浅低温以犬全脑缺血再灌注后脑组织诱导型热休克蛋白70表…

目的：研究犬全脑缺血再灌时浅低温对热休克蛋白７０（ＨＳＰ７０）表达的影响，探讨热休克蛋白在低温脑复苏中的作用。方法：采用犬心脏停跳再复苏模型。１４只犬随机分为三组：非缺血对照组（ｎ＝４）、常规治疗组（ｎ＝５）和浅低温组（ｎ＝５）。用免疫组化测定脑组织内ＨＳＰ７０表达阳性细胞数密度和反应产物灰度值。结果：犬全脑缺血再灌后ＨＳＰ７０表达明显增强（Ｐ〈０．０１）．浅低温组ＨＳＰ７０表达增强比常规治疗组更     

丙泊酚对大鼠局灶性脑缺血-再灌注时脑组织热休克蛋白70基因和蛋白表达的影响

目的观察丙泊酚对大鼠局灶性脑缺血-再灌注时脑组织热休克蛋白(HSP)70 mRNA和HSP70蛋白表达的影响,以探讨其脑保护的机制。方法采用大脑中动脉线栓法建立大鼠局灶性脑缺血-再灌注模型。60只雄性Wistar大鼠,随机分为假手术组(Sham组)、缺血-再灌注组(I-R组)和丙泊酚组(P组),每组20只。大鼠脑缺血2 h,然后进行再灌注。在再灌注3、6、24、72 h断头取脑组织,采用原位杂交法和免疫组织化学染色检测大鼠脑组织HSP70 mRNA和HSP70蛋白的表达。结果局灶性脑缺血-再灌注后,HSP70 mRNA和HSP70蛋白的表达增加(P<0.01),但HSP70 mRNA表达较早,分布范围较广泛,而HSP70蛋白表达以半暗带区为主。应用丙泊酚能显著地促进脑缺血-再灌注后脑组织中HSP70 mRNA和HSP70蛋白的表达(P<0.01),与脑缺血-再灌注组相比较,HSP70 mRNA和HSP70蛋白不仅表达增多、范围增加,而且还能延缓下降(P<0.05)。结论丙泊酚能促进大鼠局灶性脑缺血-再灌注时HSP70的表达,这可能是其脑保护作用的部分机制。     

重复电针预处理对脑缺血再灌注大鼠脑皮层热休克蛋白70表达的影响

目的 探讨重复电针刺激百会穴预处理对脑缺血再灌注大鼠脑皮质热休克蛋白70表达的影响。方法 20只雄性SD大鼠,随机分为对照组(n=10)和电针组(n=10)。对照组未行任何预处理;电针组予电针刺激百会穴,30 min·d-1,连续5d。最后一次预处理后24 h时,两组均采用颈内动脉尼龙线线栓法致大脑中动脉阻闭(120 min)。缺血再灌注后24 h将大鼠灌注固定,取脑组织行病理学观察及免疫组织化学染色,并按照McCarthy等的方法对免疫组化染色结果进行半定量分析。结果 半定量分析结果,电针组皮层HSP70表达(1.9±0.6)明显强于对照组(0.9±0.4)(P<0.05)。电针组组织病理学损害轻于对照组。结论 重复电针刺激百会穴预处理减轻脑缺血再灌注损伤与皮层HSP70表达增强有关。     

星状神经节阻滞对全脑缺血再灌注损伤家兔海马及颞叶皮质热休克蛋白70表达的影响

目的 观察星状神经节阻滞(SGB)对全脑缺血再灌注损伤家兔海马及颞叶皮质热休克蛋白70(HSP70)表达的影响,探讨SGB对全脑缺血再灌注损伤的处理效应及可能机制。方法 健康日本大耳白兔28只,随机分成四组(n=7):SGB组(E组)、生理盐水对照组(P组)、空白对照组(C组)和假手术组(S组)。采用星状神经节旁置管法制作SGB模型及六血管阻断法制作全脑缺血再灌注损伤模型。缺血10 min再灌注30 h(E、P、C组)或观察相应时间(S组)后取脑组织,使用免疫组化技术检测双侧海马CAl区及颞叶皮质HSP70的表达。结果 与P、C组比较,E组双侧海马和颞叶皮质HSP70的表达均有不同程度下降(P<0.05),且双侧之间改变无明显差异(P>0.05)。结论持续左侧SGB,可降低全脑缺血再灌注损伤家兔神经细胞HSP70的过度表达,单侧SGB的效应对于双侧脑组织损伤后的影响差异无显著性。     

