人参及人参皂甙对荷瘤小鼠血清中表皮生长因子含量的影响

给Ｃ５７ＢＬ／６小鼠移植Ｌｅｗｉｓ肺癌细胞（２×１０＾７）２周后，以放射免疫法测定其血清中表皮生长因子（ＥＧＦ）含量，肿瘤组为０．２８±０．０９μｇ／Ｌ，正常鼠组为０．１８±０．１１μｇ／Ｌ，移植肿瘤后服用人参煎剂组（人参组）为０．１６±０．１０μｇ／Ｌ，移植肿瘤后服用人参皂甙组（人参皂甙组）为０．２９±０．１１μｇ／Ｌ。肿瘤组鼠的ＥＧＦ含量明显高于正常鼠，人参组明显低于肿瘤组鼠，人参皂甙组与肿瘤     

P16蛋白表达与肺癌的关系

为探索Ｐ１６蛋白表达与肺癌（ＰＰＣ）的关系，作者应用免疫组织化学技术检测６５例ＰＰＣ组织中Ｐ１６蛋白的表达。结果显示：ＰＰＣ中Ｐ１６蛋白表达的总丢失率为３６．９２％±１８．４５％，其中腺癌（ＡＣ）组为２８．４７％±１６．３３％、鳞状细胞癌（ＳＣＣ）组为３５．９５％±１７．３６％、腺鳞癌（ＡＳＣＣ）组为５７．８８％±１０．１８％。其中６０岁以下组ＳＣＣ与６０岁以上组ＳＣＣ、低分化癌与中分化癌的Ｐ１６     

测定甲亢病人血清甲状腺刺激抗体的意义

用ＰＥＧ粗提血清中的ＩｇＧ刺激鼠甲状腺细胞（ＦＲＴＬ─５）株，测定释入培养液中的ｃＡＭＰ含量表示ＴＳＡｂ活性。所测ＴＳＡｂ活性，正常组为１００．１±４８．８％（ｎ＝１８，±ｓ）；１７例未治甲亢病组为１４４２．８±１１９８．１％，全部（１００％）ＴＳＡｂ阳性；１６例甲亢病复发组为１１４５．７±１２１７．７％，其中１４例（８７．５％）ＴＳＡｂ阳性；１０例甲亢病缓解组为１２４．２±８２．５％，其中２例（２０％）ＴＳＡｂ阳性；３例桥本氏甲状腺炎中２例在正常范围内，１例反应性增高。ＴＳＡｂ活性测定可作为甲亢病诊断及预后判断的一项指标。     

P16蛋白表达与肺癌的关系

为探索Ｐ１６蛋白表达与肺癌（ＰＰＣ）的关系，作者应用免疫组织化学技术检测６５例ＰＰＣ组织中Ｐ１６蛋白的表达。结果显示：ＰＰＣ中Ｐ１６蛋白表达的总丢失率为３６．９２％±１８．４５％，其中腺癌（ＡＣ）组为２８．４７％±１６．３３％、鳞状细胞癌（ＳＣＣ）组为３５．９５％±１７．３６％、腺鳞癌（ＡＳＣＣ）组为５７．８８％±１０．１８％。其中６０岁以下组ＳＣＣ与６０岁以上组ＳＣＣ、低分化癌与中分化癌的Ｐ１６蛋白丢失率比较，以及ＡＣ与ＡＳＣＣ，ＳＣＣ与ＡＳＣＣ的Ｐ１６蛋白表达丢失率比较，其差异有显著性（Ｐ＜０．０５）。男性ＰＰＣ与女性ＰＰＣ、左肺ＰＰＣ与右肺ＰＰＣ、以及淋巴结转移性癌与原发性ＰＰＣ的Ｐ１６蛋白表达丢失率比较，其差异无显著性（Ｐ＞０．０５）。本研究结果提示Ｐ１６蛋白可能是ＰＰＣ预后判定的重要指标之一。     

