阿奇霉素对哮喘二级预防的作用探讨

目的 通过检测炎性因子嗜酸细胞阳离子蛋白(eosinophile cationic protein,ECP)、白细胞介素-8(IL-8)、一氧化氮(No)的变化探讨阿奇霉素对哮喘高危儿气道炎症的影响及其对哮喘二级预防的作用.方法 选择初次喘息发作的具有特应性体质的毛细支气管炎患儿共223例,所有患儿应用常规治疗(β<,2>受体激动剂口服平喘,抗病毒治疗),症状控制(喘息基本消失)后随机分成四组:A组(57例)应用阿奇霉素口服(5mg/kg,每周2次,连用3个月),B组(54例)应用布地奈德混悬液氧喷(1/2支,每天2次,连用3个月),C组(57例)应用孟鲁斯特咀嚼片口服(4mg,每晚1次,连用3个月),D组(55例)空白对照,仅对症治疗.A、B、C三组均治疗3个月,分别在住院当日、用药干预前、干预后抽取静脉血,利用酶联免疫吸附测定试剂盒检测各组患儿血清中ECP、IL-8的浓度,硝酸酶还原法测NO,临床门诊及电话随访一年.结果 (1)ECP、IL-8、NO水平在A、B、C三组用药干预前与D组比较,以及A、B、C三组之间比较差异均无统计学意义,具有可比性;(2)A、B、C三组ECP、IL-8、NO水平用药后均下降,D组也有所下降,A、B、C三组与D组比较差异均有统计学意义(P均<0.01);A、B、C三组用药后ECP及NO下降水平,A组与B组比较差异无统计学意义(P>0.05),C组下降幅度较大,与A组比较差异有统计学意义(P<0.01);A、B、C三组用药后IL-8下降水平,A组幅度较大,与B、C组比较差异均有统计学意义(P均<0.01).(3)3个月内喘息再次发作人数及一年后哮喘发生情况,A、B、C三组较D组均有所减少,但与D组比较差异均无统计学意义(P>0.05),A组与B、C两组比较差异也无统计学意义(P>0.05).结论 (1)阿奇霉素对哮喘高危儿的炎性细胞因子ECP、IL-8、NO具有下调作用,对IL-8的下调作用尤为明显.(2)阿奇霉素对哮喘高危儿的ECP、NO的下调作用与布地奈德相似,但与孟鲁斯特比较有差异,对IL-8的下调作用比布地奈德及孟鲁斯特明显.(3)阿奇霉素对哮喘的二级预防具有一定的临床意义.     

糖皮质激素治疗二氧化氮致大鼠急性肺水肿实验初步研究

目的 探讨糖皮质激素对二氧化碳(NO2)所致大鼠急性肺水肿的治疗效果.方法 将SD大鼠随机分为空白对照组、染毒组及大、中、小剂量糖皮质激素治疗组,每组6只.空白对照组予净空气平衡30 min,染毒组及大、中、小剂量糖皮质激素治疗组在NO2染毒后分别给予生理盐水2.5 mg/kg和地塞米松6.0、3.0、1.0 mg/kg.测定大鼠肺湿干重比(W/D),用ELISA法测定血浆心房利尿钠肽(ANP)含量、全血超氧化物歧化酶(SOD)活力及血浆中白细胞介素-6(IL-6)、IL-10、肿瘤坏死因子-α(TNF-α)、γ-干扰素(IFN-γ)的含量.结果 与空白对照组比较,大、中、小剂量激素治疗组及染毒组大鼠肺W/D明显升高,差异有统计学意义(P<0.05);与染毒组比较,大、中、小剂量激素治疗组大鼠肺W/D明显降低,差异有统计学意义(P<0.05).与空白对照组比较,大、中、小剂量激素治疗组及染毒组大鼠全血中SOD活力明显降低,差异有统计学意义(P<0.05);与染毒组比较,大、中、小剂量激素治疗组全血中SOD活力无明显改变,差异无统计学意义(P>0.05).与空白对照组比较,染毒组大鼠血浆中ANP含量明显升高,差异有统计学意义(P<0.05);与染毒组比较,大、中、小剂量激素治疗组大鼠血浆中ANP含量明显降低,差异有统计学意义(P<0.05).与染毒组[(68.55±27.84)pg/ml]比较,大、中、小剂量激素治疗组大鼠血浆中TNFα含量[分别为(27.04±8.19)、(40.10±9.09)、(39.76±9.60)pg/ml]明显降低,差异有统计学意义(P<0.05).与染毒组[(29.29±9.31)pg/ml]比较,大、中剂量激素治疗组大鼠血浆中IL-6含量[分别为(15.97±6.18)、(19.69±5.52)pg/ml]降低,差异有统计学意义(P<0.05).与染毒组[(44.38±9.19)pg/ml]比较,大、中、小剂量激素治疗组大鼠血浆中IL-10含量[(23.24±5.14)、(27.78±8.17)、(33.29±10.42)pg/ml]降低,差异有统计学意义(P<0.05).与染毒组[(30.83±6.82)pg/ml]比较,大、中剂量激素治疗组大鼠血浆中IFN-γ含量[分别为(7.21±4.55)、(19.23±4.35)pg/ml]降低,差异有统计学意义(P<0.05).结论 大、中、小剂量糖皮质激素均具有改善肺泡壁和毛细血管的通透性及非特异性的抗炎作用,对肺水肿有明显的治疗作用,在降低炎性因子方面,以大、中剂量激素治疗组效果更为明显.     

