目的 研究乌司他丁(ulinastatin,UTI)对急性肺损伤(acute lung injury,ALI)小鼠的保护作用,并探讨其机制.方法 雄性SPF级C57/BL小鼠64只,按随机数字表均分为:健康对照组(Sham组)、Sham+UTI组、脂多糖组(LPS组)、LPS+UTI组.气管内滴注LPS建立ALI模型,Sham+UTI组和LPS+UTI组建模前30 min皮下注射UTI 10000 U/kg.监测各组小鼠72 h生存率.建模后24 h取支气管肺泡灌洗液(BALF)和肺组织,检测BALF中炎性细胞、中性粒细胞和巨噬细胞数;测定肺组织湿/干质量比(W/D);观察肺组织病理学变化并计算肺损伤评分;测定肺组织中髓过氧化物酶(MPO)活性及丙二醛(MDA)含量;测定肺组织中肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、IL-6、IL-2 mRNA水平,检测肺组织中TLR4/NF-κB表达情况.结果 LPS+UTI组小鼠生存率较LPS组明显升高,差异有统计学意义(P<0.05);LPS+UTI组肺组织W/D、肺组织病理评分及肺组织中MPO活性和MDA含量较LPS组明显降低,TNF-α、IL-1、IL-6、IL-2 mRNA水平较LPS组明显降低,且TLR4/NF-κB mRNA表达水平较LPS组显著降低,差异均具有统计学意义(P<0.05或P<0.01).结论 UTI可减轻LPS诱导的ALI小鼠肺组织的炎性反应,提高ALI小鼠生存率,这可能与UTI影响TLR4/NF-κB信号通路有关.

Objective To discuss the effect of total flavonoids of Lysimachiae Herba (TFLH) on kidney injury induced by calcium oxalate monohydrate (COM).Methods Human kidney proximal tubular epithelial cell line (HK-2 cells) was treated with different concentration of COM to simulate urinary calculi cell model in vitro.Then,cells were divided into six groups,namely control group,TFLH treated group (TF group),p38/ mitogen-activated protein kinase (MAPK) inhibitor group (SB group),COM treated group (COM group),COM and TFLH treated group (CTF group) and COM and p38/MAPK inhibitor group (CSB group).WST-1 assay was used to measure cell viability.Kidney injury molecule-1 (KIM-1),p-p38,p38 and cell autophagy related proteins LC3-Ⅱ were tested by Western blotting.Flow cytometry was used to detect the number of apoptotic cells.Results With the increase of COM concentration (0.5,1,2 and 5 mmol/L),cell viability [(85.02 ± 5.50)％,(70.27 ± 3.78)％,(58.09 ± 3.23)％ and (42.56 ± 4.13)％] was significantly decreased compared with control group (99.83 ± 3.65)％ (P ＜ 0.05).In renal tubular epithelial cells treated with COM,the expression of KIM-1,p-p38 and LC3-II were increased with the increase of time.COM could induce excessive autophagy and apoptosis in HK-2 cells,and the apoptosis rate in CSB group was lower than that in COM group [(7.91 ± 0.70)％ vs (29.90 ± 1.07)％,P ＜ 0.05].LC3-II expression in CSB group was lower than that in COM group [(0.52 ± 0.04) vs (1.17 ± 0.04),P ＜ 0.05].The level of p-p38 decreased in CTF group compared with COM group [(0.66 ± 0.06) vs (1.01 ± 0.06),P ＜ 0.05].With the increase of TFLH concentration,the survival rate of HK-2 cells increased gradually.The rate of apoptosis in CTF group was lower than that in COM group [(10.54 ± 1.07)％ vs (29.90 ± 1.07)％,P ＜ 0.05].The expression of LC3-II in CTF group was lower than that in COM group [(0.82 ± 0.10) vs (1.17 ± 0.04),P ＜ 0.05].Conclusion TFLH could inhibit excessive autophagy and apoptosis of renal tubular epithelial cells treated with COM by blocking the p38/MAPK pathway,reduce the injury of renal tubular epithelial cells,thus inhibit the formation of urinary calculi.

Objective To explore a novel improved method of simplified fluid-supplement therapy during the diuresis stage after renal transplantation.Method We adopted an improved fluid-supplement therapy to treat 26 postoperative patients of heterologous kidney transplantation after returning Liger's liquid, 500ml of 5% glucose-salt liquid, and 500ml liger's Compound back to linical wards by means of replenishing 500ml of sodium lactate sodium chloride injection in turn for fluid supplement. In addition, the patients were given originally 10～20ml of 10% calcium glubionate within 12 hours after their operations. Results Based on the results of both blood and urine determination at the first day aftert kidney transplantation, we discovered 2 patients slightly decreased sodium in blood, one displayed hypokalemia,2 patients showed slightly hyperkalemia value than normal referance level. Meanwhile, all patients manifested blood chlorate value between 101±4. Besides, another 7 patients had slightly increased blood suger value. However, no hypernatremia, hypocalcia or hypomagnesemia were found. As a result, all specific gravity ratio value were from 1.010 to 1.015 aparting from hemobilinuria existed in some patients. Conclusion The succesessful use of the new fluid-supplement therapy could effectively avoid unnecessary repeated haemospasia analysis for mornitoring and adjusting the balance of electrolyte, which could remarkably simplify and faciliate the postoperative management of renal transplantation.

目的:研究雷公藤多甙对实验性小鼠小肠移植的抗排斥作用.方法:以Balb/c小鼠作为供体,C57BL/6小鼠为受体,建立同种异位小肠移植模型.将受体分为5组,各组样本数为12只:1组,无处理(对照组);2组,单独使用雷公藤多甙10 mg/(kg.d);3组,小剂量CsA10 mg/(kg.d);4组,联合应用雷公藤多甙与小剂量CsA;5组,大剂量CsA 20 mg/(kg.d).每组抽取6只于术后5 d处死,切除移植物进行组织学检查,其余动物分别观察受体及移植物的生存期.结果:单独使用雷公藤多甙不能抑制小鼠小肠移植的排斥反应,联合应用雷公藤多甙及环孢素(CsA)可使移植物生存期明显延长.结论:雷公藤多甙与CsA协同对小鼠小肠移植的移植物有保护作用.

上腔静脉由于其特殊解剖部位,当受到外界压迫时,可出现头面部浮肿、呼吸困难、右上肢水肿等一系列症状,即上腔静脉综合征(SVCS).能引起上腔静脉综合征的病变多为恶性肿瘤所致,有报道讲,75%～80%是由肺癌所引起[1,2],10%是由恶性淋巴瘤所致.我院自1994年～1997年共收治29例SVCS病人,现将其病情治疗及预后总结如下.