藻黄胶囊Ⅱ号延缓慢性肾功能衰竭进展的实验研究

目的 囊Ⅱ号液对人肾小球系膜细胞(GMC)、增殖及分泌纤维连接蛋白(FN)、转化生长因子β1(TGF-β1)的影响.方法 体外人GMC培养,细胞成熟后进行药物孵育,观察细胞增殖情况,检测藻黄胶囊Ⅱ号液对人GMC分泌的FN、TGF-β1的影响.结果 实验研究显示藻黄胶囊Ⅱ号液可明显抑制人GMC的增殖,明显抑制人GMC分泌FN、TGF-β1.结论 藻黄胶囊Ⅱ号液可抑制人GMC的增殖及FN、TGF-β1分泌,提示其可减少肾小球和肾间质细胞外基质的堆积.     

Effect of granulocyte colony-stimulating factor on bleomycin-induced acute lung injury and pulmonary fibrosis

OBJECTIVE: Potentially fatal pulmonary toxicity is a dreaded complication of bleomycin. Increased use of granulocyte colony-stimulating factor in patients receiving chemotherapy has been paralleled by an increased incidence of bleomycin-induced pulmonary toxicity. We investigated whether granulocyte colony-stimulating factor (25 microg x kg(-1) x day(-1), 4 days) enhanced endotracheal bleomycin-induced (5 mg/kg) acute lung injury and fibrosis in rats. SETTING: University laboratory. SUBJECTS: Sprague-Dawley rats. INTERVENTIONS: We compared the effects of alveolar instillation of bleomycin in rats treated with either granulocyte colony-stimulating factor or saline. MEASUREMENTS AND MAIN RESULTS: Mortality was 25% with bleomycin only and 50% with bleomycin + granulocyte colony-stimulating factor. Granulocyte colony-stimulating factor increased alveolar neutrophil recruitment, pulmonary edema, and lung myeloperoxidase activity on day 4. Lung static compliance on day 15 was severely decreased with bleomycin alone and showed a further significant decrease when granulocyte colony-stimulating factor was added (controls, 3.85 +/- 0.14 mL/kPa; bleomycin, 1.44 +/- 0.06 mL/kPa; and bleomycin + granulocyte colony-stimulating factor, 0.65 +/- 0.09 mL/kPa; control vs. bleomycin, p <.0001; and bleomycin vs. bleomycin + granulocyte colony-stimulating factor, p =.0003). Lung morphology with bleomycin + granulocyte colony-stimulating factor showed, in addition to the changes observed with bleomycin alone, four patterns indicating more severe disease: honeycomb foci, pleural thickening with hyaline fibrosis, interstitial granuloma with increased number of macrophages but not neutrophils, and established interstitial fibrosis. Lidocaine, which prevents neutrophil adhesion to endothelial cells, inhibited granulocyte colony-stimulating factor-related exacerbation of acute lung injury (bronchoalveolar lavage fluid cells and pulmonary edema) and pulmonary fibrosis (lung static compliance and morphologic changes). CONCLUSIONS: Granulocyte colony-stimulating factor enhances bleomycin-induced lung toxicity by a mechanism that probably involves neutrophils.     

Meeting the needs of intensive care unit patient families: a multicenter study

Intensive care unit (ICU) caregivers should seek to develop collaborative relationships with their patients' family members, based on an open exchange of information and aimed at helping family members cope with their distress and allowing them to speak for the patient if necessary. We conducted a prospective multicenter study of family member satisfaction evaluated using the Critical Care Family Needs Inventory. Forty-three French ICUs participated in the study. ICU characteristics, patient and family member demographics, and data on satisfaction were collected. Factors associated with satisfaction were identified using a Poisson regression model. A total of 637 patients were included in the study, and 920 family members completed the questionnaire. Seven predictors of family satisfaction were found: one family-related factor, namely, family of French descent and six caregiver-related factors, namely, no perceived contradictions in information given by caregivers; information provided by a junior physician; patient to nurse ratio 相似文献   

1H-MRS和SPECT对脑肿瘤放疗后复发与放射性坏死的鉴别诊断价值

目的 探讨质子磁共振波谱(1H-MRS)和99mTc-甲氧基异丁基异腈(MIBI)单光子发射计算机断层显像(SPECT)对脑肿瘤患者放疗后复发(下称复发)与放射性坏死(下称坏死)的鉴别诊断作用.方法 对35例脑肿瘤患者进行1H-MRS和SPECT检查.结果 复发20例,1H-MRS表现为胆碱(Cho)波上升,N-乙酰天门冬氨酸(NAA)波下降,乳酸和脂质波升高;99mTc-MIBI摄取指数T/C比值1.9～6.7(3.7±1.5).坏死15例,1H-MRS表现为Cho、NAA、肌酸波降低;99mTc-MIBI摄取指数T/C比值0.8～1.8(1.1±0.3).两组比较均有统计学差异(P均<0.01).结论 1H-MRS和SPECT检查对脑肿瘤复发及坏死有鉴别诊断价值.     

