居室尘埃内毒素暴露与支气管哮喘及特应性疾病的关系

支气管哮喘（简称哮喘）与过敏性鼻炎等特应性疾病的患病率正不断上升,其发病的具体机制尚未完全清晰,主要是宿主免疫系统和环境相互作用的结果。内毒素是革兰阴性菌细胞壁上特有的结构,在外环境中内毒素几乎无处不在。内毒素对哮喘及特应性疾病而言是一把＂双刃剑＂,早期生活暴露于内毒素可能对疾病的发展具有保护作用;然而,暴露于高水平的内毒素环境不利于疾病的控制。     

环境微生物暴露与儿童支气管哮喘

背景和目的:既往的研究发现,微生物暴露的某些标记(如内毒素、胞壁酸等)与支气管哮喘(简称哮喘)和特异质等疾病呈负相关.这或许能够解释儿童在广泛的微生物暴露的环境(如传统的农场)中成长不易罹患哮喘和特异质的原因.     

支气管哮喘与遗传的关系

支气管哮喘是一种与遗传有关的Ⅰ型超敏反应性疾病。此症有明显家族性,50％特应性患者的子代患有特应性疾病。目前认为哮喘为多基因遗传,其特应性基因及其染色体定位是目前国外哮喘分子遗传学研究的重点。     

支气管哮喘与遗传的关系

支气管哮喘是一种与遗传有关的Ｉ型超敏反应性疾病。此症有明显家族性,５０％特应性患的子代患有特应性疾病。目前认为哮喘为多基因遗传,其特应性基因及其染色体定位是目前国外哮喘分子遗传学研究的重点。     

卫生假说的证据与困惑

英国学者Strachan于1989年首先报道了儿童花粉症的患病率与家庭大小、家中年长同胞的人数呈负相关[1],并因此提出这样一个假设:幼年早期从年长同胞身上传过来的感染性疾病对于免遭变应性疾病具有保护作用,从而较少发生湿疹、过敏性鼻炎、支气管哮喘(以下简称哮喘)等变应性疾病.这就是所谓的“卫生假说(Hygiene Hypothesis)”. 变应性疾病的类型、机体暴露的时间、暴露的类型以及机体对暴露因素的遗传易感性构成了卫生假说的理论核心.     

儿童支气管哮喘的易发因素及预防措施

支气管哮喘(下称哮喘)是小儿常见的呼吸道变态反应性疾病,近年来患病率有上升趋势。1987年以来,我院收治哮喘患儿156例(男87例,女69例),年龄2.5～12岁,现就其易发因素讨论如下。 1.遗传因素:目前认为哮喘是一种多因子遗传的过敏性疾病,与家庭“特应性”倾向有密切关系,一级亲属中尤为明显。其双亲都有“特应性”体质者子女哮喘者占     

中国儿童呼吸道及特应性疾病患病情况调查

目的 由于支气管哮喘(简称哮喘)是一种特应性疾病，且世界各地患病率差异很大，我们对北京、广州、香港三地儿童的呼吸道疾病及特应性疾病进行了比较，以确定特应性在哮喘发生中的作用。方法在北京、广州、香港三城市的9～11岁儿童中随机抽样，应用国际儿童哮喘和过敏性疾病研究(ISAAC)第二阶段问卷，由10902名儿童的父母回答问卷并对3479名儿童进行皮肤检查及皮肤变应原点刺检查。结果近年喘息、重度喘息(说话受限)、鼻(眼)结膜炎及肢体弯曲处皮炎的患病率，香港显高于北京及广州。特应性发生率香港地区(41．2％)也高于北京(23．9％)和广州(30．8％)。表明特应性与近年喘息高度相关(0R=7．74，95％CI=5．70～10．51)。对香港地区人群进一步分析发现，由内地移居香港的儿童，其过敏症状及特应性发生率显低于香港地区出生儿童。结论香港地区学龄儿童哮喘、变态反应性疾病患病率、特应性发生率最高。特应性是中国儿童哮喘发病的重要因素。     

营养素与特应性疾病

特应性疾病又称IgE介导的变态反应性疾病，如花粉症、哮喘和湿疹。近年来特应性疾病的患病率呈明显增加趋势，许多学者认为在过去的20—40年里导致特应性疾病增加的原因之一是饮食结构的改变。流行病学和免疫学研究发现，在胎儿和生命早期，通过调控饮食或补充某种营养素可能降低特应性疾病的发生。本文就近年来国内外有关营养素对特应性疾病影响的研究进展做一综述，重点介绍维生素、矿物质、类脂类等营养素对特应性疾病影响的流行病学证据及其作用机制。     

