心脏保存液种类及保存时间对离体鼠心低温保存效果的对比研究

目的研究3种心脏保存液[HTK液、FWM液和St.Thomas-Ⅱ(ST-Ⅱ)]在低温条件下保存离体鼠心的效果。方法54只雄性SD大鼠随机均分为HTK组、FWM组、ST-Ⅱ组(n=18),各组再根据低温保存时间分为4、6、8h3个亚组(n=6)。采用Langen-dorff装置进行心脏保存前后的灌注,各实验组分别使用不同保存液灌停心脏并在低温条件下保存4、6、8h,于灌停前及复灌后测定心率(HR)、冠脉流量(CF)、左心室收缩压(LVSP)、左心室内压最大上升速率(+dp/dtmax)、左心室内压最大下降速率(-dp/dtmax)等指标,并计算各指标的恢复率。灌注结束后,取心肌组织制作光镜标本,观察心肌组织结构变化。结果在相同的低温保存时间下,与ST-Ⅱ组相比,HTK组与FWM组心功能各指标恢复率明显较高,光镜下心肌组织结构变化较小。随保存时间延长,使用HTK液保存的鼠心心功能恢复率下降,组织结构发生改变,8h亚组与4、6h亚组间比较差异显著(P<0.05),而4h亚组与6h亚组间无显著差异(P>0.05)。结论在保存时间相同的条件下,HTK液及FWM液的心肌保存效果明显优于ST-Ⅱ液。HTK液保存效果随低温...     

二氧化硫污染对运动大鼠心肌收缩功能的影响及AngⅡ、AT1R的调节作用

目的:观察二氧化硫(SO2)吸入对运动大鼠心肌收缩力的影响并分析其可能机制。方法:48只SD大鼠随机分为空白对照组(RG)、单纯运动组(EG)、单纯SO2污染组(SRG)和SO2污染运动组(SEG),每组12只。SRG组和SEG组置于SO2污染环境(10 mg/m3)中1 h/d,共4周;EG组和SEG组进行电动跑轮运动(8 m/min,1 h/d,连续4周)。实验结束后,称量大鼠体重、心脏重量,并利用公式计算心脏重量指数和体重增长率。采用心脏插管技术测定各组大鼠血液动力学参数;采用放射免疫技术测定各组大鼠心肌AngⅡ含量;采用免疫组织化学技术测定各组大鼠心肌AT1R含量。结果:EG组大鼠心脏重量指数、主动脉收缩压(SBP)、脉压差(PP)、左室内压峰值(LVSP)、左室内压最大上升速率(+dp/dtmax)、左室内压最大下降速率(-dp/dtmax)显著高于RG组(P<0.01),舒张压(DBP)、心率(HR)、心肌AT1R蛋白表达水平显著低于RG组(P<0.01,P<0.05);SRG组和SEG组大鼠心脏重量指数、左室末期舒张压(LVEDP)、心肌AngⅡ含量、AT1R蛋白表达显著高于RG组(P<0.05,P<0.01),±dp/dtmax显著低于RG组(P<0.01);SEG组大鼠SBP、PP、LVSP显著低于RG组(P<0.01),HR显著高于RG组(P<0.01);且SEG组大鼠HR、LVEDP、心肌AngⅡ含量、AT1R蛋白表达显著高于SRG组(P<0.01),SBP、PP、LVSP、±dp/dtmax显著低于SRG组(P<0.01)。结论:SO2污染对运动大鼠心脏收缩功能产生显著负性变力性效应,AngⅡ及其受体AT1R蛋白表达水平上调引起RAS系统功能紊乱是导致运动大鼠心肌收缩力降低的原因之一。     

