B7-1和IL-12基因转染对肝癌细胞免疫原性的影响

目的 观察Ｂ７－１和ＩＬ－１２基因表达对人肝癌细胞免疫原性原影响。方法 分别将Ｂ７－１和ＩＬ－１２基因以逆转录病毒介导转染ＨｅｐＧ２细胞。阳性克隆细胞与健康人外周血淋巴细胞（ＰＢＬ）混合培养后,用流式细胞仪检测ＰＢＬ表面Ⅰ类人白细胞抗原（ＨＬＡ－Ⅰ）分子表达,以ＭＴＴ法检测ＰＢＬ的特异性杀伤活性Ｋ５６２细胞的活性。结果 混合ＨｅｐＧ２／Ｂ７－１ＨｅｐＧ２／ＩＬ－１２细胞组ＰＢＬ表面的ＨＬＡ－Ⅰ分子     

体外循环术后血中细胞因子及其诱生能力变化的研究

目的 观察体外循环（ＣＰＢ）心脏瓣膜置换术前后病人血中多种细胞因子水平及体外诱生能力的变化。方法 ３０例择期行心脏瓣膜置换术的病人,于术前及术后第１、３、７、１４ｄ检测血中白细胞介素１（ＩＬ－１）、白细胞介素２（ＩＬ－２）、白细胞介素４（ＩＬ－４）、白细胞介素８（ＩＬ－８）、肿瘤坏死因子α（ＴＮＦα）、和可溶性白细胞介素２受体（ＳＩＬ－２Ｒ）水平及其体外诱生能力。结果 ＩＬ－１和ＳＩＬ－２Ｒ在ＣＰ     

IL-6、IL-1和PDGF对大鼠肾小球系膜细胞生长的影响

目的：探讨白细胞介素－６（ＩＬ－６）、白细胞介素－１（ＩＬ－１）和血小板源生长因子（ＰＤＧＦ）对大鼠肾小球系膜细胞（ＭｓＣ）增殖的影响。方法：采用改良的ＭＴＴ法和ＢｒｄＵ掺入法检测ＳＤ大鼠体外ＭｓＣ悬液中加入ＩＬ－６、ＩＬ－１及ＰＤＧＦ后１２ｈ及２４ｈ的增殖情况。分７组进行观察。结果：ＩＬ－６组、ＩＬ－１组和ＰＤＧＦ组１２ｈ及２４ｈ的光密度（ＯＤ值）与标记指数（ＬＩ）均为２％ＦＣＳ组也均高,但所有实验组均不能达２０％ＦＣＳ组的细胞增殖水平。联合应用双因子刺激１２ｈ及２４ｈ均未见明显的协同促增殖作用。结论：ＩＬ－６、ＩＬ－１及ＰＤＧＦ均能在一定程度上刺激大鼠肾小球ＭｓＣ增生。联合应用双因子刺激无明显的协同效应。     

环孢素A与抗B7-1单克隆抗体联用诱导T淋巴细胞耐受的研究

目的 探讨抗原特异性无能Ｔ淋巴细胞的诱导及其耐受特性。方法 在体外建立抗原递呈细胞－Ｔ淋巴细胞－Ｂ淋巴细胞反应系统,利用环孢素Ａ（ＣｓＡ）与抗Ｂ７－１单克隆抗体联用阻断Ｂ７：ＣＤ２８共刺激途径,采用＾１３Ｈ－ＴｄＲ法检测Ｔ淋巴细胞增殖,酶联免疫吸附试验（ＥＬＩＳＡ法）测定Ｂ淋巴细胞分泌的抗体。结果 ＣｓＡ与抗Ｂ７－１单克隆抗体联用可诱致Ｔ淋巴细胞无能,无能Ｔ淋巴细胞不产生白细胞介素２（ＩＬ－２）;     

白细胞介素1α对椎间盘蛋白多糖代谢的影响

目的 研究白细胞是介素１α（ｉｎｔｅｒｌｅｕｋｉｎ－１α,ＩＬ－１α）对椎商盘髓核中蛋白多糖代谢的影响。方法 取自然流产的胎儿１具,胎龄８个月,术后４小时内无菌取出椎间盘,进行髓核组织块的体外培养,在培养液中分别加入ＩＬ－１α０．１、０．２、０．４ｎｍｏｌ／Ｌ,培养３０小时后,用Ａｌｃｉａｎ法检测培养液中踱酸软骨素的含量。在髓核组织培养液中加入ＩＬ－１α ０．３ｍｍｏｌ／Ｌ,分别培养１２、２４、７     

