大承气颗粒对重型脓毒症神经内分泌功能的影响

目的:观察大承气颗粒对重型脓毒症(SS)病人下丘脑-垂体-肾上腺(HPA)轴激素及β-内啡肽的影响.方法:12例严重腹腔感染致SS病人术后第2 d起在常规治疗基础上使用大承气颗粒,对照组为常规治疗.观察两组术后48 h、4 d、6 d内外周血皮质醇(Cor)、促肾上腺皮质激素(ACTH)和β-内啡肽(β-EP)水平改变.结果:中药组HPA轴激素恢复明显优于对照组.入院4 d中药组ACTH、Cor和ACTH/Cor明显低于入院时,β-EP与非中药组比较差异显著.入院6 d非中药组ACTH和ACTH/Cor与入院时比较仍无显著下降,而中药组各指标均显著低于入院时,其中ACTH/Cor明显高于非中药组.结论:大承气颗粒可抑制SS状态下以Cor、ACTH和β-EP为代表的神经内分泌系统过度活化,促进肾上腺皮质功能恢复.     

大承气颗粒对腹部手术后内毒素及细胞因子的影响

目的 :探讨大承气颗粒对腹部手术后血中内毒素、细胞因子等的影响。 方法 :根据手术类型及大小分层随机将2 1例患者分为 2组 :对照组采用西医综合治疗并用安慰剂 ,观察组在西医综合治疗基础上加用大承气颗粒。于术前 1d开始口服大承气颗粒 ,术后次日开始予大承气颗粒灌肠 (除外部分结肠切除者 )至可口服时 ,改用口服大承气颗粒。术前及术后 0、3、7、14d取患者外周静脉血测定内毒素、IL - 6、新喋呤。 结果 :观察组疗效优于对照组 (P <0 0 1) ;观察组在术前大便次数有增多趋势 (P =0 0 5 ) ,手术结束至术后第 3d、第 4～ 7d、第 8～ 14d大便次数显著增多 (P <0 0 1) ;术后首次出现肠鸣音、排气及大便所需时间均缩短 (P <0 0 5 ) ;术毕内毒素低于对照组 (P <0 0 5 ) ,IL - 6有降低趋势 (P =0 0 5 6 ) ;术后第 3d新喋呤亦呈降低趋势 (P =0 0 6 9)。术毕IL - 6水平与术后开始大便所需时间呈正相关 (r=0 .5 78,P <0 0 5 )。 结论 :手术前后口服和 /或灌肠使用大承气颗粒可促进中等以上腹部手术后肠功能恢复 ,降低循环内毒素水平 ,并有一定的减低术后IL - 6和新喋呤升高的作用 ,对改善术后状态有一定价值。     

在大颗粒淋巴细胞白血病中体细胞STAT3的突变

T细胞大颗粒淋巴细胞性白血病是一种罕见的淋巴组织增生性疾病,往往与自身免疫性疾病和免疫介导的血细胞减少相关。HannaLM等人对此进行研究,对76例克隆性的T细胞受体重排和大颗粒淋巴细胞增多的患者进行了目标序列捕获测序。结果：有31例发生STAT3突变,所有的突变都分部在外显子21、编码Src同源2结构域,     

新型局限性腕舟骨、大、小多角骨融合器的研制

目的研发新型腕舟骨、大、小多角骨(STT)融合器。方法根据所测国人STT三关节有关数据设计草图,先选用钛合金制出粗样,然后置入尸体腕模拟STT局限性融合,修改后制作成品。结果STT融合器分钢板与螺钉两部分：钢板部分由锥形板及相连的圆桶状结构组成,锥形板开有3个螺钉孔,各通过1枚松质骨螺钉与3块腕骨分别固定；圆桶状结构连接于锥形板下方,中空,可供植骨,外侧面制有螺纹与腕骨紧密咬合。同时还制作了配套工具。结论STT融合器设计合理,它可使3块腕骨间的固定力学强度大大提高,并可防止STT融合体向关节中心旋转及塌陷,是局限性腕骨融合术中新型、可靠的内固定方式。     

大承气颗粒药物血清对小鼠肠上皮内淋巴细胞一氧化氮产生的影响

目的:探讨大承气颗粒药物血清对小鼠肠上皮内淋巴细胞(IELs)一氧化氮产生的作用机制。方法:分离、培养IELs,以大承气颗粒药物血清和大黄酚等作用于IELs,荧光分光光度法测定培养上清液中NO含量。结果:大承气颗粒药物血清和大黄酚使IELs产生的NO分别显著低于培养液对照、正常大鼠血清及植物血凝素(P0.01,P0.05)。结论:大承气颗粒药物血清和大黄酚能相似程度地抑制小鼠IELs产生NO。     

