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国际呼吸杂志

国际呼吸杂志

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International Journal of Respiration
1981年创刊，中华医学会、河北医科大学主办。本刊原名国外医学呼吸系统分册，系医学科技期刊，中华医学会系列刊物之一。办刊宗旨：贯彻、执行国家的政策法规和规范标准，坚持理论与实践、普及与提高相结合的原则，促进国内、外学术交流。报道内容：介绍国内、外呼吸疾病的新动态、新成果、新技术和新经验。主要栏目：诊治指南、专家述评、专家共识、专家笔谈、论著、综述、继续教育、呼吸介入、研究报道、专题讲座、临床经验、病例分析、病例报告、病例讨论、呼吸读片等。读者对象：呼吸科、急诊科、ICU、小儿科、老年科、胸外科、微创治疗中心、睡眠中心、变态反应科的医师和护士，以及从事呼吸领域基础研究和临床研究的科技工作者。
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  • 发文量：7663
  • 被引量：2574
  • H指数：1
  • 开始收录时间：1984(1)
  • CNKI综合因子：0.75
  • 维普期刊影响因子： 1.52
  • 万方期刊影响因子：1.05
  • 创刊时间：1981
  • 国内刊号/CN：13-1368/R
    国际刊号/ISSN：1673-436X
  • 发行周期：半月刊
    邮发代号：18-12
  • 主管单位：中华人民共和国卫生部
    主办单位：中华医学会 河北医科大学
国际呼吸杂志-联系信息
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  • 电话：0311-86266873
  • 邮箱：guojihuxi@vip.163.com
  • 地址：河北省石家庄市中山东路361号
  • 邮编：050017
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国际呼吸杂志 >2022年第3期

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  • 摘要：目的 探讨组蛋白脱乙酰基转移酶抑制剂丙戊酸钠在博莱霉素诱导肺纤维化大鼠的肿瘤坏死因子α(tumor necrosis factor-alpha,TNF-α)表达的调节.方法 36只雄性SD大鼠随机分为控制对照组、肺纤维化组、肺纤维化+丙戊酸钠干预组.肺纤维化模型组、丙戊酸钠干预组给予博莱霉素溶液按5mg/kg气管内注入建立大鼠肺纤维化模型,对照组给予等体积生理盐水注射.各组随机于造模后第7天处死,观察支气管肺泡灌洗液(BALF)中白细胞数及LDH的变化,肺组织大体及HE变化和Masson染色,Szapiel评分,大鼠肺组织羟脯氨酸(HYP)检测及TNF-α免疫组织化学检测.结果 与对照组相比,模型组BALF中LDH、BALF白细胞数的变化(P＜0.01),肺组织TNF-α及HYP含量显著增高(P＜0.05),丙戊酸钠干预后增高的Szapiel评分,TNF-α及HYP受到明显抑制.结论 给予VPA干预后能显著降低TNF-α水平,减小早期肺部炎症,从而达到抑制肺纤维化的发生.%Objective To explore the effects of valproate,a histone deacetylase inhibitor (HDACI)of,on the expression of TNF-α in mice with bleomycin-induced pulmonary fibrosis.Methods SD mice were randomly divided into three groups,ie.a control group (CG),a bleomycin-induced pulmonary fibrosis model group (MG) and a sodium valproate-treated group (VG).The mice in CG received a single intratracheal dose of 2 ml/kg of sterile physiological saline at day 0.MG and VG were induced by a single intratraeheal dose injection of bleomycin-A5 (5 mg/kg).The mice in MG were intraperitoneally injected with sterile physiological saline (0.5 ml/d) and the rats in VG were intraperitoneally treated with sodium valproate.After treament 12 rats in each group were randomly killed on day 7,respectively.Lung tissues were taken and processed for determination hydroxyl proline contents,the expression of TNF-α and Szapiel scores.Bronehoalveolar lavage fluid (BALF) was collected for measurements of total and differential cell counts and lactic dehydrogenase (LDH) levels.Results It was found that the number of macrophage,and the LDH contentsfrom the mice treated with bleomycin alone sacrificed on the day 7 were increased compared with the mice in CG ( P ＜0.01 ).the hydroxyl proline contents,the expression of TNF-α were greatly increased ( P ＜0.05).However,Szapiel scores,LDH contents,hydroxyl proline contents,the expression of TNF-α were greatly reduced in the mice treated with bleomycin followed by valproate.Conclusions This study indicates that administration of valproate to the mice suffered from pulmonary fibrosis induced by bleomycin attenuates the fibrosis greatly reducing the expression of TNF-α,via inhibiting early inflammation and inhibiting pulmonary fibrosis.
  • 摘要：6 minute walking test (6MWT) evaluates the global and integrated responses of all the systems involved during exercise.The self-paced 6MWT assesses the submaximal level of functional capacity.The six minute walking distance may better reflect the functional exercise level for daily physical activities.%六分钟步行试验(6MWT)评价了运动过程中所有系统全面完整的反应,自定速度的6MWT评价次级量功能代偿能力水平.六分钟步行距离能最好反映能完成日常体力活动的功能代偿能 力水平.
  • 摘要：目的 观察长期无创正压通气(NIPPV)对稳定期严重慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者临床疗效及血清基质金属蛋白酶9(MMP-9)的影响.方法 选择80例处于稳定期的严重COPD合并呼吸衰竭患者,按其能否耐受并接受长期NIPPV治疗分为实验组和对照组,两组患者均给予吸氧、口服茶碱缓释片、吸入噻托溴铵等治疗,实验组在此基础上加用双水平NIPPV治疗1年.观察两组患者治疗前后圣乔治呼吸问卷评分(SGRQ评分)、呼吸困难评分(MMRC评分)、六分钟行走距离(6-MWD)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、第1秒用力呼气容积占预计值百分比(FEV1％ pred)及血清MMP-9等变化,并记录两组患者上1年及治疗后1年内急性发作及住院情况.结果 治疗前后实验组SGRQ评分、MMRC评分、6-MWD、PaO2、PaCO2、FEV1％ pred、血清MMP-9分别是(63.60±3.92)分比(51.93±3.77)分、(3.65±0.48)分比(2.43±0.50)分、(158.85±6.39)m比(248.00±9.32)m、(56.98±1.63)mm Hg比(66.58±2.23)mm Hg、(60.58±2.89) mm Hg比(51.55±2.28) mm Hg、(38.68±3.17)比(42.05±3.11)、(182.85±6.62)μg/L比(170.93±6.51)μg/L,治疗前后对照组SGRQ评分、MMRC评分、6-MWD、PaO2、PaCO2、FEV1％ pred、血清MMP-9分别是(64.40±4.33)分比(53.75±3.73)分、(3.73±0.45)分比(2.83±0.39)分、(156.50±5.88)m比(211.43±7.53)m、(56.80±1.57)mm Hg比(62.58±1.91) mm Hg、(59.90±3.49) mm Hg比(55.98±3.36)mm Hg、(38.85±2.77)比(40.80±3.16)、(180.60±5.23) μg/L比(172.83±5.22)μg/L,实验组改善优于对照组(P＜0.05或P＜0.01)；急性发作次数、住院天数等明显减少,实验组优于对照组.结论 严重COPD合并呼吸衰竭患者稳定期长期NIPPV可明显提高患者生活质量,降低血清MMP-9水平.%Objective To investigate the clinical efficacy of the treatment with long-term NIPPV in patients with stable severe COPD complicated with respiratory failure,and the impacting on serum levels of MMP-9.Methods We selected prospectively 80 outpatients of stable severe COPD complicated with respiratory failure which were divided into two groups (experimental and control group,each group 40)according to their ability to tolerate and accept the long-term NIPPV treatment,two groups of patients were given oxygen therapy,slow-release oral theophylline,and inhalation of tiotropium for one year,and added to 1 year NIPPV therapy in experimental group.The outcomes measured included the followings:SGRQ score,MMRC score,6-MWD,PaO2,PaCO2,FEV1 ％pred,the serum levels of MMP-9 and the rate of acute exacerbations of COPD and hospital days in last 1 year and following 12 months.Results After 1year,the differences of SGRQ score,MMRC score,6-MWD,PaO2,PaCO2,FEV1％ pred,MMP-9 in the experimental group [(63.60 ± 3.92) scores vs (51.93 ± 3.77) scores,(3.65 ± 0.48) scores vs (2.43±0.50) scores,(158.85±6.39) mvs (248.00±9.32) m,(56.98±1.63) mm Hg vs (66.58±2.23) mm Hg,(60.58±2.89) mm Hg vs (51.55±2.28) mm Hg,(38.68±3.17) vs (42.05±3.11),(182.85±6.62) μg/L vs (170.93 ± 6.51) μg/L] were statistically significant compared to the control group [(64.40±4.33) scores vs (53.75±3.73) scores,(3.73± 0.45) scores vs (2.83±0.39) scores,(156.50±5.88) m vs (211.43±7.53) m,(56.80±1.57) mm Hg vs (62.58±1.91) mm Hg,(59.90±3.49) mm Hg vs (55.98±3.36) mm Hg,(38.85±2.77) vs (40.80±3.16),(180.60±5.23) μg/L vs(172.83±5.22) μg/L](all P ＜0.05 or P ＜0.01),the rate of acute exacerbations COPD and hospital days were decreased,and the experimental group excelled.Conclusions Our study indicates that longterm NIPPV could significantly improve the living conditions of the patients with severe stable COPD complicated with respiratory failure,lower the serum levels of MMP-9.
