茶黄素对大鼠心脏缺血/再灌注损伤的保护作用

目的探讨茶黄素对大鼠心脏缺血/再灌注损伤的保护作用及其机制。方法将雄性SD大鼠随机分为对照组和茶黄素组。利用Langendorff灌注技术,使心脏缺血30min再灌注120min,建立大鼠离体心脏全心缺血/再灌注(I/R)损伤模型,观察茶黄素对缺血/再灌注后心肌梗死面积以及心肌超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量的变化。结果与对照组相比,茶黄素组可剂量依赖性地改善大鼠缺血/再灌注损伤后心肌的梗死面积。茶黄素组大鼠缺血/再灌注后心肌SOD活性明显高于对照组,而MDA含量则低于对照组。结论茶黄素具有明显的抗心肌缺血/再灌注损伤作用,此作用与茶黄素的抗氧化作用有关。     

胃镜下探条或自制气囊扩张治疗贲门失弛缓症疗效的对比研究

目的对比分析胃镜下应用探条或自制气囊扩张治疗贲门失弛缓症的疗效。方法1998年1月～2007年12月，胃镜下治疗贲门失弛缓症45例，其中应用自制气囊扩张22例（自制气囊组），应用探条扩张23例（探条组），比较2组疗效。结果探条组23例扩张1～9次，平均3．6次；自制气囊组22例扩张1～6次，平均2．3次。2组术中及术后均无并发症发生。首次治疗费用探条组（1542．57±281．30）元，自制气囊组（861．91±176．48）元（t=9．671，P=0．000）。扩张后3个月的疗效2组差异无显著性[探条组显效14例（61％）、有效8例（35％）、无效1例（4％），自制气囊组显效15例（68％）、有效5例（23％）、无效2例（9％），Z=-0．351，P=0．726]。扩张后6个月的疗效2组差异有显著性[探条组显效5例（22％）、有效3例（13％）、无效15例（65％），自制气囊组显效10例（45％）、有效7例（32％）、无效5例（23％），Z=2．564，P=0．010]。结论胃镜下应用探条和自制气囊扩张治疗贲门失弛缓症安全、简便，患者恢复快，尤其自制气囊扩张器设备简单，就地取材，疗效肯定，在基层医院具有良好的推广价值。     

Endocardial catheter ablation of ventricular tachycardia in patients with ventricular assist devices

BACKGROUND: The outcomes of patients with ventricular assist devices (VADs) who undergo catheter ablation for ventricular tachycardia (VT) have not been reported. OBJECTIVE: The purpose of this study was to assess the feasibility, safety, and efficacy of endocardial VT ablation in patients with VADs. METHODS: We retrospectively reviewed three cases at our institution where endocardial catheter ablation was performed in patients with VADs and incessant VT. RESULTS: Three patients with underlying cardiomyopathies and VADs underwent VT ablation for incessant VT refractory to multiple antiarrhythmic medications. In each case, VT was either eliminated or significantly ameliorated by catheter ablation. No procedure-related complications occurred. The hemodynamic stability afforded by the VAD played an important role in facilitating ablation in two of the cases. CONCLUSION: Catheter ablation for VT in VAD patients appears to be feasible, safe, and effective based on our initial experience. Several technical issues, such as decreases in ventricular volumes that can limit maneuverability of the ablation catheter and potential entrapment of the mapping catheter in the inflow cannula, need to be considered at the time of ablation.     

弥散张量成像对胶质瘤手术风险的评估

Objective To elucidate the clinical significance of diffusion tensor imaging (DTI) mainly used for protecting neurological functions in patients with gliomas. Methods Thirty - eight patients with gliomas were recruited to undergo DTI test and assess the status of neurological functions before and after surgery. According to the relationships between gliomas and adjacent white matter(WM) tracts, DTI can be classfied as the following types : type Ⅰ - displacement; type Ⅱ - Infiltration; type Ⅲ - Disruption. The neurological functions before surgery were compared in three groups,as well as the change of neurological functions after surgery was also compared in three groups. Results There were 14 cases in type Ⅰ , 16 cases in type Ⅱ, and 8 cases in type Ⅲ. There were significant difference between DTI types and preoperative neurological functions, as well as between DTI types and the change of postoperative neurological functions ( P < 0. 05 ). Conclusions DTI allows to visualizate the relationships of gliomas and adjacent WM tracts, which represent the different growth patterns of gliomas. It is useful for neurosurgeons to select suitable surgical approaches and determine appropriate extent of resection.     

