体外循环中急性肺水肿分析

目的：强调重视和加强体外循环中对肺功能的保护。方法：分析16例在体外循环中发生肺水肿患者术前的肺动脉高压,血红蛋白,肾功能和心功能情况,经PEEP＋利尿药＋激素和超滤器为主,辅以强心,扩血管药的协同治疗。结果：所有患者经治疗后气道阻力下降,均减小至术前水平,无酸中毒,尿量＞100ml/min。平均2．5天拔管停呼吸机,11例患者术后第一天均顺利脱离呼吸机。15例患者出院,1例死于MOF。结论：中度肺动脉高压、贫血和心肾功能功能不全可能是体外循环中急性肺水肿的诱发因素,体外循环时应采取措施预防预防和减轻肺功能损伤。     

Aquaporin-4 gene deletion in mice increases focal edema associated with staphylococcal brain abscess

Brain abscess is associated with local vasogenic edema, which leads to increased intracranial pressure and significant morbidity. Aquaporin-4 (AQP4) is a water channel expressed in astroglia at the blood-brain and brain-CSF barriers. To investigate the role of AQP4 in brain abscess-associated edema, live Staphylococcus aureus (10(5) colony-forming units) was injected into the striatum to create a focal abscess. Wild-type and AQP4-deficient mice had comparable immune responses as measured by brain abscess volume (approximately 3.7 mm3 at 3 days), bacterial count and cytokine levels in brain homogenates. Blood-brain barrier permeability was increased comparably in both groups as assessed by extravasation of Evans blue dye. However, at 3 days the AQP4 null mice had significantly higher intracranial pressure (mean +/- SEM 27 +/- 2 vs. 17 +/- 2 mmHg; p < 0.001) and brain water content (81.0 +/- 0.3 vs. 79.3 +/- 0.5 % water by weight in the abscess-containing hemisphere; p < 0.01) than wild-type mice. Reactive astrogliosis was found throughout the abscess-containing hemisphere; however, only a subset of astrocytes in the peri-abscess region of wild-type mice had increased AQP4 immunoreactivity. Our findings demonstrate a protective effect of AQP4 on brain swelling in bacterial abscess, suggesting that AQP4 induction may reduce vasogenic edema associated with cerebral infection.     

Fumonisin-induced pulmonary edema and hydrothorax in swine

Pulmonary edema and hydrothorax were observed in mature swine that died approximately 5 days after consuming corn screenings. These postmortem observations were reproduced in younger pigs that died within 1 week when fed the corn screenings under experimental conditions. Additionally, pulmonary edema and hydrothorax were induced in a pig that died after receiving 4 daily intravenous injections of fumonisin B₁, a toxic metabolite produced by Fusarium moniliforme.     

氧自由基与脑胶质瘤瘤周水肿关系的实验研究

目的：探讨自由基和脑胶质瘤瘤周水肿的关系。方法：体外培养大鼠C6脑胶质瘤细胞株,采用立体定向技术将细胞株接种在右侧尾状核,建立大鼠脑胶质瘤模型,共60只,术后5天将荷瘤大鼠随机分为3组（EDA高剂量组,EDA低剂量组和对照组）,每组各20只,每组10只用来测定荷瘤大鼠瘤周脑组织含水量、SOD活性及MDA含量,剩余10只用来观察荷瘤大鼠生存时间。结果：EDA干预组荷瘤大鼠瘤周脑组织含水量下降,SOD活性增高,MDA含量下降,以EDA高剂量组更为显著。各组荷瘤大鼠瘤周脑组织含水量与SOD活性呈负相关,而与MDA含量呈正相关。且EDA组荷瘤大鼠生存时间延长。结论：由基参与大鼠脑胶质瘤瘤周水肿的形成,自由基清除剂能够减轻大鼠脑胶质瘤瘤周脑组织水肿。     

Neuropathology of acute liver failure

Cerebral edema has been identified in all forms of liver disease and is closely related to the development of hepatic encephalopathy. Cerebral edema is most readily recognized in acute liver failure (ALF), while the main cause of death in patients with ALF is multi-organ failure; brain herniation as a result of intracranial hypertension does remain a major cause of mortality. The mechanisms responsible for cerebral edema in ALF suggest both cytotoxic and vasogenic injury. This article reviews the gross and ultrastructural changes associated with cerebral edema in ALF. The primary cause of cerebral edema is associated with astrocyte swelling, mainly perivascular edema and ammonia still remains the primary neurotoxin involved in its pathogenesis. The astrocytic changes were confined to the gray matter. The other organelles involved in the pathogenesis of ALF include mitochondria, basement membrane, pericytes, microglial cells, blood-brain barrier (BBB) etc. Discrete neuronal changes have recently been reported. Recent studies in animal and humans have demonstrated the microglial changes which have the potential to cause neuronal dysfunction in ALF. The alterations in BBB still remain unclear though few studies have showed disruption of tight junction proteins indicating the involvement of BBB in cellular swelling.     

