肿瘤坏死因子在内毒素诱导小鼠肺泡Ⅱ型上皮细胞凋亡中的作用

肺泡上皮细胞具有许多重要的功能 ,包括调节表面活性物质代谢、离子转运以及损伤后肺组织修复等[1 ] 。细菌内毒素 (ＬＰＳ)是革兰阴性菌引起的急性肺损伤的重要致病因素。研究表明 ,急性肺损伤可导致肺血管内皮细胞和上皮细胞凋亡[2 ] 。然而 ,ＬＰＳ对肺泡Ⅱ型上皮细胞 (ＡＥＣⅡ )的损伤效应和机制尚有待阐明。继往研究提示 ,肿瘤坏死因子(ＴＮＦ)在体外可诱导内皮细胞凋亡[3 5] 。但ＴＮＦ在ＬＰＳ诱导的ＡＥＣⅡ凋亡中的作用至今仍不清楚。笔者旨在明确内源性ＴＮＦ在ＬＰＳ诱导ＡＥＣⅡ凋亡中的作用。一、材料与方法1.试剂和实验动物 …     

放射对肺表面活性物系统的继发效应

为了在细胞水平和分子水平进一步探索放射性肺炎的机理,作者用LAF 鼠做实验,分析了放射对肺泡Ⅱ型上皮细胞释放表面活性磷脂的影响和对肺组织成分的影响。作者用剂量率为每分钟413rad 的Cs 对三组LAF 鼠分别给以胸部一次照射650,1,300(亚致死剂量)和1,950rad(致死剂量)。全部在照射后24小时,1周、4周和18周用生化方法定量测定了肺泡冲洗液中的总卵磷脂和不饱和卵磷脂和肺泡组织的蛋白和DNA;同时在光镜和电镜下进行了形     

沐舒坦预防和治疗ARDS研究进展

沐舒坦（Ambroxol)是一种较新的粘液溶解剂，近年来其对呼吸系统的保护作用倍受关注，已较多学者将其应用于ARDS的预防和治疗，取得了较好的临床效果，并对其机制进行了深入的研究。其预防和治疗ARDS的机制可能是：（1）减少TNFα和IL－1及相关炎性介质的释放，减轻SIRS在肺部的表现；（2）抗氧化作用，阻止氧自由基对肺组织的损伤；（3）刺激肺泡Ⅱ型上皮细胞合成、分泌内源性肺表面活性物质，同时抑制磷脂酶A对肺表面活性物质的降解，增加肺的顺应性；（4）减轻ARDS时气管壁离子转运和电位差的破坏。临床应用大剂量沐舒坦对ARDS的预防、治疗和转归可能具有一定疗效。     

放射性肺损伤与脑Ⅱ型上皮细胞

从肺受照后Ⅱ型一皮细胞的形态、功能及放射生物学等指标的改变来提示肺Ⅱ型上皮细胞与放射性肺损伤的关系，论证了它是放射性肺损伤的关系，论证了它是放射性肺损伤的主要靶细胞。     

放射性肺损伤

放射性肺损伤是胸部肿瘤放射治疗引起的并发症,一般有两种表现形式,早期急性放射性肺炎和后期放射性纤维化.发病机理研究主要为病理学观察,归纳起来主要有分子生物学机制、肺Ⅱ型上皮细胞损伤、血管内皮细胞受损和自由基等.损伤的发生与照射野、放射剂量、分割方式等有关.总照射剂量低于36GY无放射性肺炎发生,低于40GY无纤维化发生.其病理改变随着照射后时间延长逐渐加重,肺泡是主要受损部位.基本病变为肺充血、水肿、肺间质增厚纤维化.CT、X线是临床最常用检查方法,表现为毛玻璃样斑片状高密度影, 与正常组织分界清.放射性肺损伤不可逆转,预防比治疗更为重要.本文综述了近几年放射性肺损伤各方面研究进展.     

