日本血吸虫病流行区居民肝脾超声图象418例分析

本文报告了血吸虫病流行区418例居民的B超调查结果,本组人群中,肝实质改变率为36.12％,肝肿大率为30.38％,脾肿大率为31.82％,三者病理改变呈平行关系。肝实质改变率与治疗次数呈显著正向关系。肝、脾肿大率与治疗次数均存在正相关关系。肝实质改变与肝脏大小之间也存在显著相关关系,脾脏大小与肝实质的改变、肝脏大小均存在正相关关系。距滩地500m内居住居民肝实质改变、肝肿大率及脾肿大率均显著高于其它居地居民。     

The forgotten organ: contrast enhanced sonography of the spleen

OBJECTIVE: Ultrasound contrast agents in conjunction with contrast specific imaging techniques, are increasingly accepted in clinical use for diagnostic imaging in several organs. Contrast enhanced sonography (CES) of second-generation contrast media have shown a spleen-specific uptake of the microbubble contrast agent. The aim of this review is to illustrate indications for the use of CES in patients with suspected (peri-)splenic pathology. METHODS: This review based on the experience of transcutaneous CES in 200 patients with (peri-)splenic pathology diagnosed by B-mode sonography at an internal medicine center. CES studies were performed with a contrast-devoted unit (Acuson, Sequoia, Siemens medical solution) that had contrast-specific, continuous-mode software. A low mechanical index was used. A sulfur hexafluoride-based microbubble contrast medium (Sonovue, Bracco SpA, Milan, Italy) was injected. RESULTS: On our experience, there are several clinical conditions which may show an diagnostic advantage of CES in comparison to B-mode US. CES should be performed to investigate: (1) the perisplenic tumor to diagnose or exclude accessory spleen, (2) the small-sized spleen to diagnose functional asplenia/hyposplenia, (3) the inhomogenous spleen of unknown cause to diagnose focal lesions within the spleen, (4) the incidentally found hypoechoic splenic tumor to diagnose high vascular splenic hemangioma, (5) focal lesions suspect for splenic abscess, hematoma, infarction to confirme diagnosis, and (6) patients with abdominal trauma to diagnose or exclude splenic injury. CONCLUSION: CES is of diagnostic value in several clinical circumstances to diagnose accessory spleen, functional asplenia, small-sized splenic involvement, high vascular splenic hemangioma, and vascular splenic pathology like splenic infarction, splenic abscess, and splenic laceration.     

温阳健脾法对急性马兜铃酸肾病大鼠肾功能影响的研究

目的：观察温阳健脾法对急性马兜铃酸肾病大鼠肾功能及临床表现的影响。方法：采用关木通水煎剂灌胃复制急性马兜铃酸肾病大鼠模型,试验前后观察正常组、模型组、对照组、中药组大鼠血肌酐、尿素氮及临床症状积分的变化。结果：造模后大鼠均出现脾阳虚症状;造模组与正常组比较血肌酐、尿素氮均显著增高（P〈0.01）,表明造模成功;中药组和对照组与模型组比较血肌酐、尿素氮及临床症状积分均明显下降（P〈0.01）;中药组与对照组比较下降更明显（P〈0.05）。结论：关木通所致急性马兜铃酸肾病大鼠临床表现以脾阳虚为主,温阳健脾法能改善急性马兜铃酸肾病大鼠的肾功能和临床表现,提示对急性马兜铃酸肾病大鼠有良好的治疗作用。     

胃美舒冲剂联合莫沙必利治疗肝郁脾虚型功能性消化不良并抑郁症的临床疗效

目的：本研究探讨胃美舒冲剂联合莫沙必利治疗肝郁脾虚型功能性消化不良并抑郁症的临床疗效。方法：入选患者90例,通过抽签将患者随机分为两组,其中治疗组45例,对照组45例,对照组口服用莫沙必利分散片,治疗组在西药对照组的基础上,加用胃美舒免煎冲剂,水冲服300ml,每日2次,每次150ml。饭前半小时口服,连服8周。随访患者的临床症状,HAMD量表及SDS量表的得分。结果：两组患者的临床疗效果比较,治疗组的总有效率为（91.1%vs 75.6%）,差异有统计学意义,（P＜0.05）。两组在治疗后的抑郁HDMA及SDS评分比较：治疗组明显低于对照组差异均有统计学意义,（P＜0.05）;两组患者治疗后,常见不良反应轻微,两组差异无统计学意义（P＞0.05）。结论：莫沙必利的基础上加用胃美舒冲剂能够很好的改善患者的临床症状,降低了患者的抑郁相关评分,患者依从性较好,不良反应少且轻微,值得临床推广。     

