嗜肺军团菌血清10型致军团病爆发流行并分离培养成功

１９９２年２～３月，北京市郊某宾馆发生了一起上呼吸道感染流行。流行病学调查及细菌学检查证明，这是一起嗜肺军团菌血清１０型（Ｌｐ１０）引起的宾馆军团病爆发流行，感染率为２４．３２入（９／３７），患病率为１３．５１％（５／３７）。由Ｌｐ１０引起的军团病爆发流行在世界上属首次报道，而Ｌｐ１０分离培养成功在国内尚属首次。     

表达白细胞介素10的系膜细胞基因转移载体的建立

目的为特异性地将病毒性白细胞介素１０（ｖＩＬ１０）基因转移到肾脏提供一种手段。方法应用逆转录病毒载体介导的基因转移技术将外源性基因ｖＩＬ１０转移到大鼠肾脏系膜细胞,应用ＲＴＰＣＲ、ＥＬＩＳＡ方法检测其表达,并通过对混合淋巴细胞反应（ＭＬＲ）的影响对其活性进行分析。结果ｖＩＬ１０在转染的系膜细胞表达２００００ｐｇ·（１０６细胞）－１／２４ｈ,应用３ＨＴｄＲ掺入法检测ｖＩＬ１０对ＭＬＲ的影响,实验组明显低于对照组（Ｐ＜００５）。结论外源性基因在系膜细胞有效地转录和表达,并对ＭＬＲ有抑制作用。     

急性肺损伤小鼠血糖水平与支气管肺泡灌洗液中TNF-α、IL-1β的关系

目的：观察脂多糖（LPS）所致急性肺损伤小鼠血糖、支气管肺泡灌洗液（βALF）中TNF—OL、IL-1β的变化规律,并初步探讨它们间的关系。方法：雄性βALβ／c小鼠45只,随机分为正常对照组、麻醉对照组、LPS组（气管内给予LPS1mg／kg）,每组15只。分别于处理后1、3、6、12、24h采血,检测血糖;获取各组小鼠βALF,采用ELISA法检测其中TNF—a和IL-1β的浓度。数据结果用统计学软件SPSS17．0进行分析。结果：与正常对照组及麻醉对照组比较,LPS组小鼠血糖明显升高,12h时与正常对照组比较仍有统计学意义（P〈0．05）;βALF中TNF-α及IL-1β浓度均明显升高,24h时与正常对照组比较仍有统计学意义（P〈0．05）。LPS组小鼠血糖水平与相应时间段βALF中TNF—d浓度呈正相关（L=0．738,P〈0．05）;与相应时间段βALF中IL-1β浓度呈正相关（0=0．618,P〈0．05）。结论：LPS诱导的急性肺损伤血糖、TNF-α、IL-1β均明显升高,且血糖水平与TNF-α、IL一1β浓度有相关性。     

促孕散治疗持久黄体奶牛血清白介素与激素的相关性分析

为探讨促孕散治疗持久黄体不孕奶牛血清生殖激素和白介素含量的关系,应用ELISA法测定了促孕散治疗持久黄体不孕奶牛前后血清中促卵泡素（FSH）、促黄体素（LH）、孕激素（P4）、雌二醇（E2）、IL-1和IL-6的浓度,分析了4种激素和2种白介素间的相关关系与回归方程。结果表明,IL-1和IL-6水平与P呈负相关,与E2、FSH、LH呈正相关,结论：促孕散治疗持久黄体奶牛前后在血清中IL-1和IL-6的变化与生殖激素的分泌具有一定的相关性。     

Respiratory function changes after chemotherapy: an additional risk for postoperative respiratory complications?