150例大鼠原位肝移植手术方法比较

探索大鼠原位肝移植最佳手术方法与模型。采用雄性ＳＤ大鼠３００只，分三袖套法，改良三袖套法和二袖套法，即缝合肝上下腔静脉法行原位肝移植１５０次。各组无肝期：ＴＣ组（１５．５±５．５）ｍｉｎ，ＭＴＣ组（１３．５±３．５）ｍｉｎ，ＡＳＶＣ组（２１±４．０）ｍｉｎ。手术时间：ＴＣ组（９０±２５）ｍｉｎ，ＭＴＣ组（８０±１８）ｍｉｎ；ＡＳＶＣ组为（９５±２０）ｍｉｎ。术后血管并发症发生率；ＴＣ组为４２％，Ｍ     

一氧化氮复合猪肺泡表面活性物质治疗洗肺鼠的疗效

目的；研究不同浓度一氧化氮（ＮＯ）对肺猪泡表面活性物质（ＰＰＳ）替代治疗洗肺鼠疗效的影响。方法：６４只ＳＤ大鼠经反复肺灌洗至ＰａＯ２〉１３．４ｋＰａ和ＰａＣＯ２〈８．０ｋＰａ后，随机分成对照组、ＰＰＳ２５ｍｇ／ｋｇ组、ＰＰＳ５０ｍｇ／ｋｇ组、ＰＰＳ１００ｍｇ／ｋｇ组，各组按ＮＯ吸入与否再分成Ａ、Ｂ两亚组，观察用药后ＰａＯ２、ＰａＣＯ２、肺压力一容量环及肺实质密度变化。结果：组ＩＡ的ＰａＯ２、ＰａＣ     

不饱和脂肪酸对肺癌细胞的抑制作用

不饱和脂肪酸（ＬＡ）浓度为２５μｇ／ｍｌ，对人肺腺癌细胞系（ＳＰＣ－Ａ１）细胞和二倍体人胚肺细胞系（ＨＬＦ）细胞抑制率分别为：９８．４±２．２％，１８．０±２．１％（Ｐ＜０．００１）。表现为对恶性细胞的选择性抑制作用。ＳＰＣ－Ａ１对５μｇ／ｍｌ ＬＡ无反应，１μＭ丝裂霉素Ｃ（ＭＭＣ）对ＳＰＣ－Ａ１细胞抑制率为４３．４±２．９％而当用１μｍ ＭＭＣ处理这种对５μｇ／ｍｌ ＬＡ无反应的ＳＰＣ－Ａ１时，     

内毒素致兔急性肺损伤时内源性肺表面活性物质的改变

目的 探索脓毒症引起急性肺损伤（ＡＬＩ）时内泊性肺表面活性物质（ＰＳ）主要成分的变化。方法 制作兔脓毒性ＡＬＩ模型，进行支气管肺泡灌洗液（ＢＡＬＦ）磷脂、功能亚型聚集集体及活性的分析，Ｗｅｓｔｅｒｎ ｄｏｔ ｂｌｏｔ法和Ｎｏｒｔｈｅｒｎｂｌｏｔ法测肺表面活性物质结合蛋白（ＳＰ－Ａ）含量及ｍＲＮＡ含量的变化。结果 肺损伤后与正常组化，总磷脂（ＴＰＬ）（７．８±１．１）ｖｓ（１２．７±１．７）ｍｇ／ｋ     

银耳枸杞煎剂抗衰老作用的实验研究

为研究银耳枸杞煎剂的抗衰老作用，用化学比色法测定了给药前后小鼠血清中超氧化物歧化酶（ＳＯＤ）活力，丙二醛（ＭＤＡ）含量，测定了给药前后小鼠耐缺氧存活时间，游泳存活时间。给药前ＳＯＤ活力为８１．８３±１６．１６ＶＵ／ｍｌ，ＭＤＡ含量为４．８２±１．８４ｎＭ／ｍｌ，耐缺氧存活时间为６．４４±１．０２分，游泳存活时间为１．９１±０．６６分；给药后ＳＯＤ活力为１０８．８５±２１５２，ＭＤＡ含量为３．０５±１．２１，耐缺氧存活时间为７．６８±１．０９游泳存活时间为２．６６±０．７２。各项指标给药前后行ｔ检验，均存在显著差别。     

