金疮止血消炎药抑菌抗炎作用实验研究

目的:研究金疮止血消炎药的抑菌、抗炎作用。方法:用肉汤稀释法测定金疮止血消炎药对呼吸道常见致病菌的最低抑菌浓度(MI C);用蛋清诱发大鼠足肿胀急性炎症模型;大鼠棉球肉芽肿慢性炎症模型;二甲苯诱发小鼠耳肿胀和小鼠腹腔毛细血管通透性试验;研究金疮止血消炎药的抗炎作用。结果:金疮止血消炎药具有体外抑菌作用,对引起呼吸道感染的9种常见病原菌和致病菌均有不同程度的抑制作用;金疮止血消炎药具有抗炎作用,对大鼠蛋清性足肿胀、大鼠棉球肉芽肿、二甲苯致小鼠耳廓肿胀及小鼠腹腔毛细血管通透性试验均有不同程度的抑制作用。结论:本研究结果提示金疮止血消炎药具有抑菌、抗炎作用,为金疮止血消炎药临床用于外伤止血抗炎、溃疡、流感、上呼吸道感染、咽喉肿痛等症提供了实验研究依据。     

急性高血压对成年及老年大鼠血脑屏障通透性的影响

目的 探讨急性高血压对成年及老年大鼠血脑屏障通透性的影响。方法 用依文氏蓝染色、光镜及镧醛灌注电镜法观察去氧肾上腺素诱发的急性高血压对成年及老年大鼠血脑屏障通透性的影响。结果 成年及老年组大鼠皮质及小脑蓝染程度明显高于尾壳核、海马和丘脑。光镜下可见局灶性神经细胞肿胀、尼氏小体溶解，胞浆空亮，细胞嗜酸性增强。电镜观察内皮细胞及基底膜完整，镧离子全部位于血管腔内。结论 去氧肾上腺素诱发的高血压可以引起广泛的血脑屏障通透性升高，以皮质和小脑更为明显。同时可引起中枢神经细胞局灶性肿胀变性。     

古墨膏抗炎作用的实验研究

为研究古墨膏的抗炎作用,采用小鼠耳肿胀模型、大鼠足跖肿胀模型及小鼠腹腔毛细血管通透性增高模型观察古墨膏的抗炎作用。结果显示,古墨膏能显著抑制二甲苯所致小鼠耳肿胀,明显减轻鸡蛋清致炎大鼠足跖肿胀度,并具有抑制醋酸引起的小鼠腹腔毛细血管通透性增加作用。结果表明,古墨膏对动物炎症模型具有明显的抗炎作用。     

广痛消泡沫气雾剂对大鼠肛门水肿的作用

目的：观察大鼠肛门水肿组织病理改变和广痛消泡沫气雾剂的干预作用。方法：SD大鼠用0.16 mL巴豆油混合液致肛门肿胀,治疗组肛门内给予广痛消泡沫气雾剂,分别于给药后24 h、48 h、72 h全部处死,取肛周组织进行染色处理,显微观察空白组、模型组、治疗组及对照组病理改变。结果：空白组直肠黏膜正常;模型组直肠黏膜呈急性炎症改变;治疗组随着给药天数的增加,黏膜层溃疡逐渐好转,黏膜下层充血、水肿明显改善,血管充血、扩张消失,对照组炎症改变不明显。结论：巴豆油注射可致SD大鼠肛门水肿炎性改变;广痛消泡沫气雾剂对大鼠肛门肿胀具有抗炎、消肿的作用。     

大叶铁线莲提取物抗炎作用实验研究

目的：探讨大叶铁线莲粗提物的抗炎作用。方法：分别采用蛋清诱导大鼠足跖肿胀法、二甲苯致小鼠耳肿胀法研究大叶铁线莲提取物的抗炎作用。结果：大叶铁线莲提取物对大鼠足跖肿胀具有明显的抑制作用（醇提物P<0.01,水提物P<0.05）,显著减轻二甲苯致小鼠耳肿胀程度（P<0.05）。结论：大叶铁线莲水提物、醇提物具有明显的抗炎作用。     

