体外循环术后患者Toll样受体变化及其意义

全身炎症反应综合症（SIRS）是体外循环术后常见及严重的并发症，单核细胞在CPB早期即参与了其中的炎症反应。本研究旨在观察体外循环（CPB）围术期外周血单核细胞TLR4和CD14的变化规律。寻求新的抗炎途径。     

小儿克雷伯氏菌败血症34例临床分析

克雷伯氏菌系革兰氏阴性杆菌,已成为院内感染主要致病菌之一。其败血症病情凶险,并发症多,治疗困难且预后差,值得临床重视。我们协作组自1982年3月至1992年1月收治经血培养证实的克雷伯氏菌败血症34例,现分析如下。     

脂氧素A4对心肌缺血再灌注损伤的保护作用

Objective To investigate the roles of lipoxin A4, an endegenous lipid mediator with wide anti-inflammatory fea- tures, in attenuating myocardial ischemia-reperfusion injury and the possible mechanisms. Methods Thirty male KM mice were divid- ed randomly into three groups, 10 in each: ischemia-reperfusion group (group A), lipoxin A4 (0.1 mg/kg) group (group B) and Zn- PP (Zinc protoporphyrin Ⅸ, 25 mg/kg)phus lipoxin A4 (0.1 mg/kg)group (group C). A ischemia-reperfusion heart model was de- veloped by ligating the lift anterior descending branch of the coronary artery. A dine of 10% dehydrated alcohol in 0.2 ml for group A, a dose of isochoric lipoxin A4 for group B and a dose of isochoric ZnPP + lipoxin A4 for group C was infused into the ascending aorta through a catheter, which was kpassing the right common carotid artery, 30 minutes after reperfusion. The concentration of serum TNF-α, activities of serum crestine kinase(CK) and lactate dehydrogenase (LDH), activities of myeloperoxidase (MPO) and malond- ialdehyde (MDA) and the cell apoptosis rate in the myocardial tissue were measured 5 hours after reperfusion. Pathological features of the inflammatory infiltration in the myocardium were also observated.Results As compared with group A, the inflammatoryry infiltra- tion in the ischemic and necrotic regions tithe myocardium was reduced, with group C in the intermediate range. The serum activities of CK and LDH wine significantly lower in group B and C than that in group A, and the lowest activities were detected in group B. Similar findings were observed for MPO, an indicator for neutrophil infiltration, and MDA, an indictor for cell injury caused by oxy- gen radicals, in the myocardium. The concentration of TNF-α and the rate of cadiocyte apoptosis were decreased significantly in group B(P < 0.01). ZnPP, an inhibitor of heine oxygenase (HO)-1, attenusted the above protective effects of lipoxin A4 significantly (P<0.05). Conclusion Lipoxin A4 has protective effects against myocardial ischemia-reperfusion injury, and HO-1 may have a potential role in the protectve mechanisms of lipoxin A4, probably pertly by means of reducing the production of reactive oxygen spe- cies and TNF-α, decreasing the activation and infiltration of neutrophils, alleviating inflammatory damage and avoiding apoptosis.     

高压氧治疗一氧化碳中毒迟发性脑病的疗效观察

目的 探讨高压氧治疗一氧化碳中毒迟发性脑病的疗程的相关性。方法 对20例迟发脑病患者按高压氧疗程进行观察。结果 随着高压氧疗程的增加，患者意识障碍逐渐恢复，原有精神症状体征基本消失，直至痊愈。结论 高压氧疗程越长，对迟发性脑病的疗效越好。     

皱叶香茶菜中一新的二桥氧-对映-贝壳杉烷类二萜化合物rugosinin

香茶菜属Isodon植物中的很多对映-贝壳杉烷类二萜化合物都具有明显的生物活性。作者又从皱叶香茶菜I.rugosus地上部分甲醇提取物中分得一新的对映-贝壳杉烷     

C反应蛋白与心功能不全的关系

目的：探讨C-反应蛋白（CRP）在心功能不全中的变化及作用。方法：204例心血管病患者被分为心功能不全组（左室收缩功能不全，88例）和对照组（无心功能不全，116例），比较两组间CRP变化。结果：左室收缩功能不全组CRP水平显著高于对照组（P〈0．01）；CRP水平在心功能Ⅳ级组显著高于Ⅲ级组（P〈0．01），Ⅲ级组显著高于Ⅱ级组（P〈0．01）；冠心病组CRP显著高于高血压性心脏病（高心病）组和扩张型心肌病（扩心病）组（P均〈0．05），高心病组与扩心病组无显著差异（P〉0．05）。结论：心功能不全患者CRP水平升高与心功能不全程度关系密切，不同病因所致心功能不全CRP水平亦有不同，以冠心病CRP水平升高更明显。因此，CRP可作为评价心功能不全程度的重要参考指标。     

麝香四黄汤联合重组组织型纤溶酶原激活剂治疗急性缺血性脑血管病临床研究

目的:观察麝香四黄汤联合重组组织型纤溶酶原激活剂(rt-PA)治疗急性缺血性脑血管病(AICD)的临床疗效。方法:选取90例AICD患者,随机分为参照组及试验组各45例。参照组采用rt-PA静脉溶栓治疗,试验组在参照组基础上联合麝香四黄汤治疗。比较2组临床疗效、实验室指标及不良反应发生率。结果:试验组总有效率为93.33%,明显高于参照组的66.67%(P<0.05)。治疗后,2组血清神经元特异性烯醇化酶(NSE)、内皮素-1 (ET-1)水平均较治疗前降低(P<0.05),血清超氧化物歧化酶(SOD)、一氧化氮(NO)水平均较治疗前升高(P<0.05);试验组血清NSE、ET-1水平均低于参照组(P<0.05),血清SOD、NO水平均高于参照组(P<0.05)。试验组不良反应发生率为6.67%,参照组为4.44%,2组比较,差异无统计学意义(P>0.05)。结论:麝香四黄汤联合rt-PA治疗AICD,可有效减轻患者的神经功能受损情况,改善其血管功能,且不良反应发生率低。     

人Kv1.5通道基因转染人胚胎肾细胞的研究

目的建立表达人Kv1.5通道的细胞模型。方法采用Lipofactamine 2000脂质体将人Kv1.5通道基因转染人胚胎肾细胞(HEK293),通过荧光显微镜和全细胞膜片钳技术观测人Kv1.5通道基因的表达。结果pcDNAHKv1.5真核表达载体转染HEK293细胞2d后,荧光显微镜可观察到人Kv1.5通道表达;3d后全细胞膜片钳技术记录到人Kv1.5通道基因编码的通道电流。结论pcDNAHKv1.5真核表达载体转染HEK293细胞为人Kv1.5通道的研究提供了良好的真核细胞表达系统和细胞模型。     

供体心脏质量评估研究进展

公民逝世后器官捐献现已成为我国器官移植供体的唯一合法来源,而供体的稀缺导致边缘供心使用增加.在保证优质供心充分合理利用的前提下,如何从边缘供心中充分发掘潜在可用的供体,以最大限度利用死亡供体器官对挽救终末期心脏病患者具有重要意义.因此,对供心的合理选择及维护直接关系到患者术后的远期疗效,本文就当前供心质量评估有关现状进...