脑室注射血管紧张素II对雄性大鼠下丘脑促性腺激素释放激素含量的影响

本实验观察了脑室注射血管紧张素Ｉ（ＡＩ）对成年雄性Ｗｉｓｔａｒ大鼠下丘脑促性腺激素释放激素（ＧｎＲＨ）含量的影响。摘取下丘脑组织，匀浆化，用放射免疫分析检测匀浆上清中ＧｎＲＨ的含量。结果表明，脑室注射ＡＩ（１２０ｎｇ／２０μｌ）后６０、９０及１２０分钟，下丘脑ＧｎＲＨ含量分别为２．８８±０．４７、２．６９±０．３８及２．５４±０．５５ｎｇ／１０ｍｇ湿重组织，均显著高于盐水对照组（Ｐ＜０．０５），提示ＡＩ可促进雄性大鼠下丘脑ＧＮＲＨ的生成。     

脑室注射血管紧张素Ⅱ对雄性大鼠下丘脑促性腺激素释放激素含量？…

本实验观察了脑室注射血管紧张素Ⅱ（ＡⅡ）地成年雄性Ｗｉｓｔａｒ大鼠下丘脑促性腺激素素释放激素含量的影响。摘取下丘脑组织，匀浆化，用放射免疫分析检测奖交涉 清中ＧｎＲＨ的含量，结果表明，脑室注射ＡⅡ后６０、９０及１２０分钟，下丘脑ＧｎＲＨ含量分别为２．８８±０．４７、２．６９±０．３８及２．５４±０．５５ｎｇ／１０ｍｇ湿重组织，均显著高于盐水对照组，提示ＡⅡ可促进雄性大鼠下丘脑ＧＮＲＨ的生成。     

腹膜透析患者透出液CA125的变化

我们对３５例维持性腹膜透析（ＰＤ）患者的透出液和血清ＣＡ１２５进行检测并分析。 材料与方法 ｌ．一般资料：维持性ＰＤ患者３５例,男１５例,女２０例。平均年龄（６３．６±１２．２）岁,平均 ＢＵＮ（２５．３±４．８）ｍｍｏｌ／Ｌ,Ｓｃｒ（９８４．３±３７２．４）μｍｏｌ／Ｌ。平均透析时间（１６．５±１６．１）个月。均采用１．５％或２．５％葡萄糖乳酸盐腹透液,每日交换３～４次,每次２ ０００ｍｌ。正常对照组１０例,平均年龄（５６．７±１５．２）岁。 ２．检测方法：受检者均于清晨抽取静脉血１ｍｌ分离血清,…     

前列腺特异性抗原嘧度诊断前列腺偶发癌的临床价值

为探讨前列腺偶发癌早期诊断的有效指标，对１１例前列腺偶发癌和２０例前列腺增生症患前列腺特异性抗原嘧度进行了检测，结果前列腺偶发癌ＤＰＳＡ平均值为０．１５±０．１３ｎｇ（ｍｌ．ｃｍ＾３，（ＢＰＨ为０．０７±０．０６ｎｇ／（ｍｌ．ｃｍ＾３）。两进有非常显性差异。１１例ＤＰＡＳ〉０．１ｎｇ／（ｍｌ．ｃｍ＾３），９例为前腺偶发癌；２０例ＤＰＳＡ〈０．１ｎｇ／（ｍｌ．ｃｍ＾３），１８例为ＢＰＨ。而有     

芬太尼复合异丙酚全静脉麻醉临床评价

作为ＴＩＶＡ常用药物,芬太尼复合７０％ Ｎ２ Ｏ时 Ｃｐ５０ｉ和 Ｃｐ５０ＢＡＲ分别为３．２６ｎｇ·ｍｌ－１和４．１７ｎｇ·ｍｌ－１。与异丙酚复合时具有明显的协同效应。３ｎｇ·ｍｌ－１芬太尼可使异丙酚Ｃｐ５０ｉ和Ｃｐ５０ｓ分别减少 ８９％和 ４０％。本实验旨在利用上述效应,对芬太尼－异丙酚ＴＩＶＡ进行临床评价研究。 资料与方法 ＡＳＡⅠ～Ⅱ级,１８～５９岁行胸及上腹部手术病人４０例,随机分为芬太尼组（Ｆ组, ｎ＝ ２０）和异丙酚组（Ｐ组, ｎ＝２０）。术前３０ｍｉｎ给予安定１０ｍｇ,阿托品 ０．５ｍｇ。麻醉…     

