不同肺动脉阻断时间对肺缺血性损伤程度的影响

目的探讨不同肺动脉阻断时间对肺缺血性损伤程度的影响，试图寻找一个相对安全的阻断时间。方法选用Wistar大鼠18只，随机分为空白对照组、30min阻断组及60min阻断组。制作大鼠原位肺动脉阻断模型，分别在气管插管后行常规肺门游离，空白对照组行持续灌注及通气，余下两组分别行30min及60min肺动脉及支气管阻断。检测缺血前、再灌注5rain后动脉血氧分压（PaO2）、肺组织湿干比重（W／D）、肺水肿情况及肺组织中丙二醛（MDA）及超氧化物歧化酶（SOD）的含量。结果（1）30min阻断组的PaO3、湿干比重、MDA含量和SOD含量与对照组之间无显著差异（P〉0．05）；（2）60min阻断组的PaO2及SOD含量明显低于对照组（P〈0．05），湿干比重及MDA含量则明显高于对照组（P〈0．05）；（3）病理学结果提示60min阻断组肺水肿表现最为明显；（4）术后PaO2与湿干比重之间存在着负相关关系（r=-0．887，P〈0．05）。结论在不抗凝、不通气的情况下，暂时阻断大鼠肺动脉30min不会对肺功能有明显的损害。     

蝙蝠葛碱对兔心肌缺血再灌注时血清MDA浓度和SOD活性的影响

目的探讨蝙蝠葛碱（Dau）对兔心肌缺血再灌注（IR）时血清丙二醛（MDA）浓度和超氧化物歧化酶（SOD）活性的影响。方法24只家兔随机分为假手术对照组、缺血再灌注组、缺血再灌注＋蝙蝠葛碱（Dau）干预组各8例。结扎兔左冠状动脉前降支40min造成心肌缺血再灌注模型，观察缺血前后及再灌注不同时相点血清MDA含量和SOD活性的变化。结果家兔心肌缺血40min时血清MDA含量开始明显升高（P〈0．05），SOD活性开始明显下降（P〈0．05）。Dau（剂量3．5mg／kg）能明显降低心肌缺血40min及缺血再灌注后兔血清MDA含量，升高血清SOD活性。结论Dau通过减轻兔心肌脂质过氧化作用所造成的损伤，增强SOD活性，提高氧自由基清除能力，对兔心肌缺血再灌注损伤具有一定保护作用。     

大鼠肺缺血再灌注对肺组织乙醛脱氢酶2和醛类物质的影响

目的研究肺缺血再灌注（ischemia／reperfusion。I／R）对乙醛脱氢酶2（ALDm）活性和含量,丙二醛（MethaneI）icarboxylicAldehyde,MDA）含量及4羟壬烯醛（4-hydroxy-2·noncnal,4-HNE）含量的影响。方法选取36只250—350g的雄性sD大鼠,采用在体原位肺I／R损伤模型,根据缺血再灌注时间不同随机分为A组（空白对照组即sham组）、B组（平衡灌注15rain组）、c组（缺血停呼吸30rain组）、D组（缺血停呼吸60min组）、E组（再灌注恢复呼吸30min组）和F组（再灌注恢复呼吸60min组）,每组6只。在观察结束后取肺组织检测ALDH2活性和含量,MDA和4．HNE含量。结果A组、B组、C组、D组、E组和F组ALDH2活性分别为（2．26±0．45,2．30±0．48,2．40±0．69,2．21±0．42,2．21±0．42和2．16±0．62）,含量分别为（0．91±0．11,1．21±0．61,1．23±0．38,1．11±0．38,1．00±0．47和O．92±0．34）组间差异无统计学意义。D组、E组和F组大鼠肺MDA含量（11．03±0．51,12．10±0．29和11．73±0．57）较A组和B组（10．35±0．52和10．30±0．56）升高,差异有统计学意义（P〈0．05）;E组和F组大鼠肺MDA含量高于c组（10．87±0．62）和D组,差异有统计学意义（P〈0．05）;其他各组之间差异无统计学意义。D组、E组和F组大鼠肺4-HNE含量（2．15±0．09,2．81±0．22和2．76±0．31）较A组和B组（1．93±0．1l和1．97±0．10）升高,差异有统计学意义（P〈0．05）;E组和F组大鼠肺4-HNE含量高于c组（2．05±0．08）和D组,差异有统计学意义（P〈0．05）;其他各组之间差异无统计学意义。结论随着缺血时间的延长,肺中醛类物质（MDA和4．HNE）开始蓄积,再灌注过程中醛类物质继续升高,ALDH2活性和含量未受到明显抑制     