大黄灵脾颗粒对缺血再灌注急性肾损伤大鼠肾纤维化的干预作用

目的:探讨大黄灵脾颗粒对缺血再灌注急性肾损伤模型大鼠肾纤维化的影响。方法:30只雄性SD大鼠随机分为正常组、模型组、大黄灵脾颗粒(中药)组,每组10只,通过夹闭肾蒂45 min后恢复肾脏血流再灌注建立模型,建模成功后次日各组大鼠开始灌胃治疗,正常组和模型组灌服生理盐水,中药组给予大黄灵脾颗粒灌胃。术后12周检测各组大鼠Scr、BUN、24 h尿蛋白等生化指标;HE染色观察肾组织病理;Masson染色观察肾纤维化情况;免疫组化法检测肾组织TGF-β1和α-SMA蛋白的表达水平。结果:各组大鼠Scr、BUN差异无统计学意义(P>0.05);与模型组比较,HE染色显示中药组肾组织损伤轻于模型组,且中药组24 h尿蛋白显著低于模型组(P<0.05);Masson染色显示中药组纤维化程度较模型组明显减轻,中药组肾组织TGF-β1和α-SMA蛋白的表达水平也显著低于模型组(P<0.05)。结论:大黄灵脾颗粒可改善AKI大鼠肾脏病理,降低尿蛋白水平,抑制TGF-β1和α-SMA的表达,并减轻AKI后肾纤维化的发生。     

大承气颗粒对重型脓毒症促炎-抗炎反应平衡的影响

目的:观察大承气颗粒对重型脓毒症(SS)促炎-抗炎反应平衡的影响.方法:12例严重腹腔感染致SS病人术后第2 d起在常规治疗基础上使用大承气颗粒,对照组为常规治疗.观察术后48 h、4 d、6 d内外周血T辅助(Th)细胞亚群、单核细胞表面HLA-DR表达、血清肿瘤坏死因子(TNF)-α,白介素(IL)-10、前列腺素E2(PGE2).结果:中药组促炎-抗炎因子恢复明显优于对照组,IL-10在48 h即开始降低,TNF-α/IL-10比值恢复明显增加;单核细胞HLA-DR表达和Thl/Th2比值的恢复也快于对照组,其中HLA-DR在4 d时高于入院,而Th亚群恢复始于入院第6 d.结论:大承气颗粒不仅可抑制SS病人以TNF-α为代表的促炎因子过度分泌,还可促进抗炎介质IL-10、PGE2的下降,促进Th细胞漂移和HLA-DR表达下降的恢复,有利于免疫平衡的恢复.     

大肝癌的治疗

肝细胞癌是世界上最常见的恶性肿瘤之一.据WHO统计,全球每年新发肝癌病例超过100万,其中约55%发生在中国大陆,而且80%～90%的患者合并慢性乙型肝炎病毒感染.大部分肝癌患者病情隐匿,就诊时肿瘤较大,或合并严重的肝硬化、门静脉癌栓等.1994年,陈孝平根据肿瘤大小将肝癌分为四种类型[1]：①微小肝癌,直径≤2cm;②小肝癌,2cm〈直径≤5cm;③大肝癌,5cm〈直径≤10cm;④巨大肝癌,直径〉10cm.     

大粗隆加强型钝角钢板的研制与应用（附19例治疗报告）

作设计了大粗隆加强型钝角钢板，该铜板由连为一体的股骨干固定板、股骨颈穿入板、大粗隆固定板三部分组成。经力学测试及临床应用，结果证明该钢板结构牢固，可承受患肢非暴力状态下的动静负荷。作认为，本钢板设计增加了大粗隆部固定板，有利于大粗隆部骨折块固定，自大粗隆部穿向股骨头颈内的加压螺钉增强了股骨颈上方的抗张正力，使粗隆间骨折的整体固定稳定性提高，有效地防止髓内翻，有利于患肢早期功能锻炼。     

颗粒脂肪注射隆乳致乳腺组织、胸大肌慢性炎症2例

2008-2009年笔者共收治14例颗粒脂肪注射隆乳，其中2例自体颗粒脂肪注射隆乳后致胸大肌及乳腺组织慢性炎症伴脂肪液化，现报道如下。     

制粒工艺参数对造料过程性能的影响

在实验室制粒系统,通过改变粉料在调质器内的调质效果及制粒机工艺参数,考察了入模水分、辊模间隙及压模孔长径比(L/d)对制粒机的生产率、电耗及颗粒饲料质量的影响.结果表明:在保证颗粒质量的前提下,可通过调控入模水分、辊模间隙和压模孔长径比(L/d)等工艺参数,达到提高制粒生产率,降低电耗的目的.对于含谷物高的配合饲料,制粒的适宜条件是:调质入模水分为15%～16%,辊模间隙为0.7mm,压模孔长径比(L/d)为10.     

