2013年 · 第36卷第12期

Sixty years in the long river of history is only a moment, but for a young man just out of college, after another sixty years, it is time to enjoy the "infinitely beautiful sunset" time. In 2013, the Chinese Journal of Tuberculosis and Respiration celebrated its 60th anniversary, but she is still young and full of vitality.

Time has passed, and in the blink of an eye, Chinese Journal of Tuberculosis and Respiration ushered in its 60th anniversary. Sixty years are only a short moment in the long river of history, but they are a memorial to the colorful life of Chinese Journal of Tuberculosis and Respiration. After 60 years of ups and downs, 60 years of hard work, and 60 years of passing on the fire, Chinese Journal of Tuberculosis and Respiration has grown from a young sapling to a towering tree today, and has become the most influential and authoritative academic journal of tuberculosis and respiration in China at present, and has made remarkable achievements. In 2011, it won the 2nd China Publishing Political Award Journal Award (the first journal award). It is the only medical journal to win this honor, and it is also the only Chinese journal of tuberculosis and respiration that has entered the largest and most influential database of biomedical journals in the world-American Medical Index (Medline) and PubMed search system. The 60-year development history of Chinese Journal of Tuberculosis and Respiration condenses the hardships, efforts, hard work and dedication of experts and scholars in tuberculosis and respiration. Looking back at the past, the past is vivid in my mind, and how many scenes come to us, which makes us recall and miss it.

With the passage of time, the Chinese Journal of Tuberculosis and Respiration has ushered in its 60th anniversary. In the past 60 years, the Chinese Journal of Tuberculosis and Respiration has shown the process of tuberculosis prevention people in China who have gone through hardships and twists and finally achieved success. It encourages the prevention and treatment of tuberculosis in China to move towards new glory.

Tuberculosis is an ancient and widespread chronic infectious disease that has historically killed one in four adults and remains a public health issue of high global concern. Sixty years ago, Chinese Journal of Tuberculosis and Respiratory Diseases was founded in response to the needs of the national discipline construction of tuberculosis and respiratory diseases. It has been committed to the promotion of tuberculosis prevention and control strategies and the exploration of tuberculosis chemotherapy (referred to as chemotherapy for short), providing the best platform for communication and learning of tuberculosis prevention and control workers across the country, and also witnessing the hard efforts of tuberculosis prevention and control workers in China for tuberculosis control. A thousand years, in a flash of a finger. The most effective measure to treat tuberculosis-anti-tuberculosis drug chemotherapy has been tempered by years, including glory and loss. With the development of society and the progress of science, the research and development of new anti-tuberculosis chemotherapy drugs has seen a ray of dawn after 40 years of silence.

Since its founding in July, 1953, Chinese Journal of Tuberculosis and Respiratory Disease has recorded the footprint of China's struggle against tuberculosis, and has become the core journal for academic research and experience exchange of tuberculosis in China, making contributions to the development of tuberculosis discipline. Reviewing the basic research results of tuberculosis published in Chinese Journal of Tuberculosis and Respiratory in the past 60 years is not only a recollection of our predecessors and an affirmation of previous research achievements, but also a clarification of our responsibilities and the direction of future efforts.

Respiratory infection is not only a common infectious disease but also one of the common respiratory diseases, with a large number of cases and deaths. For a long time, due to historical reasons, the overall clinical diagnosis and treatment level of respiratory infections in China is far behind that of developed countries, and the foundation of related scientific research is also very weak. Until the 1990s, with the deepening of domestic clinical microbiology and anti-infective pharmacology research, clinical and basic research in the field of respiratory infections in China has also developed rapidly, and many important achievements have been made in etiology research and standardized diagnosis and treatment, which laid a good foundation for improving the overall level of clinical diagnosis and treatment of respiratory infections in China.

Lung cancer is the number one killer of cancer-related deaths, with approximately 1.4 million people dying from the disease every year^[1,2]。 Research data from China's Cancer Prevention and Treatment Center show that about 600,000 people in China die of lung cancer every year^[3]。 The World Health Organization estimates that the incidence of lung cancer in China will exceed 1 million in 2025^[2]It will impose a serious burden on patients, families, society and the country. Although the risk factors of lung cancer in China have been basically clarified, the prevention work has not kept up, and the diagnosis is late. Two-thirds of patients have lost the opportunity of surgery when they are discovered, and their quality of life is very poor. The 5-year survival rates in the United States and Japan are 20% and 21% respectively, while in China they are only 8%^[4]Even if a lot of medical expenses are spent, its 5-year survival rate is only 10% ~14%^[5]The reason may be related to insufficient support and the positioning of prevention and treatment strategies, that is, the "three light and one serious" situation of light prevention, light diagnosis, light management and emphasis on treatment. Therefore, in order to make patients live long and well, it is necessary to improve the level of prevention and early diagnosis, pay attention to treatment, and pay more attention to managing patients.

