P53抗体联合CYFRA21-1和CEA在非小细胞肺癌中的应用

目的：研究血清P53抗体在非小细胞肺癌临床病理特征之间的关系,并结合血清中的癌胚抗原、角质蛋白21-1以指导对临床上肺癌复发和转移的分析,用来选择合理的治疗方案。方法：正常组30例,肺良性疾病组10例,肺癌组45例,肺癌全组分别于手术前1天、术后10、30、60和90天时抽取清晨空腹静脉血2ml,23例肺癌病例于手术后120天,15例病例于手术后180天抽取清晨空腹静脉血2ml,肺良性疾病组分别于手术前1天、抽取清晨空腹静脉血2ml。正常组清晨空腹采集静脉血2ml。采用酶联免疫吸附法（ELISA）检测血清P53抗体和角质蛋白21-1,采用荧光酶标免疫法检测血清癌胚抗原。结果：血清P53抗体、CYFRA21-1和CEA在正常人组、良性疾病组、肺癌组术前阳性率的比较三种肿瘤标志物阳性率经X2检验,在肺癌组分别与正常人组和良性病例组有显著性差异（P〈0.05）,良性病例组和正常人组之间无显著行差异（P〉0.05）。并与手术后复发与转移相关。结论：联合检测癌胚抗原、角质蛋白21-1及血清P53抗体水平有助于肺部良恶性疾病的诊断;手术前后动态测定肺癌患者血清P53抗体和角质蛋白21-1的变化规律,有助于判断疗效,监测预后和指导肺癌术后的综合治疗。     

Subcellular proteomics revealed the epithelial-mesenchymal transition phenotype in lung cancer

Subcellular proteomics was used to compare the protein profiles between human lung adenocarcinoma A549 cells and human bronchial epithelial (HBE) cells. In total, 106 differential proteins were identified and the altered expression levels of partial identified proteins were confirmed by Western blot analysis. Importantly, pathway analysis and biological validation revealed epithelial-mesenchymal transition (EMT) phenotype shift in A549 cells as compared with HBE cells. The EMT phenotype of A549 cells can be increased by self-producing TGF-β1 and significantly decreased by silencing heterogeneous nuclear ribonucleoprotein (hnRNPK) expression. As EMT has been considered as an important event during malignant tumor progression and metastasis, investigating EMT and deciphering the related pathways may lead to more efficient strategies to fight lung cancer progression. By integrating the subcellular proteomic data with EMT-related functional studies, we revealed new insights into the EMT progress of lung carcinogenesis, providing clues for further investigations on the discovery of potential therapeutic targets.     

不同剂量甲泼尼龙对急性百草枯中毒大鼠早期肺损伤干预研究

目的:探讨不同剂量的甲泼尼龙(Methylprednisolone,MPS)对急性百草枯(paraquat,PQ)中毒大鼠早期肺损伤的疗效。方法:采用腹腔注射20%的PQ溶液制作大鼠急性PQ中毒的模型,随机均分为五组,正常对照组(A组)、染毒组(B组)、5mg/kg甲泼尼龙干预组(C组)、15mg/kg甲泼尼龙干预组(D组)、30mg/kg甲泼尼龙干预组(E组)。分三个不同时间点(24、72、168h)处死大鼠(每组每时间点6只)。观察各时间点大体标本,组织病理、肺系数和氧合指数。结果:光镜下肺组织病理学观察,与B组比较C、D、E组大鼠肺的病理学改变,肺泡腔内出血、渗出,炎性细胞浸润、肺泡隔炎性细胞浸润相对较轻,其中以C、E组减轻最为明显。在各组相同时间点肺系数:在三个时间点的值均比B组低(P<0.05),其中E组在24h、72h时间点上与C、D组有显著差异(P<0.05)。C、D、E组与B组的氧合指数的比较各个时间点上均与B组有差异(P<0.05),三组之间相互无明显差异。结论:本实验结果显示甲泼尼龙对急性百草枯中毒大鼠的肺损伤具有保护作用,且30mg/kg甲泼尼龙组要优于5mg/kg、15mg/kg甲泼尼龙组。     

某三甲医院2007-2011 年ICU 气管切开术后肺部感染患者208 例 临床分析

目的:探讨湖南某三甲医院重症监护病房(ICU)患者气管切开后肺部感染病原菌的类型及其耐药性,为临床经验性用药提供帮助。方法:回顾性分析ICU 208例气管切开术后并发肺部感染患者的痰细菌培养及药物敏感性测定结果。结果:共分离出420株致病菌,革兰阴性菌293株,占69.76%,其中铜绿假单胞菌98株居首位;革兰阳性菌105株,占25.24%,其中金黄色葡萄球菌47株为最多;真菌占22株,占5.23%。分离出产超广谱β内酰胺酶(ESBLs)菌87株,耐甲氧西林金黄色葡萄球菌(MRSA)24株。所分离致病菌对常用抗菌药物均有不同程度的耐药,且为多重耐药。结论:ICU气管切开患者肺部感染病原菌以革兰阴性菌为主,耐药率高,临床应加强病原学监测,重视细菌的种类分布和耐药趋势,合理使用抗生素。     

