Anti-inflammatory activities of cardamonin from Alpinia katsumadai through heme oxygenase-1 induction and inhibition of NF-κB and MAPK signaling pathway in the carrageenan-induced paw edema

Cardamonin is a chalcone isolated from Alpinia katsumadai. This study is aimed to evaluate treatment of cardamonin decreased the paw edema at the 5th hour after λ-carrageenan (Carr) administration and increased the activities of catalase (CAT) and superoxide dismutase (SOD) in the anti-inflammatory test. We also demonstrated that cardamonin significantly attenuated the malondialdehyde (MDA) level in the edema paw at the 5th hour after Carr injection. Cardamonin decreased the nitric oxide (NO), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and IL-6 levels on the serum level at the 5th hour after Carr injection. Western blotting revealed that cardamonin decreased Carr-induced inducible nitric oxide synthase (iNOS), cycloxyclase (COX-2), nuclear factor-κB (NF-κB) and MAPK [extracellular signal-regulated protein kinase (ERK), c-Jun NH(2)-terminal kinase (JNK), p38] expressions and increased heme oxygenase-1 (HO-1) expressions at the 5th hour in the edema paw. The anti-inflammatory mechanisms of cardamonin might be related to the decrease in the level of MDA, iNOS, COX-2, NF-κB, and MAPK and induction of the HO-1 expression in the edema paw via increasing the activities of CAT and SOD in the edema paw through the suppression of NO, TNF-α, IL-1β, and IL-6.     

不同时间启始头部轻度低温对高血压脑出血预后的影响

目的探讨不同启始时间应用颅脑降温治疗仪(电子冰帽)致头部轻度低温(亚低温)对高血压性脑出血预后的影响。方法72例高血压性脑出血患者随机分为治疗组和对照组,每组36例;每组再分为脑出血后第6、12和24h亚组,每亚组12例。在给予脑出血常规治疗的同时,治疗组使用电子冰帽。观察血肿体积、血肿周围水肿体积及神经功能缺损评分的变化。结果治疗后第7d与第21d的第6、12、24h开始致头部轻度低温的治疗组与相应时间的对照组血肿体积无显著性差异(P>0.05)。治疗后第21d的第6、12、24h启始的治疗组与相应时间的对照组血肿周围水肿体积比较有非常显著性差异(P<0.01)。治疗后第21d的第6、12h启始的治疗组与相应时间对照组神经功能缺损评分有非常显著性差异(P<0.01),第24h的两组间有显著差异(P<0.05)。结论第6、12和24h启始应用电子冰帽使头部轻度低温治疗高血压性脑出血,均能减轻血肿周围水肿,改善神经缺损功能,但对血肿的大小无影响。     

乙酰半胱氨酸注射液致血管性水肿1例分析

目的探讨乙酰半胱氨酸注射液致血管性水肿的原因及治疗方法。方法分析吉林大学第一医院血管外科2018年9月收治的1例动脉硬化闭塞症患者因注射乙酰半胱氨酸注射液致血管性水肿的可能性及治疗方法。结果 1例65岁女性患者因左下肢发凉、麻木、疼痛1年入院。入院第1天给予乙酰半胱氨酸注射液8 g+5%葡萄糖溶液250 mL静脉滴注,注射该药后约1小时20分钟,患者出现面部水肿、全身皮疹等血管性水肿症状,立即停药并给予抗过敏治疗,对症治疗后1 h患者上述症状消失,入院第14天病情好转出院。结论乙酰半胱氨酸注射液很可能引起该患者血管性水肿。注射该药物时应注意减小滴速,谨慎用于有药物过敏史、哮喘的患者,同时注射时应有专人陪护并注意观察。     

Future perspectives on the fibrinolytic therapy of intracerebral hemorrhages

Intracerebral hemorrhage (ICH) is associated with a high mortality and severe disability. Whereas a classical open craniotomy for hematoma removal may further traumatize brain tissue, minimally invasive surgery combines benefits of surgical clot removal with limited tissue damage and shorter surgery duration. Evacuation is often hampered by clot retraction, thus, advocating clot liquefaction to facilitate complete evacuation. The use of urokinase or recombinant tissue plasminogen activator (rtPA) alone and in combination with neuroprotective drugs in experimental studies and clinical trials is reviewed with respect to efficacy in hematoma reduction and effects on secondary brain injury. Whereas rtPA promotes delayed edema formation and inflammation after local fibrinolysis, desmoteplase (DSPA), a highly fibrin-selective plasminogen activator derived from vampire bat saliva, combines high fibrinolytic potential with lack of excitotoxicity, thus representing a novel, promising candidate for fibrinolytic therapy of ICH.     

