Diagnosis of peripheral pulmonary lesions using endorbronchial ultrasonography with a guide sheath combination with virtual bronchoscopic navigation / 中国内镜杂志

Objective To assess the diagnosis value of endorbronchial ultrasonography with a guide sheath combination with virtual bronchoscopic navigation at peripheral lung lesions. Methods 23 patients with lung peripheral lesions, 10 cases male, 13 cases female, age 29~78, the median age of 61, were retrospectively analyzed by diagnosised with EBUS-GS-TBLB combination VBN from March 2015 to December 2015. Results 23 cases of patients, 8 cases of adenocarcinoma, squamous carcinoma in 5 cases, mixed carcinoma in 1 case, 1 case of small cell carcinoma and lung metastatic carcinoma in 1 case, 2 cases were tuberculosis, 1 case of inflammation, 4 cases were negative. The total positive rate was 82.6%. Conclusion EBUS-GS-TBLB combination with VBN to the diagnosis of lung lesions with high positive rate, it is worthy of promoting clinically.

In vitro antibacterial test of Chinese medicine compound preparation for common pathogenic bacteria in upper respiratory tract infection / 天津医药

Objective To observe the antimicrobial effect of a kind of Chinese medicine Qingre compound preparation on the common pathogenic bacteria of upper respiratory tract infection (URTI). Methods A total of 163 common pathogen?ic bacteria of URTI was selected in this study, including 74 non extended-spectrum β- lactamases (ESBLs)-producing Gram-negative bacteria (33 Escherichia coli, 24 Klebsiella pneumonia and 17 Pseudomonas aeruginosa), 10 ESBLs-produc?ing Gram-negative bacteria (6 Escherichia coli and 4 Klebsiella pneumoniae) and 79 Gram-positive bacteria [11 methicil?lin-resistant Staphylococcus aureus (MRSA), 46 methicillin-sensitive Staphylococcus aureus and 22 Streptococcus pneu?moniae]. Agar dilution method was adopted to perform the quantitative drug sensibility test. Agar plates that contained differ?ent concentrations of Qingre compound preparation were prepared. The bacterial suspension was planted on the plates. Then we observed the plates after incubation, and recorded the minimum inhibitory concentration (MIC). Results The antimicro?bial rates of Qingre compound preparation were 88, 176 and 22 g/L for MIC90 of Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. The antimicrobial effects of Qingre compound preparation were coincident on the MIC 90 of ES?BLs-producing strains and non ESBLs-producing strains. The accumulated antibacterial rates of different concentrations of medicine to Pseudomonas aeruginosa were the highest. The MIC90 values of Qingre compound preparation were 11, 11 and 22 g/L for MSSA, MRSA and Streptococcus pneumoniae. The MIC90 of MRSA was coincident with MSSA, but MIC50 of MRSA was slightly higher than that of MSSA. The accumulated antibacterial rates of different concentrations of medi cine to MSSA and MRSA were all higher than those of Streptococcus pneumonia. The accumulated antibacterial rate of MSSA was similar with that of MRSA. Conclusion The Chinese medicine Qingre compound preparation could restrain common patho?genic bacteria of URTI except Klebsiella pneumoniae. The antibacterial effect of Qingre compound preparation is significant?ly better in Ggram-positive bacteria than that of Gram-negative bacteria.

OBSERVATIONS OF THE PULMONARY CAPILLARY AND ALVEOLAR CASTS UNDER THE SCANNING ELECTRON MICROSCOPE / 解剖学报

Three fresh lungs removed from three male adult dogs were injected with ABS. This material was injected into each lobe of the lung through the pulmonary artery and bronchus simultaneously. The pressure was maintained between 200～280 mmHg. The injected specimens were digested in 20～50％ HCl and peptic solutions for 7～10 days. A part of the cast replicas of the lungs was taken off and gilded with EIKO IB-3. Under SEM (HITACHIS～450) the specimens thus prepared were observed. The chief findings were as follows:Scanning electron micrographs of the injected vascular system presented a clear, three-dimensional picture of extensive capillary networks around the individual alveoli. In the septa between alveoli the capillary networks appeared to be a single layer. These networks looked like pentagonal or hexagonal rings; the meshes in between them were smaller than the vessels themselves.The capillaries observed here in the scanning stereopicture belonged to the category of the alvioli cappilary of the subpleura; the meshes of which were larger than those of other parts.Because the numerous alveoli and capillary networks surrounding the alveoli were filled with the ABS, the position and the shape of the capillary networks can be seen very clearly.The lumen of the alveoli were polyhedron in shape, various in sizes and smooth in contour. Many imprints of the alveolar type Ⅱ cell nuclei existed on the surface. The bridge formation between alveoli were really interalveolar pores; their number and diameter varied. The function of the interalveolar pores was briefly considered in this paper.

