右美托咪定对人离体妊娠子宫平滑肌自发性收缩的影响

目的研究不同浓度右美托咪定对人离体子宫平滑肌自发性收缩的影响。方法已经发生自主规律收缩的人妊娠子宫平滑肌60例。随机分为对照组和右美托咪定组,每组30例。对照组每次给予相同容量Krebs液,右美托咪定组采用累积给药法使右美托咪定溶液浓度达到1×10~(-8)、3×10~(-8)、1×10~(-7)、3×10~(-7)、1×10~(-6)、3×10~(-6)、1×10~(-5) mol/L,应用BL-420F生物信号采集处理系统记录不同浓度下子宫平滑肌的收缩强度、收缩频率及收缩持续时间。结果与对照组比较,右美托咪定浓度为1×10~(-8、3×10~(-8、1×10~(-7) mol/L时对人离体子宫平滑肌收缩强度、收缩频率和持续时间差异均无统计学意义,右美托咪定浓度为1×10~(-6)、3×10~(-6)和1×10~(-5) mol/L时人离体子宫平滑肌的收缩强度明显减弱、收缩持续时间和频率明显延长(P0.05)。结论低浓度右美托咪定对子宫平滑肌的收缩无影响,高浓度(大于1×10~(-6) mol/L)右美托咪定以剂量依赖的方式抑制人离体妊娠子宫平滑肌的收缩。     

右美托咪定对口腔鳞癌细胞增殖、迁移和侵袭的影响

目的 探讨右美托咪定对口腔鳞癌细胞增殖、迁移和侵袭的影响及机制。方法 实验一：选用人口腔鳞癌细胞系HN6和CAL27,根据右美托咪定浓度不同随机均分为六组：阴性对照组(NC组)、右美托咪定1 nmol/L组(D1组)、右美托咪定10 nmol/L组(D2组)、右美托咪定100 nmol/L组(D3组)、右美托咪定1μmol/L组(D4组)和右美托咪定10μmol/L组(D5组)。培养24、48 h后分别采用CCK-8法、划痕实验和Transwell实验检测细胞增殖、迁移和侵袭能力。实验二：利用转录组测序技术筛选右美托咪定1μmol/L处理HN6细胞12 h后差异表达的基因。采用慢病毒转染细胞，建立稳定敲低细胞色素P450 1B1(CYP1B1)的HN6细胞株。将细胞随机分为四组：shCtrl组(C组)、shCYP1B1组(CYP组)、shCtrl+右美托咪定组(CD组)和shCYP1B1+右美托咪定组(CYPD组)。采用划痕实验和Transwell实验检测HN6细胞迁移和侵袭能力。结果 实验一：与NC组比较，D2组、D3组、D4组和D5组HN6和CAL27细胞迁移率均明显升高，基质胶内...     

