低氧性肺动脉高压大鼠肺功能变化

肺功能变化如何 ,对临床上诊断各种呼吸系统疾病有重要的指导作用。在医学科研中 ,众多的呼吸系统疾病的大鼠动物模型中 ,检测大鼠动物模型的肺功能对搞好科研工作 ,指导临床防治多种呼吸系统疾病的患者有重要实用意义。但多年来 ,由于受条件限制 ,在许多大鼠疾病模型中无法检     

不同因素对肺功能影响的研究概况

肺功能作为呼吸系统疾病诊断和疗效评估的主要手段之一,临床备受重视。不仅年龄、身高,甚至出生时体质量等生理因素对肺功能也有影响,而且β2肾上腺素能受体(β2-adrenergicreceptor,β2-AR)等基因、大量细胞因子等机体内环境的改变与肺功能关系亦非常密切;吸烟、甲醇乃至粉尘等外界环境对肺功能的影响也不可忽视;2型糖尿病、脊柱侧凸等内外科疾病对肺功能也有着显著的影响。而口服茶碱、缩唇呼气法等干预手段则有利于患者肺功能的改善。     

肺功能检测在咳嗽变异性哮喘诊断的应用评价

目的探讨在咳嗽变异性哮喘诊断中应用肺功能检测的临床意义。方法选取62例咳嗽变异性哮喘患者作为观察组,另选择60例接种疫苗的正常儿童作为对照组。用同一仪器检测肺功能,用力肺活量(FCV)、残气量(RV)、最大呼气峰流速(PE)、第一秒末呼吸容积(FEV1)、RV/TLC(残气量/肺总量)、FEV1/FVC%等。同时比较咳嗽变异性哮喘常规问诊、听诊与肺功能检测确诊率与误诊率情况。结果观察组患者慢性持续期、急性发作期FVC、PEF、FEV1、FEV1/FVC%较对照组明显要低(P0.05),临床缓解期肺功能指标与对照组比较无明显差异(P0.05);肺功能检测咳嗽变异性哮喘确诊率较常规诊断明显要高,误诊率较常规诊断明显要低(P0.05)。结论肺功能检测对疾病的诊断和病情严重程度的判断等十分直观有效,值得推广使用。     

可产生模拟呼吸曲线的智能肺功能仪检校系统

目的:为适应肺功能检测仪检测校正的要求,设计并制作一款可产生模拟人体呼吸标准曲线并自动对肺功能仪作检测分析的智能肺功能仪检测校正系统。方法:系统的建立采用计算机智能操控伺服电机驱动的活塞气缸方式。结果:有关执行和应用检测结果表明,此系统可精准输出美国胸科协会推荐的24条标准用力肺活量及26条最大呼气流量波形曲线,还可提供被检测肺功能仪的详细数据。结论:本研究的智能肺功能仪检测校正系统可适用于智能测定分析被检测校正的肺功能仪的准确度和频率速度响应等情况,并可有助于医生对肺功能仪所测定的病人肺功能状况的数据指标作情况分析。     

CT肺功能成像与其临床应用

背景：随着CT技术及计算机软件的发展,CT不仅能够显示肺部的解剖结构,而且还能够测定肺功能状况,为肺功能的评估与研究提供了一个新方法。 目的：总结CT肺功能成像的分析指标及临床应用,以便将其广泛应用于临床,早期发现及监测呼吸系统疾病。 方法：应用计算机检索CNKI、PubMed数据库中1989-01/2010-05关于CT肺功能的文章,在标题和摘要中以“CT肺功能”或“computed tomography pulmonary function;quantitative CT”为检索词进行检索。选择文章内容与CT肺功能成像与其临床应用有关,同一领域文献则选择近期发表或发表在的权威杂志文章。初检得到中文文献26篇,英文文献287篇,根据纳入标准选择20篇文章进行综述。 结果与结论：肺功能的CT成像研究主要是通过肺容积、密度或象素指数的改变来反映肺组织的功能变化,以揭示肺组织的病理解剖学和病理生理学信息,以期早期发现和早期监测呼吸疾病。CT肺功能的测定在肺气肿、慢阻肺等的定量分析、肺癌及单侧肺移植后肺功能的预测等方面有着广泛的临床应用。     

