大鼠内毒素血症时中性粒细胞凋亡的发生规律及其与继发性肺损伤的关系

已有研究表明 ,创伤或感染时大量中性粒细胞 (ＰＭＮ)聚集、扣押于肺组织中 ,并与肺损伤的发生发展有密切关系。那么 ,扣押于肺中的ＰＭＮ转归如何 ,与循环血中ＰＭＮ有何区别 ,目前研究尚少。笔者动态观察了大鼠内毒素血症时肺组织中和循环血中ＰＭＮ凋亡的发生规律及其功能的改变 ,并分析它们与肺损伤之间的关系。一、材料与方法(一 )主要试剂和仪器ＤＭＥＭ培养基 (美国Ｇｉｂｃｏ公司 ) ,脂多糖 (ｌｉｐｏｐｏｌｙｓａｃｃｈａｒｉｄｅ ,ＬＰＳ ,Ｏ55Ｂ5,)、Ｈｉｓｔｏｐａｑｕｅ 1119、Ｈｉｓｔｏｐａｑｕｅ 10 83、,Ａｎｎｅｘｉｎ-Ⅴ…     

多功能外科基本技术操作练习器的研究应用

目的 本实用新型是一种"多功能外科基本技术操作练习器"(简称练习器). 方法 它包括用有机玻璃板等做成一款前低后高的练习器医案架,在医案架板面的右上角开一个圆孔安置深部打结装置,左上角开一个圆孔安置圆型缝合板,其上方设有半圆刻度尺,在两圆孔下方开一个长方形孔安置长方形缝合板,其下方设有直刻度尺,长方形孔上方,左右两圆孔之间固定一个浅部打结装置组成.结果 本练习器具有切开、缝合、结扎止血、血管穿刺、静脉切开、血管吻合、深浅部打结等多种功能.容易普及推广应用.结论 对培养外科学临床医疗系学生和提高临床医师业务基本技术操作水平有深远意义.     

促甲状腺素释放激素与HSD伍用对高原失血性休克合并肺水肿大鼠的治疗作用

目的 :研究促甲状腺素释放激素 ( TRH)与高渗氯化钠 /右旋糖酐 ( HSD)伍用对急进高原的大鼠失血性休克合并肺水肿的疗效。方法 :实验在海拔 3 76 0 m的西藏拉萨市进行 ,急进高原大鼠 49只 ,从股动脉放血至平均动脉压 ( MAP) 5 0 mm Hg( 1m m Hg=0 .133k Pa) ,静脉注射 5 0 μl/ kg油酸制造肺水肿 ,维持该血压 1h,复制失血性休克合并肺水肿模型。实验分为假手术对照组 (不放血、不给油酸 )、单纯休克组、休克合并肺水肿组、乳酸林格氏液 ( 4ml/ kg,L R)组、TRH ( 5 m g/ kg)组、HSD( 4ml/ kg)组和 TRH与 HSD合用组 ,每组 7只动物。观察给药后 15、30、6 0和 12 0 m in的血流动力学指标变化 ,30和 12 0 min的血气指标变化和 12 0 min肺、脑含水量变化。结果 :TRH及 HSD单用或伍用给药后 MAP升高 ,左心室内压 ( L VSP)、左心室内压最大变化速率 (± dp/ dt m ax)改善 ,酸碱平衡紊乱缓解、肺湿重 /干重比减少 ,其中 TRH与 HSD伍用疗效在众多方面都比两药单用为优。结论 :TRH及 HSD单用及伍用对高原失血性休克合并肺水肿大鼠有良好的抗休克及减轻肺水肿的作用 ,其中两药伍用疗效更优。     

