肺泡表面活性物质在吸入性全身麻醉中防御功能的研究进展

吸入性全身麻醉中，肺功能会受到不同程度的损伤，其最终表现为不同程度的低氧血症。而肺泡表面活性物质则可在一定程度上保护肺功能，具有防御作用。     

胸腔镜肺叶切除术后肺容积减少与患者肺功能丢失的相关性分析

背景 与目的探讨不同部位的肺叶切除术后患者肺容积减少与患者肺功能损害程度的相关性.方法 本研究共纳入苏州大学附属第一医院2019年1月-2020年7月行胸腔镜肺叶切除术的131例患者(包括左肺上叶,左肺下叶,右肺上叶,右肺中叶,右肺下叶切除术;其中男性72例,女性59例).为了比较患者术后肺功能与术前肺功能的差异,分别...     

肺癌放疗后继发肺部感染患者呼吸功能与炎性状态的变化观察

目的 观察肺癌放疗后继发肺部感染患者呼吸功能与炎性状态的变化情况.方法 选取65例肺癌放疗后继发肺部感染患者为A组,同时期65例肺癌放疗后无肺部感染患者为B组,65名健康人员为C组,然后将3组人员及A组中不同肺部感染程度患者的肺功能指标、呼吸指标及血清炎性指标进行比较.结果 A组的肺功能指标及呼吸指标均差于B组及C组,B组则差于C组;A组的血清炎性指标均高于B组及C组,B组则高于C组.A组中不同肺部感染程度患者的肺功能、呼吸功能及血清炎性指标也存在明显差异,P均＜0.05.结论 肺癌放疗后继发肺部感染患者呼吸功能与炎性状态的变化较大,应加强监测及防控.     

术前规划联合荧光胸腔镜精准肺段手术较传统胸腔镜肺段手术治疗早期肺腺癌近期结果比较

背景与目的 肺癌的死亡率居所有恶性肿瘤的第一位,但对于早期肺腺癌患者不同的肺段切除术之间手术效果及对肺功能的影响研究较少.本研究旨在评估术前规划联合荧光胸腔镜精准肺段切除术与传统肺段切除术两种手术方式对早期肺腺癌患者肺功能保留程度和近期结果比较.方法 前瞻性选取2020年1月1日-2020年10月31日于中国科学技术大...     

52例肺癌患者放疗前肺功能和放疗疗效关系分析

为了探讨放疗前肺功能与放疗疗效的关系，作者于１９８７年１月至１９９０年１２月对５２例无急、慢性呼吸衰竭的肺癌患者在放疗前做了肺功能检测和血气分析，结果表明，放疗前肺功能不能反映肿瘤乏氧程度，也不能作为肿瘤对放疗敏感性的指标，只有直接测量肿瘤原发灶内的乏氧程度才能了解肿瘤对放疗的敏感性，预测放疗的疗效。     

肺功能检查第一部分——肺功能检查的注意事项

肺功能检查第一部分肺功能检查的注意事项肺功能检查是临床上评价胸、肺疾病及呼吸生理的重要方法,对于早期检出肺和气道病变,诊断气道病变的部位,鉴别呼吸困难的病因,评估疾病的严重程度及预后,评定药物或其他治疗方法的疗效,评估胸、肺手术的耐受力及劳动强度耐受力等都是必不可少的内容。     

肺癌合并慢性阻塞性肺疾病患者围手术期气道管理现状

肺癌患者均合并不同程度的慢性阻塞性肺疾病（chronic obstructive pulmonary disease, COPD）,而COPD导致的肺功能降低对其能否手术治疗及术后并发症发生具有重要的影响。研究证明围手术期气道管理可以有效改善患者肺功能且减少术后并发症。本文针对近年来气道管理的临床应用现状及进展进行综述,主要有以下几方面：①围手术期气道管理的必要性;②围手术期气道管理的药物治疗现状与特点;③围手术期应用气道管理在改善肺功能中的价值;④围手术期需要气道管理的最佳人群;⑤围手术期气道管理应用存在的问题。     

