透析导管不同连接方式对糖尿病肾病患者血糖值的影响

目的了解不同部位留置导管患者在透析过程中动静脉端不同连接方式对血糖值的影响。方法对60例糖尿病肾病患者采用长期颈内静脉置管(20例)、临时颈内静脉置管(20例)、临时股静脉置管(20例)作为血管通路行血液透析治疗,采取自身对照法进行研究,以血液透析时留置导管动静脉端与血路管动静脉端的连接方式确定正接与反接,每例患者均行正向连接和反向连接各1次,透析至2h时从患者手指端与体外循环管路动脉端采血测血糖。结果不同置管部位管路正向连接透析时,动脉端与手指端血糖值比较,差异无统计学意义(均P>0.05);临时股静脉置管反向连接时动脉端血糖值显著低于手指端(P<0.01)。结论长期及临时颈内静脉置管,无论正向连接还是反向连接均可从体外循环管路的动脉端采血测血糖值,股静脉置管正向连接时可从动脉端采血,反向连接时,监测血糖应从外周采血,才能获得较准确的血糖值。     

不同降血糖方法对糖尿病肾脏病患者血糖及尿蛋白排泄率的影响

目的 比较早期糖尿病肾脏病患者接受不同降血糖方法治疗后血糖波动及尿蛋白排泄率（UAER）情况,探讨该期患者应用胰岛素治疗对于病程进展的预防及治疗作用.方法 选择128例糖尿病肾脏病患者,入选时肾小球滤过率（GFR）处于慢性肾脏病（CKD）1～3期,分为A组60例、B组68例;分别给予胰岛素治疗和非胰岛素治疗,对治疗结果进行分析比较,评判不同降血糖方法的疗效及影响因素.结果 A组血糖漂移度较B组显著降低（P＜0.05）A、B组UAER分别为（82.5±19.6）μg/min和（65.7±21.1） μg/min,2组比较有统计学差异（P＜0.05）.结论 应用胰岛素治疗能更好控制血糖水平,有效减缓肾脏病变进展速度,是预防及治疗糖尿病肾脏病的有效方法.     

Decreased glomerular proteinase activity in the streptozotocin diabetic rat.

Decreased glomerular proteinase activity may contribute to matrix accumulation in diabetes. Male Sprague-Dawley rats were rendered diabetic by injection of streptozotocin (STZ) 65 mg/kg i.v.; age-matched, sham-injected rats served as controls. Glomeruli from diabetic rats 1 month after STZ injection demonstrated significant decreases in collagenase and cathepsin B activities compared to control glomeruli. Treatment with insulin resulted in a slight (but not significant) increase in collagenase activity and normalized cathepsin B activity. We conclude that decreased glomerular collagenase and cathepsin B activities are present in STZ diabetes. These alterations may contribute to mesangial matrix accumulation.     

TRPC6在糖尿病肾脏疾病大鼠肾组织的表达及缬沙坦的作用

目的观察瞬时受体阳离子通道6（transientreceptorpotentialcationchannel6,TRPC6）在糖尿病肾脏疾病（diabetickidneydisease,DKD）鼠肾组织的表达及缬沙坦的作用。方法通过单肾切除联合链脲佐菌素（streptozotocin,sTZ）诱导的DKD模型随机分为糖尿病组（diabetesmellitus,DM）和缬沙坦治疗组,每组10只。另以10只大鼠作对照组（normalcontrol,NC）。缬沙坦组每天给予缬沙坦20mg／kg于饮水中,于8周、16周、24周检测不同时间点24h尿蛋白、血肌酐和血糖。24周处死动物,PAS染色和透射电镜观察肾组织学改变,激光共聚焦检测TRPC6、synaptopodin的表达和分布,免疫组化、RT-PCR检测nephrin、TRPC6mRNA和蛋白的表达。结果与NC组比较,DM组24h尿蛋白、肾质量／体质量指数、TRPC6的表达均显著高于NC组（P〈O．01）,而内生肌酐清除率（endogenouscreatinineclearancerate,Ccr）、nephrin的表达显著低于NC组（P〈0．01）。激光共聚焦显示TRPC6与足细胞标志蛋白synaptopodin高度融合,沿毛细血管袢线形分布。缬沙坦组24h尿蛋白、肾质量／体质量、TRPC6的表达较DM组显著降低,Ccr、nephrin免疫组化积分和mR-NA的表达显著增加,肾脏病理改变减轻。结论DKD大鼠足细胞TRPC6的表达显著升高,缬沙坦可能通过抑制TRPC6的表达来减轻足细胞的损伤。     

Strict metabolic control and renal function in the streptozotocin diabetic rat

Micropuncture studies were made on insulin-treated streptozotocin diabetic rats two weeks after the induction of diabetes and on age-matched control rats. Kidney size, GFR and single nephron GFR were higher in poorly controlled diabetic rats than in normal animals. Single nephron GFR rose as a result of an increase in the hydraulic pressure difference across the glomerular capillary wall caused mainly by a rise in the glomerular capillary pressure due to a diminished ratio of afferent to efferent arteriolar hydraulic resistances. Furthermore, the intratubular pressure was reduced as a result of a decrease in hydraulic resistance in the loop of Henle. Strict metabolic control prevented these changes. In conclusion, the increase in renal function in experimental diabetes is determined by the degree of metabolic control excluding a potential nephrotoxic effect of streptozotocin per se.     

