自动活检枪经皮肺穿刺检查周围型肺肿块的结果分析

目的:探讨自动活检枪经皮肺穿刺对周围型肺肿块的临床诊断价值及安全性.方法:CT检查明确为周围型肺肿块196例患者,在CT导向下,用自动活检枪经皮肺穿刺活检.结果:动活检枪经皮肺穿刺活检明确诊断周围型肺肿块187例,包括恶性肿瘤164例、结核7例和炎性假瘤14例,确诊率为95.4%,咯血及痰中带血发生率为5.6%,气胸发生率仅为15.8%.结论:经皮肺穿刺活检枪技术检查周围型肺部肿块安全、可靠、准确.     

一氧化氮合酶(NOS)等活性变化对肺癌早期诊断的研究——纤支镜活检组织50例的观察

用酶组织化学方法探讨经支气管纤维镜（简称纤支镜）活检组织,对肺癌的早期诊断。包括一氧化氮合酶（ＮＯＳ）、细胞色素氧化酶（ＣＣＯ）、乳酸脱氢酶（ＬＤＨ）、琥珀酸脱氢酶（ＳＤＨ）、酸性磷酸酶（ＡＣＰ）等。酶组织化学反应结果显示为肺癌组病人ＮＯＳ、ＬＤＨ、ＣＣＯ、ＡＣＰ的活性显著增高,分别为强阳性（）,少数呈最强阳性（）;而ＳＯＨ活性为弱阳性（＋）,较正常人组显著下降。可疑组病人ＳＤＨ活性增高呈强阳性（）或最强阳性（）,但ＮＯＳ、ＬＤＨ、ＡＣＰ的活性较肺癌组下降,分别为弱阳性（＋）或中等阳性（）。上述结果提示：ＮＯＳ等活性的变化,可作为提高肺癌早期诊断的重要指标之一。     

CT引导下经皮肺穿刺并发症的高危因素分析

目的:探讨CT引导下经皮肤肺穿刺并发症发生的高危因素.方法:回顾分析93例因肺部肿块行CT引导下经皮肤肺穿刺患者,对其性别、吸烟史、病灶大小、肿块类型、组织学分型、穿刺时体位、进针位置、进针角度和进针深度等因素与穿刺后并发症的相关性进行分析.结果:单因素分析显示吸烟史、病灶大小、肿块类型和进针深度在有并发症患者和无并发症的患者之间存在显著性差异(P＜0.05),多因素分析显示病灶大小、肿块类型和进针深度在两组患者间存在显著性差异(P＜0.05).结论:病灶大小、肿块类型和进针深度为CT引导下经皮肺穿刺并发症出现的高危因素.     

Transbronchial biopsy is useful in predicting UIP pattern

Background

The development of COPD in subjects with alpha-1 antitrypsin (AAT) deficiency is likely to be influenced by modifier genes. Genome-wide association studies and integrative genomics approaches in COPD have demonstrated significant associations with SNPs in the chromosome 15q region that includes CHRNA3 (cholinergic nicotine receptor alpha3) and IREB2 (iron regulatory binding protein 2). We investigated whether SNPs in the chromosome 15q region would be modifiers for lung function and COPD in AAT deficiency.

Methods

The current analysis included 378 PIZZ subjects in the AAT Genetic Modifiers Study and a replication cohort of 458 subjects from the UK AAT Deficiency National Registry. Nine SNPs in LOC123688, CHRNA3 and IREB2 were selected for genotyping. FEV₁ percent of predicted and FEV₁/FVC ratio were analyzed as quantitative phenotypes. Family-based association analysis was performed in the AAT Genetic Modifiers Study. In the replication set, general linear models were used for quantitative phenotypes and logistic regression models were used for the presence/absence of emphysema or COPD.

Results

Three SNPs (rs2568494 in IREB2, rs8034191 in LOC123688, and rs1051730 in CHRNA3) were associated with pre-bronchodilator FEV₁ percent of predicted in the AAT Genetic Modifiers Study. Two SNPs (rs2568494 and rs1051730) were associated with the post-bronchodilator FEV₁ percent of predicted and pre-bronchodilator FEV₁/FVC ratio; SNP-by-gender interactions were observed. In the UK National Registry dataset, rs2568494 was significantly associated with emphysema in the male subgroup; significant SNP-by-smoking interactions were observed.

