气道微生态在慢性阻塞性肺疾病中的研究进展

慢性阻塞性肺疾病（COPD）是一种慢性气道炎症性疾病,其特征为慢性呼吸道症状（呼吸困难、咳嗽、咳痰、急性加重）。感染是COPD恶化以及肺功能下降的主要原因,呼吸道微生态以及其所带来的免疫调节功能在其中发挥重要作用。新一代基因测序技术使得更清楚地了解呼吸道微生态组成及其与呼吸系统疾病相关性,不仅揭示了健康人群肺部拥有丰富的微生物群落,而且与健康人群相比,COPD患者的气道微生态结构和各菌群的相对丰度均发生了改变。本文对气道微生态在COPD中的研究进展作一综述。     

微生态与肺癌相关研究进展

人类微生物研究已经成为一个重要领域,更多的证据表明微生物在肿瘤发生、发展的过程中起关键作用.正常呼吸道微生物保持动态平衡,进一步研究呼吸道疾病的微生物变化,可能为肺癌的病因、发病机制、治疗及与预后等提供更加丰富的理论基础及证据.本文对呼吸系统微生态及具体微生物与肺癌发生、发展过程之间的可能联系及作用进行综述.     

中国肠道微生态学研究的实践

肠道微生态学研究始于对人体"正常菌群"的认识,经历了"正常菌群"、"正常微生物群"和"微生物组"三个阶段。"肠道微生物群"的深入研究催生了微生态学概念,分子生物学技术的进步推动了微生态学的发展,使肠道微生态学的基础研究和临床研究得到了进一步的发展。人体肠道菌群与消化道形成了微生态关系即微生态系,微生态系对机体的疾病发生和健康维持起重要作用。但微生态系影响机体的生态机制还缺乏充足的基础证据。随着生物技术的发展和大数据时代的到来,肠道微生态的原理、机制诠释会更加明确。     

下呼吸道微生态在支气管哮喘中的研究进展

随着二代测序的不断发展,过去人们认为无菌的下呼吸道现已被证实有多种不同的微生物群落定植.同时,越来越多的研究也证明,微生态在宿主免疫系统的发生发展中起着重要的作用.呼吸道微生态紊乱可能与多种呼吸道疾病密切相关,包括肺结核、COPD及支气管哮喘(简称哮喘)等.该研究主要回顾了近年来对哮喘患者及健康人群呼吸道微生态的研究,探讨在哮喘患者中呼吸道菌群定植的改变趋势,以及呼吸道微生态的改变与哮喘发病机制之间的关系,并且对呼吸道微生态在哮喘治疗中的研究进展进行讨论.     

肠道菌群与儿童呼吸系统疾病关系的研究进展

肠道菌群是寄居在人体肠道内的微生物群落的总称,是维持机体内环境稳定的重要因素。既往研究表明,肠道菌群失调、黏膜屏障破坏、局部免疫功能失调可能参与多种疾病的发生发展。本文主要综述了肠道菌群与呼吸道变应性疾病、喘息性支气管炎及新生儿呼吸机相关性肺炎等儿童呼吸系统疾病关系的研究进展,旨在为肠道菌群治疗儿童呼吸系统疾病提供参考。     

下呼吸道微生物菌群对宿主免疫的影响

随着细菌鉴定技术的发展,健康成年人下呼吸道存在常驻微生物菌群的观点逐渐受到认可.这类微生物菌群具有调节天然免疫和获得性免疫反应的作用.在呼吸道疾病如哮喘、COPD的发生发展过程中,宿主下呼吸道微生态环境发生改变,免疫状态也发生了改变,但两者之间的关系尚不明确.我们将围绕下呼吸道微生物菌群对宿主免疫系统的影响进行阐述,以探讨影响呼吸道疾病发生发展的因素.     

