简介：Asthmadevelopsinaboutoneadultperthousandpopulationperyear,andepidemiologicalstudiesindicatethatabout10%ofcasescanbeattributedtoexposuresatwork.However,occupationalasthmaisidentifiedlesscommonlythanthisinclinicalpractice;anincidenceof800-1000casesperyearisestimatedbytheUKSurveillanceofWork-RelatedandOccupationalRespiratoryDiseasescheme.Occupationalasthmaiseasilymissedbecause,apartfromitsassociationwithwork,

简介：Airwaydiseasesarethemostcommonlydescribedlungmanifestationsofinflammatoryboweldisease(IBD).However,thesimilaritiesindiseasepathogenesisandthesharingofimportantenvironmentalriskfactorsandgeneticsusceptibilitysuggestthatthereisacomplexinterplaybetweenIBDandairwaydiseases.RecentevidenceofIBDoccurrenceamongpatientswithairwaydiseasesandthehigherthanestimatedprevalenceofsubclinicalairwayinjuriesamongIBDpatientssupportthehypothesisofatwo-wayassociation.Futureresearcheffortsshouldbedirectedtowardfurtherexplorationofthisassociation,asairwaydiseasesarehighlyprevalentconditionswithasubstantialpublichealthimpact.

简介：AbstractBackground:The effectiveness of bronchial thermoplasty (BT) has been reported in patients with severe asthma. This study compared the effects of BT and cryoballoon ablation (CBA) therapy on the airway smooth muscle (ASM).Methods:Eight healthy male beagle dogs were included in this experiment. In the preliminary experiment, one dog received BT treatment for both lower lobe bronchus, another dog received CBA treatment for 7 s on the upper and lower lobe of right bronchus, and 30 s on the left upper and lower lobe. The treatments were performed twice at an interval of 1 month. In subsequent experiments, the right lower lobe bronchus was treated with BT, and the left lower lobe bronchus was treated with CBA. The effects of treatment were observed after 1 (n = 3) month and 6 months (n = 3). Hematoxylin-eosin staining, Masson trichrome staining, and immunohistochemical staining were used to compare the effects of BT and CBA therapy on the ASM thickness, collagen fibers synthesis, and M3 receptor expression after treatment. One-way analysis of variance with Dunnett post hoc test was used to analyze the differences among groups.Results:In the preliminary experiment, the ASM ablation effect of 30-s CBA was equivalent to that of 7-s CBA (ASM thickness: 30.52 ± 7.75 μm vs. 17.57 ± 15.20 μm, P = 0.128), but the bronchial mucociliary epithelium did not recover, and large numbers of inflammatory cells had infiltrated the mucosal epithelium at 1-month post-CBA with 30-s freezing. Therefore, we chose 7 s as the CBA treatment time in our follow-up experiments. Compared with the control group (35.81 ± 11.02 μm), BT group and CBA group (13.41 ± 4.40 μm and 4.81 ± 4.44 μm, respectively) had significantly decreased ASM thickness after 1 month (P < 0.001). Furthermore, the ASM thickness was significantly lower in the 1-month post-CBA group than in the 1-month post-BT group (P = 0.015). There was no significant difference in ASM thickness between the BT and CBA groups after six months (9.92 ± 4.42 μm vs. 7.41 ± 7.20 μm, P = 0.540). Compared with the control group (0.161 ± 0.013), the average optical density of the ASM M3 receptor was significantly decreased in 6-month post-BT, 1-month post-CBA, and 6-month post-CBA groups (0.070 ± 0.022, 0.072 ± 0.012, 0.074 ± 0.008, respectively; all P < 0.001). There was no significant difference in the average optical density of ASM M3 receptor between the BT and CBA therapy groups after six months (P = 0.613).Conclusions:CBA therapy effectively ablates the ASM, and its ablation effect is equivalent to that of BT with a shorter onset time. A neural mechanism is involved in both BT and CBA therapy.

