规模化猪场急性猪附红细胞体病的诊治

2010年7月中旬,山西省某规模化商品猪场35～40 kg的肥育猪突然出现食欲不振或废绝,体温升高,扎堆,皮肤、浆膜和黏膜苍白及黄染等为主要特征的疫病,根据流行病学、临床症状、病理剖检和实验室诊断,其被确诊为猪附红细胞体病,经过采取积极的预防和治疗措施,病情得到了有效的控制。

Acute Oral Toxicity Test of Radix aconiti lateralis preparata in Kunmin Mice

[Objective] This study aimed to investigate the acute oral toxicity of crude monkshood （Radix aconiti lateralis preparata）. [Method] Monkshood alcohol extract was prepared using soxhlet extractor. The maximum drug dose, which was the minimum dose causing 100% lethally rate in the preliminary test, was diluted into seven con- centrations in formal test. Then every mouse was orally administrated with 0.04 ml/g of the monkshood solution at single time for 7 d. Median lethal dose （LD50） and 95% confidence limit were calculated by the improved Karber method formulas. [Result] LD50 of monkshood ethanol extract was 230.12 mg/kg and 95% confidence limit of LD50 was 80.39-658.57 mg/kg. [Conclusion] Crude monkshood alcohol extract can quickly induce acute toxicity in mice.

Influence of continuous veno-venous hemofiltration on the course of acute pancreatitis

AIM： To investigate whether continuous veno-venous hemofiltration （CVVH） in different filtration rate to eliminate cytokines would result in different efficiency in acute pancreatitis, whether the saturation time of filter membrane was related to different filtration rate, and whether the onset time of CWH could influence the survival of acute pancreatitis. METHODS： Thirty-seven patients were classified into four groups randomly. Group 1 underwent low-volume CVVH within 48 h of the onset of abdominal pain （early CVVH, n = 9）. Group 2 received low-volume CVVH after 96 h of the onset of abdominal pain （late CVVH, n= 10）. Group 3 underwent high-volume CVVH within 48 h of the onset of abdominal pain （early CVVH, n = 9）. Group 4 received high-volume CVVH after 96 h of theonset of abdominal pain （late CVVH, n = 9）. CVVH was sustained for at least 72 h. Blood was taken before hemofiltration, and ultrafiltrate was collected at the start of CVVH and every 12 h during CVVH period for the purpose of measuring the concentrations of TNF-α, IL-1β and IL-6. The concentrations of TNF-α, IL-1β and IL-6 were measured by swine-specific ELISA. The Solartron 1 255 B frequency response analyzer （British） was used to observe the resistance of filter membrane. RESULTS： The survival rate had a significant difference （94.44% vs68.42%, P〈0.01） high-volume and low-volume CVVH patients. The survival rate had also a significant difference （88.89% vs 73.68%, P〈0.05） between early and late CVVH patients. The hemodynamic deterioration （MAP, HR, CVP） was less severe in groups 4 and 1 bhan that in group 2, and in group 3 than in group 4. The adsorptive saturation time of filters membranes was 120-180 min if the filtration rate was 1 000-4 000 mL/h. After the first, second and third new hemofilters were changed, serum TNF-α concentrations had a negative correlationwith resistance （r： -0.91, -0.89, and -0.86, respectively in group 1; -0.89, -0.85, and -0.76, respectively in group 2; -0.88, -0.92, and -0.82, respectively in group 3; -0.84, -0.87, and -0.79, respectively in group 4）. The decreasing extent of TNF-α, IL-1β and IL-6 was significantly different between group 3 and group I （TNF-α P〈0.05, IL-1β P〈0.05, IL-6 P〈0.01）, between group 4 and group 2 （TNF-α P〈0.05, IL-1β P〈0.05, IL-6 P〈0.01）, between group 1 and group 2 （TNF-α P〈0.05, IL-1β P〈0.05, IL-6 P〈0.05）, and between group 3 and group 4 （TNF-α P〈0.01, IL-1β P〈0.01, IL-6 P〈0.05）, respectively during CVVH period. The decreasing extent of TNF-α and IL-1β was also significantly different between survival patients and dead patients （TNF-α P〈0.05, IL-1β P〈0.05）. In survival patients, serum concentration of TNF-α and IL-1β decreased more significantly than that in dead patients. CONCLUSION： High-volume and early CWH improve hemodynamic deterioration and survival in acute pancreatitis patients. High-volume CVVH can eliminate cytokines more effidently than low-volume CVVH. The survival rate is related to the decrease extent of TNF-α and IL-1β. The adsorptive saturation time of filter membranes are different under different filtration rate condition. The filter should be changed timely once filter membrane adsorption is saturated.