Conclusions

IREB2 and CHRNA3 are potential genetic modifiers of COPD phenotypes in individuals with severe AAT deficiency and may be sex-specific in their impact.     

Semaphorins家族在肺发育与肺疾病中作用的研究进展

Semaphorins家族是一类经典的神经元轴突导向排斥性因子。最近大量研究表明,该家族除了在神经系统内发挥作用外,在肺发育与肺疾病中也起着重要作用。Semaphorins家族可通过调节肺泡上皮细胞、肺内皮细胞的增殖、黏附、迁移和凋亡,促进或抑制肺与血管的正常发育和病理过程。该文将对现阶段Semaphorins家族对肺发育过程中肺分支形成、血管形成和肺相关疾病作用的最新研究进展进行综述。     

阴道镜配合病理活检应用于宫颈疾病的诊断价值

目的评价电子阴道镜及宫颈病理活检对宫颈疾病的诊断价值。方法收集我院妇科门诊2003年至2006年宫颈疾病患者行阴道镜检查病行宫颈活检的病理结果进行对照分析。结果电子阴道镜检查后行宫颈活检1060例,病理结果显示:宫颈癌16例,宫颈上皮内瘤样变342例,宫颈炎性病变702例,阴道镜诊断宫颈上皮内瘤样变及宫颈癌的符合率分别为:93.44%和93.75%。结论阴道镜检查配合病理活检诊断宫颈疾病结果及时可靠,尤其对宫颈上皮内瘤样变的早诊断及降低宫颈癌的发生率有重要价值。     

人血清转铁蛋白遗传多态性与疾病相关的研究

本文应用等电聚焦电泳技术,调查了广州地区128例白血病、80例原发性肝癌、52例系统性红斑狼疮和1456例正常人的Tf遗传多态性分布。与正常人组相比,急性粒细胞白血病组的Tf~(C_1)基因频率显著增高(P<0.05);TfC_1C_1表型频率也显著高于正常人组(P<0.05),TfC_1C_1人群的患病相对危险率为1.9。未发现急性淋巴细胞白血病、慢性粒细胞白血病、原发性肝癌疾病组的Tf表型和基因频率与正常人组有显著性统计学差异。此外,还发现系统性红斑狼疮组的Tf~(C_2)基因频率显著高于正常人(P<0.025),Tf~(C_1)频率则相应下降(P<0.05);表型频率TfC_1C_2显著增高(P<0.005),相对危险率为2.3,TfC_1C_2相应下降(P<0.01)。     

早期周围型肺癌的X线动态观察和分析

目的探讨X线动态观察对周围型肺癌进行早期诊断的价值。方法对有X线随访资料的早期周围型肺癌14例资料进行回顾性分析。结果病灶直径≤2cm,无局部、远处、肺门及纵隔淋巴结等转移者归为早期征象;病灶直径〉2cm以上,有或无肺门,纵隔淋巴结、骨及胸膜转移者归为进展期征象。鉴别诊断中,除考虑形态学改变外,还要注意观察肿瘤的生长速度。结论X线平片发现类似病灶,应进行动态观察,查看有无恶性征象,再结合临床资料进行鉴别诊断。     

Analysis of Trace Elements in Bronchoalveolar Lavage of Patients with Diffuse Lung Diseases

Airborne trace elements are implicated in the etio-pathogenesis of a large number of pulmonary diseases. The aim of this study was to evaluate the reliability and effectiveness of direct determination of Cd, Cr, Cu, Fe, Mn, Ni, Pb, V, and Zn concentrations in bronchoalveolar lavage (BAL) samples from patients with sarcoidosis, idiopathic pulmonary fibrosis, and Langerhans cell histiocytosis and healthy (smoking and non-smoking) controls. A total of 44 individuals were recruited among sarcoidosis, idiopathic pulmonary fibrosis, and Langerhans cell histiocytosis patients and healthy (smoking and non-smoking) controls. Average Mn concentrations in BAL from patients were 45% lower than in controls (p < 0.01) and remarkable decreases in average concentrations of Cr, Ni and Zn were also found in BAL from patients with idiopathic pulmonary fibrosis and Langerhans cell histiocytosis. As these diseases are characterized by the enhanced activation of certain immunomodulatory cells and by generation of free radicals, the depressed Mn, Zn, Cr and Ni concentrations in BAL from patients may be due to oxidative stress. These preliminary results indicate that assessment of the elemental composition of BAL is a promising approach to study the pathogenesis of diffuse lung diseases and Langerhans cell histiocytosis.     

