胃癌肿瘤裂解物修饰的树突状细胞体外诱导抗原特异性细胞毒T淋巴细胞

目的　利用树突状细胞呈递肿瘤抗原的特性提高细胞毒T淋巴细胞 (CTLs)对胃癌细胞的杀伤活性。方法　胃细胞癌患者外周血来源的有核细胞体外经GM -CSF和IL -4诱导产生树突状细胞 ,负载肿瘤裂解物后诱导自体CTLs产生。用细胞毒试验检测CTLs杀伤活性 ,和用ELISA测定细胞因子的分泌。结果　胃癌患者自体来源的DC裂解物能诱导产生的CTLs对自体胃癌细胞具有高杀伤率 ,可达 83 % ;致敏的DC组中IL -12与TNF -α的浓度 ( 1161± 2 3 9pg/ml,10 44± 3 12 pg/ml)显著高于未致敏的DC组 ( P <0 .0 5 )。结论　DC能呈递胃癌裂解物 ,诱导产生抗原特异性CTLs。     

细胞毒T淋巴细胞识别人肾癌c-erbB-2蛋白

目的 为肾癌特异性免疫治疗提供实验依据。方法 采用流式细胞仪和RT-PCR方法检测人肾癌细胞系c-erbB-2和HLA-A2分子的表达。肿瘤细胞裂解物(Tuly)负载树突状细胞(DCs)体外诱导肾癌患者自体外周血单个核细胞产生特异的细胞毒T细胞(CTL)。采用CTLs杀伤表达或不表达c-erbB-2和HLA-A2的肾癌细胞。采用抗体封闭试验证实c-erbB-2的免疫原性。结果 c-erbB-2是肾癌肿瘤相关抗原。负载Tuly的DCs(DC-Tuly)诱导的CTLs特异性高杀伤c-erbB-2^ HLA-A2^ 肾癌细胞，但非特异性低杀伤c-erbB-2^-或HLA-A2^-肾癌细胞。此特异性杀伤作用能被抗c-erbB-2和抗CDs单克隆抗体封闭。结论 c-erbB-2^ 和HLA-A2^ 的肾癌患者采用过继性细胞氪疫治疗可能会提高疗效。     

以树突状细胞为基础个体化抗胃癌过继免疫治疗的研究

目的探讨负载自体肿瘤细胞裂解物的成熟树突状细胞(ATLs-mDCs)体外诱导个体化抗胃癌过继免疫治疗的效应。方法建立短期培养的原代胃癌细胞系。用ATLs-mDCs激活自体T细胞,制备肿瘤特异性细胞毒性T细胞(CTLs)。自体树突状细胞(DCs)均分为未成熟DCs、成熟DCs和ATLs-mDCs 3组,分别应用流式细胞仪及混合淋巴细胞增殖反应方法,检测DCs的免疫功能状态;应用细胞毒杀伤试验验证肿瘤特异性CTLs的杀伤活性;应用酶联免疫吸附试验(ELISA)测定DCs培养上清中白细胞介素12(IL-12)和CTLs上清中γ干扰素(IFN-γ)的分泌水平。结果ATLs-mDCs上调HLA-DR、CD80、CD83和CD86的表达水平,同时获得高效刺激自体T细胞增殖的能力。ATLs-mDCs诱导产生的CTLs对自体胃癌细胞的杀伤率为(84±11)%,显著高于对两株异体胃癌细胞的杀伤率[(19±7)%和(19±11)%(t=54.18和56.46,P值均<0.01)]。ATLs-mDCs上清液中IL-12的浓度显著高于单纯成熟DCs(t=15.47,P<0.01)及未成熟DCs(t=28.44,P<0.01)。3组DCs分别激活自体T细胞产生的CTLs上清液中INF-γ的浓度ATLs-mDCs组高于单纯成熟DCs组(t=4.84,P<0.05),并显著高于未成熟DCs组(t=13.74,P<0.01)。结论ATLs-mDCs在体外诱导产生的CTLs能有效特异性杀伤自体胃癌细胞。     

负载冻融抗原的树突状细胞诱导特异性抗膀胱癌作用的研究

目的研究负载膀胱癌冻融抗原的树突状细胞（DC）诱导的对膀胱癌细胞的特异性杀伤效应。方法反复冻融法获得BIU-87细胞抗原;人单个核细胞在含重组人GM—CSF、IL-4和TNF-a的RPMI1640培养基中体外诱导出人DC并负载肿瘤抗原;9d后成熟DC与自体T细胞共孵育诱导膀胱癌抗原特异性CTLs; 用MTT法检测其对BIU-87体外杀伤效应;用ELISA法检测DC分泌IL-12的能力。结果负载膀胱癌抗原的DC诱导的特异性CTLs可明显杀伤BIU-87细胞,在效靶比为40：1时杀伤率为（65．5±6．4）％,显著高于各对照组（P〈0．01）;负载抗原DCs较未负载抗原DCs有更强的分泌IL-12能力（P〈0．05）,而且不同时期的DC分泌的量不同。结论负载膀胱癌抗原的DC在体外可诱导出高效而特异的抗膀胱癌效应,提示以DC为中心的肿瘤生物治疗有望提高膀胱癌综合治疗水平。     