中老年肺癌患者术前肺功能锻炼依从性的影响因素分析

目的探讨中老年肺癌患者术前肺功能锻炼依从性的影响因素。方法选取2012年9月至2014年10月间收治的98例中老年肺癌患者。通过调查问卷的方式分析影响患者依从性的因素。结果多因素分析结果显示,患者术前肺功能功能锻炼依从性评分与性别、付费方式、吸烟史、饮食、食欲、睡眠质量无关,差异均无统计学意义(均P>0.05);年龄、受教育程度、居住地、与父母同住、与子女同住是影响中老年肺癌患者术前肺功能功能锻炼依从性的因素(P<0.05)。结论影响中老年肺癌患者术前肺功能功能锻炼依从性的因素为年龄、受教育程度、居住地、与父母同住、与子女同住。     

肺癌患者呼吸肌功能及其康复的研究

本文观察了62例肺癌患者的呼吸肌功能和34例接受呼吸肌康复训练的肺癌患者于训练前、中的呼吸肌功能及其它肺功能指标。结果显示:肺癌患者的Ti、Ti/Ttot和吸气储备力降低,VT/Ti增加,提示其存在着不同程度的呼吸肌功能失调。气     

高原地区食管癌贲门癌术后肺部感染

目的　探讨高原地区食管贲门癌术后肺部感染的发生原因、诱因和围手术期的预防措施。方法　回顾分析了 16 3例食管贲门癌术前伴发疾病、肺功能、术后并发症等与术后肺部感染的关系及防治措施。结果　 16 3例中 93例术后发生肺部感染 ,发生率 5 7.1% ,术前肺功能有损害者 ,术后肺部感染发生率远高于术前肺功能正常者 ,且肺部感染轻重与术前肺功能的损伤程度密切相关。结论　在高原缺氧环境下对食管贲门癌开胸术前心肺功能不全的患者应高度重视 ,积极预防     

Mitochondrial DNA 4977 BP deletion mutations in lung carcinoma

BACKGROUND: The most common and also the most often assayed mtDNA deletion mutation, degrees mtDNA 4,977 sub has been demonstrated in various types of human cancer. However, knowledge about degrees mtDNA 4,977 in lung carcinoma is poor. AIM: To study the 4,977 bp deletions of mitochondrial DNA ( degrees mtDNA 4,977) in lung cancer, adjacent histologically normal and normal lung tissue and its potential roles in the development of cancer. MATERIALS AND METHODS: Thirty-seven matched lung cancer/adjacent histologically normal and 20 histologically normal lung tissue samples in subjects without lung cancer were analyzed by PCR technique. RESULTS: degrees mtDNA 4,977 deletions were detected in 54.1% (20/37) of lung cancers, 59.5% (22/37) of adjacent normal and 30.0% (6/20) of normal lung tissue samples. No significant difference was found in the frequency of degrees mtDNA 4,977 deletions between the tumor and adjacent normal lung tissues (P value = 0.815). Moreover, no significant difference was found in the frequency of degrees mtDNA 4,977 deletions between the tumor and histologically normal lung tissues in subjects without lung cancer (P value=0.101). However, the correlation between degrees mtDNA 4,977 deletion and age and smoking factors was present in our data. STATISTICAL ANALYSIS: Fisher's exact test was used to assess the difference in different groups by the Scientific Package for Social Sciences (SPSS), version 10.0, Statistical analysis software. CONCLUSIONS: Mitochondrial DNA 4,977 bp deletion, which is not specific to lung cancer, may reflect the environmental and aging process influences operative during tumor progression.     

Utility of SPECT Lung Perfusion Scans in Assessing the Early Changes in Pulmonary Function after Radiotherapy for Patients with Lung Cancer

