大肠杆菌内毒素所致肺血管收缩部位及山莨菪碱的作用

将动、静脉阻断法用于恒速灌流的在体山羊左肺,使其总压力降区分为动脉端、静脉端及中间段三部分。大肠杆菌内毒素主要升高肺静脉端压力降及肺毛细血管压;山莨菪碱可显著缓解内毒素所致的改变,但对正常肺血管各段压力降无明显影响。5-羟色胺主要升高肺动脉端压力降,对肺静脉端及毛细血管压无明显影响。去甲肾上腺素及组胺主要升高肺静脉端压力降及肺毛细血管压,但对肺动脉端无明显影响。去甲肾上腺素和组胺可能介导内毒素性肺动脉高压。     

特发性肺纤维化的诊断及相关研究

特发性肺纤维化是间质性肺病的代表性疾病 ,其病因不明 ,预后不良。随着对本病不断的深入研究 ,诊断标准日趋完善。现结合有关文献对特发性肺纤维化的诊断和相关研究作一综述。     

肺结核与肺癌并存25例的诊断及外科治疗

目的探讨肺结核与肺癌并存的临床特点、诊断及手术治疗方法。方法对25例肺结核并存肺癌患者的临床和实验室资料进行综合分析。结果患者多为老年，多有肺结核病史，有咳嗽、咯血、胸痛等表现。肺癌漏诊率高，手术治疗效果好。结论肺结核并存肺癌时，易发生漏诊，有条件时应手术治疗。     

The Hemodynamic Mechanisms of Lung Injury and Systemic Inflammatory Response Following Brain Death in the Transplant Donor

Brain-dead donors are the major source of lungs for transplantation. Brain death is characterized by two hemodynamic phases. Initially, massive sympathetic discharge results in a hypertensive crisis. This is followed by neurogenic hypotension. Up-regulation of pro-inflammatory mediators occurs in all organs and lung injury develops; this can adversely affect graft function post-transplantation. The mechanisms of the systemic and lung inflammation are unknown. We hypothesized that the hemodynamic changes are responsible for these inflammatory phenomena. Brain death was induced by intra-cranial balloon inflation in rats. This resulted in hypertensive crisis, followed by hypotension. There was a significant increase in blood neutrophil CD11b/CD18 expression and pro-inflammatory cytokine levels in serum and bronchoalveolar lavage, compared with control animals. Rupture of the capillary-alveolar membrane was demonstrated by electron microscopy. Elimination of the hypertensive response by α-adrenergic antagonist pre-treatment prevented inflammatory lung injury, reduced the systemic inflammatory markers and preserved capillary-alveolar membrane integrity. Correction of the neurogenic hypotension with noradrenaline ameliorated the systemic inflammatory response and improved oxygenation. We conclude that the sympathetic discharge triggers systemic and lung inflammation, which can be further enhanced by neurogenic hypotension. Management of the brain-dead donor with early anti-inflammatory treatment and vasoconstrictors is warranted.     

固定剂量复合剂治疗肺结核患者依从性调查与分析

Objective To survey and analyse the treatment compliance of fixed-dose combination （FDC）,so as to provide evidences for expending use FDC nationwide. Methods Nine hundred and sixty-six primary smear positive pulmonary tuberculosis cases registered in 17 counties TB institutions from 4 provinces were randomly divid- ed into experiment and control groups. Compared compliance difference with uniform questionnaires, and analysed compliance changes with time throughout the treatment. Results Nine hundred and sixty-one cases were surveyed at the beginning, 899（93.5% ）preferred receiving treatment. There was significant difference on the percentage who prefer had drugs per day between experiment（86.8% ）and control group（42.1% ）（ P 〈 0.01 ）.At the end of intensive phase, 261（28.3 % ）cases perceived difficulty with the treatment ;213 （23.1% ）cases thought that were the doctors who lead to the insist of treatment.At the end of treatment,only 138 cases（15.5% ）thought that were the doctom who lead to the insist of treatment. Conclusion The compliance of FDC was better than control group. It might increase the compliance when decreasing the number of tablets and should expend used on TB control. The ef- fect of TB doctors decreased through the treatment. More intention should be paid in intense phase.     

