埃他卡林对人肺动脉内皮细胞内皮素系统的作用

目的研究新型ATP敏感性钾通道(KATP)开放剂埃他卡林(iptakalim,IPT)对人肺动脉内皮细胞内皮素(ET)系统的作用。方法原代培养人肺动脉内皮细胞(HPAECs),分别加入不同浓度埃他卡林,共同孵育24h后;应用放射免疫法测定各组细胞上清内皮素-1(ET-1)浓度的变化,同时用逆转录多聚酶链反应(RT-PCR)方法检测各组细胞ET-1及内皮素转换酶(ECE)mRNA表达的变化。结果在IPT浓度为10-6mol·L-1及以上时,能够剂量依赖性地抑制HPAECs合成分泌ET-1,同时也降低ET-1mRNA的表达量;在IPT浓度为10-7mol·L-1及以上时,能够剂量依赖性地降低ECEmRNA的表达量。结论IPT通过抑制人肺动脉内皮细胞ET-1和ECEmRNA的表达量,继而抑制内皮细胞合成分泌ET-1,可能成为较有前途的治疗肺动脉高压的有效药物。     

肺心病心衰期血浆内皮素含量及临床意义

目的观察肺心病心衰期患者血浆内皮素(ET1)浓度,与1组同龄无心脏病患者血浆内皮素含量对照,探讨ET1是否参与肺心病肺动脉高压心衰的病理过程。方法用放射免疫法测定30例肺心病患者心衰期血浆ET1浓度。结果肺心病心衰期血浆ET1浓度明显高于对照组。结论ET1参与肺心病肺动脉高压心衰病理过程。     

冠心病患者血浆ET、CGRP及血清NO检测分析

目的 通过检测老年冠心病患者血浆内皮素(ET)、降钙素基因相关肽(CGRP)、和血清一氧化氮(NO)的浓度变化,了解3者之间的动态平衡,探讨分析其临床意义.方法 抽取本院内科收治的冠心病患者65例,同时选取正常对照组40例,采用放免分析法测定血浆内皮素(ET)及降钙素基因相关肽(CGRP),利用硝酸还原酶法检测血清NO[1].结果 冠心病组血浆内皮素(ET)浓度水平及降钙素基因相关肽(CGRP)浓度水平均明显高于正常对照组,差异有统计学意义(P＜0.05);而血清NO浓度水平明显低于正常对照组,差异有统计学意义(P＜0.05).结论 血浆内皮素(ET)、降钙素基因相关肽(CGRP)和血清NO的浓度水平随冠心病的发展而变化,检测其浓度水平的变化可反映患者病情的严重程度;对冠心病患者的病情诊断及准确治疗提供重要临床依据.     

桃红四物汤促进内皮细胞增殖及其机制初探

目的探讨桃红四物汤促进内皮细胞增殖及其初步机制。方法以10％浓度的高、中、低剂量组含药血清和空白对照组血清培养HUVECs,观察其对HUVECs增殖、eNOS活性和NO分泌的影响。结果3种剂量的含药血清能均促进HUVECs增殖、eNOS活化和NO分泌。结论桃红四物汤通过上调eNOS—NO介导的信号途径．诱导内皮细胞增殖。     

川芎嗪对缺氧后血管内皮细胞功能保护作用的实验研究

目的 观察缺氧条件下内皮细胞培养上清液中ET和NO含量变化及川芎嗪对它们的影响。方法 采用新生儿脐静脉血管内此细胞体外原代培养方法,用放免法和化学法检测培养注中ET和NO的含量。结果 在缺氧环境中,血管内皮细胞培养上清液中ET和NO含量明显下降（P＜0.001）,加入不同浓度川花芎嗪后可使ET和NO含量明显升高,尤以NO明显。结论 川芎嗪具有保护血管内皮细胞合成、分泌ET和NO作用,对缺氧致细胞内皮的损伤具有保护作用。     

盐酸埃他卡林对血管内皮细胞分泌功能的影响

目的 :研究新型抗高血压药物盐酸埃他卡林(Ipt)对血管内皮细胞分泌功能的影响。方法 :采用灌流消化法分离小牛主动脉内皮细胞 (BAEC) ,观察Ipt对BAEC分泌内皮素 1(ET 1)、前列环素 (PGI2 )和一氧化氮 (NO)的影响 ,同时观察Ipt对培养的BAEC胞浆游离Ca2 浓度的影响。结果 :在Ipt浓度为 10 -6mol·L-1及以上时 ,能够剂量依赖性地抑制培养的BAEC合成分泌ET 1,并在Ipt 10 -5mol·L-1及以上时促进NO的合成分泌 ,同时在Ipt浓度为10 -4mol·L-1及以上时 ,显著地增高BAEC胞浆游离Ca2 浓度。结论 :Ipt通过抑制内皮细胞合成分泌ET 1和促进NO的合成分泌 ,从而使ET和NO的平衡状态得到改善 ;尚能增加内皮细胞 [Ca2 ]i,有利于内皮细胞合成NO增加 ,从而增强内皮介导的舒血管效应。     

