阿奇霉素通过抑制Th17细胞功能活性改善小鼠哮喘炎症

目的 研究阿奇霉素对Th17应答增强致气道以中性粒细胞浸润为主的小鼠哮喘炎症的作用.方法 采用卵蛋白(OVA)+内毒素(LPS)联合致敏,OVA激发的方法建立Th17应答增强致气道中性粒细胞浸润为主的哮喘小鼠模型,48只BALB/c雌性小鼠随机分为对照组、哮喘组、阿奇霉素组、地塞米松组(n=12).采用HE染色观察肺组织病理改变;小鼠肺功能仪检测气道高反应性(airway hyperreactivity,AHR);肺泡灌洗液(bronchoalveolar lavage fluid,BALF)行细胞分类计数;ELISA检测外周血OVA特异性IgE及BALF中IL-17、TNF-α、IL-8、IL-5和IFN-γ浓度;Q-PCR检测肺组织Th1、Th2和Th17细胞分化.结果 用OVA联合LPS的方法可以复制既有Th2活化和肺内嗜酸性细胞增多,又有Th17表达增强和明显中性粒细胞炎症的哮喘小鼠模型.与哮喘组比较,阿奇霉素组气道炎症细胞浸润明显改善,特别是中性粒细胞比例显著降低(P＜0.05).同时还有BALF中IL-17、TNF-α、IL-8、IL-5水平显著降低(P＜0.05);肺组织Th17细胞分化减少(P＜0.05)以及AHR改善(P＜0.05).而地塞米松组与哮喘组比较,虽然BALF嗜酸性细胞比例显著降低,但BALF中细胞总数、IL-17、TNF-α、IL-8水平及肺组织Th17细胞分化均无明显差别(P＞0.05).结论 阿奇霉素可抑制Th17细胞分化、减少炎症介质分泌从而抑制炎症细胞浸润,由此减弱Th17应答增强致气道中性粒细胞增高的小鼠哮喘炎症.     

辅助性T细胞17及IL-17在支气管哮喘小鼠中的变化

目的:探讨辅助性T细胞17(Th17)及IL-17在支气管哮喘小鼠中的变化及意义.方法:将24只BABL/c小鼠随机分为哮喘组(12只)和正常对照组(12只).用卵清白蛋白(OVA)致敏和激发建立小鼠哮喘模型;行苏木精书红(HE)染色,观察肺组织炎症改变;流式细胞术检测脾脏单个核细胞中Th17细胞比例;酶联免疫吸附法(ELISA)检测支气管肺泡灌洗液(BALF)中卟17细胞相关细胞因子I[-17水平;并计数BALF中细胞总数、嗜酸粒细胞及中性粒细胞数.结果:哮喘组肺组织及气道周围的炎症改变较正常对照组显著增强.哮喘组脾脏中Th17细胞及BALF中IL-17水平均显著高于正常对照组(P均<0.01).哮喘组BALF中细胞总数及嗜酸粒细胞计数显著高于正常对照组(P均<0.01),结论:哮喘小鼠存在Th17细胞数量增多及其分泌的IL-17水平增高,IL-17可能通过促进嗜酸粒细胞在气道的聚集而参与炎症反应,Th17细胞可能在哮喘的发病中具有重要作用.     

屋尘螨诱导气道上皮TLR4表达和影响T淋巴细胞分化在哮喘气道炎症中的作用

目的研究屋尘螨（HDM）对于气道上皮Toll样受体4（TLR4）表达及T淋巴细胞分化的影响,以进一步探讨其在哮喘小鼠气道炎症中作用。方法雌性BALB/c小鼠30只随机分为OVA哮喘模型组（OVA组）、HDM组和生理盐水对照组（对照组）。OVA组用卵白蛋白（OVA）致敏与激发建立小鼠哮喘模型,HDM组给予HDM提取液替代OVA致敏与激发,对照组用生理盐水替代OVA。观察小鼠气道及肺组织病理炎症浸润情况,支气管肺泡灌洗液（BALF）中细胞总数及细胞分类计数。ELISA检测小鼠BALF上清中IL-4、IL-5、IL-13、IFN-γ和IL-17的含量。实时荧光定量PCR法测定气道上皮TLR4 mRNA的表达,免疫印迹法测定气道上皮TLR4蛋白的表达。流式细胞技术检测小鼠外周血Th1、Th2及Th17淋巴细胞占CD4＋T淋巴细胞百分率情况。结果 OVA组支气管黏膜下水肿,黏液腺增生,以嗜酸粒细胞为主的炎症细胞浸润;HDM组出现肺泡腔及间质充血,中性粒细胞等炎症细胞浸润;对照组小鼠气道上皮无增厚,无炎症细胞浸润,肺泡壁完整。与OVA组比较,HDM组BALF细胞总数及分类计数除嗜酸粒细胞无显著差异外（P〉0.05）,其余均显著升高（P〈0.05）;HDM组BALF上清中IL-4、IL-5、IL-13及IL-17水平较OVA组明显增高（P〈0.05）,IFN-γ的表达无显著差异（P〉0.05）;HDM组气道上皮TLR4 mRNA及TLR4蛋白的表达明显增高（P〈0.05）,OVA组与对照组差异无统计学意义（P〉0.05）。与OVA组比较,HDM组外周血Th2、Th17细胞显著增高（P〈0.05）,而Th1细胞无明显变化（P〉0.05）。结论 HDM诱导气道上皮TLR4表达增高,使Th2与Th17淋巴细胞活化,气道内炎症细胞浸润,可能在哮喘气道炎症中起重要作用。     

