vascular-permeability
医学免疫学解读什么是超敏反应

组织 重构
三、临床常见的I型超敏反应性疾病
全身性过敏反应:药物过敏性休克(青霉素) 血清过敏性休克(破伤风)
皮肤过敏反应:荨麻疹、血管水肿
消化道过敏反应
呼吸道过敏反应:过敏性鼻炎和过敏性哮喘
过敏性哮喘
• 主要由花粉、真菌、尘螨、动物皮毛引起 • 发生支气管平滑肌痉挛、黏液分泌增多、
气道炎症。 • 急性发作时属于速发相反应。 • 48小时后进入迟发相才出现典型的气道炎
(一)中等大小免疫复合物的形成
抗原 + 抗体
抗原抗体复合物
大分子的免疫复合物
易被吞噬细胞清除
பைடு நூலகம்
小分子的免疫 复合物
中等大小免 疫复合物
不沉淀、易被滤过排出 存在于循环,可能沉淀
(二)中等大小可溶性免疫复合物的沉积
1.血管活性胺类物质的作用
免疫 复合物
激活补体
结合
血小板FcR
血小板活化
C3a/C5a,C3b
cause
antigen
persistent infection inhaled antigens
injected material
bacterial, viral, parasitic, etc.
mold, plant or animal antigen
serum
autoimmunity
self antigen
Examples of drug-induced type II hypersensitivity
Red cells:
Penicillin, chloropromazine, phenacetin
Granulocytes:
Quinidine, amidopyridine
【精品PPT】抗凝和溶栓英文版(源文档可编辑)

Tissue Factor
Platelet phase
Non-nucleated - arise from magakaryocytes blood vessel wall (endothelial cells) prevent
Contains a long tail of fibrin
Can detach and form emboli
Coagulation Phase
Two major pathways
Intrinsic pathway Extrinsic pathway
Both converge at a common point 13 soluble factors are involved in clotting Biosynthesis of these factors are dependent
Release ADP
More adhesion/ aggregation
Reduced blood flow (stasis)
Fibrin clot
Veins low pressure : Red thrombus is formed
Especially in valve pockets
on Vitamin K1 and K2 Most of these factors are proteases Normally inactive and sequentially activated Hereditary lack of clotting factors lead to
Initiating factor is outside the blood vessels - tissue factor
肺血管通透性指数pvpi正常范围

肺血管通透性指数pvpi正常范围
肺血管通透性指数(Pulmonary Vascular Permeability Index,PVPI)是根据多普
勒超声断层扫描技术,采用多聚离子导体(MPIPP)染血测量肺血管通透性及血流结构的
指标。
肺血管通透性指数是推测肺血管容量的重要指标,可帮助医生确定患者有无肺血管
增加通透性或通透性异常,以及指导临床决策。
肺血管通透性指数的正常范围可根据不同因素及检查条件而有所不同。
一般情况下,
幽门螺杆菌(HP)阴转对肺血管通透性指数的影响较大,医生可以按照以下标准判断PVPI的正常范围:如果HP阳性,肺血管通透性指数正常范围为0.12 ~ 0.17 m³/件2;
若HP阴性,肺血管通透性指数正常范围为0.09 ~ 0.11 m³/件2。
此外,肺血管通透性指数的正常范围也受到其它因素的影响,包括肺动脉内径、脉络
膜系统血流量和肺血管增加通透性等。
这些因素可能影响患者的肺血管增加通透性的程度,从而影响患者的PVPI正常范围。
因此,在判断PVPI正常范围时,患者的具体情况也应该
综合考虑。
此外,为了更好地评价患者肺血管通透性指数,医生还可根据不同年龄、不同子宫室
段落、不同呼吸模式等情况个性化评估PVPI正常范围。
由于不同患者肺血管通透性指数
可能有所不同,因此医生在检查时应了解患者的病史,并针对性地给出PVPI的判断。
PiCCO在ICU的使用(作者 Teboul教授)

3 major haemodynamic disorders in ICU patients ICU内主要的三个血流动力学紊乱现象
hypovolemia 血容量过低
vascular tone
Depression 血管紧张度下降
myocardial
Depression 心肌收缩力下降
补液
It is important to assess the degree of each cardiovascular disorder
PPuulmlmoonnaarry blood volume
Femoral arterial line Temperature detection
LA
LV
Temperature injection
time
Transpulmonary thermodilution CO measurement
(vs PA thermodilution)
Author
Godje Chest 1998 Sakka ICM 1999 Goedje CCM 1999 Bindels CC 2000 Goedje Chest 2000 Della Rocca BJA 2002 Sander CC 2005 Ostergaard AAS 2006
Bias (L/min)
Can PVPI enable a reliable diagnosis of increased permeability pulmonary edema?