丙种球蛋白治疗川崎病血管损伤的机制

目的探讨川崎病血管损伤过程是否与白三烯B4 白三烯B4受体1（LTB4-BLT1）通路有关，了解丙种球蛋白治疗川崎病的作用机制。 方法分别用正常血清、川崎病急性期血清、川崎病急性期血清加丙种球蛋白作用于人脐静脉内皮细胞（ECV304）48 h后，检测BLT1在细胞内mRNA水平上表达的情况，以及不同作用下内皮细胞条件培养基中LTB4的浓度。采用逆转录 聚合酶链反应（RT-PCR）法检测内皮细胞BLT1基因的表达，酶联免疫吸附试验（enzyme linked immunosorbent assay，ELISA）检测内皮细胞条件培养基中LTB4的浓度以观察内皮细胞分泌LTB4的情况。 结果内皮细胞BLT1表达水平和培养上清液中LTB4浓度在川崎病血清刺激48 h后明显上调（P＜0.01），而在用含治疗量丙种球蛋白培养液培养的内皮细胞中BLT1表达水平和培养上清液中LTB4浓度上调不明显。结论LTB4-BLT1通路参与川崎病血管内皮损伤过程，丙种球蛋白可能通过阻断LTB4-BLT1通路而起到治疗川崎病的作用。     

痰热清注射液治疗支气管哮喘的机制探讨

目的 探讨痰热清注射液对支气管哮喘患者血清内皮素(endothelin,ET)和一氧化氮(nitric oxide,NO)水平的影响.方法 支气管哮喘急性发作期患者60例,随机分为对照组和治疗组各30例.两组均给予常规抗感染、糖皮质激素、氨茶碱、复方异丙托溴铵气雾剂及吸氧对症治疗;治疗组在上述基础上予痰热清注射液20mL加入5％葡萄糖注射液500mL静滴,每日1次,2周为一个疗程.检测两组患者治疗前后的血清ET和NO水平,并选40名健康者测定血清ET和NO水平作对照.结果与结论 痰热清注射液对支气管哮喘患者血清ET和NO水平有影响,可能是其作用机制之一.     

西红花苷对低密度脂蛋白所致鹌鹑内皮细胞损伤的保护作用

目的探讨西红花苷对低密度脂蛋白(LDL)所致内皮细胞损伤的保护作用。方法在体外培养牛主动脉内皮细胞中,加入不同剂量的西红花苷培养12 h后,再加入50μg.ml-1的LDL继续培养24 h,测定培养液中NO含量,测定细胞中一氧化氮合酶(NOS)的活性。在鹌鹑饮食性动脉粥样硬化模型上,观察西红花苷连续9周预防性给药对血清LDL和血清NO的影响。结果西红花苷可浓度依赖性地提高细胞内NOS的活性(P<0.01),使细胞合成分泌的NO含量升高(P<0.01)。西红花苷能显著降低血清LDL水平,使血清NO含量提高。结论西红花苷对LDL所致内皮细胞损伤有保护作用。     

NO，ET在肺心病合并冠心病中的变化

目的：探讨NO，ET在肺心病合并冠心病心力衰竭时的变化，方法：采用放射免疫方法测定血浆NO，ET－1的含量。结果；肺心商组，肺心病并冠心病组与健康对照组血浆NO，ET－1比较有明显差异；肺心病与肺心并冠心病心力衰竭NO，ET－1含量比较也存在差异性，ET－1存在明显差异性。结论：NO在这两种疾病状态中的病理生理变化是不同的。ET－1在这两种疾病状态中的病理生理变化是相同的。     

肺结节病与中央型肺癌的鉴别诊断

分析２９例Ｉ期肺结节病和１１６例中央型肺癌的临床特点。肺结节病多发于４１岁左右女性，而肺癌则多发于５５岁左右男性。前者呼吸道症状较少，后者则较多。Ｘ线胸片：肺结节病多为双侧肺门淋巴结对称性肿大；肺癌多为单侧肺门淋巴结肿大，且常伴肺门肿块、肺不张和胸膜病变。纤维支气管镜所见肺结节病无特征性变化，而肺癌则可见增生性改变和充血、水肿等，病理可见癌细胞。     

