目的探讨纤维支气管镜检查(fiberoptic bronchoscopy,BFS)行支气管肺泡灌洗术(bronchoalveolar lavage,BAL)在儿童慢性肺炎诊断及治疗中的应用价值。方法选取慢性肺炎患儿136例,其中采用常规治疗的68例患儿设为对照组,在常规治疗基础上...目的探讨纤维支气管镜检查(fiberoptic bronchoscopy,BFS)行支气管肺泡灌洗术(bronchoalveolar lavage,BAL)在儿童慢性肺炎诊断及治疗中的应用价值。方法选取慢性肺炎患儿136例,其中采用常规治疗的68例患儿设为对照组,在常规治疗基础上运用BFS行BAL治疗的68例患儿设为观察组。记录观察组患儿BFS结果与肺泡灌洗液病原检测结果。比较2组临床疗效、症状体征消失时间、动脉血气指标及血清炎症因子水平。监测BFS行BAL可能引起的并发症发生情况。结果观察组68例行BFS的患儿镜下均有不同程度的支气管内膜炎症,其中气道发育异常11例。观察组肺泡灌洗液细菌培养阳性率明显高于痰培养阳性率(P<0.05)。观察组总有效率高于对照组(P<0.05)。观察组发热、咳嗽、肺部湿啰音、哮鸣音消失时间均显著短于对照组(P<0.05)。治疗后,观察组动脉血氧分压(arterial partial pressure of oxygen,PaO2)、酸碱度(power of hydrogen,pH)值明显高于治疗前和对照组,动脉血二氧化碳分压(partial pressure of carbon dioxide in artery,PaCO2)值明显低于治疗前和对照组(P<0.05);对照组治疗前后PaO2、PaCO2、pH值差异无统计学意义(P>0.05)。治疗后,2组血清白细胞介素6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)浓度明显低于治疗前,且观察组IL-6、TNF-α水平低于对照组(P<0.05)。观察组患儿BFS行BAL治疗过程中出现经皮血氧饱和度降低4例,支气管黏膜出血6例,但均较轻微,经对症处理后缓解。结论应用BFS行BAL治疗对儿童慢性肺炎的病因诊断、病原体检测及治疗均具有较高的临床应用价值,患儿耐受性较好。展开更多
Soil organic carbon (SOC) has great impacts on global warming, land degradation and food security. Classic statistical and geostatistical methods were used to characterize and compare the spatial heterogeneity of SOC ...Soil organic carbon (SOC) has great impacts on global warming, land degradation and food security. Classic statistical and geostatistical methods were used to characterize and compare the spatial heterogeneity of SOC and related factors, such as topography, soil type and land use, in the Liudaogou watershed on the Loess Plateau of North China. SOC concentrations followed a log-normal distribution with an arithmetic and geometric means of 23.4 and 21.3 g kg-1, respectively, were moderately variable (CV = 75.9%), and demonstrated a moderate spatial dependence according to the nugget ratio (34.7%). The experimental variogram of SOC was best-fitted by a spherical model, after the spatial outliers had been detected and subsequently eliminated. Lower SOC concentrations were associated with higher elevations. Warp soils and farmland had the highest SOC concentrations, while aeolian sand soil and shrublands had the lowest SOC values. The geostatistical characteristics of SOC for the different soil and land use types were different. These patterns were closely related to the spatial structure of topography, and soil and land use types.展开更多
