老年犬自发性前列腺增生的实验研究

目的 :以老年犬自发性良性前列腺增生 (BPH)为实验动物模型 ,观察前列腺病理解剖、组织学和生物化学特征。　方法 :选择 6～ 13岁老年杂种家犬 ,经肛门指检、直肠探头B超和手术直视下测量前列腺体积 ,10只前列腺显著增生 (BPH组 )和 6只未增生 (对照组 )的老年犬为观察对象 ,测量血清睾酮 (T)、雌二醇 (E2 )、酸性磷酸酶(ACP)和前列腺特异抗原 (PSA)水平 ,并作组织学检查。　结果 :B超和实测表明 ,BPH组前列腺体积显著大于对照组 [BPH组分别为 (14 .7± 2 .3)和 (13.8± 1.9)cm3 ,对照组分别为 (8.4± 1.0 )和 (8.4± 1.9)cm3 ,P <0 .0 1];BPH组和对照组血清激素水平差异没有显著性 [T分别为 (14 .3± 2 .9)和 (16 .4± 4 .0 )nmol/L ,E2分别为 (137.6±70 .8)和 (16 4 .4± 82 .0 ) pmol/L ,P >0 .0 5 ];ACP分别为 (6 .6 3± 2 .76 )及 (4.92± 2 .19)U/L ,BPH组高于对照组 ,但无统计学差异 (P >0 .0 5 ) ;而PSA水平分别为 (5 .6± 0 .78)及 (3.10± 0 .5 4 ) μg/L ,P <0 .0 1。组织学检查发现 ,BPH组前列腺腺体增生 ,上皮细胞高度增加 ,间质相对较少 ,腺腔内上皮细胞增生形成大量长而分支多的乳头。　结论 :自发性BPH的老年杂种家犬是人类BPH病因学和药理学研究有用的实验动物。     

胆汁胆固醇对胆囊收缩素受体表达的影响

目的　探讨胆汁胆固醇对胆囊收缩素受体 (CCK R)表达的影响。　方法　采用放射免疫分析法和受体放射配基结合法检测对照组 (n =2 5 )、高胆固醇组 (n =2 5 )、自然恢复组 (n =2 5 )及治疗组 (n =2 5 )豚鼠门静脉血CCK水平、胆囊CCK R的最大结合容量 (Bmax)和亲和力 (Kd) ,同时观察空腹胆囊体积 (FV)、胆囊胆汁量 (FB)和餐后胆囊体积 (RV)、胆囊胆汁量 (RB)及胆囊收缩率 (E)、胆汁胆固醇浓度的变化。　结果　与对照组比较 ,高胆固醇组豚鼠FV[(0 89± 0 2 6 )～ (1 34± 0 6 1)cm3 ]、FB[(0 6 8± 0 2 0 )～ (1 0 1± 0 4 3)cm3 ]、RV[(0 2 8± 0 0 8)～ (0 90± 0 5 3)cm3 ]、RB[(0 2 3± 0 0 6 )～(0 83± 0 32 )cm3 ]增大 ,E[(6 5 83± 7 32 ) %～ (47 2 2± 5 2 4 ) % ]下降 ,胆汁胆固醇浓度 [(0 4 4±0 11)～ (0 6 0± 0 13)mmol/L]升高 ,门静脉血CCK水平及CCK R的Kd无改变 ,而CCK R的Bmax[(6 0± 2 7)～ (32± 13)fmol/mg蛋白 ]下降 ;与自然恢复组比较 ,治疗组上述各项指标正常。　结论　胆汁中的高胆固醇通过下调胆囊CCK R表达而导致胆囊收缩功能障碍 ,降低胆汁高胆固醇浓度可以促进胆囊动力功能的恢复。     

