Metabolic depression and spleen and liver enlargement in juvenile Arctic charr Salvelinus alpinus exposed to chronic parasite infection

The present study on the connection between standard metabolic rate ( R _S) and chronic Diplostomum spp. infection resulted in a decrease in R _S, and an enlargement in spleen and liver sizes in the infected juvenile Arctic charr Salvelinus alpinus compared to control fish. As splenic enlargement observed in infected fish was not due to condition-related changes in the spleen, it could most probably be explained by increased leucocyte synthesis. The higher liver masses in infected S. alpinus may have been related to disorders in energetic function, which could have had major effects on biochemical regulation by the liver. The proposed metabolic syndrome with a possible reduction in insulin sensitivity in tissues results in ineffective glucose and lipid metabolism and thus it is suggested that chronic Diplostomum infection in S. alpinus might not impose direct energetic costs, but it may weaken the efficiency of energy metabolism and thus lead to lowered R _S.     

超声引导下经皮穿刺置管引流治疗重症急性胰腺炎急性胰周液体积聚的临床疗效

目的:探讨超声引导下经皮穿刺置管引流(PCD)治疗重症急性胰腺炎(SAP)急性胰周液体积聚的的临床疗效。方法:收集2009年3月~2013年10月我院收治的经临床确定的SAP急性胰周液体积聚患者51例,按随机数字表法分为观察组(26例)和对照组(25例),观察组患者给予超声引导下经皮穿刺置管引流术治疗,对照组采用剖腹引流的经典引流。比较两组患者血淀粉酶恢复至时间、住院时间、治愈率、并发症发生率。结果:观察组血淀粉酶恢复时间及住院时间均小于对照,差异有统计学意义(P0.05);观察组患者总有效率位96.2%(25/26),高于对照组的68.0%(17/25),两组比较组间差异有统计学意义(P0.05);观察组治疗后病死、腹腔出血、胰瘘发生率高于对照组(均P0.05);两组脓毒症及多器官功能障碍综合症(MODS)的比较差异无统计学差异(P0.05)结论:超声引导下经皮穿刺置管引流术治疗SAP急性胰周液体积聚效果良好,并发症的低,安全可靠,具有较大的临床推广价值。     

脓毒性心肌功能障碍

脓毒症是由感染引起的全身炎症反应综合征,证实有感染灶存在或有高度可疑的感染灶。脓毒症是ICU内重症患者的主要死亡原因,且发病率随着年龄的增长而逐渐增加。近十年来,虽然政府在救治脓毒症患者中投入了巨大的资金和技术支持,但源于脓毒症或脓毒性休克患者的病死率仍高达30%~60%。心血管系统在脓毒症与脓毒性休克的病理生理学中扮演着重要着色。过去的四五十年,开展了很多脓毒性心肌功能障碍方面的研究,也积累了不少循证医学证据。然而,心脏只是心血管系统的一部分。诸如脓毒症患者机体血流动力学的变化系脓毒症对心脏的直接效应,还是脓毒症引起心脏前、后负荷及神经体液因素的变化,继而引起心脏继发改变的研究,至今仍在继续。本文概述了近年来脓毒性心肌功能障碍的研究进展,使读者更全面地了解脓毒性心肌功能障碍的病理生理学改变,合理有效地指导脓毒症和脓毒性休克患者的临床救治。     

重症肺炎患者干扰素-r、IL-6 和TNF-alpha含量变化研究

目的：探究重症肺炎患者干扰素-r、白细胞介素-6 和肿瘤坏死因子-alpha含量变化及其临床意义。方法：选取我院收治并确诊 为肺炎的患者103 例,根据病情不同,将其分为重症肺炎组52 例及普通肺炎组51 例,同时选取同期参加健康体检人群50 例,为 对照组。比较三组成员不同时间段干扰素-r、白细胞介素-6 和肿瘤坏死因子-alpha含量,重症肺炎组患者存活与死亡组上述因子含 量情况。结果：入院6 h 后,与对照组比较,重症肺炎及普通肺炎组干扰素-r、白细胞介素-6 及肿瘤坏子因子-琢含量较高P＜ 0.05,与普通肺炎组比较,重症肺炎组重症肺炎组干扰素-r、白细胞介素-6 及肿瘤坏子因子-alpha含量较高P＜0.05;入院24 h后,与 对照组比较,重症肺炎组干扰素-r、白细胞介素-6 及肿瘤坏子因子-alpha含量较高P＜0.05,普通肺炎组与对照组比较无差异P＞ 0.05;重症肺炎死亡组患者干扰素-r、白细胞介素-6 及肿瘤坏子因子-alpha含量较高P＜0.05。结论：干扰素-r、白细胞介素-6 以及 肿瘤坏死因子-alpha参与患者的免疫调节,可间接提示患者的病程发展,可作为判断病情程度的有利依据。     

