多壁纳米碳圈对大鼠血小板黏附及实验性血栓的影响

目的 观察多壁纳米碳圈(MWCNOs)对大鼠血小板黏附及对实验性血栓的影响.方法 采用倒置荧光显微镜和流动小室,观察在不同剪切力(500 s-1、1000 s-1)作用下,20 g/ml MWCNOs对大鼠血小板黏附的影响,每组重复至少3次以上.用化学刺激法,分假手术组、溶剂组和MWCNOs组,每组6～9只大鼠,观察2 mg/kg MWCNOs对25％三氯化铁诱导大鼠颈动脉血栓形成中的血流变化及其单位长度血栓湿重的影响.结果 (1)剪切力为500s-1,MWCNOs组的血小板黏附数量(58.3±16.1 platelets/0.01 mm2)较溶剂组血小板黏附数量(190.1±36.0 platelets/0.01 mm2),差异有统计学意义.当剪切力升高至1000s-1时,MWCNOs对血小板黏附的抑制作用消失.(2)血栓形成试验中,尾静脉注射溶剂及2 mg/kgMWCNOs 0和12h后,0时间点的单位长度血栓湿重为:溶剂组0.83 0.12 mg/mm,MWCNOs组0.970.11 mg/mm,12 h时间点的单位长度血栓湿重为:溶剂组0.89 0.12 mg/mm,MWCNOs组1.01 0.15mg/mm,差异均无统计学意义(P＞0.05).同时,两个时间点溶剂组的血流变化与相应MWCNOs组相比差异无统计学意义(P＞0.05).结论 MWCNOs对离体血小板黏附存在抑制作用,而尾静脉注射MWCNOs对大鼠实验性血栓中的血流及单位长度血栓湿重无影响.     

新生儿溶血病凝血功能变化的研究

目的 探讨新生儿溶血病凝血功能的变化及其临床意义.方法 以新生儿溶血病(溶血病组)、非溶血性高胆红素血症(非溶血病组)患儿各60例为研究对象,同期出生的60例正常足月儿为对照组.测定各组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血小板计数.结果 溶血病组PT、APTT明显高于非溶血病组[(28.79±4.21)s比(18.98±241)s和(58.52±313)s比(47.26±5.81)s],且两组明显高于对照组[(13.81±1.83)s和(38.10±3.00)s],差异有统计学意义(P<0.05),而血小板计数比较差异无统计学意义(P>0.05).结论 新生儿溶血病有出血倾向,与血小板计数无关,而与PT、APTT延长有关,溶血程度越重,PT、APTT升高越明显.PT、APTT可作为新生儿溶血病患儿凝血功能检测的指标和疗效评价指标.

Abstract：

Objective To investigate the clinical significance and coagulation function changes in newborn hemolytic disease. Method The newborn hemolytic disease ( 60 cases, hemolytic disease group ), non-hemolytic hyperbilirubinemia (60 cases, non-hemolytic hyperbilirubinemia group) and normal newborn (60 cases,control group) were selected as the study subjects, the prothrombin time (PT) and activated partial thromboplastin time (APTT) were measured, and the blood platelet count at the same time was detected. Results PT and APTT in hemolytic disease group were higher than those in non-hemolytic hyperbilirubinemia group[(28.79 ?.21) s vs. (18.98?.41) s and (58.52?.13) s vs. (47.26?.81) s], and they were apparently higher than those in control group [(13.81 ?1.83) s and (38.10 ?3.00) s], the difference had statistic significance (P<0.05). There was no statistic significance to detect the blood platelet count (P> 0.05). Conclusions The newborn hemolytic disease has the bleeding tendency, and the bleeding tendency has no relationship with the quantity of the blood platelet, but relates to the extension of PT and APTT. The more serious the case is, the more obvious the PT and APTT rise. PT and APTT can be as the detection index and evaluating effect of the newborn hemolytic disease coagulation function.     

