Objective. To investigate the roles of apoptosis in the pulmonary artery remodeling of pulmonary hypertension secondary to hypoxia and illustrate the relative genes expression. Methods. Thirty rats were divided into h...Objective. To investigate the roles of apoptosis in the pulmonary artery remodeling of pulmonary hypertension secondary to hypoxia and illustrate the relative genes expression. Methods. Thirty rats were divided into hypoxia group（ 10％ O2, 8h/d） and normal control group. On the 15th day of hypoxia, pulmonary artery pressure and right ventricular hypertrophy index were measured and pulmonary artery vessels were studied by light microscope. Then terminal deoxynucleotidyl transferase- mediated dUTP nick- end labeling（ TUNEL） technique was used to detect nucleosomal DNA fragmentation of apoptotic cells. In situ hybridization and RT- PCR were used to detect the expression level of bcl- 2 and bax. Results. The pulmonary artery pressure and right ventricular hypertrophy index of hypoxia group were increased significantly, the pulmonary artery wall of hypoxic group become incrassate than control group. Apoptotic cells can be found in lung with hypoxia or without hypoxia. Compared with control group, apoptotic index of hypoxic group decreased significantly. Through the methods of in situ hybridization and RT- PCR, we found the expression of bcl- 2 increased whereas bax decreased significantly in the hypoxic group. Conclusion. The alternation in bcl- 2 and bax expression induced by hypoxia play an important role in the pulmonary artery remodeling which is the main pathologic change of pulmonary hypertension secondary to hypoxia.展开更多
OBJECTIVE To explore the application of blocking the unilateralmain pulmonary artery (MPA) in pulmonary lobectomy (PL) forpatients with stage Ⅱ and Ⅲ lung cancer, and to retrospectivelyanalyze the methods of surgery...OBJECTIVE To explore the application of blocking the unilateralmain pulmonary artery (MPA) in pulmonary lobectomy (PL) forpatients with stage Ⅱ and Ⅲ lung cancer, and to retrospectivelyanalyze the methods of surgery for blocking the unilateral mainpulmonary artery, perioperative indications, intraoperativeconcerns and postoperative cardio-pulmonary complications.METHODS During a period from January 2006 to January 2008,intra-pericardial, or extra-pericardial separation and blockade ofthe left or right MPA followed by completion of various PLs wereconducted for 30 lung cancer patients in stage-Ⅱ to Ⅲ with ill-defined anatomic structure of the pulmonary hilum and difficultpulmonary angiodiastasis.RESULTS In the 30 patients, 5 were diagnosed as stage-Ⅱb, 11stage-Ⅲa, and 14 stage-Ⅲb. During the surgery, giant tumors atthe superior pulmonary lobe, with a diameter of over 10 cm, wereseen in 13 cases, in which tumor invasion in the extra-pericardiacpulmonary artery was found in 5 cases. Hilar lymphadenectasiswith severe tumor adhesion to pulmonary blood vessel couldbe seen in 20 cases and partial tumorous invasion in thepericardium in 7. In most of the cases, adhesions existed aroundthe tumor, aorta, superior vena, and azygous vein. Invasion ofthe laryngeal and vagus nerves on the left side was found in 3cases. Of the 30 patients, simple PL was conducted in 12, andsleeve lobectomy combined with a pulmonary arterioplasty in18 cases. With a blockade of unilateral MPA, no intraoperativehemorrhea of pulmonary blood vessels occurred during surgery,when there was a clear surgical field of vision. Both PL andlymphadenectomy were smoothly completed in the 30 patients.The healthy pulmonary lobes with normal function were keptand total pneumonectomy was avoided. The time of blocking thepulmonary artery ranged from 10 to 30 min, and intraoperativeblood loss was from 200 to 300 ml. Postoperative complicatedacute pulmonary edema occurred in 5 patients and tachycardia in7 cases. Nevertheless, all patients recovered and left the hospitalafter treatment. No severe cardiopulmonary complications werefound in all patients of the group.CONCLUSION Blocking the unilateral MPA is effective todecrease the risk of intraoperative hemorrhea in the PL. It canshorten the time of surgery, improve the excision rate of lungcancer, and cut down on the rate of total pneumonectomy.展开更多
