机械通气对体外循环术后炎症反应的影响

目的：探讨体外循环（CPB）术后不同肺通气策略对肌体炎症反应的影响。方法：行室间隔缺损修补术的患者30例，随机分为两组，传统通气组（H组）和保护性肺通气组（L组），于麻醉诱导后、CPB前、CPB结束即刻、CPB结束后6小时取静脉血样测IL-6和IL-8。结果：在体外循环前H组与L组在IL-6与IL-8水平无差异，CPB结束即刻两组的IL-6与IL-8水平均明显升高，而两组间亦无差异性。在CPB结束后6小时两组的IL-6与IL-8水平继续升高，H组升高的更明显，L组仅轻度升高。结论：保护性肺通气策略可以降低体外循环术后的全身炎症反应，有利于患者肺功能的恢复。     

谷氨酰胺对脂多糖血症大鼠热休克蛋白70和肿瘤坏死因子-α表达的影响

目的：观察谷氨酰胺对脂多糖血症大鼠热休克蛋白70和肿瘤坏死因子-α的影响。 方法: 将大鼠分为脂多糖组（LPS）、谷氨酰胺组（Gln）和对照组(C)。各组动物均在给予LPS前（对照组在给予生理盐水）和后2、4、6 h采血。用放射免疫法测定血浆肿瘤坏死因子-α（TNF-α）含量。于术后6 h处死，取肺、肝、肠组织，采用SABC方法，免疫组织化学染色进行HSP70检测，并HE染色，观察组织变化。 结果： 注射LPS后2 h，LPS组血浆TNF-α表达显著升高（P<0.01），Gln可显著抑制其升高（P<0.01）。而注射LPS后4、6 h，两组血浆TNF-α浓度没有明显差异。LPS组肺、肝、肠组织的HSP70灰度值分别为（107.94±10.96）、（120.04±5.73）和（123.31±14.81）。Gln组的HSP70灰度值显著降低，分别为（89.71±9.64）、（89.38±12.03）和（107.61±14.02）（均P<0.05）。病理学观察显示, Gln组肺、肝、肠组织损伤程度比LPS组轻。 结论： 谷氨酰胺可提高热休克蛋白70的表达，对脂多糖血症大鼠有防治作用。     

急性肝功能衰竭小鼠肠屏障功能障碍的实验研究

目的探讨急性肝功能衰竭时肠屏障功能的变化。方法腹腔注射D-氨基半乳糖（D-GalN,700mg/kg）/内毒素（LPS,10μg/kg）建立小鼠急性肝功能衰竭模型,造模6h后测定小鼠血清丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）的活性,取肠内容物及肝组织进行细菌培养,同时检测肠组织二胺氧化酶（DAO）的活性。结果腹腔注射D-GalN/LPS6h后,小鼠血清中ALT、AST活性显著提高（P〈0.01）;肠道内肠杆菌、肠球菌数量明显上升（P〈0.01）,乳酸杆菌、双歧杆菌数量明显下降（P〈0.05）;肠组织DAO活性明显降低（P〈0.01）;肝脏细菌培养阳性率达100%。结论急性肝功能衰竭时肠屏障明显受损,并发生菌群失调及细菌易位。     

脂多糖性休克大鼠血浆和主要器官中硫化氢含量的变化和意义

目的：探讨内毒素休克（endotoxic shock，ES）大鼠血浆及肝、肾、心、肺、主动脉等主要器官组织中内源性硫化氢（hydrogen sulfide，H2S）的含量变化及意义。方法：用静脉注射脂多糖（lipopolysaccharide，LPS）法制备LPS攻击大鼠模型，将雄性Wistar大鼠随机分为正常对照组、LPS组、LPS+硫氢化钠（NaHS，H2S供体）组、LPS+炔丙基甘氨酸（PPG，H2S代谢酶抑制剂）组。观察给药后240 min内大鼠平均动脉压（mean arterial pressure，MAP）的变化及测定血浆和以上主要器官中H2S含量，并分析其相关性；光镜观察主要器官的形态学变化。结果：与正常对照组相比，LPS组大鼠血压迅速下降，血浆H2S含量于LPS注射后显著增高，肝、肾、心、肺和主动脉组织中H2S含量亦明显增高（均P<0.05），并出现组织结构损伤；给予PPG能显著抑制血浆以及各组织中H2S含量的增高，并可显著减轻LPS所致的血压下降（均P<0.05）和组织损伤；而给予H2S供体NaHS后，与LPS组相比，大鼠血浆以及各组织中H2S含量显著增高，血压明显下降（均P<0.05），组织损伤加重。LPS攻击大鼠血浆及组织中H2S含量与血压呈高度负相关（均P<0.05）。结论：H2S是一种新的内源性介质，可能参与了ES的一系列病理生理过程。     