吡非尼酮抗百草枯中毒小鼠肺纤维化的研究

目的 探讨吡非尼酮(PF)对百草枯(PQ)中毒小鼠肺纤维化的治疗作用,为临床治疗提供理论依据.方法 雄性ICR小鼠90只,随机分为正常对照组、PQ组、地塞米松组、25、50和100 mg/kgPF组,每组15只.正常对照组小鼠一次性空腹灌胃给予生理盐水,2 h后给予质量分数为1%羧甲基纤维素(CMC)灌胃,再每天定时空腹灌胃同等量CMC;PQ组、地塞米松组及各PF剂量组小鼠给予PQ100mg/kg一次性灌胃染毒,灌胃后2 h,再每天定时PQ组给予0.02ml/10 gCMC灌肠,PF组给予PF(25、50、100 mg/kg)和地塞米松(0.02 ml/10 g)灌胃,每天1次,共49 d.计算肺系数,HE染色,光学显微镜下观察肺组织病理改变;测定肺组织羟脯氨酸(HYP)含量,转化生长因子(TGF-β1)的mRNA表达水平、蛋白表达水平,支气管肺泡灌洗液(BALF)中的TGF-β1蛋白含量.结果 PQ组3 d生存率为53.33%,25、50、100 mg/kg PF组3 d生存率分别为46.67%、73.33%、86.67%,地塞米松组3 d生存率为80%,地塞米松组、50、100 mg/kg PF组3 d生存率明显高于PQ组和25 mg/kg PF组,差异有统计学意义(P＜0.05).25、50及100mg/kg PF组小鼠肺系数均明显低于PQ组,差异有统计学意义(P＜0.05).地塞米松组肺组织中HYP含量为(50.95±11.65)mg/g,25、50、100mg/kg PF组HYP含量分别为(44.52±9.48)、(43.27±6.01)、(40.82±5.90)mg/g,较PQ组[(74.27±3.68)mg/g]明显下降,差异均有统计学意义(P＜0.01).地塞米松组BALF中TGF-β1蛋白含量为(22.03±7.27)mg/ml,25、50、100 mg/kg PF组TGF-β1蛋白含量分别为(55.33±17.50)、(27.75±5.84)、(21.31±6.82)mg/ml,与PQ组[(52.52±15.51)mg/ml]相比,明显降低,差异有统计学意义(P＜0.01);100 mg/kg PF组肺组织TGF-β1mRNA表达水平与PQ组相比,明显下降,差异有统计学意义(P＜0.01)与PQ组比较,地塞米松组,50、100mg/kgPF组肺组织中TGF-β1蛋白表达下降,差异有统计学意义(P＜0.01).结论 PF可以减少百草枯中毒小鼠肺组织胶原沉积,减轻肺部纤维化程度.

Abstract：

Objective To study the curative effects of pirfenidone (PF)on pulmonary fibrosis induced by paraquat (PQ) in mice and to provide the theoretical basis for clinical treatment. Methods Ninety adult healthy male ICR mice were randomly divided into six groups: control group, PQ group , 2 mg/kg Dexamethasone group, 25 mg/kg PF group, 50 mg/kg PF group and 100 mg/kg PF group, there were 15 mice in each group. The corresponding volume of normal saline was given to the each mouse in control group according to the weight, after 2 h 0.1% CMC was given to the each mouse of control group one time by intragastric administration, then the CMC was administrated at regular time until sacrifice. All mice for other 5 groups were exposed to 100 mg/kg PQ by intragastric administration. At 2 h after exposure to PQ, 0.02 ml/10 g dexamethasone and 25、50、100 mg/kg PF were given to mice for dexamethasone group and for 3 PF groups by intragastric administration each day for 49 days, respectively. The lung coefficient was calculated and pathological changes of lung tissue were observed by HE staining for each mouse. The hydroxyproline (HYP)level in lung tissue was measured for each mouse. The mRNA level of and the protein level of TGF-β1 in lungtissue for each mouse were determined, and the protein level of TGF-β1 in the bronchus-alveolus lavage fluid (BALF) of each mouse was detected. Results The survival rates on the 3rd day in PQ group, 3 PF groups and dexamethasone group were 53.33%, 46.67%, 73.33%, 86.67% and 80%, respectively. The survival rates on the 3rd day in dexamethasone group, 50 mg/kg and 100 mg/kg PF groups were significantly higher than those of PQ group and 25 mg/kg PF group (P＜0.05). The lung coefficients of 3 PF groups were significantly lower than that of the PQ group (P＜0.05). The lung tissue HYP levels of dexamethasone group and 3 PF groups were 50.95±11.65, 44.52±9.48, 43.27±6.01 and 40.82±5.90 mg/g respectively, which were significantly lower than that (74.27±3.68) of PQ group(P＜0.01 ). The TGF-β1 protein levels of BALF in dexamethasone group, 50 and 100 mg/kg PF groups were 22.03±7.27, 27.75±5.84 and 21.31 ±6.82 ng/ml respectively, which were significantly lower than that(52.52±15.51 ) ng/mlof PQ group(P＜0.01 ). The expression level of TGF-β1 mRNA in 100 mg/kg PF group decreased significantly, as compared with PQ group (P＜0.01). Conclusion PF could reduce the collagen deposition and pulmonary fibrosis induced by PQ in mice lungs.     

地塞米松预处理对大鼠光气吸入性肺损伤基质金属蛋白酶-9表达的影响

目的 探讨地塞米松对大鼠光气吸入性急性肺损伤(ALI)基质金属蛋白酶-9(MMP-9)表达的影响.方法 将SD大鼠随机分为3组:正常对照组(吸入与光气染毒组同等流量的空气)、光气染毒组(吸入8.33 mg/L的光气)、地塞米松预处理组(尾静脉注入2.5 mg/kg地塞米松1 h后,吸入8.33 mg/L的光气).染毒2 h后,收集支气管肺泡灌洗液(BALF)测定中性粒细胞细胞数、蛋白含量和肺湿/干重比(W/D).用放射免疫法测定各组血清和BALF中MMP-9水平.进行肺组织的病理学检查,用免疫组化法和实时定量聚合酶链反应(PCR)测定MMP-9表达的变化.结果 与染毒组比较,预处理组大鼠肺W/D、BALF中中性粒细胞数和蛋白含量明显降低,差异有统计学意义(P＜0.01).与染毒组[血清:(9.439±0.100)μg/L、BALF:(20.640±0.446)μg/L]比较,预处理组MMP-9含量[血清(4.799±0.043)μg/L、BALF:(15.052±0.029)μg/L]明显降低,差异有统计学意义(P＜0.01).与染毒组(2.789±0.282)比较,预处理组MMP-9mRNA的表达量(1.183±0.260)明显降低,差异有统计学意义(P＜0.01).染毒组肺泡壁明显充血、增厚,肺泡壁和肺间质内可见较多白细胞浸润以及肺泡结构破坏;预处理组肺泡结构较为清晰,肺泡壁稍增厚,伴少量炎性细胞浸润.正常对照组大鼠肺、支气管组织中MMP-9蛋白表达呈弱阳性,染毒组MMP-9蛋白表达呈强阳性,预处理组肺、支气管组织中MMP-9蛋白表达明显减弱.结论 地塞米松能有效地保护大鼠光气吸入性ALT,可能通过抑制MMP-9表达而达到肺保护作用.

