葡萄糖酸镁对离体大鼠心肌缺血再灌注细胞凋亡的影响

Objective To observe the protective effect of magnesium gluconate on myocardial apoptosis by ischemia reperfusion injury in isolated rat hearts, and study the possible mechanism. Methods The hearts of 48 Sprague-Dawely rats were isolated, linked to Lange-ndorff perfusion apparatus, and randomly divided into 3 equal groups(n = 16 each) : Control group, ischemia/reperfusion (I/R) group and magnesium gheonate group. 8 rats in each group were perfused. Control group was pedused with modified KH buffer for 110min. I/B group was perfuesd with modified KH buffer for 20 min, then exposed to iscbemia for 30 min, and then reperfused with modified KH buffer for 60 min. Magnesium gheonate group was perfumed with modified KH buffer with magnesium gluconate for 20 min, then exposed to isohemia for 30 min and then reperfused with modified KH buffer with magnesium glueonate for 60 min. Lacate dehydrogenase (LDH) and ereatine kinase (CK) in the effluent liquid from the heart were measured after reperfusion. The concentration of Ca2+ and NO in the left ventricle were determined. The other 8 rats in each group were reperfused for 120 minutes as the method described before. After repeffusion, the myoeyte apoptosis was examined by Annexin-V-FITC/PI. After the two experiments the incidence of ventrieular arrhytlunias during reperfusion was assessed. Results Compared with I/R, magnesium glueonate decreased the incidence of ventricular an'hythmias(P <0. 01). The contents of CK and LDH in the effluent liquid from the heart in magnesium glueonate group was lower than that of I/R group (P <0. 01). The contents of Ca2+ and NO in the left ventricle in magnesium gluconate group was decreased than that of I/R group (P <0. 01). The index of myocyte apoptosis were significanfly lower in magnesium glueonate group than that of I/R group (apoptosis index :27.79±1.59 vs 33.61±2.10, P < 0. 01) . Conclusion Magnesium glueonate has protective effect on myocardial isohemia reperfusion injury in rats. The protective effect may be related to decreasing myocyte apoptosis by increasing the content of NO and relieving calcium overload.     

老年急性心肌梗死患者窦性心律和室性早博时QT离散度的变化及意义

对100例老年急性心肌梗死（AMI）患者、50例不稳定性心绞痛（UAP）患乾和40例正常人进行QTd检测。发现AMI患者室性早博时QTd(QTd-V)明显高于窦性心律时QTd（QTd-S)(P＜0．001）,且二者呈明显正相关;AMI患者QTd-V和QTd-S明显高于UAP组和对照组（P＜0．001）。提示老年AMI患者QTd-V和QTd-S可能具有同样的临床价值。     

近5年国外护理院研究热点的共词聚类分析

目的分析Pubmed数据库中2014-2018年护理院的研究热点和发展现状,旨在为我国护理院的发展提供参考依据。方法在Pubmed数据库中以"nursing homes"为主题进行检索,应用BICOMB 2.0对主题进行统计分析,采用SPSS 22.0进行系统聚类分析。结果共纳入1710篇文献,截取41个高频主题词,归纳出6个研究类团:护理院组织管理与流行病学研究;老年评估研究;护理院用药管理与疼痛管理研究;姑息护理与临终关怀研究;医护工作满意度研究;痴呆症患者及照顾者精神心理研究。结论国外护理院的研究热点分析利于了解该领域的研究现状和发展趋势,可为我国护理院的理论研究与实践发展提供参考。     

