关键词： lysophosphatidic acid   connexin 43 protein   immune inflammatory response   acute myocardial infarction   arrhythmia  

摘要： Lysophosphatidic acid (LPA) is an intermediate product of membrane phospholipid metabolism. Recently, LPA has gained attention for its involvement in the pathological processes of certain cardiovascular diseases. The aim of the present study was to clarify the association between the effect of LPA and the immune inflammatory response, and to investigate the effects of LPA on the protein expression levels of connexin 43 during myocardial infarction. Surface electrocardiograms of myocardial infarction rats and isolated rat heart tissue samples were obtained in order to determine the effect of LPA on the incidence of arrhythmia in rats that exhibited changes in immune status. The results demonstrated that the incidence of arrhythmia decreased when the rat immune systems were suppressed, and the incidence of arrhythmia increased when the rat immune systems were enhanced. The concentration levels of tumor necrosis factor (TNF)-alpha were determined by ELISA, and the results demonstrated that LPA induced T lymphocyte synthesis and TNF-alpha release. Using a patch-clamp technique, LPA was shown to increase the current amplitude of the voltage-dependent potassium channels (K-v) and calcium-activated potassium channels (K-Ca) in Jurkat T cells. The protein expression of connexin 43 (Cx43) was determined by immunohistochemical staining. The results indicated that LPA caused the degradation of Cx43 and decreased the expression of Cx43. This effect was associated with the immune status of the rats. There was a further decrease in Cx43 expression in the rats of the immune-enhanced group. To the best of our knowledge, these results provide the first evidence that LPA causes arrhythmia through the regulation of immune inflammatory cells and the decrease of Cx43 protein expression. The present study provided an experimental basis for the treatment of arrhythmia and may guide clinical care.

关键词： Diabetic nephropathy   Inflammatory factors   Micro inflammatory state   Rehmannia Root   地黄   微炎症状态   炎症因子   糖尿病肾病   Language of Keywords: English   Chinese  

摘要： Objective: To study the effect of Rehmannia Root on blood glucose and micro inflammatory state in diabetic rats. Methods: The model of diabetic rats was induced by high glucose and high fat diet feeding and intraperitoneal injection of STZ. The successful model rats were divided into blank control group, diabetic model group and drug treatment group. Then the blank control group and model group were given distilled water, the treatment group were given different doses of Rehmannia Root, Danshen Root and glibenclamide respectively by gavage once a day for 60 days. The blood glucose was dynamically detected by glucose meter, and the change of serum ultra sensitive C reactive protein (Hs-CRP), white blood cell mediated 6 (IL-6) and tumor necrosis factor alpha (TNF-α) was detected by ELISA. Results: After successfully modeling, the blood glucose in diabetic rats was increased significantly (P＜0.05), and the content of seruminflammation factors such as Hs-CRP, IL-6, TNFαwas increased, which was significantly lower than that of the blank group (P＜0.05). And after Rehmannia root treatment, the blood glucose level was decreased significantly (P＜0.05), and the blood inflammation factors such as Hs-CRP, IL-6 and TNF-αwere also decreased, the differences were statistically significant (P<0.05). Conclusions: Rehmannia Root can significantly reduce the blood glucose level of diabetic rats, and significantly improve the micro inflammatory state of diabetic rats. [ABSTRACT FROM AUTHOR]

关键词： Necrotizing arteritis   Pulmonary sequestration   Pulmonary hypertension   Vasculitis syndrome   Vasculopathy  

摘要： Necrotizing arteritis is a complex lesion of pulmonary hypertension, as are plexiform lesions, and is classically recognized as grade 6 in the Heath and Edwards grading scheme for hypertensive pulmonary vascular disease. The vascular changes observed in intralobar pulmonary sequestration have been reported to be similar to those observed in pulmonary hypertension, such as plexiform lesions. However, necrotizing arteritis occurring in an intralobar sequestration of a patient without systemic vasculitis syndrome has never been reported to our knowledge. Here, we report a case of a 38-year-old woman with pulmonary sequestration detected on a medical checkup. She was treated with surgery, and subsequent pathological analyses revealed necrotizing vasculitis in her sequestrated lung. We suspected systemic vasculitis syndromes, such as Takayasu arteritis, polyarteritis nodosa, and antineutrophil cytoplasmic antibody-associated vasculitis. However, physical and blood examination did not show any other abnormalities, and hence, she did not have systemic vasculitis syndrome. Immunohistochemical analyses of the resected specimen showed that inflammatory cells of the arteries were mainly composed of T lymphocytes. T-lymphocytic inflammation with little neutrophil and histiocyte infiltration may be a pathological feature of necrotizing arteritis observed in pulmonary sequestration. This is the first case to our knowledge of necrotizing arteritis in an intralobar pulmonary sequestration of a patient without systemic vasculitis syndrome. (C) 2016 Elsevier Inc. All rights reserved.