Abstract：

Objective To investigate the effects of dexamethasone on expression of matrix metalloproteinase-9 (MMP-9) in rats with acute lung injury induced by phosgene. Methods The rats were randomly divided into 3 groups: normal control group that consists of the rats with air exposure, phosgene group that consists of the rats with phosgene exposure and dexamethasone group that consists of the rats with phosgene exposure after 2.5 mg/kg dexamethasone being injected. Wet and dry ratio of the lung (W/D) was calculated, and leukocyte count and total protein content of bronchoalveolar lavage fluid (BALF) were recorded at 2 h after exposure. The concentrations of MMP-9 in the serum and BALF were measured by enzyme-linked immunosorbent assay. The pathologic changes of lung tissues were observed under light microscopy. The immunohistochemistry and the RT-PCR were used to detect the contents of MMP-9 in the lung tissue. Results Compared with phosgene group, the lung W/D, protein content and WBC count in of BALF dexamethasone group was significantly decreased (P＜0.01). MMP-9 levels of the serum and BALF in dexamethasone group were (4.799±0.043) μg/L and (15.052±0.029) μg/L, respectively, which were significantly lower than those [(9.439±0.100) and (20.640±0.446) μg/L] in phosgene group (P＜0.01). Compared with phosgene group (2.789±0.282), the expression level(1.183±0.260) of lung M MP-9 mRNA in dexamethasone group was significantly lower than that in phosgene group (P＜0.01).Histological experimental results showed the marked hyperemia and thickening of alveolar wallsand stroma cells infiltrating and more visible alveolar structure damage of alveolar walls in phosgene group while the alveolar structure and the alveolar walls were clear and slightly thickened with inflammatory cells in dexamethasone group. Immunohistochemical results showed that MMP-9 protein expression levels of lung and brochus tissues in normal control group and dexamethasone group were weakly positive, which in phosgene group were strongly positive. Conclusion Dexamethasone has a beneficial effects on acute lung injury induced by phosgene in rats due to the inhibiting MMP-9.     

幽门螺杆菌根除疗法治疗慢性特发性血小板减少性紫癜的对照研究

目的 观察幽门螺杆菌(Hp)根除疗法治疗Hp阳性的慢性特发性血小板减少性紫癜(ITP)的疗效.方法 59例Hp阳性的慢性ITP患者,按随机数字表法分为抗Hp组(治疗组,30例)和安慰剂组(对照组,29例),随访3个月后,比较两组的疗效.结果 治疗组有效率(63.3%,19/30)明显高于对照组(27.6%,8/29)(x2=7.59,P＜0.05),治疗组血小板计数升高值[(33.5±21.6)×109/L]明显高于对照组[(12.6±19.5)×109/L](t=5.52,P＜0.05).结论 Hp根除疗法可升高轻中度Hp阳性慢性ITP患者的血小板计数.

Abstract：

Objective To assess the effect of anti- Helicobacter pylori (Hp) treatment on patients with chronic idiopathic thrombocytopenic purpura (cITP). Methods Fifty-nine patients with cITP and positive-Hp were divided into two groups by random digits table:Hp eradication group (30 cases,given a standard anti-Hp treatment) and placebo controlled group (29 cases,received a placebo). The platelet response of two groups was compared after three months' follow-up. Result The platelet response in Hp eradication group (63.3%, 19/30) was significantly higher than that in placebo controlled group (27.6%,8/29 )(χ2 = 7.59, P ＜ 0.05 ), and the increasing level of platelet count in Hp eradication group [ (33.5 ± 21.6)× 109/L] was higher than that in placebo controlled group [(12.6 ± 19.5) × 109/L] (t = 5.52,P ＜0.05).Conclusion Hp eradication treatment can promote the platelet recovery in mild and moderate cITP patients with positive-Hp.     

