重症肺炎患者血清氧化应激指标和炎症因子的表达及其与肺部感染评分的关系

目的:探讨重症肺炎患者血清氧化应激指标和炎症因子的表达及其与肺部感染评分(CPIS)的关系。方法:选取2016年1月到2018年12月在西安市胸科医院接受治疗的重症肺炎患者120例作为观察组,另选取同期在该院接受治疗的普通肺炎患者120例作为对照组。比较两组患者血清中的炎症因子指标、氧化应激指标和CPIS评分,分析重症肺炎患者炎症因子指标、氧化应激指标与CPIS评分的相关性。结果:观察组患者血清中白介素-6(IL-6)、白介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)水平明显高于对照组,差异具有统计学意义(P0.05),观察组患者血清中过氧化脂质(LPO)水平高于对照组,血清中超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平低于对照组,差异具有统计学意义(P0.05),观察组患者的CPIS评分高于对照组(P0.05)。Pearson相关分析结果显示:重症肺炎患者的CPIS评分与IL-6、IL-18、TNF-α、LPO水平呈正相关(P0.05),与SOD、GSH-Px水平呈负相关(P0.05)。结论:重症肺炎患者存在明显的炎症反应和氧化应激反应,且炎症反应和氧化应激反应的程度和患者肺部感染程度密切相关。     

脓毒症患者血清氧化应激因子、炎症因子水平与APACHEⅡ评分及预后的关系研究

目的:探讨脓毒症患者血清氧化应激因子、炎症因子水平与急性生理学与慢性健康状况II(APACHEⅡ)评分及预后的关系。方法:选择2016年1月-2019年10月我院收治的脓毒症患者76例作为研究组,同期收治的相同基础疾病非脓毒症患者60例作为对照组,比较两组血清氧化应激因子[丙二醛(MDA)、超氧化物歧化酶(SOD)、一氧化氮(NO)]、炎症因子[降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素27(IL-27)]水平及APACHEⅡ评分,根据脓毒症患者预后将其分为死亡组25例、存活组51例,比较两组上述指标,并分析脓毒症患者预后的影响因素及血清氧化应激因子、炎症因子水平与APACHEⅡ评分的相关性。结果:研究组血清MDA、PCT、CRP、IL-27及APACHEⅡ评分显著高于对照组,血清SOD、NO显著低于对照组(P<0.05)。死亡组血清MDA、PCT、CRP、IL-27及APACHEⅡ评分显著高于存活组,血清SOD、NO显著低于存活组(P<0.05)。多因素logistic回归分析显示MDA升高、SOD降低、NO降低、PCT升高、CRP升高、APACHEⅡ评分升高均是脓毒症患者死亡的危险因素(OR=2.293、1.872、1.527、2.472、1.667、1.926,P<0.05)。Pearson相关性分析显示,脓毒症患者血清MDA、PCT、CRP、IL-27水平与APACHEⅡ评分呈正相关(r=0.563、0.582、0.441、0.302,P<0.05),血清NO、SOD水平与APACHEⅡ评分呈负相关(r=-301、-0.386,P<0.05)。结论:脓毒症患者血清MDA、PCT、CRP、IL-27与APACHEⅡ评分异常升高,血清NO、SOD异常降低,可能通过对上述指标进行检测从而判断患者病情及评估其预后。     

阻生智齿拔除术患者前后龈沟液中炎症因子和应激因子水平变化及临床意义

目的:探讨阻生智齿拔除术患者前后龈沟液中炎症因子和应激因子水平变化及临床意义。方法:选择我院2017年1月至2019年1月192例行阻生智齿拔除术的患者为研究对象(观察组),并选择100例口腔健康志愿者作为对照组,检测观察组阻生智齿拔除术术前、术后2d、术后5d及对照组龈沟液中白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、丙二醛(MDA)、活性氧(ROS)水平,并在术后2d记录观察组患者牙龈指数(GI),探讨各指标与患者预后的关系。结果:观察组术前龈沟液IL-8、TNF-α、MDA及ROS水平与对照组无显著差异(P0.05),术后2d、术后5d龈沟液IL-8、TNF-α、MDA及ROS水平均高于对照组(P0.05);观察组术后2d龈沟液IL-8、TNF-α、MDA及ROS水平高于术前和术后5d(P0.05),术后5d龈沟液IL-8、TNF-α、MDA及ROS水平高于术前(P0.05);GI分级3级患者龈沟液IL-8、TNF-α、MDA及ROS水平高于GI分级2级患者,GI分级2级患者龈沟液IL-8、TNF-α、MDA及ROS水平高于GI分级1级患者(P0.05);龈沟液IL-8、TNF-α、MDA及ROS水平与术后GI分级均呈正相关(P0.05)。结论:阻生智齿拔除术患者手术前后龈沟液IL-8、TNF-α、MDA及ROS水平会出现波动,且术后各指标水平可反映患者预后情况。     