肝癌切除后经门静脉化疗辅以高压氧治疗的患者血清sIL—2R,T …

目的 研究原发性肝癌（肝癌）切除后经门静脉化学药物治疗（下称化疗）配合高压氧治疗,血清可溶性白细胞介素２受体（ｓｏｌｕｂｌｅ ｉｎｔｅｒｌｅｕｋｉｎ－２ ｒｅｃｅｐｔｏｒ,ｓＩＬ－２Ｒ）,超氧化物歧化酶（ｔｏｔａｌ－ｓｕｐｅｒｏｘ－ｉｄｅｄｉｓｍｕｔａｓｅ,Ｔ－ＳＯＤ及ｍａｎｇａｎｅｓｅ－ｓｕｐｅｒｏｘｉｄｅ ｄｉｓｍｕｔａｓｅ,Ｍｎ－ＳＯＤ）的活笥变化。方法 肝癌患者２８例在２．５ａｔｍ（ａｔ     

地塞米松和川芎嗪对狼疮肾炎外周血单个核细胞白细胞介素—1 …

目的 探讨地塞米松、川芎嗪对活动期,静止期狼疮肾炎（ＬＮ）外周血单个核细胞（ＰＢＭＣ）白细胞介素－１２（ＩＬ－１２）表达的影响。方法 应用地塞米松,川芎嗪对ＬＮ患者ＰＢＭＣ培养,以正常人为对照,分别采用ＥＬＩＳＡ法和半定量ＲＴ－ＰＣＲ法检测细胞上清液及细胞ＩＬ－２和ＩＬ－１２ Ｐ４０ｍＲＮＡ表达。结果ＬＮ活动期,静止期较正常对照组ＩＬ－１２蛋白,基因水平明显增高（Ｐ〈０．０１）。地塞米松明显抑制狼     

实验性小肠移植早期排斥标志物研究

为寻找小肠移植（ＳＢＴ）早期排斥标志物，本实验采用逆转录聚合酶链式反应技术，对小鼠ＳＢＴ术后１２小时受体Ｔ细胞表面白细胞介素－２受体α链（ＩＬ－２Ｒα）编码基因进行定性检测，并对移植小肠行同期病理学检查。结果发现：同种异体移植小鼠体内ＩＬ－２α ｃＤＮＡ阳性例数均明显高于非手术、同系移植及加环孢素Ａ（ＣｓＡ）治疗的同种异体移植小鼠；移植小肠病理学检查无异常变化。提示：Ｔ细胞表面ＩＬ－２Ｒα基因的活     

白细胞介素1对Ⅱ型胶原诱导类风湿性关节炎模型的影响

以Ⅱ型 （ｔｙｐｃⅡｃｏｌｌａｇｅｎ，ＣⅡ）免疫接种ＤＢＡ／１小鼠，诱发其多发性关节炎发生，并以白细胞介素１（ｉｎｔｅｒｌｅｕｋｉｎ－１，ＩＬ－１）皮内注射，观察ＩＬ－１对关节炎发生的影响。方法采用ＣⅡ加弗氏完全佐剂（ｃｏｍｐｌｅｔｅｆｒｅｕｎｄ’ｓａｄｊｕｖａｎｔ，ＣＦＡ）给小鼠行皮内注射，并于ＣⅡ免疫接种后第１８天开始，给部分小鼠皮内注射ＩＬ－１，观察其发病情况，采用ＥＬＩＳＡ方法检测血清抗Ｃ     

体外循环后甲状腺激素与细胞免疫变化的研究

为研究体外循环（ＣＰＢ）后甲状腺激素与细胞免疫的变化及其相互关系，测定２７例ＣＰＢ心脏手术病人术前、术后第２、７、１４天三碘甲状腺原氨酸（Ｔ３）、四碘甲状腺原氨酸（Ｔ４）、逆三碘甲状腺原氨酸（ｒＴ３）、促甲状腺素（ＴＳＨ）、可溶性白细胞介素２受体（ＳＩＬ－２Ｒ）及其中１２例白细胞介素－２（ＩＬ－２）的变化；另８例于ＣＰＢ后第２天外周血单核细胞（ＰＢＭＣ）培养液中加入不同浓度的Ｔ３，测定Ｔ３对ＩＬ－２产生的影响。结果显示ＣＰＢ后血清浓度Ｔ３降低，ｒＴ３增高，Ｔ４、ＴＳＨ正常，ＳＩＬ－２Ｒ含量增高，ＰＢＭＣ产生ＩＬ－２活性降低；Ｔ３可显著增强ＣＰＢ后ＩＬ－２活性。结论：ＣＰＢ后机体呈现低Ｔ３综合征和细胞免疫功能抑制，其中ＩＬ－２降低的机制中至少部分是通过Ｔ３降低所致     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

Systemic analgesia adapted to the children's condition

A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions.