Objective:To analyze the clinical characteristics of hospitalized patients with bronchiectasis in Hainan Province, and to summarize the disease characteristics.Methods:This was a cross-sectional study involving 207 hospitalized bronchiectasis patients in the Hainan Hospital of Chinese PLA General Hospital from May 2012 to January 2022.Their final diagnosis recorded in the inpatient medical record information management system were bronchiectasis, bronchial dilation, bronchiectasis with infection, or bronchiectasis with hemoptysis.Chest high-resolution CT image data were available.Baseline characteristics, imaging manifestations, pulmonary function and sputum microbial culture data of the enrolled patients were collected.Clinical symptoms, signs, pulmonary function and sputum microbial detection rate of bronchiectasis patients with varying morphological manifestations (columnar, cystic columnar, cystic) were compared.The detection rate of sputum microorganisms in bronchiectasis patients with different distribution ranges (single lobe involvement and multiple lobes involvement) were compared.Lung function differences between bronchiectasis patients with or without specific bacteria were compared.The results of drug sensitivity test of Pseudomonas aeruginosa were analyzed.Results:A total of 207 cases were recruited, including 110 males (53.14%) and 97 females (46.86%).The mean age was (64.37±13.91) years.The elderly aged 65 years and above accounted for 55.07% (114/207).The mean age of onset was 50.73±19.39 years.History of tuberculosis, chronic obstructive pulmonary disease, bronchial asthma, interstitial pneumonia and immunosuppression due to long-term glucocorticoid treatment of tumors, leukemia, nephrotic syndrome and other causes was detected in 23.19% (48/207), 21.74% (45/207), 5.80% (12/207), 3.38% (7/207) and 9.66% (20/207) of cases, respectively.The cause of the disease could not be determined in most of patients, and only 15.46% (32/207) had identified causes; 59.38% (19/32) of bronchiectasis patients were caused by pulmonary tuberculosis.The main symptoms were cough (89.37%), expectoration (82.61%), shortness of breath (43.96%) and hemoptysis (30.43%).Cylindrical (47.34%, 98/207), mixed (16.43%, 34/207) and saccular lesions (36.23%, 75/207) were found in imaging examinations; 30.43% (63/207), 69.57% (144/207) and 18.84% (41/207) of patients had the involvement of a single lobe, multiple lobes and all lobes, respectively.Among the involved lung lobes, the right lower lobe accounted for 57.49% (119/207).Seventy-three patients underwent pulmonary function examination during hospitalization, of which 67.12% (49/73), 54.79% (40/73) and 39.73% (29/73) had obstructive ventilatory disorder, restrictive ventilatory disorder, and mixed ventilatory disorder, respectively.According to the imaging classification, there was significant difference in the percentage of forced expiratory volume in the first second to the predicted value (FEV 1%pred) of bronchiectasis patients with cylindrical, saccular and mixed lesions ( F=4.41, P=0.016), while no significant differences were found in the percentage of forced vital capacity in the predicted value (FVC% pred) and the percentage of forced expiratory volume in the first second to the predicted value (FEV 1/FVC)(both P>0.05).A total of 184 sputum samples were collected for microbial culture during hospitalization, and the positive rate was 57.07% (105/184).101 cases (54.89%) were positive for bacteria and 22 cases (11.96%) were positive for fungi.A total of 147 strains of 26 kinds of bacteria were cultured, including 136 strains of 19 Gram-negative bacteria and 11 strains of 7 Gram-positive bacteria.Two or more kinds of bacteria were detected in 34 (18.48%) cases.The bacteria with a high composition included the Pseudomonas aeruginosa 38.10% (56/147), Klebsiella pneumoniae 14.29% (21/147), and Acinetobacter baumannii 11.56% (17/147).The detection rate of Pseudomonas aeruginosa in bronchiectasis patients with the involvement of multiple lobes was significantly higher than that in those with single lobe involvement (39.53% [51/129] vs 9.09% [5/55], χ2=19.12, P<0.001).The pulmonary function indexes of bronchiectasis patients with Pseudomonas aeruginosa infection were significantly lower than those without Pseudomonas aeruginosa infection ( P<0.05). Conclusions:Bronchiectasis is common in the elderly in Hainan Province, and the etiology is unclear.The proportion of patients with previous tuberculosis infection is high.The clinical symptoms are various, and most of the pulmonary functions have obstructive ventilatory disorder.The imaging features mainly include cylindrical bronchiectasis and the involvement of multiple lobes.The detection rate of Gram-negative bacteria in sputum samples is high, and the detection of Pseudomonas aeruginosa is associated with lung dysfunction.

