Pentoxifylline reduces indirect lung injury of fresh water drowning in canis

BACKGROUND: Previous studies have suggested that pentoxifylline (PTX) exerts multiple beneficial effects on the inflammatory cascade, particularly on the function of neutrophils. We investigated whether continuous infusion of PTX could reduce indirect lung injury (ILI) caused by fresh water drowning and if so, what is the possible molecular mechanism. METHODS: Twenty 4 male canis were divided randomly into control group, fresh water drowning group (right lung), drowning treated with PTX group and PTX alone group. At different time points after drowning, the changes of hemodynamic parameters and wet/dry weight of indirect lung (left lung) tissues were compared among these 4 groups. Other measures included lung histopathology, PMN infiltration assessed by immune staining, CD11b, ICAM-1 mRNA and TNF-alphamRNA in left lung detected by RT-PCR. NF-kappaB activation in blood neutrophils and lungs were measured with electrophoretic mobility shift assay (EMSA). RESULTS: Animals treated with PTX showed a significant reduction in lung injury. PTX suppressed drowning-induced ICAM-1 and TNF-alphamRNA elevation and inhibited NF-kappaB activation in blood neutrophils and lungs. CONCLUSIONS: Continuous infusion of PTX reduces ILI caused by fresh water drowning. PTX decreases expression of ICAM-1 and TNF-alpha, possibly via inhibition of NF-kappaB.     

豚鼠结肠肌间神经丛促皮质激素释放激素神经元的表达及其生理特性

目的：研究促皮质激素释放激素(corticotrophin releasing hormone，CRF)在豚鼠结肠肌间神经丛的表达和生理功能。方法：RT-PCR、免疫荧光组织化学染色检测CRF在结肠肠肌层神经丛的表达；细胞内电生理记录结合生物素示踪法研究CRF在肠道的生理功能。结果：豚鼠的肠肌间神经丛有CRF mRNA的表达；豚鼠结肠肠肌间神经丛中有表达CRF的神经元，其形态均为DogielⅠ型神经元。CRF对豚鼠结肠肌间神经丛有很强的兴奋作用，可诱发慢的兴奋性去极化反应，而且CRF所兴奋的神经元均为表达CRFI受体的神经元。结论：CRF是肠道神经系统的兴奋性神经递质。     

氟乙酰胺中毒的抢救与护理对策

目的 总结氟乙酰胺中毒的抢救与护理措施.方法 有效彻底洗胃,准确使用解毒剂,给予针对性的心理疏导.结果 64例氟乙酰胺中毒患者经抢救,治愈63例,死亡1例,未出现再度自杀病例.结论 迅速有效的抢救可提高抢救成功率,护理对策得当能减少死亡率,预防患者再度自杀.     

造血干细胞移植相关性肠道血栓性微血管病:临床病理学特征、诊断标准和治疗

异基因造血干细胞移植（allo-HSCT）后肠道血栓性微血管病（TMA）是一种少见的、致死性的、临床表现酷似肠道GVHD的合并症，此前国内尚无报道。自2002年5月至2004年7月，在本研究所接受allo-HSCT的患者总计373例，其中184例为HLA配型全相合，189例为HLA配型至少1个位点不合的亲缘供者移植。为探索TMA的临床及其病理学特征，本研究将其中30例allo-HSCT后因严重腹泻接受结肠镜以及病理检查的患者活检组织样本进行复检研究。结果发现，7例患者样本具有TMA特征性病理学改变，占活检例数的23．3％（7／30）。全部患者均伴有巨细胞病毒（CMV）血症和CMV疾病（CMV-IP5例、CMV肠炎2例）；5例伴有乳酸脱氢酶（LDH）增高。TMA组织学特征是多发性微血管管腔内血小板-纤维素血栓；血管内皮细胞肿胀、剥脱，伴有或不伴有血管周围出血。3例样本兼有TMA和GVHD的病理学特征；4例具备TMA的病理学特征而无GVHD的组织学改变。3例患者临床表现酷似急性缺血性肠炎，均有间断性或持续性鲜血便、明显腹痛伴有迅速发展的溶血性贫血、顽固性血小板减少、肝静脉阻塞综合征（VOD）、毛细血管渗漏综合征以及低蛋白血症。在移植后活存101-254天。结论：诊治肠道GVHD的同时应排查TMA，病理学特征可资鉴别；与此同时，初步研究首次证实TMA和TMA-GVHD各自具有特定病理特征，其治疗反应及转归也有差异。     

悬吊运动技术对运动引起的腰痛的疗效分析

目的：观察悬吊运动技术（SET）对运动引起的腰痛的疗效，并与传统推拿治疗比较，为推广新的物理疗法提供依据。方法：将29例因运动引起腰痛的受试者随机分为两组，SET组15例，推拿组14例，分别进行SET治疗和推拿治疗，疗程共8周，实验开始和结束时进行VAS评分和血清CK、LDH测试。结果：①VAS评分在治疗后分别为SET治疗组1.76±1.58，推拿治疗组3.08±2.35，与治疗前相比均明显下降(P<0.01),且SET组低于推拿组(P<0.01)；②血清测试中，CK治疗后分别为SET治疗组41.32±6.88，推拿组48.75±7.12，LDH治疗后分别为SET组866±100.02，推拿组955±102.6，CK与LDH治疗后均明显下降(P<0.01)，LDH变化SET组更加明显(P<0.05)，但CK变化与推拿组相比不明显。结论：悬吊运动技术对运动性腰痛有着较好的治疗效果，由于SET技术具有明显缓解疼痛症状和治疗作用和降低血清LDH指标的效果，作为较新的无创理疗技术值得推广使用。     