Objective and method. To research the alteration of pulmonary flow spectrum of patients with congenital heart disease and the relation between pulmonary flow spectrum and pulmonary artery pr...Objective and method. To research the alteration of pulmonary flow spectrum of patients with congenital heart disease and the relation between pulmonary flow spectrum and pulmonary artery pressure, 33 patients with congenital heart disease were examined by echocardiography and catheterization. Results. The result showed that the spectrum peak early occurring in patients with pulmonary hypertension and the degree of the spectrum peak early occurring was related to pulmonary artery pressure positively. The result suggested that when the pulmonary artery systolic pressure was over 100 mmHg, the flow spectrum showed slender pattern usually. Conclusion. The slender pattern in pulmonary flow spectrum could be a semi quantity parameter to predict that the pulmonary artery systolic pressure more than 100 mmHg.展开更多
Objective： To establish the animal model for the chronic pulmonary embolism and do some research on it. Methods： Pulmonary arteriography by DSA were performed in 6 goats and the stent was released in the infer-pulmo...Objective： To establish the animal model for the chronic pulmonary embolism and do some research on it. Methods： Pulmonary arteriography by DSA were performed in 6 goats and the stent was released in the infer-pulmonary arterary. Arterial blood gas analysis and right heart catheterization were done. After 3 days of embolism, pulmonary arteriography were performed again. After the animal was sacrificed, the right and left infer-pulmonary tissues were prepared and pathologically studied. Results： Stents were smoothly released in 6 animals. Compared with that before embolism, the arterial blood gas showed no difference 10 minutes later and 3 days later of the stent released. The pulmonary angiography showed that the right infra pulmonary artery was partly blocked and the blood could still pass by. 3 d of the embolism later, the stent was placed well and the right pulmonary artery was completely blocked. Compared with that before embolism,the right atrial pressure, ventricular pressure and the pulmonary pressure in 10 rain after embolism did not change much （ P 〉 0.05 ）, while 3 d after embolism, the pressures were obviously changed（P 〈 0.05 ）. There was no atelectasis ,pleural effusion in the right infra lobe in the experimental group. The wall of blood capillary among the alve- olar wall were significantly dilated. Hyperemia and edema were also observed. Lots of monocyte infiltrated. Localized exudates appeared in alveolar. Conclusion： By releasing stent in the pulmonary, the chronic pulmonary embolism model could be established in the animal experiment, and it should have great potential value in the following study.展开更多
Although metastatic breast cancer is considered as an incurable disease, various biological drivers influence the outcomes. The use of trastuzumab in patients overexpressing HER（human epidermal growth factor recepto...Although metastatic breast cancer is considered as an incurable disease, various biological drivers influence the outcomes. The use of trastuzumab in patients overexpressing HER（human epidermal growth factor receptor 2）-2 increases long-term survival even in those patients who developed brain metastasis. Nevertheless, special attention must be paid to the risk of cardiotoxicity. We report the case of a young woman with HER-2-positive breast cancer with bone and lung disease who developed brain metastasis during treatment with trastuzumab. The treatment has been continued and she is alive and in complete remission after 16 years.展开更多
文摘Objective. To investigate the roles of apoptosis in the pulmonary artery remodeling of pulmonary hypertension secondary to hypoxia and illustrate the relative genes expression. Methods. Thirty rats were divided into hypoxia group（ 10％ O2, 8h/d） and normal control group. On the 15th day of hypoxia, pulmonary artery pressure and right ventricular hypertrophy index were measured and pulmonary artery vessels were studied by light microscope. Then terminal deoxynucleotidyl transferase- mediated dUTP nick- end labeling（ TUNEL） technique was used to detect nucleosomal DNA fragmentation of apoptotic cells. In situ hybridization and RT- PCR were used to detect the expression level of bcl- 2 and bax. Results. The pulmonary artery pressure and right ventricular hypertrophy index of hypoxia group were increased significantly, the pulmonary artery wall of hypoxic group become incrassate than control group. Apoptotic cells can be found in lung with hypoxia or without hypoxia. Compared with control group, apoptotic index of hypoxic group decreased significantly. Through the methods of in situ hybridization and RT- PCR, we found the expression of bcl- 2 increased whereas bax decreased significantly in the hypoxic group. Conclusion. The alternation in bcl- 2 and bax expression induced by hypoxia play an important role in the pulmonary artery remodeling which is the main pathologic change of pulmonary hypertension secondary to hypoxia.
