阻塞型睡眠呼吸暂停低通气综合征与代谢综合征组分关系探讨

目的:探讨阻塞型睡眠呼吸暂停低通气综合征(OSAHS)与代谢综合征(MS)组分关系。方法:对我院2003年1月至2010年7月39例诊断为OSAHS住院患者进行回顾性调查,30例同期住院病人为对照组,均记录年龄、性别,测量身高、体重、血压,检测空腹血糖、血脂,分析OSAHS患者合并MS组分情况。结果:1.OSAHS组与对照组比较,体重指数(BMI)、血压、血清甘油三酯、总胆固醇、低密度脂蛋白胆固醇、载脂蛋白A1升高,高密度脂蛋白胆固醇降低(P<0.05);2.OSAHS组与对照组相比较,无MS组分比例低于对照组,差异有统计学意义(P<0.05);3.OSAHS组与对照组相比较,OSAHS组合并MS组分,包括BMI≥25Kg/m2,血脂紊乱的比例,均高于对照组,差异有统计学意义(P<0.05)。结论:OSAHS患者易合并代谢综合征组分。     

白蛋白静脉滴注联合茵栀黄颗粒治疗新生儿黄疸血清 AKP、TBA、 FFA、γ-GT、HS-CRP的影响

目的:研究白蛋白静脉滴注联合茵栀黄颗粒对新生儿黄疸血清碱性磷酸酶(alkaline phosphatase,AKP)、总胆汁酸(totalbileacids,TBA)、游离脂肪酸(free fatty acid,FFA)、γ-谷氨酰基转移酶(γ-glutamyltransferase,γ-GT)、超敏C-反应蛋白(hypersensitive C-reactive protein, HS-CRP)的影响。方法:选择2016年1月～2019年1月我院收治的95例新生儿病理性黄疸患儿,随机分为两组。对照组服用茵栀黄颗粒治疗,观察组在服用茵栀黄的基础上静脉滴注白蛋白治疗。检测两组的血清间接胆红素(indirectreacting bilirubin,,IBIL)、总胆红素(total bilirubin,TBIL)和AKP、TBA、FFA、y-GT、HS-CRP水平。结果:观察组的有效率明显高于对照组(P0.05);两组治疗后的血清IBIL、TBIL水平明显降低(P0.05),观察组的IBIL、TBIL水平明显低于对照组(P0.05);两组治疗后的血清AKP、TBA、FFA、γ-GT、HS-CRP水平明显降低(P0.05),观察组的血清AKP、TBA、FFA、γ-GT、HS-CRP水平明显低于对照组(P0.05)。结论:白蛋白静脉滴注联合茵栀黄颗粒对新生儿黄疸的治疗效果良好,有助于促进血清胆红素和其他血清学相关指标恢复正常,且安全性好。     

Characterization of the Mechanisms Involved in the Increased Renal Elimination of Bromosulfophthalein During Cholestasis: Involvement of Oatp1

The kidneys and liver are the major routes for organic anion elimination. We have recently shown that acute obstructive jaundice is associated with increased systemic and renal elimination of two organic anions, p-aminohippurate and furosemide, principally excreted through urine. This study examined probable adaptive mechanisms involved in renal elimination of bromosulfophthalein (BSP), a prototypical organic anion principally excreted in bile, in rats with acute obstructive jaundice. Male Wistar rats underwent bile duct ligation (BDL rats). Pair-fed sham-operated rats served as controls. BSP renal clearance was performed by conventional techniques. Renal organic anion-transporting polypeptide 1 (Oatp1) expression was evaluated by immunoblotting and IHC. Excreted, filtered, and secreted loads of BSP were all higher in BDL rats compared with Sham rats. The higher BSP filtered load resulted from the increase in plasma BSP concentration in BDL rats, because glomerular filtration rate showed no difference with the Sham group. The increase in the secreted load might be explained by the higher expression of Oatp1 observed in apical membranes from kidneys of BDL animals. This likely adaptation to hepatic injury, specifically in biliary components elimination, might explain, at least in part, the huge increase in BSP renal excretion observed in this experimental model. (J Histochem Cytochem 57:449–456, 2009)     

小花清风藤的化学成分研究

利用Sephadex LH-20,硅胶柱色谱和硅胶制备薄层色谱等分离方法反复分离纯化,从小花清风藤（Sabia parviflora Wall．ex Roxb）中分离得到9个化合物,通过波谱数据分析分别鉴定它们为二十五烷酸（1）、木栓酮（2）、5-氧阿朴菲碱（3）、3-氧化齐墩果酸甲酯（4）、齐墩果酸（5）、羽扇豆-20（29）-烯-3-酮（6）、羽扇豆醇（7）、β-谷甾醇（8）、脱镁叶绿甲酯酸（9）。化合物2,6、7、9首次从该植物中分离得到。     

茵陈蒿汤联合西药治疗母儿ABO血型不合疗效分析

目的：评价中西药结合治疗对母儿ABO血型不合的疗效以及新生儿溶血发生与孕次关系的探讨。方法：对314例抗体滴度≥l：64的ABO母儿血型不合孕妇（20-45岁）进行研究,其中246例孕期给予以中西药结合治疗（茵陈蒿汤联合25%葡萄糖液、维生素C、维生素E、苯巴比妥）,68例作为对照,观察孕妇IgG抗A/B抗体效价变化及新生儿溶血发生情况。结果：治疗组抗体效价降低与对照组相比,差异有统计学意义（P〈0.05）,治疗组新生儿溶血发生率与对照组相比,差异有统计学意义（P〈0.05）。孕次越大,新生儿溶血的发生率越高。结论：中西药结合治疗对降低孕妇IgG抗A/B效价及防治新生儿溶血疗效满意,新生儿溶血发生可能与孕次呈正相关。     

Adhesion molecules in subjects with COPD and healthy non-smokers: a cross sectional parallel group study

Background

The aim of the study was to investigate how the expression of adhesion molecules changes as neutrophils migrate from the circulation to the lung and if these changes differ between non-smoking subjects and smokers with and without COPD.

