槲皮素对肺动脉高压大鼠肺动脉平滑肌细胞增殖和重构的影响

目的:研究槲皮素对野百合碱(MCT)诱导的肺动脉高压大鼠肺动脉平滑肌细胞增殖和肺动脉结构重建的调节作用。方法:成年雄性SD大鼠40只随机分为4组:正常对照组(对照组)、MCT诱导的肺动脉高压组(MCT组)、槲皮素预防组(预防组)和槲皮素治疗组(治疗组),每组10只。测量各组大鼠干预后平均肺动脉压力(mPAP);测定肺小动脉管壁厚度(WT)占动脉外径(ED)的百分比(WT%)及管壁面积(WA)占血管总面积的百分比(WA%);采用免疫组化和Western blot检测肺小动脉平滑肌细胞增殖细胞核抗原(PCNA)和平滑肌细胞抗体(α-SMA)的表达。结果:野百合碱组50mg/kg,再以生理盐水2ml/d每日灌胃一次,共20天,与对照组(生理盐水,再以生理盐水2ml/d每日灌胃一次,共20天)、预防组(MCT 50mg/kg,同时给予槲皮素100mg/kg每日灌胃一次,共20天)和治疗组(MCT 50mg/kg饲养20天后,以槲皮素100mg/kg每日灌胃一次,共20天)相比,mPAP、WT%、WA%、PCNA阳性率显著升高及PCNA、α-SMA的表达显著增多。结论:槲皮素对野百合碱诱导的大鼠肺动脉高压有预防和治疗作用,其机理可能是通过抑制肺血管中小动脉平滑肌细胞增殖,改善肺血管重构。     

蝙蝠葛中的新生物碱——蝙蝠葛新林碱

防已科植物蝙蝠葛(Menispermum daurioum DC.)的根茎,即北豆根,是一种重要的中药,具有清热解毒、消肿止痛等功效。已知含有近二十种生物碱,其中五种属双苄基四氢异喹啉类,即蝙蝠葛碱(dauricine,Ⅰ)、蝙蝠葛诺林碱(daurinoline,Ⅱ)、蝙蝠葛新诺林碱     

Prevalence of asthma, atopy, and bronchial hyperreactivity in bronchiectasis: a controlled study.

The prevalence of atopic diseases and bronchial reactivity to histamine and methacholine was determined in 36 patients with bronchiectasis and in 36 control patients matched for age, sex, and smoking history. There was no difference in the prevalence of asthma, other atopic diseases, family history of atopic diseases, or positive responses to skinprick tests (nine versus five) in the two groups. The prevalence of bronchial hyperreactivity, however, was significantly higher in the group with bronchiectasis than in the control group for both histamine (7 v 0 patients) and methacholine (6 v 0 patients). The group with bronchiectasis had more airflow obstruction (mean FEV1 67% predicted), but there was no correlation between spirometric indices and log PD20 (the log dose of histamine or methacholine causing a 20% fall in FEV1). This suggests that, although reduced airway calibre may be a factor underlying bronchial hyperreactivity in bronchiectasis, it is not the only mechanism. Further studies are needed to determine whether bronchial hyperreactivity has a causative role in the pathogenesis of bronchiectasis or whether it occurs as a result of the disease.     

In vivo and in vitro inhibitory effects of a traditional Chinese formulation on LPS-stimulated leukocyte-endothelial cell adhesion and VCAM-1 gene expression

Aim of the study

A traditional Chinese formulation Huang-Lian-Jie-Du-Tang (HLJDT) exerts anti-inflammatory effects. The present study aimed to investigate the effect of HLJDT on the LPS-stimulated leukocyte–endothelial cell adhesion and VCAM-1 gene expression both in vivo and in vitro.

Materials and methods

HLJDT was extracted from rhizoma coptidis, radix scutellariae, cortex phellodendri and fructus gardeniae in a weight rario of 1:1:1:1. In vivo leukocyte–endothelial cell adhesion was observed in rat lung after LPS stimulation (5 mg/kg, i.p.) with or without HLJDT (350 or 700 mg/kg, i.g.) pretreatment. The protein expression of vascular cell adhesion molecule 1 (VCAM-1) was analyzed by immunohistochemical method. In vitro leukocyte–endothelial cell adhesion was performed by examining the adhesion of THP-1 cells to LPS-stimulated human vascular endothelial cells with or without HLJDT pretreatment. The VCAM-1 expression at the RNA and protein levels was investigated by RT-PCR and western blot analysis, respectively. The activation of NF-κB was examined by the nuclear translocation of NF-κB by immunocytochemical method.

