The relaxant action of osthole isolated from Angelica pubescens in guinea-pig trachea

The effect of osthole, isolated from Angelica pubescens, on the contraction of guinea-pig trachea was studied. Osthole (25–100 mol/l), theophylline (10–1000 mol/l) and higher concentrations of nifedipine (0.1–100 mol/l) suppressed the contraction response curves of tracheal smooth muscle caused by carbachol, prostaglandin F₂ (PGF₂), U46619 (thromboxane A₂ analogue) and leukotriene C₄ (LTC₄) in a concentration-dependent manner. The contraction caused by high K⁺ (120 mmol/1) and cumulative concentrations of CaCl₂ (0.03–3 mmol/1) was also inhibited concentration-dependently by osthole (25–100 mol/l), theophyl line(10–1000 mol/l) and lower concentrations of nifedipine (0.01–0.1 mol/l). The relaxant actions of osthole were not affected by propranolol (1 mol/l), glibenclamide (10 mol/l) or removal of tracheal epithelium. Osthole (100 mol/l) was still effective in causing tracheal relaxation in the presence of nifedipine (1 mol/l). In Ca²⁺-free- and EGTA (0.2 mmol/1)-containing medium, the relaxing effect of osthole was more potent than in normal Krebs solution. Osthole (25 and 50 mol/l) caused 2.9 and 6.5, or 3.0 and 5.6 fold, respectively, increase in potency of forskolin or sodium nitroprusside in causing tracheal relaxation but did not affect that by cromakalim. Osthole (50 mol/l) enhanced the increase in tissue cAMP and cGMP levels induced by forskolin and sodium nitroprusside, respectively, and in higher concentrations (100 and 250 mol/l), itself increased markedly tissue cAMP and cGMP contents. Osthole (10–250 mol/l) inhibited the activity of cAMP and cGMP phosphodiesterases in a concentration-dependent manner. It is concluded that osthole exerts a nonspecific relaxant effect on the trachealis by inhibiting the cAMP and cGMP phosphodiesterases. Correspondence to: C. M. Teng at the above address     

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     

7例原发性气管恶性肿瘤与支气管哮喘的鉴别诊断

目的：了解气管肿瘤与支气管哮喘的鉴别。方法：对7例误诊为哮喘的气管肿瘤患者的临床表现和相关检查进行分析。结果：7例患者误诊时间平均5个月。与支气管哮喘的不同点有：1）呼吸困难以吸气时明显，哮鸣音多不典型，以上肺部和喉部为最响。（2）病人以喉部痰多，喉部多闻及痰鸣音。（3）咳喘随着病程的延长而逐渐加重。结论：及早对可疑病人行纤维支气管镜检查可明确诊断。     

胸锁乳突肌肌骨膜瓣喉气管重建术动物实验与临床应用

为探讨胸锁乳突肌肌骨膜瓣在喉气管重建术中的作用，切除狗环状软骨弓及部分气管前壁造成缺损，取胸锁乳突肌肌骨膜瓣修复，分别于术后２个月～８个月处死动物，观察修复情况，并取材作光镜及扫描电镜检查。结果发现：胸锁乳突肌肌骨膜瓣行喉气管重建具有良好支撑力，修复的呼吸道通畅，无瘢痕及肉芽组织形成，移植骨膜表面为粘膜上皮覆盖，深层有新骨组织形成。临床治疗５例患者，均拔除气管套管，恢复正常呼吸功能。胸锁乳突肌肌骨膜瓣是理想的喉气管重建材料。     

Vascular compression of the airway: Indications for and results of surgical management

Vascular compression of the airway is a significant cause of respiratory compromise in children. While the indications for surgical repair are sometimes life threatening, they can also be subtle. This retrospective study examines 45 surgical cases of tracheobronchial compromise secondary to vascular compression at a large children's hospital between July 1983 and February 1996. A total of 34 were diagnosed with innominate artery compression, ten with a double aortic arch and one with an anomalous right subclavian artery. The 45 patients, 25 male and 20 female, ranged in age from 12 days to 11 years at surgery (average 13 months). A total of 21 (47%) presented with proven or suspected episodes of cyanosis or apnea. All 45 patients had evidence of vascular compression during microlaryngoscopy and bronchoscopy. The diagnosis was confirmed by magnetic resonance imaging (MRI) in 23/45 (51%), barium swallow in 22/45 (49%) and aortogram in 3/45 (7%). There was one death. One patient had a tracheotomy before surgery and continues to require it after surgery. Complete resolution of symptoms was achieved in 39/45 (87%) with five requiring more than one operation before their symptoms resolved completely. A total of four patients experienced a recurrence of symptoms within a variable length of time after surgery. Surgical indications and treatment alternatives will be discussed.     

