Objective To investigate apoptosis and bcl-2 expression of dust cells in human bronchopulmonary lymph nodes and murine peritoneal macrophages treated with carbon particles and study the relation of apoptosis of dust-laden macrophages and structural changes of the lymph nodes. Methods Distribution of dust particles, apoptotic cells and structural changes of the lymph nodes were viewed on paraffin sections and ultrathin sections. Apoptosis and bcl-2 expression of dust cells in human bronchopulmonary lymph nodes and macrophages treated with carbon particles were observed with TUNEL staining and bcl-2 antibody labeling. Results In the bronchopulmonary lymph nodes of the adult group, dust particles were deposited significantly in macrophages, the lymphatic tissue decreased, collagen fibres and density of blood vessels increased. In ultrathin section, the nucleus condensed and contained vacuoles. There were TUNEL-positive cells and bcl-2 labeling positive cells in dust cells of the lymph nodes and macrophages 24*!h after phagocytizing carbon particles. Bcl-2 was expressed strongly in the active macrophages decomposing dust particles or carbon particles. Conclusion Deposition of dust particles induces apoptosis and overexpression of antiapoptotic gene bcl-2 of macrophages in human bronchopulmonary lymph nodes. Structural changes of the bronchopulmonary lymph nodes in adult may relate to apoptosis of dust-laden macrophages.

Objective To examine location of hyaluronan(HA) in macrophages and effects of HA on adhesion and migration of macrophages and explore regulating mechanism of HA. Methods HA of macrophages was labeled with aggrecan.Location of intracellular and extracellular HA of the cells was viewed using optic microscope and confocal laser scanning microscope.Effects of HA on adhesion and migration of macrophages were examined by adhesion assay and migration assay. Results Macrophage synthesized HA.HA located mainly on the membrane and in premeter and perinuclear area of the quiescent cells.In the moving cells,most of intracellular HA located in pseudopodia,tail and perinuclear area.HA was rich on the surface of the pseudopodia and tail of the cells.HA on the surface of macrophages and HA substratum increased cell adhesion and migration,addition of free HA into the medium decreased cell adhesion.Conclusion There are characteristics of HA distribution in macrophages.HA synthesized by macrophages and HA substratum promoted adhesion and migration of macrophage,while free HA reduces cell adhesion.

Objective To investigate the therapeutic efficacy of somatostatin on chylothorax after congenital heart disease surgery in children.Methods Retrospective analysis was performed in 13 postoperative chylothorax cases from Jan.2003 to Dec.2012,who were divided into control group (n =6) and treatment group (n =7),and there was no significant difference in age,weight,and time of occurrence between the 2 groups.The diagnosis standard for chylothorax was the same.The changes of chylous volume during the treatment were analyzed between 2 groups,and healing time and other data were analyzed too.Results Control group:clinical cure in 3 cases,conservative treatment failed in 3 cases(2 cases recovered after operation and 1 case died).The chyle volume of control group reduced obviously compared with post treatment from beginning [(256.6 ± 124.2) mL/d] to 1 week [(155.5 ± 85.7) mL/d] and 2 weeks [(142.3 ± 110.3) mL/d] later(t =4.623,2.099 ; P =0.002,0.044).But it did not reduce obviously in 3 weeks later[(139.4 ± 113.4) mL/d] (t =1.745,P =0.07).Treatment group:6 cases in treatment group were successful in recovery after conservative treatment and 1 case underwent operation.The chyle volume of treatment group reduced obviously compared with post treatment from beginning to 1 week [(51.2 ± 18.7) mL/d] and 2 weeks [(19.3 ± 7.05) mL/d] later (t =5.549,6.638 ;P =0.001,0.001).Compared with the control group,the difference between 2 groups in post treatment (1 week later,2 weeks hater) was of statistical significance (t =2.900,2.412 ; P =0.014,0.034).The healing time of conservative treatment in 2 groups (only for recovery) had obvious difference [(32.8 ± 1.8) d,(25.2 ± 1.7) d] (t =2.512,P =0.028).Conclusions The use of somatostatin can significantly promote the recovery of chylothorax in children,and it should be actively used in early conservative treatment.

Objective To summarize the experiences of surgical treatment for aortic coarctation and/or aortic hypoplasty associated with intracardiac anomalies in infants.Methods The clinical data of 51 cases with aortic coarctation and/or aortic hypoplasty hospitalized in Wuhan Children's Hospital between Jan.2010 and Jun.2013 were analyzed retrospectively.Thirty-two patients had received a expanded end-to-end anastomosis and 19 patients had got a end-to-side anastomosis.Autologous pericardial patch,bovine pericardial patch or autologous pulmonary patch was taken according to the circumstances during surgery.Results There were 2 intraoperative deaths because of serious low cardiac output syndrome,and 2 postoperative deaths,which could not take off long-term respiratory assistance after surgery in aortic one child and low cardiac output syndrome in the other.Three patients appeared trachyphonia but recovered basically after 3 months follow-up.Forty-seven patients were followed up for 2 months-3 years,among them,3 patients had significant upper to lower extremity systolic blood pressure gradient[＞20 mmHg(1 mmHg =0.133 kPa)],and a second operation was proposed recently for 1 of them,while the other 2 children were in follow-up.The other 44 patients did not appear obvious restenosis.The 47 cases of children had no neurologic symptoms.Conclusions There have to be positive diagnoses and strictly surgery indications for aortic coarctation and/or hypoplasty associated with intracardiac anomalies in infants.Selective antegrade cerebral perfusion or deep hypothemic circulatory arrest depends on the surgon's discretion.Both expanded end-to-end anastomosis and end-to-side anastomosis can achieve good operation effects.

Objective    To explore the distribution pattern of respiratory symptoms and relevant factors in patients with pulmonary nodules. Methods    Demographic and clinical information were collected from patients who visited the Thoracic Surgery Outpatient Clinic of Guangdong Provincial People’s Hospital from January 2021 to January 2022. Hospital Anxiety and Depression Scale (HADS) was used to assess their anxiety and depression level. Results    A total of 1 173 patients were enrolled, including 449 males and 724 females, with an average age of 46.94±11.43 years. Among the patients with pulmonary nodules, 37.7% of them had at least one respiratory symptom; 24.4% had cough, 14.0% had expectoration, 1.3% had hemoptysis and 14.9% had chest pain. Old age, male, exposure to second-hand smoking or environmental smoke, hair coloring and history of tuberculosis were major risk factors for respiratory symptoms (P<0.05). Middle age, old age, male, exposure to environmental smoke were major risk factors for cough (P<0.05); old age, smoking, larger maximum nodules diameters, exposure to environmental smoke and history of pneumonia were major risk factors for expectoration (P<0.05); male, multiple nodules, hair coloring, exposure to second-hand smoking and history of tuberculosis were major risk factors for chest pain (P<0.05). Symptomatic patients showed generally higher HADS scores than asymptomatic patients (P<0.001). Conclusion    Cough, expectoration and chest pain are the predominant respiratory symptoms for patients with pulmonary nodules. The presentation of respiratory symptoms increases patients' anxiety and depression.