肺炎支原体感染与婴幼儿哮喘

呼吸道感染是耍幼儿哮喘发病的重要因素,肺炎支原体(mycoplasma pneumoniae,Mp)与婴幼儿哮喘的关系是近年研究的热点之一.Mp作为社区获得性常见病原体之一在婴幼儿感染率有增高趋势.Mp感染导致婴幼儿哮喘初次和反复发作可能的机制为:Mp感染可直接损伤呼吸道上皮细胞、影响细胞及体液免疫、粘液分泌和呼吸道上皮内神经调节机制紊乱;反复发作与呼吸道对刺激因子呈现高反应性、呼吸道慢性炎症及婴幼儿特应性体质有关.大环内酯类药物具有抗炎和免疫调节作用.用于治疗Mp相关喘息性疾病时取得了一定疗效.     

儿童难治性哮喘的免疫功能分析

为探讨难治性哮喘不易控制的原因,对我院诊治的32例儿童难治性哮喘的免疫功能状态进行分析。结果显示,细胞免疫功能低下以及高水平的IgE分泌是儿童难治性哮喘难以控制的原因之一,由于免疫功能低下,造成反复的呼吸道感染占全部哮喘发病诱因的76．9％,医生在难治性哮喘的临床诊治决策中应当给予重视。     

儿童支气管哮喘诊断的几点思考

支气管哮喘（以下简称哮喘）是小儿常见的慢性气道疾病。5岁及以下儿童哮喘的诊断极为困难,是富有挑战性的;因为诊断只能依靠临床判断、症状评价和体征分析。病毒感染所至的喘息在婴幼儿期很常见,与哮喘鉴别较困难。目前还没有诊断婴幼儿期哮喘的特异检测手段和方法,因此诊断需要综合考虑,包括反复喘息的类型、特异体质病史、哮喘危险因素、长期随访、广泛鉴别诊断和观察对支气管舒张剂及抗炎治疗的反应。     

哮喘病的病因学及哲学思考

1　外因对支气管哮喘 (简称哮喘 )形成及发展的影响1 1　外界变应原 :外界变应原是引起哮喘发生和发展的重要因素 ,其中主要是吸入性变应原如花粉、霉菌、室内尘土、尘螨 ,蟑螂、动物毛皮等。外界变应原作用于机体后 ,使之致敏 ,并产生ＩｇＥ ,当机体再次接触该变应原时 ,体内肥大细胞上的ＩｇＥ与变应原结合 ,激活肥大细胞 ,使之释放组胺等介质 ,引起哮喘发作 ,属Ⅰ型变态反应[1,2 ] 。此外 ,奶、鱼、肉、蛋等食物性过敏原及阿司匹林类、青霉素类等药物过敏原亦可诱发哮喘。1 2　感染 :呼吸道感染尤其是病毒感染是小儿哮喘的主要原因。盛锦…     

儿童支气管哮喘诊断的几点思考

支气管哮喘(以下简称哮喘)是小儿常见的慢性气道疾病.5岁及以下儿童哮喘的诊断极为困难,是富有挑战性的;因为诊断只能依靠临床判断、症状评价和体征分析.病毒感染所至的喘息在婴幼儿期很常见,与哮喘鉴别较困难.目前还没有诊断婴幼儿期哮喘的特异检测手段和方法,因此诊断需要综合考虑,包括反复喘息的类型、特异体质病史、哮喘危险因素、长期随访、广泛鉴别诊断和观察对支气管舒张剂及抗炎治疗的反应.     

T细胞免疫球蛋白与黏蛋白-3与炎症性肠病异常免疫研究进展

T细胞免疫球蛋白与黏蛋白‐3（Tim‐3）是 T细胞免疫球蛋白与黏蛋白（Tims）家族中一个重要的成员，具有多种生物学作用，主要参与机体固有免疫及适应性免疫应答的调节，与过敏、哮喘、炎症性疾病、自身免疫性疾病、肿瘤等多类疾病相关。炎症性肠病（IBD ）是一组反复发作的慢性肠道炎症性疾病，其发病机制并不十分清楚，近年研究...     

