Megakaryocytes in human lungs in non-selected autopsy specimens-- topography of their occurrence and correlation with pulmonary thrombosis

In a 100 lungs of patients died in hospital (61 males, 39 females including 4 children) consecutively studied at autopsies in 1986 topographic quantification of megakaryocytes (MK) was performed. Mean number of MK was 31 cells per 1 cm2 of the studied sections (the range from 0 to 336 MK/cm2). More numerous MKs were observed in the upper pulmonary lobes and fibrous foci. The greatest accumulation of MK was found in the patients died from various types of shock. In the lungs with a large number of MK we found enhanced microthrombosis of the pulmonary vessels.     

巯甲丙脯酸对家兔失血性休克的作用

家兔26只,复制晚期失血性休克模型后,随机分为巯甲丙脯酸治疗组和对照组。治疗组给予巯甲丙脯酸1mg/kg及配合输液输血。治疗后1小时,平均动脉血压(MABP)、中心静脉压(CVP)、平均肾血流量(MRBF)均见明显回升,血小板聚集率显著降低,肠系膜微循环有显著性改善,治疗后3小时上述各项指标均接近正常水平。5小时存活率为91.7%。与对照组相比较差别有高度显著性(P<0.01)。本研究结果表明:巯甲丙脯酸用于晚期失血性休克,可使微血管扩张,微循环灌注增加,回心血量增加,血压回升,具有良好的抗失血性休克作用。     

Prolonged controlled hemorrhagic shock in a swine model: is there a role for mechanical circulatory assistance?

Outcomes of mechanical circulatory assistance during hemorrhagic shock were evaluated in a swine model. Pigs were bled to a mean arterial pressure of 35 mm Hg (group I, n = 3) or 40 mm Hg (group II, n = 5; group III, n = 5), maintained there for 30 minutes, and then resuscitated with fluids alone (groups I and II) or fluids plus mechanical circulatory assistance (group III). Mean blood loss was greater in group I than in groups II or III (1,037 +/- 212 vs. 862 +/- 387 ml vs. 681 +/- 117 ml, respectively; I vs. III, p < 0.05) and survival was shorter (230 +/- 25.5 min vs. 709 +/- 251 min vs. 662 +/- 428 min, respectively; I vs. II or III, p < 0.05). Cardiac arrhythmia caused death in most cases. Mean biochemical parameters increased progressively in all cases. Left anterior descending coronary artery flow stayed relatively constant in group II but increased in group III. Superior mesenteric artery flow returned to baseline in group II but increased in group III. Cardiac output was similar in groups II and III, but SGOT levels significantly differed (750 +/- 135 U/L vs. 359 +/- 157 U/L; p < 0.005). These results suggest that the swine model will be useful for studying ways to improve outcomes after prolonged hemorrhagic shock.     

网状内皮系统(RES)抑制致失血性休克兔肺损伤的实验研究

实验以肺系数、肺组织镜检、凝血指标、血气和pH值变化为指标,比较失血性休克、RES封闭和RES封闭后失血性休克过程中各项指标的变化。结果表明。失血性休克一般不引起肺的损伤,但在RES抑制的基础上,有肺损伤发生。用交叉灌流的方法,即RES封闭后失血性休克门静脉全血,灌注单纯RES封闭动物,可出现白细胞自肝、脾释放,并在肺内扣押,肺组织损伤。结果提示:RES封闭后失血性休克门静脉血中,可能存在引起肺损伤的体液因子。     

Megakaryocyte cumulation in rabbit lungs after intraperitoneal administration of casein.

In the lung capillary vessels of rabbits, 24 hr after intraperitoneal administration of saturated casein solution, megakaryocyte cumulation (MK) was observed (22 MK/cm2 of section area in treated group and 2,5 MK/cm2 of section area in control group). Megakaryocytes were found most often in the form of an elongated nucleus without cytoplasm. The authors suppose, that MK liberation from the marrow into the venous vessels may be caused by casein degradation products.     