帕金森病患者血清胱抑素C、β-淀粉样蛋白1-42检测的临床意义

目的:探讨帕金森病(PD)患者血清胱抑素C(Cys C)、β-淀粉样蛋白1-42(Aβ1-42)检测的临床意义。方法:选取2018年1月～2019年12月期间本院收治的帕金森病患者97例为研究对象纳入观察组,根据Hoehn-Yahr(HY)病情分期将观察组患者分为早期组(32例)、中期组(37例)、晚期组(28例),另选同期在我院进行体检的健康受试者50例为对照组。对各组受试者的血清Cys C、Aβ1-42、炎性因子、氧化应激指标等进行检测对比,并采用Pearson检验对PD患者的Cys C、Aβ1-42与炎性指标、氧化应激指标的相关性进行分析。结果:观察组血清Cys C、白介素-1β(IL-1β)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、丙二醛(MDA)水平均高于对照组,Aβ1-42、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平均低于对照组(P0.05)。在观察组内随着PD病情的加重,血清Cys C、IL-1β、CRP、TNF-α、MDA水平均逐渐升高,Aβ1-42、SOD、GSH-Px水平均逐渐降低,各组间对比差异有统计学意义(P0.05)。经Pearson检验分析,PD患者的Cys C与IL-1β、CRP、TNF-α、MDA呈正相关,与SOD、GSH-Px呈负相关,Aβ1-42与IL-1β、CRP、TNF-α、MDA呈负相关,与SOD、GSH-Px呈正相关(P0.05)。结论:PD患者血清中Cys C呈现高表达,Aβ1-42呈现低表达,其表达随着患者的病情加重而变化,并且与患者的炎症反应、氧化应激水平有密切的相关性。     

不同剂量乌司他丁联合阿拓莫兰对感染性休克患者氧化应激、炎症反应及预后的影响

目的:探讨不同剂量乌司他丁联合阿拓莫兰对感染性休克患者血清氧化应激、炎症反应以及预后的影响。方法:选择2014年5月至2018年6月我院诊治的100例感染性休克患者,按随机数字表法分为乌司他丁组(乌司他丁20万U/d)、阿拓莫兰组(阿拓莫兰1.8 g/d)、低剂量联合组(乌司他丁20万U/d+阿拓莫兰1.8 g/d)、高剂量联合组(乌司他丁40万U/d+阿拓莫兰1.8g/d),每组各25例。对比四组患者治疗前后的血清氧化应激指标[丙二醛(MDA)、晚期氧化蛋白产物(AOPP),超氧化物歧化酶(SOD)、总抗氧化能力(T-AOC)、谷胱甘肽过氧化物酶(GSH-Px)]、炎症反应指标[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、C反应蛋白(CRP)]的变化,并对比四组患者预后的差异。结果:高剂量联合组患者ICU住院时间、机械通气时间、治疗后急性生理与慢性健康量表(APACHEⅡ)评分、序贯器官衰竭(SOFA)评分、血清MDA、AOPP、IL-6、TNF-α、PCT、CRP水平均低于乌司他丁组、阿拓莫兰组、低剂量联合组,低剂量联合组低于乌司他丁组、阿拓莫兰组(P0.05)。高剂量联合组治疗后血清SOD、T-AOC、GSH-Px高于乌司他丁组、阿拓莫兰组、低剂量联合组,低剂量联合组高于乌司他丁组、阿拓莫兰组(P0.05)。高剂量联合组、低剂量联合组患者多器官功能障碍(MODS)发生率和死亡发生率均低于乌司他丁组、阿拓莫兰组(P0.05)。结论:乌司他丁联合阿拓莫兰治疗感染性休克效果显著,可有效抑制全身氧化应激和炎性反应,改善患者预后,且高剂量乌司他丁联合阿拓莫兰治疗感染性休克的效果最优。     

