Bronchiectasis(BE) is the third major chronic airway disease, and its incidence rate shows a continuously increasing trend. Bronchiectasis is a highly heterogeneous chronic airway disease. Due to structural alterations, airflow limitation, and mucus hypersecretion, clinical treatment faces many challenges. Particularly, problems including Pseudomonas aeruginosa-dominant drug-resistant bacterial colonization, recurrent infections, airway mucus hypersecretion, and impaired lung function are the most urgent, requiring long-term and personalized treatment and management integrating traditional Chinese and western medicine to prevent the recurrence and continuous progression of the disease. In recent years, both traditional Chinese medicine and western medicine have made certain progress in pathogenesis theories, clinical studies, and basic research regarding the therapeutic challenges of bronchiectasis. Therefore, this paper summarized relevant research from the past 10 years and explored future directions and potential advantages of integrated traditional Chinese and western medicine treatment, providing references for optimizing the clinical management strategies for bronchiectasis.
Bronchiectasis/drug therapy* ; Humans ; Drugs, Chinese Herbal/therapeutic use* ; Medicine, Chinese Traditional/methods* ; Animals

Humans ; Retrospective Studies ; Bronchiectasis ; Mycobacterium avium Complex ; Syndrome ; Nocardia Infections/drug therapy* ; Nocardia ; Mycobacterium avium-intracellulare Infection

Anti-Bacterial Agents ; therapeutic use ; Bronchiectasis ; drug therapy ; epidemiology ; etiology ; microbiology ; China ; Ciliary Motility Disorders ; drug therapy ; epidemiology ; etiology ; microbiology ; Connective Tissue ; metabolism ; Humans ; Immunoglobulins ; metabolism ; Pseudomonas aeruginosa ; drug effects ; pathogenicity

Aged ; Antifungal Agents ; therapeutic use ; Bronchiectasis ; diagnosis ; drug therapy ; Female ; Humans ; Pulmonary Aspergillosis ; diagnosis ; drug therapy ; Tomography, X-Ray Computed ; Voriconazole ; therapeutic use

BACKGROUNDCommon variable immunodeficiency (CVID) is one of the most common symptomatic primary immunodeficiency syndromes. The purpose of this article was to broaden our knowledge about CVID for better diagnosis and treatment.

METHODSClinical and immunological features of 40 Chinese patients with CVID were analyzed retrospectively.

RESULTSThe median age at onset was 11-year-old (range 4-51 years). The median age at diagnosis was 14.5-year-old (range 5-66 years). The average time of delay in diagnosis was 5.3 years (range 1-41 years). The most common main complaint was fever due to infections (35 cases, 87.5%). Pneumonia (28 cases, 70%) was the most common type of infections. Bronchiectasis was present in 6 patients (15%). Autoimmune disease was detected in 6 cases of CVID, and malignancy in 2 cases. The median total serum levels of IgG, IgA, and IgM at diagnosis were 1.07 g/L, 0.07 g/L, and 0.28 g/L, respectively. The percentages of CD3- /CD19 + B-cells were 1%-3.14%.

CONCLUSIONSInfection is the most frequent presentation of CVID. Patients with unexplainable infections should receive further examination including serum immunoglobulin (Ig) and lymphocyte subset analysis. Regular and sufficient substitution with Ig is recommended.

Adolescent ; Adult ; Aged ; Bronchiectasis ; drug therapy ; immunology ; pathology ; Child ; Child, Preschool ; China ; Common Variable Immunodeficiency ; drug therapy ; immunology ; pathology ; Humans ; Immunoglobulins ; metabolism ; Immunoglobulins, Intravenous ; Middle Aged ; Young Adult

OBJECTIVEThe purpose of this descriptive review was to delineate the current knowledge of bronchiectasis in terms of prevalence, burden of disease, pathophysiology, and management.

DATA SOURCESThe National Library of Medicines MEDLINE and PubMed database (2005-2013) were used to conduct a search using the keyword term "bronchiectasis". The references for articles being considered for inclusion were searched from additional sources such as conference proceedings.

STUDY SELECTIONCriteria for inclusion of articles included data outlining epidemiology, pathogenesis, diagnosis, and evidence-based guidelines for management of bronchiectasis. In assessing the quality of the articles, factors such as size of the population studied, clinical setting of the study, and whether or not the studies were prospective or retrospective were taken into consideration. Review articles were also included in our data collection. RESULTS Despite many advances in modern medicine, bronchiectasis still remains a significant public health problem in developed countries and the developing world. It carries a significant burden worldwide in terms of morbidity and mortality, as well as financially to the affected population. In addition, bronchiectasis may associate with chronic airflow obstruction, regardless of smoking status.

CONCLUSIONSBronchiectasis is a debilitating illness responsible for significant morbidity with a poor health-related quality of life. The condition has a substantial socioeconomic cost because both primary and secondary healthcare resources are frequently used and periods of sick leave are common.