BACKGROUND: Patients receiving chemotherapy for lung cancer usually modify their lung function during treatment with increases in forced expiratory volume in 1 second (FEV(1)) and forced vital capacity (FVC) and decreases in lung diffusion for carbon monoxide (DLCO). This prospective study was designed to evaluate functional changes in forced expiratory volume in 1 second, forced vital capacity, and DLCO after three courses of induction chemotherapy with cisplatinum and gemcitabine in stage IIIa lung cancer patients and to assess their impact on respiratory complications after lung resection. METHODS: From March 1998 to January 2001, 30 consecutive patients with N2 nonsmall cell lung cancer had surgical resection after neoadjuvant treatment. Pre-chemotherapy and postchemotherapy results of standard respiratory function tests and DLCO were compared in patients with and without postoperative respiratory complications. RESULTS: All 30 patients completed the chemotherapy protocol without respiratory complications. Significant improvements (p < 0.05) were recorded after chemotherapy in transition dyspnea score, PaO(2) (mean value from 79.8 to 86.4 mm Hg), forced expiratory volume in 1 second % (from 78.1% to 87.5%) and forced vital capacity % (from 88.1% to 103.3%). Lung diffusion for carbon monoxide was significantly impaired after chemotherapy (from 74.1% to 65.7%; p = 0.0006), as well as DLCO adjusted for alveolar volume (from 92.8% to 77.4%; p < 0.0001). One patient died after surgery and 4 patients (13.3%) experienced postoperative respiratory complications. Compared with patients without complications, these 4 patients had higher mean increase in FEV(1) after chemotherapy (+26.8% vs + 6.7%; p = 0.025), but greater mean decrease in DLCO/Va (-27.8% vs -13.6%; p = 0.03). Impact of change in DLCO on postoperative respiratory complications was not confirmed by multiple logistic regression analysis (p = 0.16). CONCLUSIONS: In lung cancer patients, forced expiratory volume in 1 second and forced vital capacity assessed after neoadjuvant chemotherapy are not reliable indicators of the likelihood of respiratory complications after surgery. The risk of respiratory complication may be directly linked to loss of DLCO/Va. Lung diffusion for carbon monoxide assessed after neoadjuvant chemotherapy is probably the most sensitive risk indicator of respiratory complications after surgery. We recommend that DLCO studies be performed before and after chemotherapy in lung cancer patients undergoing induction therapy.     

抗结核分枝杆菌培养滤液蛋白10的新型单克隆抗体的制备及其临床应用

目的 制备抗结核分枝杆菌培养滤液蛋白10(CFP-10)特定抗原肽的单克隆抗体,为建立结核病临床早期诊断的免疫学方法奠定物质基础.方法 设计并合成结核分枝杆菌CFP-10第53 ～ 66位氨基酸(14肽AAVVRFQEAANKQK)作为特定的抗原肽序列,经免疫BALB/C小鼠,取其脾细胞和小鼠骨髓瘤细胞SP2/0融合,经酶联免疫吸附试验(ELISA)检测、多次有限稀释亚克隆建立能稳定分泌抗结核分枝杆菌特异抗原肽单克隆抗体的杂交瘤细胞系,纯化该单克隆抗体,进行免疫球蛋白亚型分析,并鉴定分析该单克隆抗体在蛋白质免疫印迹法(Western blotting)、免疫沉淀法和ELISA检测中的应用效果.共检测结核分枝杆菌培养上清样本38份,非结核分枝杆菌培养上清样本20份,结核性胸水样本32份,非结核性胸水样本24份以及健康对照血清样本20份.结果 单克隆抗体免疫球蛋白亚型分析显示该杂交瘤细胞系产生的抗体类型为IgG1和κ型.该抗结核分枝杆菌CFP-10特异性单克隆抗体可成功用于Western blotting和免疫沉淀法分析.ELISA定量检测显示,该特异性抗体检测结核分枝杆菌的敏感性为78.6％ (55/70),特异性为92.2％ (59/64).结论 CFP-10特定抗原肽单克隆抗体用于结核分枝杆菌检测有较高的敏感性和特异性,可用于结核病的早期诊断.     

病毒白细胞介素-10转基因在造血干细胞中的表达

目的　观察逆转录病毒转病毒白细胞介素 10 (vIL 10 )基因在体内的表达。方法　用MSCVneo vIL 10重组体在体外转导CBA (H 2 K)小鼠的造血干细胞 (HSCs) ,给经致死照射(90 0rads)的 2 0只同基因CBA(H 2 K)小鼠注入经MSCVneo vIL 10转染的HSCs ,2× 10 6HSCs/只。酶联免疫吸附测定 (ELISA)、逆转录 聚合酶链反应 (RT PCR )、Westernblot分析vIL 10的表达。结果　移植MSCVneo vIL 10转染HSCs的 2 0只小鼠 ,移植后 8周用ELISA检测 ,其中 15只小鼠血清的vIL 10浓度为 :2 70～ 13 40ng/L ,5只小鼠血清的vIL 10为阴性。 12周后有 2只小鼠vIL 10测不出 ,13只小鼠长时间表达vIL 10达 6个月。对照组小鼠血清vIL 10均为阴性。RT PCR和Westernblot证实小鼠的器官均有vIL 10的mRNA和蛋白的表达。结论　逆转录病毒能有效地将vIL 10基因导入造血干细胞并在体内长时间表达。     

Pulmonary metastases from uterine malignancies: results of surgical resection in 133 patients

