痰热清治疗对AECOPD患者症状、血气、肺功能指标及炎性因子水平的影响

目的:探究痰热清对慢性阻塞性肺疾病发作加重期(AECOPD)患者的症状、血气、肺功能指标及炎症反应的影响。方法:选择2017年10月至2018年10月在本院就诊的AECOPD患者共100例,将其随机分为A组(对照组)和B组(研究组),每组各50例。A组进行常规治疗,B组在A组治疗方案的基础上给予痰热清治疗,比较两组患者的治疗效果、治疗前后血气指标、肺功能及血清炎症因子水平的变化。结果:治疗后,B组咳嗽、呼吸困难和啰音消失时间显著性短于A组(P0.05);两组血氧饱和度(SpO_2)均较治疗前显著上升(P0.05),动脉血二氧化碳分压(PaCO_2)、血清白细胞介素-1(IL-1)、C反应蛋白(CRP)和降钙素(PCT)水平均较治疗前显著降低(P0.05),且B组SpO_2显著高于A组(P0.05),PaCO_2及血清IL-1、CRP及PCT水平均显著低于A组(P0.05)。结论:痰热清辅助常规治疗可显著改善AECOPD患者临床症状,有效改善肺功能,减轻炎症反应。     

法舒地尔联合舒利迭对COPD合并PAH患者肺功能及血清BNP、CRP、IL-8、TNF-α水平的影响

目的:探讨法舒地尔联合舒利迭对慢性阻塞性肺疾病(COPD)合并肺动脉高压(PAH)患者的肺功能及血清脑钠肽(BNP)、C反应蛋白(CRP)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平的影响。方法:选择我院2015年2月~2017年1月收治的108例COPD合并PAH患者作为研究对象,根据患者入院顺序编号,采取随机数字表分成观察组(n=54)与对照组(n=54)。两组均给予常规治疗,观察组在常规治疗基础上联合给予法舒地尔与舒利迭治疗,对两组患者进行疗效评估,比较两组患者治疗前后的肺功能、血气分析指标以及血清BNP、CRP、IL-8、TNF-α水平的变化。结果:治疗后,两组患者的FEV1%pre、FEV1/FVC、PaO_2均较治疗前显著升高(P0.05),且观察组FEV1%pre、FEV1/FVC、PaO_2明显高于对照组(P0.05);两组患者的PaCO_2、SPAP、Tei指数、血清BNP、CRP、IL-8、TNF-α水平均较治疗前显著下降(P0.05),且观察组PaCO_2、SPAP、Tei指数、血清BNP、CRP、IL-8、TNF-α水平均明显低于对照组(P0.05)。结论:法舒地尔联合舒利迭治疗COPD合并PAH能有效改善患者的肺功能,减轻炎症反应,降低肺动脉压,疗效确切。     

不同剂量甲泼尼龙三联疗法对难治性肺炎支原体肺炎患儿免疫功能及炎性因子水平的影响

目的:探讨不同剂量甲泼尼龙三联疗法对难治性肺炎支原体肺炎患儿免疫功能及炎性因子水平的影响。方法:选取我院在2017年5月到2018年6月期间收治的120例肺炎支原体肺炎患儿,根据随机数字表法将其分为对照组、低剂量组、中剂量组和高剂量组,每组均为30例。对照组采用阿奇霉素联合头孢他啶进行治疗,低剂量组、中剂量组和高剂量组在对照组的基础上分别给予1 mg/(kg·d)、2 mg/(kg·d)、5 mg/(kg·d)的甲泼尼龙进行治疗。比较各组患儿的临床疗效、临床症状消失时间及不良反应发生情况,并比较各组患儿治疗前后CD3~+、CD4~+、CD8~+、红细胞沉降率(ESR)、C反应蛋白(CRP)、肿瘤坏子因子-α(TNF-α)、白介素-6(IL-6)水平。结果:高剂量组的总有效率高于对照组(P0.05)。高剂量组患儿临床各项症状消失时间短于中剂量组、低剂量组和对照组(P0.05),中剂量组和低剂量组患儿临床各项症状消失时间短于对照组(P0.05)。治疗后高剂量组、中剂量组、低剂量组的CD3~+、CD4~+水平高于对照组(P0.05)。治疗后高剂量组患儿的ESR、CRP、IL-6水平低于中剂量组、低剂量组和对照组,且中剂量组和低剂量组患儿的ESR、CRP、IL-6水平低于对照组(P0.05)。各组的不良反应发生率比较无统计学差异(P0.05)。结论:甲泼尼龙三联疗法治疗难治性肺炎支原体肺炎患儿疗效确切,可提高患儿免疫功能,且高剂量的甲泼尼龙三联疗法可促进患儿的临床症状改善,更明显地降低炎性因子的水平,安全可靠。     

