革兰阴性菌性腹膜炎的临床防治策略

腹膜炎是腹膜透析(PD)患者的严重并发症之一,也是引起技术失败甚至死亡的最重要原因。近年来由于PD连接系统的改善,革兰阳性(G )菌感染发生率显著下降,然而G-菌腹膜炎的发生率并未改变,在一些国家和地区甚至呈增加趋势。目前G-菌占所有PD相关性腹膜炎的20%~30%。中山大学附属第     

马兜铃酸肾病发病机制的研究进展

含马兜铃酸（AA）类成分中药导致的肾损害--马兜铃酸肾病近年受到国内外医药学界的广泛关注，其确切发病机制尚未阐明。本文总结了国内外近年来有关马兜铃酸肾病发病机制的研究概况。     

应重视和加强大肠杆菌所致腹膜透析相关腹膜炎的防治

持续性不卧床腹膜透析(CAPD)临床应用已30年,患者生存及技术存活显著改善.     

腹膜间皮细胞过氧化物酶体增殖物活化受体γ的表达及其配体对CD40和细胞间黏附分子1的影响

目的观察过氧化物酶体增殖物活化受体γ（PPAR-γ）在大鼠腹膜间皮细胞（RPMCs）中的表达以及脂多糖（LPS）的调节作用，并探讨PPAR-γ天然配体15d-PGJ2及人工合成配体ciglitazone对RPMCs表达CD40和ICAM-1的影响。方法分离及培养RPMCs，常规传代及鉴定，取第2代细胞用于实验研究。LPS不同浓度（0．1、1．0、10、50及100μg／ml）、LPS（1μg／ml）处理后不同时间点及15d-PGJ2（3μmol／L）、ciglitazone（10μmol／L）作用细胞36h后收集细胞。RT-PCR检测PPAR-γ、CD40以及ICAM-1 mRNA表达。免疫细胞化学检测PPAR-γ在RPMCs中的分布。Western印迹检测PPAR-γ及ICAM-1蛋白表达。结果（1）常规培养的RPMCs表达一定量PPAR-γ，表达部位主要分布于RPMCs细胞核内，在细胞浆微弱表达。（2）随着LPS浓度逐渐增大，PPAR-γ蛋白表达水平呈逐渐增高的趋势，LPS浓度为10μg／ml时其表达为最高峰。LPS（1μg／ml）作用12h时PPAR-γ蛋白表达最强，PPAR-γ1表达高于PPAR-γ2；之后显著降低，持续至72h。（3）LPS刺激后RPMCs CD40mRNA表达显著增强；15d-PGJ2、ciglitazone显著降低CD40 mRNA表达（P均〈0．01）。（4）LPS刺激后RPMCs ICAM-1蛋白表达显著增加：15d-PGJ2增加LPS介导的ICAM-1 mRNA表达（P〈0.01），但显著抑制ICAM-1蛋白表达（P〈0．05）。ciglitazone对LPS介导的ICAM-1 mRNA和蛋白表达均有显著抑制作用（P均〈0．05）。结论RPMCs结构性表达PPAR-γ。LPS调节PPAR-γ表达呈现先增强后抑制趋势。PPAR-γ配体可显著抑制LPS介导的CD40mRNA和ICAM-1蛋白的表达。提示RPMCs功能性表达PPAR-γ．可能通过负性调节炎症介质分泌而参与腹腔局部防御。     

Rosiglitazone down-regulates lipopolysaccharide-induced expression of CD40 and intercellular adhesion molecule 1 in rat peritoneal mesothelial cells through a NF-κB dependent mechanism

Objective To investigate the effect and mechanism by which PPARγ ligand, rosiglitasone, regulates the expression of CD40 and intercellular adhesion molecule 1 (ICAM-1) in the rat peritoneal mesothelial cells (RPMCs) induced by lipopolysaccharide (LPS). Methods RPMCs were harvested from Sprague-Dawley rat peritoneal cavity and maintained under defined in vitro conditions. The cells were randomly divided into groups as follows: medium, LPS (5 mg/L), LPS (5 mg/L)+BAY11-7085(5 μmol/L, NF-κB inhibitor), rosiglitazone (10 μmol/L or 20 μmol/L, peroxisome proliferator-activated receptor γ activator), LPS (5 mg/L)+rosiglitazone (10 μmol/L)+GW9662 (3 μmol/L, peroxisome proliferator-aetivatcd receptor γ antagonist), and LPS (5 mg/L)+vehicle (DMSO 0.2 ml/L). The expressions of CD40 and ICAM-1 RNA in RPMCs were examined by RT-PCR after 3 hour treatment, and the protein expressions of CD40, ICAM-1, p-NF-κB p65 and p-IκBα were examined by Western blot or immunofluorescence after 24 hour treatment. Results Following treatment with LPS, both the expressions of CD40 and ICAM-1 protein in RPMCs were up-regulated significantly (P<0.05), and the phosphoralation of p65 was increased greatly (1.10±0.17 vs 0.55±0.06, P<0.05). BAY11-7085 (5 μmol/L) significantly decreased the protein expression of p-p65 (0.22±0.11 vs 1.10±0.17, P<0.01), CD40 (0.34±0.02 vs 0.50±0.06, P<0.05) and ICAM-1 (0.35±0.16 vs 0.74±0.03, P<0.05). Pretreated with rosiglitazone for 3 h then added with LPS for 1 h, the levels of p-p65, CD40 and ICAM-1 in RPMCs were significantly decreased compared with those of LPS group (0.77±0.08 vs 0.90±0.10, P相似文献   