复方丹参注射液对失血性休克家兔心泵功能的影响

本文观察了复方丹参注射液对失血性休克家兔心泵功能的影响。家兔于局麻下由股动脉放血,使血压维持于40-50mmHg之间九十分钟,随之将动物分成两组。给药组于休克九十分钟后静脉输入5%葡萄糖生理盐水15ml/kg,其内加入复方丹参注射液2ml/kg,同时将放出血液输回,于三十分钟输完。观察休克前,休克时,输液后即刻,三十分钟、六十分钟、一百廿分钟的动脉血压(ABP)、中心静脉压(CVP)、心率(HR)、心输出量(CO)、心电图(ECG)、每博容量(SV)、心脏指数(CI)、左室每博功(LVSW)、总外周阻力(TPR)的变化。对照组除输入液体中复方丹参注射液用等量葡萄糖盐水代替外,其余同给药组。结果显示复方丹参注射液可明显提高休克动物的ABP、CO、SV、CI、LVSW、明显降低TPR。但作用时间持续在一小时内。其对休克的治疗作用可能是由于调节了体内血流的再分配,舒张冠脉,增加单位时间内心肌血液灌流量,改善心肌供血,对心脏功能的改善起到了良好作用。     

酚妥拉明对失血性休克家兔微循环血流动力学的影响

本研究旨在探讨酚妥拉明对失血性休克微循环血液灌流的作用.两组家兔——生理盐水对照组(n=7)和酚妥拉明治疗组(n=8),麻醉后放血至血压为5.33～6.00kPa以造成重度失血性休克.维持60min后将5mg酚妥拉明加入25ml生理盐水中静脉滴注(对照组仅滴注等量生理盐水),同时将放出的全部血液回输.观察休克及用药前后平均动脉血压、心率和肠系膜微循环变化.用显微电视录像静像步进技术测定毛细血管口径、血流速度及血流量.酚妥拉明滴往后,心率略加快,血压明显下降,血流速度和血流量显著降低,毛细血管口径两组间无明显差异.表明休克时酚妥拉明单独应用可使血压严重下降,从而加重肠系膜毛细血管的血流障碍.     

川芎嗪对失血性休克家兔肠系膜毛细血管血流动力学的影响

家兔１６只，随机分为生理盐水对照组和川芎嗪治疗组，麻醉后造成失血性休克，用显微电视录像静像步进技术测定川芎嗪对小肠系膜毛细血管内径、血流速度及血流量的作用。结果提示，川芎嗪比对照组可加快失血性休克家兔小肠系膜毛细血管血流速度、改善肠系膜微循环血流灌注，但对毛细血管口径无明显作用。     

人促红细胞生成素对肾缺血再灌注损伤的保护作用

目的 探讨促红细胞生成素(erythropoietin, Epo)对失血性休克大鼠肾损伤的保护作用.方法 建立失血性休克大鼠肾损伤模型,分为对照组、休克组及Epo治疗组3组,进行组织学观察,并检测血丙二醛(MDA)、肌酐(Cr)、素氮(BUN)和肾组织匀浆超氧化物歧化酶(SOD)、白介素-6(IL-6)水平.结果 Epo治疗组血浆MDA、Cr、BUN水平较失血性休克组组显著下降(P＜0.05);肾组织匀浆SOD显著升高、IL-6显著降低(P＜0.05).结论 Epo可提高SOD,降低IL-6,对肾缺血再灌注损伤具有保护作用.     

支气管平滑肌细胞中MK2 和MK3 过表达对细胞因子分泌的调节作用

目的:研究支气管平滑肌细胞中丝裂原活化蛋白激酶2/3(MK2/3)的过表达对细胞因子分泌的调节作用。方法:将野生型MK2和MK3腺病毒转染至人支气管平滑肌细胞中,Western blot实验检测MK2和MK3蛋白表达水平,确定转染腺病毒的最佳感染系数,检测热休克蛋白HSP27的磷酸化水平以及MK2和MK3过表达对MAPK和核因子(NF)-κB信号通路的影响。ELISA检测支气管平滑肌细胞分泌细胞因子的情况。结果:野生型MK2和MK3腺病毒转染至支气管平滑肌细胞的最佳感染系数为40,在支气管平滑肌细胞内有活性。MK2通过p38MAPK信号通路促进IL-6的分泌,抑制正常T细胞表达及趋化因子配体5(CCL5)的分泌,MK3通过NF-κB信号通路抑制RANTES/CCL5的分泌。结论:本研究揭示了MK2和MK3在支气管平滑肌细胞中通过不同的信号通路调节细胞因子的分泌,通过靶向MKs可调节支气管气道炎症反应。     