文摘OBJECTIVE To explore the application of blocking the unilateralmain pulmonary artery (MPA) in pulmonary lobectomy (PL) forpatients with stage Ⅱ and Ⅲ lung cancer, and to retrospectivelyanalyze the methods of surgery for blocking the unilateral mainpulmonary artery, perioperative indications, intraoperativeconcerns and postoperative cardio-pulmonary complications.METHODS During a period from January 2006 to January 2008,intra-pericardial, or extra-pericardial separation and blockade ofthe left or right MPA followed by completion of various PLs wereconducted for 30 lung cancer patients in stage-Ⅱ to Ⅲ with ill-defined anatomic structure of the pulmonary hilum and difficultpulmonary angiodiastasis.RESULTS In the 30 patients, 5 were diagnosed as stage-Ⅱb, 11stage-Ⅲa, and 14 stage-Ⅲb. During the surgery, giant tumors atthe superior pulmonary lobe, with a diameter of over 10 cm, wereseen in 13 cases, in which tumor invasion in the extra-pericardiacpulmonary artery was found in 5 cases. Hilar lymphadenectasiswith severe tumor adhesion to pulmonary blood vessel couldbe seen in 20 cases and partial tumorous invasion in thepericardium in 7. In most of the cases, adhesions existed aroundthe tumor, aorta, superior vena, and azygous vein. Invasion ofthe laryngeal and vagus nerves on the left side was found in 3cases. Of the 30 patients, simple PL was conducted in 12, andsleeve lobectomy combined with a pulmonary arterioplasty in18 cases. With a blockade of unilateral MPA, no intraoperativehemorrhea of pulmonary blood vessels occurred during surgery,when there was a clear surgical field of vision. Both PL andlymphadenectomy were smoothly completed in the 30 patients.The healthy pulmonary lobes with normal function were keptand total pneumonectomy was avoided. The time of blocking thepulmonary artery ranged from 10 to 30 min, and intraoperativeblood loss was from 200 to 300 ml. Postoperative complicatedacute pulmonary edema occurred in 5 patients and tachycardia in7 cases. Nevertheless, all patients recovered and left the hospitalafter treatment. No severe cardiopulmonary complications werefound in all patients of the group.CONCLUSION Blocking the unilateral MPA is effective todecrease the risk of intraoperative hemorrhea in the PL. It canshorten the time of surgery, improve the excision rate of lungcancer, and cut down on the rate of total pneumonectomy.
文摘Objective and method. To research the alteration of pulmonary flow spectrum of patients with congenital heart disease and the relation between pulmonary flow spectrum and pulmonary artery pressure, 33 patients with congenital heart disease were examined by echocardiography and catheterization. Results. The result showed that the spectrum peak early occurring in patients with pulmonary hypertension and the degree of the spectrum peak early occurring was related to pulmonary artery pressure positively. The result suggested that when the pulmonary artery systolic pressure was over 100 mmHg, the flow spectrum showed slender pattern usually. Conclusion. The slender pattern in pulmonary flow spectrum could be a semi quantity parameter to predict that the pulmonary artery systolic pressure more than 100 mmHg.
基金supported financially by the Youth Scholar Foundation of city health administration of shanghai(No044Y02)
文摘Objective： To establish the animal model for the chronic pulmonary embolism and do some research on it. Methods： Pulmonary arteriography by DSA were performed in 6 goats and the stent was released in the infer-pulmonary arterary. Arterial blood gas analysis and right heart catheterization were done. After 3 days of embolism, pulmonary arteriography were performed again. After the animal was sacrificed, the right and left infer-pulmonary tissues were prepared and pathologically studied. Results： Stents were smoothly released in 6 animals. Compared with that before embolism, the arterial blood gas showed no difference 10 minutes later and 3 days later of the stent released. The pulmonary angiography showed that the right infra pulmonary artery was partly blocked and the blood could still pass by. 3 d of the embolism later, the stent was placed well and the right pulmonary artery was completely blocked. Compared with that before embolism,the right atrial pressure, ventricular pressure and the pulmonary pressure in 10 rain after embolism did not change much （ P 〉 0.05 ）, while 3 d after embolism, the pressures were obviously changed（P 〈 0.05 ）. There was no atelectasis ,pleural effusion in the right infra lobe in the experimental group. The wall of blood capillary among the alve- olar wall were significantly dilated. Hyperemia and edema were also observed. Lots of monocyte infiltrated. Localized exudates appeared in alveolar. Conclusion： By releasing stent in the pulmonary, the chronic pulmonary embolism model could be established in the animal experiment, and it should have great potential value in the following study.
文摘Although metastatic breast cancer is considered as an incurable disease, various biological drivers influence the outcomes. The use of trastuzumab in patients overexpressing HER（human epidermal growth factor receptor 2）-2 increases long-term survival even in those patients who developed brain metastasis. Nevertheless, special attention must be paid to the risk of cardiotoxicity. We report the case of a young woman with HER-2-positive breast cancer with bone and lung disease who developed brain metastasis during treatment with trastuzumab. The treatment has been continued and she is alive and in complete remission after 16 years.
