止咳平喘合剂干预哮喘大鼠气道炎症及IL-12、IL-13水平的实验研究

目的:观察止咳平喘合剂对哮喘大鼠气道炎症及血清白介素12(Interleukin-12,IL-12)、白介素13(Interleukin-13,IL-13)水平的影响,探讨其抑制哮喘气道炎症的作用机制。方法:用改良的卵白蛋白多点注射致敏与雾化吸入激发法建立大鼠哮喘模型。将40只雄性SD大鼠随机分为4组,每组10只,分别为空白对照组、哮喘模型组、强的松对照组和中药治疗组(止咳平喘合剂组)。实验第15天起,空白对照组、哮喘模型组分别给予生理盐水10mL.kg-1,强的松对照组给予强的松混悬液10mg.kg-1,中药治疗组给予止咳平喘合剂15g.kg-1,每天1次给药,连续5天。末次雾化激发后24h处死各组大鼠留取标本。镜下观察各组哮喘大鼠肺组织病理形态变化及支气管肺泡灌洗液(BALF)中白细胞、嗜酸粒细胞(EOS)数量;用双抗体夹心酶联免疫吸附试验(ELISA)法测定大鼠血清中IL-12、IL-13含量。结果:与哮喘模型组相比,中药治疗组大鼠BALF中白细胞总数和EOS数量均显著降低,差异有统计学意义(P0.01);与哮喘模型组相比,中药治疗组大鼠肺组织气道黏膜及黏膜下层的炎性细胞浸润明显减轻;中药治疗组大鼠血清中细胞因子IL-12浓度明显高于哮喘模型组(P0.01),而IL-13浓度明显低于哮喘模型组(P0.01)。结论:止咳平喘合剂可通过提高细胞因子IL-12水平、降低IL-13的水平,来调节细胞因子失衡,从而减轻哮喘大鼠的气道炎症。     

电针足三里穴防治老年机械通气患者胃食管反流

目的:观察电针足三里穴防治老年机械通气患者胃食管反流及呼吸机相关肺炎(ventilator associatedpneumonia,VAP)的疗效。方法:ICU内82例机械通气的老年患者纳入本研究,随机分为治疗组(41例)和对照组(41例)。对照组采取常规防治胃食管反流措施,治疗组在对照组治疗方案基础上予电针足三里穴治疗。观察治疗前后两组咽后部液体胃蛋白酶阳性率变化和VAP发生率,测定两组患者治疗前后血胃动素、胃泌素水平。结果:与治疗前比较,治疗组和对照组治疗后咽后部液体胃蛋白酶阳性率均有所下降(P0.05),但治疗组治疗后咽后部液体胃蛋白酶阳性率低于对照组(P0.05),治疗组VAP发生率低于对照组(P0.05)。治疗组治疗后胃动素水平有所升高(P0.05),胃泌素水平无明显变化(P0.05)。对照组治疗前后胃动素和胃泌素水平均无明显变化(P0.05)。结论:电针足三里穴能有效改善胃肠功能,减少胃食管反流,减少呼吸机相关肺炎的发生,其机制可能与提高血胃动素水平有关。     

中医药关于治疗流感的研究进展及现状

流行性感冒,是一种由流感病毒病毒引起,具有高度传染性的急性发热性呼吸道疾病。中医药对流感的防治积累了丰富的理论和实践经验,从免疫学,药理学及病毒学等方面对中药抗病毒机制的研究提供一些思路,供同道参考。     

高白细胞性急性髓系白血病细胞基因表达谱的研究

[目的]综合分析高白细胞性急性髓系白血病不同预后患者祖细胞集落形成及对化疗药物的敏感性以及差异表达的基因。[方法]半固体集落形成法观察不同预后患者骨髓祖细胞集落形成及对化疗药物的敏感性。采用Affymetrix公司人类寡核苷酸表达谱芯片检测患者初诊时骨髓单个核细胞基因表达谱,筛选出差异表达数据。[结果](1)患者骨髓祖细胞集落形成和化疗药物的敏感性与预后密切相关,未缓解者的骨髓祖细胞集落明显高于完全缓解患者,且对化疗药物不敏感。(2)完全缓解患者白血病细胞表达上调2倍以上的基因109条,占0.5%。下调2倍以上的基因134条,占0.6%,其中与预后密切相关的为TRIM16、TM4SF1。CD34和DNMT3B。(3)差异表达的基因按功能分成离子通道运输、细胞周期、细胞骨架运动、细胞凋亡等14类。上调的主要为DNA合成修复、细胞凋亡、细胞周期和应激相关等4类;而下调的主要为蛋白翻译合成、信号传导传递、发育相关和细胞骨架运动等4类。[结论]特定的基因表达模式决定患者预后。     

