探讨BiPAP治疗重症哮喘致呼吸衰竭的效果分析

目的：对BiPAP在重症哮喘致呼吸衰竭患者中的临床治疗效果进行观察与分析。方法择选该院2013年5月—2014年5月所收治的重症哮喘致呼吸衰竭患者52例作为研究对象,随机将其分成两组,即甲组（26例）与乙组（26例）,对乙组患者予以常规治疗,在此基础上,对甲组患者予以双水平气道正压（BiPAP）通气治疗,且对其临床治疗效果进行观察与比较。结果治疗后,甲组中患者的心率、呼吸、PaO2以及PaCO2等指标均优于治疗前,差异有统计学意义（P＜0.05）;治疗后乙组患者的心率、呼吸、PaO2以及PaCO2等指标均优于治疗前,差异有统计学意义（P＜0.05）;甲组患者治疗后的PaO2与PaCO2均优于乙组患者治疗后,差异有统计学意义（P＜0.05）。结论对重症哮喘致呼吸衰竭患者给予BiPAP通气治疗,可获得较为理想的治疗效果,值得在临床上大力推广与应用。     

罗格列酮对急性心肌梗死大鼠心肌细胞凋亡及其基因表达的影响

目的:观察急性心肌梗死大鼠心肌细胞凋亡率、凋亡调控基因Fas/FasL的表达变化及罗格列酮的干预作用。方法:通过结扎雄性Wistar大鼠左冠状动脉前降支造成心肌梗死模型,心肌梗死后24 h随机分为心肌梗死组(A组,n=18)和罗格列酮干预组(B组,n=18),另设假手术组(C组,n=18)。B组每日给以罗格列酮灌胃(4 mg/kg),持续6周。A、C组每日给以等量生理盐水灌胃。6周后检测心肌非梗死区中细胞凋亡率、细胞凋亡基因Fas mRNA和Fas/FasL蛋白的表达量。结果:给药6周后急性心肌梗死组A、B组心肌细胞中心肌细胞凋亡指数、Fas/FasL及其蛋白表达与C组相比显著升高,差异有统计学意义(P<0.05);与A组相比,B组中心肌细胞凋亡指数,Fas/FasL基因及其蛋白表达显著下降,差异有统计学意义(P<0.05)。结论:大鼠心肌梗死后心肌细胞中细胞凋亡率、Fas/FasL基因及蛋白表达显著增高;而罗格列酮可以降低大鼠心肌梗死后心肌细胞中Fas/FasL基因及蛋白表达,减少心肌细胞凋亡。     

Expression and regulation of complement receptors by human natural killer cells

Integration of cellular and humoral arms of the innate immune response is fundamental to the development of powerful effector functions in host defence as well as aberrant immune responses. Here, we provide evidence in support of the relationship between complement activation and NK cell functional modulation. We demonstrate that human NK cells and both CD56^brightCD16⁻ and CD56^dimCD16⁺ populations express receptors known to detect the biologically active peptides C3a and C5a (i.e. C3aR, C5aR, C5L2) and the covalently-bound fragments C3b and metabolites iC3b and C3d which serve in immune adhesion (e.g. CR3, CR4). We also show that several pathogen- or tumour/inflammation-related stimuli differentially regulated those complement receptor expression. Furthermore, our results suggest that C3 fragments (C3a, iC3b) have a negative regulatory effect on IFN-γ production in NK cells. This work provides extensive information of human complement receptors relevant to the integrated actions of complement and NK cells which has been suggested by animal studies. The observations may act as a resource that allows further understanding and exploitation of role of complement in human health and immune mediated diseases.     

腹膜后脓肿的诊断和治疗

目的探讨腹膜后脓肿的病因,诊断和治疗。方法回顾性分析了1990-2004年诊断和治疗腹膜后脓肿33例的临床资料。结果急性坏死性胰腺炎后20例,胆囊切除胆总管探查术后4例,十二指肠损伤2例,阑尾穿孔3例,肾结石4例。超声检查确诊80%(20/25),CT检查确诊100%(22/22)。经腹部腹膜后脓肿切开置管引流25例,手术1~4次不等,后腰部切开引流8例。手术后并发应激性胃粘膜损伤致消化道出血7例,成人呼吸窘迫综合征(ARDS)5例,急性肾功能衰竭3例,死亡4例。治愈时间1~6个月,平均3.5个月。结论及时明确诊断,进行有效引流并加强营养支持是治疗成功的关键。     

在非溃疡性消化不良中ELISA法测抗幽门螺旋杆菌抗体的临床意义

非溃疡性消化不良(NUD, non-ulcer dyspepsia)是常见症候群,其病因尚未完全明了。NUD中幽门螺旋杆菌(HP Helicobacter Pylori)相关性胃炎占很大比例。针对该菌产生之抗体反应,应用酶联免疫法(ILISA)检测了335例NUD患者血清抗-HP抗体。其中208例为经细菌培养及(或)组织学检查证实的HP相关性胃炎,对其中164例进行前瞻性随机安慰剂对照研究,以评价胶态次枸橡酸铋加氟哌酸治疗效果.治疗组与安慰剂组HP清除率分别为69％与6％(P<0.01)。HP清除后患者胃粘膜炎症好转或消除,症状明显减轻,抗-HP抗体滴度下降。     