鼻咽部表面活性物质与分泌性中耳炎关系的研究

作者随机选择分泌性中耳炎（ＯＭＥ）患者４０例为观察组,另选择健康成人及儿童４０例为对照组。用分光光度计法定量测定正常人及ＯＭＥ患者鼻咽部灌洗液中代表面活性物质的卵磷脂含量,间接反遇其表面活性物质的量,以探讨ＯＭＥ的发病机理和 治疗方法。结果显示,ＯＭＥ患者鼻咽部灌洗液中卵磷脂含量为８．６３７±２．７３０ｍｇ／Ｌ,较正常对照组３９．２１２±２．４３７ｍｇ／Ｌ明显减少（Ｐ〈０．０１）,儿童患者其卵磷脂     

慢性肺动脉栓塞血栓内膜剥脱术围手术期管理

目的　探讨慢性肺动脉血栓内膜剥脱术围手术期管理的方法。方法　总结 7例慢性肺动脉栓塞剥脱术 (PTE)病例的临床资料。结果　 7例在体外循环下行肺动脉血栓内膜剥脱术 ,1例围术期死亡 ,6例存活。术后 2周测不吸氧状态下动脉血氧分压、血氧饱和度均有显著改善 (P<0 .0 5 ) ,术后 2周超声心动测肺动脉收缩压显著降低 (P <0 .0 5 ) ,生活质量明显改善。结论　术前术后积极降低肺动脉高压、纠正心功能不全 ,术后防治肺水肿及再栓塞的形成是肺动脉血栓内膜剥脱术围手术期管理的关键。     

闭塞性肺动脉高压的肺阻抗血流图

分析32例闭塞性肺动脉高压的肺阻抗血流图资料,并与右心导管检查相对照,结果表明闭塞性肺动脉高压的肺阻抗基本波形为多峰递增波,波峰延迟为其主要特点,延迟的程度与肺动脉压呈正相关。     

巨大性肺栓塞

巨大性肺栓塞是发生在肺动脉干和左右肺动脉内的栓子栓塞和血栓形成。5例巨大性肺栓塞中,4例肺动脉血栓形成继发于慢性肺心病和肺动脉高压症,另1例为肾癌术后的肺动脉栓塞。5例均发生猝死,临床无1例确诊为巨大性肺栓塞。文中对本病的发病情况、栓塞的来源和发病机制、病理改变和临床表现进行了讨论。     

Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: preliminary exploration in China

Background Pulmonary endarterectomy is safe and effective surgical treatment for chronic thromboembolic pulmonary hypertension. This study aimed to evaluate the efficacy of pulmonary endarterectomy in treatment of thromboembolic pulmonary hypertension. Methods A retrospective study of 15 patients who underwent pulmonary endarterectomy in Beijing Chaoyang Hospital was performed. Obvious pulmonary hypertension and hypoxemia were observed in all patients. Bilateral pulmonary endarterectomy was performed under cardiopulmonary bypass with profound hypothermic circulatory arrest. Results Two patients （2/15） died of residual postoperative pulmonary hypertension and bleeding complication. The other 13 cases had significant decrease in systolic pulmonary artery pressure （（92.8＋_27.4） mmHg vs. （49.3＋18.6） mmHg） and pulmonary vascular resistance （（938.7±464.1） dynes.s.cm5 vs. （316.8±153.3） dynes＇s.cm5）, great improvement in cardiac index （（2.31：LK）.69） L.min-l.m2 vs. （3.85±1.21） L.min-l.m2）, arterial oxygen saturation （0.67±O.11 vs. 0.96±0.22） and mixed venous 02 saturation （0.52±0.12 vs. 0.74±0.16） postoperatively compared to preoperative data. Mid-term follow-up showed that the cardiac function of all cases returned to NYHA class I or II, with great improvement in 6-minute walking distance （（138±36） m） and quality of life. Conclusions Bilateral pulmonary endarterectomy using cardiopulmonary bypass with the aid of deep hypothermia and circulatory arrest can effectively reduce pulmonary hypertension and provide good mid-term hemodynamic and symptomatic results with low surgical mortality rate and few complications.     

