运动对糖尿病大鼠骨骼肌细胞胰岛素受体及葡萄糖运载体的影响

目的：研究运动对链脲佐菌素所致的糖尿病大鼠骨骼肌细胞葡萄糖运载体４（ＧＬＵＴ４）基因表达及胰岛素受体结合的影响。方法：实验大鼠分成３组：糖尿病运动组、糖尿病非运动组和正常对照组。糖尿病运动组大鼠进行６周游泳耐力训练。结果：糖尿病运动组大鼠与糖尿病非运动组大鼠相比，血糖水平降低、体重增加，骨骼肌细胞膜胰岛素受体结合力有所降低，而细胞内ＧＬＵＴ４ｍＲＮＡ含量增加５６％（Ｐ＜００１）。结论：运动训练主要减少了糖尿病大鼠骨骼肌细胞胰岛素受体后的抵抗，增加了骨骼肌细胞转运和利用葡萄糖的能力，从而改善了糖尿病糖代谢紊乱。     

耐力运动对大鼠骨骼肌细胞葡萄糖运载体的影响

目的研究耐力运动对大鼠骨骼肌细胞葡萄糖运载体４（ＧＴ４）的影响。方法将ＳＤ大鼠随机分为二组：对照组和耐力运动组。耐力运动组大鼠进行６周游泳训练。制备ＧＴ４羧基端１２肽的多克隆抗体。以Ｗｅｓｔｅｒｎ印迹法对二组大鼠骨骼肌细胞ＧＴ４含量进行检测,同时检测大鼠血清胰岛素和血糖浓度。结果大鼠经过６周耐力运动,与对照组大鼠相比,骨骼肌细胞ＧＴ４含量增加３５．０％（Ｐ＜０．０１）。结论耐力运动可增加骨骼肌细胞内ＧＴ４含量,从而提高肌细胞对葡萄糖的摄取和利用     

运动对糖尿病大鼠骨骼肌细胞葡萄糖运载体4转位机制？…

目的 研究运动与链脲佐菌素（ＳＴＺ）引起的糖尿病大鼠骨骼肌细葡萄糖运载体４转位机制的影响。方法 将实验大鼠分为３组：正常对照组、糖尿病组和糖尿运动组。糖尿病运动组大鼠进行６周游泳训练,实验到期分离各组大鼠大腿股四头肌,制备细胞内、外膜、以Ｗｅｓｔｅｒｎ印迹法检测ＧＬＵＴ４蛋白含量,同时检测大鼠血清胰岛素和血糖２。结果 糖尿病大鼠骨骼２肌细胞ＧＬＵＴ４蛋白含量明显减少,与正常对照组相比,细胞内膜ＧＬ     

耐力运动对大鼠葡萄糖运载体基因表达及转位的影响

目的　研究耐力运动对大鼠骨骼肌细胞葡萄糖运载体 4(glucosetransporter 4,GLUT4)基因表达及转位机制的影响。方法　将SD大鼠随机分为两组 :对照组和耐力运动组。耐力运动组大鼠进行 6周游泳训练。用Western印迹法检测大鼠骨骼肌细胞内膜和外膜的GLUT4蛋白含量 ,用Northern杂交法和斑点印迹法检测大鼠骨骼肌细胞内GLUT4mRNA含量。实验前后检测大鼠血清胰岛素和血糖浓度。结果　运动组大鼠经过 6周游泳训练后 ,与对照组大鼠相比 ,骨骼肌细胞内膜GLUT4含量增加 16.0 %(P <0 .0 1) ,细胞外膜GLUT4含量增加 71.9% (P <0 .0 1) ,骨骼肌细胞内GLUT4mRNA含量增加2 5 .6% (P <0 .0 1)。结论　耐力运动可增加骨骼肌细胞内GLUT4基因表达水平 ,促进骨骼肌细胞内的GLUT4从内膜向细胞外膜转位 ,从而提高骨骼肌细胞对葡萄糖的摄取和利用。     

骨骼肌细胞葡萄糖运载体4的实验研究

制备大鼠骨骼肌葡萄糖运载体４羧基端１３肽的多克隆抗本，分离正常大鼠骨骼肌细胞内，外膜，并测定膜上ＧＬＵＴ４的含量。方法；采用Ｍｅｒｒｉｆｉｅｌｄ固相合成法制备ＧＬＵＴ４羧基端１３肽，免疫兔子后得到抗血清和抗体。运用蔗糖梯度超速离心法分离大鼠骨骼肌细胞内外膜，并以Ｗｅｓｔｅｒｎ印迹法测定细胞内外膜ＧＬＵＴ４蛋白的含量。     

骨骼肌细胞葡萄糖运载体4调控的研究进展

组织细胞外的葡萄糖跨膜转运进入细胞内 ,依赖于细胞膜上的葡萄糖运载体(ｇｌｕｃｏｓｅｔｒａｎｓｐｏｒｔｅｒ ,ＧＬＵＴ )转运 ,通过易化扩散作用 ,顺浓度差进入或输出细胞。目前为止 ,已发现 7种ＧＬＵＴ异构体 ,它们具有特定的组织分布。骨骼肌中存在 2种 ,即ＧＬＵＴ1和ＧＬＵＴ4。研究发现成年大鼠骨骼肌细胞中ＧＬＵＴ1仅占ＧＬＵＴ总量的 5 %～ 10 % ,而ＧＬＵＴ4是骨骼肌细胞中主要的葡萄糖运载体。由于人类通过骨骼肌代谢的葡萄糖在基础状态和高胰岛素条件下分别占机体葡萄糖代谢的 2 0 %和 75 %～ 95 % ,尤其在高胰岛素状态下 ,…     

