乌司他丁与川芎嗪合用对急性胰腺炎大鼠氧自由基影响的研究

目的探讨乌司他丁、川芎嗪两药合用对急性胰腺炎（AP）大鼠氧自由基的影响。方法SD大鼠75只,随机分为5组,每组15只。通过胰胆管逆行性注射牛磺胆酸钠制成AP大鼠模型。分别观察各实验组血清SOD、MDA的变化。结果①AP组与假手术组相比,血清SOD水平明显降低（P〈0.05）,血清MDA水平明显升高（P〈0.05）。②乌司他丁治疗组、川芎嗪治疗组及乌司他丁、川芎嗪合用组与AP组相比,血清SOD水平明显升高（P〈0.05）,血清MDA水平明显降低（P〈0.05）。③乌司他丁、川芎嗪合用组与乌司他丁治疗组、川芎嗪治疗组相比,血清SOD水平明显升高（P〈0.05）,血清MDA水平明显降低（P〈0.05）。结论乌司他丁、川芎嗪通过升高SOD保护性因子、降低MDA损伤性因子,对AP有治疗作用,而乌司他丁、川芎嗪合用效果更显著。     

阿魏酸钠对急性胰腺炎大鼠氧自由基影响的研究

目的探讨阿魏酸钠对急性胰腺炎(AP)大鼠氧自由基的影响。方法 SD大鼠60只,随机分为4组,每组15只。通过胰胆管逆行性注射牛磺胆酸钠制成AP大鼠模型。分别观察各实验组血清SOD、MDA的变化。结果①AP组与假手术组相比,血清SOD水平明显降低(P<0.05),血清MDA水平明显升高(P<0.05)。②阿魏酸钠治疗组与对照组相比,血清SOD水平明显升高(P<0.05),血清MDA水平明显降低(P<0.05)。结论阿魏酸钠通过升高SOD保护性因子、降低MDA损伤性因子,对AP有治疗作用。     

丹参注射液联合谷胱甘肽液治疗对脂肪肝大鼠脂质损伤的保护作用

[目的]探讨丹参注射液联合谷胱甘肽(古拉啶)溶液治疗对脂肪肝大鼠脂质损伤的保护作用.[方法]用高脂饲料建立大鼠非酒精性脂肪肝模型,并用丹参注射液联合古拉啶溶液进行治疗,观察药物对脂质损伤保护作用的影响.[结果]丹参注射液、古拉啶溶液及联合用药后血清总胆固醇(TC)水平分别与模型组比较差异均有统计学意义(P＜0.01,＜0.05);丹参注射液、古拉啶溶液治疗后组织中三酰甘油(TG)水平分别与模型组比较P＜0.05及P＜0.01.丹参注射液降低血清中丙二醛(MDA)水平(P＜0.05),联合用药降低组织中MDA水平(P＜0.05),古拉啶溶液升高组织中超氧化物歧化酶(SOD)水平(P＜0.05).[结论]丹参注射液、古拉啶溶液及联合用药均具降血脂、改善脂质过氧化作用;联合用药在阻止肝纤维化增生方面略有优势.     

丹参多酚酸盐对老年不稳定型心绞痛患者血清细胞因子水平的影响

目的研究丹参多酚酸盐治疗对老年不稳定型心绞痛(UAP)患者血清细胞因子水平的影响。方法将72例UAP患者随机分为常规治疗组及丹参多酚酸盐治疗组(丹参多酚酸盐组),观察治疗前后血清白细胞介素18(IL-18)、白细胞介素1(IL-1)以及可溶性细胞间黏附分子-1(sICAM-1)水平的变化,并与18名正常对照组作比较。结果UAP患者血清IL-18、IL-1、sICAM-1水平较正常对照组明显升高(P0.01),常规治疗组治疗后血清IL-18、IL-1较治疗前降低(P0.05或P0.01),而在丹参多酚酸盐组IL-18、IL-1、sICAM-1均较治疗前明显降低(P0.01),且丹参多酚酸盐组治疗后较常规治疗组下降明显(P0.05或P0.01)。结论IL-18、IL-1和sICAM-1可能不同程度参与老年不稳定型心绞痛的病理生理进程。丹参多酚酸盐对UAP患者的心血管保护作用与其显著降低IL-18、IL-1以及sICAM-1水平,从而抑制冠脉局部的炎症级联反应有关。     

