双氢青蒿素治疗对卡氏肺孢子虫肺炎大鼠肺泡巨噬细胞上清液TNF—α和NO水平的影响

目的 研究双氢青蒿素治疗对卡氏肺孢子虫肺炎大鼠泡巨噬细胞上清液TNF－α和NO水平的。方法 以醋酸可的松皮下注射Wistar大鼠建立卡氏肺孢子虫肺炎动物模型。用60mg/kg双氢青蒿素治疗实验大鼠后杀鼠取,用胶原酶消化法分离肺泡巨噬细胞,用LPS刺激培养72h,同时庙有感染组和正常对照。用TNF－α和NO试剂盒分别检测培养上清液TNF－α和NO活性。结果 感染组和治疗组TNF－α和NO水平均高于正常对照,治疗组TNF－α和NO水平则低于感染组。结论 卡氏肺孢子虫感染引起大鼠肺泡巨噬细胞分泌高水平的TNF－α和NO,胆双氢青蒿素治疗后PCR大鼠肺泡巨噬细胞产生TNF－α和NO水平降低。     

双氢青蒿素对卡氏肺孢子虫肺炎大鼠NO水平的影响

目的　研究双氢青蒿素对卡氏肺孢子虫肺炎大鼠血清和肺泡巨噬细胞上清液 NO水平的影响。　方法　以醋酸可的松皮下注射 Wistar大鼠建立卡氏肺孢子虫肺炎动物模型 ,用 6 0 mg/ kg双氢青蒿素治疗实验大鼠 ,杀鼠取肺 ,用胶原酶消化法分离肺泡巨噬细胞 ,用 L PS刺激培养 72 h,同时设有感染组和正常对照。用 NO试剂盒分别检测大鼠血清和肺泡巨噬细胞上清液 NO活性。　结果　感染组大鼠血清、肺泡巨噬细胞上清液原液以及经 L PS刺激后肺泡巨噬细胞上清液 NO浓度分别为 ( 16 7.3± 2 3.1)、( 141.6± 18.0 )和 ( 12 9.5± 2 8.4) μmol/ L,治疗组分别为 ( 111.8± 40 .6 )、( 136 .3± 35 .1)和 ( 12 9.9± 14.2 ) μmol/ L,正常对照组分别为 ( 87.2± 32 .1)、( 10 9.8± 18.0 )和 ( 136 .2± 30 .5 ) μmol/ L,可见感染组和治疗组大鼠 NO水平均高于相应的正常对照 ,治疗组 NO水平低于相应的感染组。　结论　卡氏肺孢子虫感染可能引起大鼠肺泡巨噬细胞分泌高水平 NO,经双氢青蒿素治疗后 ,PCP大鼠肺泡巨噬细胞分泌 NO水平降低。     

双氢青蒿素治疗对卡氏肺孢子虫肺炎大鼠脾细胞上清液一氧化氮水平的影响

目的研究双氢青蒿素治疗对卡氏肺孢子虫肺炎(PCD)大鼠脾细胞上清液一氧化氮(N0)水平的影响。方法以醋酸可的松皮下注射Wistar大鼠，建立卡氏肺孢子虫肺炎动物模型，用60mg／kg双氢青蒿素治疗实验大鼠，杀鼠取肺，胶原酶消化法分离脾细胞，脂多糖(LPS)刺激培养72h，用NO试剂盒检测大鼠脾细胞上清液NO活性，同时设有感染组和正常对照组。结果感染组和治疗组大鼠NO水平高于正常对照组，治疗组NO水平低于感染组。结论卡氏肺孢子虫(PC)感染可能引起大鼠脾细胞分泌高水平NO，发挥杀伤PC作用，同时加重宿主组织炎症反应，抑制宿主的免疫应答；经双氢青蒿素治疗后，PCP大鼠脾细胞分泌NO降低，组织炎症反应减轻，使宿主的免疫应答接近正常状态。     

双氢青蒿素对卡氏肺孢子虫肺炎大鼠脾细胞凋亡的影响

目的　检测双氢青蒿素对卡氏肺孢子虫肺炎 (PCP)大鼠脾细胞凋亡的影响。方法　以醋酸可的松皮下注射Wis tar大鼠建立PCP动物模型 ,用 60mg/kg双氢青蒿素治疗实验大鼠 ,杀鼠取肺 ,用胶原酶消化法分离其脾细胞 ,用PI和TUNEL染色法检测其凋亡 ,同时设有感染组和正常大鼠对照组。结果　感染组和治疗组大鼠脾细胞凋亡率显著高于正常对照组 ,治疗组大鼠脾细胞凋亡率明显低于感染组。结论　卡氏肺孢子虫感染引起大鼠脾细胞发生凋亡 ,而双氢青蒿素治疗后PCP大鼠脾细胞凋亡降低     