莫西沙星溶液雾化吸入治疗COPD合并呼吸衰竭的疗效

目的:探讨莫西沙星溶液雾化吸入治疗慢性阻塞性肺病(COPD)合并呼吸衰竭的疗效。方法:选择2014年5月~2016年5月于我院就诊的94例COPD合并呼吸衰竭患者,参照抽签法分为对照组(n=47)与研究组(n=47),对照组行常规治疗,研究组基于对照组加用莫西沙星溶液雾化吸入治疗。比较两组的疗效,血清肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素10(IL-10)水平、肌酸磷酸激酶(CK)、谷草转氨酶(AST)水平,血氧分压(PaO_2)、二氧化碳分压(PaCO_2),APACHEⅡ评分和不良反应的发生情况。结果:治疗后,研究组的总有效率显著高于对照组(P0.05),血清TNF-α、CRP、CK、LDH、AST、PaCO_2、APACHEⅡ评分均明显低于对照组(P0.05),血清IL-10、PaO_2水平均高于对照组(P0.05)。两组不良反应的发生情况比较差异无统计学意义(P0.05)。结论:莫西沙星溶液雾化吸入治疗COPD合并呼吸衰竭的疗效确切,可能与其有效抑制炎症反应,改善呼吸有关。     

持续性血液滤过联合高流量吸氧治疗重症急性呼吸综合征的疗效及对血清炎症因子水平的影响

目的:探讨持续性血液滤过联合高流量吸氧治疗重症急性呼吸综合征的疗效及对血清炎症因子水平的影响。方法:选择2013年2月至2016年2月我院接诊的60例重症急性呼吸综合征患者,通过随机数表法将其分为观察组(n=30)和对照组(n=30)。观察组采用持续性血液滤过联合高流量吸氧进行治疗,对照组采用持续性血液滤过进行治疗。比较两组临床疗效、治疗前后动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)、氧合指数、氢离子浓度指数(pH)值、呼吸频率(RR)、心率(HR)、血清C反应蛋白(CRP)、白介素6(IL-6)、白介素8(IL-8)、肿瘤坏死因子α(TNF-α)水平的变化及不良反应的发生情况。结果:治疗后,观察组有效率为76.67%,显著高于对照组(50.00%,P0.05)。两组治疗后PaO_2、PaCO_2、氧合指数、pH值、RR、HR均较治疗前明显改善,观察组患者PaO_2、氧合指数明显高于对照组,PaCO_2、pH值、RR、HR、血清CRP、IL-6、IL-8及TNF-α水平均显著低于对照组(P0.05)。治疗期间,观察组患者不良反应总发生率(10.00%)显著低于对照组(36.67%,P0.05);观察组死亡1例(3.33%),对照组死亡6例(20.00%),观察组病死率显著低于对照组(P0.05)。结论:持续性血液滤过联合高流量吸氧治疗重症急性呼吸综合征患者的临床疗效及安全性明显优于单用持续性血液滤过治疗,可能与其更有效减轻炎症反应有关。     