Suppression of Carrageenan Paw Oedema in Rats and Mice by Heparin-Induced Ec-Sods

Carrageenan-induced paw edemata of mice and rats were suppressed by 1–4 × 10³U/kg intravenous injection of heparin. High doses were less suppressive, corresponding well to the increase in plasma SOD activity. This biphasic dose response curve was also observed in our ischemic paw model of mice. Increased SOD appeared as high molecular EC-SOD C (in mice) and B (in rats) as a result of its sensitivity to a copper chelator and long retention time in the blood stream, compared to the short life of cytosolic Cu, Zn-SOD. EC-SOD C (135 kDa) failed to be detected in the plasma of heparin-injected mice by way of nitroblue tetrazolium staining after PAGE electrophoresis. Instead, SOD activity was found near 270 kDa. An excess heparin-loaded subunit of this enzyme might become inactivated or might not be able to fix to a pocket where EC-SOD eliminates O₂^?. to protect the endothelium, Electrophoresis dissociates the excess heparin resulting in an active form of [he enzyme. Paw edemata of rats were less sensitive because this species lacks the strongly heparin-binding EC-SOD C and has only the weakly heparin-binding EC-SOD B. Ischemia-induced mitochondrial swelling of the paw muscle was observed by electron microscopy and was prevented by heparin injection.     

糖尿病性黄斑水肿3D-OCT与mERG检查结果的相关性研究

目的:探讨糖尿病性黄斑水肿的三维光学相干断层扫描技术(3D-OCT)与多焦视网膜电图(m ERG)检查结果的相关性。方法:随机选择糖尿病性黄斑水肿患者40人60只眼,经荧光造影检查示黄斑部有持续性的荧光渗漏、囊样水肿,3D-OCT示黄斑中心凹厚度大于170um,对黄斑中心凹旁上、下、鼻、颞约750um处视网膜神经上皮层处厚度进行OCT自带软件的分析测量。随机选择18人35只年龄相配的正常眼为对照组以同样方法行3D-OCT黄斑旁四个方位的神经上皮厚度测量。两组用同种方法行常规黄斑部m ERG检查。所有数据应用SPSS13.0统计软件进行处理,分析3D-OCT与m ERG在影像学方面的相关性。结果:两组被检查者检查结果经统计学处理后对比发现:被检查者黄斑中央5°、10°区域N1、P1波反应密度绝对值与黄斑中心凹神经上皮层厚度具有显著的相关性(P0.05)。结论:糖尿病性黄斑水肿的神经上皮厚度的改变与黄斑区m ERG的改变具有显著相关性,主要表现为黄斑中央5°和10°区域m ERG各波反应密度的改变,且有神经上皮厚度增加的越大,m ERG各波反应密度的降低的幅度也随之变大的趋势。     

Inhibition of Cathepsin B1 by E-64, a Thiol Proteinase Inhibitor,and Its Derivatives

Four formaldehyde-resistant yeasts were isolated from soil. Three were tentatively identified as Debaryomyces vanriji and one as Trichosporon penicillatum. These yeasts almost completely consumed formaldehyde at 0.15 to 0.55% in growth medium containing glucose as carbon source, but the carbon of formaldehyde was not incorporated into the cell constituents. In formaldehyde-containing medium, yeast growth occurred after formaldehyde consumption. The yeasts showed relatively high activities of formaldehyde dehydrogenase, S-formylglutathione hydrolase and formate dehydrogenase. The resistance to formaldehyde is attributed to detoxification by oxidation.     