二氧化碳气腹对径路口及腹腔内肿瘤细胞转移的影响

目的　通过建立大鼠肿瘤动物模型 ,探讨腹腔镜手术中常用的气腹介质CO2 对径路口及腹腔内肿瘤细胞转移的影响。方法　手术前 1h于 30只Wistar大鼠腹腔内注入R15肝癌细胞株 ,然后随机将大鼠分为 3组 :免气腹组 ( n =10 )、剖腹组 ( n =10 )、CO2 气腹组 ( n =10 ) ,实验维持 2h ,2 8d后宰杀动物比较各组径路口及腹腔内的肿瘤转移。结果　CO2 气腹组、剖腹组及免气腹组在径路口、肠浆膜层、肠系膜、大网膜和膈肌等部位转移的肿瘤重量分别为 ( 32 6 .7± 2 30 .3)mg、( 181.6± 174.7)mg和 ( 2 9.0± 6 2 .8)mg( P <0 .0 5或P <0 .0 1) ;( 6 2 6 .2± 2 15 .9)mg、( 2 71.5± 2 19.2 )mg和 ( 44.3± 10 0 .1)mg( P <0 .0 5或P <0 .0 1) ;( 476 .2± 2 0 4.8)mg、( 184.0±187.1)mg和 ( 42 .5± 96 .7)mg( P <0 .0 5或P <0 .0 1) ;( 2 5 36 .5± 90 6 .6 )mg、( 112 9.1± 933 .9)mg和 ( 15 9.5± 35 4.4)mg( P <0 .0 5或P <0 .0 1) ;( 346 .1± 186 .4)mg、( 16 9.1± 16 2 .1)mg和( 11.3± 35 .7)mg(P <0 .0 5或P <0 .0 1)。结论　腹腔镜手术中的常用气腹介质CO2 是导致肿瘤细胞在径路口及腹腔内转移的主要原因。     

小剂量吗啡和曲马多关节内注射用于膝关节镜术后镇痛的临床比较

目的　观察小剂量吗啡、曲马多关节内注射用于膝关节镜手术后的镇痛效果。方法　腰麻下行膝关节镜手术的病人 6 0例 ,双盲随机分为关节内注射吗啡组 (M组 ,n =2 0 )、曲马多组 (T组 ,n =2 0 )和生理盐水对照组 (C组 ,n =2 0 )。M组在术后关节内注射小剂量吗啡 (1mg) ,T组则在术后关节内注射小剂量曲马多 (10mg) ,C组则关节内注射等体积的生理盐水。给药后 8和 2 4小时 ,在病人双足站立膝关节伸展状态下进行视觉模拟评分。结果　M组评分平均为 1 7± 1 0和 1 5±1 1,T组评分为 2 0± 1 1和 1 7± 1 2 ,C组为 3 6± 1 5和 2 4± 1 3,M组与T组评分显著低于C组 (P <0 0 5 )。M组与T组评分有显著差异 (P <0 0 5 )。结论　小剂量的吗啡和曲马多关节内注射可以有效缓解膝关节镜手术的术后疼痛 ,尤以吗啡为佳     

少精子症患者血清、精浆中游离睾酮水平的测定及意义

目的 :通过测定少精子症患者血清、精浆中游离睾酮 (FT)水平 ,分析血清、精浆FT与少精子症的关系。　方法 :正常对照组 (n =4 4 )、少精子症组 (n =4 4 )男性于上午 8:0 0～ 10 :0 0留取血标本 ;正常对照组 (n =30 )、少精子症组 (n =37)同时留取精液。男性精液常规分析判断精子密度 ,放射免疫分析法测定血清、精浆中FT水平。　结果 :少精子症患者血清中FT浓度为 [(94 .88± 4 2 .0 4 )pmol/L],与正常对照组 [(97.5 0± 4 6 .96 )pmol/L]相比差异无显著性 (P >0 .0 5 ) ,但少精子症患者精浆中FT浓度 [(0 .5 2± 0 .4 4 ) pmol/L]显著低于正常对照组 [(2 .0 1±0 .32 )pmol/L],P <0 .0 1。　结论 :精浆中FT的测定较早反映睾丸的功能 ,有利于少精子症患者的早期诊断和治疗。     

