外用红油膏对大鼠体内汞蓄积及肝肾功能的影响

目的：研究不同剂量的红油膏外用30天对大鼠体内汞蓄积及肝肾功能的影响。方法：将40只大鼠随机分成正常组、红油膏低、中、高剂量组,每组10只。各组大鼠背部造成面积为3 cm×3 cm创面,除正常组外,红油膏低、中、高剂量组分别予以4.744mg、94.88mg、189.76mg红油膏纱条外敷。持续给药30天后检测大鼠尿液、血液、肝脏及肾脏的汞含量及肝肾功能指标ALT,AST,BUN,CREAT。结果：红油膏各剂量组的血液和尿液中汞含量明显高于正常组（P﹤0.05,P﹤0.01）,红油膏中、高剂量组的肝脏、肾脏中汞含量明显高于正常组（P﹤0.01）,其中尿液、肾脏中汞含量呈剂量依赖性（P﹤0.01）;相比正常组,红油膏高剂量组中AST的含量明显升高（P﹤0.05）,红油膏中、高剂量组中BUN、CREAT的含量均明显升高（P﹤0.05,P﹤0.01）。结论：红油膏长期、超量给药可造成大鼠体内汞蓄积及肝肾毒性,但日均剂量4.744mg（相当于人体临床日均剂量230mg）且持续30天外用红油膏粉对肝肾汞蓄积及肝肾功能影响较小,可为红油膏临床安全性提供数据参考。     

大豆多肽对过度训练大鼠肾脏滤过屏障形态结构和尿液成分的影响及其机制

目的:探讨补充大豆多肽对过度训练大鼠肾脏滤过屏障形态结构和功能的影响及其可能的机制。方法:将30只雄性大鼠随机平均分为3组,分别为对照组(C)、过度训练组(OT)、过度训练 补充大豆多肽组(OS)。检测各组大鼠肾组织SOD活性和MDA含量以及尿液总蛋白、白蛋白和β-微球蛋白含量,并观察各大鼠肾脏滤过屏障形态结构的变化。结果:电镜下,OT组大鼠肾组织出现毛细血管球系膜增生,基膜基质增多,足细胞肿胀、融合,裂孔不清晰等变化;OS组肾小球基底膜厚度均匀,轻微增厚;足细胞排列有序,有足细胞足突有轻度融合现象,裂孔变小。与C组相比,OT组大鼠血清睾酮水平显著降低(P<0.01),皮质醇水平显著增高(P<0.01),尿液中的TP、Alb、β2-MG含量显著增高(P<0.01),肾组织SOD活性显著下降(P<0.01),MDA水平显著升高(P<0.01);与OT组相比,OS组SOD活性显著升高(P<0.01),MDA水平显著下降(P<0.01),尿液TP、Alb、β2-MG含量显著降低(P<0.01)。结论:大豆多肽可能是通过提高肾脏的抗氧化能力和加快自由基的清除的机制,实现了对过度训练大鼠肾脏滤过屏障形态结构完整性的维持。     

益气养阴、清利活血法对微小病变肾病大鼠血清、肾组织内皮素作用的研究

目的:观察益气养阴、清利活血中药对阿霉素诱导的微小病变肾病大鼠血清、肾组织内皮紊(ET)表达的影响,进一步探讨其肾脏保护作用机制.方法:实验动物随机分为6组:正常组、模型组、阳性对照组、中药高、中、低剂量组.用表柔比星(阿霉素)尾静脉注射法复制微小病变肾病大鼠模型,分别给予不同剂量益气养阴、清利活血中药液、强的松混悬液.测定大鼠24h尿蛋白定量、血清白蛋白(ALB)、总胆固醇(TC)、甘油三酯(TG)、尿素氮(BUN)、肌酐(Scr)、血清及肾组织ET的含量,并进行电镜下肾脏组织形态学观察.结果:与正常组比较,模型组大鼠血清、肾组织ET含量均有不同程度增高(P<0.05或0.01).益气养阴、清利活血中药可减少微小病变肾病大鼠尿蛋白的排泄量,改善血清生化指标,降低血清及肾组织ET含量(P<0.05或0.01),修复肾小球上皮细胞足突的结构.结论:微小病变肾病大鼠ET含量升高,益气养阴、清利活血法对微小病变肾病大鼠有明显疗效,并能抑制其增高的ET表达,从而减轻肾脏病理损害,缓解肾病.     

