2019年 · 第42卷第04期

In this issue, please focus on the "Chinese Expert Consensus on the Standardized Application of Inhalation Devices for Chronic Airway Diseases in Stable Phase" published in the "Diagnosis and Treatment Plan" column. Chronic airway diseases represented by chronic obstructive pulmonary disease (COPD) and bronchial asthma (asthma) are a major challenge for disease prevention and control in China at this stage. This consensus first introduces the severe situation of COPD and asthma prevention and control in China, emphasizing that inhalation therapy is the first-line basic treatment for chronic airway diseases; Then it briefly introduces the anatomical physiology and aerodynamic principles of inhalation therapy, and then focuses on the characteristics of inhalation devices and their standard use methods, including pressurized metered dose inhaler (pMDI), dry powder inhaler (DPI), soft mist inhaler (SMI) and small volume nebulizer (SVN). Finally, the consensus emphasizes the decisive role of medical staff in the efficacy of inhalation therapy.

Acute respiratory distress syndrome (ARDS) is the main cause of acute respiratory failure, in which the disruption of pulmonary microvascular endothelial barrier function is the main pathophysiological mechanism of ARDS, which is closely related to fluid accumulation and leukocyte extravasation into the alveolar space. At present, the morbidity and mortality of ARDS are still very high, so it is necessary to further explore the internal mechanism of its occurrence and development. The results of previous studies confirmed that RAB26 can coordinate the transport of ADRA2A from the Golgi apparatus to the cell membrane surface through the interaction with adrenaline receptor α 2a (ADRA2A). During the inflammatory response, ADRA2A-mediated maintenance of endothelial cell adhesion junction stability can prevent neutrophil extravasation. Therefore, we speculated that RAB26 may play a positive protective role in ARDS.