类风湿性关节炎患者血清GM-CSF, IL-6, TNF-α水平的变化及其临床意义

目的:通过检测类风湿性关节炎(RA)患者血清粒细胞-巨噬细胞集落刺激因子(GM-CSF)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平,探讨其用于RA诊断与预后判断的临床意义。方法:选取我院2013年6月~2016年12月收治的126例RA患者为RA组,并根据病情严重程度分为活动期RA组(69例)和缓解期RA组(57例)两个亚组;另选取同期于我院体检中心接受体检的55例健康体检者为对照组。采用酶联免疫吸附法(ELISA)检测所有对象的血清GM-CSF、IL-6、TNF-α水平。记录比较各组血清细胞因子水平,并分析RA组患者各细胞因子水平及DAS28间的相关性。结果:活动期RA组的血清GM-CSF、IL-6、TNF-α水平均显著高于缓解期RA组和对照组(P0.01),缓解期RA组的血清GM-CSF、IL-6、TNF-α水平亦均显著高于对照组(P0.01)。血清GM-CSF、IL-6及TNF-α水平三者间均呈显著正相关(P0.01);DAS28与血清GM-CSF、IL-6、TNF-α水平亦均呈显著正相关(r=0.473、0.584、0.675,P均0.01)。结论:类风湿性关节炎患者的血清GM-CSF、IL-6、TNF-α水平均显著上调,且与类风湿性关节炎的活动性呈显著正相关,通过检测此类细胞因子对类风湿性关节炎的早期诊断、病情评估及判断预后均具有重要临床意义。     

基于抗炎及抗氧化作用探讨微生态制剂在非酒精性脂肪肝模型大鼠中的应用价值

目的研究基于抗炎及抗氧化作用探讨微生态制剂在非酒精性脂肪肝(NAFLD)模型大鼠中的应用价值。方法选择成年雄性SD大鼠并随机分为对照组、NAFLD组、蓝莓益生菌(BP)组。后2组采用复合高脂饲料建立NAFLD模型,BP组给予蓝莓联合益生菌干预。比较3组间血清肝功能指标、炎症指标、氧化应激指标含量及肝脏组织中炎症及氧化应激信号分子表达的差异。结果 NAFLD组大鼠血清中ALT、AST、TNF-α、IL-1、IL-6、IL-18、MDA的含量及肝脏中p-p38MAPK、NF-κB的表达量明显高于对照组,血清中SOD、GPX的含量及肝脏中p-AMPK、Nrf-2的表达量明显低于对照组;BP组大鼠血清中ALT、AST、TNF-α、IL-1、IL-6、IL-18、MDA的含量及肝脏中p-p38MAPK、NF-κB的表达量明显低于NALFD组,血清中SOD、GPX的含量及肝脏中p-AMPK、Nrf-2的表达量明显高于NALFD组。结论蓝莓益生菌用于NALFD模型大鼠的干预能够改善肝功能并抑制炎症反应、氧化应激反应。     

维持性血液透析患者微炎症及氧化应激与动脉粥样硬化的关系

目的:探讨维持性血液透析患者微炎症及氧化应激状态与动脉粥样硬化的关系.方法:测定35例1年以上透析充分的维持性血液透析(maintenance hemodialysis,MHD)患者透析前血肌酐(Scr)、血尿酸(UA)、血糖(Glu)、血浆白蛋白(ALB)、甘油三酯(TG)、胆固醇(TC)、C反应蛋白(CRP)、IL-6、肿瘤坏死因子α(TIF-α)、血浆丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)、血浆谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px).应用超声测定颈动脉中层厚度(IMT)及有无颈动脉斑块形成.结果:AS组CRP、IL-6及TNF-α明显高于非AS组,两组之间差异有显著性(P＜0.05);同时,AS组血清MDA水平显著高于非AS组,SOD和GSH-Px水平显著低于非AS组,两组差异有显著性(P＜0.05).而两组在年龄、性别构成、血压、血脂、血糖、血尿酸无统计学差异.结论:微炎症及氧化应激共同参与了MHD患者动脉粥样硬化的形成.     

