ObjectiveTo enhance the cognition about the clinical characteristics of diffuse panbronchiolitis (DPB). MethodsThe data of patients with DPB searched out on the computer from January 1996 to September 2013 were retrospectively studied. ResultsThe 91 patients had a male to female ratio of 2︰1, and the mean age at onset was (40.5± 18.4) years old. The median course of disease was 7 years. The main clinical profiles included chronic cough, sputum production, exertional dyspnea, and crackles. A history of sinusitis occurred in 90.1% (82/91) of the patients. Positive rate of cold hemoagglutinin and HLA-B54 were 46.1% (30/65) and 42.1% (8/19), respectively. All patients' CT scans showed bilateral, diffuse, small centrilobular nodules. Lung function assessment showed an obstructive ventilation disfunction in 60.0% (51/85) of the patients and a mixed obstructive-restrictive pattern in 36.5% (31/85) of the patients. Thirty-four patients underwent lung biopsy. A total of 65.9% (60/91) of the patients had been misdiagnosed, and 98.8% (84/85) of the patients achieved significant improvement after the macrolide therapy. ConclusionDPB is not rare in China, but tends to be misdiagnosed or underdiagnosed. Macrolides can improve the prognosis of DPB.
Objective To evaluate systematically the effect of antibiotic treatment on ventilator-associated tracheobronchitis (VAT). Methods Pubmed,Web of Science,OVID SP (ACP Journal Club,Cochrane Central Register of Contralled Trials,Embase,Medline),as well as China National Knowledge Infrastructure,China Science and Technology Journal Database,and Wanfang Data were searched for literatures about antibiotic treatment on VAT.The search deadline was March 2016.Meta-analysis was conducted with RevMan 5.3 software. Results A total of 6 studies with 769 patients were included.Among 769 patients,432 patients were treated by antibiotics,and 337 patients in control group were treated without antibiotics.Meta-analysis showed antibiotics treatment significantly reduced incidence of ventilator-associated pneumonia compared with control group [OR=0.27,95%CI (0.17,0.43),P<0.05],and shortened length of ICU stay [MD -1.51,95%CI(-2.04,-0.98),P<0.00001] .There were no significant difference in duration of mechanical ventilation [MD -2.52,95%CI (-6.85,1.81),P=0.25],mortality [OR=0.41,95%CI(0.15,1.14),P=0.09],or drug-resistant bacteria production [OR=0.62,95%CI(0.17,2.19),P>0.05]. Conclusions Antibiotic treatment can reduce incidence of ventilator-associated pneumonia in patients with VAT.Further more high quality randomized controlled trials are needed to assess the effect of antibiotic treatment on VAT.