  • 摘要：Objective To investigate the correlation between the systemic inflammation and arterial elasticity with chronic obstructive pulmonary disease (COPD).Methods A case-control study,subjects were divided into two groups:case group:102 patients with stable COPD patients,control group:83 cases of healthy persons over the same period.Two groups of subjects using the same method applied automatic pulse wave velocity determined by measuring carotid-femoral pulse wave velocity (C-FPWV) and cervicaldorsal arterial pulse wave velocity (C-DPWV) as the main artery elastic parameters.Serum tumor necrosis faetor-α (TNF-α) measured by immunoturbidimetry and serum interleukin-1(IL-1),IL-6,TNF-α measured by radioimmunoassay.Determination of these inflammatory mediators as parameters of systemic inflammation,compared with normal control group.Results ① Case group C-FPWV,C-DPWV,IL-1,IL-6,TNF- α,hs-CRP higher than the control group,the difference was statistically significant P ＜0.05.②Case group C-FPWV with age,smoking index,systolic blood pressure,IL-1,IL-6,TNF-α,hs-CRP was positively correlated with P ＜0.05.C-DPWV with age,smoking index,IL-1,IL-6,TNF-α,hs-CRP was positively correlated with P ＜0.05.③IL-6,smoking index (years of support),TNF-α is an independent factors of C-FPWV and IL-6 is an independent factors of C-DPWV.Conclusions Systemic inflammation associated with arterial elasticity in patients with COPD.Systemic inflammation may be involved in the pathogenesis of decreased arterial elasticity in COPD patients.Systemic inflammation is a risk factor for cardiovascular disease in patients with COPD.%目的 探讨慢性阻塞性肺疾病( COPD)患者系统性炎症与大动脉弹性之间的关系.方法 采用病例对照研究的方法,研究对象分为两组:病例组:102例COPD稳定期患者；对照组:83例同期健康体检者.两组研究对象用同样的方法应用脉搏波速度自动测定仪测定颈-股动脉搏波传导速度(C-FPWV)和颈-足背动脉搏波传导速度(C-DPWV)作为大动脉弹性的参数,应用免疫比浊法测定血清超敏C反应蛋白(hs-CRP)浓度,放射免疫分析法测定血清白介素1(IL-1)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)浓度,这些炎性因子的测定作为系统性炎症的参数,与正常对照组作比较.结果 ①病例组C-FPWV、C-DPWV、IL-1、IL-6、TNF-α、hs-CRP均高于正常对照组,差异有统计学意义,P＜0.05.②病例组C-FPWV与年龄、吸烟指数、收缩压、IL-1、IL-6、TNF-α、hs-CRP呈正相关,P＜0.05.C-DPWV与年龄、吸烟指数、IL-1、IL-6、TNF-α、hs-CRP呈正相关,P＜0.05.③IL-6、吸烟指数、TNF-α是影响C-FPWV的独立因素；IL-6是影响GDPWV的独立因素.结论 系统性炎症与COPD患者大动脉弹性间存在相关性.系统性炎症可能参与了COPD患者大动脉弹性下降的发病过程,它是COPD患者发生心血管疾病的高危因素.
  • 摘要：支气管哮喘(简称哮喘)是一种慢性呼吸道炎症性疾病,这种疾病在免疫病理学、临床表型、对治疗的反应、自然史方面存在异型却是越来越明显.曾经被视为纯粹的辅助性T细胞(Th)2型淋巴细胞、免疫球蛋白E、肥大细胞、嗜酸粒细胞、巨噬细胞和细胞因子主导的过敏性疾病,疾病还涉及局部上皮细胞、间质、血管、神经系统指挥的Th2细胞表型,以及通过异常损伤修复机制的气道壁重塑.近年发现IL-17在哮喘免疫过程起着重要作用,本文就哮喘气道炎症与IL-17研究进展综述如下.%Bronchial asthma (asthma) is a chronic airway inflammation disorder.It is becoming increasingly apparent that the disease is heterogeneous with respect to immunopathology,clinical phenotypes,response to therapies,and natural history.Once considered purely an allergic disorder dominated by Th2-type lymphoeytes,IgE,mast cells,eosinophils,macrophages,and cytokines,the disease also involves local epithelial,mesenchymal,vascular and neurologic events that are involved in directing the Th2 phenotype to the lung and through aberrant injury-repair mechanisms to remodeling of the airway wall.IL-17 is implicated in numerous immune and inflammatory responses primarily as a proinflammatory regulator by inducing the expression of various inflammatory mediators,such as cytokines,chemokines,adhesion molecules,and growth factors.IL-17 has been suggested as a crucial regulator of allergic asthma.In this review,we focus primarily on the regulatory pathways and roles of IL-17 in airway inflammation and scrutinize the therapeutic potential of various strategies targeting IL-17 for asthma.
