C型利钠肽舒张兔主动脉作用机制的探讨

目的 探讨C型利钠肽(CNP)舒张血管的受体和通道机制.方法 采用兔胸主动脉环张力测定法,观察CNP和C型利钠肽受体(NPR-C)激动剂cANF4-23对肾上腺素(NE)10 μmol/L或氯化钾(KCI)60 mmol/L预收缩血管的舒张作用,及多种钾通道阻断剂对两者舒血管效应的影响.结果 1 μmol/L CNP和cANF4-23对血管的最大舒张率分别为(33.5±5.9)%、(38.4±10.6)%,两组舒血管作用比较差异无统计学意义(P>0.05);NPR-C受体阻断剂能减弱CNP的舒血管作用[(19.8±8.3)%];高钾预收缩后CNP、cANF4-23对血管舒张作用明显降低(P<0.01);优降糖或氯化钡能明显抑制CNP的血管舒张作用(P<0.05);氯化钡使cANF4-23的血管舒张作用明显降低(P<0.05).结论 NPR-C/内向整流钾通道(KIR)、NPR-C/钙通道和B型利钠肽受体(NPR-B)/ATP敏感钾通道(KATP)参与了CNP对兔主动脉的舒张作用.     

脑钠肽对猪冠状动脉的舒张作用及机制研究

目的观察脑钠肽(BNP)对猪冠状动脉舒张作用,探讨其扩血管机制。方法采用猪冠状动脉环张力测定法,观察脑钠肽对猪冠状动脉的舒张作用及C型利钠肽受体(NPR-C)拮抗剂cANF4-28、鸟苷酸环化酶抑制剂1H-(1,2,4)恶二唑(4,3-α)喹喔啉-1-酮(ODQ)和各种钾离子通道阻滞剂对其舒血管效应的影响。结果 10-6 mol/L的BNP对血管的最大舒张率为(68.5±11.5)%,ODQ、四乙胺或格列苯脲均能明显抑制脑肽钠的舒血管作用(P<0.05),cANF4-28对BNP的舒张血管作用无明显影响(P>0.05)。结论 BNP可通过激活BKCa和KATP对猪冠状动脉产生舒张作用。     

利钠肽在神经系统疾病的临床研究进展

利钠肽(natriureic peptide,NP)家族由心钠肽(a-trial NP,ANP)、脑钠肽(brain NP,BNP)、C型利钠肽(C-type NP,CNP)和树眼镜蛇属利钠肽(den-droaspisNP,DNP)4种短肽类物质组成。它们具有相似的生理作用,包括利钠、利尿、血管舒张等,并抑制兴奋的肾素-血管紧张素-醛固酮系统(renin-angiorensin-aldosterone system,RAAS)及交感神经系统。它们结构相似:中央由17个氨基酸通过二硫键连接构成一环状结构,此环状结构对于受体识别和其生物学功能是必不可少的〔1〕。NP的受体有:NPR-A、B、C。前两者为膜结合鸟嘌呤环化酶受体,经环磷酸…     

钾通道在心房利钠肽舒张猪冠状动脉中的作用

目的 探讨心房利钠肽(ANP)对猪冠状动脉的舒张作用机制.方法 采用猪冠状动脉环张力测定法,观察ANP对猪冠状动脉的舒张作用及各种钾通道阻断剂对其舒血管效应的影响.结果 10-6 mol/L的ANP对血管的最大舒张率为(60.4±22.6)％,四乙胺或格列苯脲均能明显抑制ANP的舒血管作用(P＜0.05).结论 ANP对猪冠状动脉的舒张作用可能与激活BKC和KATP有关.     

