吗啡对大鼠离体心脏再灌注损伤的保护作用

目的研究吗啡对大鼠离体心脏缺血再灌注损伤的保护作用及其机制。方法32只雄性wistar大鼠随机分为对照组,吗啡组,吗啡+纳络酮组,吗啡+格列本脲组,建立离体工作心脏模型。4℃St.ThomasⅡ停搏液诱导心脏停搏30min,观察缺血再灌注后吗啡对心排血量(CO)、左心室压力微分(±dp/dtmax)、左心室舒张压(LVDP)恢复率及乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、心肌超微结构的影响,并观察纳络酮和格列本脲对吗啡作用的影响。结果吗啡组CO、±dp/dtmax、LVDP的恢复率优于其他各组(P<0.05),LDH漏出明显低于其他组(P<0.05),心肌线粒体等超微结构损伤明显减轻;纳络酮和格列本脲可以完全阻断吗啡的心肌保护作用。结论吗啡可以减轻大鼠心肌的缺血再灌注损伤。吗啡是通过心脏局部的阿片受体及心肌细胞三磷腺苷(ATP)敏感性钾通道(KATP通道)介导产生心肌保护作用。     

As2O3预处理对离体缺血再灌注心肌的保护作用及机制

目的研究三氧化二砷(As2O3)预处理抗心肌缺血再灌注损伤中热休克蛋白(HSP)27的作用及调控机制。方法将16只缺血再灌注心肌损伤大鼠随机分为观察组和对照组各8只,观察组再灌注前24 h腹腔注射As2O3预处理,对照组灌注生理盐水。观察两组再灌注后心功能指标、心肌超微结构及心肌组织HSP27表达变化。结果观察组左心室舒张末期压力(LVEDP)、左心室压力收缩速率(LV+dP/dtmax)、左心室压力舒张速率(LV-dP/dtmax)较对照组明显增高,超微结构损伤亦减轻,HSP27表达量明显增加(P均<0.01)。结论 As2O3预处理对缺血再灌注心肌损伤有保护作用;其机制可能为上调HSP27表达。     

龙血竭总黄酮对新西兰兔心肌缺血/再灌注损伤作用的研究

目的研究龙血竭总黄酮对新西兰兔心肌缺血/再灌注损伤的保护作用。方法将30只新西兰兔随机分为三组,每组10只。采用结扎新西兰兔左冠状动脉前降支法,建立心肌缺血/再灌注损伤模型。观察心肌组织HE染色的结构变化,测量左心室内压最大上升速率(+dp/dtmax),检测心肌肌酸激酶同工酶(CK-MB)。结果龙血竭处理组心肌组织结构明显好于缺血/再灌注组;缺血/再灌注组和龙血竭处理组+dp/dtmax均明显低于假手术组(P0.01),龙血竭处理组+dp/dtmax高于缺血/再灌注组(P0.01);缺血/再灌注组CK-MB水平明显高于假手术组(P0.01),龙血竭处理组CK-MB水平高于假手术组(P0.05),并低于缺血/再灌注组(P0.01)。结论龙血竭总黄酮能够改善心肌缺血/再灌注损伤,保护心肌组织结构,稳定细胞膜结构,减少心肌CK-MB漏出,提高缺血/再灌注损伤模型心肌的收缩功能。     

虎杖苷通过PKC对大鼠离体缺血再灌注心肌的保护作用

目的:研究虎杖苷(polydatin,PD)对大鼠离体缺血/再灌注(I/R)心肌的保护作用。方法:将40只SD大鼠随机分为4组,包括I/R组,PD(I/R+PD)组,虎杖苷+蛋白激酶C(PKC)阻断剂(I/R+PD+chelerythrine)组和PKC阻断剂(I/R+chelerythrine)组。采用Langendorff灌流法建立离体心肌I/R模型,缺血40 min,再灌注共40 min,分别测量再灌20 min以及再灌40 min时心功能和酶学指标包括:心率、左室收缩压(LVDP)、左室舒张末压(LVEDP)、心室内压最大变化速率(±dp/dtmax)及磷酸激酶(PK)、乳酸脱氢酶(LDH)浓度。结果:心肌I/R可引起心脏功能I/R+PD组±dp/dtmax的恢复率明显回升(P0.05),同时,LVEDP、LVDP等指标也有明显改善(P0.05),LDH、PK浓度在复灌20和40 min时明显低于I/R组(P0.05)。说明PD能部分抑制再灌注期PK和LDH的漏出。PD还能够显著提高I/R心肌的超氧化物歧化酶(SOD)水平,并且降低丙二醛(MDA)水平,发挥心肌保护作用。应用PKC抑制剂chelerythrine则可以消除PD的上述作用。结论:PD可能通过PKC蛋白信号转导通路对I/R心肌发挥保护作用。     