清热利湿祛瘀法治疗慢性前列腺炎的临床疗效及对患者局部免疫的影响

目的:探究清热利湿祛瘀法治疗慢性前列腺炎的临床疗效,分析其对患者局部免疫功能的影响。方法:选取2017年1月至2017年6月南京中医药大学附属医院收治的慢性前列腺炎患者228例,按随机数字表法分为对照组和观察组,每组114例,2组患者均进行常规西药治疗,观察组在对照组治疗的基础上联合清热利湿祛瘀汤治疗,2组均以14 d为1个疗程,连续治疗3个疗程。治疗后统计2组临床疗效,评价2组治疗前后临床症状改善情况;分别于治疗前后检测并比较2组患者前列腺液中WBC及免疫指标的变化。结果:治疗后观察组临床总有效率高达93.86%,较对照组的73.68%显著升高(P0.01);与治疗前比较,治疗后2组患者IIEF评分明显升高,且观察组显著高于对照组(P0.01);2组患者NIH-CPSI评分及QOL评分明显降低,且观察组显著低于对照组(P0.01);与治疗前比较,治疗后2组患者前列腺液WBC均明显降低(P0.05或P0.01),且观察组显著低于对照组(P0.05);与治疗前比较,治疗后观察组前列腺液中SIg A及Ig G含量均显著降低,且显著低于对照组(P0.01)。结论:清热利湿祛瘀法可显著改善慢性前列腺患者临床症状,抑制其局部炎性反应,并可有效降低其前列腺液中免疫球蛋白含量,调节局部免疫应答,疗效显著优于常规西药治疗。     

清肺解毒饮治疗肺胃蕴热型痤疮临床研究

目的 评价清肺解毒饮治疗肺胃蕴热型痤疮的疗效.方法 将符合入选标准的93例女性痤疮患者按随机数字表法随机分为3组,每组31例.观察组口服清肺解毒饮,中药对照组口服丹参酮胶囊,西药对照组口服醋酸环丙氯地孕酮,3组均治疗4周.采用ELISA法检测血清双氢睾酮(dihydrotestosterone,DHT)、IL-6、IL-8水平,观察治疗前后的皮损变化,记录治疗期间的不良反应,评价临床疗效.结果 治疗后,观察组血清DHT[(56.94±15.74)pg/ml比(74.48±18.53)pg/ml,t=2.089]、IL-6[(22.84±11.77)pg/ml比(30.37±14.50)pg/ml,t=2.135]、IL-8[(22.64±7.38)pg/ml比(29.54±9.65)pg/ml,t=2.057]水平均低于中药对照组(P<0.05).治疗后,观察组皮损消退率[(65.4±15.0)%比(44.7±12.9)%、(42.7±13.6)%,F=6.862]与综合证候有效率[(57.2±12.6)%比(46.3±12.8)%、(44.8±11.7)%,F=5.322]均高于中药对照组与西药对照组(P<0.05).观察组与中药对照组均未见明显不良反应,西药对照组有1例恶心.结论 清肺解毒饮可降低女性肺胃蕴热型痤疮患者血清DHT、IL-6、IL-8水平,提高皮损消退率与综合证候有效率,疗效优于口服丹参酮胶囊或醋酸环丙氯地孕酮治疗.     

An evaluation of the 2010 histopathological classification of anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis: a Bayesian network meta-analysis

Background

In 2010, a new histopathological classification of ANCA-associated glomerulonephritis (ANCA-GN) based on four categories (focal, crescentic, mixed, and sclerotic) was proposed to predict renal outcome. However, this classification was the source of much debate in different populations. We aimed to evaluate this classification scheme in terms of renal survival using Bayesian network meta-analysis.

Methods

We searched Pubmed, Embase, and Medline for articles published between 1 October 2010 and 9 August 2017 that assessed the predictive value of this classification. We pooled hazard ratios (HRs) for end-stage kidney disease (ESRD) among the four categories using a Bayesian random-effects model. Clinical factors that could potentially influence renal outcome among the different trials were explored by meta-regression.

Results

Sixteen case-controlled studies, including a total of 1945 patients with 1695 endpoint events, were included. Compared with sclerotic, the HRs for ESRD were 0.45 [95% confidence interval (CI) 0.26–0.79] for crescentic, 0.34 (0.22–0.51) for mixed, and 0.24 (0.12–0.51) for focal. Pooled results showed no obvious difference between the crescentic and the mixed sub-groups (HR 1.35; 95% CI 0.90–2.0). Baseline eGFR (P?=?0.002) and the ANCA serology (P?=?0.029) were associated with renal survival.

Conclusions

The 2010 ANCA-GN classification and the extent of ANCA serology and baseline eGFR were shown to be significant predictors of renal outcome, although there was no significant prognostic difference between crescentic and mixed. The ANCA-GN classification scheme should, therefore, be optimized by combining with other established parameters, such as tubular atrophy and the proportion of normal glomeruli.