Methods

Non-smoking healthy subjects (n=22), smokers without (n=21) and with COPD (n=18) were included. Neutrophils from peripheral blood, sputum and bronchial biopsies were analysed for cell surface expression of adhesion molecules (CD11b, CD62L, CD162). Serum, sputum supernatant and BAL-fluid were analysed for soluble adhesion molecules (ICAM-1, -3, E-selectin, P-selectin, VCAM-1, PECAM-1).

Results

Expression of CD11b was increased on circulating neutrophils from smokers with COPD. It was also increased on sputum neutrophils in both smokers groups, but not in non-smokers, as compared to circulating neutrophils.Serum ICAM-1 was higher in the COPD group compared to the other two groups (p<0.05) and PECAM-1 was lower in smokers without COPD than in non-smoking controls and the COPD group (p<0.05). In BAL-fluid ICAM-1 was lower in the COPD group than in the other groups (p<0.05).

Conclusions

Thus, our data strongly support the involvement of a systemic component in COPD and demonstrate that in smokers neutrophils are activated to a greater extent at the point of transition from the circulation into the lungs than in non-smokers.     

Melatonin Prevents Oxidative Stress and Hepatocyte Cell Death Induced by Experimental Cholestasis

The induction of oxidative stress precedes liver injury during experimental obstructive jaundice (OJ). In this sense, different evidences suggest that melatonin (MEL), as antioxidant, may be useful in the protection against apoptosis and necrosis during experimental cholestasis. In addition, we will also assess if MEL-dependent protection is related to a recovery of antioxidant status disturbances induced by OJ. Cholestasis was achieved by double ligature and sectioning of the principal bile duct. MEL was injected intraperitoneally (500?μg/kg/day). Lipid peroxidation was evaluated by the measurement of malondialdehyde (MDA) content in liver. Different parameters related to antioxidant status, such as reduced glutathione (GSH), glutathione peroxidase (GPx), catalase and superoxide dismutase (SOD) were determined in liver. Liver injury was assessed by alanine aminotransferase (ALT) in serum, histological examination, DNA fragmentation and TUNEL assay. The activation of perisinusoidal stellate cells was evaluated by immunohistochemical measurement of α-smooth muscle actin in liver sections. The induction of OJ increased all the parameters related to apoptosis and necrosis in liver. The induction of liver injury was associated with stellate cell activation, as well as an increase in MDA (p<0.0001) and a reduction in GSH, GPx, catalase and SOD content (p<0.0001) in liver. MEL reduced hepatic apoptosis and necrosis (p<0.004) with a significant improvement in all oxidative stress markers. In conclusion, our results showed that MEL recovered the antioxidant status and reduced apoptosis and necrosis induced by experimental cholestasis.     

小细胞肺癌发生阻塞性肺炎相关因素分析

目的通过对小细胞肺癌患者是否发生阻塞性肺炎的相关因素对比分析,了解伴有阻塞性肺炎小细胞肺癌患者临床特点。方法采用回顾性分析方法,收集2003年1月至2013年1月大连医科大学附属第二医院所收治的经组织学或细胞学确诊的小细胞肺癌患者共450例。经核查资料后,进入统计学的伴有阻塞性肺炎组100例,不伴有阻塞性肺炎组112例,均为初治。对以下因素进行分析：性别、年龄、居住环境、吸烟情况、分期、肿瘤位置、病理类型、初始疗效、NSE（神经元特异性烯醇化酶）。计数资料率和构成比的比较采用卡方检验。结果本组研究中伴有阻塞性肺炎组患者100例中,吸烟患者占76%,小细胞未分化癌患者占81%,中心型癌患者占52%,广泛期患者占57%,NSE阳性率为92%,均高于不伴有阻塞性肺炎组患者。不伴有阻塞性肺炎组的小细胞癌患者初始疗效有效率明显高于伴有阻塞性肺炎组患者。两组在性别、年龄、居住环境方面差异无统计学意义。结论伴有阻塞性肺炎组的小细胞肺癌患者NSE阳性率高于不伴有阻塞性肺炎组。吸烟是小细胞肺癌患者发生阻塞性肺炎的高危因素。阻塞性肺炎降低小细胞癌患者化疗初始疗效。     

低位胆道恶性梗阻性黄疸术前胆红素异常的处理策略探讨(附134例报告)

目的:探讨低位胆道恶性梗阻性黄疸患者术前胆红素异常的处理策略,以提高该类患者的临床疗效。方法:回顾性分析西京医院肝胆外科2008年1月1日-2017年12月31日收治的符合研究条件的134例低位胆道恶性梗阻性黄疸(术前总胆红素≥171μmol/L)患者,按胆红素水平分为中、重度黄疸组,分析和比较两组术前黄疸的处理方法、术后肝功能、并发症情况等。结果:两组患者胆道引流后总胆红素水平均明显低于引流前,而肝功能Child-Pugh分级比较差异均无统计学意义(P0.05);两组行术前胆道引流患者与未行胆道引流患者的围手术期情况比较均无统计学差异(P0.05);两组行术前胆道引流患者与未行胆道引流患者的手术并发症的发生情况比较均无统计学差异(P0.05)。结论:对于低位胆道恶性梗阻性黄疸患者,无论中度黄疸还是重度黄疸,原则上术前不必行胆道引流。对于伴有脏器功能不全、急性炎症或其他暂不宜手术的患者,可先行胆道引流处理,限期手术。若行术前胆道引流,采用PTCD方式,更为简单安全有效。