蛇床子素在家兔心肺联合移植中对供肺的保护作用

目的研究蛇床子素在家兔心肺联合移植中对供肺的保护作用及其作用机制。方法将16只健康家兔随机分为两组,对照组肺以改良低钾右旋糖酐（LPD）液灌注并保存，实验组则将蛇床子素加入改良LPD液灌注并保存，在4℃条件下保存12h后再灌注1h，测定肺组织的湿干重比（W／D）；测定肺组织中髓过氧化物酶（MPO）的活性、丙二醛（MDA）和超氧化物歧化酶（SOD）的含量、核转录因子-kB（NF-kB）的表达以及细胞间黏附分子-1（ICAM-1）的表达；并观察肺组织病理结构的变化。结果再灌注后，实验组的W／D、MPO的活性、MDA含量及NF-kB和ICAM-1的表达低于对照组（P〈0．01），而实验组肺组织中的SOD含量较对照组增高（P〈0．05），肺组织损伤的病理变化程度较对照组轻。结论蛇床子素能减轻肺缺血再灌注损伤，对供肺具有一定的保护作用。     

山莨菪碱减轻兔肺缺血再灌注后肺水肿的实验研究

目的观察山茛菪碱减轻兔肺缺血再灌注后肺水肿的作用并探讨其可能的机制。方法建立在体兔肺缺血再灌注动物模型。10-12周龄健康家兔24只,雌雄不拘,体重2．2～2．6kg,随机分为3组,每组8只。山莨菪碱组于左肺缺血再灌注处理前静脉给予山莨菪碱3mg／kg预处理,对照组进行左肺缺血再灌注处理,假手术组只开胸并套带,不行缺血再灌注处理。各组左肺缺血1h并再灌注3h后结扎并切取左肺下叶,部分行组织学观察,部分通过测量肺湿干重的方法计算肺含水量,余肺组织按试剂盒说明书检测组织髓过氧化物酶（MPO）含量。最后经兔股静脉注射2％伊文思兰（1．5ml／kg）,然后取左肺上叶,比较3组肺血管通透性。结果缺血再灌注处理后,对照组肺含水量、MPO含量及伊文思兰含量分别为（6．6±0．5）g惶干组织、（1．16±0．14）U／g蛋白质和（173±16）μg／g湿组织,明显高于假手术组的（4．3±0．4）g/g于组织、（0．53±0．09）u／g蛋白质和（103±11）μg儋湿组织（P〈0．05）,组织损伤严重并可见严重的肺水肿;山莨菪碱组上述指标水平分别为（5．6±0．4）g／g干组织、（0．82±0.11）U／g蛋白质和（124±18）μg／g湿组织,较对照组明显下降（P〈0．05）,组织损伤轻微,肺水肿程度很轻。结论山莨菪碱通过抑制中性粒细胞生成、降低肺血管通透性等作用显著减轻了肺缺血再灌注后肺水肿的程度。     

胸段硬膜外阻滞对急性心肌缺血再灌注损伤影响的实验研究

目的 探讨胸段硬膜外阻滞（TEA）对缺血再灌注损伤心肌的保护作用。方法 将22只犬随机分为生理盐水对照组（NS组，7只）、布比卡因组（BP组，8只）及罗哌卡因组（RP组，7只）。麻醉后行T5～T6硬膜外穿刺，NS组、BP组及RP组分别于硬膜外腔注入生理盐水、布比卡因、罗哌卡因各12ml;开胸阻断左冠状动脉前降支（LAD）40min后再灌注320min。实验过程中监测平均动脉压（MAP）和心率（HR），于硬膜外腔注药前，阻断时及开放后60、120min时测血清MDA与SOD水平。结果 三组HR在实验过程中无显著变化，组间亦无差异；MAP在注药前较术前均明显升高（P〈0．05），而在以后各时点，NS组较术前无显著差异，而BP组、RP组则明显下降（P〈0．01）;三组间术前、注药前的MAP无显著差异，而阻断时、阻断末及开放60、120min时，RP组与BP组MAP明显低于NS组（P〈0.05、0．01），RP组与BP组间无差异。三组阻断末MDA与SOD较注药前无显著变化；开放60、120min时，NS组MDA显著增高，SOD明显下降（P〈0．05），而BP组与RP组MDA与SOD无明显变化。三组间各时点MDA无显著差异，注药前、阻断末的SOD亦无显著差异。开放期BP组、RP组SOD明显高于NS组（P〈0．01、〈0．05），RP组显著高于BP组（P〈0．05）。结论TEA对缺血再灌注损伤心肌有保护作用；罗哌卡因的心肌保护效果优于布比卡因。     

