硝黄散外敷联合加味五虎汤口服治疗痰热闭肺型肺炎支原体肺炎患儿对肺功能和血清TNF-α、IFN-γ、IL-4水平的影响

目的:观察硝黄散外敷联合加味五虎汤口服治疗痰热闭肺型肺炎支原体肺炎(MPP)患儿对肺功能和血清肿瘤坏死因子-α(TNF-α)、γ-干扰素(IFN-γ)、白介素-4(IL-4)水平的影响。方法:研究对象为我院2019年6月~2021年1月期间收治的MPP患儿80例,采用随机数字表法将患儿分为对照组(n=40,阿奇霉素抗感染治疗)和研究组(n=40,对照组基础上加用硝黄散外敷联合加味五虎汤口服治疗),均治疗7 d。比较两组患儿临床疗效,比较两组治疗前、治疗7 d后的中医证候积分、临床症状改善情况、肺功能和血清TNF-α、IFN-γ、IL-4水平。结果:研究组治疗7 d后的临床总有效率为92.50%(37/40),高于对照组的72.50%(29/40),差异有统计学意义(P<0.05)。与对照组相比,研究组的症状(咳嗽憋喘、发热、肺部干湿啰音)消失时间均更短(P<0.05)。与对照组相比,研究组治疗7 d后用力肺活量(FVC)、最高呼气峰流速(PEF)、第1秒最大呼气容积(FEV1)、FEV1/FVC均更高(P<0.05),研究组治疗7 d后的中医证候积分及血清TNF-α、IFN-γ和IL-4水平均更低(P<0.05)。结论:痰热闭肺型MPP患儿采用硝黄散外敷联合加味五虎汤口服治疗,可有效缩短患儿症状消失时间,显著改善其肺功能、血清炎症因子水平,疗效显著。     

HNRNPC可能成为肺腺癌独立的预后因子

为探讨RNA m⁶A甲基化调节因子在肺腺癌中的作用,从TCGA数据库下载肺腺癌患者的RNA表达数据和临床数据。通过limma软件包分析12种m⁶A调节剂的表达情况。使用Pheatmap、vioplot和corrplot软件包生成热图、小提琴图和表达相关图。采用Kaplan-Meier方法分别计算肺腺癌中12种RNA m⁶A调节因子的生存曲线。使用Cox回归和Kaplan-Meier方法分析TCGA肺腺癌患者的总体存活相关的临床病理学特征。最后用Kruskal(KS)检验和logistic回归分析临床病理学特征与HNRNPC表达的关系。 在肺腺癌的TCGA队列中,发现HNRNPC、WTAP、YTHDF3、FTO、ZC3H13、METTL14、METTL3、YTHDF1、YTHDF2这些基因是差异表达的。Kaplan-Meier生存分析显示,在这些差异表达的基因中仅仅HNRNPC和YTHDF2的表达与生存显著相关。然后,通过多因素Cox回归结果表明HNRNPC的表达在肺腺癌TCGA队列中是个独立危险因素。最后,HNRNPC在肺腺癌中的表达与临床分期(IV vs I, OR=3.692 308)和组织浸润(T2 vs T1, OR=1.776 471;T4 vs T1, OR=6.303 03)显著相关(所有p<0.05)。 结论认为HNRNPC可能作为肺腺癌的独立的预后因子。     