实验性大鼠急性心肌缺血血浆蛋白C和D-二聚体检测的研究

目的探讨垂体后叶素致急性心肌缺血的实验性大鼠血浆蛋白C和D-二聚体水平的变化和意义。方法50只大鼠随机分成正常对照组和实验模型组，腹腔注射垂体后叶素建立急性心肌缺血模型，观察注射垂体后叶素后心电图ST段变化以及血浆蛋白C活性和D-二聚体浓度生化指标。结果实验组血浆D-二聚体水平明显高于正常对照组（P〈0．01），而血浆蛋白C活性检测与正常对照组没有明显差别（P〉0．05）。结论血浆蛋白C不是垂体后叶素致实验性大鼠急性心肌缺血的主要因素，而D-二聚体增高参与了垂体后叶素致大鼠急性心肌缺血的过程。     

金纳多对体外循环脑损伤的保护作用

目的观察金纳多对体外循环脑损伤的保护作用。方法择期行风湿性心脏病二尖瓣置换术患者40例，美国麻醉医师协会分级Ⅱ～Ⅲ级，按随机数字表法随机分为银杏叶提取物组（EGB组）和对照组各20例。银杏叶提取物组（20例）：体外循环管道预充乳酸林格氏液中加入银杏叶提取物注射液1mg／kg；对照组（20例）：体外循环预充乳酸林格氏液。分别于体外循环开始前（T1）、体外循环开始后30min（T2）、体外循环结束时（L）、体外循环结束后2h（T4）、体外循环结束后6h（T5）、体外循环结束后12h（T6）、体外循环结束后24h（T7）7个时间点同步采集桡动脉及颈内静脉血，动脉血进行血气分析，静脉血测定血清S-100β蛋白、神经元特异性烯醇化酶（neuron specific enolase，NSE）浓度。结果CPB开始后即有血清S-100β蛋白和NSE浓度升高，EGB组S-100β蛋白和NSE浓度明显低于对照组，且其达峰时间提前。结论银杏叶提取物能改善脑氧供需平衡，明显减少血清脑损伤标志物S-100β蛋白和NSE的浓度升高，有明确的脑保护作用。     

高同型半胱氨酸诱导血管内皮功能障碍促进微循环障碍和微血栓形成

目的：采用蛋氨酸灌胃复制高同型半胱氨酸血症(hyperhomocysteinemia,HHcy)致内皮功能障碍,在此基础上，联合脂多糖（lipopolysaccharide，LPS）和角叉菜胶（carrageenan，Ca）造成大鼠体内广泛微血栓形成，观察血管内皮损伤和功能障碍对大鼠体内微血栓形成的促进作用。方法: ①内皮损伤模型的建立。SD大鼠随机分为对照组（control）、内皮功能障碍组（HHcy）。HHcy组采用蛋氨酸灌胃4周复制HHcy致内皮功能障碍模型，对照组以等量纯净水灌胃。4 周后检测血浆同型半胱氨酸（homocysteine，Hcy）水平，并取大鼠胸主动脉段进行血管舒张功能检测，同时检测血浆一氧化氮（NO）和血管性假血友病因子（von Willebrand factor，vWF）水平，以评价血管内皮功能状况。②Ca/LPS诱导微血栓形成。SD大鼠随机分为对照组（control）、微血栓组（Ca/LPS）、内皮功能障碍加微血栓组（HHcy＋Ca/LPS）。Ca/LPS组大鼠腹腔注射Ca，16 h再腹腔注射LPS。注射LPS 20 h后心脏采血检测凝血功能和血小板计数，镜下观测肠系膜微循环，24 h大鼠颈动脉采血结束实验，检测血浆NO和vWF值。对照组腹腔注射等量生理盐水，检测指标同模型组。HHcy＋Ca/LPS组大鼠经蛋氨酸灌胃持续4周后，再按照上述方法注射Ca/LPS，观察内皮功能障碍对大鼠微循环障碍和微血栓形成的影响。结果： ①蛋氨酸灌胃4周导致HHcy,血浆vWF水平显著升高，NO水平降低，内皮依赖性血管舒张功能显著降低，提示血管内皮功能受损，大鼠内皮功能障碍模型复制成功。②Ca/LPS组肠系膜微循环可见广泛微血栓形成，注射LPS后20 h ，通过检测凝血指标可见血液处于高凝状态。而与之比较，HHcy＋Ca/LPS组微循环障碍进一步加强，血小板计数减少，血浆NO值降低，vWF升高；注射LPS 20 h后可见血液处于继高凝状态之后的消耗性低凝状态。结论： 蛋氨酸灌胃4周导致HHcy,诱导血管内皮功能障碍。联合Ca/ LPS 造模可建立微循环障碍和微血栓形成的动物模型，而内皮功能障碍能加速加重微循环障碍和微血栓形成。     

