彩色多普勒超声诊断主动脉夹层一例

患者女,80岁,因突发腹胀、心前区疼痛伴左上肢体麻木30 min入院.患者平素身体健康,有高血压病、冠心病等病史.体检:体温36℃,脉搏76次/min,呼吸18次/min,血压150/90 mm Hg,痛苦貌,心肺(-),腹壁无膨隆,全腹软,剑下压痛明显,余腹部无压痛及反跳痛.各项检查结果如下:心电图:窦性心律,心电轴+6°,Ⅰ、Ⅱ、Ⅲ、aVF、V3～V6导联ST段轻微下移,V1～V4导联T波倒置.腹部平片:肠管积气.心肌酶五项:谷草转氨酶46 U/L,门诊拟诊胸痛原因待查,不稳定型心绞痛入院.入院后给予吸氧、心电监护,硝酸甘油持续泵入、美托洛尔控制心率、极化液营养心脏等对症治疗.     

脂多糖致肺血管内巨噬细胞分泌功能的改变

目的 探讨肺血管内巨噬细胞(PIM)在感染性急性肺损伤(ALI)发病中的作用.方法 采用改良Morton法分离、培养猪PIM;用贴壁法获得黏附的PIM,培养于RPMI 1640培养基,予10 mg/L脂多糖(LPS)刺激.用鼠胸腺细胞增殖法测定白细胞介素-1β(IL-1β)活性,酶联免疫吸附法(ELISA)测定IL-6、IL-8含量.结果 LPS刺激后,PIM释放IL-1β、IL-6和IL-8均增多,峰值分别出现在刺激后的2 h[IL-1β活性(10 400±2 389)次/min]、4 h[IL-6含量(0.80±0.36)μg/L]和6 h[IL-8含量(4.94±1.19)μg/L],与刺激前[IL-1β活性(213±85)次/min,IL-6含量(0.27±0.12)μg/L,IL-8含量(1.84±0.53)μg/L]比较差异均有统计学意义(均P＜0.01).结论 LPS刺激后,PIM分泌多种细胞因子,其中IL-1β升高最早,提示其在ALI发病早期起重要作用;而IL-6、IL-8升高较晚,且持续时间较长,可能对ALI的病情进展起重要作用.细胞因子间的相互作用在ALI的发病中似乎更为重要.

Abstract：

Objective To investigate the role of pulmonary intravascular macrophages(PIMs)in the pathogenesis of acute lung injury(ALI)due to infection. Methods Porcine pulmonary blood vessels were flushed by modified Morton method, and PIMs were isolated and cultured. The adhered PIMs were collected with adhesion method and incubated in RPMI 1640 medium. They were challenged with lipopolysaccharide (LPS, 10 mg/L). The activity of interleukin-1β(IL-1β), and contents of IL-6 and IL-8 in the culture supernatant were measured by method of thymocyte proliferation and enzyme linked immunoadsorbent assay (ELISA). Results The released contents of IL-1β, IL-6 and IL-8 from PIMs were increased significantly compared with those before LPS challenge, and they peaked at 2 hours[IL-1β activity:(10 400±2 389)scintillant count/min], 4 hours[IL-6 content:(0. 80± 0. 36)μg/L], and 6 hours[IL-8 content:(4. 94± 1.19)μg/L]after LPS challenge, and the differences were significant compared with those before LPS challenge[IL-1β activity:(213±85)scintillant count/min, IL-6 content:(0. 27 ± 0. 12)μg/L, IL-8 content:(1.84±0.53)μg/L, all P＜0. 01]. Conclusion Among the cytokines released from PIMs after LPS challenge, the increase in IL-1β occurred earlier in comparison with that of IL-6 and IL-8, suggesting that the former might play an important role at the early stage of ALI; on the other hand, though the increase in IL-6 and IL-8 contents occurred later than that of IL-1β but it lasted for a longer duration,suggesting that they might be associated with the advancement of ALI. The results also suggested that interaction of these cytokines played a more important role in the pathogenesis of ALI.     