简介：航线发炎是许多呼吸障碍的特点，例如气喘和膀胱的纤维变性。在发炎触发的航线基因表示的变化在这些疾病的致病起一个关键作用。基因连接研究建议ESE-2和ESE-3，编码上皮特定的Ets-domain-containing抄写因素，是候选人气喘危险性基因。我们这里报导et家庭抄写因素ESE-1的另一个成员的表示，以及ESE-3，起来在支气管的上皮的房间线由煽动性的cytokinesinterleukin-1beta(IL-1beta)和肿瘤坏死factor-alpha(TNF-alpha)调整了。有IL-1beta和TNF-alpha的这些房间的处理为ESE-1和ESE-3导致了信使rna表示的戏剧的增加。我们证明导致的表示被抄写因素NF-kappaB的激活调停。我们描绘了ESE-1和ESE-3倡导者并且识别了为导致cytokine的表达式被要求的NF-kappaB有约束力的序列。另外，我们也表明那ESE-1在上面调整ESE-3表示，down由cytokines调整它的自己的正式就职。最后，我们在Elf3显示出那(对人的ESE-1相应)猛烈老鼠，煽动性的cytokineinterleukin-6(IL-6)的表示是调整的down。我们的调查结果建议ESE-1和ESE-3在航线发炎起一个重要作用。

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

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简介：AbstractType 2 inflammation is a complex immune response and primary mechanism for several common allergic diseases including allergic rhinitis, allergic asthma, atopic dermatitis, and chronic rhinosinusitis with nasal polyps. It is the predominant type of immune response against helminths to prevent their tissue infiltration and induce their expulsion. Recent studies suggest that epithelial barrier dysfunction contributes to the development of type 2 inflammation in asthma, which may partly explain the increasing prevalence of asthma in China and around the globe. The epithelial barrier hypothesis has recently been proposed and has received great interest from the scientific community. The development of leaky epithelial barriers leads to microbial dysbiosis and the translocation of bacteria to inter- and sub-epithelial areas and the development of epithelial tissue inflammation. Accordingly, preventing the impairment and promoting the restoration of a deteriorated airway epithelial barrier represents a promising strategy for the treatment of asthma. This review introduces the interaction between type 2 inflammation and the airway epithelial barrier in asthma, the structure and molecular composition of the airway epithelial barrier, and the assessment of epithelial barrier integrity. The role of airway epithelial barrier disruption in the pathogenesis of asthma will be discussed. In addition, the possible mechanisms underlying the airway epithelial barrier dysfunction induced by allergens and environmental pollutants, and current treatments to restore the airway epithelial barrier are reviewed.

简介：AbstractBackground:Due to airway remodeling and emphysematous destruction in the lung, the two classical clinical phenotypes of chronic obstructive pulmonary disease (COPD) are emphysema and bronchiolitis. The present study was designed to investigate the levels of small airway immunoglobulin A (IgA) in COPD with "emphysema phenotype." The study also evaluated the associations between the small airway IgA levels and the severity of disease by the extent of emphysema versus airflow limitation.Methods:Thirty patients (20 with COPD and ten healthy smokers) undergoing lung resection surgery for a solitary peripheral nodule were included. The study was conducted from January 2015 to December 2018 in the Shanxi Dayi Hospital. The presence of small airway IgA expression was determined in the lung by immunohistochemistry. In vivo, Wistar rats were exposed to silica by intratracheal instillation. Rats were sacrificed at 15 and 30 days after exposure of silica (n = 10 for each group). We also evaluated airway IgA from rats.Results:Small airway secretory IgA (sIgA), dimeric IgA (dIgA), and dIgA/sIgA of Global Initiative for Chronic Obstructive Lung Disease grade 1-2 COPD patients showed no difference compared with smoking control subjects (5.15±1.53 vs. 6.03±0.85; 1.94±0.66 vs. 1.67±0.04; 41.69±21.02 vs. 28.44±9.45, all P > 0.05). dIgA/sIgA level in the lung of COPD patients with emphysema showed higher levels than that of COPD patients without emphysema (51.89±24.81 vs. 31.49±9.28, P=0.03). The percentage of low-attenuation area below 950 Hounsfield units was positively correlated with dIgA/sIgA levels (r=0.45, P=0.047), but not associated with the severity of disease by spirometric measurements (forced expiratory volume in the first second %pred, P>0.05). Likewise, in the rat study, significant differences in sIgA, dIgA, dIgA/sIgA, mean linear intercept, mean alveoli number, and mean airway thickness of bronchioles (VV airway, all P < 0.01) were only observed between control rats and those exposed for 30 days. However, in the group exposed for 15 days, although the VV airway was higher than that in normal rats (27.61±2.26 vs. 20.39±1.99, P<0.01), there were no significant differences in IgA and emphysema parameters between the two groups (all P>0.05).Conclusion:Airway IgA concentrations in mild and moderate COPD patients are directly associated with the severity of COPD with "emphysema phenotype" preceding severe airway limitation. This finding suggests that small airway IgA might play an important role in the pathophysiology of COPD, especially emphysema phenotype.