雌激素对去势大鼠下丘脑5-羟色胺2C及5-羟色胺6受体亚型mRNAs的影响

目的　观察雌激素对大鼠下丘脑 5 羟色胺 2C(5 HT2C)及 5 羟色胺 6(5 HT6)受体亚型mRNAs的影响。　方法　实验动物分为对照组 (C组 )、去势后又分为注射雌二醇组 (E+组 )和不注射雌二醇组 (E- 组 ) ,后两组分别在处理后 3、6、9、1 2d时提取下丘脑标本。实验采用反转录 聚合酶链反应 (RT PCR)。　结果　 5 HT2C受体亚型在E+组下丘脑的表达分别为C组 (1 0 0 % )的 (1 3 0 .6± 3 .1 ) %、(1 3 1 .0± 3 .1 ) %、(1 1 6.7±3 .2 ) %、(1 1 4 .7± 2 .6) % ,前两者与C组比较有显著差异 (P <0 .0 5) ;5 HT2C受体亚型在E- 组的表达分别为C组的 (1 2 9.8± 3 .2 ) %、(1 74.0± 6.1 ) %、(1 85.3± 5.9) %、(1 3 7.9±4.0 ) % ,均与C组存在显著差异 (分别为P <0 .0 5、P <0 .0 1、P <0 .0 1、P <0 .0 5) ;E+组与E- 组在去势后 6、9和 1 2d时差异显著 (P <0 .0 1 )。 5 HT6 受体亚型在E+组下丘脑的表达分别为C组的 (1 0 1 .2± 3 .6) %、(1 1 2 .6± 4.2 ) %、(1 1 5.9± 3 .7) %、(1 1 7.4± 4.1 ) % ,与C组比较无显著差异 (P >0 .0 5) ;5 HT6 受体亚型在E- 组的表达分别为C组的 (1 0 5.8± 4.1 ) %、(1 1 5.2± 4.4) %、(1 1 8.7± 5.4) %、(1 1 4 .7± 3 .2 ) % ,与C组比较无显著差异(P >0 .0 5) ;5 HT6 受?     

17β-雌二醇对小鼠生精细胞T型Ca~(2+)通道的作用

目的:研究17β-雌二醇(E2)对小鼠生精细胞T型钙电流(ICaT)的影响。方法:采用膜片钳全细胞记录技术观察E2对急性机械分离的小鼠生精细胞ICaT的影响。结果:E2(1、10、100μmol/L)呈浓度、电压依赖性抑制小鼠生精细胞钙电流,抑制率分别为(13.48±1.86)%、(28.98±2.70)%和(52.93±3.42)%(n=6,P<0.05)。E2对T型钙通道的半数最大抑制浓度(K50)为8.89μmol/L。100μmol/LE2显著改变T型钙通道的激活和失活特性:半数激活电压(Va1/2)和激活斜率因子(κa)分别从(-48.94±0.22)mV、(5.19±0.19)mV变为(-54.34±1.02)mV和(6.02±0.84)mV(n=5,P<0.05);而半数失活电压(Vi1/2)和失活斜率因子(κi)分别从(-56.51±0.13)mV、(3.36±0.11)mV变为(-61.78±0.50)mV、(4.25±0.37)mV(n=5,P<0.05)。结论:E2对生精细胞T型钙通道有抑制作用,呈浓度依赖性。     

术前应用乌司他丁对择期下肢关节置换术患者血清炎性因子和术后谵妄的影响

目的 探讨术前应用乌司他丁(ulinastatin,UTI)对下肢关节置换术患者血清炎性因子和术后谵妄(postoperative delirium,POD)的影响.方法 采用前瞻性、双盲、随机对照研究设计.选择65~85岁,ASA分级Ⅰ~Ⅲ级,择期行下肢关节置换术的老年患者80例,采用随机数字表法分为UTI组和对照组(每组40例).UTI组于手术开始前将30万单位UTI加入100 ml生理盐水中,30 min内静脉滴注;对照组予以等量生理盐水30 min内静脉滴注.气管插管全身麻醉下完成手术,术后行髂筋膜间隙阻滞.术前1 d行简易智能精神状态检查量表(minimum mental state examination,MMSE)评分,术后24 h(T2)、48 h(T3)、72 h(T4)用意识混乱评估法(confusion assessment method,CAM)进行谵妄评分.记录患者一般情况、术中指标(麻醉时间、手术时间、术中出血及输血量等)及术后指标(VAS评分、术后住院时间及副作用等).术前(T0)、术毕即刻(T1)、T2、T3分别采集外周静脉血3 ml,离心后批量检测血清促炎细胞因子TNF-α、IL-1β、IL-6及S100β蛋白的含量.结果 T2和T3时点CAM评分UTI组[(12.8±2.1)、(13.1±2.9)分]均显著低于对照组[(14.0±2.5)、(14.7±3.1)分](P<0.05);T2、T3和T4时点两组POD发生率比较,差异无统计学意义(P>0.05).两组患者血清S100β蛋白浓度在T1时达高峰(P<0.05),与对照组比较,UTI组T1时血清S100β蛋白浓度升高水平显著降低[(304±142)ng/L比(396±208)ng/L](P<0.05).两组患者血清IL-1β和IL-6浓度在T1、T2时点呈上升趋势,T2时达高峰(P<0.05);与对照组相比,UTI组T1、T2时血清IL-1β[(70.4±7.3)ng/L比(81.6±8.5)ng/L,(99.6±7.7)ng/L比(105.7±8.0)ng/L)]和IL-6浓度[(55±8)ng/L比(62±8)ng/L,(88±8)ng/L比(99±11)ng/L)]升高水平显著降低(P<0.05).结论 术前应用UTI可降低择期下肢关节置换术老年患者术后48 h CAM评分,改善术后认知功能,其机制可能与抑制炎性因子活化通路有关.     