Can an adequate energy intake be able to reverse the negative nitrogen balance in mechanically ventilated critically ill patients?

Purpose

Adequate energy provision and nitrogen losses prevention of critically ill patients are essentials for treatment and recovery. The aims of this study were to evaluate energy expenditure (EE) and nitrogen balance (NB) of critically ill patients, to classify adequacy of energy intake (EI), and to verify adequacy of EI capacity to reverse the negative NB.

Methods

Seventeen patients from an intensive care unit were evaluated within a 24-hour period. Indirect calorimetry was performed to calculate patient's EE and Kjeldhal for urinary nitrogen analysis. The total EI and protein intake were calculated from the standard parenteral and enteral nutrition infused. Underfeeding was characterized as EI 90% or less and overfeeding as 110% or greater of EE. The adequacy of the EI (EI EE⁻¹ × 100) and the NB were estimated and associated with each other by Spearman coefficient.

Results

The mean EE was 1515 ± 268 kcal d⁻¹, and most of the patients (11/14) presented a negative NB (−8.2 ± 4.7 g.d⁻¹). A high rate (53%) of inadequate energy intake was found, and a positive correlation between EI EE⁻¹ and NB was observed (r = 0.670; P = .007).

Conclusion

The results show a high rate of inadequate EI and negative NB, and equilibrium between EI and EE may improve NB. Indirect calorimetry can be used to adjust the energy requirements in the critically ill patients.     

牛磺酸治疗对冠心病伴高脂血症患者血脂和NO的影响

目的观察牛磺酸对冠心病患者血脂和一氧化氮（NO）的影响。方法将69例稳定性冠心病伴高脂血症患者随机分为治疗组（36例）和对照组（33例）。在常规治疗的基础上治疗组口服牛磺酸（400mg/d）,对照组不加降脂药物,疗程均为6周。结果疗程结束后治疗组血脂和NO指标改善情况均明显优于对照组,差异具有显著性意义（P〈0.05）。结论牛磺酸对冠心病患者具有良好的降脂效应和改善血管内皮功能效应,对冠心病有治疗作用。     

2013~2015年济南市大气污染物SO2和NO2对居民心血管疾病应急呼叫事件影响的急性效应

目的 定量分析济南市大气污染物SO₂和NO₂对居民心血管疾病应急呼叫事件的急性影响。 方法 描述性分析2013~2015年济南市逐日气象、空气污染物和居民心血管疾病应急呼叫事件资料。采用基于Quasi-Poisson回归的广义相加模型分别进行SO₂、NO₂与逐日居民心血管疾病应急呼叫事件的单污染物模型、滞后效应(lag1~lag7)和累积滞后效应(lag01~lag07)分析。计算污染物浓度每升高10 μg/m³,居民心血管疾病应急呼叫事件风险增加的超额危险度及95%置信区间(95%CI)。 结果 2013~2015年济南市逐日SO₂、NO₂浓度水平及居民心血管疾病应急呼叫事件数的均值分别为73 μg/m³、55 μg/m³及17人。SO₂、NO₂浓度每升高10 μg/m³,当日(lag0)居民心血管疾病应急呼叫事件风险可分别增加0.41%(95%CI:0.10%~0.72%)和0.99%(95%CI:0.27%~1.71%),同时存在显著的累积滞后效应。 结论 济南市大气污染物SO₂、NO₂均对居民心血管疾病应急呼叫事件风险存在急性效应。     

