Rho-激酶在失血性休克大鼠血管低反应发生中的作用

目的 观察Rho-激酶在失血性休克大鼠血管低反应发生中的作用。方法取失血性休克大鼠肠系膜上动脉（SMA），采用离体血管环张力测定技术，观察在失血性休克后不同时相点大鼠肠系膜上动脉血管环对梯度浓度去甲肾上腺素（NE）的收缩力，在去极化状态下（120mmol／LK^＋）血管环对梯度浓度Ca^2＋的收缩力，以及肠系膜上动脉Rho-激酶活性，分析不同时相点SMA对NE的反应性及Ca^2＋收缩反应性与Rho-激酶活性变化之间的关系；同时观察Rho-激酶激动剂血管紧张素Ⅱ（Ang-Ⅱ）、Rho-激酶特异性抑制剂Y-27632对休克2小时大鼠SMA血管反应性和钙敏感性的影响。结果 休克早期SMA对NE和Ca^2＋的反应性明显升高，最大收缩力（Emax）明显升高（P〈0.05）；但休克2小时，血管环对NE反应性和钙反应性明显降低，Emax明显降低（P〈0．01）。与正常组相比，Rho-激酶活性在休克即刻升高（P〈0．05），休克1小时和2小时时，Rho-激酶活性明显降低（P〈0．05）。SMA对NE的反应性与Rho-激酶活性变化之间呈直线正相关，相关系数r=0．9861（P〈0．05）；SMA对Ca^2＋反应性与Rho-激酶活性变化之间呈直线正相关，相关系数r=0．9704（P〈0．05）。Rho-激酶激动剂Ang-Ⅱ（10^-9mol／L）可明显升高休克2小时血管环对NE和Ca^2＋的反应性（P〈0．05或P〈0．01），而休克2小时后，Rho-激酶特异性抑制剂Y-27632可进一步降低血管环对NE和Ca^2＋的反应性。结论 失血性休克时血管平滑肌细胞Rho-激酶活性明显降低，Rho-激酶通过调节钙敏感性调节血管反应性，并在失血性休克血管低反应性的发生中起重要作用。     

钙失敏在家兔内毒素休克血管低反应性中的作用

目的观察血管平滑肌钙失敏在内毒素休克血管低反应性中的作用。方法取正常和内毒素休克家兔肠系膜上动脉（SMA）,采用离体血管环张力测定技术。以SMA血管环对梯度浓度去甲肾上腺素（NE）的收缩力反映血管反应性,用去极化状态下（120mmol／L K^＋）血管环对梯度浓度钙的收缩力反映血管的钙敏感性。观察内毒素休克低反应性血管钙敏感性变化及钙敏感性调节剂精氨酸血管加压素（arginine vasopression,AVP）和胰岛素（insulin）对血管反应性的调节作用。结果家兔脂多糖（LPS）（1mg／kg）静注后,早期（即LPS后30分钟和1小时）SMA血管环对NE和钙的反应性升高,量一效曲线左移,最大收缩力（Emax）升高（LPS1小时后P〈0．05或P〈0．01）;随着时间的延长,SMA血管环对NE和钙的反应性逐渐下降,到LPS后6小时明显降低,其量一效曲线明显右移,Emax明显降低（P〈0．01）。具有钙敏感性增强作用的AVP（1×10^-9mmol／L）可明显升高LPS后6小时SMA血管环对NE和钙的反应性（P〈0．05或P〈0．01）;而具有钙敏感性抑制作用的胰岛素则可降低LPS后1小时血管环对NE和钙的反应性（P〈0．05或P〈0．01）。结论内毒素休克血管平滑肌细胞存在钙敏感性降低,血管平滑肌细胞钙敏感性降低在内毒素休克血管低反应性的发生中起重要作用。     