高浓度二氧化氮致大鼠急性肺水肿模型的建立

目的 建立高浓度二氧化氮(NO2)染毒SD大鼠致急性肺水肿的模型.方法 将SD大鼠随机分为对照组(8只)和染毒组(30只),染毒组以(6747.47±215.24)mg/m3 NO2通过动式染毒柜染毒90 s后以净空气平衡换气30 min;对照组大鼠入染毒柜以净空气平衡30 min.染毒组分别在6、12、18、24 h拍摄大鼠胸片,各时间点取6只大鼠留取血样后处死,取肺组织做病理检查,进行肺湿/干系数测定.检测全血红细胞膜超氧化物歧化酶(SOD)活力和血浆中心钠素(ANP)浓度.结果 染毒组大鼠均在24 h内发生肺水肿,胸片显示,斑片云雾状阴影,12 h时加重,18 h时斑片影加深,遍及全肺,呈现"白肺"状,24 h后无明显恢复.HE染色显示,染毒组6 h肺泡间隙增大,泡内有少量嗜伊红液体渗出,12 h后肺泡融合,泡内嗜伊红液体增多,18 h后肺泡及组织中充满嗜伊红液体,至24 h时无恢复.染毒组6、12、18、24 h肺湿/干系数分别为5.60±0.20、6.89±0.25、8.03±0.47、7.81±0.45,与对照组(4.72±0.06)比较,差异均有统计学意义(P＜0.01);染毒组12、18、24 h肺湿/干系数与6 h相比,差异均有统计学意义(P＜0.01);染毒后18、24 h肺湿/干系数与12 h相比,差异有统计学意义(P＜0.01).与对照组比较,染毒组6、12、18、24 h红细胞膜SOD活力均明显降低,差异有统计学意义(P＜0.01).染毒组18、24 h血浆中ANP浓度分别为(136.66±35.37)、(134.10±60.41)ng/ml,明显高于对照组[(31.31±13.06)ng/ml]、染毒组6、12 h[分别为(34.71±13.42)、(47.98±7.86)ng/ml],差异均有统计学意义(P＜0.01).结论 高浓度NO2以动式染毒柜染毒SD大鼠复制急性肺水肿模型是可行的.

Abstract：

Objective To establish the rats model of acute pulmonary edema induced by inhalation of high concentrations of nitrogen dioxide (NO2). Methods 38 SD rats were divided into the experimental group ( n=30 ) and the control group ( n=8 ). 30 rats in the experimental group were exposed to (6747.47±2 5.24) mg/m3 NO2 in the exposure system. At the time point of 6, 12, 18, 24 h, chest X-ray examination was taken for the experimental group And at each time point, 6 rats were sacrificed after taking blood samples. After sacrificing,the lung of rats was taken for pathological examination and calculated lung wet/dry weight ratio. Erythrocyte superoxide dismutase (SOD) activity and plasma atrial natriuretic peptide (ANP) concentration of blood samples were detected. Results Acute pulmonary edema was successfully induced by exposure to NO2 in 30 rats within 24 hours. There were some cloudy shadows without clear edge on the chest X-ray. To the time point of 12 hours, shadows combined with each other, and to the time point of 18 hours, the whole lung became "white"on the X-ray. The situation stabilized but not improved at the time point of 24 hours. HE staining of the lung tissue showed that to the time point of 6 hours, the alveolar gap increased and small amount of eosinophilic liquid leaked into alveolar. To the time point of 12 hours, alveolar combined with each other and eosinophilic liquid increased in amount. To the time point of 18 hours, the whole alveolar was filled with eosinophilic liquid and the situation stabilized till the time point of 24 hours. Wet/dry weight ratio of the experimental group at each time point were 5.6±0.20、6.89±0.25、8.03±-0.47、7.81 ± 0.45. There was significant difference compared with the control group which was 4.72 ± 0.06 (P＜0.01). There was statistical difference between 12,18,24 h and 6 h time points (P＜0.01). Moreover, statistical difference was observed between 18,24 h and 12 h time points for wet/dry weight ratio (P＜0.01). The erythrocvte SOD activity reduced significantly. Compared with the control group, there was a statistical difference (P＜0.01) at each time point. After exposure of 18 and 24hours, plasma A NP concentration ( 136.66± 35.37) and ( 134.10±60.41 ) ng/ml respectively, which were higher than (31.31 ± 13.06 ) ng/ml of control group and ( 34.71 ± 13.42 ) ng/ml of 6 hours time point and (47.98 ± 7.86 )ng/ml. The differences were significant (P＜0.01),Conclusion High concentrations of NO2 can induce acute pulmonary edema model successfully in SD rats.     

舍曲林治疗儿童情绪障碍的临床观察

目的 了解舍曲林在儿童情绪障碍治疗中的有效性、安全性、起效时间及有效剂量.方法 对147例应用舍曲林治疗的儿童情绪障碍患儿进行回顾性分析,项目包括有效率、舍曲林用量、起效时间及不良反应.结果 137例患儿遵医嘱定期复诊.治疗后2个月,有效率为80.3%(110/137),不良反应发生率为5.8%(8/137).舍曲林有效剂量为(47.9±19.0)mg/d,起效时间为(20.4±13.2)d;儿童强迫症舍曲林有效剂量[(58.7±26.2)mg/d)]显著高于抑郁障碍[(43.6±14.0)mg/d]、广泛性焦虑障碍[(44.4±10.6)mg/d]及恐怖性焦虑障碍[(43.5±15.5)mg/d](P值均<0.01);抑郁障碍起效时间[(14.0±6.1)d]较儿童强迫症[(26.6±16.3)d]、广泛性焦虑障碍[(22.3±13.9)d]和恐怖性焦虑障碍[(21.4±12.8)d]短(P值均<0.01).结论 舍曲林是治疗儿童情绪障碍的有效药物,起效时间在2～3周,不良反应轻,多数患儿能耐受.对抑郁障碍起效较快,对儿童强迫症有效剂量较大.