简介：AbstractChronic obstructive pulmonary disease (COPD) is a heterogeneous disease characteristic of small airway inflammation, obstruction, and emphysema. It is well known that spirometry alone cannot differentiate each separate component. Computed tomography (CT) is widely used to determine the extent of emphysema and small airway involvement in COPD. Compared with the pulmonary function test, small airway CT phenotypes can accurately reflect disease severity in patients with COPD, which is conducive to improving the prognosis of this disease. CT measurement of central airway morphology has been applied in clinical, epidemiologic, and genetic investigations as an inference of the presence and severity of small airway disease. This review will focus on presenting the current knowledge and methodologies in chest CT that aid in identifying discrete COPD phenotypes.

简介：有编码Dermatophagoidespteronyssinus组2的DNA的种痘(Derp2)变应原以前在Derp上显示出它immunologic保护的效果在老鼠的2导致变应原的过敏航线发炎。在现在的学习，我们调查了是否2能施加的DNA疫苗编码Derp在老鼠模型的导致变应原的过敏航线发炎上的治疗学的角色并且在气喘探索了DNA种痘的机制特定变应原的免疫疗法。在由Derp敏化并且质问以后2，BALB/c老鼠与DNA被使免疫疫苗。细胞的渗入的度被获得。在浆液的IgE层次和在BALF的IL-4/lL-13层次被ELISA决定。肺纸巾被组织学的考试估计。在肺的STAT6和NF-B的表情被染色的immunohistochemistry决定。有DNA疫苗的老鼠的种痘禁止了航线发炎和变应原导致的粘蛋白的生产的发展，并且减少了Derp2-specificIgE水平的水平。eosinophii渗入的重要减小和在BALF的IL-4andIL-13的层次在种痘以后被观察。进一步更，DNA种痘在Derp2-immunized老鼠在肺织物禁止了STAT6和NF-Bexpression。这些结果显示DNA疫苗编码Derp2allergen能在我们的老鼠模型被用于导致变应原的过敏航线发炎的治疗。

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简介：到真菌的促进感受性经常导致是特别地困难的临床上设法的气喘的一种严重形式，导致在这些病人的增加的病态和住院。尽管B淋巴细胞可能通过IgE的生产加重气喘症状，这些房间可能也在对吸入的真菌的保护的反应是重要的。通过cytokine版本和T房间相互作用，这些淋巴细胞可能也影响航线墙纤维变性的发展和维护。JH−/−老鼠为抗体的重链部件缺乏JH基因，它为B房间功能和幸存是批评的。这些动物在很多有免疫力的回答便于B淋巴细胞的角色的说明；然而，JH−/−老鼠没被用来学习真菌的过敏症。在这研究，我们用曲霉属菌fumigatus检验了B淋巴细胞的角色模仿被环境真菌的暴露触发的人的航线疾病的鼠科的真菌的高空过敏症模型。我们在敏化的野类型的BALB/c和J暴露于的H−/−老鼠重复了真菌的暴露并且没在大航线附近在航线hyperresponsiveness，全面肺的发炎或骨胶原免职发现差别。然而，Th2类型cytokinesIL-4和IL-13的层次显著地在J相对BALB/c控制的H−/−鼠标。由对比，煽动性的cytokinesIL-17A和IL-6的层次显著地在JH−/−动物，并且有显著地更柔韧的航线嗜曙红血球过多和neutrophilia比在控制动物。一起拿，这些调查结果表明淋巴细胞帮助在肺的分隔空间调整granulocytic回答到真菌的暴露的那B。