美沙拉嗪对溃疡性结肠炎患者血清炎症因子与凝血指标的影响

目的:分析美沙拉嗪对溃疡性结肠炎患者血清炎症因子与凝血指标的影响。方法:按抽签法将102例溃疡性结肠炎患者分作对照组和研究组,各51例,对照组治疗采用柳氮磺胺吡啶,研究组治疗采用美沙拉嗪,观察两组治疗前后血清白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子α(TNF-α),血小板(PLT)、纤维蛋白原(Fg)、凝血酶原时间(PT)、D-二聚体(D-D)水平,氧化应激指标,免疫功能,临床疗效及安全性。结果:治疗后,研究组患者血清IL-1β、IL-6、IL-8、TNF-α、Fg、D-D水平及PLT均显著低于对照组,PT高于对照组,差异有统计学意义(P0.05)。研究组氧化应激过氧化脂质(LPO)、丙二醛(MDA)、超氧化物歧化酶(SOD)、免疫功能(CD3~+、CD4~+、CD8~+、CD4~+/CD8~+)改善均优于对照组(P0.05)。研究组总有效率高于对照组,不良反应率低于对照组,均有统计学差异(P0.05)。结论:美沙拉嗪治疗溃疡性结肠炎患者可显著抑制炎症,改善氧化应激状态,纠正凝血功能障碍并改善免疫功能,且临床疗效和安全性均较好。     

麻杏石甘汤合玉屏风散对支原体肺炎患儿血清炎症因子、氧化应激及T淋巴细胞亚群的影响

目的:探讨麻杏石甘汤合玉屏风散对支原体肺炎患儿血清炎症因子、氧化应激及T淋巴细胞亚群的影响。方法:选取我院儿科门诊于2016年12月至2018年7月间收治的86例支原体肺炎患儿,按随机数字表法分为观察组(43例)和对照组(43例)。对照组采用常规治疗,观察组在对照组基础上联合使用麻杏石甘汤合玉屏风散治疗,两组均治疗14 d。比较两组患儿疗效及临床症状变化情况,检测并比较两组患儿血清炎症因子、氧化应激指标和T淋巴细胞亚群变化情况,观察两组患儿治疗过程中的不良反应发生情况。结果:观察组总有效率为93.02%(40/43),高于对照组的76.74%(33/43)(P<0.05)。观察组患儿体温恢复时间、啰音消失时间、咳嗽消失时间和X线检查恢复正常时间均明显短于对照组(P<0.05)。治疗14 d后,两组患儿血清白介素-2(IL-2)水平明显升高,而白介素-4(IL-4)、白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平明显降低(P<0.05);且与对照组比较,观察组患儿治疗14 d后的血清IL-2水平明显较高,而IL-4、IL-6和TNF-α水平明显较低(P<0.05)。与治疗前比较,治疗5 d后、治疗14 d后,两组患儿血浆丙二醛(MDA)降低,超氧化物歧化酶(SOD)水平升高(P<0.05);与对照组比较,观察组治疗5 d后的血浆MDA明显较低,而SOD水平明显较高(P<0.05)。治疗14 d后,两组患儿CD3⁺、CD4⁺、CD4⁺/CD8⁺明显升高,且观察组高于对照组,而两组患儿CD8⁺明显降低,且观察组低于对照组(P<0.05)。两组不良反应比较差异无统计学意义(P>0.05)。结论:麻杏石甘汤合玉屏风散治疗支原体肺炎疗效显著,能够缓解临床症状、炎症反应,减轻患儿氧化应激状态,并可提高患儿免疫功能。     