Chicken embryo extracts enhance spleen lymphocyte and peritoneal macrophages function

Ethnopharmacological relevance

Traditionally, chicken embryo eggs are widely considered as an immunomodulatory health product in China and southeast Asia. Besides that, Compendium of Materia Medica, the most famous Chinese pharmacopoeia, has recorded that chicken embryo eggs contributed to the appetite increase and immune function enhancement, especially for the pregnant and aged.

Aim of the study

Through assessing the immune efficacy of the chicken embryo extracts on immunocompetent cells, the immunomodulatory mechanism and components were explored preliminarily.

Materials and methods

The raw material was subjected to in vitro gastric and pancreatic digestion successively, and then ligarine was added to separate the digested mixture to water-soluble fraction (WS) and lipid-soluble fraction (LS). Employing in vitro cell models, the immunomodulating activities of the extracts on immunosuppressed mouse were examined, at concentrations ranging from 10 to 500 μg/ml. The cell experiments consisted of the following experiments: spleen lymphocyte proliferation and IL-2 secretion, peritoneal macrophage phagocytosis and NO production. Before cell experiments, Kjeldal method and phenol–sulfuric acid method were employed respectively to determine the total protein and polysaccharide content of WS, and gas chromatography to analyze the fatty acid composition of LS.

Results

LS significantly enhanced the spleen lymphocyte proliferation and IL-2 secretion, while peritoneal macrophage phagocytosis and NO production activity were elevated by WS. Both extracts exhibited an immunomodulatory effect with a dose–effect relationship.

Conclusion

The findings confirmed the chicken embryo eggs as a potent immunopotentiator on the immunosuppressed mouse, which would be useful for the fruitful application of the chicken embryo eggs to serve as a superior immunostimulatory tonic. Furthermore, the two extracts exhibited a different bioactivity tendency which makes it a significative work to screen the bioactive component for further study.     

腹部推拿联合艾灸治疗脾虚型功能性便秘的临床疗效

目的：分析腹部推拿联合艾灸治疗脾虚型功能性便秘的临床疗效。方法：选取郑州人民医院2021年11月至2023年1月期间收治的78例脾虚型功能性便秘患者,其中艾灸治疗的39例患者纳入对照组,在艾灸治疗基础上联合腹部推拿治疗的39例患者纳入观察组。治疗后,比较两组患者临床疗效与相关临床指标。结果：观察组患者总有效率高于对照组,差异具有统计学意义（P <0.05）;治疗后,观察组患者排便次数、大便性状、盆底松弛程度、阻塞感、排便不尽感积分均低于对照组,差异具有统计学意义（P <0.05）;治疗后,观察组患者直肠肛管压差、力排时肛管残余压均低于对照组,差异具有统计学意义（P <0.05）;治疗后,观察组患者血清胃动素（MTL）、P物质（SP）水平均高于对照组,生长抑素（SS）水平低于对照组,差异具有统计学意义（P <0.05）。结论：腹部推拿联合艾灸治疗脾虚型功能性便秘可进一步改善患者相关临床指标。     