The research of chronic obstructive pulmonary disease (COPD for short) has gone through decades, in a flash of a finger. As a respiratory physician who grew up with the clinical prevention and treatment of COPD, the course of COPD is my work course. I remember that in the autumn of 2012, I accidentally received a letter from the masses, which wrote: "I was diagnosed with 'chronic obstructive pulmonary disease' because of cough and wheezing. The doctor prescribed me an inhalation drug, which worked very well, but the price was a little expensive. Because I couldn't reimburse the medical expenses, I couldn't afford it over time. I remember that more than 40 years ago, my father was also diagnosed with 'old chronic bronchitis'. He saw a doctor in Peking Union Medical College Hospital. The treatment effect with tracheitis No.1 was ok, and it didn't cost much money. I wonder if this drug is still available in your hospital. "Tracheitis No.1 is indeed a clinical research drug of the Department of Respiratory Medicine of Peking Union Medical College Hospital more than 40 years ago. At that time, the name of the Department of Respiratory Medicine of Peking Union Medical College Hospital was tracheitis group. The main components of tracheitis No.1 are ephedrine and aminophylline, but this drug has long disappeared. Unexpectedly, when we are talking about the Chinese dream of COPD, COPD patients are having the" nostalgic dream "of COPD. From" old chronic bronchitis "to" COPD ", decades of past events come to mind, which makes me think about it.

Bronchial asthma (asthma for short) is one of the common chronic respiratory diseases characterized by airway hyperresponsiveness, airway inflammation and airway remodeling. Its morbidity and mortality are still on the rise worldwide. According to the Global Asthma Prevention and Treatment Initiative (GINA), the number of asthma patients worldwide will increase to 400 million by 2025, and it is considered to be one of the leading causes of labor incapacity, huge medical expenditure and preventable death. With the development of social economy in China, the incidence of asthma is increasing year by year. At present, about 30 million people in China suffer from asthma. Asthma has become one of the worldwide public health problems that endanger human life and health. It has aroused the widespread attention of World Health Organization, governments and clinicians. The prevention and treatment of asthma has become an important research topic at home and abroad. Looking back on the experience of asthma prevention and treatment in China in the past 60 years, especially in the past 20 years, it is more conducive to further clarifying the thinking and clarifying the understanding, in order to improve the level of asthma prevention and treatment on the basis of the already gained experience in the future.

Interstitial lung disease is a general term for a group of clinical-pathological entities composed of different kinds of disease groups. There are many reasons, and there are great difficulties in clinical diagnosis and treatment. For a long time, basic and clinical research progress in this area has been relatively slow due to various reasons. In the late 1970s, with the reform and opening up of China and the increase of international exchanges, some new ideas of interstitial lung disease were gradually introduced into China. After entering the 21st century, with the deepening of international understanding of interstitial lung disease, this field has gradually become one of the hot spots of respiratory diseases, and the clinical and basic research work of interstitial lung disease in China has also been developed rapidly.

Lung cancer is one of the most common malignant tumors in the world, and transmediastinoscopic/thoracoscopic biopsy is the gold standard for diagnosing the staging of mediastinal lymph nodes in lung cancer. In recent years, transbronchoscopic ultrasound-guided needle aspiration biopsy (EBUS-TBNA) and transesophageal ultrasound-guided needle aspiration biopsy (EUS-FNA) have high sensitivity, specificity and less trauma in diagnosing mediastinal lymph nodes, showing a trend to replace mediastinoscopy. EBUS-TBNA and EUS-FNA are complementary to the diagnosis of mediastinal lymph nodes, and more accurate staging of mediastinal lymph nodes can be obtained by combining the two tests.

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease characterized by incompletely reversible airway obstruction. Airway inflammation is heterogeneous, so it is crucial to evaluate the pathophysiological changes of the airway. In this study, the subtypes of patients with acute exacerbation of COPD were classified based on the different proportions of inflammatory cells in induced sputum, and the differences in clinical characteristics, functional changes, expression of inflammatory mediators, drug effects and prognosis among each subtype were observed.