关键词： Internal iliac artery embolization   Systemic inflammatory response syndrome   Interventional treatment cabin  

摘要： Background: Pelvic fracture combined with massive bleeding (PFCMB) is a complex issue in clinical practice. Currently, the use of angiography and embolization for the treatment of PFCMB obtains good results. The aim of this study is to observe the effects of early internal iliac artery embolization on the SIRS in dogs with simulated-pelvic-fracture combined with massive bleeding. Methods: Twenty adult dogs were randomly divided into an embolization group (EG) and a control group (CG). For the two groups, heart rate, respiratory rate and body temperature and other physiological variables were measured, and IL-6, TNF-alpha and arterial blood gas levels were monitored. These variables were assayed every 30 min until death in the CG, while dogs in the EG underwent arterial angiography after 60 min of modeling. The internal iliac artery was embolized on the injured side. Results: The average time to SIRS in the CG was 3.56 h, occurring at a rate of 90 % (9/10) within 24 h, with a mortality rate of 50 % (5/10);the average time to SIRS for the EG was 5.33 h, occurring at a rate of 30 % (3/10) within 24 h, with a mortality rate of 10 % (1/10). When SIRS occurred in the EG, the mean plasma IL-6 level was 52.66 +/- 7.38 pg/ml and the TNF-alpha level was 11.45 +/- 2.72 ng/ml, showing a significant difference with those of the CG (P < 0.05). In the two groups, the respiratory rate and leukocyte levels were higher at each monitored time after modeling than those before modeling;the mean arterial pressure, levels of hemoglobin and oxygen partial pressure were significantly lower at each time point after modeling than those before modeling except for the mean arterial pressure at 0 h in EG;the platelet levels at 4 and 8 h were higher than those before modeling;and the differences were statistically significant (P<0.05). In the EG, the mean arterial pressure, heart rate, respiratory rate and hemoglobin levels at 2, 4 and 8 h were lower than those at 0 h;the levels of leukocytes, pl

关键词： 腹腔镜   开腹   全直肠系膜切除术   直肠癌   炎症反应   免疫  

摘要： 目的探讨腹腔镜及开腹全直肠系膜切除术对直肠癌患者围术期炎症反应及免疫的影响。方法将96例直肠癌患者随机分成开腹组和腹腔镜组,各48例。比对其围术期指标差异,记录手术前后炎症因子水平和免疫指标变化情况,分析预后结果。结果 1两组除平均术程对比无统计学意义(P>0.05)外,腹腔镜组术后肛门排气时间(1.9±0.6)d、切口拆线时间(6.5±1.6)d、总住院时间(8.9±1.8)d等围术期指标均显著低于开腹组(3.9±0.5)d、(13.3±2.0)d、(15.3±2.1)d,P<0.05;2术后3 d,两组IL-6、CRP、TNF-α等炎症因子水平均较术前显著提高(P<0.05),但腹腔镜组检测水平低于开腹组(51.4±4.5)pg/L、(49.5±5.5)mg/L、(66.3±5.5)ng/L VS(70.5±4.2)pg/L、(72.2±5.8)mg/L、(84.2±5.3)ng/L,P<0.05;CD3+、CD4^+、CD8^+等免疫指标水平均较术前显著降低(P<0.05),但腹腔镜组检测结果高于开腹组(48.2±5.0)%、(51.1±4.9)%、(27.9±2.5)%VS(35.5±4.4)%、(33.1±4.8)%、(17.5±2.6)%,P<0.05;3两组患者保肛成功率、术后并发症发生率、1年内复发率、远处转移率、近期生存率均对比无统计学意义(P>0.05)。结论将腹腔镜下全直肠系膜切除术应用于直肠癌患者的临床治疗中,可有效提升其保肛成功率,对抑制炎症反应、调节免疫功能等有利。

