The prognostic factors in the prenatal diagnosis of the echogenic fetal lung

The prenatal diagnosis of an echogenic fetal lung (EFL) is now often made in the early second trimester using high-resolution ultrasound. This ultrasound appearance is usually caused by a congenital cystic adenomatoid lung malformation (CCAM), an intrapulmonary lung sequestration or obstruction of a major airway. In order to provide prognostic guidelines to parents who may be considering termination of a fetus with these findings, we have analysed a series of 11 cases diagnosed in our centre over the past 2 years in conjunction with 60 cases from major published series. The data suggest that in the absence of non-immune hydrops fetalis (NIHF) or other anomalies, the outcome for the fetuses is excellent, with over 90 per cent survival. Neither early diagnosis (24 weeks) nor the presence of mediastinal shift is a poor prognostic indicator. In addition, it appears that if NIHF is absent at diagnosis, the chance that it will develop as the pregnancy continues is small (6 per cent). Furthermore, there is a significant (up to 30 per cent) chance that this ultrasound finding will resolve in utero. The development of in utero fetal surgical techniques may be the only hope for those hydropic fetuses who appear to have a dismal prognosis.     

Prenatal diagnosis of congenital cystic adenomatoid malformation of the lung by fetal lung biopsy

A case of type III congenital cystic adenomatoid malformation of the lung was successfully diagnosed prenatally by fetal lung biopsy. We performed this procedure at 22 weeks of gestation, using a biopsy gun system under ultrasound guidance. The pregnancy was undisturbed by the procedure but as the condition was incompatible with life, an abortion was performed. The diagnosis was confirmed at post-mortem examination. Fetal lung biopsy appears to be a useful method for prenatal diagnosis of fetal lung disorders.     

香烟中的钋-210与肺癌

本文根据文献报道,综述国内外香烟中~(210)Po放射性水平及其对人体健康的危害;介绍吸人烟雾中~(210)Po-导致肺癌发生的动物试验结果及对低剂量。辐射致癌的危险度估算,指出吸烟作为诱发呼吸系统癌变的污染源,应予控制。     

Sonographic diagnosis of cystic adenomatoid malformation in-utero

Routine ultrasound examination at 30 weeks gestation revealed an intrapulmonary cystic mass in an otherwise normal fetus. Following delivery at term, the diagnosis of congenital cystic adenomatoid malformation of the right lung was confirmed, and an elective right middle lobectomy successfully performed at nine days of age.     

空气污染与儿童肺功能指标的相关分析

采用两步回归法研究了中国4城市空气污染与儿童肺功能指标的相关关系.结果表明,PM_2.5、PM₁₀、TSP等与FEV₁、FEV₁/FVC的调整均值、FEV₁/FVC≤80%的异常率有显著的统计相关关系.说明空气中颗粒物污染是导致儿童小气道通气功能障碍的重要因素之一.研究中未发现SO₂、NO_X污染与儿童的肺功能指标有统计上的相关性.     

吸烟与非吸烟肺癌患者中P53基因突变的检测

P53基因定位于人类第17号染色体的短臂,野生型P53基因是肿瘤抑制基因。这一基因正成为研究人类肿瘤DNA的主要目标。作者运用聚合酶链反应－单链构象多态性技术（PCR－SSCP）,研究了45例石蜡包埋的肺癌组织标本中肿瘤抑制基因P53基因突变,结果发现在P53基因的第5～8外显子中共检测到19例P53基因突变的样本,检出率为42.2％,并且发现吸烟的肺癌患者中P53基因突变的检出频率明显高于非吸烟的肺癌患者。     

南昌市大气污染与居民肺癌发病率的灰色关联分析

研究结果表明:对比SO2 、NO2、PM10,霾日数与肺癌发病率的灰色综合关联系数最高,南昌市近15年来霾日数与肺癌发病率的灰色综合关联系数为0.783 8,滞后期为5年.研究旨在为保护公众健康提供科学依据,本地气象部门可以利用长期的历史数据优势,不断深化历史资料分析,结合环保、医疗等各部门的数据开展霾污染与人群健康相关研究,为政府科学开展污染治理提供决策参考.     

Amniotic fluid analysis in a fetus with laryngeal atresia

Complete laryngeal atresia is a rare congenital malformation that is known to cause hypertrophy of the fetal lung in utero. A fetus with laryngeal atresia was found to have markedly immature amniotic fluid lung maturity studies at term. Inappropriately low amniotic fluid lung maturity studies may be an important clue to the diagnosis of this condition.     

云南宣威地区燃煤排放PM10的微观形貌和粒度特征

宣威地区肺癌发病率居全国首位,并且肺癌与室内燃煤关系密切. 为了解宣威地区室内燃煤排放PM₁₀的微观形貌和粒度特征,使用小流量Minivol采样器,分别于2011年1月、3月和12月对宣威地区6个代表性乡镇的18个农户及对照点——贵州六盘水幸福村2个农户室内、外的PM₁₀进行采样. 采用扫描电子显微镜分析样品的微观形貌,并对颗粒物粒度进行统计分析. 根据微观形貌特征将PM₁₀分为烟尘集合体(链状、蓬松状、密实状)、球形颗粒(燃煤飞灰和焦油球)、矿物颗粒(规则和不规则状)、生物颗粒及超细未知颗粒. 结果表明:宣威地区室内PM₁₀微观形貌差别较大;室、内外PM₁₀的粒度分布在0.1~0.4μm内的颗粒数量所占比例较大,而1μm以上颗粒体积所占比例较大;小粒径颗粒对颗粒物数量贡献较大,而少数大粒径颗粒对体积贡献较大;宣威地区和对照点室内的PM₁₀数量-粒度和体积-粒度分布相似,室外PM₁₀数量-粒度特征相似但体积-粒度分布有所差异. 宣威地区室内的烟尘集合体和球形颗粒分别占颗粒物总数的10.5%和23.6%,高于对照点 (分别为7.7%和11.3%).      

