目的 讨论肺癌放化疗患者发生医院感染的临床特点.方法 回顾性分析80例肺癌放化疗患者临床资料,分析医院感染的发生情况.结果 放化疗患者医院感染的发生率显著高于单纯化疗和单纯放疗患者(P均<0.05);肺癌患者医院感染的最常见部位为呼吸道和肺部,主要致病菌为革兰氏阴性杆菌;肺癌放化疗患者医院感染的发生率与住院时长呈正相关.结论 医院感染是肺癌放化疗患者的常见并发症,临床上应加强对医院感染的预防和治疗.

BACKGROUND Patients with advanced non-small cell lung cancer (NSCLC) treated with cisplatin, also termed cis-diamminedichloroplatinum (CDDP) or diamminedichloroplatinum (DDP), may develop chemoresistance. This study aimed to investigate the role of long non-coding RNA (lncRNA) X-inactive specific transcript (XIST) and multidrug resistance-1 (MDR1) in tumor tissue samples and the chemoresistant human NSCLC cell lines, H460/DDP and A549/DDP, and in a murine A549/DDP tumor xenograft. MATERIAL AND METHODS Tissue samples were from patients with NSCLC who responded cisplatin (DDP-sensitive) (n=24), patients with NSCLC unresponsive to cisplatin (DDP-resistant) (n=30), and normal lung tissue (n=25). In H460/DDP and A549/DDP cells, expression of XIST, microRNA (miR)-144-3p, MDR1, and multidrug resistance-associated protein 1 (MRP1) were detected by quantitative reverse transcription polymerase chain reaction (RT-qPCR) and Western blot. The MTT assay measured cell survival and proliferation, a transwell assay evaluated cell migration, and flow cytometry measured apoptosis. Luciferase reporter, RNA immunoprecipitation (RIP), and RNA pull-down assays examined the relationship between XIST and miR-144-3p. Tumor xenografts from A549/DDP cells were studied in BALB/c nude mice. RESULTS In tissue from patients with DDP-resistant NSCLC and the mouse A549/DDP tumor xenograft, lncRNA-XIST expression was upregulated and miR-144-3p expression was inhibited. In A549/DDP and H460/DDP cells, down-regulation of lncRNA-XIST and upregulation of miR-144-3p reduced cell survival, proliferation, migration, induced apoptosis and suppressed MDR1 and MRP1 expression. CONCLUSIONS Upregulation of lncRNA-XIST was associated with cisplatin resistance in NSCLC by downregulating miRNA-144-3p in H460/DDP and A549/DDP cells, a murine A549/DDP tumor xenograft, and human tumor tissues from patients with cisplatin-resistant NSCLC.

目的:探讨血乳酸清除率在运用无创机械通气治疗Ⅰ型呼吸衰竭患者中发挥的指导作用.方法:选择兰州市第一人民医院呼吸内科收治的90例Ⅰ型呼吸衰竭患者作为研究对象,计算患者无创机械通气治疗下6h血乳酸清除率,比较存活组和死亡组各项血气指标以及高乳酸清除率组和低乳酸清除率组患者的病死率.结果:在入院时,存活组与死亡组患者的各项血气指标无显著差异(P＞0.05).治疗后,存活组乳酸、PaCO2水平低于死亡组,6h乳酸清除率、PaO2、PaO2/FiO2水平高于死亡组(P＜0.05);高乳酸清除率组的病死率低于低乳酸清除率组,差异显著(P＜0.05).结论:血乳酸清除率与Ⅰ型呼吸衰竭的预后均有关系,因此在无创机械通气治疗Ⅰ型呼吸衰竭中具有重要指导价值.

目的:讨论C反应蛋白联合血乳酸检测在呼吸衰竭患者预后评价中的效果.方法:回顾性分析兰州市第一人民医院呼吸科2016年1月至2017年3月收治的60例呼吸衰竭患者,根据预后情况分为存活组(43例)与死亡组(17例),同时选择30例健康者作为对照组,分别在入院第1天、第4天进行C反应蛋白与血乳酸检测.结果:存活组、死亡组第1天、第4天的C反应蛋白与血乳酸均高于对照组(P＜0.05);死亡组第1天、第4天的C反应蛋白与血乳酸均高于存活组(P＜0.05);存活组第4天C反应蛋白与血乳酸明显低于第1天(P＜0.05).结论:通过C反应蛋白联合血乳酸检测,能够全面掌握呼吸衰竭患者预后情况,值得临床推广.

