半合成甘油脂肪酸酯栓剂基质的多晶型变化研究

本文对半合成甘油脂肪酸酯栓剂基质进行了多晶型变化研究,加速试验发现基质在贮藏期中熔点逐步上升,软化时间也逐步延长,X线衍射测定表明有多晶型变化,从非稳定的A型转变成稳定的B型,由此带来一系列物理性变化。晶型转化的速度与温度有关,30℃时4～6d即达到稳定,而在室温下则需要更长的时间。为了保证质量,建议新制基质的熔点应控制在34～35℃之间。     

培养乳鼠心肌细胞缺氧／复氧损伤模型与黄芩苷的影响

目的:观察黄芩苷对纯化培养乳鼠心肌细胞缺氧/复氧损伤的保护作用及其作用机制。方法:实验于2006-11/2007-01在郑州大学医学院药理实验室完成。①实验分组:选用出生1～3d的SD大鼠20只,雌雄不拘,培养乳鼠心肌细胞建立缺氧/复氧损伤模型。实验分为5组:正常对照组以正常细胞培养,加入等数量的培养基,不加入任何药物,缺氧/复氧损伤模型组,缺氧/复氧损伤 0.1mg/L黄芩苷组,缺氧/复氧损伤 1mg/L黄芩苷组,缺氧/复氧损伤 10mg/L黄芩苷组。②实验评估:采用乳酸脱氢酶试剂盒测其释放量;采用黄嘌呤氧化酶法测定超氧化物歧化酶活力;硫代巴比妥酸显色法测定丙二醛含量;四唑盐比色法测定心肌细胞活力。结果:①丙二醛含量和乳酸脱氢酶活力:缺氧/复氧损伤组明显高于正常对照组(P<0.01),缺氧/复氧 10,1,0.1mg/L浓度黄芩苷组明显低于缺氧/复氧损伤组(P<0.01)。②心肌细胞超氧化物歧化酶活性:缺氧/复氧损伤组明显低于正常对照组(P<0.01),黄芩苷 10,1,0.1mg/L浓度黄芩苷组明显高于缺氧/复氧损伤组(P<0.01)。③心肌细胞活力:缺氧/复氧损伤组心肌细胞活力明显低于正常对照组,缺氧/复氧 10,1,0.1mg/L浓度黄芩苷组明显高于缺氧/复氧损伤组(P<0.01)。结论:黄芩苷具有对缺氧/复氧损伤所致心肌细胞的保护作用,可能与其抗氧化、抗自由基有关。     

Intracellular signaling mechanisms regulating the activation of human?eosinophils by the novel Th2 cytokine IL-33: implications for allergic?inflammation

The novel interleukin (IL)-1 family cytokine IL-33 has been shown to activate T helper 2 (Th2) lymphocytes, mast cells and basophils to produce an array of proinflammatory cytokines, as well as to mediate blood eosinophilia, IgE secretion and hypertrophy of airway epithelium in mice. In the present study, we characterized the activation of human eosinophils by IL-33, and investigated the underlying intracellular signaling mechanisms. IL-33 markedly enhanced eosinophil survival and upregulated cell surface expression of the adhesion molecule intercellular adhesion molecule (ICAM)-1 on eosinophils, but it suppressed that of ICAM-3 and L-selectin. In addition, IL-33 mediates significant release of the proinflammatory cytokine IL-6 and the chemokines CXCL8 and CCL2. We found that IL-33-mediated enhancement of survival, induction of adhesion molecules, and release of cytokines and chemokines were differentially regulated by activation of the nuclear factor (NF)-κB, p38 mitogen-activated protein kinase (MAPK) and extracellular signal-regulated kinase (ERK) pathways. Furthermore, we compared the above IL-33 activities with two structurally and functionally related cytokines, IL-1β and IL-18. IL-1β, but not IL-18, markedly upregulated cell surface expression of ICAM-1. IL-1β and IL-18 also significantly enhanced eosinophil survival, and induced the release of IL-6 and chemokines CXCL8 and CCL2 via the activation of the NF-κB, p38 MAPK and ERK pathways. Synergistic effects on the release of IL-6 were also observed in combined treatment with IL-1β, IL-18 and IL-33. Taken together, our findings provide insight into IL-33-mediated activation of eosinophils via differential intracellular signaling cascades in the immunopathogenesis of allergic inflammation.     