口服盐酸莫西沙星片致罕见不良反应1例

1例55岁女性患者因尿路感染口服盐酸莫西沙星1片,半小时后,患者出现全身发热伴皮肤瘙痒、呼吸急促、声音嘶哑、喉头水肿、血糖升高等不良反应急诊就医,经16d治疗后症状全部消失。     

The use of the Chandler loop to examine the interaction potential of NXY-059 on the thrombolytic properties of rtPA on human thrombi in vitro

BACKGROUND AND PURPOSE: Recombinant tissue-type plasminogen activator (rtPA) is the only globally approved treatment for acute ischaemic stroke. Other potential treatments might be administered with rtPA, making it important to discover whether compounds interfere with rtPA-induced lysis. We evaluated methods for examining the effect of the neuroprotectant NXY-059 on the lytic property of rtPA. EXPERIMENTAL APPROACH: Plasma clot formation and lysis in the presence of rtPA and NXY-059 was measured as the change in plasma turbidity. The effect of NXY-059 on rtPA-induced lysis was similarly assessed on preformed clots. Lysis of the thrombus formed in a Chandler loop measured release of fluorescent-tagged fibrinogen that had been incorporated during thrombus formation. Thrombi were exposed to both rtPA and NXY-059 throughout lysis in the presence of 80% autologous plasma and the release of label during lysis was measured. KEY RESULTS: Data interpretation is limited in the clot lysis experiments because either the rtPA was present during clot formation or the drug was added to a clot formed in static conditions. In contrast, thrombi were formed in dynamic flow conditions in the Chandler loop and the time course of lysis in plasma was examined. rtPA increased thrombolysis and the antifibrinolytic trans-4-(aminomethyl) cyclohexane carboxylic acid (AMCA) inhibited lysis. Lysis induced by rtPA was unaltered by NXY-059. CONCLUSIONS AND IMPLICATIONS: The Chandler loop method provides a reliable technique for examining the effect of compounds on rtPA-induced lysis in vitro and demonstrated that NXY-059 does not alter rtPA-induced lysis at clinically relevant concentrations of either drug.     

盐酸莫西沙星氯化钠注射液致过敏性休克

1例61岁女性患者,确诊多发性骨髓瘤IgD．LAM型ⅢA8个月,既往有青霉素类药物过敏史。治疗期间输入盐酸莫西沙星氯化钠注射液约1h,患者突然烦躁不安、呼吸困难、喉头水肿、舌尖肿胀、麻木、大汗淋漓。立即停止输入,更换输液器,给予抗过敏扩充血容量抢救,40min后患者症状缓解,神志清楚、回答切题、呼吸顺畅。1d后,患者恢复正常。     

急性脑梗死阿替普酶静脉溶栓治疗的临床分析

胃的评价急性脑梗死（Acutecerebralinfarction,ACI）患者应用阿替普酶静脉溶栓治疗的有效性与安全性。方法回顾分析2010年5月罩2013年5月78例AcI溶栓治疗的患者临床资料,并选取同期未予溶栓治疗的ACI患者80例为对照组,应用美国国立卫生研究院卒中量表（NHISS评分）和改良Rankin量表（mRS评分）评价两组的神经功能改善程度和近期预后。结果溶栓组治疗后24hNIHSS评分（7．68±4．62）,mRS评分（3．28±0．41）,治疗后7d的NIHSS评分（5．25±4．43）,mRS评分（1．11±0．62）,两组相比差异具有统计学意义（P〈0．01）。溶栓组患者齿龈出血58例（74％）,7d无症状性出血性转化14例（18％）,症状性颅内血肿3例（4％）,死亡4例（5％）。非溶栓组齿龈出血2例（3％）,7d无症状性出血性转化5例（6％）,症状性颅内血肿2倒（3％）,死亡3例（4％）。结论在ACI治疗时间窗内,阿替普酶静脉溶栓治疗,可以减轻患者的神经功能障碍评分,不增加病死率,有效安全。     

肛肠外科术后患者行药物熏洗护理效果观察

目的分析中药熏洗在肛肠手术患者中的应用效果。方法观察472例肛肠手术术后患者行中药熏洗的治疗效果,观察指标为术后48 h、120 h切口疼痛评分、水肿程度及切口愈合时间。结果患者术后48 h疼痛评分、水肿程度分别为4.6分、1.17分。术后120 h的疼痛、水肿程度评分分别为1.2分、1.01分;伤口愈合时间11.7 d。结论中药熏洗能有效减轻肛肠手术患者术后疼痛及切口周围软组织水肿,有利于手术切口的愈合。     