60Coγ射线心脏局部照射对大鼠离体心脏功能的影响

目的 研究γ射线心脏局部照射对大鼠心脏血流灌注及功能的影响,为放射性心脏损伤的防治提供实验依据.方法 12只Wistar雌性大鼠随机分为未照射组、照射组,每组6只,照射组行60Co γ射线20Gy单剂量照射,每日观察大鼠饮食、行为活动等变化,定期记录大鼠体重变化.照射后120天用超声心肌造影检测大鼠心肌血流灌注变化.照射后180天分离大鼠心脏,采用Langendorff离体心脏灌流法测定左室收缩压(LVSP)和左室内压力变化速率(dp/dtmax、dp/dtmin),并取大鼠心脏进行病理检查,用HE染色观察心肌组织病理变化.结果 照射后180天大鼠的饮食、行为、精神状态无可评价的异常变化,组间动物体重增加无明显差异.照射组大鼠心肌微循环灌注较未照射组明显减低.大鼠离体心脏功能检测示照射组大鼠LVSP、dp/dtmax、dp/dtmin均较未照射组明显减低.心肌组织HE染色显示照射组心肌细胞变性坏死、心肌纤维化.结论 γ射线心脏局部照射可致心肌血流灌注降低,导致心脏功能下降.     

血管紧张素Ⅱ对大鼠心功能四项指标的影响

目的 :研究血管紧张素Ⅱ对大鼠心功能四项指标的影响。方法 :给麻醉大鼠静脉注射外源性血管紧张素Ⅱ等因子 ,通过心室插管记录大鼠心功能四项指标的变化 ,即最高左心室内压力 (pvp) ,左心室内压最大上升速率 (dp/dt max) ,左心室内压最大下降速率 ( dp/dt max)及左心室最大上升速率时的心室内压 (Pdp/dt max)。结果 :血管紧张素Ⅱ使大鼠心功能四项参数都有不同程度的提高 ,血管紧张素Ⅱ受体拮抗剂可以阻断此作用 ,异搏定可使大鼠心功能四项参数有不同程度降低 ,且血管紧张素Ⅱ不能反转异搏定的这种作用。结论 :血管紧张素Ⅱ通过其受体提高大鼠心肌收缩力 ,增加心室顺应性 ,对心功能有改善和促进作用 ,其信号转导机制与钙离子内流有关。     

移植成血管基因修饰MSCs改善心肌梗死大鼠左室血流动力学参数的研究

目的探讨大鼠心肌梗死模型缺血心肌局部移植血管内皮生长因子（vascular endothelial growth factor,VEGF）修饰的骨髓间充质干细胞（mesenchymal stem cells,MSCs）对左室血流动力学参数的影响。方法 Percoll液密度梯度离心法分离、贴壁培养Wistar近交系大鼠MSCs,真核表达载体pcDNA3.1（-）/hVEGF165转染MSCs。30只Wistar近交系大鼠随机均分为转染组（MSCs/VEGF组）、对照组（MSCs组）、无血清培养基组（DMEM组）。结扎前降支建立急性心肌梗死模型后在梗死区边缘区行5×106（40μl）细胞移植,DMEM组行等量培养基注射。移植前细胞行CM-DiI标记。移植1个月后行心脏B超测量EF值,经右侧颈内动脉左室内置管测量如下血流动力学参数：心率（heart rate,HR）、左室收缩末压（left ventricularend-systolic pressure,LVESP）、左室舒张末压（left ventricular end-diastolic pressure,LVEDP）、最大左室内压上升速率（＋dp/dtmax）、最大左室内压下降速率（-dp/dtmax）。大体标本组织行HE、Masson染色。结果培养的MSCs呈典型贴壁生长成纤维细胞样外观,CM-DiI能近100%标记MSCs。移植后1个月MSCs/VEGF组较其余两组LVEF、LVESP、LVEDP、＋dp/dtmax、-dp/dtmax值有显著性差异（P〈0.05）,大体标本HE、Masson染色染色病理变化亦明显优于其余两组。结论大鼠心肌梗死模型梗死心肌局部移植VEGF基因转染MSCs能显著改善左室血流动力学参数,进而改善心脏功能。     