急性子提取物抗炎镇痛作用的实验研究

目的探讨中药急性子的抗炎镇痛效果，为临床合理应用提供理论依据。方法采用二甲苯致小鼠耳肿胀、冰醋酸致小鼠扭体反应、小鼠热板法、蛋清致大鼠足肿胀和肉芽肿实验观察急性子提取物的抗炎镇痛效果。结果与模型对照组比较，急性子水提物中、大剂量组小鼠扭体次数明显减少（P＜0.05），急性子水提物中、大剂量组大鼠足肿胀减轻。中、大剂量急性子水提物对小鼠耳肿胀无效，其中大剂量可延长60 min（P＜0.01）和90 min（P＜0.05）小鼠疼痛阈值；急性子醇提取物大剂量可显著减少小鼠扭体次数（P＜0.01），减轻小鼠耳肿胀程度（P＜0.05），明显延长30 min疼痛阈值（P＜0.01），减轻大鼠肿胀程度；急性子醇提物大剂量可延长60 min疼痛阈值（P＜0.01）。急性子提取物对大鼠肉芽肿无抑制作用。结论急性子提取物有一定的镇痛效果和抑制急性炎症作用。     

丙泊酚对大鼠局灶性脑缺血-再灌注低氧诱导因子-1和热休克蛋白70的影响

目的 观察丙泊酚对大鼠局灶性脑缺血-再灌注后低氧诱导因子(HIF-1)和热休克蛋白70(HSP70)的影响,探讨丙泊酚脑保护作用机制.方法 32只雄性sD大鼠,随机均分为四组,采用可逆性大脑中动脉内线栓法建立局灶性脑缺血-再灌注模型,缺血2 h再灌注24 h后断头取脑,采用免疫组化法检测HIF-1和HSP70.HE染色,光镜观察细胞形态学改变.结果 大鼠局灶性脑缺血-再灌注后大脑皮质和海马区出现神经细胞的坏死和凋亡改变,HIF-1和HSP70的表达均增加,给丙泊酚后神经细胞的肿胀、坏死、凋亡明显减少,HIF-1和HSP70蛋白的表达受到明显抑制.结论 丙泊酚对大鼠局灶性脑缺血-再灌注损伤的保护机制与减少HIFll、HSP70的表达有关.     

异丙酚对大鼠局灶性脑缺血/再灌注后细胞凋亡的影响

目的：观察异丙酚对大鼠局灶性脑缺血／再灌注后细胞凋亡的影响。方法：雄性SD大鼠，采用可逆性大脑中动脉内线栓法建立局灶性脑缺血／再灌注模型。缺血2h，再灌注2h后断头取脑，采用脱氧核昔酸末端转移酶介导的DNA原位末端标记技术检测细胞凋亡变化。HE染色，光镜观察细胞结构的改变。结果：光镜检查发现，异丙酚组细胞肿胀坏死明显减轻，异丙酚可显著减少脑缺血／再灌注后神经细胞的调亡。结论：静脉麻醉药异丙酚具有拮抗大鼠局灶性脑缺血／再灌注损伤作用，对缺血／再灌注的神经细胞有明显的保护作用。     

木芙蓉叶有效组分抗非特异性炎症的实验研究

目的观察木芙蓉叶有效组分(MFR-C)的抗非特异性炎症作用.方法通过大鼠鹿角菜致肿实验、大鼠蛋清致肿实验、小鼠腹腔毛细血管通透性实验和小鼠耳肿胀实验,对木芙蓉叶有效组分抗非特异性炎症的作用进行评定.结果 MFR-C和盐酸青藤碱对鹿角菜及蛋清所致的大鼠足肿胀具有良好的抑制作用,与空白对照组相比差异有显著性(P＜0.05);与空白组相比,MFR-C对乙酸引起的小鼠腹腔毛细血管通透性也具有良好的抑制作用,两者之间差异有显著性意义(P＜0.05);小鼠耳肿胀实验显示MFR-C有抑制二甲苯造成的非特异性耳肿胀作用,与空白组相比P＜0.05,与阳性对照组(盐酸青藤碱)相比有同样的抗炎消肿作用.结论木芙蓉叶有效组分(MFR-C)对鹿角菜、蛋清、乙酸及二甲苯引起的非特异性炎症具有良好的抑制作用.     

