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71.
不同输血方式对肺鳞癌患者围术期TNF—α和IL—lO的影响   总被引:2,自引:0,他引:2  
[目的]探讨同种输血和自体输血对肺鳞癌患者围术期肿瘤坏死因子-α(TNF-α)和白细胞介素—10(IL—10)的影响和相互关系。[方法]2001年1月至2003年1月对31例肺鳞癌患者行肺癌根治术,将其分为两组,同种输血组(A组)17例,自体输血组14例(B组)。测定两组围术期血清中TNF-α和IL—10的浓度。[结果]A组输血后d1与输血前相比血清中TNF-α、IL-10浓度增高,以IL—10变化尤为明显,输血后d5TNF-α降低并接近输血前的水平,明显低于B组,IL—10仍明显高于输血前的水平。B组中不同时问IL—10无显著变化,TNF-α于ds明显高于输血前。[结论]肺鳞癌患者围术期同种输血后血清中TNF-α降低与IL—10升高有关,IL—10升高可能是同种输血后免疫抑制的重要原因。自体输血可减轻或去除这一作用。  相似文献   
72.
Objective: Induction chemoradiotherapy followed by anatomical resection is a current therapeutic strategy for non-small-cell lung cancer with mediastinal node involvement. Dense peritracheal fibrosis and sclerosis after chemoradiotherapy cause difficult mediastinal node dissection. We evaluated a novel technique to make the mediastinal node dissection easier after induction therapy. Methods: At the end of mediastinoscopic node biopsy for staging of lung cancer, cotton-type collagen was inserted anterior and lateral to the trachea in patients with pathologically confirmed mediastinal node involve-ment (n=45). The induction therapy consisted of concurrent use of platinum-based chemotherapy and hyperfractionated radiotherapy. After the chemoradiotherapy all patients underwent a pulmonary resection with complete mediastinal node dissection 7–12 weeks after the collagen insertion. Surgical findings of the mediastinum and the time for node dissection were compared with those without collagen insertion at mediastinoscopy after chemoradiotherapy (n=5). Results: All five patients without collagen insertion showed sclerotic and fibrotic change of mediastinal nodes with severe adhesion to the trachea. In 42 of 45 patients with collagen insertion (93.3%) the collagen remained unabsorbed and separated the mediastinal nodes from the trachea. Mediastinal node dissection was easily accomplished by removing mediastinal tissues lateral and anterior to the collagen. The rate of mediastinal node separation was significantly higher with collagen insertion than without (p< 0.0001). The times for node dissection in patients with and without collagen insertion showed no significant difference. Conclusion: Cotton-type collagen insertion at staging mediastinoscopy for lung cancer separates the mediastinal nodes from the trachea and makes the node dissection easier after induction chemoradiotherapy.  相似文献   
73.
74.
目的探讨B超引导下经皮肺穿刺针吸活检对周围型肺肿块的诊断价值。方法对31例患者施行B超引导肺穿刺针吸活检56次,进行细胞学和细菌学检查。结果穿刺取材成功率为93.6%,所获细胞学资料与手术病理诊断或临床治疗随访对照,定性诊断符合率为89.7%。结论该诊断方法简便实用,并发症轻微,适于临床推广应用。  相似文献   
75.
BACKGROUND: Levels of an immunoregulatory and anti-inflammatory cytokine IL-10 are reduced in asthmatic airways, potentially contributing to more intense inflammation. Triamcinolone has anti-inflammatory properties and the anti-inflammatory effects of montelukast and formoterol have been discussed. OBJECTIVE: The purpose of this study was to define the effect of treatment with triamcinolone, montelukast and formoterol on the serum level of IL-10, eosinophil blood counts, eosinophil cationic response (ECP) and clinical parameters (symptom score, FEV1 and PC20H) in children with moderate asthma. METHODS: An 8-week, placebo-controlled and randomized, double-blind trial was carried out. The subjects were 91 children with moderate atopic asthma who were allergic to dust mite. Patients were randomly allocated to receive 400 microg triamcinolone (n = 19), 5 or 10 mg (according to age) montelukast (n = 18), 24 microg formoterol (n = 18) or placebo (n = 36). RESULTS: Seventy-nine children completed the study. After treatment with triamcinolone and montelukast the level of IL-10 in blood serum significantly increased, eosinophil blood counts and ECP levels significantly decreased and all clinical parameters improved; treatment with formoterol had no effect on IL-10 level, eosinophil blood counts in serum and bronchial hyper-reactivity; ECP level significantly decreased after treatment and asthma symptoms and FEV1 improved significantly. Mean IL-10 levels in serum before and after treatment with triamcinolone were 7.23 pg/mL with 95% CI, 6.74 -7.72% and 14.24 pg/mL with 95% CI, 11.6-16.88%, respectively (P < 0.001); with montelukast they were 6.59 pg/mL with 95% CI, 6.26-7.23% and 10.94 pg/mL with 95% CI, 8.24-12.65%, respectively (P < 0.002); with formoterol they were 7.06 pg/mL with 95% CI, 6.61-7.52% and 7.04 pg/mL with 95% CI, 6.15-7.93%. We found statistically significant correlations between serum level of IL-10 and serum level of ECP after treatment with triamcinolone and montelukast. CONCLUSION: This study demonstrates that one possible way by which triamcinolone and montelukast contribute to inhibition of inflammation is by increasing IL-10 levels.  相似文献   
76.