  • 摘要：目的 调查因心脑血管病和糖尿病住院患者吸烟状况及其戒烟意愿,探讨医师戒烟干预措施及其效果.方法 对2011年2月至6月在北京同仁医院心内科、神经内科和内分泌科住院的1 237例患者进行吸烟和戒烟状况问卷调查,其中心血管病患者592例,脑血管患者291例,糖尿病患者354例.针对现吸烟患者(n =345)进行戒烟干预,并按随机原则分为常规干预组(n=172)和强化干预组(n=173).通过电话随访出院后6个月时的吸烟和戒烟状况.结果 心脑血管病和糖尿病住院患者总吸烟率为47.0％(582/1 237),现吸烟率为27.9％(345/1 237).经过住院期间对现吸烟患者进行戒烟干预,患者戒烟意愿向戒烟行动期转变.在6个月随访中,303例接受电话随访患者总戒烟率为30.0％,强化干预组戒烟率(45.8％)高于常规干预组(21.3％),P＜0.05.结论 心脑血管病和糖尿病住院患者吸烟率高,对烟草危害认知度较低.对住院患者采用强化干预措施有助于提高戒烟率.%Objective To investigate the smoking status and the willingness to quit in hospitalized patients with cardiovascular,cerebrovascular or diabetic diseases,and to evaluate the effectiveness of a smoking cessation intervention protocol Methods From February 2011 to June 2011,1 237 patients with cardiovascular (n =592),cerebrovascular (n =291) or diabetic (n =354) diseases admitted to the wards of Departments of Cardiology,Neurology or Endocrinology,Beijing Tongren Hospital,were interviewed on the smoking status and their willingness to quit by questionnaires.Smoking cessation intervention was carried out for the 345 patients who were current smokers.They were randomized to a routine intervention group ( n =172) or an intensified intervention group ( n =173).A phone call followup was performed 6 months after discharge.Results Overall 47.0％ (582/1 237) of the patients reported smoking,and of whom 345 (27.9％,345/1 237) were current smokers. After smoking cessation interventions,most of the patients changed from the contemplation stage to the action stage.The overall point cessation rate was 30.0％ in the 303 patients who received follow up contact at 6 months after discharge,the rate was higher in the intensive intervention group (45.8％) than in the routine intervention group (21.3％,P ＜0.05).Conclusions The prevalence of smoking was high in hospitalized patients with cardiocerebrovascular or diabetic diseases,but the patients' knowledge on the hazard of smoking was inadequate.An intensive intervention program was effective and feasible in hospitalized patients.
  • 摘要：目的 了解华北电网有限公司北京电力医院(简称本院)呼吸监护室呼吸机相关性肺炎(VAP)病原菌的变迁特点及影响因素.方法 回顾性分析了2005年至2011年9月在本院呼吸监护室进行有创机械通气并发生VAP的患者共79例.使用SPSS软件17.0分析数据,描述病原菌变化特点,应用x2检验比较各年份之间、各年龄组之间以及基础病不同的患者之间VAP病原菌变化是否有意义,应用秩相关分析说明病原菌变化与年龄的相关关系.结果 7年间检出病原菌前5位的分别是；铜绿假单胞菌(23.2％)、鲍曼不动杆菌(15.9％)、耐甲氧西林金黄色葡萄球菌(13.2％)、大肠埃希杆菌(11.3％)、嗜麦芽窄食单胞菌(8.6％)；各年份之间、年龄组之间以及不同用药组之间病原菌分布有统计学差异.结论 7年来本院呼吸监护室VAP患者鲍曼不动杆菌以及耐甲氧西林金黄色葡萄球菌感染率明显增加,病原菌的分布可能与患者住院时间、年龄、抗生素的使用有关.%Objective To investigate the changing characteristics and associated factors of pathogens which caused ventilator-associated pneumonia (VAP) in the respiratory care unit.Methods A retrospective analyses was used to investigate 79 cases of VAP in the respiratory care unit from 2005 to September 2011.The data were analyzed using SPSS 17.0 software,and x2 -test was used for the analysis of variance comparison of the distribution and changing of VAP pathogens among different years,different age groups and patients with different underlying diseases.Rank correlation analysis was used to describe the correlation between pathogen change and age.Results Among the seven years,the top five for the detection of pathogens were Pseudomonas aeruginosa (23.2％),Acinetobacter baumannii (15.9％),methicillin-resistant Staphylococcus aureus ( 13.2 ％ ),Escherichia bacilli ( 11.3％),Stenotrophomonas narrow food Aeromonas (8.6％).Differences in the distribution of pathogens among different years,different age groups,and different treatment groups were statistically significant.Conclusions In the recent seven years,the incidence of VAP caused by Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus in the respiratory care unit increases significantly,the distribution of pathogens may be associated with hospitalization time,age of the patients,and the use of antibiotics.
  • 摘要：Objective To construct the recombinant lentiviral vector containing human MAGE-A3 gene and measure the expression level of MAGE-A3 in lung cancer cell line of A549.Methods The MAGE-A3 fragment was cloned into the lentiviral vector PLV with GFP by recombinant DNA technology.The resultant lentivirus were confirmed by PCR restriction enzyme digestion and DNA sequencing.Recombinant lentivirus PLV-MAGE-A3-GFP were produced from 293TAB by transient calcium-phosphate co-transfection with pCMV-dR8.91 and pCMV-VSV-G.A549 cells were infected by PLV-MAGE-A3-GFP lentivirus and the expression of MAGE-A3 was confirmed by Western blot.Results The recombinant lentiviral vector carried the MAGE-A3 gene was successfully constructed.Western blot analysis revealed that the MAGE-A3 gene could be correct transcripted and translated in A549 cell which infected by PLV-MAGE-A3-GFP.Conclusions The recombinant lentiviral vector PLV-MAGE-A3-GFP is constructed successfully,it can be used to transfect lung carcinoma cells.MAGE-A3 can be stablely expressed and promote the proliferation of A549 cell.%目的 构建重组慢病毒载体PLV-MAGE--A3-GFP,并检测其在人肺癌细胞系A549的表达情况.方法 利用DNA重组技术将MAGE-A3基因克隆到带GFP的慢病毒表达载体质粒PLV中,经限制性酶切和测序鉴定重组载体.将重组慢病毒载体PLV- MAGE- A3 -GFP与包装质粒pCMV-dR 8.91及pCMV-VSV-G共转染人胚肾上皮细胞株293TAB,包装重组慢病毒PL V-MAGE-A3-GFP,并感染人肺癌细胞株A549,用Western blot法检测MAGE-A3蛋白的表达情况.结果 限制性内切酶酶切和DNA测序分析证实,构建了重组慢病毒载体PLV-MAGE-A3-GFP,免疫荧光显微镜下观察显示慢病毒感染A549细胞后,MAGE-A3基因能够在细胞内正确地转录、翻译并稳定表达MAGE-A3基因.结论 成功构建了慢病毒载体PLV-MAGE-A3-GFP,包装的病毒能够成功感染人肺癌细胞系A549,并使MAGE-A3基因得以稳定表达,为进一步对非小细胞肺癌进行免疫治疗提供了适合的稳定转染的载体.
  • 摘要：气道上皮细胞是肺天然免疫系统的重要组成部分,通过模式识别受体识别病原相关分子模式,启动天然免疫反应,随后通过抗原呈递和共刺激信号,活化获得性免疫反应.气道上皮细胞的天然免疫反应与抵御病原菌高度相关.本文就气道上皮细胞对细菌病原的天然免疫应答研究进展作一综述.%Airway epithelial cells are an important part of the lung innate immune system,they recognize conserved structures in microorganisms,called pathogen-associated molecular patterns through apically exposed and intracellular receptors,called pattern-recognition receptors and initiate innate immune response.Subsequently,they activate adaptive immnue response through antigen presentation and co-stimulatory signals.Innate immune responses of the airway epithelium play a critical role in resisting pathongens.The research progress of innate immune response in the airway epithelium fight against respiratory bacterial pathongens is reviewed here.