肺功能残气量的测定方法及临床意义研究进展

肺功能残气量表示平静呼吸末肺内残留的气体体积,它是常规肺功能测量的重要指标之一。文章主要介绍了肺功能残气量在评估慢性阻塞性肺疾病(COPD)病变程度、区分COPD与支气管哮喘及指导急性呼吸窘迫综合征(ARDS)患者保护性机械通气策略制定等方面的临床意义,同时对传统的肺功能残气量测量方法和新的测量技术如吸气正弦波法和电阻抗断层成像法进行了综述,最后探讨了肺功能残气量测量装置的未来发展趋势。     

不同部位食道癌手术前后肺功能状态研究

目的 观察和对比不同部位食管癌手术患者治疗前后的肺功能状态变化情况.方法 选取我院2012年12月～2014年12月收治的施行食道癌根治术的100例食道癌患者作为临床研究对象,对其临床资料进行回顾性分析,根据手术部位的不同,将其中的上段食道癌患者分为A组(15例),中段食道癌患者分为B组(48例),下段食道癌患者分为C组(37例).观察和比较三组患者术前和术后的肺功能变化情况.结果 三组患者手术前和手术后的肺功能检测结果比较,(P＞0.05)差异均无统计学意义.三组患者手术后的肺功能情况均明显低于手术前,(P＜0.05)差异均有统计学意义.结论 食道癌患者手术后的肺功能会出现不同程度的降低,但不同部位的食道癌手术对患者手术前后的肺功能无明显影响.     

南极特殊环境增强中国考察队员肺功能

目的研究不同纬度南极特殊环境对中国考察队员肺功能的影响。方法采用Scope Rotary便携式肺功能仪,对2003年12月~2005年3月期间曾居留的第20次考察队的长城站12名越冬队员,中山站16名越冬队员以及南极内陆冰盖Dome-A的8名度夏队员,进行出发前和返回后的肺功能检测。结果居留南极圈边缘12个月的长城站队员,最大呼吸流速(PEFR)比出发前增加12%(P<0.05)。居留南极圈内15个月的中山站队员,最高呼吸流速(PEF)比出发前增加9%(P<0.05);肺活量(VC)、深吸气量(IC)、用力肺活量(FVC)、1秒用力呼气容积(FEV1)、用力呼气流速25%(FEF25%)和最大肺活量(MBC)较出发前分别增加7%,8%,8%,5%,9%和10%(均P<0.01)。21次在海拔4000m,夏季平均气温-50℃的Dome-A地区野外考察58d的8名队员,用力肺活量(FVC)较出发前增加10%(P<0.05)。结论居留南极考察队员的肺功能有一定程度的增强,纬度高肺功能增强更明显。肺功能增强可能是对南极环境的一种适应性反应。     

肺功能自动评价及资料管理软件

目的　设计应用中国正常人群预计值方程式的肺功能数据评价及多功能查询的资料管理软件 .方法　应用中文版的MicrosoftVisualFoxpro 6 .0进行模块化设计编程 ,模块功能包括录入、评价、查询、统计、打印、备份和用户设置处理 .结果　对 5 0 0例检测资料数据通过计算机自动评价及医师评价进行比较 ,符合率达 93%以上 ;可提供多项不同需求的资料查询 .结论　该软件评价肺功能结果可较为准确地反映我国人群肺功能的真实状况 ,也为临床及科研的资料查询提供了极大的方便     

