Th1/Th2炎症极化与肺气肿和肺纤维化

肺气肿具有Ⅰ型T辅助细胞（Th1）炎症极化的特征，表现为损伤过度和修复不足，肺实质的破坏增加，肺间质变薄。与之相反，肺纤维则具有Ⅱ型T辅助细胞（Th2）炎症极化，表现为损伤后修复过度，肺间质增厚，胶原沉积。通过调控Th1和Th2的炎症趋势来控制肺组织的损伤和修复的结局可能会为肺气肿和肺纤维化的防治提供新思路。     

Clinicopathological study of vesicoureteral reflux (VUR)-associated pyelonephritis in renal transplantation

Abstract:  We retrospectively studied the occurrence of vesicoureteral reflux (VUR)-associated pyelonephritis using renal biopsies obtained from the transplanted kidneys, and correlated the histological changes with clinical parameters. Out of a total of 131 renal biopsies performed between 1990 and 2001 on renal transplant patients at the department of Urology of Nagasaki University Graduate School of Biomedical Sciences, 12 patients showed pyuria more than twice in a single year. Seven of these 12 patients were available for determining VUR by voiding cystourethrography (VCUG). Cystoureterography demonstrated VUR in three of seven studied patients with pyuria. A histopathological examination revealed dilatation of both proximal and distal tubules in renal biopsies of transplant patients with VUR, compared to renal biopsies of transplant patients without VUR, or non-transplanted patients with thin membrane disease. One of the patients with VUR showed advanced features of chronic pyelonephritis in four consecutive biopsies at different time points, suggesting a late stage of reflux nephropathy in the transplanted kidney. We conclude from our study that the occurrence of VUR-related pyelonephritis may be one of the important long-term complications in the survival of renal allografts.     

内科微创肺减容术的研究进展

传统的外科肺减容术治疗慢性阻塞性肺疾病（COPD）有严格的适应证，并且副作用大、并发症多。于是人们研究出多种基于同样原理但是采用内科微创技术的减容方法。目前常用的内科微创肺减容术有使用单向活瓣、生物蛋白胶等封堵支气管使靶肺萎陷、不张，或采用支气管内药物灌注肺泡加封堵使靶肺组织纤维化等。此外，还有人提出人工旁路增加呼出气量的方法。尽管目前还缺少大规模的随机对照临床试验结果，但是内科微创肺减容术已展现了其巨大的临床应用前景，也将为治疗COPD提供更多的选择。     

Emphysematous pyelonephritis and renal amoebiasis in a patient with diabetes mellitus

Emphysematous pyelonephritis is an uncommon and life-threatening infection of the kidney that is characterized by gas formation within or around the kidney and is associated with diabetes mellitus and urinary tract infection. Amoebiasis is a protozoal infection caused by Entamoeba histolytica. In its invasive forms, the disease is characterized by visceral abscess formations. We present a case of concomitant emphysematous pyelonephritis and renal amoebiasis in a 42-year-old female with uncontrolled diabetes mellitus. The patient did not respond well to initial supportive treatment and antibiotherapy. Therefore, nephrectomy was performed. She did extremely well after the operation and was discharged with antidiabetics and antibiotics.     

Coexistence of renal replacement lipomatosis with xanthogranulomatous pyelonephritis

We report on a case of coexistence of replacement lipomatosis with xanthogranulomatous pyelonephritis (XGP) in the same kidney associated with staghorn calculi. A 63-year-old man was admitted to hospital complaining of a right abdominal mass. Computed tomography (CT) showed renal parenchymal atrophy with extremely increased perirenal fat. Right nephrectomy was performed. Postoperative diagnosis was renal replacement lipomatosis with XGP. Renal replacement lipomatosis and XGP have several similarities in terms of clinical background and CT findings. Sometimes it is difficult to differentiate them from malignant diseases. It is extremely rare that both conditions coexist in the same kidney. To our knowledge, only one such case has been reported.     

Pseudotumor associated with polytetrafluoroethylene sleeves

We report the case of a patient who was operated on in February 2001. We performed a wedge resection of the upper right lobe. The pathologic examination demonstrated a lung adenocarcinoma (pT2N0M0, R0). We used staple line reinforcement material (ePTFE) during the operation because the patient had an important emphysema. We re-operated in January 2005 because during follow-up we observed a suspicious image that suggested a tumoral relapse. Histopathological study showed extrinsic material compatible with the one used in the original resection.     

Mild emphysema: a novel method using formalin-fixed lungs for computed tomography and pathological analyses

We evaluated a novel method of computed tomography (CT) analysis using formalin-fixed lungs of autopsy cases with mild emphysema. Eight formalin-inflated lungs (FILs) obtained at autopsy were examined using CT after draining off the formalin and air inflation with an air pump, and subjected to pathological study including pathological scoring of emphysema and microscopic image analysis (MIA). Satisfactory CT examination was carried out within 5 h of lung fixation. The mean alveolar area determined by MIA correlated highly with the lung volume (r=0.845) and CT score (r=0.722). This method is simple compared with conventional polyethylene glycol fixation for CT and enables CT examination of resected lungs without anxiety about biohazards. Mild emphysema can be detected by MIA.     

益肾清利化瘀汤对急性肾盂肾炎大鼠病理改变的影响

目的 探讨益肾清利化瘀汤治疗尿路感染的实验室依据。方法 建立急性肾孟肾炎大鼠模型，以左氧氟沙星为对照，观察益肾清利化瘀汤对该模型的肾脏病理学改变的影响。结果 与模型组相比，益肾清利化瘀汤组和左氧氟沙星组肾孟炎症较轻，表现在肾脏纵切面仅见有粘膜充血，第7、15天肾孟粘膜病理和间质区较少的灶性淋巴细胞浸润；而模型组可见到肾包膜紧张和肾孟扩张，以及光镜下明显的灶性淋巴细胞浸润。结论 益肾清利化瘀汤能部分减轻该模型的急性肾孟炎症。     

肺气肿外科治疗的历史

为了探索治疗肺气肿的有效手术方法。人们在过去的一个世纪中付出了巨大的努力。回顾肺气肿外科治疗的发展历史,大致可分为早期探索,肺移植,肺减容术三个阶段。其中８０年代的肺移植术和９０年代发展的肺减容术被认为是治疗终末期气肿的最有效疗法。尤其是肺减术的应用为广大肺气肿患者的治疗提供了新希望。     

Xanthogranulomatous pyelonephritis: MRI findings in the diffuse and the focal type

Two cases of xanthogranulomatous pyelonephritis (XGP) are presented with emphasis on MR appearances. One case is the diffuse type of XGP secondary to chronic obstruction caused by transitional cell carcinoma of the renal pelvis. The other case is the focal or “tumefactive” type of XGP which mimics renal cell carcinoma. Received: 15 February 1999; Revised: 14 June 1999; Accepted: 8 July 1999