The incidence and prevalence of bronchiectasis have increased significantly in recent years.However, the pathogenesis and aggravation mechanism of bronchiectasis has not been fully elucidated.Some studies show that the composition and abundance change of pulmonary microbiome is one of the most important reasons for the aggravation of bronchiectasis.Therefore, it has attracted wide attention.There are many kinds of microbial colonization in the lung of patients with bronchiectasis.The core bacterial colonization varies from patients to patients.The colonization of core bacteria represented by Pseudomonas aeruginosa is an independent risk factor for the decline of lung function and increase of exacerbation frequency in patients with bronchiectasis.This article reviews the changes of pulmonary microbiome in stable and aggravated bronchiectasis, so as to provide guidance to the treatment of bronchiectasis.

目的 超声心动图对老年急性重症感染并发细胞因子风暴患者心脏检测及分析.方法 回顾性分析解放军总医院第二医学中心老年男性急性重症感染患者31例,检测白细胞计数(WBC)、中性粒细胞计数(N)、淋巴细胞计数(LWBC)、C反应蛋白(CRP)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、肌钙蛋白(cTn)T、cTnI、N末端B型钠尿肽前体(NT-proBNP)水平.采用超声心动图检测.采用彩色多普勒超声测量三尖瓣反流速度(TRV),三尖瓣反流压差(TRPG)及肺动脉收缩压(SPAP)等.结果 老年急性重症感染发病时CRP、WBC、N、LWBC、LDH、CK-MB、cTnT、cTnI、NT-proBNP明显高于发病前和病情缓解后(P<0.01).31例(100％)患者发病时均出现超声心动图异常;左心室均出现节段性或弥漫性室壁运动减弱,且TRV,TRPG,SPAP高于发病前[(4.26±1.81)m/s vs(2.91±0.78)m/s,(69.50±6.45)mm Hg(1 mm Hg=0.133 kPa)vs(34.81±2.81)mm Hg,(72.20±9.87)mm Hg vs(38.83±4.34)mm Hg,P<0.01].经治疗病情缓解后,患者超声心动图检测恢复或接近急性发病前.结论 老年急性重症感染患者细胞因子风暴下易发生心脏损伤,超声心动图可直观、准确监测心脏的变化.

目的 探索经历空间飞行后奇异变形杆菌生物学性状的改变.方法 将奇异变形杆菌分为空间飞行组菌株ST8和地面对照组菌株GT8,空间飞行组菌株搭载于"天宫二号"空间实验室并经历64 d的空间飞行,地面设立相同温度、湿度条件的同步对照组菌株GT8,待空间飞行组菌株返回地面后,对两组菌株进行形态学观察、生长曲线实验、生物被膜实验、Biolog生化代谢谱检测、抗生素敏感性实验及运动能力实验,比较两者生物学性状差异.结果 空间飞行组奇异变形杆菌菌株ST8在swimming培养基上形成的菌膜更加致密,且菌膜最大直径明显大于地面对照组菌株GT8(F=13.26,P=0.022),表明经历空间飞行后奇异变形杆菌的运动能力得到增强,而形态、生长速率、生化代谢谱、生物被膜形成能力及抗生素敏感性未发生明显改变.结论 经历空间飞行后奇异变形杆菌菌株运动能力较地面对照组菌株显著增强,而形态、生长速率、生化代谢谱、生物被膜形成能力及抗生素敏感性未发生明显改变.

Objective:To study effect of small ubiquitin related modifier protein 1(SUMO1) in inflammatory reactions mediated by tumor necrosis factor(TNF)-α and nuclear factor(NF)-κB in myocardial damage of rats with type 2 diabetes mellitus(T2DM).Methods:A total of 20 Goto-Kakizaki(GK) rats with spontaneous diabetes mellitus(DM) were randomly divided into group DM1(pure DM group,n=10) and group DM2(DM+high-fat diet group,n=10),and another 10 normal Wistar rats were regard as healthy control group.Expressions of SUMO1,TNF-α and NF-κB were measured by immunohistochemical method.Results:1.Levels of blood glucose and TG in group DM1 and group DM2 were significantly higher than those of healthy control group,and those of group DM2 were higher than those of group DM1,P0.05 all;2.Myocardial cells lined up in order and there was no hypertrophy in group DM1;but those in group DM2 showed cells loosely lined up and hypertrophy under light microscope;3 Immunohistochemical assay indicated that expression of SUMO1 in group DM2 and group DM1 were significantly higher than those of healthy control group [(44.5±1.1) vs.(27.2±2.2) vs.(21.7±3.0)],and of group DM2 was significantly higher than that of group DM1(P0.01 all);expression of TNF-α in group DM2 and group DM1 were significantly higher than that of healthy control group [(27.5±1.5) vs.(20.2±2.7) vs.(13.1±1.6)],and of group DM2 was significantly higher than that of group DM1(P0.01 all);expression of NF-κB in group DM2 and group DM1 were significantly higher than that of healthy control group [(30.1±1.7)vs.(40.7±1.5)vs.(16.0±2.6)],but of group DM1 was significantly higher than that of group DM2(P0.01 all).Conclusion:There are obvious metabolic disorders of glucose and lipid in T2DM rats,and complicated morphological changes of myocardial tissues similar to myocardial lesions in DM humans;the expressions of SUMO1,NF-κB and TNF-α significantly increase,suggest SUMO1 takes part in inflammatory reaction mediated by NF-κB,TNF-α in myocardial lesion of rat with T2DM,and may inhibit NF-κB,possesses effect of protect myocardium.

