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肺腺癌靶向治疗后转化为小细胞肺癌三例报告

免疫治疗联合化学治疗的新辅助治疗后肺鳞癌获得病理完全缓解一例

伴多种胸部 CT 征象的韦格纳肉芽肿病一例

良性气道狭窄病因分析及治疗方式总结

目的 探讨良性气道狭窄病因分析及治疗方式。方法 收集2006 年1 月至2010 年5月期间四川大学华西医院经胸部CT、纤维支气管镜或手术、病原学、病理学确诊为良性气道狭窄的住院患者100 例。对患者的病史特点、胸部影像学检查、纤支镜镜下表现、手术所见、病原微生物、病理结果及治疗方式进行统计分析。结果 在良性气道狭窄患者中, 支气管结核60 例( 60% ) , 气管切开术后15 例( 15% ) , 创伤后6 例( 6% ) , 气管插管后3 例( 3% ) , 支气管吻合术后3 例( 3% ) , 甲状腺肿3 例( 3% ) , 复发性多软骨炎2 例( 2% ) , 良性肿瘤4 例( 4%) , 其他原因4 例( 4%) 。结论 良性气道狭窄的病因常见原因是结核性, 起病较隐匿, 临床医生应注意排查肺结核患者有无气道狭窄。纤支镜下的介入治疗为治疗良性气道狭窄的主要方法。

成人非结核分枝杆菌肺病治疗研究进展

贝伐珠单抗导致心肌梗死一例

Clinical Study of the Relevant Risk factors of Hepatic Adipose Infiltration in Young People

目的:探讨青年人群中脂肪肝的相关危险因素。方法:收集2008年在我院体检中心同期体检,年龄≤45岁脂肪肝患者127人,非脂肪肝患者116人,询问病史,进行身高、体重、血生化及B超检查并分脂肪肝组和非脂肪肝组进行比较。结果:脂肪肝组肥胖、饮酒、高血脂、高血糖、肝功异常发病率明显高于对照组。结论:肥胖、饮酒是脂肪肝的重要危险因素,脂肪肝患者多伴有糖脂代谢紊乱及肝功受损。

IgG4相关性疾病误诊为结核性胸膜炎一例并文献复习

Intervention effect of PDK1 inhibitor on PGE2 expression in smoking-induced COPD mouse model

Objective To investigate the intervention effect of 3-phosphoinositede dependent protein kinase-1 (PDK1) inhibitor on prostaglandin E2 (PGE2) in smoking-induced chronic obstructive pulmonary disease (COPD) mice. Methods Fifty C57BL/6 male mice were randomly divided into normal control group, smoking group, smoking +low dose PDK1 inhibitor group, smoking + medium dose PDK1 inhibitor group and high dose PDK1 inhibitor group with 10 mice in each group. The mice in the normal control group inhaled phosphate-buffered saline twice a day for 12 weeks, and the mice in the smoking group were fumigated twice a day, 5 days per week for 12 weeks, and the other three groups were given intraperitoneal injection of low-dose PDK1 inhibitor OSU-03012 (0.25 mg/kg), medium-dose PDK1 inhibitor (0.5 mg/kg) and high-dose PDK1 inhibitor (1.0 mg/kg) respectively before smoking. After smoking, lung function was tested, the bronchoalveolar lavage fluid (BALF) of each mouse was taken for cell count, the PGE2 in serum and BALF of mice was determined by enzyme linked immunosorbent assay, and the lung tissue of mice was sectioned with paraffin and stained by hematoxylin-eosin (HE), and pathological changes were observed under microscope. Results Compared with the control group, FEV100/FVC and FEV200/FVC of the mice in each smoking group were significantly decreased (P<0.05); The number of cells in BALF of smoking group was significantly higher than that of normal control group (P<0.05). There was no significant difference in the total number of BALF cells, the proportion of neutrophils and macrophages between the smoking + low-dose PDK1 inhibitor group and the smoking group. However, the total number of BALF cells and the proportion of neutrophils in the smoking + medium dose PDK1 inhibitor group and the high dose PDK1 inhibitor group gradually decreased, while the proportion of macrophages gradually increased, compared with the normal control group, the PGE2 concentrations of serum and BALF in the smoking group and the smoking + PDK1 inhibitor group were significantly higher than those in the control group. Compared with the smoking group, the PGE2 concentrations of serum and BALF in the middle and high dose PDK1 inhibitor groups were significantly lower than those in the smoking group. HE staining of lung tissue showed that there were a large number of inflammatory cell infiltration, alveolar cavity dilatation, alveolar wall rupture and fusion, alveolar formation, significant decrease in the number of alveoli and other pathological changes in the smoking group, which were consistent with the pathological changes of COPD. The inflammatory cell infiltration, mucus obstruction and alveolar dilatation were slightly alleviated in the smoking + low-dose PDK1 inhibitor group, while the inflammatory cell infiltration, alveolar wall thinning and alveolar dilatation were improved in both the medium-dose inhibitor group and the high-dose inhibitor group, and the improvement was more obvious in the high-dose inhibitor group. Conclusion The lung function of the smoked COPD mouse decreases, the airway inflammation is obvious, and the secretion of PGE2 is also increased, while the use of PDK1 inhibitor could reduce the secretion of PGE2, reduce airway inflammation and pathological changes, and improve lung function in a dose-dependent manner.

2670例肺癌支气管镜下表现与病理类型的关系分析

目的 探讨肺癌组织学类型与纤维支气管镜下形态学的关系, 及纤维支气管镜( 纤支镜) 检查在肺癌的病理诊断中的价值及应用。方法 对2005 年1 月至2008 年6 月经病理证实的 2670 例肺癌患者纤支镜检查结果进行临床和病理回顾性分析。纤支镜检查发现可疑病变后即在直视下钳检、刷检, 送病理学检查。结论 纤支镜下肺癌的形态特点为管内增殖型1467 例( 54. 9% ) 、管壁浸润型723 例( 27. 1% ) 、管外压迫型90 例( 3. 4%) 、混合型326 例( 12. 2% ) 和正常型64 例( 2. 4% ) 。2670 例肺癌中仍以鳞状细胞癌最为常见, 占44. 9% ; 鳞状细胞癌、小细胞癌以中央型为多,在纤支镜下呈现增殖型; 腺癌以周围型为多, 在纤支镜下常呈浸润型。结果 纤支镜检查在肺癌诊断中具有重要价值, 通过纤支镜所见形态特征可以推测肺癌的可能组织类型。