结核分枝杆菌感染小鼠模型的建立与评价

目的建立结核分枝杆菌感染的小鼠模型,分析感染小鼠重量指数、组织荷菌量、组织病理改变随感染时间的变化。方法以1.1×10^5菌落形成单位（CFU）的结核分枝杆菌标准株H37Rv经尾静脉感染50只雌性BALB/c小鼠,于感染后1、2、3、4、8周杀鼠,每个时间点剖杀10只,观察肺组织病理改变并称重,计算重量指数,同时做肺和肝菌落计数。结果感染1、2、3、4、8周小鼠的肺脏器重量指数分别为0.0112±0.0036、0.0101±0.0071、0.0112±0.0046、0.0151±0.0057和0.0198±0.0069,差异有统计学意义（F=4.24,P〈0.01）;肝脏器重量指数分别为0.0558±0.0059、0.0591±0.0094、0.0569±0.0076、0.0582±0.0030和0.0619±0.0079,差异无统计学意义（F=0.86,P〉0.05）;脾脏器重量指数分别为0.0107±0.0034、0.0146±0.0060、0.018±0.0034、0.0174±0.0026和0.0204±0.0066,差异有统计学意义（F=4.01,P〉0.05）;肺菌落数分别为（4.472±0.504）log、（5.539±0.429）log、（6.294±0.478）log、（6.250±0.315）log和（6.836±0.196）log,差异有统计学意义（F=43.90,P〈0.01）。感染后1周小鼠肺组织可见病理改变,且随着感染时间的增加病变范围逐渐扩大,病变程度逐渐严重。结论成功建立了结核分枝杆菌感染小鼠模型,该模型可用于结核疫苗和药物研究。     

A comparison of mediator and catecholamine release between exercise- and hypertonic saline-induced asthma

Serum neutrophil chemotactic activity (NCA) and plasma histamine concentrations were measured in 9 asthmatic subjects with exercise-induced asthma after inhalation challenge with ultrasonically nebulized 3.6% hypertonic saline, which was administered either in a dose-dependent manner (HSDR) or as a continuous single dose (HSC), and after cycle ergometer exercise. The mean decreases in FEV1 elicited by HSDR, HSC, and exercise were 26, 27, and 25%, respectively, and were not significantly different. There was an approximate 300% maximal increase in NCA detected after both HSC and exercise challenges. Gel filtration chromatography on columns of Ultragel ACA 34 indicated that the NCA released after HSC provocation and exercise were 600 to 700 kDa. There was an approximate 100% maximal increase in NCA after HSDR challenge, and this was significantly less (p = 0.016) than that after HSC and exercise. Exercise but not hypertonic challenge was associated with a basophilia and a significant increase in plasma histamine. There was a significant increase in plasma norepinephrine concentrations after exercise but not after HSC challenge in 7 asthmatics. Epinephrine concentrations did not change after exercise or HSC inhalation. NCA was measured in 5 subjects subjected to 2 HSC challenges that were separated by 60 min. There was an increase in NCA detected after both provocations. The increase after the second challenge was significantly greater (p = 0.27 x 10(-4)) than that observed after the initial provocation, despite a substantially reduced bronchoconstrictor response after the second challenge.     

Postoperative pancreatitis, hyperamylasemia and amylase isoenzymes after parathyroidectomy for primary hyperparathyroidism

Recent studies have cast doubt on the concept of causative association between parathyroidectomy for primary hyperparathyroidism and postoperative pancreatitis. The present study indicated that the relationship was real and that the development of acute pancreatitis after parathyroid surgery was not purely incidental. Acute pancreatitis was observed postoperatively in 3 p. 100 of cases after parathyroidectomy (6/196 cases), in 37 p. 100 after pancreatic surgery (19/51 cases), but never after thyroidectomy (100 cases) or other extra-abdominal operations (100 cases). During the first five postoperative days, the incidence of hyperamylasemia was 16 p. 100 after parathyroidectomy, 47 p. 100 after pancreatic surgery, 3 p. 100 after thyroidectomy, 2 p. 100 after other extra-abdominal operations. During the same period, the frequency of hyperlipasemia was similar: 20 p. 100 after parathyroidectomy, 54 p. 100 after pancreatic surgery, 1 p. 100 after thyroidectomy, 0 p. 100 after other extra-abdominal operations. In all cases with hyperamylasemia after parathyroidectomy, the pancreatic fractions of amylase isoenzymes were abnormally elevated.     