目的对呼吸系统疾病发生真菌感染相关因素进行探讨。方法选取了2011年1月~2014年4月本人所在医院经痰液真菌培养后的38例呼吸系统疾病真菌感染确诊患者，采用真菌培养的方法了解真菌种类，并进行分析了感染因素。结果本研究中，慢性支气管炎，占42.11%，是真菌感染的基础病比例最高的。其次分别为肺肿瘤26.32%、肺源性心脏病15.79%、肺气肿10.53%、肺炎5.26%。白色念珠菌，占68.42%是呼吸系统疾病真菌感染最高的，呼吸系统疾病真菌感染与年龄、抗生素应用、病程等关系都比较直接，年龄越大、抗生素应用滥用、病程越长，患者发生真菌感染的几率越高(<0.01)。结论呼吸系统疾病患者在诊断时杜绝药物滥用，为了促进患者早日康复，给予积极有效的辅助检查措施，同时也给予合理有效的治疗措施，从而确保治疗效果。

Blood lactate concentration reacted to body tissue perfusion is a sensitive marker for cells under hypoxia.It increased significantly when the body is in a poor perfusion and low oxygen.When hypoperfusion has been controled ef-fectively,and hypoxia quickly has been corrected,the level of lactic acid in vivo decreased rapidly.The lack of oxygen is a major aspect of respiratory failure pathophysiological changes,which causing the blood lactic acid increased,further-more blood lactic acidosis.The purpose of this review is to detect blood lactic acid and to analyse of the test results.In the end,we summarized clinical significance of blood lactic acid in the common disease of respiratory failure and pro-vided rational clinical therapy for such diseases.

目的：探讨不同分期老年慢性阻塞性肺疾病(COPD)患者外周血中CD4+Foxp3+调节性T细胞(Treg细胞)变化及其与肺功能改变的相关性。方法老年COPD患者41例(实验1组)、同期定期随访的稳定期老年COPD患者46例(实验2组)、同期体检的37例健康人(对照组)，分别测定外周血中Treg细胞。结果实验组和对照组FVC%prep、FEV1%prep、FEV1/FVC%、CD4+Foxp3+%差异均有统计学意义(P<0.01)， CD4+CD25+%差异无统计学意义(P>0.05)，外周血Treg细胞比例与FEV1%prep和FEV1/FVC%之间有相关性。结论老年COPD患者调节性T细胞与肺功能改变有相关性。

Chronic obstructive pulmonary disease(COPD)is one of the common diseases in respiratory system.The late researches showed close association of some cytokines,such as TNF-α and IL-8,with the onset of COPD.As major inflammatory mediators,TNF-α and IL-8 involve in the inflammatory response of airway,which accelerate the onset and progress of local inflammation by their interaction,result in the structural reconstruction of airway and the formation of airflow obstruction and thereby influence the onset and progress of COPD.This paper reviews the association of TNF-α and IL-8 with pathogenic mechanism of COPD.

目的:观察三黄凝胶对动物炎性模型气囊灌洗液中的白细胞数和NO含量的变化。方法:60只小鼠随机分为6组,建立动物模型,予以给药处理,然后测定气囊灌洗液中的白细胞数和NO含量,并进行相关性分析。结果:三黄凝胶降低小鼠气囊炎性模型气囊灌洗液中的白细胞数和NO含量。结论:"三黄凝胶"具有治疗外科体表感染的作用机制,为临床治疗体表感染提供了理论依据。

目的观察慢性阻塞性肺疾病急性加重期(AECOPD)呼吸衰竭患者治疗前后血清中肿瘤坏死因子(TNF-α)和白细胞介素-8(IL-8)的浓度,旨在讨论两者在发病中的作用及变化特点。方法采用放射免疫分析法测定AECOPD呼吸衰竭患者治疗前后血清中的TNF-α和IL-8,同步检测动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)。结果AECOPD呼吸衰竭患者治疗前后血清中TNF-α和IL-8具有显著性差异(P<0.01),并随动脉血气指标的变化呈动态改变。结论TNF-α和IL-8在AECOPD呼吸衰竭中起着重要作用,测定血清中两者的变化对病程分析、指导治疗具有一定意义。