简介：Therespiratorysystemhastwoprincipalpurposes-tomaintainadequatearterialPaO2,andtoregulatearterialPaCO2andtherebymaintainastableacid-basestate.Botharenecessarytosustainnormaltissuemetabolism.Respiratoryfailurecanbedefinedintwoways:

简介：Theprimarysymptomsofrespiratorydisordersarebreathlessness,chestpainandcough,whichmaybeassociatedwithsputumproduction.However,disordersofthelungscanproducedistantsymptoms(e.g.non-metastaticmanifestationsoflungcancer),andnon-respiratoryconditionssuchasanaemiaandmetabolicacidosscancauseberathlessness.Adequateassessmentofanypatientrequiresafullclinicalhistoryandexamination.Thiscontributionconsidersaspectsdirectlyrelevanttotherespiratorysystem.

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简介：AbstractThe current literature lacks strong guidelines regarding surgical management of patients with aspirin-exacerbated respiratory disease (AERD), who present with the clinical triad of chronic rhinosinusitis with nasal polyposis (CRSwNP), bronchial asthma, and aspirin/nonsteroidal anti-inflammatory drug intolerance. To further define the effectiveness of sinus surgery in treating AERD patients, this review article discusses current evidence regarding outcomes associated with more extensive surgery, the benefits of frontal sinus surgery on polyposis, and the role of Draf III intervention. Numerous studies suggest that Draf III frontal sinusotomy may be an efficacious early intervention due to increased neo-ostial patency and subsequent distribution of topical therapies. Future studies that further investigate the efficacy and safety of extensive surgery in AERD patients are warranted.

简介：Thepurposeofthisstudyistodistinguishrespiratorysyncytialvirus(RSV)infectionandimmunologybetweenimmunocompetentandimmunocompromisedmurineandtoexploreimmunemechanismofRSVinfection.AtvarioustimepointsafterRSVinfectionofBALB/cmiceandnudemice,pulmonaryviraltiterswereassayed,RSVantigenwastestedbydirectimmune-fluorescentassayandimmunohistochemistry.PulmonarymRNAexpressionsofTolllikereceptor(TLR)2andTLR4wereassayedbyRT-PCR.CD4+cellsandCD8+cellsinperipheralbloodwereexaminedbyflowcytometryandplasmatotalIgEwasassayedbyELISA.Leukocytesinbronchoalveolarlavagefluid(BALF)andpulmonaryhistologywereidentifiedtoreflectairwayinflammation.ItwasfoundthatRSVtitersofbothmicepeakedonthe3rddaypostinfectionwithamuchhigherlevelofviraltiterinnudemicethaninBALB/cmiceandalongerviraldurationinnudemice(over9dayspostinfection)thaninBALB/cmice(6dayspostinfection).RSVinfectioninducedhigherviralantigenexpressioninnudemice(0.267±0.045)thaninBALB/cmice(0.168±0.031).RSVinfectionenhancedpulmonaryTLR4expressionofBALB/cmice(51.96%±11.34%)andnudemice(48.96%±12.35%)comparedwitheachcontrol(34.04%±10.06%and32.37%±9.87%respectively).CD4+peripheralbloodcellsincreasedinRSVinfectedBALB/cmice(66.51%±2.09%)comparedwiththecontrolBALB/cmice(51.63%±5.90%),andCD4+cellsandCD8+cellsweredeficientinnudemice.RSVinfectionincreasedplasmatotalIgEinbothmice,andBALB/cmicehadalargeramountofIgEonthe7thdaypostinfection(9.02ng/ml±2.90ng/ml)andonthe14thdaypostinfection(12.76ng/ml±4.15ng/ml)thancorrespondingnudemice(3.72ng/ml±1.06ng/mland7.62ng/ml±3.08ng/mlrespectivelyonthe7thand14thdaypostinfection).RSVinfectednudemicehadmoresevereairwayinflammationthaninfectedBALB/cmice.ItisconcludedthatBALB/cmiceandnudemicepresentedsimilarRSVinfectiouscharacteristics.However,

简介：AbstractAcute respiratory distress syndrome (ARDS) is one of the most common severe diseases seen in the clinical setting. With the continuous exploration of ARDS in recent decades, the understanding of ARDS has improved. ARDS is not a simple lung disease but a clinical syndrome with various etiologies and pathophysiological changes. However, in the intensive care unit, ARDS often occurs a few days after primary lung injury or after a few days of treatment for other severe extrapulmonary diseases. Under such conditions, ARDS often progresses rapidly to severe ARDS and is difficult to treat. The occurrence and development of ARDS in these circumstances are thus not related to primary lung injury; the real cause of ARDS may be the "second hit" caused by inappropriate treatment. In view of the limited effective treatments for ARDS, the strategic focus has shifted to identifying potential or high-risk ARDS patients during the early stages of the disease and implementing treatment strategies aimed at reducing ARDS and related organ failure. Future research should focus on the prevention of ARDS.