Abstract：

Objective To explore the efficacy, safety,time of drug taking effect and therapeutic dosage of sertraline in treatment of child emotional disorder. Method One hundred and forty-seven patientswith child emotional disorder were treated by sertraline and the efficacy rate, therapeutic dosage, the time of drug taking effect and adverse reaction was analyzed retrospectively. Results One hundred and thirty-seven patients were regular visited under supervision of a physician. Two months after treatment, the efficacy rate was 80.3%(110/137) and the rate of adverse reaction was 5.8%(8/137). The therapeutic dosage of sertraline was (47.9 + 19.0) mg/d. The time of drug taking effect was (20.4±13.2) d. The therapeutic dosage of sertraline in obsessive-compulsive disorder [(58.7±26.2) mg/d] was significantly higher than that in depression[(43.6±14.0) mg/d],anxiety disorder[(44.4±10.6) mg/d] and phobia[(43.5±15.5) mg/d](P < 0.01 ). The time of drug taking effect in depression[( 14.0±6.1 ) d] was significantly shorter than that in obsessive-compulsive disorder[(26.6±16.3) d,anxiety disorder [(22.3±13.9) d] and phobia [(21.4±12.8) d] (P <0.01). Conclusions Sertraline is an efficient and safe medicine in treatment of child emotional disorder. Its adverse reaction is slight and most patients can tolerate. But it takes higher therapeutic dosage in obsessive-compulsive disorder and the time of drug taking effect is earlier in depression than in other disorder.     

双柱定性气相色谱电子捕获检测器测定上海市饮用水中微量碘化物

Objective To modify and optimize gas chromatographic conditions, qualitative and quantitative method on the base of the actual national standard detection method for drinking water on testing iodide with gas chromatography, and detect iodide in drinking water of Shanghai.Methods Iodobutanone derivative was identified by gas chromatography/mass spectrometry, then two capillary columns coupled to electron capture detector were made by qualitative and quantitative analysis.Finally, 100 ml water samples were collected respectively from raw water and finished water of three plants in which water sources were Yangtse river, Huangpu river, and inner river respectively and detected by this developed method.Results The results of mass spectrometry showed that iodide would form iodobutanone which could generate 1-iodo-2-butanone and 3-iodo-2-butanone isomers by derivatization.The data of qualitative analysis by two capillary columns revealed that iodobutanone was separated completely and the total time of chromatogram separation was 19.33 min.3-iodo-2-butanone with the high response value was selected to quantitatively analyse.The linear range was 1 - 100 μg/L,and the coefficient of determination (r2) was 0.9997.The limit of detection was 13 ng/L.Recoveries were between 97.68% and 104.37% ,and relative standard deviations were between 2.14% and 4.41%.The results of iodide detected by this method in raw water and finished water in three plants in Shanghai showed that the ranking of iodide's concentration in raw water was Huangpu river (15.14 μg/L) ＞ inner river (6.97 μg/L) ＞ Yangtse river (3.55 μg/L).The level of iodide in finished water of plant 1 (3.55 μg/L and 5.92 μg/L for raw and finished water respectively) and 3 ( 6.97 μg/L and 9.62 μg/L for raw and finished water respectively) increased slightly except for plant 2( 15.14 μg/L and 1.81 μg/L for raw and finished water respectively).The relative standard deviations of all water samples measured in duplicate were less than 9.73%.Conclusion The improved method possesses higher degree of sensitivity and accuracy of qualitative and quantitative analysis than actual national standard detection method, and it is fit for trace analysis of iodide in water.     

双柱定性气相色谱电子捕获检测器测定上海市饮用水中微量碘化物

Objective To modify and optimize gas chromatographic conditions, qualitative and quantitative method on the base of the actual national standard detection method for drinking water on testing iodide with gas chromatography, and detect iodide in drinking water of Shanghai.Methods Iodobutanone derivative was identified by gas chromatography/mass spectrometry, then two capillary columns coupled to electron capture detector were made by qualitative and quantitative analysis.Finally, 100 ml water samples were collected respectively from raw water and finished water of three plants in which water sources were Yangtse river, Huangpu river, and inner river respectively and detected by this developed method.Results The results of mass spectrometry showed that iodide would form iodobutanone which could generate 1-iodo-2-butanone and 3-iodo-2-butanone isomers by derivatization.The data of qualitative analysis by two capillary columns revealed that iodobutanone was separated completely and the total time of chromatogram separation was 19.33 min.3-iodo-2-butanone with the high response value was selected to quantitatively analyse.The linear range was 1 - 100 μg/L,and the coefficient of determination (r2) was 0.9997.The limit of detection was 13 ng/L.Recoveries were between 97.68% and 104.37% ,and relative standard deviations were between 2.14% and 4.41%.The results of iodide detected by this method in raw water and finished water in three plants in Shanghai showed that the ranking of iodide's concentration in raw water was Huangpu river (15.14 μg/L) ＞ inner river (6.97 μg/L) ＞ Yangtse river (3.55 μg/L).The level of iodide in finished water of plant 1 (3.55 μg/L and 5.92 μg/L for raw and finished water respectively) and 3 ( 6.97 μg/L and 9.62 μg/L for raw and finished water respectively) increased slightly except for plant 2( 15.14 μg/L and 1.81 μg/L for raw and finished water respectively).The relative standard deviations of all water samples measured in duplicate were less than 9.73%.Conclusion The improved method possesses higher degree of sensitivity and accuracy of qualitative and quantitative analysis than actual national standard detection method, and it is fit for trace analysis of iodide in water.     