乌拉地尔对大鼠心肌细胞膜L-型钙通道电流的影响

目的观察乌拉地尔对大鼠心肌细胞膜L-型钙通道电流（ICr-L）的影响。方法急性分离的SD大鼠心肌细胞随机分为3组（n=6）：乌拉地尔组（A组）、乌拉地尔复合美西麦角组（B组）和美西麦角组（C组）。经台氏液灌流1min（T1）后，A、C组分别用含0．4μmol／L乌拉地尔、40nmol/L美西麦角的台氏液罐流1min（B）；B组先用含0．4μmol／L乌拉地尔的台氏液灌流1min（T2），然后用含40nmol／L美西麦角的台氏液罐流1min（T3），之后三组均再用台氏液灌流1min（T4）。用全细胞膜片钳技术记录T1-4时ICr-L峰值。结果与T1比较，三组T2时ICr-L峰值降低（P〈0．05），T4时ICr-L峰值差异无统计学意义；B组T3时ICr-L。峰值降低（P〈0．05）；B组T3时ICr-L峰值低于T2（P〈0．01）。结论乌拉地尔可抑制大鼠心肌细胞ICr-L可能与5-HT1A受体无关。     

链脲佐菌素诱导的糖尿病模型小鼠对炎症性关节炎的影响

目的 探讨链脲佐菌素(STZ)诱导的Ⅰ型糖尿病模型对小鼠炎症性关节炎的影响.方法 将16只6周龄SPF级雄性C57BL/6J小鼠随机分成两组,每组8只.糖尿病组小鼠采用于6周龄时一次性腹腔注射链脲佐菌素150 mg/kg建立小鼠Ⅰ型糖尿病模型;对照组注射同等体积柠檬酸盐缓冲液.在7周龄时对两组小鼠均于双侧后足足垫注射牛...     

不同剂量乌拉地尔预防垂体后叶素诱发腹腔镜子宫肌瘤剥除术患者心血管反应的效果

目的 评价不同剂量乌拉地尔预防垂体后叶素诱发腹腔镜子官肌瘤剥除术患者心血管反应的效果.方法 拟在全身麻醉下行腹腔镜子官肌瘤剥除术患者60例,采用随机数字表法,将其随机分为4组(n=15),对照组(C组)静脉注射生理盐水5ml;不同剂量乌拉地尔组(U1-3组)分别静脉注射乌拉地尔0.3、0.5、0.8 mg/kg.5min后子宫肌瘤部位注射垂体后叶素6U和生理盐水20ml混合液,随后剥除子宫肌瘤.术中维持BIS值45～55.记录垂体后叶素注射后心血管反应的发生情况.结果 C组、U1组、U2组和U3组心血管反应发生率分别为100％、67％、40％和20％.与C组比较,U1组、U2组和U3组心血管反应发生率降低(P＜0.01);与U1组比较,U2组和U3组心血管反应发生率降低(P＜0.01);U2组和U组心血管反应发生率比较差异无统计学意义(P＞0.05).结论 乌拉地尔可预防垂体后叶素诱发腹腔镜子宫肌瘤剥除术患者的心血管反应,其适宜剂量为0.5 mg/kg.     

Antifibrogenic role of valproic acid in streptozotocin induced diabetic rat penis

We investigated the therapeutic effects of valproic acid (VPA) on erectile dysfunction and reducing penile fibrosis in streptozocin (STZ)‐induced diabetic rats. Eighteen male rats were divided into three experimental groups (Control, STZ‐DM, STZ‐DM plus VPA) and diabetes was induced by transperitoneal single dose STZ. Eight weeks after, VPA and placebo treatments were given according to groups for 15 days. All rats were anesthetised for the measurement of in vivo erectile response to cavernous nerve stimulation. Afterward penes were evaluated histologically in terms of immune labelling scores of endothelial nitric oxide synthase (eNOS), vascular endothelial growth factor (VEGF) and transforming growth factor‐β1 (TGF‐β1). Slides were also evaluated in terms of collagen/smooth muscle ratio and penile apoptosis. After the treatment with VPA, erectile responses were found as improved when compared with STZ‐DM rats but not statistically meaningful. eNOS and VEGF immune expressions diminished in penile corpora of STZ‐DM rats and improved with VPA treatment. VPA led to decrease in TGF‐β1 expression and collagen content of diabetic rats’ penes. Penile apoptosis was not diminished with VPA. In conclusion, VPA treatment seems to be effective for reducing penile fibrosis in diabetic rats and more prolonged treatment period may enhance erectile functions.     

