一种新的急性败血性肺损伤模型的建立

目前国内外多采用能自主合成维生素 C的大鼠、小鼠、兔制作急性败血性肺损伤 (AL I)动物模型 ,它们与人类的局灶性、内源性内毒素所致的败血性肺损伤有一定的差异。作者利用不能自主合成维生素 C的豚鼠进行盲肠结扎穿刺 ,制作败血性肺损伤动物模型。该模型排除了自主合成维生素 C对本病发生、发展及治疗研究的干扰。经实验验证 ,利用豚鼠制作急性败血性肺损伤模型是较理想的一种新的急性败血性肺损伤模型的建立@刘志勇$江西省医学实验动物中心!南昌330006急性败血性肺损伤;;维生素C;;豚鼠     

NF-κB活化阻断剂对盲肠结扎穿刺所致豚鼠急性肺损伤的预防与治疗

目的观察NF-κB活化阻断剂是否对盲肠结扎穿刺所致豚鼠急性肺损伤具有防治作用，探讨NF-κB活化阻断剂防治肠源性肺损伤的机制。方法用盲肠结扎穿刺（CLP）法建立豚鼠急性肺损伤模型，同时经口给予布洛芬167mg／kg和肌内注射维生素E174mg／kg预防和治疗，结合动脉血气分析、外周血白细胞计数、肺湿重／下重比值（W／D）及肺组织病理变化，免疫组化方法研究肺组织NF-κB的活化。结果CLP组动物在6h后开始缓慢出现症状，呼吸急促100～110次／min（正常呼吸80～95次／min），蜷缩，对外界刺激敏感；16h有少量泡沫状分泌物由鼻腔溢出，呼吸变得窘迫，倦怠，卧伏，不喜活动；24h呼吸窘迫十分显著，泡沫状分泌物（带血性）由鼻腔溢出明显增多，呼吸频率为100-140次／min；CLP24h内死亡率可达10％，24-40h死亡数可达30％，40～56h死亡数可达80％。动脉血氧分压（PaO2）在12h开始明显下降，24h以后有恶化趋势，PaO2持续低于10kPa，外周血白细胞计数从12h开始降低，24h明显降低。术后24h已经表现出急性肺损伤。肺组织NF-κB表达活跃。动物于2d左右出现大量死亡；给药组动物治疗和预防症状有缓解，预防组的最终死亡率为40％，治疗组为60％，肺组织NF-κB表达程度均较模型组低。结论在肺损伤早期联合应用NF-κB活化阻断剂进行预防，有助于提高ALI的存活率，能减缓肠源性肺损伤的发生和进展，减轻急性肺损伤症状，进而发挥阻止病程向多器官功能衰竭发展的重要作用，这种作用机制可能是通过抑制NF-κB活化实现的。     

联用抗氧化剂及非甾体抗炎药对急性败血性肺损伤豚鼠治疗作用

利用豚鼠制作急性败血性肺损伤动物模型 ,联用抗氧化剂及非甾体抗炎药治疗后 ,观察豚鼠的颈动脉血 PCO2 、PO2 、HCO3、p H、BE及肺组织免疫组化的变化。结果显示 :联用抗氧化剂及非甾体抗炎药可以阻断急性肺损伤豚鼠肺组织中 NF- k B的过度表达 ;改善低氧血症状 ,同时可降低死亡率联用抗氧化剂及非甾体抗炎药对急性败血性肺损伤豚鼠治疗作用@李守明$江西省儿童医院!南昌330006急性败血性肺损伤;;联合治疗;;豚鼠     

