Effects of selective phosphodiesterase inhibitors on platelet-activating factor- and antigen-induced airway hyperreactivity, eosinophil accumulation, and microvascular leakage in guinea pigs

There is currently interest in the potential use of selective inhibitors of cyclic nucleotide phosphodiesterases (PDE) in the treatment of asthma. In this study we examined the effects of three selective PDE inhibitors, milrinone (PDE III), rolipram (PDE IV) and zaprinast (PDE V), on the broncoconstriction produced by antigen and histamine, the airway hyperreactivity and microvascular leakage after aerosol exposure to platelet-activating factor (PAF) and antigen, and the antigen-induced eosinophil infiltration in guinea-pig lung. Inhaled rolipram (0.01–10 mg ml^–1) inhibited dose dependently the bronchospasm produced by aerosol antigen (5 mg ml^–1) an anaesthetised, ventilated guinea-pigs. Rolipram (10 mg ml^–1) produced maximal inhibition of antigen-induced bronchoconstriction but only partial inhibition of the response to aerosol histamine (1 mg ml^–1). Milrinone and zaprinast (each 10 mg ml^–1) showed weak, or no, inhibitory effects against bronchoconstriction produced by aerosol antigen or histamine. Pretreatment with rolipram (10 mg kg^–1, i.p.) prevented airway hyperreactivity to histamine which develops 24 h after exposure of conscious guinea-pigs to aerosol PAF (500 g ml^–1) or antigen (5 mg ml^–1). The pulmonary eosinophil infiltration obtained with 24 h of antigen-exposure was inhibited by rolipram. In contrast, milrinone and zaprinast (each 10 mg kg^–1, i.p.) failed to reduce either the airway hyperreactivity of the eosinophil accumulation in these animals. Rolipram (1–10 mg ml^–1) reduced the extravasation of Evans blue after aerosol PAF (500 g ml^–1) at all airway levels while a lower dose (0.1 mg ml^–1) was only effective at intrapulmonary airways. Rolipram (0.01–1 mg ml^–1) markedly reduced airway extravasation produced by inhaled antigen (5 mg ml^–1). Zaprinast (1–10 mg ml^–1) was also effective against airway microvascular leakage produced by aerosol PAF or antigen while milrinone (10 mg ml^–1) had no antiexudative effect. These data support previous suggestions that pharmacological inhibition of PDE IV results in anti-spasmogenic and anti-inflammatory effects in the airways and may be useful in the treatment of asthma.     

舌及口底鳞癌治疗分析

目的 探讨舌及口底鳞癌淋巴转移的手术时机与方式对预后的影响。方法 舌及口底鳞癌67例,非手术组12例(为cN_(2～3)患者),手术组55例。cN_028例行原发灶切除,其中23例行选择性颈淋巴清扫。27例cN_(1～3)(cN15例、cN_(2～3)22例)行原发灶切除加根治性颈淋巴清扫,其中16例cN_(2～3)行岛状肌皮瓣修复术:结果 在34例患者中(cN_(2～3)),手术组5年生存率为54.55％(12/22),非手术组5年生存率为41.67％(5/12)。28例cN_0患者中,4例单纯癌肿切除者术后45～60天出现淋巴转移;23例行选择性颈淋巴结清扫术者,证实13例有隐匿性淋巴结转移,10例未见淋巴结转移。结论 对cN_0患者应尽早行选择性颈淋巴结清扫术。对多区域淋巴结或一个区域多个淋巴结转移的cN_(2～3)患者,手术比非手术组的生存率更高,但后者对提高5年生存质量有一定作用。     

喉鳞癌瘤内微血管及微淋巴管形态计量研究及临床意义

目的:研究喉鳞癌瘤内微血管和微淋巴管形态、分布、密度,以及相关临床意义。方法:采用5’-Nase-AlPase双重酶组织化学法和HE染色对40侧喉鳞癌标本冰冻切片进行研究。结果:光镜下微血管呈蓝色,微淋巴管呈棕色。除转移组微血管密度显著高于未转移组外,与其余临床指标均未见相关性。结论:瘤内微血管密度与淋巴转移有明显相关,而微淋巴管密度未发现明显临床意义,其机制待深入研究。     

