地塞米松对创伤失血性休克大鼠T淋巴细胞功能的影响

目的 探讨地塞米松对创伤失血性休克大鼠T淋巴细胞的功能的影响。方法 制作创伤失血性休克大鼠动物模型，随机分为正常对照组、创伤失血性休克组、创伤失血性休克地塞米松处理组。分别于模型完成的1、2、3、6、12h时间点测血浆TNF-α水平，将各组各时间点大鼠活杀，取肺、脾做病理学检查，创伤失血性休克组在2h和6h时将动物杀死后取脾行电镜检查。并取各组各时间点脾做免疫组化IL-2、IL-4标记。结果 大鼠创伤失血性休克后，血浆INF-α水平持续增高，6h达高峰。光镜下肺脏组织损伤，脾小体早期增生，后期出现萎缩。电镜显示，脾小体增生期腺淋巴细胞增殖活化，萎缩期脾淋巴细胞坏死。免疫组化显示脾小体增生期以IL-2表达为主，萎缩期以IL-4表达为主。地塞米松能显著降低血浆TNF-α表达水平，减轻脾、肺组织损伤，光镜下脾小体持续增生，免疫组化标记结果变化不大。结论 创伤失血性休克大鼠早期T淋巴细胞激活，随后出现了向TH2的漂移，最后淋巴细胞功能衰竭。原因是早期应用地塞米松抑制了过度的炎症反应，保存了淋巴细胞的功能。     

地塞米松对大鼠创伤失血性休克模型的保护作用

目的探讨早期大剂量地塞米松对大鼠创伤失血性休克的保护作用.方法制作创伤失血性休克大鼠动物模型,随机分为正常对照组(A组)、创伤失血性休克组(B组)、创伤失血性休克地塞米松处理组(C组).分别于模型完成的1、2、3、6、12 h时间点测血浆肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-10水平,取肺、脾做光镜检查.结果大鼠遭受创伤失血性休克打击后,血浆TNF-α水平持续增高,6 h达高峰;IL-1β、IL-10持续增高;光镜下肺损伤,脾小体萎缩、坏死,败血脾.地塞米松能显著降低血浆TNF-α、IL-1β、IL-10的表达水平,减轻脾、肺组织损伤,脾小体持续增生.结论早期大剂量地塞米松抑制过度炎症反应的同时,抑制IL-10的高水平表达,显示了较好的免疫调理作用.     

不同复苏液对创伤失血性休克大鼠血浆及肺组织TNF-α、IL-6及MPO的影响

目的探讨大鼠创伤失血性休克复苏时使用25%白蛋白与乳酸林格液对早期肺损伤的影响及可能机制。方法45只SD大鼠随机分为3组,假手术(Sham)组、林格液(RL)组和白蛋白(ALB)组复苏后2h取血并处死动物取肺组织测定TNF-α、IL-6表达及髓过氧化酶(MPO)活性和肺湿/干重(肺W/D)比值。结果各实验组休克复苏2h后血浆及肺泡灌洗液TNF-α、IL-6表达以及肺组织MPO活性、肺W/D比值均较Sham组高(P<0.05);ALB组复苏后维持MAP80~90mmHg所需液体较RL组明显减少(P<0.05);ALB组复苏后血浆及肺泡灌洗液TNF-α、IL-6表达以及肺组织MPO活性、肺W/D比值均较RL组低(P<0.05)。结论大鼠创伤失血性休克时血浆及肺组织TNF-α、IL-6表达及MPO活性增高,白蛋白复苏较乳酸林格液复苏肺组织损伤减轻。     