尾部悬吊大鼠不同动脉肾上腺素受体介导的血管反应性变化的差异

目的探讨模拟失重对大鼠不同动脉血管肾上腺素受体功能的影响。方法采用尾部悬吊方法模拟失重，利用离体动脉血管环测定动脉血管肾上腺素受体介导的血管反应性的变化。结果模拟失重８周大鼠腹主动脉、肠系膜前动脉与股动脉对苯肾上腺素（１０－９ｍｏｌ／Ｌ～１０－４ｍｏｌ／Ｌ）的收缩反应均减弱，而颈总动脉对苯肾上腺素的反应无明显变化；股动脉对异丙肾上腺素（１０－９ｍｏｌ／Ｌ～１０－４ｍｏｌ／Ｌ）的舒张反应在悬吊大鼠明显减弱，而颈总动脉、腹主动脉与肠系膜前动脉对异丙肾上腺素的反应无明显改变；各动脉对苯肾上腺素与异丙肾上腺素反应的敏感性（ＥＣ５０）未发现明显变化。结论８周尾部悬吊模拟失重改变了大鼠动脉血管肾上腺素受体介导的血管反应性，结果提示此变化可能是由于平滑肌信号转导或收缩装置改变所致，而肾上腺素受体本身数量或敏感性的变化在其中所起作用有限。     

腺苷A3对失血性休克血管反应性的调节作用

目的探讨腺苷A3受体（adenosine A3 receptor,A3AR）对失血性休克大鼠肠系膜上动脉对α受体激动剂（去甲肾上腺素）收缩反应性的调控作用,并初步探讨钾通道在其中的可能作用。方法建立失血性休克（40mmHg）诱导大鼠肠系膜上动脉对去甲肾上腺素（norepinephrine,NE）低反应性模型。大鼠肠系膜上动脉血管对NE诱导的收缩反应性采用离体小血管张力测定仪检测。结果结果显示,在大鼠失血性休克后0～4h,其肠系膜上动脉1级分支血管对由NE诱导的收缩反应性呈现＂双向性＂变化;A3AR激动剂（IB-MECA）可明显改善失血性休克大鼠肠系膜上动脉1级分支由NE诱导的收缩反应性,且该作用可被A3AR阻断剂（MRS1523）所拮抗;此外,大电导钙激活钾通道（BKCa）开放剂NS1619可部分拮抗IB-MECA休克血管反应性的恢复作用;但ATP依赖钾通道（KATP）开放剂吡哪地尔对IB-MECA对休克血管反应性的恢复作用无显著影响。结论A3AR参与失血性休克血管低反应性的形成,其机制可能部分与BK通道有关。     

短期模拟失重大鼠不同部位动脉血管反应性变化的比较

目的为深入探讨失重对动脉血管系统功能的影响，观察短期模拟失重大鼠不同部位动脉血管反应性的变化。方法将１６只雄性ＳＤ大鼠分为对照组与尾部悬吊呈头低３０°２周模拟失重组。利用离体动脉血管环，比较模拟失重对大鼠不同部位动脉血管反应性的影响。结果模拟失重大鼠腹主动脉与股动脉对氯化钾（１０ｍｍｏｌ／Ｌ～８０ｍｍｏｌ／Ｌ）与苯肾上腺素（１０－９ｍｏｌ／Ｌ～１０－４ｍｏｌ／Ｌ）的收缩反应均减弱，而颈总动脉对氯化钾与苯肾上腺素的反应无明显变化；腹主动脉对乙酰胆碱（１０－９ｍｏｌ／Ｌ～１０－４ｍｏｌ／Ｌ）的舒张反应在悬吊大鼠明显减弱；三处动脉对硝普钠的舒张反应均无明显变化。结论短期模拟失重可能减弱了动脉血管平滑肌的收缩能力与内皮介导的舒张能力，此变化主要局限于后半身动脉。     

失血性休克血管反应性变化与Rho激酶的关系

目的 观察休克后血管反应性变化与Rho激酶的关系.方法 分别从整体动物,离体血管环和原代血管平滑肌细胞(vascular smooth muscle cell,VSMC),观察Rho激酶活性调节剂对失血性休克后大鼠平均动脉压(MAP)、肠系膜上动脉血管管径对去甲肾上腺素(NE)收缩反应性、离体血管环和VSMC收缩反应性的影响.结果 失血性休克后大鼠对NE的升压反应和肠系膜上动脉对NE的收缩反应明显降低(P＜0.05或P＜0.01),Rho激酶激动剂精氨酸血管加压素(arginine vasopressin,AVP,0.4 U/kg)可增加失血性休克大鼠对NE的升压反应和肠系膜上动脉对NE的收缩反应(P＜0.05或P＜0.01),Rho激酶抑制剂Y-27632(3 μg/100 g)可拮抗由AVP引起NE的升压反应和肠系膜上动脉对NE收缩反应的升高.休克2 h和VSMC缺氧90 min后,血管环和VSMC对NE收缩反应性明显降低(P＜0.01).Rho激酶激动剂血管紧张素Ⅱ(angiotensin Ⅱ,Ang-Ⅱ,10-9 mol/L)可明显升高休克2 h血管环和VSMC缺氧90 min对NE反应性(P＜0.05或P＜0.01),而Y-27632(10-5 mol/L)可拮抗由Ang-Ⅱ引起的休克2 h血管环和VSMC缺氧90 min对NE反应性的增高.结论 Rho激酶可明显升高休克后血管反应性.     

