大鼠烧伤后内皮素和一氧化氮在早期肝脏损伤中的作用

目的 :观察烧伤早期肝脏微循环的变化 ,探讨内皮素 (ET)和一氧化氮 (NO)对肝脏微循环的影响。方法 :复制 30 %TBSⅢ度烧伤大鼠模型 ,测定烧伤前及烧伤后 1、3、6、12、2 4和 48h肝有效血流量(EHBF)和肝组织内NO和ET含量以及观察肝脏病理变化。结果 :烧伤后肝EHBF迅速下降 ,肝脏ET及NO含量明显增加 ,肝组织ET含量与EHBF呈显著负相关。结论 :烧伤早期肝组织ET及NO含量增高 ,二者合成与释放平衡失调 ,是导致肝微循环障碍引起肝血有效流量相对减少的重要原因。     

一氧化氮对烧伤休克大鼠微循环的作用

一氧化氮对烧伤休克大鼠微循环的作用石胜军＊吴坤莹＊一氧化氮（ＮＯ）是近年来发现的一种新的信息分子，已知其与多种生理和病理状态的调节有密切关系［１］。在烧伤休克研究中，已证实大鼠烫伤后尿中ＮＯ的稳定终产物ＮＯ－２／ＮＯ－３的量明显升高［２］；但ＮＯ在烧...     

ICAM-1单抗对烧伤休克大鼠微循环的影响

目的:探讨运用血管内皮细胞粘附分子(ICAM-1)单克隆抗体减少白细胞粘附和防治烧伤休克的效应及改善微循环的作用机制。方法:复制大鼠烧伤休克模型,用红细胞跟踪相关仪和电视测微仪测量微静脉血液流速、口径、流量,镜下观察细静脉白细胞粘附数,并记录动物存活时间。结果:单抗能减缓烧伤休克大鼠平均动脉压和微静脉血流速度的下降趋势,明显减少微静脉中白细胞附壁粘着数,使动物的平均存活时间显著延长,但仍不足24h。结论:运用ICAM-1单抗能阻断白细胞与内皮细胞的粘附,减少白细胞嵌塞微静脉,达到改善烧伤休克微循环和保护组织细胞的作用,但重症休克需要综合治疗。     

烧伤休克病人微循环改变

本文通过对48例烧伤休克病人足甲襞微循环的研究,发现烧伤休克病人存在明显的微循环紊乱。表现为管襻变细、变短、数目减少、重者管襻完全隐没;血流明显缓慢、红细胞不同程度聚集;襻周明显渗出等。因此,从临床角度上证实烧伤休克微循环紊乱的存在,并阐述其变化特点。提出微循环改变可作为烧伤休克的重要诊断及监测指标,同时对病情和预后判断具有一定参考价值。指出足甲襞是大面积烧伤病人微循环的良好观察部位。     

TNF单抗对烧伤休克大鼠白细胞粘附及微循环血流动力学的影响

本研究观察了烧伤休克大鼠血浆ＴＮＦ含量的变化以及ＴＮＦ单抗对白细胞粘附及微循环血流动力学的影响。结果表明，烧伤后血浆ＴＮＦ含量增加的同时，细静脉内ＷＢＣ附壁数明显增多，而流速、流量、壁切变率及毛细血管开放数明显低于烧伤前水平。     

