关于肺孢子虫的命名与分类

早在20世纪初,Chagas和Carinii就首次从感染克氏、路氏锥虫的豚鼠肺组织和大鼠肺组织中发现肺孢子虫,数年后,Delano夫妇进一步证实它是一种新的病原体,并为纪念Carinii学者而将其命名为卡氏肺孢子虫(pneumocystis carinii)。到了20世纪50……     

艾滋病与机会性致病原虫感染

艾滋病（ＡＩＤＳ）是当前世界上严重威胁人类健康的最疑难病症,危及ＡＩＤＳ病人生命的机会性致病原虫感染,已引起高度重视。卡氏肺孢子虫可引起子卡氏肺孢子虫肺炎,是ＡＩＤＳ病人最危险机会性感染病原体之一,刚地弓形虫主要成弓形虫脑病,是导致ＡＩＤＳ病人死亡的重要原因之一,隐孢子虫和贾第虫可引起严重腹泻,患者可因体质消耗而死亡,对这４种原虫感染做出早期诊断,及时治疗,是减少ＡＩＤＳ病人死亡率的重要措施之一。     

非HIV相关卡氏肺孢子菌肺炎(NH-PCP)患者的临床特点分析

目的:采用病例对照研究的方法,总结非-HIV相关卡氏肺孢子菌肺炎(NH-PCP)的临床特点,为此类患者的临床诊治提供经验.方法:回顾性分析了302医院住院的NH-PCP患者,及在Pubmed、CHKD和万方数据库中检索到的NH-PCP患者共202例,选择65例HIV相关卡氏肺孢子菌肺炎(HIV-PCP)患者作为对照研究,比较分析前者在临床表现、病程、预防、治疗及预后等方面的特征,为今后此类疾病的临床诊治提供经验.结果:与HIV-PCP组对比,NH-PCP组采用预防性治疗的比例低(5.24％ vs.29.2％,P＜0.001);确诊后开始抗感染治疗的时间晚(5.19±0.95天VS.1.1±0.27天,P＜0.005);两组患者应用激素治疗的比例无统计学差异(69.3％ vs.76.9％,P=0.238),病死率无统计学差异(36.6％ vs.27.7％,P=0.487).结论:NH-PCP组患者采取预防治疗的比例低,开始抗感染治疗的时间也较HIV-PVP延迟.这提示我们,重视NH-PCP的风险预测,给予积极的预防治疗及PCP经验性早期治疗至关重要.     

不同浓度中药怀牛膝加黄芪煎液对重型颅脑损伤大鼠脑组织含水量及AQP4表达的影响

目的观察低、中、高不同浓度中药怀牛膝加黄芪煎液对重型颅脑损伤大鼠脑组织含水量及水通道蛋白4(AQP4)表达的影响,探讨其治疗重型脑损伤性脑水肿最佳用药浓度及机制。方法将SD大鼠65只随机分为假手术组(5只),模型组(15只),低浓度怀牛膝加黄芪组(A组)15只,中浓度怀牛膝加黄芪组(B组)15只,高浓度怀牛膝加黄芪组(C组)15只,采用改良后Feency’s方法建立大鼠重型颅脑损伤模型。分别在1、3、7天3个时间点每组各取5只大鼠测定脑组织含水量,HE染色观察脑组织变化情况,并采用免疫组化方法检测脑组织AQP4的表达。结果模型组大鼠重型颅脑损伤后各时间点脑组织含水量、损伤灶周围AQP4的表达均高于假手术组(P0.05),HE染色观察发现模型组的脑组织肿胀水肿明显;A、B组各时间点脑组织含水量、AQP4表达水平与模型组相比较无明显降低(P0.05),HE染色观察发现与模型组基本一致;C组各时间点脑组织含水量、AQP4表达水平均较模型组降低(P0.05),HE染色观察发现与模型组比较,脑组织水肿情况有所改善。结论 C组改善重型颅脑损伤后引起的脑水肿效果最明显,其作用机制可能与减少AQP4在损伤脑组织中的表达、减轻脑细胞损害有关。     