Cystic Adenomatoid malformation of the lung: Prenatal diagnosis and outcome

During an 8-year period (1984–1992), we made the ultrasonographic diagnosis of cystic adenomatoid malformation (CAM) of the lung in 58 fetuses at 17–39 weeks' gestation. We reviewed the records of these fetuses and combined the data from 74 cases reported in the literature to determine the incidence of the different types of CAM, associated malformations, and outcome. The lesions were macrocystic in 78 (59 per cent) and microcystic in 54 (41 per cent) of the cases. CAM was left-sided in 51 per cent, right-sided in 35 per cent, and bilateral in 14 per cent of the fetuses. In 15 (11 per cent) of the fetuses there were additional malformations and 57 (43 per cent) were hydropic. The pregnancy was electively terminated in 44 (33 per cent) of the cases, including all those with bilateral CAM. There were six (5 per cent) intrauterine deaths, five in association with hydrops, and one with growth retardation and heart defect. Of the 82 (62 per cent) infants that were liveborn, 21 (26 per cent) died in the neonatal period, 15 before and six after surgery. Of the 61 survivors, 16 (26 per cent) did not require surgery. In the 88 cases where the pregnancy was not terminated, survival was better if the CAM was macrocystic (74 per cent versus 58 per cent for microcystic), if there was no hydrops (92 per cent versus 21 per cent for hydrops), and if the amniotic fluid volume was normal or decreased (82 per cent versus 53 per cent for polyhydramnios).     

云南宣威地区燃煤排放颗粒物中石英矿物的特征

云南宣威地区是我国人群肺癌死亡率最高的地区之一,过往研究表明,该区的高肺癌死亡率可能与居民室内燃煤排放颗粒物中的多环芳烃(PAHs)有关,而最近研究发现,其中的nm级石英可能是导致肺癌发生的原因, 但鲜见该区燃煤排放颗粒物中细粒石英矿物的研究. 为探究燃煤排放细粒矿物的分布特征,采集了肺癌高发区宣威市来宾镇及周边5个乡镇煤矿中的15个煤样,使用光学显微镜、X射线衍射仪(XRD)、带能谱的扫描电镜(SEM/EDS)分析了煤样的煤岩组分及矿物组成. 结果表明:宣威煤以中挥发分、较高镜质组烟煤为主,煤中主要矿物为石英、鲕绿泥石、高岭石和方解石;不同煤样中,矿物质的结晶程度有所差异;单颗粒统计结果显示,在所统计的775个矿物颗粒中,石英颗粒占37.9%,并且粒径多分布在1~2μm之间; 石英矿物颗粒的形状不规则且以微粒的形式填充在煤缝隙中. 石英与鲕绿泥石共存的现象显示,宣威煤中石英来源于富含Fe和Al的硅质热液流,而非岩石碎屑沉积;此外,在肺癌高发区(来宾镇),其煤中Si+Fe质矿物颗粒含量较Si质矿物高. 今后将重点研究石英颗粒在Fe参与下的生物活性.      

儿童肺功能的多因子及交互影响分析

在儿童肺功能横断面数据基础上,运用多元线性回归,研究了影响儿童肺功能的多因子及其交互效应.结果表明,儿童肺功能指标主要受儿童基本体质情况、呼吸系统疾病和家庭室内暴露因子以及这些因子的交互影响.儿童肺功能与空气颗粒物(PM10-2.5和TSP)的负相关比较显著,未发现与SO₂和NO_x有显著相关性.作者还对空气颗粒物与年均取暖期燃煤取暖、母乳喂养、呼吸系统疾病等因子的交互效应进行了研究,发现细颗粒物对儿童肺功能的影响更为不利.     

Prenatal diagnosis of congenital cystic adenomatoid lung malformation: A report of seven cases

Six cases of macrocystic and one case of microcystic congenital adenomatoid lung malformation were diagnosed by ultrasound between 20 and 31 weeks of gestation. Combined polyhydramnios and fetal hydrops was present in three cases, polyhydramnios alone in one case, and isolated fetal hydrops also in one case. In the remaining two cases, both polyhydramnios and fetal hydrops were absent. Fetal outcome was poor, i.e., two terminations of pregnancy, three early neonatal deaths, and two survivors.     

二氧化硫对小鼠肺细胞DNA损伤的研究

运用单细胞凝胶电泳技术（又称彗星试验）研究了SO2吸入对小鼠肺细胞DNA的损伤。结果发现，SO2可引起小鼠肺细胞DNA损伤，随SO2吸入浓度的增高而DNA损伤加重，具有明确的剂量效应关系。结果指出，即使在低浓度SO2吸入（7mg/m^3）的条件下，有DNA损伤的肺细胞也达96．8％，表明肺细胞对SO2的毒作用非常敏感。结果还指出，SO2对雌性小鼠肺细胞的DNA损伤比雄性小鼠弱，其原因尚待研究。