CTLA-4 Ig腺病毒基因治疗联合供体细胞输注诱导混合嵌合体和大鼠心脏移植耐受

目的　在心脏移植手术中实施CTLA 4Ig腺病毒基因治疗并联合术后输注供体骨髓细胞 ,诱导异基因大鼠心脏移植耐受 ,并对相关机制进行研究。方法　将异基因DA大鼠的心脏移植给受体LEW大鼠 ,同时经门静脉输注供体DA的脾细胞 (SC ,3× 10 8)、CTLA 4Ig腺病毒 [( 1～ 5 )× 10 9PFU ml],第 4天由舌静脉输注DA的骨髓细胞 (BMC ,3× 10 8)。观察、记录心脏移植物的存活时间。并对皮肤移植的受体作同样处理 ,观察皮肤移植存活情况。通过MLR、IL 2逆转实验及嵌合体的测定 ,探讨耐受机理 ,并检测了CTLA 4Ig的体内表达、TH1 TH2型细胞因子的表达。结果　单用CTLA 4Ig腺病毒基因治疗 ,或CTLA 4Ig腺病毒基因治疗联合单独的供体脾细胞或骨髓细胞能不同程度地延长异基因心脏移植物的存活 ,但不能延长皮肤移植物的存活。脾细胞、CTLA 4Ig腺病毒和骨髓细胞(SC Ad BMC)处理组的心脏移植物存活时间明显超过其它各耐受诱导组 ,并且能够诱导皮肤耐受。RT PCR实验证明 ,在受体内不同的组织CTLA 4Ig基因的表达量有所不同 ,并且随着时间的推移表达下降。TH1和TH2型细胞因子的检测显示 ,耐受大鼠体内未发现这两类细胞因子的偏移现象。MLR证明耐受大鼠的免疫应答表现为供体特异性降低 ,IL 2逆转实验、嵌合体检测表明 ,该耐受可能与     

Splenic abscess associated with endocarditis in a patient on hemodialysis: a case report

Splenic abscess is an unusual condition usually seen in immunocompromised patients or associated with intravenous drug abuses. Several conditions including trauma, immunodeficiency, corticosteroid and/or immunosuppressive therapy and diabetes mellitus have been listed under the predisposing factors for a splenic abscess. Splenic abscess in a patient on hemodialysis is a rare but life-threatening condition if not corrected. We describe a case of splenic abscess with bacterial endocarditis on maintenance hemodialysis. He had staphylococcal septicemia secondary to bacterial endocarditis at the mitral valve from the dialysis access-site infection. Although hematologic seeding from endocarditis has been the predisposing factor for splenic abscess, we postulate that access-site infections may predispose hemodialysis patients to splenic abscess. Splenic abscess may be considered as one of the causes when patients on hemodialysis develop unexplained fever.     

β-casomorphin-7对小鼠的免疫调节作用

目的：通过体外和体内方法研究β-casomorphin-7对小鼠脾脏淋巴细胞和腹腔巨噬细胞的作用.方法：利用脾细胞增殖试验和腹腔巨噬细胞中NO浓度的变化来研究体外不同的β-casomorphin-7浓度对脾脏淋巴细胞的增殖和腹腔巨噬细胞中NO浓度变化的影响,以及腹腔注射β-casomorphin-7和饮用β-casomorphin-7溶液对上述两个指标的影响.结果：体外试验表明,β-casomorphin-7在不同浓度对脾脏淋巴细胞的增殖显示了刺激和抑制的双向作用,而对NO的产生显示了明显的抑制作用（P＜0.01）.体内试验表明,β-casomorphin-7通过腹腔注射和饮用两种给药方式对脾淋巴细胞和腹腔巨噬细胞的作用是一致的.β-casomorphin-7显著地增强了脾淋巴细胞的增殖反应（P＜0.01）,且抑制了腹腔巨噬细胞NO的产生.结论：当前的试验表明,β-casomorphin-7具有免疫调节作用,且小鼠在2～3周龄时,可吸收入血发挥免疫调节作用.     

双歧杆菌脂磷壁酸延缓脾脏衰老的研究

目的　研究双歧杆菌表面分子脂磷壁酸 (LTA)在D 半乳糖诱导的衰老小鼠体内 ,对脾脏指数和脾细胞DNA损伤的影响。方法　在建立D 半乳糖诱导的衰老小鼠模型的同时 ,注射双歧杆菌LTA ;然后测定模型对照组、正常对照组、试验组小鼠的脾脏指数 ,并以单细胞凝胶电泳试验检测脾脏淋巴细胞DNA氧化损伤的情况。结果　与正常对照组相比 ,模型对照小鼠的脾脏指数显著升高 (P <0 .0 5 ) ,脾淋巴细胞DNA受到了较严重的损伤 (P <0 .0 5 ) ;用双歧杆菌LTA处理后 ,试验小鼠的脾脏指数明显下降 (P <0 .0 5 ) ,脾淋巴细胞DNA的损伤程度显著降低 (P <0 .0 5 )。结论　双歧杆菌LTA能显著抑制衰老小鼠脾脏淋巴细胞DNA的氧化损伤 ,这可能与双歧杆菌抗衰老有关。