血小板活化因子及其乙酰水解酶与支气管哮喘

血小板活化因子(PAF)是一种具有广泛生物学活性的炎症介质,血小板活化因子乙酰水解酶(PAF-AH)是其主要的降解酶,二者在支气管哮喘的发病过程中起着重要的作用.     

海南黎族哮喘患者血浆PAF及PAF—AH活性的观察

目的 探讨血小板活化因子（PAF）及乙酰水解酶（PAF—AH）等活性变化在黎族居民支气管哮喘发病机制中的意义。方法采用酶联免疫法等方法测定48例海南黎族支气管哮喘患者发作期和缓解期血浆PAF及PAF—AH的活性变化，同时观察总IgE和嗜酸细胞阳离子蛋白（ECP）水平。结果黎族哮喘发作期患者PAF、总IgE和ECP水平较正常组均明显增高，缓解期较发作期明显降低，均有显著意义（P〈0．01），缓解期仍高于正常组。但无显著意义（P〈0．05）；发作期PAF—AH活性较正常组均明显降低，缓解组较发作组明显增高，均有显著意义（P〈0．01），但缓解组仍低于正常组（P〈0．05）。结论黎族哮喘患者急性发作期血浆PAF活性明显增高、PAF—AH活性明显降低，提示PAF和PAF—AH活性变化在黎族哮喘的发生机制中可能有一定作用，其临床意义有待于进一步研究。     

肺出血新生儿血清血小板活化因子水平变化及意义

目的 探讨新生儿肺出血时血清血小板活化因子(PAF)水平的变化及其与预后的关系.方法 采用酶联免疫吸附法(ELISA)分别检测对照组(n=20)、肺出血组初期(n=28)和极期(n=28)、肺出血存活组恢复期(n=20)和肺出血组死亡前期(n=8)新生儿血清PAF水平.结果 肺出血组初期、极期血清PAF水平明显升高,均高于与对照组(P＜0.01);肺出血死亡前期血清PAF水平升高更明显,高于肺出血组极期(P＜0.05);肺出血恢复期血清PAF水平较极期明显下降(P＜0.01),但仍高于对照组(P＜0.01).结论 PAF参与了新生儿肺出血的肺损伤过程,动态监测血清PAF水平,有助于新生儿肺出血的早期防治及预后判断.     

血小板活化因子与哮喘

哮喘的发病机理目前仍不清楚。最近的研究表明哮喘是一个复杂的气道感染过程哮喘的发生不但与支气管平滑肌收缩有关,也与微血管漏出、血浆蛋白渗出、水肿、气道反应性增高和上皮细胞损害有关。许多生物活性物质参与了哮喘发作,近来认为血小板活化因子(Platelet-activating factor.PAF)在哮喘发病中起重要作用。本文复习文献就PAF在哮喘发病机理中的作用作一综述。     

支气管哮喘患者急性发作期血小板功能的变化

血小板作为一种血液中最小的细胞参与体内的多种生理病理反应,在哮喘炎症反应中的作用也越来越受到重视.有研究表明支气管哮喘急性发作期存在血小板活化[1].本文采用流式细胞技术测定支气管哮喘急性发作期患者血小板表面α颗粒膜糖蛋白(GMP-140)和血小板胞浆内游离钙离子浓度的变化,以及末梢血小板计数的变化,初步探讨血小板活化与支气管哮喘发病的关系.     

血小板活化因子与脑缺血的相关性研究

目的研究血小板活化因子(PAF)与脑缺血的相关性.方法用簿层层析法测定了脑缺血和脑出血患者血中PAF水平.结果脑缺血患者血中PAF水平急性期为(1.521±0.288)nmol/ml,恢复期为(1.045±0.221)nmol/ml,高于非脑血管病组的急性期[(0.670±0.179)nmol/ml]和恢复期[(0.661±0.172)nmol/ml]及健康对照组[分别(0.714±0.212)nmol/ml和(0.702±0.201)nmol/ml],差别均有非常显著性意义(均P＜0.01).脑出血患者血中PAF水平急性期[(1.180±0.292)nmol/ml]和恢复期[(1.108±0.295)nmol/ml]也均高于非脑血管病组和健康对照组(均P＜0.05).结论PAF在脑缺血的发病过程中可能起重要作用.     