吗啡联合有创呼吸机辅助通气治疗重症急性左心衰竭的疗效

目的:探讨吗啡联合有创呼吸机辅助通气治疗重症急性左心衰竭的临床疗效。方法:将2012年5月-2014年5月我院收治的82例重症急性左心衰竭患者随机分为观察组和对照组,各41例。两组患者均因常规药物治疗无效再行经口气管插管机械通气及对症治疗,观察组在此基础上加用吗啡静脉注射。对比两组患者的体征、症状、动血气指标及临床疗效。结果:两组治疗后血压、心率(HR)、呼吸频率(BR)、血气指标明显优于治疗前,比较差异有统计学意义(P0.05),且观察组各指标改善明显优于对照组,比较差异有统计学意义(P0.05);治疗后观察组总有效率为92.7%(38/41),高于对照组的82.9%(34/41),比较差异有统计学意义(P0.05)。结论:吗啡联合有创呼吸机辅助通气治疗重症急性左心衰竭可有效缓解患者症状,改善临床体征,临床疗效显著,值得推广。     

重症肺炎患者PCT,WBC,CRP水平与预后的相关性分析

目的:探讨重症肺炎患者降钙素原(PCT)、白细胞(WBC)、C-反应蛋白(CRP)水平与疾病的相关性。方法:回顾性分析我院ICU收治的101例重症肺炎患者,患者均采取机械通气治疗,根据生存情况分为分为生存组与死亡组,另选取同期体检的正常人共40例作为对照组。在住院时、入院后第1 d、5 d以及转出ICU(或死亡时)抽取外周血检测血清PCT、WBC以及CRP水平,同时进行APACHEⅡ评分,并应用统计学分析方法进行数据的相关性分析。结果:1与正常人群相比,重症肺炎患者的PCT、WBC以及CRP显著升高,与死亡组同期比较,生存组PCT、WBC以及CRP较低,P0.05;2与死亡组同期比较,生存组APACHEⅡ评分较低,P0.05;3相关性分析结果显示WBC、CRP、PCT与APACHEⅡ评分呈正相关P0.01。结论:重症肺炎患者的血清PCT、WBC以及CRP水平升高明显,有利于判断重症肺炎病情,对评估预后具有一定的价值。     

Serine phosphorylation on position 1033 of vinculin impacts cellular mechanics

This study evaluates the influence of S1033 vinculin phosphorylation on the mechanical properties of cells. We demonstrate that MEFvcl KO cells transfected with the non-phosphorylatable eGFP-vinculin mutant S1033A are of lower stiffness compared to MEFvcl Rescue and phospho-mimicking mutant S1033D cells, which were of similar stiffness. Analogous, 2D traction microscopy indicates that MEFvcl Rescue and MEF mutant S1033D cells generate similar strain energy, but mutant S1033A cells display ∼50% less strain energy. Fluorescence recovery after photobleaching demonstrates that the recovery time for mutant S1033A was significantly lower compared to MEFvcl Rescue and mutant S1033D and that the mobile fraction was smaller for MEFvcl Rescue and mutant S1033D than for mutant S1033A cells. This indicates that serine phosphorylation is required for the activation of vinculin and force transmission in focal adhesions.     

Age-dependent and cell-population-restricted LRRK2 expression in normal mouse spleen

Leucine-rich repeat kinase 2 (LRRK2) is the causal molecule of familial Parkinson’s disease (PD), but its true physiological function remains unknown. In the normal mouse, LRRK2 is expressed in kidney, spleen, and lung at much higher levels than in brain, suggesting that LRRK2 may play an important role in these organs. Analysis of age-related changes in LRRK2 expression demonstrated that expression in kidney, lung, and various brain regions was constant throughout adult life. On the other hand, expression of both LRRK2 mRNA and protein decreased markedly in spleen in an age-dependent manner. Analysis of purified spleen cells indicated that B lymphocytes were the major population expressing LRRK2, and that T lymphocytes showed no expression. Consistently, the B lymphocyte surface marker CD19 exhibited an age-dependent decrease of mRNA expression in spleen. These results suggest a possibly novel function of LRRK2 in the immune system, especially in B lymphocytes.     

不同时间早期肠内营养对急性重症胰腺炎患者的影响

目的:通过观察不同时间早期肠内营养对急性重症胰腺炎患者的影响,探讨急性重症胰腺炎患者早期肠内营养的最佳时机。方法:将重症急性胰腺炎患者60例分为三组:A组、B组和C组,每组20例。A组为肠外营养组予以常规治疗,B组在常规治疗的基础上通过鼻空肠管在入院3-5天内予以早期肠内营养,C组在常规治疗的基础上通过鼻空肠管在入院5天后予以早期肠内营养。抽取所有患者入院时、入院后3天、7天、14天静脉血,ELISA法测定患者血清中TNF-α、IL-6含量,并记录患者住院期间感染率、病死率、并发症发生率、住院时间、住院费用等。结果:各组患者血清中TNF-α、IL-6含量逐渐下降,B组和C组下降较A组下降明显,差异有统计学意义(P<0.05),B组和C组比较B组予以肠内营养后下降较C组明显,差异有统计学意义(P<0.05)。B组和C组感染率、病死率、并发症发生率、住院时间、住院费用较A组明显低(P<0.05),B组与C组比较感染率、病死率、并发症发生率B组明显低于C组(P<0.05)。结论:早期肠内营养可改善急性重症胰腺炎早期炎症反应,从而减低感染率、病死率、并发症发生率。在患者循环稳定条件下,越早予以肠内营养对患者的预后越有...