三种大鼠急性肺损伤模型的比较

目的 比较腹腔注射脂多糖(lipopolysaccharide,LPS)、气管滴注LPS和盲肠结扎穿刺(cecal ligation and puncture,CLP)诱导的3种急性肺损伤模型的差异.方法 70只成年SD大鼠随机分为7组:正常组、腹腔注射LPS组(10 mg/kg,LPS-IP组)及其假手术组(SHAM-1);气管滴注LPS组(5 mg/kg,LPS-IT组)及其假手术组(SHAM-2);盲肠结扎穿刺组(CLP)及其假手术组(SHAM-3).于造模后24 h,收集各组大鼠的动脉血用于血气分析,并通过二喹啉甲酸(bicinchoninic acid,BCA)蛋白测定法、血细胞计数板以及瑞氏-姬姆萨染色分别对肺泡灌洗液中的蛋白含量、细胞总数和类别进行统计,同时利用湿干比和苏木精-伊红(HE)染色法来评价肺组织的损伤程度.结果 LPS-IT组和LPS-IP组的肺灌洗液总蛋白浓度、总细胞数均高于正常组和假手术组(P＜0.05),湿干比明显增高(P＜0.05),PaO2低于正常组及相应的假手术组(P＜0.05);LPS-IT组和LPS-IP组肺组织有明显病理变化,包括肺水肿和肺泡壁增厚,炎性细胞浸润.CLP组未见明显改变.结论 在急性肺损伤的3种大鼠模型中,LPS-IT组和LPS-IP组肺损伤较为严重,CLP组未见明显肺损伤.提示腹腔注射LPS及气管给予LPS更适用于建立急性肺损伤模型以及后续应用药物的动物实验.     

脓毒症大鼠的急性肺损伤机制研究

目的 探讨脓毒症大鼠急性肺损伤的机制。方法 采用盲肠结扎穿孔术(CLP) 建立大鼠脓毒症模型。健康成年雄性SD大鼠48只,随机分为假手术组、脓毒症组,每组24只：动物模型制备成功后,各组在腹腔注入参附注射液(10 ml／kg)或等量生理盐水后,于术后3小时、12小时和24小时检测肺组织匀浆标本黄嘌呤氧化酶(XO)活力、丙二醛(MDA)、超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)的含量。光学显微镜下观察肺组织病理改变。结果 与假手术组比较,脓毒症大鼠肺组织XO、MDA活性显著升高,SOD、GSH-Px活性显著降低,差异有统计学意义(P<0.01)。结论 脓毒症大鼠存在急性肺损伤,其机制可能跟氧化应激相关。     

脓毒症肺损伤小鼠血清内皮微颗粒的变化

目的 探讨脓毒症相关肺损伤小鼠血清中内皮微颗粒(endothelial-derived microparticles, EMPs)的变化及意义。方法 C57BL/6J 小鼠随机分成结扎盲肠头尾端穿孔术(cecal ligation puncture procedure, CLP)组和假手术(Sham)组。术后24h CLP组存活的小鼠和假手术组小鼠心尖取血,离心后测定血清IL-1β、IL-6、TNF浓度,流式细胞仪检测血清中CD144⁺EMPs浓度水平。取各组肺组织测定肺湿重/干重比值(W/D),光镜下观察肺组织学的改变,电子显微镜下观察肺组织超微结构改变。结果 CLP组小鼠血清中IL-1β、IL-6、TNF浓度均高于Sham组(P<0.01);CLP组小鼠肺组织W/D高于Sham组(P<0.01)。病理学检查显示CLP术后24h小鼠出现急性肺损伤,肺泡内皮细胞损伤明显。CLP组小鼠血清中CD144+EMPs浓度高于Sham组(P<0.01)。结论 CLP术后24h小鼠发生了急性肺损伤,是较好的肺损伤的模型。内皮微颗粒浓度的升高和脓毒症相关性肺损伤密切相关,内皮微颗粒可能参与了急性肺损伤的过程。     

通腑泻热方对脓毒症大鼠生存保护及急性肺损伤的影响

【目的】观察通腑泻热方对脓毒症大鼠生存保护及急性肺损伤的影响。【方法】选用SPF级SD大鼠120只,随机分为6组,空白对照组,假手术组,模型组,中药低、中、高剂量组,每组各20只。模型组及中药各剂量组均按照盲肠结扎穿孔术(CLP)法复制脓毒症动物模型,假手术组进行开腹、取出盲肠、放回腹腔、关腹。中药低、中、高剂量组分别于造模后6、18、30、42 h给予不同浓度通腑泻热中药灌胃给药,模型组按同样时间点予相应量生理盐水灌胃,观察48 h后各组大鼠生存率,活杀取大鼠肺组织观察肺组织病理学改变并予评分。【结果】各剂量中药组和模型组大鼠都出现不同程度死亡,存活大鼠肺组织出现不同程度肺损伤;中药各剂量组生存率较模型组显著升高,大鼠急性肺损伤病理评分显著降低,与模型组比较,差异均有统计学意义(P0.01),并呈一定的剂量效应关系。【结论】通腑泻热方对脓毒症大鼠的生存具有一定的保护作用,并能改善脓毒症导致的急性肺损伤时肺组织的水肿及炎症情况。     

