银杏叶提取物对失神经骨骼肌酶活性的影响

延缓失神经肌萎是周围神经外科的重要任务之一。我们通过对大鼠坐骨神经损失后，银杏叶提取物(EGb761)对失神经骨骼肌Na^ -K^ -ATP酶及Ca^2 -ATP酶活性影响的观察，研究其对失神经骨骼肌萎缩的保护作用。     

自体血液回收对患者红细胞膜表面超微结构的影响

目的采用原子力显微镜(AFM)观察自体血液回收对患者红细胞膜表面超微结构的影响。方法择期骨科手术患者10例,术中应用自体血液回收机,切皮前采集外周静脉血2ml,自体血液回收后采集回收血2ml,肝素抗凝。采用AFM观察红细胞膜表面超微结构。结果回收血异型红细胞比例[(20.0±2.2)%]高于静脉血[(2.0±0.8)%](P<0.05)。静脉血和回收血红细胞AFM形貌、红细胞膜表面蛋白颗粒分布均存在差异。回收血红细胞膜表面平均粗糙度、均方根粗糙度高于静脉血(P<0.05)。结论自体血液回收可改变患者红细胞AFM形貌及膜表面超微结构。     

乌司他丁对体外循环下心内直视手术患者红细胞的保护作用

目的观察乌司他丁对体外循环(CPB)下心内直视手术患者红细胞的保护作用。方法20例择期行瓣膜置换术的风湿性心脏病患者,随机分为乌司他丁组(U组)和对照组(C组),每组10例。U组2万U／kg乌司他丁于切皮后锯胸骨前经颈内静脉缓慢给予半量,另半量加入预充液中,经转机进入体内。C组用等量生理盐水,用法同U组。分别于诱导后切皮前(T1)、转流15min(T2)、主动脉开放后15min(T3)、主动脉开放后30min(T4)、术毕24h(T5)抽取动脉血,测定血浆丙二醛(P-MDA)、红细胞丙二醛(E-MDA)水平、红细胞膜超氧化物歧化酶(E-SOD)、Na+-K+-A1P酶、Ca2+-Mg2+-ATP酶活性。结果与T1比较,C组T2-5时P-MDA、E-MDA水平升高,T2时E-SOD活性升高,T3-5时E-SOD浓度降低(P<0.01),U组T3,4时P-MDA、E-MDA水平升高(P<0.01);与C组比较,U组T2-5时P-MDA、E-MDA水平升高,T3-5时E-SOD活性升高(P<0.05或0.01)。与T1比较,两组T2时Na+-K+-ATP酶、Ca2+-Mg2+-ATP酶活性升高,C组T3-5时这两种酶活性降低(P<0.01);U组T2-5时这两种酶活性高于C组(P<0.05或0.01)。结论CPB期间,乌司他丁通过减轻红细胞膜脂质过氧化反应,对CPB下心内直视手术患者红细胞起到一定的保护作用。     

自体血液回收技术在临床手术中的应用

随着医学技术的迅速发展,医院规模的不断扩大,心血管外科、神经外科、脊柱外科、肝胆外科及急诊创伤外科等科手术的广泛开展,手术期间失血和输血这一矛盾日益突出.面临这一难题,本院于2003年底引进了美国美敦力公司制造的血液回收机并应用于临床,取得了良好效果.现报告如下.     

复方电解质注射液对回收红细胞膜Na~+-K~+-ATP酶活性和血液流变学的影响

目的比较复方电解质注射液和复方乳酸钠注射液对回收红细胞膜Na+-K+-ATP酶活性和血液流变学的影响,旨在探讨影响回收血液质量的原因,改良血液回收技术。方法选择骨科或脑外科手术中需行血液回收的患者40例,ASAⅠ或Ⅱ级,随机均分为复方电解质注射液组(A组)和复方乳酸钠注射液组(L组)。检测两组血液回收前、回收后红细胞膜Na+-K+-ATP酶活性、红细胞刚性指数(TK)、红细胞聚集指数(Arbc)、红细胞电泳时间(EPT),检测输注后机体红细胞膜Na+-K+-ATP酶活性。结果与回收前比较,两组回收后、输注后红细胞膜Na+-K+-ATP酶活性均显著降低(P<0.01)。与A组比较,L组回收后红细胞膜Na+-K+-ATP酶活性显著降低(P<0.01),而输注后两组红细胞膜Na+-K+-ATP酶活性差异无统计学意义。与回收前比较,两组回收后红细胞TK均显著升高(P<0.01)。与L组比较,A组回收后红细胞TK明显降低(P<0.05);两组回收前、回收后Arbc值差异无统计学意义。与回收前比较,两组回收后EPT值均缩短,但差异无统计学意义。直线相关分析显示,回收前和回收后红细胞膜Na+-K+-ATP酶活性、TK的变化无显著相关性(L组:r=0.382;A组:r=0.0081)。结论采用复方电解质注射液冲洗回收红细胞可减轻血液回收过程中Na+-K+-ATP酶活性的损害、改善红细胞变形力。改良血液回收冲洗液可能改善回收红细胞质量和血液流变学,促进组织氧供,稳定机体生理环境。     