Interesting Features of an Activated Carbon Supported Urease System

Abstract: Spherical activated carbon was employed as a new support material for the immobilization of urease. Activity and kinetic behavior of the enzyme were observed. Urease activity was decreased by 10% for the uncoated samples during the washing process whereas a 30% reduction in activity was observed for the coated samples due to the electrical discharge. Activity versus time plots generally appeared to be s-shaped curves at different initial urea levels. At high substrate concentration the kinetics no longer obeyed the Michaelis-Menten relationship due to the inhibition mechanism and diffusion for the support system.     

酸性脲酶反应动力学研究

用Ｂｅｒｔｈｌｏｔ法测定酸性脲酶酶反应过程产物ＮＨ＋４的浓度变化。实验表明，酸性脲酶反应是按Ｍｉｃｈａｅｌｉｓ机理进行。其最佳反应条件是ｐＨ＝４．５，反应温度６０℃，反应活化能Ｅａ＝３７．３４ｋＪ／ｍｏｌ，米氏常数Ｋｍ＝０．２８６８ｍｍｏｌ／Ｌ，Ｖｍ＝０．１７４４ｍｍｏｌ／Ｌ·ｍｉｎ．     

Potential contribution of optional urease-positive bacteria to idiopathic urinary calcium stone formation

The aetiology of calcium oxalate stones, which are commonly believed to be sterile, has not yet been fully elucidated. Recent bacteriological studies and investigations using the scanning electron microscope have also shown microorganisms to be present in this type of stone. These microorganisms were assumed not to be able to split urea. To list the most common urease-negative bacteria established in the human urinary system, we isolated apparently urease-negative microorganisms from a consecutive series of 58 urinary stone-forming patients by using standard selecting agars. Pure strains were incubated in an inductive medium lacking all sources of nitrogen except urea. Induction of urease activity was monitored by a test based on the reaction of phenol/hypochlorite with ammonium ions. This test revealed whether the urease negativity of a strain indicated by the selective agar was optional of absolute. All strains we investigated by this method and which were classified by standard methods as urease-negative we found produced urease activity which was clearly measurable, though it was often comparatively small. In the light of these results, the matrix theory of calcium oxalate stone development will need some modifications.     

优选前后精子顶体酶活性与IVF受精率相关性的研究

目的探讨优选处理前和处理后精子顶体酶活性的变化,及与体外受精(IVF)受精率的相关性。方法采用分光光度比色法,对接受IVF治疗的53例不育夫妇男方精液,分别测定优选处理前和处理后精子顶体酶活性,分析其与IVF受精率的相关性。结果优选处理后精子顶体酶活性与优选前比较有显著性差异(P<0.05);达到常规IVF标准并选择常规IVF治疗者,优选后的精子顶体酶活性与IVF受精率有相关性,精子顶体酶活性降低与IVF受精率降低有关。结论精子顶体酶活性与IVF受精率有相关性,并且通过精子顶体酶活性可以预测IVF受精率。     

Cytokine production and cytotoxicity of lymphocytes in patients on maintenance short- or long-term haemodialysis

The lymphocyte-mediated cytotoxicity and cytokine productionof patients under maintenance haemodialysis were studied. Thepatients were subdivided into two groups; 27 patients receivinghaemodialysis treatment for up to 3 years (group 1) and 27 patientsfor longer than 10 years (group 2). Twenty-six healthy volunteers(group 3) were used as controls. The immunological parametersassayed were NK cell and lymphokine-activated killer (LAK) cellactivities, and production of both interferon (IFN)-gamma andtumour necrosis factor (TNF)-alpha by either peripheral bloodmononuclear cells (PBMC) cultured with IL-2 or LAK cells. In group 1 both NK- and LAK-cell-mediated cyto-toxicities weresignificantly suppressed as compared to those in group 3. Thetitre of IFN produced by LAK cells was also less than that ingroup 3. On the contrary there were no significant differencesin cytokine production by PBMC in all three groups. Percentageof the cases with suppressed cytokine production seemed higherin group 1 than group 3. In addition there was a close correlationbetween the value of IFN-gamma and of TNF-alpha produced byPBMC in the patients on haemodialysis. Both the type of dialysismembranes used and the primary diseases did not significantlyinfluence the results in group 1 and group 2. From these resultsit could be speculated that there are more patients with impairedimmune function in group 1 than in group 3. In contrast therewas no significant difference in the immune function testedbetween group 2 and group 3. Our results indicate the need for a study on time kinetics concerningthe change in suppressed immune function of the patients andtheir clinical courses shortly after the beginning of haemodialysis.     

