AIM:To outline the appropriate diagnostic methods and therapeutic options for acquired bronchobiliary fistula(BBF).METHODS:Literature searches were performed in Medline,EMBASE,PHMC and LWW(January 1980August 2010)usin...AIM:To outline the appropriate diagnostic methods and therapeutic options for acquired bronchobiliary fistula(BBF).METHODS:Literature searches were performed in Medline,EMBASE,PHMC and LWW(January 1980August 2010)using the following keywords:biliobronchial fistula,bronchobiliary fistula,bronchobiliary fistula,biliarybronchial fistula,tracheobiliary fistula,hepatobronchial fistula,bronchopleural fistula,and biliptysis.Further articles were identified through crossreferencing.RESULTS:Sixtyeight cases were collected and reviewed.BBF secondary to tumors(32.3%,22/68),including primary tumors(19.1%,13/68)and hepatic metastases(13.2%,9/68),shared the largest proportion of all cases.Biliptysis was found in all patients,and other symptoms were respiratory symptoms,such as irritating cough,fever(36/68)and jaundice(20/68).Half of the patients were treated by lessinvasive methods such as endoscopic retrograde biliary drainage.Invasive approaches like surgery were used less frequently(41.7%,28/67).The outcome was good at the end of the followup period in 28 cases(range,2 wk to 72 mo),and the recovery rate was 87.7%(57/65).CONCLUSION:The clinical diagnosis of BBF can be established by sputum analysis.Careful assessment of this condition is needed before therapeutic procedure.Invasive approaches should be considered only when noninvasive methods failed.展开更多
Viruses are obligatory intracellular parasites. Most of the cells in animaland human body possess the innate ability to fight viruses. Innate immune function restrictsinfection at the early stage and delay spread of v...Viruses are obligatory intracellular parasites. Most of the cells in animaland human body possess the innate ability to fight viruses. Innate immune function restrictsinfection at the early stage and delay spread of virus. The early stage of infection is the stage ofinteraction between the virus and the host's defence system. Once the latter is breached, the earlynon-specific or innate immune components such as interferon (IFN), natural killer (NK) cells andmacrophages become active. As the infection proceeds, the adaptive (specific) immune responsedevelops, with the appearance of cytotoxic T cells, helper T cells and antiviral antibodies.Antibodies provide a major barrier to virus spread between cells and cells and are particularlyimportant in restriction of virus spread in the blood stream. Virus infection directly activates thetranscription of type Ⅰ IFN (IFN-alfa/beta) genes in infected cells, while the type Ⅱ IFN(IFN-gamma) plays an essential role in the regulation of an adaptive immune response rather thaninnate immune response. Therefore, Type Ⅰ IFN is the first defence for host and neighbouring cellsto resist virus infection.展开更多
文摘AIM:To outline the appropriate diagnostic methods and therapeutic options for acquired bronchobiliary fistula(BBF).METHODS:Literature searches were performed in Medline,EMBASE,PHMC and LWW(January 1980August 2010)using the following keywords:biliobronchial fistula,bronchobiliary fistula,bronchobiliary fistula,biliarybronchial fistula,tracheobiliary fistula,hepatobronchial fistula,bronchopleural fistula,and biliptysis.Further articles were identified through crossreferencing.RESULTS:Sixtyeight cases were collected and reviewed.BBF secondary to tumors(32.3%,22/68),including primary tumors(19.1%,13/68)and hepatic metastases(13.2%,9/68),shared the largest proportion of all cases.Biliptysis was found in all patients,and other symptoms were respiratory symptoms,such as irritating cough,fever(36/68)and jaundice(20/68).Half of the patients were treated by lessinvasive methods such as endoscopic retrograde biliary drainage.Invasive approaches like surgery were used less frequently(41.7%,28/67).The outcome was good at the end of the followup period in 28 cases(range,2 wk to 72 mo),and the recovery rate was 87.7%(57/65).CONCLUSION:The clinical diagnosis of BBF can be established by sputum analysis.Careful assessment of this condition is needed before therapeutic procedure.Invasive approaches should be considered only when noninvasive methods failed.
文摘Viruses are obligatory intracellular parasites. Most of the cells in animaland human body possess the innate ability to fight viruses. Innate immune function restrictsinfection at the early stage and delay spread of virus. The early stage of infection is the stage ofinteraction between the virus and the host's defence system. Once the latter is breached, the earlynon-specific or innate immune components such as interferon (IFN), natural killer (NK) cells andmacrophages become active. As the infection proceeds, the adaptive (specific) immune responsedevelops, with the appearance of cytotoxic T cells, helper T cells and antiviral antibodies.Antibodies provide a major barrier to virus spread between cells and cells and are particularlyimportant in restriction of virus spread in the blood stream. Virus infection directly activates thetranscription of type Ⅰ IFN (IFN-alfa/beta) genes in infected cells, while the type Ⅱ IFN(IFN-gamma) plays an essential role in the regulation of an adaptive immune response rather thaninnate immune response. Therefore, Type Ⅰ IFN is the first defence for host and neighbouring cellsto resist virus infection.
