肿瘤坏死因子-α表达在大鼠心肌梗死后室性心律失常发生中的作用

目的:探讨大鼠心肌梗死(MI)后肿瘤坏死因子-α(TNF-α)表达在室性心律失常发生中的作用。方法:采用液氮冷冻法建立大鼠MI模型。将60只雄性大鼠随机分为3组:MI组(20只)、假手术组(Sham组,20只)和TNF-α螯合剂组(rhTNFR:Fc组,20只)。在MI模型建立30d后,运用程序电刺激方法,观察诱发室性心律失常的发生情况,同时用Western Blot和激光共聚焦显微镜检测TNF-α蛋白表达水平。结果:与Sham组比较,MI组大鼠心肌组织TNF-α表达显著增加(P0.05),室性心律失常诱发率亦明显增高(P0.05);与MI组比较,rhTNFR:Fc组TNF-α表达显著减少(P0.05),室性心律失常诱发率亦明显降低(P0.05)。结论:MI后大鼠心肌组织TNF-α表达明显增加,大量TNF-α表达与MI后室性心律失常的发生密切相关。     

rhTNFR:Fc对离体大鼠心脏心肌梗死后快速室性心律失常的影响

目的:观察重组人肿瘤坏死因子受体融合蛋白(rhTNFR:Fc)对体外大鼠心脏急性缺血梗死后快速室性心律失常发生的影响,进一步探讨心肌急性缺血后心律失常机制及TNF-α在其中的作用.方法:将45只雄性大鼠随机分为3组,分别为对照组、急性心肌梗死组、急性心肌梗死加rhTNF:Fc组.Langenoff灌流大鼠体外心脏,结扎后2组大鼠的左前降支冠状动脉,记录心脏表面心电图,急性缺血0 5 h后给予S1S2程序电刺激诱发室性心动过速或心室颤动,比较各个组间发生率的差异.结果:急性心肌梗死组出现室性心律失常的发生率明显高于对照组,差异有统计学意义(P<0 01).急性心肌梗死加rhTNF:Fc组与急性心肌梗死组相比,心室颤动或室性心动过速发生率显著降低(P<0 01).对照组与急性心肌梗死加rhTNF:Fc组差异无统计学意义. 结论:特异性肿瘤坏死因子拮抗剂rhTNF:Fc能降低体外大鼠心脏急性心肌梗死后恶性心律失常的发生率.     

心力衰竭大鼠肿瘤坏死因子-α表达与室性心律失常关系的研究

目的:探讨心力衰竭(心衰)大鼠心肌组织肿瘤坏死因子-α(TNF-α)表达及其与室性心律失常发生的关系。方法:大鼠心衰模型由腹主动脉缩窄法构建并通过超声检测。运用S1S2程序刺激诱发室性心律失常(室性心动过速/心室颤动),记录各组室性心律失常诱发情况。运用免疫组化法和Western-blot法检测心肌组织TNF-α的表达。结果:与假手术组比较,心衰大鼠心肌组织TNF-α表达显著增加,室性心律失常发生率亦明显增高(P<0·05);而心衰大鼠经重组人TNF-α受体融合蛋白(rhTNFR:Fc)干预后心衰状况有所改善,TNF-α表达显著减少,室性心律失常发生率亦明显降低(P<0·05)。结论:心衰大鼠心肌组织TNF-α表达明显增加,大量TNF-α表达与心衰室性心律失常发生相关。     

TNF-α诱导连接蛋白重构在心肌梗死后室性心律失常发生中的作用

目的:研究肿瘤坏死因子-α(TNF-α)对大鼠心肌梗死后连接蛋白(Cx)43重构调节作用及其对室性心律失常发生的影响。方法:采用液氮冷冻法建立大鼠心肌梗死模型。将60只雄性大鼠随机分为3组:心肌梗死组(MI组,20只)、TNF-α螯合剂组(rhTNFR:Fc组,20只)和假手术组(Sham组,20只)。在心肌梗死模型建立30d后,运用程序电刺激方法,观察室性心律失常的诱发情况,应用Western Blot检测TNF-α、Cx43磷酸化和非磷酸化的表达水平。采用激光共聚焦显微镜方法,观察TNF-α的表达、Cx43的分布情况。结果:与假手术组比较,MI组大鼠心肌组织TNF-α表达明显增加(P0.05);Cx43磷酸化水平显著降低(P0.05),而Cx43非磷酸化水平增加(P0.05),Cx43分布呈现不均一分布;该组室性心律失常的诱发率明显增高(P0.05)。与MI组比较,rhTNFR:Fc组大鼠心肌组织TNF-α表达显著减少(P0.05);Cx43磷酸化水平表达增加(P0.05),Cx43非磷酸化水平下降(P0.05),而Cx43不均一分布有所减轻;室性心律失常的诱发率亦明显下降(P0.05)。结论:心肌梗死发生后,TNF-α可以诱导Cx43表达和分布重构,其在心肌梗死后室性心律失常发生中可能发挥重要作用。     

