Down-regulated expression of AQP5 on lung in rat DIC model induced by LPS and its effect on the development of pulmonary edema

Disseminated intravascular coagulation (DIC) is an acquired syndrome characterized by the widespread activation of coagulation, which leads to failure of multiple organs in the body. DIC of rat with lipopolysaccharide (LPS) is associated with subsequent pulmonary edema. Lung tissue is highly water permeable and expresses several aquaporins (AQPs). We therefore explored whether AQP5 involved in the pathogenesis of LPS-induced lung edema. The rats were intravenously infused with LPS (30 mg/kg) for 4 h, 6 h, 8 h, 10 h, and 12 h to induce DIC. Platelets count (PLT), D-Dimer (DD), fibrinogen (FIB), prothrombin time (PT), and activated partial thromboplastin time (APTT) were determined. Real-time quantitative PCR and Western blot were used to analyze the mRNA and protein expression of AQP5. Lung samples were stained with hematoxylin-eosin and lung wet/dry weight (W/D) ratios were measured. Here, we demonstrated that PLT and FIB values were significant decreased, the values for DD, PT, and APTT were marked increased, microthrombus was observed in lung specimens, and simultaneously with the AQP5 showed down-regulated expression following LPS infused from 4 h to 12 h. However, histopathological changes such as pulmonary edema and the increased lung W/D weight ratio were observed after LPS infused from 6 h to 12 h. These results indicated that the decreased expression of AQP5 maybe induce liquid transport obstacles between alveolar and capillary, and provides the report of AQP5 gene regulation, revealing the pathogenesis of pulmonary edema in DIC model of rat.     

不同DIC诊断评分标准对严重脓毒症患者病情评价的比较

目的:探讨不同DIC评分标准判断严重脓毒症和脓毒症休克的患者DIC和MODS发生和预后的价值。方法:收集246例严重脓毒症和脓毒症休克患者入院第1、3、7天的各项生理参数和实验室指标,分别使用ISTH显性DIC评分标准、非显性DIC评分标准和JAAMDIC评分标准进行诊断评分,同时进行SOFA评分,观察不同DIC评分标准之间确诊率、诊断时间点的差异;比较DIC确诊组间的病死率、SOFA分值的差异,绘制三种DIC评分标准的ROC曲线,计算曲线下面积,衡量各个评分系统对危重患者的病情严重程度和预后的判断准确性。结果:三种评分标准均能在一定程度上准确反映危重病患者多脏器功能衰竭的发生和预后,使用ISTH显性标准确诊的患者病死率和SOFA分值最高,诊断时间点同时或晚于ISTH非显性标准和JAAM标准;在DIC确诊组间的病死率和SOFA分值的比较上,JAAM标准与ISTH显性标准之间差异无统计学意义(P>0.05),ISTH非显性标准与ISTH显性标准之间差异有统计学意义,JAAM标准和ISTH非显性标准之间,病死率差异无统计学意义、SOFA分值差异有统计学意义;3个评分标准的ROC曲线下面积分别为0.739、0.724和0.778,相互之间比较差异均有统计学意义。结论:ISTH显性标准诊断DIC特异性最高,敏感性差;ISTH非显性标准诊断DIC敏感性最高,特异性差;JAAM标准诊断DIC敏感性和特异性均较高,对危重病患者的MODS发生和预后判断更为准确,可作为早期干预治疗的首选诊断标准。     

Tensile Behaviour of Double- and Triple-Adhesive Single Lap Joints Made with Spot Epoxy and Double-Sided Adhesive Tape