肾移植术后肺部感染的鉴别诊断

肾移植术后并肺部感染是重症监护病房患者死亡的重要原因,感染的症状及体症呈复杂多样化,变化迅速。肾移植后因长期使用免疫抑制剂,肺部感染的病原体多为混合性感染,常见的病原体如铜绿假单胞杆菌、大肠埃希菌、肺炎克雷伯氏杆菌、金黄色葡萄球菌、尤其是耐甲氧西林的金黄色葡萄球菌、结核杆菌、麻疹病毒、巨细胞病毒、呼吸道合胞病毒、真菌、军团菌及卡氏肺孢子虫等病原体引起的肺部感染,尤其是军团菌及卡氏肺孢子虫在免疫抑制患者中感染逐渐增加。从临床表现判断肺部感染病因的诊断较困难,病原学检查需要特殊的检查手段如肺泡灌洗及保护性样本刷取样,胸部X线表现具有一定的参考价值,尤其早期CT检查更有意义。为了明确肺部感染的病因学,患者表现、实验室检查结果及X线表现进行综合考虑是十分必要的,这有利于肺部感染的预防及控制。     

高压氧治疗创伤性脑损伤的效用及机制研究

目的:研究高压氧(HBO)对大鼠创伤性脑损伤(TBI)治疗效用并观察脑组织星形胶质细胞活化及胶质细胞源性神经营养因子(GDNF)和神经生长因子(NGF)表达的变化以探讨作用机制。方法:SD雄性大鼠54只,随机分为3组(n=18):假手术组、TBI组和HBO治疗组。采用Feeney法建立大鼠TBI模型,假手术组只开放骨窗,不予打击。HBO治疗组大鼠于脑损伤后6 h采用动物高压舱,以3ATA压力纯氧治疗60 min。TBI后48 h测量神经功能,然后分离脑组织,其中18只用干湿法测定脑含水量;18只脑组织用于切片,部分进行尼氏染色后作形态学观察,部分进行免疫组织化学染色,检测星形胶质细胞标记物胶质纤维酸性蛋白(GFAP)、波形蛋白(vimentin)与S100蛋白的表达;另18只大鼠取伤侧脑半球,进行Western blot分析,观察GDNF和NGF的表达。结果:HBO治疗能减轻神经功能障碍,降低脑含水量,减少海马部位神经细胞丢失,进一步激活损伤侧皮质与海马部位GFAP、vimentin与S-100阳性表达星形胶质细胞,促进损伤侧脑组织GDNF与NGF的表达。结论:HBO对创伤性脑损伤有较好治疗效果,其机制与上调GDNF和NGF的表达有关。     

艾滋病合并卡氏肺孢子菌肺炎的诊断方法研究进展

卡氏肺孢子菌肺炎是由卡氏肺孢子菌引起的一种呼吸系统机会性感染,作为AIDS、器官移植、肿瘤、化疗等免疫功能低下患者的并发症越来越突出,对其做出正确、及时的诊断也越来越重要。该文就卡氏肺孢子菌的病原学及PCP的实验诊断、影像学诊断方法的研究概况和进展作一综述。     

卡氏肺孢子虫感染小鼠动物模型的研究

采用肾上腺皮质激素的方法在国产昆明小鼠成功诱导卜氏肺孢子虫感染,在54只实验鼠中,47只发现虫体,阳性率为87．03％,表明该方法可透用于建立卡氏肺孢子虫感染的小鼠动物模型,并具有简便,经济等优点。     

米卡芬净单药或联合治疗肺孢菌肺炎7例疗效及安全性分析

<正>肺孢菌肺炎(PCP,Pneumocystis carinii pneumonia)是由耶氏(早前称为卡氏)肺孢子菌引起的一种机会性感染性真菌性肺病。复方磺胺甲噁唑/甲氧嘧啶(SMZ/TMP)由于价格低廉、疗效确切是PCP治疗的一线用药,但其胃肠道副作用大,肝肾功能损害和骨髓毒性等原因,有时导致治     

脑出血大鼠脑组织凝血酶、含水量、细胞凋亡的情况研究

为分析脑出血大鼠模型脑组织中凝血酶、含水量、细胞凋亡的情况,将120只SD大鼠随机分为3组,每组各40只,观察1组为制备的脑出血大鼠模型,观察2组为生理盐水大鼠模型,对照组为正常大鼠,所有大鼠均在相同条件下饲养。分别于术后6 h、24 h、3 d、7 d,测定大鼠脑组织凝血酶水平、脑组织含水量、及脑细胞凋亡情况。观察1组脑组织凝血酶水平、脑组织含水量、及脑细胞凋亡情况,在6 h、24 h、3 d、7 d时均高于观察2组、对照组,差异存在统计学意义(p0.05);观察2组与对照组之间各指标水平相当(p0.05)。本研究推测,脑出血大鼠血肿周围凝血酶水平高、脑细胞大范围凋亡可能是脑水肿形成的重要因素,为脑出血患者的治疗提供了新途径。     