钙调蛋白抑制剂对陈旧性心肌梗死兔室性心律失常的影响

探讨钙调蛋白抑制剂W 7对陈旧性心肌梗死(HMI)兔室性心律失常的影响,将 30只雄性日本大耳白兔随机分假手术组(Sham)、HMI组和W 7干预组。Sham组开胸但不结扎冠状动脉;HMI组和W 7干预组开胸并结扎冠状动脉左室支制备心肌梗死模型,喂养 3个月后进行研究。W 7干预组在程序刺激前以 50μmol/kg的剂量溶于20ml生理盐水中,在 10min内静脉推注,HMI组和Sham组静脉推注生理盐水。将双极电极刺入左室梗死周边部位及Sham组的相应部位,程序刺激诱发心律失常,记录室性心动过速的发生率,测定心室颤动阈值。结束实验后取出心脏并称量左室重量。结果:Sham组、HMI组和W 7组诱发室性心动过速的发生率分别为 0 /10、8 /10和 3 /10。Sham组与HMI组差异有显著性(P<0. 01);W 7组与HMI组相比较室性心律失常发生率降低,差异有统计学意义(P<0. 05)。三组的心室颤动阈值分别为 13. 30±0. 95V、8. 90±1. 37V和 11. 80±1. 14V,三组之间差异均有显著性(P<0. 01)。结论:钙调蛋白抑制剂能提高HMI兔的心室颤动阈值,降低室性心律失常的发生率。     

抗心律失常肽对陈旧性心肌梗死兔室性心律失常的影响

目的观察缝隙连接激动剂抗心律失常肽(AAP10)对陈旧性心肌梗死(OMI)兔室性心律失常的影响,并探讨其作用机制。方法将30只雄性日本大耳白兔随机分为假手术组(Sham)、OMI 组和 AAP10组,每组各10只。Sham 组开胸但不结扎冠状动脉,OMI 组和 AAP10组开胸并结扎冠状动脉左室支制备心肌梗死模型,普通饲料喂养3个月后制备兔左心室楔形心肌块的灌注模型。Sham 组和 OMI 组灌流正常台氏液,AAP10组灌流正常台氏液+AAP10(80 nmol/L)。灌流全程同时采用浮置玻璃微电极法同步记录内膜下心肌、外膜下心肌跨膜动作电位和跨壁心电图,并观察心外膜下心肌的刺激反应间期(stimulus-response-interval,SRI)和室性心动过速(室速)的诱发率。结束试验后测量梗死周边区心室壁的厚度、左室重、全心重。结果 OMI 组和 AAP10组兔均存在显著的心肌重构,并且 OMI 组兔有较高的室速诱发率(80%)。OMI 组与 AAP10组相比,AAP10显著缩短 SRI[SRI-1为(28.71±0.55)ms 与(20.59±0.79)ms;SRI-2为(38.67±0.49)ms 与(30.42±0.74)ms,P<0.01],而且 AAP10明显降低室速的诱发率(20%),但对动作电位形态和时程均无影响。结论AAP10可以在不影响动作电位形态和时程的前提下提高缝隙连接的传导速度,并可降低 OMI 兔室性心律失常的发生率。     

瑞舒伐他汀对急性心肌梗死大鼠NF-κB和IL-6表达的影响

目的:探讨瑞舒伐他汀(rosuvastatin,ROS)对大鼠急性心肌梗死(AMI)后心肌组织炎症的影响。方法: 结扎20只雄性Wistar大鼠冠状动脉的左前降支(LAD)建立心梗模型。成功后,随机分为AMI组和ROS干预组,每组10只大鼠。另取10只大鼠作为假手术(Sham)组(仅穿线不结扎)。ROS干预组给予ROS 10 mg/(kg·d)灌胃;其他两组每只大鼠每天给予2 ml生理盐水灌胃。持续4周后,处死动物,取部分心肌非梗死边缘区组织做HE染色观察病理改变;其余心肌组织分别进行免疫组化染色及RT-PCR,检测NF-κB、IL-6及二者mRNA的表达。结果: 心肌组织HE染色显示,与AMI组比较,ROS干预组心肌排列较整齐,心肌纤维断裂较少,心肌纤维样变减少,炎性细胞浸润减轻。Sham组NF-κB和IL-6均无明显表达。AMI组NF-κB和IL-6的mRNA和两种蛋白的表达均显著高于Sham组(P<0.05)。同AMI组相比较,ROS干预组NF-κB、IL-6 mRAN和两种蛋白的表达均显著下降(P<0.05),NF-κB和IL-6的表达呈正相关（r=0.85,0.75）。结论: ROS对AMI大鼠进行干预可调控NF-κB的活性,减少IL-6炎性因子的表达,可改善心肌重构。     

