目的:探讨血清胱抑素C(CysC)在特发性肺纤维化(IPF)患者稳定期和病情加重期的水平变化,研究其潜在的价值以探讨CysC水平变化与肺功能之间的关系.方法:共纳入30例IPF患者(稳定期17例,加重期13例)和15例健康受试者.检测研究对象的肺功能指标、C-反应蛋白(CRP)、CysC水平.结果:稳定期IPF及加重期IPF患者血清CysC水平均高于对照组,差异有统计学意义(P＜0.001),但两组特发性肺纤维化组间CysC水平差异无统计学意义(P＞0.05).特发性肺纤维化患者中血清CysC水平与血清CRP水平呈正相关(r=0.568,P＜0.01);CysC水平与FVC％pred呈负相关(r=-0.438,P＜0.05).结论:研究结果显示,稳定期IPF组及加重期IPF组CysC水平均升高,CysC水平的升高可能与IPF患者的肺功能下降和炎症反应有关.

目的:探讨白细胞介素-6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)在特发性肺纤维化(idio-pathic pulmonary fibrosis,IPF)患者中的表达及临床意义.方法:收集2021年1月至2022年1月佳木斯大学附属第一医院收治的特发性肺纤维化患者40例(急性发作期特发性肺纤维化(acute idiopathic pulmonary fibrosis,AEIPF)患者20例,稳定期特发性肺纤维化患者20例,健康对照组30例.分析这两组中的IL-6、CRP、肺一氧化碳弥散量(diffusion capacity for carbon mon-oxide of lung,DLCO)水平,分析IL-6、CRP在IPF患者中的表达情况和IL-6、CRP与DLCO水平的相关性,同时检测IL-6、CRP联合诊断的敏感度及特异度.结果:IL-6、CRP水平均高于健康对照组差异有统计学意义(P＜0.05);IL-6、CRP水平在急性发作期高于稳定期,差异有统计学意义(P＜0.05);IL-6、CRP与DLCO水平呈负相关;IL-6、CRP联合诊断的ROC曲线下面积即AUC值大于单独检测IL-6,但特异度及敏感度无显著差异.结论:①血清IL-6、CRP升高可能与炎症反应相关.②IL-6、CRP水平的变化可能提示IPF患者的肺功能下降.③联合检测IL-6、CRP可能为IPF诊断提供参考依据.

OBJECTIVE:To investigate the function and mechanism of circular RNA circ HIPK2 on non-small cell lung cancer cell proliferation and progression.METHODS:Patients with non-small cell lung cancer (n=40) were collected from May 2015 to August 2016.RESULTS:Circular RNA circ HIPK2 expressions were up-regulated in patients with non-small cell lung cancer, compared with paracancerous tissue. Circular RNA circ HIPK2 expressions in III-IV patients with non-small cell lung cancer were higher than those of I-II patients. Overall survival rate and disease-free survival rate of patients with high circ HIPK2 expression were lower than those of patients with low circ HIPK2 expression. Circ HIPK2 promoted cell proliferation of non-small cell lung cancer. MiR-485-5p is a target for circ HIPK2 in non-small cell lung cancer; it reduced cell proliferation and accelerated HSP90 Ubiquitination in non-small cell lung cancer.CONCLUSION:The present study suggests that circ HIPK2/miR-485-5p plays a crucial role in the progression of non-small cell lung cancer by regulating HSP90 function, thereby may be an inhibition therapeutic target of non-small cell lung cancer.