低灌注处理对家兔心肌缺血再灌注损伤的影响

目的观察低灌注处理对心肌缺血/再灌注(I/R)损伤家兔凋亡基因bcl-2、caspase 3表达及心功能的影响。方法家兔16只随机分为2组:心肌I/R组、低灌注处理组。记录两组家兔缺血前、缺血30 min及再灌180 min时的左室收缩峰压(LVSP)、左室舒张末压(LVEDP)和左室内压最大收缩/舒张变化速率(±dp/dtmax);运用免疫组化法检测心肌组织bcl-2蛋白表达;运用RT-PCR法检测心肌bcl-2、caspase-3 mRNA的表达。结果与对照组比较,低灌注处理组的±dp/dtmax、bcl-2 mRNA表达、bcl-2蛋白表达增高,而caspase-3 mRNA表达降低(P<0.05)。结论低灌注处理上调抑凋亡基因bcl-2、下调促凋亡基因caspase3的表达并能改善心肌I/R家兔的心功能。     

芦丁对大鼠离体心脏冠脉流量和血流动力学参数的影响

目的研究芦丁对大鼠离体心脏冠脉流量(CF)及血流动力学参数的影响。方法利用Langendorff实验系统,将36只大鼠随机分为6组,每组6只,观察溶剂及不同浓度芦丁(0.3μmol/L,1μmol/L,3μmol/L,10μmol/L,30μmol/L)对大鼠离体心脏冠脉流量及血流动力学参数的影响。先用正常台式液灌流大鼠心脏,待各指标稳定后,记录冠脉流量(CF)、左心室收缩压(LVDP)、左心室舒张压(LVEDP)、左心室内压最大上升速率(+dp/dtmax)和左心室内压最大下降速率(-dp/dtmax)。30min后,用含溶剂或芦丁的台式液灌流大鼠心脏,再记录各参数。观察芦丁对大鼠离体心脏冠脉流量及血流动力学参数的影响。结果 0.3μmol/L,1μmol/L,3μmol/L,10μmol/L,30μmol/L芦丁浓度依赖性增大CF值,使CF值从7.3mL/min±1.2mL/min增大到12.6mL/min±1.1 mL/min;芦丁浓度依赖性增大LVDP值和+dp/dtmax值,使LVDP值从60mmHg±2mmHg增大到73mmHg±4mmHg,使+dp/dtmax值从1 135mmHg/s±102mmHg/s增大到1 427mmHg/s±115mmHg/s;不同浓度芦丁对LVEDP和-dp/dtmax值无显著影响。结论芦丁增加离体大鼠心脏冠脉流量,对离体大鼠心脏有正性肌力作用。     

左西孟旦对离体大鼠心肌缺血——再灌注损伤的保护作用

目的:观察左西孟旦(Levosimendan,Levo)对离体大鼠心肌缺血—再灌注损伤的保护作用,并探讨其可能保护机制。方法:32只wistar大鼠随机分为四组,每组8只,利用Langendorff离体灌注装置,平衡灌注10min后,I/R组:继续K-H液灌注20min;L1组:30nmol/L Levo续灌20min;L2组:300nmol/LLevo续灌20min;L+G组:300nmol/L Levo和10μmol/L格列苯脲(Glibenclamide)续灌20min。四组均经历全心缺血缺氧30min,然后再用相应的灌注液复灌30min。观察各组LVDP、±dp/dtmax、HR、CF,测定冠脉流出液中心肌酶活性及心肌组织中ATP、Ca2+含量。结果:L2组LVDP、±dp/dtmax、HR、CF、ATP明显优于其他三组,心肌酶及Ca2+含量明显低于其他三组。结论:300nmol/L Levo对离体大鼠心肌缺血—再灌注损伤有保护作用,其可能的机制是开放KATP通道。     

三碘甲腺原氨酸对离体大鼠缺血后心肌左心功能的恢复作用

目的 :观察三碘甲腺原氨酸 (T3)对缺血后心肌左心功能的恢复作用。　　方法 :制作离体大鼠心脏常温缺血模型 ,应用 KH液灌流 30分待心脏活动稳定后 ,分为未缺血组 (n=6 ) ,未缺血 T3组 (n=6 ) ,缺血再灌注组 (n=7) ,缺血再灌注 T3组 (n=7)。比较缺血再灌注组与缺血再灌注 T3组心功能指标。　　结果 :对缺血心肌加入 T3灌流 30分后 ,左心室压差与心率乘积 [(L VSP- L VDP)× HR]、收缩期左心室内压上升速度峰值 ( dp/ dtmax)和舒张期左心室内压下降速度峰值 (- dp/ dtmax)恢复百分率均明显改善。　　结论 :T3可明显促进缺血后心肌左心室功能的恢复     

