不同方案缺血预处理对大鼠横形腹直肌肌皮瓣再灌注损伤的影响

目的 探讨不同方案缺血预处理（ischemic preconditioning，IPC）对大鼠横形腹直肌肌皮瓣（transverse rectus abdominis musculocutaneous flap，TRAM）移植后再灌注损伤的影响。方法选取雄性Wistar大鼠90只，建立TRAM模型，随机分为对照组和实验组，对照组10只，无需预处理过程，持续缺血4h后，恢复肌皮瓣血供；实验组分为8个亚组，每组10只，以微血管夹阻断腹壁下血管5min，再恢复血流5min，处理1次为sIPC5／5组，处理2次为bIPC5／5组，依次为sIPC5／10组（缺血5min／再灌注10min1次）、bIPC5／10组（缺血5min／再灌注10min2次）、sIPC10／5组（缺血10min／再灌注5min 1次）、bIPC 10／5组（缺血10min／再灌注5min2次）、sIPC10／10组（缺血10min／再灌注10min1次）、bIPC10／10组（缺血10min／再灌注10min2次），其余实验步骤与对照组相同；每组肌皮瓣恢复血供4h后，取3只处死取材，测定肌组织含水量及HE染色镜检观察骨骼肌组织结构，其余动物于术后第7天判断皮瓣成活情况，计算成活面积百分比。结果恢复血供12h后，各实验组肌皮瓣两侧边缘部分肿胀，色泽黯淡，较对照组肿胀范围小，程度轻；光镜下见各实验组肌纤维轻度肿胀，染色均一，肌纤维结构尚完整，胞核呈梭形，无明显肿胀。对照组肿胀明显，部分肌纤维断裂。各实验组与对照组相比肌组织水含量明显减少（P〈0．001），皮瓣成活面积提高了2～3倍（P〈0.001）。两次预处理对肌皮瓣成活面积的影响与相应的单次预处理比较，差异有统计学意义（P〈0．05）。结论IPC可明显减轻大鼠TRAM再灌注损伤程度，其保护效应受缺血／再灌注时间、处理次数等因素的影响。     

心脏病药膳

心脏病患者宜食小麦、绿豆等粮食类食物,宜食冬瓜、苦瓜、洋白菜、西瓜,忌腻厚味之品如动物脂肪、全乳食品,忌含胆固醇高的食物如动物脑、脊髓、肝脏和蛋黄、墨鱼、鱿鱼等,忌烟茶、咖啡,忌高糖饮食,忌暴饮暴食。     

国产阿卡波糖(胶囊)治疗2型糖尿病临床疗效观察

目的 :观察国产阿卡波糖胶囊治疗 2型糖尿病的疗效及安全性 ,并与拜耳公司研制生产的阿卡波糖 (拜唐苹 )进行比较。方法 :40例 2型糖尿病患者按随机原则平行分为治疗组 (国产阿卡波糖组 )和对照组 (拜唐苹组 )。结果 :治疗 8周后患者空腹血糖 (治疗组 :治疗前 9.45± 3.2 3mmol/L ,治疗后 6.60± 1.70mmol/L ;对照组 :治疗前 9.83± 3.81mmol/L ,治疗后 7.2 3± 2 .2 2mmol/L)及餐后两小时血糖 (治疗组 :治疗前 13.35± 3.72mmol/L ,治疗后 9.47± 3.5 4mmol/L ;对照组 :治疗前 14 .2 3± 5 .14mmol/L ,治疗后 10 .38± 4.42mmol/L)均有明显下降 ,糖化血红蛋白 (治疗组 :治疗前 7.5 1± 1.49% ,治疗后 6.48± 0 .0 1% ;对照组 :治疗前 8.36± 2 .2 6% ,治疗后 7.12± 1.33% )亦有明显改善。不良反应轻微 ,且两组间无差异。结论 :国产阿卡波糖胶囊和拜唐苹同样为一有效的口服抗高血糖药物 ,具有与拜唐苹相近似的有效性和安全性     