Results

In vivo, HLJDT dose-dependently reduced the number of leukocytes adhered to endothelium and VCAM-1 protein expression in lung venules of LPS-challenged rats. In vitro, HLJDT dose-dependently decreased the number of THP-1 cells adhered to LPS-stimulated endothelial cells and the expression of VCAM-1 both at the RNA and protein levels. The LPS-induced nuclear translocation of NF-kappa B in endothelial cells was also dose-dependently inhibited by HLJDT.

Conclusions

The present study demonstrated an additional mechanism underlying the anti-inflmmatory effect of HLJDT by inhibiting the leukocyte–endothelial cell adhesion and VCAM-1 gene expression. The inhibition of NF-kappa B activation by HLJDT might suggest a profound anti-inflammatory consequences.     

住院患者跌倒/坠床管理流程的建立和应用

目的：建立住院患者跌倒/坠床管理流程,降低患者跌倒/坠床发生率。方法：于2011年建立并实施高危患者跌倒/坠床风险评估及干预—跌倒/坠床风险评估申报—住院安全告知讲解签字—每周动态评估的管理流程。结果：住院患者跌倒发生率明显降低（P〈0.05）,护患关系更融洽。结论：住院患者跌倒/坠床管理流程的实施,能有效降低住院患者跌倒/坠床发生率。     

补体C3、补体C4联合甲状腺自身抗体检测对桥本甲状腺炎诊断和预后的意义

目的探讨补体C3、补体c4、抗甲状腺球蛋白抗体（TGAb）、甲状腺过氧化物酶抗体（TPOAb）和促甲状腺激素受体刺激抗体（TSAb）检测对桥本甲状腺炎（HT）的诊断价值和病情发展判定的意义。方法选择HT患者120例作为HT组,同期就诊的Graves病患者110例作为Graves’病组,30例健康体检者作为对照组。3组患者分别检测补体C3、补体C4、TGAb、TPOAb和TSAb,并进行比较。结果HT组和Graves病组TGAb、TPOAb和TSAb水平和阳性率较对照组明显升高,HT组TGAb和TPOAb的水平和阳性率升高较Graves病组升高更为明显,而TSAb的水平和阳性率Graves病组较HT组更为明显。HT组的补体C3和补体C4水平较对照组和Graves病组明显降低,而对照组和Graves病组无显著性差异。HT组中甲减亚组补体C3和补体C4水平的变化较甲功正常亚组和甲功亢进亚组明显降低。结论HT是最常见的自身免疫性甲状腺疾病之一,因其血清学诊断标准不具特异性,联合检测补体C3、补体C4和甲状腺自身抗体对提高HT的临床诊断以及判断病情发展具有较重要的临床意义。     

牙周基础治疗对2型糖尿病相关性牙周炎患者血糖控制的Meta分析

目的系统评价牙周基础治疗对2型糖尿病相关性牙周炎患者血糖控制的影响,探讨牙周基础治疗在糖尿病治疗中的具体作用。方法计算机检索Cochrane图书馆对照试验注册中心、Medline、EMbase、SIGLE、GreyNet、NTIS、中国生物医学文献数据库、中文科技期刊全文数据库、中国期刊全文数据库和万方数据库,查找有关牙周基础治疗对糖尿病血糖控制影响的研究。检索时限均为1991-2011年4月31日。均由2名评价者独立选择试验、提取资料和评估方法学质量,然后采用RevMan 5．1软件对资料进行Meta分析。纳入7个研究,共计471例受试患者。结果牙周基础治疗能明显降低2型糖尿病相关性牙周炎患者糖化血红蛋白的水平,组间差异有统计学意义（95％CI：-0．94—0．22,P=0．001）。治疗组牙周袋探诊深度低于对照组,组间差异也有统计学意义（95％CI：-2．26～0．69,P=0．0002）。结论牙周基础治疗有利于2型糖尿病相关性牙周炎患者总体血糖水平的控制。     

Differential aqueous and vitreous concentrations of moxifloxacin and ofloxacin after topical administration one hour before vitrectomy

PURPOSE: To investigate the penetration of ofloxacin and moxifloxacin into the aqueous and vitreous after topical administration one hour before vitrectomy surgery. DESIGN: Prospective, randomized, double-blind case series study. METHODS: Twenty-seven patients undergoing vitrectomy were randomized to receive either topical ofloxacin 0.3% or moxifloxacin 0.5% every 10 minutes for one hour before surgery. Aqueous and vitreous samples were obtained and analyzed using high-performance liquidation chromatography. RESULTS: The moxifloxacin aqueous (1.576 +/- 0.745 microg/ml) and vitreous (0.225 +/- 0.013 microg/ml) levels were significantly higher than the ofloxacin aqueous (0.816 +/- 0.504 microg/ml) (P = .0009) and vitreous (0.225 +/- 0.013 microg/ml) [P = .0054] levels, respectively. The mean moxifloxacin aqueous and vitreous levels exceeded the minimum inhibitory concentration for 90% of isolates (MIC(90)) for a wide variety of bacteria implicated in endophthalmitis. In contrast, the aqueous level of ofloxacin exceeded the MIC(90) of only a few organisms. CONCLUSIONS: Moxifloxacin applied every 10 minutes during the hour before vitrectomy penetrated the eye significantly better than ofloxacin.     

