不同复苏液体对"二次打击"致多器官功能障碍综合征的影响

目的:探讨不同复苏液体对"失血性休克 内毒素"二次打击致大鼠多器官功能障碍综合征(MODS)的影响。方法:SD大鼠90只,随机分为正常对照组、乳酸林格液复苏组和高渗盐水复苏组3组,每组各30只。先采用通过颈动脉插管放血的方法复制大鼠失血性休克的动物模型,维持平均动脉压(MAP)在35~40mmHg1h后进行液体复苏,乳酸林格液复苏组用乳酸林格液复苏,高渗盐水复苏组用7.5%高渗盐水复苏。复苏成功后30min腹腔注入内毒素复制大鼠MODS模型,分别在注射内毒素后24h和36h取血和收集相关标本,观察各组大鼠主要器官功能指标、MODS发生率以及死亡率的变化。结果:乳酸林格液复苏组、高渗盐水复苏组2组氧分压(PaO2)、谷丙转氨酶(ALT)、尿素氮(BUN)和肌酸激酶(CK)等主要器官功能指标在24h和36h均高于正常对照组,差异有统计学意义(P<0.01)。同时高渗盐水复苏组PaO2、ALT、BUN和CK在24h和36h(除PaO2)高于乳酸林格液复苏组,差异有统计学意义(P<0.01)。MODS发生率高渗盐水复苏组为20.8%,较乳酸林格液组(41.7%)明显降低(P<0.05)。高渗盐水复苏组大鼠48h内死亡率为14.2%,较乳酸林格液复苏组(28.6%)明显降低(P<0.05)。48~72h高渗盐水复苏组大鼠死亡率为21.4%,明显低于乳酸林格液复苏组(35.7%),差异有统计学意义(P<0.05)。结论:7.5%高渗盐水复苏失血性休克可明显减轻失血性休克复苏后大鼠再次予以内毒素打击时所引起的重要脏器功能损害,并且可明显降低MODS的发生率和死亡率。     

严重创伤多器官功能不全综合征大鼠模型建立

目的 建立一种接近人类特征的严重创伤多器官功能不全综合征（MODS）动物模型。方法 60只SD大鼠随机分为创伤MODS模型组及正常对照组，雌雄各半，每组30只。创伤MODS模型组大鼠30％体表面积Ⅲ度烫伤Oh后，腹腔注射大剂量内毒素（LPS）。正常对照组除不进行烫伤和腹腔注射内毒素外，其他处理方式与创伤MODS模型组相同。观察创伤MODS模型组及正常对照组伤后各时相点死亡例数和7d内死亡率、以及伤后各时相点MODS相关指标[血丙氨酸氨基转移酶（ALT），肌酸激酶（CK），尿素氮（BUN），空腹血糖（FGLU）等]和促炎症细胞因子（血TNFα，NO和IL-6）水平动态变化。结果 创伤MODS模型组大鼠死亡主要发生在烫伤1d后，7d内死亡率为53．33％，烫伤1d后死亡占总死亡例数的87．5％，正常对照组无死亡。创伤MODS模型组伤后各时相点血ALT，CK，BUN，FGLU等MODS相关指标以及血TNFα，NO和IL-6水平均明显高于正常对照组（P〈0．0001）。结论 严重创伤后腹腔注射大剂量内毒素，可成功复制创伤MODS动物模型。     

δ阿片受体激动剂DADLE对脓毒症大鼠血清HMGB1表达的影响及其作用的研究

目的观察δ阿片受体激动剂DADLE对脓毒症大鼠血清HMGB1水平及器官功能的影响。方法 96只SD大鼠分为假手术组(SO)、脓毒症组(SEP)、DADLE组[制模后腹腔内注射DADLE(5 mg/kg)],各32只。盲肠结扎穿孔(CLP)建立脓毒症模型,制模后6、12、18、24 h各取8只处死取材。ELISA法检测血清HMGB1水平及24 h ALT、AST、BUN、Cr、CK及PaO2的变化。结果 HMGB1水平在SEP组、DADLE组12 h 18 h及24 h均较SO组高(P<0.05),DADLE组则显著低于SEP组(P<0.05)。24 h时DADLE组血ALT、AST、BUN、Cr、CK均较SEP组明显改善,PaO2明显升高(P<0.05),且各指标变化与HMGB1有显著相关性(P<0.05)。结论 DADLE抑制HMGB1释放,对脓毒症大鼠重要脏器功能有保护作用。     