全脑缺血再灌注对P_(53)蛋白表达的影响

脑缺血再灌注早期某些特殊蛋白质如c—fos、热休克蛋白等合成明显增加,且与缺血后神经元的转归密切相关。近年国外有研究报道P_(53)蛋白在脑局部缺血后表达增强,且与损伤程度相关。本文旨在犬心脏停跳复苏模型上研究全脑缺血再灌注对P_(53)蛋白表达的影响。材料与方法动物模型和分组:健康杂种犬9只,体重8～12.5kg,应用本室建立的脑复苏模型进行研究。犬随机分成两组为非缺血对照组(n=4只),完成全部操作,心脏不停跳,观察24小时;缺血再灌注组(n=5只),心脏停跳18分,复苏后加强治疗24小时。监测血压、血气、Hct等,并控制在相同范围内。实验结束     

参附注射液预处理对大鼠脑缺血-再灌注损伤后HSP70和HSP90表达的影响

目的探讨参附注射液(SF)单次预处理对大鼠脑缺血-再灌注损伤的保护作用。方法30只雄性SD大鼠随机均分为单纯缺血-再灌注组(MCAO组)、SF预处理组(SF组,缺血前30 min经腹腔注射SF 10 ml/kg)和假手术组(Sham组)。MCAO组和SF组采用颈内动脉尼龙线线栓法致右侧大脑中动脉栓塞120 min。观察再灌注后24 h时脑组织病理学改变,检测热休克蛋白(HSP)70和HSP90表达。结果再灌注24 h后,SF组脑组织病理学损害轻于MCAO组。Sham组未见HSP70及HSP90表达。MCAO组可见到较多的HSP70免疫阳性细胞,明显高于Sham组(P<0.01);SF组HSP70免疫阳性细胞分布较MCAO组广泛,数量明显增多,胞浆及胞核都可见HSP70免疫阳性细胞[(1.341±0.464)vs.(0.856±0.574)](P<0.05),而SF组HSP90的表达与MCAO组相仿[(0.006±0.013)vs.(0.005±0.007)]。结论SF预处理可通过增加HSP70表达而对大鼠脑缺血-再灌注损伤起保护作用。     

丙泊酚对大鼠局灶性脑缺血-再灌注低氧诱导因子-1和热休克蛋白70的影响

目的 观察丙泊酚对大鼠局灶性脑缺血-再灌注后低氧诱导因子(HIF-1)和热休克蛋白70(HSP70)的影响,探讨丙泊酚脑保护作用机制.方法 32只雄性sD大鼠,随机均分为四组,采用可逆性大脑中动脉内线栓法建立局灶性脑缺血-再灌注模型,缺血2 h再灌注24 h后断头取脑,采用免疫组化法检测HIF-1和HSP70.HE染色,光镜观察细胞形态学改变.结果 大鼠局灶性脑缺血-再灌注后大脑皮质和海马区出现神经细胞的坏死和凋亡改变,HIF-1和HSP70的表达均增加,给丙泊酚后神经细胞的肿胀、坏死、凋亡明显减少,HIF-1和HSP70蛋白的表达受到明显抑制.结论 丙泊酚对大鼠局灶性脑缺血-再灌注损伤的保护机制与减少HIFll、HSP70的表达有关.     

头部选择性浅低温对犬心脏停跳复苏后脑组织内源性抗损伤机制的影响

目的 研究头部选择性浅低温对犬心脏停跳复苏后脑组织内源性抗损伤机制的影响。方法 15只健康杂种犬随机分为3组:手术对照组（A组,n=4）,常规治疗组（B组,n=5）,浅低温治疗组（C组,n=6）。A组动物完成麻醉和手术后心脏不停跳观察8h。B组和C组动物心脏停跳18min,心脏复苏成功后治疗8h。B组动物接受常规脑复苏治疗,C组动物接受常规脑复苏治疗和浅低温[（34± 0.5）℃]治疗。实验结束时开颅取右顶叶脑皮质供测 SOD、MDA、GSH、GSH-PX、FFA和LA用。结果 B组动物脑内FFA、LA明显高于A组（P<0.05）,GSH、GSH-Px、T-SOD、Mn-SOD、Cu-ZnSOD明显低于A组（P<0.05或0.01）。C组动物脑内GSH、T-SOD、Cu-ZnSOD明显高于B组（P<0.05或0.01）,B（两组MDA、FFA、LA无统计学差异（P>0.05）。结论 浅低温作为一种物理治疗方法,可通过增强脑组织内源性抗损伤机制发挥脑复苏作用。     