HLA-B27相关的前葡萄膜炎眼后节并发症的临床特点

目的探讨HLA—B27阳性的前葡萄膜炎眼后节并发症的临床特点及治疗。方法2002年1月至2005年10月就诊的前葡萄膜炎患者采用流式细胞术进行外周HLA-B27的检测，筛选出71-例82眼HLA-B27阳性前葡萄膜炎患者，分为两组：实验组为眼后节受累的患者24例31眼，对照组为眼后节未受累的患者47例51眼。另有HLA—B27阴性前葡萄膜炎患者74例116眼作参考。所有患者均进行裂隙灯、眼底镜等常规眼科查体，部分行眼底荧光血管造影。分析了HLA—B27相关的前葡萄膜炎眼后节并发症的临床特点。采用x^2检验及t检验进行统计学分析。结果71例82眼HLA—B27阳性前葡萄膜炎中有24例31眼占37．8％出现眼后节并发症者，包括：黄斑囊样水肿12例15眼占48．4％，视乳头水肿7例8眼占25．8％，而玻璃体炎最多见为21例27眼占87．1％，8例10眼占32．3％患者存在两种或两种以上的眼后节表现。74例116眼HLA—B27阴性者有8例12眼占10．3％有眼后节表现。实验组中发生前房成型纤维素渗出31眼中18眼占58．06％和积脓31眼中9眼占29．03％明显高于对照组（前房纤维素渗出51眼中3眼，5．88％，X^2=27．56，P〈0．01；前房积脓51眼中1眼，1．96％，X^2=13．20，P〈0．01）；实验组中伴发相关全身性疾病24例中有16例占66．67％的几率高于对照组（47例中有17例，31．66％，X^2=5．94，P〈0．05）。出现眼后节并发症的患者经全身及局部应用糖皮质激素治疗，31眼中有11眼最佳矫正视力≥1．0。结论HLA-B27阳性前葡萄膜炎易出现眼后节并发症，HLA—B27相关的前葡萄膜炎眼后节受累的患者发生相关全身性疾病和前房纤维素渗出与积脓的几率较高。     

Clinical observation on the treatment of childhood refractory idiopathic thrombocytopenic purpura with Dihuang Zhixue Capsule (地黄止血胶囊)

Objective： To observe the clinical effect of Dihuang Zhixue Capsule （地黄止血胶囊, DZC, a Chinese preparation for cooling blood and dispelling toxic substances） in the treatment of childhood refractory idiopathic thrombocytopenic purpura （RITP）, with cyclosporin A （CsA） used as the control. Methods： Forty-one children of RITP were randomized into the treated group and the control group. The 21 patients in the treated group were orally given 2 to 3 DZC capsules each time, thrice a day and the 20 in the control group were given 3 mg/kg CsA per day, with 3 months as one therapeutic course. The therapeutic efficacy, platelet count and adverse reaction in the two groups were compared at the end of the course. Results： （1） In the treated group, 1 （4.8%） patient was evaluated as cured, 3 （14.3%） as markedly effective, 5 （23.8%） as effective, 5 （23.8%） as improved, 7 （33.3%） as ineffective, with the total effective rate being 66.7%; while in the control group, the corresponding numbers were 0. 2 （10.0%）, 2 （10.0%）, 3 （15.0%）, 13 （65.0%） and 35.0%, respectively, showing statistical significance in difference between the total effective rates of the two groups （ Х^2=4.11, P=0.0426）. （2） As compared with the baseline, the platelet count increased in both groups after 2 months＇ treatment （P〈0.05）. After 3 months＇ treatment, the platelet count was higher in the treated group than in the control group （P〈0.05）. （3） The improvement of hemorrhage in the treated group after 8 weeks＇ treatment was better than that in the control group （P〈0.05）. （4） No apparent adverse reaction was observed in the treated group, while in the control group, hirsutism was shown in 15 cases; gingival hyperplasia in 10; digestive reaction in 5, liver function impairment in 5, hypertension in 2 and renal impairment in 2. Conclusion： The therapeutic efficacy of DZC is better than that of CsA, and DZC shows good compliance but brings no obvious adver