  • 摘要：Objective To explore whether p38 MAPK is involved in the mechanotransduction of A549 cells induced by cyclic mechanical stretch.Methods Cells were divided into five groups:stretch 5,15,30,60 min groups and control group.Three replicate wells were used in each group.Mechanical stretch model in vitro cultured A549 cells was established for the study.Cells were stimulated by stretch at the magnitude of 1000 μstrain for 5,15,30,60 min.Then the protein level of p38 was tested by Western blot.Results After mechanical stimulation,the protein level of phosphorylated p38 MAPK increased,which was most obviously at 30 min time point.However,the protein level of phosphorylated p38 MAPK returned to the original level at 60 min time point.Conclusions Mechanical stretch activates the expression of p38 in A549 cells,leading to secondary signal transduction and function change.%目的 探讨p38蛋白激酶(p38 MAPK)是否参与周期性机械牵拉刺激在人肺泡Ⅱ型上皮A549细胞的信号转导过程.方法 实验分对照组(刺激前)、机械牵拉(刺激后)5、15、30、60 min共5组,每组3皿细胞.建立离体的A549细胞机械牵拉模型:以大小为1000 μstrain的牵拉力刺激细胞,在刺激前和刺激后5、15、30、60 min时间点进行观察.结果 A549细胞经机械牵拉刺激后,磷酸化p38蛋白水平增加,以30 min时间点最为明显.随着机械牵拉时间的延长,在60 min时间点磷酸化p38蛋白水平下降至约基线水平.结论 机械牵拉刺激信号可激活A549细胞p38 MAPK,从而引起继发细胞信号转导及功能改变.
  • 摘要：Radiotherapy plays an important role during the comprehensive treatment on tumor while lung is medium sensitive organ to radiation exposure,for which radiation-induced lung injury must be taken into consideration as an limiting factor for radiotherapy.Deregulation of repair and regeneration after ionizing injury leads to abnormal remodeling of extracellular matrix and pulmonary fibrosis.Overwhelming generation of free radicals after oxidative stress and inflammatory response involving all kinds of inflammatory cells and cytokines are thought to be crucial subsequent events in radiation-induced lung injury.%放射治疗是肿瘤综合治疗的重要手段之一,肺是辐射中度敏感器官,在胸部肿瘤的放射治疗中,放射性肺损伤是常见的剂量限制因素.电离辐射损伤后各种因素参与的修复、再生过程的失控是最终导致肺纤维化的原因.氧化应激所致的自由基过度生成、炎症细胞及相关细胞因子参与的炎症反应过程是放射性肺损伤的关键因素,本文就相关研究作一综述.
  • 摘要：Objective To explore the protective effect of estrogen against vascular impairment caused by chronic intermittent hypoxia(CIH) and the relationship with thioredoxin-1 (Trx-1).Methods 36 adult female C57/BL6J mice were randomly divided into three groups:ovariectomized intermittent hypoxia (OVI) group,sham-operation intermittent hypoxia (SOI) group and control group.The former two groups were treated with intermittent hypoxia,and the control group was treated with intermittent air.After 28 days,the volume and weight changes of uterus were observed.Stained by hematoxylin-eosin (HE),aorta arch paraffin sections were observed to study the morphological alteration and to measure the intima-media thickness (IMT).The expression of Trx-1 protein was detected by the immunochemistry of aorta arch sections and the relative mRNA level of Trx-1 was measured by the real-time PCR.Results In the control group,the endothelium of aorta arch was smooth and continuous,the arrangement of vessel smooth muscle cells was regular,and no obvious impairment was found by HE.The irregular arrangement,hypertrophy and fibrous degeneration of smooth muscle cells,the disrupted endothelium and accumulation of endothelial cells were observed in aorta of mice in SOI group.Furthermore,the proliferation of endothelial cells and the thickening of adventitia in OVI group were also found,in addition to the pathological changes observed in SOI group.IMT in the control group,SOI group and OVI group were (38.34± 1.01 ) μm,(50.65 ± 2.09) μm and ( 64.80 ± 4.31) μm,respectively,with statistically significant differences between each two groups (P ＜ 0.01 ).The relative levels of Trx-1 mRNA expressed in thorax aorta in SOI group (8.59 ± 0.83) and OVI group (5.14 ± 1.01) were significantly higher than that in the control group (0.18+0.13,P ＜0.001).The integrated optical density of Trx-1 protein expressed in the thorax aorta were (0.84±0.10) × 103,(6.60±0.45) × 103 and (2.76±0.28) × 103 in the three groups,respectively,with statistically significant differences between each two groups ( P ＜0.001).Conelusions CIH may cause morphological alterations of vessel wall in aorta arch.Furthermore,the ovariectomy can exacerbate the impairment,and the decreased expression of Trx-1 protein may be involved in this process.%目的 研究雌激素在慢性间歇低氧致血管损伤中的保护作用及其与硫氧还蛋白-1( Trx-1)的关系.方法 36只成熟雌性C57/BL6J小鼠随机分为去卵巢间歇低氧(OVI)组、假手术间歇低氧(SOI)组以及对照组；前两组给予间歇低氧,而对照组间歇给予空气.28 d后,观察小鼠子宫的大小与形态并称重；主动脉弓石蜡切片进行HE染色,光学显微镜观察血管形态并测量血管壁内中膜厚度(IMT)；石蜡切片行免疫组化检测Trx-1蛋白表达水平；实时荧光定量PCR检测Trx-1的mRNA相对表达量.结果 HE可见对照组主动脉弓内皮光滑,平滑肌细胞排列较整齐,未见明显异常改变；SOI组可见内皮欠连续,局灶内皮细胞聚集,主动脉弓平滑肌纤维细胞排列紊乱、肥大以及平滑肌纤维样变；OVI组除可见SOI组小鼠的上述改变加重外,另可见血管局灶内膜明显增生以及外膜增厚等改变.对照组、SOI组及OVI组的IMT分别为(38.34±1.01) μm、(50.65±2.09)μm及(64.80+4.31)μm,三组间两两比较差异具有统计学意义(P＜0.01).SOI组(8.59±0.83)及OVI组(5.14±1.01)小鼠胸主动脉Trx-1mRNA相对表达量显著高于对照组(0.18±0.13),差异具有显著统计学意义(P＜0.001)；对照组、SOI组及OVI组小鼠主动脉弓Trx-1蛋白表达的累积光密度分别为(0.84±0.10)×103、(6.60±0.45)×103及(2.76±0.28)×103,三组间两两比较差异均具有显著统计学意义(P＜0.001).结论 CIH可导致主动脉弓血管壁形态改变,去卵巢可加重CIH所致主动脉弓的损害,而Trx-1蛋白表达的降低可能参与了此过程.
