改良心肌保存液热缺血冷保存对猪心保护的作用

目的 研究改良心肌保存液在心脏移植术中对热缺血冷保存猪供心的心肌保存效果.方法 16对供猪随机分为2组,建立猪同种异体原位心脏移植模型.A组以St Thomas 液、B组以自制液作为停搏液、灌注冲洗液和保存液.供心心脏停搏热缺血5 min后,以停搏液灌注,切取心脏,4 ℃灌注冲洗并低温浸泡保存4 h,施行同种异体原位心脏移植.观察移植后心脏复搏的一般情况及血清肌酸激酶同工酶(CK-MB)变化,常规苏木精-伊红、PAS染色,光镜观察心肌组织.结果 浸泡保存后B组心肌含水量低于A组,复灌后CK-MB含量也低于A组(t=2.89～3.38,P<0.05).B组PAS糖原染色评分高于A组(T=24,P<0.01).结论 改良的新型心肌保存液能较好恢复热缺血冷保存的猪供心心脏功能,减轻复灌后的心肌再灌注损伤,减少保存期间细胞内糖原的消耗,其对心肌的保护明显优于St Thomas液.     

电针内关穴对大鼠心肌缺血再灌注损伤中一氧化氮及其合酶的影响

目的研究观察电针大鼠内关穴对心肌缺血再灌注损伤 (MIRI)大鼠一氧化氮 (NO)、一氧化氮合酶 (NOS)与同功酶原生型 (cNOS)、诱生型 (iNOS)的变化 ,探讨电针内关穴对心肌细胞的保护作用。方法将大鼠分为 5组即假手术对照组、缺血再灌注模型组、电针内关保护组、电针列缺对照组、电针合谷对照组 ,每组 1 0只动物。检测各组大鼠血清中NO、NOS含量的影响。结果电针心包经内关穴升高心肌NO含量明显强于电针肺经列缺穴 (P <0 .0 5 ) ;电针心包经内关穴可使NOS、cNOS含量升高 ,与模型组比较差异显著 ,且升高心肌NOS及cNOS活性的效应亦明显强于电针列缺、合谷组 (P <0 .0 5 )。各组心肌iNOS变化不明显。结论电针内关穴可以减轻心肌缺血再灌注损伤的程度 ,对心肌细胞有良好的保护作用。     

核黄素对心肌缺血再灌注损伤时一氧化氮及其合酶的影响

目的　探讨核黄素(riboflavin)对再灌注损伤心肌保护作用的机制。方法　通过结扎左冠状动脉前降支复制在体心肌缺血再灌注损伤动物模型。将家兔随机分为4组,即假手术组(SC组)、缺血再灌注组(IRI组)、缺血预处理组(IPC组)和核黄素干预组(RBF组) ,检测不同时间点血清中一氧化氮(NO)和丙二醛(MDA)的含量以及缺血区心肌组织匀浆中一氧化氮合酶(NOS)的活性。结果　与IRI组相比,RBF组在缺血后各时点血清中NO含量升高明显(P <0 .0 5 ,P <0 .0 1) ,心肌组织匀浆中各型NOS检测结果示:RBF组cNOS的活性较高,与IRI组相比有显著性意义(P <0 .0 1)。结论　核黄素对再灌注损伤干预作用的部分机制是通过保护冠脉血管内皮,维持cNOS活性,增加NO的释放,从而对再灌注损伤的心肌有保护作用。     

猪供心不同时间热缺血移植后细胞凋亡的变化

目的研究供心常温不同时间热缺血后细胞凋亡的变化。方法利用猪原位心脏移植实施方法,18只猪随机分为3组,对照组(C,n=6)灌注低温保护液后切取供心,4℃保存4h;热缺血1组(E1,n=6)常温阻断主动脉缺血5min后灌注低温保护液后切取供心;热缺血2组(E2,n=6)常温阻断主动脉缺血10min后,灌注低温保护液后切取供心。三组低温保存供心4h后分别行原位心脏移植。供心移植2h后取左心室心肌检测心肌细胞凋亡的变化。结果供心移植2h后,E1、E2组心肌细胞凋亡明显高于C组(P<0.01),E2组心肌细胞凋亡明显高于El组(P<0.01)。结论供心热缺血时间的延长增加移植后的心肌细胞凋亡的发生。     