全胸腔镜下肺叶切除联合系统淋巴清扫对肺癌患者血清疼痛相关因子和免疫功能的影响及预后的影响因素分析

摘要 目的：探讨全胸腔镜下肺叶切除（VATS）联合系统淋巴清扫对肺癌患者血清疼痛相关因子和免疫功能的影响,并分析预后的影响因素。方法：选择我院于2014年3月~2016年3月期间收治的肺癌患者116例,采用随机数字表法分为对照组和研究组,各58例。对照组患者给予传统开胸肺叶切除联合系统淋巴清扫治疗,研究组给予VATS联合系统淋巴清扫治疗,对比两组手术相关指标、血清疼痛相关因子和免疫功能,随访记录研究组患者5年生存率,分析预后的影响因素。结果：与对照组相比,研究组手术时间更长,术中出血量更少,术后住院时间、切口长度、引流时间更短（P<0.05）。两组术后1 d去甲肾上腺素（NE）、前列腺素E2（PGE2）、P物质（SP）、皮质醇（Cor）水平均较术前升高,但研究组低于对照组（P<0.05）。两组术后1 d CD3⁺、CD4⁺、CD4⁺/CD8⁺均较术前降低,但研究组高于对照组,CD8+较术前升高,但研究组低于对照组（P<0.05）。单因素分析结果可知：研究组患者的预后与组织分化、吸烟史、病灶直径、临床分期、清扫淋巴结个数有关（P<0.05）。多因素Logistic回归分析结果可知：临床分期、清扫淋巴结个数是研究组患者预后的影响因素（P<0.05）。结论：ATS联合系统淋巴清扫可减轻肺癌患者术后疼痛及免疫抑制,虽然手术时间更长,但可以改善其他围术期指标。此外,临床分期、清扫淋巴结个数是患者预后的影响因素,应引起临床重视。     

脂蛋白脂肪酶基因敲除对急性高脂血症性胰腺炎所致肺损伤的影响及其机制研究

摘要 目的：研究脂蛋白脂肪酶（lipoprotein lipase,LPL）基因敲除对雨蛙素诱导的高脂血症急性胰腺炎小鼠肺损伤的影响。方法：将C57BL/6小鼠分为三组,Control组和AP-Model组为野生型C57 BL/6小鼠,LPL ko组为LPL基因敲除C57 BL/6小鼠;Control组小鼠正常饲养,AP-Model和LPL ko组小鼠建立高脂血症性急性胰腺炎模型,比较三组小鼠死亡率、胰腺和肺病理损伤以及血清淀粉酶（amylase, AMY）、丙二醛（malondialdehyde, MDA）、肿瘤坏死因子-α（Tumor necrosis factor-α, TNF-α）和白介素-6（Interleukin-6, IL-6）含量。结果：急性胰腺炎建立48 h后,Control组、AP-Model组和LPL ko组小鼠死亡率分别为0 %、20 %和40 %。与Control组相比,AP-Model组和LPL ko组小鼠急性胰腺炎诱导24和48 h后的胰腺和肺组织湿/干重比值,胰腺和肺组织病理评分,血清AMY、MDA、TNF-α和IL-6含量均显著升高（P<0.05）;与AP-Model组相比,LPL ko组小鼠急性胰腺炎诱导24和48 h后的胰腺和肺组织湿/干重比值,胰腺和肺组织病理评分,血清AMY、MDA、TNF-α和IL-6含量均显著升高（P<0.05）。结论：LPL基因敲除小鼠急性高脂血症性胰腺炎肺损伤更严重,其机制可能与LPL基因敲除引起更强的氧化应激和炎症有关。     

替雷利珠联合白蛋白紫杉醇治疗晚期肺癌的疗效分析及对T细胞亚群的影响

摘要 目的：研究替雷利珠联合白蛋白紫杉醇治疗晚期肺癌的疗效分析,并探讨其对T细胞亚群的影响。方法：选择2018年7月到2021年10月在院接受治疗的晚期肺癌患者80例,根据治疗方式不同分为单一治疗组和联合组,每组40例。单一治疗组患者接受白蛋白紫杉醇治疗,联合组患者接受替雷利珠联合白蛋白。比较两组患者治疗后临床疗效、不良反应以及治疗前后血清IgA和IgG含量,以及外周血CD4⁺和CD8⁺T细胞亚群。结果：（1）联合组患者临床治疗有效率为87.5 %,显著高于单一治疗组67.5 %的临床治疗有效率（P<0.05）;（2）两组患者治疗后肝肾损伤、呕吐、乏力、白细胞减少、神经毒性以及手足综合征等不良反应发生率无显著差异（P>0.05）;（3）联合组患者治疗后血清IgA和IgG均显著高于单一治疗组患者（P<0.05）;（4）联合组治疗后CD4⁺和CD4⁺/CD8⁺T淋巴细胞比例均显著高于单一治疗组（P<0.05）,而CD8⁺T淋巴细胞比例均显著低于单一治疗组（P<0.05）。结论：替雷利珠联合白蛋白紫杉醇治疗可以显著提高晚期肺癌患者临床治疗有效率,但不增加不良反应发生率,并可有效改善患者免疫功能。     