肺复张策略对健侧肺氧合及顺应性的影响

目的 评价肺复张策略(lung recruitment maneuvers,LRM)对健侧肺氧合及顺应性的影响. 方法 ASA分级Ⅱ级择期行胸腔镜辅助下肺切除术患者40例,采用随机数字表法分为对照组(C组)和实验组(L组),每组20例.C组术中常规单肺通气(one lung ventilation,OLV),L组OLV 20 min后进行1次LRM,两组均在OLV结束关闭胸腔前进行1次肺复张.分别于患者麻醉前(T0),OLV后20 min(T1),LRM后15 min(T2)、30 min(T3)、45 min(T4)及OLV结束(T5)时,采集患者生命体征数据并采集动脉血样本进行血气分析,根据公式计算肺顺应性(dynamic compliance,Cdyn). 结果 与C组相比,L组PaO2在T2[(150±11) mmHg比(204±21) mmHg,1 mmHg=0.133 kPa]、T3[(154±12) mmHg比(176±14) mmHg]、T5[(442±20) mmHg比(473±15) mmHg]时点均升高(P＜0.05),Cdyn在T2[(21±3) ml/cmH2O比(25±3) ml/cmH2O,1 cmH2O=0.098 kPa]和T5[(26±3) ml/cmH2O比(31±5)ml/cmH2O)]时点提高(P＜0.05). 结论 LRM可以有效改善OLV期间氧合及Cdyn,单次LRM提高PaO2有效时间为30 min,在15 min左右PaO2改善最为明显.     

酸性成纤维细胞生长因子基因转染改善缺血心肌血流灌注的研究

目的　探讨酸性成纤维细胞生长因子 (aFGF)基因重组腺病毒 (Ad .aFGF)转染改善缺血心肌血流灌注的作用。方法　小型猪左冠回旋支 (Lcx)放置Ameroid环后 4周 ,注射Ad .aFGF(n =7)、空病毒 (Ad .Null,n =6 )、磷酸盐缓冲液 (PBS ,n =6 )于Lcx供血区域 ,每头 10点 ,每点 1× 10 9pfu或 10 0 μl的PBS。 4周后 ,单光子计算机断层扫描 (SPECT )和心脏超声分别检测局部血流灌注和心功能。注射点心肌Ⅷ因子免疫组织化学染色观察血管新生。结果　SPECT显示Ad .aFGF组心肌核素摄取评分 ( 76 .1± 2 .9)显著高于Ad .Null组 ( 6 4.6± 3 .0 ,P <0 .0 1)和PBS组( 6 5 .4± 3 .9,P <0 .0 1) ;超声显示Ad .FGF组节段性室壁收缩期增厚率 ( 34.1± 1.8) %显著高于Ad .Null组 [( 2 4.2± 2 .3) % ,P <0 .0 1]和PBS组 [( 2 3 .7± 2 .2 ) % ,P <0 .0 1] ;免疫组织化学显示Ad .aFGF组心肌中血管密度 [( 32 .8± 1.9)个 /每高倍视野 (HPF) ]显著高于Ad .Null组 [( 18.2±1.5 )个 /HPF ,P <0 .0 1]和PBS组 [( 17.3± 1.7)个 /HPF ,P <0 .0 1]。结论　Ad .aFGF转染慢性缺血心肌可增加血流灌注 ,改善心功能。     

Utility of c2 monitoring in prediction of diastolic dysfunction in renal transplant recipients