简介：Background:InJapan,studiesonacupuncturetherapyforrespiratorydiseasehaverarelybeenreported.Additionally,mostofthereportsaredifficultforoverseasresearcherstoaccessbecausetheyarewritteninJapaneseandcannotbelocatedusingMedline.Purpose:ToreviewstudiesonacupunctureandmoxibustiontherapyforrespiratorydiseaseconductedinJapan.Datasources:Theresultsofaliteraturesearchusing'IgakuChuoZasshiWeb'andtheMedicalOnlineLibrary,bothofwhichareJapanesedatabases,coveringtheperiodbetween1979and2006.Studyselection:Thisstudyreviewedreferencescitedinretrieveddocumentsand

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简介：AbstractAspirin-exacerbated respiratory disease (AERD) is frequently diagnosed in patients with severe type 2 airway inflammation presenting with nasal polyps and severe asthma. It has been associated with a recalcitrant course with high medical and surgical requirements. The advent of recent biological and other targeted treatments show promise in the medical management of patient with AERD. The goal of complete disease control where patients no longer require recurrent surgical procedures, systemic corticosteroid exposure and may live with a stable and relatively normal quality of life is now within reach. Further work is necessary to identify biomarkers predictive of treatment response.

简介：AbstractImportance:Acute respiratory infections are quite prevalent in children. Transient hyperphosphatasemia (TH) is defined as the transient elevation of serum alkaline phosphatase (ALP) level, which occurs mainly in infants and children without liver or bone disorders. Although no apparent cause has been identified, a possible association of respiratory infections with TH has been reported in the literature.Objective:In this study, we aimed to investigate the association between TH and respiratory infectious diseases.Methods:We collected the results of biochemical investigations, including ALP level, for a period of 5 years in our hospital. We then examined the patients with transiently elevated ALP levels of > 2000 U/L.Results:During the observation period, 1501 blood samples were collected from 1097 patients. Marked elevation of serum ALP level was observed in 12 patients. All patients with hyperphosphatasemia, except for one with Fanconi syndrome attributable to the underlying Wilson’s disease, were aged < 5 years and were diagnosed with TH. Ten of these 11 patients with TH had acute respiratory infections. Marked ALP elevation was not found in any patients with non-inflammatory diseases. ALP isoenzyme profiles showed a characteristic pattern in all six patients in whom the ALP isoenzyme test was conducted.Interpretation:Our results suggest an association between respiratory infections and TH. The consideration of TH in patients with acute respiratory infections may lead to earlier and accurate diagnosis of this condition, thereby avoiding unnecessary medical interventions.

简介：AbstractNeurocritical care (NCC) is not only generally guided by principles of general intensive care, but also directed by specific goals and methods. This review summarizes the common pulmonary diseases and pathophysiology affecting NCC patients and the progress made in strategies of respiratory support in NCC. This review highlights the possible interactions and pathways that have been revealed between neurological injuries and respiratory diseases, including the catecholamine pathway, systemic inflammatory reactions, adrenergic hypersensitivity, and dopaminergic signaling. Pulmonary complications of neurocritical patients include pneumonia, neurological pulmonary edema, and respiratory distress. Specific aspects of respiratory management include prioritizing the protection of the brain, and the goal of respiratory management is to avoid inappropriate blood gas composition levels and intracranial hypertension. Compared with the traditional mode of protective mechanical ventilation with low tidal volume (Vt), high positive end-expiratory pressure (PEEP), and recruitment maneuvers, low PEEP might yield a potential benefit in closing and protecting the lung tissue. Multimodal neuromonitoring can ensure the safety of respiratory maneuvers in clinical and scientific practice. Future studies are required to develop guidelines for respiratory management in NCC.

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简介：Acomputationalfluiddynamics(CFD)approachisusedtostudytherespiratoryairflowdynamicswithinahumanupperairway.Theairwaymodelwhichconsistsoftheairwayfromnasalcavity,pharynx,larynxandtracheatotriplebifurcationisbuiltbasedontheCTimagesofahealthyvolunteerandtheWeibelmodel.Theflowcharacteristicsofthewholeupperairwayarequantitativelydescribedatanytimelevelofrespiratorycycle.Simulationresultsofrespiratoryflowshowgoodagreementwiththeclinicalmeasures,experimentalandcomputationalresultsintheliterature.Theairmainlypassesthroughthefloorofthenasalcavityinthecommon,middleandinferiornasalmeatus.Thehigherairwayresistanceandwallshearstressesaredistributedontheposteriornasalvalve.Althoughtheairwaysofpharynx,larynxandbronchiexperiencelowshearstresses,itisnotablethatrelativelyhighshearstressesaredistributedonthewallofepiglottisandbronchialbifurcations.Besides,two-dimensionalfluid-structureinteractionmodelsofnormalandabnormalairwaysarebuilttodiscusstheflow-induceddeformationinvariousanatomymodels.Theresultshowsthatthewalldeformationinnormalairwayisrelativelysmall.

简介：WemadeclinicalobservationsonthetherapeuticeffectofacupunctureonacuteupperrespiratorytractinfectionandcomparedwiththeeffectofparacetamolandAntondine,Theresultshowedthatacupuncturetherapycouldallayfevermorerapidlythandrugs,solongasthedifferentiationofsyndromesiscorrectandtheacupointisselectedproperly.

简介：Objective:Tostudytheclinicaltherapeuticeffectofanisodamineonrespiratoryfunctionafterseverebraininjury.Methods:Ninetypatientswithrespiratorydysfunctionfollowingseverebraininjuryweredividedintotwogroups:atreatmentgroup(n=45,treatedwithroutinetherapyplusanisodamine)andacontrolgroup(n=45,treatedwithroutinetherapyonly).Thepulmonaryventilationfunctionandoxygenationfunctionwerecomparedbetweenthetwogroups.Results:Inthetreatmentgroup,12hoursaftertreatmenttherespiratoryratereduced,thepartialpressureofcarbondioxide(PCO2),thepartialpressureofoxygeninarterialblood(PaO2)andoxygenationexponentincreased,thedeadspaceventilationdoseandthepulmonaryalveolus-partialpressureofarterialoxygendifferencedecreased,andtheventilationfunctionoftherespiratorytractandpulmonaryoxygenationfunctionimproved.Therewasasignificantdifferencebetweenthetwogroups(P<0.01).Noside-effectwasfoundexceptaslightincreaseofintracranialpressureandheartrate.Conclusions:Anisodaminecanimprovepulmonaryventilationfunctionandoxygenationfunctionanddecreasetheincidenceofhypoxemiamarkedly.Itiseffectiveintreatingrespiratorydysfunctionafterseverebraininjury.

简介：Litopenaeusvannamei,aeuryhalinespecies,canbeculturedatawiderangeofsalinities.Theemergenceoffreshwaterpond-cultureofL.vannameiisanimportantpreludetothecontinueddevelopmentofshrimpcultureinChina.Inthisstudy,wecomparedtherespiratorymetabolismofjuvenileL.vannameiculturedinfreshwaterandsaltwaterbymeasuringtheiroxygenconsumptionrate(OCR),ammonium-typenitrogenexcretionrate(AER)andpyruvatekinase(PK)andlactatedehydrogenase(LDH)activitiesatdifferentmoltingstagesinordertophysiecologicallycharacterizejuvenileL.vannameiunderfreshwaterconditions.TheresultsshowedthatOCRwassignificantlyhigherinsaltwaterthaninfreshwateratallstagesofmoltingcycle.However,variationofOCRamongmoltingstagesinsaltwaterwassimilarwiththatinfreshwater,andthehighestOCRwasobservedatpost-moltingstage.Atallstagesofmoltingcycle,AERwassignificantlyhigherinfreshwaterthaninsaltwater,andthehighestwasobservedatpost-moltingstage.TheactivityofPKwassignificantlyhigherinsaltwaterthaninfreshwater.Conversely,theactivityofLDHwashigherinfreshwaterthaninsaltwateringeneral.SignificantvariationofPKandLDHactivitiesinmoltingcyclewasobservedinsaltwaterandfreshwater.TheresultsindicatedthataerobicmetabolismofjuvenileL.vannameiwasmoreactiveinsaltwaterthaninfreshwater;whileitsproteinmetabolismwasmoreactiveinfreshwaterthaninsaltwater.

简介：一个实验被进行在谷物在二个米饭变化，IR36和达利充满和颖果的呼吸特点上学习氮(N)率和申请时间的效果。处理在bothtillering和孕穗期(CK)没有N申请顶肥被在于，N顶肥在的6g/pot直到ering舞台和在孕穗期的N顶肥的2g/pot，N顶肥在的2g/pot直到ering舞台和在孕穗期的N顶肥的6g/pot。结果证明N肥料箱的合适的利用是有用的坚持说涨潮满足，更高的呼吸速度和在迟了的充满的米饭颖果的更高的脱氢酶活动分阶段执行，并且延长为充满并且维持米饭颖果的更高的呼吸速度和脱氢酶活动的功课。在启动的更多的N申请与更多的N申请在相比是更有效的到ering为止。