CircPUM1 promotes the malignant behavior of lung adenocarcinoma by regulating miR-326

CircRNAs are reported to be implicated in the development of lung cancer. This study focused on assessing the expression, functions and molecular mechanism of circPUM1 in lung adenocarcinoma. Here, it showed that circPUM1 is significantly upregulated in both lung adenocarcinoma cell lines and tissues. Furthermore, silencing of circPUM1 impaired the proliferation, migration and invasion ability, and increased apoptosis in A549?cells. Nevertheless, overexpression of circPUM1 in SPC-A1 cells has the opposite effect. Silencing of circPUM1 inhibits the tumorigenesis in nude mice. Mechanistically, circPUM1 could sponge miR-326 and promote the expression of its downstream proteins Cyclin D1 and Bcl-2. In summary, this present study revealed that circPUM1 functions as an oncogene to promote the tumorigenesis of lung adenocarcinoma through circPUM1/miR-326/Cyclin D1 and Bcl-2 axis. This indicates that circPUM1 may act as a potential therapeutic target for lung adenocarcinoma.     

云南树鼩肝脏结构的光,电镜观察

本文报告了树肺脏的一般结构和超微结构。与人和灵长目相似，其肺实质也是由导气部和呼吸部构成。但不同的是其细支气管粘膜形成很高的皱襞。在电镜下Ｃｌａｒａ细胞电子密度高，顶部胞质中含有大量膜包颗粒，这些结构与大白鼠和家兔的结构相似。许多毛细血管外方都包绕着基膜和肺泡Ⅰ型上皮细胞的胞质。气血屏障由肺泡上皮细胞、融合的基膜和内皮细胞胞质构成。说明树肺脏不但是呼吸器官，也是一些激素和介质产生及代谢的重要器官。本文为研究树的正常生理功能及分类提供形态学资料。     

Effects of nitric oxide synthase inhibitors on systemic hypotension, cytokines and inducible nitric oxide synthase expression and lung injury following endotoxin administration in rats

Endotoxin shock is characterized by systemic hypotension, hyporeactiveness to vasoconstrictors and acute lung edema. A nitric oxide synthase (NOS) inhibitor, N^G-monomethyl-L-arginine (L-NMMA) has been shown to be effective in reversing acute lung injury. In the present study, we evaluated the effects of NOS blockade by different mechanisms on the endotoxin-induced changes. In anesthetized rats, lipopolysaccharide (LPS,Klebsiella pneumoniae) was administered intravenously in a dose of 10 mg/kg. LPS caused sustained systemic hypotension accompanied by an eightfold increase of exhaled NO during an observation period of 4 h. After the experiment, the lung weight was obtained and lung tissues were taken for the determination of mRNA expressions of inducible NOS (iNOS), interleukin-1 (IL-1) and tumor necrosis factor--(TNF-). Histological examination of the lungs was also performed. In the control group injected with saline solution, mRNA expressions of iNOS, IL-1 and TNF- were absent. Four hours after LPS, the mRNA expressions of iNOS and IL-1 were still significantly enhanced, but TNF- was not discernibly expressed. LPS also caused a twofold increase in lung weight. Pathological examination revealed endothelial damage and interstitial edema. Various NOS inhibitors were given 1 h after LPS administration. These agents included N-nitro-L-arginine methyl ester (L-NAME, 10 mg/kg), a constitutive NOS and iNOS inhibitor; S,S-1,4-phenylene-bis-(1,2-ethanedinyl) bis-isothiourea dihydrobromide (1,4-PBIT, 10 mg/kg), a relatively specific iNOS inhibitor, and dexamethasone (3 mg/kg), an inhibitor of iNOS expression. These NOS inhibitors all effectively reversed the systemic hypotension, reduced the exhaled NO concentration and prevented acute lung injury. The LPS-induced mRNA expressions of iNOS and IL-1 were also significantly depressed by these NOS inhibitors. Our results suggest that NO production through the iNOS pathway is responsible for endotoxin-induced lung injury. Certain cytokines such as IL-1 are possibly involved. These changes are minimized by NOS inhibitors through different mechanisms.     