蒿甲醚用于卡氏肺孢子虫肺炎大鼠的治疗及其对IL-6影响的研究

目的 从病理学和细胞因子角度探讨蒿甲醚对大鼠卡氏肺孢子虫肺炎（Pneumocystiscarinii Pneumonia POP）的治疗效果和作用机理。方法 给SD大鼠皮下注射地塞米松磷酸钠建立卡氏肺孢子虫肺炎动物模型，治疗组给予蒿甲醚治疗。ELISA双抗夹心法分别检测血清和支气管肺泡灌洗液中1L-6水平。结果 与感染对照组比较，蒿甲醚治疗组症状显著改善、肺印片中卡氏肺孢子虫包囊数目显著减少、肺组织炎症明显减轻、血清和肺泡灌洗液中IL-6水平明显下降。结论 蒿甲醚具有一定抗大鼠卡氏肺孢子虫肺炎作用，能够降低PCP大鼠IL-6。     

经双氢青蒿素治疗后卡氏肺孢子虫肺炎大鼠的肺部病理学变化

目的　研究经双氢青蒿素治疗后卡氏肺孢子虫肺炎 (PCP)大鼠肺部病理学变化。方法　以地塞米松磷酸钠皮下注射Wistar大鼠建立卡氏肺孢子虫肺炎动物模型 ,用 6 0mg/kg双氢青蒿素治疗实验大鼠 ,杀鼠取肺 ,用光镜和电镜观察肺部病理学变化 ,同时设有感染对照组和正常对照组。结果　肺印片中卡氏肺孢子虫 (Pc)包囊数目显著减少 ,肺组织炎症明显减轻 ,Pc滋养体表膜和核膜破裂 ,胞质中出现大量空泡和高电子密度颗粒 ,Pc包囊中也出现空泡 ,囊内小体变性坏死。结论　双氢青蒿素可杀死Pc滋养体和包囊 ,从而减轻肺组织的炎症反应。     

用半巢式PCR检测无创性标本诊断卡氏肺孢子虫肺炎的实验研究

目的无创性诊断卡氏肺施子虫肺炎。方法采用一对半引物进行半巢式DHFR－PCR检测实验大鼠无创性标本——支气管液、血清及活检标本——肺及肝脏组织中的卡氏肺孢子虫DNA。结果从59只经病理学检查证实的卡氏肺孢子虫肺炎大鼠中采集到的上述4种标本，卡氏肺孢子虫DNA的半巢式DHFR－PCR检出率分别为72.7％（32／44），37.3％（22／59），94．9％（56／59）和36．4％（8／22），而DHFR－PCR的检出率则仅为25％，13．6％，71．2％和9．1％。12只轻度感染的PCP大鼠的无创性标本中卡氏肺孢子虫DNA的检出率由刚提高至41．7％。正常鼠标本及各种病原体对照的半巢式DHFR－PCR均为阴性。结论用半巢式DHFR－PCR无创性地诊断大鼠卡氏肺孢子虫肺炎具有敏感、特异、省时、省力等优点；本文在血和肝中检出卡氏肺孢子虫DNA，提示在卡氏肺孢子虫肺炎大鼠模型中存在虫血症和肺外卡氏肺孢子虫感染。     

大鼠实验性卡氏肺孢子虫肺炎中IL-2,IL-6的变化

目的 建立大鼠实验性卡氏肺孢子虫肺炎的模型,观察血清和肺泡灌洗液中IL-2和IL-6的变化.方法 给SD大鼠皮下注射地塞米松磷酸钠建立卡氏肺孢子虫肺炎动物模型,酶免法检测支气管肺泡灌洗液中IL-2和IL-6含量及血清中IL-6含量;放免法检测血清中IL-2含量.结果 感染组大鼠血清和肺泡灌洗液中IL-2和IL-6含量均显著高于正常对照组.结论 卡氏肺孢子虫肺炎大鼠血清和肺泡灌洗液中IL-2和IL-6升高.     

保元汤加减对卡氏肺孢子虫肺炎模型大鼠的免疫调节作用初探

目的 观察中药保元汤加减煎剂对卡氏肺孢子虫肺炎模型大鼠免疫状态的调节作用，以探索中医药治疗卡氏肺孢子虫肺炎的新途径。方法 在造模不同时间，以保元汤加减煎剂给卡氏肺孢子虫肺炎(PCP)模型大鼠灌胃，2ml／次，1次／d，于造模后第8周末，测定各组实验大鼠淋巴细胞转化率及T细胞亚群百分率。结果 预防组大鼠淋巴细胞转化率明显高于PCP模型对照组，其值与正常对照组差异无显著性；预防组和治疗组大鼠的CD4^ 及CD4^ ／CD8^ 值高于PCP模型对照组和治疗对照组，预防组CD4^ 及CD4^ ／CD8^ 值与正常对照组差异无显著性。结论保元汤加减煎剂，可提高卡氏肺孢子虫肺炎模型大鼠的机体免疫功能，可作为防治卡氏肺孢虫子肺炎的药物。     

