全身炎症反应综合征患者致炎因子与抗炎因子的变化及相关性研究

目的 观察全身炎症反应综合征（SIRS）患者血浆中致炎因子肿瘤坏死因子－α（TNF-α）、白介素－6（IL－6）和抗炎因子转化细胞生长因子－β（TGF-β）、白介素－10（IL－10）的变化规律及其相关性。方法 符合SIRS诊断48例，分别在入院后第1、8小时和第2、3、4天清晨空腹抽肘静脉血3mL，测定TNF－α、IL－6、TGF－β和IL－10，并设对照组。结果 TNF－α和IL－6各监测点均比对照组显著升高（P＜0．05，P＜0．01），TGF－β和IL－10入院后第小时与对照组比较无显著差异，第8小时以后各监测点均比对照组显著升高（P＜0．05，P＜0．01），TNF－α和IL－6峰值出现早于TGF－β和IL－10，致炎因子与抗炎因子具有显著的相关性。结论 拮抗炎症因子的同时提高机体免疫功能，达到致炎因子与抗炎因子的平衡是治疗SIRS的新思路。     

杀菌-通透性增加蛋白对脓毒症大鼠肝组织致炎与抗炎细胞因子表达的影响

目的：探讨杀菌－通透性增加蛋白（BPI）对脓毒症大鼠肝组织致炎与抗炎细胞因子表达的影响。方法：采用大鼠盲肠结扎穿孔（CLP）致脓毒症模型,动物随机分为正常对照组、脓毒症组和BPI治疗组。分别于CLP后12和24小时处死动物,检测肝组织肿瘤坏死因子－α（TNF－α）、白介素－10（IL－10）mRNA及其蛋白表达以及肝功能指标的改变。结果：脓毒症动物肝组织TNF－α及IL－10基因和蛋白表达均显著升高（P＜0．05或P＜0．01）,其中CLP后12小时组织TNF－α蛋白水平升高幅度明显大于IL－10的改变。BPI治疗12小时组TNF－α基因及蛋白均显著下降（P＜0．05或P＜0．01）,而IL－10则不同程度地升高;同时,治疗组12小时肝功能指标亦明显改善。结论：脓毒症早期应用BPI治疗可明显抑制肝组织TNF－α等致炎细胞因子表达,并上调局部组织IL－10等抗炎细胞因子的产生,从而有助于恢复体内炎症反应平衡与减轻脓毒症所致肝损伤。     

内毒素致急性肝损伤机制的实验研究

目的 研究内毒素肝损伤时，枯否氏细胞（Kupffer cells,KC）逐步由免疫防御型转变为效应型致肝损伤的机理。方法 昆明种小鼠72只，一次性尾静脉内注射不同剂量（1mg/kg、10mg/kg）大肠杆菌内毒素（LPS），复制内毒素肝损伤模型。采用免疫组化方法观察小鼠肝脏清道夫受体（scavenger receptor,SR），CD14表达变化；酶联免疫吸附法（ELISA）测定肝组织肿瘤坏死因子（TNF－α）、白介素－6（IL－6）的水平，光镜观察肝组织学变化。结果 内毒素肝损伤过程中，KC表面SR进行性下调，且与内毒素呈明显的量效关系；KC表面CD14表达呈进行性上调，但加大内毒素剂量并未使其进一步增加。SR表达的平均光密度值（OD值）与肝组织TNF－α、IL－6及血浆丙氨酸氨基转移酶（ALT）、总胆红素（TBIL）呈显著的负相关，CD14表达的平均OD值与肝组织TNF－α、IL－6及血浆ALT、TBIL水平呈显著的正相关。结论 内毒素肝损伤过程中，枯否氏细胞SR表达下调，CD14表达上调可能是枯否氏细胞由免疫防御细胞转化为致炎效应细胞导致肝损伤的机制之一。     