The use of protein as a carrier of methotrexate for experimental cancer chemotherapy. IV. Therapy of murine melanoma B16 by human serum albumin-methotrexate derivative

The influence of methotrexate bound to human serum albumin (HSA-MTX) and of free methotrexate (MTX) on B16 melanoma growth, dissemination and survival time of tumor-bearing animals was investigated. It was found that the growth of tumor was slower after therapy with the HSA-MTX derivative than after free MTX treatment. The reduction in tumor size recorded on day 21 after tumor transplantation was more significantly pronounced after HSA-MTX derivative therapy than in case of free MTX treatment. Contrary to our expectation there was no proportional difference in life span prolongation after therapy with these drugs. Comparing metastatic dissemination, the number and size of pulmonary metastatic colonies after HSA-MTX administration was more significantly reduced than after free MTX therapy.     

Non-parallel secretion of pancreatic amylase and trypsinogen following hepatectomy in rats.

To explore the changes in exocrine pancreatic function in the stages of active regeneration and recovery after hepatectomy, we measured the caerulein-stimulated amylase and trypsinogen output in anesthetized rats 4 days and 8 days after about 70% hepatectomy. Both 4 days and 8 days after hepatectomy, the amylase output was significantly greater than in the control groups. On the other hand, 4 days after hepatectomy, the trypsinogen output was almost the same as in the control groups, and 8 days after hepatectomy, it was significantly lower than in the control groups. Thus, the secretion of amylase and trypsinogen 8 days after hepatectomy was not parallel. The amylase content of the pancreas was significantly larger after hepatectomy than in the control groups, but the trypsinogen content was significantly smaller. These results indicate a non-parallel secretion of pancreatic digestive enzymes, as well as differences in the functions of the acinar cells after partial hepatectomy, and the important role of amylase in glucose metabolism after hepatectomy.     

Assessment of speed of an anti-platelet effect after two different doses of acetylsalicylic acid by flocculation

Acetylsalicylic acid inhibits aggregation of blood platelets through affecting arachidon acid metabolism--a precursor of thromboxan which is a strong platelet aggregation inhibitor. A standard method for measurement of aggregation activity blockade (in percents) of platelet rich plasma is turbidimetric aggregomethry based on spectrophotometric principle. According to results of recent studies administration of acetylsalicylic acid is one of the basic pillars of prevention of thrombotic complications in atherosclerotic arterial disease. Acetylsalicylic acid doses differ from study to study. An aim of our work was to measure speed of two different doses of acetylsalicylic acid. RESULTS: Level of aggregation activity blockade in samples of platelet rich plasma was measured by aggregometry in 26 healthy volunteers after administration of four inductors of thrombocyte aggregation (arachidon acid, adenosindiphosphate, collagen, and ristocetin). The samples were taken before administration and 120, 240, and 360 minutes after single peroral administration of 100 or 400 mg of acetylsalicylic acid. Samples of plasma were analysed immediately after sampling. Before drug administration there was no aggregation activity in 27.7% of the sample after arachidon acid administration, 28.3% after ADP administration, 21.5% after collagen administration and 25.3% after ristocetin administration. After administration of 400 mg of acetylsalicylic acid and administration of arachidon acid as an inductor 89.9% of the aggregation activity of the sample was blocked after 120 minutes, 89.6% after 240 minutes, and 90.6% after 360 minutes. After administration of adenosindiphosphate as an inductor 71.7% of the aggregation activity of the sample was blocked after 120 minutes, 68.3% after 240 minutes, and 69.9% after 360 minutes. And, after administration of ristocetin as an inductor 64% of the aggregation activity of the sample was blocked after 120 minutes, 66.4% after 240 minutes, and 54% after 360 minutes. Blockade of aggregation activity after collagen administration was not statistically significant. After administration of 100 mg of acetylsalicylic acid and administration of arachidon acid 83.8% of the aggregation activity of the sample was blocked after 120 minutes, 89.2% after 240 minutes, and 89.6% after 360 minutes. After adenosindiphosphate administration statistically significant blockade of aggregation activity was achieved after 360 minutes in the 56.7% of the sample. Also after collagen administration 42.5% of aggregation activity of the sample was blocked significantly after 360 minutes while ristocetin has not proved to influence aggregation in a statistically significant manner. CONCLUSION: Both doses of acetylsalicylic acid influenced aggregation activity of platelets in a statistically significant manner as soon as after 120 minutes following their peroral administration. However, they had different ability to influence platelets response to alternative ways of activation--by adenosindiphosphate, collagen, and ristocetin. 400 mg dose blocked these ways while 100 mg dose was efficient in blocking these ways after 360 minutes and in case of ristocetin--an inductor used to monitor platelet adhesion ability--100 mg dose has not led to statistically significant blockade at all.     

