脂质过氧化物与大鼠烫伤后急性肺损伤的关系

本文从体内氧自由基引发的链产物——LPO为主要指标,观察大鼠烫伤后LPO变化与血清CH_(50),PMN,以及肺血管通透性间的关系。结果表明:烫伤后急性肺损伤的发生与补体活化、激活PMN,使其在肺内聚集释放氧自由基,引发血管内皮细胞膜脂过氧化反应有关。     

Prognostic index to identify patients who may not benefit from whole brain radiotherapy for multiple brain metastases from lung cancer

Palliative whole brain radiotherapy (WBRT) is often recommended in the management of multiple brain metastases. Allowing for WBRT waiting time, duration of the WBRT course and time to clinical response, it may take 6 weeks from the point of initial assessment for a benefit from WBRT to manifest. Patients who die within 6 weeks (‘early death’) may not benefit from WBRT and may instead experience a decline in quality of life. This study aimed to develop a prognostic index (PI) that identifies the subset of patients with lung cancer with multiple brain metastases who may not benefit from WBRT because of ‘early death’. The medical records of patients with lung cancer who had WBRT recommended for multiple brain metastases over a 10-year period were retrospectively reviewed. Patients were classified as either having died within 6 weeks or having lived beyond 6 weeks. Potential prognostic indicators were evaluated for correlation with ‘early death’. A PI was constructed by modelling the survival classification to determine the contribution of these factors towards shortened survival. Of the 275 patients recommended WBRT, 64 (23.22%) died within 6 weeks. The main prognostic factor predicting early death was Eastern Cooperative Oncology Group (ECOG) status >2. Patients with a high PI score (>13) were at higher risk of ‘early death’. Twenty-three per cent of patients died prior to benefit from WBRT. ECOG status was the most predictive for ‘early death’. Other factors may also contribute towards a poor outcome. With further refinement and validation, the PI could be a valuable clinical decision tool.     

肺灌注显像在Ⅲ期非小细胞肺癌调强放疗中对功能肺的保护

目的 探讨肺灌注显像在Ⅲ期非小细胞肺癌(NSCLC)调强放疗(IMRT)保护功能肺的可行性。方法 选择拟行放疗的Ⅲ期NSCLC患者24例,分别行PET-CT和SPECT定位,图像传至治疗计划系统进行图像融合。根据SPECT图像确定功能肺(FL)和非功能肺(NFL),FL是指放射性计数为最大放射性计数的30%以上(包括30%)的区域,其他区域为NFL。肺灌注受损分为4级:0级,无灌注受损;1级,肿瘤及其周围局部肺灌注受损;2级,达1叶肺灌注受损;3级,超过1叶肺灌注受损。根据SPECT图像提供的肺功能信息制定IMRT计划进行优化,尽可能降低FL的照射体积剂量。采用配对t检验统计分析优化前后的IMRT计划的肺组织剂量参数变化。结果 患者均有不同程度的肺灌注缺损,其中肺灌注受损1级8例,2级6例,3级10例。根据SPECT提供的肺功能信息优化IMRT计划后WLV和FLV均有不同程度降低,而FLV降低程度更加明显。优化后WLV₁₀、WLV₁₅、WLV₂₀、WLV₂₅、WLV₃₀和FLV₁₀、FLV₁₅、FLV₂₀、FLV₂₅、FLV₃₀差异有统计学意义。结论 根据SPECT图像提供的肺功能信息优化IMRT计划以保护Ⅲ期NSCLC功能肺是可行的。     

低剂量辐射增强小鼠肿瘤基因-放射治疗效应的免疫学机制研究

目的 探讨低剂量辐射全身照射对小鼠Lewis肺癌移植肿瘤基因-放疗方案中的免疫增强作用机制。方法 小鼠右后肢皮下接种Lewis肺癌细胞建立荷瘤模型,基因-放疗组中小鼠肿瘤局部注射由多聚乙烯亚胺包裹的pEgr-IL18-B7.1重组质粒,分别接受由2 Gy 局部照射和0.075 Gy 全身照射组合的不同治疗方案,通过³H-TdR标记方法检测小鼠CTL和NK细胞毒活性,ELISA方法检测TNF-α和IFN-γ分泌活性,观察各治疗组对荷瘤小鼠抗肿瘤免疫的作用。结果 在pEgr-IL18-B7.1基因治疗方案中,单次大剂量辐射局部照射后加多次低剂量全身照射与常规多次大剂量辐射局部照射相比,小鼠CTL和NK细胞毒活性显著增强,TNF-α和IFN-γ分泌活性有不同程度的增高。 结论 低剂量辐射可以通过促进CTL和NK细胞毒效应,上调TNF-α和IFN-γ细胞因子表达,从而增强机体抗肿瘤免疫功能,提高肿瘤基因-放疗的抑瘤效果。     