CBLB502对放射性肺炎和肺纤维化的防护作用研究

目的研究CBLB502对放射性肺炎和放射性肺纤维化的防护作用，从而证实CBLB502作为临床抗放射药物的可行性。方法C57BIM6J小鼠20Gy单次照射后24h、1个月、3个月和5个月取肺组织用TUNEL方法对肺泡上皮细胞和血管内皮细胞的凋亡进行检测，HE染色观察纤维化病理变化，免疫组织化学方法检测特异性指标表达，以及受照部位皮毛和皮肤的病理变化。结果CBLB502抑制了照射后小鼠肺泡上皮细胞和血管内皮细胞的凋亡，减缓了肺纤维化进程，同时减少层黏连蛋白表达，维持表面活性蛋白B表达量，受照皮肤的炎症反应也明显减轻。结论CBLB502对照射后放射性肺炎和放射性肺纤维化的发生和进程有防护作用。     

高原RDS表面活性物质相关蛋白A、B、CmRNA表达的变化

作者观察了高原呼吸窘迫综合征 (ＲＤＳ)时表面活性物质相关蛋白 (ＳＰ)Ａ、Ｂ、ＣｍＲＮＡ表达与影响因素 ,了解其变化情况 ,并探讨其在急性肺损伤中的作用机制及意义。作者采用了高原ＲＤＳ动物模型 ,利用分子生物学技术观察肺组织肺泡Ⅱ型上皮细胞表面活性蛋白及其基因的表达。结果显示 :ＳＰ -Ａ、ＳＰ -Ｂ和ＳＰ -Ｃ斑点杂交结果表明 ,油酸组ＳＰ -Ａ、ＳＰ -Ｂ和ＳＰ -ＣｍＲＮＡ表达的相对含量均显著低于对照组。油酸可抑制ＳＰ -Ａ、ＳＰ -Ｂ和ＳＰ -ＣｍＲ ＮＡ在高原ＲＤＳ中的表达 ,严重的低氧血症、肺组织细胞损伤及胞内酶活性…     

MMP-12异常表达对放射性肺损伤大鼠肺内成纤维细胞转化的影响

目的 观察放射性肺损伤过程中基质金属蛋白酶12(MMP-12)过表达对肺成纤维细胞转化的作用.方法 32只雄性Wistar大鼠,体重250～280g,随机分为正常对照组(n=8)和照射组(n=24).照射组用20Gy60Co γ射线进行全胸照射,分别于照射后1、2、4周行肺组织取材,每时间点8只.应用明胶酶谱法检测MMP-12酶活性变化,组织特殊染色法观察肺泡壁弹力纤维降解情况,透射电镜观察肺泡Ⅱ型上皮细胞与肺间质细胞间的"信号交流"(cross talking)现象,ELISA法检测肺组织中TGF-β1含量,免疫组化检测肺组织a-平滑肌肌动蛋白(a-SMA)表达情况.结果 MMP-12酶活性在照射后1周开始增高,至照射后4周时有所下降;肺泡壁基底膜弹力纤维照射后1周开始出现降解断裂,4周时最为严重;肺组织TGF-β1含量和a-SMA免疫组化阳性信号在1～4周内随照后时间延长而逐渐升高.电镜观察肺泡Ⅱ型上皮细胞与肺间质细胞间出现"信号交流"现象.结论 照射后肺组织MMP-12酶活性增高,可能通过降解基底膜弹力纤维促进成纤维细胞转化,启动肺纤维化的发生.     

内源性肺表面活性物质相关蛋白特性的研究进展

目前,国内外研究表明肺表面活性物质的异常与肺部疾病的发生、发展关系密切。近些年国内学者逐渐认识到在急性肺损伤/急性呼吸窘迫综合征的发病中肺表面活性物质相关蛋白的异常比肺表面活性物质的减少更有意义。所以,关于外源性肺表面活性物质制剂的替代治疗也日益受到重视。因此,本文就肺表面活性物质相关蛋白的研究进展做一综述。     

放射性肺炎

在胸部恶性肿瘤的放射治疗中 ,肺组织会受到不同程度的照射。当肺组织接受较高剂量和 /或较大容积的照射 ,或患者对放射线敏感时 ,可能发生放射性肺炎。1　发病率及病因〔1〕　　有症状的放射肺炎的发病率为 5 %～ 15 %。发病与下列因素有关 :(1)受照射肺的容积 :剂量相同时受照射肺组织容积越大 ,发生率越高。 (2 )受照射剂量 :放射剂量 <15Ｇｙ时 ,很少发生放射性肺炎 ;若 >6 0Ｇｙ会发生不同程度的放射性肺炎。 (3)分割方式 :总剂量相同时 ,分割次数越少 ,总疗程越短 ,放射性肺炎的发病率越高。 (4)受照射部位 :上肺及近纵隔的肺组织较下…     

成批煤气爆燃烧伤的救治体会

报道治疗因煤气泄漏爆炸烧伤病员7例，经应用MEBT技术积极救治，其中6例于伤后17天痊愈出院，另一例特重伤员也于伤后30天康复出院。作者认为：应严格按照MEBT／MEBO要求进行规范治疗，正确处理生命体征、休克、感染、脏器功能和创面的辨证关系。同时，不能忽视外科营养在过程中的重要作用，它是创面修复的物质保证。     

Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

新疆石河子地区奶牛隐性乳房炎的调查与分析

采用LMT法对新疆石河子地区三个规模化奶牛场泌乳牛群进行了隐性乳房炎检测,共检测994头泌乳牛3976个乳区.结果表明:奶牛隐性乳房炎阳性率为81.9%,乳区阳性率为49.1%.数据分析表明,不同年龄、胎次以及有无卧床奶牛的隐性乳房炎阳性率差异显著(P<0.05),后乳区的隐性乳房炎感染率显著高于前乳区感染率(P<0.05),隐性乳房炎乳区发生数也明显影响当日产奶量(P<0.05).     

Sex differences in neuromuscular fatigability in response to load carriage in the field in British Army recruits

Objectives

Women are resistant to neuromuscular fatigue compared to men in response to a range of exercise tasks. The sex differences in the neuromuscular responses to load carriage have yet to be investigated.

Decrease in eccentric hamstring strength in runners in the Tirol Speed Marathon

Background

The local muscular endurance of knee flexors, during eccentric work in particular, is important in preventing or delaying kinematic changes associated with fatigue during treadmill running. This result, however, may not be transferable to overground running.

Objective

To test the hypothesis that overground running is associated with eccentric hamstring fatigue.

Methods

Thirteen runners (12 male and one female) performed an isokinetic muscle test three to four days before and 18 hours after a marathon. Both legs were tested. The testing protocol consisted of concentric and eccentric quadriceps and hamstring contractions.

Results

There were no significant differences between peak torque before and after the race, except that eccentric peak hamstring torque (both thighs) was reduced.

Conclusion

Overground running (running a marathon) is associated with eccentric hamstring fatigue. Eccentric hamstring fatigue may be a potential risk factor for knee and soft tissue injuries during running. Eccentric hamstring training should therefore be introduced as an integral part of the training programme of runners.     

肺心病慢性呼吸性酸中毒合并代谢性酸碱失衡判断方法探讨(附80例次血气分析)

目的：对42例肺心病慢性呼吸性酸中毒患者的80例次血气测定结果。方法：用不同的酸碱图（卡）及代偿公式进行酸碱类型的初步差别分析。结果：结合临床表现、各种影响因素与治疗反应等作出综合判定。结论：比较二种判定的差异，并提出较为实用、可靠的判断建议，以助于复合型呼吸性酸碱失衡的临床诊断与处理。     

Oxalosis in primary hyperoxaluria in infancy

Primary hyperoxaluria (PH1) is a rare inborn autosomal recessive metabolic disorder due to the deficiency of hepatic alanine-glyoxylate-aminotransferase. This deficiency results in excessive synthesis and urinary excretion of oxalate, inducing renal stone formation and deposition of calcium oxalate in the kidney, bone, myocardium, and vessels (systemic oxalosis, SO) in the most severely affected individuals. We report renal and skeletal changes in a 3-month-old girl with PH1 and SO. Intense cortico-medullary hyperechogenicity and increased homogeneous radiopacity of normal-sized kidneys suggested the diagnosis of SO. Skeletal survey showed osteopenia and characteristic symmetrical metaphyseal transverse bands in long bones, progressively becoming more dense and migrating towards the diaphysis. Multiple pathological and slowly healing fractures of the limbs occurred at the dense band level. A radiopaque rim was then observed in flat bones, epiphyseal nuclei, and vertebral bodies. Inflammatory granulomatous reaction, induced by the presence of oxalate crystals in the marrow spaces, coexisted with progressively evident radiological signs of secondary hyperparathyroidism, with partially overlapping features. The patient was treated by peritoneal dialysis and hemodialysis until combined liver–kidney transplantation. There are no previous reports of infants treated with hemodialysis for more than 2 years.     

Interventional radiology in oncology in private practice

Interventional oncology in private practice requires expert training and can be performed in a stand-alone facility for type 1 procedures in a hospital setting for type 2 and 3 procedures where subspecialized radiologists, state-of-the-art equipment, and postprocedure hospital monitoring are available. A multidisciplinary effort with oncologists, internal medicine physicians and anesthesiologists is necessary. The practice of interventional oncology requires around the clock availability, meticulous and established protocols and procedures and a financial investment. On the other hand, it is professionally gratifying because of constant technical advances and the impact on patients.