介入治疗周围动脉硬化闭塞症的围手术期护理

周围动脉硬化闭塞症(PAOD),是指周围动脉硬化导致动脉狭窄,甚至发生闭塞,使远端组织出现相应缺血痉挛或坏死的疾病,是全身血管系统性动脉粥样硬化的一种标志,包括下肢动脉硬化症、颈动脉硬化症、肾动脉硬化症、肠系膜动脉硬化症等,以年老、高血压、高脂血症、糖尿病、吸烟、体力活动少等     

肌少症患者生命质量的影响因素研究

<正>肌少症又称肌肉减少症,是指因持续骨骼肌量流失、强度和功能下降而引起的综合征[1]。肌少症泛指骨骼肌细胞去神经支配、线粒体功能障碍、炎性、激素合成及分泌改变以及由以上过程引发的一系列后果,如肌力下降、易疲劳、代谢紊乱、骨折等[2]。肌少症常见于老年群体,伴发步履缓慢、站立困难、易摔伤等症状,重度的肌少症还会损害器     

家族性石骨症——附1个家系的调查报告

石骨症(Osteopetrosis)是一种罕见疾病。Karshner(1926年)根据本症骨骼特点命名为石骨症,本症又名大理石骨病、广泛性脆性骨硬化症、粉笔样骨、先天性骨硬化症等。Albers-Sh(?)nberg(1904年)首先描述本症的骨骼在X线照片上的特点,因此本症又称Albers-Sch(?)nberg病。     

探讨皮质醇增多症的临床表现和内分泌检查的意义

目的探讨皮质醇增多症的临床表现和内分泌检查的意义。方法从39例患者年龄、性别、病程及实验室检查等方面,观察各种原因所致皮质醇增多症患者不同的临床表现。结果通过测定血、尿皮质醇,大、小剂量地塞米松抑制试验等有助于皮质醇增多症的鉴别诊断。结论内分泌检查有助于各种原因皮质醇增多症的鉴别诊断。     

精浆果糖和中性α-葡糖苷酶测定对少精子症/无精子症诊断的意义

目的:探讨精浆果糖和中性α-葡糖苷酶(neutral α-glucosidase,NAG)测定对少精子症、无精子症诊断中的意义.方法:对192例少精子症/无精子症患者进行精浆果糖和NAG定量检测,并且结合病史、体格检查、精液常规检查、直肠B超及睾丸活检等进行分析.同时以36例精液常规正常、配偶正在怀孕的男子精液进行相同生化项目检测作为对照组.结果:132例少精子症患者中,因附属性腺炎症、输精管道不完全性梗阻而引起梗阻性少精症27例;在60例无精子症患者中,梗阻性无精子症39例.结论:精浆果糖和NAG等生化组项检测对于梗阻性少/无精子症病因诊断中具有无刨、快速等优点,有利于寻找病因和指导治疗.     

胰源性门静脉高压症的诊断和治疗

<正>孟令勤姚旭在门静脉高压症中,肝外型门静脉高压症患者占5%～10%。区域性门静脉高压症亦称为左侧门静脉高压症、局限性门静脉高压症等,占肝外型门静脉高压症的5%,是引起上消化道出血的罕见原因[1]。根据病因,区域性门静脉高压症可分为胰源性、脾源性和腹膜后源性3类,以胰源     

影响新生儿硬肿症预后因素分析及护理体会

目的通过分析住院新生儿硬肿症的不同预后及死亡原因,探讨导致新生儿硬肿症不同预后的原因,以提高新生儿硬肿症抢救成功率及护理效果。方法收集在我科住院203例新生儿硬肿症的临床资料,分析预后、死亡原因、护理效果。结果治愈及好转148例,死亡55例,病死率37.2%。早产儿、极低及低出生体重儿、中重度硬肿症、冬春季发病者、在乡镇地区发病者病死率高于足月儿、正常出生体重儿、轻度硬肿症、夏秋季发病者、在市区发病者。直接导致死亡病因：弥散性血管内凝血并肺出血、呼吸衰竭、肾功能衰竭、严重心力衰竭、呼吸机相关性肺炎、败血症并中毒性脑病等。结论新生儿硬肿症不良预后与胎龄、体重、硬肿程度、发病季节、原发病等有密切关系,窒息、感染、早产、低体重、低温、乡镇地区出生等是影响新生儿硬肿症预后的重要因素,应加强围产期保健、提倡住院分娩、注意新生儿体温护理、预防感染、加强病情观察等,以减少新生儿硬肿症的发生及死亡。     

