虫对慢性血瘀型大鼠血液流变性和红细胞免疫功能的影响

摘要:目的:观察虫对慢性血瘀型大鼠血液流变性和红细胞免疫功能的影响。方法:模拟阴虚火旺复制慢性血瘀大鼠模型,用毛细血管法测定不同切速下的全血比粘度、血浆比粘度,常规法测定红细胞压积。参照郭氏法测定红细胞免疫粘附功能指标,并将其与血液流变性有关指标作一相关分析。结果:虫能明显降低瘀血大鼠的全血比粘度、血浆比粘度和红细胞压积;提高瘀血大鼠红细胞C3b受体花环率,使红细胞免疫复合物花环率下降,血清红细胞免疫粘附促进因子活性增强,而抑制因子减弱;血液粘度与红细胞C3b受体花环率的相关分析呈显著负相关。结论:虫不仅有活血化瘀作用,还具有促进红细胞免疫功能的功效。     

Adrenergic,purinergic, and endothelial mediators and modulators of norepinephrine-induced mesenteric autoregulatory escape

We evaluated the effects of potential factors in autoregulatory escape from norepinephrine-induced vasoconstriction in rat anterior mesenteric artery. We determined mesenteric artery blood flow velocity with a pulsed Doppler, sonic flowmeter, and systemic arterial blood pressure with a transducer. A 4-min norepinephrine infusion (0.125–1.0 × 10^–8 M/min) intravenously evoked a dose-dependent, initial vasoconstriction that was followed by rapid escape of blood flow toward or above the control value during sustained norepinephrine administration. Neonatal capsaicin treatment enhanced vasoconstrictor responses to norepinephrine but failed to affect escape parameters. Propranolol decreased norepinephrine-induced escape dose dependently. Adenosine deaminase attenuated escape, and the combination of this enzyme plus propranolol nearly abolished escape from norepinephrine-induced vasoconstriction. Methylene blue also diminished autoregulatory escape. These findings suggest that norepinephrine-induced autoregulatory escape involves simultaneous -adrenoceptor, purinergic, and endothelial mediation. Norepinephrine-evoked mesenteric vasoconstriction appears to involve predominantly ₂-adrenoceptors and is modulated by peptidergic sensory nerves and adenosine.NIH grant number supporting these studies: USPHS # DK37050.     

Myocardial infarction in an adult resulting from coronary ancurysms previously documented in childhood after an acute episode of Kawasaki's disease

Coronary aneurysms resulting from a previous episode of Kawasaki'sdisease are considered an important cause of myocardial infarctionin children. A case of a 19-year-old man presenting with anacute myocardial infarction associated with coronary aneurysmsis described. These coronary lesions were previously evaluatedangiographically and echocardiographically at the age of 13years, 5 months after the acute episode of a Kawasaki's disease.     

Epidural anaesthesia for elective Caesarean section does not influence fetal umbilical artery blood flow indices

This prospective study was completed to determine the influence of epidural anaesthesia on the fetoplacental circulation of normal subjects. Thirty-seven normal pregnant patients at term, undergoing elective Caesarean section, had Doppler measurements of the fetal umbilical artery blood flow velocity before and after epidural anaesthesia using lidocaine 2% without epinephrine. There were no differences in systolic/diastolic, resistance or pulsality indices following epidural anaesthesia. These results suggest that this technique has no adverse effect on fetoplacental circulation in normal non-labouring subjects. Cette étude prospective a pour but de déterminer l’influence de l’anesthésie épidurale sur la circulation foeto-placentaire dans le contexte d’une grossesse normale. Des indices de vélocité du flot de l’artère ombilicale foetale ont été mesurés par Doppler chez trentesept patientes gravides à terme, sans complications, programmées pour une césarienne élective, avant et après une anesthèsie épidurale utilisant la lidocaine 2% sans épinéphrine. Les indices de rapport systole/diastole, de résistance et de pulsatilité sont demeurés inchangés après l’induction de l’anesthésie épidurale. Ces constatations suggèrent que l’anesthésie épidurale n’a pas d’influence sur la circulation foetoplacentaire chez des patientes enceintes normales à terme qui ne sont pas en travail.     