  • 摘要：目的 探讨患有肺血栓栓塞症的孕妇的诊断和治疗.方法 我院收治1例大面积肺血栓栓塞症的孕妇,根据临床表现,进行超声心动图,相应的实验室检查方法,给予溶栓和抗凝治疗.结果 心脏超声提示:左肺动脉内回声:栓子?三尖瓣轻度反流,肺动脉高压,肺动脉瓣少量反流,主肺动脉增宽.心电图:QⅢTⅢ现象.低氧血症.行溶栓和抗凝治疗,随后胎儿B超显示胎儿心跳正常、胎盘宫底,羊水深度3.5 cm,内透声清.终止孕娠而获得胎儿的心、肺病理学观察,无异常改变、孕妇无出血等并发症发生,1个月后出院.结论 孕娠早期合并肺栓塞时,超声心动图、实验室和临床资料可以作出快速诊断和治疗的决定.患有致命性肺栓塞的孕妇,溶栓治疗不应该因怀孕而被禁用.%Objective To study the diagnosis and treatment of pregnant women with pulmonary embolism.Methods A pregnant woman with pulmonary embolism according to clinical manifestations,echocardiography,and laboratory screening method was cured by thrombolytic therapy. Results Echocardiography showed artery echo in left lung.Embolism,mild backflow in the tricuspid valve,pulmonary hypertension,a small amount of regurgitation in the pulmonary valve,and widening of the main pulmonary artery were observed.ECG:QⅢ TⅢ.Ultrasound showed that the fetal heartbeat was normal after thrombolysis and anticoagulation therapy.The amniotic fluid index was 3.5 cm and clear.After artificial induction,the fetal heart and lungs were found to be normal under pathological examination.The patient experienced no hemorrhaging or other complications.After one month,the patient was discharged from the hospital.Conclusions Thrombolytic therapy is useful for pregnant women with massive pulmonary embolism.With echocardiography,ultrasound,laboratory testing,and clinical manifestation,fast diagnoses and early treatment become possible.
  • 摘要：目的 评价P53抗体和U1-AsnRNP(核内小核糖体蛋白U1-A)抗体检测对非小细胞肺癌的诊断价值和临床意义.方法 采用酶联免疫吸附法检测了46例非小细胞肺癌患者血清中的P53抗体及U1-AsnRNP抗体,并以43名健康人血清作对照.结果非小细胞肺癌组血清P53抗体浓度的中位数(四分位数间距)[25.38 μg/L(65.69 μg/L)]明显高于对照组血清P53抗体浓度的中位数(四分位数间距)[10.45 μg/L(10.44 μg/L)],两组间比较差异有统计学意义(P =0.000)；非小细胞肺癌组血清U1-AsnRNP抗体浓度的中位数(四分位数间距)和对照组血清U1-AsnRNP抗体浓度的中位数(四分位数间距)分别为165.57 U/L(104.51 U/L)、170.05 U/L(74.12 U/L),两组间比较差异无统计学意义(P=0.715);应用ROC曲线对P53抗体和U1-AsnRNP抗体对非小细胞肺癌的诊断价值进行了评价,ROC曲线下面积分别0.717、0.478,P53抗体诊断非小细胞肺癌的敏感性和特异性分别为62.2％、79.1％.结论 P53抗体对非小细胞肺癌的诊断有较好的敏感性和特异性,血清P53抗体检测对非小细胞肺癌诊断有一定的临床意义；U1-AsnRNP抗体对非小细胞肺癌的诊断价值欠佳.%Objective To evaluate the diagnostic value and clinical significance of the detection of P53 antibody and small nuclear ribosomalprotein U1-A (U1-AsnRNP) antibody to non-small cell lung cancer (NSCLC).Methods Forty-six patients with NSCLC were tested for P53 antibodies and U1AsnRNP antibodies by enzyme linked immunosorbent assay,forty-three healthy persons were recruited as controls.Results The concentration of serum P53 antidbody in patients was obviously higher than that in control group [25.38 μg/L(65.69μg/L) vs 10.45 μg/L(10.44 μg/L)].There was statistical significance between the two groups ( P =0.000).The concentration of serum U1-AsnRNP antidbody in patients was 165.57 U/L ( 104.51 U/L),and it was 170.05 U/L (74.12 U/L) in control group.There was no statistical significance between the two groups ( P =0.715).ROC curve analysis was done in order to evaluate their diagnostic value to NSCLC,which showed the area under the ROC curve of P53 antibody and U1-AsnRNP antibody were 0.717 and 0.478.P53 antibody sensitivity and specificity of diagnosis to NSCLC were 62.2％ and 79.1％,respectively.Conclusions The P53 antibody for the diagnosis of NSCLC demonstrates better sensitivity and specificity,and the decection of serum P53 antibody has certain clinical significance in diagnosis of NSCLC.The U1-AsnRNP antibody has poor value in diagnosis of NSCLC.
  • 摘要：Non-small cell lung cancer (NSCLC) is the most common cancer severely endangering human health.Epidermal growth factor receptor (EGFR) is a tyrosine kinase receptor.Lots of mutations in the area of tyrosine kinase have been found in NSCLC,and the mutations are highly correlated with the clinical response of tyrosine kinase inhibitor (TKI).Therefore,EGFR mutations have been the strong predictor for TKI.Screening people of EGFR mutations for targeted therapy has important clinical significance.At present,the detection technology of EGFR mutations include sequencing,RT-PCR,ARMS,DHPLC,HRM,mutant-enriched PCR,PCR-SSCP,PCR-RFLP,microfluidics digital PCR,PCR-LDR,FP,CE,PNA-LNA,and so on.%非小细胞肺癌(non-small cell lung cancer,NSCLC)是严重危害人类健康的常见恶性肿瘤.表皮生长因子受体(epidermal growth factor receptor,EGFR)属于酪氨酸激酶受体,在NSCLC中发现EGFR酪氨酸激酶区常发生各种突变,这些突变和酪氨酸激酶抑制剂(TKI)的疗效密切相关.因此,EGFR突变成为NSCLC患者应用TKI药物强预测因子,临床筛选EGFR突变人群行TKI药物靶向治疗具有重要的临床指导意义.目前用于EGFR突变检测的方法有:直接测序法、RT-PCR、ARMS、DHPLC、HRM、突变富集PCR、PCR-SSCP、PCR-RFLP、微数字PCR、PCR-LDR、荧光偏振法、毛细管电泳法、PNA-LNA等.
  • 摘要：目的 了解我院5年内铜绿假单胞菌的耐药性,并对其耐药性与抗菌药物用量的关系进行分析.方法 分析我院2006年1月至2010年12月病房分离的铜绿假单胞菌的耐药率,并对5年中8种抗生素的年用量与这些药物对铜绿假单胞菌的耐药性进行统计分析.结果 对铜绿假单胞菌最敏感的抗菌药物为哌拉西林/他唑巴坦和阿米卡星,敏感率分别为62％～79％和70％～76％；三代头孢中最敏感的为头孢他啶,敏感率为52％～69％；左氧氟沙星敏感率为42％～64％；碳青霉烯的敏感率仅为36％～62％.铜绿假单胞菌对头孢哌酮钠/舒巴坦、碳青霉烯类抗生素的耐药率与其用药频度呈正相关(r=1,P＜0.05).结论 我院铜绿假单胞菌耐药性和头孢哌酮钠/舒巴坦、碳青霉烯类抗生素的大量应用有直接关系,必须严格控制该类药物应用；同时应用抗生素轮换和替换策略、合理应用抗菌药物、严格执行消毒隔离制度等,防止耐药菌的产生和传播.%Objective To understand the antibiotic resistance of Pseudomonas aeruginosa of our hospital in five years,and the relationship between resistance and amount of antibiotic use in order to guide the rational drug use.Methoàs The data were retrieved from January 2006 to December 2010 in the ward of our hospital,including the antibiotics sensitivity of Pseudomonas aeruginosa and the use of these drugs,then were statistically analyzed.Results Pseudomonas aeruginosa was most sensitive to piperacillin/tazobactam and amikacin.The sensitivity rate were 62％ ～79％ and 70％ ～76％.Ceflazidime was the most sensitive in three generation cephalosporins (52％ ～69％),levofloxacin was 42～64％,and carbapenern was only 36％ ～ 62％.The defined daily dose system of cefoperazone/sulbactam and carbapenem with drug resistance showed significant positive correlations ( r =1,P ＜0.05).Conclusions The resistance in Pseudomonas aeruginosa shows significant positive correlations with cefoperazone/sulbactam and carbapenem using.We must strengthen the limitation of them,apply antibiotics cycling strategy,and execute disinfection and isolation system strictly in order to decrease the development and transmission of resistance.
