TGFβ1基因对血管内皮细胞细胞外基质表达及与基质黏附的影响

了解TGFβ1基因对血管内皮细胞表达细胞外基质蛋白及与基质黏附力的影响。用DOTAP脂质体转染p MAMneo TGFβ1于原代培养的脐静脉内皮细胞,经G4 18筛选,TGFβ1表达经免疫荧光鉴定。Western blot确定 型胶原、纤黏连蛋白的表达,微管吸吮系统确定内皮细胞与基质的黏附力。结果表明生理情况下的内皮细胞能表达少量的TGFβ1及胶原、纤黏连蛋白。经G4 18筛选,外源性TGFβ1在血管内皮细胞中稳定表达,能显著提高胶原、纤黏连蛋白纤维的表达及细胞与基质的黏附。说明TGFβ1在血管组织工程中促进内皮细胞的黏附具有一定的应用价值。     

过氧化物酶增殖体激活受体α在急性肺损伤大鼠肺组织的表达及其意义

目的: 观察内毒素(LPS)复制的急性肺损伤（ALI）大鼠肺组织过氧化物酶增殖体激活受体α（PPARα）表达的变化,探讨PPARα在ALI中可能的作用。方法: 将40只雄性Wistar大鼠随机分为对照组、LPS致伤1 h组、2 h组、4 h组和8 h组。用LPS(5 mg/kg) 静脉注射复制大鼠ALI模型，分别在LPS致伤后1 h、2 h、4 h、8 h时处死大鼠，测定各组肺组织湿/干重比（W/D）及肺组织病理变化；采用RT-PCR法检测肺组织中PPARα mRNA的表达；采用免疫组化法检测肺组织中PPARα的表达。结果: LPS致伤后2 h、4 h、8 h肺组织W/D均显著高于对照组（均P< 0.01）；LPS致伤后2h、4h PPARα mRNA表达分别显著低于对照组（均P < 0.01）；而LPS致伤4h和8h组PPARα表达阳性细胞数显著低于对照组（均P< 0.05）。结论: PPARα在ALI大鼠肺组织表达降低。表明PPARα在急性肺损伤的发病机制中具有重要作用。     

含辛伐他汀药物血清对兔血管平滑肌细胞增殖的直接作用及意义

目的 :探讨辛伐他汀对体外培养兔血管平滑肌细胞增殖的影响及意义。方法 :16只雄性新西兰兔随机分为血清对照组和三个不同剂量的辛伐他汀亚组 (每日分别给予辛伐他汀 5mg/kg、10mg/kg、15mg/kg) ,7天后采血并混合每组 4只兔血 ,无菌分离制备三亚组的辛伐他汀含药血清。采用内皮素 1(ET 1)刺激正常喂饲原代培养兔主动脉血管平滑肌细胞的方法 ,建立血管平滑肌细胞增殖模型。采用MTT及3H TdR法检测各组辛伐他汀含药血清对血管平滑肌细胞增殖的作用。结果 :与不含药的正常对照组相比 ,不同亚组辛伐他汀含药血清呈剂量依赖性抑制血管平滑肌细胞增殖 (P <0 .0 1～0 .0 5 )。结论 :兔口服辛伐他汀后的血清具有抑制血管平滑肌细胞增殖的作用     

不同浓度缺氧预适应小鼠脑匀浆提取液对PC12细胞缺氧耐受性的影响

目的： 探讨缺氧预适应小鼠脑匀浆提取液(HP extract)对PC12细胞缺氧耐受性的影响。方法: 复制小鼠急性重复缺氧模型，制备HP extract。在培养PC12细胞中加入HP extract使其终浓度分别为0.2、0.8、3.2、6.4、12.8 g/L(HP组)。以同浓度正常小鼠脑匀浆提取液(N extract)作为对照组(N组)。缺氧(2%O2) 培养24、48、72 h后, 采用四唑盐（MTT）比色法检测各组细胞活力 (A570值)并检测缺氧24、48、72 h乳酸脱氢酶（LDH）透出率、缺氧24 h早期凋亡率(Annexin V-FITC/PI双染流式细胞仪检测)、缺氧72 h晚期凋亡率(Hoechst33258染色荧光显微镜检测)。结果: HP extract浓度低于6.4 g/L(包括6.4 g/L), 缺氧培养24 h时, HP组A570值显著高于同浓度N组, 其 LDH透出率显著低于同浓度N组。随缺氧时间延长, 高浓度HP extract逐渐失去细胞保护作用。至72 h时浓度高于6.4 g/L(包括6.4 g/L)HP extract有促细胞凋亡作用, 此时HP组A570值显著低于同浓度N组, 其LDH透出率和晚期凋亡率均显著高于同浓度N组。结论: 缺氧预适应小鼠脑匀浆提取液对PC12细胞缺氧耐受性的影响呈浓度依赖性和时间依赖性。     

Evaluation of high protein intake to improve clinical outcome and nutritional status for patients with burns: a systematic review

Background and aimPatients with severe burns undergo a local and systemic response to the injury. As part of this response the patient becomes hypermetabolic. Current guidelines advise high protein intakes to counteract the catabolic response to burns, but this appears to be based on minimal experimental evidence. Hence the aim of this review was to examine the evidence for improvements in nutritional status and clinical outcome with the administration of high protein intakes for patients with burns.MethodsEight databases were searched for clinical trials with burn patients receiving two or more levels of protein intake at or above the level recommended for healthy individuals (0.75 g/kg/d) and presenting results for at least one of the following pre-defined outcomes: nitrogen balance, length of stay, weight change, survival, physical therapy index, protein fractional synthetic rate, immunological measurements, bacteraemic days, systemic antibiotic days and net protein synthesis.ResultsSix studies were included, 4 of which were randomized trials. All had major methodological limitations, in particular none was blinded. There was too much heterogeneity in study design, patient characteristics and the timing and magnitude of the interventions to justify formal meta-analysis. There was no reliable evidence of improvement in nitrogen balance, but there was some evidence of increased weight gain on higher protein diets. One small study reported an increase in survival and significant improvements in infection rates and some indicators of immune function in children. Length of stay was not significantly improved. There was weak evidence of an improvement in muscle strength and endurance but no significant increase in protein synthesis in muscle or skin, or net protein synthesis in the whole body.ConclusionThere is currently only very weak evidence to justify administering high protein diets to patients following burns.     