人PTPRK基因在上皮性卵巢肿瘤中的表达及其意义

目的探讨受体型蛋白酪氨酸磷酸酶(PTPRK)基因在良性、交界性和恶性上皮性卵巢肿瘤及正常卵巢上皮组织中的表达规律及其与卵巢癌的关系.方法应用免疫组化间接法检测50例卵巢癌、13例良性上皮性卵巢肿瘤、14例交界性上皮性卵巢肿瘤及10例正常卵巢上皮组织中PTPRK基因的表达,采用Kaplan-Meier生存分析比较卵巢癌患者PTPRK蛋白表达与五年生存率的关系.结果(1)良性、交界性上皮性卵巢肿瘤和卵巢癌组中,PTPRK基因的阳性表达率分别为53.9%、57.1%、18.0%,显著低于正常卵巢上皮组的表达率100%(P均＜0.001).卵巢癌组中PTPRK基因的阳性表达率显著低于良性上皮性卵巢肿瘤组(P＜0.001)和交界性上皮性卵巢肿瘤组(P＜0.01).(2)卵巢癌高分化组中PTPRK基因的表达率为62.5%,显著高于中分化组(18.8%)和低分化组(6.3%)(P＜0.01).卵巢癌淋巴结无转移组PTPRK基因的表达率为27.3%,显著高于无阳性表达的淋巴结有转移组(P＜0.05).(3)PTPRK基因表达阳性组与表达阴性组的5年生存率分别为66.7%、46.7%,两组比较,差异无显著性(P＞0.05).结论PTPRK基因表达缺失发生在上皮性卵巢肿瘤组织中,肿瘤分化程度越低或者淋巴结已有转移则该基因表达缺失越明显.PTPRK基因可能是一种肿瘤抑制基因,其不同程度的表达缺失与上皮性卵巢肿瘤的发生和发展有关.     

胃癌术后腹腔淋巴瘘的相关因素分析

目的:探讨胃癌术后腹腔淋巴瘘的相关因素.方法:回顾分析26例胃癌术后腹腔淋巴瘘(LF)与肿瘤分期、肿瘤部位、术式、淋巴结转移、早期肠内营养(EN)及肝硬化间关系.结果:术后LF发生率为7.60%,早期肠内营养组高于非肠内营养组(14.29%比3.70%,P＜0.01);pTNMⅡ、Ⅲ期高于Ⅰ、Ⅳ期,Ⅲ期高于Ⅱ期(11.95%比7.94%,P＜0.05);D2以上术高于D2术(11.05%比4.23%,P＜0.01);胃中、上部癌高于下部癌(11.80%比3.05%,P＜0.01);淋巴结转移组高于未转移组(9.59%比4.07%,P＜0.05);是否合并肝硬化两组无显著差异(8.09%比6.54%,P＞0.05).结论:D2及D2以上术式、pTNMⅡ、Ⅲ期、中上部癌、淋巴结转移、术后早期EN是胃癌术后LF的危险因素.     

人参皂甙Rg3在小鼠肝癌淋巴结转移模型中诱导细胞凋亡的作用

目的:观察人参皂甙Rg3对小鼠肝癌淋巴结转移模型中肿瘤细胞凋亡的诱导作用,探讨人参皂甙Rg3抗肿瘤淋巴结转移的机制.方法:建立小鼠肝癌淋巴结转移模型;光镜和透射电镜下观察各组(Rg3预防组、Rg3治疗组、Rg3与顺铂联合治疗组、顺铂治疗组及对照组)中原发瘤及转移瘤组织的形态学结构改变,并通过流式细胞仪分析肿瘤细胞的凋亡.结果:Rg3预防组及治疗组电镜下(5份样品)可见较多细胞凋亡小体的形成(5/5,4/5);顺铂治疗组的形态改变以细胞破坏为主,凋亡的细胞较少;联合治疗组细胞的凋亡和坏死程度相当.流式细胞学检测分析结果为:Rg3预防组、治疗组及联合治疗组均见细胞凋亡的特征峰(5/5),而顺铂治疗组为1/5,对照组未见凋亡峰(0/5).结论:人参皂甙Rg3抗肿瘤细胞淋巴结转移的作用与诱导细胞凋亡有关.     

