急性肺损伤（ALI）和急性呼吸窘迫综合征（ARDS）是临床常见的危重病症，是指非心源性的各种肺内外因素导致的急性进行性呼吸衰竭，临床上以呼吸窘迫，顽固性低氧血症和非心源性肺水肿为特征。急性呼吸窘迫综合征是急性肺损伤的严重阶段。肺微血管通透性增高而导致的肺泡渗出液中富含蛋白质的肺水肿及透明膜形成，并伴有肺间质纤维化由肺内炎症细胞为主导的肺内炎症失控导致的肺泡毛细血管膜损伤形成肺水肿是其共同的病理特征。因此是否能有效清除肺泡内过多液体，维持肺泡腔内相对干燥的环境，对于有效的气体交换具有十分重要的意义，并且在一定程度上决定了病情的转归[1]。
Extrinsic allergic alveolitis is a general term for type Ⅲ or Ⅳ allergic pneumonia caused by repeated inhalation of various antigenic organic dusts and low molecular weight chemicals in susceptible people. The lesions involve alveolar, pulmonary interstitial, and airway. The main clinical manifestations are cough, expectoration, and dyspnea. Clinically, extrinsic allergic alveolitis is classified into acute, subacute, and chronic forms. Extrinsic allergic alveolitis has a great impact on the pulmonary function of patients. Timely treatment will improve clinical symptoms and inhibit the development of disease. The current treatment plan is mainly avoiding exposure to antigen, glucocorticoid therapy, immunosuppressive therapy, anti-fibrotic therapy, and lung transplantation.
Objective To evaluate the efficacy and safety of local triamcinolone combined with conventional interventional therapy in the treatment of benign airway stenosis. Methods PubMed, Cochrane Library, EMbase, Web of science, wanfang, VIP and China National Knowledge Infrastructure were searched by computer between the establishment of the database and August, 2019, and all literatures on the local treatment of benign airway stenosis using triamcinolone combined with conventional interventional therapy were searched. According to inclusion and exclusion criteria, 2 researchers screened the literatures and performed the data extraction and methodological quality evaluation. Meta-analysis was performed with Revman5.2 and Stata software. Results In total, nine randomized controlled trials were included in this meta-analysis, including 449 patients with airway stenosis. The total result showed that in the comparison of short-term efficacy, there were no statistically significant differences in breathability score (SMD=–0.16, 95%CI –0.45 - 0.13, P=0.27), airway diameter (SMD=0.14, 95%CI –0.13 - 0.41, P=0.30), and cross-sectional stenosis rate (SMD=–0.01, 95%CI –0.36 - 0.34, P=0.96) between the treatment group and the control group. In the comparison of long-term efficacy, the breathability score (SMD=–2.53, 95%CI –3.78 - –1.28, P<0.05), airway diameter (SMD=1.31, 95%CI 0.83 - 1.78, P<0.05), cross-sectional stenosis rate (SMD=2.58, 95%CI: 2.11~3.08, P<0.05), and FEV1(SMD=0.42, 95%CI 0.13 - 0.70, P=0.004) of patients in the treatment group were all better than those in the control group. But in terms of adverse reactions, the incidence of bleeding in the airway between two groups was similar (RR=2.00, 95%CI 0.88 - 4.52, P=0.10), other adverse reactions such as blood glucose and plasma cortisol levels were mild, which can be relieved symptomatically. Conclusion Current evidence suggests that topical triamcinolone combined with conventional interventional therapy for benign airway stenosis has a better long-term clinical efficacy with fewer adverse reactions and better overall patient tolerance, which has clinical application value
【摘要】 目的 研究合并2型糖尿病的冠心病患者冠状动脉病变程度与血清视黄醇结合蛋白4（retinol-binding protein 4，RBP4）水平的相关性。 方法 2008年10月-2010年4月选择性冠状动脉造影确诊的冠心病患者共120例，分为单纯冠心病组（A组）60例和冠心病合并糖尿病组（B组）60例，检测血糖、血脂、胰岛素以及脂联素、RBP4水平；根据冠状动脉造影结果，以Gensini评分评判冠状动脉病变程度。 结果 B组空腹血糖、胰岛素、RBP4均显著高于A组（Plt;0.05）；冠状动脉病变程度更重（Plt;0.05）。相关性分析显示RBP4水平与低密度脂蛋白胆固醇、胰岛素抵抗和冠状动脉病变积分呈正相关（r=0.312、0.322、0.314，Plt;0.05）。与脂联素水平呈负相关（r=-0.362，Plt;0.01）。 结论 冠心病合并2型糖尿病患者RBP4明显升高，且与冠状动脉狭窄程度呈正相关。