微生态制剂及其临床应用

微生态学(microecology)是一门新兴的生命科学分支,是研究正常微生态群与宿主之间相互依赖、相互制约关系的边缘学科.微生态制剂(microbioecological preparation)是根据微生态学原理,利用对宿主有益的正常微生物及其代谢产物和生长促进物质所制成的制剂,通过调整微生态失调,保持微生态平衡,提高宿主的健康水平或改善健康状态[1].近年来,微生态制剂在临床上的应用日益广泛,它在防治感染,合理使用抗生素,调节机体正常菌群平衡,提高机体免疫力和健康水平,促进生长发育等方面发挥着重要作用,但同时还应关注其安全性.     

微生态制剂的临床应用

微生态学 (ｍｉｃｒｏｅｃｏｌｏｇｙ)是一门新的生命科学分支 ,在保健医学、疾病预防和治疗方面具有重要的理论和实践意义。近年来 ,由于临床上一些治疗手段的应用 ,如大量新的高效抗生素和免疫抑制剂的广泛使用、放疗等 ,使人体正常菌群发生改变和失衡 ,从而导致临床疾病的发生。为了使微生物菌群重新获得平衡 ,治疗或治愈疾病 ,微生态制剂(益生菌、益生元、合生元 )的临床应用受到了关注和重视。本文仅就这一方面的研究近况作一介绍。1　肠道微生态1 1　肠道微生态平衡　正常菌群在人体表构成一个生物层 ,形成生物屏障。在粘膜层的细菌称…     

感染性腹泻的微生态疗法

0 引言从微生态学观点来说,胃肠道受到外界因素的影响导致内部的微生态失调将导致腹泻.对于感染性腹泻的防治,目前仍以抗生素治疗为主.但应用抗生素治疗的弊端已愈来愈引起人们的重视,微生态制剂的兴起是治疗感染性腹泻的又一重要手段,它具有调节肠道菌群失调及改善肠道生态环境的作用,对急、慢性腹泻和抗生素引起的肠道菌群失调有良好的预防和治疗作用.微生态防治的本质是以扶植正常菌群,拮抗致病或条件致病菌,调整和恢复微生态平衡为日的的一种预防和治疗方法.1 肠道的微生态平衡正常情况下,由正常微生物群、宿主和外环境构成的生态系统是相互平衡的.从出生到死亡人体与正常菌群之间保持着和谐的共生关系.新生儿刚出生时肠道是无菌的,出生后2h 左右开     

胃肠道微生态与消化性溃疡关系的研究进展

微生态学是研究正常微生物群结构、功能及其与宿主相互依赖及相互制约关系的生命科学分支。胃肠道内栖息的微生物之间保持共生或拮抗关系,与人类的健康及疾病有密切关系。目前研究发现胃肠道微生物菌群可能参与了消化性溃疡的发病过程,此外,微生态制剂在防治消化性溃疡的应用方面也已取得初步结果。本文就胃肠道微生态与消化性溃疡相关性的研究进展作一概述。     

The Use of Probiotics in Head and Neck Infections

Recurrent episodes of infections in the upper respiratory tract are very common. The pathogenesis behind these recurrences is still not well understood, but much attention has been paid to the adherence of the microorganisms to epithelial structures and to the protective function of the normal bacterial flora (bacterial interference). Thus, in vitro as well as in vivo studies have shown that both aerobic and anaerobic bacteria of the normal flora in the upper respiratory tract can hinder the growth of pathogens and the establishment of a renewed infection. Studies have shown that lack of interfering bacteria facilitates recurrence of these diseases. Recolonization with interfering alpha-streptococci has been performed successfully in acute streptococcal pharyngotonsillitis, as well as in acute otitis media. The number of recurrences has significantly been lowered in these diseases after recolonization with alpha-streptococci, which is the dominating normal bacteria in the upper respiratory tract. Several mechanisms have been proposed to be responsible for this interaction, such as competition of the adhering sites at the epithelial cells, production of hydrogen peroxide, competition for nutritients, and production of specific growth inhibiting factors such as bacteriocins. Other human components like lactoferrin are also important in the defense against microorganisms, and are important parts of the unspecific and specific immune system.     