强酸化电位水腹腔灌注对腹腔粘连影响的研究

目的 探讨腹腔手术后应用强酸化电位水腹腔灌注对腹腔粘连的影响。方法 大耳白兔24只,其中实验组 12只,对照组 12只,腹腔内分别连续灌注强酸化电位水和生理盐水 5 d,灌注结束后 10 d再开腹观察并测定粘连肠段羟脯氨酸。结果 对照组粘连程度以Ⅲ～Ⅳ级肠粘连为主(10只),实验组以Ⅰ～Ⅱ肠粘连为主(9只)。两者差异有显著性(P<0.05)。对照组羟脯氨酸的水平为 0.274±0.043,实验组羟脯氨酸的水平为 0.201±0.018。两者差异有显著性(P<0.05)。结论 腹腔内灌注强酸化电位水对腹腔粘连有预防作用。     

纤维素酶活性麦稃霉菌固体发酵物的流化床干燥试验

对含水分５０％～６０％（湿基）的纤维素酶（β－（１．４，１．３）－葡聚糖内切酶）活性麦稃霉菌固体发酵物湿坯，经过分散化预处理后，在不同的空气流速下进行的流化床干燥试验进行了研究。在干燥温度为７０℃、空气流速为３ｍ／ｓ的条件下，将含水分５５％的物料干燥至确定的终点８％（湿基），可以保留９０％左右的酶活率，其效果与冷冻干燥法和低温（４０℃）烘箱干燥法相当。认为湿基８％左右的物料水分含量应该是制品的干燥终点。对物料酶活性保留和流化床干燥控制有关的湿含量影响和干制品粒度级分的重量、水分含量和酶活含量分布也进行了试验研究。     

Differential effects of halothane,enflurane, isoflurane,and sevoflurane on the hemodynamics and metabolism in the perfused rat liver in fasted rats

The effects of volatile anesthetics on hepatic hemodynamics and metabolism were studied using isolated liver perfusion. The liver was isolated from overnight-fasted male Sprague-Dawley rats and placed in a recirculating perfusion-aeration system. The liver was perfused through the portal vein at a constant pressure of 12 cmH₂O. Four volatile anesthetics, halothane, enflurane, isoflurane, and sevoflurane, were administered at concentrations identical to 1 and 2 times the minimal alveolar concentration (MAC). All the anesthetics maintained hepatic flow and decreased hepatic oxygen consumption. Among the anesthetics tested, isoflurane produced the largest decrease in hepatic oxygen consumption. At 2 MAC, the percent decrease in oxygen consumption by isoflurane was significantly greater than that by halothane. The increase in lactate concentration in the recirculating perfusate was significantly enhanced by the volatile anesthetics, and the enhancement was less remarkable in the isofluranetreated group than in the enflurane-or sevoflurane-treated groups. These results indicate that volatile anesthetics alter hepatic carbohydrate metabolism but maintain hepatic blood flow when the perfusion pressure is kept constant. Isoflurane exerts exceptional influence on hepatic oxygen consumption and lactate production, and may be preferable for operations that limit the oxygen supply to the liver.     

全脂大豆热处理条件及其营养评价

通过ＤＳＣ分析，研究了不同含水量的大豆，尿酶及美拉德反应情况，发现水分高的大豆易变性，尿酶失活快于美拉德反应的产生，说明了有效赖氨酸在高水分时保持率较高的机理。控制大豆热处理工艺，使得尿酶活力降至０．４ｍｇ／（ｇｍｉｎ）以下，而大豆中有效赖氨酸的保持率为８０％．通过热处理工艺中温度、时间、水分等参数的分析，得出尿酶活力与有效赖氨酸、氮溶指数之间呈正相关（但非线性相关）；有效赖氨酸与尿酶活力与胰蛋白酶活力呈正相关。