PVPI
10 9 8 7 6 5 4 3 2 1 0
ALI/ARDS
*
Hydrostatic pulmonary edema
cut-off = 3 Se = 85 %
血管外科专业英语

20. anticoagulant therapy 抗凝治疗 21. Low molecular weight heparin 低分子量肝素 22. heparin 肝素 23. protamine sulfate 硫酸鱼精蛋白 24. Warfarin sodium 华法令钠片 25. Antiplatelet therapy 抗血小板治疗 26. Thrombolytsis 溶栓疗治疗 27. Streptokinase SK 链激酶 28. Urokinase UK 尿激酶 29. rt-PA 阿替普酶
/Buerger病
12. arterial aneurysm 动脉瘤 13. abdominal aortic aneurysm AAA腹主动脉瘤 14. aoreic dissection AD 主动脉夹层 15. Thoracoabdominal aortyic aneurysm TAAA 胸腹主动脉瘤 16. Aortic dissecting aneurysm 主动脉夹层动脉瘤 17. Raynaud’s syndrome 雷诺综合征 18. Varicose veins of lower extremity 下肢静脉曲张 19. Primary incompetence of deep venous valve of lower limbs
血管成形术
6. stenting 支架植入术 7. arterial bypass 动脉旁路转流术 8. thromboangiitis obliterans (TAO)血栓闭塞性脉管炎
Buerger病 9. arterial embolism 动脉栓塞
肺血管通透性指数诊断急性呼吸窘迫综合征的临床价值

急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)是1967年由Ashbaugh首先报道的一组不同原因导致的以呼吸频速、严重低氧血症、肺弹性明显丧失为特征的临床综合征,之后在1994年欧美共识会议上对ARDS的定义进行了规范和修订,提出了相应的诊断标准[1],并明确提出ARDS是在感染、创伤和休克等疾病过程中,由不同病因造成的具有明显特征的肺损伤,病理上表现为弥漫性肺泡损伤,以肺泡上皮和毛细血管内皮损伤、肺泡膜通透性明显增加导致高蛋白性肺泡和间质水肿而肺毛细血管静水压不高为病理生理特征,低氧血症与呼吸窘迫为主要表现的临床综合征[2-3]。
虽然ARDS的诊断标准提出已久,但在实际临床诊疗应用中,依然存在诸多问题与缺陷,值得商榷。
如肺毛细血管通透性明显增加是ARDS区别于心源性肺水肿的特征性改变,故应在诊断标准中体现,使诊断标准更具特征性[2-4]。
ARDS联席会议提出的诊断标准仅包含了X线胸片双肺均有斑片状阴影,说明有肺水肿的改变,然而肺水肿的原因包括高静水压性和高毛细血管通透性两种,诊断标准尚无法区别这两种类型,所以其难以作为反映肺毛细血管通透性明显增加的标志,有必要寻找反映肺毛细血管通透性明显增加的标志性指标。
随着脉搏指示剂连续心排血量(pulse indicator continuous car-d iac output,PiCCO)监测技术的进步,可根据热稀释曲线计算出血管外肺水(EVLW)、心脏舒张末期总容积量(GEDV)、胸腔内总血容量(ITBV)及肺内血容量(PBV),并根据公式计算肺血管通透性指数(PVPI)。
其中,PVPI即可用来反映肺毛细血管通透性[2]。
一旦能够量化反映肺毛细血管通透性的改变这一ARDS特征性病理生理改变,就会使诊断的特异性与准确性明显提高。
1资料与方法1.1一般资料选择2006年6月至2007年5月本院ICU收治的16例进行PiCCO监测的急性呼吸衰竭患者,其中男11例,女5例,年龄16~82岁。
血管内皮生长因子(专业知识值得参考借鉴)

血管内皮生长因子(专业知识值得参考借鉴)一概述血管内皮生长因子(vascularendothelialgrowthfactor,VEGF),又称血管通透因子(vascularpermeabilityfactor,VPF)是一种高度特异性的促血管内皮细胞生长因子,具有促进血管通透性增加、细胞外基质变性、血管内皮细胞迁移、增殖和血管形成等作用。
血管内皮生长因子有5种不同的亚型,根据氨基酸的数目命名为:VEGF121、VEGF145、VEGF165、VEGF189、VEGF206,其中VEGF165为VEGF主要存在形式。
二家族及受体1.家族血管内皮生长因子是一个家族,包括VEGF-A、VEGF-B、VEGF-C、VEGF-D、VEGF-E和胎盘生长因子(PGF)。
通常VEGF即VEGF-A。
VEGF-A可促进新生血管形成和使血管通透性增加,VEGF-B在非新生血管形成的肿瘤中起作用,VEGF-C和VEGF-D在癌组织的新生血管和新生淋巴管的形成过程中起作用,VEGF-E也是一种潜在的新生血管形成因子,PGF促进新生血管形成,使血管通透性增加,在实验性脉络膜新生血管中PGF的表达明显增高。
2.受体与血管内皮生长因子进行特异性结合的高亲和力受体称为血管内皮生长因子受体(vascularendothelialgrowthfactorreceptor,VEGFR),主要分为3类VEGFR-1、VEGFR-2、VEGFR-3。
VEGFR-1和VEGFR-2主要分布在肿瘤血管内皮表面,调节肿瘤血管的生成;VEGFR-3主要分布在淋巴内皮表面,调节肿瘤淋巴管的生成。
三生物学功能1.促进内皮细胞增生VEGF是一种血管内皮细胞的特异性有丝分裂原,在体外可促进血管内皮细胞的生长,在体内可诱导血管增生。
尤其是在低氧环境下,VEGF与内皮细胞膜上VEGF 受体结合,引起受体的自身磷酸化,从而激活有丝分裂原活化蛋白激酶(MAPK),实现VEGF的有丝分裂原特性,诱导内皮细胞增生。
血管内皮生长因子生物学功能及中医药治疗研究进展

•前沿进展•血管内皮生长因子生物学功能及中医药治疗研究进展刘炳男1,周霞1,张文倩2,刘韦成2,胡夏晓2【摘要】 血管新生是机体重要的生理、病理过程之一,与多种疾病的发生发展密切相关。
近年研究发现,血管内皮生长因子(VEGF )通路可调节血管新生,且VEGF 在营养及保护神经、肿瘤靶向治疗、增加血管通透性、促进血管新生、促进子宫内膜修复、促进创伤愈合、凝血、血细胞分化等方面具有重要作用。
中医药可通过多靶点、多途径地调节VEGF 而发挥治疗作用。
本文主要综述了VEGF 的生物学功能及中医药治疗研究进展。