鸦胆子油乳联合放疗治疗鼻咽癌的临床疗效观察

目的:探讨鸦胆子油乳联合放疗治疗鼻咽癌的临床疗效及安全性。方法:将在我科就诊的154例鼻咽癌患者随机分为对照组和治疗组,治疗组患者在常规放射治疗的基础上联合鸦胆子油乳治疗,而对照组患者单纯接受常规放射治疗。待治疗结束后,观察并比较两组患者的临床疗效、血液学指标及不良反应的发生情况。结果:对照组和治疗组的临床有效率分别为63.16%、82.05%,治疗组的临床有效率明显高于对照组,两组间比较有统计学差异(P0.05)。治疗后,治疗组患者的血液学指标如白细胞计数、红细胞计数、血红蛋白水平、CD4+/CD8+等均显著高于对照组,不良反应如恶心呕吐、张口困难、吞咽困难、声音嘶哑、口腔炎均明显低于对照组,差异具有统计学意义(P0.05)。结论:鸦胆子油乳联合放射治疗能够有效提高鼻咽癌患者的临床疗效,并且降低放疗所致的各种不良反应,值得临床推广应用。     

补骨脂抑制人工关节假体周围骨溶解的研究

目的：探讨中药补骨脂对人工关节置换术后假体周围骨溶解,假体无菌性松动的核因子KB受体活化因子配体-核因子KB受体活化因子受体-骨保护素（RANKL-RANK-OPG）信号通路的作用。方法：取24只200＋5g雌性SD大鼠。随机分为A、B、C组,均注射钛颗粒溶液建立骨溶解模型,术后A组采用中药补骨脂水溶液腹腔注射,B组采用外源性OPG腹腔注射作为阳性对照,C组采用生理盐水腹腔注射作为阴性对照。给药4周后,通过免疫组化及反转录聚合酶链反应（RT-PCR）检测各组动物体内RANKL／RANK的表达水平变化。结果：用药4周后,3组12只大鼠背部气囊均为厚壁囊腔,骨溶解模型成功建立,免疫组化及RT-PCR检测RANKIJRANK均呈阳性表达。免疫组化RANKL平均光密度（AOD）值A组（0．168±0．017）、B组（0．147±0．009）明显低于C组（0．314±0．011）,差异有统计学意义（P〈0．05）;A组、B组之间比较无明显差异。RANKAOD值测定A组（0．172±0．015）、B组（0．193±0．045）明显低于C组（0．342±0．007）,差异有统计学意义（P〈0．05）;A组、B组之间比较无明显差异。RT-PCR检测RANKL相对量A组（0．575±0．143）、B组（0．543±0．174）明显低于C组（0．951±0．362）,差异有统计学意义（P〈0．05）;A组、B组之间比较无明显差异。RANK相对量A组（0．433±0．025）、B组（0．611±0．209）明显低于C组（0．871±0．211）,差异有统计学意义（P〈0．05）;A组、B组之间比较无明显差异。结论：中药补骨脂对人工关节置换术后假体周围骨溶解,假体无菌性松动具有抑制作用。     

地塞米松抑制卡氏肺孢子菌肺炎β2-防御素和Dectin-1受体的表达

目的研究卡氏肺孢子菌肺炎（Pneumocystis carinii pneumonia,PCP）鼠肺Dectin-1和β2-防御素的表达变化,探讨地塞米松对Deetin-1和B2-防御素的影响与疾病发生的相互关系。方法实验分4组：正常对照组、Pc刺激组、PCP模型组以及PCP模型恢复组。免疫抑制方法建立PCP动物模型,改良四胺银（Groeoti’s methenamine—silver nitrate method,GMS）染色检测Pc包囊;肺组织切片HE染色观察肺组织病理变化;实时荧光定量和Westernblot检测Deetin-1和B2-防御素的mRNA以及蛋白的表达。结果Pc刺激组的Dectin．1和β2-防御素的mRNA以及蛋白的表达明显高于正常对照组（P〈0．05）;Pc刺激组和PCP恢复组的Dectin-1和β2-防御素的mRNA以及蛋白显著高于PCP组（P〈0．05）,而PCP恢复组与PCP组肺部炎症无明显差别。结论对免疫功能正常宿主,Dectin-1受体和p2-防御素可能在防Pc感染中起重要作用;地塞米松抑制了鼠肺Deetin-1和β2-防御素的表达,这可能与PCP疾病的发生和发展有关。     

Morphological characteristics of the kidney and lung in the neonatal rats observed after 16 days spaceflight.

