静脉血栓栓塞症( venous thromboembolism, VTE) 包括肺血栓栓塞( pulmonary embolism, PE) 、深静脉栓塞( deep venous thrombosis, DVT) 和游走性栓塞性浅静脉炎, 是肿瘤发展自然病程及抗肿瘤治疗过程中的常见并发症。流行病学资料表明肿瘤患者VTE 发生率比非肿瘤患者高2～4 倍[1] 。在各种肿瘤类型中, 肺癌并发VTE 几率较高, Blom等[2] 研究表明肺癌患者发生VTE 的风险比非肿瘤病人高20 倍。大约3% 的肺癌患者在肿瘤诊断后的1 年内发生VTE[3] 。
Objective To observe barrier function changes of gut mucosa in rats with acute respiratory distress syndrome(ARDS)．Methods Forty SD rats were randomized to an experiment group (n：30)and a control group(n=10)．Oleic acid was injected via vena femoralis to establish ARDS ratmode1．Subgroups in the experiment group were randomly divided by time 30 min，2 h，4 h interval after injection(n=10 in each subgroup)．Concentration of D-lactate and endotoxin and activity of diamineoxidase in blood plasma were measured．Histopathological changes of small intestine were observed under light microscope．Results Compared with the control group，the activation of diamine oxidase in the experiment group was higher after 30 min of injection(Plt;0.01)．Concentration of D-lactate，the activity ofdiamine oxidase and endotoxin level in the experiment group were all elevated after 2 hours of injection(all Plt;0.05)，and further elevated after 4 hours．In the rats’villous interstitial after 2 hours of the injection，there were edema，hyperemia，and infiltration of neutrophils，eosinophils and lymphocytes．After 4 hours ofthe injection，the villous epithelium showed desquamation，necrosis，denaturalization and erosion，associated with infihration of lymphocytes and neutrophils in the mucosa．Conclusion In oleic acid-induced ARDS．permeability of gut mueosa increases and gut barrier is dysfunctional．
ObjectiveTo investigate the changes of autophage-related protein in lung tissues of rats with chronic obstructive pulmonary disease (COPD). MethodsPassive cigarette smoking was used to establish COPD model in rats. The mRNA and protein expressions of PI3K, total AKT, phosphorylated-AKT, total mTOR, phosphorylated-mTOR, and autophagy-related genes including LC3Ⅱ/Ⅰ, Beclin1, Atg5, Atg7, Atg12, P62 in lung tissues were measured by real-time PCR and Western blot. The autophagy level was compared between the COPD rats and the normal rats by LC3B immunohistochemistry. ResultsReal-time PCR analysis showed that the mRNA expressions of Beclin1, Atg5 and Atg12 significantly increased in lung tissues of the COPD rats compared with the normal rats (all P < 05). There was no significant difference between the COPD rats and the normal rats as for Atg7 mRNA expression (P > 0.05). Western blot analysis showed that the protein expressions of PI3K, p-AKT/AKT and p-mTOR/mTOR significantly decreased, the protein expressions of LC3 Ⅱ/Ⅰ, Atg5, and Beclin1 increased, and protein expression of P62 significantly decreased in lung tissues of the COPD rats compared with the normal rats (all P < 05). LC3B immunohistochemistry showed that the LC3B expression was higher in the COPD rats than that in the normal rats. ConclusionThe level of autophagy significantly increases in COPD rats with decreased expression of upstream proteins in autophagy signal pathway and increased expression of autophage proteins.
Objective To investigate the clinicopathologic features, diagnosis, treatment and prognosis of the primary lymphoepithelioma-like carcinoma (PLELC) of the lung. Methods Clinical and pathological data of one patient with PLELC of the lung were reviewed. PLELC of the lung was analyzed through review of literatures. Results A mass in the upper lobe of the left lung and atelectasis were detected by CT in a 36 year old nonsmoker male. He presented with cough, expectoration, fever and shortness of breath for one month. Neoplasm in left main bronchus was observed through bronchoscopy. Histological study showed cohesive clusters of comprising syncytial-appearing cells with vesicular nuclei and tumor infiltrating lymphocytes. Immunohistochemistry showed positive expression of Epstein-Barr virus (EBV) encoded small nuclear RNA. Nasal CT scan was negative for suspicious nasopharyngeal mucosal lesion or tumor. Then he was diagnosed as PLELC. The patient received docetaxel+nedaplatin regimens for 6 cycles with stable disease, but one month later after the end of chemotherapy, he was readmitted to hospital for dyspnea. CT scans showed progression of the lesion with massive pericardial effusion and pleural effusion. The patient could not tolerate chemotherapy, then received supportive treatment and died soon. Totally 18 Chinese articles and 25 foreign articles were screened out. Literature review suggested that patients with PLELC of the lung usually occurred in young nonsmokers and without gender difference. PLELC of the lung was closely associated with EBV infection. Its clinical manifestations were not specific, so that histopathological and immunohistochemical analyses were the main method of diagnosis. PLELC of the lung may respond to chemotherapy and radiotherapy. Surgery-based multimodality treatment was recommended. Patients with early or resectable disease had better prognosis, but patients with unresectable disease had poor prognosis. Conclusions PLELC of the lung may be closely associated with EBV infection. Histopathological and immunohistochemical analysis is the main method of diagnosis. Surgery-based multimodality treatment should be recommended because of its high response to chemotherapy and radiotherapy. Patients with early or resectable disease have better prognosis.