Characteristics of injuries among infants who fall from bed

IntroductionAccidental falls are the most common causes of injury among infants. Due to their limited ability to move independently, falling from bed or other types of furniture (such as sofas or armchairs) is considered the most common reason for such injury. However, little is known about the frequency and types of injury associated with this type of fall among infants. This study aimed to determine the incidence and characteristics of injury among infants presented at emergency departments (ED) after falling from bed or similar furniture.MethodsThe retrospective analysis of infants under one year old presenting at ED after falling from bed (or similar furniture) was performed over a four-year period (2016–2019). Patient demographics, incidence and patterns of injury, outcomes, and ED resources use were evaluated as part of the study.ResultsIn total, 1,439 infants were included in the study, of whom 782 (54.3%) were male and 657 (45.7%) female. The median age of the patients was 7 months (interquartile range [IQR]: 6–9 months). More than half the infants (n = 812, 56.4%) had minor injuries, such as abrasions, bruising, contusions, and lacerations. There were significant injuries for 135 (9.4%) infants. The most common fracture was skull fracture (n = 59, 4.1%), followed by proximal fracture of the upper extremities (n = 26, 1.8%). Six (0.4%) patients had radial head subluxation. Traumatic brain injury featured for 30 (2.1%) infants (intracranial hemorrhage/cerebral contusion). While the majority of patients (n = 1352, 94%) were discharged from ED, 86 (6%) infants were hospitalized, all due to head injuries. A neurosurgical intervention was performed with three (0.2% of all patients) of the hospitalized patients.ConclusionFalling from bed causes skull fractures, traumatic brain injury, and long bone fractures among infants. Therefore, campaigns should be organized to raise awareness of these risks among parents and caregivers of infants. In addition, the use of safety equipment (such as bed rails) and creating a safe environment can help prevent significant injuries.     

The evaluation of intracranial bypass patency in neurosurgical practice

BackgroundThe patency of cranial bypasses must be carefully evaluated during and after the microsurgical procedure. Although, several imaging techniques are used to evaluate the patency of bypasses, their findings are sometimes difficult to interpret.PurposeThe goal of this study was to assess the consistency of different diagnostic modalities for evaluating intracranial bypass patency.Patients and methodThis prospective study included 19 consecutive patients treated with EC-IC or IC-IC bypass for MoyaMoya disease (MMD) or complex/giant aneurysms between June 2016 and June 2018. In the early postoperative period (< 7 days), all patients had transcranial Doppler (TCD), CT angiography (CTA) and MRA to demonstrate patency of anastomoses and to confirm exclusion of the aneurysm. When findings of anastomosis patency differed between these techniques, conventional angiography was performed.ResultsAll anastomoses were patent on indocyanine green videoangiography at the end of microsurgical procedure. The results of noninvasive postoperative exams were consistent to demonstrate the patency of anastomoses in 13 patients. In 4 patients, a discrepancy in patency of anastomoses arose between TCD, CTA and MRI in the early postoperative period. In 2 other patients, the interpretation of bypass patency remained inconclusive before the decision to occlude the aneurysm. In these 6 patients, a significant edema was noted in 2 cases, a postoperative subdural hematoma in 1 case, a low flow in the anastomosis in 1 case and vasospasm in 2 cases. The anastomosis was patent on the conventional angiography in five patients.ConclusionNoninvasive imaging techniques provide useful data about the patency but their findings should be carefully interpreted due to local anatomical, physiological, and pathological factors. In case of discrepant findings, conventional angiography including supraselective catheterization of the donor vessel is suggested.     

前列腺素、一氧化氮和钾通道在鼠兔缺氧肺血管反应钝化中的作用

目的:探索前列腺素、一氧化氮和电压依赖性钾通道在高原动物鼠兔的缺氧性肺血管收缩反应钝化中的作用。方法:用鼠兔肺组织条替代肺血管进行实验,并以Wistar鼠肺组织条作为对照组。分别观察环加氧酶(cyclooxygenase,COX)抑制剂吲哚美辛(indomethacin)、一氧化氮合酶(nitricoxidesynthase,NOS)阻断剂L-NAME、电压门控的钾通道的阻断剂4-AP,对缺氧性肺血管收缩反应的影响。结果:(1)吲哚美辛组:吲哚美辛使鼠兔肺组织条的缺氧张力升高平均值比用吲哚美辛前增加64.7%;Wistar鼠肺组织条仅增加19.7%;两组差异显著,P＜0.05;(2)L-NAME组:L-NAME使鼠兔肺组织条缺氧性张力升高平均值增加102.7%;Wistar鼠肺组织条仅增加60.7%;两组差异显著,P＜0.05;(3)4-AP组:4-AP使鼠兔肺组织条缺氧张力平均值降低43.8%;Wistar鼠肺组织条降低28.53%;两组无显著差异,P＞0.05。结论:(1)NO和前列腺素在肺血管缺氧收缩反应中可能起调节作用,而电压门控的钾通道可能起介导作用;(2)鼠兔肺血管对缺氧收缩反应性钝化的机制中NO和前列腺素可能起更重要的介导作用,而电压门控的钾通道可能不起重要作用。