The aim of this study is to examine the structural development in kidney and lung macroscopically which relate with cardiovascular system in rats raised in space. Twenty three nine-day old rats and six fifteen-day old rats, which were launched at these ages and nursed by their dams in the Space Shuttle Colombia for 16 days (STS-90; Neurolab). Seventeen animals of the nine-day old rats were defined as the nine-day group, and the rest was defined as the re-adaptation group, which were reared on the ground for 30 more days after landing. The organs were weighed and the ratio of the organ weight to the body weight (body weight ratio) was calculated. Both of lung and kidney in flight rats were significantly heavier than ground controls in the body weight ratio. We found that the kidney in the nine-day and the fifteen-day group tended to extend of dorsal-ventral length in macroscopic observations. However, this difference was not observed in the re-adaptation group. These results suggest that space environment may affect in kidney development. On the other hand, the lung had no differences in macroscopic structure among flight and control groups.     

Effects of repeated cycles of starvation and refeeding on lungs of growing rats.

Adult male rats were subjected to four cycles of mild starvation (2 wk) and refeeding (1 wk) and were compared with a fed group. Starvation was induced by giving rats one-third of their measured daily food consumption. During each starvation cycle, rats lost approximately 20% of their body weight. Despite catch-up growth and overall weight gain, starved rats had lower final body weight than fed rats. Lung dry weight and lung volumes were also reduced in the starved group. The mechanical properties of air- and saline-filled lungs did not change significantly with repeated cycles of starvation. Mean linear intercept was similar in the two groups, but alveolar surface area was reduced in the starved rats. Total content of crude connective tissue and concentration per lung dry weight of hydroxyproline and crude connective tissue were reduced in starved rats. We conclude that lung growth is retarded in growing rats subjected to repeated cycles of mild starvation and refeeding, as manifested by smaller lung volume and reduced alveolar surface area. Because alveolar size is unchanged, a reduced number of alveoli is most likely responsible for decreased lung volumes.     

The expression of Cav3.1 on T-type calcium channels of rats with subarachnoid hemorrhage

To study delayed cerebral vasospasm (DCVS) induced by subarachnoid hemorrhage (SAH), 60 healthy Sprague Dawley (SD) rats were randomly divided into 5 groups (12 rats in each group), namely sham operation group, blood injection model group, nimodipine group, flunarizine hydrochloride group, and normal group. Then, the physiological parameters were detected, and after the rats were killed under anesthesia, the degree of nerve injury, vasospasm as well as the therapeutic effect of drugs were evaluated by Western Blot (WB). Neurological impairment (NI), endothelial contraction and spasm were obvious in rats following blood injection. The expression of Cav3.1 on T-type calcium channels was significantly higher in the blood injection model group than in the sham operation group along with the normal group. Moreover, Cav3.1 mRNA was expressed in all groups. The Cav3.1 expression in blood injection model group and two drug groups were significantly higher than that in sham operation group and lower than that in blood injection model group. Vasospasm was improved in two drug groups, which indicated that calcium channel antagonists nimodipine and flunarizine hydrochloride had a certain therapeutic effect on DCVS in rats. The decrease in body weight and food intake of the two groups of rats treated with drugs decreased, and the delayed vasospasm was improved, but the expression of Cav3.1 was not changed significantly, indicating nimodipine and flunarizine hydrochloride had a therapeutic effect on delayed vasospasm in rats, but Cav3.1 expression on calcium channels was not affected.     

Effects of starvation and refeeding on elastase-induced emphysema

Adult rats received pancreatic elastase (75 U/100 g) intratracheally and were divided into three groups: fed, starved, and refed. Starved rats received one-third of their measured daily food consumption until they lost 40% body weight. The refed group was fed after 40% weight loss. A control group received saline intratracheally. Saline volume-pressure curve was shifted more significantly to the left of the control group in starved than in fed rats and was superimposed in refed and fed groups. Mean linear intercept was larger and alveolar surface area was smaller in starved than in fed rats compared with the control group; both were similar in fed and refed rats. Protein and hydroxyproline content of the lung were higher in fed than in control and in starved groups; after refeeding these returned to the control values. We conclude that starvation aggravates elastase-induced injury and that refeeding results in the complete recovery of the mechanical but only partial recovery of the morphometric changes induced by starvation.     