婴幼儿先心病不阻断升主动脉心内直视手术42例分析

目的：分析４２例〈３岁的婴幼儿在不阻断升主动脉下,行心内直视手术的效果。方法：４２例患儿均常规建立体外循环,不阻断升主动脉,不做心脏停跳液灌注,转机后立即阻断上下腔静脉,其中１１例小体重复杂先心者降温,使心脏完全停跳后行心内操作,余３１例均在浅低温或常温心脏跳动下行心内操作,体外循环时间１０￣８７ｍｉｎ,平均３７．６４ｍｉｎ。结果：本组４２例死亡２例,余４０例均痊愈出院。经术后半年随访３６例,无任     

从中医理论探索方药的作用机理

主要以所承担过的科研课题的研究思路及研究结果为依据,论述从传统中医理论探索方药作用机理的重要性。文中从养阴生津方药治疗热瘀证的作用、血分证中运用活血化瘀法的作用、辛开苦降法的作用及解表法的作用等方面论述从中医的特有理论出发,可以在探索方药作用机理时提供思路、开拓新的研究领域。同时,中医传统证治理论也要不断发展、提高,在运用传统证治理论研究方药作用机理时,不能完全被其所束缚,随着对证治理论认识的发展,对方药作用机理的认识也必然会出现一个飞跃。     

中西医结合治疗再生障碍性贫血——附30例临床观察

目的：探讨中西医结合治疗再生障碍性贫血的疗效。方法：采用中医补肾健脾,益气活血的克障汤,辅以西药综合治疗。结果：本组共治疗再生障碍性贫血３０ 例,经２６ 个月治疗,总有效率８０％ 。结论：中西医结合治疗疗效明显优于单纯使用西药组,早期诊断、早期治疗和坚持长期治疗是本病早日康复的关键。     

Effects of a leucocyte depleting arterial line filter on perioperative proteolytic enzyme and oxygen free radical release in patients undergoing aortocoronary bypass surgery

BACKGROUND: Proteolytic enzymes and oxygen free radicals released from activated leucocytes contribute significantly to the organ dysfunction associated with cardiopulmonary bypass. Leucocyte depletion during extracorporeal circulation should reduce the release of these toxic compounds and thereby improve postbypass myocardial and pulmonary function. Recently, a leucocyte-specific arterial line filter to achieve leucocyte depletion during clinical perfusion has become commercially available. The aim of this study, therefore, was to evaluate the influence of the leucocyte depleting arterial line filter on proteolytic enzyme release, oxygen free radical release and postbypass pulmonary and myocardial function in patients undergoing bypass surgery. METHODS: Forty patients undergoing elective aortocoronary bypass surgery were included into this prospective, randomized clinical study, 20 in the leucocyte depletion (LG-6 group, leucocyte-specific arterial line filter) and 20 in the control group (AV-6 group, standard arterial line filter). White cell count, differential white cell count, plasma elastase concentration, plasma malondialdehyde concentration and C-reactive protein were determined before, twice during and immediately after cardiopulmonary bypass, at the end of surgery and 6 and 20 h thereafter. RESULTS: White cell count, differential white cell count, malondialdehyde and C-reactive protein were not significantly different between LG-6 and control patients. Plasma elastase concentrations were significantly (P < or = 0.03) higher during and immediately after extracorporeal circulation in LG-6 group patients. Need for inotropic support, arterial pO2 after extracorporeal circulation and perioperative CK MB mass and troponin I release were not different between the two groups of patients. CONCLUSION: The use of a leucocyte depleting arterial line filter is associated with an increased release of the proteolytic enzyme elastase, but does not reliably and consistently achieve effective leucocyte depletion during clinical perfusion. In contrast to previous studies, we could not demonstrate any significant difference in postbypass pulmonary or myocardial function between patients perfused with the leucocyte-specific arterial line filter and control patients. Our data do not support the routine use of a leucocyte depleting arterial line filter during clinical perfusion in patients undergoing elective aortocoronary bypass surgery.     