sarcoidosis^[1]It is a non-caseous necrogranulomatous disease with unknown etiology, mainly involving the lungs and lymphatic system, and can also invade the spleen, heart, skin, muscles, eyes and other systemic systems. However, pleural lesions are relatively rare, and cases with pleural effusion as the main manifestation are even rarer. The involvement of sarcoidosis in the pleura was first found by autopsy in 1933^[2]。 The early literature reported that the incidence rate was only 0.16% ~0.73%^[3,4]Some scholars even believe that "if pleural lesions are found, other granulomatous diseases should be considered"^[5]。 However, with the widespread application of high-resolution CT (HRCT) and thoracoscopic techniques, more sarcoidosis pleural lesions have been found^[6]。 Some people abroad have defined this as "pleuro-pulmonary sarcoidosis" (PPS)^[7], but this definition has not yet been widely accepted. At present, most scholars believe that pleural lesions are part of intrathoracic sarcoidosis. In recent years, there have been many reports abroad that the incidence of sarcoidosis reaches 10% ~20%, or even higher^[8,9]。 There are more and more reports of related cases in China, among which 14 cases of sarcoidosis complicated with pleural effusion are reported in the literature with the largest number of cases^[10]。 Sun Yongchang et al.^[11]After summarizing the domestic case reports, it was found that the incidence of sarcoidosis pleural lesions in China is 3.4% ~16.7%, with an average of 5.6%. Correct understanding of this disease is of great significance to clinical work. The current status of diagnosis and treatment of sarcoidosis pleural lesions is summarized as follows.

With the acceleration of industrial development and urbanization, air pollution has brought more and more threats to human health. Atmospheric pollution includes suspended particulate matter pollution, gaseous pollution, and odor pollution, where suspended fine particulate matter (PM_2.5) Because of its irregular shape, long suspension time in the atmosphere, small particle size and large specific surface area, it is easy to enrich toxic and harmful substances in the air, and can enter the body with breathing, even into the alveoli or blood circulation system, directly leading to cardiovascular and respiratory diseases, so it has aroused widespread concern all over the world. The PM will now be_2.5The relationship between carrier components and respiratory health is reviewed below.

Pulmonary function test is an important diagnostic tool in the epidemiological and clinical evaluation of respiratory diseases, especially in the early diagnosis, severity classification, disease progression and efficacy evaluation of respiratory diseases. Correct interpretation of pulmonary function test results depends on comparison with normal reference values. Therefore, it is very important to choose appropriate normal reference values for pulmonary function, otherwise it will lead to incorrect diagnosis and improper treatment, thus increasing the corresponding social medical burden^[1,2]And ultimately have an impact on the formulation of social health policies. Pulmonary function testing includes many different items, among which pulmonary ventilation function testing is the most commonly used in clinic and one of the research hotspots. This article summarizes the normal reference values of pulmonary ventilation function test indexes as follows.

venous thromboembolism (VTE) includes pulmonary thromboembolism (PTE) and deep venous thrombosis (DVT), which are two clinical manifestations of the same disease at different sites and stages. VTE is a common disease with a high mortality rate. In recent years, VTE has attracted more and more attention from medical circles at home and abroad. Statistics from some domestic hospitals show that the number of hospitalized cases and the ratio of disease composition of PTE have a significant increase trend. The data show that the number of symptomatic VTE occurs in more than 1.5 million people every year in Europe, the number of VTE-related deaths is about 543,500 per year, and the number of sudden fatal PTE is 435,000^[1]； The number of cases of VTE in the United States exceeds 2 million each year, with approximately 296 370 VTE-related deaths and 101 032 sudden fatal PTE per year^[2]。 The study of the International Cooperative Register for Pulmonary Embolism showed that the mortality rate of PTE was 11.4% (280/2454) at 2 weeks and 17.4% (426/2454) at 3 months^[3]。 Therefore, it is particularly necessary to make a correct diagnosis of PTE patients, especially early risk stratification, and then standardized treatment to reduce the mortality rate and improve the prognosis. This review aims to summarize the current indexes on PTE risk stratification at home and abroad, so as to suggest clinical.

Tuberculosis has long been one of the global health concerns, with approximately 8.7 million new cases in 2011, and the burden of tuberculosis remains significant^[1]。 The retreatment of tuberculosis is one of the important problems in the field of tuberculosis treatment, but the mechanism of its occurrence is not clear. Biofilm-producing properties of MTB as a potential mechanism for retreatment of tuberculosis formation^[2]。 Bacterial biofilm is a polymer matrix produced by bacteria, which can encapsulate bacterial cells to form special structural communities and adhere to inert or living surfaces^[3]Thus protecting the bacteria from host immunity and drug attack. This study investigated the relationship between the formation of MTB biofilm and the retreatment of tuberculosis and its therapeutic drugs, and provided new ideas for the prevention and treatment of tuberculosis.

