Effect of ipratropium bromide on airway and pulmonary muscarinic receptors in a rat model of chronic obstructive pulmonary disease

Objective　To observe the level of muscarinic receptors in airway and lung tissues, and the effect of inhaled ipratropium bromide on these receptors in a rat model of chronic obstructive pulmonary disease (COPD). Methods　This model was developed by exposure of rats to 250 ppm SO2 gas, 5?h/d, 5d/wk, for a period of 7 wk. The COPD rats inhaled 0.025% aerosolized iratropium bromide for 20 min, 2 times daily, in an airtight chamber. Muscarinic receptors in airway and lung tissues of normal rats, ipratropium bromide-treated COPD rats and the recovering COPD rats were measured by the radio-ligand binding assay. Results　Airway/lung pathology and pulmonary function tests showed that chronic SO2 exposure caused pathophysiologic changes similar to those observed in human COPD. The density (0.038±0.011, pmol/mg protein) and affinity (Kd, 23±11 pmol/L) of muscarinic receptors in airway and lung tissues of COPD rats were not changed compared with those of normal control rats (0.030±0.008 and 29±19, respectively, P>0.05). Densities of the muscarinic receptors were not changed after inhalation of ipratropium bromide for 5 days, but increased significantly after inhalation for 30 days, as compared with those of the untreated COPD rats. The muscarinic receptors returned the normal levels at day 6 after cessation of ipratropium bromide treatment. There were no differences among different groups of rats in equilibrium dissociation constants (Kd). Conclusion　A rat model of COPD with pathophysiologic changes similar to the human counterpart was developed using chronic SO2 exposure. There was no significant change in the number and function of muscarinic receptors in airway and lung tissues of the COPD rats, but upregulation of the muscarinic receptors was observed after long-term inhalation of ipratropium bromide.     

99mTc-DTPA气溶胶显像测定呼吸道粘液纤毛清除功能

为进一步研究呼吸道疾病时的粘液纤毛清除功能,采用99mTc-DTPA气溶胶吸入显像,通过电影显示定性和定量指标分析.对18 例健康受试者和患者进行了显像研究,得到气道清除率和粘液纤毛清除率的正常值,并观察了32例慢性阻塞性肺病(COPD)患者气管-支气管纤毛清除功能的改变.结果显示,健康受试者与COPD患者粘液纤毛清除率(mm/min)分别为3.89±0.92和1.32±0.59,两者比较有显著性差异(P＜0.01),COPD患者不同时间气道清除率和粘液纤毛清除率均明显低于健康受试者(P＜0.01).本研究方法简便客观,具有定性观察和定量分析的优点,对于呼吸系统其它疾病(如支气管扩张、原发性纤毛无运动)的研究及药物疗效的评价具有重要的临床实用价值.     

胆汁泡蛋白ELISA检测法的建立与初步临床应用

目的 建立胆汁泡蛋白快速检测法,筛选有效的胆石症防治手段。方法 获取３３．５ｋｄ胆汁泡蛋白,通过微量抗原免疫法获得高效价抗体,建立ＥＬＩＳＡ标准曲线;并应用ＥＬＩＳＡ法测定正常人、胆石症患者胆汁和血清中泡蛋白含量,同时观察不同溶石防药和利胆冲剂、胆酸钠等对泡蛋白的影响。结果 建立了ＥＬＩＳＡ标准曲线,其曲线方程为Ｙ＝０．０３５Ｘ（ｒ＝０．９９）;正常人胆汁和血清中３３．５ｋｄ泡蛋白含量都明显较胆固     

慢性阻塞性肺病胸腔镜肺减容手术的治疗观察

目的 评价胸腔镜肺减容手术对重度慢性肺病的治疗疗效和病情改善情况。方法 对我院１０例重度慢性阻塞性肺病患者行肺减容手术后随访１年半观察,同时与１０例未做手术的重度ＣＯＰＤ患者比较,比较其在入院次数,肺功能改善情况（自行上楼比较）、吸氧时间、生活自理能力等方面的差异。结果 手术组病人因慢性支气管炎急性发作、肺部感染再次入院次数明显减少,自行上楼气急明显比手术前减轻,吸氧时间明显减少,、生活自理能力增     

Primary colorectal non-Hodgkin's lymphoma

Background: The gastrointestinal tract is the most common site of extranodal involvement in non-Hodgkin's lymphoma (NHL). Primary colorectal NHL comprises 13–18% of all gastrointestinal NHL but is not commonly reported as a separate entity. Methods: This was a retrospective review of the medical records of 19 patients over a 16-year period to evaluate the clinical features and behavior of colorectal NHL. Results: A pediatric group of seven male patients presented at an early stage with acute symptomatology. The primary tumor was located in the ileocecum in all cases and intussusception was common. An adult group of 12 patients presented at a later stage with chronic symptomatology. Staging study results were positive by bone marrow biopsy in four of 16 patients (25%), by lymphangiography in six of 11 patients (54.5%), and by gallium scan in eight of 10 patients (80%). Seven patients relapsed a median of 8 months after treatment. Three other patients died during treatment, one died of other causes, and one died without receiving treatment. The remaining seven patients are alive from 41 to 231 months without evidence of disease. Five of these patients are in the pediatric group, where the median survival was >72 months. The overall median survival was 45 months. Conclusion: Colorectal NHL is a disease that affects both the pediatric and adult population. Although pediatric patients have an excellent prognosis with anticipated long-term survival after treatment, long-term survival can be expected in 50% of adult patients. In both groups of patients, multimodality therapy with surgery, chemotherapy, and radiation is the treatment of choice.Presented at the 46th Annual Cancer Symposium of The Society of Surgical Oncology, Los Angeles, California, March 18–21, 1993.     

