兔急性肺血栓栓塞模型血液动力学检测方法的研究

目的:建立操作简单、检测简便、耗资低廉的急性肺血栓栓塞兔模型。方法:经右心室插管注入4个兔自体血栓,栓塞肺动脉,通过观察不同时间点右心室收缩压的变化、肺内残留栓子数及肺脏组织病理学变化,判断栓塞是否成功。结果:注入栓子后1h,右心室收缩压明显上升,与注栓前比较有显著性差异(P<0.05)。病理观察,肉眼每只兔均可见注入的4个栓子,大小与注入前近似;镜下全部兔均有肺栓塞的病理改变。结论:用此种方法建立急性肺血栓栓塞模型真实可信。     

急性肺栓塞家兔血流动力学参数及组织病理学改变

目的:观察急性肺栓塞(APE)家兔血流动力学及组织病理学变化。方法:从家兔颈静脉注入自体血栓,观察APE后家兔基本表现和死亡率,以及呼吸频率(RR)、平均呼吸深度(MDR);动态监测右心室压力(RVP)和最大上升(下降)速率±dp/dtmax以及颈动脉血压(AP)等血流动力学指标的改变,并行肺组织病理学检查。结果:APE家兔成活率为86.9%。注栓后RR和MDR持续升高,与栓塞前比较均具有统计学差异(P<0.05或P<0.01)。右心室收缩压(RVSP)栓塞即刻达峰值,6h下降到栓塞前,右心室舒张压(RVDP)与栓塞前比较无统计学差异。+dp/dtmax栓塞即刻达峰值,4h下降到栓塞前,-dp/dtmax栓塞即刻升高后恢复到栓塞前。APE后动脉收缩压(SAP)、舒张压(DAP)均持续下降,观察8h也未出现恢复。HE染色可见肺动脉内有血栓及肺小静脉扩张和大量炎性细胞浸润等病理改变。结论:自体血栓经颈静脉注入造成的APE可致血流动力学和肺组织形态学改变,尤以右心室收缩压和AP变化显著。     

急性肺栓塞犬肺动脉压、血管紧张素Ⅱ水平的变化及氯沙坦的作用

目的：观察肺栓塞前后肺动脉压、血浆血管紧张素Ⅱ水平的变化，探讨氯沙坦对肺栓塞肺动脉高压的影响。方法：将犬自体血栓经导管选择性栓塞肺动脉，左、右心导管监测血液动力学，建立急性肺栓塞模型。将模型犬随机分为对照组、氯沙坦组。氯沙坦组给予氯沙坦0.5 mg/kg (iv)，再给予0.05 mg·kg^-1·min^-1静滴30 min；对照组同期输入等量生理盐水。监测两组栓塞前、模型复制后用药前、用药后1 h、2 h、3 h肺动脉压的变化。对照组同期采集肺动脉血，放免法测定血浆血管紧张素Ⅱ水平。结果：两组注栓后肺动脉压较注栓前明显升高（P<0.01），对照组肺动脉压在模型复制后3 h内无显著变化（P>0.05），氯沙坦组用药1 h后肺动脉压较用药前开始下降（P<0.01），以后继续下降,3 h后与对照组同期比较下降更明显（P<0.01）。肺栓塞后血浆血管紧张素Ⅱ水平各时点较注栓前明显升高（P<0.05）。结论：肺栓塞时血浆血管紧张素Ⅱ水平升高，氯沙坦能降低肺动脉高压，它对肺栓塞治疗可能有益。     

慢性肺动脉血栓栓塞动物模型的建立

背景：目前国内外接近人体生理学的慢性肺动脉血栓栓塞的动物模型较少见。 目的：采用自体血栓反复注射法建立慢性肺动脉血栓栓塞的动物模型。 方法：将家兔随机分为栓塞组和假栓塞组,栓塞组家兔肺动脉多次注入自体血栓,假栓塞组用生理盐水替代血栓。 结果与结论：栓塞组干预4周后解剖肺动脉并经病理检测可发现有血栓机化,肺动脉CT造影均可见局部肺动脉截断征,以及炎症、梗死、胸膜增厚等间接征象,肺动脉解剖及病理均可发现实验兔肺动脉血栓形成机化及慢性炎症改变。结果证实,采用兔自体血栓反复注射法可成功建立慢性肺血栓栓塞动物模型。     

急性肺栓塞时左右心室压力容量关系变化的实验研究

目的: 建立急性肺栓塞（APE）动物模型，探讨急性肺栓塞时左右心室压力容量关系变化。方法: 成年杂种犬7只，依据动物模型建立过程中不同时段和压力负荷程度分为肺栓塞前组、中度肺栓塞和重度肺栓塞3组，采用漂浮导管经肺动脉内注射缝线线段的方法建立中度APE和重度APE动物模型，并测量心导管压力指标；使用超声心动图声学定量技术获得同步容量指标；两者结合建立左右心室简易压力容量关系。结果: 中度APE时，右室压力容量关系图明显向右上移位，面积扩大明显，环的形态由近似三角形向矩型转变；左室压力容量关系图则小幅度左下移位，形态无明显变化；重度APE时，右室压力容量关系图右上移位且面积缩小，形态不规则。左室压力容量关系图则较大幅度左下移位，面积缩小，形态不规则。结论： 急性肺栓塞时左右心室压力容量关系变化是APE血流动力学变化和临床预后的理论基础，是探讨APE血流动力学变化的实用、简便、直观方法。     

实验性急性肺动脉高压的血流动力学变化

实验性急性肺动脉高压的血流动力学变化中国医学科学院中国协和医科大学阜外医院肺心病研究室（北京１０００３７）崔希忠程显声李智刘岩熊长明１１％急性肺栓塞患者于发病后１小时内死于循环衰竭，但其血流动力学动态改变和机制尚不清楚。本实验研究了模拟主肺动脉血栓形...     