室缺修补术并肺高压体外循环后肺通气和血流临床干预的效应对比

目的观察肺高压室缺修补术(左向右分流)患儿体外循环(cardiopulmonary bypass,CPB)后增加肺通气或扩张肺血管对肺内分流和肺顺应性的临床影响。方法3组(60例)患儿随机分为A组(对照组20例)常规呼吸管理、B组(20例)CPB后用前列腺素E1、C组(20例)CPB后增加肺通气量,观察CPB前、CPB后30分的动脉血二氧化碳分压(PaO2)和呼气末二氧化碳分压(PETCO2)的差值(Pa-ETCO2)、肺顺应性(Cmpl)、平均动脉压力(mean blood pressure,MBP)和肺内分流率(Qs/Qt)、呼吸指数(respiration index,RI)的变化。结果组内比较,CPB后30 min C组的Pa-ETCO2差值增加和Cmpl降低(P<0.05)、Qs/Qt和RI升高(P<0.05);B组的Pa-ETCO2、Qs/Qt和RI明显低于同时点C组(P<0.05或P<0.01),Cmpl高于同时点C组(P<0.05)。结论小儿心脏手术CPB后心肺功能正效应并不即时体现,肺部存在明显肺内分流及无效腔通气,通气/血流失调,肺顺应性减低,单纯增加通气量改善不大,扩张肺血管可明显改善肺顺应性、减少肺内分流。     

术前肺功能与肺切除术后并发症的关系

肺切除术后并发症风险性与术前肺功能和预期术后肺功能指标明显相关。在术前选择合适的病人手术，对于降低术后的死亡率和并发症率十分重要，其中最具代表性的指标为FEV1％、DLCO％、FEV1％PPO、DLCO％PPO等。     

大鼠高肺血流性肺动脉高压形成中肺血管结构的变化

目的探讨大鼠高肺血流性肺动脉高压形成中肺血管结构的动态变化规律.方法80只雄性SD大鼠,随机分为分流组和对照组,每组40只.分流组大鼠经腹主动脉-下腔静脉穿刺术建立高肺血流动物模型,对照组大鼠除不作穿刺术外,其余手术过程同分流组.两组分别在术后1、3 d及1、4、8周经右心插管法测量肺动脉收缩压(SPAP)、肺动脉平均压(MPAP);取心脏组织,称量右心室与左心室 室间隔重量之比[RV/(LV SP)];取肺组织制作光学显微镜及电子显微镜标本,在光镜下观察肺小动脉中肌型动脉(MA)、部分肌型动脉(PMA)及非肌型动脉(NMA)构成比例及MA的相对中膜厚度(RMT)和相对中膜面积(RMA)的变化,电镜下观察肺小动脉超微结构的变化.结果与对照组比较,SPAP和MPAP在分流组术后1、3 d及4周时差异无显著性,分流术后1、8周时,SPAP、MPAP均显著高于对照组(P＜0.01);分流术后8周,RV/(LV SP)显著升高(P＜0.05);与对照组比较,分流术后1、3 d及1周时MA、PMA、NMA占肺小血管总数的百分比在两组之间差异无显著性,分流术后4、8周时大鼠MA、PMA占肺小血管总数的百分比明显增高(均P＜0.01),而NMA百分比明显降低(均P＜0.01);RMT、RMA在分流术后1、3 d及1、4周与对照组比较差异无显著性;分流术后8周时明显增高(P＜0.05).肺小动脉超微结构在分流术后3 d时仅为内皮细胞肿胀、体积增大;分流术后1周时,除内皮细胞结构改变外平滑肌细胞增大、内弹力层厚薄不均;分流术后4周时平滑肌细胞与内弹力层呈垂直生长,由收缩表型向合成表型转化;分流术后8周时细胞间见胶原纤维堆积.结论肺血管结构重建呈现明显的时间依赖性,内皮细胞肿胀出现最早,平滑肌结构改变次之,最后出现细胞外基质异常堆积.     