肺炎链球菌3型多糖对支气管哮喘小鼠气道炎症及Treg/Th17细胞的影响

目的观察肺炎链球菌3型多糖(T3P)对支气管哮喘小鼠气道炎症以及Treg/Th17细胞的影响,探讨T3P对哮喘小鼠的免疫调节作用。方法 BALB/c小鼠随机分成对照组、哮喘组和T3P组,每组8只。哮喘组以卵清蛋白(OVA)致敏、气道激发建立哮喘模型,对照组以PBS代替,T3P组在OVA致敏前皮下注射T3P进行干预。观察小鼠肺组织病理改变,对支气管肺泡灌洗液(BALF)进行细胞计数及分类,ELISA法检测血清OVA特异性IgE(OVA-IgE)以及BALF中白介素4(IL-4)、干扰素γ(IFN-γ)、IL-10、IL-17浓度,实时荧光定量PCR法检测肺组织中转录因子Foxp3和RORγt mRNA表达水平,流式细胞术检测Treg和Th17细胞占CD4~+细胞百分比。结果 T3P组小鼠肺组织炎症反应程度弱于哮喘组,血清OVA-IgE,BALF中细胞总数、嗜酸粒细胞比例以及IL-4、IL-17浓度均低于哮喘组(P<0.05),IFN-γ、IL-10浓度高于哮喘组(P<0.05),小鼠肺组织Foxp3 mRNA表达水平及Treg占CD4~+细胞百分比均高于哮喘组(P<0.05),RORγt mRNA表达水平和Th17细胞占CD4~+细胞百分比均低于哮喘组(P<0.05)。哮喘组和T3P组小鼠肺组织Foxp3-mRNA/RORγt-mRNA比值及Treg/Th17细胞比例与BALF中嗜酸粒细胞数量呈负相关。结论 T3P可以通过抑制过敏原特异性IgE表达调节Th1/Th2、Treg/Th17细胞平衡,抑制气道炎症。     

吸入脂多糖对哮喘小鼠气道炎症和气道黏液分泌的影响

目的 观察哮喘小鼠吸入脂多糖 （LPS,作为刺激原）其气道炎症和气道黏液分泌的变化 。 方法 30只清洁级BALB/c小鼠随机分为哮喘组 (AST组)、LPS哮喘组 （LAS组）和正常组 (NS组),每组10只。哮喘组用卵清白蛋白 （OVA）致敏和激发制作哮喘模型,LPS哮喘组在哮喘模型的基础上加用LPS (50 μg/mL)雾化吸入30 min,正常组用生理盐水代替OVA。检测各组小鼠支气管肺泡灌洗液 (BALF)细胞总数和细胞分类计数,采用ELISA检测BALF中的白细胞介素4 (IL-4)和肿瘤坏死因子-α （TNF-α）水平,HE染色观察肺部病理学改变,用阿尔辛蓝-过碘酸雪夫 (AB-PAS)染色气道杯状细胞,免疫组织化学法检测肺组织中黏蛋白5ac (Muc5ac)的表达,荧光定量RT-PCR检测Muc5ac mRNA在肺内的表达。并分析Muc5ac蛋白表达与各指标的相关性。 结果 AST及LAS组小鼠较NS组在BALF中的细胞总数、嗜酸性粒细胞、单核细胞、淋巴细胞百分比,IL-4和TNF-α水平、肺组织AB-PAS阳染面积, Muc5ac蛋白和mRNA表达明显升高,其差异均有统计学意义 (P均<0.05)。LAS组较AST组上述气道炎症（除单核细胞数外）和气道黏液高分泌指标明显增高,差异均有统计学意义 (P<0.05)。气道Muc5ac蛋白表达与BALF中细胞总数、嗜酸性粒细胞数、IL-4、TNF-α水平、气道AB-PAS染色阳性着色面积均呈正相关（P均<0.05）。 结论 OVA致敏和激发的哮喘小鼠出现以嗜酸性粒细胞、淋巴细胞浸润为主的气道炎症及杯状细胞增生的气道黏液高分泌,且气道炎症和气道黏液高分泌关系密切。LPS可使气道炎症和气道黏液高分泌加重,可能与LPS激发了体内炎症介质的生成、活化有关。     

