间质性肺疾病支气管肺泡灌洗液中FN和IgG的临床研究

同步检测并对比１１例正常对照者和２５例间质性肺疾病（ＩＬＤ）病人支气管肺泡灌洗液（ＢＡＬＦ）和外周血中纤维连接素（ＦＮ）和ＩｇＧ水平并探讨其意义。结果表明：（１）正常人ＢＡＬＦ和外周血中ＦＮ水平相近（Ｐ＞０．０５）；ＩＬＤ病人ＢＡＬＦ中ＦＮ水平明显增加，并高于其血浆中ＦＮ水平（Ｐ＜０．０１），而各组血浆ＦＮ水平相近（Ｐ＞０．０５）。（２）ＩＬＤ病人ＢＡＬＦ中ＩｇＧ水平明显增加，外周血中ＩｇＧ水平也略有增加。（３）ＩＬＤ病人ＢＡＬＦ中ＦＮ、ＩｇＧ均与细胞总数呈正相关，其中ＩＰＦ组ＢＡＬＦ中ＦＮ与中性粒细胞（％）呈正相关（Ｐ＜０．０５），非ＩＰＦ组ＢＡＬＦ中ＦＮ、ＩｇＧ均与淋巴细胞（％）呈正相关（ＦＮ：Ｐ＜０．０１；ＩｇＧ：Ｐ＜０．０５）。（４）ＩＬＤ病人ＢＡＬＦ中ＦＮ和ＩｇＧ之间呈明显的正相关（Ｐ＜０．０１）。以上结果提示：ＩＬＤ病人ＢＡＬＦ中ＦＮ水平明显增加，它可作为ＩＬＤ肺泡炎活动性的一个标志，而ＢＡＬＦ中ＩｇＧ水平增高可能反映ＩＬＤ体液免疫活动性的一个侧面。     

特发性肺纤维化患者支气管肺泡灌洗液谷胱甘肽和透明质酸的检测

应用生化法和放射免疫分析法分别检测了不吸烟的１０例特发性肺纤维化（ＩＰＦ）患者和６例正常对照者支气管肺泡灌洗液（ＢＡＬＦ）和血中谷胱甘肽（ＧＳＨ）及透明质酸（ＨＡ）水平，以判断氧自由基代谢异常与肺纤维化的关系。结果：①ＩＰＦ患者ＢＡＬＦ中ＧＳＨ水平明显低于正常对照组（Ｐ＜０．０５）；②ＩＰＦ患者ＢＡＬＦ中ＨＡ水平明显高于正常对照组（Ｐ＜０．０５），且与嗜中性粒细胞计数呈显著正相关（ｒ＝０．６３４，Ｐ＜０．０５）；③血中ＧＳＨ和ＨＡ含量在病变组和对照组无明显差别。说明肺组织局部ＧＳＨ降低对肺纤维化形成有一定作用，ＢＡＬＦ中ＨＡ测定对判定肺泡炎程度有一定意义。     

闭塞性细支气管炎伴机化性肺炎和普通型间质性肺炎的支气管肺泡洗出液细胞学分析

目的为了解支气管肺泡洗出液（ＢＡＬＦ）细胞学在闭塞性细支气管炎伴机化性肺炎（ＢＯＯＰ）和普通型间质性肺炎（ＵＩＰ）的特征。方法分别对经病理学证实的、不吸烟的７例ＢＯＯＰ和７例ＵＩＰ的ＢＡＬＦ中细胞分类计数和Ｔ淋巴细胞亚群进行了测定。结果与ＵＩＰ组相比，ＢＯＯＰ组的淋巴细胞比率、ＣＤ＋８细胞比率均明显升高，而ＣＤ＋４／ＣＤ＋８比率明显降低（Ｐ均＜０．０１）；与ＢＯＯＰ组相比，ＵＩＰ组的中性粒细胞明显升高（Ｐ＜０．０５）。结论测定ＢＡＬＦ中的细胞分类计数和Ｔ淋巴细胞亚群，对鉴别ＢＯＯＰ和ＵＩＰ有指导作用，对研究二者不同的病理生理学过程，也可提供有益的线索     

