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儿童麻醉评估与围手术期风险预测中国专家共识(2024版)

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中华医学杂志 2024年第29期104卷 2688-2700页

作者：中华医学会麻醉学分会小儿麻醉学组中华医学会麻醉学分会器官移植麻醉学组中国心胸血管麻醉学会日间手术麻醉分会中华医学会麻醉学分会小儿麻醉学组中华医学会麻醉学分会器官移植麻醉学组中国心胸血管麻醉学会日间手术麻醉分会

0～15岁儿童围手术期不良事件的发生率为5.2%, 术前科学准确的麻醉评估是保障患儿手术安全的重要环节, 围手术期风险预测是以数字量化评价围手术期风险水平, 对危险程度进行分层。为进一步规范儿童麻醉评估方法, 识别危险因素, 中华医... 详细信息

0～15岁儿童围手术期不良事件的发生率为5.2%, 术前科学准确的麻醉评估是保障患儿手术安全的重要环节, 围手术期风险预测是以数字量化评价围手术期风险水平, 对危险程度进行分层。为进一步规范儿童麻醉评估方法, 识别危险因素, 中华医学会麻醉学分会组织了儿童专科医院、综合性医院的麻醉学专家和公共卫生学院的统计学专家共同撰写了《儿童麻醉评估与围手术期风险预测中国专家共识(2024版)》。其中麻醉评估包括病史采集、体格检查、实验室检查、美国麻醉医师协会全身状况分级、困难气道评估、危重症患儿识别与评估等, 围手术期风险预测包括术前焦虑、围手术期呼吸不良事件、反流误吸、苏醒期谵妄、术后恶心呕吐、术后转入儿童重症监护病房、术后急性肾损伤、围手术期死亡、非心脏手术先天性心脏病患儿院内死亡风险预测。本共识共形成16条推荐意见, 旨在推动麻醉医师熟悉儿童麻醉评估的内容, 识别围手术期不良事件的危险因素, 并采取针对性措施降低不良事件的发生, 提高患儿围手术期安全。

关键词：儿童麻醉评估风险预测专家共识

Effects of Body Temperature on Pressure Changes Inside Chamber when Using Plethysmography to Measure Lung Function of Mice

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Effects of Body Temperature on Pressure Changes Inside Chamb...

Treatment of bronchoscopic argon plasma coagulation for tumorous endobronchial tuberculosis

2006年浙江省呼吸系病学术年会

作者： Wei-hua Xu, Hua-hao Shen respiratory disease Institute of Zhejiang University, Hangzhou, China respiratory Department of the Second Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, China

Introduction Plethysmography is widely used to assess lung function including tidal volume in rodents. Mitzner and Tankersley pointed out that the pressures generated inside the chamber arise from two sources: gas compression and gas conditioning. Lundblad et al. testified further that temperature and humidity played the role on pressure inside the chamber.

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Treatment of bronchoscopic argon plasma coagulation for tumo...

中华医学会呼吸病学年会——2011（第十二次全国呼吸病学学术会议）

作者： Deguang Mu,Enqing Fu,Tonggang Liu,Yonghong Xie,Faguang Jin Dept.of respiratory disease,Tangdu Hospital

Objective To investigate the efficacy and safety of bronchoscopic argon plasma coagulation(APC) for tumorous endobronchial tuberculosis. Methods In this study,we analyzed the records of 52 patients with tumorous *** o...

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难治性肺癌中国专家共识

中华结核和呼吸杂志 2024年第4期47卷 301-312页

作者：中华医学会呼吸病学分会胡成平陈良安不详中南大学湘雅医院长沙410000 解放军总医院第一医学中心北京100853

肺癌在我国的发病率及病死率均居恶性肿瘤之首,严重危害人民的生命健康。难治性肺癌指对标准治疗反应低,或尚无标准治疗,缺乏高效低毒治疗方案的肺癌。目前对于难治性肺癌尚缺乏明确定义及治疗相关共识。为了更好地指导临床合理、安全... 详细信息