脾静脉闭塞引起门静脉高压症2例

目的:探讨两例脾静脉闭塞引起门静脉高压症分析其原因,主要由急、慢性胰腺炎或肿瘤、创伤、脾静脉炎症等引起,其病理改变为瘀血性脾肿大产生左侧门静脉高压症,此症有别于肝硬化所致的门脉高压症,主要有①无典型肝脏疾病史; ②肝功能属正常范围;③既往可能有胰腺炎病史;④门奇断流术可根治此症。     

利奈唑胺致血小板减少症的研究进展

血小板减少症是利奈唑胺所致严重不良反应之一。利奈唑胺所致血小板减少症的危险因素为高龄、女性、治疗周期长、联用3种以上抗生素、基础血小板计数低、肾功能不全等。利奈唑胺引起血小板减少症的局部症状可见牙龈、鼻腔出血,紫癜等,严重者可出现胃肠道出血;全身症状则以发热、寒颤、全身酸痛、恶心、呕吐、腹痛、关节痛等常见。利奈唑胺致血小板减少症的机制可能包括骨髓抑制、免疫介导或氧化应激。维生素B6可能对利奈唑胺致血小板减少症有效,但机制尚未明确。     

75例无精子症患者病因分类及分析

目的通过综合无精子症患者生殖器彩超检查、性激素(TSH、LH、E2、T、PRL)水平检测、染色体检查结果等,统计分析其病因,研究总结无精子症患者的病因构成情况。方法选取2015年1月～2017年10月湖南中医药大学第一附属医院男科门诊就诊共75例无精子症患者,收集患者生殖系统彩超、性激素水平、染色体检查结果、既往病史资料等资料,分析患者病因,按输精管道是否通畅区分梗阻性和非梗阻性无精子症两大类。梗阻性无精子症根据彩超、MRI等明确男性生殖管道发育是否正常,区分为先天性梗阻(包括附睾、输精管、精囊腺发育异常或缺如)和获得性梗阻(生殖管道无明显发育异常);非梗阻性无精子症则根据血清性激素水平、染色体核型、Y染色体微缺失等区分为睾丸因素(包含由于饮食习惯、内分泌、温度、睾丸扭转、外伤及隐睾等原因导致的无精子症)和睾丸前因素(包含由于染色体异常、Y染色体微缺失等原因导致的无精症)进行分类、比较。结果在所有75例患者中,梗阻性无精子症占26.67%(20/75),非梗阻性无精子症占66.67%(50/75),其中睾丸生精功能障碍占44.00%(33/75),染色体异常占16.00%(12/75),AZF缺失占6.67%(5/75);其他原因中药物性导致的占1.33%(1/75);原因不明5.33%(4/75)。结论睾丸生精功能障碍、生殖道梗阻、染色体异常是导致无精子症的主要原因,仍有少数患者病因不明。     

Effects of progesterone metabolites on fatty acids of the hepatic endoplasmic reticulum membranes

The effect of 2 selected progesterone metabolites on the phospholipid fatty acid composition of the liver and microsomal function was studied in the female rat. 16α-Hydroxyprogesterone significantly increased microsomal phospholipid content and the total amount of fatty acids esterified to phospholipids parallel with aminopyrine N-demethylase activity. Phospholipid changes were attributable to phosphatidylcholine and phosphatidylethanolamine. Both saturated and unsaturated fatty acids were enhanced. In contrast, 5β-pregnane-3α-ol-20-one caused a reduction of microsomal phospholipids, phosphatidycholine, together with decreased aminopyrine N-demethylase activity and total microsomal fatty acid content. Pregnanolone decreased both saturated and unsaturated fatty acids and its action on unsaturated acyl components was greater than on the saturated ones. Changes in fatty acids were manifested in palmitic, stearic and lignoceric acids among saturated fatty acids and in palmitoleic, oleic, linoleic, eicosaenoic, eicosadienoic, eicosatrienoic, arachidonic, eicosapentenoic, docosatrienoic, docosapentenoic and docosahexenoic acids among unsaturated ones. Total liver phospholipids were unaltered by either 16α-hydroxyprogesterone or 5β-pregnane-3α-ol-20-one. These test compounds, however, modified total hepatic fatty acid content. 16α-Hydroxyprogesterone increased total fatty acids and both saturated and unsaturated acyl components, whereas 5β-pregnane-3α-ol-20-one decreased these parameters. Major changes were manifested in saturated fatty acids such as stearic, arachidic and lignoceric acids, and in unsaturated ones such as palmitoleic, linoleic, eicosatrienoic and docosapentenoic acids. The action of these compounds on phospholipid fatty acids of hepatic microsomes may be causally related to their effect on drug-metabolizing activity of the endoplasmic reticulum.     

