Revisit on congenital bronchopulmonary vascular malformations: a haphazard branching theory of malinosculations and its clinical classification and implication.

We propose a haphazard branching theory to support the concept of bronchopulmonary malinosculations, and we apply this theory to classify congenital bronchopulmonary vascular malformation (BPVM) based on the anatomical results we have found. Between January 1990 and December 1997, a total of 22 pediatric patients (10 male and 12 female), aged 2 days to 14 years (median, 19.6 months), with congenital BPVM were enrolled in this retrospective study. Study modalities include the clinical features and plain chest films (n = 22) plus at least two of the following: echocardiography (n = 13), barium esophagraphy (n = 2), bronchoscopy (n = 4), contrast bronchography (n = 8), high-resolution direct coronal CT (n = 1) and electron beam or ultrafast CT (n = 1) of the chest, MRI (n = 10), MRA (n = 1), contrast cineangiocardiography (n = 9), surgery (n = 11), or autopsy (n = 2). The salient clinical features were recurrent lung infections in 14 patients, acute respiratory distress in 13, associated cardiovascular malformations in 8, dextroversion in 7, congestive heart failure in 7, dextrocardia in 4, and complex congenital heart diseases in 4. There were abnormal openings (malinosculations) of the pulmonary airway in 20 patients: to an artery in 12, to a vein in 8, and to the lung parenchyma in 9. These 22 patients with congenital BPVM can be classified into bronchial malinosculation (10 cases), arterial malinosculation (2 cases), and bronchoarterial malinosculation (10 cases). Congenital BPVM can be classified in terms of bronchopulmonary malinosculation based upon a haphazard branching theory, in which abnormal communications between two independent systems (primitive foregut system and aortic-pulmonary arch system) occurred coincidentally rather than causally.     

硒对紫外线诱导HLF细胞凋亡的保护作用

目的：探讨紫外线诱导人HLF细胞凋亡时DNA降解特点，以及硒对紫外线诱导细胞凋亡的保护作用。方法：紫外线分别照射体外培养的人肺成纤维细胞3min和5min，同时添加亚硒酸钠（8ng/ml），设立对照组。利用吖啶橙荧光染料染色鉴定凋亡细胞，利用琼脂糖凝胶电泳检测DNA ladder。结果：紫外线可以诱导人肺成纤维细胞（28代）凋亡，作用存在时间效应关系。紫外线诱导人肺成纤维细胞凋亡时，未出现典型的DNA ladder现象。硒对于紫外线诱导的细胞凋亡有显著的抑制作用。结论：DNA ladder不能作为细胞凋亡的唯一的标志，紫外线诱导的细胞凋亡与DNA ladder的出现并不总是一致的。硒具有拮抗紫外线诱导的细胞凋亡作用。     

TRH、EGF及地塞米松促进未成熟胎肺组织分化及表面活性物质合成的研究

目的 比较TRH、EGF与地塞米松对未成熟胎肺形态发育及表面活性物质水平的影响。方法 在兔妊娠第22－24d或第24－26d分别用TRH、EGF或地塞米松母体静脉注射治病，通过光镜、图像分析及电镜等技术观察胎肺的形态结构，并检测胎肺的磷脂水平。结果 光镜下，TRH、EGF与地塞米松治疗组第25d及27d胎肺肺泡腔、肺泡间隔发育均明显好于对照组；EGF、TRH与地塞米松治疗组第27d胎肺的肺泡腔与肺泡间隔的面积比无明显差异。但EGF和TRH治疗组第25d胎肺的肺泡腔与肺泡间隔之比明显小于地塞米松治疗组。电镜下，三个治疗组第27d胎肺内含有板层体的Ⅱ型上皮细胞数量明显多于对照组，但各治疗组及对照组第25d的胎肺Ⅱ型上皮细胞胞浆内几乎未见明显板层体，相反胞浆内糖原含量却非常丰富。此外，三个治疗组27d胎肺的磷脂水平均明显高于对照组。结论 EGF、TRH及地塞米松在兔妊娠第24－26d母体治疗均能促进胎肺的形态发育和表面活性物质的合成，三种治疗方法对胎肺的影响程序无明显不同；在妊娠第22－24d治疗，地塞米松对胎肺形态结构的促进作用较EGF和TRH更明显，但三者对Ⅱ型上皮细胞分化及表面活性物质的合成均无明显影响。     

三尖杉酯碱诱导慢性髓系白血病K-562细胞凋亡的实验研究

目的阐明三尖杉酯碱（HT）作用于K562细胞的机制。方法应用细胞形态、DNA凝胶电泳和流式细胞仪等检测,观察HT对K562细胞株的作用方式,进一步用RT-PCR方法研究bcr/abl基因在转录水平的改变。结果0.01～100.00μg/ml浓度HT可诱导K562细胞凋亡,并呈时间和剂量依赖性。随着药物作用时间的延长,bcr/abl基因的转录下调。结论低浓度HT就可通过抑制bcr/abl基因的表达,诱导K562细胞凋亡。     