  • 摘要：Objective To improve our recognition of microscopic polyangiitis (MPA) by analyzing clinical data of ten MPA patients.Methods The clinical manifestations,pulmonary computerized tomography,laboratory test results,pathology and follow-up material were retrospectively analyzed in ten MPA patients.Results Respiratory,renal and constitutional symptom were presented in all patients.Moreover,three patients (30 ％) were involved central nervous system,four patients (40 ％) had digestive system symptom,and two patients (20％) were found severe rash.In pulmonary computerized tomography,fibrosis and pleural thickening were main kinds of patterns in MPA,companion with patchy consolidation and ground glass opacities.Fibrinoid necrosis in pathology was common characteristic in both renal and skin biopsy.All patients were followed up,and four patients died,of whom two patients died from subarachnoid hemorrhage and cerebral hemorrhage.Conclusions Fibrosis and pleural thickening in pulmonary computerized tomography are main kinds of patterns in MPA.However,respiratory and renal as well as central neurological involvement indicates poor prognosis.%目的 对10例显微镜下多血管炎(microscopic polyangiitis,MPA)患者各项临床资料进行分析,以便提高对该病的认识.方法 回顾性分析了10例MPA患者的临床表现、实验室检查,影像学资料及病理特点,同时对每例患者进行随访.结果 所有患者均有呼吸系统、肾脏及全身症状,3例有中枢神经系统累及,4例有消化系统症状,2例则伴有全身皮疹.胸部CT主要以肺间质纤维化及胸膜增厚为主,伴有斑片状实变影及磨玻璃影.肾脏及皮肤活组织检查病理的共同特点主要是小血管纤维素样坏死.对所有患者进行随访,4例死亡患者中2例分别死于蛛网膜下腔出血及脑出血.结论 本研究MPA患者胸部CT主要表现为肺间质纤维化及胸膜增厚,肺及肾脏累及提示预后不佳,而中枢神经系统累及常预示预后凶险.
  • 摘要：目的 探讨成人人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)合并肺部病变的临床特点和影像学征象.方法 收集我院2004年1月至2011年5月期间收治的12例HIV阳性伴肺部病变的住院患者病历资料,分别对年龄段、临床症状、体征以及辅助检查结果进行分析.结果 12例HIV感染患者均为男性,年龄(41.42±7.92)岁,入院前误诊为弥漫性间质性肺病的占75.00％,临床表现为非特异性呼吸道症状为主,其中发热75.00％,咳嗽41.67％,咯痰16.67％,气促91.67％.除1例外其他CD4+T细胞绝对值均＜100/μl,胸部CT大多表现为两肺弥漫性磨玻璃影,合并卡氏肺孢子菌肺炎更为常见,主要集中在肺门区域,上肺更为典型.结论 由于免疫功能极度抑制,HIV/AIDS患者的临床症状及影像学不典型,容易误诊.对于肺部影像学表现为弥漫性间质性改变,呼吸道症状不明显,特别是以咳嗽、发热、气促为主,而咯痰少见的患者,应及时筛查HIV.%Objective To study the clinical characteristic and imaging findings of pulmonary infection in adult human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS).Methods The clincial date of 12 cases of pulmonary infection with HIV who were treated in Changhai Hospital from January 2004 to May 2011 were analyzed,including the clincial profiles,immunological status,chest radiological characteristics.Results All were men and almost had a CD4+ count less than 100/μl,average age was (41.42+7.92) years old.75.00％ of the patients were misdiagnosed as diffuse interstitial pneumonia.The symptoms included cough (41.67％),fever (75.00％),short of breath (91.67％).Typical imaging findings were bilateral diffuse ground grass opacities distributing in perihilar regions,which were more often found in PCP.Conclusions Because of the severe immunosuppression,the clinical symptoms and appearance of chest radiological charcteristics are not so typical.HIV antibody test should be taken for the person who has the symptom of fever,short of breath and cough with less sputum,and diffuse interstitial changes in the chest X ray or CT scan.
  • 摘要：Objective To discuss the value of vibration response imagine (VRI) on evaluating the pulmonary function of interstitial lung disease (ILD).Methods 80 patients who were diagnosed as ILD from June 2010 to September 2011 enrolled in this study.Then,all the patients took the VRIxp pulmonary function test so as to make a comparison with the traditional pulmonary function test.This paper analyzed the advantage and disadvantage of VRIxp and the traditional pulmonary function teat in evaluating the pulmonary function of ILD by observing the changes of patients' condition after the test respectively.Results The changes and significance of the main VRIxp parameters:①By observing airflow distribution map and maximum vibration energy diagram,a variety of abnormities were discovered such as the out-sync of the images and the size difference in all patients.②It is found that 69 patients had abnormal energy distribution.According to grouping of the various disease types and CT scan,the energy values were compared which indicated that the abnormities had no statistical significance.③ The energy curve had some abnormities such as the platform and curve separation.④The study showed that VRIxp could qualitatively,quantificationally detect the abnormal breath sounds and VRIxp was more sensitive than that of traditional auscultation (the positive rate were 90.00％ vs 82.50％,respectively).⑤VRIxp could locate the lesion directly by combining air distribution figure with regional energy distribution.The accuracy rate was as high as 91.25％ compared with CT scan.Comparing with traditional pulmonary function technology,there were some advantages of VRI.①For some patients,their ventilatory functions were detected as normal by traditional pulmonary function technology,while through VRI test,the results were abnormal.And the lesions were consistent with HRCT.② By evaluating conditions of patients before and after pulmonary function test,VRIxp was less secondary effects than traditional pulmonary function technology (the positive rate were 0.32 vs 6.59,respectively).Conclusions VRIxp,as a new method,can test the pulmonary function of subjects in normal breathing state.VRIxp has many advantages over traditional pulmonary function technology,such as displaying the volume change of lung in a dynamic,direct,fast,and accurate way.It also can detect the lesion and the abnormal breath sounds more sensitively.More importantly,it has no side effect on the patients' condition.It is especially suitable for the patients of ILD who have serious dyspnea.%目的 探讨振动反应成像系统(vibration response imaging,VRI)在间质性肺疾病(ILD)患者肺功能评价中的应用价值.方法 选取我院2010年6月至2011年9月临床诊断为ILD的患者80例,进行VRIxp肺功能检查,并与传统肺功能进行比较,观察患者肺功能检查前后病情变化,分析VRIxp和传统肺功能在ILD患者肺功能评价上的优劣.结果 VRIxp主要参数变化及意义:①观察气流分布图及最大振动能量图发现所有受试者均存在图像不同步、大小不一等不同程度的异常；②69例受检者存在能量分布异常,根据不同疾病类型分组及CT表现分组比较能量值,差异无统计学意义;③能量曲线出现平台及曲线分离等异常表现；④VRIxp可客观定性、定量检出异常呼吸音,且检出率较传统听诊高,分别为90.00％、82.50％;⑤结合气流分布图及区域能量分布可定位病灶,本组73例VRIxp与CT定位一致,病灶定位准确率达91.25％.与传统肺功能比较:①传统肺功能通气功能正常者VRI检测结果均存在异常,且病变部位与HRCT相符；②肺功能检查前后受检者病情变化评分,传统肺功能检测评分差值为6.59,VRI检测前后评分差值为0.32.VRI对患者病情影响较小.结论 VRIxp是一种在患者平静呼吸状态下即可进行肺功能测定的一种新方法,较传统肺功能有诸多优势:可动态、直接、快速且准确地观测到肺容积的变化、判断病变部位和更为敏感地发现肺部异常呼吸音,且对患者病情无影响,特别适用于以呼吸困难为突出表现的ILD患者.