瑞芬太尼对正常和高血压大鼠基底动脉平滑肌细胞的不同作用

目的评价瑞芬太尼对正常和高血压大鼠基底动脉平滑肌细胞上大电导钙激活钾通道(BKCa)和电压门控钾通道(Kv)激活电流的影响。方法自发性高血压大鼠(spontaneously hypertensive rats,SHR)和同源正常血压(wistar-kyoto,WKY)大鼠,采用酶消化法急性分离基底动脉平滑肌细胞,每种大鼠选择6个基底动脉平滑肌细胞,采用全细胞膜片钳技术记录外向电流幅度。加入瑞芬太尼3×10-7mol/L,分别记录所设置的方波刺激(step刺激)方案中所有刺激电压下给药前(基础水平)和给药后电流幅度,并计算净电流=给药后电流幅度-基础值;采用浓度累积法给药,分别记录+60 m V刺激电压下给药前(基础值)和给予10-10、10-9、10-8、10-7、10-6、10-5mol/L瑞芬太尼后电流幅度,计算电流增加率和瑞芬太尼增加基底动脉平滑肌细胞电流幅度的半数有效浓度(EC50);另取每种大鼠6个基底动脉平滑肌细胞,加入瑞芬太尼3×10-7mol/L后分别给予BKCa阻滞剂四乙胺(tetraethylammonium,TEA)和Kv阻滞剂4-氨基吡啶(4-aminopyridine,4-AP),再分别加入其相应的瑞芬太尼混合液,记录每一次给药后的电流幅度。结果两种大鼠基底动脉平滑肌细胞给瑞芬太尼后在0、+20、+40和+60 m V刺激电压下产生的净电流依次明显增大(P0.05);10-10、10-9、10-8、10-7mol/L瑞芬太尼作用下,两种大鼠基底动脉平滑肌细胞外向电流增加率依次明显升高(P0.05);与WKY大鼠比较,瑞芬太尼增加SHR基底动脉平滑肌细胞电流幅度的(EC50)明显升高(P0.05);与基础值比较,两种大鼠基底动脉平滑肌细胞瑞芬太尼给药后电流幅度明显升高,TEA给药后或4-AP给药后电流幅度明显降低(P0.05);与TEA给药后或4-AP给药后比较,TEA+瑞芬太尼给药后或4-AP+瑞芬太尼给药后两种大鼠基底动脉平滑肌细胞电流幅度明显升高(P0.05)。结论瑞芬太尼呈电压依赖性和浓度依赖性激活两种大鼠基底动脉平滑肌细胞BKCa和Kv电流,瑞芬太尼对SHR基底动脉平滑肌细胞上BKCa和Kv激活电流的作用较WKY大鼠弱。     

瑞芬太尼对人肠系膜小动脉平滑肌细胞大电导钙激活钾通道的影响

目的 观察瑞芬太尼对人肠系膜小动脉平滑肌细胞大电导钙激活钾通道(BKCa)的影响,探讨其扩张血管的机制.方法 酶消化法急性分离人肠系膜小动脉平滑肌细胞,采用全细胞膜片钳技术,+80 mV钳制电压下记录不同浓度瑞芬太尼(1.2、4.8、19.4、77.4和310.0 nmol/L)给药后人肠系膜小动脉平滑肌细胞BKCa电流及达峰时间,计算BKCa激活率.结果 瑞芬太尼可激活BKCa,使电流密度-电压曲线上移,激活电压不变;随瑞芬太尼浓度升高,BKCa激活率逐渐升高(P＜0.01),19.4 nmol/L时BKCa激活率趋于稳定;各浓度瑞芬太尼给药后BKCa电流达峰时间比较差异无统计学意义(P＞0.05);瑞芬太尼浓度与BKCa激活率成对数曲线关系,其半数最大激活效应浓度为(118±7)nmol/L.结论 瑞芬太尼浓度依赖性地激活人肠系膜小动脉平滑肌细胞BKCa,该作用可能是其产生扩张血管作用的机制.     

自噬在右美托咪定减轻大鼠高糖离体心肌细胞缺氧复氧损伤中的作用

目的评价自噬在右美托咪定减轻大鼠高糖离体心肌细胞缺氧复氧损伤中的作用。方法正常培养的对数期大鼠H9c2心肌细胞,以1×106个/ml密度接种于6孔板,采用随机数字表法分为4组(n=15):对照组(C组)、高糖缺氧复氧组(HG+H/R组)、右美托咪定组(DEX组)和右美托咪定+自噬抑制剂3-甲基腺嘌呤组(3-MA组)。细胞密度达到50%时,使用含1%胎牛血清+1%双抗的培养基孵育24 h。采用高糖培养基(糖浓度33 mmol/L)培养24 h,37 ℃下培养箱(95%N2+5%CO2)培养4 h,复氧(90%O2+10%CO2)2 h,制备高糖心肌细胞缺氧复氧损伤模型,DEX组和3-MA组于缺氧前1 h时加入右美托咪定,终浓度5 μmol/L,3-MA组右美托咪定孵育1 h时加入3-MA,终浓度5 μmol/L。于复氧后2 h时采用CCK-8法测定细胞活力,采用试剂盒检测上清液LDH活性,采用Western blot法检测自噬相关蛋白LC3、P62和Beclin-1的表达,计算LC3Ⅱ/LC3Ⅰ比值,采用RT-PCR法检测P62和Beclin-1 mRNA的表达。结果与C组比较,HG+H...     