地塞米松对创伤休克大鼠肝脏热休克蛋白70表达的影响

目的 探讨地塞米松对创伤休克肝组织中热休克蛋白70(HSP70)的表达变化以及对肝脏结构和功能的影响.方法 雄性健康Wistar大鼠72只,采用双侧股骨骨折伴失血性休克创伤模型,随机分成止常对照组12只,创伤休克组30只,创伤休克地塞米松组30只,地塞米松采用腹腔注射给药.动态观察伤后0.5、2、4、6、8 h大鼠肝组织HSP70、肝脏病理、肝功能、TNF-α、IL-6等变化.HSP70采用免疫印迹法测定其蛋白含量,并进行计算机图像分析.结果 HSP70伤后2h较正常对照相比差异有统计学意义,伤后6 h达到高峰,伤后8 h仍持续在较高水平.TNF-α、IL-6伤后逐渐升高,并于伤后6 h达到高峰,和正常组相比,差异有统计学意义.光镜下伤后4 h肝窦内淤血明显,有大量炎性细胞浸润;血清ALT、TB伤后4 h开始增高,8 h达到峰值.腹腔注射地塞米松后,HSP70在伤后各个时相点的表达均较创伤休克组明显增强,峰值仍然在伤后6 h.TNF-α、IL-6伤后各个时相点均迅速回落.肝脏大体淤血、肿胀明显减轻;光镜下伤后4 h肝细胞变性明显好转,肝窦内见淤血减轻,仅见少许淋巴细胞及中性粒细胞浸润;血清ALT、TB明显下降.结论 地塞米松可增强HSP70在创伤失血性休克后肝组织中的表达,可减轻创伤失血性休克后肝脏的继发性损害,表明地塞米松对创伤休克后肝脏的保护作用与HSP70密切相关.     

利多卡因对失血性休克兔细胞因子的影响

目的：探讨利多卡因对失血性休克再灌注兔细胞因子的影响。方法：18只白兔随机分为3组，每组6只，利多卡因组（L组）、失血性休克组（H组）和对照组（C组）。L组于放血前静脉注射利多卡因2．5mg／kg，此后每隔1h静注利多卡因1mg／kg维持，L组与H组建立失血性休克模型后，分别于放血前、失血性休克2h、再灌注2h各从股静脉取血测定血浆肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）含量，C组在上述对应时间点测定血浆TNF-α和IL-6含量。结果：C组TNF-α和IL-6含量各时间点比较差异无显著性（P〉0．05）；H组与L组在休克2h、再灌注2hTNF-α和IL-6含量与放血前相比均明显升高（P〈0．05），且呈上升趋势；与H组相比，L组休克2h、再灌注2hTNF-α和IL-6含量均明显下降（P〈0．05）。结论：早期小剂量静注利多卡因能减少失血性休克兔促炎细胞因子TNF-α和IL-6含量．从而对机体产生一定的保护作用。     

眼镜蛇毒因子抑制补体激活对创伤失血性休克大鼠血浆内毒素含量的影响

目的观察眼镜蛇毒因子（CVF）抑制补体激活对创伤失血性休克大鼠血浆内毒素含量的影响。方法80只雄性SD大鼠随机分成对照组和CVF组。建立刨伤失血性休克模型，于休克前及复苏后1、6和24h取血．检测血浆内毒素（LPS）、血清肿瘤坏死因子-α（TNF-α）含量及血清二胺氧化酶（DAO）和总补体活性（CH50）。结果对照组大鼠复苏后1h血CH50水平迅速下降，血LPS、TNF—α水平均明显升高，随后均快速恢复至休克前水平;DAO活性在复苏后1h和6h明显升高，然后快速下降。CVF组大鼠除CH50水平始终〈5％，其余各指标复苏后1h仅略升高，复苏后各时间点均较对照组相应时间点明显降低（P〈0．05或P〈0．01）。结论在创伤失血性休克中使用补体抑制剂CVF可明显减轻补体激活导致的肠道损伤及肠屏障破坏，减少LPS移位的发生，明显降低血浆LPS含量。     

失血性休克大鼠中性粒细胞表面CD18和血清TNF-α的变化

目的:探讨失血性休克大鼠中性粒细胞表面CD18和血清TNF-α变化对创伤及休克病理生理过程的影响。方法:大鼠剪尾取血作为正常对照,颈部去皮颈动脉结扎剪断插管作为实验对照,建立失血性休克动物模型;将其分为正常对照组、实验对照组(创伤组)和实验休克组(失血性休克组),每组均为8只。用单克隆抗体标记,流式细胞仪检测大鼠失血性休克急性期中性粒细胞表面CD18的动态表达,以及用ELISA法检测大鼠血清TNF-α水平变化。结果:正常对照组大鼠不同时间点中性粒细胞表面CD18表达量(平均荧光道数)以及血清TNF-α水平之间的差异无显著性(P>0.05)。与正常对照组相比,创伤组中性粒细胞表面CD18表达量以及血清TNF-α水平均上调,3h达峰值,4、5h持续高水平;失血性休克组两者亦均上调;但与创伤组比较,3h后则呈下调趋势。结论:创伤后中性粒细胞表面CD18表达上调,增强白细胞-内皮细胞黏附反应,有助于局部创伤愈合、修复并抵抗感染。失血性休克组CD18表达下调,可减少白细胞-内皮细胞过度黏附及嵌塞毛细血管,有助于机体疏通微循环,改善灌流量。     