自体血液回收对全髋关节置换术患者炎性因子的影响

目的:观察自体血液回收对骨科手术患者炎性因子的影响。方法:40例择期行全髋关节置换手术患者,ASA分级Ⅱ级,采用随机数字表法分为两组:自体血液回收组(A组)和异体输血组(B组),每组20例。回收组术中应用血细胞回输仪进行血液收集、回输,两组均于输血前(T1)、输血后1h(T2)、4h(T3)、8h(T4)四个时点测定血浆TNF-α、IL-6、IL-10浓度。记录患者术中回收血量,异体浓缩红细胞量及血浆用量。结果:手术开始至术后24h内回收组输注异体浓缩红细胞量及血浆用量较对照组明显减(P<0.05);两组患者输血后TNF-α、IL-6、IL-10较输血前显著均增高(P<0.05),与A组比较,B组TNF-α、IL-6在输血后各时点显著增高,而IL-10则明显降低(P<0.05)。结论:全髋置换术中使用自体血回收技术,可明显减轻的TNF-α、IL-6、IL-10等炎性因子表达程度的改变。     

术中自体血液回收对体外循环术后全身性炎性反应的影响

目的　探讨在体外循环手术中使用洗涤式自体血液回收机 (ATS)对术后全身性炎性反应的影响。方法　将择期体外循环冠状动脉旁路移植术 (CABG)的 12例患者随机分为两组 (每组 6例 ) ,实验组 :将手术野渗血和停机后机血混合经 ATS处理后回输 ;对照组 :将停机后机血直接回输。于围手术期测定两组补体终末复合物(s C5b- 9)、白细胞介素 - 6 (IL - 6 )等炎性因子指标。实验组分别测定 ATS处理前后炎性因子指标。　结果　实验组回收血经 ATS处理后红细胞压积 (HCT)明显升高 (P<0 .0 1) ,s C5b- 9、肿瘤坏死因子 - α(TNF- α)和 IL- 6水平显著降低 (P<0 .0 5 )。停机 6小时、2 4小时和 4 8小时 ,实验组 s C5b- 9变化率均低于对照组 (P<0 .0 5 ) ,停机 4 8小时 ,实验组 IL - 6变化率低于对照组 (P<0 .0 5 ) ,术后两组 TNF- α水平以及变化率差别无显著性意义 ;停机 4 8小时 ,实验组中性粒细胞(PMN)显著低于对照组 (P<0 .0 1)。　结论　在体外循环手术中使用 ATS回收术野渗血和停机后机血可以去除绝大部分炎性介质 ,回输后可以降低术后部分炎性介质的水平 ,减轻体外循环术后的炎性反应。     

冠状动脉旁路移植术中自体血液回收对红细胞的影响

目的观察经国产自体-3000型血液回收机(北京京精医疗设备公司)回收处理的红细胞变形性、小变形性、取向性和在体内半衰期的改变. 方法连续在非体外循环下行冠状动脉旁路移植术患者20例,根据术中是否进行自体血液回收分为两组,实验组(n=10):术中行血液回收;对照组(n=10):术中不行血液回收.对实验组经自体血液回收处理的红细胞和对照组未经回收处理的红细胞分别采用激光衍射法测定红细胞变形指数(DI),最大取向指数[(DI)or.max],最大小变形指数[(DI)d.max]和采用同位素51Cr标记法测量红细胞在体内的半衰期(51C1/2). 结果实验组经血液回收处理的红细胞DI,(DI)or.max,(DI)d.max和51C1/2与对照组比较差别无显著性意义(P>0.05). 结论在心脏不停跳冠状动脉旁路移植术中,国产自体-3000型血液回收机对回收处理后的红细胞变形性、小变形性、取向性以及在体内的半衰期没有明显的影响.     

