布地奈德联合特布他林雾化吸入治疗对毛细支气管炎患儿潮气呼吸肺功能、T细胞亚群及血清炎性因子的影响

摘要 目的：探讨布地奈德联合特布他林雾化吸入治疗对毛细支气管炎患儿潮气呼吸肺功能、T细胞亚群及血清炎性因子的影响。方法：选取2019年1月~2019年12月期间我院收治的毛细支气管炎患儿98例,采用随机数字表法分为对照组（常规方案治疗）和观察组（对照组基础上加用布地奈德联合特布他林雾化吸入治疗）,各49例。记录两组治疗1周后总有效率。对比两组治疗前、治疗1周后的潮气呼吸肺功能指标[吸气/呼气时间比（Ti/Te）、达峰时间比（TPTEF/TE）、达峰容积比（VPEF/VE）、每千克潮气量（Vt/kg）]、T细胞亚群[CD3⁺、CD4⁺、CD8⁺及CD4⁺/CD8⁺]、血清炎性因子[降钙素原（PCT）、C反应蛋白（CRP）]。比较两组不良反应发生率。结果：+、CD4⁺、CD4⁺/CD8⁺均高于治疗前,且观察组高于对照组（P<0.05）,PCT、CRP、CD8+均低于治疗前,且观察组低于对照组（P<0.05）。两组患儿不良反应发生率对比无统计学差异（P>0.05）。结论：雾化吸入特布他林联合布地奈德治疗毛细支气管炎患儿疗效显著,可有效改善患儿T细胞亚群、潮气呼吸肺功能,减轻患儿炎性反应,且安全性好。     

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。     

Software simulation of tumour motion dose effects during flattened and unflattened ITV-based VMAT lung SBRT

PurposeRestricted studies comparing different dose rate parameters are available while ITV-based VMAT lung SBRT planning leads to perform the analysis of the most suitable parameters of the external beams used. The special emphasis was placed on the impact of dose rate on dose distribution variations in target volumes due to interplay effects.MethodsFour VMAT plans were calculated for 15 lung tumours using 6 MV photon beam quality (flattening filter FF vs. flattening filter free FFF beams) and maximum dose rate of 600 MU/min, 1000 MU/min and 1400 MU/min. Three kinds of motion simulations were performed finally giving 180 plans with perturbed dose distributions.Results6FFF-1400 MUs/min plans were characterized by the shortest beam on time (1.8 ± 0.2 min). Analysing the performed motion simulation results, the mean dose (Dmean) is not a sensitive parameter to related interplay effects. Looking for local maximum and local minimum doses, some discrepancies were found, but their significance was presented for individual patients, not for the whole cohort. The same was observed for other verified dose metrics.ConclusionsGenerally, the evaluation of VMAT robustness between FF and FFF concepts against interplay effect showed a negligible effect of simulated motion influence on tumour coverage among different photon beam quality parameters. Due to the lack of FFF beams, smaller radiotherapy centres are able to perform ITV-based VMAT lung SBRT treatment in a safe way. Radiotherapy department having FFF beams could perform safe, fast and efficient ITV-based VMAT lung SBRT without a concern about significance of interplay effects.     

Impact of lung density on isolated lung tumor dose in VMAT using inline MR-Linac

PurposeThis study investigated the impact of lung density on the isolated lung tumor dose for volumetric modulated arc therapy (VMAT) in an inline magnetic resonance linear accelerator (MR-Linac) using the Monte Carlo (MC) simulation.MethodsCT images of the thorax phantoms with lung tumors of 1, 2, and 3 cm diameters were converted into voxel-base phantoms with lung densities of 0.1, 0.2, and 0.3 g/cm³, respectively. The dose distributions were calculated for partial-arc VMAT. The dose distributions were compared using dose differences, dose volume histograms, and dose volume indices.ResultsIn all cases, the inline magnetic field significantly enhanced the lung tumor dose compared to that at 0 T. For the 1 cm lung tumor, the inline magnetic field of 1 T increased the minimum dose of 95% of the Planning target volume (PTV D₉₅) by 14.0% in 0.1 g/cm³ lung density as compared to that in 0.3 g/cm³ at 0 T. In contrast, at 0 and 0.5 T, the PTV D₉₅ in 0.3 g/cm³ lung density was larger than that in lung density of 0.1 g/cm³. For the 2 cm lung tumor, a similar tendency to 1 cm was observed, whereas the dose impact of lung density was smaller than that for 1 cm. For the 3 cm lung tumor, the lung tumor dose was independent of lung density at 0.5 T and 1.0 T.ConclusionThe inline MR-Linac with the magnetic field over 1 T can enhance the PTV D₉₅ for VMAT regardless of the lung density.     