目的:研究在肺癌的诊断中,HE4的价值及HE4、CEA、NSE和CYFRA21-1联合检测对肺癌诊断的价值.方法:取42例肺癌患者、50例肺良性疾病患者及50例健康体检者血清.采用化学发光法对三组人群血清中的HE4、CEA、CYFRA21-1和NSE检测,并进行相关统计学分析.结果:①肺癌组患者的血清HE4水平明显高于肺良性疾病组(P＜0.05)和健康对照组(P＜0.05),差异有统计学意义;灵敏度及特异度最高指标为HE4,分别为64.27％和95.78％;HE4的AUC值为0.851,所以HE4的诊断效能较好.②联合检测的灵敏度为89.13％,明显优于单独检测.结论:①HE4可能作为诊断肺癌的血清肿瘤标志物;②联合检测HE4、CEA、NSE及CYFRA-21对肺癌的诊断价值优于单独检测.

目的:研究Th22细胞及效应因子IL-22与IL-9在肺癌患者外周血中的表达及相关性分析.方法:收取2018-11 ～2019-05在我院住院确诊为肺癌患者35例为实验组;对照组为来自于同一时期门诊体检的35例健康人群;用流式细胞术检测外周血中Th22细胞(CD4+ IL-22+)的比例,用酶联免疫吸附(ELISA)法检测血清中IL-22、IL-9的表达水平.结果:在肺癌患者中,Th22细胞、IL-22、IL-9因子的表达均高于对照组(P＜0.01),差异有显著性,并且Th22细胞与效应因子IL-22在实验组表达水平呈正相关,IL-22因子、IL-9因子的表达水平呈正相关.结论:肺癌患者外周血中Th22、IL-22、IL-9的表达频率明显升高,与肺癌的发生发展相关,有望为肺癌的研究增添新的思路.

目的 探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者血清中分泌型卷曲相关蛋白1(SFRP1)及分泌型卷曲相关蛋白5(SFRP5)的水平表达及其与病情严重程度的关联.方法 选取2019年3月—2020年1月于本院呼吸与危重症医学科确诊的AECOPD患者45例作为研究对象,设为急性加重组;另选同期健康体检者30名作为对照组.根据慢性阻塞性肺疾病基层诊疗指南(2018版)将急性加重期组按临床分级分为A组(AECOPDⅠ级,19例)、B组(AECOPDⅡ级,16例)和C组(AECOPDⅢ级,10例)三组.通过观察肺功能参数:FEV1％pred、FVC％pred及FEV1/FVC％,分析对比急性加重组各组的气流受限严重程度;采用酶联免疫吸附法(ELISA)测定血清SFRP1及SFRP5水平.结果 急性加重期患者SFRP1水平显著高于正常对照组,各组AECOPD患者SFRP1水平存在显著差异(P<0.05):A组<B组<C组;急性加重期患者SFRP5水平显著低于正常对照组,各组AECOPD患者SFRP5水平存在显著差异(P<0.05):A组>B组>C组.相关性分析显示:AECOPD患者血清SFRP1与肺功能参数FEV1％pred(r=-0.483,P<0.05)、FVC％pred(r=-0.380,P<0.05)及FEV1/FVC％(r=-0.334,P<0.05)呈负相关;AECOPD患者血清SFRP5与肺功能参数FEV1％pred(r=0.600,P<0.05)、FVC％pred(r=0.576,P<0.05)及FEV1/FVC％(r=0.490,P<0.05)呈正相关.结论 血清SFRP1及SFRP5水平与AECOPD患者病情严重程度和气流受限密切相关,可作为反映AECOPD患者病情的参考指标.

目的 探讨Th22细胞及效应因子IL-22在肺癌患者外周血中的表达程度,并探讨其与肺癌淋巴结转移及肿瘤大小、病理类型的相关性.方法 选取2018年11月～2019年5月在我院住院确诊的肺癌患者40例为实验组;对照组为随机选取来自于同一时期门诊体检的40例健康人群;用流式细胞术检测外周血中Th22细胞(CD4+IL-22+)的比例,用酶联免疫吸附(ELISA)法检测血清中IL-22浓度变化;对比观察两组Th22细胞及IL-22因子的表达变化.结果 在肺癌患者中,Th22细胞、IL-22因子的表达均高于对照组(P＜0.01),从相关性分析图看出二者呈正相关(r=0.631,P＜0.01);且实验组患者有淋巴结转移者与无淋巴结转移者比较,Th22细胞、IL-22因子数值增大,差异有显著性(P＜0.05);实验组随着肿瘤直径逐渐增大,病理类型不同,Th22细胞、IL-22因子数值增加,差异有统计学意义(P＜0.01).结论 肺癌患者外周血中Th22、IL-22表达频率明显升高,与肺癌病理类型、淋巴结转移、肿瘤大小密切相关,有望为肺癌的研究增添新的思路.