CIRCADIAN VARIATION IN ONSET OF ACUTE CARDIOGENIC PULMONARY EDEMA IS INDEPENDENT OF PATIENTS' FEATURES AND UNDERLYING PATHOPHYSIOLOGICAL CAUSES

Background. The present study aimed to confirm the existence of a circadian pattern in the onset of acute pulmonary edema (APE) and to verify whether sex, age, preexisting diseases, and clinical causes determining the event may influence it. Subjects and Methods. The study considered all consecutive cases of APE observed at the St. Anna General Hospital of Ferrara, Italy, during a 7-year period from January 1, 1992, to December 31, 1998. The sample population was divided into subgroups by sex, age (<75 and ≥75 years), presence or absence of diabetes and hypertension, clinical causes determining the event (i.e., acute myocardial infarction (AMI), pulmonary embolism, arrhythmias). The most important associated or concomitant diseases were also considered (i.e., coronary heart disease and angina, previous myocardial infarction, chronic cardiac failure, dilatative cardiopathy, chronic atrial fibrillation, valvular disease, chronic obstructive pulmonary disease, chronic cor pulmonale, malignancy, chronic renal failure). Time of symptom onset of each event was recorded accurately, then tabulated into 24 increments of 1h (e.g., 06:00 to 06:59 was reported as 6 A.M.). For statistical chronobiological analysis, partial Fourier series were used. Results. During the 7-year period, 1321 consecutive cases of APE in 1014 different subjects were observed. The majority of events occurred at night, and statistical analysis showed a 24h rhythmicity both in the total sample population and in all considered subgroups, with the only exception being patients with pulmonary embolism and arrhythmias, for which the small number of cases made the study of rhythms in APE impossible. Conclusions. The nighttime preference in the occurrence of APE appears to be quite independent of all demographic features or underlying pathophysiological causes. (Chronobiology International, 17(5), 705–715, 2000)     

氧自由基与脑胶质瘤瘤周水肿关系的实验研究

目的:探讨自由基和脑胶质瘤瘤周水肿的关系。方法:体外培养大鼠C6脑胶质瘤细胞株,采用立体定向技术将细胞株接种在右侧尾状核,建立大鼠脑胶质瘤模型,共60只,术后5天将荷瘤大鼠随机分为3组(EDA高剂量组,EDA低剂量组和对照组),每组各20只,每组10只用来测定荷瘤大鼠瘤周脑组织含水量、SOD活性及MDA含量,剩余10只用来观察荷瘤大鼠生存时间。结果:EDA干预组荷瘤大鼠瘤周脑组织含水量下降,SOD活性增高,MDA含量下降,以EDA高剂量组更为显著。各组荷瘤大鼠瘤周脑组织含水量与SOD活性呈负相关,而与MDA含量呈正相关。且EDA组荷瘤大鼠生存时间延长。结论:由基参与大鼠脑胶质瘤瘤周水肿的形成,自由基清除剂能够减轻大鼠脑胶质瘤瘤周脑组织水肿。     

高原脑水肿患者血浆的蛋白质组学研究

目的：高原脑水肿是急性高原病的重症表现之一,其发病机制尚不完全清楚。本实验目的是应用蛋白质组学方法研究高原脑水肿发病时血浆蛋白质表达的变化,为研究高原脑水肿发病分子机制以及高原脑水肿的预防、诊断及治疗提供重要的分子标志物。方法：应用二维凝胶电泳（2D）结合质谱的方法比较了一例高原脑水肿（HACE）患者与高原肺水肿（HAPE）和轻型急性高原反应（mAMS）患者血浆蛋白表达的差异,对差异蛋白进行鉴定,最后用ELISA方法检测载脂蛋白E含量。结果：我们检测到HACE与HAPE患者血浆比较有6个差异蛋白质点,HACE与mAMS患者血浆比较也有6个差异蛋白质点,质谱鉴定结果显示两组比较中都有载脂蛋白E含量变化,ELISA检测结果与二维凝胶电泳结果一致。结论：本实验首次将蛋白质组学技术应用到高原脑水肿研究中,并且发现了可能与高原脑水肿发病密切相关的载脂蛋白E,该蛋白对于研究高原脑水肿发病分子机制以及疾病的预防、诊断及治疗的意义有待进一步研究。     

AQP-4在几种常见类型脑水肿中的表达及其作用

脑水肿是指各种原因导致的脑组织水含量增多,可导致脑容积增大、颅内压增高,脑水肿发病机制复杂,是多种颅脑疾病如脑静脉血栓形成、脑缺血、脑出血、脑组织创伤等的主要病理生理改变之一,其形成严重影响疾病预后,是颅脑疾病中致残、致死的主要原因。水通道蛋白(Aquaporin,缩写为AQP)是一个具有高度选择性通透水的膜通道蛋白家族,包括200多个家族成员,其蛋白质分子结构中有一狭窄的亲水性孔道,通过该孔道水分子从水位势能高的一侧迅速扩散到势能低的一侧,而其它的物质则不能通过;AQP-4是脑内含量最多的水通道蛋白,最近研究表明AQP-4参与多种颅脑疾病的脑水肿的形成及消退。本文就AQP-4在几种常见类型脑水肿中的表达及作用进行综述。     