Bronchiectasis ; diagnosis ; drug therapy ; epidemiology ; Humans

Various forms of hypogammaglobulinemia can occur in patients with autoimmune diseases and vice versa. We report a 13-yr-old boy with membranous nephropathy and common variable immunodeficiency. He presented with the nephrotic syndrome, pneumonia with bronchiectasis, and profound hypogammaglobulinemia. Renal biopsy showed diffusely thickened glomerular capillary walls with 'spikes' suggesting a membranous nephropathy. Secondary causes were ruled out by laboratory studies; however, heavy proteinuria persisted with steroid therapy. Cyclosporine and intravenous immunoglobulin were added, and the patient was discharged with decreased proteinuria. Hypogammaglobulinemia may have a deleterious impact on the immune dysregulation in some patients with membranous nephropathy.
Adolescent ; Bronchiectasis/etiology ; Common Variable Immunodeficiency/complications/*diagnosis/drug therapy ; Cyclosporine/therapeutic use ; Drug Therapy, Combination ; Glomerulonephritis, Membranous/complications/*diagnosis/drug therapy ; Humans ; Immunoglobulins/therapeutic use ; Immunosuppressive Agents/therapeutic use ; Injections, Intravenous ; Kidney/pathology ; Male ; Pneumonia/etiology ; Proteinuria/etiology ; Steroids/therapeutic use

OBJECTIVETo observe the therapeutic effect of tiotropium bromide powder inhalation on stable bronchiectasis.

METHODSTwenty-two patients with stable bronchiectasis received inhalation of totropium bromide powder at the daily dose of 18 microg, and on days 1 and 28, the patients were examined for forced expiratory volume in one second (FEVl), predicted value [FEVl(%)], forced expiratory volume (FEV), and FEVl/FVC. The symptom score and BODE index were also recorded.

RESULTSAfter 1 month of inhalation therapy, the FEV1% of the patients showed a moderate increase but the increment was not statistically significant (t=-1.875, P>0.05); the symptom score and BODE index decreased significantly after the therapy (t=7.091, P<0.001; t=2.982, P<0.05).

CONCLUSIONLong-term inhalation of tiotropium bromide powder can improve the clinical symptoms and BODE index and enhance the exercise tolerance and quality of life of the patients with bronchiectasis.

Administration, Inhalation ; Adult ; Aged ; Bronchiectasis ; drug therapy ; Female ; Forced Expiratory Volume ; Humans ; Male ; Middle Aged ; Powders ; Receptor, Muscarinic M3 ; antagonists & inhibitors ; Scopolamine Derivatives ; administration & dosage ; Tiotropium Bromide

BACKGROUND/AIMS: Paraquat-induced lung injury has been considered a progressive and irreversible disease. The purpose of this study was to report the long-term evolution of lung lesions in eight survivors with significant paraquat-induced lung injuries who could be followed-up for longer than 6 months. METHODS: We retrospectively examined high-resolution computed tomography and pulmonary function test of eight survivors with significant paraquat-induced lung injurys. RESULTS: High-resolution computed tomography revealed a predominant pattern of irregularly shaped consolidation with traction bronchiectasis at 1-2 months after paraquat poisoning, a mixed pattern of irregularly shaped consolidation and ground-glass opacity at 3-12 months, and a mixed pattern of consolidation, groundglass opacity, and honeycombing at 1-2 years. At 3-12 months after paraquat ingestion, the areas of consolidation had markedly decreased and the decreased lung volume had returned to normal. At 1-2 years after paraquat poisoning, the cystic changes had disappeared. At 2-3 years after paraquat poisoning, the decrease in forced vital capacity had greatly improved to the normal range. CONCLUSIONS: Recovery of nearly normal pulmonary structure and function may occur over several years following paraquat poisoning. Pulmonary function (both forced vital capacity and forced expiratory volume in 1 sec) evolved toward normal in the long-term survivors of paraquat poisoning with initial prominent lung injuries.
Adolescent ; Adult ; Aged ; Bronchiectasis/chemically induced ; Female ; Follow-Up Studies ; Forced Expiratory Volume ; Herbicides/*toxicity ; Humans ; Lung/*drug effects/physiopathology/radiography ; Lung Injury/*chemically induced/physiopathology/radiography/therapy ; Lung Volume Measurements ; Male ; Middle Aged ; Paraquat/*toxicity ; Pulmonary Fibrosis/chemically induced ; Recovery of Function ; Retrospective Studies ; *Survivors ; Time Factors ; Tomography, X-Ray Computed ; Vital Capacity ; Young Adult

No abstract available.
Bronchiectasis/chemically induced ; Forced Expiratory Volume ; Herbicides/*toxicity ; Humans ; Lung/*drug effects/physiopathology/radiography ; Lung Injury/*chemically induced/physiopathology/radiography/therapy ; Lung Volume Measurements ; Paraquat/*toxicity ; Pulmonary Fibrosis/chemically induced ; Recovery of Function ; *Survivors ; Time Factors ; Tomography, X-Ray Computed ; Vital Capacity