ZLN005通过上调PGC-1α表达诱导巨噬细胞的M2型分化减轻脓毒症引起的急性肺损伤

目的:在脓毒症诱导的急性肺损伤(ALI)中探究小分子化合物ZLN005的作用及相关机制.方法:利用盲肠结扎穿孔(CLP)术建立小鼠脓毒症诱导的急性肺损伤模型,并按处理方式的不同将小鼠分为四组,假手术(Sham)组,ZLN005组、CLP组及CLP+ZLN005组;应用RT-PCR、免疫荧光染色及Western blot...     

不同目标血糖脓毒症大鼠肝、肺损伤的病理分析

目的：利用盲肠结扎穿孔伴严重腹腔感染造成的脓毒症模型,探讨胰岛素不同目标血糖对脓毒症肝、肺组织形态的影响。方法选取40只SD大鼠随机分为5组,通过盲肠结扎穿孔术（CLP）法制备大鼠脓毒症模型,按分组进行不同处理：假手术组（Sham组）,CLP组,目标血糖控制A组、B组和C组,每组8只。CLP术后12 h处死,通过组织形态观察,对肝、肺损伤不同病理积分进行评估。结果肝、肺组织病理总评分在CLP及血糖处理后明显高于Sham组（P＜0．05）。在单项肝、肺的观察指标中,A组与Sham组比较,差异无统计学意义（P＞0．05）;3组血糖组肝、肺损伤程度随着血糖水平升高病变渐进加重,两两比较差异有统计学意义（P＜0．05）。肺损伤主要表现为肺泡壁毛细血管充血、肺小叶及间质水肿、支气管炎,CLP组与血糖控制A、B、C 3组比较,与A、B组差异有统计学意义（P＜0．05）,与C组差异无统计学意义（P＞0．05）。肝损伤主要为肝细胞水样变性及脂肪变性,CLP组与血糖控制A、B、C 3组比较,差异有统计学意义（P＜0．05）,CLP组出现了明显碎片状坏死。结论脓毒症大鼠的肝、肺损伤程度随着血糖水平升高逐渐加重,控制血糖可使脓毒症模型鼠的肝、肺的损伤减低。     

肾上腺髓质素对腹腔感染所致肺损伤大鼠肺组织中PPAR-γ的影响

目的探讨肾上腺髓质素(ADM)对腹腔感染所致急性肺损伤(ALI)大鼠肺组织中过氧化物酶体增殖物激活受体γ(PPAR-γ)蛋白表达的影响。方法采用盲肠结扎穿孔(CLP)制作大鼠腹腔感染模型,随机分为假手术组(Sham)、Sham ADM组,CLP组和CLP ADM治疗组。持续监测各组大鼠颈动脉压力。分别于手术后6h、18h测定支气管肺泡灌洗液(BALF)中白细胞计数及肿瘤坏死因子α(TNF-α)含量;肺组织HE染色及肺损伤组织学评分;测定肺组织湿/干重比值(W/D);用Westernblot法观察肺组织中PPAR-γ蛋白表达变化。结果各组之间平均动脉压在各时段差异无统计学意义(P>0.05)。CLP组6h、18h时的肺损伤组织学评分(P<0.05)以及BALF中白细胞数(P<0.05)、肿瘤坏死因子α(TNF-α)含量均明显高于Sham组和CLP ADM组(P<0.05)。CLP组在18h的W/D值较Sham组和CLP ADM有明显升高(P<0.05),而CLP ADM组18h的W/D值低于CLP组(P<0.05)。CLP组6h、18h大鼠肺组织中PPAR-γ蛋白表达较Sham组和CLP ADM均有显著下降(P<0.05)。结论肾上腺髓质素可以减轻腹腔感染大鼠的肺损伤程度,并且上调肺损伤大鼠肺组织中PPAR-r蛋白的表达。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.