右美托咪定对MCF-7乳腺癌细胞增殖、迁移和凋亡的影响

目的探讨右美托咪定对MCF-7乳腺癌细胞增殖、迁移和凋亡的影响。方法将MCF-7乳腺癌细胞分为六组,右美托咪定组(D1组、D2组、D3组、D4组、D5组)和对照组(C组)。D1、D2、D3、D4、D5组加入右美托咪定,终浓度分别为1 000、100、10、1、0.1 ng/ml,C组加入等容积的生理盐水。通过噻唑蓝(MTT)法观察右美托咪定对MCF-7乳腺癌细胞增殖的影响,通过划痕实验观察右美托咪定对MCF-7乳腺癌细胞迁移的影响,应用凋亡试剂盒结合流式细胞仪检测右美托咪定对MCF-7乳腺癌细胞凋亡的影响。结果与C组比较,D1、D2、D3、D4、D5五组乳腺癌细胞增殖率、迁移距离和凋亡率差异均无统计学意义。结论右美托咪定对MCF-7乳腺癌细胞的增殖、迁移和凋亡无明显影响。     

右美托咪定对人结肠癌细胞增殖和自噬的影响

目的： 探讨右美托咪定对人结肠癌细胞增殖和自噬的影响。
方法： 实验一中,选择处于对数生长期的人结肠癌细胞LoVo和HCT116,将细胞分为八组：LoVo-1组（L0-1组）、LoVo+右美托咪定1 nmol/L-1组（L1-1组）、LoVo+右美托咪定10 nmol/L-1组（L10-1组）、LoVo+右美托咪定100 nmol/L-1组（L100-1组）、HCT116-1组（H0-1组）、HCT116+右美托咪定1 nmol/L-1组（H1-1组）、HCT116+右美托咪定10 nmol/L-1组（H10-1组）和HCT116+右美托咪定100 nmol/L-1组（H100-1组）。细胞加药处理24、48 h时采用CCK-8法检测细胞增殖率,细胞加药处理24 h时收集细胞,采用Western blot法检测微管相关蛋白1轻链3（LC3）-Ⅱ、自噬相关蛋白Beclin-1含量。实验二中,选择处于对数生长期的人结肠癌细胞LoVo和HCT116,将细胞分为四组：LoVo-2组（L0-2组）、LoVo+右美托咪定10 nmol/L-2组（L10-2组）、HCT116-2组（H0-2组）和HCT116+右美托咪定10 nmol/L-2组（H10-2组）。细胞加药处理24 h时,收集细胞,采用免疫荧光法观察LC3蛋白表达情况并计算LC3位点阳性率;细胞加药处理24 h时,收集细胞,采用透射电镜观察自噬体。
结果： 实验一中,与L0-1组和L1-1组比较,L10-1组和L100-1组细胞加药处理后24、48 h细胞增殖率明显降低,细胞加药处理后24 h LC3-Ⅱ、Beclin-1蛋白含量明显升高（P<0.05）。与H0-1组和H1-1组比较,H10-1组和H100-1组细胞加药处理后24、48 h细胞增殖率明显降低,细胞加药处理后24 h LC3-Ⅱ、Beclin-1蛋白含量明显升高（P<0.05）。实验二中,与L0-2组比较,细胞加药处理后24 h L10-2组LC3位点阳性率明显升高（P<0.05）。与H0-2组比较,细胞加药处理后24 h H10-2组LC3位点阳性率明显升高（P<0.05）。L0-2组和H0-2组细胞膜完整,细胞核清晰。L10-2和H10-2组细胞膜破坏,细胞器排列紊乱,可见大量自噬小体及自噬溶酶体。
结论： 右美托咪定可能通过诱导自噬,抑制结肠癌细胞的增殖。     