热休克蛋白70家族的功能和在神经保护中的作用

脑缺血耐受的实验研究发现,诱导热休克蛋白70家族(HSP70)的表达增加可能是内源性脑保护机制之一。HSP70包括两种蛋白:Hsp70(诱导型)和Hsc70(结构型)。本文就这两种蛋白的功能、表达的调节及在不同应激反应中表达的相关性作一综述。     

不同剂量氯胺酮对大鼠脑组织热休克蛋白70表达的影响

氯胺酮为脑组织中兴奋性氨基酸受体NMDA型的非竞争性受体拮抗药,实验证实有神经保护作用[1]。热休克蛋白70(heatshockprotein,HSP70)的主要功能是维持细胞蛋白自稳,提高细胞对应激的耐受,使细胞耐受缺血能力增强[2]。本文采用腹腔注射氯胺酮,研究大鼠脑组织海马热休克蛋白的表达,探讨氯胺酮神经保护的机理。材料与方法一、动物分组　由湖北医科大学动物中心提供健康、雄性Wistar大鼠20只,体重(200～250)g。随机分成2组:生理盐水对照组(A组,n=6);氯胺酮组(n=14),再按不同剂量分成2小组,即B组(50mg/kg)(n=7)、C组(100mg/kg)(n=7)。根据大…     

胸腰椎骨折椎弓根内固定断裂与植骨融合方式的相关性分析

[目的]探讨胸腰椎骨折椎弓根螺钉内固定系统内固定术后,椎弓根螺钉断裂与植骨融合方式之间的关系,以探讨胸腰椎骨折植骨融合的最佳方式。[方法]回顾性研究1995年5月~2005年12月本院脊柱外科收治的胸腰椎骨折病人197例,其中A组单纯内固定(不植骨)患者14例,B组“H”形椎板植骨21例,C组横突间植骨67例,D组椎间、椎内联合横突间植骨95例。[结果]术后随访6~32个月,内固定断裂12例,其中A组4例,B组3例,C组5例,D组0例,4组中D组内固定断裂率显著低于其他3组(P<0.05)。[结论]椎间、椎体内联合横突间植骨重建脊柱三柱的稳定性,符合人体生物力学原理,能有效降低内固定断裂的发生。     

On the measurement of the functional properties of the CFTR

A number of methods are currently employed to assess the functional properties of CFTR channels and their response to pharmacological potentiators, correction of the defective CFTR trafficking, and vectorial introduction of new proteins. Here we review the most common methods used to assess CFTR channel function. The suitability of each technique to various experimental conditions is discussed.     

The Measurement of the Inclination Angle of the Hamate and Analysis of the Inclination Angle for the Rotation Deformity of the Little Finger in the Fixation of the Carpometacarpal Joint

ObjectiveComplex base fractures of the fifth metacarpal bone and dislocation of the fifth carpometacarpal joint are more prone to internal rotation deformity of the little finger sequence after fixation with a transarticular plate. In the past, we have neglected that there is actually a certain angle of external rotation in the hamate surface of transarticular fixation. This study measured the inclination angle of the hamate surface relative to the fifth metacarpal surface for clinical reference.MethodsIn a prospective single‐center study, we investigated the tilt angle of 60 normal hamates. The study included thin‐layer computed tomography (CT) data from 60 patients from the orthopaedic clinic and inpatient unit from January 2017 to March 2020, including 34 men and 26 women who were 15~59 years old, average 35 years old. The CT data of 60 cases in Dicom format of the hand was input into Mimics and 3‐Matics software for three‐dimensional (3D) reconstruction and measuring the angle α between hamate surface and the fifth metacarpal surface. According to the possible placement of the transarticular plate on the fifth metacarpal surface, we measured the angle β between the hamate surface 1 and the fifth metacarpal surface and the angle γ between the hamate surface 2 and the fifth metacarpal surface.ResultsThe average angle between the hamate surface and the fifth metacarpal surface was 11.66°. The hamate surfaces 1 and 2 have an external rotation angle of 7.30° and 7.51° on average with respect to the fifth metacarpal surface, respectively. There is no statistically significant difference in the angles between the two groups (P > 0.05).ConclusionsThe horizontal angle of the dorsal side of the hamate is different from the back of the fifth metacarpal surface, and the hamate has a certain external rotation angle with respect to the fifth metacarpal surface. No matter how the transarticular plate is placed, the plate always has a certain external rotation angle relative to the fifth metacarpal surface. When the fixation is across the fifth carpometacarpal joint, if the plate does not twist and shape, it will inevitably cause internal rotation of the fifth metacarpal, resulting in internal rotation deformity of the little finger sequence.     