以农村社区卫生服务需求为导向 重构高等职业教育临床医学专业课程体系

探讨地方性医学高等职业院校三年制临床医学专业教育改革,根据建设社会主义新农村,广泛开展新型农村合作医疗的特点、需求、内容,结合三年制临床医学专业课程设置的现状,针对城乡社区全科医生素质、能力、技能需求的特点,改变传统的三年制临床医学专业课程设置及教学模式,加强高等职业教育专科生素质、能力、技能的培养,以适应农村社区卫生服务的需要。     

应重视和加强大肠杆菌所致腹膜透析相关腹膜炎的防治

持续性不卧床腹膜透析(CAPD)临床应用已30年,患者生存及技术存活显著改善.     

Rosiglitazone down-regulates lipopolysaccharide-induced expression of CD40 and intercellular adhesion molecule 1 in rat peritoneal mesothelial cells through a NF-κB dependent mechanism

Objective To investigate the effect and mechanism by which PPARγ ligand, rosiglitasone, regulates the expression of CD40 and intercellular adhesion molecule 1 (ICAM-1) in the rat peritoneal mesothelial cells (RPMCs) induced by lipopolysaccharide (LPS). Methods RPMCs were harvested from Sprague-Dawley rat peritoneal cavity and maintained under defined in vitro conditions. The cells were randomly divided into groups as follows: medium, LPS (5 mg/L), LPS (5 mg/L)+BAY11-7085(5 μmol/L, NF-κB inhibitor), rosiglitazone (10 μmol/L or 20 μmol/L, peroxisome proliferator-activated receptor γ activator), LPS (5 mg/L)+rosiglitazone (10 μmol/L)+GW9662 (3 μmol/L, peroxisome proliferator-aetivatcd receptor γ antagonist), and LPS (5 mg/L)+vehicle (DMSO 0.2 ml/L). The expressions of CD40 and ICAM-1 RNA in RPMCs were examined by RT-PCR after 3 hour treatment, and the protein expressions of CD40, ICAM-1, p-NF-κB p65 and p-IκBα were examined by Western blot or immunofluorescence after 24 hour treatment. Results Following treatment with LPS, both the expressions of CD40 and ICAM-1 protein in RPMCs were up-regulated significantly (P<0.05), and the phosphoralation of p65 was increased greatly (1.10±0.17 vs 0.55±0.06, P<0.05). BAY11-7085 (5 μmol/L) significantly decreased the protein expression of p-p65 (0.22±0.11 vs 1.10±0.17, P<0.01), CD40 (0.34±0.02 vs 0.50±0.06, P<0.05) and ICAM-1 (0.35±0.16 vs 0.74±0.03, P<0.05). Pretreated with rosiglitazone for 3 h then added with LPS for 1 h, the levels of p-p65, CD40 and ICAM-1 in RPMCs were significantly decreased compared with those of LPS group (0.77±0.08 vs 0.90±0.10, P相似文献   

CBS教学法在高职医学生急诊医学教学中的应用

地方性医学高职教育具有中国特色的医学教育模式,是我国医学教育的补充,它存在的根本宗旨就是要为解决广大农村社区缺医少药,从根本上改变其落后的卫生面貌,实现“2000年人人享有卫生保健”的全球战略目标而培养合格、适用的社区全科医学人材。高职教育以学制短,实用性强为其主     

狼疮肾炎患者肾组织CD40及其配体表达的免疫组织化学分析

目的　探讨CD40 CD40配体 (CD40L)相互作用在狼疮肾炎 (LN)发病机制中的可能作用。方法　用免疫组织化学方法对 2 0例LN患者肾组织CD40和CD40L的表达进行检测 ,并对其与肾脏病变的相关性进行分析。结果　Ⅲ、Ⅳ型LN肾组织CD40表达较正常对照组显著上调 (P <0 0 1) ,除系膜细胞、内皮细胞和肾小管上皮细胞CD40表达增强外 ,还出现CD40阳性的间质浸润细胞。Ⅲ、Ⅳ型LN患者肾组织CD40L表达亦显著增强 (P <0 0 1) ,其分布范围与CD40一致。Ⅱ、Ⅴ型LN患者肾组织CD40表达范围和强度与正常肾组织大致相似。LN肾组织CD40表达与病变活动指数相关 (r =0 78,P <0 0 1)。结论　CD40 CD40L在肾脏局部的相互作用可能在LN发生和发展中起重要作用。