肺癌在我国的发病率及病死率均居恶性肿瘤之首,严重危害人民的生命健康。难治性肺癌指对标准治疗反应低,或尚无标准治疗,缺乏高效低毒治疗方案的肺癌。目前对于难治性肺癌尚缺乏明确定义及治疗相关共识。为了更好地指导临床合理、安全、有效地治疗难治性肺癌,中华医学会呼吸病学分会肺癌学组的专家,针对我国肺癌实际诊疗情况,参考了国内外最新研究数据、相关指南共识及专家临床实践经验,制定了本共识。共识围绕难治性SCLC、难治性驱动基因阳性NSCLC、难治性驱动基因阴性NSCLC、精准诊疗新技术方案等四个方面分别给出推荐意见,为我国医师提供难治性肺癌的用药建议和参考。

关键词：肺肿瘤治疗专家共识

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Hypoxia Induces Transforming Growth Factor-β1 Gene Expression in the Pulmonary Artery of Rats via Hypoxia-inducible Factor-1α

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Acta Biochimica et Biophysica Sinica 2007年第1期39卷 73-80页

作者： Yongliang JIANG Aiguo DAI Qifang LI and Ruicheng HU Depoptment of respiratory Medicine,Hunan Institute of Gerontology,Hunan Province Geriatric Hospital,Changsha 410001,China Department of respiratory Medicine Hunan Institute of Gerontology Hunan Province Geriatric HospitalChangsha 410001 China

The present study was undertaken to investigate the dynamic expression of hypoxia induciblefactor-1 α (HIF-1α) and transforming growth factor-β1 (TGF-β1) in hypoxia-induced pulmonary hypertensionof *** was found that mean pulmonary arterial pressure (mPAP) increased significantly after 7 d *** artery remodeling index and right ventricular hypertrophy became evident after 14 d ***-1α mRNA staining was less positive in the control,hypoxia for 3 d and hypoxia for 7 d,butbegan to enhance significantly after 14 d of hypoxia,then remained *** of HIF-1 α protein inthe control was less positive,but was up-regulated in pulmonary arterial tunica intima of all hypoxic ***-β1 mRNA expression in pulmonary arterial walls was increased significantly after 14 d of hypoxia, butshowed no obvious changes after 3 or 7 d of *** pulmonary tunica adventitia and tunica media,TGF-β1 protein staining was less positive in control rats,but was markedly enhanced after 3 d of hypoxia,reaching its peak after 7 d of hypoxia,and then weakening after 14 and 21 d of *** blottingshowed that HIF- 1α protein levels increased significantly after 7 d of hypoxia and then remained at a highlevel. TGF-β1 protein level was markedly enhanced after 3 d of hypoxia,reaching its peak after 7 d ofhypoxia,and then decreasing after 14 and 21 d of *** correlation analysis showed that HIF-1αmRNA, TGF-β1 mRNA, TGF-β1 protein were positively correlated with mPAP,vessel morphometry andright ventricular hypertrophy ***-β1 protein (tunica adventitia) was negatively correlated withHIF-lα *** together,our results suggest that changes in HIF-lα and TGF-β1 expression afterhypoxia play an important role in hypoxia-induced pulmonary hypertension of rats.

关键词： hypoxia inducible factor-1α transforming growth factor-β1 hypertension lung hypoxia

Effects of CpG oligodeoxynucleotide on transcription factors GATA-3 and T-bet mRNA expression in asthmatic mice

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Acta Pharmacologica Sinica 2005年第9期26卷 1117-1122页

作者： Zu-qun WU~(1,2) Yi-ping XU~3 Hua XIANG~4 Hua-hao SHEN~11 Department of respiratory Medicine,the Second Affiliated Hospital,4 Department of Pathology,the First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou 310009,China 3 Department of respiratory Medicine,Renji Hospital,Shanghai Second Medical University Shanghai 200001,China Department of respiratory Medicine the Second Affiliated Hospital Hangzhou China Department of respiratory Medicine Renji Hospital Shanghai Second Medical University Shanghai China Department of Pathology the First Affiliated Hospital School of Medicine Zhejiang University Hangzhou China