硝苯地平联合硫酸镁对高龄孕妇妊娠高血压的临床疗效及机制研究

目的:探讨硝苯地平联合硫酸镁对高龄孕妇妊娠高血压的临床疗效及可能机制。方法:收集我院高龄孕妇妊娠高血压患者54例,随机分为A组和B组,各27例。A组给予100 m L 5%葡萄糖注射液加入20 m L 25%的硫酸镁注射液静脉滴注,30 min内滴完;再给予500 m L 5%葡萄糖注射液加入40 m L 25%硫酸镁注射液1~2 g/h,静脉滴注;B组在A组用药的基础上给予给予硝苯地平控释片30 mg/次口服,1次/日,2组患者均治疗7 d。治疗结束后,比较两组患者血压、C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)及蛋白尿水平。结果:与治疗前相比,两组患者治疗后收缩压、舒张压、CRP、IL-6、TNF-α及蛋白尿水平均显著降低(P0.05);与A组比较,B组患者收缩压、舒张压、CRP、IL-6、TNF-α及蛋白尿水平较低(P0.05)。结论:硝苯地平联合硫酸镁对高龄孕妇妊娠高血压有较好的临床疗效,推测其机制与降低CRP、IL-6及TNF-α水平有关。     

BIPAP与舒利迭对慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者血清IL-6、IL-8及TNF-α水平的影响

目的:研究BIPAP呼吸机联合舒利迭治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的临床效果及对患者血清IL-6、IL-8及TNF-α水平的影响。方法:选取2015年8月至2016年7月我院收治的84例慢性阻塞性肺疾病合并II型呼吸衰竭患者,根据入院顺序分为观察组和对照组,42例每组。对照组使用BIPAP呼吸机完成治疗,观察组采取舒利迭配合BIPAP呼吸机治疗。比较两组患者治疗前后血气指标(pH值、二氧化碳分压(PaCO_2)、动脉血氧分压(PaO_2)),肺功能指标(功能残气量(FRC)、残气量(RV)、深吸气量(IC)、肺活量(FVC)、第一秒用力呼气容积(FEV1)),生理指标(血压、呼吸频率、心率),血清IL-6、IL-8及TNF-α水平的变化及不良反应的发生情况。结果:治疗后,观察组的p H值、Pa O2水平较治疗前显著升高(P0.05),PaCO_2较治疗前显著降低(P0.05),而对照组的pH值、PaCO_2、PaO_2水平和治疗前相比无显著差异(P0.05),观察组的pH值、PaO_2水平显著高于对照组(P0.05),PaCO_2显著低于对照组(P0.05);两组患者FRC、RV、IC、FVC、FEV1水平较治疗前显著升高(P0.05),和对照组相比,观察组的FRC、RV、IC、FVC、FEV1水平较高(P0.05);两组患者血压、呼吸频率、心率、血清IL-6、IL-8、TNF-α水平较治疗前显著降低(P0.05),且观察组以上指标均明显低于对照组(P0.05)。结论:应用舒利迭配合BIPAP呼吸机治疗慢性阻塞性肺疾病合并II型呼吸衰竭患者能有效改善患者肺功能,可能与其显著降低患者血清IL-6、IL-8及TNF-α水平有关。     

不同剂量瑞舒伐他汀用于急诊PCI患者的疗效及对Lp-PLA2、IL-6、TNF-α的影响

目的:探讨不同剂量瑞舒伐他汀对急诊经皮冠状动脉介入术(PCI)患者疗效及脂蛋白相关磷脂酶A2(Lp-PLA2)、白介素(IL)-6、肿瘤坏死因子(TNF)-α的影响。方法:选择2014年2月至2016年2月我院接诊的120例急性冠状动脉综合症(ACS)患者,均急诊行PCI,以随机数表分为A组(n=40),B组(n=40)和C组(n=40),三组PCI术后均给予常规治疗,在此基础上,A组瑞舒伐他汀剂量10 mg,B组20 mg,C组30 mg,均1次/d,睡前服用,连续用药7 d。比较三组治疗前后心率(HR)、心功能以及Lp-PLA2、IL-6、TNF-α的变化,并随访一年,记录心血管不良事件发生率。结果:治疗后,三组HR、心功能指标、Lp-PLA2、IL-6、TNF-α较治疗前均显著改善(P0.05);在HR中,C组B组A组,组间比较均具有显著差异(P0.05);在左心室舒张期末内径(LVEDD)、左心室收缩期末内径(LVESD)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左室射血分数(LVEF)结果中,C组改善程度明显优于B组和A组,组间比较均具有显著差异(P0.05);在Lp-PLA2、IL-6、TNF-α中,C组B组A组,组间比较均具有显著差异(P0.05);随访结果显示,C组再狭窄发生率明显低于B组和A组,A组心肌梗死明显高于C组(P0.05),三组心源性休克、死亡率比较无显著差异(P0.05)。结论:在急诊PCI患者术后应用40 mg的瑞舒伐他汀效果显著,其有助于改善心功能,降低不良心血管事件发生率,其内在机制可能和降低Lp-PLA2、IL-6、TNF-α的表达相关。     