BACKGROUND: A number of experimental studies have suggested that cyclosporine (CsA) toxicity induces cardiac modifications which may cause diastolic dysfunction over the course of time. Doppler echocardiography with tissue Doppler imaging (TDI) could consistently detect diastolic dysfunction. The purpose of this study was to assess diastolic dysfunction using C2 monitoring of CsA exposure in stable renal transplant patients. PATIENTS AND METHODS: Seventy-eight kidney recipients including 42 men and 36 women of overall mean age of 52 +/- 9 years were obtained in 47 living and in 31 cases from cadaveric donations over 12 or more months after transplantation using cases from CsA, mycophenolate mofetil, and steroid. C2 levels were measured by an enzyme multi-immune assay technique. The patients underwent conventional and Doppler echocardiography with TDI. RESULTS: The patients were divided into 2 groups according to C2 levels less than 500 mug/L (group 1, n = 40) versus greater than 500 mug/L (group 2, n = 38). The demographic parameters, serum creatinine and lipid levels, systolic and diastolic blood pressures, number and type of antihypertensive medications, and conventional echocardiographic parameters did not differ significantly between the groups. However, group 1 patients showed significantly higher isovolumic relaxation time (109 +/- 27 vs 86 +/- 14 ms), early diastolic deceleration time (189 +/- 52 vs 137 +/- 59 ms), and lower values of E velocity (56 +/- 32 vs 92 +/- 27 cm/s) and E/A ratios (0.81 +/- 0.23 vs 1.15 +/- 0.46) than group 2. TDI studies revealed significantly lower E'/A' (0.76 +/- 0.25 vs 1.09 +/- 0.32, P < .05) in group 1 versus group 2. CONCLUSION: The data suggested that the higher C2 levels may induce diastolic dysfunction in the hearts of kidney recipients without impairment of contractile performance.     

Nephropathy and retinopathy in type 2 diabetic patients living at moderately high altitude and sea level

BACKGROUND: High-altitude-induced hypoxia results in various diseases, such as chronic mountain sickness and high altitude retinal edema, and may affect severity and incidence of some cardiovascular diseases. In order to evaluate the effects of moderately high altitude on diabetic nephropathy and retinopathy, a cross-sectional study was planned. MATERIAL METHOD: Long-term type II diabetic residents of sea level (n=75, 38 male, 37 female, mean age 51.9+/-10.5 in Trabzon and Zonguldak cities) and moderately high altitude (h = 1,727 m, n = 73, 28 male, 45 female, mean age 48.3+/-12.1, Van city) were compared. RESULTS: No difference was observed in terms of age, gender, diabetes duration, body mass index, smoking, systolic, diastolic, and mean arterial blood pressure values, serum glucose levels, cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, hemoglobin, HbA1C, hypertension control, or blood pressure medications and retinopathy incidence. Mean 24 h protein excretion (210.0+/-139.9, 127.8+/-112.1 mg; P=0.00), proteinuria prevalence (57.5% versus 33.3%, p=0.003), and serum creatinine levels (1.04+/-0.22 versus 0.84+/-0.21, p = 0.00) were significantly higher in the highlanders, glomerular filtration rate (GFR) was significantly lower in sea level (SL) patients (90.9+/-26.5 versus 83+/-21.1, p=0.05). CONCLUSION: Tendency to diabetic nephropathy as indicated by higher proteinuria and creatinine levels is increased among type 2 diabetic patients living at moderately high altitude. Prospective studies are needed to confirm these findings.     

Effect of repeated intravenous iron administration in haemodialysis patients on serum 8-hydroxy-2'-deoxyguanosine levels.

BACKGROUND: Iron supplementation is a mainstay for management of renal anaemia in patients receiving haemodialysis (HD). Although it is well known that a single intravenous iron (IVIR) administration transiently enhances oxidative stress in HD patients, the consequence of repeated IVIR administration is still unknown. This study aims to clarify the time course of changes in serum 8-hydroxy-2'-deoxyguanosine (8-OHdG), a marker of DNA oxidative injury, during a period of repeated IVIR administration in HD patients. METHODS: Twenty-seven patients (62+/-14 years and 23 males) on long-term HD participated in this study. All patients had been on HD more than 6 months and none had received a blood transfusion or iron therapy in previous 6 months. The patients were divided into three groups according to the baseline haematocrit (Ht) and serum ferritin (FTN) levels as a marker of body iron stores: IVIR group (Ht<30% and FTN<100 ng/ml; n=7); High FTN group (Ht>or=30% and FTN>or=100 ng/ml; n=11); and low FTN group (Ht>or=30% and FTN<100 ng/ml; n=9). The IVIR group patients received 40 mg of ferric saccharate i.v. after each HD session until Ht increased by 5%. Serum 8-OHdG and other parameters were prospectively monitored for 10 weeks. RESULTS: At baseline, the serum ferritin level was independently associated with 8-OHdG in a multiple regression model (total adjusted R2=0.47, P<0.01). All patients in the IVIR group achieved the target Ht level during the study. IVIR administration resulted in significant increases in 8-OHdG levels (0.22+/-0.07-0.50+/-0.16 ng/ml: baseline to 10 week) as compared with both the high FTN group (0.52+/-0.20-0.58+/-0.28 ng/ml) and the low FTN group (0.39+/-0.11-0.36+/-0.11 ng/ml) (ANOVA for repeated measures P<0.01). Additionally, serum 8-OHdG and serum ferritin changed in the same manner. CONCLUSIONS: Repeated IVIR administration for HD patients was associated with signs of increased oxidative DNA injury, as reflected by increased serum levels of 8-OHdG. As these changes were accompanied by increased serum ferritin levels, excess body iron stores might play an important role in oxidative stress.     