Nrf2/HO-1信号通路在右美托咪定减轻小胶质细胞氧糖剥夺-复氧复糖损伤中的作用

目的评价核因子-E2相关因子2(Nrf2)/血红素氧合酶-1(HO-1)信号通路在右美托咪定减轻小胶质细胞氧糖剥夺-复氧复糖损伤中的作用。方法 BV-2小胶质细胞加入含10%胎牛血清的高糖DMEM培养基,以1.5×104个/ml的密度接种于96孔培养板(200 μl/孔)或以2×105个/ml密度接种于6孔培养板(每孔2 ml),置于37 ℃、含5%CO2-21%O2-74 %N2的正常培养箱中培养。采用随机数字表法分为5组(n=30):正常对照组(C组)、右美托咪定组(D组)、氧糖剥夺/复氧复糖组(OGD/R组)、氧糖剥夺/复氧复糖+右美托咪定组(OGD/R+D组)和氧糖剥夺/复氧复糖+右美托咪定+ML385组(OGD/R+D+ML组)。C组在正常培养箱中继续培养26 h;D组加入终浓度为10 μmol/L的右美托咪定孵育2 h,随后在正常培养箱中培养26 h;OGD/R组、OGD/R+D组、OGD/R+D+ML组更换为无糖DMEM培养基,置于37 ℃、含5%CO2-1%O2-94 %N2的培养箱中培养2 h,然后换为含10%胎牛血清的高糖DMEM培养基,在正常培养箱中培养24 h;...     

右美托咪定预先给药对脂多糖诱导乳鼠原代小胶质细胞炎性介质释放的影响

目的 评价右美托咪定预先给药对脂多糖诱导乳鼠原代小胶质细胞炎性介质释放的影响.方法 培养乳鼠原代小胶质细胞,采用随机数字表法,将其分为3组:对照组(C组)、脂多糖组(L组)和右美托咪定预先给药组(D组),每组10孔.C组去血清细胞培养液培养,L组加入脂多糖(终浓度1 μg/ml),D组加入右美托咪定(终浓度1 ng/ml),1h后加入脂多糖(终浓度1μg/ml).作用24h后采用Griess法测定培养上清液一氧化氮(N0)浓度,采用酶联免疫吸附法测定培养上清液前列腺素E2(PGE2)、IL-1β和TNF-α浓度,采用RT-PCR法测定细胞诱导型一氧化氮合酶(iNOS) mRNA的表达.结果 与C组比较,L组和D组细胞iNOS mRNA表达上调,上清液NO、PGE2、IL-1β和TNF-α浓度升高(P＜0.01);与L组比较,D组上述指标差异无统计学意义(P＞0.05).结论 右美托咪定预先给药对脂多糖诱导乳鼠原代小胶质细胞炎性介质释放无明显影响.     

不同浓度右美托咪定对糖氧剥夺/再灌注诱导神经细胞凋亡的影响

目的研究不同浓度右美托咪定对糖氧剥夺/再灌注(OGD/R)诱导神经细胞凋亡的保护作用。方法应用全反式维甲酸(ATRA)和十四烷酰佛波醇乙酯酸(TPA)序贯诱导人源性神经母细胞瘤(SH-SY5Y)分化为神经细胞,均分为六组。选择OGD12h/R12h构建OGD/R模型。D0、D1、D2、D3、D4、D5组在OGD开始即刻分别加入右美托咪定0、0.1、1、10、100、1 000μmol/L。于再灌注12h后,采用MTT法检测细胞存活率,流式细胞凋亡法检测细胞凋亡水平,以观察不同浓度右美托咪定对OGD/R诱导神经细胞凋亡的保护作用。随后选择保护效果确切组,应用Westernblot法检测内质网(endoplasmic reticulum,ER)应激特异性蛋白-中脑星形胶质细胞源性神经营养因子(mesencephalic astrocyte-derived neurotrophic factor,MANF)含量以及促凋亡蛋白Caspase-3活性和CHOP含量。结果与D0组比较,D1、D2组细胞存活率和细胞凋亡率差异无统计学意义;D4、D5组细胞存活率明显下降,细胞凋亡率明显升高(P0.01或P0.05);D3组则显著改善并提高了OGD/R诱导后神经细胞的存活率,抑制了细胞凋亡(P0.01)。Westernblot结果显示,D3组细胞MANF含量明显高于D0组(P0.01),Caspase-3活性和CHOP含量明显低于D0组(P0.01)。结论右美托咪定在10μmol/L终浓度时对OGD/R诱导的神经细胞凋亡具有保护作用,并显著提高了细胞存活率。右美托咪定神经保护作用的机制可能与上调ER应激特异性蛋白MANF,抑制凋亡蛋白caspase-3和CHOP的表达相关。     