偏头痛相关血管活性药物实验筛选

目的偏头痛与血流异常相关,探讨偏头痛相关血管活性药物对血流速度的影响。方法采用脉冲多普勒血流计对肾上腺素组、去甲肾上腺素组、多巴胺(DA)组、溶媒组、正常组大鼠颈总动脉血流速度动态监测,评价血管活性药物对颈总动脉血流速度变化指数(BFVCI)的影响。结果肾上腺素、去甲肾上腺素、多巴胺均使血流速度下降。结论血流异常可能是偏头痛发病机制之一。     

超声波导入的促渗作用及其对皮肤微观结构的影响

目的考察超声波导入对高乌甲素水凝胶经皮渗透的促进作用及其对皮肤角质层微细结构的影响。方法制备了高乌甲素卡波姆凝胶,分别采用频率为800 kHz和1 MHz的超声波在体外进行了经鼠皮渗透实验,定时测定接受室药物浓度并计算经皮渗透参数。制备皮肤切片,分别采用光镜和扫描电镜观察皮肤及角质层微细结构的改变。结果800 kHz和1 MHz的超声波导入对高乌甲素稳态透皮速率的促渗倍数分别达到约7倍和23倍。角质层微细结构观察发现超声波引起了皮肤表面空隙的增加和结构的改变。结论超声波导入显著促进了高乌甲素的经皮渗透,并提示空化效应是引起促渗作用的重要因素。     

同种异体移植骨髓间质干细胞治疗大鼠心梗后心室重构

目的： 观察骨髓间质干细胞（MSCs）移植对大鼠心梗后心室重构和心功能的影响，比较成年大鼠MSCs与乳鼠MSCs移植疗效，初步探讨同种异体移植的可行性。方法: 分别取大鼠和乳鼠的骨髓，体外分离、扩增培养MSCs，Brdu标记。在结扎冠脉后1-2 h 分别将大鼠MSCs和乳鼠MSCs分点注射到异体大鼠心脏梗死边缘区，6周后，采用超声心动图和解剖直测法获得大鼠心功能、心室重构和病理学资料。结果: 细胞移植组左室舒张末期内径和收缩末期内径短于、室壁厚于对照组，重量指数和心室腔都明显小于对照组。组织病理表现细胞移植组心梗区心肌数目多于、血管密度大于对照组，细胞外基质胶原的形成和血管周围胶原沉积均明显少于对照组，心梗区可见Brdu阳性细胞。但大鼠MSCs移植组和乳鼠MSCs移植组间无明显差异。结论: 同种异体骨髓间质干细胞可以在心梗区定植，减少胶原形成，促进心肌和血管生成，从而延缓心梗后心室重构，提高左室收缩和舒张功能。成年鼠干细胞移植与乳鼠干细胞移植具有相似的效果。     

Proximal humerus exposure with the inverted-L anterolateral deltoid flip approach,anterolateral deltoid splitting approach,and deltopectoral approach: A comparative cadaveric study