地塞米松预处理对大鼠光气吸入性肺损伤基质金属蛋白酶-9表达的影响

Objective To investigate the effects of dexamethasone on expression of matrix metalloproteinase-9 (MMP-9) in rats with acute lung injury induced by phosgene. Methods The rats were randomly divided into 3 groups: normal control group that consists of the rats with air exposure, phosgene group that consists of the rats with phosgene exposure and dexamethasone group that consists of the rats with phosgene exposure after 2.5 mg/kg dexamethasone being injected. Wet and dry ratio of the lung (W/D) was calculated, and leukocyte count and total protein content of bronchoalveolar lavage fluid (BALF) were recorded at 2 h after exposure. The concentrations of MMP-9 in the serum and BALF were measured by enzyme-linked immunosorbent assay. The pathologic changes of lung tissues were observed under light microscopy. The immunohistochemistry and the RT-PCR were used to detect the contents of MMP-9 in the lung tissue. Results Compared with phosgene group, the lung W/D, protein content and WBC count in of BALF dexamethasone group was significantly decreased (P＜0.01). MMP-9 levels of the serum and BALF in dexamethasone group were (4.799±0.043) μg/L and (15.052±0.029) μg/L, respectively, which were significantly lower than those [(9.439±0.100) and (20.640±0.446) μg/L] in phosgene group (P＜0.01). Compared with phosgene group (2.789±0.282), the expression level(1.183±0.260) of lung M MP-9 mRNA in dexamethasone group was significantly lower than that in phosgene group (P＜0.01).Histological experimental results showed the marked hyperemia and thickening of alveolar wallsand stroma cells infiltrating and more visible alveolar structure damage of alveolar walls in phosgene group while the alveolar structure and the alveolar walls were clear and slightly thickened with inflammatory cells in dexamethasone group. Immunohistochemical results showed that MMP-9 protein expression levels of lung and brochus tissues in normal control group and dexamethasone group were weakly positive, which in phosgene group were strongly positive. Conclusion Dexamethasone has a beneficial effects on acute lung injury induced by phosgene in rats due to the inhibiting MMP-9.     

肿瘤坏死因子-α、白细胞介素-6、血小板活化因子与重症颅脑损伤凝血功能障碍的相关性探讨

目的 探讨肿瘤坏死因子（TNF）-α、白细胞介素（IL）-6和血小板活化因子（PAF）与重症颅脑损伤后凝血功能障碍的相关性和作用机制.方法 选择2009年1月至2012年6月创伤指数≥17分、格拉斯哥昏迷量表评分≤10分、除外合并其他部位损伤及在急诊科死亡的重症颅脑损伤患者65例（观察组）,在救治的同时检测血小板计数（PLT）、活化部分凝血活酶时间（APPT）、凝血酶原时间（PT）、D-二聚体（D-D）及TNF-α、IL-6、PAF,选取同期健康体检者43例作为对照组,比较两组上述指标的差异.结果 与对照组比较,观察组PLT减少,APTT及PT明显延长,D-D明显升高,差异均有统计学意义[（74.91±30.70）×109/L比（191.52±23.31）×109/L、（69.44±15.52）s比（22.47±9.41）s、（30.37±8.22）s比（9.57±4.53）s、（1 934.92±708.49） U/L比（105.78±44.53） U/L] （P＜0.01）.与对照组比较,观察组TNF-α、IL-6和PAF升高[（39.93±18.88） μg/L比（1.28±0.59）μg/L、（417.61±73.66） μg/L比（63.93±41.49） μg/L、（16 359.91±4 321.92） ng/L比（3 823.45±529.72） ng/L],差异均有统计学意义（P＜0.01）.观察组PLT与TNF-α、IL-6和PAF呈负相关（r=-0.929 2,-0.944 5,-0.932 4,P＜0.01）,APTT与TNF-α、IL-6和PAF呈正相关（r=0.910 2,0.932 7,0.9786,P＜ 0.01）,PT与TNF-α、IL-6和PAF呈正相关（r=0.934 1,0.9554,0.9786,P＜0.01）,D-D与TNF-α、IL-6和PAF呈正相关（r=0.9421、0.9438、0.9418,P＜0.01）.结论 TNF-α、IL-6、PAF参与了重症颅脑损伤后凝血功能障碍的发生、发展.急诊救治重症颅脑损伤患者时应对TNF-α、IL-6、PAF进行早期干预,减轻应激反应、炎性反应,或许可能改善重症颅脑损伤患者的凝血功能,防止或减轻凝血功能障碍,降低重症颅脑损伤患者的病死率.     