IL-12基因修饰树突状细胞体外诱导免疫杀伤肝癌细胞

树突状细胞(dendritic cell，DC)是体内功能最强的抗原呈递细胞，通过IL-12基因修饰DC可望使其在呈递肿瘤抗原的同时又持续分泌高滴度的IL-12，从而更有效地诱导T淋巴细胞增殖、分化，进一步增强特异性抗肿瘤免疫。我们采用HepG2肝癌细胞株的肿瘤相关抗原(TAA)致敏IL-12基因修饰的DC，观察了其体外诱导自体T淋巴细胞产生特异性抗肝癌免疫的效能。     

胎儿来源的树突状细胞体外诱导抗前列腺癌效应的实验研究

目的研究胎儿来源树突状细胞(DC)体外诱导抗前列腺癌的特异性细胞免疫效果。方法从胎儿骨髓、肝脏获得单个核细胞,经重组人粒细胞-巨噬细胞集落刺激因子(rhGM-CSF)、重组人白细胞介素-4(rhIL-4)和重组人肿瘤坏死因子-α(rhTNF-α)诱导产生DC。50%~70%硫酸铵饱和沉淀法获取前列腺癌细胞DU145含热休克蛋白(HSP)成分的细胞溶解物,以该抗原负载DC,激活胎脾细胞产生肿瘤特异性细胞毒性T淋巴细胞(CTL)。MTT法检测CTL对DU145、PC3和EJ细胞的杀伤效应。结果胎儿骨髓、肝脏可诱导出功能成熟的DC,高表达CD1 a、CD86、HLA-DR和CD83。负载DU145抗原的DC可诱导产生CD8+CTL。CD8+T细胞表型由转化前的(14.09±2.46)%变为转化后的(62.76±2.64)%。对DU145细胞有明显细胞毒作用,显著高于对EJ细胞杀伤效应(P<0.01)。结论含HSP成分的肿瘤细胞溶解物负载胎儿来源DC,体外可诱导出特异性抗肿瘤免疫应答。     

肾癌树突状细胞疫苗的体外活性研究

目的 探讨负载人肾癌细胞抗原肽制备树突状细胞(DC)疫苗体外杀伤肾癌细胞的作用.方法 利用细胞膜酸洗脱法获得人肾透明细胞癌细胞株786-0细胞表面抗原肽.外周血单个核细胞在体外经人粒细胞一巨噬细胞集落刺激因子,白细胞介素4和脂多糖诱导获得成熟的DC,并负载分离到的抗原肽制备DC疫苗.利用疫苗体外诱导出特异性细胞毒性T淋巴细胞(CTL)作为实验组.同时设置4个对照组,对照组1用未负载抗原肽的DC和单个核细胞混合培养,对照组2用单个核细胞进行培养,对照组3用抗原肽与单个核细胞混合培养,对照组4用未负载抗原肽的DC单独培养.4个对照组也加入同实验组相同的各种因子进行培养.51Cr释放法检测特异性CTL的杀伤活性.结果 疫苗诱导的特异性CTL对肾癌细胞的杀伤活性为(31.93±5.05)%,与对照组(5.88±2.26)%、(8.03±6.70)%、(9.70±2.09)%、(9.35±3.58)%相比差异有统计学意义(P<0.05).结论 负载抗原肽的DC疫苗体外试验有高效的抗肾癌细胞活性.     

活性氧对膀胱癌树突状细胞调节的研究

我们通过细胞培养方法观察外源性活性氧自由基一氧化氮（NO）、羟自由基对膀胱癌患者树突状细胞（DC）刺激自体淋巴细胞增殖及对DC诱导细胞毒性T细胞（CTLs）杀伤膀胱癌细胞株T-24的影响，了解NO、羟自由基对DC递呈抗原功能的影响。现报告如下。     