BNP与NT-proBNP的现代医学认识

人类和非人类脊椎动物利钠肽家族(NP)包括A型(ANP)、B型(BNP)、C型(CNP)、D型(DNP)、V型(VNP)利钠肽和肾型肽尿扩张素。其受体有3种,其中受体A和B作为鸟苷酰环化酶配对受体起生物学效应,受体C作为细胞质主受体起清除肽分子和可能的调节细胞增生的作用。利钠肽的作用为维持循环系统的容量、渗透压和压力调节的稳态,并在心肌结构和功能控制中起自分泌和旁分泌的作用。BNP的生物学效应包括扩张血管、利尿、排钠、拮抗肾素-血管紧张素-醛固酮系统及抗心肌纤维化。     

脑钠肽诊治心力衰竭的研究进展

脑钠肽(Brain natriuretic peptide,BNP)是1988年由Sudoh等[1]首次从猪脑内分离出一种心血管肽类激素。它与心房钠肽(Atria natriuretic peptide,ANP),C型利钠肽(C-typenatriuretic peptide,CNP)同属利钠肽家族,都具有利钠、利尿、舒张血管的作用,在心衰中可以拮抗交感神经、抗     

脑钠素与心力衰竭关系研究进展

脑钠素(brain natriuretic peptide,B-type natri-uretic peptide,BNP)是一种主要由心室肌合成和分泌的心脏激素,与心钠素(atria natriuretic peptide,ANP)、C型利钠肽(CNP)及晚近发现的D型利钠肽(DNP)[1]同属利钠肽家族成员,它具有利钠利尿和舒张血管作用,并拮抗肾素.血管紧张素.醛固酮系统(RAAS)和交感神经活性,敏感而特异地反映     

C型利钠肽在慢性肺心病中的变化及临床意义

慢性阻塞性肺疾病（COPD）发展到慢性肺源性心脏病的中心环节是低氧性肺动脉高压的形成，而在低氧性肺动脉高压的形成的过程中，肺小动脉收缩和血管平滑肌细胞增殖起着重要作用，因而有效阻断这二个环节是防治肺动脉高压的关键。C型利钠肽（c—type natriuretic peptide；CNP）是近期发现的第三个利钠肽家族成员之一，具有较强的扩张血管、抑制血管平滑肌细胞增殖的作用。我们在慢性肺心病各期中检测了血浆CNP、舒血管活性肽（ADM）水平，探讨了二者在肺动脉高压形成过程中的作用，现报告如下。     

利钠肽系统与高血压的研究进展

利钠肽系统主要包括ANP、BNP、CNP及其受体NPRA、NPRB、NPRC,利钠肽通过与其受体结合从而发挥一系列生理作用如利钠、利尿、扩张血管而起降压作用。近年来研究发现,改变某一利钠肽或利钠肽受体成分表达,血压将出现不同程度改变(升高或下降);注射利钠肽可使血压下降。利钠肽系统在高血压诊治方面有可能在临床上受到日益重视。     

17β-雌二醇对离体大鼠冠状动脉张力的影响及其机制

目的观察17β-雌二醇对离体大鼠冠状动脉张力的影响及其机制。方法采用离体血管张力实验方法,大鼠冠状动脉环的张力舒缩状态采用PowerLab和DMT系统记录。用10^-6mol／L苯肾上腺素预收缩血管,血管内皮完整与否用10^-6mol／L乙酰胆碱对血管环是否有舒张来判断。观察17β-雌二醇对内皮完整及去内皮大鼠冠状动脉血管张力的影响,以及内皮型一氧化氮合酶抑制剂左旋硝精氨酸甲酯、鸟苷酸环化酶抑制剂亚甲蓝、钙激活钾通道阻断剂四乙胺、ATP敏感钾通道的阻断剂格列本脲、L-型钙通道激动剂（-）BayK8644及雌激素受体阻断剂ICI182780对这一过程的影响。用最大舒张率判断药物的作用,即加药后与加药前收缩幅度的百分比。结果1713一雌二醇可引起内皮完整的冠状动脉浓度依赖性的舒张反应,去内皮后最大舒张率显著降低（P〈0．05）。左旋硝精氨酸甲酯和亚甲蓝均可抑制17β-雌二醇的舒血管作用,显著降低了冠状动脉环的最大舒张率（P〈0．05）;四乙胺、格列本脲、（-）BayK8644可以使17β-雌二醇对冠状动脉的舒张作用减弱（P〈0．05）;雌激素受体特异性阻断剂ICI182780对此作用无显著影响（P〉0．05）。结论17β-雌二醇可引起内皮依赖性的冠状动脉舒张,其作用与一氧化氮合酶／一氧化氮系统激活、钙激活钾通道和ATP敏感钾通道开放、钙通道抑制有关,但与雌激素受体无关。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.