内毒素血症时小鼠肺局部致炎及抗炎因子与急性肺损伤的关系

目的：探讨内毒素血症休克时肺部从控性炎症反应致炎及抗炎及抗炎因子的变化规律及其与急性肺损伤的关系。方法：建立小鼠内毒素肺损伤动物模型,分别采用小鼠肿瘤坏死因子－α－（ＴＮＦ－α）、白介素－６（ＩＬ－６）、ＩＬ－４、ＩＬ－１０酶联免疫吸附法（ＥＬＩＳＡ）试剂盒检测肺组织匀浆液内上述细胞因子含量,同时观察肺操作程度及动物２４小时内的存活率。结果：注射内毒素（ＬＰＳ）后１小时,１ｍｇ／ｋｇ和１０ｍｇ＝／     

血浆置换治疗对重型病毒性肝炎血清内毒素和炎性介质的影响

目的：应用血浆置换技术，探讨其对重型病毒性肝炎患者体内内毒素和炎性因子水平的影响。方法：50例例重型病毒性肝炎患者和血浆置换治疗，于血浆置换治疗前，治疗结束时，治疗后24小时，48小时分别抽血测血清内毒素（ET）、TNFα及IL－6的水平。结果：重型生地炎患者血清内毒素、TNFα、IL－6的水平明显升高，血浆置换治疗结束时血清内毒素、TNFα、IL－6的水平明显低于治疗前水平（P＜0．05）。治疗后48小时内毒素、TNFα、IL－6的水平有所上升，但存活组较治疗前明显下降（P＜0．05），而死亡组与治疗前无明显变化（P＞0．05）。结论：血浆置换治疗能有效清除重型病毒性肝炎血清内毒素和炎性介质，治疗后血清内毒性和炎性介质的水平动态变化可能是判断血浆置换治疗重型病毒性肝炎预后的一个指标。     

急性心肌梗死与再灌注后血浆肿瘤坏死因子α、白细胞介素-6的变化

目的：观察急性心肌梗死（AMI）再灌注治疗患者血浆肿瘤坏死因子α（TNF－α）、白细胞介素－6（IL－6）浓度的动态变化评价其意义，方法：对发病6h内AMI患者48例进行溶栓治疗。测定患者溶栓前、溶栓后0．5、1、2、4、12、48h及1周血浆TNF－α、IL－6浓度。结果：36例再通，12例未通。溶栓前TNF－α、IL－6浓度都升高。溶栓后未通组TNF－α、IL－6均于48h达高峰。峰值都大于再通组。再通组TNF－α高峰不明显。IL－6于12h达峰后回落。结论：AMI患者血浆TNF－α、IL－6动态变化反映AMI炎性反应。再灌注挽救心肌而减轻的炎症足以抵消再灌注损伤。     

乌司他丁对急性坏死性胰腺炎大鼠肺局部致炎因子的影响及意义

目的：探讨乌司他丁（UTI）对急性坏死性胰腺炎（ANP）所诱发的肺 部炎症因子的影响及意义。方法：Wistar大鼠72只随机分为正常对照组（8只），ANP模型组（32只）和UTI治疗组（32只），建立大鼠ANP模型，在术后3，6，12和24h用ELISA法检测肺组织匀浆中IL－1β和TNF－α两种细胞因子的含量，同时进行PaO2和肺湿重／干重比值的测定。结果：ANP组术后3hIL-1β和TNF－α明显升高，并分别于术后6h和12h达到峰值，UTI组炎症因子升高幅度明显低于ANP组（P＜0．05），且于术后24h基本恢复正常，结论：UTI能明显减少ANP大鼠肺组织中IL－1β和TNF－α的含量，减轻了由细胞炎症因子介导的急性肺损伤。     