黄芪对慢性肾功能衰竭大鼠抗氧化作用的研究

目的 探讨黄芪对慢性肾功能衰竭(CRF)大鼠肾功能和血浆超氧化物歧化酶(SOD)活性及丙二醛(MDA)含量的影响.方法 将大鼠随机分为假手术组、模型组及黄芪低、中、高剂量组,每组8只.采用切除5/6肾的方法制备CRF模型.黄芪各组予不同浓度的黄芪水煎液2 ml/d灌胃(低、中、高剂量组分别含生药量0.1、0.2、0.4 kg/L),模型组及假手术组均予等量蒸馏水灌胃.8周后观察各组大鼠血清肌酐(SCr)、尿素氮(BUN)及血浆SOD、MDA水平的变化.结果 模型组大鼠SCr、BUN、MDA明显高于假手术组,SOD活性明显低于假手术组(P均<0.01);黄芪各剂量组SCr、BUN、MDA均较模型组显著降低,SOD活性则显著升高(P<0.05或P<0.01),其中以黄芪高剂量组最为明显(P均<0.05).结论 黄芪能明显改善CRF大鼠的肾功能及体内的氧化应激反应;高剂量的黄芪抗氧化能力优于低剂量.     

黄芩素对2型糖尿病大鼠肾组织氧化应激的影响及其作用机制

目的:探讨黄芩素(baicalein,BAI)对2型糖尿病大鼠肾组织氧化应激的影响及机制.方法:对链脲佐菌素(streptozotocin,STZ)诱导的2型糖尿病大鼠随机分为对照组、模型组、低剂量组[黄芩素(80 mg/(kg·d)]和高剂量组[黄芩素(160mg/(ks·d)],治疗12周后检测各组大鼠尿白蛋白排泄率(UAER)、血糖(BG)、血肌酐(Scr)、血尿素氮(BUN)、内生肌酐清除率(Ccr)等变化;测定肾组织中丙二醛(MDA)的含量及谷胱甘肽-过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)和过氧化氢酶(CAT)活性.应用RT-PCR方法检测P22phox mRNA及P47phoxmRNA的表达.结果:两治疗组较模型组尿白蛋白、尿素氮水平和肾脏肥大指数明显改善.与对照组比较,模型组大鼠的MDA含量显著增加(P<0.01),SOD、GSH-Px、CAT活性显著降低(P<0.01);两治疗组糖尿病大鼠肾组织中MDA含量明显降低,SOD、CAT、GSH-Px活性显著增强.P22phox mRNA及P47phox mRNA的相对含量在模型组分别为(0.370±0.028)、(1.005±0.116)明显高于对照组(0.098±0.029)、(0.340±0.055),(P<0.01);低剂量组较模型组显著降低,分别为(0.275±0.029)、(0.740±0.088)(P<0.01).高剂量组降低更明显,分别为(0.193±0.013)、(0.660±0.083)(P<0.01).两治疗组之间各指标无明显差异.结论:BAI对2型糖尿病大鼠肾组织具有明显的保护作用,其机制可能是通过下调P22phox mRNA及P47phox mRNA的表达,提高肾组织中SOD、GSH-Px、CAT活性,降低MDA含量,从而减轻自由基对糖尿病大鼠肾组织的氧化损伤,延缓糖尿病及其并发症的发生发展.     