Chronic thromboembolic pulmonary hypertension: a review

Chronic thromboembolic pulmonary hypertension (CTEPH) is a unique form of pulmonary hypertension resulting from obstruction of the pulmonary artery by fibrotic thromboembolic material, usually initiated by recurrent or incomplete resolution of pulmonary embolism. This distinct form of pulmonary hypertension is classified under Group 4 of the World Health Organization classification. Further investigations are usually initiated, with transthoracic echocardiography followed by right heart catheterisation and pulmonary angiography as the gold standard. Definitive treatment is usually in the form of surgical pulmonary endarterectomy. Inoperable CTEPH is medically treated with pharmacological agents such as phosphodiesterase Type 5 inhibitors, endothelin receptor antagonists, soluble guanylate cyclase stimulators and prostacyclin. Recent developments have made balloon pulmonary angioplasty a viable option as well.     

Pulmonary artery injury management during pulmonary thromboendarterectomy

Pulmonary thromboendarterectomy （PEA） is the recommended treatment for chronic thromboembolic pulmonary hypertension （CTEPH）.1 Pulmonary artery injury is a major risk factor during PEA performed at less experienced surgical centers and is associated with adverse short-term consequences.In-hospital mortality may be as high as 15% in some PEA case series,with pulmonary artery injury and persistent pulmonary hypertension as the principal etiologies.2 Many techniques have been used to prevent pulmonary artery injury during PEA,but once the injury occurs,the prognosis is poor and may even result in death.Out of 202 PEA procedures performed at our surgical center,we successfully managed two cases of severe pulmonary artery injury and report our experience in the present case series.Keywords：chronic thromboembolic pulmonary hypertension; pulmonary thromboendarterectomy; pulmonary artery injury     

Pulmonary oligemia maneuver can alleviate pulmonary artery injury during pulmonary thromboendarterectomy procedure

Background Pulmonary thromboendarterectomy (PTE) has evolved as a treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH). This study aimed to characterize if pulmonary oligemia maneuver (POM) can alleviate pulmonary artery injury during PTE procedure.

Methods A total of 112 cases of CTEPH admitted to Beijing Anzhen Hospital from March 2002 to August 2011 received PTE procedure. They were retrospectively classified as non-POM group (group A, n=55) or POM group (group B, n=57). Members from group B received POM during rewarming period, whereas members from group A did not.

Results There were three (5.45%) early deaths in group A, no death in group B (0) (Fisher’s exact test, P=0.118). Six patients in group A needed extracorporeal membrane oxygenation (ECMO) as life support after the PTE procedure, no patients in group B needed ECMO (Fisher’s exact test, P=0.013). The patients in group B had a shorter intubation and ICU stay, lower mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR), higher partial pressure of oxygen in artery (PaO₂) and arterial oxygen saturation (SaO₂) and less medical expenditure than patients in group A. With a mean follow-up time of (58.3 ± 30.6) months, two patients in group A and one patient in group B died. The difference of the actuarial survival after the procedure between the two groups did not reach statistical significance. Three months post the PTE procedure, the difference of residual occluded pulmonary segment between the two groups did not reach statistical significance (P=0.393).

Conclusion POM can alleviate pulmonary artery injury, shorten ICU stay and intubation time, and lower down the rate of ECMO after PTE procedure.