肺血管内巨噬细胞的分离、培养及鉴定

肺血管内巨噬细胞的分离、培养及鉴定李胜亮陈正堂金敬顺肺血管内巨噬细胞（ｐｕｌｍｏｎａｒｙｉｎ－ｔｒａｖａｓｃｕｌａｒｍａｃｒｏｐｈａｇｅ，ＰＩＭ）是肺巨噬细胞亚群之一，有高度的吞噬活性，在某些刺激因素作用下能释放多种炎症介质，因而在肺的防御和损伤中有...     

肺血管内巨噬细胞与急性肺损伤

肺血管内巨噬细胞（ＰＩＭ）是单核吞噬细胞系统的成员，是肺巨噬细胞亚群之一。本着重综述ＰＩＭ的结构、生物活性及其在急性肺损伤中的作用。     

肺巨噬细胞及有关趋化性细胞因子在鼠急性肺损伤中的作用

肺巨噬细胞（ＰＭ）及有关的趋化性细胞因子如巨噬细胞炎性蛋白（ＭＩＰ）２、单核细胞趋化蛋白（ＭＣＰ）１等在急性肺损伤（ＡＬＩ）中的作用，国内尚未见报道。现将我们的研究结果报告如下。一、材料与方法１ＡＬＩ模型的复制及分组：Ｗｉｓｔａｒ大鼠５０只，雌...     

急诊超声诊断输尿管结石144例体会

目的探讨急诊超声对输尿管结石的诊断价值。方法对经急诊超声检查的144例输尿管结石伴14例肾周积液的病例行回顾性总结,分析声像图特征,总结诊断方法及体会。结果 144例患者中首次确诊者101例,占70.1%(101/144),二次以上复查确诊者42例,占29.2%(42/144),仅1例未检出,占0.7%(1/144),14例伴肾周积液表现为肾周线条状或月牙形液性暗区。结论急诊超声对输尿管结石具有独特的诊断价值,应用多体位、多切面的检查方法能提高输尿管结石的检出率,能及时发现有无合并肾周积液,动态观察其变化,对临床诊治具有重要指导意义。     

脂多糖致肺血管内巨噬细胞释放几种细胞因子的改变

目的 探讨肺血管内巨噬细胞（ＰＩＭ）释放的细胞因子在感染性急性肺损伤（ＡＬＩ）发病中的作用。方法 仿Ｍｏｒｔｏｎ法灌洗肺血管床,贴壁法分离猪ＰＩＭ,培养于ＰＩＭ１６４０培养基,予１０μｇ／ｍｌ脂多糖（ＬＰＳ）刺激,胸腺细胞增殖法测ＰＩＭ培养上清白细胞介素１β（ＩＬ－１β）活性,酶联免疫吸附试验（ＥＬＩＳＡ）法测肿瘤坏死因子α（ＴＮＦα）、白细胞介素６（ＩＬ－６）、白细胞介素８（ＩＬ－８）含量。结果     

30例四氧化二氮群体吸入中毒急救分析

临床资料 本组30例青年男性患者,年龄19-58岁,平均32.4岁,均因吸入泄漏的四氧化二氮（N2O4）气体30-50 min后急诊入院。临床表现：所有患者均有胸闷、心悸、气急,头晕、恶心,流涕、咽痛,刺激性咳嗽、呼吸困难;咳棕黄色痰14例;烦躁不安、意识障碍1例。查体：血压80-160/50-90 mmHg;体温〉37.2℃者21例,其中体温〉38℃者10例;呼吸浅快、     

颌下蜂窝组织炎超声误诊1例

患者男,42岁。主因咽喉部及右侧颈部疼痛不适3天来院就诊。临床检查：咽、喉部充血水肿,双侧下颌区肿胀,血常规：血象增高。临床申请腮腺、颌下腺、舌下腺、淋巴结超声检查。超声所见：双侧腮腺及下颌下腺体积增大,回声不均匀性减低,CDFI：示其内血供丰富,双侧颈部可见多个肿大淋巴结结节,舌下腺区可见范围约27mm×12mm的无回声区,内见多发条状回声（图1～4）。     

药物性肾损害2例

1 病例报告 例1 女性,66岁,因颜面水肿,腰痛,尿少6d于1997年9月2日入院。入院10d前因受凉出现头痛、发热,自服“APC”3～4片/d,3d内共服10片,第4天后出现颜面部水肿,腰痛,伴尿少、乏力、纳差、恶心、呕吐。既往无高血压病史。体检:血压20.0/13.0kPa,眼睑及双下