产前给药地塞米松对大鼠胎肺形态发育的影响

目的:比较产前给予不同剂量、不同疗程的地塞米松(DEX)对大鼠胎肺形态发育的影响.方法:15只孕鼠随机分为5组,每组3只.小剂量DEX单程组:孕16、17天注射等量生理盐水,孕18天腹腔注射DEX 0.4 mg/(kg·d).小剂量DEX多程组:孕16、17、18天腹腔注射DEX 0.4 mg/(kg·d).大剂量DEX单程组:孕16、17天注射等量生理盐水,孕18天腹腔注射DEX0.8 mg/(kg·d).大剂量DEX多程组:孕16、17、18天腹腔注射DEX 0.8 mg/(kg·d).生理盐水组:孕16、17、18天注射等量生理盐水.孕19天每只孕鼠取6只胎鼠肺组织作为早产鼠肺模型,通过光镜观察及电镜技术,分析比较各组用药对胎肺形态发育的影响.结果:光镜下,小剂量DEX单程、多程组及大剂量DEX单程、多程组每视野肺泡计数,平均肺泡间隔厚度均低于生理盐水组(P＜0.01),平均肺泡表面积均高于生理盐水组(P＜0.01).透射电镜观察,地塞米松治疗组Ⅱ型肺泡上皮内多见板层小体且染色深、致密;胞质内线粒体等细胞器多见,而生理盐水组内难见板层小体、少见细胞器;基底膜呈现由完整到断裂不连续、由厚薄均一到厚薄不均甚至无法辨认的变化.结论:产前给药地塞米松能显著促进胎肺发育,但随着给药剂量和次数的增多,肺泡化受阻和基底膜受损现象逐渐明显.     

氨溴索?糖皮质激素对大鼠胎肺形态发育的影响

目的:比较产前给药氨溴索和糖皮质激素(地塞米松、倍他米松)对大鼠胎肺形态发育的影响.方法:12只孕鼠随机分成四组:生理盐水对照组,氨溴索组,地塞米松组,倍他米松组.通过光镜观察、图像分析及电镜观察比较各组孕鼠的胎仔肺组织形态发育差异.结果:光镜下各治疗组呼吸膜周径大于对照组(P＜0.05),肺泡表面积大于对照组(P＜0.01),肺泡间隔均低于对照组(P＜0.01).倍他米松组与地塞米松组相比肺泡间隔小(P＜0.01),呼吸膜周径及肺泡表面积大(P＜0.01).透射电镜下各治疗组肺泡Ⅱ型上皮内可见板层小体,细胞器多见,倍他米松组和地塞米松组上述改变尤为明显;而对照组内未见板层小体、细胞器少见.结论:氨溴索、地塞米松、倍他米松均能促进肺发育,且倍他米松效果优于地塞米松.氨溴索无激素用药的毒副作用,可能成为产前促进胎肺成熟的更好的选择.     

产前单次应用地塞米松和氨溴索对胎鼠及子代鼠肺形态的影响

目的:探讨产前单次联合给药小剂量地塞米松和氨溴索对胎鼠及生后子代大鼠肺形态发育的影响?方法:36只孕鼠随机分成2组:地塞米松加氨溴索干预组(n=9)和生理盐水对照组(n=9)?在妊娠第17天,干预组腹腔注射地塞米松0.2 mg/(kg·d)加氨溴索100 mg/(kg·d),对照组腹腔注射等体积的生理盐水?取两组孕19天,生后3天,生后7天胎(仔)鼠肺组织,通过光镜和电镜技术,观察在大鼠肺发育的不同阶段两组肺组织形态发育差异?结果:①光镜下:孕19天干预组胎鼠肺每视野平均原始肺泡计数大于对照组(P < 0.05),平均原始肺泡腔面积大于对照组(P < 0.01),平均原始肺泡间隔厚度小于对照组(P < 0.01)?生后3天干预组仔鼠肺每视野平均囊泡表面积大于对照组(P < 0.05),平均囊泡间隔厚度小于对照组(P < 0.05),平均囊泡计数与对照组相比无显著差异(P > 0.05)?生后7天干预组仔鼠肺每视野平均肺泡表面积大于对照组(P < 0.05),平均肺泡间隔厚度小于对照组(P < 0.05),平均肺泡计数与对照组相比无显著差异(P > 0.05);②透射电镜观察:孕19天胎鼠肺干预组Ⅱ型肺泡上皮细胞绒毛发育较对照组密集完整,可见板层小体,对照组难见板层小体?生后3天及7天的仔鼠肺干预组和对照组均可见大量板层小体,但干预组较对照组板层小体染色深?致密,且可见大量线粒体等发达的细胞器?结论:小剂量地塞米松联合氨溴索产前单次用药,不仅能促进大鼠胎肺成熟,也可促进其生后一段时期的肺发育且未产生明显不良影响?     