胆道梗阻肝细胞膜Na+/K+ATP酶的变化

目的动态观察在胆道梗阻和梗阻缓解过程中,肝细胞膜Na+/K+ATP酶活性变化的规律。方法对130只胆道梗阻大鼠模型的260份样本进行组织化学染色,结合免疫电镜方法,在肝细胞膜上染色定位Na+/K+ATP酶,计算机图像分析测定,半定量比较肝细胞膜Na+/K+ATP酶活性。结果Na+/K+ATP酶广泛存在于肝细胞膜上,但其活性(相对灰度比值)在肝细胞血窦面、肝细胞间面和肝细胞毛细胆管面呈不均匀分布,分别为107.60±16.64、74.40±9.37、90.30±8.04。反映了肝细胞分泌胆汁的正常极性。Na+/K+ATP酶活性在胆道梗阻和梗阻缓解过程中随着胆红素水平的升高或降低而发生变化,并且随着梗阻和缓解的时间延长而明显下降或改善。在梗阻14d时,分别降为84±10、60±7、65±15;在梗阻14 d缓解1 d时,Na+/K+ATP酶活性分别为86±14、62±6、68±19,而在缓解7 d时其活性分别恢复为96±8、65±6、85±7。结论胆道梗阻对肝细胞膜Na+/K+ATP酶活性的影响可能与胆道梗阻时肝细胞代谢胆红素障碍有关。     

巴曲酶复合低温对全脑缺血再灌注期间ATP酶活性的影响

目的 观察低温，巴英酶及巴曲酶复合低温对沙土鼠全脑缺血后海马组织Ｎａ＾＋－Ｋ＾＋－ＡＴＰ酶，Ｃａ６２＋－ＡＴＰ酶活性的影响。方法 利用沙土鼠全脑缺血模型，观察全脑缺血１０分及再灌２０分，６０分时，低温，巴曲酶及巴曲酶复合低温对海马组织Ｎａ＾＋－Ｋ＾＋－ＡＴＰ酶，Ｃａ＾２＋－ＡＴＰ酶活性的影响。     

不同镇痛方法对肺叶切除术病人红细胞膜ATP酶活性的影响

目的探讨术后不同镇痛方法对肺叶切除术病人红细胞膜ATP酶（ATPase）活性的影响.方法选择40例ASAⅠ～Ⅱ级、行肺叶切除术病人,随机分为病人自控硬膜外镇痛（PCEA）组和病人自控静脉镇痛（PCIA）组,每组20例.PCEA组为0.125%布比卡因加3 μg/ml芬太尼,PCIA组为曲马多3 mg/ml＋芬太尼2 μg/ml＋恩丹西酮0.03 mg/ml.两组手术均在相同全麻下完成.分别于麻醉前、术毕、术后24和48 h抽取肝素抗凝血1ml测定红细胞膜ATPase活性.结果PCIA组ATPase数值在术后24和48 h明显低于PCEA组（P＜0.05）,PCIA组和PCEA组ATPase数值在术后24和48 h与术前比较差异有显著性（P＜0.05）.结论PCEA和PCIA术后镇痛效果优良,但PCIA对红细胞膜ATPase活性有抑制作用,提示PCEA更有益病人术后的康复.     

Effects of halothane on membrane potentials and membrane ionic currents in single bullfrog atrial cells

Halothane exerts negative inotropic and negative chronotropic actions on the isolated heart in experimental animals. In order to assess directly the actions of halothane in myocardium, we studied the effects of halothane on membrane potentials and transmembrane ionic currents in single isolated frog atrial cells obtained by the enzymatic dissociation method. The results show: (a) that the action potential is prolonged and its plateau phase and overshoot are depressed, but the resting potential remains unchanged; (b) that there is a significant inhibition of a time- and voltage-dependent outward K+ current and a slow inward Ca2+ current, with a slight decrease of a fast inward Na+ current following halothane (1.0-4.0%) application; and that halothane has no effect on another K+ current, time-independent current.     

