Pericardial fluid analysis in scleroderma (systemic sclerosis)

A patient with scleroderma who presented with pericarditis and effusion is described. Aspirates from this pericardial effusion had the characteristics of an exudate with no evidence of autoantibodies, immune complexes or complement depletion. These findings suggest that the mechanisms operating in the production of pericardial effusion in scleroderma may be different from those found in rheumatoid arthritis and systemic lupus erythematosus.     

膨大素对川麦冬生长发育及其产量和质量的影响

目的研究膨大素对川麦冬生长发育及其产量、质量的影响。方法在收获期随机采样测定川麦冬的生物学性状及产量,用SPSS软件分析川麦冬生物学性状与产量的相关性规律;用UV法测定川麦冬中的总皂苷,考察膨大素的施用量和施用方式对其质量的影响。结果川麦冬的植株生物学性状(除块根直径、株高外)对产量均有显著影响,影响程度为单株块根重>块根数>分蘖数>块根长>百粒重>冠幅。膨大素能促进川麦冬植株地上部分的生长,明显增加块根数、单株块根重,显著提高川麦冬的产量;除低剂量外,膨大素降低了川麦冬总皂苷的含量,且随着剂量的增加,作用越强。结论膨大素能促进川麦冬的生长发育,显著提高川麦冬的产量,且与多效唑分段合用时效果更佳。不同剂量膨大素对川麦冬总皂苷含量的影响差异较大,低剂量有利于川麦冬总皂苷的积累。     

多层螺旋CT对尘肺患者不同分期中肺动脉直径变化评价的临床价值

目的:研究多层螺旋CT(multislice spiral computrd tomograghy,MS-CT)对尘肺患者不同分期中肺动脉直径变化评价的诊断价值.方法:选择在我院接受治疗的符合尘肺病诊断标准的30例尘肺I期,30例尘肺Ⅱ期和30例Ⅲ期尘肺病患者及30例正常人进行CT扫描,测量肺动脉(MPA)直径、右肺动脉(RAP)直径、左肺动脉(LAP)直径、主动脉/升主动脉比值(RPAA)及主动脉/降主动脉比值(RPDA).结果:尘肺病患者的MAP、LAP、RAP直径,RPAA、RPDA比值显著大于健康对照组(P＜0.05),三期尘肺组MAP、LAP、RAP直径,RPAA、RPDA比值＞二期尘肺组MAP、LAP、RAP直径,RPAA、RPDA比值＞一期尘肺组MPA值(P＜0.01或P＜0.05).FEV1％与MAP、LAP、RAP直径,RPAA、RPDA比值均呈现显著的负相关性(P＜0.05).结论:尘肺组肺动脉MAP、LAP、RAP直径,RPAA、RPDA比值与尘肺分期有显著关系,采用多层螺旋CT测量肺动脉直径对尘肺病分期诊断具有较高的价值,可以作为临床对尘肺分期诊断和鉴定的一种辅助手段.     

血栓通胶囊抗急性心肌缺血及抗血栓形成的作用研究

目的 研究血栓通胶囊对冠脉结扎致急性心肌缺血模型大鼠的保护及抗血栓形成的作用。方法 采用结扎左冠状动脉前降支法复制急性心肌缺血大鼠模型,观察血栓通胶囊对各组大鼠心电图、心肌梗死范围以及乳酸脱氢酶(lactate dehydrogenase,LDH)、肌酸激酶(creatine kinase,CK)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、α-羟丁酸脱氢酶(α-hydroxybutyrate dehydrogenase,α-HBDH)、肌酸激酶同工酶MB(creatine kinase-MB,CK-MB)的影响;采用体外方法,观察血栓通胶囊对血栓形成及血小板聚集的影响。结果 血栓通胶囊60、30、15 mg/kg组可显著减少心肌缺血模型大鼠心肌梗死范围,降低血清LDH、CK及CK-MB水平;其中血栓通胶囊60 mg/kg组对心电图异常发生百分率有明显抑制作用。血栓通胶囊30、15 mg/kg可显著促进体外血栓溶解;血栓通胶囊60、30、15 mg/kg可显著抑制体外ADP、胶原诱导血小板聚集。结论 血栓通胶囊对大鼠急性心肌缺血引起的损伤有保护作用,可能与抗血栓形成有关。     

中药有效成分治疗高尿酸血症基础研究进展

对高尿酸血症(HUA)具有治疗作用的中药主要有效成分有黄酮类如槲皮素、越桔果渣黄酮、葛根素和红旱莲总黄酮等,皂苷类如穿山龙总皂苷和萆薢总皂苷等,香豆素类如秦皮总香豆素和岩白菜素等。这些有效成分可以通过多个靶点和作用机制防治HUA,已阐明的主要机制包括:1直接促进尿酸排泄,抑制尿酸生成;2直接抑制血清和肝黄嘌呤氧化酶和腺苷脱氨酶活性;3下调肾尿蛋白转运体1和葡萄糖转运子9及其基因表达预防尿酸过度生成,上调肾有机阴离子转运体1蛋白及其基因表达促进尿酸排泄;4调节雌二醇和三磷酸甘油醛脱氢酶水平;5改善或减少HUA的脂质过氧化。     