呼吸道病毒感染在婴幼儿喘息及支气管哮喘发病中的作用

本文综述呼吸道病毒感染在婴幼儿毛细支气管炎、支气管哮喘(简称哮喘)等喘息性疾病中的作用,及病毒感染对哮喘和变态反应性疾病的影响.呼吸道病毒感染可以损伤气道上皮,直接激活末梢神经,导致气道细胞产生多种炎性细胞因子及趋化因子,导致喘息、咳嗽等临床症状的产生,同时影响机体免疫功能,导致免疫功能紊乱.呼吸道病毒感染对喘息及哮喘患儿的影响是急性损害和长期作用并存,特应性体质的患儿对病毒感染更加敏感.有效地控制婴幼儿时期的呼吸道病毒性感染,可以减少喘息性疾病的发作,并最终减少哮喘的发生.     

特应性哮喘和非特应性哮喘的死亡比较

英国胸腔学会1979年调查了15—64岁死于哮喘的90例患者,对资料完全的86例根据特应状态进行分类,52例(60％)是特应性的(Atopic),34例是非特应性的(Non-atopic)。特应性的证据是①对一种或多种常见的过敏原进行的皮肤划痕过敏试验阳性;②其它过敏性疾病的存在,如湿疹,结膜炎或枯草热;③哮喘发作史;④由特定的环境过敏原,如狗、猫、马、整理床位、清扫房间和割草等引起的其它过敏反应;⑤夏季哮喘或夏季加重的长年哮喘。     

Medical and Psychology Students' Knowledge and Attitudes Regarding Aging and Sexuality

The current study surveys medical and doctoral psychology students (N = 100) from an urban northeastern university regarding knowledge and attitudes toward elderly sexuality and aging using the Facts on Aging Quiz, the Aging Sexuality Knowledge and Attitudes Scale, and measures of interest in gerontology, academic/clinical exposure to aging and sexuality, and contact with elders. The current study found that psychology students demonstrated greater aging knowledge than medical students; however, both groups showed gaps in knowledge about sexuality. Married students had greater academic/clinical exposure and greater knowledge about aging but less permissive attitudes toward elderly sexuality. Generally, knowledge about aging was the strongest correlate of knowledge about sexuality. Level of knowledge about sexuality was not associated with attitudes. Attitudes toward sexuality and aging may be more strongly tied to demographic variables reflective of religious beliefs or adherence to sociocultural norms.     

Cement and Concrete Nanoscience and Nanotechnology

Concrete science is a multidisciplinary area of research where nanotechnology potentially offers the opportunity to enhance the understanding of concrete behavior, to engineer its properties and to lower production and ecological cost of construction materials. Recent work at the National Research Council Canada in the area of concrete materials research has shown the potential of improving concrete properties by modifying the structure of cement hydrates, addition of nanoparticles and nanotubes and controlling the delivery of admixtures. This article will focus on a review of these innovative achievements.     

Leptin and cellular and innate immunity in abstinent alcoholics and controls

BACKGROUND: Basic studies indicate that in vitro and in vivo doses of leptin modulate cellular immune responses. Given evidence that concentrations of leptin are altered in alcoholics who also show immune abnormalities, this study examined the relationships between circulating levels of leptin and markers of cellular and innate immunity. METHODS: Circulating levels of leptin, natural killer cell (NK) activity, interleukin-2 (IL-2)-stimulated NK activity, and concanavalin A-stimulated production of IL-2, IL-6, IL-10, and IL-12 were compared between abstinent DSM-IV alcohol-dependent men (n = 27) and age- and gender-matched controls (n = 34). RESULTS: As compared with controls, alcoholics showed lower NK activity (p < 0.01) and a trend for lower levels of leptin (p = 0.055). In the total sample, leptin predicted NK activity (beta = 0.33; p < 0.05) after controlling for the confounding influence of body mass index, alcohol intake, and smoking. Leptin was not correlated with any of the cytokine measures. To examine whether the effects of leptin were mediated by its direct action on NK, additional studies examined in vitro effects of leptin on NK activity in healthy volunteers (n = 10); leptin doses (0.1, 1, and 10 nM) yielded levels of NK activity comparable to those with media alone. CONCLUSIONS: These data show that circulating levels of leptin are associated with NK activity in humans and suggest that abnormal in vivo concentrations of leptin may contribute to the declines of NK activity in alcoholics who are at risk for infectious diseases.     