抗感染治疗新靶点——细菌生物膜

自然条件下,微生物以浮游和生物膜两种生长状态存在,不同生长状态细菌的生物学特征存在显著差异。研究认为细菌生物膜是细菌耐药性形成的重要机制之一,是许多慢性感染性疾病反复发作和难以控制的主要原因。细菌生物膜主要经定植、释放和影响宿主免疫系统而致病,临床常见生物膜相关感染包括生物医学材料相关感染和慢性感染。细菌生物膜及其相关感染,日益成为临床医疗工作的重点和难点。以细菌生物膜为对象,从细菌生物膜及其细菌的生物学特征出发,寻找其特异性药物作用靶点,进行定向药物研发,是解决细菌耐药性和细菌生物膜相关感染的有力措施。     

抗感染治疗新靶点--细菌生物膜

自然条件下,微生物以浮游和生物膜两种生长状态存在,不同生长状态细菌的生物学特征存在显著差异.研究认为细菌生物膜是细菌耐药性形成的重要机制之一,是许多慢性感染性疾病反复发作和难以控制的主要原因.细菌生物膜主要经定植、释放和影响宿主免疫系统而致病,临床常见生物膜相关感染包括生物医学材料相关感染和慢性感染.细菌生物膜及其相关感染,日益成为临床医疗工作的重点和难点.以细菌生物膜为对象,从细菌生物膜及其细菌的生物学特征出发,寻找其特异性药物作用靶点,进行定向药物研发,是解决细菌耐药性和细菌生物膜相关感染的有力措施.     

支气管哮喘诊断和治疗的哲学启示

1　支气管哮喘诊断和治疗的发展演化支气管哮喘 (Ｂｒｏｎｃｈｉａｌａｓｔｈｍａ)简称哮喘 (Ａｓｔｈ ｍａ) ,是一种古老的疾病 ,表现为反复发作性的气喘、胸闷、咳嗽、咳痰 ,可在短时间内自行缓解或经药物治疗而缓解 ,缓解时可完全恢复正常。早在 2 50 0～ 30 0 0年以前人们就已认识到气道阻力增高可以引起呼吸困难。但由于当时对本病的病因、病理缺乏认识 ,对本病的治疗只能是凭经验用一些简单的草药治疗。随着对呼吸系统的深入研究 ,对支气管哮喘的研究也有了很大的进展。 2 0世纪 50年代末至 70年代初 ,人们把支气管哮喘定义为 :发作性…     

婴幼儿喘息的分类和小儿哮喘的鉴别诊断

喘息是小儿时期常见的症状,尤其是婴幼儿。婴幼儿喘息分为三种类型：一过性的早期喘息,只发生在3岁以前的喘息。无家族的哮喘病史,与过敏原的致敏无关,与父母吸烟有关。持续性的早发的喘息,即非过敏的喘息,与病毒感染诱发有关。晚发的喘息/哮喘,即过敏性的喘息, 有湿疹和哮喘的气道病理特点。在诊断支气管哮喘前,还必须排除以下疾病：先天性气道和肺的发育异常,先天性心、血管异常,异物吸入,胃食管返流,支气管结核,纤毛不动综合征,免疫缺陷病等。     

女性生殖道支原体感染的诊治探讨

生殖道支原体感染是一种性传播疾病。支原体感染与不孕及输卵管妊娠有关,并可导致多种不良妊娠结局。泌尿生殖道支原体阳性并不能确诊为性病,也不一定需要治疗。具有致病性,是支原体感染需要治疗的重要条件。目前对于支原体感染的诊断和治疗仍存在很多问题,必须加强管理。     

Illness-specific catastrophic thinking and overperception in asthma.

OBJECTIVE: This study investigated the role of illness-specific catastrophic thinking in symptom perception in asthma. DESIGN AND MAIN OUTCOME MEASURES: A total sample of 72 patients with intermittent to moderate persistent asthma completed the Catastrophizing about Asthma Scale and completed the Asthma Symptom Checklist to measure retrospective symptom reporting. In addition, symptoms were concurrently assessed during different respiratory challenges eliciting mild and ambiguous versus salient and pronounced symptoms. RESULTS: Catastrophic thinking in general, when patients are not having an exacerbation, is related to an increase in emotional symptoms, especially in ambiguous situations where respiratory difficulties could occur. Catastrophic thinking during exacerbations is related to an increase in emotional symptoms as well as in respiratory symptoms during respiratory challenges. CONCLUSION: These strong relationships between catastrophic thinking and increased perception of asthma symptoms suggest a link between illness-specific catastrophic thinking and overperception. Consequently, catastrophic thoughts are an important target for psychological interventions in support of drug treatment.     