  • 摘要：Objective To explore the change and significance with serum adiponectin level in the patients with lung cancer.Methods Serum adiponectin level of 54 cases of lung cancer and 24 cases of healthy controls was determined by ELISA.Results Serum adiponectin were (191.86±24.38) μg/L and ( 183.39+51.34) μg/L in healthy concol group and lung cancer group,adiponectin concentrations showed no significant difference in two groups ( P ＞ 0.05 ).While no similar relationship was found between adiponectin and pathological types,TNM stages (all P＞ 0.05).There were significant difference among the primary lung cancer group [(192.96±45.89) μg/L] and the metastatic lung cancer group [(158.52± 57.82) μg/L].Serum adiponectin level was associated with lung cancer with lympg metastasis ( OR =0.19,P =0.013).Conclusions The lower serum adiponectin suggests higher invasion and lympg metabasis,which may be used as a serum marker to evaluate the progression of lung cancer.%目的 观察肺癌患者血清脂联素水平的变化,并探讨其意义.方法 酶联免疫吸附法测定54例肺癌患者和24名健康人的脂联素浓度.结果 对照组及肺癌患者血清脂联素水平分别为(191.86±24.38)μg/L、(183.39±51.34) μg/L,两组之间差异无统计学意义(P＞0.05)；不同病理类型及TNM分期的肺癌患者血清脂联素水平差异无统计学意义(P值均＞0.05)；发生远处转移后肺癌患者血清中脂联素的表达水平[(158.52±57.82)μg/L]与未远处转移的肺癌患者血清脂联素水平[(192.96±45.89) μg/L]比较差异有统计学意义(P＜0.05)；多因素同归分析显示,低血清脂联索水平与肺癌发生远处转移相关(OR =0.19,P=0.013).结论脂联素水平的降低提示肺癌患者具有更高的侵袭性和转移性,可能成为反映肺癌患者疾病进展的一个血清指标.
  • 摘要：恶性胸腔积液是由恶性肿瘤胸膜转移或原发于胸膜的恶性肿瘤所致,早期诊断困难,临床迫切需要实验室提供检查手段,以诊断恶性胸腔积液.本文就恶性胸腔积液的实验诊断进行综述.%Malignant pleural effusion (MPE) is caused by malignant tumor metastasis or primary tumor in the pleural malignancy,Tt's difficult for early diagnosis.New laboratory detection methods are urgently needed to diagnose the disease.This article reviews the laboratory diagnosis of MPE.
  • 摘要：目的 探讨噻托溴铵(思力华)联合沙美特罗替卡松(舒利迭)吸入治疗中重度支气管哮喘(简称哮喘)合并慢性阻塞性肺疾病(COPD)的临床疗效.方法 将126例中重度哮喘合并COPD患者随机分人对照组与观察组,对照组患者接受沙美特罗替卡松吸入,给予观察组患者噻托溴铵联合沙美特罗替卡松吸入.比较两组患者治疗前及治疗后1年肺功能的改变,急性发作次数、住院次数、急性发作的间隔时间以及生活质量.结果 治疗后观察组第1秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEVt％pred)和用力肺活量(FVC)显著优于对照组(P＜0.05)；随访1年,观察组急性发作次数及住院次数显著少于对照组(P＜0.05),急性发作的间隔时间差异无统计学意义(P＞0.05)；观察组生活质量SGRQ评分各维度及总分显著低于对照组,差异有统计学意义(P＜0.05).结论 噻托溴铵联合沙美特罗替卡松吸入可显著改善中重度哮喘合并CO PD患者肺功能,提高临床疗效及患者生活质量.%Objective To explore the clinical effect of tiotropium combined with salmeterol fluticasone propionate in medium and heavy bronchial asthma (asthma) merger chronic obstructive pulmonary disease (COPD).Methods 126 cases with medium and heavy asthma merger COPD were randomly divided into control group and experience group.Control group were given salmeterol flutieasone propionate inhalation,and experience group were treated with tiotropium combined with salmeterol fluticasone propionate.The change of lung function,time of acute attack,frequency ofhospitalization and acute onset of the next interval before and 1 year after treatment were compared between two groups.Results FEV1,FEV1 ％ rnpred and FVC after treatment in experience group were superior to that in control group (P＜0.05).In the follow-up of 1 year,time of acute attack and frequency of hospitalization in experience group were much less than that in control group (P＜0.05),and there was no significant different of acute onset of the next interval between two groups (P＞0.05).Each dimension and total score of SGRQ after intervention in experience group were much lower than that in control group (P＜0.05).Conclusions Tiotropium combined with salmeterol fluticasone propionate for medium and heavy asthma merger COPD can greatly improve the lung function,clinical effect and patients'life quantity.
  • 摘要：目的 比较中重度慢性阻塞性肺疾病(COPD)患者运动耐力的性别差异.方法 本研究对151例中、重度COPD患者的肺功能(PFT)和功率递增心肺运动试验(CPET)结果进行了分析.将患者分为Ⅱ级COPD组和Ⅲ级COPD组.并选择43例年龄、性别、身高、体质量相匹配的正常人作为对照组.本研究测定第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、峰值运动功率(Peak Load)、峰值摄氧量(Peak (V)O2)、峰值心率(Peak HR)、峰值氧脉搏(Peak(V)O2/HR)、最大分钟通气量(M(V)E)、气促指数(M(V)E/MVV)等指标.本研究分别在不同COPD分级和性别之间分析比较了上述指标的差异.结果 Ⅱ级COPD组和Ⅲ级COPD组的女性患者的Peak (V)O2实/预％和Peak (V)O2/HR实/预％较同组男性更高(P值均＜0.05).Ⅲ级COPD男性患者的运动耐力较Ⅱ级有明显降低(P＜0.0001),然而,Ⅲ级、Ⅱ级COPD女性患者之间运动耐力差异无统计学意义(P=0.246).结论 在中、重度COPD患者中,男性运动耐力下降较女性更为严重,吸烟可能是造成这一差异的重要因素.%Objective To compare gender differences in exercise capacity of patients with moderate and severe chronic obstructive pulmonary disease (COPD).Methods We examined 151 pulmonary function tests (PFT) and incremental cardiopulmonary exercise testing (CPET) performed in patients with moderate and severe COPD.They were divided into stage Ⅱ and stage Ⅲ COPD group.We enrolled 43 healthy subjects who were matched by age,sex,height,and weight as a control group.We measured FEV1,FVC,Peak Load,Peak (V)O2,Peak HR,Peak (V)O2/HR,M (V)E,M (V)E/MVV et al.We compared these results between different stages and genders.Results Women in stage Ⅱ and stage Ⅲ had higher Peak (V)O2％ predicted and Peak (V)O2/HR％predicted than men (P＜0.05).There was a significant reduction in exercise capacity for men in stage Ⅲ compared with stage Ⅱ (P＜0.0001),however,there was no significant difference between stage Ⅲ and stage Ⅱ for women (P=0.246).Conclusions Male patients with moderate and severe COPD have a more severe reduction in exercise capacity than female and smoking may be a significant factor contributed to the difference.