丹参多酚酸盐注射液对实验性结肠炎小鼠血清脂肪因子水平的影响

目的通过测试血清脂肪因子水平,了解丹参多酚酸盐是否对脂肪因子产生影响,进一步探讨丹参多酚酸盐治疗实验性结肠炎的可能机制。方法选用雄性BALB/C小鼠30只随机分为对照组、模型组、丹参多酚酸盐干预组,饮用5%DSS造模,14 d后检测相应指标。结果与模型组比较,干预组的肠道炎症明显减轻(P0.01)。模型组小鼠血清瘦素、趋化素均较对照组升高(P0.05),但脂联素降低(P0.05);干预组仅血清瘦素较模型组低(P0.05),脂联素和趋化素与模型组相比,差异无统计学意义(P0.05)。结论丹参多酚酸盐对小鼠实验性结肠炎具有一定的治疗作用,其机制之一可能是调节脂肪因子。     

丹参多酚酸盐对老年不稳定型心绞痛患者内皮功能的影响

目的 观察丹参多酚酸盐对老年不稳定型心绞痛患者内皮功能的影响.方法 选取82例老年不稳定型心绞痛患者,随机分为治疗组(42例)与对照组(40例),对照组采用常规治疗,治疗组在常规治疗的基础上辅以丹参多酚酸盐注射液治疗14 d.分别使用硝酸还原法与酶联免疫吸附法测定2组治疗前后血清一氧化氮(NO)和血浆内皮素(ET)水平.结果 治疗后与对照组相比,治疗组血清NO 水平显著增高(P＜0.05),血浆ET 水平显著降低(P＜0.05).结论 丹参多酚酸盐注射液能明显增加老年不稳定型心绞痛患者NO水平,降低ET水平,改善血管内皮细胞功能.     

海风藤酮对急性胰腺炎大鼠的治疗作用

目的:观察海风藤酮对急性胰腺炎(AP)大鼠自由基水平的影响.方法:♂SD大鼠120只随机分为对照组(n=40),AP组(n=40)和海风藤酮(SM)治疗组(n=40).观察3,6,12和24 h大鼠血浆丙二醛(MDA)、超氧化物歧化酶(SOD)、淀粉酶(AMY)、腹水量、胰腺病理等指标的变化.结果:与对照组比较,AP组腹水、血清AMY和MDA升高,SOD水平降低,且有差异统计学意义,经海风藤酮治疗后,治疗组腹水(24 h:4.03±1.36 mL vs 5.15±1.69 mL,P＜0.05),血清AMY(24 h:69.6±6.7 μkat/L vs 136.6±13.4 μkat/L,P＜0.01)和MDA(24 h:1.45±0.19 nmol/L vs 1.98±0.27 nmol/L,P＜0.05)水平显著降低,SOD水平显著升高(24 h:35.27±8.34 nmol/Lvs19.03±8.74 nmol/L,P＜0.05).AP组大鼠胰腺病理变化均显著性升高,而治疗组与AP组相比在早期(3,6 h)胰腺病理变化明显减轻.结论:海风藤酮通过降低损害因子MDA,升高保护因子SOD对AP有治疗作用.     

奥曲肽对重症急性胰腺炎大鼠枯否细胞m2极化功能的调节作用

目的探讨生长抑素类似物奥曲肽对重症急性胰腺炎(severe acute pancreatitis,SAP)大鼠枯否细胞(Kupffer cells)m2极化功能的调节作用。方法采用经胰管逆行注射5%牛黄胆酸钠和0.9%NaCl分别建立大鼠重症急性胰腺炎模型和对照组模型。36只SD大鼠随机分为六组:假手术组(S)、SAP组、奥曲肽治疗组(ST)、生理盐水治疗组(NT)、奥曲肽预防组(SP)、生理盐水预防组(NP),分别于造模后24 h处死,胶原酶Ⅳ体内灌注肝脏,采用25%、50%Percoll液密度梯度离心法提取肝Kupffer细胞。Elisa检测血清中TNF-ɑ、IL-4、IL-10水平,RT-PCR检测肝Kupffer细胞内极化水平,即TNF-ɑ、IL-4、IL-10的表达,HE染色观察胰腺组织病理损伤情况。结果 (1)SAP组、生理盐水治疗组和预防组血清中TNF-ɑ的水平明显升高,与奥曲肽治疗组相比差异显著(P<0.05或0.01),与奥曲肽预防组比较并无明显差异。奥曲肽治疗组和预防组IL-4水平明显增高,与其他组相比有显著差异(P<0.01),而其两组之间IL-4水平无差异。IL-10水平在奥曲肽治疗组明显升高,与SAP组、生理盐水治疗组和预防组相比差异显著(P<0.01),而IL-10水平在奥曲肽预防组并未见明显升高,与奥曲肽治疗组相比有明显差异(P<0.05)。(2)肝脏Kupffer细胞中,与假手术组相比,TNF-ɑ在SAP组的表达明显上升(P<0.01),而在奥曲肽治疗组和预防组的表达明显降低,与假手术组、SAP组比较差异显著(P<0.01)。IL-4的表达量在SAP组明显下降,与假手术组相比差异显著(P<0.01),而在奥曲肽治疗组和预防组的表达量明显上升,与SAP组、生理盐水治疗组和预防组相比差异显著(P<0.05或0.01)。SAP组与假手术组相比,IL-10的表达量显著降低(P<0.01),而其表达量在奥曲肽治疗组和预防组明显升高,与假手术组、SAP组、生理盐水治疗组和预防组相比差异明显(P<0.01或0.05)。(3)SAP组、生理盐水治疗组和预防组胰腺组织出血、水肿、坏死明显,奥曲肽治疗组和预防组胰腺组织炎症明显减轻。结论肝Kupffer细胞在SAP病情发展中起着重要作用,奥曲肽通过影响其中TNF-ɑ、IL-4和IL-10的表达和分泌,从而调节Kupffer细胞m2极化功能,对SAP具有一定的治疗作用。     