小儿病毒性心肌炎的氧自由基变化及其相关因素

对６１例病毒性心肌炎（ＶＭＣ）患儿检测了ＳＯＤ、ＧＳＨ－ＰＸ、ＭＤＡ。发现ＶＭＣ患儿发病１周内ＳＯＤ、ＧＳＨ－ＰＸ下降,ＭＤＡ升高;经大剂量维生素Ｃ治疗后,ＳＯＤ、ＧＳＨ－ＰＸ、ＭＤＡ于４～６周恢复正常。ＳＯＤ、ＧＳＨ－ＰＸ与ＣＫ－ＭＢ呈负相关;与ＥＦ、ＦＳ呈正相关;ＭＤＡ与ＣＫ－ＭＢ呈正相关,与ＧＳＨ－ＰＸ、ＳＯＤ呈负相关。ＭＤＡ升高与否和心电图ＳＴ－Ｔ改变有关,ＧＳＨ－ＰＸ、ＳＯＤ降低与否和心     

川芎嗪对冠心病患者脂质过氧化作用及血液流变学的影响

对４２例冠心病患者应用川芎嗪治疗前后的血清脂蛋白代谢、过氧化脂质、抗氧化酶活性及血液流变学进行了对照观察。结果表明：①血清ＴＧ、ＴＣ、（ＬＤＬ＋ＶＬＤＬ）－Ｃ值及ＴＣ／ＨＤＬ－Ｃ比值均明显降低（Ｐ〈０．０１，Ｐ〈０．０５），而ＨＤＬ－Ｃ则显著升高（Ｐ〈０．０５）；②ＭＤＡ水平显著降低（Ｐ〈０．０１），ＳＯＤ及ＧＡＴ活性明显提高（Ｐ〈０．０５，Ｐ〈０．０１）；③血浆粘度、红细胞压积和纤维蛋白原均降低     

Ⅱ型糖尿病合并高血压患者氧化损伤及抗氧化酶活性的研究

目的：评价氧化损伤及抗氧化酶活性对型糖尿病（ Ｎ Ｉ Ｄ Ｄ Ｍ）及其伴发高血压（ Ｈ Ｔ）的影响。　方法与结果：采用鲁米诺依赖的中性粒细胞化学发光法,对１３６ 例 Ｎ Ｉ Ｄ Ｄ Ｍ 患者（其中 ７０ 例不伴有 Ｈ Ｔ,６６ 例伴有 Ｈ Ｔ）及３０ 例年龄匹配的健康对照者, 检测其外周血中性粒细胞产生氧自由基（ Ｏ Ｆ Ｒ）的水平。采用化学定量法,测定其血浆脂质过氧化终末产物－ 丙二醛（ Ｍ Ｄ Ａ）的浓度及抗氧化酶－ 超氧化物歧化酶（ Ｓ Ｏ Ｄ）、谷胱甘肽过氧化物酶（ Ｇ Ｓ Ｈ Ｐｘ）的活性。 Ｎ Ｉ Ｄ Ｄ Ｍ 伴发 Ｈ Ｔ组,其 Ｐ Ｍ Ｎ┐ Ｃ Ｌ 峰值、积分和吞噬指数均明显高于 Ｎ Ｉ Ｄ Ｄ Ｍ 不伴 Ｈ Ｔ组及健康对照组;血浆 Ｍ Ｄ Ａ浓度较后两组也明显升高（ Ｐ均＜ ０．０１）; Ｎ Ｉ Ｄ Ｄ Ｍ 组及 Ｎ Ｉ Ｄ Ｄ Ｍ 伴发 Ｈ Ｔ组的血浆 Ｓ Ｏ Ｄ和 Ｇ Ｓ Ｈ Ｐｘ 活性较正常对照组均明显降低（ Ｐ均＜ ０．０１）;但与 Ｎ Ｉ Ｄ Ｄ Ｍ 组相比, Ｎ Ｉ Ｄ Ｄ Ｍ 伴发 Ｈ Ｔ组的血浆 Ｓ Ｏ Ｄ 和 Ｇ Ｓ Ｈ Ｐｘ 活性其差异无显著性（ Ｐ均＞ ０．０５）; Ｐ Ｍ Ｎ┐ Ｃ Ｌ峰值与 Ｍ Ｄ Ａ呈明显正相关（ｒ＝ ０．７４８６, Ｙ＝ １５９．８ Ｘ＋ １３２．２, Ｐ＜ ０．０１,     