白细胞介素-10对急性肺损伤炎症/抗炎介质表达的影响

目的探讨白细胞介素-10(IL—10)对急性肺损伤(ALI)大鼠炎症介质／抗炎介质表达的影响。方法向气道内滴注内毒素(LPS，10mg／kg)建立大鼠ALI模型。54只雄性SD大鼠随机分为对照组、LPS损伤组、LPS加IL-10组，每组18只，各组又分为2、6和24h3个亚组，每个亚组各6只。按各时间点观察大鼠动脉血氧分压(PaO2)、支气管肺泡灌洗液(BALF)中细胞总数及分类计数、肺系数、BALF总蛋白水平及肺病理，同时用逆转录-聚合酶链反应(RT—PCR)方法检测肺组织中炎症介质／抗炎介质的表达。结果①LPS损伤组大鼠PaO2呈进行性降低；肺系数、BALF总蛋白水平及BALF中细胞总数均明显增加，分类以中性粒细胞为主；肺病理示肺内中性粒细胞大量浸润，伴出血、透明膜形成。LPS加IL-10组的各项指标均较LPS损伤组减轻。②LPS损伤组肺组织肿瘤坏死因子-α(TNF—α)mRNA表达于2h达高峰，随后迅速下降；白细胞介素-1β(IL—1β)mRNA表达于2h显著升高，6h达高峰，随后迅速下降；IL-1受体拮抗剂(IL—1ra)mRNA表达6h开始升高，且为峰值。24h仍高于对照组。LPS加IL-10组肺组织TNF—αmRNA、IL-1βmRNA表达受抑，而IL—1ra mRNA表达不受影响。结论①ALI早期TNF—αmRNA、IL-1βmRNA表达明显增加，而IL—1ra mRNA表达滞后，提示在无外来干预情况下，ALI早期存在炎症介质／抗炎介质的失衡。②IL-10可明显抑制炎症介质表达，不影响抗炎介质表达，有利于重建炎症介质／抗炎介质平衡，减轻LPS所致ALI。     

补锌对重型烧伤患者细胞因子的影响

目的：探讨补锌对重型烧伤患者细胞因子水平的影响。方法：对32例重型烧伤患者随机分为治疗组（A），组服用葡萄糖酸锌口服液，口服等渗盐水为对照组（B组），于伤后当天开始用药，持续28d，检测伤后1、3、14和28d时血清内毒素，肿瘤坏死因子－α（TNF－α）和白细胞介素－6（IL－6）含量。结果：（1）在伤后1、3d,2组间血清内毒TNF－α和IL－6水平无明显差别（P＞0．05）。（2）在伤后14d及28d，A组血清内毒素、TNF－α和IL－6含量显著低于B组。结论：补锌能降低重型烧伤患者细胞因子的水平。减轻烧伤后全身炎症反应综合征（SIRS）和多器官功能障碍综合征（MODS），提高治愈率。     

维拉帕米对重症急性胰腺炎大鼠肺损伤的保护作用

目的：探讨钙通道阻滞剂维拉帕米对重症急性胰腺炎（SAP）大鼠肺损伤的影响。方法：wistar大鼠45只，随机分为假手术组、SAP组和维拉帕米治疗组，观察动物血清中白细胞介素－1（IL－1）、白细胞介素－6（IL－6）和肿瘤坏死因子－α（TNF－α）的含量，肺组织病理学变化。结果：SAP时，大鼠血清中IL－1、IL－6和TNF－α的含量均显著升高（P＜0．01），肺损伤严重，维拉帕米治疗组炎性细胞因子水平显著下降（P＜0．05），肺病理损害程度显著减轻（P＜0．05）。结论：维拉帕米可抑制SAP大鼠炎性细胞因子IL－1、IL－6、TNF－α的产生释放，减轻肺损伤的程度。     

Measurement of L-carnitine and acylcarnitines in body fluids and tissues in children and in adults

We have developed a reliable and validated radio-enzymatic method for the assay of L-carnitine and acylcarnitines, using a modification of existing methods. The sensitivity of the assay is 10 mumol/l using 10 microliters of plasma or urine. It is also suitable for measurements of carnitine in a 10 mg sample of liver or muscle obtained by percutaneous biopsy. The use of N-ethylmaleimide in the reaction mixture together with an excess of [1-14C]acetyl CoA ensures that the reaction proceeds to completion and a linear response is obtained. Using this method control ranges have been established for plasma and urine carnitine concentrations in healthy children and adults, and for the carnitine content of liver and muscle in adults. No significant difference was found between fasting and post-prandial plasma carnitine levels. An age-related increase was found in urinary total carnitine and acylcarnitine concentration throughout childhood. These data provide a reliable basis for studies of patients with abnormal carnitine and acylcarnitine metabolism, distribution and excretion.     

Rosamicin in Urethral and Vaginal Secretions and Tissues in Dogs and Rats

In animal studies we investigated the distribution of rosamicin in plasma and urethral and vaginal tissues in rats as well as in urethral and vaginal secretions in dogs. We found concentration ratios between urethral secretion and plasma of 1.9 and between vaginal secretion and plasma of 2.4. The rosamicin concentrations in urethral and vaginal tissue significantly exceeded the levels of all other tissues investigated. Because rosamicin could be valuable for the treatment of bacterial urethritis and the colonization of the vaginal introitus with fecal bacteria in women, it should be investigated clinically in this respect.     