8-Hydroxyguanosine formed in human lung tissues and the association with diesel exhaust particles

Diesel exhaust particles consist of various organic chemicals, heavy metals, and carbon particles. Knowledge of the fate of organic chemicals and carbon particles in the lungs is important to determine the mechanisms responsible for lung tumors. In the present study, diesel particle extracts were found to show mutagenicity for YG3003, a sensitive strain to some oxidative mutagens, as well as other mutant strains, and those of lung tissues obtained from lung cancer patients exhibited potent mutagenicity. Formation of 8-hydroxyguanosine (8-OHdG) as a biomarker of oxidative damage was analyzed with in vitro and in vivo assay systems. The 8-OHdG was detected in all 22 cases of lung tissues with carcinomas tested and their levels increased with the increasing age of the patients, suggesting a correlation between age and the presence of carbon particles in lung tissues. Therefore, the formation of 8-OHdG due to diesel exhaust particles was investigated via intratracheal injections into mice. 8-OHdG formation was elevated when carboneceous particles, after removal of organic chemicals with various solvents, were administered to mice, but it was not elevated when polyaromatic compounds such as benzo[a]pyrene, 1,8-dinitropyrene, and 1-nitropyrene were used in the same procedure in mice. The carboneceous particles were formed from a giant particle that was aggregated by micro-particles with diameters of 1.47 +/- 1.34 to 1.05 +/- 0.83 microm. These results suggest that carboneceous particles, but not mutagens and carcinogens, promote the formation of 8-OHdG, and that as a mechanism, alveolar macrophages may be involved in oxidative damage. The oxidative damage may be due to the fact that the mutation is involved with the generation of a hydroxyl radical during phagocytosis, and the hydroxyl radical leads to hydroxylation at the C-8 position of the deoxyguanosine residue in the DNA.     

Benzene metabolism in human lung cell lines BEAS-2B and A549 and cells overexpressing CYP2F1

Benzene is an occupational and environmental toxicant. The main human health concern associated with benzene exposure is leukemia. The toxic effects of benzene are dependent on its metabolism by the cytochrome p450 enzyme system. The cytochrome p450 enzymes CYP2E1 and CYP2F2 are the major contributors to the bioactivation of benzene in rats and mice. Although benzene metabolism has been shown to occur with mouse and human lung microsomal preparations, little is known about the ability of human CYP2F to metabolize benzene or the lung cell types that might activate this toxicant. Our studies compared bronchiolar derived (BEAS-2B) and alveolar derived (A549) human cell lines for benzene metabolizing ability by evaluating the roles of CYP2E1 and CYP2F1. BEAS-2B cells that overexpressed CYP2F1 and recombinant CYP2F1 were also evaluated. BEAS-2B cells overexpressing the enzyme CYP2F1 produced 47.4 +/- 14.7 pmols hydroxylated metabolite/10(6) cells/45 min. The use of the CYP2E1-selective inhibitor diethyldithiocarbamate and the CYP2F2-selective inhibitor 5-phenyl-1-pentyne demonstrated that both CYP2E1 and CYP2F1 are important in benzene metabolism in the BEAS-2B and A549 human lung cell lines. The recombinant expressed human CYP2F1 enzyme had a K(m) value of 3.83 microM and a V(max) value of 0.01 pmol/pmol p450 enzyme/min demonstrating a reasonably efficient catalysis of benzene metabolism (V(max)/K(m) = 2.6). Thus, these studies have demonstrated in human lung cell lines that benzene is bioactivated by two lung-expressed p450 enzymes.