Investigation of the remaining lung function after lung surgery using ventilation and perfusion scintigraphy

The lung function after lung resection was studied in 18 patients using ventilation and perfusion scintigraphy. All patients underwent posterolateral thoracotomy. Scintigraphy was performed before and 1 month after surgery in 8 lobectomized patients and in 4 partially resected ones. Another 8 patients underwent scintigraphy 6.5 to 43 months after lobectomy. Mean transit time (MTT) on scintigraphy was used to estimate a regional washout function in lung. The value of MTT on the operated side minus MTT on the contralateral side increased after surgery. This change was more remarkable in lobectomized patients than in partially resected ones. MTT on the operated side lung was even more prolonged after operation. Reduction of %V and %Q was observed on the operated side of remaining lung after surgery, and Q decreased more than V after lobectomy.     

Up to nine-years' experience with the Allcarbon prosthetic heart valve

BACKGROUND AND AIM OF THE STUDY: The Allcarbon tilting disc valve has been used for valve replacement at the present authors' institution since 1993. Herein is reported their experience with Allcarbon valve implantation. METHODS: Between March 1993 and December 1998, Allcarbon valves were implanted in 599 patients (341 males, 258 females; mean age 36.2 years; range: 7-64 years). Among patients, 238 underwent mitral valve replacement (MVR), 217 aortic valve replacement (AVR), and 144 double valve replacement (DVR). The etiology of valve disease was rheumatic in 91% of cases. Follow up was 95.7% complete; cumulative follow up was 3,185 patient-years. RESULTS: Operative mortality was 2.2% (13/599). Actuarial survival at eight years was 96.6 +/- 1.2% after MVR, 96.1 +/- 1.3% after AVR, and 97.9 +/- 1.2% after DVR. Freedom from valve thrombosis at eight years was 97.0 +/- 1.3% after MVR, 100% after AVR, and 90.0 +/- 9.5% after DVR. Freedom from major bleeding at eight years was 90.0 +/- 2.7% after MVR, 93.5 +/- 2.6% after AVR, and 79.7 +/- 7.6% after DVR. There was one embolic episode after MVR. No structural valve failure was observed. Freedom from reoperation on implanted valves at eight years was 96.1 +/- 1.4% after MVR, 97.9 +/- 1.0% after AVR, and 97.9 +/- 1.5% after DVR. On completion of follow up, 91.3% of survivors were in NYHA class I, 8.5% in class II, and 0.2% in class III. CONCLUSION: Among a population of mostly young patients with rheumatic valve disease, the Allcarbon valve showed satisfactory clinical performance when implanted in the mitral and aortic positions.     

Parietal cell vagotomy in dogs. Influence on heidenhain pouch acid secretion, serum gastrin concentration, gastric emptying and motility.