目的:观察体外膈肌起搏器对慢性阻塞性肺疾病患者的治疗效果.方法:选取2018-09～2019-01在我院住院治疗的慢性阻塞性肺疾病患者60例,随机将其分为药物组和联合组,药物组采用药物治疗方式干预,联合组在药物组的基础上加用体外膈肌起搏器治疗,治疗时间共为2周,观察两组患者治疗后的症状、体征、肺功能变化情况.结果:治疗后,两组患者各项指标均有所改善,但药物组明显低于联合组(P＜0.05).结论:体外膈肌起搏器对慢性阻塞性肺疾病患者的临床效果较好,可以有效地改善呼吸功能,提高患者生存质量.

剖析目前医学专业学生在校学习期间缺少对医学知识的综合运用,致使所学科目各自独立、界限分明,无法使其掌握的理论知识综合运用融合到临床实践中去的实际问题,提出并在呼吸内科教学中进行多学科协作的教学模式的探索.阐述多学科协作教学模式的概念、内涵及其在当代诸多医学教育模式中的作用,探讨引入此新模式的可行性、必然性及诸多问题的解决途径.将各自独立的临床课程、将理论与临床实践进行交叉融合,提高医学生理论知识综合掌握能力及临床实践能力,为临床医学教学改革开创新的思路.

目的 研究呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)与高迁移率族蛋白B1(high-mobility group box 1,HMGB1)在支气管哮喘(简称哮喘)患者中的表达水平及相互关系.方法 以2017 GINA指南标准[1]为指导,选取65例于我院呼吸内科就诊的患者及健康体检者为研究对象,其中支气管哮喘患者(哮喘组)36例,健康体检者(对照组)29例,采用酶联免疫吸附法(ELISA)检测两组患者血清HMGB1水平,NO分析仪行FeNO检测.结果 支气管哮喘组FeNO:92.47±33.09ppb,血清HMGB1:134.64±46.20 ug/L;对照组FeNO:9.73±3.69ppb,血清HMGB1:83.60±28.41 ug/L;与对照组比较,哮喘组FeNO水平明显升高(P<0.05),血清HMGB1水平显著增高(P<0.05),哮喘组FeNO水平与血清HMGB1水平成正相关(r=0.535,P<0.01).结论 血清HMGB1含量与FeNO水平可在一定程度上反应支气管哮喘的炎症程度,为支气管哮喘的炎症评估及治疗提供重要的临床依据.

目的 研究Notch3受体在非小细胞肺癌(NSCLC)组织中的表达情况,探讨Notch3受体与NSCLC发病的相关性.方法 外科手术切除后由病理确诊为NSCLC 80例患者(临床病理资料完整,术前未经放、化疗及其他抗肿瘤治疗)的肺癌组织,40例正常肺组织(为癌旁距离肿块边缘5 cm以上、经病理HE染色证实为正常的肺组织),免疫组织化学SP法检测肺癌组织及癌旁正常肺组织中Notch3受体的表达.结果 NSCLC肺组织中Notch3受体水平明显高于对照组(χ2=19.937,P<0.01);Notch3受体水平与患者性别,年龄,组织类型(肺腺、鳞癌)无相关性(P>0.05);TNMⅢ+Ⅳ期中Notch3受体水平阳性率为73.3％,TNMⅠ+Ⅱ期阳性率为44.0％,差异有统计学意义(χ2=6.519,P<0.05);有淋巴结转移患者的Notch3受体阳性表达率为84.2％,无淋巴结转移患者的阳性率为28.6％,差异有统计学意义(χ2=24.953,P<0.05).结论 Notch3受体的表达水平与NSCLC的TNM分期、淋巴结转移密切相关,Notch3受体参与了NSCLC的发病及进展,对NSCLC患者的疾病进展及预后有重要意义;同时,阻断其表达有望成为NSCLC靶向治疗的新靶点.

