胎儿胃动脉微血管的实验观察

采用ABS灌注法对30例新鲜胎儿尸体（6－10月）的胃壁内动脉的微血管进行了观察和测量。结果表明,浆膜下丛呈干型,血管稀疏;肌丛由浆膜下丛和粘膜下丛返支构成,各部肌层血管密度,大弯最高,小弯最低;粘膜下丛在胃底部密度最高,幽门后壁和胃小弯密度最低;粘膜动脉发自粘膜下丛,动脉间有吻合支,粘膜丛血管密度胃底最高,小弯最低,粘膜血管丛内未见到动脉－静脉吻合。     

Children under stress - COMT genotype and stressful life events predict cortisol increase in an acute social stress paradigm

Dopamine and norepinephrine are key regulators of cognitive and affective processes. The enzyme catechol-O-methyltransferase (COMT) catabolizes catecholamines and the COMT Val158Met polymorphism has been linked to several neuropsychiatric variables. Additionally, stressful life events (SLEs) contribute substantially to affective processes. We used the stress-induced activation of the hypothalamic-pituitary-adrenal axis to investigate the effects of COMT and SLEs on the cortisol response in 119 healthy children (8-12 yr). Saliva cortisol was measured during and after the Trier Social Stress Test for Children. SLEs were assessed with a standardized interview with one of the children's parents. Linear regression analysis revealed a significant effect for COMT, with Met allele carriers showing a higher cortisol response (β=0.300, p=0.001). In turn, more SLEs lead to a less pronounced cortisol increase (β=-0.192, p=0.029) probably indicating increased resilience. Our results further underscore the essential and differential role of genetic variation and environmental factors on stress responsivity.     

Vascular wall shear stress in clinical practice

Wall shear stress is a fluid dynamic quantity that is gradually emerging as a potentially important factor of coronary atherosclerosis. Methods, therefore, of estimation of shear stress in the arterial system are of clinical relevance. The purpose of this review is to define wall shear stress, review the various methods that have been used for its assessment in human circulation, and examine the methodological limitations and applicability of each method in clinical practice.     

Life under stress: the probiotic stress response and how it may be manipulated

The continuing expansion of interest in probiotic bacteria has led to an increase in manufactured Functional Foods and medicines containing these bacteria. Given the intestinal origin of these microorganisms, the challenges these sensitive bacteria face in order to be in a highly viable state throughout processing, storage and gastrointestinal transit to the site of action in the human gut are enormous. These bacteria encounter stresses including temperature, acid, bile, exposure and osmotic and oxidative stress in both product matrices and during gastrointestinal transit. However, like all bacteria, probiotic bacteria retain a broad arsenal of molecular mechanisms to combat the often lethal environmental stresses encountered during processing and following ingestion. A comprehensive appreciation of these mechanisms should inevitably lead to the design and manufacture of probiotic cultures, which retain greater viability through to the target site in the intestine. This review attempts to catalogue the cellular processes available to probiotic bacteria to facilitate survival in stressful conditions, and to speculate on how manipulation of these cellular systems can lead to production of designer strains with enhanced viability in food systems and efficacy following ingestion.     

Paraquat-induced oxidative stress and dysfunction of the glutathione redox cycle in pulmonary microvascular endothelial cells

Oxidative stress and changes in the antioxidant defense system that include the glutathione redox cycle in cultured pulmonary microvascular endothelial cells after exposure to paraquat at 0.1 and 0.5 mM were examined as a function of time. Cell viability was substantially lost 72 h after exposure to 0.5 mM paraquat, but not 0.1 mM paraquat. Viability loss was accompanied by increased glutathione-protein mixed disulfide formation, as well as a loss in glyceraldehyde-3-phosphate dehydrogenase activity, indicating a low defense potential. At 4 h after exposure to paraquat at both doses, however, a marked loss in NADPH was found, together with a decrease in aconitase activity. With 0.5 mM paraquat, increased NADP(+) accompanied by NADPH loss diminished constantly after 48 h without recovery of lost NADPH, suggesting destruction of pyridine nucleotides under oxidative stress. NAD(+) decreased 72 h after exposure to 0.5 mM paraquat, but NADH was not influenced. 3-Aminobenzamide did not protect the loss in NADP(+) or NAD(+) and cell viability. Although oxidized glutathione did not increase by exposure to paraquat at both doses through a 96-h exposure period, reduced glutathione increased at 48 to 72 h, with an increase in glutathione disulfide reductase activities. In contrast, a marked loss in glutathione peroxidase activity was produced 48 h after exposure to 0.5 mM paraquat, preceding cell injury. Mercaptosuccinate, an inhibitor of glutathione peroxidase, distinctly hastened viability loss by paraquat. These results indicate that the reduced ability of the glutathione redox cycle, leading to high oxidative stress, is closely associated with paraquat-induced cytotoxicity.     