Bombesin and vasoactive intestinal polypeptide in the developing lung: marked changes in acute respiratory distress syndrome

The quantitative distribution of bombesin- and vasoactive intestinal polypeptide (VIP)-like immunoreactivities was determined by RIA and immunocytochemistry in regions of trachea, bronchus, and whole lung at various stages of human fetal development and in neonates, children, and adults. In addition, these two immunoreactivities were studied in infants that had died of the acute respiratory distress syndrome. The concentration of bombesin-like immunoreactivity in the whole respiratory tract steadily increased during gestation, reaching a plateau at birth. In the lung, the bombesin concentration remained almost unchanged during childhood, but decreased to one tenth in the adult. In neonates with the acute respiratory distress syndrome, there was a significantly lower bombesin content in all regions of the respiratory tract compared to either normal full-term infants or 24- to 28-week-old fetuses. Immunocytochemistry localized bombesin immunoreactivity within mucosal neuroendocrine cells present in the airway epithelium throughout the respiratory tract and particularly in the intrapulmonary airways. The number of cells increased throughout gestation, reflecting the pattern found by RIA, and were greatly decreased in acute respiratory distress syndrome patients. VIP concentrations were much lower than those of bombesin and did not change significantly with gestational age. In contrast to bombesin, VIP was mainly concentrated in the upper respiratory tract. In infants with the respiratory distress syndrome, the VIP content was not different from normal. These results are compatible with the possibility that bombesin-like peptides may have a role in the normal development of the human lung.     

Eikenella corrodens discitis after spinal surgery: case report and literature review

Eikenella corrodens is part of the normal flora of the mouth and upper respiratory tract and is usually associated with dental and head and neck infections. We report a case of Eikenella discitis occurring soon after spinal surgery in an otherwise healthy patient, review the literature on bone and joint infections unrelated to human bites and fist-fight injuries, and stress the importance of definitive diagnosis in post-operative spinal infections.     

Gemella endocarditis: consider the colon

Gemella species, including Gemella morbillorum, are part of the normal flora of the human oropharynx, upper respiratory tract and gastrointestinal tract. Differentiation of Gemella from viridans streptococci in the laboratory may be difficult. Although uncommonly pathogenic, they have been implicated in a variety of human infections, most notably infective endocarditis. Dental instrumentation appears to be the usual source of infection. The case is reported of Gemella morbillorum native valve endocarditis, which was associated with an underlying colonic carcinoma. An association with colonic neoplasm has been described in three previous cases of endocarditis attributed to Gemella. It is well documented that Streptococcus bovis endocarditis may occur in the setting of colonic neoplasia. It is suggested that colonic investigation should be considered in patients with Gemella endocarditis, in whom no other source is apparent.     

A case of septic arthritis due to infection with Gemella morbillorum

Gemella morbillorum is a facultatively anaerobic Gram-positive coccus which forms part of the normal flora of the oro-pharynx and the upper respiratory tract. It rarely causes human infection but has been described previously in cases of empyema and lung abscess, septic shock, endocarditis, meningitis, and osteomyelitis. We describe a case of septic arthritis due to G. morbillorum occurring in an otherwise healthy 42-year old man and review previous reports of infection in the literature.     

Peptostreptococcus anaerobius infective endocarditis complicated by spleen infarction

Peptostreptococcus sp., which are normal flora of human mucocutaneous surfaces, can be recovered in mixed infections involving the skin, soft tissue, respiratory tract, gastrointestinal tract and genitourinary tract. Peptostreptococci are rarely reported to be the cause of infective endocarditis. Because of their fastidiousness, peptostreptococci are difficult to isolate and are often overlooked. The authors report a case of Peptostreptococcus infective endocarditis of a native mitral valve complicated by splenic infarction. The authors also review the literature to identify features of infective endocarditis caused by Peptostreptococcus anaerobius.     

