肺泡巨噬细胞凋亡对肺间质纤维化的影响

目的了解肺泡巨噬细胞的凋亡对肺间质纤维化进展的影响。方法收集一组肺间质纤维化患者的肺泡巨噬细胞（AM）,与正常组进行对比,检测两组AM产生细胞因子的活性;然后以干扰素-γ（IFN-1）诱导肺间质纤维化患者AM凋亡,对照诱导前后AM凋亡情况,同时检测诱导前后AM产生细胞因子的活性。结果肺间质纤维化患者AM培养上清液中肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）水平均明显高于对照组（P〈0．01）;AM的诱导凋亡率较自然凋亡率明显增高（P〈0．01）;诱导后AM产生细胞因子的活性明显低于诱导前的AM（P均〈0．01）。结论在肺间质纤维化的早期,利用IFN-γ诱导其AM凋亡,就可抑制AM产生细胞因子TNF-α、IL-6、IL-8等,从而控制肺泡炎,阻止肺间质纤维化的进程。     

扶正化瘀平喘法对哮喘患儿细胞因子及免疫功能影响的临床研究

目的探讨扶正化瘀平喘法对哮喘发作患儿血浆内皮素(ET)、肿瘤坏死因子-α(TNF-o)及免疫功能的影响.方法将95例哮喘发作患儿随机分为治疗组和对照组,治疗组49例采用扶正化瘀平喘法配合舒利迭治疗,对照组46例应用舒利迭治疗.观察两组病例临床疗效及治疗前后患儿细胞因子血浆ET、TNF-α、白细胞介素5(IL-5)、白细胞介素8(IL-8)的含量,免疫功能及肺功能(FEV1、FEV%)变化.结果治疗组在临床疗效,血浆ET、TNF-α、IL-5、IL-8的降低,免疫功能及肺功能(FEV1、FEV%)的改善方面明显优于对照组(P＜0.05).结论扶正化瘀平喘法能有效降低哮喘发作患儿细胞因子含量,缓解气道炎性反应.     

评价早期肺缺血再灌注损伤敏感性的细胞因子探讨

[目的]探讨敏感反映早期肺缺血再灌注损伤的细胞因子.[方法]复制兔早期在体肺缺血再灌注模损伤模型,分别于左肺门阻断2h和恢复灌注1h后采取动脉血液标本行血气分析和采用酶联免疫吸附法测定动脉血白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和肿瘤坏死因子-α(TNF-α);摘取左肺行病理学检查和测定湿、干质量及湿干重比.并与缺氧对照组比较,动态观察细胞因子的水平变化.[结果]成功制作兔早期在体肺缺血再灌注损伤模型,在实验全过程中,两组外周血的IL-6和IL-8含量均无明显变化(P>0.05);恢复灌注1h后,缺血再灌注组的IL-1β和TNF-α含量明显高于对照组和灌注前(P<0.01).[结论]细胞因子IL-1β和TNF-α是评价兔早期肺缺血再灌注损伤敏感性的细胞因子.     

银杏提取物与丹参酮ⅡA磺酸钠对慢性乙型肝炎患者肝纤维化指标及细胞因子的影响

目的 观察银杏提取物与丹参酮ⅡA磺酸钠对慢性乙型肝炎患者肝纤维化指标及细胞因子的影响.方法 入选慢性乙型肝炎患者96例,随机分为常规纽或治疗组,每组48例.常规组行常规保肝治疗,治疗组在常规保肝治疗基础上加用银杏提取物和丹参酮ⅡA磺酸钠治疗,疗程为12周.另入选30例健康体检人群为正常对照组.检测各组研究对象肝功能、血清透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PC Ⅲ)、Ⅳ型胶原(CⅣ)、转化生长因子-β1(TGF-β1)、白细胞介素-6(IL-6)和肿瘤坏死因子-α[(TNF-α)水平的差异.结果 治疗前慢性乙型肝炎患者血清HA、LN、PC Ⅲ、C Ⅳ、TGF-β1、IL-6和TNF-α水平明显高于对照组(均P<0.05).治疗12周后,治疗组上述指标的水平较治疗前及常规组均有显著降低(均P<0.05).结论 银杏提取物与丹参酮ⅡA磺酸钠治疗慢性乙型肝炎肝纤维化的可能机制是降低了患者血清炎性细胞因子的水平.     

双相Ⅰ型障碍患者治疗前后血清细胞因子水平比较及相关性分析

目的比较双相Ⅰ型障碍患者治疗前后血清细胞因子水平的变化,分析细胞因子水平与症状之间的相关性。方法选择2017年9月至2018年1月在合肥市第四人民医院治疗的双相Ⅰ型障碍患者40例,采用酶联免疫吸附试验检测治疗前后患者血清白细胞介素6(IL-6)、白细胞介素10(IL-10)、白细胞介素17(IL-17)、白细胞介素23(IL-23)、肿瘤坏死因子-α(TNF-α)水平。采用杨氏躁狂量表(YMRS)进行症状评估。结果与治疗前相比,治疗后患者血清IL-10、IL-23、TNF-α水平降低,IL-17水平升高,差异有统计学意义(P<0.05);患者治疗前后血清IL-6水平相比,差异无统计学意义(P>0.05)。治疗前后,各细胞因子水平与YMRS评分无相关性(P>0.05)。结论双相Ⅰ型障碍患者治疗前后的血清血细胞因子水平变化明显,疾病症状与血清细胞因子水平无相关性。     