尼可地尔对离体大鼠心肌缺血再灌注损伤的影响

目的:探讨钾通道开放剂尼可地尔对离体大鼠心肌缺血再灌注损伤(MIRI)的影响。方法:建立Langendorff离体心脏灌流系统,44只大鼠随机分为4组:正常组、缺血再灌注组(I-R组)、腺苷(100μmol/L)缺血再灌注组(A/I-R组)、尼可地尔(200μmol/L)缺血再灌注组(N/I-R组),每组11只。分别记录并分析各组左心室发展压(LVDP)、左心室内压力最大上升/下降速率(±dp/dt_(max))、再灌注心律失常(RA)、心肌梗死面积以及左心室心肌组织的乙醛脱氢酶2(ALDH2)、抗凋亡基因B淋巴细胞瘤-2(Bcl-2)以及促凋亡基因B淋巴细胞瘤-2相关x蛋白(Bax)的表达水平。结果(:1)N/I-R组再灌注30 min与再灌注45 min的LVDP均高于I-R组与A/I-R组(P均0.05)。(2)I-R组再灌注30 min及45 min的±dp/dt_(max)均低于N/I-R组和A/I-R组(P均0.05)。N/I-R组再灌注30 min及45 min的±dp/dtmax均高于A/I-R组(P均0.05)。(3)与I-R组比较,N/I-R组和A/I-R组的RA评分均降低(P均0.01)。N/I-R组与A/I-R组差异无统计学意义(P=0.771)。(4)N/I-R组和A/I-R组心肌梗死面积均低于I-R组(P均0.01),N/I-R组心肌梗死面积最小(P0.05)。(5)与正常组比较,I-R组线粒体ALDH2表达明显减少,Bcl-2、Bax的表达增加;N/I-R组线粒体ALDH2表达增加,A/I-R组表达减少,N/I-R组和A/I-R组的Bcl-2、Bax的表达均增加。与I-R组比较,N/I-R组以及A/I-R组Bcl-2/Bax的比值均增大(P均0.05);在抗凋亡方面N/I-R组与A/I-R组差异无统计学意义(P0.05)。结论:尼可地尔可以减少MIRI,对心肌起到保护作用,其总体作用效果优于腺苷。尼可地尔可上调线粒体ALDH2、Bcl-2表达以及下调Bax的基因蛋白的表达。     

前列腺素E1脂质体对大鼠离体心肌缺血再灌注损伤的保护作用

目的 考察前列腺素E1脂质体(Lipo-PGE1)对大鼠离体心肌缺血再灌注(IR)损伤的保护作用.方法 将24只大鼠随机分成3组,Lipo-PGE1治疗组,PGE1治疗组及对照组(IR组),治疗组给予含药停搏液,对照组单纯给K-H液;37℃下建立心肌IR模型,预灌注15 min,缺血40 min,再灌注40 min,分别测量复灌20 min、复灌40 min时心功能指标:心率、左室收缩压(LVDP)、左室舒张末压(LVEDP)、心室内压最大变化速率(±dp/dtmax)及磷酸激酶(CPK)、乳酸脱氢酶(LDH)浓度.结果 Lipo-PGE1治疗组±dp/dtmax的恢复率较PGE1组大(P＜0.01),LDH 浓度在复灌20和40 min时明显低于IR组(P＜0.01).而PGE1组复灌20和40 min时CPK释放量低于IR组而高于Lipo-PGE1治疗组,说明PGE1能部分抑制再灌注期CPK的漏出而脂质体包裹能增强这种效应.结论 Lipo-PGE1对实验性心肌IR损伤有保护作用.     

妊娠时间与肺结核复发的相关性研究及诊治对策

目的 分析肺结核史患者妊娠时间和肺结核复发间相关性.方法 选取我院收治的有肺结核史的妊娠妇女576例作为研究对象,对其妊娠前肺结核治疗、治愈后妊娠时间、妊娠后复发肺结核等进行分析,总结有肺结核史育龄女性的妊娠时间和肺结核复发之间的关系.结果 肺结核治愈后不同时间段妊娠者的结核复发率比较,差异具有显著性（P＜0.05）,停药后间隔时间越久妊娠,肺结核复发的几率越小.结论 加强孕期痰菌检查,及早发现复发肺结核,提高母婴安全.     