No change was observed in fasting Heidenhain pouch (HP) acid secretion and fasting serum gastrin concentration following parietal cell vagotomy (PCV) in six dogs whereas significant increase in food-stimulated pouch secretion and serum gastrin concentration was observed. The increase in pouch secretion after PCV took place mainly in the first 2 h after meal. The maximum serum gastrin concentration was reached at 15 min after feeding before as well as after PCV. Maximum in HP secretion was reached later, at 120 min before and at 90 min after surgery. Gastric emptying studies, using a food-barium meal, showed a slight decrease in the emptying rate after PCV in two dogs, while it was unchanged in the others. Cineradiography showed an unaffected antral motility in all dogs after PCV.     

The effect of indomethacin on exercise-induced bronchoconstriction and refractoriness after exercise

Exercise causes bronchoconstriction in asthmatic subjects, which is usually followed by a refractory period during which exercise of the same intensity will cause less bronchoconstriction. This study examined the role of contractile prostaglandins in the initial bronchoconstriction after exercise and the role of inhibitory prostaglandins in the refractoriness after exercise. Subjects were pretreated with indomethacin, 50 mg twice daily, on 1 occasion or placebo on 2 occasions for 3 days. This was followed by 2 exercise challenges on a bicycle ergometer at least 30 min apart. Indomethacin did not alter the initial bronchoconstriction after exercise. The maximal fall in FEV1 after the first exercise challenge after placebo was 0.67 +/- 0.17 L and 0.68 +/- 0.17 L, and after indomethacin it was 0.67 +/- 0.12 L. Indomethacin, however, did prevent refractoriness after exercise. The maximal fall in FEV1 after the second exercise challenge after placebo was 0.31 +/- 0.06 L and 0.36 +/- 0.12 L, and after indomethacin it was 0.64 +/- 0.12 L. These results indicate that indomethacin pretreatment does not alter bronchoconstriction after exercise, and they also indicate that indomethacin pretreatment prevents refractoriness after exercise in asthmatic subjects.     

脑梗死患者血清C-反应蛋白水平变化及临床意义

目的观察脑梗死患者不同时期血清C-反应蛋白(CRP)的变化及病情的严重性和预后的关系,探讨脑梗死患者不同时期血清CRP水平的临床意义。方法对病程在2周以内的90例脑梗死患者在入院时及1周后进行血清CRP水平的测定,应用美国国立卫生研究院卒中量表及Barthel指数记分对入选患者在入院时及3个月后的神经功能缺损程度进行评分。结果入院时的CRP水平低于入院1周后的CRP水平,但其差异无显著意义。前者与患病当时及病后3个月神经功能缺损的严重程度显著相关,且这种相关性存在着量化的关系,而后者则无此相关。结论根据脑梗死患者病后2周内的CRP水平可以对病情的严重性及预后进行量化的判定。     

Adaptive changes in postprandial motility after intestinal resection and bypass

An electromyographic technique was used to study the changes in postprandial motility induced by jejunal and ileal resection and jejunal bypass (50% reduction of total length of small bowel). Electrodes were implanted in rats throughout the intestine. Compared to control animals, the duration of postprandial interruption of the myoelectric complex (DIMC) was rapidly increased after jejunal resection, more gradually augmented after jejunal bypass, and remained constant after ileal resection. The frequency of occurrence of spike bursts during the postprandial period was significantly decreased in the short remaining proximal segment after jejunal resection and was not changed in the ileum. The jejunal bypass induced no change in the frequency throughout the remaining bowel. Ileal resection was followed by a decrease on the jejunum. The percentage of slow waves superimposed by a spike burst remained constant after jejunal resection and bypass but was significantly decreased after ileal resection on the whole remaining intestine. These results show important modifications in postprandial motor activity of the small bowel, which appear rapidly after jejunal resection, more gradually after jejunal bypass, and which are less pronounced after ileal resection. This electromyographic study emphasizes the role of intestinal motility in the development of adaptation after small bowel resection or bypass.     