N-乙酰半胱氨酸对多器官功能障碍综合征大鼠器官的保护作用及其机制

目的 通过观察N-乙酰半胱氨酸(NAC)对多器官功能障碍综合征(MODS)大鼠的器官功能、核因子(NF)-kB、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6的影响,探讨NAC对MODS的器官保护作用及其机制.方法 将35只Sprague-Dawley大鼠分为假手术对照(Sham)组(5只)、MODS组(15只)、MODS+NAC组(15只).用肠缺血/再灌注结合酵母多糖腹腔注射制作成MODS大鼠动物模型,动脉夹夹闭肠系膜上动脉45 min,然后松夹恢复灌注,在恢复灌注12 h后,腹腔注射酵母多糖与0.9%氯化钠溶液混悬液(250 mg/kg).MODS+NAC组在恢复再灌注时,注射NAC 150 mg/kg.于注射酵母多糖18 h后,测定大鼠的动脉血氧分压(PaO_2)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)、尿素氮(BUN)、肌酐(Cr)、肌酸激酶(CK),取肝、肾组织,应用凝胶迁移率法检测NF-kB的活性,酶联免疫吸附试验检测大鼠的血清TNF-α、IL-6含量,留肺、肝脏、肾、小肠标本行病理组织学检查.结果 MODS组大鼠的PaO_2较Sham组大鼠显著降低(P<0.01),而MODS+NAC组大鼠的PaO_2较MODS组大鼠显著升高(P<0.01).MODS组大鼠的ALT、AST、TBIL、BUN、Cr、CK均较Sham组显著升高(P值均<0.01),而MODS+NAC组大鼠上述指标较MODS组大鼠显著降低(P值均<0.01).MODS组大鼠的血清TNF-α、IL-6含量较Sham组显著升高(P值均<0.01),而MODS+NAC组则较MODS组大鼠显著降低(P值均<0.01).MODS组大鼠的肝脏、肾脏NF-kB活性均较Sham组显著升高(P值均<0.01),而MODS+NAC组则较MODS组显著降低(P值均<0.01).Sham组大鼠肺、肝脏、肾脏及小肠的病理表现基本正常,MODS组大鼠各器官存在明显的病理损伤,而MODS+NAC组的病理损伤程度较MODS组有所好转.结论 应用NAC可以对MODS大鼠起到器官保护作用,其机制可能与抑制NF-kB活性从而减少炎性因子合成有关.     

心导管留置术对大鼠脏器功能影响的实验研究

目的观察心导管留置术对大鼠血培养和脏器形态、功能的影响,为临床前药理研究制备稳定可靠的动物模型.方法采用改良的心导管留置术建立大鼠模型,每24小时定时采血作血培养并检测血白细胞(WBC)和丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、尿素氮(BUN)、肌酐(Cr)、肌酸磷酸激酶(CK)等生化指标和血浆内毒素(LPS)水平,术后7 d取心、肝、肾作病理形态学观察.结果术后大鼠血培养均未检出细菌,血中WBC、ALT、AST、BUN、＆及LPS基本在正常范围内,CK值变化较大但术后第7天恢复正常.心、肝、肾无病理学改变.结论此心导管留置术对大鼠感染和脏器功能影响小,动物模型稳定可靠.     

加味黄连解毒汤对MODS大鼠一氧化氮系统的影响

目的 探讨加味黄连解毒汤对多器官功能障碍综合征(MODS)大鼠一氧化氮(NO)、一氧化氮合成酶(NOS)系统的影响及对脏器的保护作用.方法 通过腹腔注射酵母多糖的方法制作MODS大鼠模型,观察加味黄连解毒汤对MODS大鼠模型的生命体征、血浆丙氨酸转氨酶(ALT)、肌酐(Cr)以及外周血、心脏、小肠等组织器官N0系统变化和组织病理的影响.结果 中药组动物血清及小肠、心脏组织NO、NOS与模型组比较有显著差异,且小肠、心脏等组织病理也明显改善.结论 加味黄连解毒汤能有效地改善MODS大鼠脏器功能及病理形态,其机制可能是减轻促炎介质及诱导型一氧化氮合酶(iNOS)过度活化.     