Extracellular fluid and its proteins: dehydration, shock, and recovery

This review highlights characteristics of extracellular fluid (ECF) that are often overlooked. ECF has, in addition to plasma and interstitial fluid (ISF) surrounding cells, a third large compartment, the ISF of skin and connective tissue. This acts as a reservoir that gives up ECF to plasma volume (PV) in order to sustain circulation in the event of either shock or dehydration. While Starling forces drive filtration, ECF is returned to PV more by lymph and less by Starling forces than previously appreciated. Lymph return to PV is dependent on physical activity and muscle contraction to overcome gravity. Regional change in metabolic rate alters the need for oxygen and nutrients that is met by a regional increase in capillary blood flow. Blood flow is controlled by vasoactive compounds released in response to a drop in PO₂; these relax capillary smooth muscle to increase blood flow and delivery of oxygen and nutrients. Plasma proteins, including albumin, are filtered into the interstitium through larger pores than those filtering ECF. The rate of protein filtration is set by size and charge of these larger endothelial pores and by size and charge of proteins. Charge of these pores, hence albumin permeability, is regulated by many of the same vasoactive compounds that control capillary flow. As a consequence, in response to gravitational stress and other forms of shock that reduce effective circulation, albumin as well as ECF is rapidly shifted from plasma and sequestered in ISF. When this has occurred, as in burn shock, restoration is better effected by generous expansion of ECF with Ringer’s solution alone, rather than with Ringer’s solution supplemented with human serum albumin or other colloid. Restoring both PV and ISF volume restores lymph circulation and returns sequestered albumin to PV. Received: 12 November 1998 / Revised: 30 March 1999 / Accepted: 2 April 1999     

Stimulus duration modulates the interaction between opioids and nitric oxide in hypoxic pial artery dilation

Since recent studies show that pial artery dilation during a 20 or 40 min hypoxic exposure was less than that observed during a 5 or 10 min exposure, stimulus duration determines the nature of the vascular response to hypoxia. Decremented hypoxic pial dilation during longer exposure periods results, at least in part, from decreased release of methionine enkephalin (Met), an opioid known to contribute to dilation during hypoxia. Nitric oxide and cGMP contribute to both release and the vascular response to this opioid. The present study was designed to determine if the stimulus duration modulates the interaction between opioids and NO in hypoxic pial dilation using newborn pigs equipped with a closed cranial window. Elevation of CSF cGMP during hypoxia (Po2 approximately 35 mmHg) was dependent on stimulus duration (435+/-31, 934+/-46, 747+/-25, and 623+/-17 fmol/ml cGMP during normoxia and after 10, 20, and 40 min of hypoxia). Met-induced pial dilation during hypoxia was also stimulus duration dependent (7+/-1, 10+/-1, and 15+/-1, vs. 4+/-1, 6+/-1, and 8+/-2 vs. 2+/-1, 3+/-1, and 5+/-1% for 10(-10), 10(-8), 10(-6) M Met during normox and after 20, and 40 min of hypoxia). Additionally, the release of cGMP by Met during hypoxia was also stimulus duration dependent (1.8+/-0.1 vs. 1.6+/-0.1 vs. 1.3+/-0.1 fold change in CSF cGMP for 10(-8) M Met during normoxia and after 20 and 40 min of hypoxia). These data indicate that the diminished role of Met in pial dilation during longer hypoxic exposure periods results from a diminished capacity of this opioid to elicit dilation. Such impaired dilation is correlated with diminished stimulated cGMP release. These data also suggest that diminished CSF cGMP release during prolonged hypoxia contributes to decreased release of Met during longer hypoxic periods. Therefore, stimulus duration modulates the interaction between opioids and NO in hypoxic pial artery dilation.