阻塞性黄疸肠粘膜屏障功能损害的机制及丹参保护作用

目的 :观察阻塞性黄疸 (阻黄 )时肠粘膜屏障功能损害与中性粒细胞 (PMN)的关系及丹参的保护作用。方法 :SD大鼠 48只分为 4组 :假手术对照组 (SO+NS)、阻黄组 (BDL +NS)、治疗对照组 (SO+SM)及丹参治疗组 (BDL+SM) ,于胆管结扎第 7、1 4天两个时相点分别检测门静脉内毒素、小肠髓过氧化酶 (MPO)和小肠二胺氧化酶 (DAO)活性 ,观察肠粘膜结构变化。结果 :BDL+NS组第 7、1 4天两时相点 ,内毒素逐渐增高 [(1 .0 77± 0 .336) Eu/ m L→ (2 .1 85± 0 .566) Eu/ m L ,P<0 .0 1 ] ,小肠 MPO活性升高 [(2 .850± 1 .2 2 0 ) U/ mg→(4.92 9± 1 .371 ) U/ mg,P<0 .0 1 ] ,小肠 DAO活性逐渐下降 [(1 .70 3± 0 .355) U/ mg→ (1 .2 1 8± 0 .40 7) U/ mg,P<0 .0 5] ,肠粘膜损伤评分升高。 BDL+SM组第 7天时与 BDL+NS组比较内毒素降低和 DAO活性升高均很显著 ,基本接近 SO+SM组水平 ,第 1 4天时与 BDL+NS组比较内毒素显著降低和 DAO活性显著升高 ,但与 SO+SM组差异仍有显著性 ,而 BDL+SM组的 MPO活性却逐日增高 ,第 7、1 4天时与 BDL +NS组差异无显著性 (P>0 .0 5)。结论 :PMN聚集并活化是阻黄时肠粘膜屏障功能损害的重要机制 ;丹参能早期保护肠粘膜屏障功能 ,但不是通过阻止 PMN聚集来实现的。     

比索洛尔联合氨茶碱对慢性心力衰竭合并慢性阻塞性肺病的疗效观察

目的 观察比索洛尔联合氨茶碱缓释片治疗慢性心力衰竭合并慢性阻塞性肺病(COPD)的疗效.方法 62例慢性心力衰竭合并COPD的患者随机分为对照组和观察组2组.对照组30例采用常规对症处理；观察组32例在常规处理基础上加用比索洛尔和氨茶碱缓释片.比较两组3个月后的疗效.结果 观察组心功能、左心室射血分数、平均1 s用力呼...     

Effect of azithromycin on airway inflammation and airway mucus hypersecretion in rats with chronic obstructive pulmonary disease

AIM: To observe the effect of azithromycin on the rats with chronic obstructive pulmonary disease (COPD), and to explore the underlying mechanism about the airway inflammation and mucus hypersecretion. METHODS: Male SD rats were randomly divided into normal control group, COPD model group, azithromycin treatment group. The COPD model was established by the method of cigarette smoking combined with intratracheal injection of LPS. Pathological changes of the bronchi and lung tissues of the rats were observed with HE staining. Pulmonary ventilation function in the rats was detected with pulmonary function instrument. The levels of IL-8, IL-17 and TNF-α in bronchoalveolar lavage fluid (BALF) were measured by ELISA. The expression of MUC5ac and TLR4 at mRNA and protein levels in bronchi and lung tissues was determined by real-time PCR and Western blot.RESULTS: HE staining showed that the changes of bronchi and lung tissues in model group were consistent with typical pathological manifestations of COPD. Compared with model group, these changes were alleviated in treatment group. The pulmonary functions in model group were significantly decreased compared with control group. The levels of IL-8, IL-17 and TNF-α in the BALF in model group were significantly increased compared with control group (P <0.05). The expression of MUC5ac and TLR4 at mRNA and protein levels in model group was significantly higher than that in control group (P <0.05). Compared with model group, the degree of the descent in pulmonary function in treatment group was significantly lessened. Compared with model group, the levels of IL-8, IL-17 and TNF-α in treatment group were significantly inhibited (P <0.05). Furthermore, the expression of MUC5ac and TLR4 at mRNA and protein levels in treatment group was significantly lower than that in model group (P <0.05). CONCLUSION: Azithromycin decreases the levels of IL-8, IL-17 and TNF-α in the BALF of COPD model rats, inhibits the protein expression of MUC5ac and TLR4 in the lung tissues, thus playing a preventive and therapeutic role to reduce airway inflammation and airway mucus hypersecretion.     