慢性饮酒、吸烟与骨质疏松的相关性研究

目的 探讨长期大量慢性饮酒、吸烟等不良生活方式与骨质疏松的关系.方法 以乏力、腰背痛、双下肢酸困为主诉,且有长期大量慢性饮酒史、吸烟史,无其他慢性疾病史的年轻男性患者45例为观察对象,测定其血钙(Ca)、血磷(P)和血肌酐(Cr)、尿素氮(BUN)、血糖(Glu)、天门冬酸氨基转移酶(AST)、丙氨酸基转移酶(ALT)、血清碱性磷酸酶(ALP)、甲状腺功能、全段甲状旁腺激素(iPTH)、1,25-二羟维生素D3[1,25-(OH) 2D3]、双能X线骨密度仪测定腰椎L1-4及左侧股骨近段(包括颈、股骨颈上部、大粗隆)骨密度(BMD),分析饮酒、吸烟对骨量的影响.以感冒发热就诊、年龄相当、无饮酒、吸烟史及慢性疾病史的45例男性为对照组.结果 观察组1,25(OH)2D3水平均降低,血钙水平偏低,血磷正常,碱性磷酸酶呈不同程度地升高,骨密度T值提示观察组27例骨质疏松,12例骨量减少,6例正常骨量;而对照组仅有6例为骨量减少,1例骨质疏松,38例为正常骨量,两组比较差异有统计学意义(P＜0.05).结论 长期慢性大量饮酒吸烟影响骨量,甚至易导致骨质疏松.     

自身免疫与动脉粥样硬化的发生发展

在动脉粥样硬化的发生发展过程中,自身免疫具有重要作用,本文就近年有关动脉粥样硬化的免疫机制的研究进展作一简要综述.     

Neutropenia and agranulocytosis in England and Wales: incidence and risk factors

The objectives of this study were to estimate the incidence of idiosyncratic neutropenia and agranulocytosis in England and Wales and to evaluate their risk factors and outcomes. The study was conducted using data from the General Practice Research Database. All cases of idiosyncratic neutropenia or agranulocytosis were identified and the incidence was estimated. This was followed by a nested case-control study, estimating odds ratios with drug exposure from conditional logistic regression. From 1987 to 1999, 3,224 patients with idiosyncratic neutropenia (50 with agranulocytosis) were identified. The incidences of neutropenia and agranulocytosis were estimated to be 120 and 7 cases per million people per year, respectively. The adjusted odds ratios for neutropenia were 34.7 (95% confidence interval 12.0-99.7) for current users of thyroid inhibitors, 9.5 (4.4-20.8) for users of disease-modifying antirheumatic drugs, and 7.6 (4.9-11.9) for users of aminosalicylates. Other drugs with statistically significantly increased risks of neutropenia included antibacterial drugs, non-opioid analgesics, NSAIDs, antidepressants, ulcer-healing drugs, and anti-epileptics. The increase in risk of neutropenia predominantly occurred during the first months of treatment. For most drugs investigated in this study, there was no relationship to daily dose. The excess 1-year mortality was low among neutropenia and agranulocytosis cases and mostly explained by the underlying disease state. In conclusion, the highest risks of neutropenia were generally found in patients starting treatment. The excess 1-year mortality was low among neutropenia and agranulocytosis cases and can be mostly explained by the underlying disease state.     

中青年超重和肥胖与高血压及高同型半胱氨酸血症的相关性研究

目的探讨中青年超重和肥胖与高血压及高同型半胱氨酸血症的相关性。方法选取2012年1月—2013年10月在我院进行常规健康体检者750例,测量受试者血压、身高、体质量及血清同型半胱氨酸(Hcy)水平。结果男性超重、肥胖检出率分别为36.87%(198/537)和13.97%(75/537),均高于女性的16.43%(35/213)和7.50%(16/213)(P0.05)。超重者和肥胖者高血压和高同型半胱氨酸血症检出率分别为21.03%(49/233)和11.16%(26/233)、46.12%(42/91)和41.76%(38/91),均高于正常者的9.16%(37/404)和2.23%(9/404),肥胖者高于超重者(P0.01)。收缩压(SBP)、舒张压(DBP)及血清Hcy与BMI呈正相关(r值分别为0.639、0.515、0.497,P0.01)。结论中青年尤其是男性超半数存在超重或肥胖,高血压及高同型半胱氨酸血症与BMI呈正相关,超重和肥胖者高血压及高同型半胱氨酸血症的发生率高,应积极防治。