P16INK4、PCNA在肺癌中表达的研究

目的 通过检测肺癌组织中p16、PCNA的表达，探讨其在肺癌发生发展中的作用及相互关系。方法 采用S—P免疫组化方法，检测83例肺癌标本及15例正常肺组织标本中P16^INK4和PCNA的表达。结果 P16^INK4和PCNA在正常肺组织和肺癌组织中表达的阳性率存在显著性差异。P16^INK4表达的阳性率在小细胞癌与非小细胞癌之间有显著性差异。PNTM分期高的肺癌标本P16^INK4及PCNA表达阳性率显著高于分期低的肺癌标本。不同分化程度的肺癌组织P16^INK4及PCNA表达阳性率有显著性差异。结论 肺癌的发生与P16^INK4的低表达和PCNA的高表达有关。而P16^INK4的表达与肺癌的组织学类型、分化程度、临床分期有关；PCNA的表达与肺癌的分化程度、临床分期有关。     

两种艾灸法对二肾一夹型高血压大鼠血压和血管内皮细胞内分泌功能的影响

目的:应用两种艾灸疗法治疗两肾一夹肾血管性高血压大鼠(2K1C-RHR),评价这两种艾灸疗法的降压作用,并对其降压机理作初步的探讨。方法:建立2K1C-RHR模型,并将其随机分为六组:灸法Ⅰ组(百会、神阙、足三里)、灸法Ⅱ组(关元、涌泉、足三里)、卡托普利组、灸法Ⅰ+卡托普利组、灸法Ⅱ+卡托普利组、高血压对照组,另设正常对照组。经过10天治疗后,测量血压,并测定血浆中内皮素(ET)、一氧化氮(NO)。结果:高血压对照组的收缩压(SBP)、舒张压(DBP)明显高于正常对照组,各治疗组的SBP、DBP明显低于高血压对照组(P<0.01),各治疗组间则没有明显差异(P>0.05)。血浆NO含量各组间没有明显差异(P>0.05)。各治疗组与正常对照组的血浆中ET含量明显低于高血压对照组(P<0.01)。各治疗组ET/NO比值接近正常对照组(P>0.05)且明显低于高血压对照组(P>0.05)。结论:两种艾灸疗法有良好的降压作用,其降压机理与及纠正ET与NO的失衡状态有关。     

Lung function development in the first 2 yr of life is independent of allergic diseases by 2 yr

The aim of the study was to assess if lung function at birth predicts lung function at 2 yr and secondly, if lung function development was influenced by the common phenotypes of recurrent bronchial obstruction (rBO) or atopic eczema (AE) by 2 yr. Lung function was assessed at birth (n = 802) and at 2 yr within the prospective birth cohort study 'the Environment and Childhood Asthma Study' in Oslo. The 135 children with lung function measured at birth by tidal flow volume (TFV) loops and passive respiratory mechanics, who were included in a nested case-control study were reinvestigated at 2 yr with clinical examination, TFV loops (n = 90) (mean age 26.6 (3.7 s.d.) months), skin prick test and parental interview. Children were categorized into quartiles (lower, middle two, upper) according to time to peak tidal expiratory flow/total expiratory time (t(PTEF)/t(E)) at birth as well as clinical phenotype based on the presence of rBO and/or AE (ever) by 2 yr. The observed reduction in mean t(PTEF)/t(E) from birth to 2 yr within the quartiles, were not significantly different after controlling for 'regression to the mean'. t(PTEF)/t(E) at birth correlated significantly with t(PTEF)/t(E) at 2 yr, (r = 0.475, p < 0.001). Children with both rBO and AE by 2 yr had significantly lower t(PTEF)/t(E) at 2 yr (p = 0.002) and at birth (p = 0.027), compared with children with no rBO or AE. Clinical phenotype at 2 yr did not influence the change in t(PTEF)/t(E) from birth to 2 yr. This study demonstrates a clear tracking of lung function from birth, not influenced by rBO or AE by 2 yr.     