  • 摘要：Objective To investigate the effects and mechanisms of Quercetin on PDGF-BB induced proliferation and migration of human airway smooth muscle cells(HASMCs).Methods HASMCs derived from hurran bronchus were divided into six groups:control group,PDGF-BB group,PDGF-BB and Quercetin intervention group,Quercetin group,U0126 group,PDGF BB and U0126 intervention group.Proliferation was measured by MTT.Migration was examined by Transwell test.The protein expressions of p-ERK and eyclin D1 were determined by western blot analysis.Results PDGF-BB (20μg/L)significantly induced proliferation and migration of HASMCs as compared to control.Quercetin(20～80μmol/L) inhibited the HASMCs proliferation and migration in response to PDGF BB (20μg/L).The phosphorylated protein levels of ERK and cyclin D1 in PDGF-BB group were higher than those of the control group (P＜0.05),but decreased in PDGF-BB and Quercetin intervention group compared with control group (P＜0.05).Conclusions It appears that quercetin can directly inhibit PDGF-BB induced HASMCs proliferation and migration via the modulation of the ERK/cyclin D1 pathway.%目的 体外培养人气道平滑肌细胞(human airway smooth muscle cells,HASMCs),探讨槲皮素(Quercetin,Que)对血小板源性生长因子BB(PDGF-BB)刺激的HASMCs增殖和迁移的影响及其机制.方法体外培养HASMCs,分为六组；对照组、PdGF-BB组、Que与PDGF-BB联合干预组、Que组、U0126组、U0126与PDGF-BB联合干预组.四甲基偶氮唑蓝(MTT)微量比色法测定HASMCs增殖,transwell法观察细胞迁移,Western blot法检测ERK的磷酸化及Cyclin D1表达水平.结果 与对照组相比,PDGF-BB(20μg/L)显著诱导HASMCs增殖和迁移(P＜0.05),Que(20～80μmol/L)呈浓度依赖性抑制PDGF-BB诱导的HASMCs的增殖和迁移(P＜0.05).PDGF-BB组ERK磷酸化及Cyclin D1 表达水平较对照组明显增高(P＜0.05).Que(80μmol/L)及PDGF-BB干预组其表达量低于PDGF-BB组,此抑制作用与ERK特异性拮抗剂U0126作用相当(P＞0.05).结论 Que抑制PDGF-BB诱导的HASMCs的增殖和迁移,可能是通过调节ERK/Cyelin D1通路起作用.
  • 摘要：Objective To explore the effect of captopril on ventilator induced lung injury (VILI) by observing the relationship between apoptosis and angiotensin Ⅱ (Ang Ⅱ) in lungs of rats with high tidal volume ventilation.Methods Thirty male wistar rats were randomly divided into three groups:control group,high tidal volume ventilation (H-VT) group,captopril pretreatment group.Lung pathological changes were observed by macroscopy.The lung ALI scores,wet/dry weight ratio and the levels of protein (TP) in BALF were calculated.Apoptosis of the lung cells was detected by using terminal deoxynueleodityl transferasc-mediated nick-end labeling (TUNEL).AngⅡ contents in lung tissues were detected by ELISA.Results The lung ALI scores,wet/dry weight ratio and the levels of TP in BALF,Ang Ⅱ contents and apoptotic index in H-VT group were remarkably elevated (all P＜0.01),and followed by significant pathological changes of lung,Compared with H-VT group above all indexs showed marked decreased in captopril group (all P＜0.01),and followed by lighter pathological changes of lung.Conclusions Apoptosis is a crucial mechanism of VILI.Captopril executes lung-protective effects during mechanical ventilation via apoptosis-suppressed with high tidal volume ventilation.%目的 通过观察大潮气量机械通气大鼠肺组织细胞凋亡水平和肺内血管紧张素Ⅱ(AngⅡ)含量的变化,探讨血管紧张素转换酶抑制剂——卡托普利对呼吸机所致肺损伤(VILI)的防治作用.方法 雄性Wistar大鼠30只,随机分为对照组、大潮气量机械通气组(H-VT)和卡托普利干预组(CAP).观察各组大鼠肺组织病理学改变,测定其急性肺损伤(ALI)评分、支气管肺泡灌洗液(BALF)总蛋白含量和肺湿/干重比值(W/D).采用DNA断端末端标记法(TUNEL)检测肺组织细胞凋亡指数,采用ELISA法检测肺组织AngⅡ含量.结果 H-VT组大鼠肺组织ALI评分、W/D,BALF总蛋白含量、肺组织AngⅡ含量及细胞凋亡指数均明显高于对照组(P值均＜0.01),且出现明显肺组织病理学改变.CAP组大鼠肺组织上述指标均较H-VT组明显降低(.P值均＜0.01),同时肺组织病理学改变也较H-Vr组明显减轻.结论 肺组织细胞凋亡在VILI发病中具有重要作用,卡托普利可通过降低大潮气量机械通气大鼠肺组织细胞凋亡水平,对V1LI起一定保护作用.
  • 摘要：目的 探讨成人特发性肺含铁血黄素沉着症(idiopathic pulmonary hemosiderosis,IPH)的主要临床特点、诊断、治疗及预后.方法 收集近10年我院收治的成人IPH患者,总结其临床特点、治疗方法及预后,并结合国内外相关报道进行文献分析.结果 近10年共诊断7例成人IPH患者,男4例,女3例,年龄14～41岁,平均24岁.主要临床表现为发热(6/7)、咯血(5/7)、呼吸困难(5/7).主要体征有肺部啰音(3/7)、肝脾肿大(2/7).主要胸部影像学表现为磨玻璃影(7/7)、实变影(3/7)、气胸影(1/7).7例患者住院期间均应用糖皮质激素治疗,其中3例患者因呼吸衰竭行糖皮质激素冲击及机械通气治疗,所有患者均病情好转后出院,随访l～74个月,均存活.结论 成人IPH主要特点为不明原因的咯血、肺部浸润影及贫血,对糖皮质激素治疗反应较好,预后相对较好,与文献报道一致.%Objective To analyze the main clinical feature,diagnosis,treatment and prognosis of adult idiopathic pulmonary hemosiderosis (IPH).Methods The clinical data of adult IPH patients treated in our hospital in the near ten years were collected,reviewed and analyzed together with domestic and abroad literature.Results Seven cases of adult IPH patients were diagnosed,4 male and 3 female,aged from 14 to 41,mean 24 years.The main clinical manifestations included fever(6/7),hemoptysis(5/7)and dyspnea(5/7).The main signs were rale (3/7) and hepatosplenomegaly (2/7).The main image demonstrations were ground-glass opacity (7/7),consolidation (3/7) and pneumothorax (1/7).All the patients received glucocorticoids treatment,3 of them received glucocorticoids stoss therapy and mechanical ventilation.All patients were improved and discharged from hospital.All patients were followed up and alive.The follow-up time was different from 1 to 74 months.Conclusions Adult IPH is characterized by hemoptysis,pulmonary infiltrates and anemia of unknown etiology.Good response to glucocorticoids treatment and a relatively good prognosis were seen in adult IPH cases and that were coincided with literature.

    国际呼吸杂志的期刊信息

    • 曾用名：国外医学（呼吸系统分册）;国外医学(呼吸系统分册);国外医学：呼吸系统分册;国外医学.呼吸系统分册;国外医学:呼吸系统分册
    • 创刊时间：1981
    • 地区：CN
    • 语言：中文
    • 热门主题：中华医学会;河北医科大学
    • 学科分类：

    国际呼吸杂志的获奖情况

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