烫伤后大鼠心肌力学变化及血清心肌肌钙蛋白T在心肌损伤诊断中的应用

目的 :探索烫伤后大鼠心肌舒缩功能变化及心肌肌钙蛋白T(cTnT)在心肌损伤诊断中的应用。方法 :复制大鼠 30 %TBSAⅢ°烫伤动物模型。观察非烫伤对照组及烫伤后 1、3、6、12、2 4、48、72小时左心室力学参数(LVSP、LVEDP、±dp/dtmax)和血清cTnT、CK、LDH含量变化。结果 :(1)动物烫伤后 1小时 -dp/dtmax显著下降 ,LVEDP明显升高 ;LVSP、+dp/dtmax伤后 3小时显著下降 ,均于 12小时变化最大 ,至 72小时变化仍较明显 (P <0 0 1) ;(2 )cTnT于伤后 1小时显著上升 ,12小时比对照值升高 43倍 ,至 72小时仍保持在高水平 ;而LDH、CK分别于伤后 3小时、6小时开始上升 ,至 72小时已接近正常 (P <0 0 5 )。结论 :(1)烫伤后大鼠左心室舒缩功能明显下降 ,且舒张功能障碍的发生早于收缩功能 ;(2 )cTnT是诊断烧伤后心肌损伤的可靠指标。     

自噬在X射线照射所致心肌线粒体损伤中的作用

目的观察X射线照射对大鼠心肌线粒体功能的影响以及自噬在线粒体功能损伤中的作用。方法将135只实验大鼠分成假照射组（10只）、照射组（80只）和照射＋3．甲基腺嘌呤（3-MA）组（45只）,假照射组接受0GyX射线照射,照射组给予20Gyx射线照射,照射＋3-MA组接受20Gvx射线照射前30min腹腔注射2μl 3-MA。采用蛋白免疫印迹法和实时定量PCR法检测心肌细胞的LC3II及Beclin1蛋白表达及其mRNA水平变化,检测左心室舒张压及＋-dP／dtmax（左心室压力上升及下降的最大速率）等离体心功能指标。结果与假照射组相比,照射组大鼠经20GyX射线照射后离体心功能在21d时出现降低;而在1d时心肌组织线粒体功能便出现了损伤;同时,心肌细胞自噬水平在3h、6h、12h、1d、2d、4d及7d时出现明显上升,与假照射组之间的差异显著,且在6h达到最高值。与照射组相比,照射＋3一MA组大鼠心肌LC3II及Beclin1表达水平明显下降,且心功能出现异常的时间提前至14d。结论x射线照射损伤大鼠心肌线粒体功能并诱导自噬发生,可能是心肌保护的重要因素。     

高压氧对心肌梗死大鼠模型梗死面积及左室功能的影响

目的 探讨高压氧(HBO)治疗对急性心肌梗死(AMI)大鼠模型梗死面积及左室功能的影响.方法 50只健康雄性SD大白鼠,分为左冠状动脉未结扎组12只,另38只以手术方式结扎左冠状动脉,术后6 h 5只大鼠死亡,存活的33只再分为HBO对照组(n=16)和HBO组(n=17),HBO组心肌梗死后应用HBO治疗,7 d后测量心肌梗死面积、左心室收缩压和舒张压差(LVEDP)及左心室内压最大上升和下降速率(±dp/dtmax)的变化.结果 HBO组与HBO对照组相比,心肌梗死面积明显减小(P<0.05),左室功能明显好转(P<0.05).结论 及早应用HBO治疗可以明显减少AMI大鼠模型心肌坏死面积,并且可以改善左室的收缩及舒张功能.     