肺功能检查专用一次性呼吸过滤器的研制

目的 研制一种肺功能检查专用一次性呼吸过滤器.方法 采用AutoCAD计算机辅助结构绘图软件,设计出由外部成形硬壳与内部纤维过滤膜组成的呼吸过滤器,并制备其样品,检测其性能.结果 成功设计、绘制并生产出肺功能检查专用一次性呼吸过滤器.经检测,其细菌过滤效率(99.99%)、密闭性能(无漏气)、气流阻力[(0.82±0.08)cm H2O·L-1·S-1]、死腔容积[(63±1)ml]均符合美国胸科协会.欧洲呼吸学会(ATS/ERS)标准;并经临床试用表明其对肺通气功能指标无显著影响.结论 国产一次性呼吸过滤器在肺功能检测中应用,可有效阻隔患者呼出气体中的细菌,预防交叉感染,使用简便,价格较低,适于国内推广应用.     

Lung/skin connections in occupational lung disease

PURPOSE OF REVIEW: Exposure to occupational and environmental agents can cause a spectrum of lung diseases that are predominantly immune-mediated. Research and prevention have focused primarily on the respiratory tract. Recent studies, however, suggest that the skin may also be an important route of exposure and site of sensitization. This article highlights key findings, focusing on isocyanate asthma and chronic beryllium disease. RECENT FINDINGS: Occupational lung diseases such as isocyanate asthma and chronic beryllium disease continue to occur despite reduced airborne exposures. Although challenging to quantify, recent studies have documented isocyanate and beryllium skin exposure, even with the use of personal protective clothing. Factors that impair skin barrier function, such as trauma, may promote sensitization to such agents. Animal studies demonstrate that skin exposure to isocyanates and protein allergens is highly effective at inducing sensitization, with subsequent inhalation challenge eliciting asthmatic responses. Limited clinical studies suggest a similar role for human skin exposure to certain sensitizing agents. SUMMARY: Recent findings support a greater focus on the role of skin exposure in the development of certain occupational and environmental lung diseases. Although further research is needed, it is prudent to reduce both skin and inhalation exposures.     

Pulmonary Function Changes in Experimental Graft-versus-Host Disease of the Lung

Pulmonary graft-versus-host disease (p-GVHD) is a serious complication after allogeneic stem cell transplantation (allo-SCT) of high morbidity and high mortality. We characterized breathing patterns and pulmonary function changes in correlation to lung histopathology and survival by using a well-established murine model of p-GVHD. Lethally irradiated B6D2F1 mice received SCT from either syngeneic B6D2F1 or allogeneic C57BL/6 animals. Within 6 weeks, severe p-GVHD developed in allogeneic recipients characterized by progressive interstitial, alveolar, peribronchial, and periluminal inflammatory cell infiltration, whereas in syngeneic recipients lung histology remained normal. Allogeneic recipients demonstrated decreased minute ventilation (MV), reduced peak inspiratory and expiratory flow rates as early as 1 week after SCT. In addition, allo-SCT resulted in restrictive pulmonary function changes as early as 7 days after transplantation and in progressive airflow obstruction within 6 weeks. Decreased breathing abilities and pulmonary function changes of allogeneic recipients were associated with increased mortality and the severity of acute graft-versus-host disease (aGVHD). These findings show that p-GVHD can be characterized by changes in pulmonary function and functional respiratory insufficiency. Furthermore, our data strengthen the understanding, that the lung is a critical target organ of aGVHD.     

The Effect of Particulate Matter Reduction by Indoor Air Filter Use on Respiratory Symptoms and Lung Function: A Systematic Review and Meta-analysis