关键词： 重症中暑   肠黏膜屏障   全身炎症反应   相关性  

摘要： 目的观察重症中暑对肠黏膜屏障功能的影响，并探讨其与全身炎症反应的相关性。方法SPF级雄性BALB／c小鼠按随机数字表法分为正常对照组、40℃热打击组、42℃热打击组，每组6只。正常对照组小鼠始终置于（25．0±0．5）℃常温下；热打击组小鼠置于温度（35．5±0．5）℃、湿度（60±5）％环境直至体温达40℃或42℃后，于常温下复温12h。各组小鼠内眦取血，采用酶联免疫吸附试验（ELISA）检测血浆脂多糖（LPS）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）水平及二胺氧化酶（DAO）活性，紫外分光光度计检测血浆D-乳酸水平。处死小鼠，取肠系膜淋巴结（MLN）、肝、脾、肺、肾组织及门、腔静脉血进行细菌菌落计数，观察肠道细菌移位情况；取回肠组织，镜下观察小肠黏膜组织形态学和超微结构改变。采用Pearson分析判断肠黏膜屏障功能损害与全身炎症反应的相关性。结果与正常对照组比较，热打击后小鼠血浆LPS、炎症指标TNF—α和IL-6水平、肠屏障功能指标DAO和D-乳酸水平以及细菌移位率均明显升高，以42℃热打击组损伤更为明显[LPS（EU／L）：740±50比340±40，TNF-α（ng／L）：148．06±36．61比12．89±1．67，IL-6（ng／L）：110．91±9．97比18．02±2．20，DAO（U／L）：1760±400比670±50，D-乳酸（mg／L）：9．60±1．48比5．08±0．28，细菌移位率：78．6％（33／42）比9．5％（4／42），均P〈0．01]。相关性分析结果显示：42℃热打击小鼠血浆LPS、TNF-α、IL-6与DAO活性（r值分别为0．834、0．808、0．836）和D-乳酸（r值分别为0．811、0．811、0．800）均呈显著正相关（均P=0．000）。镜下观察显示，热打击后小鼠肠黏膜组织及超微结构均出现明显病理学改变，以42℃热打击造成的损伤更加明显，出现肠黏膜明显萎缩、绒毛脱落、淋巴细胞及中性粒细胞浸润、表面微绒毛稀疏及排列紊乱、上皮细胞间紧密连接增宽、线粒体明显肿胀、内质网明显扩张。结论重症中暑早期即可导致小鼠肠黏膜损害，且肠黏膜屏障功能障碍与全身炎症反应密切相关。

关键词： 组合型人工肾   微炎症   临床效果   护理  

摘要： 目的观察组合型人工肾(HD+HP)对维持性血液透析患者微炎症状态的作用及护理措施。方法选择血液透析患者120例,随机分为对照组和试验组,每组60例。对照组行血液透析每周3次,每次4 h,试验组在对照组治疗的基础上,每2周加血液灌流1次。2组患者分别于治疗前和治疗后3个月、6个月分别空腹采静脉血,生化检测患者的超敏C-反应蛋白(hs-CRP)、血红蛋白(Hb)和血清白蛋白(ALB)水平,观察2组患者上述指标的变化。结果治疗前2组患者血hs-CRP、Hb、ALB差异无统计学意义(P>0.05),治疗后3、6个月后对照组3项指标较治疗前无明显改变;而试验组在治疗3个月后较治疗前血hs-CRP水平有所下降,Hb、ALB水平上升(P<0.05),治疗6个月后血hs-CRP水平显著下降(P<0.05),Hb、ALB水平显著上升(P<0.05)。结论组合型人工肾治疗维持性血液透析患者,可全面有效清除体内小中大分子毒素,有利于缓解微炎状态,更好的改善患者症状,提高生存质量;同时应用过程中严格遵守无菌操作,密切观察,有效护理,对于减轻不良反应,提高疗效非常重要。