潮气量对极低出生体重儿高频震荡通气时p(CO2)的影响及最佳设置分析

目的观察极低出生体重儿高频震荡通气(high-frequency oscillation ventilation, HFOV)时血p(CO₂)的变化,探讨潮气量对血p(CO₂)的影响及最佳潮气量值。方法接受HFOV治疗的极低出生体重儿80例,记录通气过程中各项参数,包括呼吸频率、呼吸幅度、平均气道压、吸入氧浓度、潮气量、每分通气量、p(CO₂)、二氧化碳扩散系数(carbon dioxide diffusion coefficient, DCO₂),共监测毛细血管血气数据812个,其中p(CO₂)≥55 mm Hg的血气数据439个为观察组,p(CO₂)<55 mm Hg的血气数据373个为对照组,比较2组呼吸参数;采用多因素logistic回归分析极低出生体重儿p(CO₂)升高的影响因素;绘制ROC曲线,评估潮气量及其他通气参数对极低出生体重儿p(CO₂)升高的预测效能。结果观察组吸入氧浓度(0.49±0.13)高于对照组(0.32±0.14)(P<0.05),潮气量[(1.62±0.37)mL/kg]、每分通气量[(0.61±0.29)mL/kg]及DCO₂[(32.49±14.92)mL²/s]均低于对照组[(2.18±0.52)mL/kg、(0.92±0.23)mL/kg、(68.47±31.44)mL²/s](P<0.05);潮气量(OR=0.028,95%CI:0.006~0.132,P<0.001)、每分通气量(OR=0.003,95%CI:<0.001~0.028,P<0.001)、DCO₂(OR=0.936,95%CI:0.910~0.963,P<0.001)是极低出生体重儿p(CO₂)升高的影响因素;潮气量、每分通气量、DCO₂的最佳截断值分别为1.81 mL/kg、0.62 mL/kg、38.84 mL²/s时,预测极低出生体重儿p(CO₂)升高的AUC分别为0.833(95%CI:0.766~0.887,P<0.001)、0.596(95%CI:0.516~0.673,P<0.001)、0.830(95%CI:0.762~0.885,P<0.001),灵敏度分别为81.25%、93.75%、72.50%,特异度分别为75.00%、31.25%、93.75%,潮气量及DCO₂预测极低出生体重儿p(CO₂)升高的AUC明显高于每分通气量(P<0.05)。结论潮气量对使用HFOV呼吸支持的极低出生体重儿p(CO₂)有明显影响,保持潮气量不低于1.81 mL/kg对控制p(CO₂)水平有较好指导价值。     

低剂量皮内接种乙型肝炎重组疫苗与血源性疫苗的比较试验

作者将153名抗-HBs、抗-HBc和HBsAg均为阴性的志愿者分成三组:分别皮内接种重组疫苗1μg(0.1ml)、皮内接种血源性疫苗2μg(0.1ml)、肌肉接种重组疫苗10μg(1.0ml)。所有受试者均在第0、30和150天接种疫苗。每次接种后第1、2、4和7天观察注射部位是否出现红斑、硬结、局部肿胀、色素沉着等。并在第30、150、200和360天采血,检测抗-HBs和抗-HBc水平。在接种3针后,抗-HBs低于100mIU/ml者,需皮内     

甲型肝炎与乙型肝炎疫苗的联合接种

该联合疫苗由甲型肝炎病毒(HAV)人二倍体纤维母细胞培养灭活后的甲型肝炎疫苗和酵母乙型肝炎疫苗所组成,每剂量含有20μg的乙肝表面抗原/p24(HBsAg/p24)、0.3μg的HAV抗原和1.5mg的氢氧化铝。给15名血清阴性的年青成人志愿者注射联合疫苗,每针间隔1个月共注射3针。作者用放免法检测抗-HAV和抗-HBs,在第1针     

携带鼠粒细胞巨噬细胞集落刺激因子基因腺病毒载体对B16黑色素瘤的抑制作用

目的 :观察携带鼠粒细胞巨噬细胞集落刺激因子基因腺病毒载体 ( Ad CMVGM- CSF)对B1 6黑色素瘤的致瘤性及抑制作用。方法 :将 B1 6黑色素瘤细胞与 Ad CMVGM- CSF在 37℃、5 %CO2 培养箱中孵育 ( RPMI- 1 640培养基 ) 2 h后注射到 C5 7BL/ 6小鼠右侧背部皮下 ( MOI=5 0 0 ) ,观察 Ad CMVGM- CSF对 B1 6黑色素瘤致瘤性的抑制作用 ;观察瘤内一次注射及二次注射对 B1 6黑色素瘤的抑制作用。结果 :Ad CMVGM- CSF能有效地抑制 B1 6黑色素瘤细胞的致瘤性 ,抑瘤率达 60 %;瘤内一次注射 Ad CMVGM- CSF可延缓肿瘤的生长 ,二次瘤内注射 Ad CMVGM- CSF能够强化抗肿瘤效果。结论 :Ad CMVGM- CSF具有抑制肿瘤生长的作用