乌司他丁对慢性阻塞性肺疾病急性加重期肿瘤坏死因子-α、白细胞介素-6、白细胞介素-8表达的影响

目的 探讨乌司他丁对慢性阻塞性肺疾病急性加重期(AECOPD)细胞炎性因子肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)影响.方法 将121例慢性阻塞性肺疾病急性加重患者随机分为两组,治疗组在综合治疗基础上加用乌司他丁,对照组为综合治疗,治疗前后观察血清细胞因子(TNF-α、IL-6、IL-8)变化.结果 两组治疗后均能降低血清TNF-α、IL-6、IL-8的表达,且治疗组优于对照组.结论 乌司他丁能降低AECOPD患者血清中TNF-α、IL-6、IL-8表达.     

孟鲁司特对过敏性紫癜患儿血浆细胞因子水平的影响及其临床疗效

目的研究孟鲁司特对过敏性紫癜患儿血浆细胞因子水平的影响及其临床疗效。方法将该院收治的70例过敏性紫癜患儿随机分为观察组和对照组各35例,对照组患儿接受常规治疗2周,观察组患儿在此基础上加用孟鲁司特口服治疗2周。观察两组患儿治疗前后血浆细胞因子水平变化及临床效果和不良反应发生情况。结果两组患儿治疗后血浆白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-12(IL-12)及肿瘤坏死因子-α(TNF-α)水平均较治疗前显著下降(P0.01),且治疗后观察组患儿血浆IL-6、IL-8、IL-12及TNF-α水平显著低于对照组(P0.01);观察组患儿治疗总有效率94.3%,显著高于对照组治疗总有效率的74.3%(P0.05),两组患儿不良反应发生率差异无统计学意义(P0.05)。结论孟鲁司特用于治疗过敏性紫癜能显著降低血浆细胞因子水平,具有良好的效果,值得临床推广应用。     

参麦联合丹参治疗重度烧伤患者脓毒症的疗效观察

目的:观察参麦注射液和丹参注射液对重度烧伤患者脓毒症中炎性细胞因子肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平的影响,探讨参麦注射液和丹参注射液在重度烧伤患者脓毒症治疗中的作用。方法:将60例重度烧伤致脓毒症患者随机分为两组:治疗组及对照组各30例。用放射免疫分析法检测治疗前、后炎性细胞因子肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)的水平。结果:治疗组TNF-α、IL-6、IL-8有显著下降。结论:参麦联合丹参注射液可显著降低炎性因子水平,从而保护多器官功能。     

血管重建术治疗血栓闭塞性脉管炎患者的疗效观察

目的探讨血管重建术治疗血栓闭塞性脉管炎(TAO)患者临床治疗效果。方法选取有介入治疗指征的下肢TAO患者18例为治疗组,用血管重建术加西药治疗;选取同期单纯用西药治疗的TAO患者31例为对照组,两组疗程均为3个月。比较两组患者治疗效果,观察治疗前后两组患者血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和肿瘤坏死因子-α(TNF-α)的变化情况。结果两组治疗效果比较差异无统计学意义(P>0.05)。治疗前两组血清IL-6、IL-8和TNF-α水平比较差异无统计学意义(P>0.05)。治疗后,治疗组血清IL-6、IL-8和TNF-α显著降低(P<0.01);对照组血清IL-8和TNF-α水平显著降低(P<0.01),IL-6水平变化不大(P>0.05);治疗组IL-6、IL-8和TNF-α均显著低于对照组(P<0.01)。提示治疗组对患者免疫损伤的改善作用优于对照组。结论血管重建术治疗TAO对改善患者的临床症状和炎症细胞因子功能紊乱的效果优于单纯西药治疗,为提高临床疗效奠定基础。     

高龄慢性阻塞性肺疾病急性加重期患者IL-8、IL-6、TNF-α水平变化与肺功能相关性研究

目的探讨高龄慢性阻塞性肺疾病(COPD)急性加重期患者白细胞介素-8(IL-8)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平变化及与肺功能相关性的临床意义。方法采集高龄COPD患者急性加重期及治疗后缓解期外周静脉血,检测IL-8、IL-6、TNF-α水平,采用肺功能检测仪检测两组患者FEV1%pred的变化。结果高龄COPD急性加重期细胞因子水平随综合评估分级递增而逐渐增加(P<0.01);急性加重期IL-8、IL-6、TNF-α水平明显高于缓解期组(P<0.05);急性加重期及缓解期IL-8、IL-6、TNF-α水平与肺功能指标FEV1%pred呈负相关(P<0.01)。结论高龄COPD患者IL-8、IL-6、TNF-α水平的变化可作为衡量高龄COPD患者病情严重程度和判断患者的疗效及预后的重要指标,且与肺功能负相关。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.