白藜芦醇对中性粒细胞性哮喘小鼠肺组织炎症的抑制作用及其机制

目的：探讨白芦藜醇对中性粒细胞性哮喘小鼠肺组织炎症的抑制作用,并阐明其作用机制。方法：选取18只C57BL/6J雌性小鼠,采用脂多糖（LPS）+卵白蛋白（OVA）联合致敏方法建立中性粒细胞性哮喘小鼠模型,随机分为模型组（LPS+OVA组）、白藜芦醇组（Res组,于激发前2 h灌胃30 mg·kg^-1白藜芦醇）和N-乙酰半胱氨酸组（NAC组,于激发前2 h灌胃3 mmol·kg^-1 N-乙酰半胱氨酸）;同时选取6只同周龄小鼠作为正常对照组（PBS组）。于乙酰甲胆碱雾化期间观察各组小鼠的行为学变化,采用肺功能仪分析小鼠气道高反应（AHR）,光学显微镜观察支气管肺泡灌洗液（BALF）中细胞总数和炎症细胞,HE染色观察各组小鼠肺组织病理形态表现,酶联免疫法（ELISA）检测各组小鼠BALF上清中白细胞介素17（IL-17）水平,特异性荧光探针DCF-DA染色分析肺组织活性氧（ROS）水平,丙二醛（MDA）试剂盒检测肺组织匀浆中MDA水平。结果：与PBS组比较,LPS+OVA组小鼠Penh值、细胞总数、炎症细胞、气道炎症及评分均明显升高（P<0.05或P<0.01）,BALF上清中IL-17水平明显升高（P<0.01）,肺组织内ROS荧光强度明显升高,肺匀浆中MDA水平明显升高（P<0.01）。与LPS+OVA组比较,Res组和NAC组小鼠Penh值、细胞总数、炎症细胞、气道炎症及评分明显降低（P<0.05或P<0.01）,BALF上清中IL-17水平均明显降低（P<0.05）,肺组织内ROS荧光强度降低,肺匀浆中MDA水平明显降低（P<0.01）。结论：白藜芦醇能够有效抑制中性粒细胞性哮喘小鼠肺组织中的炎症反应,其机制可能与白藜芦醇抑制体内发生的氧化应激反应有关。     

呼吸道合胞病毒感染促进哮喘小鼠气道分泌TSLP和Th2炎症反应

目的 探讨呼吸道合胞病毒(RSV)对哮喘小鼠胸腺基质淋巴细胞生成素(TSLP)分泌的影响,以探索RSV对哮喘小鼠Th1/Th2免疫反应的调节作用.方法 雌性BALB/c小鼠32只.随机分成4组,分别为磷酸盐缓冲液(PBS)对照组、鸡卵白蛋白(OVA)组、RSV组、OVA/RSV组;应用OVA腹腔注射致敏、OVA气道雾化结合RSV滴鼻激发哮喘;无创肺功能检测小鼠气道反应性,ELISA法检测小鼠血清IL-4、IFN-γ、IL-5、IL-13水平;ELISA法检测气管灌洗液(BALF)TSLP含量并进行细胞分类计数;小鼠肺组织病理观察炎症反应,免疫组化观察小鼠气管上皮细胞TSLP表达水平.结果 RSV感染促进哮喘小鼠呼吸道分泌TSLP增加,OVA/RSV组小鼠TSLP浓度达(2.13±0.05)ng/ml,高于其他组(P<0.01);同时促进IL-4、IL-5、IL-13等Th2型细胞因子的分泌,并增加IFN-γ分泌;0VA/RSV组BALF细胞总数、嗜酸性粒细胞数、中性粒细胞数、淋巴细胞数与其他各组比较均明显增加;无创肺功能检测显示OVA/RSV组小鼠气道反应性明显增高,乙酰甲胆碱浓度达6.25 mg/ml时,Penh值(318.66±50.87)明显增加,与其他各组比较具有统计学意义(P<0.01);病理观察显示RSV感染明显加重哮喘小鼠气道炎症细胞浸润;免疫组化染色证实RSV/OVA组小鼠气道上皮细胞TSLP表达量较高.结论 RSV感染可以增加小鼠气道上皮细胞表达TSLP,促进Th2细胞因子的表达,加重哮喘小鼠肺部Th2炎症反应.     