心肌缺血/再灌注损伤后的肺组织损伤

目的初步探讨心肌缺血／再灌注损伤对肺组织损伤的可能机制。方法选取雄性成年SD大鼠（4～6月龄）,体重130～160g,建立成年大鼠缺血／再灌注模型。运用CK和MPO试剂盒检测肌酸激酶（CK）和髓过氧化物酶（MPO）的含量,运用双抗体夹心ABC—ELISA法检测细胞间黏附分子-1（ICAM-1）的含量。结果与伪手术组相比,缺血／再灌注大鼠的AN／AAR比值明显增高（P〈0．05）,CK在心肌缺血／再灌注大鼠血清中的含量明显升高（P〈0．05）,MPO与ICAM-1在心肌缺血／再灌注组大鼠血清和肺组织中含量明显升高（P〈0．05）。结论大鼠心肌缺血再灌注损伤后肺组织受到一定的损伤,可能与体循环中炎性介质的作用及肺组织的炎性应激有关。     

参附注射液抑制兔再灌注肺组织NF-kB表达的实验研究

目的初步探讨参附注射液改善兔肺保存效果及可能的作用机制。方法16只健康家兔随机分为两组,对照组肺加入棉子糖（30mmol／L）的改良低钾右旋糖酐（LPD）液灌注及保存,实验组则将参附注射液（40mg／L）加入改良LPD液灌注及保存。在4℃保存12h后再灌注1h,测定动脉血氧分压（PaO2）、肺组织的干湿比（W／D）、肺组织中髓过氧化物酶（MPO）活性、NF—KB的表达并观察肺组织病理结构的变化。结果再灌注15min后,两组的Pa02逐渐降低,但实验组PaO2的降低程度明显低于对照组（P〈0．01）;再灌注后,实验组的W／D和MPO也明显低于对照组（P〈0．01）,肺组织NF-kB的表达也明显低于对照组（P〈0．01）,肺组织病理变化较对照组轻。结论参附注射液可抑制再灌注肺组织中NF—kB的表达,减轻肺缺血再灌注损伤,改善肺功能,对兔肺具有保护作用。     

缺血预处理与缺血后处理对大鼠肾脏的保护作用对比观察

目的比较缺血预处理及缺血后处理对大鼠肾脏缺血再灌注损伤的保护作用。方法建立大鼠肾脏缺血（45min）再灌注模型。将24只健康Wistar大鼠随机分为假手术（SO）、缺血再灌注（Ia）、缺血预处理（IP）及缺血后处理（IPo）组,各6只。IP组于缺血前给予3周期的8min缺血、5min再灌注,IPo组于缺血后（再灌注前）给予6周期的10s再灌注、10s缺血。24h后观察血清肌酐（Cr）、尿素氮（BUN）、NO;取肾脏组织测定其超氧化物歧化酶（SOD）和丙二醛（MDA）。结果与IR组相比,IPo组及IP组血清Cr、BUN、NO和MDA水平降低（P〈0．05）,肾组织中SOD、MDA水平升高（P〈0．05）;IPo组与IP组相比,以上指标无显著性差异（P〉0．05）。结论IP和IPo对大鼠肾脏缺血再灌注都有保护作用,二者保护作用无区别。     

