早期联合用药对矽尘致大鼠肺纤维化的影响

目的：探讨早期用药对矽尘致大鼠肺纤维化的影响。方法采用ＳＤ大鼠,低剂量石英寺非暴露式气管注入染尘（２０ｍｇ／鼠）后３ｄ,在病变早期阶段开始给药,分别治疗２个月和５个月。疗效指标为肺湿重、肺胶元含量、肺总脂含量及肺内矽性病变分级。结果：以肺湿重、肺总脂为依据的综合疗效指标显示,各用药组都显著低于染尘对照组。肺内矽性病变分级亦有相应的差异。结论：早期联合用药对大鼠肺纤维化有一定阻断作用,其疗效优于各单     

Radiographic silicosis and lung cancer risk among workers in Ontario

A case-control study, nested in a cohort of workers under surveillance for silicosis in 1979 or later, was undertaken to assess lung cancer risk in relation to the ILO coding scheme for the pneumoconioses. The subjects of this study are from the 41 matched quartets, consisting of one worker with silicosis and three age-matched controls, in which a lung cancer case was diagnosed. The odds ratio for lung cancer among subjects with ILO classification 1/0 or more, in comparison to subjects with category ≤ 0/1, was 3.27 (95%CI = 1.32–8.2). Adjustment of the radiographic risk for the effect of cumulative radon exposure had the effect of increasing the odds ratio for the association between ILO category ⩾1/0 and lung cancer. Although small smoking differences could account for the increased lung cancer odds ratio among workers with silicosis, the empirical evidence suggests that these smoking differences do not exist. It is concluded on the basis of two North American studies of silica exposed workers that radiographic silicosis is a marker for an increased risk of lung cancer. Am. J. Ind. Med. 34:244–251, 1998. © 1998 Wiley-Liss, Inc.     

Silicosis,mixed dust pneumoconiosis,and lung cancer

A total of 764 autopsy cases with a pathological diagnosis of nonasbestos pneumoconiosis were investigated in a search for lung cancer: 146 patients bore 148 lung cancers (19.1%). The incidence of a lung cancer was associated positively with aging, longer occupational exposures, and smoking habits. A reverse correlation was found between carcinogenesis and the severity of pneumoconiosis. A statistically significant increase in the incidence of certain types of lung cancer (squamous cell carcinoma + small cell carcinoma) was found in silicotic lungs with massive fibrosis as compared to lungs with mixed dust pneumoconiosis of comparable severity. Although there appears to be no dose-response relationship in general between silicosis and lung cancer, it is advisable to consider the possibility that a presumptive silica-induced carcinogenesis might be masked by the severe fibrosis of a silicotic type, which obliterates the lung tissue in a different way from asbestosis, which is associated with epithelial proliferation. Am. J. Ind. Med. 32:595–599, 1997. © 1997 Wiley-Liss, Inc.     

矽肺病患者痰液的诱导方法

[目的]通过优化痰液诱导和处理条件,探讨适宜的痰液诱导和处理方法。[方法]以不同浓度的高渗盐溶液、不同诱导时间对40例Ⅰ期矽肺患者进行雾化痰液诱导;用不同稀释倍数的0.1%二硫苏糖醇（DTT）及不同的水浴时间对痰液进行处理。[结果]3%、4%、5%浓度高渗盐水诱导成功率分别为80.00%、82.50%、60.00%;而6%浓度仅为22.50%,明显低于3%、4%、5%溶液（P〈0.01）;4%、5%之间的差异有统计学意义（P〈0.05）;3%、4%之间的差异无统计学意义（P〉0.05）。3%浓度高渗盐水诱导时间25、30 min的成功率分别为77.50%、92.50%。痰液37℃水浴30、40、50 min溶解状况明显优于20 min,差异有统计学意义（P〈0.05）;而30 min、40 min、50 min水浴差异无统计学意义（P〉0.05）。4倍DTT与2倍体积DTT稀化对痰液溶解状况及痰液中IL-6和TNF-α水平均无明显影响（P〉0.05）。[结论]以3%、4%的高渗盐水雾化吸入20、30 min痰液诱导满意率较高且得到的痰液质量较佳,经过水浴30-40 min,加入2倍或4倍0.1%DTT处理的稀化程度较好。     