Objective To study the expression and significance of IL-35,Th17/Treg imbalance in rats with pulmonary fibrosis. Methods A total of 60 healthy male and female Wistar rats were randomly divided into two groups:30 rats in the control group(the normal saline group),and 30 rats in the pulmonary fibrosis group(the bleo-mycin group). Every 10 rats in the control group and the model group were sacrificed on the 7th day, the 14th day and the 28th day respectively. The lung tissue and alveolar lavage fluid were collected from each group to observe the morphological changes of lung tissue by HE staining and Masson trichrome staining. The levels of Treg,Th17 cells, IL-35 and IL-17 were detected in bronchial rinse and lung tissue. The relationship between IL-35 and Th17/Treg was analyzed. Results 1. Compared with the control group, the inflammation and pulmonary fibrosis degree was more significant in the pulmonary fibrosis group,and the inflammation of the lungs was the most pronounced at the 7th day. 2. The expression of IL-35 and Treg cells in the pulmonary fibrosis group was significantly lower than that in the con-trol group. The expression of IL-17 and Th17 cells was significantly higher than that of the control group. 3. There was a significant negative correlation between IL-35 and IL-17 expression in the pulmonary fibrosis group (r= -0. 378,P<0.01),IL-35 was positively correlated with Treg cell expression (r=0.461, P<0.01), and IL-35 was negatively correlated with Th17 / Treg cell expression (r= -0.386,P<0.01). Conclusion The research on the expression and relativity of IL-35, IL-17 and Th17/Treg cells in rat pulmonary fibrosis group and control group re-veals that IL-35 may be involved in the regulation of Th17/Treg cell balance in lung fibrosis,and the regulation of IL-35 may be a new target for the treatment of pulmonary fibrosis.

Objective To explore the relationship and the distribution of MTHFR C677T and A1298C with lung cancer in Han population in Heilongjiang. Methods 225 lung cancer patients were taken as the experimental group and the outpatient physical examination of healthy people as the control group. The genotype of MTHFR C677T and A1298C was detected by Sanger dideoxy chain termination method. Results The genotype distribution of MTH-FR C677T TT in the experimental group was significantly higher than that in the control group(23.1% vs 10.7%,P<0.05). The risk ratio of lung cancer with TT genotype was 2.517,and 95% CI was 1.490-4.254. There was no significant difference in MTHFR A1298C genotype distribution frequency between the experimental group and the con-trol group (P>0.05). Conclusion MTHFR C677T TT genotype is significantly associated with lung cancer, and A1298C has no association with lung cancer.

Objective To study the expression of IL-37 and Smad3 in lung tissue of rats with bleomycin induced pulmonary fibrosis,and to explore the role and significance of PF in the occurrence and development of pulmonary fibrosis.Methods 45 Sprague Wistar rats were randomly divided into the normal control group (the N group),the bleomycin group (the B group),and the dexamethasone group (the D group),15 rats in each group.The B group and the D group were given intratracheal bleomycin lung 4mg/kg fibrosis model,and the N group was given the same volume of normal saline as the control group.Based on the second day of pulmonary fibrosis model,the group D was injected with dexamethasone 3mg/kg,and the group B and N were intraperitoneally injected with normal saline as control.The rats were sacrificed 7,14 and 28 days after modeling.HE staining was used to evaluate the morphological changes,and hydroxyproline and IL-37 in lung tissue was measured by alkali hydrolysis and enzyme linked immunosorbent assay (HYP).The expression of Smad3mRNA in lung tissue were detected by RT-PCR.Results (1) HE staining showed that the group B and D gradually developed into fibrosis.The level of Hyp at each time point was significantly higher in the group B and D than in the group N (P ＜ 0.05).(2) IL-37 content in the seventh day increased significantly in the group B and D.but it was still higher than that in the group N (P ＜ 0.05).(3) Smad3mrna expression increased gradually in the group B and D (P ＜ 0.05).Conclusion IL-37 and Smad3 play important roles in the pathogenesis of pulmonary fibrosis in rats,and they may be involved in the occurrence and development of pulmonary fibrosis.