PurposeExposure to particulate matter (PM) is a key public health issue, but effective intervention has not yet been established. A systematic literature review and meta-analysis has been conducted to assess the relationship between the use of air filters, one of the most commonly studied interventions, and respiratory outcomes in patients with chronic respiratory diseases.MethodsWe systematically reviewed intervention studies on PM using PubMed, EMBASE, and Cochrane databases up to September 2019. Studies that included data on PM concentration changes and respiratory symptoms or lung function in patients with respiratory diseases were eligible for inclusion. Effect estimates were quantified separately using the random-effects model.ResultsSix studies were included in the quantitative analysis. Air filter use reduced indoor PM2.5 by 11.45 µg/m³ (95% confidence interval [CI], 6.88, 16.01 µg/m³). Air filter use was not associated with improvements in respiratory symptoms in 5 of the 6 studies or significant changes in the predicted forced expiratory volume in one second (FEV1) (mean change, −1.77%; 95% CI, −8.25%, 4.71%). Air filter use was associated with improved peak expiratory flow rate by 5.86 (95% CI, 3.5, 8.19 of standardized difference).ConclusionsThe findings of this systematic review suggest that air filters may reduce indoor PM and increase peak expiratory rate in asthmatic patients. However, most studies showed no significant effects of air filters on respiratory symptoms or FEV1. Further studies in regions with high-density PM may provide additional information on this issue.Trial RegistrationPROSPERO Identifier: CRD42020156258     

高位硬膜外麻醉对肺通气和血气的影响

为探讨高平面硬膜外阻滞麻醉对肺通气功能的影响,对29例无明显心肺疾患的择期手术成年病人于硬膜外麻醉前后进行肺功能测试和血气分析。结果:麻醉后肺活量,肺活量占预计值百分比、补呼气量、补吸气量、最大通气量及最大用力呼气流量容积曲线的呼气流量均有显著降低(P<0.05)。提示选择高位硬膜外阻滞时对肺通气功能有一定影响,应用时应有呼吸支持的准备。     

T细胞在肺上皮细胞损伤与修复中的作用和机制

肺上皮细胞在呼吸系统中起着重要的保护作用。然而,各种病理因素如感染、创伤和炎症等可以导致肺上皮细胞的损伤,进而引发呼吸系统疾病。在肺上皮细胞损伤和修复过程中,T细胞扮演着关键角色,并通过接触或者释放多种免疫介质来参与这一过程。不同亚群的 T细胞分别承担着增强抗炎反应、清除感染的致炎作用以及促进血管新生和上皮细胞增殖的修复作用。本综述旨在总结T细胞在肺上皮细胞损伤和修复中的作用,并阐述其参与肺疾病发病和缓解的可能机制。     

Effect of Ruxolitinib on Lung Function after Allogeneic Stem Cell Transplantation

Ruxolitinib, a selective Janus kinase (JAK)1/2 inhibitor, has recently been proposed for steroid-refractory chronic graft-versus host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (HSCT), particularly in severe skin cGVHD. Lung function impairment is common in severe skin cGVHD through concomitant bronchiolitis obliterans syndrome (BOS) or restrictive lung disease (RLD) from skin sclerosis. To date, no treatment has shown a benefit on lung function in this context. We retrospectively assessed the effect of ruxolitinib on lung function in a cohort of 70 patients diagnosed with sclerotic-type skin cGVHD between March 2015 and April 2018. Among these patients, 36 received ruxolitinib. To handle confounding by indication bias, exposure groups were matched on the propensity score to receive ruxolitinib, incorporating age, myeloablative conditioning, total body irradiation, BOS, forced expiratory volume in 1 second (FEV₁), forced vital capacity (FVC), and tobacco use at the time of cohort entry, as well as the time from transplantation. The 1:1 matching used a greedy-matching algorithm with replacement, with a caliper of 0.10. FVC and FEV₁ trajectories during follow-up were compared in the matched samples, using linear mixed-effects models. The median duration of follow-up of the 46 matched patients was 58 months (interquartile range, 32 to 84 months). Ten patients had an RLD (6 exposed, 4 unexposed), and 13 patients were diagnosed with BOS (8 exposed, 5 unexposed). FEV₁ decreased significantly over time independent of exposure to ruxolitinib (P < .0001). The FEV₁ trajectory was similar in the exposed patients and the unexposed patients (P = .11). In conclusion, ruxolitinib administration did not demonstrate any improvement in the course of respiratory function in allogeneic HSCT recipients with sclerotic-type skin cGVHD.     