不同方法提取大海马脂类及脂肪酸组成分析

采用临界CO2萃取法、三氯甲烷-甲醇提取法、无水乙醇浸提法、石油醚索氏提取法及乙酸乙酯索氏提取法提取大海马脂类成分,通过GC-MS法对其脂肪酸组成进行分析,从总脂含量、脂肪酸甲酯(FAMEs)含量和脂肪酸组成等方面对大海马的5种脂类提取方法进行比较研究。结果表明：5种提取法方法提取的大海马总脂含量分别为21.21 mg/g、76.71 mg/g、50.58 mg/g、30.49 mg/g、25.17 mg/g;脂肪酸甲酯含量分别为20.93 mg/g、53.53 mg/g、27.82 mg/g、29.11 mg/g、23.95 mg/g;采用GC-MS分别鉴定了17、14、15、14、16种成分,其中不饱和脂肪酸占总脂肪酸含量的33.30 %~42.66 %。因此,可根据实际需求采用不同方法对大海马脂类进行提取及加工利用。     

阿魏酸-磷脂复合物的制备及其物理特性

目的制备阿魏酸-磷脂复合物,提高阿魏酸的脂溶性,以期进行进一步的制剂研究。方法采用溶剂挥发法制备阿魏酸-磷脂复合物,并以单因素法优化制备工艺,对复合物进行红外及X-衍射分析,考察阿魏酸表观油水分配系数的变化。结果阿魏酸磷脂复合物的制备工艺为:以无水乙醇为溶剂,药物-磷脂投料摩尔比为1∶1,室温下磁力搅拌4 h,真空干燥;红外及X-衍射图谱验证了复合物的形成;阿魏酸-磷脂复合物在0.1 mol.L-1HCl中的表观油水分配系数显著提高。结论阿魏酸磷脂复合物提高了阿魏酸的脂溶性。     

Phospholipids in the liver of the pregnant rat: changes in fatty acid content and composition

Pregnancy in the rat was associated with changes in hepatic phospholipids. All changes returned to the prepregnancy levels 2 to 3 weeks postpartum. The total phospholipid content was reduced significantly, mainly representing a reduction of phosphatidylcholine, -ethanolamine, and lysophosphatidylcholine fractions. Hepatic fatty acid content was also reduced and the composition was modified since both saturated and unsaturated acyl components were decreased with more pronounced changes in unsaturated acids. Total liver saturated fatty acids with 14 to 16 carbon atoms remained unaltered; stearic acid was reduced and arachidic and lignoceric acids were elevated. Among unsaturated fatty acids, palmitoleic, oleic, eicosatrienoic, arachidonic, eicosapentaenoic, and docosapentaenoic were decreased, docosatrienoic and docosahexaenoic were raised, whereas eicosaenoic and eicosadienoic did not change. In the phosphatidylcholine and -ethanolamine fractions, unsaturated acyl components also showed significant reduction. By and large they reflected the fatty acid changes occurring in total liver with the exception of the docosahexaenoic acid which was diminished in both fractions. The overall effect of pregnancy thus indicated a modification in unsaturated fatty acid content leading to the construction of less fluid membranes which may be responsible for the reduced enzyme activity of the endoplasmic reticulum.     

The role of amino phospholipids in the removal of the cito- and geno-toxic aldehydes produced during lipid oxidation.

The role of amino phospholipids in the removal of 4-hydroxy-2-alkenals and 4,5-epoxy-2-alkenals was studied to determine the fate of highly toxic oxygenated aldehydes produced in foods as a consequence of lipid oxidation. The results obtained showed that phosphatidylethanolamine rapidly removed both exogenously added aldehydes as well as the endogenously produced aldehydes when its fatty acid chains were oxidized in the presence of an oxidative stress inducer. This removal, which was always produced in the range of pH (6-9) and temperature (25-60 degrees C) studied, produced the corresponding carbonyl-amine reaction products between the aldehydes and the amino group of the amino phospholipid. These results suggest that, in the presence of amino phospholipids, the oxidation of polyunsaturated fatty acid chains is not likely to produce free oxygenated aldehydes in enough concentration to pose a significant risk for human health. On the other hand, these compounds contributed to the formation of specific carbonyl-amine reaction products whose toxicity is mostly unknown at present.     

Susceptibility of lipids to mercurials

Affinity of mercury compounds to various phospholipids and fatty acids were examined. Inorganic mercury showed a higher affinity to lipids containing unsaturated fatty acids than to those composed of saturated fatty acids. This suggests that inorganic mercury may easily act on the double bonds of fatty acid residues in phospholipids which are major components of the biomembrane. On the other hand, methylmercury was almost inert to these lipids regardless of the presence or absence of unsaturated bonds.     