卡氏肺孢子虫感染大鼠血清中酶学变化及意义

目的探讨卡氏肺孢子虫(PC)感染大鼠血清中酶学变化的意义。方法应用地塞米松诱导建立卡氏肺孢子虫肺炎(PCP)大鼠模型(PCP组),于造模前(0周)及造模后3、6、9、12周断尾取血,检测血清中丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)水平;于12周后采集肺泡灌洗液(BALF)检测ALT、AST、ALP、LDH水平。结果PCP组血清ALP、AST水平从造模第3周以后显著高于正常对照组(P<0.05),ALT及LDH水平无明显规律性变化。结论ALP、AST可作为PCP感染的辅助诊断指标。     

辛伐他汀对血脂异常人群缺血性脑卒中的预防

目的研究辛伐他汀对血脂异常人群缺血性脑卒中的预防作用。方法将2853例血脂异常人群分为预防组(693例)和对照组(2160例),预防组给予辛伐他汀20mg/d,睡前口服。分析2组血脂变化、心脑血管事件、脑卒中等差异。结果预防组受试者糖尿病患病率比对照组高,预防组随访率98．7%,对照组随访率96．2%。预防组低密度脂蛋白胆固醇较对照组低[(2．54±1．01)mmol/L vs(4．12±1．29)mmol/L,P＜0．05],5年生存率高(94．13% vs 83．47%,P＜0．01),缺血性脑卒中和心脑血管事件发生率低。2组死亡的主要原因是:心脑血管疾病、肿瘤和感染。吸烟、高血压、肥胖和糖尿病是脑卒中和心脑血管事件的高危因素。结论辛伐他汀能有效降低血脂异常人群的心脑血管事件。     

Treatment of cachexia with ghrelin in patients with COPD

STUDY OBJECTIVES: Ghrelin is a novel growth hormone (GH)-releasing peptide that also induces a positive energy balance by decreasing fat utility and stimulating feeding through GH-independent mechanisms. We investigated whether ghrelin improves cachexia and functional capacity in patients with COPD. METHODS: This is an open-label pilot study. Human ghrelin (2 microg/kg bid) was IV administered to seven cachectic patients with COPD for 3 weeks. Food intake, body composition, muscle strength, exercise capacity, pulmonary function, and sympathetic nerve activity were examined before and after ghrelin therapy. RESULTS: A single administration of ghrelin markedly increased serum GH (21-fold). Three-week treatment with ghrelin resulted in a significant increase in mean (+/- SEM) body weight (49.3 +/- 3.6 to 50.3 +/- 3.8 kg; p < 0.05). Food intake was significantly increased during ghrelin therapy. Ghrelin increased lean body mass and peripheral and respiratory muscle strength. Ghrelin significantly increased Karnofsky performance status score and the distance walked in 6 min (370 +/- 30 to 432 +/- 35 m; p < 0.05), although it did not significantly alter pulmonary function. Ghrelin attenuated the exaggerated sympathetic nerve activity, as indicated by a marked decrease in plasma norepinephrine level (889 +/- 123 to 597 +/- 116 pg/mL; p < 0.05). CONCLUSIONS: These preliminary results suggest that repeated administration of ghrelin improves body composition, muscle wasting, functional capacity, and sympathetic augmentation in cachectic patients with COPD.     

Efficacy of eprosartan in combination with HCTZ in patients with essential hypertension

This randomised, double-blind study was designed to investigate the efficacy of a once-daily (OD) combination of the AT(1) receptor blocker, eprosartan 600 mg, and the thiazide diuretic, hydrochlorothiazide (HCTZ) 12.5 mg, in patients with mild to moderate hypertension (sitting diastolic blood pressure (sitDBP) > or =98 mm Hg and < or =114 mm Hg) not adequately controlled with eprosartan 600 mg OD. A total of 494 patients entered the open-label monotherapy run-in phase, which consisted of eprosartan 600 mg OD for 3 weeks. Patients who responded to monotherapy were not eligible to enter the randomised phase of the study and were withdrawn. The remaining 309 patients were then randomised to either eprosartan 600 mg plus HCTZ 12.5 mg OD or to continue on eprosartan 600 mg OD. In the eprosartan plus HCTZ combination group, both sitDBP and sitting systolic blood pressure (sitSBP) were significantly reduced compared with the eprosartan monotherapy group. In addition, the response rate was higher in the combination group compared with the monotherapy group. There were no significant effects on reduction of sitDBP due to gender, prior use of antihypertensives or baseline severity of hypertension. The tolerability profile for the combination group was similar to that for the monotherapy group. Headache was the most frequent adverse event in both treatment groups. The majority of adverse events were mild to moderate in intensity. In this study of patients who were unresponsive to eprosartan monotherapy for 3 weeks, a combination product of eprosartan 600 mg and HCTZ 12.5 mg was shown to be an effective and well tolerated treatment.