目的 动态观察特发性肺纤维化患者服用激素前后外周血Th22细胞及其相关因子IL-22的表达,探讨其与疾病的关系.方法 抽取实验组患者激素治疗前、治疗1个月后、治疗2个月后、治疗3个月后和健康对照者的外周血,采用流式细胞术检测Th22细胞水平,ELISA法检测IL-22水平,将所得数据进行统计学处理.结果 实验组Th22细胞比例(7.67±2.11)%和IL-22水平(821.92±253.48)pg/ml明显高于健康对照组[(1.89±1.02)%和(279.91±95.31) pg/ml] (P<0.05),激素治疗3个月后两项指标均显著下降[(5.20±1.98)%和(522.98±168.30)]pg/ml(P<0.05),但仍明显高于健康者,且在不同性别的患者中二者表达亦有所差异.结论 Th22细胞及其相关因子IL-22参与了特发性肺纤维化的发病过程,且对激素治疗敏感.

目的 探讨IL-9和TGF-β1在慢性肺心病患者中的水平及临床分析.方法 采用酶联免疫分析法分别检测30例肺心病患者及20例健康对照者血清中的IL-9和TGF-β1的表达水平.结果 (1)肺心病患者血清IL-9和TGF-β1水平均高于对照组(P＜0.01),并且不同缺氧程度的肺心病患者血清IL-9和TGF-β1水平均不同,差异均有统计学意义(P＜0.01).(2)肺心病患者血清IL-9和TGF-β1呈正相关(r=0.801,P＜0.05).血清IL-9和TGF-β1与PaO2均分别呈负相关(r=-0.735,P＜0.05;r=-0.784,P＜0.05).结论 IL-9和TGF-β1参与了肺心病发病过程,二者联合检测对其诊治有着重要的临床意义.

正>近年来PTE作为呼吸科常见急症、危重疾病,其发病率正逐年增高,由于肺血栓栓塞症临床症状无明显特异性[1],导致其临床漏诊率高、检出率低。因此,使PTE患者得到早期诊断,提高诊断率,并获得及时正确治疗,可大大降低医院患者病死率,本研

Objective To study the expression and significance of CCR6,Th9 related factors and Th17/Treg imbal-ance in rats with pulmonary fibrosis.Methods 63 rats (male SD)were randomly divided into three groups:Normal sa-line control group ( N group ),Pulmonary fibrosis model group (F group ),Dexamethasone treatment group ( D group).Made the rat model of pulmonary fibrosis by injecting bleomycin through the trachea.The lung tissues and the bronchoalveolar lavage fluid of three groups rats were taken at 7 d,14 d and 28 d respectively.HE staining was used to observe the pathological changes of lung tissue in rats.The expression of CCR6 and IL-9 in lung tissue of three groups were evaluated by immunohistochemistry.Detection of PU.1mRNA level in bronchoalveolar lavage fluid by fluores-cence PCR.Flow cytometry was used to detect the expression of Th17 and Treg cell.And analyzed the correlation be-tween CCR6 ,Th9 and Th17/Treg cell.Results 1 .Compared with the N group,the inflammation degree and the pulmo-nary fibrosis degree of the lung tissue was significant in F group and D group,and pulmonary inflammation in the 7d is most obvious.2.About the level of the CCR6,PU.1mRNA,IL-9,Th17,F,D group of rats at different time points were significantly higher than N group(P<0.05).The expression level of Treg cells in F and D group was lower than that in control group(P<0.05).3.The expression levels of CCR6,Th9 and PU.1mRNA were significantly positively correla-ted with Th17,and negatively correlated with Treg (P<0.01).Conclusion Compared with the control group,the ex-pression levels of CCR6,Th9 related factors and Th17/Treg were significantly increased in rats with pulmonary fibro-sis.It is concluded that CCR6,Th9 related factors may be involved in the pathogenesis of pulmonary fibrosis about Th17/Treg imbalance to promote the proliferation of lung fibroblasts.It may plays an important role in the pathogene-sis of pulmonary fibrosis.