The influence of age on Leydig cell function in patients with varicocele

In a large group of patients with varicocele (n = 108, mean age: 30.9 years) Leydig cell function was investigated by determining the plasma levels of gonadotrophins under basal conditions and after GnRH stimulation, and by measuring the plasma levels of 17-OH-progesterone (17-OH-P), testosterone (T), dihydrotestosterone (DHT) and oestradiol (E2). There was a significant positive correlation between age and the peak plasma LH values after GnRH stimulation (n = 48, r = 41, P less than 0.01). Conversely, an inverse correlation was observed between age and the basal plasma levels of 17-OH-P (n = 56, r = 0.47, P less than 0.01) and T (n = 108, r = 0.27, P less than 0.01). In normals controls of the same age range (n = 46, mean age: 30 years) such correlations were absent. In patients with varicocele, the 17-OH-P/T ratio was increased significantly in peripheral plasma under basal conditions (P less than 0.01) and after hCG stimulation (P less than 0.05), and a similar increase was found in spermatic venous blood. This suggests that in varicocele patients there is some enzymatic impairment involving the last steps of T biosynthesis. In order to verify the influence of ologozoospermia on plasma steroid levels we divided the patients into 2 groups according to sperm count (more than or less than 10 X 10(6)/ml). Three analyses of variance were then carried out between these 2 groups of patients: 1) analysis of peripheral plasma T levels; 2) analysis of peripheral plasma levels of 17-OH-P and 3) spermatic vein levels of these 2 steroids. However, none of these analyses revealed any significant difference between the 2 groups of patients. When we re-grouped the patients according to age (15-30 and 30-45 years) the same analyses of variance revealed significant differences. These results therefore suggest that the duration of idiopathic varicocele per se influences Leydig cell activity.     

Estradiol and high-dose dihydrotestosterone treatment causes changes in cynomolgus monkey prostate volume and histology identical to those caused by testosterone alone.

To evaluate the effects of testosterone (T), dihydrotestosterone (DHT), and estradiol (E2) on the regulation of prostate growth and tissue composition, the following study was conducted in a nonhuman primate model. Fifteen adult, long-term castrated cynomolgus monkeys were randomly assigned to receive implants filled with T (0.19 +/- 0.01 g), DHT alone (0.21 +/- 0.01 g), or (99%) DHT + (1%) E2 (0.21 +/- 0.01 g). Prior to and at 4-week intervals during the treatment phase of 252 days, prostate volumes (PV), body weight, ejaculate weight, hormone levels (of T, DHT, and E2), and red blood cell count were measured. Five adult, intact monkeys served as controls for prostate volume and histology. At the end of the study, histological analysis of an ultrasound-guided prostate biopsy was performed. T levels increased significantly in the T group compared with baseline (P < 0.01) and with the DHT and DHT + E2 groups (P < 0.05). Both groups receiving DHT showed higher DHT levels than did animals in the T group (P < 0.001). E2 levels in all groups increased over time (P < 0.05), although significant differences (P < 0.01) could only be detected between the DHT + E2 and the DHT group. Prostate volume in all groups increased (at baseline: T = 1.03 +/- 0.12 ml, DHT = 1.08 +/- 0.15 ml, DHT + E2 = 1.13 +/- 0.09; at day 252: T = 5.83 +/- 1.00, DHT = 4.72 +/- 0.9, DHT + E2 = 5.05 +/- 0.62) over time (P < 0.001), whereas no differences could be detected between the groups. Prostate biopsy could be performed successfully in 15 out of 20 monkeys. Prostate tissue evaluation between the treatment groups and the evaluated intact monkeys revealed no differences in the status of secretory epithelia, nuclear chromatin, excretory vacuoles, interstitial stroma, smooth muscles, and total functional status, whereas the prostate of a long-term castrated monkey showed severe atrophy. Thus, both androgens fully restored prostate volume and ejaculatory function. Highly supraphysiological DHT serum levels are not associated with abnormal volumetric or histological changes of the prostate. Comparing the DHT group with the DHT + E2 group, an additional stimulatory effect of normal or slightly elevated estrogens on the prostate cannot be found in the presence of highly supraphysiological DHT levels.     