七氟烷吸入麻醉对单肺通气患者血清IL-6、IL-10、MIP-2、SP-D及HMGB1水平的影响

目的:探讨七氟烷吸入麻醉对单肺通气患者血白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、巨噬细胞炎性蛋白-2(MIP-2)、人肺表面活性特异蛋白(SP-D)及高迁移率族蛋白1(HMGB1)水平的影响。方法:选择2014年9月~2016年9月于我院行单肺通气的患者108例,参照抽签法分为两组,每组各54例。对照组行常规麻醉,实验组采用七氟烷麻醉,比较两组通气前后血清IL-6、IL-10、MIP-2、SP-D、HMGB1、丙二醇(MDA)、超氧化物歧化醇(SOD)、平均动脉压(MAP)、心率(HR)水平的变化及并发症的发生情况。结果:通气前,两组血清IL-6、IL-10、MIP-2、SP-D、HMGB1、MDA、SOD、MAP、HR水平比较差异均无统计学意义(P0.05)。通气后,两组血清IL-6、IL-10、MIP-2、SP-D、HMGB1、MDA水平均较治疗前显著上升,而实验组以上指标均明显低于对照组;两组血清SOD、MAP、HR均较治疗前显著降低,且研究组低于对照组,差异均有统计学意义(P0.05)。结论:七氟烷吸入麻醉能够抑制单肺通气患者血清IL-6、IL-10、MIP-2、SP-D及HMGB1水平上升,改善机体的氧化应激状态,利于血流动力学的稳定,发挥肺部保护作用。     

Apocynin Alleviates Renal Ischemia/Reperfusion Injury Through Regulating the Level of Zinc and Metallothionen

The purpose of this research was to evaluate the protective effects of apocynin on renal ischemia/reperfusion (I/R) injury (RI/RI) in rats. Rats preconditioned with apocynin were subjected to renal I/R. Zinc levels in serum and renal tissues, blood urea nitrogen (BUN), and serum creatinine (Scr) were detected. We further measured the activity of superoxide dismutase (SOD); the content of malondialdehyde (MDA), IL-4, IL-6, IL-10, and TNF-α; and the expression of metallothionein (MT) in the renal tissues. Results indicated that the levels of MDA, IL-4, IL-6, IL-10, TNF-α, and MT in the kidney tissue and serum BUN and Scr levels in RI/RI group were significantly higher than those in sham-operated group, while the levels of serum Zn and kidney Zn and SOD were reduced in RI/RI group. Apocynin treatment further decreased the levels of MDA, IL-6, TNF-α, and serum BUN and Scr, whereas it significantly increased the levels of Zn, SOD, IL-4, IL-10, and MT in the kidney tissue and serum Zn. These findings suggest that apocynin might play a protective role against RI/RI in rats through regulating zinc level and MT expression involving in oxidative stress.     

Alteration of renal functional, oxidative stress and inflammatory indices following hepatic ischemia-reperfusion

Liver ischemia/reperfusion (IR) injury is a complex phenomenon that may cause local as well as remote organ injuries. Reactive oxygen species (ROS) along with many pro- and anti- inflammatory cytokines are implicated in the development of organ injury. The renal functional, histological, oxidative stress and inflammatory indices were studied during a short and a longer period of liver IR. Rats were subjected to either sham operation or 90 min partial liver ischemia followed by 4 or 24 h of reperfusion. Serum ALT, AST, ALK and LDH levels, BUN and creatinine, renal MDA level, SOD and catalase activities were evaluated as well as serum IL-6 and IL-10 concentrations along with renal histological evaluation. Ninety minutes liver ischemia /4 h reperfusion caused an increase in BUN and renal MDA levels and a decrease in SOD and catalase activities. It also caused an increase in serum IL-6 and IL-10 levels. 24 h liver reperfusion resulted in a reduction in BUN levels and lower oxidative damages demonstrated by a decrease in renal MDA levels and an increase in renal SOD and catalase activities comparing to 4 h reperfusion group. Evaluations indicated improvement in histology such as less cytoplasmic vacuolation and lower tubular debris. Serum inflammatory indices (IL-6 and IL-10 levels) were also reduced. This study showed that liver IR damage causes renal injury including functional, inflammatory and oxidative status changes. The remote kidney damage was then improved by continuing reperfusion from 4 to 24 h.     