大鼠光辐射烧伤后早期组织器官功能指标变化

目的观察模拟光辐射烧伤早期大鼠血浆中肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)及脏器含水量变化等早期损伤机制.方法(1)宏观和光镜观察大鼠在烧伤后早期(5min～72h)的病理变化和不同时间点脏器含水量;(2)放射免疫分析法对上述不同时间点大鼠血浆中的TNF-α和IL-6进行测定.结果(1)伤后5min～72h各脏器含水量出现8.3%～24.3%之间增加;(2)伤后72h内血浆中TNF-α和IL-6较伤前增高,2h达到高峰,并具有统计学差异.结论TNF-α、IL-6在伤后早期脏器损害机制中占有重要地位.     

乳酸钠林格液联合己酮可可碱对重度失血性休克大鼠早期复苏后肠组织炎症因子表达及肠屏障功能的影响

目的 观察乳酸钠林格液联合己酮可可碱对重度失血性休克大鼠早期复苏后肠组织中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-10表达,血浆中肠脂肪酸结合蛋白(i-FABP)的变化及肠组织病理学变化的影响.方法 选择健康成年雄性SD大鼠48只,随机分为对照组(C组)、单纯休克组(NR组)、乳酸钠林格液复苏组(LR组)和乳酸钠林格液联合己酮可可碱复苏组(LR/PTX组),每组12只.采用改良wigger′s法复制失血性休克模型.用酶联免疫吸附试验(ELISA)检测肠组织中IL-6、IL-10和血浆中i-FABP含量;用免疫组织化学技术检测肠组织TNF-α的表达和分布.制作电镜标本及苏木素-伊红(HE)染色观察肠组织病理变化.结果 与NR、LR组比较,LR/PTX组小肠组织的病理损害明显减轻(P<0.01);肠组织TNF-α、IL-6表达明显下降, IL-10表达显著升高(P<0.01);血浆i-FABP的含量明显下降(P<0.01).结论 LR/PTX能抑制重度失血性休克大鼠早期肠组织TNF-α、IL-6表达,促进IL-10表达,减少血浆中i-FABP的含量,从而起到肠保护作用.     

富氢羟乙基淀粉对非控制性失血性休克大鼠血浆炎症因子和氧化损伤的影响研究

目的探讨富氢羟乙基淀粉(HHES)对非控制性失血性休克大鼠血浆白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超氧化物歧化酶(SOD)和丙二醛(MDA)的影响及其作用机制。方法制备非控制性失血性休克大鼠模型,30只Wistar雄性大鼠随机分为三组,每组10只,sham组(假处理组)、对照组(休克+输注羟乙基淀粉)、实验组(休克+输注富氢羟乙基淀粉)。观察各组在0 min、45 min、105 min、225 min的平均动脉压(MAP)、心率和24 h存活率,以及复苏后血浆IL-6、TNF-α、SOD和MDA水平的变化。结果输液后45 min、105 min和225 min各时间点实验组和对照组MAP、HR比较,差异无统计学意义(P 0. 05)。在105 min、225 min时间点实验组IL-6、TNF-α、MDA水平较对照组降低,而实验组SOD水平较对照组增高,差异有统计学意义(P 0. 01)。结论富氢羟乙基淀粉对非控制性失血性休克大鼠有复苏作用,能抑制失血性休克引起的炎症反应,减少MDA生成和SOD消耗,从而减轻氧化损伤。     

1，5-脱水山梨醇的性质及其临床应用

1，5-脱水山梨醇（1，5-anhydro-D-glncitol；1，5-AC）是一种存在于人类血液中的正常化合物，由于其代谢稳定，在血液中波动范围小，可反映血糖短期的变化．具有空腹血糖、果糖胺和糖化血红蛋白所不具有的优点，在糖尿病诊断与治疗中具有很高的价值和意义。     