MORPHOLOGICAL OBSERVATION ON THE CORONARY ARTERIES OF THE RABBIT HEART / 解剖学报

The coronary arteries of 80 rabbit hearts were studied.Suspension of red lead oxide (Pb_3O_4)in turpentine was injected into the coronary artery.With clearing method and angiographic technique,we studied the branches of the left and right coronary artery, the angle between the anterior descending branch and the left circumflex branch of the left coronary artery,the relationship between the anterior descending artery and the great cardiac vein,the origin of the sinoatrial nodal artery and the atrioventricular nodal artery as well as the type of branch in coronary artery.The results were outlined as follows: 1.The angle between the anterior descending branch and the left circumflex branch is 35～45?in more than one half of the cases(54.5%). 2.The anterior descending branch is often small and short and accompanies the great cardiac vein.It may exist in four forms:1)Both branches run closely to each other. 2)Both run along with each other but leaving a distance in between.3)Both are over- lapping each other.4)Both are crossing each other between the inferior margin of the left auricle and pulmonary artery cone.Ligation of the anterior descending branch in animal experiments should be appropriately made between the right inferior margin of the auricle and the pulmonary artery cone. 3.The left ventricular branch is a direct continuation of the circumflex branch and gives off branches to anterior and posterior wall of the left ventricle. 4.There is an independent ventricular septal artery in the rabbit heart. 5.The sinoatrial nodal artery of the rabbit heart arises frequently from the right coronary artery(86.6%)and the atrioventricular nodal artery from the left coronary artery(72.5%). 6.Commonly the distribution of the coronary blood supply from the left and right coronary arteries to rabbit heart is nearly a balanced circultion(67.5%).Next frequent is the preponderance of the left coronary artery(28.8%),and the preponderance of the right coronary artery occurs only in 3.7%.

OBSERVATIONS OF THE HUMAN PULMONARY CAPILLARIES AND ALVEOLAR CASTS UNDER THE SCANNING ELECTRON MICROSCOPE / 解剖学报

The architecture of the alveolus and its capillaries of human lung injected withsolution of ABS in methyl ethyl ketone was studied under the SEM.The results wereoutlined as follows:1.The alveolar casts were observed from the subpleural and intralobular septu-lar surfaces.The human alveolus is irregular polygon in appearance.The size ofthe alveolus is variable,its surface is smooth,there are many depressions of the topof type Ⅱ cells.The bridge-like structure between two adjacent alveoli are thecasts of the alveolar pores.They are variable both in size and number,and ofround or oval shapes with smooth surface.2.Capillaries of the subpleural space and interlobular septulum are transitional,and identical in appearance.Meshes of the capillary network are larger than thoseof other parts,but more closer in density compared with those in dog.Each capil-lary is branched from the metaarteriole.3.Capillaries in the alveolar septum is a single layer of dense network,theirdiameter are larger than those of the mesh hole.They originate mainly from thecapillaries of subpleural space and interlobular septulum.

SCANNING ELECTRON MICROSCOPY ON THE MICROVASCULATURE OF THE MONKEY PAROTID GLAND / 解剖学报

The microvasculature of monkey parotid gland was observed by scanning electron microscope. The capillary networks around the acini were loose and the capillary networks around the ducts were dense and sinusoidal in type. The capillary networks around both the acini and intercalated duct and sinusoidal capillary networks around both the striated duct and intralobular duct were supplied by the blood passing through the acinar or duct arterioles from interlobular and intralobular artery. The capillary networks around the acini showed three draining forms: (1) draining into the vein directly; (2) draining into the capillary network around the striated duct through capillaries; (3) draining into the capillary network around the striated duct through venules. The latter form (venules) is named as "portal system". The capillary networks around the striated duct showed two draining forms: (1) they continued to form the capillary network around the intralobular duct; (2) they converged into venules which accompanied by the intralobular duct. The arterio-venous anastomoses were not observed in the parotid gland. However, arterio-arterial and venovenous anastomoses were found in interlobular region.

