AIM： To investigate the structural and biochemical changes in the early stage of reperfusion in the rat livers exposed to lobar ischemia-reperfusion （IR）. METHODS： The median and left lobes of the liver were subje...AIM： To investigate the structural and biochemical changes in the early stage of reperfusion in the rat livers exposed to lobar ischemia-reperfusion （IR）. METHODS： The median and left lobes of the liver were subjected to 60 min ischemia followed by 5, 10, 30, 45, 60 and 120 min reperfusion. Blood samples were taken at different time intervals to test enzyme activities and biochemical alterations induced by reperfusion. At the end of each reperfusion period, the animals were killed by euthanasia and tissue samples were taken for histological examination and immunohistochemistry. RESULTS： Cell vacuolation, bleb formation and focal hepatitis were the most important changes occur during ischemia. While some changes including bleb formation were removed during reperfusion, other alterations including portal hepatitis, inflammation and the induction of apoptosis were seen during this stage. The occurrence of apoptosis, as demonstrated by apoptotic cells and bodies, was the most important histological change during reperfusion. The severity of apoptosis was dependent on the time of reperfusion, and by increasing the time of reperfusion, the numbers of apoptotic bodies was significantly enhanced. The amounts of lactate dehydrogenase, alanine aminotransferase, aspartate aminotransfrase, creatinine and urea were significantly increased in serum obtained from animals exposed to hepatic IR. CONCLUSION： Inflammation and subsequent apoptotic cell death were the most important changes in early-stage hepatic reperfusion injury, and the number of apoptotic bodies increased with time of reperfusion.展开更多
Acute lobar nephritis(ALN) is a localized non-liquefactive inflammatory renal bacterial infection, which typically involves one or more lobes. ALN is considered to be a midpoint in the spectrum of upper urinary tract ...Acute lobar nephritis(ALN) is a localized non-liquefactive inflammatory renal bacterial infection, which typically involves one or more lobes. ALN is considered to be a midpoint in the spectrum of upper urinary tract infection, a spectrum ranging from uncomplicated pyelonephritis to intrarenal abscess. This condition may be difficult to recognize due to the lack of specific symptoms and laboratory findings. Therefore the disease is probably underdiagnosed. Computed tomography scanning represents the diagnostic gold standard for ALN, but magnetic resonance imagine could be considered in order to limit irradiation. The diagnosis is relevant since initial intravenous antibiotic therapy and overall length of treatment should not be shorter than 3 wk. We review the literature and analyze the ALN clinical presentation starting from four cases with the aim to give to the clinicians the elements to suspect and recognize the ALN in children.展开更多
AIM To systematically review reports on deceased-donor-lobar lung transplantation(dd LLTx) and uniformly describe sizematching using the donor-to-recipient predicted-total lung-capacity(pT LC) ratio. METHODS We set ou...AIM To systematically review reports on deceased-donor-lobar lung transplantation(dd LLTx) and uniformly describe sizematching using the donor-to-recipient predicted-total lung-capacity(pT LC) ratio. METHODS We set out to systematically review reports on ddL LTx and uniformly describe size matching using the donorto-recipient pT LC ratio and to summarize reported oneyear survival data of ddL LTx and conventional-LTx. We searched in Pub Med, CINAHL via EBSCO, Cochrane Database of Systematic Reviews via Wiley(CDSR),Database of Abstracts of Reviews of Effects via Wiley(DARE), Cochrane Central Register of Controlled Trials via Wiley(CENTRAL), Scopus(which includes EMBASE abstracts), and Web of Science for original reports on ddL LTx. RESULTS Nine observational cohort studies reporting on 301 ddL LTx met our inclusion criteria for systematic review of size matching, and eight for describing one-year-survival. The dd LLTx-group was often characterized by high acuity;however there was heterogeneity in transplant indications and pre-operative characteristics between studies. Data to calculate the pT LC ratio was available for 242 ddL LTx(80%). The mean pT LCratio before lobar resection was1.25 ± 0.3 and the transplanted pT LCratio after lobar resection was 0.76 ± 0.2. One-year survival in the ddL LTxgroup ranged from 50%-100%, compared to 72%-88%in the conventional-LTx group. In the largest study ddL LTx(n = 138) was associated with a lower one-year-survival compared to conventional-LTx(n = 539)(65.1% vs84.1%, P < 0.001). CONCLUSION Further investigations of optimal donor-to-recipient size matching parameters for ddL LTx could improve outcomes of this important surgical option.展开更多