Narrowing of airway caused by ingestion of methyl ethyl ketone peroxide

Although ingestion of methyl ethyl ketone peroxide (MEKP) is rare, it carries a high risk of morbidity and mortality. This paper reports the first such case from Turkey in which a 70-year-old man unintentionally ingested MEKP in his kitchen. The patient was brought into the emergency department (ED) within 1 hour of ingestion, with the symptoms of sore throat, shortness of breath, nausea and vomiting. Visual examination of the oropharynx revealed minor burns and uvular edema. A laryngoscope examination performed in the ED showed superficial mucosal injury with edema of the oropharynx, uvula, posterior pharynx, epiglottis, arytenoids and vocal cords. Lateral cervical radiography revealed a narrowing of airway due to a thickened epiglottis. After the diagnostic evaluation was completed, the patient was admitted to the gastroenterology intensive care unit for monitoring of adverse reactions. During follow-up, the patient made an uneventful recovery. Ingestion of MEKP generally results from accidental ingestion from a container. Therefore, these containers should be kept in safe places. In addition, the priority following the ingestion of MEKP should be given to maintain open and adequate airway in the ED.     

Tissue plasminogen activator mediated blood-brain barrier damage in transient focal cerebral ischemia in rats: relevance of interactions between thrombotic material and thrombolytic agent

Thrombolysis with tPA for acute ischemic stroke is associated with an increased risk of intracerebral hemorrhage. We investigated the impact of thrombolysis with tPA on the blood-brain barrier in a suture occlusion model in rats. Cerebral ischemia was performed for 2 h followed by 22 h of reperfusion. Treatment groups received either saline (A), 10 mg/kg bw rtPA (B) or "activated" rtPA (ArtPA, C, rtPA with in vitro clot contact). Blood-brain-barrier damage assessed by Evans blue extravasation as a permeability marker was significantly enhanced in basal ganglia of group C compared to groups A or B. Likewise was the upregulation of MMP-9. Interestingly, results of the rtPA and saline group showed only minor and not statistically significant differences. The results of the present study indicate a major role for thrombus-thrombolytic interaction in focal cerebral ischemia with subsequent increased BBB permeability.     

中国烧伤液体复苏公式改良应用

目的 探讨严重烧伤休克期液体复苏的方法.方法 63例大面积烧伤矫正使用中国烧伤复苏公式指导治疗.葡萄糖溶液以100 ml/h匀速补给;电解质和胶体的补给速度先快后慢,前12 h根据患者的临床治疗反应每小时进行调整,后12 h匀速补给.结果 复苏第1小时电解质和胶体补液量占全天总量的12.0%,第2小时占9.89%,第3小时为9.02%;前3 h补液总量占全天总量的30.91%.至伤后第6小时占其总量的41.97%,第8小时占54.90%,12 h为70.02%;后12 h仅占29.98%.全部病例均平稳度过休克期.结论输液速度和方式对成功休克复苏具有重要意义,片面追求增加补液量可能是个误区.     

静脉溶栓治疗急性心肌梗死临床分析

目的探讨急性心肌梗死不同院前静脉溶栓方案的安全性与可行性。方法本研究为随机、前瞻性试验,入选病例随机分为尿激酶组和重组组织型纤溶酶原激活剂(rtPA)组,未入选的病例用低分子肝素治疗,比较其疗效和近期并发症。结果3组的年龄、梗死部位、性别等对比差异无统计学意义。冠脉再通率rtPA组(82.1%)明显高于尿激酶组(55.3%),有显著的统计学意义(P<0.05)。4周时室壁瘤形成rtPA组(10.7%)明显低于低分子肝素组(33.3%),有显著的统计学意义(P<0.05),但rtPA组与尿激酶组差异无统计学意义。心衰、死亡、恶性心律失常、出血的发生率3组无统计学差异。4周时左室射血分数(LVEF)3组无统计学差异。心衰、死亡、室壁瘤形成再通组明显低于未通组(P<0.05),而两组恶性心律失常未见明显的统计学意义。结论院前进行急性心肌梗死溶栓治疗快速、安全,可首选rtPA50mg溶栓,若有禁忌证,可选用低分子肝素治疗。     