缩窄门静脉主干1／2加丝线慢性栓塞术制备犬门静脉高压症模型

目的:探索操作简便且效果满意的门静脉高压症动物模型制备方法.方法:缩窄门静脉主干1/2加丝线慢性栓塞术,通过22条犬进行实验.结果:除1条死亡外.其余21条术后3～4周时门静脉压力升高至2.83±0.66kPa(术前1.33±0.28kPa,P<0.001):胃镜、门静脉造影及病理学检查证实,17条犬有食管胃底曲张静脉形成,形成率80.95%(其中方法完善后制备的14条、形成率100%),12条发生门脉高压性胃病,发生率57.14%.1条观察至术后4月.门静脉高压症表现仍然存在.结论:该法简便易行、建立模型周期短、成功率高且质量可靠并较持久.     

Statins suppress MMP2 secretion via inactivation of RhoA/ROCK pathway in pulmonary vascular smooth muscles cells

Recent studies have shown that statins ameliorate hypoxia-induced pulmonary hypertension in animal models. Yet, the underlying molecular mechanisms have not been completely understood. Here, we investigated the hypothesis that statins regulate vascular remodeling by modulation of matrix metalloproteinases (MMP) secretion in primary cultured pulmonary artery smooth muscle cells (PASMCs). Angiotensin II induced a concentration-dependent MMP2 secretion. A 2.75 fold increase was achieved by 100 nM angiotensin II stimulation for 24 h in primary cultured PASMCs (P<0.01 versus control), which was reversed by silencing Ras homolog gene family member A (RhoA) or inhibition of its downstream Rho-associated kinase (ROCK). There was no effect of angiotensin II on the expression of tissue inhibitors of matrix metalloproteinases (TIMPs). Pre-exposure of cells to simvastatin concentration-dependently blocked angiotensin II-stimulated MMP2 release. MMP2 release was reduced to1.34 fold increase in the presence of 10 microM simvastatin (P<0.01 versus angiotensin II-stimulated cells). We further revealed that simvastatin suppression of RhoA activation mediated its inhibitory effect on angiotensin II-triggered MMP2 release. Similarly, simvastatin suppressed endothelin-1-induced MMP2 release through RhoA/ROCK pathway. These results indicated a novel statins-regulation of RhoA/ROCK signaling against pulmonary vascular remodeling, and suggest that statins could prove useful in targeting this pathway in pulmonary hypertension and other disease conditions.     

p42MAPK siRNA诱导HeLa细胞凋亡的相关基因表达研究

目的 应用小干扰RNA(siRNA)沉默HeLa细胞MAPK p42,研究其诱导细胞凋亡的分子机制.方法 将筛选的MAPK p42靶向小干扰RNA(p42MAPK siRNA)用脂质体转染至HeLa细胞.激光共聚焦显微镜观察小干扰RNA处理的细胞内钙变化,免疫组织化学法检测细胞Bcl-2和Bax的表达,流式细胞仪检测细胞内Caspase-3的活性.结果 小干扰RNA-I和小干扰RNA-2均可诱导HeLa细胞内钙升高,导致Bcl-2表达下调和Bax表达上调,但是Caspase-3未参与细胞凋亡过程.结论 MAPK p42小干扰RNA介导的HeLa细胞凋亡与Bcl-2/Bax通路有关.     

HPLC法测定小儿咳喘灵颗粒中绿原酸的含量

目的:建立高效液相色谱法测定小儿咳喘灵颗粒中绿原酸的含量.方法:采用Analytical Technology(AT)C18柱(200mm×4.6 mm,5μm);以乙腈-0.2%磷酸溶液(13:87)为流动相;检测波长为327 nm;流速为1 ml·min-1;室温操作.结果:绿原酸在0.083～0.83 μg的浓度范围内呈线性关系,r=0.999 9,平均回收率为99.2%,RSD为0.7%.结论:该法简便、准确可靠,可用于该药的质量控制.     

骨髓单个核细胞移植可影响急性心肌梗死后心室重构

目的 观察同种异体骨髓单个核细胞(bone marrow mononuclear cells, BM-MNCs)移植对大鼠急性心肌梗死后左心室重构的影响.方法 健康雄性Wistar大鼠40只,随机均分为对照组和实验组.分别将制备的培养基和BM-MNCs悬液经心外膜下种植对照组和实验组梗死心肌周围.结果 移植术后4周,实验组左心室非梗死区心肌骨桥蛋白基因(OPN mRNA)、Ⅰ型胶原和AngⅡ含量均显著低于对照组(P均<0.05).Pearson直线相关分析表明,实验组和对照组心肌AngⅡ、Ⅰ型胶原与OPN mRNA三者之间两两均呈正相关(P均<0.05).结论 同种异体骨髓单个核细胞移植可能通过抑制大鼠心肌Ⅰ型胶原合成,下调心肌AngⅡ和OPN基因表达,减轻左心室重构.