Influence of ethanol on systemic and pulmonary hemodynamics in anesthetized dogs

Immediate circulatory reactions to acute intragastric ethanol administration were studied by a catheterization technique in spontaneously breathing dogs. Diluted ethanol was given in a dosage of 1 g/kg in test group I (n = 11), and 2 g/kg in group II (n = 10). The control group (n = 14) received only water. The highest blood ethanol concentration was 0.90 ± 0.07 mg/ml (mean ± SE) in group I, and 1.97 ± 0.10 mg/ml in group II. Heart rate and cardiac output increased (p < 0.001), but stroke volume, mean aortic blood pressure and right atrial blood pressure remained practically unchanged. Systemic vascular resistance decreased. Mean pulmonary arterial blood pressure increased markedly in both test groups (p < 0.001) while pulmonary arterial wedge pressure did not change. The pulmonary arterial resistance increased (p xyl 0.01). Changes in respiratory rate or volume and arterial pO₂ were negligible in group I, but respiratory minute volume decreased in group II. In conclusion, ethanol in concentrations 0.5 to 2.0 mg/ml increased resistance in the pulmonary arterial tree, indicating pulmonary arterial vasoconstriction, but reduced systemic vascular resistance, thus putting a concept of peripheral vasodilation in favour.     

川芎嗪注射液对家兔失血性休克的作用

为了检查川芎嗪注射液对失血性休克的作用,失血性休克家免于输回血后分别静脉输入不同剂量的川芎嗪注射液。结果表明,休克状态下和对照组相较,输入0.1ml/kg的川芎嗪注射液可改善外周血流但不降低血压,减少血管内液外移;输入0.2ml/kg的川芎嗪注射液虽使外周血流有所改善,但使血压降低。     

失血性休克家兔血浆中分子物质及血糖含量的动态变化

用改进的紫外吸收法及葡萄糖氧化酶法分别测定了家兔失血性休克前后不同时间动脉和静脉血浆中分子物质（ＭＭＳ）及血糖含量的动态变化。结果表明，在家兔失血性休克后３０ｍｉｎ，动、静脉血浆ＭＭＳ含量比休克前显著降低；血糖含量则显著升高。随着休克发展，ＭＭＳ含量逐渐回升，在动物临终前呈显著升高，并且静脉血浆含量显著高于动脉血浆含量，血糖浓度则随休克发展不断升高。输血组在休克３０ｍｉｎ后将血液回输，血压恢复，Ｍ     

Compartmental analysis of RBC circulation through the rabbit kidney.

This experiment involved 12 rabbits of both sexes, weighing 2.1 kg. After anesthesia, the kidneys were exposed, isolated and cannulated in the renal artery, ureter and sometimes in the vein as well. The kidney were perfused through the renal artery with Krebs-Henseleit solution, which were then filtered to be free of particles, gased with 95% O2-5% CO2, and kept at 37 degrees C. We measured RBCs concentrations by means of Coulter Counter in the venous outflow collected, and plotted them against the volume perfused. Using 2 different flow rates, 9 ml/min (group I) and 19 ml/min (group II), we found that the RBCs decreased in a multiexponential decay fashion and a biophysical model for each flow rate was constructed. These models indicated that there were more cell stores (2.20 x 10(10)) in the fast compartment of group II than in group I (1.72 x 10(10)). This difference is not statistically significant, but certainly coincides with urine flow collected from ureter cannula during perfusion. Our present data clearly suggest that in order to clear 99% blood cells out of 10-12 gm rabbit kidneys, at least 3-6 ml of cell free perfusate is required while clearing the whole blood cells out of human kidneys (200-240 gm) may need 600 ml or more. Thus, we recommend that at least 600 ml of perfusate should be used to clear most of the blood cells in the renal vasculature before renal transplantation is performed.     