白藜芦醇对大鼠心肌梗死后室性心律失常及长期存活率的影响

目的 研究白藜芦醇对大鼠心肌梗死后室性心律失常、心室重构和长期存活率的影响.方法 将SD大鼠随机分成假手术组、心肌梗死组、白藜芦醇治疗组(治疗组).心肌梗死组和治疗组开胸结扎冠状动脉左前降支,假手术组不结扎.植入性射频发射器记录24 h心电图,并分析心肌梗死后24 h内室性心律失常发病率;侵入性在体电生理检测评价室性心律失常的诱发率;全细胞膜片钳技术检测白藜芦醇对单个心室肌细胞的电生理作用;免疫荧光染色观察心肌细胞的结构改变.结果 与心肌梗死组相比,治疗组明显抑制了心肌梗死导致的室性心动过速和心室颤动发病率,治疗组室性心动过速的诱发率低于心肌梗死组,差异有统计学意义(46%vs 81%,P<0.01).14周后,治疗组心肌梗死面积和死亡率较心肌梗死组分别下降了20%和33%.膜片钳记录显示白藜芦醇抑制了L型钙电流.免疫荧光染色发现治疗组心肌细胞横断面积小于心肌梗死组.结论 白藜芦醇可以通过抑制大鼠心肌L型钙电流发挥抗心律失常作用,并抑制了左心室重构,提高了大鼠心肌梗死后的存活率.     

大鼠心肌反复短暂缺血再灌注损伤时的心律失常观察

20只大鼠乙醚麻醉后开胸结扎左冠脉主干10min、放松5min,反复10次。病理学检查证实40％大鼠发生了心肌坏死。持续心电监测显示在冠脉结扎后均出现ST段明显升高,实验期间心律失常的发生率为100％,出现最多的是室性早搏、室性心动过速和心室颤动,其发生高峰在第1次再灌注期间,若早期发生了严重室性心律失常,则其后再发的机率明显降低,提示心肌缺血预适应可减少室性心律失常的发生。     

重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白对炎性关节炎患者关节置换术后恢复的影响

目的 探讨重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白(rhTNFR:Fc)对炎性关节炎患者关节置换术后恢复的影响.方法 回顾分析67例应用rhTNFR:Fc或传统改变病情抗风湿药(DMARDs)治疗的炎性关节炎患者行关节置换术后伤口感染发生例数、伤口愈合时间、炎症期时间(体温≥37.5 ℃)及抗生素应用时间.根据所应用药物分为rhTNFR:Fc组和传统DMARDs组.其中,rhTNFR:Fc组单用rhTNFR:Fc或rhTNFR:Fc联合传统DMARDs;传统DMARDs组单用或联合应用2种或2种以上传统DMARDs.统计学处理根据数据类型选择t检验或非参数检验.结果 67例患者中,rhTNFR:Fc组18例,传统DMARDs组49例.rhTNFR:Fc组1例出现伤口感染,传统DMARDs组0例,差异无统计学意义(P＞0.05).rhTNFR:Fc组炎症期时间为(4±3) d,传统DMARDs组为(3±3)d,差异无统计学意义(P＞0.05).rhTNFR:Fc组伤口愈合时间为(14.0±3.1)d,传统DMARDs组为(14.7±2.9)d,差异无统计学意义(P＞0.05).rhTNFR:Fc组术后抗生素应用时间为(14.8±9.3)d,传统DMARDs组为(10.3±2.7)d,差异有统计学意义(P＜0.05).结论 炎性关节炎患者围手术期应用rhTNFR:Fc不增加关节置换术后伤口感染发生率,不延长伤口愈合时间及炎症期时间.