Melatonin ameliorates carbon tetrachloride-induced hepatic fibrogenesis in rats via inhibition of oxidative stress

Melatonin is reported to exhibit a wide variety of biological effects, including antioxidant and anti-inflammatory. Evidence shows the important role of oxidative stress in the etiopathogenesis of hepatic fibrosis. The aim of this study was to investigate the protective effects of administration of melatonin in rats with carbon tetrachloride-induced fibrosis for 6 weeks. Hepatic fibrotic changes were evaluated biochemically by measuring tissue hydroxyproline levels and histopathogical examinations. Malondialdehyde (MDA), an end product of lipid peroxidation, and glutathione peroxidase (GSH-px) and superoxide dismutase (SOD) levels were evaluated in tissue homogenates by spectrophotometry. The nuclear factor-kappaB (NF-kappaB) in liver tissue was examined by immunohistochemistry. Tumor necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) concentrations in Kupffer cells (KCs) culture supernatants were measured with ELISA. The rats injected subcutaneously with CCl4 for 6 weeks resulted in hepatic fibrotic changes increased hydroxyproline and MDA levels, and decreased GSH-px and SOD levels, whereas melatonin reversed these effects. Furthermore, melatonin inhibited the expression of NF-kappaB in liver tissue and decreasing production of proinflammatory cytokines such as TNF-alpha and IL-1beta from KCs in fibrotic rats. These present results suggest that melatonin ameliorates carbon tetrachloride-induced hepatic fibrogenesis in rats via inhibition of oxidative stress and proinflammatory cytokines production.     

口腔H.pylori感染与慢性牙周炎患者龈沟液中细胞因子和MMPs/TIMPs水平的相关性

目的探讨口腔H.pylori感染与慢性牙周炎患者龈沟液中细胞因子及与MMPs/TIMPs水平的相关性。方法选择2017年1月至2019年1月在本院诊断为慢性牙周炎的162例患者作为慢性牙周炎组,根据病情严重程度分为轻度(80例)、中度(59例)、重度(23例);取同期在本院进行常规口腔检查的健康志愿者100例作为正常对照组,对比各组研究对象口腔H.pylori感染率的差异。根据口腔H.pylori感染与否将慢性牙周炎组患者进一步分为H.pylori(+)组(72例)和H.pylori(-)组(90例),对比其血清炎症因子[白介素-1β(IL-1β)、白介素-8(IL-8)、白介素-35(IL-35)、肿瘤坏死因子α(TNF-α)]、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]和MMPs/TIMPs[基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶组织抑制剂-2(TIMP-2)]水平的差异。结果慢性牙周炎组患者口腔H.pylori阳性率高于正常对照组,且随病情严重程度增加H.pylori阳性率上升(P<0.05)。慢性牙周炎患者中,H.pylori(+)组患者龈沟液中IL-1β、IL-8、IL-35、TNF-α的水平高于H.pylori(-)组;H.pylori(+)组患者龈沟液中MDA的水平高于H.pylori(-)组,SOD的水平低于H.pylori(-)组。H.pylori(+)组患者龈沟液中MMP-3、TIMP-2的水平高于H.pylori(-)组,MMP-3/TIMP-2比值高于H.pylori(-)组(P<0.05)。结论口腔H.pylori感染可能是导致慢性牙周炎患者病情加重的原因之一。     