长托宁预防兔主动脉阻断所致脊髓损伤的实验研究

24只家兔，随机分为假手术组（A组）、缺血再灌注组（B组）和长托宁组（C组），各8只。B、C组阻断腹主动脉40min，再灌注7d。C组于阻断腹主动脉前15min一次性静注长托宁0．2mg／kg。分别测定阻断前（C0）、开放前即刻（C40）、再灌注60min（R60）及7d（R7d）血清MDA、SOD、TNF-α、IL-1β、CK、CK-BB值；观察术后兔后肢神经功能和脊髓形态学变化。结果B、C组家兔与A组相比，血清MDA、CK、CK-BB、TNF-α、IL-1β水平上升、SOD水平降低；C组家兔上述指标变化程度较小。C组家兔瘫痪发生率明显低于B组，其后肢神经功能亦明显好于B组。认为长托宁能显著抑制缺血再灌注损伤脊髓细胞的破坏。其机理可能与其抗氧化、抗炎、改善微循环的作用有关。     

Microscopic-sized "microthymoma" in patients with myasthenia gravis

BACKGROUND: In 2005, Cheuk et al reported two patients with microscopic-sized thymomas and proposed the term microthymoma to distinguish it from the nodular hyperplasia of thymic epithelium, so-called microscopic thymoma. Here, we present microthymomas that were found in 196 patients with myasthenia gravis (MG) who had undergone thymectomy. MATERIALS AND METHODS: Thymic tissues in 196 patients with MG who underwent thymectomy or thymothymomectomy were examined. Of these patients, 73 patients had thymoma indicated by CT before surgery, and the other 123 patients had no mediastinal tumors. From the resected thymic tissues, an average of 14 hematoxylin-eosin-stained sections (range, 4 to 55 sections) were prepared for microscopic examination. The histologic type of the thymoma was classified according to the World Health Organization (WHO) classification. RESULTS: From the 196 patients, we found three microthymomas in 3 patients (1.5%). While these three tumors could not be seen grossly in pathology section, they were found microscopically (range, 2 to 4 mm). The histologic subtype according to the WHO classification system was B1 in one patient and B2 in two patients. CONCLUSION: Microthymoma was found in 3 of 196 patients (1.5%) with MG. Microthymoma might exist in thymus of patients with MG, even in patients who have no thymoma indicated by CT.     

World Trade Center "sarcoid-like" granulomatous pulmonary disease in New York City Fire Department rescue workers

BACKGROUND: Previous reports suggest that sarcoidosis occurs with abnormally high frequency in firefighters. We sought to determine whether exposure to World Trade Center (WTC) "dust" during the collapse and rescue/recovery effort increased the incidence of sarcoidosis or "sarcoid-like" granulomatous pulmonary disease (SLGPD). METHODS: During the 5 years after the WTC disaster, enrollees in the Fire Department of New York (FDNY) WTC monitoring and treatment programs who had chest radiograph findings suggestive of sarcoidosis underwent evaluation, including the following: chest CT imaging, pulmonary function, provocative challenge, and biopsy. Annual incidence rates were compared to the 15 years before the WTC disaster. RESULTS: After WTC dust exposure, pathologic evidence consistent with new-onset sarcoidosis was found in 26 patients: all 26 patients had intrathoracic adenopathy, and 6 patients (23%) had extrathoracic disease. Thirteen patients were identified during the first year after WTC dust exposure (incidence rate, 86/100,000), and 13 patients were identified during the next 4 years (average annual incidence rate, 22/100,000; as compared to 15/100,000 during the 15 years before the WTC disaster). Eighteen of 26 patients (69%) had findings consistent with asthma. Eight of 21 patients (38%) agreeing to challenge testing had airway hyperreactivity (AHR), findings not seen in FDNY sarcoidosis patients before the WTC disaster. CONCLUSION: After the WTC disaster, the incidence of sarcoidosis or SLGPD was increased among FDNY rescue workers. This new information about the early onset of WTC-SLGPD and its association with asthma/AHR has important public health consequences for disease prevention, early detection, and treatment following environmental/occupational exposures.     

Echocardiographically detected mass "in transit" in early amniotic fluid embolism.