OBJECTIVE Radiation-induced lung injury commonly follows radiotherapy (RT) fortumors within and near the thorax. Lung function is usually measured by pulmonary function tests (PFTs). But RT-induced regional changes of pulmonary function cannot be accurately evaluated by PFTs. Lung perfusion scintigraphy compared with other radiographic methods can assess well regional pulmonary physiological function, and a 3-dimensional conformal radiotherapy planning system can quantitatively calculate irradiation dosage. The purpose of this study is to assess, by lung perfusion scintigraphy, early changes in the pulmonary function of patients with lung cancer when receiving thoracic 3-dimensional conformal radiotherapy (3D-CRT).METHODS Nineteen patients receiving thoracic 3D-CRT for lung cancer were studied. A single photon emission computed tomography (SPECT)lung perfusion scan, X-ray or CT scan before RT and after 40～50Gy radiation were performed. Pre-RT SPECT lung perfusion images were classified by comparing lung perfusion defects with radiological abnormalities before RT. Grade 0: There was no lung perfusion defect in the area of radiological abnormality. Grade 1: The size of the radiological abnormality was similar to the area of the lung perfusion defect. Grade 2: The area of the lung perfusion defect was bigger than the size of the radiological abnormality and extended to one lobe of the lung. Grade 3: The area of lung perfusion defect exceeded one lobe of the lung. The radiation field with more than 20 Gy was drawn as a region of interest (ROI). The proportion of radioactive dose within this ROI relative to total lung dose in one slice was calculated.RESULTS All patients had lung perfusion defects, nine patients with grade 1,five patients with grade 2 and five patients with grade 3 damage,respectively. All tumors in the 19 patients were reduced in CT or X-ray images to various degrees after 40～50 Gy radiation. The mean proportion of ROI in 19 patients was 53.7±29.8% before radiation as compared to 57.6±22.6% during RT. The difference between these two groups was not significant (P=0.280). The decreased relative lung perfusion post-RT was found in six patients, whereas the increased relative lung perfusion post-RT was observed in 13 patients.CONCLUSION SPECT lung perfusion scaning is a simple, convenient and useful method for assessing regional lung function pre-RT and for monitoring the changes in regional lung function after irradiation.     

PAK Group I的活性减弱促进肺癌细胞对EGFR-TKIs的敏感性

目的:探讨p21活化激酶(p21-activated kinase,PAK)是否影响肺癌细胞对EGFR-TKIs的敏感性.方法:肺癌细胞系中加入PAK Group I抑制剂(IPA3)后,应用MTT、流式细胞术观察肺癌细胞的增殖能力.结果:IPA3和吉非替尼虽然能在不同程度上抑制肺癌细胞的增殖,但二者的联合用药能明显增强对肺癌细胞增殖的抑制作用.结论:PAK Group I的活性减弱后能抑制肺癌细胞的增殖,促进肺癌细胞对EGFR-TKIs的敏感性.     

Injury to the lung from cancer therapy: Clinical syndromes, measurable endpoints, and potential scoring systems

Toxicity of the respiratory system is a common side effect and complication of anticancer therapy that can result in significant morbidity. The range of respiratory compromise can extend from acute lethal events to degrees of chronic pulmonary decompensation, manifesting years after the initial cancer therapy. This review examines the anatomic-histologic background of the lung and the normal functional anatomic unit. The pathophysiology of radiation and chemotherapy induced lung injury is discussed as well as the associated clinical syndromes. Radiation tolerance doses and volumes are assessed in addition to chemotherapy tolerance and risk factors and radiation-chemotherapy interactions. There are a variety of measurable endpoints for detection and screening. Because of the wide range of available quantitative tests, it would seem that the measurement of impaired lung function is possible. The development of staging systems for acute and late toxicity is discussed and a new staging system for Late Effects in Normal Tissues (LENT) is proposed.     

Evidence for allosteric variants of wild-type p53, a tumour suppressor protein

A tumour suppressor function for p53 is indicated in human lung cancer and in carcinoma of the colorectum. Loss of suppressor function, by mutation of the p53 gene, is associated with activation of p53 as an oncogene. The suppressor (wild type) and oncogenic (mutant) forms of the murine p53 protein are distinguishable at the molecular level by reactivity with anti-p53 monoclonal antibodies. For example, activated mutant p53 fails to react with PAb246 (p53-246 degrees). We now demonstrate that wild type p53 mRNA can be expressed either as p53-246+ or p53-246 degrees. We propose that p53-246 degrees may represent an allosteric variant of wild type p53 compatible with positive growth control. Thus, for wild type p53 the variants p53-246+ and p53-246 degrees may reflect suppressor and activator functions of p53 in the normal control of cell proliferation. For human p53 we present evidence that the epitope recognised by PAb1620 is analogous to that for PAb246 on murine p53. Thus the epitope for PAb1620 may prove to be of use as a marker for wild type human p53 with anti-oncogenic function.     

