Acceptance and effects of nasal lavage in volunteer woodworkers

Wood dust is an irritant and is carcinogenic to the nasal mucosa. It inhibits its own clearance from the nose. It therefore makes sense to lavage retained wood dust from the nose following exposure. To our knowledge this is the second study conducted to determine whether the procedure of nasal lavage reduces nasal symptoms in woodworkers. Forty-six woodworkers from 150 approached volunteered to trial nasal lavage using gravity fed, home-made unbuffered isotonic saline for 2 months in a crossover trial and then be followed-up a year later. The group reported significantly decreased nasal symptoms and over half continued to use nasal lavage voluntarily after 1 year. Results support the findings of the previous study that nasal lavage improves nasal symptoms and supplements those findings with data indicating patterns of voluntary usage following the study's conclusion. It is concluded that nasal lavage is an acceptable, effective and inexpensive option with minimal side effects for woodworkers who experience nasal symptoms and who wish to try the procedure.     

间质性肺疾病支气管肺泡灌洗液中内皮素的检测及其意义

目的　探讨内皮素 ( ET)在间质性肺疾病 ( ILD)发生发展中的作用及其诊断价值。方法　利用放射免疫直接测定法 ,检测 1 0例肺结节病和 8例特发性肺纤维化 ( IPF)患者外周血和支气管肺泡灌洗液 ( BALF)中内皮素的含量 ,并与 8例健康非吸烟者对照。结果　肺结节病和 IPF患者血浆和 BAL F中 ET的含量分别为 62 .1 4± 2 9.2 2 ng/L ,1 7.4 0± 2 .4 1 ng/L和 76.92± 71 .90 ng/L,1 0 .4 0± 3.1 3ng/L,均明显高于正常对照组 ( 2 0 .0 8± 8.37ng/L 和 4 .0 4± 0 .5 5 ng/L) ,P <0 .0 1 ;研究组 BALF中 ET与 Pa O2 呈负相关 ( r=- 0 .5 38,P<0 .0 1 ) ,与细胞总数呈正相关 ( r =0 .64 9,P <0 .0 1 )。其中结节病和 IPF的 BAL F中 ET水平分别与淋巴细胞和中性粒细胞呈明显正相关 ( r =0 .71 2 ,P <0 .0 1 ;r =0 .81 3,P <0 .0 1 )。结论　 ET在肺结节病和 IPF发生发展中起重要作用 ,并可做为判断疾病活动性的一项参考指标。     

常见大气细菌对动物肺损伤的实验研究

为研究大气微生物对人体健康的影响,于１９９７年对上海市大气细菌污染进行了调查。在此基础上,采用大鼠经气管灌注细菌悬液２４小时后,分析肺灌洗液组成的方法,就大气细菌对动物呼吸系统损伤方面进行了研究。同时比较了不同地区大气细菌对大鼠肺细胞的损伤效应。结果发现大气细菌污染严重地区的细菌染毒组ＡＬＢ、ＬＤＨ、ＡＣＰ、ＡＫＰ、中性粒细胞等指标比清洁区升高更为显著,提示大气中常见细菌可对肺组织造成损伤。     

肺癌患者血清与支气管肺泡灌洗液四项放免肿瘤指标同步检测的结果分析

对３８例肺癌患者的血清和支气管肺泡灌洗液（ＢＡＬＦ）同步进行ＣＥＡ、ＣＡ－５０、ＡＦＰ、ＳＦ的检测。结果显示：肺癌ＢＡＬＦ的ＣＥＡ浓度测值７３％明显高于血清中ＣＥＡ浓度;ＣＡ－５０浓度测值６８％高于血清;ＳＦ９２％明显低于血清中测值;而ＡＦＰ在肺癌患者无论血清及灌洗液中,阳性率均低于７％,但仍是ＢＡＬＦ的浓度测值敏感于血清。提示支气管肺泡灌洗液的ＣＥＡ、ＣＡ－５０与血清的同步检测是目前肺癌早期诊断的主要优选方法之一。     

