ObjectiveTo observe repairing process of trachea epithelium cells in chlorine-induced airway epithelial injury.MethodsTwelve mice were exposed to chlorine gas and prepared the mice model of airway damage. Three mice were executed respectively on 2nd, 4th, 7th, 10th day after exposure to chlorine gas, and tracheal tissues were collected. In addition 3 normal mice served as control. Airway repair and cell proliferation were detected by EdU labeling method. The basal cell markers keratin 5 (K5), keratin 14 (K14) were adopted as the tracheal epithelial markers for locating the position of the proliferation of repairing cells. Morphological analysis was adopted to measure the proliferation rate as well as the recovery of the false stratified epithelium.ResultsIn the control group, cell proliferation rate was very low, all basal cells expressed K5, and most basal cells did not express K14. Most of epithelial cells shed from the trachea epithelium after exposure to chlorine gas. 2-4 days after chlorine exposure, K5 and K14 expression basal cells increased, K14 expression cells increased greatly. In the peak period of cell proliferation, only a small number of ciliated cells appeared in the repairing trachea area. Epithelial cells repaired fast and widely at the bottom of the trachea.ConclusionThe trachea residual basal cells play roles of progenitor cells and repair the airway epithelium after chlorine damage in mice.
ObjectiveTo investigate the risk factors, prognostic factors and prognosis of Multidrug-Resistant Acinetobacter Baumannii (MDR-AB) infection of lower respiratory tract in Intensive Care Unit (ICU) of the Second Affiliated Hospital of Anhui Medical University. MethodsUsing retrospective analysis, we reviewed and compared clinical data of 77 AB infections in lower respiratory tract cases in ICU from January 2013 to March 2015. According to the resistance, patients were divided into a MDR-AB group and a NMDR-AB group. Then the risk factors, prognostic factors and prognosis of MDR-AB infection were analyzed. ResultsA total of 58 cases in the MDR-AB group, 19 cases in the NMDR-AB group were included. The result showed that, the MDR-AB infection in lower respiratory tract could significantly prolong the length of ICU stay (18.5±16.0 vs. 10.6±9.3 days, P<0.05) and increase the mortality (44.8% vs. 11.1%, P<0.01). Logistic regression analysis showed that the independent risk factors for MDR-AB infection in lower respiratory tract included Acute Physiology and Chronic Health Evaluation Ⅱ (Apache Ⅱ) score >15 (OR=0.138, 95%CI 0.03 to 0.625, P=0.01) and use of carbapenems (OR=0.066, 95%CI 0.012 to 0.0346, P=0.001). The independent prognostic factors included placement of drainage tube (OR=8.743, 95%CI 1.528 to 50.018, P=0.015) and use of vasoactive drugs (OR=12.227, 95%CI 2.817 to 53.074, P=0.001). ConclusionThe MDR-AB infection in lower respiratory tract can significantly prolong the length of ICU stay and increase the mortality. The Apache Ⅱ score >15 and use of carbapenems are the risk factors, and the placement of drainage tube and use of vasoactive drugs can increase the mortality of MDR-AB infection of lower respiratory tract in ICU.
Objective To analysis the risk factors for lower airway bacteria colonization and ventilator-associated pneumonia ( VAP) in mechanically ventilated patients. Methods A prospective observational cohort study was conducted in intensive care unit. 78 adult inpatients who underwent mechanical ventilation( MV) through oral endotracheal intubation between June 2007 and May 2010 were recruited. Samples were obtained from tracheobronchial tree immediately after admission to ICU and endotracheal intubation( ETI) , and afterward twice weekly. The patients were divided naturally into three groups according to airway bacterial colonization. Their baseline characteristics, APACHEⅡ score, intubation status and therapeutic interventions, etc. were recorded and analyzed. Results In the total 78 ventilated patients, the incidence of lower airway colonization and VAP was 83. 3% and 23. 1% , respectively. The plasma albumin( ALB) ≤29. 6 g/L( P lt; 0. 05) , intubation attempts gt; 1( P lt; 0. 01) were risk factors for lower airway colonization. In the patients with lower airway colonization, preventive antibiotic treatment, applying glucocorticoid and prealbumin( PA) ≤ 69. 7 mg/L were risk factors for VAP ( P lt; 0. 05) . Conclusions The risk factors for lower airway colonization in ventilated patients were ALB≤29. 6 g/L and intubation attempts gt; 1. And for lower airway colonized patients, PA ≤ 69. 7 mg/L, preventive antibiotic treatment and applying glucocorticoid were risk factors for VAP.