运动训练对老年大鼠肌细胞葡萄糖转运蛋白的影响

目前研究表明 ,随年龄增加葡萄糖耐量逐渐降低。这种与年龄相关的葡萄糖耐量降低被认为是由于外周组织对胰岛素的抵抗[1] 。在外周组织中 ,骨骼肌是胰岛素促进葡萄糖利用的最主要部位 ,如果骨骼肌对葡萄糖的利用率下降可表现明显的胰岛素抵抗。研究发现 ,骨骼肌细胞摄取葡萄糖主要依靠细胞膜上的葡萄糖转运蛋白 (ｇｌｕｃｏｓｅｔｒａｎｓｐｏｒｔｅｒ ,ＧＬＵＴ) ,其中ＧＬＵＴ4是骨骼肌最主要的转运蛋白 ,它的含量多少决定了骨骼肌利用葡萄糖的速率。本研究的目的是观察老年大鼠骨骼肌ＧＬＵＴ4含量的变化 ,以及运动训练对老年大鼠骨骼肌…     

葡萄糖运载体4

胰岛素抵抗是２型糖尿病患者糖利用障碍的主要原因之一。研究发现胰岛素受体后缺陷在胰岛素抵抗的环节中,意义尤为突出,其中外周组织,主要是骨骼肌和脂肪组织对葡萄糖摄取、利用减少是受体后胰岛素抵抗的主要原因。而葡萄糖的跨膜转运是骨骼肌细胞利用葡萄糖的主要限速步骤。目前研究表明,这一过程是依靠细胞膜上的特殊转运蛋白来完成的,这种特殊转运蛋白称为葡萄糖运载体（ｇｌｕｃｏｓｅｔｒａｎｓｐｏｒｔｅｒ,ＧＬＵＴ）。骨骼肌细胞中存在两种ＧＬＵＴ,分别为ＧＬＵＴ１和ＧＬＵＴ４,前者主要位于骨骼肌细胞外膜上,只在基础状…     

牛磺酸应用于冠心病康复的可行性研究：对运动大鼠血清脂质的影响

为观察牛磺酸应用于冠心病康复的可行性，我们研究了牛磺酸对运动大鼠血清脂质的影响。结果表明：运动＋牛磺酸组血清中牛磺酸深度较对照组、运动组都显著增加。与对照组比较，运动组血清中ＣＨ、ＬＤＬ显著降低，运动＋牛磺酸组ＣＨ、ＬＤＬ和ＴＧ都显著降低；、与运动组比较，运动＋牛磺酸组的ＴＧ显著降低，ＨＤＬ显著增加。提示牛磺酸可能使运动降血脂的作用更加完全而有效，牛磺酸在冠心病等与血脂有关疾病的预防、治疗和康复过     

运动对大鼠骨骼肌胰岛素信号转导蛋白表达和活性的影响

目的：观察运动对大鼠骨骼肌中胰岛素信号转导蛋白表达和活性的影响，探讨运动调节骨骼肌葡萄糖转运的细胞内机制。方法：将20只SD大鼠随机分为运动组和对照组，运动组按Ploug方法进行8w的游泳训练。结果：运动组大鼠游泳8w后骨骼肌中蛋白激酶B蛋白表达和磷酸化程度均增加，细胞外信号调节激酶蛋白表达有上升趋势．磷酸化程度显著增加。结论：运动可激活正常骨骼肌中胰岛素信号传递两大途径中的关键蛋白，这可能是运动增强骨骼肌的胰岛素敏感性，促进葡萄糖转运的机制之一。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.     

Evidence-Based Pain Management and Palliative Care in Issue Four for 2009 of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly. Issue 4 for 2009 contains 4027 complete reviews, 1906 protocols for reviews in production, and 11447 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 600,000 randomized controlled trials, and 12,200 cited papers in the Cochrane methodology register. The health technology assessment database contains over 7500 citations. This edition of the Library contains 90 new reviews, of which 19 have potential relevance for practitioners in pain and palliative medicine.     

Wie zuverlässig sind Angaben zu nichtentzündlichen ausgedehnten Schmerzen?

ZusammenfassungFragestellung Es wurde geprüft, wie sich der Differenziertheitsgrad zweier Schmerzmessmethoden auf Angaben zur Ausgedehntheit klinischer Schmerzen auswirkt. Zugleich wurde der Referenzzeitraum variiert, über den die Patienten berichten sollten.Methode Erfasst wurde der Einfluss zu Lasten der Befragungsdifferenziertheit durch den Vergleich zweier Körperschema-Bildvorlagen. Drei Referenzzeiträume (Schmerz aktuell, letzte Woche, letztes halbes Jahr) wurden vorgegeben.Ergebnisse Patienten mit ausgedehnten Schmerzen gaben bei differenzierter Befragung um so mehr Schmerzen an, je weiter die Schmerzen zurück lagen und je größer der Berichtszeitraum war. Patienten mit gelenknahen Schmerzen gaben bei hoch differenzierter Befragung weniger ausgedehnte Schmerzen in der Vergangenheit an als bei globaler Einschätzung. Patienten mit Rückenschmerzen berichteten bei differenzierter Befragung zum aktuellen Schmerz über weniger ausgedehnte Schmerzen als bei globaler Befragung.Schlussfolgerung Die Angaben zur Schmerzausdehnung variieren vor allem bei Patienten mit ausgedehnten Schmerzen in Abhängigkeit von der Differenziertheit der Befragung. In diesen Fällen ist die Wahrscheinlichkeit erhöht, dass sich die Beschwerdesymptomatik zumindest teilweise erst in der Reaktion auf die situativen Befragungsbedingungen konstituiert und daher nicht auf andere Befragungsbedingungen generalisiert werden kann.