复苏液温度对急性失血性休克兔肠系膜微循环的影响

目的观察兔失血性休克输注不同温度的复苏液时肠系膜微循环的变化特点,为临床复苏应用适宜的复苏液温度提供依据。方法选择健康新西兰雄兔32只,随机分为四组：假手术组、低温组、常温组、温热组,后三组复制休克模型,模型稳定30min后将后三组按相同速度分别给予低温、常温、及温热平衡液和自体血复苏,于休克前、休克时、开始复苏后1、2、3h分别测定兔肠系膜微血管管径、红细胞流速、微血管数目的变化及平均动脉压的变化。实验结束后取邻近部位小肠做病理检查。结果液体复苏后低温组、常温组、温热组兔肠系膜微血管管径、红细胞流速、微血管数目及平均动脉压均高于休克时（P〈0.05）。复苏过程中温热组兔肠系膜微血管管径、红细胞流速及平均动脉压高于常温组和低温组（P〈0.05）。邻近部位小肠病理学检查结果低温复苏组兔小肠出血坏死、黏膜脱落较常见,而常温复苏组及温热液体复苏组的病变较轻,表现为组织水肿较常见。结论失血性休克可引起兔肠系膜微循环障碍,微血管管径、红细胞流速、微血管数目均下降,温热液体复苏更有助于改善肠系膜微循环。     

Hematological and serum biochemistry comparison between cotton hair thread and silk suture on surgical skin wounds of rabbits

A total of 12 rabbits randomly assigned into three groups (I, II, and III) of 4 rabbits each were used. A 6-cm-long paralumber skin incision was aseptically performed in groups I and II using xylazine (0.5 mg/kg) and ketamine (22 mg/kg) as premedicant and anesthetic, respectively. The incised skins in group I rabbits were apposed with conventional silk suture, while the incised skins in the group II rabbits were approximated with cotton hair thread (CHT). Group III served as a control (no surgery). The hematological and serum biochemistry responses following the use of these sutures were evaluated. Packed cell volume (PCV), red blood cell (RBC) count, total and differential white blood cell (WBC) counts, total protein, and albumin and globulin levels were determined using standard methods at presurgery (day 0) and on postoperative days 1, 3, 7, 10, 14, and 21 in all the groups. Hematological and serum biochemistry parameters were analyzed using one-way analysis of variance (ANOVA). The means of PCV and RBCs in rabbits in groups I, II, and III showed no significant variations (p?>?0.05) throughout the study. The WBC count increased significantly (p?p?>?0.05) throughout the study. However, at day 3 postsurgery, the means of lymphocytes in rabbits in groups I and II increased significantly (p?p?>?0.5), but they vary and are significantly higher (p?p?>?0.05) throughout the study. Cotton hair Thread elicited insignificant hematological and serum biochemical changes compared to the conventional silk suture material.     

Antigenic differences between human platelets and megakaryocytes.

To investigate the apparent paradox in the observation that most patients with immune thrombocytopenias have normal or increased numbers of megakaryocytes (MKs), the extent of antigenic cross-reactivity between normal platelets and MK was examined. Indirect immunofluorescence and ultrastructural studies were carried out by means of four antisera specific for platelets: anti-GpIb, anti-GpIIb/IIIa, anti-PLA1, and an antiserum from a patient with quinidine-induced thrombocytopenia. Following incubation of freshly collected marrow with these antisera, MK were first identified by phase-contrast microscopy and then inspected for fluorescence. Almost all MKs were found reactive with the last three antisera, albeit to a variable extent. In contrast, only 24% reacted with anti-GpIb. The pattern of fluorescence, ie, rim, partial or cytoplasmic, appeared to be related to the extent of MK fragmentation. Only rim fluorescence of living MKs could be interpreted to indicate that the platelet epitope was exposed on the surface of the precursor cell. The observations suggest that platelet antigens are variably expressed on the plasma membranes of MKs. In a clinical setting, the heterogeneity among platelet target antigens and the extent to which these are exposed on MKs at various stages of maturation may dictate the severity of the thrombocytopenia and degree of ineffective thrombocytopoiesis.     

Significance of leukocytes in endotoxic shock.