Systemic Research on Chronicity Factors in Infantile Asthma

This work is the result of research into chronicity factors in infantile asthma. The research had two main goals. The first, using a sample of 100 asthmatic children, was to reconstruct the therapeutic history of the individual patients on the hypothesis that the therapeutic intervention they had undergone in fact conditioned the quality of the cure demand. The second was to evaluate the influence of family dynamics on the chronic development of infantile asthma. A comparison was made between two interactive models using a sample of 10 families with asthmatic children with chronic tendencies and a sample of 10 normal families. The results show that typical dysfunctional interactive patterns exist in the experimental sample and that they are correlated with the perpetuation of the asthmatic symptom. The paper concludes that every therapeutic intervention that is limited to dealing with the biological component of the asthmatic symptom and ignores the influence of family dynamics becomes itself a major chronicity factor. Thus a “systemic” intervention is considered necessary to prevent chronicity.     

盆腔炎感染的相关因素

盆腔炎是育龄期妇女的常见病和多发病,常见的病原体有细菌、念珠菌、解脲脲原体、沙眼衣原体等。结合临床检测及文献报道,发现年轻女性盆腔炎解脲脲原体感染率较高,是盆腔炎的高发人群。解脲脲原体感染患者合并其他病原微生物感染的情况相当严重。对患者进行全面系统的病原生物检测,对于预防和有效治疗盆腔炎感染十分重要。     

新入园幼儿的皮质醇变化与上呼吸道感染的关系：气质的作用

采用酶联免疫吸附法分析唾液皮质醇和日志记录上呼吸道感染(upper respiratory tract infection; URI)的方法, 考察新入园的59名幼儿皮质醇变化与两个月期间患URI次数、持续时间的关系, 同时检测了幼儿气质在其中的作用。结果发现, 新入园幼儿在国庆小长假后的第一周内, 其皮质醇变化的整体趋势表现为下午的皮质醇水平比上午的皮质醇水平高; 上、下午皮质醇水平的变化幅度与其患URI次数显著负相关, 注意分散度与患URI次数呈显著正相关, 幼儿的自我控制能力与其患URI的平均持续时间显著负相关; 趋避性能够调节上、下午皮质醇水平变化幅度与URI的平均持续时间的关系。研究表明, 幼儿面对新入园这一急性压力事件时, 皮质醇水平的暂时性升高对免疫系统产生了一定的刺激作用来抵抗URI。幼儿气质的认知、情绪的或注意的不同过程与URI以及对皮质醇变化水平与URI关系的作用机制有所不同。     

Daily stress and anxiety and their relation to daily fluctuations of symptoms in asthma and chronic obstructive pulmonary disease (COPD) patients

Although stress and anxiety have long been assumed to play an exacerbatory role in asthma, no study has systematically documented that daily exacerbations of asthma symptoms are related to stress and/or anxiety. In this study, 24 airways obstruction patients (12 asthmatics and 12 chronic obstructive pulmonary disease patients) were instructed to monitor the severity of daily respiratory symptoms. In addition, subjects recorded their daily anxiety level and the number and perceived impact of daily stressors. The results showed that although there were differences between high- and low-stress days for both groups, there were no differences between groups on symptom severity or between high- and low-anxiety days, as measured by the State-Trait Anxiety Inventory (STAI). Thus, although the number and impact of daily stressors were found to be directly associated with the severity of asthma symptoms, anxiety does not appear to have a direct role in the exacerbation of asthma. The findings failed to support the anxiety theory of asthma but provided an explanation for the poor results obtained in previous treatment studies which employed anxiety management with asthmatics.     

呼吸危重症临床决策中的若干问题

在临床实践中,呼吸危重症的诊断和治疗存在着一些不同的观点。就其中某些热点问题,如慢性阻塞性肺疾病合并哮喘的诊断和机械通气的指征、肺栓塞的诊断、急性呼吸窘迫综合征的治疗、呼吸重症监护病房的建设和呼吸危重症的伦理学问题进行阐述,以期提高对呼吸危重症的认识。     

Unravelling the nature of early (autobiographical) memory

ABSTRACT

In this article, I provide an overview of the problems associated with understanding the nature of early autobiographical memory and discuss issues concerning the forgetting of these memories (infantile/childhood amnesia). Specifically, I provide a brief exegesis as to whether such memories are stored in a fragile manner to begin with, become difficult to retrieve over time, or both. In order to answer this and other related questions, I review the contribution of the articles in this special issue to understanding the enigma that is infantile/childhood amnesia. I then outline some of the issues that remain and suggest a functional approach to understanding why the forgetting of early experiences may be more adaptive than remembering them. I conclude by suggesting that infantile amnesia may actually begin during infancy itself.