Fertilization and pregnancies following intracytoplasmic injection of testicular spermatozoa

Purpose Intracytoplasmic injection (ICSI) with testicular sperm was performed in 16 couples. All men had ductal obstruction and failed previous attempts of epididymal sperm microaspiration.Methods Testis tissue was obtained by excisional biopsies and incubated in HEPES buffered EBSS medium over 24 h at 37C. Motile sperm (Grade 1 to 2) were recovered in 13 patients and fertilized a total of 62 oozytes. Four pregnancies were achieved.Results One healthy boy and two girls (twin pregnancy) were born.Conclusions The ongoing pregnancies revealed no fetal abnormalities on ultrasound scanning.Presented at the IXth World Congress on In Vitro Fertilization and Alternate Assisted Reproduction, April 3–7, 1995, Vienna, Austria.     

The anterolateral funiculus in the spinal cord in amyotrophic lateral sclerosis

We carried out a morphometric study on the myelinated fibers in the anterolateral funiculus (ALF) and lateral corticospinal tract (LCS) in the cervical segment of the spinal cord of 13 patients with classic amyotrophic lateral sclerosis (ALS), 6 of whom had been on a respirator: 5 age-matched subjects were used as controls. The results obtained revealed that: (1) the fiber-size distributions of the myelinated fibers in the ALF and LCS of the control subjects had peaks at 2 m; (2) there were marked and significant losses of large myelinated fibers in the ALF and LCS of ALS patients; (3) the patients who required respirator support showed more severe degeneration in the ALF than those who required none; and (4) the degree of myelinated fiber loss in the LCS did not correlate with either the illness duration or the history of respirator use.     

Analysis of T-cell receptor expressing lymphocytes infiltrating squamous cell carcinomas of the upper aerodigestive tract

T-lymphocytes expressing T -cell receptors (TCRs) of the / type have been suggested to play an important role in mucosal defense against infection and neoplastic transformation. In this study, an immunohistochemical investigation was performed on the distribution of / and / TCRs among tumor-infiltrating lymphocytes. Thirteen patients with squamous cell carcinomas of the upper aerodigestive tract were studied, using monoclonal antibodies and an avidin-biotin-peroxidase technique. Most of the T-cells had an / TCR. Only 1.6% of the T-cells within the cancer tissue and 1.2% of the T-cells in the parenchyma adjacent to the cancer tissue expressed /gd TCRs. These results are consistent with the results of similar studies in bronchial and breast carcinomas. Biopsies from normal oral mucosa in nine healthy individuals showed that 1.3% of the T -cells within the epithelium and 1.0% of those in the lamina propria adjacent to the epithelium expressed / TCRs. Quantitatively the results do not support the theory that / T-cells play an important role in the immunological response against cancer tissue in the mucosa of the upper aerodigestive tract. The functional role of these cells in the mucosa and in response to carcinomas is, however, still uncertain.     

Bile-duct diameter at the porta hepatis and liver biopsies in Indian children with biliary atresia

Fibrous remnants from the porta hepatis and wedge biopsies of the liver were studied in 60 patients with biliary atresia. The patients were divided into three groups on the basis of bile duct diameter — I: no ducts; II: <50 m; III: >50 m. The liver damage was classified into three grades on the basis of ductular and parenchymal histopathologic changes and extent of inflammatory pathology. There was no correlation between severity of hepatic damage and duct diameter, although the levels of serum bilirubin and alkaline phosphatase varied in direct proportion to the degree of hepatic damage. There was an inverse relationship between age and duct diameter, but neither correlated with bile flow at surgery or in the postoperative period. The data suggest that Indian children with biliary atresia follow a different clinical course compared to those from Japan and Western countries. Correspondence to: V. Bhatnagar     

睡眠呼吸暂停综合征患者夜间睡眠呼吸参数的变化及护理对策(英文)

目的：探讨睡眠呼吸暂停综合征（ＳＡＳ）患者夜间睡眠呼吸参数的变化及相应护理对策。方法：对１６例ＳＡＳ住院患者在治疗前、睡眠姿势训练、气道持续正压（ＣＰＡＰ）呼吸机治疗三种状态下,进行整夜多导睡眠仪监测。结果：在ＳＡＳ整夜呼吸紊乱中,零点以后其危险因素大大增加,出现严重低氧血症,血压升高,心律失常,尤其是呼吸暂停时间延长,次数增加。而侧卧位可显著地改善低氧血症,最低血氧饱和度（ＳａＯ２）从（６２±１９）％升高至（８３±１１）％（Ｐ＜０．０１）,ＣＰＡＰ呼吸机治疗能使呼吸调节障碍得到明显的恢复,呼吸暂停由（４４．３±２２．６）次降至（０．２５±０．５４）次（Ｐ＜０．０１）。结论：护理上应密切观察病情变化,特别是零点以后应加强巡视,除观察呼吸运动外还应警惕脑血管病及心脏疾病的发生,对不具备ＣＰＡＰ呼吸机治疗条件者宜采取睡眠时督促取侧卧位。对ＳＡＳ患者进行健康教育也是减少危险因素的重要护理措施。