骨髓间充质干细胞移植治疗矽肺小鼠肺炎及肺纤维化

背景：矽肺对职业人群健康的影响日益严峻,目前没有有效治疗的方法。 目的：观察骨髓间充质干细胞移植对矽肺的治疗作用。 方法：36只C57BL/6小鼠随机摸球法均分为3组。对照组小鼠气管内注入生理盐水;矽肺模型组和骨髓间充质干细胞移植组小鼠气管内注入二氧化硅混悬液建立矽肺模型;骨髓间充质干细胞移植组于造模后6 h尾静脉输注骨髓间充质干细胞。 结果与结论：肺组织羟脯氨酸的含量矽肺模型组和骨髓间充质干细胞移植组高于对照组,差异均有显著性意义(P < 0.01);骨髓间充质干细胞移植组含量明显低于矽肺模型组,差异有显著性意义(P < 0.01)。矽肺模型组和骨髓间充质干细胞移植组小鼠的肺系数均高于对照组(P < 0.01),其中骨髓间充质干细胞移植组低于矽肺模型组,差异有显著性意义(P < 0.01)。白细胞介素1β的表达矽肺模型组和骨髓间充质干细胞移植组高于对照组 (P < 0.01);骨髓间充质干细胞移植组低于矽肺模型组,差异均有显著性意义(P < 0.01)。转化生长因子β1在肺组织中的表达同样为矽肺模型组(P < 0.01)和骨髓间充质干细胞移植组(P < 0.05)高于对照组;骨髓间充质干细胞移植组低于矽肺模型组,差异有显著性意义(P < 0.01)。说明骨髓间充质干细胞移植可以减轻肺部炎症反应和纤维化程度。     

用HOPE-MED8050动式染尘控制系统建立大鼠矽肺模型

[目的]采用动式染尘控制系统建立大鼠矽肺模型.[方法]40只SD大鼠随机分为1d、3d、7d、2周、4周、8周、12周及对照组,每组5只;大鼠暴露的染尘浓度为170～ 190 mg/m3,每天染尘2h,至各组相应的染尘时间段处死动物(对照组于12周末处死),称量体重与肺脏重量,计算肺脏器系数,检测肺组织羟脯氨酸(Hyp)含量并对肺组织进行病理组织学观察.[结果]染尘室浓度稳定持久.肺脏器系数随染尘时间延长而逐渐增加;1d组肺组织轻度充血、水肿;7d组血管周围可见较多炎细胞围绕,以单核细胞和淋巴细胞为主;2周组可见肺泡内有红染物及泡沫细胞;4周组巨噬细胞呈结节状,肺泡上皮细胞部分脱落,少量纤维组织增生;8周组纤维性增生更甚,同时可见肺泡Ⅱ型上皮细胞腺营样增生;12周组出现纤维性结节,而对照组的大鼠肺部无明显异常.肺组织内Hyp含量随染尘时间延长而增加.[结论]采用动式染尘控制系统可建立大鼠矽肺模型.     

Accelerated silicosis in workers exposed to agate dust in Guangzhou, China.

BACKGROUND: An investigation of a small private agate mill was prompted by an agate worker who presented with silicosis in Guangzhou, China, in December 1998. METHODS: The work processes and records of dust measurements of the mill were examined. The mean total dust concentrations ranged from 3.0 to 9.9 mg/m3; 86-88% of the particles' diameter was smaller than 5.0 microm. Free SiO2 content from agate samples was measured. Occupational history was obtained and X-ray chest and lung function was carried out. RESULTS: Free SiO2 content of the agate was 90.5%. Thirty-two men involved in processing agate stone were examined. The mean ( +/- SD) age was 29.8 ( +/- 4.9) years and the mean (+/- SD) duration of exposure was 3.5 (+/- 1.7) years. Fifteen cases (47%) were diagnosed as accelerated silicosis. Up to September 1999, three had died from respiratory failure and five were in critical condition. CONCLUSIONS: Silicosis is an important problem in primitive work environments.     

汉防己甲素和磷酸羟基喹哌联合用药治疗早期矽肺疗效观察

目的 探索汉防己甲素和磷酸羟基喹哌联合用药治疗早期矽肺的疗效。方法 治疗组15人,其中0^ 7人,矽肺I8人,汉防己甲素200mg/d,100mg/p.o,bid,每周服用6d;磷酸羟基喹哌0.5g,p.o,每周1次,服用3个月后休息1个月为1个疗程,共治疗6个疗程,为期2年,对照组15人,0^ 7人,矽肺18人,应用安慰剂,每次2片,每周2次,疗程同治疗组,结果 用药2年后,临床症状改善,机体抵抗力增强,肺功能改善都优于对照组,血清铜蓝蛋白,血清肿瘤坯 煞费苦心因子经治疗后较治疗前降低。与对照组相比,差异有显著性。结论 说明早期矽肺抗纤维化治疗是有一定疗效的,而且无任何副反应,该方案是安全的。