Similarities and differences in clients treated and in medications prescribed by APRNs and psychiatrists in a CMHC

This study is part of a larger study comparing prescribing practices of psychiatrists and advanced practice psychiatric nurses (APRNs) using the following three groups of patients: patients treated by psychiatrists, those treated by APRNs, and those treated by both APRNs and psychiatrists at different times in 1 year. Demographics for 5507 patients were examined. A subsample of APRNs and psychiatrists prescribed similar total numbers of medications. Psychiatrists prescribed more types of antidepressant medications other than the SSRI antidepressants, and they prescribed more than twice the number of benzodiazepines. APRNs prescribed more SSRIs and spent more time with clients during medication visits.     

Postural strategies and falls in elderly and in parkinsonism]

OBJECTIVE: To use a posture analysis to show the evolution of postural pattern connected with falls.MATERIAL AND METHOD: It is a prospective study on two groups of 16 persons of more than 60 years. A group concerns 16 small disability off drug parkinsonian patients, a group concerns 16 healthy witnesses. All the persons benefited from a posture recording by means of a force platform and were followed during 1 year. RESULTS: Data analysis underlines three groups of persons corresponding to three postural patterns, independently of the presence of Parkinson disease. A group (n = 18) did not contain fallers, the second (n = 10 ) contained 20% of fallers, the third (n = 4) contained 100% of fallers. Differences between the groups were identified on 16 posturographic parameters. DISCUSSION: A group has a good functional value and one does not record any fall. Its characteristics, which correspond to a category of persons who compensate well for the phenomena of ageing, are found in the literature. A group has an intermediate functional value and regrets 20% of fallers. Kinetic profile reveals a tendency to the stiffness of the posture. This group is going to operate rather ankle strategies. A group has an inferior functional value and regrets 100% of fallers. Kinetic profile seems disrupted and not to be able to adapt itself in a satisfactory way to the situation otherwise than by stereotypical reactions. This group is going to operate systematically much less stabilizing hip strategies. CONCLUSION: A close determinism between physiological neuromotor ageing and Parkinson disease does exist. We showed with a prospective follow-up, the arisen of fall and showed the evolution of postural patterns related to fall. It appears as well that evolution mainly follows three stages leading from a small risk of fall gait pattern to a major risk of fall gait pattern.     

Racial differences in oxidative stress and inflammation: in vitro and in vivo

African American race is an independent risk factor for enhanced oxidative stress and inflammation. We sought to examine whether oxidative-stress and inflammatory markers that are typically measured in humans also differ by race in cell culture. We compared levels between African American and Caucasian young adults and then separately in human umbilical vein endothelial cells (HUVECs) from both races. We found heightened oxidative stress and inflammation in the African Americans both in vitro and in vivo. African American HUVECs showed higher nitric oxide (NO) levels (10.8 ± 0.4 vs. 8.8 ± 0.7 μmol/L/mg, p = 0.03), Interleukin-6 (IL-6) levels (61.7 ± 4.2 vs. 23.9 ± 9.0 pg/mg, p = 0.02), and lower superoxide dismutase activity (15.6 ± 3.3 vs. 25.4 ± 2.8 U/mg, p = 0.04), and also higher protein expression (p < 0.05) of NADPH oxidase subunit p47phox, isoforms NOX2 and NOX4, endothelial nitric oxide synthase (NOS), inducible NOS, as well as IL-6. African American adults had higher plasma protein carbonyls (1.1 ± 0.1 vs. 0.8 ± 0.1 nmol/mg, p = 0.01) and antioxidant capacity (2.3 ± 0.2 vs. 1.1 ± 0.3 mM, p = 0.01). These preliminary translational data demonstrate a racial difference in HUVECs much like that in humans, but should be interpreted with caution given its preliminary nature. It is known that racial differences exist in how humans respond to development and progression of disease, therefore these data suggest that ethnicity of cell model may be important to consider with in vitro clinical research.