Objective:To explore the effect of terbutaline sulfate combined with shunning on acute attack of asthma complicated with lobar pneumonia in children.Methods:One hundred and fifty children with acute attack of asthma a...Objective:To explore the effect of terbutaline sulfate combined with shunning on acute attack of asthma complicated with lobar pneumonia in children.Methods:One hundred and fifty children with acute attack of asthma and lobar pneumonia were randomly divided into routine group(seventy-five cases)and combined group(seventy-five cases).The routine group was given routine treatment.The study group was treated with routine therapy plus terbutaline sulfate plus shunning.The changes of pulmonary function and serum inflammatory factors before and after treatment,clinical effect and safety were compared between the two groups.Results:Respiratory time/inspiratory time(Ti/Te),peak time ratio(TPTEF/TE),peak volume ratio(VPEF/VE),tidal volume per kilogram(Vt/kg)were increased in both groups after treatment(P<0.05),which in the combined group were higher than the routine group after treatment(P<0.05).After treatment,serum levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)in both groups decreased significantly(P<0.05),and those in the combined group were lower than those in the routine group(P<0.05).There was a significant difference in clinical effect distribution between the two groups(P<0.05).The total effective rate of the combined group was higher than that of the routine group(P<0.05).The incidence of adverse reactions in the combined group was slightly higher than that in the routine group(P>0.05).Conclusion:On the basis of routine treatment,terbutaline sulfate combined with shunning can significantly improve pulmonary function and serum inflammatory factors in children with acute attack of asthma and lobar pneumonia,with ideal effect and safe.展开更多
Congenital lobar emphysema is characterized by distress due to hyperinflation of the affected lung lobe(s). We report the case of a 2-month-old infant with congenital left lower lobe emphysema. A 2-month-old female in...Congenital lobar emphysema is characterized by distress due to hyperinflation of the affected lung lobe(s). We report the case of a 2-month-old infant with congenital left lower lobe emphysema. A 2-month-old female infant, born at term without incident, was hospitalized for respiratory distress. On a postnatal day 15, respiratory distress occurred. On admission, he weighed 3400 g and was apyretic. He had a polypnea of 58 cycles/min and a oxygen saturation of hemoglobin of 90% on room air. A chest radiograph revealed hyperclarity of the left lung. Chest CT revealed left lower lobe emphysema. He underwent a left lower lobectomy. The postoperative course was uneventful. He was discharged from the hospital 7 days after surgery without sequelae. Physicians should be aware that congenital lobar emphysema can present with respiratory distress in infants. A chest CT scan confirms the diagnosis. Surgical treatment is effective.展开更多
Objective: To study the effect of small-dose glucocorticoids + azithromycin therapy on inflammatory response and stress response in children with lobar pneumonia. Methods:Children with mycoplasma pneumoniae lobar pneu...Objective: To study the effect of small-dose glucocorticoids + azithromycin therapy on inflammatory response and stress response in children with lobar pneumonia. Methods:Children with mycoplasma pneumoniae lobar pneumonia who were treated in the First People's Hospital of Ziyang between January 2015 and January 2018 were chosen as the research subjects and randomly divided into two groups: GCs group were treated with low-dose glucocorticoids + azithromycin, and control group were treated with azithromycin. The inflammatory response indicators and stress response indicators in serum and peripheral blood were measured before treatment as well as 3 d and 5 d after treatment. Results: Compared with those of same group before treatment, peripheral blood TLR4, NF-κB, NOX2, p38MAPK, iNOS, GRP78, PERK, ATF4, CHOP and Caspase-12 expression intensity as well as serum TNF-α, HMGB-1, ICAM-1, NO, MDA and 8-OhdG levels of both groups were significantly decreased after treatment, and peripheral blood TLR4, NF-κB, NOX2, p38MAPK, iNOS, GRP78, PERK, ATF4, CHOP and Caspase-12 expression intensity as well as serum TNF-α, HMGB-1, ICAM-1, NO, MDA and 8-OhdG levels of GCs group after treatment were significantly lower than those of control group. Conclusion: Small-dose glucocorticoid +azithromycin therapy is more effective than azithromycin therapy to suppress the inflammatory and stress response in children with lobar pneumonia.展开更多
