急性乳腺炎

急性乳腺炎多发生于产后1～2个月的哺乳妇女,尤以初产妇多见。常因哺乳时被婴儿吮破乳头,细菌趁机侵入;加之排乳不畅,以致细菌得以繁殖而发病。中医称之为"乳痈",并将其分为脓未成和脓     

急性肾损伤诱导急性肺损伤的研究进展

急性肾损伤是一种ICU患者中常见的疾病,致死率较高,当合并肺损伤时,致死率显著提高,可达到80%。急性肾损伤可导致全身体液灌注量增加,血浆渗透压升高进而引起肺水肿和急性呼吸衰竭。同时,炎症反应,氧化应激,细胞凋亡和可溶性调节因子代谢异常等也可能参与急性肾损伤诱导的肺损伤。对急性肾损伤诱导肺损伤的临床认识和可能发病机制的研究,将有助于临床疾病的治疗和死亡率的降低,同时也将有助于对其它肾脏疾病发病机制的认识。     

急性高原病合并急性肾衰3例

例 1:某女、16岁、汉族、学生 ,由内地乘车到拉萨 ,途中有胸闷、气促、恶心、呕吐胃内容物数次 ,以神志恍惚、尿少 1+ 天入院 ,诊断为高原性脑昏迷、急性肾衰。入院时血肌酐 30 8ｕｍｏｌ/Ｌ血尿素氮 2 4ｍｍｏｌ/Ｌ ,尿蛋白土±～ +,因病情危重 ,于入院第四天死亡。例 2 :某女、39岁、青海回族、流动人员 ,由西宁乘车到拉萨 ,途中感头痛、恶心、呕吐少量胃内容物 ,以神志恍惚 ,无尿 2天入院。诊断同上。查血肌酐4 94ｕｍｏｌ/Ｌ ,血尿素氮 2 2 5ｍｍｏｌ/Ｌ ,尿蛋白 +— ,经保守治疗 ,病情无好转 ,血肌酐上升至 80 4 μｍｏｌ/Ｌ ,血尿素…     

急性心肌梗死并发急性胰腺炎1例

<正>患者男性,60岁,以"突发性胸痛伴大汗6h"为主诉入院。自6h前因情绪激动后出现胸痛,位于胸骨后,呈烧灼感,伴大汗,为持续性,无恶心及呕吐,无放散痛。病后就诊于当地医院,做心电图检查提示     

急性胰腺炎并发急性肾功能衰竭

自1956年Lucke描述急性胰腺炎可致“下肾单位肾病”以来,已报告了近30例患者发生此现象。急性胰腺炎发生急性肾功能衰竭者,常由剖腹术、胃肠道出血或休克所致。因循环虚脱而产生急性肾小管或肾皮质坏死,致使出现急性肾功能衰竭。有的患者因麻醉药对肾脏有毒性作用,引起急性肾功能衰竭。     

急性有机磷中毒并发急性胰腺炎1例

患者,女,44岁,因空腹服敌敌畏50 mL,约10 min后出现呕吐、大汗、神志不清、呼吸困难,1 h后送当地医院洗胃、注射阿托品(量不详),4 h后来我院急诊.就诊前无大量进食酒肉史,既往无胆胰疾病史.     

急性非特异性心包炎误诊为急性心肌梗死

[病例]男,50岁。自诉4小时前无明显诱因突然出现心前区闷痛,吸气及左侧卧位时加重,偶有咳嗽,无发热,含服速效救心丸15粒不能缓解而来就诊。查体:体温36.6℃,呼吸18/min,血压98/60 mmHg。意识清,表情痛苦,口唇紫绀,颈静脉无怒张,双肺呼吸音清晰,心界不大,心率66/min,律齐,各瓣膜听诊区未闻及杂音,无心包摩擦音,双下肢无浮肿。心电图示Ⅱ,Ⅲ,avF,avL,V2-6导联ST段弓背向下抬高0.1～0.2mv,T波高尖,考虑急性心肌梗死（AMI）。立即肌注罂栗碱、哌替啶、静脉滴注硝酸甘油,心电监护心电图的动态改变。半小时后观察心电图 ST-T波似有动态改变,给予生理盐水100 ml加尿激酶100万单位静脉滴注,用药10分钟左右患者自诉心前区闷痛难忍,心电图无明显变化。继续观察5分钟疼痛不能缓解     

急性胃肠炎诱发大面积急性心肌梗死1例

患者,男性.45岁.因"2月前心前区疼痛持续2小时"而在当地医院就诊.患者于2个月前因突发心前区压榨性疼痛及放散痛伴大汗淋漓、胸闷、气短,持续2小时,含服硝酸甘油不缓解而到当地医院就诊,当时检查心电图为V1～V6、Ⅱ、Ⅲ、aVF、V3R、V4R、V5R ST段弓背上抬0.2～0.6mm.     

急性脑血管病并发急性肾损伤相关因素分析

目的对急性脑血管病并发急性肾损伤的相关原因进行分析,并探讨相关的防范和干预措施,以为疾病的预防和治疗提供一些参考意见。方法收集自2011年5月至2013年5月来我院就诊的入院时无肾功能异常的急性脑血管病患者120例(其中包括并发急性肾损伤的患者40名),分为观察组和对照组,分别有并发性肾损伤和没有并发性肾损伤,对两组病人的肾功能相关临床指标进行监测,观察治疗结果和干预效果。结果 40名并发AKI患者死亡率达22.5%,脑出血患者并发AKI死亡者6,经过对比,观察组的死亡率远远高于对照组的患者。结论发现AKI的并发与患者的年龄、性别、是否"三高"、脑部损伤与否、均有关系。     

急性心肌梗死合并急性脑梗死36例分析

目的通过分析急性心肌梗死合并急性脑梗死的病发机制,寻找治疗急性心肌梗死合并急性脑梗死的有效方法,有效降低其病死率。方法选择2009年4月至2012年4月我院收治的36例急性心肌梗死合并急性脑梗死患者作为本次研究对象,对36例患者的临床资料进行回顾和分析。结果 36例急性心肌梗死合并急性脑梗死患者预防和治疗后,24例得到治愈,10例好转,还有2例病残。结论急性心肌梗死合并急性脑梗死的病死率高,临床治疗应以预防为主,以提高临床治疗效率,帮助患者尽快恢复健康。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.