大鼠烧伤休克时血浆TNF含量和微循环的变化

ＳＤ大鼠分为正常对照组、烧伤给盐水组和烧伤给虎杖组。复制大鼠烧伤休克模型，观察大鼠烧伤休克早期血浆ＴＮＦ含量的变化和微循环的改变，并且观察了虎杖４号对上述改变的影响。显微电视放大４０００倍条件下观察微循环。用Ｌ９２９细胞株生物法测定血浆ＴＮＦ含量并观察动物的肺病理形态学改变。结果表明，大鼠血浆ＴＮＦ含量在烧伤后１ｈ即有明显的升高，烧伤后４．５ｈ达高蜂（６．３±０．５ｎｇ／ｍｌ），比烧伤前（０．３±０．１ｎｇ／ｍｌ）增高２０倍，而此时细静脉中白细胞附壁粘着数亦增加７倍；开放灌流的毛细血管数减少６０％；肺部有明显的白细胞聚集及肺损伤。烧伤给虎杖治疗组动物在烧伤４．５ｈ时，其ＴＮＦ含量为３．１±０．５ｎｇ／ｍｌ，比烧伤给盐水组下降了５０％，白细胞附壁数亦减少８０％（与盐水组比较），开放灌流的毛细血管数接近正常，肺部白细胞的聚集及肺损伤程度明显减轻。本研究提示烧伤后血浆ＴＮＦ的升高参与了白细胞粘着和微循环紊乱的发生，而虎杖４号对其有明显抑制作用。     

200例糖尿病患者甲襞微循环观察

本文报告200例糖尿病患者的甲襞微循环改变,参照田牛氏加权积分法进行综合定量评价.其中Ⅰ型糖尿病56例、Ⅱ型糖尿病144例,对照组350例;两组进行观察比较,结果显示糖尿病组总积分值明显高于对照组(P相似文献   

烧伤大鼠休克期红细胞趋化因子受体结合活性的变化

目的 :探讨烧伤大鼠休克期红细胞趋化因子受体 (ECKR)结合活性的变化。方法 :SD大鼠随机分成烧伤组和对照组 ;烧伤组大鼠体表总面积 (TBSA)的 30 %为Ⅲ度烫伤。应用ELISA法 ,以IL 8为配体检测烧伤后休克期不同时间点ECKR的结合活性。结果 :伤后 0 .5h起 ,大鼠ECKR的结合活性均明显下降 ,并维持至伤后 4 8h ,与对照组相比较差异显著 (P <0 .0 1)。不同时间点相比较 ,自伤后 2h起大鼠ECKR的结合活性呈逐渐下降趋势 ,至伤后 2 4h达最低值 ;伤后 4 8h ,大鼠ECKR的结合活性则有明显升高 ,与对照组相比较差异均显著 (P <0 .0 5～ 0 .0 1)。结论 :烧伤后ECKR的结合活性明显下降 ,提示红细胞可能通过趋化因子家族的作用参与了对炎症的调控     

兔烧伤休克延期复苏微循环研究

目的研究兔烧伤休克延期复苏的时间界限及复苏补液和用药的较好方法。方法①实验1:6组大白兔 ,每组6只 ,全麻后致伤40%Ⅲ度。分别以致伤后Ⅰ组1/2h,Ⅱ组1h ,Ⅲ组1 .5h ,Ⅳ组2h ,Ⅴ组2 .5h ,Ⅵ组3h开始复苏。②实验2:4组大白兔 ,每组7只。均以致伤2.5h开始输液。液体性质分别为A组 :生理盐水 ;B组 :生理盐水 全血 ;C组 :生理盐水 山莨菪碱 ;D组 :生理盐水 全血 山莨菪碱。观察平均动脉压 (MAP)、心率 (HR) ,用显微电视录像技术测定毛细血管口径 (VCD)、血流速度 (BFV)及血流量 (BFR)。结果①Ⅰ、Ⅱ、Ⅲ组动物之间各项观测指标无明显差异 (P>0.05) ;Ⅳ、Ⅴ、Ⅵ组之间各项观测指标也无明显差异 (P>0.05) ;但两大组之间的差异有显著性 (P<0.05)。②A组各项指标同实验① ;C组MAP、HR值与A组比差别无显著性。B、D两组在补液后5h已同正常值无差别 (P>0.05)。BFV、BRF指标中 ,C组有一过性短暂上升 ,B、D两组于6h后上升与A、C两组有显著差别 (P<0 .05)。结论兔烧伤休克大致与达到2h即为延期复苏。在抗休克治疗中 ,胶体的补充是必须的 ,血管活性药物的使用在此效果不很明显。     