BackgroundReduction of the posterior aspect of proximal humerus fracture, such as far-retracted greater tuberosity or posterior articular head split fracture via a deltopectoral or deltoid splitting approach, is difficult and usually needs extensive dissection. The inverted-L anterolateral deltoid flip approach, which is developed from the deltoid splitting approach, accesses the proximal humerus via lateral deltoid flap lifting. This study compared the area and arc of surgical exposure to the proximal humerus of this proposed approach to existing approaches.MethodsEleven cadaveric specimens were used. Deltopectoral and deltoid splitting approaches were carried out on the right and left shoulder, respectively. Soft tissue was retracted after completion of a surgical approach to expose the proximal humerus, and dot-to-dot marking pins were placed along the border of exposed area. An additional area with a full shoulder rotation was also marked on the deltopectoral side. An inverted-L deltoid flip approach was further carried out on a deltoid splitting side with a posterior extending incision along the acromion process and the deltoid detachment from the acromion process. The additional area of exposure was subsequently marked. All soft tissue around the proximal humerus was taken down, and the glenohumeral joint was disarticulated. Area of exposure and axial images were taken for further processing and measurement.ResultAn average distance of the axillary nerve from the acromion process of the deltoid splitting and the deltopectoral approaches were 49.15 mm and 57.35 mm, respectively (P < 0.05). The average area of exposure of the inverted-L deltoid flip, deltoid-splitting, deltopectoral, and deltopectoral with full rotation approaches were 2729.81mm², 1404.39mm², 1325.41mm², and 2354.78mm², respectively (P < 0.05). Mean arc of exposure lateral to bicipital groove of the inverted-L deltoid flip, deltoid splitting, deltopectoral, and deltopectoral with full rotation approaches were 151.75degrees, 105.02degrees, 61.68°, and 110.64°, respectively (P < 0.05).ConclusionThe inverted-L anterolateral deltoid flip approach provides the most posterior access to the proximal humerus. However, it requires more soft tissue dissection and awareness of tension on the axillary nerve. This approach could be an alternative for displaced posterior head splits or far-retracted greater tuberosity proximal humerus fractures.     

Comparison of methemoglobin levels in food protein-induced enterocolitis syndrome and other gastrointestinal diseases in neonates

Introduction and objectivesMethemoglobinemia has been reported to be associated with severe food protein-induced enterocolitis syndrome (FPIES). However, no reports have evaluated methemoglobin (MHb) levels in FPIES without symptomatic methemoglobinemia or the usefulness of MHb measurement for the diagnostic prediction of FPIES. To evaluate the MHb levels of patients with neonatal-onset FPIES and determine whether MHb levels are higher in FPIES than in other gastrointestinal diseases.Patients and methodsEleven neonates with severe acute FPIES (FPIES group) and 139 neonates with other gastrointestinal diseases (non-FPIES group) were included in this study. Patient characteristics, symptoms, and venous blood test values (MHb, pH, HCO₃⁻, and C-reactive protein) were evaluated.ResultsThe median age at onset was 16 days vs. 1 day; males comprised 64% vs. 46%, the median gestational age was 38 weeks vs. 38 weeks, the median birth weight was 2710 g vs. 2880 g, and the median hospitalization duration was 31 days vs. 6 days for the FPIES vs. non-FPIES groups, respectively. MHb (%) was higher in the FPIES group than in the non-FPIES group [median (range), 1.1 (0.6–10.9) and 0.6 (0.3–1.2), respectively, p < 0.001]. There were no differences in terms of pH, HCO₃⁻, and C-reactive protein (p > 0.05). In the receiver operating characteristic analysis for FPIES diagnosis based on MHb (%), the area under the curve was 0.885, specificity was 97.1%, and sensitivity was 72.7% at a MHb cutoff of 1.0.ConclusionHigh MHb levels may help diagnose severe acute FPIES in neonates, but careful evaluation is needed.     

LC-MS/MS法测定人血浆中盐酸舍曲林的浓度

目的建立LC-MS联用测定人血浆中盐酸舍曲林血药浓度的方法。方法采用Waters AlltimaTMC18柱(100mm×2．1 mm,3．0μm),柱温30℃;流动相:0．1％甲酸溶液-乙腈=40:60(V/V);流速0．2 mL·min-1;进样量2止;气动辅助电喷雾离子化(ESI),正离子检测,SRM,盐酸舍曲林:[M H]离子m/z 306．1,碎片子离子m/z 275．1,碰撞能量18 V;内标:盐酸帕罗西汀[M H]离子m/z 330．1,碎片子离子m/z 192．1,碰撞能量27 V。结果该法专属性好,对盐酸舍曲林的最低检测限为0．673μg·L-1,血浆样品检测的线性、精密度、回收率等指标均符合生物样品分析标准,在应用中取得良好的效果。结论本法可用于血浆中盐酸舍曲林的测定。