新型的胆源性胰腺炎动物模型

目的 研制一种与临床胆源性胰腺炎（Ｂｐ）相似的动物模型。方法 采用电压３伏和频率２０Ｈｚ的电针刺激大鼠行走十二指肠内的胆胰管末端，结果 电针刺激胆胰管１小时后，见胰腺轻微的肿胀及充血，饲养２４小时后，血淀粉酶和尿淀粉酶均明显升高，胰腺肿胀及充血明显。镜下见胰腺间质水肿及大量的炎性细胞浸润，小叶内蛋白样积液，胰腺沟细胞空泡样变和局灶性坏死。结论 该模型符合急性胰腺炎的病理改变，它的病理生理变化更符合     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Is the recovery profile of mivacurium independent of the rate of decay of its plasma concentration in patients with normal plasma cholinesterase activity?

Background: The duration of action of muscle relaxants is poorly correlated to the rate of decay of their plasma concentration. The plasma concentration of mivacurium may rapidly decrease below its active concentration because of the extensive hydrolysis of mivacurium. By inflating a tourniquet on one upper limb for 3 min after the administration of atracurium, mivacurium or vecuronium, we studied the influence of the initial decline of their plasma concentration on their effect. Methods: In 50 patients anaesthetised with thiopental, isoflurane and fentanyl, the effect of bolus doses of 0.15 or 0.25 mg . kg^?1 mivacurium (MIV 15, MIV 25), 0.3 or 0.5 mg . kg^?1 atracurium (ATR 30, ATR 50) and 0.06 or 0.1 mg . kg^?1 vecuronium (VEC 06, VEC 10) were measured on both arms (evoked response of the adductor pollicis to train-of-four stimulation every 12 s), a tourniquet being applied on one arm just before and during 3 min after the muscle relaxant bolus. Results: Tourniquet inflation of 3 min almost abolished the neuromuscular effect of mivacurium. In the vecuronium groups and in the ATR 50 group, tourniquet inflation did not modify the maximum degree of depression of the twitch response. Also, the duration of action of vecuronium was unaffected by the tourniquet. In the ATR 30 group, times to return of the twitch response to 25% (duration 25%) and 75% (duration 75%) of control response were significantly shorter in the cuffed arm, 23 min vs 27 min, and 41 min vs 45 min, respectively. In the ATR 50 group, only duration 25% was significantly shorter in the cuffed arm (41 min vs 45 min). Conclusion: The results suggest that the rate of decline of the plasma concentration of mivacurium is so rapid, that a very low and almost clinically ineffective concentration is present as soon as 3 min after its administration. The results also indicate that the recovery from a mivacurium-induced neuromuscular blockade is not influenced by the rate of decay of its plasma concentration in patients with genotypically normal plasma cholinesterase.     

Membranes in Artificial Organs

Abstract: Membrane processes play a pivotal and enabling role in modern replacement therapy for acute and chronic organ failure and in the management of immunologic diseases. In fact, virtually all contemporary extracorporeal blood purification methods employ membrane devices, and the next generation of artificial organs and tissue engineering therapies are almost certain to be similarly grounded in membrane technology. In this short essay, we comment on the similarities and differences among synthetic membranes and their natural counterparts and also provide a critical overview of the demographics and technology of hemodialysis, hemofiltration, apheresis, oxygenation, and emerging membrane technologies and applications.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Dilemma of Membrane Biocompatibility and Reuse

Abstract: Numerous articles have been published on the multiple use of dialyzers and on the effect of different reprocessing chemicals and techniques on the dialyzer biocompatibility and performance. The results often appear contradictory, especially those comparing standard biocompatibility parameters. Despite this confusion, a discerning review of the published works allows certain limited conclusions to be drawn. Reprocessing of used hemodialyzers changes the biocompatibility profile of a dialyzer as defined by the parameters complement activation. leukopenia, and cytokine release. The effect of reprocessing depends on the chemicals and reprocessing technique applied and also on the type of membrane polymer being subjected to the reprocessing procedure. Reports of pyrogenic reactions indicate that the flux of the membrane also influences how suitable it is for safe reuse. An increased risk of allergic and pyrogenic reactions appears to be associated with dialyzer reuse. Furthermore, there has been a lack of investigations into the immunologic effect of the layer of adsorbed and chemically altered proteins that remains on the inner surface of reprocessed dialyzers. We conclude that the clinical benefit of dialyzer reuse cannot be generally accepted from a biocompatibility point of view.