目的:分析鲍曼不动杆菌感染患者的临床分布,探讨血清C反应蛋白(CRP)测定与其耐药率相关性.方法:对2015年1月～2016年6月明确检验存在鲍曼不动杆菌感染患者(剔除同一患者多次分离的重复菌株及定植菌株)临床资料进行分析,统计分析鲍曼不动杆菌感染患者年龄、性别、住院科别、标本种类;同时对74例行血清CRP检测患者以CRP≤8 mg/L(正常组)、9～ 40 mg/L、41～80mg/L、≥81 mg/L进行分段,研究血清CRP定量与耐药率相关性.结果:281例鲍曼不动杆菌感染患者男性占67.6％,年龄大于60岁患者占64.1％;标本种类以痰液的检出率最高;临床科室分布第一位为重症医学科(49.8％),其次为呼吸内科29例(10.3％);血清CRP增高组菌株耐药率明显高于血清CRP正常组菌株(P＜0.01),血清CRP增高组不同阶段菌株间耐药率比较无统计学意义(P＞0.05).结论:鲍曼不动杆菌血清CRP与耐药率在某种意义上存在相关性,但血清CRP不同增高阶段与耐药率无明显相关性,值得对血清CRP与其耐药率进行深一步研究.

Objective To study the expression of NLRP3 and IL-18 in pulmonary tissue of bleomycin-in-duced pulmonary fibrosis rats,and to explore the expression and significance of NLRP3 and IL-18 in PF. Methods 45 clean Wistar rats were randomly divided into the healthy control group (the N group),the bleomycin group (the group B),and the dexamethasone treatment group (the group D),15 rats in each group. The group B and D were given intratracheal injection of bleomycin 4mg/ kg pulmonary fibrosis model,and the group N was given the same vol-ume of saline as control. On the basis of pulmonary fibrosis model,the group D was daily given intraperitoneal injec-tion of dexamethasone 3mg/ kg from the second day,and the group B and N was treated with intraperitoneal injection of saline as controls. The rats in each group were sacrificed at 7,14 and 28 days after modeling. The histopathologi-cal changes of lung tissue were evaluated by HE staining. Hydroxyproline(HYP) in lung tissue homogenate was de-termined by alkaline hydrolysis and enzyme, and NLRP3 content and RT-PCR were used to detect the expression of IL-18 mRNA in lung tissue. Results (1) HE staining showed that the pathological changes of lung tissue in the group B and D were observed. On the 7th day,a large number of inflammatory cells were found in the interstitial and alveolar lumen,and the inflammation gradually decreased with the passage of time,and gradually developed into late fibrosis (P<0.05). (2) The expression of NLRP3 and IL-18mRNA in the group B and D increased gradually to the highest point on Day 7,and then decreased gradually (P<0.05). (3) The expression of NLRP3 and IL-18mRNA in the group D was lower than that in the group B at the same time(P<0.05). Conclusion NLRP3 and IL-18 play important roles in the early stage of pulmonary fibrosis and may be involved in the development and progression of pul-monary fibrosis.