Objective To investigate the protective effects of antitumor necrosis factor-α antibody （TNF-αAb） on lung injury after cardiopulmonary bypass （CPB） and their mechanisms. Methods Forty healthy New Zealand white rabbits，weighting 2.0-2.5 kg，male or female，were randomly divided into 4 groups with 10 rabbits in each group. In groupⅠ，the rabbits received CPB and pulmonary arterial perfusion. In group Ⅱ，the rabbits received CPB and pulmonary arterial perfusion with TNF-αAb. In group Ⅲ，the rabbits received CPB only. In group Ⅳ，the rabbits only received sham surgery. Neutrophils count，TNF-α and malondialdehyde （MDA） concentrations of the blood samples from the left and right atrium as well as oxygenation index were examined before and after CPB in the 4 groups. Pathological and ultrastructural changes of the lung tissues were observed under light and electron microscopes. Lung water content，TNF-α mRNA and apoptoticindex of the lung tissues were measured at different time points. Results Compared with group Ⅳ，after CPB，the rabbitsin group Ⅰ to group Ⅲ showed significantly higher blood levels of neutrophils count，TNF-α and MDA（P＜0.05），higherTNF-α mRNA expression，apoptosis index and water content of the lung tissues （P＜0.05），and significantly lower oxyg-enation index （P＜0.05） as well as considerable pathomorphological changes in the lung tissues. Compared with group Ⅱ，after CPB，the rabbits in groups Ⅰ and Ⅲ had significantly higher blood concentrations of TNF-α （5 minutes after aortic declamping，220.43±16.44 pg/ml vs.185.27±11.78 pg/ml，P＜0.05；249.99±14.09 pg/ml vs.185.27±11.78 pg/ml，P＜0.05），significantly higher apoptosis index （at the time of CPB termination，60.7‰±13.09‰ vs. 37.9‰±7.78‰，P＜0.05；59.6‰±7.74‰ vs. 37.9‰±7.78‰，P＜0.05），significantly higher blood levels of neutrophils count and MDA （P＜0.05），significantly higher TNF-α mRNA expression and water content of the lung tissues （P＜0.05），and significantly loweroxygenation index （P＜0.05） as well as considerable pathomorphological changes in the lung tissues. Compared with groupⅠ，rabbits in group Ⅲ had significantly higher above parameters （P＜0.05） but lower oxygenation index （P＜0.05） only at 30 minutes after the start of CPB. Conclusion Pulmonary artery perfusion with TNF-αAb can significantly attenuate inflammatory lung injury and apoptosis of the lung tissues during CPB.
目的 探討18氟-脫氧葡萄糖（18F-FDG）雙探頭符合線路對非小細胞肺癌胸內淋巴結轉移的診斷價值，并分析其假陽性、假陰性診斷的原因。 方法 回顧性分析2010年12月－2012年6月非小細胞肺癌患者161例的臨床資料，其中腺癌122例，鱗癌23例，其他類型16例。分析患者術前18F-FDG雙探頭符合線路顯像對肺門、縱膈淋巴結的診斷結果（其中陽性53例，陰性108例），以術后病理診斷為金標準，評價其診斷價值。分析9例假陽性、26例假陰性診斷患者的吸煙史、慢性支氣管炎肺氣腫、肺結核病史、局限性肺炎、腫瘤標志物、淋巴結短徑、腫瘤原發灶T/N比值、外周血白細胞等指標。 結果 18F-FDG雙探頭符合線路單光子發射計算機斷層成像（SPECT）診斷非小細胞肺癌淋巴結轉移的靈敏度、特異性、準確性、陽性預測值、陰性預測值分別是62.9%、90.1%、78.3%、83%、75.9%。假陽性組患者慢支炎肺氣腫、局限性肺炎者高于真陽性組。假陰性組的淋巴結短徑、原發灶T/N比值小于真陽性組。 結論 18F-FDG雙探頭符合線路SPECT是術前診斷肺癌淋巴結轉移的有效手段；假陽性淋巴結與慢支炎肺氣腫、局限性肺炎有關；假陰性淋巴結與淋巴結短短徑小、原發腫瘤攝取18F-FDG低有關。
ObjectiveTo investigate the effects of short-time hyperoxia ventilation on lung tissue and pulmonary surfactant proteins C and D (SP-C and SP-D) in rats.MethodsSixteen male Sprague-Dawley rats were randomly divided into two groups (n=8): hyperoxia group (FiO2=0.90), air group (FiO2=0.21). Tracheal intubations were administrated after anesthesia, and rats in two groups were exposed hyperoxia or air ventilation for 4 h. At the same time, carotid artery blood gas was analyzed after 2 h and 4 h of ventilation, then oxygenation index (OI) was calculated. Four hours later, the anterior lobe of right lung was taken to observe the pathological change and the injury level was scored. The middle lobe of right lung was prepared for making tissue homogenate, and the remaining part of the lung was used to measure the wet/dry weight (W/D) ratio. The bronchoalveolar lavage fluid (BALF) was prepared in left lung. The content of SP-C and SP-D were detected in lung tissue homogenate and BALF by ELISA.ResultsComparing with hyperoxia group, the arterial partial pressure of oxygen, lung histopathology score and lung W/D ratio in air group were significantly increased (P<0.05), but OI, the content of SP-C and SP-D in lung tissue homogenate and BALF were significantly decreased (P<0.05).ConclusionHyperoxia ventilation for 4 h in rats can cause lung injury histologically, and reduce the concentration of SP-C and SP-D apparently in the lungs.
摘要:目的:應用區域阻抗法測定慢性阻塞性肺疾病（COPD）患者的肺血流灌注及肺通氣分布的變化,與放射性核素肺顯像方法比較,探討肺區域阻抗方法的臨床應用價值。 方法: 測定對象為18例中重度COPD患者,均為男性,平均年齡63.8歲,應用肺區域阻抗法及放射性核素法,分別測定肺血流灌注及肺通氣的分布。〖HTH〗結果〖HTSS〗: 本研究發現肺區域阻抗法在測定肺血流灌注分布方面,僅在左下肺區域高于核素法測得的數值(Plt;0.05),余肺區測定結果相近,無顯著差異。在肺通氣的測定方面,阻抗法所得數值與核素法測得的數值有一定的不同,在左上、右上區域高于核素法測得的數值,在左中肺區測得的數值低于核素法測得的數值(Plt;0.05),余肺區測定結果相近,無顯著差異。結論: 雖然目前區域阻抗方法暫不能取代放射性核素的測定,但作為一種輔助手段,可簡便、快速了解肺內的通氣、血流等生理病理改變。Abstract: Objective: To evaluate the clinical capability of regional electric impedance pneumograph and scintigraphy in measurement of pulmonary perfusion and ventilation in patients with COPD. Methods: Thirtytwo patients with different respiratory diseases underwent regional electric impedance pneumograph and scintigraphy, the pulmonary perfusion and ventilation were obtained and recorded. Results:The pulmonary perfusion results got by regional electric impedance pneumograph in the left lower region was lower than the results measured by scintigraphy, there were significant difference (Plt;0.05), and no difference in other pulmonary region. The pulmonary ventilation results got by regional electric impedance pneumograph in the both upper region were higher and in the left middle region were lower than the results measured by scintigraphy, there were significant difference(Plt;0.05), and no difference in other pulmonary region. Conclusion:The result got by regional electric impedance pneumograph could not replace the result got by scintigraphy at present, but this is a quick, simple,and convenient measurement to get parameter of the pulmonary perfusion and ventilation.