不同血液净化模式对治疗脓毒症多脏器功能衰竭的疗效

目的 分析脓毒症所致多脏器功能衰竭病患采取不同血液净化模式的疗效差异。方法 选取2020年1月至2020年12月本院收治的脓毒症所致多脏器功能衰竭病患共68例作为研究对象,依据随机数表法将其划分成两组,每组各34例,对照组予以连续静脉-静脉血液滤过(CVVH),观察组予以脉冲高容量血液滤过(PHVHF),统计并比较两组治疗前后的急性生理学和慢性健康情况II(APACHE II)评分、血肌酐(Scr)、尿素氮(BUN)、谷丙转氨酶(ALT)、天门冬氨酸氨基转移酶(AST)、白细胞计数(WBC)、平均动脉压(MAP)、心率(HR)、体温及动脉血氧分压(PaO2)水平。结果 治疗前,两组APACHE II评分、Scr、BUN、ALT、AST、WBC、MAP、HR、体温以及PaO2水平对比无显著差异(P0.05);治疗后,观察组APACHE II评分、Scr、BUN、ALT、AST、WBC、MAP、HR及体温低于对照组,PaO2水平高于对照组(P0.05)。结论 CVVH和PHVHF对脓毒症所致多脏器功能衰竭病患均有一定疗效,但后者较前者疗效更佳,更可改善患者的生命体征、肝肾功能以及血气分析等指标,以减轻其炎症反应。     

大鼠腹腔感染致多器官功能障碍模型的建立及病理学观察

目的:建立大鼠腹腔自身粪便感染导致多器官功能障碍综合怔(MODS)的动物模型.方法:采用健康Wistar 大鼠80只,随机分为正常对照组和模型实验组,每组40只.正常对照组大鼠腹腔注入灭菌生理盐水(1.5 mL/100 g体重).模型实验组大鼠腹腔注射自身粪便匀浆上清液造成感染后,观察各组动物血气分析及肝肾生化指标及脏器病理变化.结果:与正常对照组比较,模型实验组动物血气分析指标动脉血氧分压(PaO2)、动脉血氧分压/吸入氧浓度比值(PaO2/FiO2)降低,血浆总胆红素(T.BIL)、血肌酐(Cr)含量升高,肺、肝、肾等脏器病理改变明显.结论:大鼠腹腔自身粪便感染可以成功复制MODS模型.     

全身炎症反应综合征动物模型发病机制的研究

目的 通过建立全身炎症反应综合征(SIRS)大鼠模型,探讨多器官功能障碍综合征(MODS)可能的发病机制.方法 采用腹腔注射酵母多糖悬液方法复制大鼠SIRS模型,雄性SD大鼠共50只,随机分成正常对照组(正常对照组,20只)和腹腔注射酵母悬液组(注射酵母悬液组,30只).观察各组大鼠的症状、体征、血气、肺、肝、小肠病理及电镜改变、血清及肺泡灌洗液的细胞因子的变化.结果 注射酵母悬液组大鼠的症状、体征均有明显变化,与正常对照组比较差异有统计学意义(P＜0.05);注射酵母悬液组大鼠动脉血氧分压及氧合指数明显降低,与正常对照组比较差异有统计学意义(P＜0.05);注射酵母悬液组大鼠肺、肝及小肠脏器病理及电镜改变明显,均出现以急性炎症为主的非特异性病理损害;注射酵母悬液组大鼠血清及肺泡灌洗液的肿瘤坏死因子(TNF-α)、干扰素(IFN)、IL-4、IL-10、IL-18水平均显著升高,与正常对照组比较差异均有统计学意义(P＜0.05).结论 以腹腔注射酵母多糖悬液的方法可成功复制出SIRS模型,对发病机制的探讨为进一步MODS的临床研究提供了实验基础.     

亚高原与高原地区绵羊多脏器功能障碍综合症血清生化指标的比较

目的本文旨在通过不同的海拔高原地区的多脏器功能障碍综合征(MODS)绵羊模型的生化指标来探讨MODS的高原性发病特点。方法将12只绵羊随机分为两组,每组6只,分别在高原地区夏河桑科草原(平均海拔在3100 m)和亚高原地区兰州市(平均海拔在1520 m),动物全麻后,以6μg/kg内毒素(LPS)于30 min内静脉泵入建立MODS模型。观察各组的体征表现,测定不同时点各组血清生化指标的改变。结果高原地区的MODS模型绵羊死亡率以及不同时段血清的CK、CK-MB、AST、ALT、CRE生化指标明显高出亚高原地区,只有ALP指标亚高原地区与高原地区的变化基本相近。结论 MODS在伴随着海拔升高的高原地区危害程度更大。     

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.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.     

Development Is A High Level Inheritance for China Time-honored Brand Products

<正>As culture is the soul of a nation,the three books,"History of Chinese Philosophy,""History of Chinese Culture"and"History of Chinese Science and Technology"have demonstrated the superiority of our great Chinese culture,and its significant impact in the field of international culture.Both core value and practical value of the Chinese culture are very clear,reflected in the views of universe,nature,life,health,disease,and therapy and related considerations,concepts,and technical methods.