【关键词】 血管内皮生长因子;血管新生;中医药;生物学功能;综述【中图分类号】 R 341 【文献标识码】 A DOI :10.3969/j.issn.1008-5971.2019.05.004刘炳男,周霞,张文倩,等.血管内皮生长因子生物学功能及中医药治疗研究进展[J ].实用心脑肺血管病杂志,2019,27(5):12-15.[ ]LIU B N ,ZHOU X ,ZHANG W Q ,et al.Progress on biological function of vascular endothelial growth factor andtreatment of traditional Chinese medicine [J ].Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease ,2019,27(5):12-15.Progress on Biological Function of Vascular Endothelial Growth Factor and Treatment of Traditional Chinese Medicine LIU Bingnan 1,ZHOU Xia 1,ZHANG Wenqian 2,LIU Weicheng 2,HU Xiaxiao 21.The Second Affiliated Hospital of Shandong Traditional Chinese Medicine University ,Jinan 250001,China2.College of Traditional Chinese Medicine ,Shandong Traditional Chinese Medicine University ,Jinan 250014,China Corresponding author :ZHOU Xia ,E-mail :lusy2000@【Abstract 】 Angiogenesis is one of vital physiological and pathological processes ,and it is closely correlated with theoccurrence and development of dozens of diseases. Recent researches found that ,vascular endothelial growth factor (VEGF )pathway may adjust the angiogenesis ,moreover VEGF play important roles in neurotrophy ,neuroprotection ,targeting therapy of tumor ,increase of vasopermeability ,promotion of angiogenesis ,promoting recovery of endometrium and wound healing ,blood coagulation ,hematopoitic cell differention and so on. Traditional Chinese medicine may come into play through adjusting VEGF by multiple targets and pathways. This paper mainly reviewed the progress on biological function of VEGF and treatment oftraditional Chinese medicine.【Key words 】 Vascular endothelial growth factors ;Angiogenesis ;Traditional Chinese medicine ;Biologicalfunction ;Review1.250001山东省济南市,山东中医药大学第二附属医院2.250014山东省济南市,山东中医药大学中医学院通信作者:周霞,E-mail :lusy2000@血管内皮生长因子(vascular endothelial growth factor ,VEGF )最初被命名为血管通透因子(vascular permeability factor ,VPF ),具有促进血管内皮细胞增殖、迁移及存活等作用。
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Protocol for evaluating vascular permeability in wildtypeand PRTg miceTom MurphyCreated: 9/14/011) Female Tiel-PR Tg mice and wildtype control litter-mates aged 6-9 wks were ovariectimized and allowed to recover for 7-10 days.Making estrogen and progesterone stock solutions:For estrogen (17 beta-estradiol from Sigma), weigh out 10 mg and add to 1 ml 200-proof EtOH. This will yield a lOmg/ml solution. Mix by vortexing. Perform a 1:100 dilution by adding 5 µl of the lOmg/ml solution to 495 µl EtOH. This will leave you with the 100µg/ml stock solution which you can keep at -20C for probably about 2 weeks.For the progesterone stock: Weigh out 5-10 mg progesterone (Sigma) and add to the corresponding amount of EtOH to yield a 1mg/ml solution. (For example: 6.7mg progesterone would be added to 6.7ml EtOH). Mix by vortexing and store at -20C -stableabout 2 weeks.2) The mice were treated with the following hormone regime: Inject mice subcutaneously (on their underside) for 3 days (once a day around 10-11AM) with 100 ng 17 β-estradiol (Sigma) dissolved in 0.1 ml sesame oil. 1- Directions: Take a 1.5ml tube and place 10 µl of the lOOug/ml stock solution into the tube.Add 990 µl sesame oil to the same tube and vortex immediately and thoroughly (the EtOH will have a tendency to move to the top of the oil). Injecting 100 µl will deliver long estrogen. In reality, inject about 120 µl to account for some backflow leakage. Animals receiving vehicle get injected with 100 µl sesame oil alone. Make sure to go s.c. and not i.p. The skin should balloon out if you inject the 100 µl s.c. Wetting the hair with a small amount of 70% EtOH will help the injection because the skin can be more easily visualized.3) On Days 4 and 5 the mice received no treatment.4) On days 6-8, mice received lµg progesterone (Sigma) and 6.7 ng 17-β -estradioi in 0.1 ml sesame oil (once a day around 10-11AM).