依达拉奉对胸腔镜手术中单肺通气氧化应激反应及炎性反应的影响

目的观察依达拉奉对胸腔镜手术中单肺通气肺损伤的影响。方法选择择期行胸腔镜肺叶切除手术的肺癌患者40例,均为男性,年龄47~65岁,身高165~183cm,体重64~85kg,BMI30kg/m2,ASAⅠ或Ⅱ级。随机将患者分为两组:对照组(C组)和依达拉奉组(E组),每组20例。E组于手术前30min开始静脉输注依达拉奉30mg(溶于100ml生理盐水),30min内输注完毕;C组以等量生理盐水同速滴注。记录手术时间、术中单肺通气时间;记录开胸前(T1)、开胸后单肺通气开始时(T2)、单肺通气30min(T3)、单肺通气60min(T4)、单肺通气结束(T5)、术毕(T6)时的PETCO2和气道压峰值(Pmax)。两组分别于T1和T6时取肘静脉血样5 ml,检测血清IL-8、IL-10、TNF-α和血清肺表面活性蛋白A(SP-A)的水平。结果两组各时点PETCO2、Pmax差异无统计学意义。与T1时比较,T6时两组血清IL-8、IL-10、TNF-α、SP-A浓度明显升高(P0.05);T6时E组IL-8、TNF-α、SP-A浓度明显低于C组(P0.05),两组IL-10浓度差异无统计学意义。结论依达拉奉预先给药可抑制单肺通气时氧化应激反应及炎性反应。     

Effect of vitamin E therapy on oxidative stress and erythrocyte osmotic fragility in patients on peritoneal dialysis and hemodialysis

BACKGROUND: Several medications have been tested with the aim of decreasing oxidative stress and erythrocyte osmotic fragility in patients on dialysis. The aim of the present study was to assess the influence of vitamin E therapy on oxidative stress and erythrocyte osmotic fragility in patients on hemodialysis (HD) and peritoneal dialysis (PD). METHODS: This was a placebo-controlled study. The study was performed on 34 HD patients, 13 PD patients and 22 healthy volunteers with a mean age of 45.57 +/- 8.54 years. HD patients were divided into 2 groups: treatment (n=19) and control (n=15). Vitamin E was administered, 300 mg/day, to the HD treatment group and PD patients for 20 weeks. Lipid peroxidation, antioxidant condition and erythrocyte osmotic fragility (EOF) were examined before and after treatment. RESULTS: Before the treatment, the levels of EOF (p<0.001) and malondialdehyde (MDA) (p<0.001) were significantly lower, and erythrocyte superoxide dismutase (SOD) (p=0.001) and vitamin E levels (p<0.001) were significantly higher in the healthy group than PD and HD groups. Serum vitamin E increased from 0.93 +/- 0.16 to 1.09 +/- 0.14 mg/dL (p=0.001), EOF decreased from 0.49% +/- 0.03% to 0.42% +/- 0.04% NaCl (p<0.001), and plasma MDA values decreased from 2.77 +/- 0.87 to 2.20 +/- 0.767 nmol/mL (p=0.018) in the HD treatment group after vitamin E treatment. Levels of EOF decreased from 0.51% +/- 0.09% to 0.43% +/- 0.03% NaCl in the PD treatment group after vitamin E treatment (p=0.021). CONCLUSION: Vitamin E therapy is effective in decreasing the levels of EOF in patients on HD and PD, and it is also effective in decreasing lipid peroxidation in patients on HD.     

Serum testosterone levels and score of chronic mountain sickness in Peruvian men natives at 4340 m

Life at high altitudes (>4000 m) is associated with higher erythropoiesis. Haemoglobin ≥21 g dl(-1) is considered as excessive erythrocytosis and is a sign of chronic mountain sickness (CMS). The present study was designed to determine an association between serum testosterone (T) and serum oestradiol (E(2) ) levels with the score of CMS. One hundred and seventeen men natives from low altitude (150 m) and 103 men natives from high altitude (4340 m) were studied. The presence of breathlessness or palpitations, sleep disturbance, cyanosis, dilatation of veins, paraesthesia, headaches, tinnitus and Hb ≥21 g dl(-1) , have been included for the CMS score. Men living at high altitude had higher CMS score (P < 0.001), serum T (P < 0.05) and serum E(2) levels (P < 0.04) and had lower serum luteinising hormone levels (P < 0.005) than men living at sea level. At high altitude, the group with the highest CMS score (≥10) showed higher chronological age, SpO(2) , serum T and ratio T/E(2) than the group with CMS score of ≤4. Some symptoms of CMS as sleep disorders and paraesthesia were more related to high serum T level; cyanosis was more related to higher haemoglobin values. In conclusion, higher serum T levels were associated to higher scores of CMS.     