大剂量甲氨蝶呤化疗致急性肾衰竭2例

2例患者大剂量甲氨蝶呤（MTX）化疗导致急性肾衰竭。第l例为53岁女性，因非霍奇金淋巴瘤给予大剂量MTX化疗：先用MTX500mg0．5h时内静脉滴注、3500mg24h内泵入，然后用亚叶酸钙进行解救，首次剂量为30mg／m^2，以后15mg／m^2，每隔6h肌内注射1次，解救8次。患者无慢性肾脏病史，化疗前肾功能正常（SCr97．1μmot／L，BUN4．78mmol／L）。化疗后第4天，出现颜面及双手轻度水肿，尿量减少，SCr升至151Ixmol／L。给予甲泼尼龙、呋塞米和碳酸钙一维生素D3对症治疗，并碱化尿液，监测肾功能（SCr最高达275μmot／L），化疗后第13天肾功能恢复至正常（SCr96μmol／L）。第2例为29岁男性，因急性淋巴细胞白血病给予大剂量MTX化疗：MTX500mg0．5h内静脉滴注、4500mg24h内泵入，解救方案同例1。患者无慢性肾脏病史，化疗前肾功能正常（SCr86．9μmol／L，BUN5．35mmol／L）。化疗后第3天出现全身水肿、尿量减少，SCr升至235μmol／L（最高达360μmol／L）。给予对症治疗，同例1。化疗后第30天肾功能恢复至正常（SCr89ttmol／L）.     

The potential benefits of 1.5% hetastarch as a cardioplegia additive

INTRODUCTION: Myocardial edema is a clinically relevant problem found in post-ischemic reperfused hearts. The objective of this study was to understand the effects of hetastarch-supplemented cardioplegia on post-ischemic edema and cardiac function. MATERIALS AND METHODS: Swine hearts were arrested with either St. Thomas Hospital cardioplegia with (n=6) or without (n=7) 1.5% hetastarch. Following hypothermic global ischemia, hearts were crystalloid reperfused in a four-chamber isolated working mode. RESULTS: Hetastarch decreased myocardial water content gains after three hours of reperfusion (control versus hetastarch, hour 0: 67+/-5% versus 67+/-3%, NS; hour 3: 82+/-2% versus 78+/-1%, p=0.1). Post-ischemic control group left ventricular end-diastolic pressures were elevated after 1h (in mm Hg, hour 0: 13+/-2, hour 1: 19+/-3, hour 2: 19+/-3, hour 3: 20+/-2) but remained stable (<16 mm Hg) in the hetastarch group. Post-reperfusion creatine phosphokinase perfusate levels in the hetastarch treated hearts were decreased (control: 1.6 IU/l/g versus hetastarch: 0.6 IU/l/g, p=0.15). DISCUSSION/CONCLUSIONS: Hetastarch treatment delayed myocardial edema development and attenuated myocardial creatine kinase efflux, thereby preserving diastolic function.     

Delayed intervention in experimental stroke with TRC051384--a small molecule HSP70 inducer

Induction of HSPs is a natural response of stressed cells that protects against many insults including acute ischemia. TRC051384, a novel compound belonging to substituted 2-propen-1-one class is a potent inducer of heat shock protein 70 (HSP70). The aim of this study was to investigate the ability of TRC051384 in reducing neuronal injury and disability upon delayed treatments (4 and 8 hours post ischemia onset) in a rat model of transient cerebral ischemia.Focal cerebral ischemia was produced in rats by occluding the MCA using the intra luminal suture technique. Rats subjected to 2 hours focal cerebral ischemia were administered by intra-peritoneal route, TRC051384 or vehicle every 2 hours for 48 hours, from 4th hour or 8th hour after onset of ischemia. Progression of infarct and edema was assessed up to 48 hours post ischemic insult using magnetic resonance imaging and the neurological disability and survival studied till 7 days.Here we show for the first time that treatment with TRC051384 significantly reduces stroke associated neuronal injury (87% reduction in area of penumbra recruited to infarct, and 25% reduction in brain edema) and disability in a rat model of transient ischemic stroke even when administered 8 hours post onset of ischemia. Significant improvement in survival (50% by day2 and 67.3% by day 7) was observed with TRC051384 treatment initiated at 4 hours after ischemia onset. Induction of HSP70 by TRC051384 involves HSF1 activation and results in elevated chaperone and anti-inflammatory activity. These results show that TRC051384 has the potential to be developed as a novel pharmacological agent for the treatment of ischemic stroke.     