Overview of Lung Transplantation

Although significant gains have been made in improving lung function and survival in cystic fibrosis (CF), ultimately respiratory failure is the leading cause of mortality in these patients. For CF patients with end stage lung disease, lung transplantation is an option for treatment. The field of lung transplantation has progressed markedly in the last 20 years. Nonetheless it remains a technically complex and challenging procedure, and patients are at risk for numerous short term and long term complications. Potential transplant recipients must be physically and psychologically prepared for the arduous process involved in lung transplantation. This article will review the history of lung transplantation, indications for transplantation, surgical techniques, and complications of transplantation.     

Function of lung surfactant and its deterioration

Lung surfactant(LS) is a mixture of several lipids and four apolipoproteins(SP-A, -B, -C and -D) and lowers surface tension at air-liquid interface of alveoli. Most of LS is synthesized and secreted by alveolar type II cells. Although lamellar bodies are storage granules of LS, each component appears to take independent intracellular routes to reside in the granules. Patients with infantile respiratory distress syndrome(IRDS) or acute respiratory distress syndrome(ARDS) develop fatal respiratory failure due to lack of LS. In addition, acute phase of interstitial pneumonia also shows deterioration of LS and increased alveolar surface force resulting in decreased lung compliance. SP-A and SP-D are used as serum marker to evaluated activity of interstitial lung diseases. Recently, growing evidences are accumulating that LS plays a role in innate host defense in the lung against large species of bacteria, mycoplasma, and viruses.     

In Silico Ventilation Within the Dose-Volume is Predictive of Lung Function Post-radiation Therapy in Patients with Lung Cancer

Lung cancer is a leading cause of death worldwide. Radiation therapy (RT) is one method to treat this disease. A common side effect of RT for lung cancer is radiation-induced lung damage (RILD) which leads to loss of lung function. RILD often compounds pre-existing smoking-related regional lung function impairment. It is difficult to predict patient outcomes due to large variability in individual response to RT. In this study, the capability of image-based modelling of regional ventilation in lung cancer patients to predict lung function post-RT was investigated. Twenty-five patient-based models were created using CT images to define the airway geometry, size and location of tumour, and distribution of emphysema. Simulated ventilation within the 20 Gy isodose volume showed a statistically significant negative correlation with the change in forced expiratory volume in 1 s 12-months post-RT (p?=?0.001, R?=?? 0.61). Patients with higher simulated ventilation within the 20 Gy isodose volume had a greater loss in lung function post-RT and vice versa. This relationship was only evident with the combined impact of tumour and emphysema, with the location of the emphysema relative to the dose-volume being important. Our results suggest that model-based ventilation measures can be used in the prediction of patient lung function post-RT.

     

Lung injury in preterm neonates: the role and therapeutic potential of stem cells

Continuous improvements in perinatal care have allowed the survival of ever more premature infants, making the task of protecting the extremely immature lung from injury increasingly challenging. Premature infants at risk of developing chronic lung disease or bronchopulmonary dysplasia (BPD) are now born at the late canalicular stage of lung development, just when the airways become juxtaposed to the lung vasculature and when gas-exchange becomes possible. Readily available strategies, including improved antenatal management (education, regionalization, steroids, and antibiotics), together with exogenous surfactant and exclusive/early noninvasive ventilatory support, will likely decrease the incidence/severity of BPD over the next few years. Nonetheless, because of the extreme immaturity of the developing lung, the extent to which disruption of lung growth after prematurity and neonatal management lead to an earlier or more aggravated decline in respiratory function in later life is a matter of concern. Consequently, much more needs to be learned about the mechanisms of lung development, injury, and repair. Recent insight into stem cell biology has sparked interest for stem cells to repair damaged organs. This review summarizes the exciting potential of stem cell-based therapies for lung diseases in general and BPD in particular.