Idiopathic pulmonary fibrosis (IPF) is a progressive fibrotic interstitial lung disease of unknown causes, ultimately leading to hypoxemia, respiratory failure, and even death.The incidence of IPF has been increasing in recent years, and its prognosis is poor.IPF is currently a challenging disease, the diagnosis and treatment of which have been highly concerned.Four years later, an international multidisciplinary expert committee has reviewed the diagnosis and treatment of IPF from the 2018 version, and once again updated the guidelines for the diagnosis and treatment of IPF.This review provides a detailed interpretation of the diagnosis and treatment of IPF in the " Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults: An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline (2022 Edition)" .

外周血嗜酸性粒细胞计数＞0.5×109/L时称为嗜酸粒细胞增多症,嗜酸性粒细胞增多根据病因可分为原发性、继发性和特发性,继发性嗜酸性粒细胞增多症的原因有很多种,但药物诱导是其常见原因之一.文章着重阐述哪些药物能引起血嗜酸性粒细胞增多及其可能机制、临床症状和相关诊疗.

Objective:To explore the effects of ERp57 on fibroblast activation and its function and mechanism in the pathogenesis of pulmonary fibrosis.Methods:Immunohistochemical staining and Western blot were used to detect the expression level of ERp57 in lung tissues of idiopathic pulmonary fibrosis patients and bleomycin-induced pulmonary fibrosis in mice.In vitro, primary lung fibroblasts were cultured and ERp57-siRNA liposomes were transfected into fibroblasts.Western blot was used to detect the effect of siRNA interference with ERp57 expression on the activation of fibroblasts.Results:In the lung tissues of idiopathic pulmonary fibrosis patients and bleomycin-induced pulmonary fibrosis mice, the expression level of ERp57 was significantly up-regulated, and it was mainly expressed in fibroblasts.In vitro, experiments revealed that the expression level of ERp57 increased in a time-dependent manner in human primary fibroblasts after transforming growth factor-β 1 stimulation.In line with those results, knockdown of ERp57 expression can significantly inhibit fibroblast activation. Conclusions:ERp57 is closely related to the pathogenesis of pulmonary fibrosis and suppression of ERp57 expression can significantly inhibit the activation of fibroblasts.

目的:调查新型冠状病毒肺炎(COVID-19)患者抑郁、焦虑及失眠的情况,评估新型冠状病毒(SARS-CoV-2)感染对患者心理方面的影响以及发生心理疾病的风险因素.方法:对收治的560例COVID-19患者进行横截面研究.分别采用9项患者健康问卷(PHQ-9)、7项广泛性焦虑障碍量表(GAD-7)和失眠严重指数(ISI)问卷,自拟一般状况调查表调查患者抑郁、焦虑、失眠情况以及人口学基本特征,采用单因素和多因素Logistic回归法分析抑郁、焦虑、失眠的影响因素.结果:在490例受访者中,182例(37.1％)表现为抑郁,154例(31.4％)出现焦虑,148例(30.2％)出现失眠.多因素Logistic回归法分析显示离异或丧偶、受访时仍在医院治疗、家人感染SARS-CoV-2是发生抑郁的独立危险因素[OR 95％ CI分别为3.653(1.238,11.327),1.818 (1.040,3.182),1.620 (1.087,2.434),P＜0.05].多因素Logistic回归分析显示,重症患者出现抑郁症状的风险较入院时轻症患者低[OR 95％ CI 0.420(0.251,0.686),P＜0.05].女性、受访时仍在医院治疗、家人存在SARS-CoV-2感染是焦虑的独立危险因素[OR95％ CI分别是1.664 (1.115,2.492),2.643 (1.520,4.610),1.708 (1.125,2.621),均P＜0.05].受访时处于隔离期或仍在住院治疗中的患者发生失眠的风险明显升高[OR 95％ CI分别是2.107 (1.344,3.327),2.215 (1.262,3.879),均P＜0.05].结论:抑郁、焦虑和失眠为COVID-19患者常见的心理疾病.我们应给与COVID-19患者更多的心理关怀和心理疏导.