呼吸道合胞病毒感染加重哮喘模型小鼠气道炎症及气道阻力的观察

【】 目的 探讨呼吸道合胞病毒(RSV)感染加重哮喘模型小鼠气道炎症及气道阻力变化的影响。方法 6～8周龄雄性BalB/c小鼠30只,每组10只,随机分为空白组、OVA组(哮喘模型组)、OVA/RSV组(RSV+哮喘模型组)3组。OVA组用卵清蛋白(OVA)致敏和激发;OVA/RSV组在OVA 致敏后,隔日用RSV滴鼻,连续3次,复制急性病毒感染哮喘模型;空白组予等量PBS。末次激发24h后,用小鼠动物呼吸机(Buxco RC系统)检测小鼠气道反应性;收集支气管肺泡灌洗液(BALF)进行细胞学分析;留取肺组织,进行HE染色、PAS染色、VG染色,观察肺组织炎症反应。结果 OVA组肺功能和BALF嗜酸粒细胞比例(EOS％)与正常组相比差异有显著性 (P<0.05);OVA/RSV组肺功能和BALF中嗜酸粒细胞比例(EOS％) 与正常组相比有极显著性差异(P<0.01);OVA/RSV组气道反应性及BALF中嗜酸粒细胞比例(EOS％)与哮喘组相比差异有显著性 (P<0.05)。OVA组小鼠肺组织有炎性细胞浸润,气道可见粘液分泌物,气道周围可见胶原增生。OVA/RSV组小鼠肺组织有明显炎性细胞浸润,肺泡腔明显狭窄,毛细血管扩张充血,气道可见明显粘液分泌物,气道周围胶原增生明显。结论 呼吸道合胞病毒感染能明显增加重哮喘模型小鼠肺部组织炎症反应同时气道阻力明显增高。     

布地奈德抑制支气管哮喘小鼠TSLP及Th2优势免疫作用的研究

目的:研究布地奈德抑制哮喘小鼠Th2优势应答的作用及其机制?方法:选择24只6周龄SPF级BALB/c小鼠,随机分为3组:正常对照组?哮喘模型组?布地奈德组,每组8只?卵白蛋白(OVA)致敏和激发制作哮喘模型?小鼠末次雾化吸入激发24 h后,采用小鼠肺功能仪检测气道对乙酰胆碱(Ach)的阻力;苏木精-伊红(HE)染色观察气道炎症浸润情况;支气管肺泡灌洗液(BALF)瑞氏染色计数嗜酸性粒细胞百分比;酶联免疫吸附试验(ELISA)测定血清总IgE?BALF液中白细胞介素4(IL-4)和IL-13;免疫印迹(Western blot)测定肺组织胸腺基质淋巴细胞生成素(TSLP)表达水平?结果:与正常对照组比较,哮喘模型组气道阻力?气道炎症?血清总IgE?BALF中Th2细胞因子(IL-4?IL-13)以及肺组织TSLP蛋白表达明显增高(P < 0.05)?与哮喘模型组比较,布地奈德组各项观测指标均明显降低(P < 0.05)?结论:布地奈德通过降低肺组织TSLP表达?抑制Th2细胞因子水平而降低哮喘气道炎症和气道高反应性,可能是糖皮质激素治疗哮喘的重要机制?     

呼吸道合胞病毒对致敏小鼠气道反应性的影响及机制探讨

目的：探讨呼吸道合胞病毒（RSV）对致敏小鼠气道反应性的影响。方法：Balb／C小鼠30只，随机分成3组，分别为磷酸盐缓冲液（PBS）对照组，鸡卵白蛋白（OVA）组和OVA／RSV组。应用OVA腹腔注射致敏、OVA气道雾化吸人结合RSV滴鼻激发复制哮喘模型，支气管肺泡灌洗液（BALF）作细胞分类计数，酶联免疫吸附试验（ELISA）测定BALF上清中白细胞介素（IL）-4、IL-5、干扰素（IFN）-γ含量，肺组织切片行苏木精-伊红（HE）染色观察病理变化，动物体描箱法测定气道反应性（以肺阻力RL表示）。结果：与OVA组比较．OVA／RSV组BALF中细胞总数、嗜酸性粒细胞、淋巴细胞、中性粒细胞均明显增加（P均〈0．01），BALF上清中IFN-γ、IL-4、IL-5含量均明显升高（P〈0．01）；与OVA组比较，OVA/RSV组支气管黏膜增厚．管腔收缩、狭窄，上皮破坏，支气管周围炎症细胞浸润加重．气道反应性亦明显升高（P〈0．01）。结论：OVA致敏小鼠RSV感染后可导致气道反应性明显增加．并和OVA致敏哮喘气道反应性增高具有不同的病理生理特征。     

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…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

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.     

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.     

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.