1992～2001年海南省结核病防治工作情况分析

目的　分析海南省结核病防治工作现状和经验。方法 根据全省各市(县)上报的结核病报表和有关总结材料,分析结核病现状、防治对策及效果。结果 海南省应用现代结核病控制策略以来,1992～2000年共检查可疑肺结核病患者192077例,查痰48670例,查痰率25.3%。发现并登记活动性肺结核病人31822例,其中涂阳病人22946例,涂阳新登记率从1992年12.8/10万上升到2000年48.4/10万。至2001年12月止,共治愈了21625例涂阳病人,总治愈率达94.2%。结论 海南省结核病疫情严重,近10年来经过应用现代结核病控制策略,取得显著成效,证明该策略是控制结核病流行最有效的技术措施。     

小剂量肝素联用巯甲丙脯酸治疗慢性肺心病急性发作期66例疗效分析

目的探讨综合疗法并用小剂量肝素、巯甲丙脯酸治疗慢性肺心病急性发作期的疗效.方法慢性肺心病急性发作期患者随机分为治疗组(66例)、对照组(62例),两组均进行综合治疗,但治疗组加用了小剂量肝素和巯甲丙脯酸,然后观察并比较其症状、体征、血气指标和血液黏稠度.结果治疗组的血液流变学变化、症状与体征的改善及总好转率明显优于对照组P＜0.01.结论慢性肺心病急性发作期病人在综合治疗的基础上加用小剂量肝素和巯甲丙脯酸可显著提高疗效.     

Pulmonary resection for metastases from colorectal cancer

Aim: The prognosis of patients with disseminated colorectal carcinoma is poor except for those with single organ pulmonary or hepatic metastases. The objective of the present study was to evaluate the result of pulmonary metastasectomy for colorectal secondary and to identify the prognostic factors. Methods: This was a retrospective study of 80 patients who had pulmonary metastasectomy for pulmonary secondary from colorectal carcinoma in Queen Elizabeth Hospital, Hong Kong. Results: The overall 5‐year and 10‐year survival rates of the entire cohort were 42.5% and 35.5%, respectively. High premetastasectomy carcinoembryonic antigen (> 20 μg/dL), short disease‐free interval (< 12 months) and incomplete resection were the independent prognostic factors. Neither the characteristics of the primary colorectal tumour nor the number of metastatic nodules had a significant contribution to the long‐term survival. Six patients underwent second pulmonary metastasectomy and three were still free from tumour recurrence after the second operation. Conclusion: Patients with pulmonary metastases from colorectal carcinoma would benefit from pulmonary metastasectomy. High premetastasectomy carcinoembryonic antigen and short disease‐free interval were negative predictive factors for survival. Long‐term follow‐up study is required, as recurrence can occur more than 5 years after pulmonary metastasectomy. Also, whether the survival benefit is due to surgical treatment effect or lead‐time bias remains undecided.     

肺心病血液光量子治疗前后血液流变性质变化及机制探讨

１５例肺心病血液高粘滞患者自体血２５０ｍｌ用ＸＺＹ－Ⅰ型量子血液治疗机进行紫外线照射和充以纯氧后再输入，每周一次，最多连续做三次（平均１．８６±０．７１次）后，作者发现血液全血高切、低切粘度，全血高切、低切还原粘度，血浆比粘度，血浆纤维否白原含量，红细胞聚集指数，红细胞电泳率等有显著性改变，单纯常规治疗组１５例患者血液流变无此变化，分析认为，这些变化可能与红细胞聚集性降低、纤维蛋白源溶解度提高及血氧饱和度增加有关。