血清和支气管肺泡灌洗液多种肿瘤标志物联合检测对肺癌诊断价值的探讨

目的：探讨血清和支气管肺泡灌洗液（ＢＡＬＦ）中肿瘤标志物联合检测对肺癌诊断的价值。方法：采用放射免疫分析方法对癌胚抗原（ＣＥＡ）、铁蛋白（ＦＴ）和（β２－ＭＧ）进行分析。结果：肺癌患者血清及ＢＡＬＦ中ＣＥＡ、ＦＴ浓度均明显高于肺良性病变组,两组比较有显著性差异（Ｐ〈０．０１或Ｐ〈０．０５）。ＢＡＬＦ中ＣＥＡ、Ｆ物浓度 血清浓度,且腺癌ＣＥＡ和ＦＴ浓度高于鳞癌和小细胞未分化癌。β２－ＭＧ的血清和ＢＡ     

Einfluß der orthograden darmspülung mit Prepacol® und Polyäthylenglykollösung auf die dauer des postoperativen Ileus nach kolorektalen resektionen

Zusammenfassung In einer prospektiv randomisierten Studie wurden bei 100 Patienten mit elektiven konventionellen (n=66) oder laparoskopischen (n=34) kolorektalen Resektionen die präoperative Darmvorbereitung mit einer 2 1-Polyäthylenglykol(PEG)-haltigen Lösung plus Prepacol® (Gruppe A, n=50) und die mit einer 4 1-PEG-Lösung (Gruppe B, n=50) verglichen. Im Rahmen der Studie wurde auch der Einfluß der Art und Qualität der Darmvorbereitung auf die Dauer des postoperativen Ileus untersucht. Die Qualität der Darmvorbereitung wurde wührend der Resektion am eröffneten Darm mit einem 4-Punkte-Score durch den Chirurgen bestimmt. Das Zeitintervall vom Ende der Operation bis zum ersten postoperativen Windabgang und dem ersten Stuhlgang wurden dokumentiert. Die Qualität der Darmvorbereitung wurde in beiden Gruppen als gleich gut beurteilt (Gruppe A: 94%; Gruppe B: 84%; p=0,5). Das postoperative Intervall bis zum Abgang von Winden (A: 3,1 ± 1,2 Tage; B: 3,2 ± 13 Tage; p = 0,6) und zum ersten Stuhlgang (A: 3,9 ± 1,3 Tage; B: 4,1 ± 1,3 Tage; p=0,5) war in beiden Patientengruppen etwa gleich lang. Als einziger Faktor mit eigenständigem Einfluß auf die Dauer des postoperativen Ileus in der multivariaten Analyse (Alter, Geschlecht, Vorbereitung, Operationsdauer, Operation, Operationstechnik) wurde die Operationstechnik (laparoskopisch oder konventionell) identifiziert. Der erste Stuhlgang trat nach laparoskopischeu Resektionen bereits nach durchschnittlich 3,2±1,1 Tagen auf, nach konventionellen Operationen dagegen erst nach 4,3±1,2 Tagen (p=0,001). Die Art (41 PEG oder 21 FEG plus Prepacol®) und Qualität der Darmvorbereitung beeinflußten die Dauer der postoperativen Motilitätsstörung nicht.

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Effect of bowel lavage with prepacol and polyethylene glycol on the duration of postoperative ileus following colorectal resection

In a prospective randomized study in 100 patients undergoing conventional (n=66) or laparoscopic (n=34) colorectal resection, mechanical lavage with 2 1 of a polyethylene glycol (PEG) solution (group A, n=50) combined with a laxative was compared with lavage with 4 1 of PEG alone (group B, n=50). The influence of bowel preparation on postoperative Hens was investigated. The efficacy of bowel preparation was determined intraoperatively by a surgeon blind to the type of preparation. The time interval between the end of the operation an first flatus or bowel movement was recorded. The efficacy of preparation was no different between the groups (group A: 94%, group B: 84%; P=0.5). The time lapse before first flatus (A: 3.1 ± 1.2 days, B: 3.2 ± 1.3 days; P = 0.6) or bowel movement (A: 3.9 ± 1.3 days, B: 4.1 ± 1.3 days; P = 0.5) also did not differ between the groups. The only factor found in multivariate analysis (age, sex, operation, duration and type of surgery, bowel preparation) to prolong the duration of postoperative ileus was the type of surgery. The first bowel movement occurred 3.2 ± 1.1 days after conventional surgery and 4.3±1.2 days (P<0.001) after laparoscopic surgery. The type of preoperative bowel preparation had no influence on the duration of postoperative Hens. The postoperative interval before the first bowel movement was shorter after laparoscopic surgery.

