白藜芦醇对重症急性胰腺炎大鼠腹腔巨噬细胞功能的影响

目的：探讨腹腔巨噬细胞（PM）在大鼠重症急性胰腺炎（SAP）中的作用,并观察白藜芦醇（Res）对SAP大鼠PM功能的影响。方法：36只大鼠随机分为假手术（SO）组、SAP组和Res组3组。制模后4、12h剖杀大鼠。分离PM并培养24h。RT—PCR法检测PM中肿瘤坏死因子-α（TNF-α）mRNA和白介素-1β（IL-1β）mRNA的表达;酶联免疫吸附法（EUSA）检测细胞培养液及血清中TNF-α和IL-1β的水平。取胰腺组织行HE染色及病理学评分。结果：与SAP组比较,Res组胰腺损伤程度明显减轻;SAP组PM中TNF—mnRNA和IL—1βmRNA的表达、细胞培养液及血清中TNF-α和IL-1β水平均高于SO组（P〈0．001）;与SAP组比较,Res组PM中TNF-αmRNA和1L-1βLRNA的表达、细胞培养液及血清中TNF-α和IL-1β水平明显下降（P〈0．001）,但仍高于SO组（P〈0．05）。结论：PM在SAP发病机制中起非常重要的作用;Res能显著减轻SAP时胰腺组织损伤,其机制与抑制PM功能,从而抑制TNF-α和IL-1β的分泌有关。     

人脐带间充质干细胞对大鼠重症急性胰腺炎的保护作用

目的 研究人脐带间充质干细胞(ucMSCs)对大鼠重症急性胰腺炎(SAP)的保护作用.方法 135只雄性SD大鼠随机分成对照组(Sham组),SAP组和SAP+ucMSCs组,每组45只.采用5％牛磺胆酸钠(0.1ml/100g)逆行胰管注射的方法制作大鼠SAP模型,SAP+ucMSCs组通过尾静脉注射CM-DiI标记的ucMSCs(1×107个/kg).各组于术后12、24、72h处死取材,统计大鼠死亡率,HE染色观察各组胰腺组织病理学改变并评分,荧光显微镜观察ucMSCs定植情况,ELISA法测定大鼠血清淀粉酶和脂肪酶、肿瘤坏死因子α(TNF-α)、白介素1β (IL-1β)、白介素4(IL-4)和白介素10(IL-10)的表达情况.结果 ucMSCs可定植在胰腺组织的损伤区域,可降低72h SAP大鼠的死亡率(SAP组为66.7％,SAP+ucMSCs组为20.0％).ucMSCs移植后大鼠各时间点血清淀粉酶和脂肪酶水平明显降低(P＜0.01),胰腺组织病理学评分、炎性因子TNF-α、IL-1β水平明显降低,抗炎因子IL-4、IL-10水平明显升高(P＜0.05或P＜0.01).结论 人脐带间充质干细胞移植治疗可减轻重症急性胰腺炎的胰腺组织损伤和炎症程度.     

牙髓炎成牙本质细胞P2X7受体表达意义

目的探讨成牙本质细胞中P2X7受体(P2X7R)表达在牙髓炎发病及病情进展中的意义。方法取轻度牙髓炎、重度牙髓炎患者和健康者第三磨牙各20例,采用Real-time PCR法检测P2X7R mRNA表达水平,采用Western blotting法检测P2X7R蛋白表达水平;另采用ELISA法检测上述第三磨牙供者的血清样本中IL-1β、IL-6和TNF-α等炎症因子水平。结果按健康组、轻度牙髓炎组、重度牙髓炎组的顺序,第三磨牙成牙本质细胞中P2X7R mRNA和蛋白表达水平均显著增高,患者血清中IL-1β、IL-6的水平显著增高;轻度牙髓炎患者血清中TNF-α与健康人比较,显著升高(P<0.05);但重度牙髓炎患者与轻度牙髓炎患者比较,血清中TNF-α则显著降低(P<0.05)。在轻度牙髓炎患者中,P2X7R mRNA表达与IL-1β水平显著正相关(P<0.05),P2X7R蛋白表达与IL-1β、IL-6和TNF-α水平均呈正相关(P<0.05);在重度牙髓炎患者,P2X7R mRNA表达与IL-1β和IL-6水平均呈正相关(P<0.05),P2X7R蛋白表达与IL-1β和IL-6水平均呈正相关(P<0.05)。结论成牙本质细胞P2X7R表达在牙髓炎发病和病情进展过程中表达增高,且该过程伴随IL-1β、IL-6和TNF-α等炎症因子表达增加。     