静脉输注甘露醇开放血脑屏障对抗生素透过血脑屏障的影响

目的　通过快速静脉输注甘露醇可逆性开放血脑屏障 (BBB) ,探知此方法能否增加抗生素透过BBB的量 ,在何时达到最高峰 ,其通透量增加后临床上有无不良反应。方法　采用自身配伍设计 ,共 6个样本组。对照组仅使用抗生素 ;其余 5组分别在使用甘露醇前 60、3 0min ,同时使用甘露醇后 3 0、60min使用抗生素 ,各组皆取使用抗生素后 1h的脑脊液测其抗生素浓度。抗生素选用头孢三嗪。结果　测量值经过q检验 ,经 2 0 %甘露醇处理前后的CSF中的头孢三嗪浓度差异有非常显著性。全组患者经临床观察未出现神经系统的不良反应。结论　经静脉快速输注2 0 %甘露醇后可以使透过BBB的水溶性抗生素的量增加 ,两者使用的顺序是在抗生素使用 3 0min内即给予甘露醇快速滴注。该方法不会增加低神经毒性抗生素在中枢神经系统的不良反应。     

三角韧带损伤的手术治疗

[目的]探讨踝关节三角韧带损伤的手术治疗及效果。[方法]2002年4月-2005年4月治疗伴有三角韧带损伤的踝关节骨折40例，均采用切开复位和坚强内固定，并修复重建三角韧带，恢复踝关节内外侧结构的稳定性。下胫腓联合分离仍不稳定者，给予皮质骨螺钉横向内固定。[结果]全部病例得到16个月-3a随访，平均1．5a。按齐氏疗效评定标准：优良30例，可8例，差2例，优良率75％。[结论]强调踝关节骨折切开解剖复位，坚强内固定的同时，应充分重视修复重建三角韧带。     

Influence of the design of the prosthesis on the outcome after hemiarthroplasty of the shoulder in displaced fractures of the head of the humerus

We reviewed 39 patients with displaced three- and four-part fractures of the humerus. In 21 patients (group A) we had used an anatomical prosthesis for the humeral head and in 18 (group B) an implant designed for fractures. When followed up at a mean of 29.3 months after surgery the overall Constant score was 51.9 points; in group A it was 51.5 and in group B 52.4 points. The subjective satisfaction of the patients was assessed using a numerical rating scale and was similar in both groups. In group A complete healing of the tuberosities was found in 29% and 50% in group B. Partial integration was seen in 29% of group A and in only one patient in group B, while resorption was noted in 43% of group A and 44% of group B. The functional outcome was significantly better in patients with complete or partial healing of the tuberosities (p=0.022). The specific trauma prosthesis did not lead to better healing of the tuberosities. The difference in clinical outcome obtained by the two designs did not reach statistical significance.     

Preservation of the pylorus and resection of the head of the pancreas

The historical evolution of the pylorus-preservation resection of the head of the pancreas is traced from the first resections early in this century to relative standardization of the operation, to a lowering of the operative mortality, and to an interest in improving nutritional status after resection. There are many theoretical advantages for the function of the upper gastrointestinal tract after pylorus and gastric preservation, such as maintenance of gastric capacitance and equilibration of osmotic pressure in gastric digestants, foodstuff digestion and absorption, and bowel motility. After the pylorus-preserving resection, gastric emptying is normal, pyloric function to prevent duodenal reflux is often normal, and gastric acids and serum levels of duodenal hormones are at normal levels, whereas after standard pancreatoduodenectomy, all of these are often abnormal. No prospective blinded studies have been published comparing nutritional values after the two operative procedures, but evidence is presented of a satisfactory result with regard to gastric capacitance, body weight gain, and lack of postgastrectomy symptoms. An undoubted advantage of the pylorus-preserving feature is a simplification of the operation. These gains are achieved without increase in operative mortality, without increase in the incidence of jejunal ulcer, and without theoretical or actual decrease in value of the procedure as a cancer operation, except in patients with duodenal carcinoma proximal to the ampulla of Vater.