激光照射治疗对脑性瘫痪患儿临床微循环影响的研究

目的研究低强度半导体激光鼻黏膜照射对脑瘫患儿临床微循环的影响。方法选取50例脑瘫患儿予激光鼻腔照射治疗,观察照射后红细胞聚集及甲襞微循环变化情况。结果激光照射治疗组红细胞聚集改善率为60.47%,远高于对照组的26.83%(P<0.01)。且经激光照射治疗后,脑瘫患儿甲襞微循环有明显改善(P<0.01)。结论低强度激光血液照射疗法可以改善脑瘫患儿红细胞聚集异常,改善脑瘫患儿微循环障碍。     

Scopolamine-induced amnesia can be prevented by heat shock pretreatment in rats

The current study used the passive avoidance test to examine whether heat shock pretreatment has an effect on the memory impairment induced by scopolamine. Heat shock protein (HSP) 72 overexpression was detected in different brain structures in rats 16 h after heat shock treatment, but not in rats receiving no heat shock or 48 h after heat shock treatment. The step-through latency of either pre- or post-training administration of scopolamine in rats 16 h after heat shock treatment was significantly higher than those of the rats receiving no heat shock or 48 h after heat shock treatment. However, rats, 16 h after heat shock treatment and having been given scopolamine, performed no better than rats treated only with scopolamine. Hence, the present results indicate that heat shock has a protective, but not therapeutic, effect on the memory impairment induced by scopolamine by overexpression of HSP72 in rat brain.     

Reduction of hepatitis C virus by dialysis membrane

Recently, it has been reported that hepatitis C virus (HCV) RNA levels in blood are reduced after a hemodialysis procedure and that HCV RNA levels in blood are significantly lower in hemodialysis patients than in nonuremic subjects. The present study was designed to examine whether there were differences in the reduction of HCV RNA levels in blood between different dialysis membranes used in a hemodialysis procedure in maintenance hemodialysis patients with HCV. Dialyzers made of polysulfone, ethylenevinylalcohol, polyacrylonitril, polymethylmethacrylate, cellulose diacetate, and cellulose triacetate were used. We took an aliquot of blood from blood tubing at the inlet and the outlet of each dialyzer to measure serum HCV RNA levels. Furthermore, the filtrate was concurrently collected to measure its HCV RNA level at the dialysis outlet. We found that serum HCV RNA levels were reduced when dialyzers made of polysulfone, polyacrylonitril, polymethylmethacrylate, cellulose diacetate, and cellulose triacetate were used. Particularly, serum HCV RNA levels were reduced significantly when dialyzers made of polymethylmethacrylate (P<0.05) and cellulose diacetate (P<0.1) were used. No HCV RNA was detected in the filtrate of any dialysis membrane. These results suggest that the reduction of hepatitic C viral particles in blood is different in each dialysis membrane used in a hemodialysis procedure, and that viral particles may be adsorbed onto the inner surface of the dialysis membranes. This work was presented at the Annual Meeting of the Japanese Society of Dialysis Therapy in Fukuoka, Japan, in 2000     

Sickness behavior of rats with abdominal sepsis can be improved by antibiotic and G-CSF prophylaxis in clinic modeling randomized trials

Background and aim: In clinical sepsis research nearly all immune-modulators have demonstrated no benefit in regard to the 28-day mortality rate. Other endpoints such as quality of life have become more attractive, but clinically relevant animal models analyzing an equivalent to quality of life by measurement of sickness behavior are extremely rare. The concept of clinic modeling randomized trials was used in an animal trial to model clinical complexity and conditions of a randomized clinical trial.Methods: 80 adult male Wistar rats were randomly assigned to (1) control: anesthesia and sham operation, (2) sepsis: laparotomy and peritoneal infection with human stool bacteria, (3) sepsis with antibiotic prophylaxis: cefuroxime/metronidazole and (4) sepsis with antibiotic plus a cytokine prophylaxis with granulocyte-colony stimulating factor (GCSF). Endpoints were physiological and behavioral parameters.Results: The combination of antibiotics plus G-CSF was most effective in reducing mortality. All infected animals showed reduced open field activity acutely after infection, and recovery was improved during the 9 day follow-up in rats with prophylactic treatments. In the social interaction test, but not in the elevated plus-maze anxiety test, prophylaxis was also efficient, especially with antibiotics and G-CSF.Conclusions: The results show that improving sickness behavior in septic rats with G-CSF plus antibiotics may be a promising approach.Received 23 June 2004; returned for revision 26 July 2004; accepted by M. J. Parnham 30 August 2004     