紫外线照射自血回输对肺心病患者血液抗氧化能力的影响

为进一步探讨紫外线照射自血回输（ＡＵＶＩＢ）对肺心病急性加重期患者辅助治疗的机理，对４８例肺心病患者ＡＵＶＩＢ治疗前后血液中超氧化物歧化酶（ＳＯＤ）、丙二醛（ＭＤＡ）、谷胱甘肽过氧化物酶（ＧＳＨ－Ｐｘ）、过氧化氢酶（ＣＡＴ）活性进行了检测，并以正常人作对照。结果发现：肺心病患者ＳＯＤ水平虽高于正常对照组，但无显著差异（Ｐ＞００５），ＭＤＡ含量显著高于正常对照组（Ｐ＜００１），而ＧＳＨ－Ｐｘ与ＣＡＴ活性明显低于正常对照组（Ｐ＜００５）。经ＡＵＶＩＢ辅助治疗后，ＧＳＨ－Ｐｘ与ＣＡＴ活性显著升高（Ｐ＜００５），ＭＤＡ水平显著降低（Ｐ＜００５）。说明ＡＵＶＩＢ能提高肺心病患者血液抗氧化能力     

氧化修饰低密度脂蛋白及抗氧化剂在糖尿病血管病变中的作用

为探讨氧化修饰低密度脂蛋白（ＯＸＬＤＬ）及抗氧化剂在糖尿病血管病变中的作用，采用酶联免疫吸附双抗体夹心法（ＥＬＡＳＡ法），测定了６０例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）病人及３０例正常对照者血浆ＯＸＬＤＬ水平。结果显示：（１）ＮＩＤＤＭ组与正常对照组比较，血浆ＯＸＬＤＬ水平显著增高（Ｐ＜０．０１）。ＮＩＤＤＭ有血管病变组与无血管病变组比较，血浆ＯＸＬＤＬ水平显著增高（Ｐ＜０．０５）。（２）２０例ＮＩＤＤＭ病人用维生素Ｃ及维生素Ｅ治疗后，血浆ＯＸＬＤＬ水平显著下降（Ｐ＜０．０５）。（３）血浆ＯＸＬＤＬ水平与ＬＤＬ－Ｃ、ＨＤＬ、ＴＧ、ＴＣ、ＡｐｏＡ１及ＡｐｏＢ均无显著相关性。提示ＯＸＬＤＬ可能与糖尿病血管病变的发生和发展有关。抗氧化治疗可能对预防血管病变的发生有一定的作用。     

间质性肺疾病支气管肺泡灌洗液中性粒细胞趋化因子和肿瘤坏死因子水平及其临床意义

目的探讨间质性肺疾病（ＩＬＤ）时中性粒细胞趋化因子（ＮＣＦ）和肿瘤坏死因子（ＴＮＦα）与ＩＬＤ活动性的关系。方法用膜滤过和放射免疫法检测１１例结节病、７例特发性肺间质纤维化（ＩＰＦ）患者和８名健康者血清及支气管肺泡灌洗液（ＢＡＬＦ）中ＮＣＦ活性及ＴＮＦα水平。结果７例ＩＰＦ患者ＢＡＬＦ中ＮＣＦ、ＴＮＦα分别为２０３±４４ｃｅｌｓ／１０ＨＰ、１１７±２９ｎｇ／Ｌ，明显高于８名对照组（８３±４５ｃｅｌｓ／１０ＨＰ、６５±１４ｎｇ／Ｌ、Ｐ＜０．０１）；１１例结节病患者ＢＡＬＦ中ＮＣＦ、ＴＮＦα分别为１８６±５０ｃｅｌｓ／１０ＨＰ、１２±３ｎｇ／Ｌ，明显高于８名对照组（Ｐ＜０．０１）。ＩＰＦ组ＢＡＬＦ中ＮＣＦ、ＴＮＦα均与中性粒细胞百分比呈正相关（ＮＣＦ：ｒ＝０．８９，Ｐ＜０．０１，ＴＮＦα：ｒ＝０．８６，Ｐ＜０．０５），结节病组ＢＡＬＦ中ＮＣＦ、ＴＮＦα均与淋巴细胞百分比呈正相关（ＮＣＦ：ｒ＝０．７８，Ｐ＜０．０１；ＴＮＦα：ｒ＝０．７３，Ｐ＜０．０１）。结论ＩＰＦ和结节病患者ＢＡＬＦ中ＮＣＦ、ＴＮＦα水平可做为肺泡炎活动性的标志     