【Abstract】 Objective To explore the relationship between the level of serum retinol-binding protein 4 (RBP4) and the extent of coronary lesions in coronary heart disease (CHD) patients accompanied with type 2 diabetes mellitus (T2DM). Methods A total of 120 patients with CHD diagnosed by coronary arteriongraphy between October 2008 and April 2010 were enrolled. The patients were divided into two groups: CHD group (60 patients); CHD accompanied with T2DM group (60 patients). The levels of serum insulin, adiponectin and RBP4 were measured. All the patients underwent coronary angiography and the extent of coronary lesions was assessed quantitatively based on the Gensini′s scoring system. Results The levels of serum insulin, plasma RBP4 and the extent of coronary artery stenosis in CHD accompanied with T2DM group were significantly higher than those in CHD group (Plt;0.05). Correlation analysis showed that the level of RBP4 was positively correlated with LDL-C, insulin resistance index and the coronary artery narrow degree（r=0.312, 0.322, 0.314; Plt;0.05); and negatively correlated with adiponectin (r=-0.362, Plt;0.01). Conclusion The significant elevated plasma RBP4 in CHD patients accompanied with T2DM is positively correlated with the extent of coronary artery lesion.
Three-dimensional (3D) cell culture model is a system that co-culture carriers with 3D structural materials and different types of cells in vitro to simulate the microenvironment in vivo. This novel cell culture model has been proved to be close to the natural system in vivo. In the process of cell attachment, migration, mitosis and apoptosis, it could produce biological reactions different from that of monolayer cell culture. Therefore, it can be used as an ideal model to evaluate the dynamic pharmacological effects of active substances and the metastasis process of cancer cells. This paper compared and analyzed the different characteristics of cell growth and development under two-dimensional (2D) and 3D model culture and introduced the establishment method of 3D cell model. The application progress of 3D cell culture technology in tumor model and intestinal absorption model was summarized. Finally, the application prospect of 3D cell model in the evaluation and screening of active substance was revealed. This review is expected to provide reference for the development and application of new 3D cell culture models.
ObjectiveTo analyze the effects of alcohol consumption on oral flora of middle-aged and elderly men from the core area of southwestern China, and explore the relationship between excessive-alcohol-consumption-related flora and alcohol-related cancer.MethodsFrom March to June 2018, saliva samples of target subjects were collected for 16S ribosomal RNA gene sequencing, and a questionnaire survey which took drinking history of each participant as the target variable was conducted. According to the amount of alcohol consumed, the subjects were divided into non-drinking group, moderate-drinking group, and excessive-drinking group. The microbial analysis of α diversity, analysis of group difference of oral flora abundance, bacterial function prediction, and receiver operating characteristic (ROC) curve model prediction were carried out.ResultsA total of 59 subjects were included. There were 23 cases (39.0%) in the non-drinking group, 23 cases (39.0%) in the moderate-drinking group, and 13 cases (22.0%) in the excessive-drinking group. The average age was (61.90±8.85) years. Excessive drinking increased the abundance of oral flora (P<0.05), and could change the abundance of specific genus such as Peptostreptococcus and TM7［G-6］ (P<0.05) and regulate cancer-related pathways (P<0.05). ROC analysis found that a panel of three genus oral bacteria such as TM7［G-6］ might effectively distinguish the non-drinking group from the excessive-drinking group (area under curve=0.915).ConclusionsGenus of Peptostreptococcus and TM7_［G-6］ are the potential oral flora biomarkers for the excessive-drinking of target subjects. Some excessive drinking-related flora are closely related to oral cancer.