络通纤溶饮对博莱霉素诱导肺纤维化大鼠透明质酸和层黏连蛋白含量的影响

目的研究络通纤溶饮对博莱霉素诱导肺纤维化(PF)大鼠的血清及支气管肺泡灌洗液(BALF)中透明质酸(HA)和层黏连蛋白(LN)含量的影响。方法 SD大鼠120只,分为正常对照组、PF模型组、强的松组、络通纤溶饮低剂量组和络通纤溶饮高剂量组5组,每组24只;造模各组大鼠气管内滴注博莱霉素A5,正常对照组气管内滴注等量无热源生理盐水。手术后第2天开始,给对照组与模型组大鼠灌服生理盐水(10ml/kg);给低剂量组和高剂量组大鼠灌服中药水煎剂(12.3g/kg、24.6g/kg);给强的松组大鼠灌服强的松混悬液(6mg/kg)。各组动物于手术后第7、14、28天分3批断头处死。取血,分离血清;取BALF,测定其中HA和LN含量。结果与对照组相比,模型组大鼠血清和BALF中HA含量明显升高(P均<0.01),且第7天达到峰值;LN含量呈持续性增加(P均<0.01)。经用药干预,与模型组相比,高、低剂量组和强的松组大鼠各时间点血清和BALF中HA和LN含量均明显下降(P<0.05、P<0.01);与强的松组比较,第7天时高剂量组大鼠BALF中LN含量明显降低(P<0.05),第14天与第28天时高、低剂量组血清和BAL...     

胡芦巴多糖A2对糖尿病大鼠肾脏CTGF表达的影响

目的 探讨胡芦巴多糖A2对实验性糖尿病大鼠肾脏结缔组织生长因子(CTGF)表达的影响.方法 链脲佐菌素诱发大鼠糖尿病后给予胡芦巴多糖A2治疗,观察其对血糖、肾功能及A2对肾脏CTGFmRNA、蛋白表达的影响.结果 A2组大鼠血糖明显低于模型组(P<0.01);尿蛋白排泄率(Ualb)、血肌酐(Scr)和尿素氮(BUN)均显著低于模型组(P<0.01);RT-PCR结果表明A2组大鼠肾脏CTGFmRNA表达明显下调(P<0.01);Western blot结果发现A2组大鼠肾脏CYGF蛋白表达明显减少(P<0.01).结论 糖尿病大鼠给予A2治疗后,可通过降低血糖,改善糖尿病大鼠肾脏功能,A2可能通过下调CTGFmRNA和蛋白表达抑制ECM增多,从而减轻糖尿病肾脏病变.     

rhKD/APP对肾脏缺血再灌注损伤大鼠的肾保护作用

目的 观察对大鼠肾缺血再灌注损伤的保护和治疗.方法 取wistar大鼠60只,根据给药不同随机分为6组,伪手术组,模型组,小、中、大剂量组、对照组.造模24小时后检测血清肌酐(Cr)、尿素氮(SUN)、尿NAG,并光镜、电镜观察肾脏组织病理变化.结果 各实验组与伪手术组比较Cr、BUN、NAG明显升高(P<0.05),与模型组比较rhKD/APP中、大剂量组、对照组Cr、BUN、NAG明显降低(P<0.01 or P<0.05),小剂量组无明显差异.光镜电镜观察rhKD)/APP中、大剂量组、对照组细胞损害较模型组明显减轻.结论 rhKD/APP对大鼠肾缺血再灌注损伤确实具有器官保护作用.     