妊娠期高血压疾病凝血指标变化

目的 探讨妊娠期高血压疾病患者凝血指标变化的意义.方法 收集66例妊娠期高血压疾病患者(妊娠期高血压组)及70例正常妊娠晚期孕妇(对照组),行血小板计数(PC)、平均血小板体积(MPV)、凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)检测.结果妊娠期高血压组与对照组比较,PC[(178.32±51.08) × 10~9/L比(186.17±40.02)× 10~9/L]、PT[(10.54±0.54)s比(11.07±0.49)s]、APTT[(26.23±3.12)s比(28.08±4.31)s]显著下降(P<0.05或<0.01);FIB[(5.34±0.68)g/L比(4.02±0.73)g/L]、MPV[(11.10±2.31)fl比(8.95±1.37)fl]、D-D[(0.46±0.27)mg/L比(0.18±0.19)mg/L]显著增加(P<0.01).重度子痫前期患者与轻度子痫前期患者比较,FIB、D-D显著增加(P<0.01).早发型子痫前期患者与晚发型子痫前期患者比较,PT明显缩短(P<0.05),FIB、D-D明显增加(P<0.05或<0.01).结论 妊娠期高血压疾病呈明显高凝状态;早发型子痫前期患者较晚发型子痫前期患者高凝状态和凝血功能障碍更严重.     

大剂量肝素吸入治疗重症毛细支气管炎

目的了解大剂量肝素雾化吸入治疗重症毛细支气管炎的效果及安全性。方法将76例重症毛细支气管炎患儿随机分对照组(n=38)与治疗组(n=38)。在常规治疗的基础上,对照组加用肝素每次100u/kg,溶于4ml生理盐水中,以压缩空气式雾化器雾化吸入,每天2次,连续4d;治疗组肝素用量为每次5000u,用法及疗程同对照组。在第一次雾化结束后30min及治疗后24h,对治疗组检测PT、APTT及血小板数量。结果第一次雾化治疗后30min,对照组呼吸频率减少(8.7±4.4)次/分,心率减少(16.1±5.4)次/分;而治疗组的为(16.1±4.6)次/分及(22.3±4.5)次/分;两组的有显著性差异(t=7.16及5.4,p<0.01)。两组的哮鸣音消失时间分别为(6.07±0.98)d和(5.54±1.07)d,有显著性差异(t=2.25,p<0.05)。两组的总有效率分别为71.1%和92.1%,也有显著性差异(2=5.6,p<0.05)。PT、APTT、血小板计数均正常。结论大剂量肝素雾化吸入治疗重症毛细支气管炎疗效显著、安全,值得基层推广使用。     

速碧林治疗急性脑梗塞疗效分析

目的　评价速碧林治疗急性脑梗塞的临床效果及安全性。方法　选取 4 8h内脑梗塞患者 85例 ,均给予常规治疗。治疗组 4 5例 ,加用速碧林 0 4ml腹壁下注射 ,q12h× 10天 ,并检查治疗前后的血小板、出凝血时间、凝血酶原时间。治疗前后评估其肌力恢复情况。结果　治疗组疗效明显优于对照组 (P <0 0 5 ) ,治疗组治疗前后血小板、出凝血时间、凝血酶原时间无明显差别。结论　速碧林治疗急性脑梗塞安全有效。     

浓缩鱼油对兔血小板聚集和凝血时间及组织脂肪酸含量的影响

本文观察兔给予浓缩鱼油后血小板聚集和凝血时间及组织脂肪酸含量的变化。27头雄性青紫兰兔分为三组(橄榄油对照组、鱼油Ⅰ组和鱼油Ⅱ组)。鱼油Ⅰ组以灌胃法给予浓缩鱼油2ml/天/头,鱼油Ⅱ组以同法给予4ml/天/头,对照组给予橄榄油4ml/天/头,实验期均为10周。结果表明,与对照组相比,鱼油Ⅰ、Ⅱ组的血小板聚集率明显降低(P<0.001),凝血时间显著延长(P<0.001)。鱼油组动物的血浆、血小板、心肌及主动脉均含廿碳五烯酸(EPA)和廿二碳六烯酸(DHA),这些组织的(ω-3/ω-6族脂肪酸的比值明显高于对照组,脂肪酸分布的模式与实验动物的血小板聚集率及凝血时间的变化吻合。     