Dual adhesives are mainly used to increase the strength of single lap joints (SLJs) by reducing the stress concentration at its ends. However, they can also be used to design the characteristics of the joint so that its operation and failure occur in several stages. This paper presents the results of uniaxial tensile tests for dual-adhesive and triple-adhesive SLJs. The adherends were made of aluminum and glass fiber-reinforced polymer (GFRP) composite. For dual-adhesive SLJs, 10 epoxies and 1.6 mm thick double-sided adhesive tape were used. The stiffest (Epidian 53 (100 g) + “PAC” hardener (80 g)) and most elastic (Scotch-Weld 2216 B/A Translucent) joints were determined, which were then used in a triple-adhesive joint with the same double-sided adhesive tape. Circular holes of different diameters from 8 mm to 20 mm were made in the double-sided adhesive tape, which were filled with liquid epoxy adhesive by injection after the adherends were joined. By using the double-sided adhesive tape, the geometry of the epoxy joints was perfect, free of spews, and had a constant thickness. The effect of the spot epoxy joint diameters and the arrangement of stiff and elastic joints in the SLJs were analyzed using digital image correlation (DIC).     

急性早幼粒细胞白血病治疗体会

急性白血病(AL)系造血系统恶性克隆性疾病。按FAB分类,AL分为急性淋巴细胞白血病(ALL)和急性髓性白血病(AML)。急性早幼粒细胞白血病(APL)属FAB分类中M3型AML。APL是一种独特类型的AML,以特殊的形态学、超微结构、细胞遗传学和临床表现为特征。该型白血病出血倾向严重,易并发弥     

Mechanical Properties and Failure Behavior of Dry and Water-Saturated Foliated Phyllite under Uniaxial Compression

Phyllite is widely distributed in nature, and it deserves to be studied considering rock engineering applications. In this study, uniaxial compression tests were conducted on foliated phyllite with different foliation angles under dry and water-saturated conditions. The impacts of water content and foliation angle on the stress–strain curves and basic mechanical properties of the Phyllite were analyzed. The experimental results indicate that the peak stress and peak strain decrease first and then increase with increasing foliation angle as a U-shape or V-shape, and the phyllite specimens are weakened significantly by the presence of water. Moreover, an approach with acoustic emission, digital image correlation, and scanning electron microscopic is employed to observe and analyze the macroscopic and mesoscopic failure process. The results show that tensile microcracks dominate during the progressive failure of phyllite, and their initiation, propagation, and coalescence are the main reasons for the failure of the phyllite specimens. The water acts on biotite and clay minerals that are main components of phyllite, and it contributes to the initiation, propagation, and coalescence of numerous microcracks. Finally, four failure modes are classified as followed: (a) for the specimens with small foliation angles α = 0° or 30° (Saturated), both shear sliding and tensile-split across the foliation planes; (b) for the specimens with low to medium foliation angles α = 30° (Dry) or 45°(Saturated), shear sliding dominates the foliation planes; (c) for the specimens with medium to high foliation angles α = 45° (Dry) or 60°, shear sliding dominates the foliation planes; (d) for the specimens with high foliation angles α = 90°, tensile-split dominates the foliation planes.     

Diagnosis and treatment of bbstetrics disseminated intravascular coagulation in resource limited settings

BackgroundDisseminated intravascular coagulation (DIC) is one of the commonest causes of abnormal bleeding during pregnancy and puerperium. Its successful management is a challenging feat in resource limited settings (RLS).AimTo determine Obstetricians'' approach in diagnosing and treating obstetrics DIC in a RLSMethodA semi-structured pre-tested 4-sectioned questionnaire was used to collect demographic data of Nigerian obstetricians and data on their practice in the diagnosis and treatment of obstetrics DIC.ResultsA total of 171 obstetricians responded. Preeclampsia was the most frequent cause identified (70.2%) followed by postpartum haemorrahge (58.3%). Platelet count determination was the test mostly used (95.9%) to make a diagnosis of DIC whereas, antithrombin assay was the least (20.6%) requested investigation. While about two-third would monitor the evolution of DIC, a little less than half of the obstetricians would not repeat laboratory testing more than every 2 days, reason mainly (61.8%) due to patient''s financial constraint. Almost three-quarter of them preferred fresh whole blood as the first line of treatment of DIC.ConclusionDIC remains a challenge in the obstetrics practice in RLS especially in investigations, monitoring and index of suspicion for non-overt DIC.     

