A rare case of allergic granulomatous angitis (Churg Strauss syndrome) with positive anti-glomerular basement membrane (GBM) antibody in serum]

A 33-year-old man with a 6-month history of rhinitis and bronchial asthma was referred to our hospital with polyarthralgia, severe anemia, hypoxemia, mononeuropathy multiplex, and renal insufficiency with hematuria. Marked eosinophilia was observed in his sputum, peripheral blood, and bronchoalveolar lavage fluid (BALF). In addition, his sputum contained many hemosiderin-laden macrophages, indicative of pulmonary hemorrhage. His chest roentgenogram on admission showed diffuse ground grass appearance. High resolution computed tomography (HRCT) demonstrated diffuse high density areas throughout the lung fields and characteristic irregularity and enlargement of the peripheral pulmonary arteries. His general condition rapidly deteriorated, but dramatically improved with oral steroid administration, and his major symptoms disappeared within a few days. Examination of the biopsied lung tissue revealed unequivocal evidence of pulmonary angitis with marked eosinophilic infiltration and perivascular granulomas. Bone marrow biopsy showed hyperplasia of eosinophilic leukocytes in contrast to the low cellularity. Suppression of erythroid hemopoiesis was thought to be the primary cause for his rapidly progressive anemia. Serum anti-GBM antibody titer returned to within the normal range soon after the initiation of steroid therapy.     

益肺抗纤方对博莱霉素诱导大鼠肺纤维化的防治作用

目的 :观察益肺抗纤方抗肺纤维化的作用。方法 :实验用雄性Wistar大鼠分为 4组 ,对照组、模型组、益肺抗纤方组、地塞米松组 ;对照组气管内注入生理盐水 ,其余 3组气管内注入博莱霉素制作大鼠肺纤维化模型。造模后 ,益肺抗纤方组给益肺抗纤方 10ml/kg灌胃 ,地塞米松组给地塞米松 1.5mg/kg腹腔注射 ,模型组和对照组均给生理盐水灌胃 ,均给药 1次 /d。观察各组大鼠肺部病理变化 ,测定各组第 7d、2 8d肺组织超氧化物歧化酶(SOD)、脂质过氧化物 (LPO)和羟脯氨酸 (HP)的含量。结果 :气管内注入博莱霉素第 2 8d时 ,模型组多呈 3级肺纤维化和 1级肺泡炎改变 ;益肺抗纤方组多呈 1级纤维化改变 ,肺泡炎不明显 ;地塞米松组多呈 1级纤维化和 1～ 3级肺泡炎改变 ;对照组呈正常肺结构。第 2 8d时 ,模型组和地塞米松组肺组织SOD活性均较对照组明显下降 (P <0 .0 1和P <0 .0 5 ) ,地塞米松组较模型组SOD活性下降更明显 (P <0 .0 5 ) ;益肺抗纤方组与对照组之间SOD活性无明显差别。对照组、模型组、益肺抗纤方组肺组织LPO含量明显低于地塞米松组 (P <0 .0 1) ;益肺抗纤方组与对照组和模型组之间无明显差别。结论 :益肺抗纤方可通过提高SOD活性 ,降低脂质过氧化 ,减轻氧自由基损伤 ,抑制胶原沉积 ,保护肺组织     

慢性阻塞性肺疾病和支气管哮喘患者血浆及痰液P物质的测定

OBJECTIVE: To investigate the role of substance P (SP) in chronic obstructive pulmonary disease (COPD) or asthma. METHOD: Plasma and sputum samples were obtained from 26 COPD patients and 20 asthmatic patients as well as 12 healthy subjects for measurement of SP content. RESULTS: Patients with COPD had significantly higher levels of SP in the plasma (7.9+/-2.6 pmol/L) and sputum (53.8+/-12.5 pmol/L) than the healthy subjects (3.6+/-1.7 pmol/L and 6.2+/-2.3 pmol/L, respectively, P<0.01). The asthmatic patients also had significantly higher SP levels (8.3+/-3.1 pmol/L and 46.9+/-10.2 pmol/L, respectively) than the healthy subjects, but there was no significant difference between COPD and asthmatic patients (P>0.05). CONCLUSION: SP may be involved in the airway inflammation process in COPD and asthma.     

Beta-defensin genomic copy number is not a modifier locus for cystic fibrosis

Human beta-defensin 2 (DEFB4, also known as DEFB2 or hBD-2) is a salt-sensitive antimicrobial protein that is expressed in lung epithelia. Previous work has shown that it is encoded in a cluster of beta-defensin genes at 8p23.1, which varies in copy number between 2 and 12 in different individuals. We determined the copy number of this locus in 355 patients with cystic fibrosis (CF), and tested for correlation between beta-defensin cluster genomic copy number and lung disease associated with CF. No significant association was found.     

Safety and efficacy of oral nemonoxacin versus levofloxacin in treatment of community-acquired pneumonia: A phase 3, multicenter,randomized, double-blind,double-dummy,active-controlled,non-inferiority trial

Background/Purpose

Nemonoxacin is a novel nonfluorinated quinolone with excellent in vitro activity against most pathogens in community-acquired pneumonia (CAP), especially Gram-positive isolates. The purpose of this study was to assess the efficacy and safety of nemonoxacin compared with levofloxacin in patients with CAP.