异甘草酸镁对大鼠百草枯中毒肺纤维化治疗作用的研究

目的 探讨异甘草酸镁(MgIG)对大鼠百草枯(paraquat,PQ)中毒所致肺纤维化的防治作用及可能的机制.方法 健康的SD雄性大鼠30只,随机分成5组:正常对照组、染毒对照组、MgIG低剂量(15 mg/kg)组、MgIG中剂量(30 mg/kg)组和MgIG高剂量(45 mg/kg)组;用20% PQ溶液按15 mg/kg行腹腔注射制作大鼠PQ中毒肺损伤模型,各治疗组于染毒后24 h按相应剂量MgIG行腹腔注射,正常对照组及染毒对照组注射生理盐水(按MgIG中剂量组的相应容量计算),直至死亡或被处死.于染毒后第14天全部处死,取肺组织行HE染色及Masson染色行病理学观察,并测定肺组织内羟脯氨酸(HYP)含量,同时取血清测定细胞间黏附因子-1(ICAM-1)及基质金属蛋白酶-9(MMP-9)含量.结果 所有大鼠均无自然死亡;光镜观察到染毒对照组静脉瘀血、淋巴增生、纤维母细胞增多,肺泡上皮增生明显,间质增厚.与染毒对照组相比,MgIG中剂量组的肺组织瘀血、水肿明显减轻,肺纤维化病理表现明显较轻,且肺内HYP明显下降(P均<0.01);血清中ICAM-1及MMP-9含量也明显降低(P<0.05或P<0.01).结论 MgIG中剂量对百草枯中毒大鼠肺组织纤维化损伤有一定的防治作用.     

褪黑素对糖尿病周围神经病变大鼠氧化应激及周围神经功能和形态的作用

背景:课题组前期针对糖尿病肾病的实验显示,褪黑素可以显著提高糖尿病大鼠血浆和肾脏内抗氧化酶的活性,改善肾脏的形态学变化。目的:在前期实验的基础上,进一步观察褪黑素对糖尿病周围神经病变大鼠氧化应激和周围神经功能和形态的作用。设计、时间及地点:随机对照动物试验,于2005-04/11在解放军第二军医大学动物实验中心完成。材料:2月龄健康雄性SD大鼠,单次腹腔注射链脲佐菌素60mg/kg诱导建立糖尿病大鼠模型。方法:将糖尿病模型大鼠维持饲养8周建立糖尿病周围神经病变大鼠模型,然后按体质量随机分为3组:模型组,褪黑素0.5,10mg/(kg·d)组,以未造模、鼠龄及体质量相匹配的8只大鼠为正常对照组。褪黑素0.5,10mg/(kg·d)组大鼠每日16:00灌胃给予相应剂量的褪黑素,其他2组大鼠予等量体积分数为0.02的乙醇溶液灌胃,持续8周。主要观察指标:检测各组大鼠坐骨神经内超氧化物歧化酶、谷胱甘肽过氧物酶活性和脂质过氧化产物丙二醛含量的变化,大鼠摆尾阈值、坐骨神经神经传导速度和超微结构的变化。结果:各组糖尿病大鼠坐骨神经传导速度显著低于正常对照组(P<0.01),褪黑素0.5,10mg/(kg·d)治疗后神经传导速度高于模型组(P<0.05,0.01)。褪黑素0.5,10mg/(kg·d)组丙二醛含量低于模型组(P<0.01),血清超氧化物歧化酶、谷胱甘肽过氧物酶活性高于模型组(P<0.01)。模型组大鼠坐骨神经多数有髓纤维髓鞘板结构破坏严重,出现裂隙、空泡等现象,轴突严重被挤压,轴突变性、萎缩。褪黑素治疗后坐骨神经纤维的髓鞘仍不正常,但较模型组明显减轻,褪黑素10mg/(kg·d)组改变要好于褪黑素0.5mg/(kg·d)组。结论:褪黑素能有效抑制糖尿病周围神经病变大鼠的氧化应激反应,改善神经功能和结构变化。糖尿病时自由基损伤和抗氧化能力的降低可能在糖尿病周围神经病变的发生发展中发挥重要作用。     

创伤高血糖与感染和MODS早期诊断和干预

本文详细介绍了创伤后血糖应激适度理论,以及高血糖与感染和多器官功能不全综合征的关系;提出涉及胰岛B细胞功能不全的MODS实验诊断新方案和极化液个体化干预新措施,可早期发现创伤MODS、降低感染率及MODS发生率和病死率。     