Pulmonary alveolar proteinosis (PAP) is a syndrome characterized by abnormal deposition of periodate Schiff (PAS) -stained positive lipoproteins in the alveoli, which is classified into congenital, idiopathic (IPAP) and secondary (SPAP). SPAP cases are rare. At present, the domestic research on SPAP is mainly case reports, and there is no systematic report on SPAP. This study reported two patients with SPAP admitted to the Department of Respiratory Medicine of the First Affiliated Hospital of Guangzhou Medical University from March to September 2012. Combined with the literature review, the clinical data, secondary factors and prognosis of SPAP were analyzed.

In recent years, the basic research, diagnosis and treatment of pulmonary hypertension have made rapid progress. Pulmonary arterial pressure measurement is widely used in the diagnosis, disease and curative effect evaluation of pulmonary hypertension. Clinically, right cardiac catheter and spectral Doppler ultrasound are used to measure pulmonary artery pressure, and Swan-Ganz catheter is used for right cardiac catheter in human and large animals. However, even the smallest floating catheter is still too large in rats. In this study, with reference to relevant data at home and abroad, and combined with the clinical method of human percutaneous transluminal coronary angioplasty (PTCA), the right cardiac catheter is used to measure pulmonary artery pressure in rats.

Since Japanese scholar Shigeru Ikeda introduced fiberoptic bronchoscopy to the world in 1968, bronchoscopy technology has been rapidly popularized in the world, and now it has become an indispensable means of etiological diagnosis and local treatment of respiratory diseases. However, in clinical work, patients have poor tolerance to conventional bronchoscopy, and symptoms such as choking, holding breath, body movement, airway spasm and even hypoxia are prone to occur during the operation. Therefore, post-stimulation stress reactions such as increased blood pressure and rapid heart rate often occur. There are often painful memories after the operation, and most patients are reluctant to undergo multiple operations. Since midazolam and propofol short-acting sedatives have been widely used in critical care departments in the past 10 years and the development of painless gastrointestinal endoscopy, the clinical demand for painless bronchoscopy has also emerged. The American society of anesthesiologists (ASA) grades 3-4 patients are more seriously ill, often with multiple underlying diseases or major organ failure, which increases the risk of painless bronchoscopy. We applied painless bronchoscopy to ASA3-4 patients without artificial airway protection and explored the safety of painless bronchoscopy in such patients.

The patient was a 47-year-old female, farmer. He was admitted to hospital on 30 August 2010 for "intermittent cough with hemoptysis for 15 days". The patient began to cough 15 days ago, coughed a small amount of white sticky sputum, and had two hemoptysis at the beginning of the disease. The local hospital diagnosed pulmonary tuberculosis, and the sputum tuberculosis was negative. He was given isoniazid, rifampicin, ethambutol and pyrazinamide anti-tuberculosis treatment for about 15 days, and there was no hemoptysis again, but the cough did not improve. During the course of the disease, the patient had no fever and night sweats, no fatigue, no chest tightness and shortness of breath, no chest pain, normal defecation, appetite and sleep, and no obvious weight loss. There is no special history in the past, and it is denied that there is a history of hypertension and diabetes, no special contact history, and no familial genetic diseases. Admission physical examination: body temperature 37.2 ℃, pulse 76 beats/min, breathing 19 beats/min, blood pressure 120/80 mm Hg (1 mm Hg =0.133 kPa), weight 60 kg, clear consciousness, good spirits, moderate nutrition, no swelling of superficial lymph nodes in the whole body, no subcutaneous nodules palpable, rosy lips, stable breathing, slightly low breathing sounds in both lungs, no dry or wet rales in both lungs, uniform heart rhythm, soft abdomen, no liver and spleen under the costs, no tenderness and rebound pain, no deformity of joints in the limbs, and no edema in both lower limbs.

Acute exacerbation of chronic obstructive pulmonary disease (COPD) is an acute event in the course of COPD, manifested by worsening of respiratory symptoms beyond the normal daily variation amplitude, requiring a change in the original drug treatment. Acute exacerbation of COPD has a negative impact on the quality of life, accelerates the rate of pulmonary function decline, increases the mortality rate of patients, especially hospitalized patients, and increases the social and economic burden^[1]。 Although in practical clinical work, the vast majority of patients with acute exacerbation of COPD are treated with antibiotics, this approach has always been controversial. With the development of etiology and clinical research of acute exacerbation of COPD, and the accumulation of evidence-based medical evidence, the methods of antibacterial treatment of acute exacerbation of COPD are often revised and adjusted. We introduce the changes of antibacterial treatment strategies for acute exacerbation of COPD in the most influential global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease (referred to as the global strategy for COPD) and the European guidelines for the management of lower respiratory tract infections in adults, and explore their implications for clinical and research work of COPD in China.