Mucoepidermoid carcinomas （MECs） had always been recognized as salivary gland tumors mainly steming from parotid and submandibular salivary glands. Eater, studies showed that MECs can occur in bronchus, esophagus, l...Mucoepidermoid carcinomas （MECs） had always been recognized as salivary gland tumors mainly steming from parotid and submandibular salivary glands. Eater, studies showed that MECs can occur in bronchus, esophagus, lacrimal glands, pancreas, thymus, and thyroid gland. MECs in bronchus are usually centrally located and are proposed to originate from submucosal minor salivary-type glands in large airways.展开更多
Lung transplantation has been performed internationally as an effective treatment for a variety of end-stage lung＇diseases. A great disparity between the supply of donor organs and the demand of potential recipients ...Lung transplantation has been performed internationally as an effective treatment for a variety of end-stage lung＇diseases. A great disparity between the supply of donor organs and the demand of potential recipients has resulted in longer waiting time and annual increases in deaths on the lung transplant waiting list. Living-donor lobar lung transplantation （LDLLT） has become an established strategy to deal with the shortage of cadaveric donors. Encouraged by Starnes et al and Date et al, we began to apply the operation to a critically ill patient with bronchopulmonary dysplasia （BPD） firstly at Shanghai Pulmonary Hospital in China.展开更多
A representative human upper respiratory tract model consisting of oropharyngeal and asymmetric tracheobronchial(TB) airways from the trachea(G0) to the main lobar bronchi(G2) was constructed. Laminar-to-turbulent air...A representative human upper respiratory tract model consisting of oropharyngeal and asymmetric tracheobronchial(TB) airways from the trachea(G0) to the main lobar bronchi(G2) was constructed. Laminar-to-turbulent airflow for typical inhalation modes as well as micro-particle transportation,wall deposition and mass flow to lobes was simulated using the CFX10.0 software from Ansys Inc. The numerical particle deposition efficiency of the oropharynx region and two generations(G1 and G2) of TB airways shows great agreement with the experimental data obtained from realistic casts. The particle deposition pattern indicates that inertial impaction is the primary mechanism in the human upper airway,and turbulence dispersion performs crescent influence especially for small particles. The initial positions of particles with different fates are confined to specifically concentrated zones. The particle mass distributions of five lobes are close to airflow distributions. The upper lobes receive fewer particles than lower lobes and the right middle lobe receives the least.展开更多
基金Supported by University of Tehran,Vice chancellor forresearch and technology
文摘AIM： To investigate the structural and biochemical changes in the early stage of reperfusion in the rat livers exposed to lobar ischemia-reperfusion （IR）. METHODS： The median and left lobes of the liver were subjected to 60 min ischemia followed by 5, 10, 30, 45, 60 and 120 min reperfusion. Blood samples were taken at different time intervals to test enzyme activities and biochemical alterations induced by reperfusion. At the end of each reperfusion period, the animals were killed by euthanasia and tissue samples were taken for histological examination and immunohistochemistry. RESULTS： Cell vacuolation, bleb formation and focal hepatitis were the most important changes occur during ischemia. While some changes including bleb formation were removed during reperfusion, other alterations including portal hepatitis, inflammation and the induction of apoptosis were seen during this stage. The occurrence of apoptosis, as demonstrated by apoptotic cells and bodies, was the most important histological change during reperfusion. The severity of apoptosis was dependent on the time of reperfusion, and by increasing the time of reperfusion, the numbers of apoptotic bodies was significantly enhanced. The amounts of lactate dehydrogenase, alanine aminotransferase, aspartate aminotransfrase, creatinine and urea were significantly increased in serum obtained from animals exposed to hepatic IR. CONCLUSION： Inflammation and subsequent apoptotic cell death were the most important changes in early-stage hepatic reperfusion injury, and the number of apoptotic bodies increased with time of reperfusion.