微量乳腺组织内癌胚抗原测定对乳癌的诊断价值

应用放射免疫技术对７例健康自愿者，４９例乳腺良性包块病人及４０例乳癌病人进行微量乳腺组织内癌胚抗原测定。结果发现：健康组ＣＥＡ值１４．３±２．７ｎｇ／ｍｇ组织，乳腺良性包块组ＣＥＡ值１５．８±０．７ｎｇ／ｍｇ组织，两组间无显著性差异。乳癌组事，远离癌中位乳腺组织内ＣＥＡ值来３２．０±２．８ｎｇｇ／ｍｇｇ组织癌组织内ＣＥＡ值５５．１±３．３ｎｇ／ｍｇ组织，非癌部位与癌两组间有显著性差异；乳癌组的非癌     

腓浅神经卡压症的解剖学基础

在４０侧成人下肢标本上观测了腓浅神经的走行、长度、分支及其卡压的因素等。设外踝最突出点为Ａ点，胫骨粗隆与腓骨头连线的中点为Ｂ点。同时，确定了该神经从腓骨长、短肌之间浅出处（Ｃ点）及穿出深筋膜处（Ｅ点）的体表位置。其中Ｅ点位于Ａ点的近侧８．３ｃｍ±１．１ｃｍ，ＡＢ线前方０．８ｃｍ±０．２ｃｍ，Ｃ点位于Ａ点的近侧１５．４ｃｍ±１．５ｃｍ，ＡＢ线后方０．６ｃｍ±０．２ｃｍ。并按自身比例换算成相对值：ＡＥ／ＡＢ为０．２６±０．０３；ＡＣ／ＡＢ为０．４９±０．０４。本文为临床探讨腓浅神经卡压症的病因提供解剖学基础资料。     

麻醉期间大量快速输血后血钾和酸碱平衡的观察

目的：探讨麻醉期间大量输血对钾和酸碱平衡的影响。方法：对４７例术中输血４５８０±２０６１ｍｌ的病人，于输血前、中、后分别采血进行血钾、血气和红细胞压积等１１项床边监测。结果：输血后血钾正常３１例，〈３．５ｍｍｏｌ／Ｌ１４例（２９％），仅２例〉５．５ｍｍｏｌ／Ｌ（４．２％）。输血中、后的血钾分别平均为３．７２±０．３４和３．７０±０．２８ｍｍｏｌ／Ｌ，明显低于输血前的４．１０±０．１８ｍｍｏｌ／Ｌ（     

外科理论与实践杂志函授继续医学教育─—体液平衡专题试题答案

一、单选题（每题１分,共２０题,共２０分） １．每摄入１ｃａｌ（４．１８Ｊ）热量需相应补充Ｂ水分。 Ａ． ２ｍｌＢ． １ｍｌＣ． ０．５ｍｌＤ． １．５ｍｌ ２．１ｋｇ水中每个毫渗量的特异颗粒能使水的冰点下降Ｃ。 Ａ．２℃ Ｂ．２．６８℃ Ｃ．１．８６℃ Ｄ．１．６８℃ ３．血清渗透压每１ｍｍｏｌ的变化都将引起尿渗透压Ａ的变化。 Ａ． ９５ｍｍｏｌＢ． １００ｍｍｏｌＣ． ５０ｍｍｏｌ Ｄ．７５ｍｍｏｌ ４．肾素是相对分子质量４０ ０００的Ｃ。 Ａ．类固醇激素Ｂ．氨基酸Ｃ．蛋白水解酶 Ｄ．脂肪酶 ５．右心房压力每升高…     

Doxacurium的临床肌松及心血管效应

将１６例患根据Ｄｏｘａｃｕｒｉｕｍ剂量的不同分成两组，组１０．０３ｍｇ／ｋｇ，组２０．０５ｍｇ／ｋｇ，观察该药的肌松和心血管效应。结果起效时间分别为２４２±４２秒、１９６±３７秒，Ｔ１２５％恢复时间为６７．３±２６６分、１１６．５±３２．４分，恢复指数为５８．０±２１．３分、６９．５±２５．５分，提出组２比组１起效时间短、作用时间长。两组患均未观察到心血管及其他副反应。     

雌二醇和睾酮对雄鼠下丘脑-垂体的反馈调节作用

4组(每组n=5)成年雄性 S-D 大鼠,去势后7天,分别肌注7天的丙酸睾丸酮(T 组)、苯甲酸雌二醇(E_2组)、丙酸睾丸酮+胃灌注三苯氧胺(T+FTMX 组)和豆油(对照组)。然后用放射免疫法测定各组大鼠下丘脑促性腺激素释放激素(GnRH)含量和外周血促黄体生成素(LH)水平。结果示:T 和E_2组大鼠平均血浆 LH 水平分别为1.42±0.23和1.87±0.19U/L,均明显低于对照组的4.46±0.31U/L(P 均<0.01)。下丘脑的 GnRH 含量分别为3196±331和2862±791pg/100mg 湿重组织,均显著高于对照组的1057±34pg/100mg 湿重组织(P 均<0.01)。T+TMX 组大鼠的平均血浆 LH 水平和下丘脑 GnRH 含量和 T 组无差别(P 均>0.05)。     