紫外－可见分光光度法测定八爪金龙中总皂苷的含量

目的：测定苗药八爪金龙中总皂苷的含量。方法：用紫外－可见分光光度法进行含量测定,采用正交试验优化测定条件。结果：该法测定的最优条件为加入5％香草醛－冰醋酸0．6 ml和高氯酸1．0 ml,于80℃水浴中反应20 min;线性方程为Y＝44．87X＋0．365（r＝0．998）,百两金皂苷B在0．0452～3．8700 mg范围内呈良好线性关系;平均回收率为101．3％（n＝9）,RSD为1．67％。结论：该法用于测定八爪金龙中总皂苷的成分,具有简单、易操作、重复性良好的优点,可为进一步研究八爪金龙提供参考。     

Radioembolization with yttrium-90 microspheres work up: Practical approach and literature review

Radioembolization (RE) is a selective internal radiotherapy technique in which yttrium-90 blended microspheres are infused through the hepatic arteries. It is based on the fact that primary and secondary hepatic tumors are vascularized mostly by arterial blood flow whereas healthy hepatocytes obtain their blood supply mostly from the portal network. This enables high radiation doses to be delivered, sparing the surrounding non-malignant liver parenchyma. Most of the complications are caused by unexpected particles passing into the gastrointestinal tract through branches originating from the main hepatic arterial supply. Knowledge of this hepatic arterial network and of its variations and the technical considerations this raises are required in preparation for treatment. This work describes the specific anatomical features and techniques for this anatomy through recent literature illustrated by cases from our own experience.     

Comparison of the Efficacy of Drug-eluting Stents Versus Bare-metal Stents for the Treatment of Left Main Coronary Artery Disease

Background:

Recent studies reported that percutaneous coronary intervention with stent implantation was safe and feasible for the treatment of left main coronary artery (LMCA) disease in select patients. However, it is unclear whether drug-eluting stents (DESs) have better outcomes in patients with LMCA disease compared with bare-metal stent (BMS) during long-term follow-up in Chinese populations.

Methods:

From a perspective multicenter registry, 1136 consecutive patients, who underwent BMS or DES implantation for unprotected LMCA stenosis, were divided into two groups: 1007 underwent DES implantation, and 129 underwent BMS implantation. The primary outcome was the rate of major adverse cardiac events (MACEs), including cardiovascular (CV) death, myocardial infarction (MI), and target lesion revascularization (TLR) at 5 years postimplantation.

Results:

Patients in the DES group were older and more likely to have hyperlipidemia and bifurcation lesions. They had smaller vessels and longer lesions than patients in the BMS group. In the adjusted cohort of patients, the DES group had significantly lower 5 years rates of MACE (19.4% vs. 31.8%, P = 0.022), CV death (7.0% vs. 14.7%, P = 0.045), and MI (5.4% vs. 12.4%, P = 0.049) than the BMS group. There were no significant differences in the rate of TLR (10.9% vs. 17.8%, P = 0.110) and stent thrombosis (4.7% vs. 3.9%, P = 0.758). The rates of MACE (80.6% vs. 68.2%, P = 0.023), CV death (93.0% vs. 85.3%, P = 0.045), TLR (84.5% vs. 72.1%, P = 0.014), and MI (89.9% vs. 80.6%, P = 0.029) free survival were significantly higher in the DES group than in the BMS group. When the propensity score was included as a covariate in the Cox model, the adjusted hazard ratios for the risk of CV death and MI were 0.41 (95% confidence interval [CI]: 0.21–0.63, P = 0.029) and 0.29 (95% CI: 0.08–0.92, P = 0.037), respectively.

Conclusions:

DES implantation was associated with more favorable clinical outcomes than BMS implantation for the treatment of LMCA disease even though there was no significant difference in the rate of TLR between the two groups.     

三七总皂苷对博来霉素诱导的大鼠急性弥漫性肺泡损伤的保护作用研究

目的研究三七总皂苷(PNS)对博来霉素诱导的大鼠急性弥漫性肺泡损伤(ADAD)的保护作用。方法将24只SD大鼠随机分为3组,A组静脉注射0.9%氯化钠溶液1.5 ml/kg作为对照;B组和C组静脉注射博来霉素诱导ADAD,而后B组注射0.9%氯化钠溶液,C组静脉注射PNS,均连续注射3 d。3 d后测定3组动脉血浆肿瘤坏死因子α(TNF-α)水平、支气管肺泡灌洗液(BALF)中巨噬细胞(PAM)和中性粒细胞(PMN)总数、BALF中蛋白质和肺组织中超氧化物歧化酶(SOD)水平;计算肺组织含水率;光学显微镜下观察肺组织形态学改变。结果 B组大鼠TNF-α水平、PMN总数、蛋白质及含水率高于C组,C组高于A组(P0.01);B组SOD水平低于C组,C组低于A组(P0.05)。3组PAM总数比较,差异无统计学意义(P0.05)。光学显微镜下观察到B组肺组织间质水肿、细胞浸润明显,相比C组肺组织以上改变明显减轻。结论 PNS对博来霉素诱导的大鼠ADAD具有减轻和保护作用。