MDS患者白细胞介素2受体表达研究

本实验以２８例ＭＤＳ（ＲＡ１８例、ＲＡＥＢ和ＲＡＥＢ－Ｔ１０例）和１０例ＡＮＬＬ为研究对象，采用ＡＰＡＡＰ和ＥＬＩＳＡ法检测患者外周血单个核细胞（ＰＨＡ刺激前后）的ＭＩＬ－２Ｒ和培养血清中ＳＴＬ－ＩＲ，结果表明：经ＰＨＡ刺激培养４８ｈ后，ＭＤＳ和ＡＮＬＬ患者Ｔａｃ抗原阳性率明显低于正常人（Ｐ＜０．０１）ＲＡＥＢ和ＲＡＥＢ－ｔ组Ｔａｃ＋率比ＲＡ低，与ＡＮＬＬ差异无显著性（Ｐ＞０．０５）；血清中ＳＴＬ－２Ｒ在ＭＤＳ各亚型中均高于正常对照组（Ｐ＜０．０５），其中以ＲＡＥＢ及ＲＡＥＢ－ｔ为著。认为ＭＤＳ患者免疫反应及监视能减弱；ＳＴＲ－２Ｒ与ｍＩＬ－２Ｒ无相关；ＩＬ－２Ｒ表达异常可能与造血抑制有关。     

The clinical significance of mast cell tryptase in bronchial alveolar lavage fluid in interstitial lung diseases]

Mast cell tryptase plays an important role in fibrosis. Tryptase levels in bronchial alveolar lavage fluid (BALF) from patients with interstitial lung diseases are frequently increased, but little is known of the clinical significance. The study population consisted of 93 patients [38 with sarcoidosis, 23 with collagen vascular disease (CVD), and 32 with idiopathic pulmonary fibrosis (IPF)]. BALF tryptase levels were measured with a newly developed B12 antibody-fluoroimmunocap method (UniCAP method), which can detect an activated form of tryptase. We examined the relationship between BALF tryptase levels and clinical parameters of the diseases. BALF tryptase was detected in 7 (18.4%) patients with sarcoidosis, 7 (30.4%) with CVD, and 14 (45.8%) with IPF. In tryptase-positive group, serum ACE levels and the numbers of BALF-mast cells and lymphocytes were higher than the tryptase-negative group in sarcoidosis, serum LDH levels were higher in CVD, and the number of BALF-lymphocyte and Hugh-Jones grade were higher in IPF. Furthermore, tryptase-positive IPF cases had a poorer outcome than the tryptase-negative group by Kaplan-Meier analysis. Tryptase in BALF detected with the UniCAP method may be associated with disease activity in sarcoidosis and CVD, and with severity and poor prognosis in IPF. BALF tryptase measurement may be useful in the assessment of disease activity and severity in various interstitial lung diseases.     

间质性肺疾病支气管肺泡灌洗液中性粒细胞趋化因子和肿瘤坏 …

OBJECTIVE: To investigate the relationship between the level of the neutrophil chemotactic factor(NCF), tumor necrosis factor-alpha(TNF-alpha) in patients with interstitial lung disease(ILD) and the activity of ILD. METHOD: The NCF activities in the BALF and in the serum from 11 patients with sarcoidosis, 7 with idiopathic pulmonary fibrosis (IPF) and 8 normal subjects were determined using the membrane filter and radio-immunoassay. The level of TNF-alpha was also detected. RESULT: In the 7 IPF patients, the level of NCF and TNF-alpha (203 +/- 44 cells/10 HP, 11.7 +/- 2.9 ng/L) in the BALF was higher than that in 8 control patients (83 +/- 45 cells/10 HP, 6.5 +/- 1.4 ng/L, P < 0.01). The level of NCF and TNF-alpha in the BALF from 11 patients with sarcoidosis (186 +/- 50 cells/10 HP, 12 +/- 3 ng/L) was highet than those in 8 control patients (P < 0.01). The level of NCF and TNF-alpha in the BALF from patients with IPF was positive correlated with the percentage of neutrophil (NCF: r = 0.89, P < 0.01; TNF-alpha: r = 0.86, P < 0.05). The level of NCF and TNF-alpha in the BALF of patients with sarcoidosis was positive correlated with the percentage of lymphocyte (NCF: r = 0.78, P < 0.01; TNF-alpha: r = 0.73, P < 0.01. CONCLUSION: The level of NCF and TNF-alpha in the BALF from patients with IPF and sarcoidosis can act as the marker of the activity of alveolitis of IPF and sarcoidosis.     