<正>肺动脉高压是不同病因导致的、以肺动脉压力和肺血管阻力升高为特点的一组病理生理综合征,主要病理机制是血管收缩、血管重塑和原位血栓形成,最终导致右心室后负荷增加,右心衰竭。目前肺动脉高压的定义仍然采用了1987年美国国立卫生研究院(NIH)进行肺动脉高压登记注册时规定的血流动力学

OBJECTIVE:To investigate the inpatient pulmonary hypertension (PH) surveillance in a single center of cardiovascular hospital during last ten years.METHODS:In this retrospective analysis, data from patients with discharge diagnosis as PH from Jan. 1996 to Dec. 2005 were collected.RESULTS:A total of 7085 out of 106 640 patients (6.63%) were documented as PH during the survey period and 3.77% PH was idiopathic, 65.93% PH originated from congenital heart diseases, 22.61% from left heart diseases, 5.66% from thrombotic diseases, 0.89% from respiratory diseases, 0.61% from connective tissue diseases, 0.51% from pulmonary vasculitis and 0.03% from portal hypertensive diseases. Both total inpatient number and patients with PH increased year by year during the last 10 years in our hospital. The number of in-hospital patients with PH was significantly higher in 2004 - 2005 than that in 1996 - 2003 (P < 0.0001) and more PH was originated from cardiomyopathy and valvular heart diseases. Idiopathic pulmonary hypertension also tended to increase and PH due to congenital heart diseases was significantly reduced during 2004 - 2005.CONCLUSION:The data from a single center of cardiovascular hospital shows a tendency for increased in-hospital prevalence of pulmonary hypertension during the last ten years.

肺动脉高压（pulmonary artery hypertension,PAH）是不同病因导致的、以肺动脉压力和肺血管阻力升高为特点的一组病理生理综合征。美国国立卫生研究院（national institutesof health,NIH）将 PAH 定义为:平均肺动脉压力在静息状态下大于25mm Hg（1mm Hg=0.133kPa）,在运动状态下大于30mm Hg,而肺毛细血管压或者左心房压力小于15mm Hg。PAH 已经成为一个重要的医疗保健问题,NIH 对194例特发性 PAH 患者的统计,平均生存期仅为2.8年,1、3与5年的生存率分别为68%、48%和34%,与恶性肿瘤相仿。然而目前尚无根治的方法,病因和发病机制研究是实现有效防治的惟一途径,也是目前 PAH 研究的热点和难点。近年来在PAH 的发病机制研究方面取得的最重要的进展之一就是发

肺动脉高压(PH)是不同病因导致的、以肺动脉压力和肺血管阻力升高为特点的一组病理生理综合征,主要病理学改变为血管收缩、血管重构和原位血栓形成,其特征为内皮细胞和平滑肌细胞增殖所引起的阻塞性病变.近年来国外在肺动脉高压的发病机制、临床分类、诊断标准和治疗研究等方面均取得了较大进展,特别是2004年美国胸科医师学会和欧洲心脏病学会分别发表了有循证医学证据的肺动脉高压诊断与治疗指南.2006年国家科技部制定了"十一五"科技支撑计划重大项目课题"提高肺动脉高压诊治水平的研究",旨在制定有我国循证医学证据的肺动脉高压诊治方案.面对肺动脉高压研究所取得的诸多新进展,我国肺动脉高压防治研究工作者应加强对肺动脉高压新知识的学习,结合中国国情和临床具体实践予以正确运用.现就有关肺动脉高压的新知识简介如下,供同仁们参考.