Ventilation imaging of the lung: Comparison of hyperpolarized helium-3 MR imaging with Xe-133 scintigraphy

RATIONALE AND OBJECTIVES: To compare hyperpolarized helium-3 (HHe) magnetic resonance imaging (MRI) of the lung with standard Xe-133 lung ventilation scintigraphy. MATERIALS AND METHODS: We performed a retrospective review of 15 subjects who underwent HHe MRI and Xe-133 lung ventilation imaging. Coronal MRI sections were acquired after a single inhalation of HHe gas, and standard posterior planar lung ventilation scintigraphy was performed during continuous breathing of Xe-133 gas. The first breath scintigram of each patient was compared with a composite MR image composed of the sum of the individual MR images and with the individual helium-3 MR images. Ventilation defects on the two imaging modalities were compared for size, conspicuity, and concordance in presence and location. Assessment was done separately for each of four lung quadrants. RESULTS: Comparing the composite HHe MR images with Xe-133 scintigraphy, ventilation defect size, conspicuity and concordance were the same in 67% (40/60), 63% (38/60), and 62% (37/60) quadrants, respectively. Comparing the individual HHe MR image sections with the Xe-133 ventilation scan, there was concordance between the ventilation defects in 27% (16/60) of quadrants. More defects were identified on the individual HHe MR images in 62% (37/60) of quadrants. CONCLUSION: There was good agreement between composite HHe MR image and first breath Xe-133 scintigraphic images, supporting the widely held assumption that HHe MRI likely depicts first breath lung ventilation.     

survivin、P53蛋白在非小细胞肺癌的表达及其相关性研究

目的 :研究survivin、P5 3蛋白在非小细胞肺癌 (NSCLC)组织的表达及其生物学意义 ,并探讨其相关性。　方法 :用免疫组化 (S P法 )染色技术对 95例NSCLC组织石蜡标本进行survivin、P5 3蛋白表达的检测和分析。　结果 :survivin、P5 3在肺癌细胞中阳性表达率 (6 2 .1 %、5 5 .8% )明显高于癌旁的正常肺组织 (1 4 %、7% ) (P <0 .0 1 )。survivin的表达与肿瘤病理分级、组织学分型、淋巴结转移、TNM分期无明显相关 (P >0 .0 5 ) ;P5 3表达与淋巴结转移相关 (P <0 .0 5 ) ,而与肿瘤病理分级、组织学分型、TNM分期无明显相关 (P >0 .0 5 ) ;此外 ,survivin与P5 3蛋白的表达呈显著正相关 (r =0 .5 72 ,P <0 .0 1 )。　结论 :凋亡抑制蛋白survivin与突变型P5 3蛋白在NSCLC的发生发展中可能起协同作用 ,也提示抑癌基因p5 3(野生型 )可能对survivin的表达起负反馈调节作用。survivin和P5 3蛋白可作为靶点用于NSCLC靶向治疗的研究     

双光气致急性损伤对兔肺泡Ⅱ型细胞形态学的影响

目的：通过对日本大耳兔双光气肺损伤后肺泡Ⅱ型细胞内磷脂和形态学变化的观察，探讨双光气对肺Ⅱ型细胞的损伤及其机制．方法：将纯种日本大耳白兔35只随机分为对照组(n＝10)、染毒即刻组(n＝5)、染毒2h组(n＝5)染毒4h组(n＝5)、染毒8h组(n＝5)、染毒12h组(n＝5)；采用浓度一时间法动态式染毒，染毒后按不同时间点对实验动物进行颈总动脉插管放血处死，取肺并用肺灌洗液对支气管肺泡进行灌洗，然后取肺组织作冰冻切片，进行电镜观察，并测定细胞内磷脂含量．结果：肺Ⅱ型细胞内磷脂含量在染毒即刻开始时较正常组含量下降(P＜0．01)；在染毒2h时降到最低，之后上升(P＜0．05)，而在4h后又下降(P＜0．05)．染毒终止后，损伤逐渐加重，染毒后2h磷脂因消耗而降低．染毒后4h，由于代偿功能启动，磷脂短暂升高，出现致伤性代偿期．从染毒2h后开始，细胞损伤加重，磷脂合成进入失代偿期，合成逐渐减少．到染毒后8h，肺泡Ⅱ型细胞内细胞处于致伤性和致死性细胞改变的临界点，细胞出现致死性改变，磷脂合成、分泌停止，细胞出现死亡．结论：兔在双光气染毒12h内，肺泡表面活性物质磷脂的改变有差异，随细胞损伤程度发生改变，出现明显中毒分期：即致伤性改变期、致伤性代偿期、致伤性失代偿期、致死性改变期．