Effect of lipid feeding on endothelium dependent relaxation in rabbit aortic preparations

The effect of a cholesterol enriched diet on concentration responses to 5-hydroxytryptamine, ergometrine, and acetylcholine and on endothelium dependent relaxation was investigated in rabbit aortic strip preparations. Sensitivity to ergometrine was slightly reduced after both two and 10 weeks of cholesterol feeding. Sensitivity to 5-hydroxytryptamine was slightly reduced after two but not after 10 weeks of cholesterol feeding. Sensitivity to acetylcholine was not altered at two or 10 weeks in the absence of endothelium, but the endothelium dependent lowering of the constrictor concentration-response was almost abolished after 10 weeks of cholesterol feeding. Likewise the endothelium dependent relaxant response of preconstricted preparations to acetylcholine was almost abolished after 10 weeks of cholesterol feeding. Thus this model of hyperlipidaemia leads after 10 weeks to loss of endothelium dependent relaxation.     

Gastric emptying following vagotomy and antrectomy and proximal gastric vagotomy.

Gastric emptying of solid meals labelled with 129Cs was studied in patients for up to one year after vagotomy and antrectomy or after proximal gastric vagotomy. Significant delay was found one month after vagotomy and antrectomy but this had returned to normal by six months. No delay was found after proximal gastric vagotomy. The effect of posture on gastric emptying was also studied in the same subjects. No significant differences were found between gastric emptying in the supine or sitting positions after solid meals.     

经皮冠状动脉介入治疗术后电解质变化及其临床意义

目的 分析经皮冠状动脉介入治疗（PCI）术前、术后电解质变化情况及其临床意义.方法 收集行PCI病例113例,术前及术后次日均行电解质检测;术后24 h心电监测.结果 术后血钠、氯水平无明显变化,血钾水平多有不同程度下降,术后低钾组心律失常发生率较高.结论 PCI术后常可出现低钾血症,其较易导致心律失常.     

Effects of cirrhosis and ageing on the elimination and bioavailability of ranitidine.

The plasma concentrations of ranitidine after oral and intravenous administration have been measured in 10 healthy young adults, nine cirrhotic patients, and eight healthy elderly people. In the first of these bioavailability was 51 +/- 4% and half life 161 +/- 11 minutes after oral and 124 +/- 5 minutes after intravenous administration. In the cirrhotics bioavailability was increased to 70 +/- 7%, clearance was reduced, and there was a modest increase in half life. In the elderly bioavailability was similar to that in young adults, clearance was markedly reduced, and half life was prolonged to 241 +/- 7 minutes after oral and 194 +/- 11 minutes after intravenous administration. It is predicted that blood levels in cirrhotics and the elderly would be 50 to 60% higher than in healthy young adults after repeated oral administration of similar doses.     

PLASMA LEVELS OF NORETHINDRONE AFTER SINGLE ORAL DOSE ADMINISTRATION OF NORETHINDRONE AND LYNESTRENOL

Single oral doses of 0.3 mg, 0.5 mg and 5 mg Norethindrone (NET) and 0.5 mg and 5 mg Lynestrenol (lyn) were given to five women. Lynestrenol is probably metabolized through NET and exerts its main biological activity as NET. Plasma concentrations of NET were determined by a radioimmunoassay at different intervals after administration of the tablets. Peak concentrations of NET were found within two hours after intake of each table. The plasma half life of Net after NET and lyn administration for the period 8-24 h was 8-11 h. No significant difference was found between the half life of NET and the NET tablets and after the lyn tablets. When 5 mg NET was given the plasma half life of NET for the period 24-72 h was around 10 h and this was significantly shorter than the half-life of NET after 5 mg lyn, which was 16 1/2 h. The systemic availability of the drugs was estimated by calculating and comparing the areas under the plasma concentration versus time curve (AUC). 0-24 H. The AUC 0.24 after 0.3 MG NET was almost identical to the AUC 0.24 after 0.5 mg lyn. The AUC 0-24 after 0.5 mg NET was significantly larger than after 0.5 lyn. No difference was found between the AUC 0-24 after 5 mg lyn and 5 mg NET. This study supports the concept of a conversion from lyn to NET. It also shows that there were only minor pharmacokinetic differences between the drugs when all samples were measured as NET.     