腹膜后纤维化与肾积水发生关系的临床研究

目的：探讨腹膜后纤维化（RPF）导致肾积水的原因及诊治经验。方法：回顾分析2004年1月—2010年12月24例腹膜后纤维化致肾积水患者的诊治资料。结果：（1）RPF患者常见首发症状为腰背痛或腹痛（69.2%）;（2）红细胞沉降率（ESR）增快和血清IgG4升高最常见。超声检查仅提示上尿路积水。RPF的静脉肾盂造影（IVP）和CT尿路成像（CTU）表现具有特征性。IVP肾盂输尿管显影不良时,CTU能较清晰的显示上尿路影像。CT扫描发现腹膜后软组织肿块9例（37.5%）,优于超声检查;（3）输尿管松解和腹腔化手术治疗22例;行肾切除术1例;行输尿管置双J管术1例。最终确诊为继发性RPF8例,其中4例为术前诊断,3例为术中腹膜后软组织肿块冷冻活检证实,1例为术后病理证实;（4）特发性RPF手术后肾积水均获长期缓解,而继发性RPF的预后取决于原发疾病及其治疗方案。结论：影像学检查是诊断RPF的重要手段,CTU优于超声检查和IVP。输尿管松解和腹腔化手术可以使特发性RPF输尿管梗阻得到长期的缓解,术中对肿块进行冷冻活检有助于鉴别特发性和继发性RPF,及时调整治疗方案。     

Fibrinogen and fibrin structure and functions

Fibrinogen molecules are comprised of two sets of disulfide-bridged Aalpha-, Bbeta-, and gamma-chains. Each molecule contains two outer D domains connected to a central E domain by a coiled-coil segment. Fibrin is formed after thrombin cleavage of fibrinopeptide A (FPA) from fibrinogen Aalpha-chains, thus initiating fibrin polymerization. Double-stranded fibrils form through end-to-middle domain (D:E) associations, and concomitant lateral fibril associations and branching create a clot network. Fibrin assembly facilitates intermolecular antiparallel C-terminal alignment of gamma-chain pairs, which are then covalently 'cross-linked' by factor XIII ('plasma protransglutaminase') or XIIIa to form 'gamma-dimers'. In addition to its primary role of providing scaffolding for the intravascular thrombus and also accounting for important clot viscoelastic properties, fibrin(ogen) participates in other biologic functions involving unique binding sites, some of which become exposed as a consequence of fibrin formation. This review provides details about fibrinogen and fibrin structure, and correlates this information with biological functions that include: (i) suppression of plasma factor XIII-mediated cross-linking activity in blood by binding the factor XIII A2B2 complex. (ii) Non-substrate thrombin binding to fibrin, termed antithrombin I (AT-I), which down-regulates thrombin generation in clotting blood. (iii) Tissue-type plasminogen activator (tPA)-stimulated plasminogen activation by fibrin that results from formation of a ternary tPA-plasminogen-fibrin complex. Binding of inhibitors such as alpha2-antiplasmin, plasminogen activator inhibitor-2, lipoprotein(a), or histidine-rich glycoprotein, impairs plasminogen activation. (iv) Enhanced interactions with the extracellular matrix by binding of fibronectin to fibrin(ogen). (v) Molecular and cellular interactions of fibrin beta15-42. This sequence binds to heparin and mediates platelet and endothelial cell spreading, fibroblast proliferation, and capillary tube formation. Interactions between beta15-42 and vascular endothelial (VE)-cadherin, an endothelial cell receptor, also promote capillary tube formation and angiogenesis. These activities are enhanced by binding of growth factors like fibroblast growth factor-2 (FGF-2) and vascular endothelial growth factor (VEGF), and cytokines like interleukin (IL)-1. (vi) Fibrinogen binding to the platelet alpha(IIb)beta3 receptor, which is important for incorporating platelets into a developing thrombus. (vii) Leukocyte binding to fibrin(ogen) via integrin alpha(M)beta2 (Mac-1), which is a high affinity receptor on stimulated monocytes and neutrophils.     