简介：AbstractIntroduction:Congenital nasal pyriform aperture stenosis (CNPAS) is a rare congenital condition of structural nasal obstruction. Respiratory distress, stertor, and poor feeding are often presenting features.Case Presentation:We report a case of a newborn diagnosed with CNPAS at 3 weeks of life. The diagnosis was missed on a nasoendoscopy at day 3 of life but was realised following a facial CT when the infant presented with ongoing symptoms of upper airway obstruction. Nasal dilation was performed successfully.Conclusion:CNPAS should be considered in any neonate with upper airway obstruction. A normal nasoendoscopy does not exclude the diagnosis.

简介：AbstractObjectives:Patients with obstructive sleep apnea (OSA) are at increased risk of perioperative and postoperative morbidity. The use of continuous positive airway pressure (CPAP) in the perioperative period may be of potential benefit. However, among patients who have undergone endonasal skull base surgery, many surgeons avoid prompt re-initiation of CPAP therapy due to the theoretical increased risk of epistaxis, excessive dryness, pneumocephalus, repair migration, intracranial introduction of bacteria, and cerebrospinal fluid (CSF) leak. The objective of this article is to review the most up-to-date literature regarding when it is safe to resume CPAP usage in the patient undergoing endonasal skull base surgery.Data Sources and Methods:This review combines the most recent literature as queried through PubMed regarding the safety of CPAP resumption following endonasal skull base surgery.Results:Recent surveys of skull base surgeons demonstrate little consensus regarding the post-operative management of OSA. Recent cadaveric studies suggest that approximately 85% of delivered CPAP pressures are transmitted to the sphenoid sinus. Further, at frequently prescribed CPAP pressure settings, common sellar reconstruction techniques maintain their integrity while preventing very little transmission of pressure into the sella. In small retrospective case series, patients with OSA who received CPAP immediately following transsphenoidal pituitary surgery had similar rates of surgical complications as OSA patients who did not receive CPAP in the immediate post-operative period. Concerns of reinitiating CPAP too early, such as the development of pneumocephalus, rarely develop.Conclusions:There remains a paucity of objective data regarding when it is safe to resume CPAP following endonasal skull base surgery. Recent cadaveric studies and small retrospective case series suggest that it may be safe to resume CPAP earlier than is often practiced following endonasal skull base surgery.

简介：AbstractImportance:Pediatric hypervascular primary airway tumors are progressive, fatal lesions with a low incidence, and the disease is often more serious than that in adults.Objective:To evaluate the clinical efficacy and safety of interventional therapeutic bronchoscopy combined with conservative treatment and bronchial arterial embolization in children with primary airway tumors.Methods:We retrospectively analyzed the clinical data of four pediatric patients with hypervascular primary airway tumor between 2017 and 2019 at Beijing Children’s Hospital.Results:Two patients were low-grade bronchial mucoepidermoid carcinoma, one patient was pleomorphic adenoma, and one was bronchial leiomyoma. Interventional therapeutic bronchoscopy combined with bronchial arterial embolization was used for treatment (all four patients received general anesthesia). The tumors were safely resected in all patients via interventional bronchoscopy. There were no severe complications related to the procedures. All patients were followed up for 5-12 months, and one low-grade bronchial mucoepidermoid carcinoma recurred.Interpretation:Interventional therapeutic bronchoscopy combined with bronchial arterial embolization appears to be a safe and efficient therapeutic method associated with less trauma and fewer complications, including no serious adverse events, in children with hypervascular primary airway tumors without bronchus wall infiltration.

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