肺挫伤致肺水肿患者血浆中E-SLT,IL-8,TNF-α和ET-1的变化

目的本研究观察胸部外伤所致肺水肿病人血中E-选择素、TNF、白细胞介素-8和内皮素的变化.方法用固相双夹心酶联免疫吸附法和放免技术共测定了24例胸部外伤病人在治疗前后血中E-选择素、肿瘤坏死因子、白细胞介素-8和内皮素浓度.结果临床肺水肿病人血中E-选择素、肿瘤坏死因子、白细胞介素-8和内皮素的浓度在发病时明显升高,与正常对照组比较,差异有显著性(P＜0.001).治愈后恢复正常,治疗后各项指标与正常对照组比较差异无显著性(P>0.05),但治疗前后差异有显著性(P＜0.001).结论E-选择素、肿瘤坏死因子、白细胞介素-8和内皮素在肺水肿发病机制中起着重要,随着这些因子的升高出现肺水肿并逐渐加重,这些因子降低后肺水肿逐步消失.因此对这些因子的检测有助于估计病情和评价疗效.     

Efficacy of Lung Cancer Screening; Comparison of Results from a Case-Control Study and a Survival Analysis

A case-control study to evaluate the efficacy of lung cancer screening conducted by us showed that lung cancer screening may reduce the mortality of the disease up to 28%. Assuming this efficacy is unbiased, and that the screening rate is 51.6%, which was observed in the control group in the above study, the number of lung cancer deaths prevented by screening in the study period was calculated to be 47 for males and females combined. In the same study population, screen-detected lung cancer patients (N = 207) in the same study period were followed and the 7-year survival rate (46.9%) was compared to the 5-year survival rate (11.3%) obtained by the Osaka Cancer Registry, in which screen-detected lung cancer patients were only 1.8%. The number of lung cancer deaths prevented by screening, estimated by the difference in the above two survival rates, was 74 (95% confidence interval; 55–93). The number of lung cancer deaths prevented by screening estimated from the case-control study was significantly lower than that estimated from the survival analysis. This indicates that the efficacy of lung cancer screening estimated by the case-control study was within the range that could be explained by the actual long-term survivors among the screen-detected patients in the study population.     

冠心病行为模式与心理状态的相关性探讨

目的为探讨Ａ型行为在冠心病（ＣｏｒｏｎａｒｙＨｅａｒｔＤｉｓｅａｓｅ，ＣＨＤ）中的作用及与心理状态的相关性。方法对１１４例ＣＨＤ及３７例非ＣＨＤ应用心理测验方法对照调查。结果发现Ａ型行为的人易患ＣＨＤ。ＣＨＤＡ型行为者在焦虑、抑郁、人际关系、认识、敌对性症状因子分较ＣＨＤ非Ａ型行为者有明显增高。ＣＨＤ非Ａ型行为者也具有一些特有的心理症状。结论ＣＨＤ病人的行为模式与病后的某些心理表现呈正相关。     

Are chronic wheezing and asthma-like attacks related to FEV1 decline? The Cracow study

Analysis is presented of the relationship between decline in ventilatory function and possible symptoms of bronchial hypereactivity. Data comes from three consecutive surveys within a 13-year follow-up study of a population sample of 1747 persons (718 males and 1029 females) who completed spirometric testing and interviews. Chest symptoms recorded in the two initial surveys were used as baselines for the prognostic study on FEV₁ change. To evaluate changes in lung function the FEV₁ decline index, expressed as percentage of FEV₁ loss during the study period, was calculated. Chronic wheezing and asthma-like attacks were very strongly related to FEV₁ baseline level. Multiple linear regression analysis for each separate symptom including age and smoking habits as confounders and showed that the FEV₁ decline index was higher and more significant when wheezing and asthma-like attacks or chronic cough were present. When the combination of symptoms were introduced into the regression model, the effect of wheezing became insignificant. Only attacks of shortness of breath in both sexes and chronic cough in women were significantly associated with more rapid FEV₁ decline. However, the effect of persistent wheezing in men had a rather substantial impact on FEV₁ change. Comparing the effect of the number of cigarettes smoked with the effect of symptoms, one can see that FEV₁ decline due to attacks of shortness of breath is comparable to that seen with heavy smoking. There was no strong evidence that the symptoms under study precede the more rapid FEV₁ decline.     