关键词： 全身炎症反应综合征   黄芪   肠屏障功能   人类  

摘要： 目的:观察黄芪对全身炎症反应综合征(SIRS)患者肠屏障功能的保护作用,为临床治疗提供参考。方法:SIRS患者45例,采用随机数字表法将其分为3组,分别为A组、B组与C组,每组各15例。3组分别给予常规治疗、常规加黄芪水煎液灌肠、常规加黄芪水煎液口服及灌肠治疗,共治疗7 d。对3组患者进行APACHEⅢ评分,治疗前后测定二胺氧化酶(DAO)和内毒素(ET)水平,记录治疗前后肠鸣音的变化情况。结果:治疗后C组的APACHEⅢ评分最低为(11.9±1.6)分,B组的APACHEⅢ评分为(13.5±2.7)分,A组的APACHEⅢ评分最高为(16.5±2.0)分,3组的APACHEⅢ评分两两之间比较均具有统计学意义(P<0.05);治疗后C组患者DAO水平最低为(1.39±0.25)U/mL,A组患者的DAO水平最高为(2.47±0.47)U/mL,3组患者的DAO水平两两之间的差异均有统计学意义(P<0.05);而C组、B组的内毒素(ET)水平与A组之间的差异具有统计学意义(P<0.05);治疗后C组患者的肠鸣音增加的最多,其与A组及B组治疗后的肠鸣音之间的差异均有统计学意义(P<0.05),而A组与B组之间的差异无统计学意义(P>0.05)。结论:黄芪对全身炎症反应综合征患者的肠屏障功能具有较好的保护作用,使用黄芪水煎液灌肠联合口服的方法效果更优。

关键词： 百日咳毒素   多发性硬化   血管内皮生长因子   神经元   血管新生   小鼠  

摘要： 目的探讨百日咳毒素(PTx)对实验性自身免疫性脑脊髓炎(EAE)小鼠模型的作用及机制。方法将C57BL/6小鼠随机分为正常对照组、EAE组和PTx治疗组,每组12只。EAE组和PTx治疗组用MOG 35-55诱导EAE模型。PTx组于建模后第7天给予腹腔注射1000 ng的PTx。随后观察两组临床症状,组织学染色评价炎症反应和脱髓鞘改变,并观察VEGF和血管新生现象,并用Western blot检测脊髓VEGF和Collagen IV的整体水平。在体外,用PTx刺激原代培养的神经元,评价PTx对在体外对神经元VEGF表达的影响。结果 PTx能减轻EAE模型的炎症反应和脱髓鞘改变,在大脑PTx将炎症评分从(3.4±0.55)分降至(1.2+0.45)分,P<0.01;脱髓鞘评分从(3.6+0.55)分降至(1.4+0.55)分,P<0.01。在脊髓PTx将炎症评分从(3.6+0.55)分降至(1.0+0.71)分,P<0.01;脱髓鞘评分从(4.2+0.84)分降至(1.4+0.55)分,P<0.01。Western blot检测显示,与正常对照组比较,EAE组VEGF下降49.0%(P<0.01),Collagen IV下降36.0%(P<0.01);PTx治疗后,与EAE组比较,VEGF上升59.5%(P<0.01),Collagen IV上升45.0%(P<0.01)。体外实验显示,PTx治疗24 h后VEGF在神经元上的表达增加,与正常对照相比,100 ng/ml组上调34.6%(P<0.01),400 ng/ml组上调76.9%(P<0.01)。结论 PTx可上调神经元内源VEGF的表达和血管新生现象,继而在EAE模型中起保护作用。

关键词： 经皮肾镜碎石取石术   全身炎症反应综合征   风险因素   右美托咪定  

摘要： 【目的】探讨经皮肾镜碎石取石(PCNL)术后发生全身炎症反应综合征(SIRS)的影响因素。【方法】回顾性分析2011年1月至2014年4月我院诊断泌尿系结石并行PCNL术患者资料415例,经过排除,最终纳入分析251例。对比SIRS组和非SIRS组其他围术期并发症的发生率,并对术后发生SIRS的可能相关因素进行单因素和Logistic多因素回归分析。【结果】1术后发生SIRS69例,未发生SIRS 182例,两组术前一般情况比较无统计学差异(P>0.05)。2SIRS组患者术后血红蛋白(HGB)≤90 g/L、肌酐(SCr)≥1.5倍基线值、术后住院≥8 d的发生率明显高于SIRS阴性患者,具有统计学差异(P<0.05)。3单因素分析结果显示:结石直径≥50 mm,铸型结石,尿培养阳性,手术时间≥120 min,通道大小,术中未使用右美托咪定与PCNL术后SIRS相关(P<0.05)。4Logistic多因素回归分析发现手术时间≥120 min(P=0.001,OR=3.011)、尿培养阳性(P=0.005,OR=5.48)、术中未使用右美托咪定(P=0.019,OR=2.099)为PCNL术后SIRS的独立危险因素。【结论】PCNL术后SIRS的发生受多个因素综合作用的影响,其中手术时间、尿培养阳性、术中未使用右美托咪定为PCNL术后SIRS的独立危险因素,可作为预测术后SIRS的依据。右美托咪定对PCNL术后SIRS的影响,有待进一步研究证明。