C57BL/6J和C3H/HeN小鼠放射性肺损伤进程的比较研究

目的比较C57BL/6J和C3H／HeN两种小鼠放射性肺损伤进程的异同。方法采用20Gy^60Coγ射线照射C57BL/6J和C3H／HeN两种小鼠复制动物模型，应用天狼猩红染色、羟脯氨酸含量测定、免疫组织化学等方法检测Ⅰ、Ⅲ型胶原分布、羟脯氨酸含量、纤连蛋白（FN）、层粘连蛋白（LN）和α-平滑肌肌动蛋白（α—SMA）表达变化。结果照后1、3和6个月C57BL/6J小鼠肺组织病变经历炎症期、增生期和纤维化期，胶原沉积增多，照后1和3个月FN表达明显高于对照组（P〈0．01），照后6个月逐渐减少，LN表达在照后呈渐进性增加，α-SMA表达比C3H／HeN强；照后1、3和6个月C3H／HeN小鼠肺组织主要表现为间质性炎症改变，FN表达于照后1、3和6个月与对照组相比无明显变化，LN表达于照后1和3个月明显增强，6个月逐渐减少。结论20Gy^60Coγ射线照射成功复制易，抗放射性肺纤维化动物模型。C57BL/6J小鼠发生放射性肺纤维化，以胶原沉积增多出现早且显著为特征；C3H／HeN小鼠未发生放射性肺纤维化。     

64层螺旋CT肺动脉成像低管电压设置结合个体化对比剂应用的对照研究

Objective To investigate the feasibility of the low tube voltage setting and personalized contrast agent application in 64-row multi-slice spiral CT pulmonary angiography.Methods Ninety patients with high risk of pulmonary artery embolism were sequentially enrolled in the study and divided into 3 groups employing completely randomized design: (1) Regular group included 30 patients using 120 kV and fixed dose of 70 ml contrast agent, (2)Another 30 patients were in 120 kV group, using 120 kV and the contrast amount was determined according to the patient weight (1.0 ml/kg), (3) The remaining 30 patients were included in 100 kV group, using 100 kV and the contrast amount was also determined according to the patient weight(1.0 ml/kg).Administration of contrast agent was completed within 20 seconds for all the patients, followed by 20 ml of saline.The objective and subjective indexes for assessing CT image quality, CT dose index volume (CTDIvol) and effective received dose (ERD) were compared between 120 kV group and 100 kV group; then the contrast media volume, injection rate, objective CT image indexes and subjective indexes for image quality was compared between the 100 kV group and regular group.The variance analysis and post hoc test were employed for the statistical analysis.Results Compared with 120 kV group(3.4± 0.7), the image quality of 100 kV group(5.2±1.8)had higher noise(52.9%), but subjective index for the image quality demonstrated no differences(q=0.272 ,P=0.063)in mediastinum window while CTDIvol and ERD decreased for 34.9%[(9.5±0.0) vs (14.6±0.0) mGy]and 36.8%[(3.8±0.6) vs (2.4± 0.4) mSv].The mean CT values on pulmonary artery of 100 kV group[(269.2±54.7) HU]were 13.4% (31.8/237.4) higher than the 120 kV group[(237.4±62.9) HU], but there was no statistical differences eornpared to normal group(q=0.172,P=0.260).Conclusion Using low kV setting (100 kV) to reduce radiation dose is proved to be effective and feasible in 64-MSCT pulmonary angiography.Personalized contrast agent injection has clinical application value for specific patient group.     

Type II pneumocytes modulate surfactant production in response to cigarette smoke constituents: Restoration by vitamins A and E

This study was to evaluate the effects of cigarette smoke constituents upon type II pneumocyte surfactant production in vitro, and how vitamins A and E may alter the response. Freshly isolated type II pneumocytes from Sprague–Dawley rats were incubated 20 h in medium with fetal bovine serum that was or was not treated with cigarette smoke. The number of adherent cells was inversely related to the dose of smoke or benzo(a)pyrene. Despite the decreased number of treated cells, the total amount of surfactant per culture well was unchanged, whereas surfactant production per cell was significantly increased (P < 0.05). Vitamin A concentration was significantly (P < 0.05) lower in the smoke-treated serum compared with untreated serum. When vitamin A or E was added to the cigarette smoke-treated serum, cell adherence and surfactant production returned to control values. In conclusion, cigarette smoke constituents or benzo(a)pyrene alone decreased the number of adherent type II pneumocytes, but did not alter surfactant amounts because of an increased production of surfactant per cell. Type II pneumocytes seem to adjust surfactant production dependent upon the number of type II pneumocytes to produce it and vitamin A or E enhance cell attachment in the presence of the smoke toxins.     

支撑喉镜手术治疗声带息肉小结

目的:观察支撑喉镜下手术治疗声带息肉/小结的疗效.方法:对100例声带息肉/小结的患者在全麻下行支撑喉镜手术.结果:100例中,术后3d发音恢复正常31例,术后6d发音恢复正常34例,好转35例,随访3mo无复发.结论:支撑喉镜下手术治疗声带息肉/小结疗效好、创伤小、精确度较高,但同时要注意并发症的预防和处理.     