文摘Acute lobar nephritis(ALN) is a localized non-liquefactive inflammatory renal bacterial infection, which typically involves one or more lobes. ALN is considered to be a midpoint in the spectrum of upper urinary tract infection, a spectrum ranging from uncomplicated pyelonephritis to intrarenal abscess. This condition may be difficult to recognize due to the lack of specific symptoms and laboratory findings. Therefore the disease is probably underdiagnosed. Computed tomography scanning represents the diagnostic gold standard for ALN, but magnetic resonance imagine could be considered in order to limit irradiation. The diagnosis is relevant since initial intravenous antibiotic therapy and overall length of treatment should not be shorter than 3 wk. We review the literature and analyze the ALN clinical presentation starting from four cases with the aim to give to the clinicians the elements to suspect and recognize the ALN in children.
基金the Flight Attendant Medical Research Institute (FAMRI)
文摘AIM To systematically review reports on deceased-donor-lobar lung transplantation(dd LLTx) and uniformly describe sizematching using the donor-to-recipient predicted-total lung-capacity(pT LC) ratio. METHODS We set out to systematically review reports on ddL LTx and uniformly describe size matching using the donorto-recipient pT LC ratio and to summarize reported oneyear survival data of ddL LTx and conventional-LTx. We searched in Pub Med, CINAHL via EBSCO, Cochrane Database of Systematic Reviews via Wiley(CDSR),Database of Abstracts of Reviews of Effects via Wiley(DARE), Cochrane Central Register of Controlled Trials via Wiley(CENTRAL), Scopus(which includes EMBASE abstracts), and Web of Science for original reports on ddL LTx. RESULTS Nine observational cohort studies reporting on 301 ddL LTx met our inclusion criteria for systematic review of size matching, and eight for describing one-year-survival. The dd LLTx-group was often characterized by high acuity;however there was heterogeneity in transplant indications and pre-operative characteristics between studies. Data to calculate the pT LC ratio was available for 242 ddL LTx(80%). The mean pT LCratio before lobar resection was1.25 ± 0.3 and the transplanted pT LCratio after lobar resection was 0.76 ± 0.2. One-year survival in the ddL LTxgroup ranged from 50%-100%, compared to 72%-88%in the conventional-LTx group. In the largest study ddL LTx(n = 138) was associated with a lower one-year-survival compared to conventional-LTx(n = 539)(65.1% vs84.1%, P < 0.001). CONCLUSION Further investigations of optimal donor-to-recipient size matching parameters for ddL LTx could improve outcomes of this important surgical option.
基金General project of natural science foundation of Jiangsu province(No.BK20151112)Medical innovation team of Jiangsu province(No.CXTDB2017016).
文摘Objective:To explore the effect of terbutaline sulfate combined with shunning on acute attack of asthma complicated with lobar pneumonia in children.Methods:One hundred and fifty children with acute attack of asthma and lobar pneumonia were randomly divided into routine group(seventy-five cases)and combined group(seventy-five cases).The routine group was given routine treatment.The study group was treated with routine therapy plus terbutaline sulfate plus shunning.The changes of pulmonary function and serum inflammatory factors before and after treatment,clinical effect and safety were compared between the two groups.Results:Respiratory time/inspiratory time(Ti/Te),peak time ratio(TPTEF/TE),peak volume ratio(VPEF/VE),tidal volume per kilogram(Vt/kg)were increased in both groups after treatment(P<0.05),which in the combined group were higher than the routine group after treatment(P<0.05).After treatment,serum levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)in both groups decreased significantly(P<0.05),and those in the combined group were lower than those in the routine group(P<0.05).There was a significant difference in clinical effect distribution between the two groups(P<0.05).The total effective rate of the combined group was higher than that of the routine group(P<0.05).The incidence of adverse reactions in the combined group was slightly higher than that in the routine group(P>0.05).Conclusion:On the basis of routine treatment,terbutaline sulfate combined with shunning can significantly improve pulmonary function and serum inflammatory factors in children with acute attack of asthma and lobar pneumonia,with ideal effect and safe.