内源性H2S对LPS所致大鼠急性肺损伤时肺动脉高压的影响及其与一氧化氮的相互作用

目的： 探讨硫化氢（H2S）对脂多糖（LPS）所致急性肺损伤时肺动脉高压（PAH）的影响及H2S/胱硫醚-γ-裂解酶（CSE）体系和一氧化氮（NO）/一氧化氮合酶（NOS）体系在其发生机制中的相互作用。 方法： 将72只大鼠随机分为生理盐水（NS）对照组、LPS组、LPS+L-NAME组、LPS+PPG组，检测给药后2、4、6、8 h的平均肺动脉压（mPAP），以及4、8 h血浆H2S、NO含量和iNOS、cNOS活性、肺组织NO含量和iNOS、cNOS、CSE活性，免疫组化法测定肺组织iNOS蛋白表达，并结合肺光镜形态等指标综合评价肺损伤程度。 结果： LPS组各时点的mPAP显著高于对照组，给药后4、8 h，NO含量、iNOS活性和蛋白表达升高，cNOS活性及H2S含量、CSE活性降低，肺组织损伤较重。预先给予L-NAME可减轻LPS所致上述指标的改变。而预先给予PPG可加重LPS所致肺损伤，但对cNOS活性无明显影响。 结论： LPS使内源性H2S减少导致mPAP升高； H2S/CSE体系与NO/NOS体系共同参与LPS所致急性肺损伤时PAH形成的调控机制，在其中呈相互的负性调节作用。     

微型膜式氧合器在大鼠体外循环中的应用

目的建立大鼠体外循环（cardiopulmonary bypass，CPB动物模型）。方法选用雄性SD大鼠，经右颈静脉、股静脉插管引流，股动脉插管灌注建立CPB。CPB使用微型膜式氧合器，运转1h，期间监测血流动力学指标、心电图、血气及电解质的变化。结果8只大鼠CPB中血流动力学稳定，血气结果满意，完全符合满意CPB标准，停机后心血管和呼吸功能恢复。结论利用微型动物膜式氧合器建立的大鼠CPB模型，具有安全、稳定、简单、实用的特点，是进行与CPB相关脏器损伤研究可靠的实验平台。     

不同输液方式复苏产兔失血性休克对肠黏膜屏障的影响

目的:观察不同输液方法复苏非控制性失血性休克产兔对血清二胺氧化酶(DAO)活性、D-乳酸水平的影响,探讨限制性输液复苏对休克后肠黏膜屏障的保护作用。方法:将30只产后6 h的新西兰大白兔随机分成3组,①假休克组(P组)、②传统液体复苏组(PNL组)、③限制性液体复苏组(PLH组),建立非控制重度失血性休克模型,分别于休克30min后接受不同复苏方案,于休克后90 min接受手术止血和输血输液治疗。于0 min、90 min、180 min、4 h抽血检测各组血清二胺氧化酶(DAO)活性、D-乳酸水平。结果:失血性休克时缺血再灌注损伤导致血清DAO活性、D-乳酸水平显著增高,其中DAO活性、D-乳酸水平PNL组、PLH组显著高于P组,PNL组显著高于PLH组(P<0.05)。结论:限制性输液复苏较传统液体复苏能显著降低肠黏膜通透性,保护肠黏膜屏障。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.