文摘目的探讨纤维支气管镜检查(fiberoptic bronchoscopy,BFS)行支气管肺泡灌洗术(bronchoalveolar lavage,BAL)在儿童慢性肺炎诊断及治疗中的应用价值。方法选取慢性肺炎患儿136例,其中采用常规治疗的68例患儿设为对照组,在常规治疗基础上运用BFS行BAL治疗的68例患儿设为观察组。记录观察组患儿BFS结果与肺泡灌洗液病原检测结果。比较2组临床疗效、症状体征消失时间、动脉血气指标及血清炎症因子水平。监测BFS行BAL可能引起的并发症发生情况。结果观察组68例行BFS的患儿镜下均有不同程度的支气管内膜炎症,其中气道发育异常11例。观察组肺泡灌洗液细菌培养阳性率明显高于痰培养阳性率(P<0.05)。观察组总有效率高于对照组(P<0.05)。观察组发热、咳嗽、肺部湿啰音、哮鸣音消失时间均显著短于对照组(P<0.05)。治疗后,观察组动脉血氧分压(arterial partial pressure of oxygen,PaO2)、酸碱度(power of hydrogen,pH)值明显高于治疗前和对照组,动脉血二氧化碳分压(partial pressure of carbon dioxide in artery,PaCO2)值明显低于治疗前和对照组(P<0.05);对照组治疗前后PaO2、PaCO2、pH值差异无统计学意义(P>0.05)。治疗后,2组血清白细胞介素6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)浓度明显低于治疗前,且观察组IL-6、TNF-α水平低于对照组(P<0.05)。观察组患儿BFS行BAL治疗过程中出现经皮血氧饱和度降低4例,支气管黏膜出血6例,但均较轻微,经对症处理后缓解。结论应用BFS行BAL治疗对儿童慢性肺炎的病因诊断、病原体检测及治疗均具有较高的临床应用价值,患儿耐受性较好。
文摘目的研究血清高迁移率族蛋白B1(high mobility group box 1,HMGB1)、粒细胞-巨噬细胞集落刺激因子(granulocyte-macrophage colony-stimulating factor,GM-CSF)、乳酸脱氢酶(lactate dehydrogenase,LDH)在慢性肺炎患儿的水平变化及相关性,以期为疾病的诊疗提供参考。方法选取慢性肺炎患儿66例,作为肺炎组,另选取健康对照儿童80例,为对照组。检测并比较2组儿童血清HMGB1、GM-CSF、LDH水平。肺炎组儿童根据病情严重程度分为重症组和轻症组,对比两组HMGB1、GM-CSF、LDH水平。以Pearson相关性分析法分析肺炎组中血清HMGB1、GM-CSF、LDH三者的关系。并以受试者工作特征曲线(receiver operating characteristic curve,ROC)评价血清HMGB1、GM-CSF、LDH对慢性肺炎患儿病情严重程度的评估价值。结果肺炎组的血清HMGB1、GM-CSF、LDH水平高于对照组,差异有统计学意义(P<0.001);肺炎患儿重症组的血清HMGB1、GM-CSF、LDH水平高于轻症组,差异有统计学意义(P<0.001)。Pearson相关性分析,血清HMGB1与GM-CSF及LDH水平均呈正相关(r=0.340、0.508,P<0.05),且LDH与GM-CSF水平呈正相关(r=0.553,P<0.05)。ROC结果显示,HMGB1、GM-CSF和LDH分别以11.26μg/L、116.89μg/L和335.41 U/L为截断值,评估慢性重症肺炎的曲线下面积(area under the curve,AUC)分别为0.790、0.787、0.781,三者联合为0.906,联合评估的AUC均高于单独使用,差异有统计学意义(P<0.05)。结论外周血HMGB1、GM-CSF、LDH水平的升高与慢性肺炎患儿的发生发展有关,且三者水平在慢性肺炎患儿中互为正相关,联合检测时对于病情评估有良好的效能。
基金Project supported by the National Key Basic Research Program (973 Program) of China (No.2007CB106803)the National Programs for Science and Technology Development of China (No.2006BAD09B06)the Scientific ResearchInnovation Team Support Program of the Northwest A&F University, China
文摘Soil organic carbon (SOC) has great impacts on global warming, land degradation and food security. Classic statistical and geostatistical methods were used to characterize and compare the spatial heterogeneity of SOC and related factors, such as topography, soil type and land use, in the Liudaogou watershed on the Loess Plateau of North China. SOC concentrations followed a log-normal distribution with an arithmetic and geometric means of 23.4 and 21.3 g kg-1, respectively, were moderately variable (CV = 75.9%), and demonstrated a moderate spatial dependence according to the nugget ratio (34.7%). The experimental variogram of SOC was best-fitted by a spherical model, after the spatial outliers had been detected and subsequently eliminated. Lower SOC concentrations were associated with higher elevations. Warp soils and farmland had the highest SOC concentrations, while aeolian sand soil and shrublands had the lowest SOC values. The geostatistical characteristics of SOC for the different soil and land use types were different. These patterns were closely related to the spatial structure of topography, and soil and land use types.