BACKGROUND: Amniotic fluid embolism is a catastrophic illness related to the passage of fetal material into the pulmonary circulation causing cardiovascular collapse. CASE: A 29-year-old female sustained cardiopulmonary arrest during delivery presumably due to amniotic fluid embolism. A right atrial mass "in transit" was detected by echocardiography. It had an appearance and pattern of motion that was suggestive of a gelatinous consistency and is likely to have been an amniotic fluid embolus. There was also evidence of acute right ventricular overload. CONCLUSION: We recommend that echocardiography be considered early on such conditions to gain more insight into the pathogenesis of this complication.     

Portable exhaled nitric oxide measurement: Comparison with the "gold standard" technique

Background:The measurement of fractional exhaled nitric oxide (FENO) can assist in the diagnosis of asthma and may also act as a useful surrogate inflammatory marker on which to base treatment decisions in asthma management algorithms. Until recently, this technique was confined to research facilities and secondary care institutions. A portable nitric oxide analyzer (MINO; Aerocrine AB; Smidesvägen, Sweden) has been developed, but few data exist comparing this device with established, larger laboratory-based analyzers (NIOX; Aerocrine AB).Methods:A total of 101 asthmatic patients (64 treated with regular inhaled corticosteroids) and 50 healthy volunteers had simultaneous FENO measurements undertaken using NIOX and MINO devices.Results:In both asthmatic patients and healthy volunteers, there was a good correlation between the measurements obtained using each device (r= 0.94 and 0.96, respectively). Altman-Bland plots confirmed this agreement. Receiver operating characteristic curves discriminating asthmatic patients from healthy volunteers obtained using the NIOX and MINO showed a sensitivity of 83.2% and a specificity of 72% using cutoff values of 13 and 12.5 parts per billion, respectively.Conclusion:FENO values obtained using a portable analyzer correlate well with those obtained using an established laboratory analyzer and can be used to discriminate asthmatic from nonasthmatic patients. This may facilitate the measurement of asthmatic airway inflammation in primary care.     

"Synaptic" Ribbons in the Pineal Gland of the Horse

Previous studies on the ultrastructure of the horse pineal gland did not report the presence of "synaptic" ribbons, functionally enigmatic pinealocyte organelles regularly occurring in other mammalian species. The aim of the present study was to reinvestigate the horse pinealocyte in this respect. Careful investigations here reported allowed detection of "synaptic" ribbons in the pinealocytes of all the examined animals, although in a relatively low number (5.4 +/- 2.0 per 20,000 microns 2 of pineal tissue; mean +/- SD). The ultrastructure of "synaptic" ribbons in pinealocytes of the horse resembles closely that observed in other mammalian species.     

补肾益精方对切除卵巢大鼠骨质疏松模型腰椎骨生物力学性能的影响

目的：探讨被 肾益精方对去卵巢大鼠骨质疏松模型松质骨生物力学性能的影响,方法：40只10月龄Wistar雌性大鼠随机分为正常对照组,模型对照组,补肾益精方组和倍美力组,每组10只,正常对照组做假手术,其余3组做卵巢切除术,术后3个月开始给药,连续用药满90天,处死,取出第3腰椎,测定其骨质含量并进行压应力测试与分析,结果：补肾益精方组比模型组腰椎骨的骨质含量提高了6．19％,最大承载力增加了21．66％,极限强度增加了16．93％,结论：应用补肾益精方可以明显改善去卵巢大鼠骨质疏松模型松质骨的生物力学性能。     

青海"三江源"地区鼠疫血清流行病学调查分析

目的对青海省"三江源"地区开展鼠疫血清流行病学调查,了解分析流行态势,为该地区鼠疫防治措施的制定与落实提供依据。方法对历年的鼠疫细菌学资料进行总结分析,对"三江源"部分地区人及各种动物采血做血清抗体调查。结果该地区发现15种动物可自然感染鼠疫,10种动物血清存在鼠疫抗体,人群血清鼠疫抗体阳性率达2.47%。结论"三江源"地区动物鼠疫持续流行,参与染疫的动物种类多,时常波及人间造成人间鼠疫流行,人群存在部分隐性感染鼠疫者。尚有部分地区需进行深入的自然疫源地调查。     

"Ultrasound comet-tail images": a marker of pulmonary edema: a comparative study with wedge pressure and extravascular lung water