钙激活的氯通道gob-5和粘蛋白基因Muc5ac在小鼠哮喘模型肺部的表达

目的：研究“钙激活的氯通道”成员之一gob-5和粘蛋白基因Muc5ac在小鼠哮喘模型肺部的表达。 方法： 22只清洁级BALB/c小鼠随机分成哮喘组和对照组，用逆转录聚合酶链反应法（RT-PCR）和免疫组化法分别测定肺组织gob-5 mRNA和粘蛋白基因Muc5ac蛋白的表达。 结果： 小鼠哮喘组肺组织gob-5 mRNA表达阳性（0.2297±0.0186，A），而对照组未出现gob-5 mRNA的表达(P<0.01)；哮喘组Muc5ac蛋白表达（0.6637±0.0127，A）明显高于对照组（0.2060±0.0179，A）（P<0.01）；哮喘组肺组织gob-5 mRNA表达与Muc5ac蛋白表达呈直线正相关（r=0.864, P<0.05）。 结论： Gob-5 mRNA表达的上调可能在哮喘小鼠气道粘液过度分泌中起着关键作用；抑制gob-5的表达将为哮喘的治疗提供新的策略。     

三氧化二砷抑制体外培养小鼠气道成纤维细胞增殖及c-myc与c-sis表达

目的：探讨三氧化二砷 (As2O3))对体外培养的小鼠气道成纤维细胞 (FB)增殖及原癌基因c-myc与c-sis表达的影响。 方法： 按不同药物分7组，在体外培养的FB中分别加入浓度为0.25、0.5、1.0、2.0和4.0 μmol/L的As2O3，在1、3、5和7 d后用记数法观察FB生长情况，并用流式细胞仪（FCM）检测不同浓度药物 对各组FB增殖的影响及各组c-myc与c-sis的阳性表达率。 结果： 各种实验浓度的As2O3对FB均有抑制作用，并有时间剂量效应。流式细胞仪分析显示，随着浓度的增高，G1期细胞比例逐渐增高，G2/M期细胞比例降低，浓度为2.0和4.0 μmol/L的As2O3能显著抑制c-myc与c-sis的表达。 结论： As2O3能抑制FB的增生，其机理可能与其下调c-myc与c-sis的表达有关。     

白藜芦醇苷对慢性常压低氧性肺动脉高压模型中磷脂酶A2、一氧化氮和内皮素水平的影响

目的： 观察白藜芦醇苷（PD）对慢性常压低氧性肺动脉高压大鼠血浆及肺匀浆中磷脂酶A2(PLA2)、一氧化氮（NO）和内皮素1（ET-1）水平的影响，并探讨可能的机制。 方法: 29只健康SD大鼠随机分为正常对照组、单纯低氧组和低氧加PD组。右心导管法检测大鼠肺动脉平均压力（mPAP），观察右室/左室+室间隔重量比值（R/L+S）、血浆及肺匀浆中PLA2活性、NO和ET-1含量的变化。 结果: 低氧21 d后大鼠mPAP、R/L+S、血浆及肺匀浆中PLA2活性和ET-1含量显著高于对照组，NO含量显著低于对照组。PD预处理组上述变化可受抑制或减轻。 结论: PD可有效防治慢性常压低氧性大鼠肺动脉压力的升高，其机理与抑制PLA2活性及ET-1释放，促进NO产生有关。     

MAPK 通路抑制剂对低氧高二氧化碳性肺动脉收缩的影响

目的： 观察肺主动脉环、二级肺动脉环在急性低氧高二氧化碳介质中张力的变化；探讨 MAPK 信号通路抑制剂 U0126、SB203580 对低氧高二氧化碳性肺血管收缩的影响。方法: 制备离体 SD 大鼠肺主动脉环、二级肺动脉环。分别观察肺主动脉环、二级肺动脉环在常氧及急性低氧高二氧化碳介质中的张力变化；在急性低氧高二氧化碳条件下分别用 U0126、SB203580 孵育二级肺动脉，观察各自对低氧高二氧化碳性肺动脉收缩的影响。结果: 在常氧条件下,肺主动脉、二级肺动脉张力均无明显变化。急性低氧高二氧化碳条件下二级肺动脉发生双向性收缩反应，肺主动脉只在低氧高二氧化碳早期出现较明显的收缩峰，后期则变化不明显。二级肺动脉分别经ERK1/2上游激酶抑制剂 U0126、p38 MAPK 通路抑制剂 SB203580 孵育后，Ⅱ期持续收缩幅度明显下降（P<0.05)，Ⅰ期快速收缩峰、Ⅰ期舒张均没有明显变化。结论: 在离体条件下，急性低氧高二氧化碳（PO₂ = 30-35 mmHg，PCO₂=55-60 mmHg)可使肺主动脉出现早期快速收缩，并可使二级肺动脉环发生双向性收缩反应；急性低氧高二氧化碳条件下，U0126、SB203580 均能减弱二级肺动脉环的Ⅱ期持续收缩反应。这为临床治疗缺氧和高碳酸血症引起的肺血管收缩及肺动脉高压提供了理论依据。     

磷脂酶A2活性与慢性常压低氧性肺动脉高压关系的研究

目的:研究磷脂酶A₂(PLA₂)活性及其相关炎症介质在大鼠慢性常压低氧性肺动脉高压形成中的作用。方法:29只健康SD大鼠随机分为正常对照组、单纯低氧组和低氧加白藜芦醇苷(PD)组。右心导管法检测大鼠肺动脉压力(mPAP),观察右室/左室+室间隔比值(R/L+S)、血浆和肺匀浆中PLA₂、血栓素B₂(TXB₂)、6-酮-前列腺素F_1α(6-k-PGF_1α)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平的变化。结果:低氧3周后大鼠mPAP、R/L+S、血浆及肺匀浆中PLA₂活性、TXB₂、MDA含量显著升高;6-k-PGF_1α、SOD水平下降。用PD预处理后可减轻上述变化。结论:PLA₂通过相关炎症介质及与自由基的相互作用在慢性低氧性肺动脉高压的形成中起着重要的介导作用。