FTY720对大鼠同种异体异位心脏移植物缺血-再灌注损伤的影响

目的:观察FTY720对同种异体异位心脏移植物缺血-再灌注损伤的影响并探讨其相关机制.方法:利用Cuff技术建立颈部异位心脏移植模型.FTY720组(n=6)受体鼠自术前3 d开始至手术当日管饲FTY720,剂量为3 mg/kg;对照组(n=6)受体鼠自术前3 d开始至手术当日管饲生理盐水,剂量为1 mL/kg.于移植后8 h切取移植心脏,电镜下观察心肌组织超微结构变化;TUNEL法测细胞凋亡,计算凋亡指数;测定心肌组织中超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量和髓过氧化物酶(MPO)活性.结果:移植后8 h,FTY720组心肌细胞形态基本正常,仅轻度水肿,间质水肿和炎性细胞浸润不明显;电镜超微结构显示心肌肌丝排列整齐,肌原纤维间轻度水肿,线粒体饱满,嵴密,水肿不明显,无明显的肌丝断裂现象.FTY720组只有少量心肌细胞凋亡,凋亡指数为(9.20±1.12),对照组心肌细胞凋亡明显,凋亡指数为(16.10±1.65)(t=8.475,P<0.001).FTY720组SOD活性较对照组升高[(51.03±5.54)mmol/g vs.(28.39±2.38)mmol/g],而MDA含量[(10.90±1.93)U/g vs.(16.27±1.36)U/g]和MPO活性[(4.38±1.43)mU/g vs.(9.26±1.41)mU/g]下降(t分别为9.197、5.571和5.592,P均<0.001).结论:FTY720能减轻大鼠移植心脏缺血-再灌注损伤.     

三味檀香散抗心肌损伤的作用及对一氧化氮的影响

目的观察三味檀香散对抗大鼠心肌缺血再灌注损伤的作用及对心肌组织一氧化氮（NO）水平的影响,探讨三味檀香散对心肌缺血再灌注损伤保护作用及作用机制。方法采用结扎冠状动脉法制作大鼠心肌缺血再灌注模型。实验大鼠随机分为伪手术组（SO）,缺血再灌注模型组（IR）,阳性对照组（Positive Control,三味檀香散高（Higher Dose）、低剂量组（Lower Dose）,记录各组大鼠心电图ST段变化、测定心肌组织匀浆中一氧化氮合酶（NOS）、诱导性一氧化氮合酶（iNOS）及NO的含量,并留取心脏进行组织形态学观察。结果高、低剂量的三味檀香散组大鼠心电图ST段移位明显低于模型纽（P〈0．05或P〈0．01）,三味檀香散高、低剂量组心肌NOS、iNOS含量水平低于模型组;低剂量组心肌NO含量低于模型组（P〈0．05或P〈0．01）;形态学观察显示三味檀香散高、低剂量纽能明显减轻缺血再灌注损伤区心肌细胞的病理改变。结论三味檀香散对大鼠的心肌缺血再灌注损伤具有一定的保护作用,其机制可能与抑制心肌NOS（尤其是iNOS含量）及减少NO过量产生有关。     

一氧化氮与一氧化氮合酶对心肌的保护作用

目的：测定心肌缺血再灌注与心肌缺血后处理时大鼠心肌损伤程度,探讨一氧化氮（NO）与一氧化氮合酶（NOS）对心肌的保护作用。方法：将健康雄性Wistar大鼠分为对照组、实验组、激动剂组及抑制剂组4组,建立离体心肌缺血再灌注损伤模型。使用高效液相色谱仪（HPLC）测定心脏灌流液中NO的含量与心肌中NOS活性。测定乳酸脱氢酶（LDH）活性及心肌梗死面积。结果：平衡末,4组之间冠状动脉循环液中NO含量差异无统计学意义（P〉0．05）;对照组处理后与实验组后处理后NO含量相比差异有统计学意义（P〈0．05）;激动剂组再灌注后与对照组处理后NO含量相比差异有统计学意义（P〈0．05）;抑制剂组后处理后与实验组后处理后NO含量相比差异有统计学意义（P〈0．05）。实验组心肌组织NOS活性高于激动剂组与抑制剂组（P〈0．05）。实验组心肌组织LDH活性低于激动剂组与抑制剂组（P〈0．05）。实验组与对照组梗死面积比较差异有统计学意义（P〈0．05）;激动剂组及抑制剂组心肌梗死面积均低于对照组（P〈0．05）。结论：NO可有效降低缺血再灌注对心肌的损伤。NO与NOS在缺血后处理对再灌注损伤心肌保护机制中起重要作用。     

