Branches of the left pulmonary artery vascularizing the left upper pulmonary lobe

The studies were carried out on 100 left lungs taken from dead human bodies of both sexes whose age varied from 16 to 80 years. The pulmonary artery and the bronchus were injected with a 65% solution of duracryl and then digested in sulfuric acid. The specimens obtained were examined to determine the number and dimensions of the branches of the left pulmonary artery penetrating into the upper lobe of the left lung as well as the places at which they branch off from this artery. It was found that in most cases 4 branches ramified from the left pulmonary artery. Their length was 30 mm at the most, and their diameter, 12 mm. In about 50% of the cases the branches which penetrated into the lobe were the apicoanterior trunk, the lingular branch and 1 or 2 subsegmental branches, in about 25% of the cases almost all segmental branches penetrated into the lobe separately. In about 20% of the cases the apicoposterior trunk and independent segmental or subsegmental branches were present. Only in about 5% of the cases did the branches under consideration include the apicoposteroanterior trunk and the remaining segmental and subsegmental branches.     

肺部微生物组成与特发性肺纤维化生存率相关性研究

目的 运用16S rRNA基因测序技术分析特发性肺纤维化（idiopathic pulmonary fibrosis,IPF）患者支气管肺泡灌洗液（bronchoalveolar lavage fluid,BALF）的微生物组成,研究肺部微生物组成与IPF预后相关性。方法 选择2016年3月—2018年3月在本院诊治的IPF患者39例,作为IPF组,以体检健康成年人为对照组,40例。收集患者临床资料、生存时间,检测治疗前肺泡灌洗液中微生物组成。结果 IPF组Shannon指数明显高于对照组（P=0.024）。IPF组患者奈瑟氏球菌、金黄色葡萄球菌、溶血葡萄球菌、肺炎链球菌检出率明显高于对照组（P=0.005,0.003,0.003,0.000）。39例IPF患者随访时间为2~60个月,随访结束时患者死亡20例,存活19例,生存率为48.7%,平均生存时间39.8个月,奈瑟球菌、金黄色葡萄球菌、溶血葡萄球菌、肺炎链球菌检出与IPF患者的预后成反比。结论 IPF患者肺内微生物多样性增加,奈瑟球菌、金黄色葡萄球菌、溶血葡萄球菌、肺炎链球菌检出与IPF患者生存率呈负相关,可能成为改善IPF的潜在靶点。     

肺纤维化初期肺动脉高压大鼠肺动脉反应性的变化

目的：观察肺纤维化初期肺动脉高压大鼠肺动脉血管反应性的变化。方法：66只雄性SD大鼠,随机分为博莱霉素（BLM）组和手术对照（Sham）组。BLM组为气管内一次性滴注BLM（5 mg/kg）;Sham组为气管内滴注等容量的生理盐水（NS）。应用离体血管张力检测技术测定大鼠肺动脉血管反应性变化;用HE显示肺动脉壁病理形态学变化;Masson染色检测肺纤维化程度;右心漂浮导管技术测定大鼠平均肺动脉压。结果：①BLM组大鼠的肺动脉血管（保留内皮和去内皮）对苯肾上腺素（PE）的收缩反应均弱于Sham组（P均〈0.05）。②BLM组大鼠肺动脉血管（保留内皮）对氯化乙酰胆碱（Ach）的舒张反应明显弱于Sham组（P〈0.01）。③Sham组有内皮的肺动脉血管对L-NAME和PE联合作用的收缩反应明显强于PE单独作用（P〈0.01）,而BLM组有内皮肺动脉血管对L-NAME和PE联合作用的收缩反应与对PE单独作用比,其差异无统计学意义（P〉0.05）。④BLM组肺动脉内皮细胞脱落。⑤BLM组大鼠肺组织呈现纤维增生初期的病理特征,且大鼠的平均肺动脉压明显高于Sham组（P〈0.05）。结论：肺纤维化形成初期肺动脉高压大鼠肺动脉血管反应性出现异常。     

Normal nomogram of the pulmonary artery

With the aim to establish quantitative characteristics of the pulmonary artery in order to use them in planning operations on congenital heart diseases, the data of morphometric investigations on the pulmonary artery has been studied in 83 hearts of newborns, children and mature persons died from causes not connected with any cardiovascular disorders. The regression equations are calculated; they reflect certain dependence between the quantitative characteristics of the pulmonary artery and the area of the body surface.     

Multireceptor activation of the pulmonary chemoreflex

Schertel et al. (J. Appl. Physiol. 61: 1237-1240, 1984) reported that pulmonary C fibers initiate the prompt apnea followed by rapid shallow breathing evoked by pulmonary arterial injections of capsaicin. However, doubt has remained as to whether these changes in breathing pattern are induced exclusively by direct stimulation of pulmonary C fibers or whether secondary stimulation of slowly adapting pulmonary stretch receptors by capsaicin-induced reflex bronchoconstriction also contributes to the response. To determine the contribution of this secondary mechanism to changes in breathing pattern, we evoked the pulmonary chemoreflex in spontaneously breathing dogs before and after blockade of muscarinic receptors with atropine. Right atrial injections of capsaicin before the administration of atropine induced a classical pulmonary chemoreflex, i.e., apnea, hypotension, and bradycardia followed by rapid shallow breathing and bronchoconstriction. After atropine, all components of the pulmonary chemoreflex induced by right atrial injections of capsaicin remained intact except bronchoconstriction. However, the absolute magnitude of the change in each component of the reflex except apnea was significantly attenuated. We conclude that the classic pulmonary chemoreflex is a complex phenomenon initiated primarily by stimulation of pulmonary C fibers but significantly influenced by secondary stimulation of slowly adapting pulmonary stretch receptors.     

Pathology of the human pulmonary paracoccidioidomycosis

Lungs of twelve patients with chronic paracoccidioidomycosis (Pb) were studied in an attempt to understand the pathogenesis of the pulmonary disease. Ribbons of the lung parenchyma including the hilar region and directed towards apical, basal and lateral regions were subdivided into sections from the hilar, intermediate and peripheral segments. The following histopathological reactions directly or indirectly related to P. brasiliensis were described and analysed in relation to the number of slides studied and the pulmonary region involved: (1) pneumonic reaction; (2) early granulomatous formation; (3) mature and healed granulomata; (4) mixed pattern (early and mature granuloma in the same pulmonary area visualized in the slide); (5) pulmonary fibrosis.It was concluded that chronic pulmonary Pb is a recurrent disease affecting equally both lungs. Fibrosis was connected mainly with the progressive evolution of the granulomata towards cicatrization and to a lesser degree probably to a direct induction by the fungi. Based chiefly on the tendency of the fibrosis to run around bronchi and to make up septa interconnecting bronchi and vessels it was hipothesized that these findings were the result of a previous chronic specific lymphangitis by the fungi. Hilar fibrosis would be the result of this lymphangitis and/or of the progression of the specific granulomatous reaction seen in the hilar lymph nodes.Non specific forms of arteritis and areas of destructive emphysema related to granulomatous inflammation and fibrosis were described. Three cases developed pulmonary hypertension.