严重烧伤大鼠胃粘膜血流量和Na~+-K~+-ATP酶活性的改变及对胃粘膜电位差的影响

目的　观察大鼠严重烧伤后胃粘膜血流量 (GMBF)和Na+ K+ ATP酶活性的变化 ,探讨其对胃粘膜电位差 (GTPD)的影响。　方法　制作烧伤大鼠模型 ,分别采用激光多普勒微循环血流计、电生理记录仪和生化法 ,检测大鼠伤前及伤后 3、6、12、2 4、4 8h时GMBF、GTPD和胃粘膜Na+ K+ ATP酶活性的改变 ;另设正常大鼠为对照组 ,于相同时相点检测以上指标。随后对各指标进行相关性分析。　结果　与对照组比较 ,大鼠烧伤后 3～ 2 4hGMBF与Na+ K+ ATP酶活性均明显降低 (P <0 .0 5～ 0 .0 1) ,GTPD于伤后 6～ 4 8h明显下降 (P <0 .0 5～ 0 .0 1) ,3项指标均于 12h时降至最低。相关性分析结果显示 :Na+ K+ ATP酶活性随GMBF的降低而下降 (r =0 .4 17,P <0 .0 1) ;GMBF的减少或Na+ K+ ATP酶活性的降低 ,均可引起GTPD降低 (r =0 .4 5 3或 0 .5 2 7,P <0 .0 1)。　结论　大鼠严重烧伤后 ,GMBF减少 ,Na+ K+ ATP酶活性降低 ,二者均为引起胃粘膜屏障功能受损的主要原因     

二氮嗪对长时程低温保存移植鼠心ATP酶的影响及意义

目的观察线粒体ATP敏感性钾离子通道开放剂二氮嗪(Diazoxide,DE)对移植鼠心心肌细胞膜Na+-K+-ATPase和肌浆网Ca2+-ATPase活性的影响,并探索DE处理后Celsior液对长时程低温保存鼠心的作用。方法SD雄性大鼠192只随机分为4组,即A组(单纯Celsior液保存5h)、B组(30μmol/L DE+Celsior液保存5h)、C组(30μmol/L DE+Celsior液保存8h)、D组(30μmol/L DE+Celsior液保存10h)。利用改良Heron法大鼠颈部异位心脏移植模型,供体鼠心按各组要求保存后移植于受体,观察移植心脏30s内复跳率、心率;检测心肌细胞膜Na+-K+-ATPase和肌浆网Ca2+-ATPase活性;观察心肌超微结构。结果(1)复跳率和心率:心脏移植术后30s复跳率各组均无显著性差异;B组、C组心率明显较A组、D组快,A组、D组心率差异无显著性意义。(2)两酶活性测定:B、C、D3组心肌细胞膜Na+-K+-ATPase活性随着保存时间的延长呈显著递减性降低,但仍高于A组,仅D组与A组差别无显著性意义;B组、C组肌浆网Ca2+-ATPase活性显著高于D组、A组,D组与A组差别无统计学意义。(3)心肌超微结构:各组心肌结构保护均较好,肌纤维排列整齐,肌节清,线粒体肿胀不明显;B、C、D3组线粒体嵴结构较为清楚。(4)D组和A组各指标差别均无显著性意义。结论移植鼠心在长时程冷缺血期间,DE对心肌组织ATP酶活性有较好的保护作用,此作用随着保存时间的延长而减弱。且DE处理后Celsior液冷保存鼠心10h仍与国际公认的Celsior液安全冷保存时间5h效果相当。     

Diabetes-induced alterations in latissimus dorsi muscle properties impair effectiveness of dynamic cardiomyoplasty in rats

Short-term diabetes was induced in male Wistar rats with streptozotocin injection. The effects of diabetes on latissimus dorsi (LD) muscle contractile and biochemical properties and acute cardiomyoplasty (CDM) were assessed and compared with data from 16 control rats. Isometric force, contractile properties, and fatigue were measured in electrically stimulated muscles (0.3 ms, 1-256 Hz), and Na+K+ and Ca2+ATPase activities were quantified in muscle membrane preparations. Systolic arterial pressure and aortic blood flow were recorded at rest and during LD muscle stimulation. Compared with control muscle, diabetic muscle showed smaller maximum specific tetanic tension and lower rates of rise and fall in force. Diabetic LD muscle also showed lower muscle enzyme activities. Twitch tension and fatigue did not differ between groups. Smaller increases in aortic flow and systolic pressure after CDM were found in diabetic rats compared to controls. The marked decrease in CDM effectiveness in diabetic rats likely reflected the alterations in muscle properties associated with diabetes.     