核黄素对离体大鼠心肌再灌注损伤时冠脉内皮的影响

目的　观察离体大鼠心肌缺血再灌注时冠脉内皮变化及核黄素 (riboflavin ,RBF)对其影响 ,并探讨其作用机制。方法　取 30只SD大鼠 ,2 5 0～ 30 0g ,随机分成 3组 ,即正常对照组 (NC组 ,n =10 )、缺血再灌注组 (I/R组 ,n=10 )、核黄素预处理组 (RBF预处理组 ,n =10 ) ,采用Langendorff离体心脏灌流装置 ,通过降低灌流量后复灌造成心脏I/R模型 ,测定缺血前、缺血后和再灌各个时段冠脉流出液中vWF、NO水平及CPF ,实验结束后取心肌组织测定NOS、SOD活性和MDA含量。结果　RBF预处理组与I/R组比较 ,冠脉流出液中NO含量显著增加 (P <0 .0 1) ,vWF含量降低 (P <0 .0 1) ,CPF明显升高 (P <0 .0 1) ,同时 ,心肌中TNOS、eNOS、SOD活性升高 (P <0 .0 1) ,MDA含量下降 (P <0 .0 1)。结论　RBF可以减轻离体大鼠心肌缺血再灌注损伤 ,其机制可能与其保护冠脉内皮免于受损及NO介导的冠脉扩张效应 ,改善低灌注状态 ,增强心肌抗氧化能力有关。     

再灌注兔吸入一氧化氮对肺组织一氧化氮合酶表达的影响

目的　探讨再灌注时吸入一氧化氮 (NO)对兔肺一氧化氮合酶 (NOS)同功酶表达的影响 .方法　 40只健康新西兰大白兔随机分成 4组 ,每组 10只 .假手术组 ( 组 ) ;假手术+吸入 NO组 ( 组 ) ;缺血再灌注组 ( 组 ) ;缺血再灌注 +吸入 NO组 ( 组 ) .通过阻断左肺门 6 0 min,随即阻断右肺门 ,造成左肺单侧再灌注 2 40 min. , 组在阻断右肺门前 5min吸入 5 0× 10 - 6NOppm.再灌注 2 40 min后 ,各组取左下叶组织 ,采用免疫组化方法检测再灌注肺 NOS同功酶表达变化 .结果　 1 , 组肺组织未见 i NOS的表达 ,e NOS在内皮细胞表达正常 . 2 组内皮细胞、肺泡上皮细胞、平滑肌细胞等均可见大量 i NOS表达 (分别为 91.6 7%,83.3%和 81.6 %.与 相比 P<0 .0 5 ) ,e NOS表达下调 (5 6 .5 7%.与 相比 P<0 .0 5 ) . 组肺组织 i NOS表达受抑制 ,e NOS表达正常 .结论　 1再灌注肺组织 e NOS表达减弱 ,i NOS表达增强 ,导致 NO合成增多 ,造成肺组织缺血灌注损伤 . 2吸入NO能抑制肺组织 i NOS表达 ,维持 e NOS在内皮细胞的正常表达 ,减轻肺再灌注损伤 .     

改良心肌保护液对短暂常温热缺血供心移植后的保护作用

①目的　探讨改良心肌保护液对短暂常温热缺血供心移植后的保护作用。②方法　 1 8只家猪随机分为 3组 ,对照组 (C组 ) :供心低温灌注Thomas保护液后切取心脏 ,4℃保存 4h后行原位心脏移植 ;热缺血组 (W组 ) :供心低温灌注Thomas保护液前常温缺血 5min ,4℃保存 4h后行原位心脏移植 ;改良心肌保护液组 (E组 ) :供心常温缺血 5min后用改良保护液灌注 ,4℃保存 4h后行原位心脏移植。以心排血量 (CO)、心肌含水率、丙二醛 (MDA)、ATP、肌钙蛋白I(cTnI)水平和心脏超微结构作为观察指标。③结果　E组心肌含水率、MDA含量和cTnI含量明显低于W组 (F =4 .0 1～ 5 .78,q =2 .5 5～ 3.2 2 ,P <0 .0 5 ) ;E组CO和ATP含量明显高于W组 (F =4 .82～ 5 .6 3,q =2 .80～ 3.1 2 ,P <0 .0 5 ) ;E组与C组各指标相比差异无显著性 (q=1 .90～ 2 .4 8,P >0 .0 5 ) ;超微结构显示 ,E组心肌损伤较W组明显减轻。④结论　改良心肌保护液可有效改善供心因短暂常温热缺血而造成的结构和功能损害     

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…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.