家兔急性肺栓塞对肺血管内皮细胞超微结构及血清一氧化氮含量的影响

目的 探讨急性肺栓塞（APE）对肺血管内皮细胞（PVECs）的结构及血清一氧化氮（NO）含量的影响。 方法 19只日本大耳兔,随机分成假手术组、栓塞2 h、4 h组(n=3)和8 h组（n=10）。通过输入自体血栓建立家兔急性肺栓塞模型后,采用HE染色光学显微镜下观察肺的病理组织学变化;透射电子显微镜下观察PVECs在肺栓塞2 h、4 h及8 h的超微结构变化;硝酸还原酶法测定相应时间点血清NO含 结果 HE染色显示栓塞组肺动脉内有血栓,肺间质炎性病变,肺淤血;透射电子显微镜显示,栓塞组PVECs水肿、破裂,线粒体肿胀,内质网空泡化,并随栓塞时间延长PVECs出现坏死脱落,细胞器溶解。肺栓塞2 h、4 h和8 h血清NO含量均低于栓塞前,与栓塞前比较差异有显著性意义（P＜0.05）。 结论 家兔APE可致PVECs超微结构改变和血清NO含量下降,且两者间关系密切。     

急性肺血栓栓塞大鼠肺组织中COMT和MAO表达降低

目的探讨急性肺血栓栓塞大鼠的肺组织中儿茶酚胺代谢相关酶类氧甲基转移酶(COMT)和单胺氧化酶(MAO)的表达变化。方法建立大鼠急性肺血栓栓塞模型,分别在血栓栓塞后1、8、24和48 h采取心脏穿刺法取血,用半定量RT-PCR法和Western blot法检测COMT、MAO-A及MAO-B的mRNA和蛋白表达;用HPLC法检测血清中儿茶酚胺水平。结果在急性肺栓塞的不同时间点,COMT、MAO-A及MAO-B的mRNA和蛋白水平均逐渐降低,而血清中肾上腺素(EPH)和去甲肾上腺素(NE)呈逐渐升高趋势。结论急性肺栓塞大鼠的血清儿茶酚胺水平升高源自肺组织内的降解减少。本研究部分阐明了急性肺栓塞导致肺动脉高压的分子机制。     

建立椎动脉急性血栓栓塞犬模型:微球囊导管临时隔截取栓

背景:为了避免机械取栓术中血栓脱落造成远端栓塞,作者以期运用微球囊临时隔截的方法来建立防止血栓脱落的保护装置。目的:探讨采用微球囊临时阻断动脉血流并隔截栓塞段保护下行机械碎栓、吸栓联合溶栓治疗超急性脑梗死的安全性和可行性。方法:Beagle犬10只在全身麻醉下经股动脉插管将微球囊导管送至优势侧椎动脉内并充盈球囊临时阻断血流,经微导管注入自体血栓建立椎动脉血栓栓塞模型,按治疗方法均分为2组,对照组采用单纯支架取栓,实验组采用微球囊导管临时阻断血流并隔截靶动脉后行机械碎栓吸栓联合药物溶栓。两组治疗后均行数字减影血管造影复查栓塞椎动脉再通状况;采用血栓性脑缺血血流分级进行血流动力学评估。造模前及取栓后12 h行磁共振弥散加权成像。建模后12 h行核磁共振成像检查后处死动物行病理检查,统计两组血管再通成功率及并发症。结果与结论:10只beagle犬的优势侧椎动脉均成功出现血栓栓塞。对照组中2只犬椎动脉完全再通,3只犬椎动脉部分再通,其中1只犬椎-基底动脉与颅内动脉中可见多处小点状充盈缺损,颅内动脉显影差,对比剂返流,建模后12 h磁共振弥散加权成像示左侧颞顶叶稍高信号影,病理检查示左侧大脑颞叶动脉腔内见血栓形成。实验组中5只犬椎动脉均完全再通,未见脑梗死。实验组血管再通率高于对照组(P0.05)。结果证实,在急性脑动脉栓塞血管再通中采用微球囊导管临时阻断血流并隔截靶动脉保护下机械碎栓、吸栓联合尿激酶溶栓,可有效防止小栓子脱落栓塞远端动脉,安全有效。     

超声在急性肺栓塞诊断与疗效评估中的应用

肺栓塞(pulmonary embolism,PE),即肺动脉栓塞,是指肺动脉及其分支由栓子阻塞的病理过程,最常见的栓子为血栓,血栓随血流到达肺动脉形成肺栓塞.肺栓塞是危害人类健康的重要疾病,在美国,每年有200 000人因肺栓塞住院,5000人死于肺栓塞,其发病率在心血管病中仅次于冠心病和卒中,死亡率为全部死因的第3位[1].由于临床表现随栓塞范围不同差异较大,诊断较困难,因而常导致诊断和治疗的延误.PE在急性病程内可危及生命,未经治疗者的病死率约为25%～30%,而在经充分抗凝治疗后,致命性或复发性PE的发生率可降至7%以下[2-3],因此,PE的早期诊断显得尤为重要.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.