目的:探索炎性疾病患者的乳酸林格氏液(Ringer's lactate,RL)液体动力学特征以及炎性生物标记物是否可以作为协变量影响RL分布和排泄。方法:本研究为前瞻性队列研究。选择40例美国麻醉医师分级(ASA)I-II级,腹腔镜下择期胆囊切除术(胆囊炎组,n=20)或者腹腔镜下急诊阑尾切除术(阑尾炎组,n=20)。所有患者麻醉诱导前开始输注RL,按15 mL/kg,35 min内输毕。采用酶联免疫(enzyme-linked immunosorbent assay,ELISA)方法测定血浆炎症(TNF-α,IL-10和CRP)或者内皮损伤生物标记物(syndecan-1,SDC-1);利用血红蛋白(Hb)稀释-时间曲线和尿量,使用Phoenix软件,采用非线性混合效应模型分析计算RL液体动力学参数和协变量的影响。结果:与胆囊炎组相比,阑尾炎组RL从组织间隙到血浆的转运速率常数(k21)显著降低(14×10-3min-1 versus 35×10-3min-1;P=0.012)。阑尾炎组C反应蛋白(CRP)升高[中位数38.1(1.8-143.6) μg/mL versus 1.3(0.1-159.0) μg/mL;P<0.001];与清醒状态相比,麻醉期间(输液开始后30~45 min),液体从中央室中到外周室的转运速率常数(k12)显著增加(57×10-3min-1 versus 32×10-3min-1;P<0.01)。清除速率常数(k10)降低90%(0.6×10-3min-1 versus 5.3×10-3min-1;P<0.001)。无论在清醒状态还是麻醉状态下低血压均能降低液体清除;炎症或者内膜损伤的生物标记物不能作为显著影响RL液体动力学参数的协变量。结论:阑尾炎或者胆囊炎患者术前输入液体后“炎症反应的生物标记物”不是RL的液体动力学的协变量,但是两组患者中,全身麻醉期间输入液体的清除率下降。 相似文献
Evaluation of kinetic distribution and behaviors of nanoparticles in vivo provides crucial clues into their roles in living organisms. Extracellular vesicles are evolutionary conserved nanoparticles, known to play important biological functions in intercellular, inter‐species, and inter‐kingdom communication. In this study, the first kinetic analysis of the biodistribution of outer membrane vesicles (OMVs)—bacterial extracellular vesicles—with immune‐modulatory functions is performed. OMVs, injected intraperitoneally, spread to the whole mouse body and accumulate in the liver, lung, spleen, and kidney within 3 h of administration. As an early systemic inflammation response, increased levels of TNF‐α and IL‐6 are observed in serum and bronchoalveolar lavage fluid. In addition, the number of leukocytes and platelets in the blood is decreased. OMVs and cytokine concentrations, as well as body temperature are gradually decreased 6 h after OMV injection, in concomitance with the formation of eye exudates, and of an increase in ICAM‐1 levels in the lung. Following OMV elimination, most of the inflammatory signs are reverted, 12 h post‐injection. However, leukocytes in bronchoalveolar lavage fluid are increased as a late reaction. Taken together, these results suggest that OMVs are effective mediators of long distance communication in vivo. 相似文献
Numerical simulations were performed on flow and heat transfer performances of heat exchangers having six helical baffles of different baffle shapes and assembly configurations, i.e., two trisection baffle schemes, two quadrant baffle schemes, and two continuous helical baffle schemes. The temperature contour or the pressure contour and velocity contour plots with superimposed velocity vectors on meridian, transverse and unfolded concentric hexagonal slices are presented to obtain a full angular view. For the six helix baffled heat exchangers, the different patterns of the single vortex secondary flow and the shortcut leakage flow were depicted as wel as the heat transfer properties were compared. The results show that the optimum scheme among the six configurations is a circumferential overlap trisection helix baffled heat exchanger with a baffle incline angle of 20° (20°TCO) scheme with an anti-shortcut baffle structure, which exhibits the second highest pressure dropΔpo, the highest overal heat transfer coefficient K, shel-side heat transfer coefficient ho and shel-side average comprehensive index ho/Δpo. 相似文献
Construction of multifunctional stimuli-responsive nanotherapeutics enabling improved intratumoral penetration of therapeutics and reversal of multiple-drug resistance (MDR) is potent to achieve effective cancer treatment. Herein, we report a general method to synthesize pH-dissociable calcium carbonate (CaCO3) hollow nanoparticles with amorphous CaCO3 as the template, gallic acid (GA) as the organic ligand, and ferrous ions as the metallic center via a one-pot coordination reaction. The obtained GA–Fe@CaCO3 exhibits high loading efficiencies to both oxidized cisplatin prodrug and doxorubicin, yielding drug loaded GA–Fe@CaCO3 nanotherapeutics featured in pH-responsive size shrinkage, drug release, and Fenton catalytic activity. Compared to nonresponsive GA–Fe@silica nanoparticles prepared with silica nanoparticles as the template, such GA–Fe@CaCO3 confers significantly improved intratumoral penetration capacity. Moreover, both types of drug-loaded GA–Fe@CaCO3 nanotherapeutics exhibit synergistic therapeutic efficacies to corresponding MDR cancer cells because of the GA–Fe mediated intracellular oxidative stress amplification that could reduce the efflux of engulfed drugs by impairing the mitochondrial-mediated production of adenosine triphosphate (ATP). As a result, it is found that the doxorubicin loaded GA–Fe@CaCO3 exhibits superior therapeutic effect towards doxorubicin-resistant 4T1 breast tumors via combined chemodynamic and chemo-therapies. This work highlights the preparation of pH-dissociable CaCO3-based nanotherapeutics to enable effective tumor penetration for enhanced treatment of drug-resistant tumors.