限制性液体复苏对肝脏缺血-再灌注损伤的影响

Objective To investigate the effects of limited resuscitation on hepatic ischernia-reperfusion in-jury in rots with hemorrhagic shock. Method Uncontrolled hemorrhagic shock was induced in 54 rats by transect-ing the middle branch of the splenic artery to produce standardized massive splenic injury. Resuscitation started when the mean arterial pressure (MAP) reached 40 mmHg. The rats were randomly divided (n = 9per group) in-to sham-operated group (SS), or one of five treatment groups in which infusion of Ringer' s solution was continually administrated to maintain MAP at 40 (RS40), 50 (RS50), 60 (RS60), 80 (RS80) or 100 mmHg (RS100) for 45 minutes (T45 point). After the bleeding was controlled, resuscitation was continued with Ringer's solution and whole blood (2:1) to increase the MAP to 100 mmHg for 120 minutes (T165 point), which was followed by obser-vation for 240 minutes (T405 point). All animals were observed for 240 minutes or until death. Blood specimens were collected at TO, T45, T165 and T405 for determination of blood lactate levels. At the end of the experiment,a small amount of hepatic tissue was collected to measure tissue blood perfusion, total antioxidative capacity (TAOC), Na+K+ ATPase activity and malondialdehyde (MDA) levels. Results At T405, the blood lactate lev-els in the RS80 and RS100 groups [(3.60±0.68) and (3.84 ± 1.09) mmol/L, respectively] were significantly higher than those in the SS, RS40, RS50 and RS60 groups [(2.00±0.66),(2.74±1.45),(2.43 +0.94) and (2.07±0.95) mmol/L, respectively;all:P < 0.05]. The MDA levels were significantly higher in the RS80 and RS100[(7.32±0.31) and (7.71±0.23) nmol/mg,respectively] than those in the SS, RS40, RS50 and RS60 groups[(4.95±0.80),(6.14±0.94),(6.42±0.48) and (6.84±0.36) nmol/mg, respeetively;all: P <0.05]. The Na+ K+ ATPase and TAOC levels were significantly lower in all of the RS groups than those in the SS group (all: P < 0.05), and those in the RS80 and RS100 groups was significantly lower than those in the RS40,RS50 and RS60 groups (all: P <0.05). Blood perfusion in the RS80 and RS100 groups was significantly lower than that in the other groups (all: P < 0.05). Conclusions If hemorrhage is uncontrolled, limited resuscitation appears to balance the needs for organ perfusion, improve the microcircttlation and decrease lactate levels. Fur-thermore, limited resuscitation could decrease ischemia-reperfusion injury in liver tissue.     

强直性脊柱炎患者Th17细胞与CD4+CD25+FoxP3+调节性T细胞的变化及意义

目的 探讨强直性脊柱炎( ankylosing spondylitis,AS)患者Th17和CD4+ CD25+ FoxP3+调节性T细胞比例及相关细胞因子水平的变化及意义.方法 强直性脊柱炎患者40例,正常同年龄对照37例.采用流式细胞术检测外周血Th17与调节性T细胞的比例,双抗体夹心酶联免疫吸附法( ELISA)检测血清IL-6、IL-23、IL-17和TGF-β水平.结果 AS组患者外周血Th17细胞比例明显高于对照组[(1.02±0.34)％vs(0.68:±0.29)％,P＜0.05],CD+ CD25+ FoxP3+细胞比例明显低于对照组[(3.77±0.81)％ vs (4.69±1.23)％,P＜0.05].AS患者血清中IL-6、IL-23、IL-17水平明显高于对照组[ (6.15±2.71) ng/L vs(3.31±1.65) ng/L; (9.44±3.12) ng/ml vs (5.82±2.61) ng/ml;( 10.53±4.97) ng/L vs (6.78±3、26) ng/L,P均＜0.01];差异有统计学意义.与对照组相比,AS组TGF-β水平有下降的趋势[(4,76±2.15) ng/ml vs(5.16±2.02) ng/ml,P＞0.05],但差异无统计学意义.AS患者血清各细胞因子含量与临床及实验室指标无相关性.结论 强直性脊柱炎患者Th17与CD4+CD35+FoxP3+调节性T细胞比例失衡,血清IL-6、IL-23、IL-17和TGF-β水平变化,这些原因可能参与强直性脊柱炎免疫发病过程.     

体内金属异物与应对措施

本文对留置体内的金属异物从留置原因、对机体的影响、定位方式及治疗进行综述,对定位、治疗现状及不足进行探讨和展望。     

N-乙酰-L-半胱氨酸对肠道缺血-再灌注损伤及远处器官的保护作用

目的：观察补充Ｎ 乙酰 Ｌ 半胱氨酸（ＮＡＣ）在大鼠肠系膜上动脉夹闭致缺血 再灌注损伤时对肠、心和肺的保护作用。方法：大鼠肠系膜上动脉夹闭４５ 分钟后松夹,于松夹前或松夹后５ 分钟给予ＮＡＣ（５０ ｍ ｇ／ｋｇ）,测定松夹后２、４ 和６ 小时肠、心和肺组织总巯基（ＴＳＨ）、非蛋白巯基（ＮＰＳＨ）、丙二醛（ＭＤＡ）和髓过氧化物酶（ＭＰＯ）的改变。结果：给予ＮＡＣ可明显增加组织ＮＰＳＨ水平,降低ＭＤＡ 和ＭＰＯ含量;但松夹后给予ＮＡＣ者效果要优于松夹前给予者。结论：ＮＡＣ通过清除自由基对缺血 再灌注引起的肠和远处器官起到保护作用