丹参多酚酸盐对脑梗塞后患者血浆纤溶平衡的影响

目的:探讨丹参多酚酸盐对脑梗塞(CI)后患者循环中纤溶平衡的影响。方法:入选60例CI病例,随机分为常规治疗组(30例)和丹参多酚酸盐组(丹参组,30例),丹参组给予丹参多酚酸盐0.2g静脉滴注,每日1次,疗程2周;另选20例健康体检者作为健康对照组,治疗前后检测血浆组织型纤溶酶原激活物(tPA)和纤溶酶原激活物抑制剂-1(PAI-1)浓度。结果:与健康对照组比较,治疗前CI患者tPA水平[(17.19±2.95)ng/ml∶(11.55±2.41)ng/ml]明显降低、PAI-1水平[(40.49±7.08)ng/ml∶(82.52±8.69)ng/ml]明显升高(P均0.05);与治疗前比较,治疗后CI两组患者tPA水平[丹参组(11.76±2.12)ng/ml∶(21.58±1.37)ng/ml,常规治疗组(11.35±2.18)ng/ml∶(14.48±1.79)ng/ml]明显升高,PAI-1水平[丹参组(83.94±9.41)ng/ml∶(39.18±6.54)ng/ml,常规治疗组(81.10±7.81)ng/ml∶(62.47±5.89)ng/ml]明显降低(P均0.05),且丹参组疗效明显优于常规治疗组(P0.05)。结论:丹参多酚酸盐可以改善脑梗塞患者纤溶系统平衡,且疗效优于常规治疗。     

艾司洛尔联合丹参多酚酸盐对老年冠心病心绞痛患者心功能、血流动力学及氧化应激指标的影响

目的探讨艾司洛尔联合丹参多酚酸盐治疗老年冠心病心绞痛患者的临床疗效及对氧化应激的影响。方法108例老年冠心病心绞痛患者,根据治疗方式的不同分为对照组、观察组各54例。对照组给予艾司洛尔治疗,观察组给予艾司洛尔联合丹参多酚酸盐治疗,比较两组治疗疗效、不良反应发生情况及治疗前后的心功能、血液流变学、氧化应激指标水平变化。结果观察组的治疗总有效率显著高于对照组(P<0.05);治疗后两组左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)较治疗前明显降低,而左室血压血分数(LVEF)明显升高(P<0.05),且观察组LVESV、LVEDV水平低于对照组,LVEF值高于对照组(P<0.05);治疗后两组血浆黏度、全血黏度低切、全血黏度高切、纤维蛋白原水平均显著低于治疗前(P<0.05),且观察组各血液流变学指标水平显著低于对照组(P<0.05);治疗后两组超氧化物歧化酶(SOD)水平均显著高于治疗前,丙二醛(MDA)水平均显著低于治疗前(P<0.05),且观察组SOD明显高于对照组,MDA明显低于对照组(P<0.05);两组不良反应总发生率比较无明显差异(P>0.05)。结论对老年冠心病心绞痛患者应用艾司洛尔联合丹参多酚酸盐治疗能够取得较好的临床疗效,对患者的心功能有明显的改善效果,同时能够降低血液黏稠度及氧化应激程度,且安全可靠。     

A patient with rectal ulcer with severe stenosis presenting with perforated peritonitis

We report a patient with rectal ulcer with severe stenosis, who underwent urgent surgical treatment for perforated peritonitis. The 54-year-old man suddenly developed cramping abdominal pain and fever while hospitalized, with signs of peritoneal irritation. An emergency laparotomy was performed, and severe stenosis of the rectum and a perforated lesion on the oral side approximately 10 cm distant from the stenosis were found, with massive abdominal purulent fluid. He was treated by rectosigmoid colon resection with transverse colon loop colostomy. Histopathologically, the stenosis was caused by ulceration extending to all muscular layers of the rectum, with inflammatory changes. Benign rectal stenosis is so rare that differential diagnosis from malignancy may be difficult when there are inflammatory changes in the surrounding tissues. However, it is necessary to keep in mind the likelihood of this disease in differentiation from rectal cancer. Received: December 21, 1998 / Accepted: May 28, 1999     