- Directions: Take a 1.5ml tube and mix 33.5 µl of the 100 µg/ml estrogen stock solution with 466.5 µl EtOH (final volume 500µl) to make a 1:14.93 dilution and therefore a 6.7µg/ml stock solution. Store solution at -20C for at max 2 weeks. Add 10 µl each of the 6.7 µg/ml estrogen stock and 1mg/ml progesterone stock solutions to a 1.5ml tube and thenadd 980 µ l sesame oil. Vortex immediately and throughly. Injecting 100 µl will deliver 6.7ng estrogen and 1µg progesterone. In reality, inject about 110 µ1 to account for some backflow leakage.5) 5-7 hours after receiving the last hormone treatment on day 8, the mice were injected by tail vein with 1 ml/kg 3% Evans Blue dissolved in 0.9% saline for injection.- Directions: remove evans blue stock bottle from 4C and place on magnetic stirrer for 1-2 hours. Remove 3-4 ml and place in plastic tissue specimen container. Sonicate on setting 5 with 5-10 pulses for about 1 min. Keep tube on ice and make sure you cover the top of the container (with the probe sticking out of it) with parafilm to keep the E.B from spraying out. Filter the EB after sonication with a 0.22 µm syringe filter to remove any particles left in the solution. Weigh the mice (probably will be around 20-25g) and measure out the amount of EB (in µl) that matches their weight. Then add 0.9% saline for injection to a final volume of 100 µl (easier to inject 100µl then 20-25µl). For example for a 25g mouse, add 25 µlEB to 75 µl saline in a 1,5ml tube. Pull solution up in 0.5cc insulin syringe. Inject into tail vein using plastic restrainer and warming the tail in 45C water.Note the time of injection - perfusion will be 20 mins following injection.6) 15 min after injection, the mice were anesthetized with isoflurane using a 50ml conical nosecone device.2. Around 19 min after injection, the chest cavity was opened to expose the heart, the right atria removed, the left ventricle cut, and perfused at 120 mmHg through the ascending aorta with 1% paraformaldehyde in 0.05M citrate buffer, pH 3.5 for 2 min. The time between the chest cut and the start of perfusion was 8-15 sec and optimally occurred at the 20 min timepoint3 .- To make the PFA: dissolve lOg PFA in about 200-300ml dH20 at 50-60C. Once in solution add 14.7g sodium citrate. Bring the total volume up to about 800-900ml with dH20. pH the solution to 3.5 (you will need to add a lot of acid). Top the PFA off with dH20 to the final volume of 1L. Filter solution with #50 Whatman paper.7) After perfusion, the first 4 cm of intestine located immediately distal to the stomach was resected and the lumen flushed with fixative. The uterine horns were also dissected and each tissue was blotted between 2 pieces of Whatman filter paper for 10 sec (place a full pipette blue tip container on top of paper and count to 10) and weighed (wet weight). The tissues were placed in 1 ml of fomiamide (in labeled glass 7ml solvent-saver type tubes) o/n at 56°C to extract the Evans Blue. The following day, the tissues were