同种异基因肝脏非实质细胞对小鼠移植皮片存活的影响

目的探讨输注同种异基因肝脏非实质细胞(NPC)对小鼠移植皮片存活的影响及其机制。方法选用123只近交系小鼠,其中C3H小鼠65只、C57BL/6小鼠58只。20只C3H小鼠作移植供体;40只C3H小鼠肝脏为NPC来源;余下5只C3H小鼠作混合淋巴细胞培养(MLC)的刺激物,由每分钟放射性荧光闪烁计数(cpm)值表示。58只C57BL/6小鼠分为实验组50只、对照组8只。对照组小鼠仅作皮肤移植,未行NPC输注。实验组50只小鼠尾静脉输入由40只C3H小鼠肝脏制备的2×107个NPC,48h后腹腔注射环磷酰胺200mg/kg,并接受C3H小鼠皮片移植。于NPC输注前及输注后各时相点处死实验组小鼠,每时相点5只。检测血清白细胞介素(IL)4水平、脾淋巴细胞嵌合体水平及cpm值,并观察2组小鼠的存活时间。结果实验组小鼠皮片存活时间为(70.0±17.2)d明显长于对照组;NPC输注后IL4、嵌合体水平逐渐上升,而cpm值逐渐降低。NPC输注后60d实验组小鼠IL4为(251.5±11.0)ng/L,脾脏嵌合体水平达到(26.30±1.04)%。结论IL4、嵌合体水平的升高对诱导和保持免疫耐受起着重要的作用。     

Hyaluronan based heparin free coated open and closed extracorporeal circuits for high risk coronary revascularization

This prospective randomized study compares the inflammatory response and fibrinolytic activation of fully coated/uncoated and open/closed extracorporeal circuits (ECC) in high risk patients. Over a 2-month period, 48 patients with EuroSCOREs 6 or greater undergoing coronary revascularization were prospectively randomized to one of the four perfusion protocols: Group 1: Closed and totally hyaluronan based heparin free coated (Vision HFO-GBS-HF, Gish Biomedical, Rancho Santa Margarita, CA) ECC with a soft-shell coated venous reservoir (SVR11S2-HFC, Gish Biomedical) and a hard-shell cardiotomy (CAPVRF44, Gish Biomedical) (n = 12); Group 2: Closed and totally uncoated identical ECC with soft-shell uncoated venous reservoir and a hard-shell cardiotomy (n = 12); Group 3: Open, totally hyaluronan based heparin free coated ECC (n = 12); and Group 4: Control-open, uncoated ECC (n = 12). Blood samples were collected at T1: Baseline; T2: 15 minutes after cardiopulmonary bypass (CPB) initiation; T3: before cessation of CPB; T4: 15 minutes after protamine reversal, and T5: in the intensive care unit. Serum IL-6 levels were significantly lower at T2 in all study groups, at T3 for coated groups, and T4 for closed+coated group (p < .05 versus control). Creatine kinase M-band (MB) levels in coronary sinus blood demonstrated well preserved myocardium after CPB in both coated groups versus Control (p < .05). Neutrophil CD11b/CD18 levels were significantly lower for all study groups versus control at T2, for both coated groups at T3 and only for closed + coated group at T4 (p < .05). Postoperative hemorrhage (mL) was 510 +/- 40 in closed + coated and 536 +/- 40 in open + coated groups (control: 784 +/- 48, p < .05). No significant differences in thrombin-antithrombin complex and free plasma hemoglobin were observed. Desorbed protein amount on ECC (mg/dL) was 1.7 +/- .01 in closed+coated, 2.01 +/- .01 in open+coated, and 3.3 +/- .015 in control groups (p < or = .05). Use of a closed and completely heparin free coated ECC may reduce neutrophil degradation, cytokine release characterized by improved clinical outcomes including reduced blood loss, reduced requirement for inotropes, and reduced atrial fibrillation.