吸烟和二手烟暴露严重危害人类健康,吸烟管理也是围手术期一个重要的公共卫生问题。吸烟患者术后呼吸系统、心血管系统并发症的发生率显著升高,烟草对术后疼痛控制、伤口愈合及术后康复指标均有不利影响。加速康复外科(enhanced recover...吸烟和二手烟暴露严重危害人类健康,吸烟管理也是围手术期一个重要的公共卫生问题。吸烟患者术后呼吸系统、心血管系统并发症的发生率显著升高,烟草对术后疼痛控制、伤口愈合及术后康复指标均有不利影响。加速康复外科(enhanced recovery after surgery,ERAS)提倡通过充分的循征医学证据来优化围术期处理措施,减轻患者手术的应激反应,减少术后并发症,达到快速康复的目的。本文遵从加速康复外科理念,通过检索各国文献指南证据,对围手术期戒烟策略、戒烟时间及二手烟暴露处理和戒烟方法作一综述,为临床围手术期吸烟管理提供参考。展开更多
Inflammatory bowel disease(IBD) is a chronic condition with a pathogenic background that involves both genetic and environmental factors.Although important progress has been made regarding the former in the last decad...Inflammatory bowel disease(IBD) is a chronic condition with a pathogenic background that involves both genetic and environmental factors.Although important progress has been made regarding the former in the last decade,scarce knowledge is available for the latter.In this sense,smoking remains the most important environmental factor in IBD.Active smoking increases the risk of developing Crohn's disease(CD).Moreover,CD patients who start or continue smoking after disease diagnosis are at risk for poorer outcomes such as higher therapeutic requirements and disease-related complications,as compared to those patients who quit smoking or who never smoked.However,the harmful effect of active smoking is not uniform in all patients or in all clinical scenarios.Interventions designed to facilitate smoking cessation may impact the course of the disease.In this article,the available evidence of the deleterious effects of smoking on CD is reviewed in detail,and alternative therapeutic approaches to CD in smokers are proposed.展开更多
Objective To establish a smoke-induced chronic bronchitis rat model and evaluate the patho-logical change semi-quantitatively, and study the characteristics of the inflammatory cells in the bronchoalveolar lav-age flu...Objective To establish a smoke-induced chronic bronchitis rat model and evaluate the patho-logical change semi-quantitatively, and study the characteristics of the inflammatory cells in the bronchoalveolar lav-age fluid (BALF) in various stages. Methods Chronic bronchitis sequential rat model was established by passively inhaling smoke mixture. Experiments were performed in 30 young male Sprague-Dawley rats, which comprised 5 groups in random, i.e.,4 chronic bronchitis model groups and 1 control group. After stained with hematoxylin and eosin, the specimens were studied by semi-quantitative method to evaluate the morphologic changes in various stages. Meanwhile, the inflammatory cells of the BALF and the activity of myeloperoxidase (MPO) of lung tissue were analysed. Results During the process of the chronic bronchitis, the pathologic score was increasing as time went on, and the typical morphologic changes of chronic bronchitis emerged in the group 7 weeks. The total number of inflammatory cells in BALF was increasing as time went on, correlated with the pathologic scores (P <0.01). And the percentage of lymphocyte increased as well as positively correlated with pathologic scores (P < 0. 05) , whereas that of macrophage decreased and negatively correlated with pathologic scores (P <0. 05). The MPO lever of lung tissue was correlated with the pathologic scores (P < 0. 01). But the percentage of the neutrophil in the BALF was just in a high level during the first week, then it maintained relatively lower. Conclusion Smoke-induced chronic bronchitis is a slowly progressive inflammation process. The model we established is convenient and simple for the longitudinal study on the inflammatory process of chronic bronchitis and the therapy in the early stage. The semi-quantitative evaluation for the pathological change is with much more value. During the inflammatory sequential process of early stage of chronic bronchitis, the cellular characteristics are similar to that of the common chronic inflammation.展开更多
文摘吸烟和二手烟暴露严重危害人类健康,吸烟管理也是围手术期一个重要的公共卫生问题。吸烟患者术后呼吸系统、心血管系统并发症的发生率显著升高,烟草对术后疼痛控制、伤口愈合及术后康复指标均有不利影响。加速康复外科(enhanced recovery after surgery,ERAS)提倡通过充分的循征医学证据来优化围术期处理措施,减轻患者手术的应激反应,减少术后并发症,达到快速康复的目的。本文遵从加速康复外科理念,通过检索各国文献指南证据,对围手术期戒烟策略、戒烟时间及二手烟暴露处理和戒烟方法作一综述,为临床围手术期吸烟管理提供参考。
基金Supported by CIBEREHD,funded by the Instituto de Salud CarlosⅢ,from the Spanish Ministry of Health
文摘Inflammatory bowel disease(IBD) is a chronic condition with a pathogenic background that involves both genetic and environmental factors.Although important progress has been made regarding the former in the last decade,scarce knowledge is available for the latter.In this sense,smoking remains the most important environmental factor in IBD.Active smoking increases the risk of developing Crohn's disease(CD).Moreover,CD patients who start or continue smoking after disease diagnosis are at risk for poorer outcomes such as higher therapeutic requirements and disease-related complications,as compared to those patients who quit smoking or who never smoked.However,the harmful effect of active smoking is not uniform in all patients or in all clinical scenarios.Interventions designed to facilitate smoking cessation may impact the course of the disease.In this article,the available evidence of the deleterious effects of smoking on CD is reviewed in detail,and alternative therapeutic approaches to CD in smokers are proposed.
基金Supported by the fund from Shanghai Science and Technology Committee (004119060)
文摘Objective To establish a smoke-induced chronic bronchitis rat model and evaluate the patho-logical change semi-quantitatively, and study the characteristics of the inflammatory cells in the bronchoalveolar lav-age fluid (BALF) in various stages. Methods Chronic bronchitis sequential rat model was established by passively inhaling smoke mixture. Experiments were performed in 30 young male Sprague-Dawley rats, which comprised 5 groups in random, i.e.,4 chronic bronchitis model groups and 1 control group. After stained with hematoxylin and eosin, the specimens were studied by semi-quantitative method to evaluate the morphologic changes in various stages. Meanwhile, the inflammatory cells of the BALF and the activity of myeloperoxidase (MPO) of lung tissue were analysed. Results During the process of the chronic bronchitis, the pathologic score was increasing as time went on, and the typical morphologic changes of chronic bronchitis emerged in the group 7 weeks. The total number of inflammatory cells in BALF was increasing as time went on, correlated with the pathologic scores (P <0.01). And the percentage of lymphocyte increased as well as positively correlated with pathologic scores (P < 0. 05) , whereas that of macrophage decreased and negatively correlated with pathologic scores (P <0. 05). The MPO lever of lung tissue was correlated with the pathologic scores (P < 0. 01). But the percentage of the neutrophil in the BALF was just in a high level during the first week, then it maintained relatively lower. Conclusion Smoke-induced chronic bronchitis is a slowly progressive inflammation process. The model we established is convenient and simple for the longitudinal study on the inflammatory process of chronic bronchitis and the therapy in the early stage. The semi-quantitative evaluation for the pathological change is with much more value. During the inflammatory sequential process of early stage of chronic bronchitis, the cellular characteristics are similar to that of the common chronic inflammation.