Peripheral blood leukopenia and the sequestration of large numbers of polymorphonuclear leukocytes in pulmonary capillaries have been observed in experimental shock. It has been suggested that the lysosomal enzymes released from these damaged and sequestered leukocytes may contribute to systemic hypotension and pulmonary capillary damage. This study was undertaken to evaluate the role of leukocytes in endotoxic shock.Six rhesus monkeys rendered leukopenic by total body irradiation (mean white blood count, 358/cu mm) were compared with six normal nonleukopenic monkeys (mean white blood count, 10,550/cu mm) for two hours after injection of E. coli endotoxin. The effects of irradiation alone were evaluated in three additional animals which did not receive endotoxin.Following the injection of endotoxin, the mean cardiac output and systemic pressure decreased more than 50% in both the leukopenic and normal groups. Metabolic acidosis developed in both groups. The mean arterial PO₂ was unchanged, but the alveolar-arterial O₂ gradients increased. Differences between the two injected groups were not significant in these parameters.Light and electron microscopy demonstrated sequestered polymorphonuclear leukocytes and platelets in pulmonary capillaries in the nonirradiated group, but leukocytes were virtually absent in sections from lungs of the leukopenic animals. In spite of this difference, significant endothelial swelling and perivascular edema were demonstrable in both groups. No significant histologic abnormalities were noted in the three irradiated leukopenic control animals who did not receive endotoxin.Leukopenia provided no protection from the hemodynamic effects or the histological damage in pulmonary capillaries observed after administration of endotoxin.     

In vivo effects of intravascularly applied Escherichia coli hemolysin: dissociation between induction of granulocytopenia and lethality in monkeys

The effects of intravascular application of endotoxin-depleted Escherichia coli hemolysin (HlyA) was studied in rabbits and monkeys. In rabbits, bolus application of HlyA calculated to effect final blood levels of approximately 2-3 HU/ml (200–300 ng/ml) caused an acute fall of polymorphonuclear blood leukocytes to less than 20% of starting levels within 5 min. Additionally, platelet counts dropped to approximately 30% of starting levels, whereas lymphocyte counts varied considerably and seldom fell to less than 50%. Nine out ten animals that received 2–4 HU/ml toxin died within 90 min post application. These animals presented with signs of acute respiratory failure and post mortem inspection of the internal organs revealed hemorrhagic pulmonary edema. Other internal organs appeared unaffected. Application of less than 1 HU/ml HlyA was never fatal (n = 9), and only transient leukopenia was noted. Monkeys presented with a remarkable and different response. Two animals were repeatedly given HlyA at high doses ranging from 3 to 10 HU/ml. Both animals developed selective granulocytopenia, but following a short, transient drop in blood pressure they showed no severe clinical signs of cardiovascular or pulmonary malfunction. Histological examinations revealed accumulation of polymorphonuclear granulocytes in both animals in liver, lung and spleen. Very high leukocyte elastase levels were measured in one animal over a period of 1.5h. The present results demonstrate a remarkable tolerance of monkeys towards the leukocidal effects of E. coli hemolysin. Lethality in rabbits must be due to additional effects of the toxin, possibly on cells in the pulmonary vasculature. Neither pulmonary sequestration of granulocytes nor massive release of elastase from these cells is in itself sufficient to provoke pulmonary dysfunction in monkeys.     

失血性休克家兔血液粘度变化及β-七叶皂甙钠的保护作用

目的 :研究失血性休克时的血液粘度变化 ,寻求起保护作用的药物。方法 :采用家兔失血性休克模型 ,测定休克前后的血液粘度、血浆粘度、红细胞压积。结果 :单纯休克组休克后 1 0min、30min、60min家兔血液粘度逐渐升高 (P <0 .0 5 ) ,而 β -七叶皂甙钠组在休克后 1 0min、30min的血液粘度无明显升高 (P >0 .0 5 ) ,休克后 60min其血液粘度亦明显低于单纯休克组 (P <0 .0 5 )。结论 :失血性休克后家兔血液粘度明显升高 ,而 β -七叶皂甙钠能明显降低血液粘度 ,对综合治疗失血性休克有临床意义。