Protein intake and nitrogen balance in male non-active adolescents and soccer players

Recommendations for the requirements for protein intake amount usually to 0.8–1.0 g·kg^–1 body mass·day^–1 in adolescents without any reference to the undertaking of acute exercise or to the training status. The present investigation intended to determine the nitrogen balance and protein intake in 8 healthy male non-active adolescents and 11 adolescent soccer players, both groups aged about 15 years. An assessment of nutrient intake was obtained by analysing 7 day food records collected by a questionnaire. Nitrogen excretion rate was determined and nitrogen balance was calculated from the mean daily protein intake and the urinary excretion. The results showed that the nutritional status of the two groups was similar. Nevertheless, we found that their diets were quite inappropriate in terms of the intakes of carbohydrate, some minerals (zinc, calcium, magnesium), vitamins (A, B6, D) and fibre. A positive nitrogen balance was observed from a mean protein intake of 1.57 g·kg^–1 body mass·day^–1 in these adolescents, whether they were non-active or athletes. Thus, the present investigation indicated that the growth and development in non-active adolescents and in adolescent soccer-players give rise to a need for a higher protein intake than is usually recommended. However, the higher protein requirements did not seem to be related only to the increased energy expenditure imposed by the exercise training in the soccer-player group. Electronic Publication     

空气SO2和NOx污染及灰色动态预测

目的：分析并预测上海火车站（上海站）地区空气SO2和NOx污染状况，方法：运用灰色系统方法并根据上海站大气监测点1988－1999年空气SO2和NOx的监测数据建立灰色动态预测模型并进行预测，结果：1988－1999年上海站地区空气SO2和NOx污染水平逐年下降，2000－2002年预测SO2平均浓度一，四季度为0．0216mg/m^3,二，三季度为 0．0142mg/m^3,预测NOx平均浓度一，四季度为0．0706mg/m^3，二，三季度为0．0492mg/m^3，结论：灰色模型适合上海站地区空气SO2和NOx的污染预测。     

Transformants of Neurospora crassa with the nit-4 nitrogen regulatory gene: copy number,growth rate and enzyme activity

Summary nit-4 is a pathway-specific regulatory gene which controls nitrate assimilation in Neurospora crassa, and appears to mediate nitrate induction of nitrate and nitrite reductase. The NIT4 protein consists of 1090 amino-acid residues and possesses a single GAL4-like putative DNA-binding domain plus acidic, glutaminerich, and polyglutamine regions. Several mutants with amino-acid substitutions in the putative DNA-binding domain and a nit-4 deletion mutant, which encodes a truncated NIT4 protein lacking the polyglutamine region, are functional, i.e., they are capable of transforming a nit-4 mutant strain. However, transformants obtained with most of these nit-4 mutant genes possess a markedly reduced level of nitrate reductase and grow only slowly on nitrate, emphasizing the need to examine quantitatively the affects of in vitro-manipulated genes. The possibility that some mutant genes could yield transformants only if multiple copies were integrated was examined. The presence of multiple copies of wild-type or mutant nit-4 genes did not generally lead to increased enzyme activity or growth rate, but instead frequently appeared to be detrimental to nit-4 function. A hybrid nit-4-nirA gene transforms nit-4 mutants but only allows slow growth on nitrate and has a very low level of nitrate reductase.     

婴儿手术前后能量代谢和氮平衡变化的初步观察

对24例1岁以内普外手术无并发症的病儿围手术期应用间接热卡计(Indirect Calorimetry)对静息能量消耗(REE)进行了测定,并对其中14例进行了手术前后氮平衡的观察。结果显示:1、术前REE与体重(r=0.93),体表面积(r=0.88),年龄(r=0.86)和身高(r=0.84)相关。2、手术前第1天及术后第1～5天的REE结果差异无显著性(P>0.05)。3、术后及早补充氮能不同程度地纠正负氮平衡,甚至获得正氮平衡。