EXPRESSION OF INTERCELLULAR ADHESION MOLECULE IN LUNG TISSUES OF EXPERIMENTAL ACUTE LUNG INJURY AND THE AFFECT OF RHUBARB ON IT

Objective. To approach the relation and the possible mechanism between the expression of intercellular adhesion molecule (ICAM1) mRNA and acute lung injury (ALI) and the mechanisms of rhubarb in the prevention and treatment of the lung injury. Methods. Lipopolysaccharide (LPS) was injected into the sublingual vein of male Wistar rats to perform ALI animal model. The rats were divided into 4 groups: LPS group, control group, rhubarb group and dexamethasone group. Macroscopic and histopathological examinations were performed and biological markers were measured for the lung specimens. The markers included lung wet/dry weight, the rate of neutrophils and protein content in the pulmonary alveolar lavage fluid, pulmonary vascular permeability and pulmonary alveolar permeability index. Molecular hybridization method was used to determine the expression of ICAM1 mRNA. Results. In the lung tissues, the ICAM1 mRNA expression was increased in the endothelial cells of pulmonary veins and capillaries, rhubarb and dexamethasone had the action of decreasing the expression. The light reflex value in the gray scale scanning showed that in the comparison between the LPS and the control group, the gray scale value of the lung tissues in ALI was significantly increased, thus the light reflex value was markedly decreased (P<001), demonstrating the expression of ICAM1 mRNA was increased. In comparison with the LPS group, dexamethasone and rhubarb could decrease the gray scale value of the lung tissue significantly, thus the light reflex value was elevated (P<001, P<005); the corresponding pathologic changes of lung tissues and the biological markers of the lung injury were significantly decreased or ameliorated. Conclusions. The increase of the expression of ICAM1 mRNA in the lung tissues of ALI plays the roles in ALI. The application of rhubarb and dexamethasone can decrease the expression and ameliorate the lung damage; its mechanism is possibly via the inhibition of ICAM1 mRNA expression.

Serum inter-cellular adhesion molecule 1 is an early marker of diagnosis and prediction of severe acute pancreatitis

AIM:To determine if serum inter-cellular adhesion molecule 1(ICAM-1)is an early marker of the diagnosis and prediction of severe acute pancreatitis(SAP) within 24 h of onset of pain,and to compare the sensitivity,specificity and prognostic value of this test with those of acute physiology and chronic health evaluation(APACHE)Ⅱscore and interleukin-6(IL-6). METHODS:Patients with acute pancreatitis(AP)were divided into two groups according to the Ranson's criteria:mild acute pancreatitis(MAP)group and SAP group.Serum ICAM-1,APACHEⅡand IL-6 levels were detected in all the patients.The sensitivity,specificity and prognostic value of the ICAM-1,APACHEⅡscore and IL-6 were evaluated. RESULTS:The ICAM-1 level in 36 patients with SAP within 24 h of onset of pain was increased and was significantly higher than that in the 50 patients with MAP and the 15 healthy volunteers(P<0.01).The ICAM-1 level(25 ng/mL)was chosen as the optimum cutoff to distinguish SAP from MAP,and the sensitivity,specificity,positive predictive value,negative predictive value(NPV),positive likelihood ratio and negative likelihood ratio were 61.11%,71.42%,0.6111,0.7142, 2.1382 and 0.5445,respectively.The area under the curve demonstrated that the prognostic accuracy of ICAM-1(0.712)was similar to the APACHE-Ⅱscoring system(0.770)and superior to IL-6(0.508)in distinguishing SAP from MAP. CONCLUSION:ICAM-1 test is a simple,rapid and reliable method in clinical practice.It is an early marker of diagnosis and prediction of SAP within the first 24 h after onset of pain or on admission.As it has a relatively low NPV and does not allow it to be a stand-alone test for the diagnosis of AP,other conventional diagnostic tests are required.

A Molecular Adsorbent Recycling System in Treating Posthepatectomy Acute Hepatic Failure Patients with Hepatocellular Carcinoma:a Bridge to Liver Transplantation

OBJECTIVE To evaluate the effect and safety of a Molecular Adsorbent Recycling System （MARS） in treating posthepatoectomy hepatic failure （AHF） patients surgically treated for primary hepatocellular carcinoma （HCC）. METHODS 12 AHF patients induced by resection of HCC were treated with MARS before orthotopic liver transplantation （OLT）. Their vital signs, urine volume, APACHElll and Glasgow scores were monitored. Routine laboratory blood tests, measurements of coagulatory function, liver and kidney function, serum ammonia, lactic acid and blood gas were conducted before and after treatment with MARS. All of the patients were followed up for a period of 6 months after OLT for prognosis and complication assessment. RESULTS Each patient was treated with MARS for 2-5 times （average of 3.6） with a length of 8-24 h each time. Their mean arterial blood pressure and urine volume were improved, APACHE III and Glasgow scores were better. Liver function was improved with the following alterations before and after treatment with MARS： serum ammonia （127.1±21.4 umol/L vs. 77.4±19.7 umol/L, P〈0.05）, lactic acid （6.53±0.45 mmol/L vs. 3.75± 0.40 mmol/L, P〈0.05） and total bilirubin （452.3±153.7 umol/L vs. 230.9± 115.2 umol/L, P〈0.05）. However, there was no significant change in platelet count （44.25±3.60×10^9/L vs. 43.19±8.26×10^9/L, P〉0.05） on international normalized ratio （INR） （2.74±0.50 vs. 2.82±0.60, P〉0.05）, which showed the safety of MARS. For all patients no serious adverse effects occurred during the treatment with MARS. CONCLUSION MARS is effective and safe for treatment of AHF patients with HCC, especially as a bridge to OLT when a donor organ is not available.

午夜悄悄话

Q:我结婚10年了,和妻子性生活一直正常,然而最近突然发生射精不顺畅的现象,有时甚至不能射精,这是怎么回事如何进行治疗呢还有。