Objective To investigate the causal relationship between 91 circulating inflammatory proteins and respiratory tract infection by bidirectional Mendelian randomization. Methods single nucleotide polymorphisms (SNPs) for 91 inflammatory circulating proteins were derived from GWAS data from a genome-wide association study of 14 824 subjects of European ancestry on the Olink Target platform, and SNPs for acute bronchitis, acute bronchiolitis, and acute laryngitis and tracheitis were derived from GWAS pooled data in the FinnGen database. Inverse variance weighting method was used as the main research method to conduct bidirectional Mendelian randomization analysis, and Cochran’ IVW Q test, MR-Egger regression method and one by one elimination method were used to conduct sensitivity tests to evaluate heterogeneity and horizontal pleiotropy. In order to reduce the incidence of Class I errors and improve the feasibility of the study, Bonferroni correction was performed.ResultsLevels of C hemokine C-X-C motif ligand 6 (CXCL6), matrix metalloproteinase-1 (MMP-1), hepatocyte growth factor (HGF), interleukin-10 (IL-10), chemokine C-X3-C motif ligand 1 (CX3CL1), and TNF-related activation-induced cytokine (TRANCE) were causally associated with acute bronchitis. MMP-1 level [OR: 1.239 0, 95%CI: 1.111 6-1.382 2, P<0.000 5] had a significant causal relationship with acute bronchitiss and played a promoting role. Levels of macrophage inflammatory protein-1α (MIP-1α), signaling lymphocyte activating molecules, and FMS-associated tyrosine kinase 3 ligand (FIt3L) were potentially causally associated with acute bronchiolitis. There was a potential causal relationship between C-X-C motif chemokine 5 (CXCL5), T cell surface glycoprotein CD6 subtype (CD6), fibroblast growth factor 19 (FGF-19), C-C motif chemokine 23 (CCL23), monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor ligand superfamily member 12 (TNFSF12) levels and acute laryngitis and tracheitis. In reverse Mendelian randomization analysis, there were no positive results between acute bronchitis, acute bronchiolitis and 91 inflammatory factors. Acute laryngitis and tracheitis [OR: 1.076 3,95%CI: 1.012 9-1.143 7, P=0.017 6] were potentially causally associated with FGF-19 levels. Conclusions MMP-1 level have a significant causal relationship with acute bronchitis. The levels of other inflammatory factors such as CXCL6, HGF, MIP-1 alpha, FIt3L, CXCL5, FGF-19 are potentially causally associated with respiratory tract infections. MMP-1 may be an important target for the prediction or treatment of acute bronchitis.
ObjectiveTo systematically review the protective effect of serum maternal respiratory syncytial virus (RSV) antibodies on infants with RSV infection. MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI and WanFang Data databases were electronically searched to collect observational studies on the correlation between serum maternal RSV antibodies and infants with RSV infection from inception to July 18, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies, then, qualitative analysis was performed. ResultsA total of 19 studies were included, and 60% of those studies suggested that a higher level of maternal antibodies could prevent RSV infection. However, the remaining 40% of them showed that there was no significant difference in the level of RSV maternal antibodies between the infected group and the non-infected group. Further more, in the studies of the correlation between maternal antibody level and disease severity after RSV infection, 55% of those showed that maternal antibody level was negatively correlated with disease severity. ConclusionThe protective effect of serum maternal RSV antibodies on infants reported in different studies varies. Whether it can prevent RSV infection and affect the severity of RSV infected children still needs to be explored.