蝮蛇抗栓酶对家兔DIC肠系膜微循环障碍的影响

本实验结果表明,蝮蛇抗栓酶可明显改善微循环障碍,增快血流速度,解除RBC聚集,促进毛细血管血流再通,减少白细胞贴壁粘附(P<0.01)。证明蝮蛇抗栓酶对实验性家兔DIC有显著治疗作用。     

肝素治疗妇产科弥漫性血管内凝血的探讨

目的 探讨肝素在妇产科弥漫性血管内凝血中的应用.方法 选择本院2000年1月～2005年3月间收治并抢救的18例弥漫性血管内凝血的病例资料进行回顾分析和总结.结果 导致弥漫性血管内凝血的主要原因产后出血,其次是子痫前期,使用肝素后,抢救成功率为94.44%,死亡率为5.56%.结论 妇产科急性弥漫性血管内凝血发病急骤,病势凶险,只要做到早期诊断,正确治疗,可显著降低死亡率.     

弥散性血管内凝血患者凝血及纤溶分子标志物改变

弥散性血管内凝血(disseminated intravascular coag-ulation,DIC)是由多种因素导致毛细血管、小静脉及微动脉内形成广泛的血小板—纤维蛋白微血栓,不仅消耗了大量凝血因子和血小板,而且可进一步激活体内纤维蛋白溶解系统,在临床上主要表现为出血、溶血、栓塞、组织坏死和器官功能衰竭。过去诊断主要依靠对凝血和纤溶物质含量和活性的检测。近年来研究表明,其血浆凝血和纤溶激活的分子标志物变化具有更敏感更特异的意义,对DIC的早期诊断和观察病情具有重要的临床价值。我们对部分凝血和纤溶分子标志物在DIC患者体内的变化进行了观察,现报道如下。     

Selective inducible nitric oxide synthase inhibition attenuates organ dysfunction and elevated endothelin levels in LPS-induced DIC model rats

Summary. We examined the role of nitric oxide (NO) produced by an inducible isoform of NO synthase (iNOS) using N[6]‐(iminoethyl)‐lysine (L‐NIL), a selective iNOS inhibitor, in the rat model of lipopolysaccharide (LPS)‐induced disseminated intravascular coagulation (DIC) and investigated changes in organ function, plasma levels of NOX (metabolites of NO) and endothelin. We induced experimental DIC by the sustained infusion of 30 mg kg^?1 LPS for 4 h via the tail vein. We then investigated the effect of L‐NIL (6 mg kg^?1, from ? 0.5 to 4 h) on LPS‐induced DIC. Blood was withdrawn at 4 and 8 h, and all four groups (LPS with or without L‐NIL at 4 and 8 h) consisted of eight rats. Three of the animals in the 8‐h LPS group died, and we examined blood samples from five rats in this group. None of the other rats died. The LPS‐induced elevation of creatinine, alanine aminotransferase, glomerular fibrin deposition and plasminogen activator inhibitor was significantly suppressed by L‐NIL coadministration, although L‐NIL did not affect the platelet count, fibrinogen concentration or the level of thrombin–antithrombin complex. Moreover, plasma levels of the D‐dimer that reflect the lysis of cross‐linked fibrin were significantly increased by L‐NIL coadministration in the LPS‐induced DIC model. Plasma levels of NOX and endothelin were obviously increased by LPS infusion. However, both levels were significantly suppressed in the LPS + L‐NIL group, when compared with the LPS group. Although mean arterial pressure (MAP) was significantly decreased between 2 and 8 h compared with the control in the LPS group, this depression was significantly attenuated in the LPS + L‐NIL group. Our results suggest that NO induced by iNOS contributes to hypotension (depressed MAP), the progression of hepatic and renal dysfunction, microthrombus deposition and elevated endothelin levels in the rat model of LPS‐induced DIC.