严重腹腔感染时大鼠胃黏膜血流量和Na+-K+-ATP酶活性变化对胃黏膜电位差的影响

目的探讨严重腹腔感染状态下大鼠胃黏膜血流量和Na+-K+-ATP酶活性变化对胃黏膜电位差的影响. 方法利用大鼠盲肠结扎穿孔造成腹腔严重感染动物模型,应用激光多普勒微循环血流计和电生理记录仪检测穿孔前和穿孔后3、6、12、24、48 h 胃黏膜血流量和胃黏膜电位差变化;应用生化法测定各时相大鼠胃黏膜Na+-K+-ATP酶活性. 结果胃黏膜血流量(mV)在盲肠穿孔后3 h (43.7±2.8)与对照组(57.9±2.7)相比明显降低(P<0.05),12 h(31.9±2.6)降至最低(P<0.01),24 h(44.7±2.7)开始回升,48 h(52.9±2.8)仍低于对照组.Na+-K+-ATP酶活性(nmol pi/min/mg蛋白)在盲肠穿孔后3 h(113±14)较对照组(153±12)显著降低(P<0.05),12 h(92±10)降至最低(P<0.01),仅为对照组(153±124)的48.5%,48 h(128±13)仍未恢复正常.胃黏膜电位差(mV)在盲肠穿孔后 6 h(15.2±1.4)较对照组(23.1±1.6)显著下降(P<0.05),12 h(11.6±1.4)降至最低(P<0.01),24 h(17.0±1.5)仍显著低于对照组[(22.6±1.6),P<0.05],48 h(18.9±1.5)显著低于对照组[(22.4±1.5),P<0.05]. 结论严重腹腔感染状态下胃黏膜血流量减少和Na+-K+-ATP酶活性降低是引起大鼠胃黏膜屏障功能受损的主要原因.     

Effects of trapidil on ATPase, lipid peroxidation, and correlation with ultrastructure in experimental spinal cord injury

The present study was performed to investigate the effect of trapidil on ischemic damage of cells after spinal cord injury. The injury was produced by extradural clip compression of the exposed spinal cord in rats according to Rivlin and Tator. The ten rats in group 1 were used to determine normal findings without any surgery or medication. On the 15 rats in group 2, only six-level laminectomy was performed to determine the influence of the total laminectomy on the biochemical factors measured and the light and ultrastructural findings. The 15 rats each in groups 3 and 4 were used as trauma and trapidil (40 mg/kg) treatment groups, respectively. The injury actually produced a significant decrease in Na⁺–K⁺/Mg⁺² ATPase activity of the injured segments as early as 10 min after trauma. Trapidil attenuated Na⁺–K⁺/Mg⁺² ATPase inactivation in the traumatized rats for 120 min after treatment (P<0.05) and significantly reduced the malone dialdehyde content below that in the traumatized group at all determined times (P<0.05). Light and electron microscopic findings supported the biochemical results. Received: 17 April 2000 / Accepted: 27 September 2000     

Ca2+Mg3+-ATPase activity in erythrocyte membranes in hypercalciuric nephrolithiasic patients

SUMMARY: Ca²⁺Mg²⁺ATPase is an enzyme involved in calcium transport across biological membranes. In order to determine its possible role in the pathogenesis of calcium nephrolithiasis, we assessed Ca²⁺Mg²⁺-ATPase activity in erythrocyte membranes from 18 hypercalciuric (HC) nephrolithiasic patients (nine with absorptive hypercalciuria (AHC), nine with renal hypercalciuria (RHC)) and eight normocalciuric healthy controls (C). Participants took no medication for at least 3 months before the study and remained on a diet containing approximately 25 mmol of calcium per day for 14 days. Pump activity was measured in calmodulin-free red blood cell membranes and expressed in umol of phosphate released per mg of membrane protein per h. There were statistically significant differences in pump activity between groups (1.43±0.07; 1.93±0.1; 1.65±0.06; C, AHC, RHC, respectively, P < 0.005 (three groups) and P < 0.02 AHC versus RHC. Enzyme activity was positively correlated with 24-h urinary calcium excretion (r = 0.64, P < 0.01) in HC patients; no such relationship was found in C. In conclusion, erythrocyte membrane Ca²⁺Mg²⁺ATPase activity is increased in HC. Differences in enzyme activity between AHC and RHC may reflect different degrees of a single generalized epithelial calcium transport disturbance.