多柔比星肾病肾损伤早期核因子-κB和血管紧张素ⅠⅡ的表达及关系探讨

目的　探讨在多柔比星 (阿霉素 )肾病综合征 (NS)幼年大鼠肾损伤过程中核因子 (NF) κB和血管紧张素ATⅠ、ATⅡ的表达及其相关性。方法　 4周龄雄性Wistar大鼠单侧肾切除加腹腔注射阿霉素造成NS模型 ,分别以免疫组织化学和原位杂交检测ATⅠ、ATⅡ和NF κB。结果　肾病组随着病变时间的延长 ,NF κB和ATⅠ、ATⅡ表达的强度和部位均呈增强趋势 ,治疗组在相同时间点则两者都有不同程度下调 (P <0 .0 5 )。结论　在阿霉素肾病损伤过程中NF κB和ATⅠ、ATⅡ起着介导作用。     

杏贝冲剂对哮喘豚鼠磷脂酶A2的影响

目的:探讨杏贝冲剂对哮喘气道炎症关键物质磷脂酶A₂(PLA₂)的影响。方法:以卵蛋白激发造成豚鼠哮喘模型,观察杏贝冲剂作用下PLA₂及其介导的支气管-肺泡灌洗液(BALF)中炎细胞成分、血浆炎性介质血栓素B₂(TXB₂)、6-酮-前列腺素F_1α(6-K-PGF_1α)的变化,并对哮喘症状加以分析。结果:杏贝冲剂治疗组PLA₂、TXB₂水平降低,BALF中嗜酸细胞成分明显减少,哮喘激发时间和症状改善。结论:杏贝冲剂通过对PLA₂的影响,起到抗炎控制哮喘的作用。     

A simple and inexpensive particle agglutination test to distinguish recent from established HIV-1 infection.

OBJECTIVES: We sought to modify the Serodia HIV-1/HIV-2 particle agglutination assay (PA), a simple and cost-effective HIV assay that is used globally for the detection of HIV antibodies, as a sensitive/less sensitive test (S/LS) to identify recently infected individuals and to estimate HIV incidence. METHODS: The Serodia PA test was modified as an S/LS test (PA-LS) by using HIV antigen-coated gelatin particles at a dilution of 1:68 and a specific diluent, and calibrated using 37 HIV clade B seroconversion panels (309 samples) from Trinidad and from a commercial source that were tested at dilution intervals from 1:10 to 1:80,000. The greatest sensitivity for correctly classifying samples from recent and established infections was determined by receiver operator curve (ROC) analysis. RESULTS: At a 1:40,000 sample dilution and a days post-seroconversion cutoff of 190 days, the PA-LS test yielded a 97% sensitivity for classifying recent and established infection samples. Furthermore, at a 1:20,000 dilution, the positive predictive value for correctly identifying recently infected individuals was 99%. The PA-LS test offers a 30-44-fold cost saving over currently available S/LS tests. CONCLUSION: A modified, low cost and simple-to-perform PA test is appropriate for use in resource-limited countries, and has exhibited excellence in distinguishing recent from established HIV infection.     

Repair of bile duct defect with full-thickness vascularized jejunal patch

The use of a vascularized jejunal patch for the reconstruction of bile duct injuries is presented. The method has been used in 1 patient with a common bile duct stricture and in 1 patient with a noncircumferential bile duct defect. The procedure has the advantages of technical simplicity, primary mucosal coverage, lasting elasticity, and minimal risk for stricture formation.

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Resumen Se presenta el uso de un parche vascularizado de yeyuno para la reconstrucción de lesiones del canal colédoco. Se reseca un segmento móvil del yeyuno lo suficientemente amplio para cubrir el defecto, asegurándose de que existe buena irrigación para el segmento, visualizando los vasos por transiluminación con luz ordinaria. La continuidad del intestino es restablecida mediante anastomosis término-terminal. Se utiliza la parte mesentérica del segmento intestinal, el cual es ascendido por vía retrocólica. Se sutura mucosa con mucosa con una sola capa de puntos separados de ácido poliglicólico 5-0. Se coloca un tubo-en-T para drenaje, el cual es retirado a las 6 semanas. El método ha sido utilizado en un caso de estenosis del colédoco y en un caso con un defecto circunferencial del mismo canal biliar. El procedimiento tiene la ventaja de la simplicidad técnica, la cobertura primaria de la mucosa, la elasticidad permanente y un mínimo riesgo de que se produzca estenosis.

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Résumé L'emploi d'un patch jéjunal bien vascularisé pour traiter les blessures de la voie biliaire fait l'objet de l'article. La méthode a été utilisée pour un cas de sténose de la voie biliaire principale et un cas de plaie n'intéressant pas la totalité de la circonférence du canal biliaire. Elle a pour avantages sa simplicité technique et le fait qu'elle assure une couverture muqueuse, sa persistante élasticité et le fait qu'elle présente un risque réduit de sténose.