体外循环与全身炎症反应综合征

体外循环 (cardiopulmonarybypassCPB)能够引起以心血管功能和肺功能改变为特征的全身炎症反应综合征 (systemicinflammatoryresponsesyndromeSIRS)。虽然大多数病人CPB引起的SIRS仅表现为一定程度的器官功能障碍 ,经过病人机体的自身调节、临床干预等措施 ,患者的死亡率很低 ,但如患者伴有严重的肺损伤或合并其它重要器官的严重功能障碍 ,则可导致SIRS发展失控 ,患者的死亡率可明显增高。因此 ,充分认识CPB引起SIRS的病理生理机制对于降低高风险患者的死亡率、保证CPB下的心血管手术更安全具有十分重要的意义。1　CPB引起SIR…     

Thl/Th2型细胞因子与妊高征相关性的研究

目的 :探讨 Thl/ Th2型细胞因子与妊高征的相关关系。方法 :随机抽取 4 2例妊高征孕妇和 30例正常孕妇静脉血 ,采用 RIA、EL ISA法检测其血清中 TNF- α、IL- 10水平。结果 :与正常孕妇相比 ,妊高征患者 TNF- α水平显著升高 ,有统计学意义 (P<0 .0 5 ) ;IL - 10水平下降 ,有显著性差异 (P<0 .0 5 ) ;IL— 10 / TNF-α比值下降 ,差异有显著性 (P<0 .0 1)且 TNF-α水平与收缩压、舒张压、平均动脉压、尿蛋白半定量及水肿和水肿级别呈显著正相关。而 IL - 10和 IL - 10 / TNF-α比值与收缩压、舒张压、平均动脉压及尿蛋白呈显著负相关。结论 :妊高征患者存在 Thl/ Th2型细胞因子网络失衡 ,与病情密切相关     

术后早期炎性肠梗阻的诊治体会

术后早期炎性肠梗阻 (early postoperative inflammatoryileus,EPII)发生在腹部手术后早期 ,多数为术后 1～ 2周内出现 ,由于腹部手术创伤或腹内炎症等原因导致肠壁水肿和渗出 ,形成一种机械性与动力性同时存在的粘连性肠梗阻。与其它类型的肠梗阻相比 ,有其特殊的病因及病理发展过程 ,因而处理上与其它肠梗阻有较大差别。本文收集我院1996～ 2 0 0 2年诊治的 EPII共 18例 ,现分析如下。1　临床资料1.1　一般资料 :本组 18例 ,男 14例 ,女 4例 ,年龄 7～ 6 9岁。我科手术后发生 5例 ,外院手术后转入 13例。肠梗阻术后 6例 ,消化性溃疡穿…     

静注丙种球蛋白治疗RSV毛细支气管炎的疗效观察

1　对象和方法1.1　对象　 2 0 0 2 - 10～ 2 0 0 3 - 0 2我科住院的毛细支气管炎 (简称毛支 )患儿 ,诊断符合《实用儿科学》毛支诊断标准 ,鼻咽分泌物呼吸道合胞病毒 (RSV)检测阳性的毛支患儿 6 0例 ,男 4 0例 ,女 2 0例 ,年龄 4 0日龄～ 18月龄 ,随机分为治疗组 3 0例 ,常规组 3 0例。两组在年龄、性别、病情严重程度方面无显著差异。取正常 2 5例为对照组 ,系年龄、性别相匹配的健康儿童 ,采血前 2周无感染史。1.2　方法　治疗组在常规治疗基础上 ,于入院后 4 8h内加用静注丙种球蛋白 (IVIG) (卫生部成都生物制品所 ) 1g/ (kg· d)静…     