Production of cytotoxin VT in enteropathogenic and non-enteropathogenic Eschericha coli strains of porcine origin

Abstract We have investigated the production of verotoxin (VT) in 55 enteropathogenic and 48 non-enteropathogenic Escherichia coli strains of porcine origin, belonging to 48 serotypes. VT cytotoxin was only produced by seven out of the eight enteropathogenic strains with serotypes O138:K81, O139:K82, O141:K85ab and O141:K85ac. Five haemolytic non-enteropathogenic E. coli , four with serotypes O75:K-, O75:K95 and O2:K2, and one not typable, synthesized a new thermolabile product not related with enterotoxin (LT) or VT, and which induced the formation of multinucleate cells in Vero monolayers.     

Can the Day 0 CT-scan predict the post-implant scanning? Results from 136 prostate cancer patients

PurposePost-implant CT-scanning is an essential part of permanent prostate brachytherapy. However, the evaluation of post-implant CT dosimetry is not straightforward due to the edema that can modify the dose to the prostate and to the organs at risk. The aim of this study is to evaluate the impact of the timing of the post-implant CT-scan on the dosimetric results and to verify if the Day 0 scan findings can predict Day 50 scanning.Methods136 consecutive patients who received monotherapy with I-125 implants were selected for this study. Two sets of 8 dosimetric quality parameters corresponding to 2 different CT-scans (Day 0 and Day 50) were calculated and compared. The dosimetric parameters included are the percentage volume of the post-implant prostate receiving 80%, 100% and 150% of the prescribed dose, the doses covering 80% and 90% of the prostate volume and the Dose Homogeneity Index. The values of the dose covering 1 cm³ of the rectum and urethra were assessed.ResultsAll the dosimetric parameters of the Day 50 were higher than those of the Day 0 scan. Linear functions were obtained that calculate D₉₀ and V₁₀₀ values at Day 50 based on the Day 0 findings. Rectal and urethral parameters tended to be underestimated on Day 0 CT-scan relative to Day 50 based dosimetry.ConclusionsPredicting the Day 50 dosimetry from the Day 0 scan could be a possible alternative to a Day 50 scan only in specific situations, but with a degree of uncertainty in the predicted values.     

急性酒精处理对大鼠脑内AQP4表达的影响

目的:探讨急性酒精处理对大鼠脑内水通道蛋白4(aquaporin-4,AQP4)表达变化的影响。方法:32只雄性SD成年大鼠随机分为低剂量酒精组(LA)、中剂量酒精组(MA)、高剂量酒精组(HA)和生理盐水对照组(NS)。其中前三组通过腹腔注射不同剂量的酒精制作大鼠急性酒精中毒模型,生理盐水对照组腹腔注射等剂量的生理盐水。免疫组化方法检测了脑内前额皮质、胼胝体和室管膜AQP4的表达变化。结果:AQP4表达于各组大鼠的前额皮质、胼胝体和室管膜,LA组平均相对灰度值(ARG)分别为1．455±0．142,1．583±0．114,1．422±0．111,HA组ARG值分别为1．432±0．131,1．567±0．143,1．412±0．119,均高于NS组ARG值1．414±0．119,1．523±0．123,1．402±0．128(P＜0．05),MA组AQP4阳性表达显著增强,ARG值1．602±0．124,1．595±0．149,1．433±0．008,明显高于NS组ARG值1．414±0．119,1．523±0．123,1．402±0．128(p＜0．01)。结论:急性酒精中毒能使大鼠脑内AQP4表达显著增加,其表达的变化可能与急性酒精中毒时脑水肿有关。     

水通道蛋白4与脑水肿研究进展

水通道蛋白4(AQP4)是膜水通道蛋白家族的一员,在脑组织中高表达,是控制水进出脑组织的通道。近年来发现,AQP4的功能和表达与脑水肿密切相关。同时脑水肿又是和脑疾病治疗密切相关的病理过程,对两者的研究或许可以为我们带来更多的临床治疗新思路。本文综述了AQP4的结构、表达、调控与功能以及AQP4与脑水肿关系的研究进展。     