异丙酚对大鼠离体主动脉的舒张作用

为探讨异丙酚对血管张力直接影响的作用机制,通过观察不同浓度的异丙酚对大鼠离体主动脉环等长张力的影响及异丙酚对分别经过亚甲蓝、维拉帕米和四乙胺孵浴处理的血管环的作用。结果显示,异丙酚对去内皮和内皮完整的血管环均可产生浓度依赖性舒张作用,去内皮与内皮完整的血管环比较,其舒张作用差异无显著性意义;四乙胺可增强异丙酚对血管环的舒张作用,而维拉帕米可减弱异丙酚对血管环的舒张作用（P＜0.05）,亚甲蓝不影响异丙酚对血管环的舒张效应。提示异丙酚对血管平滑机的舒张作用与其对电压依赖性钙离子通道的作用有关。     

尾部悬吊大鼠不同动脉肾上腺素受体介导的血管反应性变？…

目的 探讨模拟失重对大鼠不同动脉血管肾上腺素受体功能的影响。方法 采用尾部悬吊方法模拟失重，利用离体动脉血管环测定动脉血管肾上腺素受体介导的血管反应性的变化。结果 模拟失重８周大鼠腹主动脉，肠系膜前动脉与股动脉对能上腺素（１０＾－９ｍｏｌ／Ｌ～１０＾－４ｍｏｌ／Ｌ）的收缩反应均减弱，而颈总动脉对苯肾上腺素的反应无明显变化；股动脉对异丙肾上腺素（１０＾－９ｍｏｌ／Ｌ～１０＾－４ｍｏｌ／Ｌ）的舒张反应     

运动对大鼠血管反应性的影响

为探讨运动对血管反应性的影响，本文在大鼠游泳训练模型上，观察了大鼠离体主动脉环收缩和舒张反应性的变化。结果表明，运动后血管对去甲肾上腺素和血管紧张素Ⅱ两种收缩血管物质的反应性降低，对内皮依赖的舒张血管物质乙酰胆硷的舒张反应性增强，对非内皮依赖的舒张血管物质硝普钠的反应性无改变。提示运动后血管对收缩物质的反应性降低和对内皮依赖的舒张血管物质的反应性增强可能是运动防治某些心血管疾病的机理之一。     

腺苷A3受体调控低氧血管反应性的实验研究

目的 探讨腺苷A3受体(A3AR)是否参与低氧血管反应性的调节,为寻找调节创伤/休克时阻力血管对血管活性物质反应性的药物调控靶位提供依据.方法 采用低氧孵育离体大鼠肠系膜上动脉血管环模型,观察A3AR激动剂IB-MECA及阻断剂MRS1523对低氧血管收缩反应性及钙敏感性的影响.结果 缺氧3h可诱导大鼠肠系膜上动脉对NE的收缩反应性及钙敏感性显著降低;缺氧前30min使用IB-MECA对缺氧诱导的大鼠肠系膜上动脉对NE的收缩反应性及钙敏感性均无明显影响;缺氧同时或缺氧后30min使用IB-MECA均可明显改善缺氧低反应血管对NE的收缩反应性并部分改善其钙敏感性;缺氧同时使用MRS1523可使缺氧低反应血管对NE的收缩反应性进一步降低,但MRS1523对缺氧低反应血管钙敏感性无明显影响.PKC抑制剂stausoprine (1×10-7mol · L-1)及Rho激酶抑制剂Y-23187 (1×10-5mol · L-1)均可明显拮抗A3AR激动剂IB-MECA对低氧血管反应性及钙敏感性的恢复作用.结论 A3AR参与大鼠低氧血管对NE收缩反应性的调节,其机制与A3AR部分改善低氧血管钙敏感性有关,PKC及Rho激酶可能参与了A3AR对低氧血管收缩反应性及钙敏感性的调节.     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.