Silencing LINC00504 inhibits cell proliferation,invasion as well as migration and promotes cell apoptosis in lung cancer cells via upregulating miR-876-3p

LINC00504 acts as an oncogene and associates with unfavorable prognosis in patients with lung cancer. Silencing LINC00504 may be a promising strategy for treatment of lung cancer and its effects were firstly investigated in lung cancer cells this study. The gene expression level of miR-876-3p as well as LINC00504 were measured via PCR assay. The cell proliferation was investigated through Cell Counting Kit-8 (CCK-8) assay and colony formation assay. Flow cytometry was applied for detection of cell apoptosis. Wound healing and transwell assay were performed for measurement of cell migration and invasion respectively. The apoptosis related protein expressions were measured by western blot. Luciferase report assay was conducted for verification the target gene. LINC00504 was higher expressed in five types of lung cancer cells studied herein when compared with the control normal cells. LINC00504 knockdown exerted inhibitory effects on cell apoptosis, cell migration as well as cell invasion and promoted cell apoptosis. All the effects mentioned above were counteracted by miR-876-3p inhibitor. Silencing LINC00504 possessed anti-proliferation, repression of cell invasion as well as migration and pro-apoptosis effects via targeting up-regulation of miR-876-3p in lung cancer cells, proving the new therapeutic targets and highlighting the potential application in future diagnosis and treatment in lung cancer.     

T-UCRs with digestive and respiratory diseases

From the perspective of histoembryology, the lung, gaster, and intestines that derived from the endoderm of the gastrula are structurally homologous. The interplay of intestines and lung in many pathologic changes is called the gut-lung axis. RNAs transcribed from ultraconserved regions (T-UCRs) are highly evolutionarily conserved in many mammalian genomes and have been found to be important in the pathogenesis and diagnosis of many diseases. More and more studies in recent years have shown that T-UCRs play important roles both in digestive and respiratory diseases. Taking the gut-lung axis as the entry point, this review summarizes the T-UCRs related to digestive and respiratory diseases in recent years. Meanwhile, these T-UCRs and their targets can lay a foundation for future drug research.     

二十四式简化太极拳联合呼吸功能训练对中老年COPD患者肺功能、运动耐力及心理状态的影响

摘要 目的：探讨二十四式简化太极拳联合呼吸功能训练对中老年慢性阻塞性肺疾病（COPD）患者肺功能、运动耐力及心理状态的影响。方法：选取2019年4月~2020年8月期间我院收治的中老年COPD患者81例,按照信封抽签法分为对照组（40例,给予呼吸功能训练干预）和观察组（41例,给予二十四式简化太极拳联合呼吸功能训练干预）,均干预6个月。对比两组干预前、干预6个月后的肺功能、运动耐力、心理状态及生活质量。结果：两组干预6个月后用力肺活量（FVC）、1 秒用力呼气容积( FEV1)、FEV1/FVC升高,且观察组高于对照组（P<0.05）。两组干预6个月后呼吸症状、疾病影响、活动受限评分降低,且观察组低于对照组（P<0.05）。两组干预6个月后6 min步行试验（6MWT）距离延长,且观察组长于对照组（P<0.05）。两组干预6个月后人际关系、抑郁、偏执、敌对、焦虑、恐惧评分降低,且观察组低于对照组（P<0.05）。结论：中老年COPD患者经二十四式简化太极拳联合呼吸功能训练干预后,肺功能、运动耐力、生活质量及心理状态均得到显著改善,提示该康复训练方案可用于辅助中老年COPD患者的治疗。     

金银花提取物对重症急性胰腺炎肺损伤大鼠的保护作用及机制研究

摘要 目的：探讨金银花提取物对重症急性胰腺炎肺损伤大鼠的保护作用及其分子机制。方法：选择60只大鼠并将其分为假手术组、模型组、金银花低剂量组、金银花中剂量组和金银花高剂量组。比较各组的肺组织和胰腺组织病理评分。采用全自动血气分析仪检测各组大鼠血氧分压、二氧化碳分压和氧合指数。采用酶联免疫吸附法检测各组炎症因子[白细胞介素（IL）-1、IL-6和肿瘤坏死因子-α（TNF-α）]水平。免疫印迹法检测各组肺组织中NF-κB通路相关蛋白（p-p65、p-IκBα、p65和IκBα蛋白）水平。结果：与假手术组相比,模型组肺组织和胰腺组织病理评分以及二氧化碳分压明显升高（P<0.05）。与模型组相比,金银花各剂量组肺组织和胰腺组织病理评分以及二氧化碳分压明显下降,并且呈剂量依赖性（P<0.05）。与假手术组相比,模型组血氧分压和氧合指数明显下降（P<0.05）。与模型组相比,金银花各剂量组血氧分压和氧合指数明显升高,并且呈剂量依赖性（P<0.05）。与假手术组相比,模型组IL-1、IL-6和TNF-α水平以及p-p65和p-IκBα蛋白水平明显升高（P<0.05）。与模型组相比,金银花各剂量组IL-1、IL-6和TNF-α水平以及p-p65和p-IκBα蛋白水平明显下降,并且呈剂量依赖性（P<0.05）。结论：金银花提取物对大鼠重症急性胰腺炎肺损伤具有一定保护作用,能够升高血氧分压和氧合指数并降低二氧化碳分压,并且其保护作用可能是通过抑制NF-κB通路介导的促炎症因子IL-1、IL-6和TNF-α的产生,缓解炎症性肺损伤。