Critical Appraisal on the Role and Outcome of Emergency Colectomy for Uncomplicated Right-sided Colonic Diverticulitis

Background Emergency colectomy is well accepted for treating complicated right-sided colonic diverticulitis. However, the role of colectomy for uncomplicated diverticulitis is not well defined. The aim of this study was to evaluate the short-term and long-term surgical outcome of uncomplicated right-sided diverticulitis in our locality. Patients and Methods Retrospective chart review of patients operated for right-sided diverticulitis over a 20-year period was conducted. Recurrent attacks of right-sided diverticulitis, re-operation rate and re-hospitalisation rate were the long-term parameters of interest. An updated telephone interview was carried out for all surviving patients. Results Seventy-four patients (35 males and 39 females), median age 35.5 (range 16–70) years, were operated for uncomplicated diverticulitis. Thirty patients underwent colectomy, whereas the others underwent appendectomy with diverticulectomy (n = 8) or appendectomy alone (n = 36). All short-term parameters were less favourable for the colectomy group, including higher complication rate, slower return of gastrointestinal function, higher requirement of parenteral analgesic and longer hospital stay. Without colectomy, only 2 patients developed recurrent diverticulitis necessitating hospitalisation, both of whom resolved on conservative treatment. On the other hand, 1 patient required re-operation after colectomy because of intestinal obstruction. The overall re-hospitalisation rate was comparable between the colectomy and the non-colectomy group (16.7% vs. 13.6%). Conclusions Emergency colectomy can eradicate suspicious lesions and eliminate risk of recurrent diverticulitis but at the expense of higher morbidity rates. As the natural course of uncomplicated right-sided colonic diverticulitis is usually benign, conservative treatment with minimal surgery may be a better therapeutic option.     

老年阻塞性睡眠呼吸暂停综合征与心血管疾病的研究进展

0 引言 睡眠呼吸暂停综合征(sleep apnea syndrome, SAS)是指每晚7 h睡眠中出现持续10 s以上的呼吸暂停大于30次或睡眠呼吸暂停/低通气指数(AHI,即平均每小时呼吸暂停次数 低通气次数)≥5,60岁以上老年人AHI≥10.SAS分为三型,即阻塞性(obstructive sleep apnea, OSA)、中枢性(central sleep apnea, CSA)和混合性(mixed sleep apnea, MSA).     

Sonographic estimation of fetal weight in maerosomic fetuses: diabetic versus non-diabetic pregnancies

The objective of this study is to compare the accuracy of sonographic estimation of fetal weight of macrosomic babies in diabetic vs non-diabetic pregnancies. All babies weighing 4,000 g or more at birth, and who had ultrasound scans performed within one week of delivery were included in this retrospective study Pregnancies with diabetes mellitus were compared to those without diabetes mellitus. The mean simple error (actual birthweight--estimated fetal weight); mean standardised absolute error (absolute value of simple error (g)/actual birthweight (kg)); and the percentage of estimated birthweight falling within 15% of the actual birthweight between the two groups were compared. There were 9,516 deliveries during the study period. Of this total 1,211 (12.7%) babies weighed 4,000 g or more. A total of 56 non-diabetic pregnancies and 19 diabetic pregnancies were compared. The average sonographic estimation of fetal weight in diabetic pregnancies was 8% less than the actual birthweight, compared to 0.2% in the non-diabetic group (p < 0.01). The estimated fetal weight was within 15% of the birthweight in 74% of the diabetic pregnancies, compared to 93% of the non-diabetic pregnancies (p < 0.05). In the diabetic group, 26.3 % of the birthweights were underestimated by more than 15 %, compared to 5.4% in the non-diabetic group (p < 0.05). In conclusion, the prediction accuracy of fetal weight estimation using standard formulae in macrosomic fetuses is significantly worse in diabetic pregnancies compared to non-diabetic pregnancies. When sonographic fetal weight estimation is used to influence the mode of delivery for diabetic women, a more conservative cut-off needs to be considered.     

SLICE: An algorithm for incorporating ultrasonography in the assessment of shocked or breathless patients

SLICE is an algorithm for the integration of point-of-care ultrasound in the assessment and resuscitation of the shocked or breathless patient. It aims to determine the patient's fluid status, and identify reversible causes for the patient's clinical picture. SLICE stands for ‘In a patient who is Shocked/Short of breath, scan the Lungs, IVC, Cardiac and Extra regions as indicated’. Its key advantages are that it explicitly guides resuscitative fluid management, can be performed rapidly and by clinicians with a broad range of sonographic experience, and can be used in a broad range of clinical scenarios. Its use has been successfully taught and implemented in routine clinical practice at our local institution.