Gremlin-1 for the Differential Diagnosis of Idiopathic Pulmonary Fibrosis Versus Other Interstitial Lung Diseases: A Clinical and Pathophysiological Analysis

Purpose

The differential diagnosis of interstitial lung diseases (ILDs), particularly idiopathic pulmonary fibrosis (IPF) versus other non-IPF ILDs, is important for selecting the appropriate treatment. This retrospective study aimed to explore the utility of gremlin-1 for the differential diagnosis.

Methods

Serum gremlin-1 concentrations were measured using an ELISA in 50 patients with IPF, 42 patients with non-IPF ILD, and 30 healthy controls. The baseline clinical data, including pulmonary functions, prognosis, and three serum biomarkers (Krebs von den Lungen-6 [KL6], surfactant protein-D [SP-D], and lactate dehydrogenase [LDH]), were obtained through a medical record review for analyzing their associations with serum gremlin-1 concentrations. To evaluate the origin of gremlin-1, we performed immunostaining on lung sections.

Results

Serum gremlin-1 concentrations were significantly higher in patients with IPF (mean concentration, 14.4 ng/mL), followed by those with non-IPF ILD (8.8 ng/mL) and healthy controls (1.6 ng/mL). The area under the curve for IPF versus non-IPF ILDs was 0.759 (95% confidence interval, 0.661–0.857), which was superior to that of KL6/SP-D/LDH. The sensitivity and specificity for gremlin-1 (cutoff, 10.4 ng/mL) was 72 and 69%, respectively. By contrast, serum gremlin-1 concentrations were not associated with the pulmonary functions nor the prognosis in all patients with ILDs. In immunostaining, the gremlin-1 was broadly upregulated in IPF lungs, particularly at myofibroblasts, bronchiolar/alveolar epithelium, and CD163-positive M2-like macrophages.

Conclusions

Gremlin-1 may be a useful biomarker to improve the diagnostic accuracy for IPF compared to non-IPF ILDs, suggesting a role of this molecule in the pathogenesis of IPF.

     

Expression of S100A9 and KL-6 in common interstitial lung diseases

By evaluating S100 calcium binding protein A9 (S100A9) and Klebs von den Lungen-6 (KL-6) expression in patients with 4 common interstitial lung diseases (ILDs), we aimed to investigate whether S100A9 or KL-6 can be of any value in the differential diagnosis of these ILDs and simultaneously signal the disease progression.We collected the data of patients diagnosed with the 4 ILDs and underwent fiber-optic bronchoscopy and BAL in the First Affiliated Hospital, China Medical University from January 2012 to December 2020. The data related to BGA, C-reactive protein, pulmonary function test, total number and fraction of cells, T lymphocyte subsets in bronchoalveolar lavage fluid (BALF), and the expression of S100A9 and KL-6 in BALF and serum were collected. We analyzed, whether S100A9 or KL-6 could serve as a biomarker for differential diagnosis between the 4 common ILDs; whether the levels of S100A9 and KL-6 correlated with each other; whether they were correlated with other clinical parameters and disease severity.This study included 98 patients, 37 patients with idiopathic pulmonary fibrosis (IPF), 12 with hypersensitivity pneumonitis, 13 with connective tissue disease-associated ILD, and 36 with sarcoidosis (SAR): stage I (18), stage II (9), stage III (5), and stage IV (4). The expression of KL-6 in BALF was significantly higher in IPF patients than other 3 groups (all P-value < .05). However, there was no significant difference in the levels of S100A9 in BALF and serum between the 4 groups (P-value > .05). The levels of S100A9 in BALF of IPF patients was positively and significantly correlated with KL-6 expression and the percentage of neutrophils in BALF (P-value < .05). Along with the stage increase of SAR patients, the level of S100A9 in BALF gradually increased, which was negatively and significantly correlated with the forced vital capacity/predicted, carbon monoxide diffusing capacity/predicted%, and PaO₂ (all P-value < .05).The expression of KL-6 in BALF can be used as a biomarker to differentiate IPF from the other 3 common ILDs. While, this was not the case with expression of S100A9 in BALF and serum. However, the expression S100A9 in BALF is useful to indicate the progression of SAR. Thus, simultaneous measurement of KL-6 and S100A9 levels in BALF makes more sense in differential diagnosing of the 4 common ILDS.     