组织因子途径抑制物在急性肺栓塞家兔肺动脉内的表达

目的：探讨家兔急性肺栓塞后组织因子途径抑制物(TFPI)在肺动脉组织内的表达及其临床意义。方法：取栓塞3，8，24h后的急性肺栓塞动物模型的栓塞部位肺动脉和栓塞远端肺动脉，同时设实验对照组，取正常肺动脉，应用RT—PCR方法检测肺动脉组织内TFPI mRNA的表达水平。结果：肺栓塞后3h和8h组，栓塞远端肺动脉TFPI的表达显著低于栓塞部位肺动脉，并低于对照组的正常肺动脉(P＜0．01)；栓塞24h组，栓塞远端、栓塞部位和正常肺动脉之间比较差别无统计学意义。结论：栓塞部位肺动脉TFPI的表达水平短期内高于栓塞远端肺动脉，并可能对局部的凝血活性起调节作用，避免血栓的进一步延展。     

Current understanding of the role of bosentan in inoperable chronic thromboembolic pulmonary hypertension

Chronic thromboembolic pulmonary hypertension may occur in the context of incomplete lysis of acute pulmonary emboli, resulting in the obstruction of pulmonary blood flow, as well as progressive right ventricular dysfunction and failure. The treatment of choice for this condition is surgical removal of the obstructing material. However, in many patients, surgery is not possible due to either an unfavourable distribution of the disease, the development of a concurrent small vessel pulmonary arteriopathy, or the presence of significant comorbid conditions. There is increasing evidence that the medical therapies that are used in other forms of pulmonary hypertension may also be effective in inoperable chronic thromboembolic pulmonary hypertension. This article examines the rationale for the use of the oral dual endothelin receptor antagonist bosentan in this life-threatening condition.     

Bleomycin-induced pulmonary toxicity in chemotherapy for testicular cancer

Bleomycin is an antibiotic agent with antitumour activity, discovered in 1966 by Umezawa et al. Today, bleomycin is commonly used in chemotherapy for various tumour types. In testicular cancer especially, bleomycin is one of the key drugs in induction chemotherapy. It has the advantage of less myelotoxicity; however, its severe and potentially fatal pulmonary toxicity has limited its dose intensity. Several clinical trials have focused on eliminating bleomycin from the regimen or reducing the bleomycin dose for testicular cancer patients with good prognosis. However, the results indicate that bleomycin is still an essential component of induction chemotherapy when only three courses are administered. This review will focus on bleomycin-induced pulmonary toxicity in chemotherapy for testicular cancer, followed by a brief review of recent basic understanding of the pathogenesis of lung fibrosis.     

肺表面活性物质治疗足月新生儿肺出血的临床研究

目的 评价PS在足月新生儿肺出血中的治疗作用。方法 40例肺出血足月新生儿,随机分为组PS组（机械通气＋气管内滴注血凝酶和PS）和对照组（机械通气＋气管内滴注血凝酶）,每组20例,机械通气12 h,行血气分析,同时记录呼吸机的相关参数（RR、Vte、PIP、Pmean、Crs）;治愈新生儿肺出血停止平均时间 和撤离呼吸机时间及病死率。结果 PS组治愈18例,死亡2例;对照组治愈17例,死亡3例,病死率（10% vs 15%）较相近（P﹥0.05）;PS组肺出血停止和辅助通气时间较对照组明显缩短（43.78±8.14 vs 50.65±7.77,70.56±6.92 vs 76.06±7.29,h）（P﹤0.05）;呼吸力学指标PS组PIP和 Pmean 低于对照组（27.72±1.41 vs 28.12±1.27,24.50±1.54 vs 26.06±1.25 , cmH2O）（P﹤0.05）,Crs高于对照组（0.85±0.13 vs 0.76±0.09, ml/cmH2O）（P﹤0.05）, RR和Vte两组间比较无明显变化（P﹥0.05）;两组氧动力学指标PaO2 、SaO2比较变化相近（P﹥0.05）,PS组PaO2/ Fi O2高于对照组（234.11±30.14 vs 215.88±14.30）（P﹤0.05）。结论 外源性 PS主要通过改善氧合及呼吸力学效应等机制,有效防治足月新生儿肺出血。     

Cardiopulmonary haemodynamics in lambs during induced capillary leakage immediately after preterm birth

