference on Pulmonary Embolism and Pulmonary Vascular Diseases and the 2nd International Symposium on Pulmonary Circulation Diseases of Chinese Medical Association were held in Beijing from August 21 to 23, 2009. This conference was sponsored by the Respiratory Branch of Chinese Medical Association and the International Institute of Pulmonary Vascular Diseases, co-organized by the National Collaborative Group for the Prevention and Treatment of Pulmonary Embolism-Deep Vein Thrombosis, the Expert Committee of Pulmonary Circulation of American Thoracic Society, the Expert Committee of Cardiopulmonary and Critical Care Medicine of American Heart Society, and undertaken by Beijing Chaoyang Hospital-Beijing Institute of Respiratory Diseases affiliated to Capital Medical University. More than 20 well-known experts from the fields of pulmonary vascular diseases and pulmonary circulation at home and abroad attended this meeting, and made wonderful special reports on the latest progress and evidence-based medicine conclusions of pulmonary embolism-deep vein thrombosis, pulmonary hypertension and pulmonary vasculitis at home and abroad in recent years. The meeting also conducted academic exchanges in the form of case discussions and posters, which fully demonstrated China's research and clinical level in this field. At the same time, the meeting also held the National Pulmonary Embolism-Deep Vein Thrombosis Prevention and Treatment Cooperation Group Working Meeting, the National "Eleventh Five-Year Plan" Science and Technology Support Project-Research Phase Working Meeting on Improving the Diagnosis and Treatment of Pulmonary Embolism, the Committee of Pulmonary Embolism and Pulmonary Vascular Disease of Respiratory Disease Branch of Chinese Medical Association and the Expert Strategy Seminar of China Center of International Academy of Pulmonary Vascular Diseases. More than 500 doctors in the field of pulmonary vascular diseases from across the country attended this meeting.

The 1st working meeting of the 7th editorial committee of Chinese Journal of Tuberculosis and Respiration was held in Beijing from December 15 to 17, 2009. Academician Zhong Nanshan, honorary editor-in-chief, 8 consultants including Duanmu Hongjin (Professor Cui Dejian asked for leave), 84 editorial members including Liu Youning (12 asked for leave) and 48 corresponding editorial members (8 asked for leave) attended the meeting. Luo Ling, deputy secretary-general in charge of magazine work of Chinese Medical Association, You Suning, president and editor-in-chief of Chinese Medical Association magazine, Cai Lifeng, vice president, and all members of the editorial department attended the meeting.

The 7th event of Beijing Young Respiratory Scholars Salon in 2009 was held on October 29th, 2009. This event was hosted by Dr. Huang Hui, Department of Respiratory Medicine, Peking Union Medical College Hospital. The theme of this event was "Application of glucocorticoids (abbreviated as hormones) in idiopathic interstitial pneumonia (IIP)".

Since the opening of the column "New H1N1 Influenza" in the 9th issue of 2009, this magazine has received and published some related articles one after another. Since the first case of new type A (H1N1) in mainland China was reported, this journal has received submissions from all over the country one after another, and we will select some representative articles from them to publish one after another. This issue publishes "Clinical Characteristics Analysis of 127 Cases of New Influenza A (H1N1) in Fujian Province" written by Chen Yusheng et al. and "Two Cases of New Influenza A (H1N1) with Pneumonia and Hypoxemia" written by Cai Hourong et al. The former objectively and detailedly described the clinical characteristics and treatment results of novel influenza A (H1N1) cases in Fujian Province in the early stage of prevention and control in China, and analyzed whether there was a correlation between age, body temperature, hemogram and antiviral intervention and disease course. The results showed that patients ≤5 years old, with body temperature>38 ℃ and elevated white blood cell and lymphocyte count had a long symptomatic duration; Early application of oseltamivir antiviral therapy can help shorten the course of the disease; The course of this disease is self-limiting, and the prognosis of patients without complications is good. This conclusion is representative for the description of clinical characteristics of current cases in China. The latter described in detail the clinical manifestations, chest CT features and treatment process of two patients with pneumonia, and distributed a large number of imaging data, which provided experience for the treatment of new cases of influenza A (H1N1).