柏正平教授运用补肺益肾膏治疗COPD稳定期临床经验

湖南省名中医柏正平教授认为慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）稳定期肺、脾、肾亏虚为发病之本,痰浊、瘀血为病理产物,治以补肺健脾、温肾固本、祛痰化瘀,临床采用自拟膏方补肺益肾膏对COPD稳定期患者进行调理,增强患者体质,减少急性发作次数,提高患者生活质量,为COPD稳定期的临床治疗提供有效方法。     

导致母猪繁殖障碍性疾病的原因及防制措施

近几年,吉林省双辽市大力发展牧业经济,养猪业规模不断扩大,母猪的存栏量大幅度提高。但有些规模化养猪场母猪因在产仔季节感染繁殖障碍疾病,给养殖场造成巨大经济损失。笔者结合多年实践,就导致母猪繁殖障碍性疾病的原因及防制措施作一简要介绍,供养殖场（户）参考。     

Diagnostic value of Th17 cells in symptom severity and prognosis of chronic obstructive pulmonary disease

AIM: To observed the correlation between Th17 cell level and the symptom severity and prognostic factors of chronic obstructive pulmonary disease (COPD), and to explore the clinical application value of Th17 cell level in assessing the prognosis of patients with COPD. METHODS: The patients with diagnosed COPD (n=110) in our hospital during May 2013 to December 2014, and 40 healthy subjects were enrolled in the study. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD), the COPD patients were divided into group A (low risk, less symptoms), group B (low risk, more symptoms), group C (high risk, less symptoms) and group D (high risk, more symptoms), which were given inhaled corticosteroid/long-acting β₂ agonist or corticosteroid/long-acting β₂ agonist+long-acting antimuscarinic agent treatment for 3 months. The proportion of Th17 cells, cytokines (IL-17 and IL-6), the COPD assessment test (CAT) score, age, body mass index, pulmonary function and the times of acute exacerbation of COPD in previous 1 year were observed before and after treatment. The correlation analysis between the level of Th17 cells and other clinical characteristics was performed. RESULTS: Th17 cell, IL-17 and IL-6 levels in COPD group were significantly higher than those in control group (P < 0.05). With the increase in the severity of COPD symptoms, Th17 cells, cytokines (IL-17 and IL-6) and CAT score in groups B and D were significantly higher than those in groups A and C (P < 0.05). The univariate analysis showed that the levels of Th17 cells in groups B and D before treatment were positively correlated with the CAT score (P < 0.05), which were negatively correlated with FEV₁ , FEV₁% Pred, FVC and FVC% Pred. The levels of Th17 cells were not correlated with the CAT score, FEV₁, FEV₁% Pred, FVC and FVC% Pred in groups A and C. The levels of Th17 cells after treatment were positively correlated with the CAT score, which were negatively correlated with FEV₁ , FEV₁% Pred, FVC and FVC% Pred (P < 0.05). CONCLUSION: The peripheral Th17 cell level has a good correlation with IL-17, IL-6, CAT score and pulmonary function in COPD patients, suggesting a potential value to predict the symptom severity and prognosis of COPD.     

沙美特罗/福替卡松对中重度慢阻肺患者稳定期的疗效观察

目的探讨沙美特罗／福替卡松治疗中重度慢阻肺患者稳定期的临床疗效．方法将132例稳定期中重度慢阻肺患者分为两组，对照组患者66例采用氨茶碱治疗，观察组患者66例采用沙美特罗／福替卡松治疗，治疗时间为4周，采用圣·乔治呼吸疾病问卷评定患者治疗前后的生存质量，分析两组患者相关临床指标的改变情况、治疗效果、不良反应情况．结果两组患者治疗后的指标FEV1，FEV1／预计值，FEV1／FVC，6min步行距离均明显增加，而圣·乔治呼吸疾病问卷评分却明显下降；观察组指标FEV1，FEV1／预计值，FEV1／FVC，6min步行距离、总有效率均明显高于对照组；观察组圣·乔治呼吸疾病问卷评分明显低于对照组，差异具有统计学意义（P〈0．05）；观察组不良反应发生率低于对照组，差异不具有统计学意义（P〉0．05）．结论沙美特罗／福替卡松是治疗稳定期中重度慢阻肺的有效药物，可明显改善肺功能，提高治疗效果，并发症少，安全性高．     

Recurrent airway obstruction: A review

Recurrent airway obstruction is a widely recognised airway disorder, characterised by hypersensitivity‐mediated neutrophilic airway inflammation and lower airway obstruction in a subpopulation of horses when exposed to suboptimal environments high in airborne organic dust. Over the past decade, numerous studies have further advanced our understanding of different aspects of the disease. These include clarification of the important inhaled airborne agents responsible for disease induction, improving our understanding of the underlying genetic basis of disease susceptibility and unveiling the fundamental immunological mechanisms leading to establishment of the classic disease phenotype. This review, as well as giving a clinical overview of recurrent airway obstruction, summarises much of the work in these areas that have culminated in a more thorough understanding of this debilitating disease.