儿科重症监护室先天性心脏病合并呼吸道感染患儿的病毒性病原学研究

目的：总结儿科重症监护室中先天性心脏病合并呼吸道感染患儿的病毒性病原谱。方法收集2010年6月至2012年6月因呼吸道感染入住本院儿科重症监护室的患儿咽拭子标本622份,其中先天性心脏病合并呼吸道感染患儿咽拭子34份。应用多重聚合酶链反应(PCR)技术对呼吸道病毒进行检测,并对照分析合并先天性心脏病患儿的病毒性病原学特点。结果①34份先天性心脏病组咽拭子标本中,呼吸道病毒检测阳性20份(58.8%),588份非先天性心脏病组咽拭子标本中,呼吸道病毒检测阳性368份(62.6%)。②先天性心脏病组中,最常见的病毒分别为人鼻病毒(human rhinovirus,HRV)8份,呼吸道合胞病毒(respiratory syncytial virus, RSV)6份,人博卡病毒(human bocavirus,HBoV)4份,腺病毒(adenovirus,ADV)2份;非先天性心脏病组中,最常见的病毒分别为 HRV 160份,RSV 104份,ADV 72份,HBoV50份;其他病毒阳性率较低。③先天性心脏病组中,混合病毒感染有2份(2/20,10.0%),非先天性心脏病组中,混合病毒感染有110份(110/368,29.9%)。结论本地区儿科重症监护室中先天性心脏病合并呼吸道感染患儿的病原体中病毒性病原体检出率高,以鼻病毒、呼吸道合胞病毒、人博卡病毒和腺病毒最常见,病毒谱和非先天性心脏病组相似。     

Neutrophil chemotactic factors in the respiratory tract of patients with chronic airway diseases or idiopathic pulmonary fibrosis.

This study was designed to clarify the contributions of specific neutrophil chemotactic factors (NCF) in neutrophil accumulation in the human respiratory tract associated with various diseases. The activity and characteristics of the NCF in the bronchoalveolar lavage (BAL) fluid and culture media of alveolar macrophages obtained from normal volunteers, control patients, patients with chronic airway diseases (CAD) and patients with idiopathic pulmonary fibrosis (IPF) were examined. The BAL fluid from normal volunteers contained NCF comparable with the chemotactic factors interleukin-8 (IL-8) and leukotriene B4 (LTB4). Analysis of the biochemical characteristics of NCF released from alveolar macrophages suggests that they are derived from alveolar macrophages. The NCF activities in BAL fluids from patients with CAD and IPF were higher than those in BAL fluids from normal volunteers and control patients. Biochemical analysis demonstrated that several kinds of NCF, including those derived from the complement component C5 and alveolar macrophages, were present in the BAL fluid from patients with CAD and respiratory infections. The especially marked increase of C5-derived NCF indicate their importance in neutrophil accumulation in the respiratory tract of patients with CAD. Alveolar macrophages released different types of NCF after different lengths of culture periods (4 h and 24 h). Alveolar macrophages from patients with IPF released larger amounts of NCF than alveolar macrophages from normal volunteers, indicating the importance of alveolar-macrophage-derived NCF as well as C5-derived NCF in neutrophil accumulation in the respiratory tract of patients with IPF. These results suggest that various types of NCF increase in response to different disease states of the respiratory tract and serve to regulate the accumulation of neutrophils.     

Anatomical study of the pulmonary lymphatics

As the result of anatomical as well as histological investigations on the lymphatics of the human lung, the authors have arrived at the following conclusions: 1. According to the distribution and the direction of lymph flow, pulmonary lymphatics are classified into two systems and four groups. 2. The lymphatics cannot be found in the interalveolar septum. 3. The extravascular fluid pathway system plays an important role for cleaning particles in the most peripheral part of the respiratory tract where no lymphatics are found. 4. Efferent lymph flow reaches the venous angles via two routes on both sides respectively.