体外循环围术期单核细胞CD14及脂多糖受体表达变化

目的探讨体外循环围术期单核细胞脂多糖受体(TLR4)变化及其意义。方法选取低温体外循环心脏直视术患者28例，分别于T1(麻醉诱导前)、T2(术后30min)、T3(术后6h)、T4(术后24h)、T5(术后48h)5时点抽取外周血2ml，淋巴细胞分离液分离出单个核细胞(PBMC)，PE-抗人-TLR4单抗及FITC-抗人-CD14单抗标记，流式细胞术(FCM)分析单核细胞膜上TLR4、CD14的表达变化；ELISA法检测血清中白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)浓度变化。结果与术前比较，体外循环(CPB)术后30min单核细胞CD14、TLR4表达均下调；术后6h，两者表达上调；术后第1天，CD14表达恢复正常，TLR4表达继续上调，于术后第2天达到高峰。术后IL-6浓度持续增高，于术后24h达到高峰；TNF-α于术后30min出现高峰。结论单核细胞TLR4及CD14介导了体外循环术后的炎症反应，TLR4受体水平的变化反映着CPB后机体免疫功能。     

二次回风与一次回风在药厂净化空调中的能耗分析

药厂净化空调特点是净化面积较大、净化级别要求相对较高,在设计中,大多数采用一次回风系统,但使用一次回风系统,设备和施工费用相应提高;二次回风系统设计不但能满足温湿度及洁净度要求,而且节省了能源的消耗.本文以某洁净车间为例,比较二次回风与一次回风在空调过程中的使用与能耗情况.从计算结果可以得出结论,在送风量大的净化空调工程中,二次回风系统比一次回风系统在节能方面要优胜的多.     

北玄参根中4个具神经保护作用的新环烯醚萜苷

作者曾从北玄参Scrophularia buergeriana Miquel根90％甲醇提取物中分得10个苯丙烷类化合物并研究了它们对谷氨酸损害的原代培养的大鼠皮质细胞的神经保护作用。因此对该提取物进行了以生物活性为导向的进一步分离。     

脂氧素A4对心肌缺血再灌注损伤的保护作用

Objective To investigate the roles of lipoxin A4, an endegenous lipid mediator with wide anti-inflammatory fea- tures, in attenuating myocardial ischemia-reperfusion injury and the possible mechanisms. Methods Thirty male KM mice were divid- ed randomly into three groups, 10 in each: ischemia-reperfusion group (group A), lipoxin A4 (0.1 mg/kg) group (group B) and Zn- PP (Zinc protoporphyrin Ⅸ, 25 mg/kg)phus lipoxin A4 (0.1 mg/kg)group (group C). A ischemia-reperfusion heart model was de- veloped by ligating the lift anterior descending branch of the coronary artery. A dine of 10% dehydrated alcohol in 0.2 ml for group A, a dose of isochoric lipoxin A4 for group B and a dose of isochoric ZnPP + lipoxin A4 for group C was infused into the ascending aorta through a catheter, which was kpassing the right common carotid artery, 30 minutes after reperfusion. The concentration of serum TNF-α, activities of serum crestine kinase(CK) and lactate dehydrogenase (LDH), activities of myeloperoxidase (MPO) and malond- ialdehyde (MDA) and the cell apoptosis rate in the myocardial tissue were measured 5 hours after reperfusion. Pathological features of the inflammatory infiltration in the myocardium were also observated.Results As compared with group A, the inflammatoryry infiltra- tion in the ischemic and necrotic regions tithe myocardium was reduced, with group C in the intermediate range. The serum activities of CK and LDH wine significantly lower in group B and C than that in group A, and the lowest activities were detected in group B. Similar findings were observed for MPO, an indicator for neutrophil infiltration, and MDA, an indictor for cell injury caused by oxy- gen radicals, in the myocardium. The concentration of TNF-α and the rate of cadiocyte apoptosis were decreased significantly in group B(P < 0.01). ZnPP, an inhibitor of heine oxygenase (HO)-1, attenusted the above protective effects of lipoxin A4 significantly (P<0.05). Conclusion Lipoxin A4 has protective effects against myocardial ischemia-reperfusion injury, and HO-1 may have a potential role in the protectve mechanisms of lipoxin A4, probably pertly by means of reducing the production of reactive oxygen spe- cies and TNF-α, decreasing the activation and infiltration of neutrophils, alleviating inflammatory damage and avoiding apoptosis.     

临床辨证失误二则

1.葛根芩连汤治泄泻,痢如故黄某某,男,42岁。因发热、腹胀、腹泻红白粘液便3天而于1990年4月20日入院。患者于3天前因饮食不洁而突发发热、腹胀腹痛,泄泻红白粘液便,日达数十次。到某医院大便化验后诊断为“细菌性痢疾”。服用“痢特灵”等药后病情未见好转,求诊于余。查:舌质淡红,苔黄厚,昧沉滑。予清热利湿之葛根芩连汤治疗。葛根15g黄芩10g 黄连6g 白芍15g 广香6g 槟榔10g     

东北刺人参根脂肪酸成分的化学研究

采用 GC—MS 技术首次对东北刺人参根脂肪酸成分进行定性定量分析,从中鉴定出14种成分。主要成分为异油酸(isooleic acid)、壬二酸(azelaic acid)、3—羟基十六烷酸(3—hedroxy—hexadcanoic acid)。     

天麻素注射液合丁咯地尔治疗短暂性脑缺血50例疗效观察

目的:观察天麻素加丁咯地尔治疗短暂性脑缺血发作的疗效。方法:随机选择短暂性脑缺血发作(TIA)患者50例为治疗组,静滴天麻素0.6/日,丁咯地尔200mg/日;50例为对照组,静滴川芎嗪120mg/日、胞二磷胆碱500mg/日,10天1疗程,治疗前后应用经颅多普勒血液诊断系统(TCD)测定VA、BA、PCA血流速度。结果:天麻素加丁咯地尔治疗后VA、BA、PCA血流速度明显改善,与对照组相比有显著差异(P<0.01),治疗总有效率92.5%,与对照组相比差异显著(P<0.01)。结论:天麻素加丁咯地尔是控制短暂性脑缺血发作较好的药物,作用快,不良反应少。     

头孢噻肟钠联合尿激酶封管在永久性置管中醮临床应用

目的探讨头孢噻肟钠联合尿激酶封管在永久性置管中的临床疗效。方法选取本院透析中心2010年1月～2013年2月经颈内静脉长期留置导管的48例患者为研究对象,随机分为对照组23例,观察组25例,对照组予普通肝素封管,观察组每半月在对照组的基础上予头孢噻肟钠联合尿激酶封管,其他时间封管同对照组。结果观察组感染率、血流量、回路静脉压、上机前发生抽吸导管不畅事件的例次与对照组比较差异有统计学意义（P〈0.05）。缩论头孢噻肟钠联合尿激酶封管能减少导管感染及导管功能不良事件的发生率,延长永久性导管使用寿命,提高透析充分性,值得临床推广应用。