Hydrogen sulfide: A novel mechanism for the vascular protection by resveratrol under oxidative stress in mouse aorta

Reactive oxygen species (ROS) decreases bioavailability of nitric oxide (NO) and impairs NO-dependent relaxations. Like NO, hydrogen sulfide (H₂S) is an antioxidant and vasodilator; however, the effect of ROS on H₂S-induced relaxations is unknown. Here we investigated whether ROS altered the effect of H₂S on vascular tone in mouse aorta and determined whether resveratrol (RVT) protects it via H₂S. Pyrogallol induced ROS formation. It also decreased H₂S formation and relaxation induced by l-cysteine and in mouse aorta. Pyrogallol did not alter sodium hydrogensulfide (NaHS)-induced relaxation suggesting that the pyrogallol effect on l-cysteine relaxations was due to endogenous H₂S formation. RVT inhibited ROS formation, enhanced l-cysteine-induced relaxations and increased H₂S level in aortas exposed to pyrogallol suggesting that RVT protects against “H₂S-dysfunctions” by inducing H₂S formation. Indeed, H₂S synthesis inhibitor AOAA inhibited the protective effects of RVT. RVT had no effect on Ach-induced relaxation that is NO dependent and the stimulatory effect of RVT on H₂S-dependent relaxation was also independent of NO. These results demonstrate that oxidative stress impairs endogenous H₂S-induced relaxations and RVT offers protection by inducing H₂S suggesting that targeting endogenous H₂S pathway may prevent vascular dysfunctions associated by oxidative stress.     

Chronic life stress,acute stress events,and substance availability in relapse

This study evaluated additive and interactive models of the effects of acute stressful life events, chronic life stressors, and immediate substance availability on substance use following alcohol and drug treatment. One hundred and two veterans meeting DSM-IV criteria for alcohol, cannabis, or stimulant dependence at treatment entry completed quarterly interviews for one year. Severe chronic stressors and substance availability predicted an increased risk of initiating substance use posttreatment (OR?=?5.18 and 3.18, respectively). However, the chronic stressors and immediate substance availability were associated with less protracted substance use (F (2, 67)?=17.30, p?<?0.001). Substance availability also predicted fewer total drinks consumed. In contrast to chronic stressors, recent stressful life events were not predictive of posttreatment substance initiation or severity. None of the interactions between stress and substance availability were significant. These findings support a model where chronic stressors and substance availability independently add to the risk for alcohol or drug use following treatment.     

Low frequency arterial wall movements for indirect blood pressure measurement in man. Validation of a method for non-invasive assessment of blood pressure under the influence of isoprenaline and angiotensin

In order to measure blood pressure noninvasively, the second derivative of the low frequency wall movements of the brachial artery were registered with a piezo-electric pressure probe during deflation of a Riva-Rocci cuff along with the actual cuff pressure. Two characteristic phenomena of this signal have been suggested to reflect systolic and diastolic blood pressure. Appearance of a positive spike phenomenon (S) was suggested to indicate systolic blood pressure and disappearance of a negative preanacrotic notch (D) to indicate diastolic blood pressure. To prove the validity of these suggestions, these phenomena were assessed in 10 young healthy males during isoprenaline and angiotensin induced changes of blood pressure. Intraarterial (A. radialis) and auscultatory (A. brachialis) blood pressures were recorded simultaneously. Determination of systolic blood pressure with the S phenomenon agreed well with invasive and auscultatory results. Invasive diastolic values agreed well with the cuff pressure at the last signal before disappearance of the preanacrotic notch (D1). Data from auscultation agreed less well with the D1 phenomenon. With increasing doses of isoprenaline, the diastolic measurements (D1) tended to be lower than the invasive ones. However, this discrepancy was far discreeter than that seen with ordinary auscultatory blood pressure measurement. We therefore conclude that registrations of low frequency arterial wall movements yield distinct characteristic spike phenomena useful for measurement of blood pressure in good agreement with the invasive method. In addition, the method provides clearly documented records and should be useful in situations which rely on a valid indirect method.     

Compression characteristics of powders: radial die wall pressure transmission and density changes

An instrumented single punch tablet machine was used to study the relations between axial pressure, radial die wall pressure and density changes in beds of powder undergoing compression. Aspirin, sodium chloride, paracetamol, paracetamol-polyvinylpyrrolidone and sucrose crystals were examined. The development and transmission of radial pressure during loading and unloading of the bed is discussed in relation to yield and elastic behaviour of the powder. The relation between mean stress and relative density of the compact is explained on the basis of plastic flow and/or crushing of the particles. Differences in stress vs density relations due to difference in particle size of sucrose were due to initial packing conditions in the die and not to differences in pressure transmission.     