VEGF and IL-18 in induced sputum of lung cancer patients

Cytokines are key players in the biological processes of malignant tumors and special interest has been focused on cytokines exerting tumor and anti-tumor properties, such as vascular endothelial growth factor (VEGF) and Interleukin-18 (IL-18). Aim of this study was to assess IL-18 and VEGF levels in induced sputum of lung cancer patients at diagnosis, and assess their possible association with the histological type of cancer, the stage and the overall patient survival. Seventy six patients with a diagnosis of lung cancer were recruited and were followed up for 48months. Thirteen healthy smokers and 16 healthy non-smokers were used as control groups. VEGF and IL-18 were measured by ELISA in sputum supernatants at the time of diagnosis. Lung cancer patients had significantly higher baseline IL-18 and VEGF levels compared to healthy controls (p<0.001). No difference was found in IL-18 and VEGF levels between the various stages in non-small cell lung cancer (NSCLC) and between limited and extended small cell lung cancer (SCLC). However, the ratio of VEGF/IL-18 was significantly higher in NSCLC compared to SCLC patients (p=0.018). In extended SCLC overall survival was inversely associated with baseline sputum VEGF levels (p=0.034) and estimated mortality risk was 1.14 (95% CI 1.006-1.283) for an increase of 100pg/ml in VEGF levels. Such association was not found regarding baseline IL-18 levels. VEGF levels in induced sputum may have a prognostic role in the survival of SCLC. The ratio VEGF/IL-18 in induced sputum differs between NSCLC and SCLC, indicating differences in angiogenesis mechanisms and/or immunological response in these two major histological types of lung cancer.     

铜绿假单胞菌家兔肺部感染模型的建立与评价

目的:建立铜绿假单胞菌(PA,又名绿脓杆菌)肺部感染动物模型,并从病理学及细菌学、影像学等方面进行评价,研究铜绿假单胞菌对肺组织的致病作用。方法:24只健康清洁级新西兰大白兔随机分成2组,实验组采用经皮气管穿刺法,隔日注入铜绿假单胞菌反复感染家兔,对照组施以生理盐水。接种后隔日一次行胸部CT扫描。比较二组家兔的体温、血象及肺组织匀浆菌落计数;观察病理组织改变及胸部CT影像学变化。结果:注菌组家兔白细胞总数显著升高,肺组织匀浆菌落计数显著高于对照组。CT表现为双侧多发斑片状模糊影,部分可见实变及脓肿灶。大体标本可见家兔肺部结节、脓肿及出血灶,病理学镜下观察发现注菌组家兔肺组织内多个脓肿灶形成,大量中性粒细胞浸润,肺泡腔内大量渗出,部分出血,肺泡壁充血及肺水肿。随着注菌次数增多及时间推移,逐渐出现如肺泡间隔增厚、肉芽肿形成、实变等慢性肺部炎症的病理表现。结论:使用经皮气道穿刺法接种铜绿假单胞菌至新西兰兔肺部,可成功建立兔铜绿假单胞菌肺部感染模型。     

以VEGF/VEGFR 为靶点的肺癌治疗药物研究进展

目的:论述以血管内皮生成因子(VEGF)及其受体VEGFR为靶点的肺癌的研究现状,探讨VEGF及VEGFR与肺癌发生及发展的关系,为肺癌抗血管生成的治疗提供新的药物作用途径。方法:依据近年国内外的相关文献,进行归纳和分析,对VEGF及肺癌发生相关系统进行研究,并在此基础上,提出肺癌抗血管治疗的新思路。结果:研究发现,在肺癌的发生及发展过程中,VEGF出现过量表达。为达到抑制其促血管生成的作用,以VEGF/VEGFR为靶点,研制抑制VEGF活性的药物或干扰VEGFR的药物,可在一定程度上实现通过抑制相关抗血管生成治疗肺癌的目的。结论:利用新的抗血管途径有望在肺癌治疗中研发出新药,提高肺癌治疗效果。     

野生仙人掌多糖对肺鳞癌细胞SK-MES-1 生长的抑制作用

目的:探讨仙人掌多糖对体外肺鳞癌细胞(SK-MES-1)生长抑制作用。方法:体外培养SK-MES-1细胞,四甲基偶氮唑盐(MTT)法观察野生仙人掌多糖对其生长的抑制,计算最低抑制浓度及抑制率;观察不同浓度多糖对细胞形态的影响;SDS-PAGE凝胶电泳简析不同组别蛋白质表达的差异。结果:野生仙人掌多糖24 h和48 h对肿瘤细胞的最低抑制浓度和抑制率分别为0.0625 mg/ml.34.06%和0.0625 mg/ml 35.37%;不同组间蛋白质表达有差异。结论:野生仙人掌多糖对SK-MES-1肺鳞癌细胞有抑制作用。     

心理治疗对支气管肺癌患者化疗依从性的影响

目的:探讨心理治疗对支气管肺癌患者化疗依从性的影响。方法:本院收治的支气管肺癌患者80例,随机分为对照组和观察组。对照组进行化疗的支气管肺癌患者采用常规专业护理措施。观察组:在对照组常规专业护理措施的同时,患者行心理治疗措施。结果:观察组满意度高于对照组;观察组的依从性优于对照组。结论:心理治疗不但可以提高支气管肺癌患者在化疗期间的满意度;而且可以提高支气管肺癌患者对化疗的依从性。