1. Early postnatal events might play a critical role in the development of cardiorespiratory diseases of prematurity. Although the exact mechanism is unknown, capillary leakage resulting in increased interstitial fluid volume has been postulated to play a critical role. We investigated the effects of capillary leakage, induced by a volume load, on cardiopulmonary and systemic haemodynamics immediately after preterm delivery. 2. Fetal sheep were instrumented at 129 days gestation, delivered and ventilated. After 15 min, lambs in the volume load group received intravenous saline (50 mL/kg) infused over 10 min; control lambs received no infusion. At 30 min, lambs underwent a pulmonary challenge by increasing positive end-expiratory pressure (PEEP) by 2 cmH(2)O every 10 min to 10 cmH(2)O, with similar decrements back to baseline PEEP. Pulmonary blood flow (PBF) and arterial pressures were recorded in real-time and cardiovascular variables were measured by Doppler echocardiography. 3. Total protein concentration in the bronchoalveolar-lavage fluid was higher in volume load lambs compared with controls, and histological interstitial fluid retention was evident in volume load lambs, both indicative of capillary leak. PBF increased immediately after the volume load, but PBF, pulmonary and systemic arterial pressures, and oxygenation all deteriorated during the PEEP challenge compared with controls, coinciding with an increase in downstream pulmonary resistance. Three of six volume load lambs had pulmonary haemorrhage, which was not observed in control lambs. 4. Capillary leakage had moderate effects, but subsequent high levels of PEEP had significant negative effects on cardiopulmonary and respiratory function in preterm lambs. Capillary leakage might contribute to postnatal cardiopulmonary failure in preterm infants.     

The inhibitory action of pgf2α on release of [3H]noradrenaline enhanced by α2-adrenoceptor blockade,sodium-pump inhibition and 4-aminopyridine in the main pulmonary artery of the rabbit

Large concentrations of prostaglandin PGF_2α inhibited the stimulation (2 Hz) evoked release of [³H]noradrenaline from the isolated main pulmonary artery of the rabbit (the inhibition caused by 3 × 10^?5 M PGF_2α was 62%). Furthermore, PGF_2α inhibited the release evoked by stimulation when it was enhanced by different procedures. During blockade of presynaptic α₂-adrenoceptors by 3 × 10^?7 M yohimbine, which by itself enhanced the overflow of [³H]NA in response to stimulation, the inhibitory action of PGF_2α was more pronounced (78.2%). In tissue in which the Na⁺-pump was inhibited (K⁺-free treatment) where the overflow of ³H was markedly increased, PGF_2α exerted nearly equal inhibition of transmitter release to that observed in control experiments (64.3%). The inhibitory effect of PGF_2α on the stimulation-evoked release of [³H]NA was less pronounced (32.1%) in the presence of 10^?4M 4-aminopyridine (a blocker of K⁺ -channels).     

中西医结合治疗慢性阻塞性肺疾病急性期疗效观察

目的:探讨慢性阻塞性肺部疾病患者急性发作期的治疗中,单纯应用西药治疗与中西医结合治疗疗效对照。方法:将96例患者随机分成治疗组和对照组两组,治疗组48例,应用鱼腥草注射液加用盐酸左氧氟沙星注射液联合治疗,对照组48例,单纯应用盐酸左氧氟沙星注射液治疗。结果:治疗组与对照组显效率比较,总显效率比较差异显著(X2=54.08,P<0.01)。结论:中西医联合治疗慢性阻塞性肺疾病急性发作疗效显著。     

胸腔镜解剖性肺段切除在治疗肺部小结节中的应用

目的：探讨胸腔镜解剖性肺段切除在治疗肺部小结节中的安全性和可行性。方法回顾分析2010年2月至2014年2月于我院行胸腔镜解剖性肺段切除治疗直径小于2 cm的肺部结节的47例患者的临床资料。分析统计手术时间、出血量、术后胸管停留时间、术后住院时间、手术费用,观察术后并发症发生情况,术后复查情况。结果手术时间110～245 min,平均146 min,术中出血量50～950 ml,平均233 ml。术后胸管引流时间2～11天,平均3.7天;术后住院时间4～13天,平均7.3天。未发现围手术期死亡病例。结论胸腔镜解剖性肺段切除是一种安全有效的方法,在治疗直径小于2 cm的肺结节中的应用将会越来越广泛。     

吸入一氧化氮改善犬吸入性损伤肺功能及作用机制

为评价吸入一氧化氮(NO)在犬烟雾吸入性损伤肺功能改善效果及验证其作用机制。作者把21只犬随机分为三组,烟雾吸入后,对照组单纯吸氧,治疗组吸氧+0.0045％(45ppm)NO,连续监测12小时血气变化;正常组不致伤,用于建立组织学对照。数据行多个样本均数间方差分析。结果,吸入NO组能明显改善肺氧合功能(P<0.05),对肺通气功能也具有明显改善作用(P<0.05);动脉血和肺组织环磷酸乌苷(cGNP)明显升高(P<0.01)。结论,吸入NO能明显改善肺功能,作为吸入性损伤的综合治疗,吸入NO可推荐临床应用。