肺癌发病及骨转移相关因素分析

目的:探讨肺癌发病的可能相关因素。方法:选择87例确诊为肺癌的患者,收集患者的一般资料,临床信息以及诊断和治疗信息,其中伴骨转移者39例。结果:发病年龄平均67.8岁;6例(35.3%)女性患者为吸烟者,58例(97.7%)男性患者有吸烟史。女性吸烟人数及吸烟量增多;咳嗽为最常见的症状;病理组织学男性患者多为鳞癌,女性腺癌多见;Ⅲ和Ⅳ期明显多于Ⅰ期和Ⅱ期。虽然外科手术治疗后可以提高患者生存时间,接受外科手术患者仍较少。骨转移与性别、年龄和放化疗与否无关,与病理类型有关。结论:年龄、吸烟与肺癌发病密切相关,多数患者就诊时为中晚期,多只能接受姑息治疗,早期诊断及其重要。腺癌患者需警惕骨转移。     

丝孢酵母与钙和杀菌剂配合对苹果采后病害的抑制效果(英文)

研究一种从桃果实上分离获得的拮抗菌———丝孢酵母 (Trichosporonsp .)对苹果 (MalusdomesticaBorkh .)采后病害的防治效果 ,包括接种不同浓度的拮抗菌与不同病菌之间的拮抗作用 ,以及拮抗菌与钙或与杀菌剂配合对苹果灰霉病和青霉病的抑制效果。结果表明 ,拮抗菌和病菌孢子的浓度都明显地影响其抑菌效果。拮抗菌的使用浓度越大 ,病菌孢子的接种浓度越低 ,其抑病效果越好。当丝孢酵母菌的使用浓度达到 10 8colony_formingunits(CFU) /mL时 ,可完全抑制接种在苹果上的灰霉菌 (BotrytiscinereaPers.)和青霉菌 (Penicilliumexpansum (Link)Thom)(<10 6spores/mL)的致病力。用 10 6～ 10 7CFU/mL的丝孢酵母与 5 0 μL/L的扑海因配合对苹果采后灰霉病和青霉病的抑制效果明显地好于单独使用相同剂量的拮抗菌或杀菌剂。在丝孢酵母的悬浮液中加入 1%～ 2 ?Cl2 可显著地提高拮抗菌对灰霉病和青霉病的抑制效果。     

不同病理分期肺腺癌患者血清代谢组学研究

肺癌是当今世界最常见的恶性肿瘤之一,其新发率和死亡率多年来都居于各类癌症之首,其中85%的肺癌都是非小细胞癌,而腺癌又是最常见的非小细胞癌。肺癌的高隐匿性是造成其高死亡率的最主要原因,因此为肺癌的早期诊断和病理分期寻求高效可靠的方法是十分必要的。代谢组学揭示了小分子代谢物的一系列变化,反映了生命活动的最终状态,因此也能直接反映疾病不同发展阶段的病理生理变化。本研究利用核磁共振氢谱(1H-NMR),对在我院就诊的27例不同病理分期的肺腺癌患者和13例健康志愿者进行了血清代谢物分析,运用正交偏最小二乘判别分析(OPLS-DA)对1H-NMR数据进行建模,单变量统计分析对模型进行评价。结果表明肺腺癌患者组的血清中有14种代谢物出现明显差异,其中丙酮酸、丙氨酸、NAC1、乳酸、GPC和甘氨酸比起对照组来有显著上升,而葡萄糖、谷氨酰胺、亮氨酸、异亮氨酸、缬氨酸、丙酮、乙酰乙酸和苏氨酸则显著下降。而在不同分期肺腺癌患者间进行比较后发现,异亮氨酸、乙酰乙酸、NAC1和乳酸的变化与肺腺癌的发展有相关性,可能是肺腺癌早期诊断和分期的潜在生物标志物。