Clinical significance of MCP-1 levels in BALF and serum in patients with interstitial lung diseases.

It has previously been reported that the expression of monocyte chemoattractant protein-1 (MCP-1) in the lung tissues of patients with idiopathic pulmonary fibrosis (IPF) was different from that in the tissues of patients with other interstitial lung diseases (ILDs). The aim of this study was to determine whether this difference reflects the amount of MCP-1 in the bronchoalveolar lavage fluid (BALF) or serum of patients with ILD, and whether such a correlation, if it exists, is clinically useful. MCP-1 concentrations in the BALF and sera were evaluated in 86 patients with ILDs including IPF, acute interstitial pneumonia, interstitial pneumonia with collagen vascular disease (IP-CVD), chronic interstitial pneumonia (CIP), bronchiolitis obliterans-organizing pneumonia, sarcoidosis, hypersensitivity pneumonitis, and in 10 normal healthy volunteers who were controls (NC). BALF MCP-1 levels were significantly elevated in the IPF, IP-CVD, CIP and sarcoidosis groups compared with the NC group. The level in the IPF group was significantly higher than that in any other patient group. Serum MCP-1 levels in the IPF, IP-CVD, CIP and sarcoidosis groups were significantly higher than the NC group. No statistical difference was found in serum MCP-1 levels between the IPF, IP-CVD and CIP groups. BALF MCP-1 levels were significantly higher than serum MCP-1 levels in the IPF group and lower than in the IP-CVD and CIP groups. Serum MCP-1 levels correlated with the clinical course of ILD treated with corticosteroid therapy. These results show that measurement of monocyte chemoattractant protein-1 levels in both bronchoalveolar lavage fluid and serum may be helpful in discriminating idiopathic pulmonary fibrosis from other types of interstitial lung disease and that monitoring of serum monocyte chemoattractant protein-1 may be useful for predicting the clinical course of interstitial lung diseases.     

间质性肺疾病患者血清和支气管肺泡灌洗液中内皮素1活？…

评价内皮素对肺纤维化发生，发展作用的影响。方法利用同位素放射免疫直接测定法，检测１０例肺结节病和８例特发性肺纤维化患外周血和支气管肺泡灌洗液中内皮素１（ＥＴ－１）的活性，并与８名健康非吸烟进行对照。结论ＥＴ－１在肺结节病和ＩＰＦ发病机制中起着重要作用，并可作为疾病活动性判定的一项重要参考指标。     

BALF N-acetylglucosaminidase and beta-galactosidase activities in idiopathic pulmonary fibrosis

The lysosomal enzymes N-acetylglucosaminidase (N-ACGA) and beta-galactosidase (beta-gal) are involved in cellular collagen metabolism and may, therefore, be markers of fibrosis in idiopathic interstitial pneumonias, such as idiopathic pulmonary fibrosis (IPF). N-ACGA and beta-gal were analyzed in the bronchoalveolar lavage fluid (BALF) of patients with the histologic pattern of usual interstitial pneumonia (UIP, n=10) and controls (n=9). Cellular distribution in BALF as well as the concentration of TGF-beta a well-known mediator of fibroblast matrix deposition were correlated to the enzyme activities in both groups of patients. We found that both, N-ACGA (UIP: 25.2 nmol/l s +/- 3.4; controls: 73 nmol/l s +/- 1.3) and beta-gal (UIP: 4.7 nmol/l s +/- 0.5; controls: 2.4 nmol/l s +/- 0.3) were elevated significantly in BALF of patients with IPF compared to that of control patients (P<0.003). This increase was paralleled by an increase in neutrophils (IPF: 17.9% +/- 21.8; controls: 5.4% +/- 6.3; P=0.03) and eosinophils (IPF: 2.0% +/- 1.5; controls: 0.2% +/- 0.45; P=0.002) in BALF fluid. In addition, N-ACGA activity correlated closely with lung function (FVC, TLC, and DLCO), transforming growth factor-beta (TGF-beta) in BALF (r=0.77, P=0.008) and activated lymphocytes (r=0.66, P=0.0021). Our findings suggest that measurement of lysosomal enzymes such as N-ACGA may represent a useful indicator of fibrotic activity in IPF.     

