难治性气管异物的处理

目的　探讨难治性气管异物的处理方法。方法　回顾 1994～ 2 0 0 3年 10年内收治的 12 5 8例气管异物中 ,10 9例难治性气管异物 (塑料笔帽、鸡骨头、图钉、钢珠、苍耳子球、玩具、带壳花生米、气门芯等 )的处理过程。患者年龄最小的为 8个月 ,最大的为 43岁。异物史最长达 12年。结果　 89例难治性气管异物直接从支气管镜下取出 ,19例行气管切开 ,1例气门芯异物开胸取出。结论　在处理难治性气管异物时要做好充分的术前准备 ,正确判断和处理并发症。     

Gun shot wound neck

All penetrating neck wounds are potentially very dangerous and require emergency treatment. The choice of treatment for the stable patient remains controversial, a number of studies encouraging mandatory surgical exploration and a similar number encourage selective surgical exploration. Knowledge of the physical properties of the penetrating object or weapon can help to determine a treatment plan and predict the risk of injury- All tracheal and esophageal injuries with structural damage should be repaired primarily. A case of Gun Shot Wound Neck was air evacuated to Army Hospital R & R Delhi Cantt in a tracheostomised state. Patient was evaluated in detail, he had trachea esophageal fistula. The management of this case is discussed along with principles of management of war injuries.     

大鼠气管上皮细胞体内—体外转化模型的研究

本研究建立了大鼠气管上皮细胞体内－体外转化模型，大鼠气管内滴注苯并芘，三天后处死大鼠，消化气管上皮细胞，接种于无血清完全培养基。细胞形成集落后，换为选择培养基继续培养五周，统计转化率。结果显示，２５ｍｇ／ｋｇ和５０ｍｇ／ｋｇ的苯并芘可诱导大鼠气管上皮细胞转化及微核增加，用同样方法研究了煤焦沥青提取物，结果表明，剂量为８ｍｇ／ｋｇ和２５ｍｇ／ｋｇ的煤焦沥青提取物能明显诱导大鼠气管上皮细胞转化。     

气管与主支气管肿瘤的影像诊断（附32例报告）

作者对３２例经病理证实的气管与主支气管良、恶性肿瘤的影像学表现进行分析，归纳为３型：腔内型、壁增厚型和腔内外型。后２种类型提示恶性，而无蒂的腔内型表现者不能鉴别良，恶性。作者还评价了常规体层、ＣＴ及ＭＲＩ诊断气管与主支气管肿瘤的优、缺点，讨论了影像诊断的作用。     

Regulation of 5-hydroxytryptamine-induced calcium mobilization by cAMP-elevating agents in cultured canine tracheal smooth muscle cells

The effects of increases in cellular adenosine 3′5′-cyclic monophosphate (cAMP) on 5-hydroxytryptamine-(5-HT-) induced generation of inositol phosphates (IPs) and increases in intracellular Ca²⁺ ([Ca²⁺]_i) were investigated using canine cultured tracheal smooth muscle cells (TSMCs). Cholera toxin and forskolin induced concentration- and time-dependent cAMP formation with half-maximal effects (−logEC₅₀) produced at concentrations of 7.0 ± 0.5 and 4.9 ± 0.4  respectively. Pretreatment of TSMCs with either forskolin or dibutyryl cAMP inhibited 5-HT-stimulated responses. Even after treatment for 24h, these agents still inhibited the 5-HT-induced Ca²⁺ mobilization. The inhibitory effects of these agents produced both depression of the maximal response and a shift to the right of the concentration response curves of 5-HT. The water-soluble forskolin analogue L-858051 [7-deacetyl-7β-(γ-N-methylpiperazino)-butyryl forskolin] significantly inhibited the 5-HT-stimulated accumulation of IPs. In contrast, the addition of 1,9-dideoxy forskolin, an inactive forskolin analogue, had little effect on this response. Moreover, SQ-22536 [9-(tetrahydro-2-furanyl)-9-H-purin-6-amine], an inhibitor of adenylate cyclase, and both H-89 [N-(2-aminoethyl)-5-isoquinolinesulphonamide] and HA-1004[N-(2-guanidinoethyl)-5-isoquinolinesulphonamide], inhibitors of cAMP-dependent protein kinase (PKA), attenuated the ability of forskolin to inhibit the 5-HT-stimulated accumulation of IPs. These results suggest that activation of cAMP/PKA was involved in these inhibitory effects of forskolin. The AlF₄ ⁻-induced accumulation of IPs was inhibited by forskolin, suggesting that G protein(s) are directly activated by AlF₄ ⁻- and uncoupled from phospholipase C by forskolin treatment. These results suggest that activation of cAMP/PKA might inhibit the 5-HT-stimulated phosphoinositide breakdown and consequently reduce the [Ca²⁺]_i increase or inhibit both responses independently. Received: 14 March 1996/Accepted: 10 April 1996     