The 6th Academic Conference on Chronic Obstructive Pulmonary Disease, jointly sponsored by the Chronic Obstructive Pulmonary Disease (COPD) Group of Respiratory Disease Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Tuberculosis and Respiratory Disease, and co-organized by General Hospital of Ningxia Medical University and Respiratory Disease Branch of Ningxia Medical Association, was held in Yinchuan, Ningxia Hui Autonomous Region from July 26 to 28, 2013. Academician Zhong Nanshan, academician of Chinese Academy of Engineering, and Professor Liu Youning, former chairman of Respiratory Disease Branch of Chinese Medical Association, made important speeches at the opening ceremony. Members of COPD Group of Respiratory Disease Branch of Chinese Medical Association and more than 300 medical and scientific researchers who have been engaged in basic and clinical research of COPD for a long time attended this meeting. The conference invited Professor Qiao Renli of the University of Southern California and Professor Darcy D. Marciniuk of the University of Sasktchewan in Canada to exchange on hot issues related to COPD.

I was particularly happy to read Mu Xinlin and others published in the 9th issue of this journal in 2013^[1]In the novel "Clinical Study on the Screening of Ciliated Columnar Epithelial Cells and Trichomonas cockroach in Bronchoalveolar Lavage Fluid", the author conducted a very detailed morphological and ultrastructural study on the active cells with cilia at the apex in BALF of 6 patients with different lung diseases (excluding "Trichomonas cockroach pulmonary infection"), and confirmed that they were bronchial ciliated epithelial cells, and questioned the vast majority of cases of Trichomonas cockroach pulmonary infection reported in China, believing that flagellar cells found in BALF or sputum as the main diagnostic basis were not Trichomonas cockroach, let alone the diagnosis of pulmonary infection caused by Trichomonas cockroach. This is recommended in the magazine's "Introduction to this issue" and the article's "Editor's Note". This once again aroused my interest in the "cold case" of "Trichomonas cockroach lung infection".

Time is like running water, and the dead are like husbands. Sixty years have passed since the publication of this journal in 1953. I would like to thank all the readers, authors and editors who have cared, supported and helped us over these sixty years. This issue sets up a column to commemorate the 60th anniversary of its founding. At the beginning, Professor Zhong Nanshan and Professor Liu Youning personally wrote a commemorative manuscript "Riding the Wind and Waves for Sixty Years", recalling the development and changes of this journal in the past 60 years, reviewing the history accompanied by glory in hardships, looking forward to the future shining with hope in thorns, recalling the turbulent years of the past, and looking forward to the glorious future. Li Wenhui, director of the editorial department of this magazine, edited and reviewed the manuscript "Breathing for 60 years, passing on the fire from generation to generation for a hundred years". He recalled the footprints and achievements of this magazine in the past 60 years since its inception. On behalf of all members of the editorial department of this magazine, he would like to express his sincerest thanks and highest respect to all colleagues, leaders at all levels, successive editors in chief and editorial board, reviewers, readers and authors who have made great contributions to Chinese Journal of Tuberculosis and Respiration. At the beginning of its publication, it was the Chinese Journal of Tuberculosis. In this commemorative column, Professor Tu Dehua, Professor Xiao Heping and Professor He Ya, Professor Zhang Zongde and Professor Liu Fei recalled the development of the discipline in the past 60 years from the aspects of chemotherapy, prevention and control and basic research of tuberculosis, and looked forward to the future of tuberculosis treatment and prevention and control. The subject review and prospect written by the Infectious Disease Group, Lung Cancer Group, China Lung Cancer Prevention and Control Alliance, Chronic Obstructive Pulmonary Disease Group, Asthma Group, Interstitial Pulmonary Disease Group, Critical Care Medicine Group, Sleep Apnea Group, Pulmonary Embolism and Pulmonary Vascular Disease Group and Interventional Respiratory Disease Group of Chinese Medical Association respectively launched a wonderful historical picture from the perspective of the development of various disciplines. "Analysis of Articles Published in Chinese Journal of Tuberculosis and Respiration from 2003 to 2012", compiled and written by Lu Xiaodong and others from the editorial department of this journal, lists the specific information of the manuscripts reported in this journal in the past 10 years, and carries out data analysis, with detailed content. On the occasion of the 60th anniversary of the publication of this journal, Professor Shi Siren is impressed by the development of respiratory interventional diagnosis and treatment in recent years. The special manuscript recalls the whole process of his first interventional treatment of lung diseases 50 years ago. The historical materials are precious and worth reading.