沐舒坦?地塞米松预防早产儿肺透明膜病的疗效对比研究

目的:比较沐舒坦、地塞米松预防早产儿肺透明膜病的疗效.方法:所有病例均为胎龄在28～34周的早产儿,产前使用地塞米松,且首剂应用至胎儿娩出时间超过24 h但不足7天者为地塞米松组;产前未使用地塞米松治疗但出生后1 h内应用沐舒坦预防者为沐舒坦组;产前未使用地塞米松出生后也未应用沐舒坦者为对照组.比较3组早产儿肺透明膜病的发生情况,早产儿感染及沐舒坦药物不良副作用发生情况.结果:①地塞米松组早产儿肺透明膜病的发生率(10.9%)和沐舒坦组(15.6%)比较无统计学差异(P＞0.05),但与对照组(36.7%)比较有统计学差异(P＜0.05);②早产儿感染的发生率地塞米松组为26.1%虽高于沐舒坦(13.3%)和对照组(16.7%),但经比较无统计学差异(P＞0.05);③沐舒坦组未发现沐舒坦药物不良反应.结论:产前给药地塞米松、生后早期给药沐舒坦均能显著降低早产儿肺透明膜病的发生;产前给药地塞米松疗效优于生后早期给药沐舒坦;但考虑到应用地塞米松带来的诸多不良反应,生后早期给药沐舒坦可成为临床上预防早产儿肺透明膜病的更好选择.     

地塞米松、TRH、EGF对宫内感染模型未成熟胎肺的影响

目的 研究地塞米松、EGF及TRH在感染情况下对早产胎肺的影响。方法 建立孕兔宫内感染模型,分别用地塞米松EGF、TRH联合先锋霉素V治疗3d,通过光镜、电镜观察胎肺的感染程度及结构分经。结果 地塞米松治疗组胎肺感染程度明显重于EGF治疗组和对照组,EGF、TRH治疗组和对照组之间无明显差异。光镜下可见地塞米松、EGF治疗组胎肺组织形态发育明显较对照组成熟、肺泡扩张更明显、肺泡腔较对照组更大、更规则、肺泡间隔更薄,而TRH治疗组胎肺发育程度介于地塞米松、EGF治疗组与对照组之间。电镜下,可见各治疗组与对照组明显不同,地塞米松、EGF和TRH治疗组胎肺Ⅱ型上皮细胞比对照组更成熟,胞浆内板层体数量明显多于对照组,对照组胎肺Ⅱ型上皮细胞内板层体较少见,但0常见有肺不张或肺萎陷征象。结论 在感染条件下,地塞米松,EGF和TRH均能促进胎肺的发育成熟,但地塞米松同时具有加重胎儿肺部感染的危险。     

盐酸氨溴索对胎鼠肺表面活性物质的影响

目的:探讨盐酸氨溴索(沐舒坦)对胎鼠肺表面活性物质合成的影响.方法:选择健康清洁级妊娠的SD大鼠18只,随机分为3组,沐舒坦治疗组6只,地塞米松治疗组6只,对照组6只.各组大鼠于妊娠第16、17、18天尾静脉分别注射沐舒坦75 mg/kg、地塞米松0.8 mg/kg、生理盐水2 ml/只.于妊娠第19天剖宫产,取出胎仔肺测定磷脂含量(肺表面活性物质主要成分为磷脂).结果:沐舒坦治疗组肺磷脂含量为(0.72土0.06)mmol/g湿肺,地塞米松治疗组为(0.73±0.19)mmol/g湿肺,对照组为(0.62±0.09)mmol/g湿肺,沐舒坦治疗组、地塞米松治疗组与对照组差异有显著性(P＜0.01),沐舒坦治疗组与地塞米松治疗组之间差异无显著性(P＞0.05).结论:沐舒坦能促进胎鼠肺表面活性物质合成,且与地塞米松作用效果相似,有可能成为临床上促胎肺成熟的药物.     