Migraine and genetic and acquired vasculopathies

It is remarkable that migraine is a prominent part of the phenotype of several genetic vasculopathies, including cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL), retinal vasculopathy with cerebral leukodystrophy (RVCL) and hereditary infantile hemiparessis, retinal arteriolar tortuosity and leukoencephalopahty (HIHRATL). The mechanisms by which these genetic vasculopathies give rise to migraine are still unclear. Common genetic susceptibility, increased susceptibility to cortical spreading depression (CSD) and vascular endothelial dysfunction are among the possible explanations. The relation between migraine and acquired vasculopathies such as ischaemic stroke and coronary heart disease has long been established, further supporting a role of the (cerebral) blood vessels in migraine. This review focuses on genetic and acquired vasculopathies associated with migraine. We speculate how genetic and acquired vascular mechanisms might be involved in migraine.     

Telemedicine and teleradiology technologies and applications

Summary. Telemedicine and teleradiology hold the key for improving future health care delivery. In this paper we first review current communication and computer technologies used in telemedicine and teleradiology. Five examples in teleradiology applications are given including hospital-integrated picture archiving and communication systems, tele-neuro-imaging, telemammography, university consortium teleradiology service, and teleradiology for second opinion. Parameters important to teleradiology applications like costs, image quality, system reliability, and turn around time are considered. Data security is discussed, including patient confidentiality and image authenticity-which will be a major issue in future teleradiology applications.     

Physician and Nurse Practitioner Teamwork and Job Satisfaction: Gender and Profession

Designing interprofessional primary care teams composed of physicians and nurse practitioners (NPs) is a national priority. We assessed how profession and gender affect teamwork and job satisfaction among primary care physicians and NPs by using survey data from 186 physicians and 398 NPs practicing in New York State. Our regression models show profession (NP vs physician) moderates the associations of gender with teamwork and job satisfaction. Among NPs, men had higher job satisfaction than women. Among physicians, women had higher job satisfaction than men. Our results can benefit interprofessional primary care teams to optimize their professional and gender mix.     

妊娠合并血小板减少症与心、肝、肾脏器损伤

目的探讨妊娠合并血小板减少症伴随重要脏器的损伤情况。方法前瞻性研究我院及北华大学附属医院2004年10月至2005年5月妊娠合并血小板减少症的临床资料，对41例妊娠合并血小板减少症者尿素氮（BUN）、肌酐（CREA）、谷丙转氨酶（ALT）、乳酸脱氢酶（LDH）的测定及妊娠期高血压疾病与血小板计数（PLT），血小板平均体积（MPV）和血小板体积分布宽度（PDW）参数的测定进行对比分析。结果妊娠合并血小板减少症患者心、肝、肾等重要脏器均有不同程度的改变，且随着血小板计数降低，损害程度加剧，差异具有显著性（P〈0．01）。妊娠期高血压疾病，随着疾病程度的加重，血小板计数较正常孕妇明显减少，MPV、PDW明显升高，有显著性差异（P〈0．01）。结论血小板参数是判断疾病的重要参考指标，肝、肾、心脏器损伤程度与血小板计数具有相关性。     

Literature and poetry: Pleasure and practice

The value of a humanities perspective in the initial and continuing education of practising nurses and midwives is discussed briefly. It is suggested that nursing requires a blend of both science and sensitivity and that empirical knowledge alone is insufficient for one who cares for others. The value of literature in relation to the notions of catharsis, vicarious experience and insight into the lives of patients will be discussed. Some examples of literature that may be used to help nurses gain insight into aspects of death and dying, midwifery, physical disability and mental illness are presented.     

Migraine and stroke in childhood and adolescence

Over 3 years we evaluated two patients, an adolescent and a child, with migraine-like headache and ischemic stroke. Based on our clinical observations and on liter: review of migraine and stroke in the pediatric age group, we believe that the criteria of migrainous infarction outlined by the International Headache Society (IHS) could be occasionally too restrictive Therefore, we suggest subclassifying migrainous infarction into: (i) "definite", referring to the patient: ischemic stroke fulfills all the IHS criteria, (ii) "possible", referring to ischemic strokes which I 1 some, but not all, criteria. This subclassification of migrainous infarction may be relevant in cal practice and in human research studies.