用好磺脲类降糖药

磺脲类降糖药,主要是通过刺激胰岛β细胞释放胰岛素,而实现降糖作用的。此类药物由于生物半衰期不同,药效时间也有长短之分。短效的有:糖适平、美比达、迪沙片、甲苯磺丁脲、诺和龙等,日服3次。中效的有:优降糖、达美康,日服2次。长效的有:瑞易宁、格列本脲,日服1次。本文重点介绍不同时效磺脲药的合理应用问题。     

吗啡预处理-后处理对大鼠离体心脏缺血再灌注损伤的影响

Objective To evaluate the effects of morphine preconditioning-postconditioning on ischemia-reperfusion (I/R) injury in isolated rat hearts. Methods Male SD rats weighing 180-200 g were killed after intraperitoneal injection of heparin 500 U/kg. The hearts were immediately removed and perfused in a Langendorff apparatus with K-H solution gassed with 95%O2-5%CO2 .HR and left ventricular systolic pressure (LVSP) were measured from a fluid-filled latex balloon in the left ventricle. Global myocardial ischemia was induced by interrupting perfusion for 45 min followed by 60 min reperfusion. Forty isolated rat hearts were randomly divided into 5 groups (n = 8 each): group 1 (I/R); group II morphine preconditioning (M1 ); group Ⅲ morphine postconditioning (M2); group IV M1 + M2; group V 5-hydroxydecanoate (5-HD) + M2. Group M1 was perfused with K-H solution containing morphine 3.0 μmol/L for 20 min 30 min before ischemia followed by 10 min normal K-H solution perfusion. Group M2 was perfused with K-H solution containing morphine 3.0 μmol/L for 10 min at the beginning of reperfusion followed by 50 min normal K-H solution perfusion. Group 5-HD + M2 was perfused with K-H solution containing morphine 3.0 μmol/L+ 5-HD 10-4 mmol/L for 10 min at the beginning of reperfusion followed by 50 min normal K-H solution perfusion. Myocardial CK-MB activity was measured and myocardial infarct size (IS/AAR) detennined (by 2,3,5-triphenyl tetrazolium staining) at the end of 60 min reperfusion. Results The preconditioning, postconditioning and combination of preconditioning and postconditioning with morphine 3.0 μmol/L perfusion for 10 min all provided cardio-protective effects in terms of IS/AAR and myocardial activation of CK-MB. Conclusion Although the combination of morphine preconditioning and postconditioning can protect the heart against I/R injury, the effects are similar to those of either of them alone, and the reason may be that either of them alone protects the heart against I/R injury via activating mitoKATP .     

胃癌中性糖脂的分离及纯化

作者应用甲醇氯仿抽提胃癌总脂,经sephadex-A25离子交换层析,florisil层析的方法从28g胃癌组织中分离纯化出中性糖脂(?)1.1mg,经高效薄层色谱分析,与标准品对照证实,条带清楚,纯度可靠。为胃癌中性糖脂抗原的研究打下了基础。     

地戈辛治疗慢性收缩性心衰地位的变迁

洋地黄类药物用来治疗心力衰竭 (简称心衰 )己历经 2 0 0多年 ,一直是临床上治疗心衰的首选药物。上世纪 90年代以来 ,对心衰的研究取得了重大进展 ,对洋地黄治疗心衰的问题进行多中心的广泛合作及大量的病例研究后 ,一致认为 ,洋地黄类药物治疗慢性收缩性心衰 (ＣＳＨＦ)已不是处于重要地位 ,而是降为辅助性用药。其原因主要是 :①心衰发生发展机理的进展及治疗学概念的根本性改变 ;②治疗心衰目标的根本性改变 ,强调降低心衰的病死率和住院率 ;③血管紧张素转换酶抑制剂 (ＡＣＥＩ)治疗ＣＳＨＦ具有突出的优越性。1　心衰发生发展机理的进…