我国骨关节结核诊治的回顾与展望

骨关节结核是危害人们健康的严重感染性疾病,近95％由他处结核病继发而来.罹患骨关节结核疾病后几乎均将致残,严重影响人们的健康、工作和生活.建国以来在党和国家的关心和支持下,骨关节结核的诊治水平取得了长足进步.时至今日,由于多种原因,学科发展和被重视程度受到一定的制约,同整个医疗行业的发展不相适应.回顾过去,展望未来,我们需要重新审视骨关节结核的诊治方法,努力推进骨关节结核诊疗技术的科学发展.     

Replication and Inhibitors of Enteroviruses and Parechoviruses

The Enterovirus (EV) and Parechovirus genera of the picornavirus family include many important human pathogens, including poliovirus, rhinovirus, EV-A71, EV-D68, and human parechoviruses (HPeV). They cause a wide variety of diseases, ranging from a simple common cold to life-threatening diseases such as encephalitis and myocarditis. At the moment, no antiviral therapy is available against these viruses and it is not feasible to develop vaccines against all EVs and HPeVs due to the great number of serotypes. Therefore, a lot of effort is being invested in the development of antiviral drugs. Both viral proteins and host proteins essential for virus replication can be used as targets for virus inhibitors. As such, a good understanding of the complex process of virus replication is pivotal in the design of antiviral strategies goes hand in hand with a good understanding of the complex process of virus replication. In this review, we will give an overview of the current state of knowledge of EV and HPeV replication and how this can be inhibited by small-molecule inhibitors.     

Effect of phosphorylation of MAPK and Stat3 and expression of c-fos and c-jun proteins on hepatocarcinogenesis and their clinical significance

AIM To study the effect of phosphorylation ofMAPK and Stat3 and the expression of c-fos andc-jun proteins on hepatocellular carcinogenesisand their clinical significance.METHODS SP immunohistochemistry was usedto detect the expression of p42/44~(MAPK), p-Stat3,c-fos and c-jun proteins in 55 hepatocellularcarcinomas (HCC) and their surrounding livertissues.RESULTS The positive rates and expressionlevels of p42/44~(MAPK), p-Stat3, c-fos and c-junproteins in HCCs were significantly higher thanthose in pericarcinomatous liver tissues (PCLT).A positive correlation was observed between theexpression of p42/44~(MAPK) and c-fos proteins, andbetween p-Stat3 and c-jun, but there was nosignificant correlation between P42/44~(MAPK) and p-Stat3 in HCCs and their surrounding livertissues.CONCLUSION The abnormalities of Ras/Raf/MAPK and JAKs/ Stat3 cascade reaction maycontribute to malignant transformation ofhepatocytes. Hepatocytes which are positive forp42/ 44~(MAPK), c-fos or c-jun proteins may bepotential malignant pre-cancerous cells.Activation of MAPK and Stat3 proteins may be anearly event in hepatocellular carcinogenesis.     

心电图、心电向量图与冠状动脉造影结果对比分析

目的:通过分析心电图(Electrocardiogram,ECG)和心电向量图(Vectorcardiogram,VCG)的改变与冠脉造影（CAG）结果进行对比,探讨ECG、VCG在冠状动脉病变中的诊断价值。方法: 选择2008年1月~2009年12月临床拟诊断为冠心病患者108例,行常规ECG、VCG检查,并于1周内进行CAG,对检查结果依据各自的诊断标准进行判定,以CAG为标准诊断法,利用四格表法,计算相关评价真实性的指标并进行比较。结果: ①VCG检测的灵敏度、特异度、准确度显著高于ECG(P<0.05,P<0．01)。②ECG、VCG阳性率与冠脉病变支数组间比较:在单支病变、双支病变中,VCG阳性率明显高于ECG(P<0.05),左主干或三支病变无统计学意义;组内比较:ECG组左主干或三支病变组较单支病变、双支病变阳性率高(P<0.05,P<0.01);VCG组左主干或三支病变组较单支病变阳性率高(P<0.05);与双支病变阳性率比较无统计学意义;③ECG、VCG阳性率与冠脉病变程度组间比较:冠脉病变狭窄50%～69%的VCG阳性率明显高于ECG (P<0.05),其他两组阳性率比较无统计学意义;组内比较:ECG组冠脉病变狭窄≥90%较50%～69%、70%～89%的阳性率高(P<0.05,P<0.01); VCG组狭窄≥90%较50%～69%阳性率高（P<0.01),其他无统计学意义。结论: VCG对冠心病检测价值显著高于ECG。     