碘海醇注射液致过敏反应和严重血小板减少及凝血功能异常

1例63岁女性行冠状动脉 CT 增强检查,静脉注射造影剂碘海醇80 ml（350 mg/ ml）。CT 检查结束留观6 min 时,患者出现手掌瘙痒、双眼结膜充血水肿、周身大汗、黑曚、恶心,呕吐少量胃内容物,随后出现唇紫、颜面水肿、四肢凉、皮肤花斑、注射部位出血。血气分析：血氧饱和度0.83,氧分压47 mmHg（1 mmHg =0.133 kPa）。距 CT 检查结束近1 h,实验室检查示血小板计数19×109/ L,凝血酶原时间（PT）18 s,凝血酶时间（TT）6 s。给予抗过敏、补充凝血因子、纠正酸中毒和电解质紊乱等治疗。距 CT 检查结束约7.5 h,患者血小板计数8×109/ L。次日,患者身体多处出现大片瘀斑,体温38.1℃,血小板计数6×109/ L。继续行对症和支持治疗,患者情况逐渐好转,第4天体温恢复正常,颜面水肿消失,瘀斑明显减轻;第6天血小板计数和凝血功能各项指标均恢复正常。     

Administration of exogenous tissue plasminogen activator reduces oedema in mice lacking the tissue plasminogen activator gene

It has recently become apparent that tissue plasminogen activator (tPA) modulates inflammation in diseases such as rheumatoid arthritis (RA) and acute respiratory distress syndrome (ARDS). We have shown previously that tPA has anti-inflammatory activity in in vivo models of oedema or inflammation. The present study investigated the ability of exogenous recombinant tPA (rtPA) to reduce carrageenan-mediated oedema in mice lacking the tPA gene, testing the hypothesis that rtPA treatment may be beneficial in diseases such as RA and ARDS in which there is a paucity of endogenous tPA. Knockout mice deficient in the tPA gene and matching wild-type mice received an intraplantar injection (25 micro L) of carrageenan (1.5%, w/v) following either vehicle (sterile water for injection) or tPA (12 mg/kg). Footpad oedema was measured, an oedema index was calculated and tissue myeloperoxidase (MPO) activity was determined. Mean oedema indices were higher in untreated tPA (-/-) mice than untreated wild-type mice. Pretreatment with rtPA in either tPA (-/-) or wild-type mice reduced the mean measured peak footpad oedema index by 63 and 48%, respectively. Tissue MPO activity was not different between treatment groups. We conclude that exogenous rtPA has the ability to reduce acute oedema without altering neutrophil infiltration into the site of injury in both tPA (-/-) and wild-type mice and that endogenous tPA may participate in the inflammatory process, as evidenced by higher oedema indices in untreated tPA (-/-) mice. These data provide support for the potential clinical utility of exogenous rtPA in the treatment of inflammatory diseases, such as RA and ARDS, in which there is a paucity of tPA.     

头孢哌酮／舒巴坦误用致喉头水肿

1例46岁腹水与腹腔感染男性患者未行皮试静脉滴注瑞普欣（头孢哌酮／舒巴坦）3g。1 min后出现颜面、颈部潮红，全身瘙痒，口唇舌麻木，呼吸困难，体检显示SPO2 0．98，BP 90／60mmHg，P110次／min，喉镜检查示喉头水肿。经吸氧和对症治疗，1h后症状缓解。该患者半个月前曾使用铃兰欣（头孢哌酮／舒巴坦），出现皮肤瘙痒。     

Cortical and medullary kidney tissue levels of cefonicid in human beings

Cefonicid concentration has been determined microbiologically in cortical and medullary tissue in 30 patient undergoing surgery because of neoplastic disease localized within the kidney. Each subject received 1 g of cefonicid intramuscularly in a single administration. The patients were divided into six groups, from which samples of blood and tissue were collected 2, 4, 6, 8, 12, 24 h respectively after treatment with the drug. The mean peak serum levels appeared at the second hour (74.96 +/- 8.14 mcg/ml) and the decay shows a monoexponential behaviour, reaching a minimum value of 5.4 +/- 2.33 mcg/ml at the 24th hour. In the cortical tissue of the kidney the peak levels appeared at the fourth hour (26.22 +/- 8.87 mcg/g), while at the 24th hour levels were about 3.08 +/- 0.81 mcg/g. A very similar behaviour could also be observed in the medullary tissue of the kidney with peak levels at the fourth hour (25.82 +/- 10.06 mcg/g) and levels of 3.48 +/- 0.85 mcg/g at the 24th hour. A delay in the decay of tissue levels in comparison with the decay of blood levels could be observed from the eighth hour.