转Survivin基因树突状细胞抗消化道肿瘤的免疫效应研究

目的　研究转染Survivin的树突状细胞 (DC)在体外诱导高效而特异的抗消化道肿瘤免疫效应。方法　用脂质体作为介质 ,将Survivin基因转染入DC ,用Westernblot法检测培养上清Survivin的表达 ,检测这种DC分泌细胞因子白介素 (IL 12 )、肿瘤坏死因子 (TNF) α的功能 ,以及表面分子CD1a、CD83、MHcⅡ、CD80、CD86表达的高低 ,用MTT法诱导人特异的细胞毒性T淋巴细胞 (CTLs)的能力。结果　培养上清中均可以检测到Survivin表达 ;转基因DC的上清IL 12、TNF α两种细胞因子含量为 (2 65 .2± 3 2 .7)ng/L和(4 3 7.1± 83 .5 )ng/L明显比单纯DC组高(P <0 .0 5 ) ;转基因DC表面高表达CD1a、CD83、MHCⅡ、CD80、CD86;转基因的DC提呈的T细胞对胃癌细胞、结肠癌细胞、胆管癌细胞杀伤率分别为 :65 %、77%、85 % ,而未修饰的单纯DC杀伤作用较低。结论　Survivin基因转染修饰的DC能诱导细胞毒性T淋巴细胞的特异性 ,显著地提高DC的抗原提呈功能 ,体外能诱导高效而特异的抗癌免疫效应。     

干扰素γ诱导蛋白10基因修饰小鼠树突状细胞的抗前列腺癌作用研究

目的　探讨转染干扰素γ诱导蛋白 10 (IP 10 )基因构建的加载树突状细胞 (DC)瘤苗 ,对特异性细胞毒T淋巴细胞 (CTL)的诱导作用。　方法　将RM 1细胞的裂解产物作为肿瘤抗原加载小鼠骨髓来源的DC(Tuly DC) ,将IP 10DNA插入真核表达质粒 ,通过脂质体法将IP 10基因转染至Tuly DC ,构建DC瘤苗 ;RT PCR法检测IP 10基因转染成功 ,趋化实验检测对淋巴细胞的趋化作用 ,混合淋巴细胞反应 (MLR)检测瘤苗刺激T细胞的增殖能力 ,MTT法检测瘤苗诱导的特异性CTL的杀伤活性。　结果　转染DC的IP 10表达明显增强 ,其上清对淋巴细胞有较强的趋化作用 ;DC瘤苗刺激T细胞增殖能力增强 ,每分钟闪烁计数值分别为 18913.0 9± 2 735 .33(1∶10 )和 17736 .6 7± 2 5 31.70 (1∶2 0 ) ,与各对照组相比差异有显著性意义 (P <0 .0 1) ;DC瘤苗诱导的CTL对RM 1细胞的特异性杀伤率分别为 (37.95± 5 .2 6 ) % (效靶比 2 0∶1)和 (43.87± 7.6 3) % (效靶比 4 0∶1) ,均高于各对照组 ,差异有显著性意义 (P <0 .0 1)。　结论　所构建的前列腺癌DC瘤苗能有效提高其抗原提呈功能和特异性CTL的诱导。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

Systemic analgesia adapted to the children's condition

A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions.     

Intraoperative autotransfusion is associated with modest reduction of allogeneic transfusion in prosthetic hip surgery

Background: The efficacy of intraoperative salvage and washing of wound blood and the predictors of allogeneic red cell transfusions in prosthetic hip surgery are insufficiently known.
Methods: In 96 patients, undergoing primary or revision surgery, salvaged and washed red cells and, if necessary, allogeneic blood were used to keep haematocrit not lower than 33%. The bleeding of red cells during hospital stay was calculated from the red cell balance. The preoperative red cell reserve (millilitres of red cells in excess of a haematocrit of 33%) was estimated and the difference between this volume and the total bleeding of red cells was retrospectively used to classify patients with regard to the need for red cells. Stepwise regression analysis was used to define patient-related variables associated with allogeneic blood transfusion.
Results: Preoperative knowledge of the type of operation (primary, revision), the preoperative red cell reserve, and the body mass could predict roughly half of the need for banked blood (r²=0.45). Only one-third of the total bleeding of red cells was retransfused. For complete avoidance of allogeneic blood, autotransfusion was most effective in patients with a moderate need (0–4 u). However, 32% of such patients required allogeneic blood.
Conclusions: Autotransfusion has a limited efficacy to decrease the need for allogeneic blood, and other blood-saving methods should be added for this purpose. It is difficult to predict the need for allogeneic blood preoperatively.     