Detection and characterization of the product of hydroethidine and intracellular superoxide by HPLC and limitations of fluorescence

Here we report the structural characterization of the product formed from the reaction between hydroethidine (HE) and superoxide (O(2)(.-)). By using mass spectral and NMR techniques, the chemical structure of this product was determined as 2-hydroxyethidium (2-OH-E(+)). By using an authentic standard, we developed an HPLC approach to detect and quantitate the reaction product of HE and O(2)(.-) formed in bovine aortic endothelial cells after treatment with menadione or antimycin A to induce intracellular reactive oxygen species. Concomitantly, we used a spin trap, 5-tert-butoxycarbonyl-5-methyl-1-pyrroline N-oxide (BMPO), to detect and identify the structure of reactive oxygen species formed. BMPO trapped the O(2)(.-) that formed extracellularly and was detected as the BMPO-OH adduct during use of the EPR technique. BMPO, being cell-permeable, inhibited the intracellular formation of 2-OH-E(+). However, the intracellular BMPO spin adduct was not detected. The definitive characterization of the reaction product of O(2)(.-) with HE described here forms the basis of an unambiguous assay for intracellular detection and quantitation of O(2)(.-). Analysis of the fluorescence characteristics of ethidium (E(+)) and 2-OH-E(+) strongly suggests that the currently available fluorescence methodology is not suitable for quantitating intracellular O(2)(.-). We conclude that the HPLC/fluorescence assay using HE as a probe is more suitable [corrected] for detecting intracellular O(2)(.-).     

大鼠骨髓间充质干细胞的分离培养和外源基因的导入

目的探讨绿色荧光蛋白基因转染骨髓间质干细胞的可行性。方法采用F icoll-PaqueTMP lus淋巴细胞分离液,根据细胞密度梯度原理,分离大鼠骨髓间充质干细胞(rM SC s)并进行体外原代培养和传代扩增,倒置相差显微镜观察细胞生长情况,免疫细胞化学法对其初步鉴定。流式细胞仪分析转染效率。结果原代和传代培养的细胞呈现梭形外观,具有较强的生长增殖能力;细胞均一表达CD44、CD54、CD106、CD29抗原。电穿孔法转染rM SC s转染率为32.8%±3%。结论采用比重为1.077 g/L的F icoll-PaqueTMP lus能分离获得大鼠骨髓间充质干细胞,经原代培养和传代培养能够迅速扩增。电穿孔法具有较高的介导外源基因表达于rM SC s的效率。     

Effect of phosphorylation of MAPK and Stat3 and expression of c-fas and c-jun proteins on hepatocarcinogenesis and their clinical significance

AIM To study the effect of phosphorylation ofMAPK and Stat3 and the expression of c-fos andc-jun proteins on hepatocellular carcinogenesisand their clinical significance.METHODS SP immunohistochemistry was usedto detect the expression of p42/44MAPK, p-Stat3,c-fos and c-jun proteins in 55 hepatocellularcarcinomas (HCC) and their surrounding livertissues.RESULTS The positive rates and expressionlevels of p42/44MAPK, p-Stat3, c-fos and c-junproteins in HCCs were significantly higher thanthose in pericarcinomatous liver tissues (PCLT).A positive correlation was observed between theexpression of p42/44MAPK and c-fos proteins, andbetween p-Stat3 and c-jun, but there was nosignificant correlation between p42/44MAPK and p-Stat3 in HCCs and their surrounding livertissues.CONCLUSION The abnormalities of Ras/Rat/MAPK and JAKs/ Stat3 cascade reaction maycontribute to malignant transformation ofhepatocytes. Hepatocytes which are positive forp42/ 44MAPK, c-fos or c-jun proteins may bepotential malignant pre-cancerous cells.Activation of MAPK and Stat3 proteins may be anearly event in hepatocellular carcinogenesis.     

医源性消化道出血常见病因及其防治

目的分析医源性消化道出血的常见病因,并探讨防治措施。方法就临床所见的69例医源性消化道出血进行分析。结果医源性消化道出血分布于临床各科室,病因各不相同,但以外科手术、外伤、脑血管意外、。肾功能衰竭、呼吸功能衰竭、激素治疗、阿司匹林治疗等为主,临床上多以黑便为主要症状;对于已发生的医源性消化道出血,及时予制酸剂和胃黏膜保护剂治疗,能及时止血,大出血时经积极止血及抗休克治疗,甚至内镜治疗效果良好。结论医源性消化道出血各个临床科室均常见,病因各异,经积极、合理的治疗多预后良好。     

Overweight and Obesity and Progression of ADPKD

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