维生素D受体在糖尿病肾病足细胞损伤及蛋白尿缓解中的作用

目的探讨维生素D受体(VDR)在糖尿病肾病(DKD)足细胞中的表达水平及在足细胞损伤及蛋白尿缓解中的作用。方法(1)本研究纳入了65例诊断患有2型糖尿病(伴或不伴蛋白尿)的患者,并纳入了25例年龄和性别相匹配的健康体检者为对照组。根据白蛋白/肌酐(ACR)的尿排泄比例对2型糖尿病患者进行分组,分别为无蛋白尿(ACR<30 mg/g,n=24)、微量白蛋白尿(ACR 30~300 mg/g,n=18)和临床蛋白尿(ACR>300 mg/g,n=23)。另选择25例经肾活检确诊的DKD患者作为DKD组。正常肾脏组织标本均取自泌尿外科同一时期肾脏肿瘤切除患者10例。将各组检测指标进行对比,同时采用实时定量PCR、ELISA法和免疫组化法检测VDR在各组患者的血液、尿液样本和肾脏组织中的表达情况,以及使用Pearson相关分析分析VDR与尿蛋白的相关性。(2)在2型糖尿病肾病小鼠模型中对上述结果进行验证,将遗传背景均为C57BLKs/J的雄性db/db小鼠及同窝出生的db/m小鼠,随机分为正常对照组(A组)、DKD对照组(B组)、DKD二甲基亚砜处理组(C组)、DKD帕立骨化醇(VDR激动剂)处理组(D组),C、D组连续腹腔注射处理8周,对照组不做任何处理。小鼠10周龄时开始连续干预8周,在小鼠22周龄(开始干预后12周)检测各组小鼠体重、血、尿生化指标对比;Western印迹法检测β⁃catenin、VDR的变化;免疫荧光观察足细胞标志蛋白podocin及足细胞损伤蛋白α⁃SMA的表达变化。结果(1)与正常健康对照组相比,无蛋白尿组、微量白蛋白尿组和临床蛋白尿组的糖尿病患者血浆中VDR的mRNA和蛋白水平均较低(均P<0.05);与无蛋白尿组的糖尿病患者相比,微量白蛋白尿组和临床蛋白尿组的糖尿病患者血浆中VDR的mRNA和蛋白水平均较低(均P<0.05)。(2)与正常健康对照组相比,无蛋白尿糖尿病组和DKD组患者血浆中VDR的mRNA和蛋白水平均较低(均P<0.05);与无蛋白尿糖尿病组患者相比,DKD组患者血浆中VDR的mRNA和蛋白水平亦较低(均P<0.05)。(3)免疫组化结果显示,DKD组肾组织中VDR的表达明显少于正常对照组。(4)DKD患者血浆中VDR mRNA相对水平与ACR呈负相关(r=-0.342,P<0.05)。(5)各组尿液上清液中VDR的水平与血浆中的水平呈相反趋势。(6)Western印迹结果显示,B组、C组肾小球足细胞β⁃catenin蛋白表达高于D组(均P<0.05),VDR蛋白的表达低于D组(均P<0.05);免疫荧光结果显示,B组、C组肾小球足细胞podocin的表达低于D组(均P<0.05),α⁃SMA的表达高于D组(均P<0.05)。结论VDR高表达缓解DKD足细胞损伤及蛋白尿。     

Comparison of University of Wisconsin and University of Pittsburgh solutions for heart transplantation