CPS1调节恶性肿瘤发生发展的研究进展

氨基甲酰磷酸合成酶1（carbamoyl phosphate synthetase 1,CPS1）在生理状态下是肝脏特异性蛋白,表达于肝脏线粒体内,催化尿素循环第一步反应,是肝脏发挥解毒功能的关键酶之一,其表达和活性受多因素调控。病理状态下,CPS1在原发性肝癌、非小细胞肺癌、小肠癌、结直肠癌、脑胶质瘤、膀胱癌等恶性肿瘤中亦存在不同程度的上调或下调,并在不同肿瘤中发挥不同功能,主要通过调节物质代谢参与肿瘤发生、发展并影响患者预后。本文针对CPS1蛋白结构和功能、表达和调控以及CPS1在肿瘤发生发展过程中的作用进行文献综述。     

非小细胞肺癌患者肿瘤部位与大小对肺功能的影响

目的探讨非小细胞肺癌患者的肿瘤部位与大小对肺功能的影响。方法随机选取2012年10月至2014年4月间就诊的非小型肺癌患者148例,按病变部位将患者分为中央型组(65例)和周围型组(83例)。按肿瘤最大直径将患者分为A组(<3 cm)49例,B组(3⁵ cm)50例,C组(>5 cm)49例。对所有患者进行肺功能测定,比较中央型组和周围型组患者的肺功能情况,A组、B组和C组患者的肺功能情况。结果中央型组患者的各项肺通气功能指标均明显低于周围型组,差异均有统计学意义(P<0.05);而中央型组的弥散功能指标与周围型组相比,差异无统计学意义(P>0.05)。A、B、C组之间进行比较,肿瘤小的患者肺通气功能指标均明显高于肿瘤大的患者,且每两组之间比较,差异均有统计学意义(P<0.05);而3组之间弥散功能指标比较,差异无统计学意义(P>0.05)。结论非小细胞肺癌患者肿瘤部位与大小会明显影响肺功能,且通气功能受影响较大。     

Hyperthermia of mouse lungs: technique and control of critical parameters

A microwave heating technique which combines essential life support, monitoring and heating systems has been developed, and is in use for the investigation of pathophysiological responses of the murine lung to hyperthermia alone and in combination with other therapeutic modalities. The technique enables heating of most of the lung volume to within 1 to 1.5 degrees C of the target temperature. To ensure reproducibility and develop a programmed heating regimen, we have controlled microwave power, coupling of microwave power into the animal and surface temperature as well as respiration frequency, volume and temperature of inspired air and central core temperature. Cardiac function is also monitored via EKG and heart rate. With these controls, and a thermal probe in contact with the lung, we can achieve a given target temperature at a specified microwave power level and maintain that temperature within +/- 0.5 degree C for the desired heating time without surface burns and little or no procedure-related acute lethality.     

Optimum beam angles for the conformal treatment of lung cancer: a CT simulation study

Treatment of lung cancer is often performed with cone-down oblique beams to spare spinal cord and normal structures. However, there is no optimum technique to determine oblique beam angles when a CT simulation is not available. Impact of oblique beam angle was investigated in this study. Fifteen patients with centrally located lung tumors were immobilized and scanned using a CT simulator. The target volumes, left and right lungs, and spinal cord were delineated on each slice. Patients were simulated starting with anterior-posterior treatment beams and subsequently an oblique opposed pair beam from 0 degrees up to 60 degrees at an interval of 5 degrees to optimize the projection of target-to-cord distance and minimize the lung volume in the treatment fields. Analysis was performed with a dose volume histogram (DVH) in each beam orientation. The distance between the target volume and spinal cord was linearly related to the angle of the beam. A larger angle facilitated further sparing of the spinal cord; however, progressively more lung volume was exposed. The 50% DVH data for lung volume was used as an indicator of lung volume. Although, the minimum lung volume was irradiated with an angle of 30 degrees, the additional lung treated increased by only 8 +/- 7% of the total lung volume for 30-60 degrees beam angles and cord distance increased by 18.5 mm. A 30 degrees oblique parallel-opposed beam for the cone-down treatment of lung provided minimum lung volume in the irradiated field; however, the spinal cord distance increased linearly with beam angle. A CT simulator is ideally suited for simulation of lung cancer to maximize the clearance from the spinal cord and minimize the additional lung volume irradiated. Int. J. Cancer (Radiat. Oncol. Invest.) 90, 359-365 (2000).