有氧运动抑制心力衰竭大鼠心脏脂质沉积:AMPK-PPARα信号通路的作用

目的:观察8周有氧运动对心力衰竭大鼠心脏脂质沉积和心功能的影响,探讨AMP激活的蛋白激酶(AMPK)—过氧化物酶体增殖物激活受体α(PPARα)信号通路在其中的作用机制。方法:结扎大鼠冠状动脉建立心梗后心衰模型,术后4周随机分为假手术安静组(Sham组)、心梗安静组(MI-Sed组)和心梗运动组(MI-Ex组)。MI-Ex组进行为期8周的跑台运动,Sham组和MI-Sed组保持安静状态。实验结束后,左心室导管法测定血流动力学参数包括左心室收缩期压力(LVSP)、左心室舒张末期压力(LVEDP)、左心室压力最大上升速率(+dp/dtmax)和左室压力最大下降速率(-dp/dtmax);比色法测定心肌和血浆游离脂肪酸(FFA)水平;氧化酶法测定心肌甘油三酯含量;实时荧光定量PCR检测心肌PPARα和肉碱棕榈酰转移酶-1(CPT-1)mRNA水平;Western blot法检测心肌总AMPKα、磷酸化的AMPKα(p-AMPKα)、PPARα和CPT-1蛋白表达水平。结果:与Sham组比较,MI-Sed组LVSP、±dp/dtmax显著性下降(均为P<0.01),LVEDP则显著性升高(P<0.01);血浆FFA、心肌FFA和甘油三酯水平升高(均为P<0.01);心肌PPARα和CPT-1 mRNA及蛋白显著降低(均为P<0.01),p-AMPKα蛋白显著升高(P<0.05)。与MI-Sed组比较,MI-Ex组LVSP、±dp/dtmax显著性升高(均为P<0.01),LVEDP则显著性下降(P<0.01);血浆FFA、心肌FFA和甘油三酯水平显著降低(均为P<0.01);心肌PPARα和CPT-1 mRNA和蛋白以及p-AMPKα蛋白水平均显著性升高(均为P<0.01)。结论:长期有氧运动活化AMPK-PPARα信号通路,上调CPT-1表达,促进心肌对FFA的氧化利用,从而减轻HF后心脏脂质过度沉积、改善脂毒性心脏异常并提高心功能。     

PI3K-Akt信号通路及β2-AR蛋白在外源性硫化氢后处理减轻大鼠离体心肌缺血再灌注损伤中的作用

目的 探讨外源性硫化氢后处理是否激活β2-AR受体减轻大鼠离体心肌缺血再灌注损伤。方法 70只雄性Sprague Dawley（SD）大鼠随机分为5组（n=14）：缺血/再灌注组（I/R）、硫化氢后处理组（N）、溶媒组（D）、LY294002组（L）、硫化氢后处理＋LY294002组（N＋L）。采用离体心脏Langendorff灌注模型,各组平衡灌注20min后,停灌40min,复灌60min。记录平衡末及灌注结束时的心率（HR）、左室内压上升最大速率（＋dp/dtmax）、左室内压下降最大速率（-dp/dtmax）、左室发展压（LVDP）、左室舒张末期压（LVEDP）、冠脉流量（CF）;灌注结束时,心肌HE染色观察心肌组织形态;Western blot测定β2-AR、Caspase-3、p-Akt和p-ERK的表达水平。结果 平衡末各组间心功能指标（基础值）差异无统计学意义（P〉0.05）。复灌60min时,与I/R组相比,N组能明显改善心功能各项指标（P〈0.05）,使心肌组织形态有改善,β2-AR、p-Akt和p-ERK表达水平升高,而活化的Caspase-3表达水平降低（P〈0.05）。LY294002逆转了硫化氢后处理改善心功能指标及升高p-Akt、pERK、β2-AR和降低Caspase-3表达水平的作用。结论 外源性硫化氢后处理通过激活PI3K-Akt信号通路和调节β2-AR受体蛋白的表达,参与离体大鼠心肌缺血再灌注损伤的保护作用。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.