Echinocandin Treatment of Pneumocystis Pneumonia in Rodent Models Depletes Cysts Leaving Trophic Burdens That Cannot Transmit the Infection

Fungi in the genus Pneumocystis cause pneumonia (PCP) in hosts with debilitated immune systems and are emerging as co-morbidity factors associated with chronic diseases such as COPD. Limited therapeutic choices and poor understanding of the life cycle are a result of the inability of these fungi to grow outside the mammalian lung. Within the alveolar lumen, Pneumocystis spp., appear to have a bi-phasic life cycle consisting of an asexual phase characterized by binary fission of trophic forms and a sexual cycle resulting in formation of cysts, but the life cycle stage that transmits the infection is not known. The cysts, but not the trophic forms, express β -1,3-D-glucan synthetase and contain abundant β -1,3-D-glucan. Here we show that therapeutic and prophylactic treatment of PCP with echinocandins, compounds which inhibit the synthesis of β -1,3-D-glucan, depleted cysts in rodent models of PCP, while sparing the trophic forms which remained in significant numbers. Survival was enhanced in the echincandin treated mice, likely due to the decreased β -1,3-D-glucan content in the lungs of treated mice and rats which coincided with reductions of cyst numbers, and dramatic remodeling of organism morphology. Strong evidence for the cyst as the agent of transmission was provided by the failure of anidulafungin-treated mice to transmit the infection. We show for the first time that withdrawal of anidulafungin treatment with continued immunosuppression permitted the repopulation of cyst forms. Treatment of PCP with an echinocandin alone will not likely result in eradication of infection and cessation of echinocandin treatment while the patient remains immunosuppressed could result in relapse. Importantly, the echinocandins provide novel and powerful chemical tools to probe the still poorly understood bi-phasic life cycle of this genus of fungal pathogens.     

大鼠Walker-256移植性肺癌模型的建立

目的建立大鼠Walker-256移植性肺癌模型,探讨应用Walker-256癌细胞建立大鼠移植性肺癌模型的可行性。方法 SD大鼠经尾静脉注射高、中、低三种不同细胞浓度的大鼠Walker-256细胞悬液,观察大鼠的生存时间、体重变化、移植性肺癌模型的成模率,其他脏器转移情况及病理形态学变化情况。结果注射癌细胞后14 d,模型组大鼠均出现体重下降、摄食减少等体征,与正常对照组比较体重明显降低（P〈0.05）;注射癌细胞后21d,高浓度组大鼠开始出现死亡;高、中、低三组不同细胞浓度的移植性肺癌成模率分别为100%、80%、30%,模型组大鼠肝脏系数和肺脏系数均高于正常对照组。病理结果显示,模型组大鼠肺部可见明显的癌症病灶,而其他脏器未发现明显异常。结论注射高浓度Walker256癌细胞（3×105个细胞/只）能成功复制移植性肺癌模型,为移植性肺癌模型的建立和应用提供实验依据。     

不同干预疗法对去卵巢骨质疏松大鼠肱骨骨矿物质含量影响

目的:对比观察不同干预疗法对去卵巢骨质疏松大鼠肱骨骨矿物质含量的影响。方法:按体重将80只成年雌性SD大鼠分层后随机分为假手术组和去卵巢组。手术11周时,将去卵巢组大鼠按体重分层后又随机分为去卵巢组、跑台运动组、振动组、金雀异黄酮组、氯化锂组和雌激素组。跑台运动组每周进行4次45 min、速度18 m/min、跑道倾角5°的跑台训练;振动组每天进行2次15 min、频率90 HZ/min、7次/周的振动治疗;金雀异黄酮组每天按体重灌胃1次金雀异黄酮,剂量为1 mg/kg体重;氯化锂组每周按体重腹腔注射氯化锂3次,剂量为15 mg/kg;雌激素组每周按体重颈部皮下注射3次17β-雌二醇,剂量为25μg/kg。持续处理8周时,于末次处理结束36-48小时内,按解剖位置截取双肱骨,称量肱骨湿重、去脂肪干重以及煅烧后的灰重。结果:与假手术组比较,去卵巢组肱骨湿重/体重、去脂肪干重/体重和灰重/体重均显著下降;与去卵巢组比较,跑台运动组、振动组、金雀异黄酮组和雌激素组肱骨湿重/体重、去脂肪干重/体重、灰重/体重均显著增加,而氯化锂组虽有所升高,但差异无显著性。结论:除氯化锂处理外,其他几种处理均能减缓去卵巢骨质疏松大鼠肱骨骨量的丢失,对防治去卵巢骨质疏松大鼠的骨质疏松有一定的作用。