羟乙基淀粉130/0.4急性高容量血液稀释对脊柱手术患者凝血功能的影响

目的 采用羟乙基淀粉130/0.4行急性高容量血液稀释(AHH),观察其对脊柱手术患者凝血功能的影响.方法 将30例择期脊柱手术患者按随机数字表法分为AHH组和对照组,每组各15例.AHH组静脉滴注羟乙基淀粉130/0.4 15 ml/kg,速度25 ml/min,切皮前完成,实现扩容20%～300%;对照组采用常规输液;分别于麻醉诱导前(T0)和麻醉诱导后1h(T1)、术毕(T2)采颈内静脉血4ml,检测血红蛋白(Hb)、红细胞压积(Hct)、血小板计数(P1t)、凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB);观察并记录上述三个时间点的心率、平均动脉压(MAP)和中心静脉压(CVP).结果 两组心率、MAP组内及组间比较差异均无统计学意义(P>0.05);AHH组CVP在T1和T2[(11.8±1.1)、(11.3±1.0)cm H2O(1 cm H2O=0.098 kPa)]均较T0[(6.3±0.7)cmH2O]升高(P<0.05),且高于对照组(P<0.05);AHH组Hb、Hct在T1和T2均较T0降低(P<0.05),且低于对照组(P<0.05);AHH组Plt和FIB在T1和T2均较T0减少或降低(P<0.05),与对照组比较差异无统计学意义(P>0.05);两组PT、TT和APTT组内及组间比较差异均无统计学意义(P>0.05).结论 以羟乙基淀粉130/0.4行AHH,对脊柱手术患者凝血功能无明显影响.     

血栓弹力图在妊娠合并血小板减少症的临床应用研究

目的：评价血栓弹力图（thrombelastography,TEG）在妊娠合并血小板减少症孕妇凝血功能监测中的应用价值。方法：收集66例妊娠合并血小板减少症孕妇（其中血小板（platelets,PLT）计数（50-99）×109/L孕妇50例,〈50×109/L孕妇16例）（实验组）和同期112例健康孕妇（对照组）,分别进行TEG、凝血酶原时间（prothrombin time,PT）、活化部分凝血活酶时间（activated partial thromboplastin time,APTT）、凝血酶时间（thrombin time,TT）及纤维蛋白原（fibrinogen,Fg）检测,并分析其与PLT值的相关性。结果：与正常对照组相比,实验组反应时间（R值）、凝血时间（K值）、PT值及APTT值均升高,而α角、最大振幅（MA值）与凝血综合指数（CI值）均降低（P〈0.05）;与PLT（50-99）×109/L亚组相比,PLT〈50×109/L亚组K值升高,MA值及CI值均降低（P〈0.05）;K值、MA值及CI值均与PLT值显著相关（相关系数r分别为-0.43、0.51、0.40,P均〈0.05）,其他检测指标与PLT值均无相关性（P〉0.05）。结论：TEG可作为监测妊娠合并血小板减少症孕妇凝血功能状态的有用指标。     

抑肽酶对肝移植患者围手术期血液保护的临床研究

目的 研究抑肽酶对肝移植患者围手术期期血液保护的效应.方法 将40例行原位背驮式肝移植术患者随机分为两组:对照组(C组)20例,抑肽酶组(A组)20例.A组首量1 ×106kU,持续量0.25×106kU/h持续静脉泵注抑肽酶,直至术毕,C组泵注等量0.9%氯化钠溶液.于术前(T1)、无肝期前5min(T2)、新肝期5 min(T3)、新肝期30 min(T4)和新肝期120 min(T5)采集颈内静脉血检测凝血功能,包括凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(TIB)、血栓弹力扫描仪(TEG)的反应时间(R)等.记录两组术中总出血量和血浆、血小板、液体输入量,并记录两组回收血洗涤量和红细胞悬液洗涤量.结果 A组患者术中总出血量、回收血洗涤量、红细胞悬液洗涤量及血浆、白蛋白、胶体输入量[(3708±1910)、(1321±488)、(2121±785)、(2568±904)、(200±63)、(3830±897)ml]明显低于C组[(5676±2241)、(2034±734)、(2697±978)、(3725±1374)、(259±83)、(5065±1505)ml](P<0.01或<0.05).两组T1各凝血功能指标比较,差异均无统计学意义;T2～T5A组的PT、APRR、TT和R均较C组同一时间点缩短(P<0.05或P<0.01).结论 在肝移植术中应用抑肽酶能够有效地改善围手术期期凝血功能,减少术中出血量,减少异体血及血浆代用品的输注量,具有很好的血液保护效应.     

妊娠晚期血小板参数及凝血指标异常结果分析

目的:总结分析妊娠晚期导致孕妇血小板及凝血检测结果异常的原因、发生频率以及检测方法上要注意的问题。方法:以2008年9月～2009年8月间的住院孕妇作为研究对象,按妊娠并发症分类,以正常晚期妊娠妇女作为对照,分析血小板参数、凝血常规四项(PT、APTT、TT、FIB)。结果:①妊娠高血压综合征(PIH)组和妊娠糖尿病(GDM)组的血小板平均体积(MPV)值高于对照组;②妊高征组血小板降低、MPV升高、凝血指标未见明显异常。③妊娠糖尿病组的PT、APTT、FIB与对照组比较有显著性差异。④妊娠晚期孕妇发生血小板减少的原因以妊娠生理性原因和重度妊高征为主(58.4%和20.7%),其他原因还包括:双胎妊娠、母儿血型不合、EDTA依赖性假性PLT减少。结论:多种妊娠相关性疾病可引起妊娠晚期孕妇的血小板减少,血小板参数异常,同时需要注意鉴别EDTA依赖性假性PLT减少,避免误诊。