Tracheal Transplantation: Superior and Inferior Thyroid Artery Perfusion Territory

Objective: To determine the perfusion territories of the superior and inferior thyroid arteries in humans. Tracheal transplantation is a potential option for management of long-segment tracheal stenosis. However, the maximum length of vascularized trachea that can be reliably transplanted has not been established. Study Design: The tracheal vascular territory of individual superior and inferior thyroid arteries was determined separately in 10 humans postmortem. Methods: India ink was infused unilaterally under controlled pressure into the superior (n = 5) and inferior (n = 5) thyroid arteries of cadaveric tracheas. Tracheas were sectioned longitudinally and the caudalmost extent of mucosal dye staining was determined via microscopic assessment. Results: The tracheal perfusion territory of the superior thyroid artery was two to five rings (1.7 ± 0.5 cm) and the inferior thyroid artery, nine to 13 rings (6.5 ± 1.1 cm). In both cases, the tracheal mucosa on the contralateral side was stained to the same caudal level. Conclusions: The inferior thyroid artery was shown to perfuse the trachea maximally to the 13th ring (8.1 cm). As such, the unilateral inferior thyroid artery would serve as a suitable vascular component for long-segment tracheal transplantation in humans.     

美托洛尔和芬太尼对高血压病人气管插管致循环系统反应的作用

目的:考察美托洛尔和芬太尼对高血压病人气管插管致循环系统反应的作用。方法:选取4 0例需气管插管全麻手术的高血压病人,随机分成4组,每组1 0例。于麻醉诱导前各组分别静脉输液:A组用生理盐水(1 0mL) ;B组用美托洛尔4 0 μg kg 生理盐水(1 0mL) ;C组用芬太尼2 μg kg 生理盐水(1 0mL) ;D组用美托洛尔4 0 μg kg 芬太尼2 μg kg 生理盐水(1 0mL)。测定插管前后心率(HR)、收缩压(SAP)、舒张压(DAP) ,并计算心率收缩压乘积(RPP) ,于相应时间点采集动脉血标本测定血浆去钾肾上腺素(NA)和肾上腺素(Ad)的浓度。结果:气管插管后1和3分钟,A组病人的SAP、DAP、HR、RPP及血浆NA和Ad浓度均有显著升高(P <0 . 0 5 ) ,B组病人插管后血浆NA浓度明显大于C、D组(P <0 .0 5 ) ,D组病人SAP、DAP、HR及血浆NA和Ad浓度较基础值无明显差异(P >0 . 0 5 )。结论:行全麻手术的高血压病人气管插管时存在明显的循环系统应激反应,单独应用美托洛尔4 0 μg kg或单独应用芬太尼2 μg kg仅能部分抑制插管反应,二者联用则能更有效地抑制插管反应。     

海藻糖在气管低温保存中的保护机制

目的探讨海藻糖在气管低温保存中的保护作用和机制。方法新鲜配制4组保存液，其中：Ⅰ组LPD；Ⅱ组LPD 10％DMSO；Ⅲ组LPD 0．15M海藻糖；Ⅳ组LPD 10％DMSO 0．15M海藻糖。切取SD大鼠气管后立即分别放入含上述4种溶液的冻存管，在程序降温仪降至-80℃后投入液氮中保存。20d后对气管标本进行HE染色和Bcl-2、Pax蛋白检测(免疫组化)，并将其异位移植到Wistar大鼠腹腔，15d后取出移植气管，观察组织学变化。结果4种保存液低温保存气管20d后，Ⅲ组和Ⅳ组气管结构完整，软骨细胞Pax蛋白表达较低，尤其Ⅳ组保存效果最好，同种异体异位移植后生长良好。各组Bcl-2蛋白表达无明显区别。结论在气管低温保存中海藻糖的保护作用主要是通过对软骨细胞的保护实现的，抑制软骨细胞Pax基因的表达是其中的保护机制之一。海藻糖和DMSO合用保护作用更好。