维生素D缺乏对大鼠肺发育影响的形态学研究

目的:研究维生素D(VitD)缺乏对大鼠肺发育的形态学影响.方法:雌性SD孕鼠随机分为正常对照组、VitD缺乏模型组及干预组3组,每组6只.对照组予光照及含VitD的正常饲料喂养;模型组及干预组予以避光、不含VitD的饲料喂养,2周后与成熟SD雄性大鼠交配,于孕17、18、19天干预组以活性VitD(0.5 mg/kg)灌胃,并恢复光照及正常喂养;模型组及对照组予以等体积生理盐水灌胃.各组取孕20天的胎肺及生后1天新生鼠肺组织,通过光镜观察和电镜技术.分析研究VitD缺乏对肺发育的形态学影响.结果:光镜下,孕20天模型组及干预组胎肺肺泡平均表面积、平均呼吸膜周径均小于同龄正常对照组(P<0.05),平均肺泡间隔厚度大于对照组(P<0.05);生后1天新生鼠模型组肺泡平均表面积、平均呼吸膜周径小于对照组(P<0.05),平均肺泡间隔厚度大于对照组(P<0.05),干预组肺泡平均表面积、平均呼吸膜周径大于模型组,平均间隔厚度小于模型组(P<0.05).电镜下,孕20天及生后1天的模型组的板层小体数量均明显少于对照组,且孕20天模型组糖原沉积丰富,生后1天模型组板层小体结构疏松,可见板层小体排空现象;干预组上述变化较模型组有所改善.结论:孕期VitD缺乏抑制了孕晚期胎鼠及新生大鼠的肺发育,补充活性维生素D可逆转上述抑制作用.     

兔宫内感染模型地塞米松处理后母-胎组织的形态学改变

目的了解产前母体地塞米松处理是否加重妊娠母-胎组织感染,并比较其在非感染和感染条件下对胎肺发育的影响.方法于妊娠第24天建立兔宫内感染模型,并于模型建立当天开始耳静脉注射地塞米松和先锋霉素,连续用药3d.于妊娠27d留取胎肺、胎盘、母体子宫和肺组织进行形态学检查.结果无论感染模型还是非感染模型,地塞米松处理组胎肺均比对照组胎肺的肺泡腔更大、更均匀,而肺泡间隔更薄,地塞米松处理后胎肺肺泡腔的表面积明显大于对照组,而肺泡间隔表面积明显小于对照组(P<0.05).超微结构显示感染模型地塞米松处理组胎肺的Ⅱ型细胞内板层体数目多于对照组,但相对于非感染模型地塞米松处理组则有所减少.地塞米松组胎肺和胎盘的感染程度均明显重于对照组(P<0.05);而母体子宫和母肺的感染程度有高于对照组的趋势.此外,地塞米松组发生早产和胎仔死亡的孕兔数明显高于对照组(P<0.05).结论 Dex产前处理可促进兔胎肺形态发育和Ⅱ型上皮细胞成熟,但在宫内感染情况下,其促胎肺发育的作用会受到一定程度的影响,且具有加重母-胎组织的感染程度、加速早产发生及增加胎儿死亡的可能.因此,在感染或可疑感染的情况下,临床应慎重使用地塞米松促胎肺成熟.     

沐舒坦治疗新生儿胎粪吸入综合征的疗效及护理

目的 探讨沐舒坦支气管肺泡灌洗术治疗胎粪吸入综合征的疗效及护理. 方法对照组采用常规治疗,治疗组在常规治疗的基础上加用沐舒坦支气管肺泡灌洗术.结果 通过沐舒坦支气管肺泡灌洗,实现清除吸入的胎粪颗粒,增加肺表面活性物质的生成.两组治疗前后比较pH值、PaO2、PaCO 2、 SaO2、治愈率等各项指标差异均有显著性(P<0.05).结论 沐舒坦支气管肺泡灌洗术治疗胎粪吸入综合征安全有效.     

盐酸氨溴索片预防新生儿呼吸窘迫综合征临床研究

目的探讨母亲产前未用过激素的早产儿在生后12h内应用盐酸氨溴索片(商品名沐舒坦)预防新生儿呼吸窘迫综合征的效果.方法早产儿120例,按区组随机分为沐舒坦应用组和观察组各60例,观察两组新生儿呼吸窘迫综合征(RDS)及其并发症的发生率.结果(1)沐舒坦组RDS发生率为25.0%,对照组为66.7%,两组有显著差异(P＜0.01);(2)沐舒坦组RDS的严重程度较对照组轻,有显著差异(P＜0.05);(3)沐舒坦组支气管肺发育不良、脑室内出血及获得性肺炎的发生低于对照组(P＜0.01).结论对产前母亲未用过激素的早产儿生后立即静脉给沐舒坦可以降低早产儿RDS的发病率及其并发症的发生率.     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.     

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…     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.