缺氧对肾小管上皮细胞分泌外泌体的影响

目的    观察缺氧对肾小管上皮细胞分泌外泌体的影响,探讨外泌体在缺氧致肾脏损伤中的作用及机制。 方法    （1）常氧（21% O₂）及缺氧（1% O₂）分别处理大鼠肾小管上皮细胞（NRK-52E）48 h,收集细胞上清液并使用高速梯度离心法分离外泌体。采用透射电镜、纳米示踪分析、Western印迹、蛋白浓度定量鉴定并比较两组外泌体的基本特性。（2）在共培养实验中,以不同浓度（1、10、50、100、300 mg/L）的常氧外泌体、缺氧外泌体分别干预脂多糖（LPS）诱导的大鼠原代腹腔巨噬细胞,使用实时荧光定量PCR与酶联免疫吸附试验（ELISA）法分别检测巨噬细胞白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）、诱导型氮氧化物合酶（iNOS）水平;使用Western印迹法检测巨噬细胞磷酸化（p）STAT/STAT及细胞因子信号传导抑制蛋白1（SOCS1）的蛋白表达;最后,使用实时荧光定量PCR法检测常氧外泌体与缺氧外泌体中炎性反应相关微RNA（microRNA,miR）的表达差异。 结果    （1）离心得到的囊泡具有外泌体典型的结构,粒径小于150 nm,表达外泌体标志蛋白CD63,说明分离得到外泌体。缺氧对肾小管上皮细胞分泌的外泌体形态、粒径分布比例无明显影响,但提高了外泌体的分泌量。（2）缺氧外泌体相比于常氧外泌体促进了LPS诱导的M1型巨噬细胞IL-6、TNF-α、iNOS 的表达和分泌（均P＜0.01）,同时提高STAT的磷酸化水平并减少SOCS1的蛋白表达（均P＜0.01）;对炎性反应相关microRNA检测发现缺氧外泌体中miR-155、miR-27a表达量较常氧外泌体明显升高（P＜0.05）。 结论    缺氧可改变外泌体的生物学功能,表现为协同促进LPS诱导的M1型巨噬细胞的表型转化,这可能是慢性肾脏病微炎性反应状态持续的原因之一。     

In Vitro Function and Durability Assessment of a Novel Polyurethane Heart Valve Prosthesis

Abstract While flexible-leaflet, central-flow prosthetic heart valves promise relief from anticoagulation therapy, they continue to be restricted by inadequate durability. In consequence, a novel trileaflet valve, made entirely from polyurethane, has been developed. A batch of 6 consecutively manufactured polyurethane valves was subjected to hydrodynamic function and accelerated fatigue testing. Computerized data acquisition and control systems have been introduced to improve valve testing methodologies. In terms of hydrodynamic function, the polyurethane valve demonstrates transvalvular pressure gradients similar to those for a bioprosthetic valve (Carpentier-Edwards) and levels of retrograde flow significantly less than those for either the bioprosthetic valve or a bileaflet mechanical valve (St Jude Medical). The equivalent of 10 years of cycling without failure has been exceeded by all 6 polyurethane valves in accelerated fatigue tests with 2 valves remaining intact after 674 million cycles (equivalent to approximately 17 years) in continuing tests. Highspeed photography revealed considerable differences in leaflet motion between valves cycled at accelerated and physiological rates.     

Negative pressure ventilation vs. spontaneous assisted ventilation during rigid bronchoscopy: A controlled randomised trial

Background: Ventilation during interventional rigid bronchoscopy (IRB) under general anaesthesia (jet ventilation, positive pressure ventilation and spontaneous assisted ventilation) may offer some difficulties. This study compares the effectiveness during IRB of intermittent negative pressure ventilation (INPV) and spontaneous assisted ventilation (SAV). Methods: Thirty-eight patients submitted to IRB were randomised into two groups: SAV or INPV. All patients received a total intravenous anaesthesia; INPV patients were paralysed. Pre-and intra-operative arterial blood gases and O₂ flow through a rigid bronchoscope were assessed. The endoscopist applying a subjective score evaluated the operating conditions. Results: Patients of the INPV group, as compared to the SAV group, required a lower dosage of fentanyl (2.6 ± 1.8 (μg · kg^?1· h^?1 vs. 6.6 ± 4.8 μg · kg^?1· h^?1), a lower O₂ supply (3.3 ± 2.8 1/min vs. 11.6 ± 3.4 1/min), a shorter recovery time (5.4 ± 2.9 min vs. 9.8 ± 7.1 min) and no manually assisted ventilation (0 ± 0 vs. 1 ± 1.1 nd?/procedure). Intraoperative PaCO₂ was higher in the SAV (8.1 ± 1.3 kPa) than in the INPV group (5.0 ± 1.6 kPa) and intraoperative pH differed in the two groups (7.26 ± 0.05, SAV vs. 7.47 ± 0.08, INPV). Operating conditions, as assessed by a subjective score, were considered better with INPV than with SAV (4.9 vs. 4.3). Conclusions: As compared to SAV, INPV in paralysed patients during IRB reduces administration of opioids, shortens recovery time, prevents respiratory acidosis, excludes the need for manually assisted ventilation, reduces 02 need and affords optimal surgical conditions. INPV appears a safe, non-invasive and effective ventilatory management during IRB.