removed from the formamide and the A620 of the samples and standard curve was measured on aspectophotometer and the results were expressed as ng Evans Blue/tissue and ng Evans Blue/mg tissue4.Directions for reading samples:The amount of EB in the experimental samples will be calculated by interpolating to a standard curve. To make the standard curve, perform a 1:1000 dilution of the 3% stock solution (30mg/ml) by adding 1 µl stock: 1000 µl formamide. This will make a 30 µg/ml solution. Label 8 1.5ml tubes 1-8 for each of the points in the standard curve. The first point on the standard curve will be 12.9 µg/ml. Make this by adding 430 µl of the 30 µml solution to 570 µl formamide.Then perform a 2x dilution series by adding 500 µl of the 12.9 µg/ml solution to 500 µl formamide and repeat each time adding 500 µl of the more concentrated EB solution to 500 µl formamide. At the end, the standard curve points will be 12.9, 6.45, 3.225, 1.6125, 0.806, 0.403, 0.2015, and 0.1µg /ml. By the time you get to the last 2 dilutions, the solution will look pretty much clear by eye.Load the Evans Blue protocol in the SoftMax program. In the template window, label the wells for the 8 standards and all the experimental samples (use some system such as M1 duo and M1ut to denote which mouse and tissue is in each well). Add 200 µI/well formamide and blank the plate. Make sure to remove all of the formamide from the crevices of the well by suction and add 200 µI/well of each of the standards and experimental samples to a microtiter plate. Be careful to add the correct solution to the correct well and to not cross-contaminate. Read the plate and print out the curve and the unknowns grid. The numbers in the MeanResult column are the amount ofEB (in µg/ml). Since the samples were extracted in 1ml, this will give you the amount (in µg, or you can convert to ng) of EB/tissue. To get the amount of EB in ng/mg tissue, multiply the values in the MeanResult column by 1000 (to convert them to ng) and divide them by the wet weight of the tissue.1. It is difficult to handle perfusing more than 6-8 mice in one day. Therefore if a greater number of mice are to receive treatment, it is best to stagger the hormone injections so that no more than 6-8 are to receive Evans Blue on the final day.2 Using an inhaled anesthetic is preferred as indictable such as avertin seem to stimulate vascular leakage in the intestine. However, the mouse's breathing must be carefully monitored and the amount of isoflurane inhalation adjusted accordingly to ensure that it does not die before the 20 injection time has elapsed.3 If many mice (5-8 mice) are going to be perfused, it may be easiest if you time the injections and perfusions to be overlapping (i.e. inject one mouse and then after waiting 10-15 min, inject the next mouse so that after you are done perfusing the first, the next mouse will be ready in a few minutes). Place the intact mice on ice until you are done with the perfusions and then dissect the tissue.4 After reading the samples, the 200 µl aliquot in the microtiter plate can be discarded. Store the remaining 800 µl in the solvent saver tubes indefinitely as they can be re-read on the spectrophotometer in the future should the need arise.。