肾移植术后肺部感染的诊治

目的：探讨治疗肾移植术后肺部感染的有效方法。方法：对我院1999年至2002年发生的23例肾移植术后肺部感染病人治疗方法和结果总结，结果：发现强调提高病人机体免疫力水平的治疗方法效果明显。结论：肾移植术后肺部感染的主要病因是机体免疫水平的低下，提高机体免疫水平是治疗移植后肺部感染的最重要手段。     

In vivo comparison of two through-plane MR velocity mapping methods: Fast fourier encoding and phase mapping

Magnetic resonance imaging maps of velocity were acquired with a 1.5-T system in 10 subjects in a plane perpendicular to the main pulmonary artery. Velocity images were successively acquired with a method developed from Fourier-encoding velocity imaging (FEVI) principles with eight gradient steps and one excitation, and with two-point phase-subtraction mapping. Reconstruction in FEVI was implemented by zero-filling interpolation around the eight gradient steps and then around the four central steps. The methods were compared by using estimates of noise in velocity measurements based on the difference between the experimental map and a smooth fitted map. For the same acquisition time, FEVI with four encoding steps was more precise in velocity measurements than phase mapping. Precision was further increased by the use of eight encoding steps, but acquisition time was doubled.     

Temporary vena cava filters in the prevention of pulmonary embolism during total hip arthroplasty

Thromboembolism constitutes one of the most dangerous complications during the immediate postoperative period of prosthetic surgery. Pharmacological prophylaxis and mechanical vascular compression are not always sufficient to protect from this surgical complication. In patients at greatest risk for thromboembolism, often with a positive history for pulmonary embolism, temporary vena cava filters may be used to reduce the incidence of vascular and pulmonary complications. However useful, these filters cannot be routinely used in orthopedic surgery. We present our results with the use of Filcard RFO2 vena cava filters in an open, randomized study of 30 patients. Received: 5 November 2001/Accepted: 30 November 2001     

吸入一氧化氮对心瓣膜置换术后肺动脉高压患者血流动力学的影响

目的：观察吸入一氧化氮（ＮＯ）对心瓣膜置换术后肺动脉高压患者血流动力学的影响。方法：选择９例心瓣膜置换术后伴肺动脉高压的病人，吸入ＮＯ０．００３％，观察三个时象点：吸入ＮＯ前；开始吸入ＮＯ后１５分钟；停止吸入ＮＯ后１５分钟。结果：吸入ＮＯ能显著降低肺动脉压和肺循环阻力指数（Ｐ＜０．０１），停止吸入ＮＯ１５分钟后，肺动脉压和肺循环阻力指数恢复到原有水平。在整个观察过程中，心率、平均动脉压、中心静脉压、肺动脉楔压、体循环阻力指数和心脏指数均无显著变化（Ｐ＞０．０５）。结论：吸入ＮＯ具有选择性肺血管扩张作用，是治疗心瓣膜置换术后肺动脉高压的较理想药物。     

哮喘缓解期联用乌体林斯和黄芪注射液等穴位注射控制哮喘发作的临床观察

目的　观察哮喘缓解期联用乌体林斯、黄芪注射液、鱼腥草注射液穴位注射控制哮喘发作的疗效 ,探讨其作用机理。方法　哮喘缓解期患者 5 6例 ,随机分成两组。治疗组 3 2例采用相同穴位交替选择药物 ,隔日穴位注射治疗 ;对照组 2 4例予常规治疗。并观察两组疗效及治疗前后用力肺活量 (FVC) ,1秒钟用力呼气量 (FEV1)和肺活量 (VC)的变化。结果　两组总有效率为 96.87%和 79.17% ,治疗组优于对照组 ( χ2 =10 ,P <0 .0 1)。治疗组治疗前后肺功能明显改善 ,治疗前后比较VC分别为 ( 1.79± 0 .43 )L和 ( 2 .91± 0 .64 )L ,P <0 .0 5 ;FVC分别为 ( 1.64± 0 .46)L和 ( 2 .0 9±0 .62 )L ,P <0 .0 5 ;FEV1分别为 ( 0 .92± 0 .70 )L和 ( 1.3 5± 0 .3 5 )L ,P <0 .0 5。对照组治疗前后肺功能改善不明显 (P均<0 .0 5 )。治疗组明显优于对照组。结论　在哮喘缓解期联用乌体林斯、黄芪注射液、鱼腥草注射液穴位注射控制哮喘发作的临床疗效优于常规治疗     

SP-C对重组肺表面活性物质活性的影响

目的 探讨不同浓度的肺表面活性物质(PS)相关蛋白C(SP-C)与合成脂质构成的重组PS活性的变化。方法 从新鲜猪肺的灌洗液中提取PS,从PS中分离出SP-C。将二棕榈酰磷脂酰胆碱、二油酰磷脂酰胆碱和棕榈酰油酰磷脂酰甘油按60:20:20的重量比混合,即为合成脂质(SL),将SP-C按1％、2％、3％(与脂质的重量比)加入SL中,制成三种重组PS:RS-1、RS-2和RS-3。将上述物质溶于生理盐水中即为实验液体。用气泡型表面张力计测定各实验液体的表面张力。将PS缺如的未成熟胎兔随机分为4组:PS、SL、RS-3和对照组。分别向PS、SL和RS-3组气道内注入PS、SL、RS-3液;对照组未注入任何物质。然后进行人工通气,通气后5、10、15、20min测定各组潮气量。结果 PS的最小表面张力(γmin)为(0.9±0.3)mN/m,SL的γmin为(22.6±1.3)mN/m,明显高于PS(P<0.01);随SP-C浓度的增加γmin逐渐降低,RS-3的γmin降至(0.7±0.1)mN/m(与PS相比,P>0.05)。通气20min时,PS组、RS-3动物的潮气量分别达到(25±7)ml/kg、(25±4)ml/kg,明显高于对照组和SL组(P<0.01)。结论 不含SP-C的合成脂质表面活性低,加入SP-C后构成的重组PS表面活性明显增强。