高原红细胞增多症患者血小板参数变化

目的:探讨拉萨地区高原红细胞增多症(HAPC)患者血小板参数变化.方法:采集63例高原红细胞增多症患者、42例高原正常居民、30例平原健康体检者静脉血(EDTA-K2抗凝血),美国雅培CELL-DYN200全自动血球分析仪分析标本.结果:与平原正常人相比较,高原正常居民及HAPC患者血小板计数(PLT)、血小板压积(PCT)均显著下降(P＜0.01),血小板平均体积(MPV),血小板分布宽度(PDW)显著升高(P＜0.01).HAPC患者与高原正常居民相比较,PLT、PCT进一步下降,两组间差异有显著性(P＜0.05);PDW、MPV则无差异性.结论:高原缺氧环境可致外周血液中血小板破坏增多,骨髓血小板代偿性增生、外周血血小板参数显著改变,但这种代偿功能有限,在HAPC患者表现尤为明显.     

哮喘患者氧化—抗氧化系统的改变及其临床意义

目的探讨支气管哮喘(哮喘)患者体内氧化-抗氧化系统的改变及其临床意义.方法观察了40侧哮喘发作期病人、10例健康人和20例治疗组病人,用生化方法测定血清超氧化物歧化酶(SOD)、过氧化氢酶(CAT)活性、丙二醛(MDA)含量和1秒钟用力肺活量实测值/预计值百分比.结果 (1)哮喘发作期患者SOD、CAT活性显著低于正常对照组(P＜0.01),MDA含量高于正常对照组(P＜0.05).(2)MDA含量与1秒钟用力肺活量实测值/预计值百分比呈显著负相关(r=-0.38P＜0.01).SOD活性与MDA含量呈显著负相关(r=-0.48 P＜0.001).(3)治疗组比发作组SOD、CAT活性明显增高(P＜0.01).结论哮喘患者体内存在氧化-抗氧化失衡现象,它在哮喘的发病机制中可能起重要的作用.     

甲泼尼龙对哮喘患者血清IL-18、IL-33水平的影响

目的:观察白介素-18(IL-18)、白介素-33(IL-33)在哮喘患者发病过程中的作用,及甲泼尼龙对支气管哮喘患者血清IL-18、IL-33水平的影响及治疗效果.方法:选取本院收治的急性发作期支气管哮喘患者30例(观察组),给予全身应用甲泼尼龙40～80 mg/d治疗,共治疗3～5 d,同时辅助局部雾化吸入治疗1～2周,病情得到控制后采用酶联免疫法检测复查患者外周血清IL-18、IL-33、免疫球蛋白E(IgE)水平及血常规变化,并设同期来院体检正常者30例(对照组),进行对比分析.结果:观察组血清IL-18、IL-33、IgE、嗜酸性粒细胞(EOS)水平均明显高于对照组,差异具有统计学意义(P＜0.05);观察组缓解期血清IL-18、IL-33、IgE及EOS水平明显低于发作期治疗前,差异具有统计学意义(P＜0.05);观察组缓解期血清白细胞(WBC)、中性粒细胞(N)、EOS水平升高仍明显高于对照组,差异具有统计学意义(P＜0.05).结论:IL-18、IL-33在支气管哮喘发病过程中起协同促炎作用,全身应用糖皮质激素能有效降低支气管哮喘患者IL-18、IL-33的产生,改善患者哮喘状态.     

血小板活化因子与哮喘

血小板活化因子 (plateletactivatingfactor ,PAF)是一磷脂类化合物 ,1972年由Benveniste等发现 ,最初被认为与血小板的聚集和活化有关 ,故命名为血小板活化因子[1] 。虽PAF的作用远不止活化血小板 ,但此名一直沿用至今。现已研究表明PAF是一种具有广泛生物学活性的重要炎性介质 ,在包括哮喘在内的许多疾病的发病机制中有着重要作用。1　PAF的产生、合成途径PAF是一种对磷脂酶A2 敏感的、与花生四烯酸 (AA)代谢密切相关的脂质递质 ,分子量为 110 0 ,是一种在 1位以醚链连接长碳链 ,2位连接乙酰基 ,3位连接磷酰胆碱的甘油酯 ,化学名…     

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…     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.