白头翁加味汤治疗溃疡性结肠炎的作用研究

目的：观察白头翁加味汤治疗溃疡性结肠炎（UC）的临床有效性、安全性及评估4种炎症因子的临床监测意义。方法：将入选的78例UC患者随机分为两组：对照组和试验组,各39例。对照组采用柳氮磺胺吡啶片常规治疗;试验组采用白头翁加味汤灌肠治疗。两组均以一个月为一疗程,连续观察两个疗程。比较两组有效率、安全性及其治疗前后血清中MDA浓度、SOD活力、IL-4和COX-2含量。结果：试验组、对照组总有效率分别为94.9%、79.5%,试验组明显＞对照组,具有统计学意义（P＜0.05）。试验组治疗前后相比,血清MDA浓度和COX-2浓度均显著下降,SOD 活性和IL-4含量均明显升高,具有统计学意义（P<0.05）;治疗后试验组与对照组相比,血清MDA 和COX-2浓度均显著下降,SOD 活性和IL-4含量均明显升高,具有统计学意义（P<0.05）。结论：应用白头翁加味汤治疗UC,血清MDA浓度、SOD活力、IL-4和COX-2含量均明显改变,可用于临床指标监测,且其疗效优于对照组,安全性高,不良反应少。     

降钙素原在呼吸道感染性疾病诊疗中的应用价值

目的探讨降钙素原(serum procalcitonin,PCT)对呼吸道感染性疾病的诊疗价值。方法选取我院收治的呼吸道感染性疾病患者47例和同期健康体检人群41例进行PCT水平测定,比较两组间PCT值的变化,并分析感染性疾病组PCT水平的分布情况。结果感染组中血清PCT水平高于健康体检人群,差异具有统计学意义(P0.05);在健康对照组中,41例体检者PCT值均波动于0.01~0.25ng/mL;感染性疾病组中,PCT值高于0.25mg/mL的比例约为57.45%,高于参考值1.0ng/mL的比例为34.04%。结论定量检测血清PCT水平对常见呼吸道感染性疾病的诊断及治疗具有一定的指导意义,但单独应用该指标敏感性低,需结合其他指标综合判断。     

胰腺癌诊断筛查方式发展的回顾性分析

目的梳理胰腺癌诊断筛查方式的历史沿革,探究在中国人口基数大、经济处于发展中的背景下,如何实现胰腺癌的"早诊早治"。方法采用系统回顾的方法进行分析。计算机检索CNKI、VIP、WanFang Data、Web of Science、PubMed和EMbase数据库,同时由两名研究员独立检索百度搜索引擎,检索时限均从建库至2018年2月28日,搜集胰腺癌筛查方法及效果评价的相关报道,进行定性描述。结果共117篇文献纳入研究。国内对胰腺癌筛查方式的探索经历了萌芽、启蒙和成长三个阶段。现有筛查方式有临床表现、影像学方法、血清肿瘤标记物和分子生物学基因诊断四种,各有利弊。单一手段无法实现较高特异性和灵敏度,联合检测成为必然趋势。考虑到应用过程中的效益问题,在高危人群中进行筛查可以有效缩小人群范围,实现精准筛查。结论我国针对胰腺癌筛查方面的研究较国外有较大差距。筛查方法呈现多样性,联合检测是必然趋势。在高危人群中进行胰腺癌筛查将成为技术瓶颈下的突破口。     

肺炎支原体CARDS毒素对小鼠IgE反应的影响及机制

目的 通过肺炎支原体产生的特异性CARDS毒素对血清总IgE的作用,研究其对机体过敏反应的影响.方法 60只SPF级BALB/c小鼠分为对照组和感染组,采用CARDS毒素暴露小鼠模型,评价CARDS毒素特异性反应;肥大细胞脱颗粒研究确定CARDS毒素特异性IgE的功能;Western blot检测JAK3及STAT6的...