大容量全肺灌洗术对尘肺患者肺功能、血气指标及炎症因子的影响

目的:探讨大容量全肺灌洗术(WLL)对尘肺患者肺功能、血气指标及炎症因子的影响。方法:选取2016年10月到2019年10月在我院接受治疗的尘肺患者48例作为本次研究对象,根据随机数字表法将患者分为WLL组和常规组各24例,给予常规组患者汉防己甲素、乙酰半胱氨酸泡腾片等常规药物治疗,在常规组的基础上给予WLL组患者联用双侧同期WLL治疗。分别于治疗前3天和治疗后2周检测并对比两组患者白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平、血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)、肺泡动脉氧分压差(PA-aO_2)、用力肺活量(FVC)、一秒用力呼气容积与用力肺活量的比值(FEV1/FVC%)及最大通气量与预计值的比值(MVV%)。结果:两组治疗前肺功能指标、血气指标、炎症因子水平比较差异均无统计学意义(P0.05),两组治疗后PA-aO_2较治疗前水平明显降低,FVC、FEV_1/FVC%、MVV%、PaO_2、PaCO_2均较治疗前显著上升,IL-6、TNF-α水平与治疗前比较均明显降低(P0.05);治疗后两组PA-aO_2比较差异无统计学意义(P0.05),治疗后WLL组的FVC、FEV_1/FVC%、MVV%、PaO_2、PaCO_2均高于常规组,IL-6、TNF-α水平均低于常规组,差异均有统计学意义(P0.05)。结论:WLL可明显改善尘肺患者肺功能和血气指标,降低患者血清内IL-6、TNF-α的水平,减轻炎症反应,临床疗效确切,值得临床推广应用。     

不同剂量甲泼尼龙对急性百草枯中毒大鼠早期肺损伤干预研究

目的:探讨不同剂量的甲泼尼龙(Methylprednisolone,MPS)对急性百草枯(paraquat,PQ)中毒大鼠早期肺损伤的疗效。方法:采用腹腔注射20%的PQ溶液制作大鼠急性PQ中毒的模型,随机均分为五组,正常对照组(A组)、染毒组(B组)、5mg/kg甲泼尼龙干预组(C组)、15mg/kg甲泼尼龙干预组(D组)、30mg/kg甲泼尼龙干预组(E组)。分三个不同时间点(24、72、168h)处死大鼠(每组每时间点6只)。观察各时间点大体标本,组织病理、肺系数和氧合指数。结果:光镜下肺组织病理学观察,与B组比较C、D、E组大鼠肺的病理学改变,肺泡腔内出血、渗出,炎性细胞浸润、肺泡隔炎性细胞浸润相对较轻,其中以C、E组减轻最为明显。在各组相同时间点肺系数:在三个时间点的值均比B组低(P<0.05),其中E组在24h、72h时间点上与C、D组有显著差异(P<0.05)。C、D、E组与B组的氧合指数的比较各个时间点上均与B组有差异(P<0.05),三组之间相互无明显差异。结论:本实验结果显示甲泼尼龙对急性百草枯中毒大鼠的肺损伤具有保护作用,且30mg/kg甲泼尼龙组要优于5mg/kg、15mg/kg甲泼尼龙组。     

Characteristics of the membranes of the pellicle of the ciliatePseudomicrothorax dubius