Evaluation of atrial vulnerability with transoesophageal stimulation in patients with atrioventricular junctional: Comparison with patients with ventricular pre-excitation and with normal subjects

The aim of our work was to evaluate the inducibility of atrialfibrillation in a group of patients with atrioventricular junctionalreentrant tachycardia and to compare it with that of patientswith a Kent-type ventricular pre-excitation (Wolff-Parkinson-Whitesyndrome) and a control group. One hundred and twenty-five subjects were separated into groups.Group 1 comprised 49 Wolff-Parkinson-White patients, with amean age of 26.4, range 10.66 years; group 2, 51 patients withatrioventricular junctional reentrant tachycardia inducibleby transoesophageal atrial stimulation andlor clinically documented,with a mean age of 43.4, range 16–78 years; group 3, 25control subjects with a mean age of2.64, range 13–76 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min^–1 and 150.min^–1; atrial stimulation for 10 s at a rate of 200–300–400–500–600.min^–1 with intervals of 10 s between stimulations, fivesuccessive ‘ramp-up’ atrial stimulations for 9 swith the rate increasing from 100 to 800. min^–1 with intervalsof 10 s between stimulations. The end point was the completionof the protocol or induction of sustained atrial fibrillation(>1 min). The chi-square test was used for statistical analysis. Our resultsshowed that in group 1 atrial fibrillation was induced in 27149patients (55.1%); this was sustained in 13149 (26.5%) and non-sustainedin 14149 (28.5%); in group 2, atrial fibrillation was inducedin 22151 patients (43.0%); it was sustained in 7151 (13.7%)and non-sustained in 15151 (29.4%); in group 3, sustained atrialfibrillation was not induced in any subject and in only onesubject was a non-sustained atrial fibrillation (4 s) induced. The chi-square test showed that group 2 vs group 1 were non-significant,while group 2 vs group 3 and group 1 vs group 3 were significant(P<0.003 and P<0.0007, respectively). Therefore group 2 patients showed a greater atrial vulnerabilityin comparison to the control subjects and a similar vulnerabilityto group 1 patients. It is possible that the greater atrialvulnerability in the patients of group 2 was due to the doublenodal pathway.     

肿瘤病人弓形虫感染分析

在肿瘤的发生和发展进程中 ,多伴有免疫功能低下或缺陷 ,从而极易遭受各种感染。弓形虫是机会感染因子 ,当患者免疫功能受损时 ,易于感染 ,还会使隐性感染激活 ,引起低热不退、淋巴结肿和脑神经系统的反应 ,此现象尚未引起临床医师的重视。近年来 ,我们对 4 0 9例肿瘤病人进行了弓形虫感染及弓形虫病的分析观察 ,报告如下 :1　材料与方法1 1　材料　 30 4例病人血清取自江西省肿瘤医院住院或门诊病人 ,随机抽样后低温保存待检 ,10 5例取自其他医院送检样品 ,有急性症状者随到随检 ,以便及时做病原学检测。1 2　弓形虫病诊断方法1 2 1　免疫…     

Infection with Rhodococcus equi in a patient with sarcoidosis treated with corticosteroids

A 51-year-old female farmer was diagnosed as having sarcoidosis. During 4 years of observation, slow radiological progression was observed. Cough then developed, necessitating treatment with corticosteroids. After 28 months of continuous treatment with prednisolone in low doses (5-7.5 mg daily), she suffered fever episodes, recurrent haemoptyses, general malaise and loss of weight. A chest roentgenogram showed a left upper lobe infiltrate, which progressed and finally cavitated, and rib destruction. Despite efforts, including a thoracotomy, 22 months passed before a diagnosis could be made. Blood and sputum cultures and cultures from the destroyed rib showed growth of Rhodococcus equi, a common soil organism which can cause infections in foals and other animals. Treatment with rifampicin and erythromycin was successful. R. equi has been reported to cause infection in patients with neoplastic disease and/or immunosuppression, but the disease might be more common than is suggested by the sparse case reports in the literature, owing to lack of familiarity with the organism, which will tend to be overlooked as a contaminant.     

Treating patients with lupus with B-cell depletion

A new era in the treatment of systemic lupus erythematosus has dawned with the increasing introduction of monoclonal antibodies and other approaches, that target the key molecules involved in the pathogenesis of the disease. At present the ability to block the CD20 molecule on those B cells that carry this marker has proved the most effective way to treat patients resistant to conventional immunosuppressive drugs. However, these studies have all been open label and the results of double blind controlled studies are eagerly awaited.