Aim:To investigate effects ofCpG oligod'eoxynucleotide(CpG ODN)on the mRNAexpression of transcription factors GATA binding protein 3(GATA-3)and T-boxexpressed in T cells(T-bet)in asthmatic ***:An asthmatic mousemodel was established and treated with CpG *** inflammatory cells andeosinophils in bronchoalveolar lavage fluid(BALF)were counted and inflamma-tory cell infiltration in lung tissue was ***-y and interleukin-4concentrations in BALF and splenocyte culture supernatants were detected us-ing an enzyme-linked immunosorbent *** factor GATA-3 and T-bet mRNA expression in splenocytes and lung tissue were detected by reversetranscription-polymerase chain ***:Total inflammatory cells andeosinophils in BALF were reduced in the CpG ODN-treated group compared withthe asthma group,and inflammatory cell infiltration in lung tissue was also signifi-cantly *** ODN treatment increased the interferon-γ concentrationbut decreased the interleukin-4 concentration in both BALF and splenocyte cul-ture ***-3 mRNA expression was reduced in both lung tissueand splenocytes in the CpG ODN-treated group,while the mRNA ratio ofT-bet toGATA-3 in splenocytes was ***:CpG ODN treatment inhibitsairway inflammatory cell infiltration and regulates interferon-y/interleukin-4 syn-thesis in asthmatic mice,possibly through a mechanism of downregulation ofGATA-3 mRNA expression in both lung tissue and splenocytes.

关键词： asthma inflammation CpG oligodeoxy-nucleotide GATA-3 T-bet mice

慢性阻塞性肺疾病合并尘肺病临床管理中国专家共识

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中华结核和呼吸杂志 2024年第8期47卷 730-737页

作者：慢性阻塞性肺疾病合并尘肺病临床管理中国专家共识撰写组陈亚红不详北京大学第三医院呼吸与危重症医学科北京100191

慢性阻塞性肺疾病(简称慢阻肺)常与其他疾病共存(合并症),尘肺病是其中一个重要的合并症。尘肺病与慢阻肺之间相互影响,表现在患病风险、疾病严重程度、急性加重风险与疾病进展程度、治疗药物及非药物治疗方案等。目前临床上普遍存在对... 详细信息

慢性阻塞性肺疾病(简称慢阻肺)常与其他疾病共存(合并症),尘肺病是其中一个重要的合并症。尘肺病与慢阻肺之间相互影响,表现在患病风险、疾病严重程度、急性加重风险与疾病进展程度、治疗药物及非药物治疗方案等。目前临床上普遍存在对慢阻肺合并症的认识不足,对于慢阻肺合并尘肺病患者缺乏明确的临床诊治指导。在循证证据和临床经验的基础上,撰写组提出5条推荐意见,以期提高不同级别医院尤其是基层医疗机构医务工作者对慢阻肺合并尘肺病患者的识别与管理。

关键词：疾病严重程度基层医疗机构药物治疗方案患病风险慢性阻塞性肺疾病慢阻肺不同级别医院尘肺病

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Montelukast modulates lung CysLT1 receptor expression and eosinophilic inflammation in asthmatic mice

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Acta Pharmacologica Sinica 2004年第10期 101-106页

作者： Yan-jun ZHANG, Lei ZHANG, Shao-bin WANG, Hua-hao SHEN, Er-qing WEIDepartment of Pharmacology, Zhejiang University School of Medicine, Hangzhou 310031 Zhejiang Provincial Centre for disease Control and Prevention, Hangzhou 310009 Department of respiratory diseases, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China

AIM: To determine the expressions of cysteinyl leukotriene receptors, CysLT1 and CysLT2, in airway eosinophilic inflammation of OVA-induced asthmatic mice and the modulation by montelukast, a CysLT1 receptor antagonist. METHODS: Asthma model was induced by chronic exposure to ovalbumin (OVA) in C57BL/6 mice. The eosino-phils in bronchoalveolar lavage (BAL) fluid and lung tissues were counted, IL-5 level in BAL fluid was measured, and CysLT1 and CysLT2 receptor mRNA expressions were detected by semi-quantitative RT-PCR. RESULTS: Montelukast (6 mg/kg, once per day for 20 d) significantly suppressed the increased eosinophils in BAL fluid and lung tissue, and increased IL-5 level in BAL fluid in OVA challenged mice. OVA challenge increased CysLT1 but decreased CysLT2 receptor mRNA expression. Montelukast inhibited the increased CysLT1 but not the reduced CysLT2 expression after OVA challenge. CONCLUSION: CysLT receptors are modulated immunologically, and montelukast inhibits up-regulation of CysLT1 receptor

关键词： leukotriene receptors leukotriene antagonists asthma inflammation montelukast

Serum myostatin levels and skeletal muscle wasting in chronic obstructive pulmonary disease

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Serum myostatin levels and skeletal muscle wasting in chroni...