CpG ODN刺激的寻常性银屑病中性粒细胞培养上清液对HaCaT细胞增殖的影响

Objective To investigate the role of nentrophils in the pathogenesis of psoriasis vulgaris. Methods Neutrophils were isolated from venous blood samples of 25 patients with psoriasis vulgaris (including 13 cases of active psoriasis and 12 cases of inactive psoriasis) as well as 25 normal human con-trols, and cultured. Then, these neutrophils were grouped and treated with lipopolysaccharide (LPS, 100 g/L),CpG-A (50 mg/L), CpG-B (50 mg/L), and RPMI 1640 culture medium, respectively, for 24 hours followed by the collection of culture supematants. Human keratinocytes (HaCaT) were cultured in the presence of su-pematants of treated or untreated nentrophils for 72 hours followed by the detection of cell proliferation with MTT assay. To determine the role of proinflammatory factors, SOD/CAT and monoclonal antibody to IL-8 and TNF-alpha of 400 u/mL were used to pretreat HaCaT cells 1 hour prior to the stimulation with super-natants of neutrophils. Results Compared with culture medium, the supematant of unstimulated neutrophils from normal controls or patients with inactive psoriasis had no significant effect on the proliferation of HaCaT cells (P ＞ 0.05), but that from patients with active psoriasis markedly promoted the proliferation of HaCaT cells (t = 2.41, P < 0.05). ARe, stimulation by LPS, CpG-A and CpG-B, the supematant of active patient-derived neutrophils significantly promoted the proliferation of HaCaT cells compared with that of normal control-derived nentrophils (t = 3.11, 2.89, 2.29, respectively, all P < 0.05). In comparison with tmstimulated neutrophils, the supematant from LPS- and CpG-A stimulated nentrophiles significantly accelerated the pro-liferation of HaCaT cells. Furthermore, the proliferation of HaCaT cells induced by the supematants of LPS-,CpG-A-, CpG-B-stimulated neutrophils from psoriatic patients was statistically suppressed by the pretreat-ment with the monoclonal antibody to IL-8, TNF-alpha and SOD/CAT (all P < 0.05). Conclusions In patients with psoriasis vulgaris, there is an abnormal secretion of IL-8, TNF-alpha and superoxide by neutrophils in peripheral blood, and these proinflammatory factors could promote the proliferation of HaCaT cells.     

肝病中的炎性细胞因子调节

大多数急、慢性肝病是以肝内各种前炎和抗炎性细胞因子表达增强的炎性过程为特点的。这些细胞因子是很多炎性肝功能失调的驱动力，常导致肝纤维化和肝硬化。[第一段]     

高热惊厥患儿血清几种细胞因子的测定及意义

【目的】测定高热惊厥(febrile convulsion,FC)时患儿血清几种细胞因子水平变化并探讨其意义。【方法】对82例高热惊厥患儿(FC组)及上感患儿(上感组)40例、正常儿童(正常组)41例分别测定IL-6、IL-8、IL-10和TNF-α水平。【结果】FC患儿血清IL-6、IL-8和TNF-α水平明显高于上感组和正常组,差异有显著性(P<0.001)。【结论】FC发作时患儿血清中IL-6、IL-8和和TNF-α水平明显增高,说明在惊厥发作时有细胞免疫因素的参与。     

早产预测和诊断的研究进展

早产是指妊娠满 2 8周至不足 3 7周 (1 96～ 2 5 8日 )之间终止者。早产约占分娩总数的 5 %～ 1 5 % ,75 %以上的围生儿死亡与早产有关[1] 。存活的早产儿常合并严重的疾病 ,如 :呼吸窘迫综合征、坏死性肠炎、颅脑发育异常、视力或听力缺陷等 ,使小儿所在家庭乃至全社会负担增加[2 ] 。因此 ,早期预测早产 ,诊断早产 ,从而更好地防治早产 ,是降低围生儿病率和死亡率的关键。本文就早产的诊断及近年来预测早产的各项指标作一综述。1　早产的诊断目前 ,文献对早产的诊断标准差别不大 ,主要是 :孕周在 2 8～ 3 7周 ;宫缩存在 1ｈ以上 ,持续时间…