38例非小细胞癌脑转移的综合治疗分析   总被引:1,自引:1,他引:0  
目的探讨非小细胞肺癌脑转移的有效治疗方案.方法对38例非小细胞肺癌脑转移患者进行头部、胸部放疗并结合全身化疗的综合治疗.结果近期疗效的有效率为76.3%(29/38).神经精神症状缓解率73.7%(28/38),肺部症状缓解率60.5%(23/38).1年生存率31.5%(12/38),2 a生存率10.5%(4/38).结论合理采用综合治疗可有效提高非小细胞肺癌脑转移患者的生存率.  相似文献   
77.
BACKGROUND: The role of atopy in the evolution to chronic obstructive disease remains controversial. AIM: We aimed to assess the association between individual sensitization to common allergens and lung function. METHOD: We analysed data from 12,687 subjects aged 20 to 44 years, from 34 centres in 15 countries participating in the European Community Respiratory Health Survey (ECRHS). Participants performed a blood test, lung function test, methacholine challenge, and answered an administered questionnaire. The relationships between specific IgE, FEV1 and FEV1/FVC ratio were assessed for each study centre stratified by sex, followed by random effects meta-analysis. RESULTS: Asthmatics sensitized to house dust mite had a lower FEV1 (-119 mL in women and -112 mL in men) and FEV1/FVC ratio (-1.95%, and -2.48%) than asthmatics without sensitization. Asthmatics sensitized to cat had a lower FEV1 (statistically significant for women only) and a lower FEV1/FVC ratio. Asthmatic women sensitized to grass had a lower FEV1 and a lower ratio, and those sensitized to Cladosporium had a lower FEV1. A weak association was found with sensitization to cat and to Cladosporium among non-asthmatic women, which disappeared after adjusting for BHR. CONCLUSION: We conclude that atopy was related to a lower lung function, which was only apparent among asthmatics. This relationship was explained by specific sensitization to cat and to house dust mite, the latter being homogeneous across areas.  相似文献   
78.
项红军  赵佐庆  李纪鹏  张志培 《医学争鸣》2002,23(21):1974-1977
目的:研究大鼠小肠缺血再灌注后后血中一氧化氮(NO),超氧化物歧化酶(SOD)的浓度变化以及肺组织中Bax,Bcl-2的表达,探讨小肠缺血再灌注后对肺组织的损伤,方法:建立小肠缺血再灌注模型,分对照 ,再灌注后0,30min,1,2h,1,3,7d共8组,于各时点检测血中Bax,Bcl-2的表达情况。结果:大鼠小肠缺血再灌注后NO浓度0min明显升高,2h时降低,随后升高,7d时达高峰,SOD浓度0min明显下降,2h 时升高,随后下降,7d时达最低,Bax,Bcl-2免疫阳性细胞主要位于肺组织中血管内皮细胞和肺泡上皮细胞,再灌注0min,Bax,Bcl-2阳性细胞率增多,30min时Bax,Bcl-2阳性细胞率均升高分别为17.1%和78.1%,Bcl-2表达高于Bax,两者差别显著(P<0.01),2h时降低,其后升高,7d时阳性细胞率达高峰分别为94.1%和83.4%,Bax表达明显高于Bcl-2,两者差异显著(P<0.01)。结论:大鼠小肠缺血再灌注后可引起血中NO,SOD的浓度变化和Bax及Bcl-2阳性细胞在肺组织中的表达改变并可能引起肺组织细胞凋亡和损伤。  相似文献   
79.
江涛  赵玲 《蚌埠医学院学报》2002,27(6):540-541,F004
目的:提高对肺癌脑转移CT诊断的认识.方法:回顾性分析48例经手术及病理证实的肺癌脑转移的CT表现及特征.结果:腺癌21例,鳞癌11例,小细胞癌15例,细支气管肺泡癌1例.多发灶41例,单发灶7例.CT发现脑部转移灶126个;囊性病灶99个,实性病灶16个,囊实性病灶11个.幕上病灶112个,幕下病灶14个.结论:CT对肺癌脑转移有重要的诊断价值.  相似文献   
80.
434例肺癌淋巴结转移及其廓清的临床研究   总被引:1,自引:0,他引:1  
目的:研究肺癌淋巴结转移的方式与规律,以探讨肺癌淋巴结合理的手术廓清范围。方法:对434例肺癌患者施行手术并予淋巴结廓清,回顾性分析病理证实的转移淋巴结的分布情况。结果:手术共清除2198组淋巴结,病理证实有癌细胞转移的749组。淋巴结转移率T1期为16.5%,T2期33.5%,T3期35.6%,T4期52.3%,T1期和T4期的组间有显著性差异(P<0.01)。上叶肺癌上纵膈与下纵膈淋巴结转移有显著差异。左上叶肺癌第5组淋巴结有30.6%转移,左下叶和右中、下叶肺癌第7组淋巴结有26.5%转移。结论:除T1期肺癌淋巴结转移仅限于区域性上纵膈或下纵膈外,总体上,上叶肺癌以上纵膈淋巴结转移居多,而中、下叶肺癌则上、下纵膈均可发生淋巴结转移。左上叶肺癌第5组淋巴结转移和中、下叶肺癌第7组淋巴结转移是上、下纵膈之间淋巴结扩大转移的信号。原发肺癌除T1期可仅行区域性上纵膈或下纵膈淋巴结清扫外,均应行系统性肺门和上下纵膈淋巴结廓清。  相似文献   
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