侧脑室接种隐球菌感染大鼠模型的脑组织含水量变化研究

目的探讨隐球菌中枢神经系统感染大鼠模型的脑组织含水量变化。方法侧脑室接种隐球菌构建中枢神经系统隐球菌感染的大鼠模型,大鼠随机分为实验组和对照组,实验组大鼠侧脑室注射隐球菌菌悬液,对照组大鼠侧脑室注射生理盐水。两组分别采用干湿重法于6h、12h、24h、48h、72h动态检测大鼠脑组织含水量的变化。结果大鼠隐球菌中枢神经系统感染后,脑组织含水量于6h开始明显升高,12h到达高峰,后逐渐下降,但仍明显高于对照组;与对照组差异有统计学意义。结论隐球菌中枢神经系统感染后的大鼠脑组织含水量与对照组差异明显。     

隐球菌感染小鼠模型脑组织含水量的变化

目的探讨隐球菌中枢神经系统感染小鼠模型脑组织含水量变化。方法尾静脉接种隐球菌构建中枢神经系统隐球菌感染的小鼠模型,小鼠随机分为实验组和对照组,免疫抑制后实验组小鼠尾静脉注射隐球菌菌悬液,对照组小鼠尾静脉注射生理盐水。两组分别采用干湿重法动态观察小鼠脑组织含水量变化。结果小鼠隐球菌中枢神经系统感染后脑组织含水量于6h开始明显升高,24h达高峰,后渐下降,与对照组比较差异有统计学意义。结论成功构建了隐球菌中枢神经系统感染脑水肿小鼠模型。     

大鼠肢体缺血/再灌注后多器官水肿及丹参的预防作用

目的:探讨大鼠肢体缺血/再灌注(LI/R)导致的多器官水肿及丹参的防治作用。方法:Wistar大鼠24只随机分为3组(n=8):对照组(C组)、缺血/再灌注组(I/R组)和丹参预处理组(SM组)。以止血带法制作大鼠肢体缺血/再灌注模型,SM组在再灌注前30 min经尾静脉推注丹参注射液5 ml/kg。准确留取每只动物的心、肝、肾、肺、脑、肠及骨骼肌组织各1 g,恒温烘干后称其干重并计算各组织的湿干重比值(W/D)。采用ELISA法测定血清白细胞介素1(IL-1)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNFα-)含量;采用生物化学方法测定超氧化物歧化酶(SOD)活性及丙二醛(MDA)含量。光镜下观察骨骼肌组织的形态学变化。结果:LI/R后各组织W/D均增加(P<0.05,P<0.01),血浆SOD活性降低而MDA含量增加(P<0.05,P<0.01),血清IL-1、IL-6、TNFα-水平均升高(P<0.05,P<0.01),骨骼肌组织镜下可见炎细胞浸润、肌纤维间隙增宽等病理改变。而SM组与单纯再灌注组比较,血清炎症因子水平下降,氧化损伤程度减轻,镜下组织形态学变化有所改善。结论:大鼠肢体缺血/再灌注可导致多器官水肿,丹参可通过抑制炎症反应、抗氧化等途径在一定程度上预防肢体缺血/再灌注后多器官的水肿。     

Ischemia-induced brain iron delocalization: Effect of iron chelators

Tissue damage in cerebral ischemia may be produced by acidosis-induced delocalization of intracellular iron which acts as a catalyst in oxidative reactions. Acidosis was induced either by homogenization and incubation of rat cortical homogenates in acidified buffers or by submitting hyperglycemic rats to complete ischemia, a procedure that leads to intracellular lactic acidosis. The level of low molecular weight species (LMWS) iron was measured after filtration of tissue homogenates through a 10,000 Mr ultrafiltration membrane. When cortical tissue was homogenized in buffer pH 7, the level of LMWS iron was equal to 0.21 μg/g. It was significantly enhanced by acidification of the homogenization medium, reaching 0.34 μg/g at pH 6 and 0.75 μg/g at pH 5. When the tissue was homogenized in water, the LMWS iron level reached 0.17 μg/g in normoglycemic rats and 0.38 μg/g (p < 0.5) in hyperglycemic rats. Both aerobic incubation of homogenates for 1 h at 37°C and inclusion of EDTA in the homogenization medium led to further increases in the iron level. In order to demonstrate the deleterious role of iron in brain ischemia, the effect of treatment with bipyridyl, an iron-chelating agent, was assessed by measuring regional brain edema by the specific gravity method, 24 h following induction of thrombotic brain infarction. The treatment significantly attenuated the development of brain edema, reducing the water content of the infarcted area by about 2.5%. Taken together, these results support the hypothesis that a significant component of brain ischemic injury involves an iron-dependent mechanism.