烫伤大鼠早期小肠内热休克蛋白70表达的研究

目的探索大鼠烫伤早期小肠内热休克蛋白70（HSP70）的表达规律及临床意义。方法将30只健康Wistar大鼠分为6组：烫伤后2h．8h、24h、3d．7d和正常对照组。各组大鼠分别取小肠标本,HE染色观察组织结构变化,免疫组化染色结合图像分析测定HSP70的表达。结果大鼠烫伤后各组小肠组织HSP70的表达均迅速增加,与正常对照组比较差异均有统计学意义（P〈0．05）;烫伤大鼠早期HSP70在小肠表达强弱与其病理损伤评分成正相关关系（rs=0．943／1．000,P〈0．05）。结论大鼠烫伤后组织器官内HSP70的表达情况在一定条件下可以作为判断其损伤程度的指标。     

Prevalence of TT virus infection in Italian dialysis patients

OBJECTIVE: A novel DNA virus, transfusion-transmitted virus (TTV) is identified from the serum of a patient from acute hepatitis non-A-E. Few reports have been published on patients with renal disease. Patients on dialysis were at high risk of blood-borne viral infections and little is known about the prevalence of this virus in dialysis patients. In order to verify the prevalence of infection from TTV in these patients, we have examined the incidence of TTV in Italian patients with dialysis. METHODS: Serum samples of 85 patients and 65 healthy individuals were examined. In order to evidence the presence of the TTV virus, a method of the seminested polymerase chain reaction (PCR) with TTV-specific primers derives from the N22 region deIl'ORF-1 of the virus has been used and products were analyzed by agarose-gel electrophoresis. All serum samples were also analyzed to markers HBV and HCV. RESULTS: The prevalence of TTV DNA in dialysis patients [35/85 (41.7%)] was significantly higher than in healthy population [7/65 (10.7%)]. Among TTV positive dialysis patients, HCV coinfection was present in six cases. The positivity rate for TTV-DNA tends to increase with age. CONCLUSION: Transfusion-transmitted virus had a high prevalence in Italian-dialysis patients. In our study the virus did not have an important clinical effect on patients; but remains the possibility that it may aggravate liver disease caused by HCV. However, the question of whether TTV infection might have a possible effect on dialysis patients requires further investigation in larger groups.     

硫苷脂减轻严重烧伤延迟复苏大鼠远隔脏器能量代谢紊乱

目的研究硫苷脂对烧伤延迟复苏大鼠远隔脏器能量代谢紊乱的保护作用。方法SD大鼠给予30%Ⅲ度烧伤延迟复苏,伤后随机分为对照组和硫苷脂治疗组。在烧伤后9h,测定两组动物肺、心、肝、肾的Na -K -ATP酶活性、Ca2 -Mg2 -ATP酶活性和髓过氧化物酶(MPO)活性、蛋白浓度。结果硫苷脂治疗组在伤后9h,肺、心、肝、肾的Na -K -ATP酶活性、Ca2 -Mg2 -ATP酶活性明显增加,MPO活性明显减少。结论硫苷脂能减轻烧伤延迟复苏大鼠远隔脏器能量代谢紊乱。硫苷脂抑制中性粒细胞聚集是其重要机理之一。     

A new approach to determining homopolymer domain sizes in polycarbonate-polyether dialysis membranes by solid-state NMR

—The size of micro-separated domains of polyether (PEO), —[CH₂CH₂O]_n—, and polycarbonate (PC), —[(C₆H₄)—C(CH₃)₂—(C₆H₄)—OCO₂]_m—, in the dialysis membrane 'Gambrane®' have been determined using an advanced solid-state NMR technique which exploits differences in ¹H spin diffusion. The characteristic diameter of a PEO domain is 4.8 ± 1.4 nm and that of PC is 5.2 ± 1.4 nm with a mixed phase region of 0.8 ± 0.5 nm.     