Diabetic rats and mice are resistant to porcine and human insulin: flawed experimental models for testing islet xenografts

Pepper AR, Gall C, Mazzuca DM, Melling CWJ, White DJG. Diabetic rats and mice are resistant to porcine and human insulin: flawed experimental models for testing islet xenografts.
Xenotransplantation 2009; 16: 502–510. © 2009 John Wiley & Sons A/S. Abstract: Background: Islet transplantation is potentially a promising therapy for the restoration of carbohydrate control to diabetic patients. However, the global application of islet transplantation requires a ubiquitous source of β cells. The xenotransplantation of porcine islets would provide such a source. Success in porcine islet xenografting has been achieved in diabetic primates. However, there are few reports of reversal of diabetes with porcine islet xenografts in rodent models of diabetes, relative to the number of successful rodent experiments performed as allografts. Here we report for the first time the inability of porcine (and human) insulin to control blood glucose levels in diabetic rodents determined by a series of dose escalating studies. Methods: Insulin was administered intravenously to streptozotocin induced diabetic Lewis rats, Balb/c and athymic Balb/c mice (n = 5 per group) at the following doses: Group I “physiological dose” (pd) of 0.16 U/kg for a total dose of 40 mU to a 250 g rat. Group II received 0.64 U/kg (4xpd), group III 1.6 U/kg (10xpd) and group IV 6.4 U/kg (40xpd). Blood glucose levels were monitored in each animal at seven time points: 0 (pre‐injection), 10 min, 20 min, 30 min, 45 min, 1 h, 1.5 h, 2 h and 3 h post‐injection. Serum insulin levels were also determined. Results: Diabetic Lewis rats achieved a maximum reduction in blood glucose from 22.1 ± 1.8mmol/l to 8.0 ± 3.1 mmol/l (a 63.7% reduction), 90 minutes post‐injection of 6.4 U/kg dose of porcine insulin (40xpd). Human insulin was less effective at reducing blood glucose levels in rats than porcine insulin (P < 0.001). Porcine insulin reduced blood glucose levels in Balb/c mice from a mean of 18.2 ± 2.1 mmol/l to a hypoglycemic minimum of 1.26 ± 0.18 mmol/l a reduction of 93.0%, 60 min post‐injection of the maximum dose of 6.4 U/kg. Balb/c mice were significantly more responsive to porcine insulin than Lewis rats at doses of 0.64 U/kg (P < 0.001), 1.6 U/kg (P < 0.05) and 6.4 U/kg (P < 0.001). Athymic Balb/c nude mice reached a maximum reduction in blood glucose from 21.6 ± 1.8 mmol/l to 3.6 ± 0.9 mmol/l (a 83.4% reduction) 120 min post‐injection at a dose of 6.4 U/kg. Overall, athymic Balb/c nude mice were more resistant to porcine insulin than immunocompetent Balb/c mice at doses of 0.64 U/kg (P < 0.001), 1.6 U/kg (P < 0.001) and 6.4 U/kg (P < 0.05). Insulin diluent alone marginally increased blood glucose levels in all animals tested. Conclusions: Our results suggest that restoration of normoglycemia in diabetic rodents is not ideal for testing porcine islets xenografts since the reversals of diabetes in these species requires 20 to 40 times the dose of porcine insulin used in humans.     

Ghrelin, an endogenous growth hormone secretagogue, is a novel orexigenic peptide that antagonizes leptin action through the activation of hypothalamic neuropeptide Y/Y1 receptor pathway

Ghrelin, an endogenous ligand for growth hormone secretagogue (GHS) receptor originally isolated from the stomach, occurs in the hypothalamic arcuate nucleus and may play a role in energy homeostasis. Synthetic GHSs have activated the hypothalamic arcuate neurons containing neuropeptide Y (NPY), suggesting the involvement of NPY in some of ghrelin actions. This study was designed to elucidate the role of ghrelin in the regulation of food intake. A single intracerebroventricular (ICV) injection of ghrelin (5-5,000 ng/rat) caused a significant and dose-related increase in cumulative food intake in rats. Ghrelin (500 ng/rat) was also effective in growth hormone-deficient spontaneous dwarf rats. Hypothalamic NPY mRNA expression was increased in rats that received a single ICV injection of ghrelin (500 ng/rat) (approximately 160% of that in vehicle-treated groups, P < 0.05). The ghrelin's orexigenic effect was abolished dose-dependently by ICV co-injection of NPY Y1 receptor antagonist (10-30 microg/rat). The leptin-induced inhibition of food intake was reversed by ICV co-injection of ghrelin in a dose-dependent manner (5-500 ng/rat). Leptin reduced hypothalamic NPY mRNA expression by 35% (P < 0.05), which was abolished by ICV co-injection of ghrelin (500 ng/rat). This study provides evidence that ghrelin is an orexigenic peptide that antagonizes leptin action through the activation of hypothalamic NPY/Y1 receptor pathway.     