Effect of gentamicin on lipid peroxidation in rat renal cortex

We examined the hypothesis that lipid peroxidation participates in the pathogenesis of aminoglycoside-induced nephrotoxicity. Male Sprague-Dawley rats were injected subcutaneously with gentamicin, 100 mg/kg per day, for 1-4 days. Twenty-four or forty-eight hours after the last injection the rats were killed and the renal cortex was processed for total phospholipids, malondialdehyde (MDA), phospholipid fatty acid composition, superoxide dismutase, catalase and glutathione. Gentamicin induced a significant increase in total renal cortical phospholipids which was evident after a single injection and by the third injection reached a plateau 17% above the baseline level. MDA, an end product of lipid peroxidation, increased from 0.674 +/- 0.021 nmole/mg protein in the control group to 0.931 +/- 0.053 nmole/mg protein (P less than 0.001) 48 hr after the fourth injection. As another index of lipid peroxidation, we determined the shift from polyunsaturated to saturated fatty acids of renal cortical phospholipids. By the second injection of gentamicin we detected a significant decline of arachidonic acid (20:4) present in phospholipid. By the fourth injection, arachidonic acid had fallen 48% below control and was accompanied by reciprocal increases of more saturated fatty acids including linoleic (18:2), oleic (18:1) and palmitic (16:0) acids. The number of double bonds per mole of fatty acid declined from a baseline value of 1.62 +/- 0.01 to 1.20 +/- 0.02 (P less than 0.001) by the fourth injection of drug. Superoxide dismutase showed no consistent alteration, whereas catalase activity (k) fell from the control value of 0.221 +/- 0.007 min to 0.155 +/- 0.009 min (P less than 0.01) by the third injection, where k is the first-order rate constant. Total and reduced glutathione declined after the fourth injection of gentamicin accompanied by a shift to oxidized glutathione with an increase in the ratio of oxidized to total glutathione. These data support the conclusion that accelerated lipid peroxidation occurs early in the course of gentamicin administration and raise the possibility that lipid peroxidation is a proximal event in the injury cascade of gentamicin nephrotoxicity.     

GC-MS analysis of fatty acids in phospholipids from Chlorella vulgaris cultivated synchronously in the presence of propranolol

Changes in the content and composition of fatty acids in phospholipids were determined to estimate the effect of propranolol on the growth of unicellular green algae Chlorella vulgaris cultivated synchronously. The general biological activity of the cells and the division coefficient (DC) as well as the cell synchronisation were disturbed by propranolol in a concentration dependent manner. Also, the effect of propranolol on the fatty acids content of Chlorella vulgaris phospholipids was proportional to its concentration.     

Effect of human kidney lipids on human kidney renin activity

The major lipids of human kidney tissue were isolated by solvent extraction, and the lipid composition was determined by thin-layer chromatographic techniques. The positional distribution of fatty acyl groups in ethanolamine and choline phosphatides was determined after enzymatic hydrolysis. Major phosphatides were assayed for plasmalogen content. Triglycerides were characterized by argentation chromatography. The fatty acyl composition of these lipids was also determined. The effect of intact triglycerides, phospholipids, 1- and 2-monoacyl phosphatides and ether lipids on renin activity in vitro was determined by incubations with 3-[U¹⁴C]valyl tetradecapeptide renin substrate. Kidney triglycerides, 1-monoacyl and 2-monoacyl phosphatidylethanolamines and phosphatidylcholines significantly inhibited renin activity. The renin-inhibitory effect of these lipids was comparable to inhibition by hog kidney phospholipid inhibitor. The intact phospholipids and cholesterol potentiated human kidney renin activity. Phosphatidylserines and synthetic glyceryl ether lipids have no significant effect. These results indicate that lipid-induced inhibition of human renin activity does not require the ethanolamine moiety, acyl group unsaturation, or the presence of a hydroxyl group at the 2-position. Additionally, no specific structure-activity relationships can describe lipid-renin interactions.     

Relationship between lipid composition and drug metabolizing capacity of human liver

Summary The relationship between hepatic glycerolipids and microsomal drug-metabolizing enzymes was studied in liver biopsies from 41 subjects. The series included obese, diabetic, epileptic and chronic alcoholic patients, all of whom were hospitalized for suspected hepatic ailments (fatty liver, hepatitis or cirrhosis). Therapy with enzyme-inducing anticonvulsants was associated with high phospholipid and cytochrome P-450 and low triacylglycerol concentration in the liver. In patients with fatty liver or cirrhosis low phospholipid and cytochrome P-450 and high triacylglycerol concentrations were observed. There was a significant correlation (r (Pearsons's product moment correlation coefficient) =0.91) between the hepatic phospholipid and cytochrome P-450 concentration. The cytochrome P-450 concentration was inversely related (r=–0.74) to the triacylglycerol concentration. The positive correlation between hepatic phospholipids and drug-metabolizing enzymes could be interpreted as indicating that in human liver phospholipid and cytochrome P-450 synthesis share common regulators, or that phospholipids are necessary for the maximum rate of cytochrome P-450 synthesis.