Abstract：

Objective To investigate the affect of rhTNFR:Fc on the postoperative recovery of patients with inflammatory arthritis after arthroplasty. Methods Patients with inflammatory arthritis undergoing arthroplasty were included and divided into rhTNFR:Fc group (rhTNFR:Fc only or combined with conven-tional DMARDs) and conventional DMARDs group (monotherapy with or combination of conventional DMARDs). We retrospectively analyzed the incidence of postoperative infection, wound healing time, the febrile period (body temperature ≥37.5 ℃) and the duration of antibiotics treatment after arthroplasty. x2 test and t test were used for statistical analysis. Results Sixty-seven patients were included, 18 in the rhTNFR: Fc group and 49 in the conventional DMARDs group. One postoperative infection occurred in rhTNFR :Fc group but none in the DMARDs group. There was no significant difference by Fisher's exact test (P＞0.05). The febrile duration was (4±3) days in the rhTNFR :Fc group and (3±3) days in the conventional DMARDs group, the difference was not statistically significant (P＞0.05). The wound healing time was (14.0±3.1) days in the rhTNFR :Fc group and (14.7±2.9) days in the conventional DMARDs group, which was not statistically different(P＞0.05). The duration of antibiotics treatment after operation was (14.8±9.3) days in the rhTNFR: Fc group and (10.3±2.7) days in the conventional DMARDs group, the difference was statistically significant (P＜0.05). Conclusion Using rhTNFR:Fc during perioperative period in patients with inflammatory arthritis does not increase the risk of infectious complications or extending wound healing time and the febrile duration.     

青少年高血压的研究进展

随着人们生活和行为方式的改变,高血压发病明显呈年轻化趋势。在青少年时期识别高血压病高危人群有助于早期进行有效干预和治疗,降低未来高血压的发生率及其严重性。现试从青少年高血压的诊断、发病因素、特点、治疗策略等方面的研究进展作一综述。     

Morbidity in cardiovascular diseases in immigrants in Sweden

INTRODUCTION: Although immigration to Sweden has increased in the last few decades, the incidence rates of cardiovascular disease and coronary heart disease in immigrants are unknown. The aim of the present study is to estimate whether place of birth affects the incidence rates of cardiovascular disease and coronary heart disease. MATERIAL AND METHODS: The study was designed as a follow-up study on morbidity in cardiovascular disease and coronary heart disease between 1 January 1997 and 31 December 1998, including three and a half million persons with age range 35-64 years, of whom 550 000 were born abroad, from the database MigMed consisting of the whole Swedish population. Incidence rates and relative risks were estimated by indirect standardization and a proportional hazard model. RESULTS: The age-adjusted risk of coronary heart disease was higher in most foreign-born groups than in Swedes. For example, in nine of 12 male groups, the relative risks varied between 1.1 and 2.2, and in seven of 12 female groups, the relative risks varied between 1.4 and 2.5. When also adjusting for level of education and employment status, the risks were still high, but on a lower level. CONCLUSIONS: Foreign-born people possess an over-risk of cardiovascular or coronary heart disease(CVD/CHD) compared with Swedish-born persons, also when level of education and employment status are taken into account.     

C·肉毒杀鼠素(冻干剂)应用研究

目的为研究C·肉毒杀鼠索对杀灭达乌尔黄鼠(简称黄鼠)的大面积应用情况和对家畜、家禽的毒害作用,进行了C·肉毒杀鼠素的应用研究.方法大面积投毒采用ES-2药饵撒播机[1],间隔约80m进行条投.羊、鸡采用直接灌胃.结果大面积应用的灭鼠率为83.72%.对羊、鸡最高剂量分别为500万MLD、150万MLD,均未出现中毒现象.结论 C·肉毒杀鼠素是较为理想的草原大面积杀灭黄鼠的理想、首选药物.     

Pulmonary sporotrichosis in Oklahoma in susceptibilities in vitro

Six cases of pulmonary sporotichosis were observed in 2 institutions in Oklahoma City, Okla. Three of the patients were treated with iodides with or without surgery. Although one patient required a second course of iodides, the patients have remained well after at least 34 months of follow-up. Three patients treated with amphotericin B, single course as well as multiple courses, and other antifungal agents (hydroxystilbamidine and miconazole) have all relapsed. These cases and a reviewed of more than 40 cases of pulmonary sporotrichosis susceptibilities of Sporothrix schenckii that we observed in vitro suggest that amphotericin B is not an effective agent for the treatment of pulmonary sporotrichosis. It is our opinion that the treatment of choice for pulmonary sporotrichosis is a supersaturated solution of potassium iodide. If the patient is allergic to the medication or fails to respond, then a combination of amphotericin B plus flucytosine may be tried.     

高龄老年高血压的临床研究进展

随着社会老龄化进程的加快,80岁以上高龄老人的绝对数量以及占总人口的比例均在增加,如何提高高龄老年高血压的防治水平备受关注。现试从高龄老年高血压的临床特点、治疗策略等方面的临床研究进展作一综述。