Postoperative Intensive Care Treatment after Esophageal Resection

The aim of this article is to give a short review of problems associated with the intensive caretreatment of patients after esophageal resection.Pulmonary dysfunction,supraventricular tachyarrhyth-mia,anastomotie leakage and mental disorders are the topics covered.Systemic inflammatory reaction andsepsis is the linking topic between these specific complications.Pulmonary dysfunction having an incidenceof up to 40% is the most important complication.Low tidal volume ventilation,pain management includingepidural analgesia and early tracheostomy are the mainstay of therapy.Supraventricular tachyarrhythmiais an early indicator of emerging complications.Its symptomatic treatment is standardized using electriccardioversion,beta-blockers and amiodarone.Anastomotic leakage must be suspect in any septic episode.Endoscopy and contrast studies allow for precise diagnosis.Interventional endoscopy is increasingly suc-cessful in the therapy of these leakages.Microbiological surveillance and specific antibiotic therapy ensurethat a complication does not cause a septic cascade leading to multiorgan failure.The workload on ICUcaused by a patient after esophageal resection still exceeds that of most other patients with gastrointestinalsurgery.     

基质金属蛋白酶在肺癌组织中的表达及临床意义

目的 探讨基质金属蛋白酶(MMP2、MMP9)及其抑制物(TIMP1、TIMP2)在肺癌组织中的表达及与肺癌临床分期、淋巴结转移的关系。方法 用免疫组织化学的方法观察肺癌组织MM2、MMP9、TIMP1、TIMP2的表达。结果 肺癌组织中MMP2、MMP9、TIMP1、TIMP2的表达显著高于正常肺组织,与临床分期、淋巴结转移有显著相关性。临床分期越高,MMP2、MMP9的表达越强,TIMP1、TIMP2的表达越弱。结论 MMP2、MMP9参与肺癌的侵袭和转移,是值得重视的生物学标志。     

血管内皮生长因子及其受体与上皮性卵巢癌发展

目的　探讨血管内皮生长因子 (VEGF)及其受体 (KDR)与上皮性卵巢癌发展的关系。方法　用免疫组化方法检测 4 5例人上皮性卵巢癌中VEGF及KDR的表达 ,分析VEGF及KDR表达与卵巢癌FIGO分期、淋巴结转移及预后的关系。结果　 4 5例上皮性卵巢癌中 ,VEGF、KDR表达阳性率分别为 73.3% (33/ 4 5 )、5 7.8% (2 6 / 4 5 )。Ⅲ～Ⅳ期卵巢癌VEGF表达阳性率 (94 .4 % ,17/ 18)高于Ⅰ～Ⅱ期卵巢癌 (5 9.3% ,16 / 2 7)。淋巴结转移阳性组中VEGF表达阳性率 (10 0 % ,12 / 12 )高于淋巴结转移阴性组 (16 / 2 6 ,6 1.5 % ) ,(P <0 .0 5 )。VEGF表达阴性者生存率高于VEGF表达阳性者 (P =0 .0 4 7)。不同组织学类型上皮性卵巢癌中VEGF表达无明显差异。KDR表达与卵巢癌分期、淋巴转移及预后无关。结论　VEGF与上皮性卵巢癌发展有关。     

食管癌气管食管沟巨大淋巴结转移15例报告

 目的　评价CT检查和放射治疗对食管癌和气管食管沟淋巴结转移的诊断、治疗价值和疗效。方法　收集我科自 1992年 3月至 2 0 0 1年 5月治疗的食管癌气管食管沟巨大淋巴结转移 15例。常规放射治疗 12例 ,3例配合立体照射。 13例按计划完成放射治疗 ,照射剂量 6 5Gy。 结果　按计划完成放疗的患者局部病变完全缓解率为 10 0 %。 12例生存 6～ 18个月 ,中位生存时间 10个月 ,1例已生存 2年仍健在。结论　CT对食管癌治疗方案的制定有重要的参考价值 ,食管癌气管食管沟淋巴结转移者放疗应作为首选。