【Abstract】 Objective To investigate the effects of respiratory syncytial virus ( RSV) infection on the dynamic changes of airway hyperresponsiveness ( AHR) in ovalbumin ( OVA) -induced asthma in mice.Methods 60 BALB/c female mice were randomly divided into PBS control group ( A group, n = 6) , OVA group, OVA/RSV group, dexamethasone group ( D group, n =6) . Kinetics of AHR of OVA group mice was carried out on day 21, 25, 29 and 33 ( B1, B2, B3, B4 groups, n =6) , and the same with the OVA /RSV group( C1, C2, C3, C4 groups, n = 6 ) . The mouse asthma model was established by OVA-sensitization of intraperitoneal injection and repeated inhalation of OVA while the mice in OVA/RSV group were treated with combined intranasal inoculation with RSV ( 1. 0 ×106 pfu/mL in 50 μL) . Airway resistance of expiringphase ( RL ) and compliance of throax and lung ( CTL ) with different doses of acetylcholine ( Ach) were measured. Lung tissue sections were stained with hematoxylin and eosin ( HE) and periodic acid-Schiff ( PAS) for general morphology. Results Compared with B1 group, RL increased and CTL decreased in C1 group when Ach dose is above 5 g/L ( P lt; 0. 05, respectively) , and the effects prolonged ( 6 d, 10 d after challenge with OVA, respectively) much more than B1 group ( 2 d after challenge with OVA) . Compared with C1 group, RL decreased and CTL increased in D group and the infiltration of inflammatory cells was obviously alleviated in C1 group after treatment with dexamethasone. Conclusions Airway hyperresponsiveness increases obviously in OVA-sensitized and RSV-infected mice. The prolonged increase inRL and decrease in CTL ( 6 d, 10 d, respectively) may imply that RSV infection aggravates airway inflammation. The small airway inflammation may play a critical role in the persistence of airway hyperresponsiveness.
Objective To evaluate the safety and efficacy of Jinlianqingre capsule in treatment of acute upper respiratory tract infection （external wind-heat syndrome）. Methods A multi center, double-blind, double dummy, randomized controlled trial was conducted. A total of 226 patients with acute upper respiratory tract infection were randomized into two groups：the trial group （116 patients）received Jinlianqingre capsule and the control group （110 patients） received Jinlianqingre granule. The therapeutic courses of both groups were 3 days. Results The total significant effective rates and the total effective rates of acute upper respiratory tract infection were 66.38 % and 95.69% in the trial group respectively, and 60.91% and 95.45% in the control group respectively. There were no statistical differences between the two groups （P 〉0.05）. The total significant effective rates and the total effective rates of Chinese medicine symptoms were 70.69% and 97.41% in the trial group respectively, and 69.09% and 93.64% in the control group respectively. There were no statistical differences between the two groups （P 〉0.05）. Besides, the efficacy of Jinlianqingre capsule was better than that of Jinlianqingre granule with respect to fever duration after treatment; there were statistical differences between the two groups （P〈0. 05 ）. No adverse effects were found in the trial group. Conclusions Jinlianqingre capsule is effective and safe in treatment of acute upper respiratory tract infection （external wind-heat syndrome）.