OBJECTIVE: The long-term results of the surgical treatment for patients with pulmonary metastases from uterine malignancies were clarified. METHODS: A total of 133 patients who underwent pulmonary metastasectomy for uterine malignancies were enrolled in the Metastatic Lung Tumor Study Group of Japan between March 1984 and February 2002. These patients constituted the study population, and their clinical, pathologic, and prognostic data were retrospectively analyzed. RESULTS: The morbidity and mortality rates related to the operation were minimal (1% and 1%, respectively). The 5- and 10-year survivals after the surgical resection in all cases were 54.6% and 44.9%, respectively. The 5-year survivals for each histologic type were estimated to be 46.8% for squamous cell carcinoma (n = 58), 40.3% for cervical adenocarcinoma (n = 13), 75.7% for endometrial adenocarcinoma (n = 23), 86.5% for choriocarcinoma (n = 16), and 37.9% for leiomyosarcoma (n = 11). In the univariate analysis, the following were shown to be associated with poor survival: primary tumor in the cervix, short disease-free interval (<12 months), large number of resected metastases (> or =4), and large tumor size (> or =3 cm). After mutual adjustment, short disease-free interval (<12 months) alone was related to risk of death (hazard ratio = 2.26, 95% confidence interval = 1.06-4.78) for 105 patients, excluding patients with choriocarcinoma and miscellaneous histologic types. CONCLUSION: Pulmonary metastasectomy for uterine malignancies is a safe and acceptable treatment to improve survival. Patients with a disease-free interval of 12 months or more are good candidates for this treatment if there is adequate control of the primary tumor without extrapulmonary metastasis.     

Preoperative imaging of the lung sentinel lymphatic basin with computed tomographic lymphography: a preliminary study

BACKGROUND: Preoperative localization of the sentinel node basin would guide selective lymph node dissection. We tried to identify these nodal stations with indirect computed tomographic lymphography using a conventional extracellular contrast agent, iopamidol. METHODS: Eleven consecutive patients scheduled to undergo anatomic resection of suspected lung cancer, without lymphadenopathy, were given a peritumoral injection of undiluted iopamidol under computed tomography guidance, and lymphatic migration was assessed by multidetector-row helical computed tomography. RESULTS: There were no complications such as bleeding, pneumothorax, or allergic reactions. Enhanced nodes were detected in all but 1 patient who had diffuse lymph nodal calcification. Enhanced nodes were identified at 32 ipsilateral intrathoracic nodal stations (20 hilar stations and 12 mediastinal stations). The average length of the longer axis of the enhanced nodes was 4.8 mm (range, 3 to 8 mm), and the average attenuation of the enhanced nodes was 132 (range, 46 to 261) Hounsfield units. In 9 patients with confirmed lung cancer, enhanced nodes appeared at 26 nodal stations, and all apparent enhanced nodes were identified as actual lymph nodes at appropriate position during lymphadenectomy. None of the resected lymph nodes had metastatic involvement. CONCLUSIONS: Indirect computed tomographic lymphography with the peritumoral injection of iopamidol effectively depicts the drainage nodes unless they are diffusely calcified. Although further study is required, this method could guide selective lymph node dissection.     

Comparison of mutational changes in involved N1 lymph nodes with those in primary tumors in stage II non-small cell lung cancer: a pilot study

OBJECTIVES: Surgical resection is the standard treatment for stage II non-small cell lung cancer, but recurrence rates approach 60%. This study compared mutational changes in involved lymph nodes and primary tumors from patients with stage II non-small cell lung cancer to determine whether risk factors for recurrence could be identified. METHODS: Forty patients with resected stage II non-small cell lung cancer (excluding T3 N0 disease) were studied. Microdissection was performed on primary tumors and lymph nodes. Analysis was performed across 9 genomic loci by using polymerase chain reaction amplification. The ratio of fractional allelic loss between involved lymph nodes and primary tumors was used to stratify patients into high-risk (fractional allelic loss ratio of >or=1) and low-risk (fractional allelic loss ratio of <1) groups. RESULTS: The median age of the patients was 68 years (range, 42-85 years). Median follow-up was 30 months. Fractional allelic loss was greater in patients with squamous carcinomas compared with that in adenocarcinomas, but survival was similar (35 vs 39 months). The median survival was 35 months in high-risk patients and was not reached in low-risk patients (P =.3). Disease-free survival was 24 months in high-risk patients and was not reached in low-risk patients (P =.35). In the subset with adenocarcinoma (n = 18), median survival was 24 months in the high-risk group; no deaths occurred in low-risk patients (P =.01). Also, disease-free survival was 14 months in high-risk patients and was not reached in the low-risk patients (P =.05). CONCLUSIONS: Squamous cancers demonstrate greater mutational changes than adenocarcinomas; this does not affect outcome. The patients with low-risk adenocarcinomas demonstrated superior outcomes compared with those of other patients. These results should be confirmed in larger studies.