新形势下护理队伍压力分析

21世纪,随着社会经济和科学技术的飞速发展及医疗模式的转变,社会上对临床护理工作水平提出了更高的要求。而由于工作性质、环境的特殊性,以及人际关系、社会评价等方面都对护理人员的心理带来很大的压力。只有正确分析这些压力的来源,才能采取正确的措施,减缓压力促进护理水平的提高。     

军事训练伤患者生命质量影响因素分析

目的探讨军事训练伤患者生命质量的主要影响因素,从而为增进军事训练伤患者生命质量提供参考。方法用SF-36量表评价105例军事训练伤患者的生命质量,同时调查可能影响生命质量的训练情况、文化因素,以及被调查对象的个人特征和患病情况,进行相关统计学分析,找出其主要影响因素。结果生命质量与各单因素在部分领域有关,相关分析提示,各影响因素大多对部分维度呈中、低度相关,多元回归分析发现,临床病情对患者健康相关生活质量的影响作用比常见的一些人口学指标更为重要,所有因素对各维度变异的解释作用为25.2%～72.3%。结论常见的人口学资料及临床病情共同用于解释军事训练伤患者相关生活质量下降的意义有限,导致军事训练伤患者相关生活质量下降最为主要的因素尚需进一步研究。     

Correlates of life stress in an alcohol treatment sample

Men in alcohol dependence treatment commonly report elevated levels of stressful life experiences prior to entering treatment. Clinical researchers have argued that training patients to cope with stress is an important aspect of therapy for alcohol dependence. Current age and age of onset of alcohol dependence are two patient characteristics that may relate to stress and allow mental health care providers to anticipate patient needs more readily. This study examines whether current age and age of onset of alcohol dependence are related to the type of stress experienced preceding treatment. Participants were 350 male veterans receiving inpatient treatment for alcohol dependence who completed a semistructured interview-based life stress assessment. The likelihood of life events related to achievement, relationship, and legal problems decreased with age; the likelihood of health difficulties increased with age; and age and age of onset of alcohol dependence interacted to predict health difficulties. These results indicate that the nature of some stress experiences prior to treatment for alcohol dependence may be related to current age and the course of alcohol dependence.     

糖尿病微血管并发症对老年2型糖尿病患者生活质量的影响

目的:了解糖尿病微血管并发症对老年2型糖尿病患者生活质量的影响.方法:选择2014年1月至2015年9月嘉定镇社区60岁及以上2型糖尿病患者400例生活质量评价采用健康状况调查简易量表(SF-36)及自制老年2型糖尿病患者生活质量量表.结果:81.5%(326/400)的老年2型糖尿病患者有不同程度的糖尿病肾病或视网膜病变.糖尿病微血管并发症的患病与SF-36量表和自制老年2型糖尿病生活质量调查量表的得分都明显相关,微血管并发症的程度越重,两者的得分越低(P<0.001).结论:糖尿病微血管并发症可明显降低老年2型糖尿病患者的生活质量,应加强糖尿病患者的早期干预,防止并发症的发生.     

Coronary microvascular dysfunction in patients with microvascular angina: analysis by TIMI frame count

We have previously reported that angina pectoris persists in patients with coronary microvascular spasm (MVS) even on calcium channel blockers. Because measurement of myocardial lactate production in the coronary sinus is necessary to diagnose MVS, a more feasible diagnostic method needs to be developed. In this study, we examined the diagnostic significance of Thrombolysis in Myocardial Infarction (TIMI) frame count, a marker of coronary blood flow, in 131 consecutive patients who underwent provocation test for coronary spasm with acetylcholine (ACh). Epicardial coronary spasm (ES) was diagnosed as more than 75% of ACh-induced vasoconstriction noted by coronary angiography. MVS was diagnosed as ACh-induced myocardial ischemia (chest pain, ischemic ECG changes, and myocardial lactate production) without ES. TIMI frame count was significantly increased in patients with MVS alone (n = 35) and those with ES + MVS (n = 16) compared with those with ES alone (n = 53) or those with no myocardial ischemia (Normal, n = 27) either before and after intracoronary ACh and even after intracoronary isosorbide dinitrate (ISDN) in both the left anterior descending (LAD) and the left circumflex coronary artery (LCX). TIMI frame count in LAD correlated well to that in LCX in patients with MVS, suggesting diffuse impaired coronary microcirculation in the myocardium. These results suggest that increased TIMI frame count in response to ACh reflects microvascular dysfunction in MVS and that ISDN may not be enough to relieve MVS. Thus, TIMI frame count may be useful to diagnose MVS without requiring coronary sinus catheterization or myocardial lactate production measurement.     

Disability and quality of life in post-traumatic stress disorder: impact of drug treatment

The degree of functional disability and quality of life (QOL) impairment in patients with post-traumatic stress disorder (PTSD) is at least comparable with, and in many instances greater than, that of patients with other anxiety and mood disorders. Multidimensional QOL assessments in PTSD have utility in capturing aspects of individual patient experience and satisfaction related to health and treatment, and have fairly robust sensitivity to treatment effects. Despite the growing number of epidemiological and clinical studies detailing QOL in PTSD, there are few studies of the impact of pharmacological agents on QOL outcomes, and none that have included an economic component to evaluate the resource consequences of the disorder. To date, the selective serotonin reuptake inhibitors have been shown to confer significant acute (and longer term) QOL and psychosocial benefits. Further investigation of the relationship of QOL to PTSD symptom severity, disability, treatment outcome and cost, among the different drug treatment modalities, is clearly needed.