Summary The membranes of the pellicle of the ciliatePseudomicrothorax dubius are investigated using thin section electron microscopy and freeze-fracture replicas. The plasma membrane is covered by a surface coat and is connected to the outer alveolar membrane by short, sometimes branched, bridges. The inner alveolar membrane is coated on both sides. The epiplasm lies in intimate contact with the cytoplasmic surface of this membrane, and there is a corresponding deposit on the other surface. This deposit is regularly striated.The epiplasmic layer and the alveoli are interrupted at sites of cytotic activity,e.g., the attachment sites of trichocysts, the cytoproct, and the parasomal sacs. The striated deposit ends where the epiplasm ends, indicating a direct relationship between these two epimembranous layers.There is a deposit along the sides of the first part of the tip of the trichocysts, and in this region the trichocyst membrane is free of intramembranous particles.The membrane of the parasomal sacs has a coat on both surfaces. That on the extraplasmic surface is similar to the surface coat of the plasma membrane. The origin of the cytoplasmic coat is unknown. The cytotic activity of these sacs is indicated by their highly irregular profiles.     

The early development of the tail and the transformation of the shape of the nucleus of the spermatid of the domestic fowl,Gallus gallus

Summary The differentiation of the spermatid, especially in reference to the formation of the flagellum, and transformation of the shape of the nucleus was investigated in the domestic fowl.In the early stage of the spermatid, a prominent Golgi apparatus appears around the centrioles. The Golgi vesicles then surround the axial-filament complex which develops from the distal centriole. These vesicles fuse to form continuous membrane at the earliest stage of flagellar formation, and in the succeeding stage Golgi lamellae are attached to the plasma membrane of the developing flagellum. From these observations, it is assumed that Golgi apparatus may be a source of the membrane system of the flagellum.The microtubules distributed around the nucleus form the circular manchette. The anterior region of the nucleus with the manchette is cylindrical in shape and the posterior region without it remains irregular in shape. When the circular manchette has been completed, the whole nucleus acquires a slender cylindrical shape. The circular manchette then changes into the longitudinal manchette. The nuclei of spermatids without a longitudinal manchette are abnormal in shape. In view of these observations it is assumed that the nuclear shaping of the spermatid may be accomplished by circular manchette and the maintenance of shape of the elongated nucleus by longitudinal manchette.The authors wish to thank Mr. Takayuki Mori for his helpful suggestions and technical advices     

Characterization of the composition of the aqueous humor and the vitreous body of the eye of the frog Rana temporaria L

This study aimed to analyze the aqueous humor (AH) and the vitreous body (VB) of the eye of the adult frog Rana temporaria L. as a representative species of amphibians, which lead a semi-terrestrial life. The presence of collagen, albumin, uric acid and electron donors was shown in both media; however, there are slight differences in their concentrations. To determine collagen, a spectral-fluorescent probe, cyanine dye, was used. The presence of collagen in AH of the frog was found at the first time. The total content of electron donors (ascorbic and uric acids, tryptophan, and tyrosine) in VB and HA was roughly estimated at ~ 1.5 × 10^− 4 mol/L. Both VB and AH absorb light in similar UV regions. The total protein and albumin contents in AH were found to be somewhat higher than those in VB. The uric acid content was at an equally low level in both intraocular media. It is supposed that the similarity of VB and AH compositions shown in this work is due to some exchange between VB and AH contents in the course of accommodation. The role of intraocular fluids in physiological functions of the eye and in protecting the retina against UV light is discussed.     

Observations on the permeability of the choriocapillaris of the eye

Summary The choriocapillaris is a fenestrated capillary bed located posterior to the retinal pigment epithelium. It serves as the main source of supply to the photoreceptors, retinal pigment epithelium, and other cells of the outer retina. The permeability of these capillaries to intravenously injected ferritin (MW — approx. 480,000; mol. diam. 11 nm) was examined in the mouse, rabbit, and guinea pig, each of which is characterized by a different type of retinal vascularization. In all three species, the bulk of the ferritin remained in the capillary lumina, where it appeared to be blocked at the level of the diaphragmed fenestrae. Some ferritin was present in endothelial cell vacuoles. The results confirm previous work on the rat choriocapillaris and indicate that the barrier function of the choriocapillary endothelium is present even among species in which the retinal circulation differs significantly.Supported by NIH grant EY03418