紫檀芪调节Keap-1/Nrf2/HO-1信号通路对非酒精性脂肪肝大鼠氧化应激和细胞凋亡的影响

摘要 目的：研究紫檀芪调节Kelch样ECH关联蛋白1（Keap-1）/核因子E2相关因子2（Nrf2）/血红素加氧酶-1（HO-1）信号通路对非酒精性脂肪肝（NAFLD）大鼠氧化应激和细胞凋亡的影响。方法：将60只SD大鼠随机分为对照组、模型组、紫檀芪低剂量组（30 mg/kg）、紫檀芪高剂量组（60 mg/kg）、紫檀芪（60 mg/kg）+N-（4-（2,3-二氢-1-（2''-甲基苯甲酰）-1H-吲哚-5-基）-5-甲基-2-噻唑基）-1,3-苯并二氧唑-5-乙酰胺（ML385）（30 mg/kg）组，每组12只。模型组与药物干预组大鼠以高脂饲料饲养诱导NAFLD模型，对照组大鼠以普通饲料饲养，各组连续喂养12周。以紫檀芪和ML385分组处理14 d后（对照组以等剂量生理盐水处理），检测各组大鼠脂代谢指标[三酰甘油（TG）、总胆固醇（TC）及游离脂肪酸（FFA）水平]、肝指数、肝功能指标[谷丙转氨酶（ALT）及谷草转氨酶（AST）]水平、血清白细胞介素（IL）-17、IL-6、IL-10、氧化应激指标[丙二醛（MDA）、超氧化物歧化酶（SOD）及过氧化氢酶（CAT）]水平；原位末端标记法（TUNEL）染色检测各组大鼠肝细胞凋亡率；蛋白免疫印迹法检测各组大鼠肝组织凋亡相关蛋白及Keap-1/Nrf2/HO-1通路相关蛋白表达。结果：与对照组相比，模型组大鼠血清IL-10、SOD及CAT水平、肝组织Nrf2、HO-1、Bcl-2表达水平显著降低（P＜0.05），TG、TC及FFA水平、肝指数、ALT及AST水平、血清IL-17、IL-6、MDA水平、肝细胞凋亡率、肝组织Keap-1及Bax表达水平显著升高（P＜0.05）。与模型组相比，紫檀芪低、高剂量组大鼠血清IL-10、SOD及CAT水平、肝组织Nrf2、HO-1、Bcl-2表达水平均升高（P＜0.05），TG、TC及FFA水平、肝指数、ALT及AST水平、血清IL-17、IL-6、MDA水平、肝细胞凋亡率、肝组织Keap-1、Bax表达水平均降低（P＜0.05）；与紫檀芪低剂量组相比，紫檀芪高剂量组大鼠血清IL-10、SOD及CAT水平、肝组织Nrf2、HO-1、Bcl-2表达水平升高（P＜0.05），TG、TC及FFA水平、肝指数、ALT及AST水平、血清IL-17、IL-6、MDA水平、肝细胞凋亡率、肝组织Keap-1及Bax表达水平降低（P＜0.05）；与紫檀芪高剂量组相比，紫檀芪+ML385组大鼠血清IL-10、SOD及CAT水平、肝组织Nrf2、HO-1、Bcl-2表达水平降低（P＜0.05），TG、TC及FFA水平、肝指数、ALT及AST水平、血清IL-17、IL-6、MDA水平、肝细胞凋亡率、肝组织Bax表达水平升高（P＜0.05）。结论：紫檀芪可能通过激活Keap-1/Nrf2/HO-1信号通路，改善NAFLD大鼠脂代谢水平，调节炎症反应及氧化应激，减轻肝组织脂肪变性及细胞凋亡。     

Serum levels of TNF-alpha,sIL-2R,IL-6, and IL-8 are increased and associated with elevated lipid peroxidation in patients with Behçet's disease

AIM: Behçet''s disease (BD) is asystemic immunoinflammatory disorder and the aetiopathogenesis is to be specified. Cytokines play a role in immune response and in many inflammatory diseases. The aim of this case-control study is to investigate serum pro-inflammatory cytokine tumour necrosis factor (TNF)-alpha, interleukin-1beta (IL-1beta), soluble IL-2 receptor (sIL-2R), IL-6, and chemokine IL-8 levels in patients with BD. We also determined the end product of lipid peroxidation (malondialdehyde (MDA)) in BD patients as an index for oxidative stress. METHODS: A total of 37 patients (19 men, 18 women) with BD (active, n = 17; inactive, n = 20) and 20 age-matched and sex-matched healthy control subjects (11 men, nine women) included in this cross-sectional, blinded study. Serum TNF-alpha, IL-1beta, sIL-2R, IL-6 and IL-8 levels were determined by a spectrophotometer technique using the immulite chemiluminescent immunometric assay. Lipid peroxidation was evaluated by Wasowicz et aL The levels of cytokines and lipid peroxidation in the active period were compared with the inactive period of the disease. Results are expressed as mean +/- standard error. RESULTS: IL-1beta levels were below the detection limits of the assay (< 5 pg/ml) in all samples. Mean levels of MDA (8.1+/-0.7 micromol/l), sIL-2R (800+/-38 U/ml), IL-6 (12.6+/-1.1 pg/ml), IL-8 (7.2+/-0.4 pg/ml), and TNF-alpha (7.9+/-0.5 pg/ml) in active BD patients were significantly higher than those in inactive patients (4.3+/-0.5 micromol/l, p < 0.01; 447+/-16 U/ml, p < 0.001; 8.3+/-0.6 pg/ml, p = 0.006; 5.3+/-0.1 pg/ml, p < 0.001; and 5.1 0.2 pg/ml, p < 0.001; respectively) or control subjects (2.1+/-0.2 micromol/l, p < 0.001; 446+/-20 U/ml, p < 0.001; 6.4+/-0.2 pg/ml, p < 0.001; 5.4+/-0.1 pg/ml, p < 0.001; and 4.7+/-0.1 pg/ml, p < 0.001, respectively). On the contrary, only the mean IL-6 level was significantly different between inactive BD and control subjects (p = 0.02). All acute phase reactants were significantly higher in active BD than in inactive period (for each, p < 0.01). Conclusions: High levels of sIL-2R, IL-6, IL-8 and TNF-alpha indicate the activation of immune system in BD. Serum sIL-2R, IL-6, IL-8 and TNF-alpha seem to be related to disease activity. Increased lipid peroxidation suggests oxidative stress in BD and therefore tissue damage in such patients. Amelioration of clinical manifestations would be envisaged by targeting these cytokines, chemokines and lipid peroxidation with pharmacological agents.     