Objective To evaluate the clinical efficacy and safety of pazufloxacin for the treatment of moderate and severe acute bacterial respiratory infections.Methods A multicenter randomized controlled trial was conducted to compare the efficacy and safety of pazufloxacin versus levofloxacin. Patients in the pazufloxacin group were treated with pazufloxacin (500 mg twice daily for 7 to 10 days), and patients in the levofloxacin group were treated with levofloxacin (300 mg twice daily for 7 to 10 days). Results A total of 134 patients were enrolled in the study, 68 cases in pazufloxacin group and 66 cases in levofloxacin group were assessable for clinical efficacy by full analysis set(FAS). At the end of the treatment, in FAS analysis the total cure rates and effective rates were 52.9% and 86.7% in pazufloxacin group, 57.6% and 87.9% in levofloxacin group, in PPS analysis the total cure rats and effective rates were 57.1% and 93.7% in pazufloxacin group respectively, 61.3% and 93.6% in levofloxacin group. The bacterial clearance rates were 92.5% and 94.3% respectively. There were no statistically significant differences between the two groups. Adverse reactions were observed in 16.2% of patients in the pazufloxacin group and in 16.7% of patients in the levofloxacin group. These reactions were mainly local stimulation, nausea and diarrhea. No serious adverse event was reported in either group. Conclusion Pazufloxacin is as effective and safe as levofloxacin for the treatment of moderate to severe acute respiratory infections.
Objective To understand the changing patterns and characteristics of the number of patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) before, during, and in the post-epidemic period of the COVID-19 pandemic and the Association between acute respiratory infections and hospitalization of patients with AECOPD. Methods A retrospective analysis was conducted to count the patients hospitalized for AECOPD in the Department of Respiratory Medicine of the Third Affiliated Hospital of Chongqing Medical University from July 2017 to June 2024. The pattern of change in the number of AECOPD hospitalizations and the associations with patients with respiratory tract infections in outpatient emergency departments were analyzed. Results During the COVID-19 epidemic, the number of hospitalizations of patients with AECOPD did not increase compared with the pre-epidemic period. Instead, it significantly decreased, especially in the winter and spring peaks (P<0.05). The only exception was a peak AECOPD hospitalization in the summer of 2022. COPD inpatient mortality and non-medical discharge rates tended to increase during the epidemic compared with the pre-epidemic period. Analysis of the curve of change in the number of patients with respiratory infections in our outpatient emergency departments during the same period revealed a downward trend in the number of patients with respiratory infections during the epidemic and an explosive increase in the number of patients with respiratory infections in the post epidemic period, whose average monthly number was more than twice as high as that during the epidemic. Correlation analysis of the number of patients with respiratory infections between AECOPD hospitalizations and outpatient emergency departments showed that there was a good correlation between the two in the pre-epidemic and post-epidemic periods, and the correlation between the two in the post-epidemic period was more significant in particular (r=0.84-0.91, P<0.001).In contrast, there was no significant correlation in 2021 and 2022 during the epidemic (r=0.24 and 0.50, P>0.05 ). The most common respiratory infection pathogens among AECOPD hospitalized patients during the post-epidemic period were influenza virus, COVID-19 virus, and human rhinovirus, respectively. Conclusions The pandemic period of COVID-19 infection did not show an increase in the number of AECOPD hospitalizations but rather a trend towards fewer hospitalizations. Respiratory infections were strongly associated with the number of AECOPD hospitalizations in the pre- and post-pandemic periods, while the correlation between the two was poorer during the pandemic period. Influenza virus was the most important respiratory infection pathogen for AECOPD during the post-epidemic period.
ObjectiveTo evaluate clinical efficacy of mannatide for recurrent respiratory tract infection (RRTI) and its influence on immune function. MethodsThe Cochrane Library (Issue 12, 2013), PubMed, EMbase, CNKI, CBM, VIP and WanFang Data were searched for the randomized controlled trials (RCTs) that investigated the clinical and immune effect of mannatide in RRTI from inception to December 2013. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of included studies. Then meta-analysis was performed using the software RevMan 5.1.0. ResultsA total of 18 studies involving 1 481 patients were included. The results of meta-analysis showed that compared with the placebo group, the mannatide group was superior in total effectiveness and improving the levels of T-lymphocyte subsets and antibody (P < 0.05); compared with the levomisole group, the mannatide group was superior in total effectiveness and improving the level of T-lymphocyte subsets (P < 0.05), but not in improveming antibody level. ConclusionMannatide improves clinical efficacy in the treatment of RRTI and patients' immune function.