文摘Congenital lobar emphysema is characterized by distress due to hyperinflation of the affected lung lobe(s). We report the case of a 2-month-old infant with congenital left lower lobe emphysema. A 2-month-old female infant, born at term without incident, was hospitalized for respiratory distress. On a postnatal day 15, respiratory distress occurred. On admission, he weighed 3400 g and was apyretic. He had a polypnea of 58 cycles/min and a oxygen saturation of hemoglobin of 90% on room air. A chest radiograph revealed hyperclarity of the left lung. Chest CT revealed left lower lobe emphysema. He underwent a left lower lobectomy. The postoperative course was uneventful. He was discharged from the hospital 7 days after surgery without sequelae. Physicians should be aware that congenital lobar emphysema can present with respiratory distress in infants. A chest CT scan confirms the diagnosis. Surgical treatment is effective.
文摘Objective: To study the effect of small-dose glucocorticoids + azithromycin therapy on inflammatory response and stress response in children with lobar pneumonia. Methods:Children with mycoplasma pneumoniae lobar pneumonia who were treated in the First People's Hospital of Ziyang between January 2015 and January 2018 were chosen as the research subjects and randomly divided into two groups: GCs group were treated with low-dose glucocorticoids + azithromycin, and control group were treated with azithromycin. The inflammatory response indicators and stress response indicators in serum and peripheral blood were measured before treatment as well as 3 d and 5 d after treatment. Results: Compared with those of same group before treatment, peripheral blood TLR4, NF-κB, NOX2, p38MAPK, iNOS, GRP78, PERK, ATF4, CHOP and Caspase-12 expression intensity as well as serum TNF-α, HMGB-1, ICAM-1, NO, MDA and 8-OhdG levels of both groups were significantly decreased after treatment, and peripheral blood TLR4, NF-κB, NOX2, p38MAPK, iNOS, GRP78, PERK, ATF4, CHOP and Caspase-12 expression intensity as well as serum TNF-α, HMGB-1, ICAM-1, NO, MDA and 8-OhdG levels of GCs group after treatment were significantly lower than those of control group. Conclusion: Small-dose glucocorticoid +azithromycin therapy is more effective than azithromycin therapy to suppress the inflammatory and stress response in children with lobar pneumonia.
文摘Mucoepidermoid carcinomas （MECs） had always been recognized as salivary gland tumors mainly steming from parotid and submandibular salivary glands. Eater, studies showed that MECs can occur in bronchus, esophagus, lacrimal glands, pancreas, thymus, and thyroid gland. MECs in bronchus are usually centrally located and are proposed to originate from submucosal minor salivary-type glands in large airways.
文摘Lung transplantation has been performed internationally as an effective treatment for a variety of end-stage lung＇diseases. A great disparity between the supply of donor organs and the demand of potential recipients has resulted in longer waiting time and annual increases in deaths on the lung transplant waiting list. Living-donor lobar lung transplantation （LDLLT） has become an established strategy to deal with the shortage of cadaveric donors. Encouraged by Starnes et al and Date et al, we began to apply the operation to a critically ill patient with bronchopulmonary dysplasia （BPD） firstly at Shanghai Pulmonary Hospital in China.
基金supported by the National Natural Science Foundation of China (10672081)the Foundation of Chinese State Key Laboratory of Loess and Quaternary Geology
文摘A representative human upper respiratory tract model consisting of oropharyngeal and asymmetric tracheobronchial(TB) airways from the trachea(G0) to the main lobar bronchi(G2) was constructed. Laminar-to-turbulent airflow for typical inhalation modes as well as micro-particle transportation,wall deposition and mass flow to lobes was simulated using the CFX10.0 software from Ansys Inc. The numerical particle deposition efficiency of the oropharynx region and two generations(G1 and G2) of TB airways shows great agreement with the experimental data obtained from realistic casts. The particle deposition pattern indicates that inertial impaction is the primary mechanism in the human upper airway,and turbulence dispersion performs crescent influence especially for small particles. The initial positions of particles with different fates are confined to specifically concentrated zones. The particle mass distributions of five lobes are close to airflow distributions. The upper lobes receive fewer particles than lower lobes and the right middle lobe receives the least.