气管组织工程的研究策略及其展望

气管组织工程是近10年来国内外研究的热点和难点问题,取得了一些进展.但如何更好地遴选基质材料、实现种子细胞共培养、上皮化以及再血管化来构建组织工程化气管仍需要不断寻求新的研究思路和策略.本文从气管重建和理想化气管替代物的角度,回顾了近年来在组织工程气管方面的研究进展,并对未来的研究作出展望.     

RT-PCR法检测HNP1基因在气管上皮细胞转染后的表达

采用脂质体转染法将人中性粒细胞防御素（ Ｈ Ｎ Ｐ１ ）的 ｃ Ｄ Ｎ Ａ 重组真核表达质粒ｐ Ｂａｂｅ Ｎｅｏ Ｈ Ｎ Ｐ１导入无血清培养的人和兔的气管粘膜上皮细胞,利用逆转录聚合酶链反应（ Ｒ Ｔ Ｐ Ｃ Ｒ）法,在核酸水平检测 Ｈ Ｎ Ｐ１ 在气管上皮细胞的表达。结果：在人和兔的转染上皮细胞中均可检测到 Ｈ Ｎ Ｐ１ｍ Ｒ Ｎ Ａ 的表达,而在未转染的上皮细胞中 Ｒ Ｔ Ｐ Ｃ Ｒ检测结果呈阴性。这一结果与作者先前用免疫组化法在蛋白质水平上检测的结果一致,并证明ｐ Ｂａｂｅ Ｎｅｏ Ｈ Ｎ Ｐ１ 转染至气管粘膜上皮细胞后能得到有效表达。     

Experimental study of human tracheal heterografts in pigs

Summary In 12 three-months-old pigs a window-shaped tracheal defect was made and the defect closed by a precisely fitting Cialit-fixed, human tracheal heterograft. The macroscopic, microscopic, scanning and transmission electron microscopic investigation of the grafted area revealed that the tracheal epithelium was formed by microvillous epithelial cells primarily. 3 months after grafting cartilage of the tracheal transplant survived but after 9 months was replaced by a tight scar. The connective tissue plate thus formed was sufficiently stable to maintain normal respiration in the pigs.This work was supported by the Fonds zur Förderung der wissenschaftlichen Forschung (Project no. 3494)The authors thank A. Laminger and G. Sulzer for photographic work     

国产、进口乌拉地尔对全麻气管拔管心血管反应的比较观察

目的 :观察国产、进口乌拉地尔对全麻拔管期心血管反应的影响。方法 :60例无高血压病史的择期全麻手术病人随机分为 3组 ,分别为国产乌拉地尔组、进口乌拉地尔组和对照组。三组病人麻醉诱导均相同。术毕当病人符合拔管指征时 ,静注乌拉地尔 0 4mg/kg ,或等量生理盐水 (对照组 )。观察记录拔管前、拔管时、拔管后 1分钟、5分钟的SP、DP、HR ,并计算SP与HR的乘积RPP。结果 :对照组拔管后SP、DP、HR、RPP均较拔管前显著升高 (P <0 0 5 ) ,尤以拔管时至拔管后 1分钟为著 (P <0 0 1)。围拔管期两组乌拉地尔组的血流动力学变化非常相似 ,SP、DP较拔管前均无明显变化 ,而HR则均明显升高 (P <0 0 5 ) ,与对照组相比SP、DP和RPP的变化均明显降低(P <0 0 1)。结论 :国产乌拉地尔与进口制剂具有同等的降压效能 ,可削弱拔管期高血压反应