BACKGROUND: Echographic examination of the lung surface may reveal multiple "comet-tail images" originating from water-thickened interlobular septa. These images could be useful for noninvasive assessment of interstitial pulmonary edema. STUDY OBJECTIVE: The purpose of this study was to assess the diagnostic accuracy of lung comet-tail images compared with chest radiography, wedge pressure, and extravascular lung water (EVLW) quantified by the indicator dilution method (PiCCO System, version 4.1; Pulsion Medical Systems; Munich, Germany). METHODS AND PATIENTS: We enrolled 20 patients (mean age, 62.6 +/- 11.5 years [+/- SD]). Patients were studied before, immediately after, and 24 h following cardiac surgery with chest ultrasound, chest radiography, pulmonary artery catheterization, and the PiCCO system. Performing echo scanning (right and left hemithorax, from second to fourth intercostal space, from parasternal to midaxillary line), an individual patient comet score was obtained by summing the number of comets in each scanned space. RESULTS: A total of 60 comparisons were obtained. Significant positive linear correlations were found between comet score and EVLW determined by the PiCCO System (r = 0.42, p = 0.001), between comet score and wedge pressure (r = 0.48, p = 0.01), and between comet score and radiologic lung water score (r = 0.60, p = 0.0001). CONCLUSIONS: The presence and the number of comet-tail images provide reliable information on interstitial pulmonary edema. Therefore, ultrasonography represent an attractive, easy-to-use, bedside diagnostic tool for assessing cardiac function and pulmonary congestion.     

三格式化粪池粪便无害化处理的效果

目的 评价三格式化粪池对人粪便的无害化处理效果,为农村改厕提供科学依据.方法 2009年在江苏省内5个市选取130座三格式化粪池作为评价对象,采集三格式化粪池第1格和第3格样品,检测其中的粪大肠菌群(FC)、寄生虫卵(血吸虫卵、蛔虫卵和钩虫卵)、化学需氧量(COD)、五日生化需氧量(BOD_5)和氨氮(NH_3-N),观察各指标的变化情况,用统计软件SPSS 13.0对数据进行统计分析.结果 三格式化粪池第1格、第3格粪液FC达标率分别为3.1%和100%,两者差异有统计学意义(P=0.000 1,P<0.01).分别有1座和4座化粪池第1格检测到钩虫卵和蛔虫卵,密度为1～2个/100 ml.第3格FC、COD、BOD_5和NH_3-N去除率分别为(99.96±0.03)%,(60.69±21.77)%,(60.13±23.20)%和(44.14±24.61)%.与第1格相比差异均有统计学意义(P均<0.01).结论 三格式化粪池对人粪便处理达到了无害化卫生标准要求,可作为农村粪便无害化处理的有效形式进行推广.     

Gelatin "shots" as a new method for alcohol administration in a laboratory setting

BACKGROUND: This experiment was designed to compare gelatin "shots"-a new procedure for administering alcohol in a laboratory setting-to the alcohol beverage method. We proceeded to test whether the two methods were comparable in terms of alcohol absorption, metabolism, and effects on mood and whether gelatin "shots" were better than the beverage in disguising alcohol in a blind, placebo comparison. METHODS: Healthy volunteers participated in a two-phase trial. In the first phase they completed 2 days of testing during which the effects of alcohol-delivered in beverage (1 day) or gelatin "shots" (alternative day)-on blood and breathalyzer concentrations and mood were assessed. In the second phase participants completed 2 days of testing and were asked to identify if samples contained alcohol or placebo. The presentation of alcohol and placebo and the presentation of beverage or gelatin "shots" were random. RESULTS: In the first phase there was a significant time-by-condition interaction in the blood alcohol concentration. Two-and-a-half hours after the alcohol was administered, those given gelatin "shots" had slightly lower but statistically significant blood alcohol concentrations. There was a significant time effect for breathalyzer alcohol levels but no condition or condition-by-time interaction. There were no differences between the two methods on any of the subjective mood measures. In the second phase of the study there were differences in the ability to differentiate alcohol from placebo between the two conditions with significantly more participants making errors in the gelatin "shots" than in the beverage condition. CONCLUSIONS: Our findings indicate that gelatin "shots" are an effective method for delivering alcohol to humans in a laboratory setting. This method may be superior to the alcohol beverage mixture in a placebo-controlled design because gelatin "shots" mask the alcohol much better than a beverage and are easier to administer.