First-pass pulmonary retention of sufentanil at three different background blood concentrations of the opioid

Using a double-indicator technique, we have studied, in 10 patientsundergoing aorto-coronary bypass surgery, first-pass pulmonaryretention of sufentanil. Pulmonary retention was studied atthree pseudo steady-state background blood concentrations of2.8 (0.66), 6.9 (1.2) and 15.9 (2.6) ng ml^–1, respectively,produced by a computer-controlled infusion. Mean first-passpulmonary retentions at these concentrations were 68 (95% confidenceintervals 62–73), 65 (60–70) and 60 (52–67)%,respectively. First-pass pulmonary retention of sufentanil wassignificantly lower at the highest background concentrationcompared with the lowest background concentration. First-passpulmonary retention of sufentanil was partly satu-rable in therange of concentrations used for clinical purposes.     

不同剂量的雌激素对大鼠子宫内膜机械损伤后修复的影响

目的本研究旨在探讨不同剂量的雌激素对大鼠子宫内膜机械损伤后修复的影响。方法选择动情期Wistar雌鼠50只,随机分为正常对照组、损伤组、损伤+10μg雌激素组、损伤+100μg雌激素组。除正常对照组外,对各组大鼠左侧宫腔进行机械搔刮,搔刮后立即皮下注射17β-雌二醇,剂量分别为0μg/100μl、10μg/100μl、100μg/100μl,连续7d。损伤后21d合笼交配,见栓后5.5d通过HE染色观察各组子宫内膜形态改变,免疫组织化学观察各组间容受相关分子整合素αvβ3、白血病抑制因子(LIF)的表达情况,观察见栓后7d各组间两侧子宫着床点个数。结果 (1)孕5.5d,HE染色可见损伤组和损伤+100μg雌激素组腺体数目明显减少,实质细胞减少,纤维化面积较大;正常对照组和损伤+10μg雌激素组腺体丰富,实质细胞多。(2)免疫组织化学染色可见:损伤各组与正常对照组比较,内膜αvβ3、LIF表达量显著下降(P0.05);损伤+10μg组与损伤组、损伤+100μg组比较,αvβ3、LIF表达量显著增多(P0.05);损伤组与损伤+100μg组比较,αvβ3表达量无显著性差异(P0.05),LIF表达量显著减少(P0.05)。(3)孕7d,与正常对照组及各组自身对照侧比较,损伤各组损伤侧着床点个数显著减少(P0.01);损伤各组间比较,损伤+10μg组着床个数较损伤组、损伤+100μg组稍增多,但无显著性差异(P0.05);损伤+100μg组与损伤组比较,着床个数相当,无显著性差异(P0.05)。结论机械损伤后,子宫内膜在自然修复情况下不仅存在形态结构差异,且容受功能出现明显下降;外源性雌激素干预可在一定程度上促进子宫内膜修复,改善子宫内膜容受功能,其中10μg剂量(相当于大鼠生理剂量)效果最佳,大剂量的雌激素可能导致子宫内膜容受性的下降。     

不同剂量加巴喷丁对糖尿病神经病理性痛大鼠的镇痛效应

目的 探讨不同剂量加巴喷丁对糖尿病神经病理性痛大鼠的镇痛效应.方法 健康雄性SD大鼠,周龄6周,体重180～200 g,腹腔注射链脲霉素60mg/kg制备糖尿病模型,取模型制备成功的大鼠24只,随机分为4组(n=6):对照组(C组)腹腔注射生理盐水0.6 ml;不同剂量加巴喷丁组(G_(1～3)组)分别腹腔注射加巴喷丁30、60或120 mg/kg,每日2次,每次注射量0.6 ml,连续给药21 d.于加巴喷丁给药前(T_0)、第1次给药后30 min(T_1)、60min(T_2)、120 min(T_3)、180 min(T_4)、240 min(T_5)及给药7 d(T_6)、14 d(T_7)、21 d(T_8)时测定大鼠机械痛阈.结果 各组大鼠机械痛阈基础值比较差异无统计学意义(P>0.05).与C组和G_1组比较,G_2组和G_3组机械痛阈升高(P<0.05);与G_2组比较,G_3组机械痛阈升高(P<0.05).与T_0时比较,G_2组T_(2～8)时机械痛阈升高,G_3组T_(1～8)时机械痛阈升高,两组均于T_2时达峰值(P<0.05).与T_2时比较,G_2组和G_3组T_(1,3～8)时机械痛阈降低(P<0.05).结论 加巴喷丁60和120 mg/kg对糖尿病神经病理性痛大鼠可产生镇痛效应,而长期应用可产生药物耐受现象.