The effectiveness of University of Wisconsin (UW) and University of Pittsburgh (UP) solutions for the preservation of rat hearts was compared. Lewis rat hearts were preserved with UW (group A, n=45) or UP (group B, n=45) solution for 0 or 24 h and then transplanted heterotopically into the recipients' abdomen. Ten recipients in each group were observed to obtain 1-week graft survival rates. Tissue water content and tissue content of adenine nucleotides were measured 2 h after transplantation in six grafts from each group. Six hearts preserved for 0 h and seven hearts preserved for 24 h were taken from each group 24 h after grafting for histopathology. The 1-week graft survival rates of groups A24 and B24 were 60% and 10%, respectively. In the 24-h preserved grafts, adenosine triphosphate (ATP) and energy charge [(ATP+adenosine diphosphate/2)/(ATP+adenosine diphosphate+adenosine monophosphate)] of groups A and B were 0.972±0.165 and 0.200±0.123 mg/g wet tissue (P<0.05) and 74.4% and 61.1% (P<0.05), respectively. The tissue water content of group A24 was 71.7%, whereas that of group B24 was 74.1% (P<0.05). Histopathology revealed more severe muscle edema and necrosis and infiltration of polymorphonuclear cells in group B24 than in group A24. We conclude that UW solution is more appropriate for rat heart preservation than UP solution.     

Role of Conventional and Diffusion-Weighted Magnetic Resonance Imaging of Spinal Treatment Protocol for Hydatid Disease

Objective:

To demonstrate the role of magnetic resonance imaging (MRI) in determining the treatment protocol for hydatid disease of the spine.

Design:

Case report; literature review.

Findings:

Diffusion-weighted MRI can help differentiate complicated infected hydatidosis from abscesses, epidermoid cysts from arachnoid cysts, and benign from malignant vertebral compression fractures. It is also helpful in differentiating between abscesses and necrotic tumors.

Conclusion:

Diffusion-weighted MRI can help differentiate between infections requiring immediate surgery and those that can be treated medically with antihelmintic treatment.     

罗伊适应模式对腹股沟疝无张力疝修补术后恢复情况的影响

目的探讨罗伊适应模式对患者腹股沟疝无张力疝修补术后恢复情况的影响。 方法将2016年1月至2019年5月在秦皇岛市第二医院择期进行无张力修补术治疗的120例腹股沟疝患者，按照随机数字法分为对照组和观察组，每组各60例。对照组采用常规护理治疗，观察组在对照组的基础上采用罗伊适应模式。比较2组患者的术后临床指标、心理状态、围手术期并发症发生情况及满意度。 结果术后观察组患者的首次排气时间、恢复正常饮食时间、离床活动时间和术后住院时间均低于对照组（P<0.05）；术后观察组患者的抑郁自评量表（SDS）和焦虑自评量表（SAS）评分显著低于对照组（P<0.05）；术后2组患者均无切口感染发生，2组患者尿潴留、急性疼痛、认知功能障碍、发热、血肿等发生率相比无统计学差异（P>0.05）；术后观察组患者护理满意度为96.67%，显著高于对照组的83.33%（P<0.05）。 结论在常规护理的基础上，罗伊适应模式用于患者腹股沟疝无张力修补围手术期，能有效改善术后患者的焦虑/抑郁情绪，不增加围手术期并发症，促进术后患者的恢复及提高治疗满意度。     

Long-term follow-up of callotasis lengthening of the capitate after resection of the lunate for the treatment of stage III lunate necrosis

The callotasis lengthening technique was used to gradually lengthen the capitate after resection of the lunate in stage IIIa necrosis in 23 patients. Results of ten patients with a follow-up of at least 5 years showed rapid and sufficient callus formation in every patient regardless of age. The callotasis lengthening modification of the Graner II operation provides all advantages and avoids the major inconvenience of the traditional Graner II operation. There was no increased rate of disturbed fracture healing. Results of the DTPA-gadolinium MRI study did not show any significant impairment of vascularization within the region of the capitate bone. With the “intrinsic bone formation,” contrary to every other intercarpal arthrodesis at the wrist, there is no need for an additional bone graft.     