产超广谱β-内酰胺酶(ESBLs)菌株检测及耐药性分析

目的了解我院送检标本中产超广谱β-内酰胺酶(ESBLs)细菌的检出率及耐药情况,指导临床医生合理有效地使用抗生素。方法用NCCLS推荐的确证试验对临床分离的198例革兰氏阴性杆菌进行ESBLs鉴定,抗生素敏感测定采用K-B琼脂扩散法。结果共检出产超广谱β-内酰胺酶(ESBLs)菌株42株,总检出率21.4%;其中大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌的ESBLs检出率分别为20.6%、23.7%及16.7%。检出的产ESBLs细菌对所有青霉素类抗生素产生耐药,多数菌株对三代头孢类抗生素的耐药率>80%,对磺胺类、喹诺酮类抗生素的耐药率也在60%以上。氨基糖苷类对产ESBLs菌表现出较好的抗菌作用,亚胺培南对所有产ESBLs菌表现出最强抗菌作用。结论第三代头孢菌素和亚胺培南的大量应用是产生ESBLs菌的主要原因,亚胺培南、阿米卡星、庆大霉素是产ESBLs菌株临床治疗有效的药物。     

Differentiation of CD3-4-8- human fetal thymocytes in vivo: characterization of a CD3-4+8- intermediate

Human thymocyte differentiation was examined by injecting fetal thymic progenitor populations into human thymic xenografts in SCID-hu mice. Thymic progenitors were fluorescently labeled with the lipophilic dye PKH2. The phenotypes of their progeny could be identified by flow cytometric analysis of cells with a very high fluorescent PKH2 signal. Intrathymic injection of purified triple negative (TN) CD3-4-8- thymocytes resulted in the sequential appearance of CD3-4+8-, CD3-4+8+, and CD3+4+8+ cells, with the subsequent appearance of small numbers of phenotypically mature CD3+4+8- and CD3+4-8+ cells over a 4-d period. Sorted CD3-4+8- thymocytes injected intrathymically rapidly differentiated to CD4+8+ cells. CD4+8+ fetal thymocytes in cell cycle differentiated into phenotypically mature CD3+4+8- and CD3+4-8+ populations, whereas nondividing CD4+8+ cells failed to differentiate after intrathymic transfer. The number of cell divisions that occurred between the injection of TN thymocytes and their progeny at different time points was estimated based on the decrease in the intensity of the PKH2 label. The average length of the cell cycle for the TN population was calculated to be 24 h. The SCID-hu model thus provides a useful tool for studying the kinetics of cell division and differentiation of human thymocytes in vivo.     

Pharmacokinetics of (+/-)-, (+)-, and (-)-gossypol in humans and dogs

Pharmacokinetic parameters of (+/-)-, (+)-, and (-)-gossypol were determined in humans and dogs after a single oral or intravenous dose. Mean (+/- SD) oral bioavailability of (+/-)-gossypol in dogs was 30.9% +/- 16.2%. Studies in dogs who received single intravenous injections revealed that the elimination t1/2 and volume of distribution of (+)-gossypol were five and six times those of (-)-gossypol, respectively, whereas total body clearance and the AUC of the two enantiomers were similar. Data from men receiving the compounds orally show that the average peak plasma concentration and the AUC of (+)-gossypol are significantly greater than those of the (-)-isomer. The rate constants of alpha, beta, ka, k21, and k10 for (-)-gossypol are significantly greater than those for (+)-gossypol, indicating higher rates of mass transfer of the (-)-species. In humans the elimination t1/2 of (+)-gossypol was 29 times as that of (-)-gossypol, a difference that is more striking than that found in dogs. The elimination t1/2 of (+/-)-gossypol in humans averages 286 +/- 179 hours.     

颞浅动脉旁注射护理服务项目的成本核算

目的探讨颞浅动脉旁注射(以下简称颞浅注射)护理成本核算方法。方法根据项目成本核算有关公式完成颞浅注射护理成本核算,并与当前收费作比较。结果根据实际情况核算出颞浅注射护理成本。结论提供了较为科学的核算方法,为更合理地制定价格提供了依据。     