OBSERVATIONS ON THE VASCULAR ARCHITECTURE OF THE GALL-BLADDER IN THE FULL TERM FETUS UNDER THE SCANNING ELECTRON MICROSCOPE / 解剖学报

The SEM specimens of the blood vessels of the gall-bladder in the full term fetus were produced with the methyl methacrylate cast. The specimens were dryed and gilded with EIKO. IB-3. and then observed under scanning electron microscope. The microvessels of the wall of gall-bladder obviously were divided into three layers, namely: serous vessels, muscular vessels and mucous vessels. The serous and muscular vessels are similar to that of the intestinal canal. However the mucous vessels were characterized by subepithelial capillary networks and veins of large calibre in the lamina propria. The capillary networks were connected directly with the venous plexus by the capillaries. There are fewer arterioles passing and branching among the venous plexuses. Each arteriole was connected to capillary networks. The short capillary was seen frequently between the arterioles and the venous plexus, serving as communication between them.

OBSERVATION ON VASCULAR CASTS OF UVEA NEWBORNS BY SCANNING ELECTRON MICROSCOPY / 解剖学报

Ten fresh eye balls removed from five newborn cadavers were studied.About2-4 hrs after death,cadavers were injected through both common carotid arteries withABS at a constant pressure between 120～150 mmHg.ABS-injected eyes were enucleatedand were cut into halves through equator or meridian.The specimens were digestedin 40% KOH.The corrosion-cast models of blood vessels in uvea were observed underthe SEM.The chief results of observation were as follows:Within the choroid,the blood vessels lie in stratified layers.The large vesselsare located in the outermost layer,next to this layer are smaller vessels.The innermostlayer consists of a continuous single layer of capillaries.The choriocapillaries end around the optic disc.This finding indicates that thechoriocapillaries are not directly involved in the disc circulation.Each short posterior ciliary artery supplied a segment of the choriocapillaries,with some capillary anastomosis between segments,so that the choriocapillaries werearranged in one plane as a single continuous layer of capillaries forming a network.The network of the choriocapillaries consisted of lobules of choriocapillaries.The precapillary arteriole lie in its center.In each lobule meshed capillaries appearedto radiate from a central focus.The postcapillary venule lay on the periphery of thelobule.The lobules varied in their geometric configuration,forming irregularlytriangular to hexagonal shapes.The average size of a lobules of newborn's chorioca-pillaries was 230/420? to 460/520?.The diameter of the choriocapillary varies between8? and 20?.The blood vessels of the ciliary body and iris divide from large circular arteryof iris and long posterior ciliary arteries.Each ciliary process contained a small arterywhich randomly branched to form a capillary network.It is drained by venule.

THREE-DIMENSIONAL MICROANGIOARCHITECTURE OF THE SUBMANDIBULAR GLAND IN MONKEY / 解剖学报

In monkey submandibular gland there were two types of capillary networks, which were apparently different in calibre and architecture, i. e. the capillary networks around the acini and the capillary networks around the striated ducts. They originate from their respective precapillary arterioles stemed from intralobular terminal arterioles. Between the two types of capillary networks they are connected by both capillaries and postcapillary venules. The latter were called portal vessels. The capillary networks around the striated duct have two types of draining vessels. First, they converged to form postcapillary venules, which continued to form intralobular veins. Second, they directly continued to form the capillary networks around the intralobular ducts. The capillary networks around the intralobular ducts directly supplied blood through precapillary arteioles around the duct besides they connected respectively with the capillary networks around the acini and striated ducts through capillaries. Furthermore, a ring-shaped constriction was observed distinctly at the intralobular terminal arteriole.

OBSERVATION OF THE VASCULAR ARCHITECTURE OF THE RAT TESTIS / 解剖学报

The gross vessels and microvasculature of the rat testis were observed by clear method and corrosion cast method under SEM. The present study noted that there were two kinds of the microvascular arrangement around the circumference of the seminiferous tubule. The first one could be called the intertubular vessels. This vessel was either individual precapillary arteriole or two parallel capillaries connected by a few small branches to form network. The intertubular vessels were located in triangular columns of interstitial tissue between the seminiferous tubules and parallel with the tubules. The second one could be called the peritubular capillaries. These capillaries connected the intertubular vessels in the manner of a rope ladder, and encircled the seminiferous tubule, formed the peritubular capillary network in the subepithelium of the seminiferous tubule. Authors presume that this vascular feature of the architecture surrounding the seminiferous tubules may be related to high blood flow required in the metabolic activity of the tubules and it may contribute to immediate effect of androgen secreting in the interstitial tissue of the testis on the seminiferous tubules. In the article, the gross vascular feature of the arrangement in the rat testis and the microvascular arrangement in the visceral layer of tunica vaginalis of it is described in detail. Their functional significance is also discussed.

OBSERVATION OF ADULTS' GLOMERULAR CAST BY SCANNING ELECTRON MICROSCOPY / 解剖学报

Two fresh kidneys removed from two male adult bodies, about 48 hrs. after death, were injected through the renal artery with ABS (a copolymer of allyl cyanide, butadiene and styrolene) at a constant pressure between 250-280 mmHg. Corrosion casts were prepared for the study of glomerular vasculature. Small specimens were cut out from the kidney were digested in 20% HCl and 10% peptic solution. Cast replicas of renal arteries and their branches were removed and examined with the SEM (Hitachi H-500 with Scanning accessories HSE_2). The chief results of observation were as follows: The corrosion-cast models of adults' glomerular vessels observed under the SEM consisted of two kinds: the spherical glomerulus and the chrythsanthemum-like glomerulus. The system of capillary loops of the spherical glomerulus was interconnected by anastomosed vessels. The lobular patterns of the glomerular capillary loops as described in the mouse kidney by Hall were not observed. The chrythsanthemum-like glomerulus consisted of many branches of capillaries, either longer or shorter, and most ended blindly. No more than one efferent or afferent vessel have been observed in our corrosioncast specimen of the adults' glomerular vessels. In general, the afferent and efferent arteriole enters or exits at the hilum of glomerulus. Rarely, the efferent vessel left the glomerulus at the oppositeside of the hilum. By-pass tract between the afferent and efferent vessels was not found in our casts. Constrictions of the afferent arterioles such as those shown in rats by Shonyo and Mann ('44) were not demonstrated in the adults' kidneys. Sometimes, there is a constriction near the point of origin of the afferent arteriole.

BRANCHES AND PATTERNS OF DISTRIBUTION OF THE CORONARY ARTERIES (CORDIS) IN CHINESE / 解剖学报

Observations on the coronary arteries of 100 embalmed hearts from 56 adults and 44 children, have been made. The results are as follows: (1) The point of origin of coronary arteries was found vertically on the margin of the aortic sinus in 69.4% of the left and 52.8% of the right respectively and horizontally at the middle third of the aortic sinus in 79.7% of the left and 67.5% of the right respectively. (2) The external diameter at the opening of the left coronary artery is greater than the right in both adults and children. The mean value of the external diameter at the opening of the left coronary arteries was 0.41?0.14 cm and of the right 0.31?0.02 cm, in children, while in adult, the figures were 0.53?0.02 cm and 0.45?0.02 cm respectively. (3) The accessory coronary artery occurred in 10%.The percentage is lower than other reports in China. (4) The branch and distribution of the left coronary artery were studied thoroughly; its diagonal branch occurred in 38.4%.The mean value of the angle between the left anterior descending branch and the left circumflex artery was about 80?. In one the left circumflex artery was absent. (5) The branch and distribution of the right coronary artery were also investigated carefully. Fifty six percent of the right coronary arteries terminate in the heart, diaphragmatic surface between the crux of the heart and the obtuse margin. The posterior descending branch of right coronary artery ended in the middle-lower third of the posterior longitudinal sulcus of the heart. The occurrence of desending septum artery is 6.1%. (6) An investigation on the posterior superior septum artery and Kugel’s artery has been made: the former, 45.5% of which originated from the right coronary artery, possessed only one branch while the latter, which has been seen in three cases, occurred in 30%. (7) The common type of distribution, in which the posterior wall of the left ventricle was supplied by the right circumflex branch, occurred in 80.2%.

OBAERVATIONS ON THE A-S NODE ARTERY AND A-V NODE ARTERY IN CHINESE / 解剖学报

A Study of one hundred hearts (adults 56, children 44) has been made. The S-A mode arteries and A-V node arteries are measured and analysed. The chief results are as fo11ows: (1) 67% of S-A node arteries originated from the right coronary artery; 33% arose from the left coronary artery. A number of the S-A node arteries arising from the right coronary artery were the continuation from the anterior right atrial branch. Occasionally, they may be come from the intermediate right atrial branch or intermediate left atrial branch. (2) The distance between the right S-A node artery origin and the aortic root was about 1.28?0.12 cm in adults, and 0.85?0.09 cm in children, while between the left S-A node artery origin and the bifurcation of the left coronary artery, it was about 0.84?0.19 cm in adults and 0.41?0.03 cm in children. The external diameters of the S-A node arteries were measured. The mean value was as follows: 0.17?0.01 cm (adults); 0.12?0.01 cm (children). (3) The relation between the origins of S-A node artery and A-V node artery may be divided into six types. ①The S-A node artery and A-V node artery which originated from the right coronary artery were about 58.06%. ②The S-A node artery arising from the left coronary artery and the A-V node artery originating from the right coronary artery occurred in 30.11% ③The S-A node artery originated from the right coronary attery, while the A-V node artery arose from the left. This condition was about 6.45%.④The type that the S-A node artery arose from both coronary arteries, and the A-V node artery originated from the right was about 3.22%.⑤Both the S-A node artery and A-V node artery arising from left coronary artery occurred in 1.08%.⑥The A-V node artery originating from the left and right coronary arteries, and the S-A node artery arising from the right coronary artery were about 1.08%.

THE EXPERIMENTAL INVESTIGATION ON THE COURSE OF ESTABLISHING CORONARY COLLATERAL CIRCULATION OF THE HEART IN RABBIT / 解剖学报

The course of estahlishing coronary collateral circulation has been studied after ligating the anterior descending branch of the left coronary artery (L. A. D.) of the heart in 20 rabbits. Another 5 rabbits were studied as control group. The experimental results were as follows: (1) The rabbit electrocardiograms EGG were made before and after the ligation of the L. A. D. The EGG of control group was made only before killing. In these experiments, the pathological changes of No. 28 were observed immediately after ligating the L. A.D. It was found that the T wave was inverted in standard lead I, and that the volts of the QRS complex in lead Vc fell apparently. This phenomenon may be interpreted as myocardial ischemia in the anterior wall of the heart. After ligating the L. A. D. the S-T segment of No. 27 in AVL lead elevated and exceeded I mm, and the depressive Q wave in Vc lead was greater than the one-fourth of the R wave before killing. All of the phenomenen observed in the rabbit entirely confirmed the myocardial infarction and myocardial ischemia. In No. 25, the T wave was inverted in standard lead I, and the QRS complex in lead Vc was not only shallow in depth but also very little. The conditions accounted probably for myocardial ishcmia. During 4 to 21 days after ligating the L. A. D.,the pathological changes in the EGG occurred frequently.The rabbit ECG gradually became normal from 21 st day on. (2) The coronary arteries of the rabbit hearts were injected with X-ray contrast medium and were examined. The X-ray film thus obtained were compared with the specimen after they were cleared. At the same time, sections of the heart walls (the infarcted area and its surrounding areas) of fifteen rabbits were studied carefully under microscope. Our primary impression was that only a few newly formed vessels in the central part of the infarct till the fourth day after ligating the L. A. D. The vessels surrounding of the infarct show a slight winding and distension. During 10 to 28 days, the number of the newly formed vessels in the infarct increased gradually day by day. The vessels surroundings the infarct were also highly crooked and distended, especially in the anterior wall of the right ventricle. This is possibly the most active period in the establishment of coronary collateral circulation. During 28 to 49 days, the morphology of the vessels in the infarct area became similar to that of the corresponding area of the control group. (3) The significance of the coronary collateral circulation on the heart wall was discussed.