不同尿钙水平的Gitelman综合征患者临床特点比较

目的观察不同尿钙水平Gitelman综合征(GS)患者的临床特点,探讨尿钙在GS疾病临床分型中的价值。方法收集2016—2018年来自中国国家罕见病注册系统(NRSC)、在北京协和医院行SLC12A3基因检测诊断为GS患者的临床资料,分析其尿钙特点,比较不同尿钙水平患者的临床和实验室检查指标。氢氯噻嗪试验按照标准操作流程进行,测定患者基线和用药后3 h内氯离子排泄分数改变量的最大值(ΔFECl)。结果共有83例GS患者被纳入研究,其中低尿钙患者53例(63.86%)。低尿钙组尿钙/肌酐比明显低于非低尿钙组[(0.085±0.058)mmol/mmol比(0.471±0.284)mmol/mmol,t=7.349,P<0.001]。两组患者在年龄、性别、估算肾小球滤过率、血压、血尿电解质水平、代谢性碱中毒方面差异均无统计学意义。低尿钙组患者乏力(χ2=4.595,P=0.032)及多尿(χ2=5.778,P=0.016)发生比例低于非低尿钙组,两组患者在其他临床症状方面差异无统计学意义。低尿钙和非低尿钙组各有16例患者行氢氯噻嗪试验,中位ΔFECl结果分别为0.539%(0.430%,1.283%)和0.829%(0.119%,1.298%),均提示对氢氯噻嗪无反应,组间差异无统计学意义(U=130.000,P=0.956)。结论GS患者中低尿钙比例为63.86%,尿钙水平与疾病临床表型、NCC功能损伤严重程度之间均无明确相关性。     

Safety and tolerability of single intravenous doses of sugammadex administered simultaneously with rocuronium or vecuronium in healthy volunteers

BACKGROUND: Sugammadex rapidly reverses rocuronium- and vecuronium-induced neuromuscular block. To investigate the effect of combination of sugammadex and rocuronium or vecuronium on QT interval, it would be preferable to avoid the interference of anaesthesia. Therefore, this pilot study was performed to investigate the safety, tolerability, and plasma pharmacokinetics of single i.v. doses of sugammadex administered simultaneously with rocuronium or vecuronium to anaesthetized and non-anaesthetized healthy volunteers. METHODS: In this phase I study, 12 subjects were anaesthetized with propofol/remifentanil and received sugammadex 16, 20, or 32 mg kg(-1) combined with rocuronium 1.2 mg kg(-1) or vecuronium 0.1 mg kg(-1); four subjects were not anaesthetized and received sugammadex 32 mg kg(-1) with rocuronium 1.2 mg kg(-1) or vecuronium 0.1 mg kg(-1) (n=2 per treatment). Neuromuscular function was assessed by TOF-Watch SX monitoring in anaesthetized subjects and by clinical tests in non-anaesthetized volunteers. Sugammadex, rocuronium, and vecuronium plasma concentrations were measured at several time points. RESULTS: No serious adverse events (AEs) were reported. Fourteen subjects reported 23 AEs after study drug administration. Episodes of mild headache, tiredness, cold feeling (application site), dry mouth, oral discomfort, nausea, increased aspartate aminotransferase and gamma-glutamyltransferase levels, and moderate injection site irritation were considered as possibly related to the study drug. The ECG and vital signs showed no clinically relevant changes. Rocuronium/vecuronium plasma concentrations declined faster than those of sugammadex. CONCLUSIONS: Single-dose administration of sugammadex 16, 20, or 32 mg kg(-1) in combination with rocuronium 1.2 mg kg(-1) or vecuronium 0.1 mg kg(-1) was well tolerated with no clinical evidence of residual neuromuscular block, confirming that these combinations can safely be administered simultaneously to non-anaesthetized subjects. Rocuronium and vecuronium plasma concentrations decreased faster than those of sugammadex, reducing the theoretical risk of neuromuscular block developing over time.     