早期生长反应基因-1在大鼠急性胰腺炎合并肺损伤中的作用

目的 探讨早期生长反应基因-1(EGR-1)在急性胰腺炎(AP)合并肺损伤中的作用.方法 将24只雄性Wistar大鼠随机均分为4组,分别于胆管内逆行注入生理盐水或不同浓度牛磺胆酸钠溶液,3h后处死动物,留取血清、胰腺及肺组织.检测血清TNF-α、IL-1β水平,进行胰腺组织病理评分,测定肺组织湿重/干重比,并对肺组织进行EGR-1免疫组化染色.另将原代培养的肺泡巨噬细胞(AM)分别采用不同浓度胰弹性蛋白酶进行刺激,通过免疫细胞化学染色检测EGR-1在AM的表达,并检测培养液中TNF-α、IL-1β的浓度.结果 肺组织免疫组化染色显示,EGR-1表达随AP病情加重而增强,并与TNF-α、IL-1β、胰腺组织病理评分及肺组织湿重/干重比均呈显著正相关,且表达细胞类型也有所不同.AM表达EGR-1程度与培养液TNF-α、IL-1β水平呈显著正相关,EGR-1在AM中的表达有ERK1/2信号途径的参与.结论 EGR-1可能在AP合并肺损伤中起重要作用,其机制可能与其介导炎性细胞因子生成有关.     

与凋亡相关的斑点样蛋白在大鼠急性胰腺炎中的作用机制

目的 研究大鼠发生急性胰腺炎时,与凋亡相关的斑点样蛋白(ASC)在胰腺组织的表达及其与caspase-1和IL -1β的关系,为评价 ASC在大鼠急性胰腺炎时的作用机制提供实验依据.方法 (1)将20只健康、成年的SD大鼠随机分成2组,一组进行急性胰腺炎造模,另一组作为正常对照组.造模24 h后处死大鼠,取大鼠新鲜血清,测定血清淀粉酶活性及IL-1β含量.取大鼠胰腺组织,用免疫组化技术检测ASC和caspase-1在胰腺组织中的表达情况.(2)RT-PCR法扩增大鼠胰腺组织中ASC mRNA.结果 (1)急性胰腺炎组血清淀粉酶和IL-1β水平较正常对照组水平均显著升高,两者间差异有统计学意义(P<0.01).(2)免疫组化检测、分析发现:ASC和caspase-1在正常对照组大鼠胰腺组织中少量表达,在急性胰腺炎组表达显著增加,两组间差异有统计学意义(P<0.01).(3) RT-PCR检测发现:急性胰腺炎组大鼠胰腺组织中ASC mRNA的含量明显多于正常对照组.结论 当发生胰腺炎时,大鼠胰腺组织中ASC的表达上调并调节caspase-1的活化,导致IL-1β的分泌增加,引起炎症反应,从而证明ASC在胰腺炎的发病中起重要作用.     

腹腔穿刺引流对重症急性胰腺炎大鼠胰腺细胞凋亡的影响及机制

目的探讨腹腔穿刺引流(APD)对重症急性胰腺炎(SAP)大鼠胰腺细胞凋亡的影响,并探讨其可能的分子机制。方法将成年雄性SD大鼠随机分为假手术(SO)组、SAP组、APD组,每组18只。SAP组、APD组大鼠经胰胆管逆行微量泵入5%牛磺胆酸钠制备SAP模型,APD组进一步由右下腹导入一胃管进行引流。每组设置6、12、24 h时间点,收集腹主动脉血和胰腺组织。酶联免疫吸附法(ELISA)检测血清淀粉酶、炎性因子及内毒素的变化;HE染色观察胰腺组织损伤情况;原位末端转移酶标记法(TUNEL)检测胰腺组织细胞凋亡情况;Western blotting和免疫组化法检测凋亡相关蛋白及磷脂酰肌醇3-激酶/蛋白激酶B(PI3K/AKT)信号通路蛋白的表达。结果 APD组大鼠胰腺组织坏死、水肿情况明显好于SAP组,病理学评分下降(P<0.05)。APD组大鼠血清淀粉酶、肿瘤坏死因子α(TNF-α)、白介素(IL)1β、IL-6及内毒素水平明显低于SAP组(P<0.05),胰腺细胞凋亡数量明显高于SAP组(P<0.05),胰腺组织凋亡蛋白裂解的半胱氨酸天冬氨酸蛋白酶-3(cleaved-...     

Caspase-1激活的细胞因子在实验性重症急性胰腺炎肾损害中的作用

目的 研究Caspase-1激活的细胞因子在实验性重症急性胰腺炎(SAP)肾损害中的作用.方法 SD大鼠32只,随机分为正常对照组(HC组)、SAP6h组、SAP12h组、SAP18h组,每组8只.采用5%牛磺胆酸钠逆行注入胰胆管诱发大鼠SAP模型.通过HITACHI-7150型自动生化分析仪检测大鼠血清尿素氮(BUN)、肌酐(Cr),ELISA法测定血清IL-1β水平,酶化学法测定肾组织髓过氧化物酶(MPO)活性,半定量RT-PCR检测肾内Caspase-1、IL-1β及IL-18 mRNA的表达.结果 SAP造模后各组血清BUN、Cr和IL-1β水平显著升高,并伴有肾组织MPO显著增加,与HC组相比差异均具有统计学意义(P＜0.01).HC组肾内可见Caspase-1及IL-18 mRNA表达,但IL-1β mRNA表达较弱;SAP各组肾内Caspase-1、IL-1β及IL-18 mRNA表达显著上调(P＜0.01).结论 Caspase-1激活、IL-1β及IL-18的过度表达可能与SAP肾损害有关.     