Ferroelectric performance of nylons 6-12, 10-12, 11-12, and 12-12

Nylons have great potential for electrical applications requiring high polarizability and low dielectric loss. Recently, the narrow single hysteresis loop with relaxor ferroelectricity and the double hysteresis loop due to antiferroelectricity have been reported in nylon random copolymers, terpolymers, and common even-numbered nylons. Although several studies of ferroelectric nylons have been reported, even–even-numbered and odd–even-numbered nylons have not been sufficiently explored. Here, the ferroelectricity of spin-coated even–even-numbered and odd–even-numbered nylons was investigated. A series of even–even-numbered nylons, including nylons 6-12, 10-12, and 12-12, and an odd–even-numbered nylon, nylon 11-12, were polymerized with 1,10-dodecanedicarboxylic acid (12) and four aliphatic diamines with various methylene units, 1,6-hexanediamine (6), 1,10-decanediamine (10), 1,11-undecanediamine (11), and 1,12-dodecanediamine (12). The obtained nylon polymers were spin coated and then subjected to melt-quenching or thermal annealing followed by quenching. From the X-ray diffraction and the electrical hysteresis loop data, the correlation between the ferroelectricity and the crystal parameters of crystallinity and crystallite size of the γ crystal phase was investigated. Furthermore, the free volume of the nylon samples was estimated to correlate with the ferroelectricity. Temperature-dependent ferroelectricity was investigated for nylon 10-12. At a high temperature, the nylon samples showed a narrow polarization–electric field hysteresis loop and a rhombus-shaped polarization current–electric field hysteresis loop due to the relaxor ferroelectricity. This behaviour was caused by electrically rotating the nanodomains with weakened hydrogen bonds at higher temperatures.

Nylons have great potential for electrical applications requiring high polarizability and low dielectric loss.     

Pure apraxia of speech - a case report -

Apraxia of speech (AOS) is the impairment of motor programming. However, the exact nature of this deficit remains unclear. In particular, AOS without other speech-language deficit is called pure AOS, but it is very rare. When diagnosing AOS, the characteristic of articulation is considered a crucial criterion, which has been proposed for differentiating AOS from phonological and dysarthric disorders. The present study reports on pure AOS in a 37-year-old right-handed male after a left insular, front, temporal infarction. This report may be useful for further AOS study and diagnosis in the clinical setting.     

儿童疑似肺炎支原体感染者血清、支气管灌洗液、胸腔积液、脑脊液MP-Ab-IgM检测的结果分析

目的 分析肺炎支原体肺炎(MPP)患儿血清、支气管灌洗液、胸腔积液及脑脊液的肺炎支原体(MP)MP-Ab-IgM检测结果。方法 选取2013年3月～6月在首都医科大学附属北京儿童医院疑似MP感染的278例住院患儿的血清、支气管灌洗液、胸腔积液及脑脊液标本,采用颗粒凝集的方法检测MP-Ab-IgM。结果181例患儿(男孩104例,女孩77例)的不同标本中MP呈阳性反应。278例患儿均进行了血清标本检测,共检出阳性血清标本170例,总检出率为61.2%(170/278),144例同时进行了支气管灌洗液检测,检出阳性62例,检出率为43.1%(62/144); 19例同时进行了胸腔积液标本检测,检出阳性13例,检出率为68.4%(13/19); 15例同时进行了脑脊液标本检测,检出阳性1例,检出率为6.7%(1/15)。各年龄组间检出率分别为:6个月～1岁组29.0%(9/31),～3岁组51.0%(25/49),～5岁组56.1%(23/41),～16岁组79.0%(124/157),6个月～1岁组与其他年龄组比较差异有统计学意义(P<0.05); ～3岁与～5岁组间差异无统计学意义(P>0.05),而与～16岁组间差异有统计学意义(P<0.05)。在6个月～1岁,～3岁,～5岁,～16岁四个年龄组中,同一患儿检测的不同类型MP-Ab-IgM阳性标本,其对应结果为A:血清类(111例)7,21,13和70; B:血清-支气管灌洗液类(45例)0,2,5和38; C:血清+胸腔积液类(7例)0,1,2和4; D:血清+脑脊液(1例)0,0,0和1; E:血清+支气管灌洗液+胸腔积液类(6例)0,0,2和4; F:支气管灌洗液类(11)2,1,1和7。结论 MP感染多种多样,有低龄化趋势,且有逐年增多的趋势。不同年龄组间血清阳性检出率随年龄增长逐渐增加,婴幼儿阳性检出率明显升高,重症患儿多发于年龄较大的患儿。