自由基在实验性胃癌及癌前病变发生中的作用

目的探讨自由基在胃癌及其癌前病变发生中的作用．方法将１００只Ｗｉｓｔａｒ大鼠分为２组，实验组（７０只），给予１００ｍｇ／Ｌ甲基硝基亚硝基胍（ＭＮＮＧ）水溶液自由饮用３０ｗｋ，对照组（３０只）饮用自来水．选５个时相点，动态观察ＭＮＮＧ诱发实验性胃癌及其癌前病变过程中大鼠体内丙二醛（ＭＤＡ）、脂质过氧化物（ＬＰＯ）、谷胱甘肽过氧化物酶（ＧＳＨＰＸ）及超氧化物歧化酶（ＳＯＤ）等的变化情况．结果在实验组，ＭＤＡ平均含量在５２ｗｋ非常显著地大于０ｗｋ（Ｐ＜００１），并显著地大于１６ｗｋ以前（Ｐ＜００５）．胃癌组织ＭＤＡ含量显著高于胃癌癌前病变组织（Ｐ＜００５）．癌组织ＬＰＯ的含量显著高于癌前病变组织（Ｐ＜００５）．实验组，总ＳＯＤ和ＣｕＺｎＳＯＤ活性在５２ｗｋ明显低于１６ｗｋ之前（分别为Ｐ＜００５和Ｐ＜００１）．癌组织ＣｕＺｎＳＯＤ含量非常显著地小于正常胃粘膜（Ｐ＜００１），亦明显低于胃粘膜异型增生和肠上皮化生（Ｐ＜００５）．在３０ｗｋ和５２ｗｋＧＳＨＰＸ活性显著低于１６ｗｋ以前．结论自由基在实验性胃癌及其癌前病变发生中具有一定作用，自由基清除剂可能对胃癌的综合防治具有积极意义     

Interstitial lung diseases: characteristics at diagnosis and mortality risk assessment

As the diagnostic assessment of the different forms of interstitial lung disease (ILD) is similar, this study aims to compare age, sex, the functional and broncho-alveolar lavage fluid (BALF) findings at diagnosis between the different forms of ILDs. In addition we want to determine which of these variables determine survival. We evaluated 315 patients (176 males and 139 females) in whom the diagnosis was made of sarcoidosis (n = 87), ILD due to connective tissue disease (n = 56), hypersensitivity pneumonitis (n = 50), idiopathic pulmonary fibrosis (IPF) (n = 64), other forms of idiopathic interstitial pneumonia (n = 29) or ILD due to an undefined form of fibrosis (n = 29). We analysed the role on outcome of type of disease, gender, age at diagnosis, type of cells in BALF, FVC and DLCO. In a Kaplan-Meier analysis IPF has the worst outcome in comparison with other types of ILDs. A Cox regression analysis showed that type of ILD, FVC, age at diagnosis and % of macrophages in BALF predict outcome of patients affected by ILD.     

Angiotensin Converting Enzyme in Sarcoidosis and in Silicosis

Angiotensin converting enzyme(ACE) activities of broncho-alveolar lavage fluid(BALF) and serum in patients with sarcoidosis and with silicosis were measured. Serum ACE was measured by enzymic assay and radioimmunoassay. There was a close relationship between ACE activity and content (r=0.78). Serum ACE activities in patients with active sarcoidosis (37.5 ± 11.1 nmol/min/ml, mean ± SD) and with silicosis (25.5 ± 9.3) were significantly elevated from the control (18.6 ± 6.0). BALF ACE activities in the control, patients with active sarcoidosis and with silicosis were 0.23 ± 0.19 nmol/min/ml, 0.94 ± 0.97 and 0.38 ± 0.05, respectively. BALF ACE in patients with active sarcoidosis and with silicosis were significantly different from the control. When BALF ACE was corrected by the cell count of alveolar macrophage (per 10⁶ cells), activity was significantly different from control only in the patients with sarcoidosis. Moreover, only the alveolar macrophages in sarcoidosis were stained by immunofluorescence and immunocytochemistry using rabbit anti-human ACE antibody. Induction of ACE in alveolar macrophage might have an important role for the activity or progression of sarcoidosis.