滥用药物与生命质量退化的伦理思考

本文从生命质量的内涵入手,分析了滥用药物的直接和间接、近期和远期的危害,通过论证得出了滥用药物必将引起人类生命质量退化的结论.以期从一个新的认识度唤起人们对滥用药物问题的重视、并由此引出了一些对医学目的以及滥用药物控制措施的思考.     

Small-airways dysfunction in never smoking asbestos exposed Danish plumbers

Summary Among 701 Copenhagen plumbers we examined the lung function of 23 never smokers, who had removed asbestos insulation and intermittently been exposed to high levels of asbestos for about 25 years without being exposed to welding fume. The plumbers had significantly lower TLC, MEF₂₅, MEF₅₀, closing volume and closing capacity in comparison to 23 never smoking electricians without asbestos exposure. There was no reduction in TL_CO. Pulmonary clearance of aerosolized ^99mTc-DTPA was normal indicating that the asbestos had not induced increases in pulmonary epithelial permeability. However, in 11 of the 23 plumbers the ^99m-Tc-DTPA ventilation scintigrams had a slightly irregular and spotty appearance, which together with the results of the lung function tests are suggestive of small airways' dysfunction. None of the subjects had symptoms or clinical signs of lung disease.     

实验性急性胰腺炎肺内细胞凋亡状况及其意义的初步探讨

目的：探讨重症急性胰腺炎时肺内细胞凋亡的状况及其在肺损伤发病机制中的意义。方法：以不同浓度牛磺胆酸钠液逆行胰胆管注射造成大急急性水肿性胰腺炎（AEP)与急性坏死性胰腺炎(ANP)两种模型，测定血浆TNF-α与内毒素水平的动态变化，免疫组化检测肺内TNF-α的表达，并以TUNEL法结合激光扫描共聚焦显微镜检测肺组织切片内细胞凋亡的情况。结果：正常时大鼠肺内偶见淋巴细胞及纤维母细胞等发生凋亡，诱导AEP或ANP后凋亡细胞数量无明显变化。随着肺损伤的出现，少许浸润的炎细胞、肺泡上皮细胞及血管内皮细胞等发生了凋亡。凋亡指数(‰)在ANP组呈一过性下降，在ANP组表现为持续下降，在6h后各时点均显著低于AEP组相应值(P＜0．05)。分析表明，ANP组血中TNF-α、内毒素含量的增加与凋亡指数的变化存在负相关(P＜0.05)。结论：ANP时肺内浸润的以中性粒细胞为代表的大量炎细胞出现延迟凋亡，这种现象可能是肺损伤发生的重要前提，同时内毒素血症及TNF-α的过度合成可能是中性粒细胞延迟凋亡的部分原因。     

TLV-1-associated myelopathy in China

This case report documents the first patient from main land China with an HTLV-1-associated myelopathy. The available epidemiological data suggest a low rate of HTLV 1 infection in China, although the surveys are comparatively small. Possible transmission routes and the risk of encountering the disease outside endemic areas are discussed.     

饮食习惯与肺癌关系的病例—对照研究

为探明上海市女性非吸烟者肺癌与饮食习惯的关系，作者于１９９２年２月１日￣１９９３年１２月３１日在上海市区开展了一项基于全人群的病例对照研究，共调查非吸烟女性肺癌新发病例５０４例和按频数配对的年龄相差５岁以内的女性非吸烟对照６０１人。在调查了年龄、经济收入等因素后，发现蔬菜、水果和β－胡萝卜素、维生素Ｃ等营养素的摄入量与肺癌危险性呈负相关，线性趋势均有显著性。与最高摄入组相比，蔬菜、水果、β－胡萝卜