The effects of peritoneal dialysis and hemodialysis on serum tumor necrosis factor-alpha, interleukin-6, interleukin-10 and C-reactive-protein levels

BACKGROUND: Markers of an acute phase reaction, such as C-reactive protein (CRP) or tumor necrosis factor-alpha (TNF-alpha) and interleukin (IL)-6, are predictive for cardiovascular morbidity and mortality in normal subjects and in chronic renal failure patients. In this study, we aimed to investigate serum TNF-alpha, IL-6, IL-10 and CRP levels in continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) patients. MATERIALS AND METHODS: Serum levels of TNF-alpha, IL-6, IL-10 and CRP levels were measured in 30 patients who were just diagnosed with end-stage renal failure and treated, with 16 CAPD (nine female, seven male) and 14 HD (eight female, six male) patients, before CAPD or HD treatment and after 3 months from the beginning of CAPD or HD in patients with no clinical signs of infection. The control groups were 20 healthy persons of similar age and sex. Serum levels of TNF-alpha, IL-6, IL-10 and CRP were measured by enzyme-linked immunosorbent assay in stable CAPD and HD patients and in healthy persons. RESULTS: The mean serum levels of TNF-alpha, IL-6, IL-10 and CRP showed no significant differences between the CAPD and HD patients for the beginning values and the third month of treatment. However, serum TNF-alpha, IL-6, IL-10 and CRP levels were higher than the control group in the CAPD and HD patients regarding the beginning values and the third month of treatment (p < 0.001). CONCLUSIONS: CAPD and HD of the renal replacement therapy have no effects on serum CRP and cytokines.     

依达拉奉联合醒脑静治疗急性脑出血的临床疗效观察

目的:探究依达拉奉联合醒脑静治疗急性脑出血(ACH)的临床疗效及对炎症指标的影响。方法:本研究于2013年2月~2015年2月期间,选择我院收治的ACH患者128例为研究对象,采用随机数字法将其分为研究组(65例)和对照组(63例)。两组患者均给予一般常规治疗并给予依达拉奉,研究组患者在此基础上联用醒脑静注射液治疗。观察两组患者治疗前后炎症因子变化、采用美国国立卫生研究院的卒中量表(NIHSS)评价神经功能缺损修复情况、采用格拉斯哥昏迷评分(GCS)评价患者意识状态,并对比治疗后临床疗效。结果:治疗后两组患者C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平和NIHSS评分均出现明显降低(均P0.05),GCS评分均出现明显升高(P0.05),且研究组上述指标改善均优于对照组,差异均存在统计学差异(均P0.05);治疗后研究组有效率为87.69%,显著高于对照组的69.84%(X2=6.125,P=0.013)。结论:依达拉奉联合醒脑静治疗ACH,能够改善患者神经功能损伤及炎症反应,预后好,疗效确切,具有重要的临床价值。