     

中药脑肺康对地鼠实验性肺气肿及肺动脉高压的防治作用

目的 观察中药肺康对缺氧性肺动脉高压和肺气肿的防治效果并探讨其作用机制。方法 以弹性蛋白酶溶液滴注入金黄地鼠气管内,正常饲养３０ｄ后,常压下缺氧１５ｄ,分别设立中药脑肺康预防组、治疗组、肺气肿＋缺氧组及正常对照组。于处死动物前,测量平均肺动脉压,取静脉血进行循环内皮细胞计数;处死后测量右心肥大指数,光镜下计数左侧肺支气管肺泡灌洗液内细胞总数,对右侧肺进行光镜图像分析。结果 中药脑肺康预防组和治疗３     

Metabolites of nitric oxide in the lower respiratory tract of children

Nitric oxide (NO) is produced in the upper and lower respiratory tract and can be detected in exhaled air of both healthy individuals and subjects with pulmonary diseases. Recent studies have shown that exhaled NO is mainly derived from the upper airways. There is, however, evidence that in aqueous solutions NO is rapidly converted to distinct oxides of nitrogen. We therefore studied the stable NO metabolites nitrate and nitrite in broncho-alveolar lavage (BAL) fluid and serum as indicators of NO formation in the lower respiratory tract. The study population consisted of 31 healthy children undergoing elective surgery for nonpulmonary illnesses and 13 immunosuppressed children with pneumonia. Nitrate and nitrite were determined photometrically. Nitrate was found in BAL fluid of all children. In children with pneumonia, nitrate concentrations in BAL fluid were significantly higher than in healthy children. A significant correlation was observed between nitrate in BAL fluid and serum of immunosuppressed children with pneumonia. Nitrite was not detected in any of the BAL fluid or serum samples. Conclusions Our results suggest that in the lower airways significant amounts of NO are metabolised to nitrate. Studies on NO in pulmonary diseases should therefore include determination of nitrate in lower airway fluids. Received: 21 August 1996 / Accepted: 12 December 1996     

腹腔灌洗联合前列地尔治疗重症急性胰腺炎疗效观察

目的：了解腹腔灌洗联合前列地尔对重症急性胰腺炎的疗效。方法：回顾分析内科保守治疗组(A组18例)、腹腔灌洗组(B组12例)、腹腔灌洗前列地尔联合治疗组(C组15例)三组间腹痛缓解时间、消失时间，血淀粉酶恢复正常时间，C反应蛋白(CRP)浓度变化，急性肺损伤(ALI)的发生率，死亡率的差异。结果：C组血淀粉酶恢复正常时间短于A组和B组；C组CRP浓度、ALI的发生率均低于A组和B组。腹痛缓解时间、消失时间B组和C组均短于A组(P＜0．05，但B、C两组间比较差异无统计学意义。腹腔灌洗和前列地尔有降低死亡率的趋势，但3组间死亡率差异无统计学意义(P＞0．05)。结论：腹腔灌洗联合前列地尔治疗重症急性胰腺炎优于单纯的保守治疗和腹腔灌洗。     

结肠癌切除术中吻合器吻合与手法缝合临床资料分析

目的探讨结肠癌切除术中吻合器吻合与手法缝合的疗效。方法1998~2005年收治91例患者,根据临床表现分为梗阻组(观察组)41例,无梗阻组(对照组)50例,术中肠道灌洗后各组均分别进行吻合器吻合和手法缝合。结果两组均未发生吻合口漏。观察组:吻合器吻合出现2例切口感染,手法缝合出现4例吻合口狭窄。对照组:吻合器吻合出现1例切口感染,2例吻合口出血;手法缝合出现2例吻合口狭窄,3例切口感染。结论手法缝合与吻合器吻合均安全可靠,但前者更经济实惠,易被广大普通患者所接受。