Magnetic resonance imaging for the evaluation of rejection of a kindney allograft in the rat

Orthotopic DA (RT1^a) into Lewis (RT1¹) rat kidney allografts and control Lewis-into-Lewis grafts were assessed by magnetic resonance imaging (MRI) and perfusion measurement after intravenous injection of a superparamagnetic contrast agent. MRI anatomical scores (range 1–6) and perfusion rates were compared with graft histology (rank of rejection score 1–6). Not only acute rejection, but also chronic events were monitored after acute rejection was prevented by daily cyclosporine (Sandimmune) treatment during the first 2 weeks after transplantation. In acute allograft rejection (n=11), MRI scores reached the maximum value of 6 and perfusion rates were severely reduced within 5 days after transplantation; histology showed severe acute rejection (histologic score 5–6). In the chronic phase (100–130 days after transplantation), allografts (n=5) manifested rejection (in histology cellular rejection and vessel changes), accompanied by MRI scores of around 2–3 and reduced perfusion rates. Both in the acute and chronic phases, the MRI anatomical score correlated significantly with the histological score (Spearman rank correlation coefficient r _s 0.89, n=30, P<0.01), and perfusion rates correlated significantly with the MRI score or histological score (r _s values between-0.60 and -0.87, n=23, P<0.01). It is concluded that MRI represents an interesting tool for assessing the anatomical and hemodynamical status of a kidney allograft in the acute and chronic phases after transplantation.     

Cost-effectiveness of three combinations of antiemetics in the prevention of postoperative nausea and vomiting

Background. This study compares the cost-effectiveness of threecombinations of antiemetics in the prevention of postoperativenausea and vomiting (PONV). Methods. We conducted a prospective, double-blind study. NinetyASA I–II females, 18–65 yr, undergoing general anaesthesiafor major gynaecological surgery, with standardized postoperativeanalgesia (intrathecal 0.2 mg plus i.v. PCA morphine), wererandomly assigned to receive: ondansetron 4 mg plus droperidol1.25 mg after induction and droperidol 1.25 mg 12 h later (Group1); dexamethasone 8 mg plus droperidol 1.25 mg after inductionand droperidol 1.25 mg 12 h later (Group 2); ondansetron 4 mgplus dexamethasone 8 mg after induction and placebo 12 h later(Group 3). A decision analysis tree was used to divide eachgroup into nine mutually exclusive subgroups, depending on theincidence of PONV, need for rescue therapy, side effects andtheir treatment. Direct cost and probabilities were calculatedfor each subgroup, then a cost-effectiveness analysis was conductedfrom the hospital point of view. Results. Groups 1 and 3 were more effective (80 and 70%) thanGroup 2 (40%, P=0.004) in preventing PONV but also more expensive.Compared with Group 2, the incremental cost per extra patientwithout PONV was €6.99 (95% CI, –1.26 to 36.57) forGroup 1 and €13.55 (95% CI, 0.89–132.90) for Group3. Conclusion. Ondansetron+droperidol is cheaper and at least aseffective as ondansetron+ dexamethasone, and it is more effectivethan dexamethasone+droperidol with a reasonable extra cost. Br J Anaesth 2003; 91: 589–92     

Fibrinogen-thrombin collagen patch reinforcement of highrisk colonic anastomoses in rats

AIM To evaluate the effectiveness of human fibrinogenthrombin collagen patch(TachoSil~?) in the reinforcement of high-risk colon anastomoses.METHODS A quasi-experimental study was conducted in Wistar rats(n = 56) that all underwent high-risk anastomoses(anastomosis with only two sutures) after colectomies. The rats were divided into two randomized groups: Control group(24 rats) and treatment group(24 rats). In the treatment group, high-risk anastomosis was reinforced with TachoSil~? (a piece of Tacho Sil? was applied over this high-risk anastomosis, covering the gap). Leak incidence, overall survival, intra-abdominal adhesions, and histologic healing of anastomoses were analyzed. Survivors were divided into two subgroups and euthanized at 15 and 30 d after intervention in order to analyze the adhesions and histologic changes. RESULTS Overall survival was 71.4% and 57.14% in the TachoSil~? group and control group, respectively(P = 0.29); four rats died from other causes and six rats in the treatment group and 10 in the control group experienced colonic leakage(P 0.05). The intra-abdominal adhesion score was similar in both groups, with no differences between subgroups. We found non-significant differences in the healing process according to the histologic score used in both groups(P = 0.066).CONCLUSION In our study, the use of TachoSil~? was associated with a non-statistically significant reduction in the rate of leakage in high-risk anastomoses. TachoSil~? has been shown to be a safe product because it does not affect the histologic healing process or increase intra-abdominal adhesions.