急性肺损伤大鼠TNF-α、IL-1β、IL-1ra mRNA的表达及药物干预

目的观察急性肺损伤(ALI)大鼠肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)、白介素-1受体拮抗剂（IL-1ra）mRNA的动态表达及白介素-10(IL-10)、地塞米松(Dex)对TNF-α、IL-1β、IL-1ra的干预作用。方法气道内滴注内毒素(LPS)10mg／k建立大鼠ALI模型。72只雄性SD大鼠随机分为对照组、损伤组、LPS加IL-10组、LPS加Dex组，每组18只(2、6、24h各6只)。采用RTPCR方法检测肺组织TNF-α、IL-1β及IL-1ra mRNA的表达水平，光镜下观察肺组织病理改变。结果损伤组肺组织TN-α mRNA表达2h达高峰，随后迅速下降；IL-βmRNA表达2h显著升高，6h达高峰，随后迅速下降；IL-1ra mRNA表达6h开始升高，且为峰值，24h仍高于对照组。IL-10及Dex可明显抑制肺组织TNF-α及IL-1βmRNA的表达，但对IL-1ra mRNA表达无明显影响。肺组织病理检查见IL-10组、Dex组的肺损伤较损伤组明显减轻。结论急性肺损伤时，TNF-α及IL-1βmRNA表达明显早于IL-1ra mRNA，提示ALI早期存在炎症介质／抗炎介质失衡。IL-10、Dex可明显抑制TNF-α及IL-1βmRNA的表达，但不影响IL-1ra mRNA的表达，这有利于炎症介质／抗炎介质平衡的重建，减轻大鼠ALI。     

Caspase-1抑制剂对实验性重症急性胰腺炎肺损伤的保护作用

目的 评价Caspase-1抑制剂二甲基苯甲酰羟甲酮对实验性重症急性胰腺炎(SAP)肺损伤的保护作用.方法 SD大鼠42只,随机分为3组:健康对照组(HC组,n=6);SAP造模 生理盐水组(SAP-S组,n=18);SAP造模 ICE抑制剂组(SAP-ICE-Ⅰ组,n=18).以5%牛磺胆酸钠逆行注入胰胆管制作大鼠SAP模型.SAP-S组于造模后2h腹腔注射生理盐水1ml,12h后重复1次;SAP-ICE-Ⅰ组于造模后2h腹腔注射ICE抑制剂.HC组模拟胰胆管穿刺操作,但不注射药物.采用ELISA法测定血清IL-1β水平;半定量RT-PCR检测肺内Caspase-1,IL-1β及IL-18 mRNA的表达,并观察肺湿干重比率及组织病理变化.结果 SAP-S组血清IL-1β水平在6h、12h、18h时分别为276.77±44.92、308.99±34.95、311.60±46.51pg/ml,显著高于HC组(P<0.01);SAP-ICE-Ⅰ组与SAP-S组比较水平显著降低(P<0.01).HC组肺内可见Caspase-1、IL-1β及IL-18 mRNA表达;与HC组比较,SAP-S组3个时间点的表达水平显著上调(P<0.01);SAP-ICE-Ⅰ组与SAP-S组比较,IL-1β及IL-18mRNA的表达显著下调(P<0.01),Caspase-1 mRNA表达则无显著改变.SAP-S组肺湿干重比率比HC组显著升高(P<0.05,P<0.01);且显著高于SAP-ICE-Ⅰ组(P<0.05).Caspase-1抑制剂治疗使肺损伤程度减轻.结论 Caspase-1的激活、IL-1β及IL-18的过度表达在SAP肺损伤过程中发挥重要的作用;抑制Caspase-1可有效地保护SAP肺损伤.     

腹腔穿刺引流对重症急性胰腺炎大鼠肠道TLR4表达的影响及意义

目的探讨早期腹腔穿刺引流(APD)对重症急性胰腺炎(SAP)大鼠肠道Toll样受体4(TLR4)表达的影响及意义。方法雄性SD大鼠随机分为假手术(Sham)组、SAP组和APD组,每组15只。采用5%牛磺胆酸钠胰胆管逆行注射法建立SAP大鼠模型,在此基础上于大鼠右下腹置入引流管建立APD模型。建模后24h采集血样、小肠和胰腺组织,HE染色观察小肠组织和胰腺组织的病理学变化,采用全自动生化仪检测血清淀粉酶和脂肪酶活性,鲎试剂法检测血清内毒素水平,紫外比色法检测血清二胺氧化酶(DAO)活性,ELISA法检测小肠组织肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平以及血清D-乳酸水平,TUNEL法检测肠黏膜上皮细胞凋亡情况,RT-PCR检测小肠组织TLR4 mRNA的表达水平,免疫组化和Western blotting检测TLR4信号通路关键分子和凋亡相关蛋白的表达。结果与SAP组比较,APD组大鼠小肠和胰腺组织病理损伤明显减轻,病理评分明显降低(P<0.05),血清淀粉酶、脂肪酶和DAO活性以及TNF-α、IL-6、D-乳酸和内毒素水平也明显降低(P<0.05)。...     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.