阿司匹林对大鼠脊髓损伤细胞凋亡的保护作用

目的 观察阿司匹林对大鼠慢性压迫性脊髓损伤后神经细胞凋亡及神经功能恢复的影响。方法选择65只体重为220～250g的Wistar大鼠（雌雄不限），于T10部位置入后路渐进式压迫装置，制作成慢性压迫性脊髓损伤模型。随机分为阿司匹林治疗组（A组，30只）、生理盐水对照组（B组，30只）和假手术组（C组，5只）。应用原位末端脱氧核糖核苷酸转移酶介导dUTP标记技术，分别于慢性压迫性脊髓损伤后1、3、7、14、28d做行为学评价，并取材对脊髓损伤区进行细胞凋亡检测。结果A、B组均发现细胞凋亡，A组与B组细胞凋亡率相比差异有显著性（P〈0．05），A组与B组行为学评价相比差异有显著性（P〈0．05），神经细胞凋亡情况与运动功能改变具有相关性。结论 阿司匹林对慢性脊髓压迫损伤后所导致的神经细胞凋亡产生抑制作用。     

IL-1Ra基因多态性在冠心病病人心血管事件中的作用

目的 探讨白细胞介素-1受体拮抗剂(interleukin-1 receptor antagonist,IL-1Ra)基因多态性与冠心病患病率及心血管事件发生的关系.方法 利用聚合酶链式反应(PCR)技术对220例冠心病患者及100例正常对照者IL-1Ra基因进行扩增;检测冠心病患者的高敏感性C反应蛋白、血清总胆固醇、甘油三酯、低密度脂蛋白和体重指数;所有冠心病患者随访12个月,了解患者在出院后1年内的心血管事件.结果 冠心病患者和正常人的IL-1Ra基因多态性分布的差别没有统计学意义;出院后未发生心血管事件的冠心病患者Ⅱ型基因型携带率高于其他基因型.结论 监测IL-1Ra基因多态性不能预测冠心病的发生;但其多态性中Ⅱ型基因对已患冠心病患者的预后有一定保护作用.     

Laparoscopic cholecystectomy in a patient with a biventricular cardiac assist device.

Evaluation and management of abdominal pathology in patients with ventricular assist devices is likely to become increasingly important as the utilization of these devices expands. Ventricular assist devices represent a class of intracorporeal or paracorporeal mechanical devices that augment cardiac output in patients with congestive heart failure. Patients with ventricular assist devices supporting both right and left ventricles (biventricular assist devices) are uniquely challenging to the general surgeon because these devices restrict direct access to the abdominal cavity and because of the perioperative implications of biventricular heart failure. We describe herein the first reported successful laparoscopic cholecystectomy in a patient with a paracorporeal biventricular assist device. Cholecystectomy was performed in this patient for acute cholecystitis that occurred while the patient was awaiting heart transplantation. Our results add weight to the small body of evidence that laparoscopy is well tolerated in ventricular assist devices patients. The unique aspects of the biventricular assist device patient make laparoscopic abdominal intervention particularly suitable in this patient population.     

Transforming growth factor alpha treatment alters intracellular calcium levels in hair cells and protects them from ototoxic damage in vitro

To determine if transforming growth factor alpha (TGFα) pretreatment protects hair cells from aminoglycoside induced injury by modifying their intracellular calcium concentration, we assayed hair cell calcium levels in organ of Corti explants both before and after aminoglycoside (i.e. neomycin, 10⁻³M) exposure either with or without growth factor pretreatment. After TGFα (500ng/ml) treatment, the intracellular calcium level of hair cells showed a five-fold increase as compared to the levels observed in the hair cells of control cultures. After ototoxin exposure, calcium levels in hair cells of control explants showed an increase relative to their baseline levels, while in the presence of growth factors pretreatment, hair cells showed a relative reduction in calcium levels. Pretreatment of organ of Corti explants afforded significant protection of hair cell stereocilia bundle morphology from ototoxic damage when compared to explants exposed to ototoxin alone. This study correlates a rise in hair cell calcium levels with the otoprotection of hair cells by TGFα in organ of Corti explants.