简介：AbstractBackground:The ongoing transmission of the Middle East respiratory syndrome coronavirus (MERS-CoV) in the Middle East and its expansion to other regions are raising concerns of a potential pandemic. An in-depth analysis about both population and molecular epidemiology of this pathogen is needed.Methods:MERS cases reported globally as of June 2020 were collected mainly from World Health Organization official reports, supplemented by other reliable sources. Determinants for case fatality and spatial diffusion of MERS were assessed with Logistic regressions and Cox proportional hazard models, respectively. Phylogenetic and phylogeographic analyses were performed to examine the evolution and migration history of MERS-CoV.Results:A total of 2562 confirmed MERS cases with 150 case clusters were reported with a case fatality rate of 32.7% (95% CI: 30.9-34.6%). Saudi Arabia accounted for 83.6% of the cases. Age of ≥ 65 years old, underlying conditions and ≥ 5 days delay in diagnosis were independent risk factors for death. However, a history of animal contact was associated with a higher risk (adjusted OR = 2.97, 95% CI: 1.10-7.98) among female cases < 65 years but with a lower risk (adjusted OR = 0.31, 95% CI: 0.18-0.51) among male cases ≥ 65 years old. Diffusion of the disease was fastest from its origin in Saudi Arabia to the east, and was primarily driven by the transportation network. The most recent subclade C5.1 (since 2013) was associated with non-synonymous mutations and a higher mortality rate. Phylogeographic analyses pointed to Riyadh of Saudi Arabia and Abu Dhabi of the United Arab Emirates as the hubs for both local and international spread of MERS-CoV.Conclusions:MERS-CoV remains primarily locally transmitted in the Middle East, with opportunistic exportation to other continents and a potential of causing transmission clusters of human cases. Animal contact is associated with a higher risk of death, but the association differs by age and sex. Transportation network is the leading driver for the spatial diffusion of the disease. These findings how this pathogen spread are helpful for targeting public health surveillance and interventions to control endemics and to prevent a potential pandemic.

简介：AbstractRespiratory viruses are major human pathogens that cause approximately 200 million pneumonia cases annually and induce various comorbidities with chronic obstructive pulmonary disease (COPD), resulting in significant health concerns and economic burdens. Clinical manifestations in respiratory viral infections and inflammations vary from asymptomatic, mild, to severe, depending on host immune cell responses to pathogens and interactions with airway epithelia. We critically review the activation, effector, and regulation of T cells in respiratory virus infections and chronic inflammations associated with COPD. Crosstalk among T cells, innate immune cells, and airway epithelial cells is discussed as essential parts of pathogenesis and protection in viral infections and COPD. We emphasize the specificity of peptide antigens and the functional heterogeneity of conventional CD4+ and CD8+ T cells to shed some light on potential cellular and molecular candidates for the future development of therapeutics and intervention against respiratory viral infections and inflammations.

简介：AbstractBackground:With the progress of globalization, international mobility increases, greatly facilitating cross-border transmission of respiratory infectious diseases (RIDs). This study aimed to analyze the epidemiological characteristics and factors influencing imported RIDs, with the goal of providing evidence to support adoption of high-tech, intel-ligent methods to early find imported RIDs and prevent their spread in China.Methods:We obtained data of imported RIDs cases from 2014 to 2018 from the Inbound Sentinel Network of Customs and the National Notifiable Diseases Reporting System in China. We analyzed spatial, temporal, and population distribution characteristics of the imported RIDs. We developed an index to describe seasonality. Pearson correlation coefficients were used to examine associations between independent variables and imported cases. Data analyses and visualizations were conducted with R software.Results:From a total of 1 409 265 253 inbound travelers, 31 732 (2.25/100 000) imported RIDs cases were reported. RIDs cases were imported from 142 countries and five continents. The incidence of imported RIDs was nearly 5 times higher in 2018 (2.81/100 000) than in 2014 (0.58/100 000). Among foreigners, incidence rates were higher among males (5.32/100 000), 0–14-year-olds (15.15/100 000), and cases originating in Oceania (11.10/100 000). The vast majority (90.3%) of imported RIDs were influenza, with seasonality consistent with annual seasonality of influenza. The spatial distribution of imported RIDs was different between Chinese citizens and foreigners. Increases in inbound travel volume and the number of influenza cases in source countries were associated with the number of imported RIDs.Conclusions:Our study documented importation of RIDs into China from 142 countries. Inbound travel poses a significant risks bringing important RIDs to China. It is urgent to strengthen surveillance at customs of inbound travelers and establish an intelligent surveillance and early warning system to prevent importation of RIDs to China for preventing further spread within China.