氨基胍等对严重烧伤大鼠一氧化氮表达及烧伤休克的影响

目的:研究一氧化氮合酶(NOS)抑制剂与严重烧伤大鼠体内NO产量、NOS表达以及平均动脉压(MAP)变化的关系。方法:复制大鼠重症烧伤模型,检测应用非选择性NOS抑制剂L-NAME和选择性诱生型NOS(iNOS)抑制剂氨基胍(AG)后大鼠血液中NO代谢产物(NO₂^-／NO₃^-)以及肺和十二指肠组织中神经型NOS(nNOS)mRNA的表达水平,同时测定各组大鼠的MAP。结果:烧伤后大鼠血液中NO₂^-／NO₃^-含量显著增高,L-NAME和AG都能抑制NO₂^-／NO₃^-的升高,P<0.01;烧伤后nNOS的mRNA表达在肺和十二指肠中均有不同程度升高,AG和L-NAME使nNOS表达增加,L-NAME作用更为显著,P<0.01;烧伤后大鼠MAP略有上升,然后进行性下降,L-NAME组大鼠MAP显著升高,但于3h后急剧下降,AG组大鼠MAP下降速度明显低于对照组。结论:结构型NOS(cNOS)与iNOS在烧伤休克病理生理过程中的作用明显不同,iNOS活性过度增高与烧伤休克发病关系密切。     

Clinical outcomes and mortality in elderly peritoneal dialysis patients

OBJECTIVES:

To evaluate the clinical outcomes and identify the predictors of mortality in elderly patients undergoing peritoneal dialysis.

METHODS:

We conducted a retrospective study including all incident peritoneal dialysis cases in patients ≥65 years of age treated from 2001 to 2014. Demographic and clinical data on the initiation of peritoneal dialysis and the clinical events during the study period were collected. Infectious complications were recorded. Overall and technique survival rates were analyzed.

RESULTS:

Fifty-eight patients who began peritoneal dialysis during the study period were considered for analysis, and 50 of these patients were included in the final analysis. Peritoneal dialysis exchanges were performed by another person for 65% of the patients, whereas 79.9% of patients preferred to perform the peritoneal dialysis themselves. Peritonitis and catheter exit site/tunnel infection incidences were 20.4±16.3 and 24.6±17.4 patient-months, respectively. During the follow-up period, 40 patients were withdrawn from peritoneal dialysis. Causes of death included peritonitis and/or sepsis (50%) and cardiovascular events (30%). The mean patient survival time was 38.9±4.3 months, and the survival rates were 78.8%, 66.8%, 50.9% and 19.5% at 1, 2, 3 and 4 years after peritoneal dialysis initiation, respectively. Advanced age, the presence of additional diseases, increased episodes of peritonitis, the use of continuous ambulatory peritoneal dialysis, and low albumin levels and daily urine volumes (<100 ml) at the initiation of peritoneal dialysis were predictors of mortality. The mean technique survival duration was 61.7±5.2 months. The technique survival rates were 97.9%, 90.6%, 81.5% and 71% at 1, 2, 3 and 4 years, respectively. None of the factors analyzed were predictors of technique survival.

CONCLUSIONS:

Mortality was higher in elderly patients. Factors affecting mortality in elderly patients included advanced age, the presence of comorbid diseases, increased episodes of peritonitis, use of continuous ambulatory peritoneal dialysis, and low albumin levels and daily urine volumes (<100 ml) at the initiation of peritoneal dialysis.