Early alteration of coronary hemodynamics in late restenosis after coronary angioplasty

It is not known whether changes in coronary hemodynamics may antedate the development of restenosis after percutaneous coronary transluminal angioplasty (PTCA). The purpose of this study was to evaluate the early change in coronary microvascular function in patients with late restenosis after PTCA. Coronary hemodynamics were studied in series before, immediately after, 2 weeks and 3 months after successful PTCA in 12 male patients with a single lesion of the left anterior descending coronary artery. In each patient, great cardiac venous flow (GCVF) and oxygen content were measured both at baseline and during hyperemia induced by adenosine infusion. The sequential changes of coronary hemodynamics were compared between patients with and without restenosis at 3 months after PTCA. Basic characteristics did not differ between the patients with (n = 6) and those without restenosis (n = 6). Luminal diameter stenosis (in percentage) was also similar between the two groups both before (79.2 +/- 18.4% vs 83.0 +/- 9.6%, p = NS) and up to 2 weeks after PTCA (25.8 +/- 10.9% vs 28.5 +/- 7.9%, p = NS). In patients without restenosis, basal and hyperemic GCVF was unchanged up to 2 weeks after PTCA. There was a significant increase in CFR 3 months after PTCA. In patients with restenosis, basal GCVF was significantly increased and hyperemic GCVF was unchanged immediately after PTCA. However, 2 weeks after PTCA, basal GCVF was decreased while luminal diameter was still preserved. In comparison with those without restenosis, patients with restenosis had significantly lower CFR before (1.98 +/- 0.42 vs 2.69 +/- 0.46, p = 0.019), immediately after (1.47 +/- 0.27 vs 2.24 +/- 0.47, p = 0.006) and 3 months after PTCA (1.51 +/- 0.32 vs 3.40 +/- 0.54, p = 0.001). In patients without restenosis, the recovery of coronary microvascular function was delayed up to 3 months after PTCA. In patients with late restenosis, basal coronary microvascular tone was altered within 2 weeks after PTCA suggesting early deterioration of coronary microvascular function before the development of angiographic restenosis.     

A case of multidrug-resistant pulmonary tuberculosis cured by the regimen including thiacetazone

A 30 years-old-male was referred to our hospital for surgical treatment of multidrug-resistant tuberculosis in April 1998, three years after diagnosis of tuberculosis. All first-line anti-tuberculosis drugs and second-line anti-tuberculosis drugs were resistant on drug susceptibility tests by Ogawa medium. The right upper lobectomy was done because of massive hemoptysis and enlargement of cavitary lesion in June 1998, but this surgical operation was complicated with, bronchial fistula and chronic empyema. Open drainage surgical treatment for chronic empyema was done one month after lobectomy. Sputum culture for M. tuberculosis converted 4 months after the lobectomy, but bacteriological relapse occurred 17 months after initial operation. The new cavitary lesion on middle left lung field developed and sputum smear and culture were continuously positive. Immunotherapy with interferon-gamma via aerosol didn't show any clinical effect. Thiacetazone, sparfloxcin, pyrazinamide, cycloserine was prescribed after 21 months of the initial operation. Four months after changing the regimen sputum smear and culture converted to negative. Chemotherapy was terminated in June 2003, two years after negative conversion. Three years after the termination of treatment no relapse occurred. We considered thiacetazone was effective in this case, because all of the drugs was companied with thiacetazone were resistant by the drug susceptibility tests and were previously used.     

房间隔缺损并发心房纤颤患者应用Amplatzer伞封堵房缺后心房纤颤的电复律治疗

目的 :初步评价房间隔缺损并发心房纤颤患者应用 Am platzer伞封堵房间隔缺损后心房纤颤的电复律疗效。方法 :2例患者 （5 1～ 5 3岁 ）。在透视及食管超声心动图监视下经导管置入 Amplatzer伞封堵房间隔缺损。术后即时行超声心动图 ,术后 2 4h,和 1,3,6月 ,分别行经胸超声心动图评价房间隔缺损治疗效果。术后 6月行电复律。结果 :2例患者疗效均佳 ,房间隔未见残余分流 ,电复律成功 ,患者转为窦性心律 ,复律后无并发症及 Amplatzer伞移位。结论 :应用 Am platzer伞封堵房间隔缺损并发心房纤颤患者 ,电复律易成功 ,是一种安全有效的复律方法。