早期先兆流产妇女血浆β-内啡肽的研究

为了解有自然流产史早期先兆流产妇女外周血浆β 内啡肽（β ＥＰ）、促性腺激素释放激素（ＧｎＲＨ）、人绒毛膜促性腺激素（ｈＣＧ）和孕酮（Ｐ４）的变化。随机选择孕７～８周的有反复自然流产史的先兆流产妇女２０例，于治疗前及后（孕１０～１２周）测血浆β ＥＰ、ＧｎＲＨ、ｈＣＧ和Ｐ４水平（ＲＩＡ法）。随机选择正常早孕妇女２０名，分别于孕７～８和１０～１２周进行上述４项测定，收集孕１０～１２周不全流产妇女外周血同样进行以上测定，后两组作为对照。结果：（１）正常早孕妇女孕１０～１２周血浆β ＥＰ、ＧｎＲＨ、ｈＣＧ和Ｐ４水平比孕７～８周时值明显上升（Ｐ＜０．０１）。（２）孕７～８周时，先兆流产妇女血浆β ＥＰ值明显高于正常相应孕周水平（Ｐ＜０．０１），ＧｎＲＨ、ｈＣＧ和Ｐ４则明显低于正常早孕组（Ｐ＜０．０１）。经过给予心理支持、中药综合治疗后，先兆流产症状消失，１６例足月分娩，其孕１０～１２周时的４项水平与相应孕周间无显著差异（Ｐ＞０．０５）。（３）不全流产组除血β ＥＰ值明显高于正常早孕组水平（Ｐ＜０．０１）外，其他则明显低于正常妊娠早孕组水平（Ｐ＜０．０１）。认为β ＥＰ在自然流产的发生中可能起着重要作用。     

TNF-α抑制剂对重症急性胰腺炎大鼠肾损伤的影响

目的：探讨肿瘤坏死因子α（TNF-α）抑制剂对重症急性胰腺炎（SAP）大鼠肾损伤的影响。方法：60只SD大鼠随机分成假手术组,SAP组,TNF-α抑制剂治疗组,每组20只。各组建模48 h后处死动物并收集标本,测血清淀粉酶,TNF-α,尿素氮和肌酐;应用TUNEL法检测肾细胞凋亡,计算凋亡指数（AI）;并用免疫组化法检测肾脏组织NF-κB的表达,RT-PCR检测ET-1 mRNA的表达。结果：假手术组的各项指标均低于SAP组和治疗组（P＜0.05）。SAP组TNF-α,血清淀粉酶,尿素氮,肌酐和NF-κB IOD水平分别为（185.36±10.95）ng/L,（7 257.30±361.20）U/L,（17.28±0.87）mmol/L,（78.83±3.02）μmol/L和316.25±20.90,治疗组以上指标分别为（124.32±15.11）ng/L,（6182.60±291.63）U/L,（13.66±0.88）mmol/L,（68.68±3.38）μmol/L和241.90±19.04,两组间比较差异有统计学意义（P＜0.05）。SAP组AI为3.33±0.49,明显低于治疗组的7.04±0.41（P＜0.05）。SAP组中ET-1 mRNA水平明显高于治疗组和假手术组（P＜0.05）。结论：TNF-α抑制剂可促进大鼠肾脏细胞凋亡,减轻炎症反应对肾的损伤,改善肾脏功能。     

High- or low-potassium solutions for the storage of abdominal and thoracic organs

Background: Clinically, intracellular type solutions are the most widely used solutions to preserve organs. The optimal ion composition of preservation solutions, however, is still unknown and extracellular-type solutions have frequently been superior to intracellular solutions in various experimental studies. Materials and methods: In this study, we measured extracellular (interstitial) electrolyte concentrations in rat livers, kidneys, hearts and lungs at 4°C by means of microdialysis sampling. Results: After 24 h cold ischaemia, [Na⁺]_int and [K⁺]_int were 104±25 mmol/l and 6.5±0.7 mmol/l in hearts, 92±12 mmol/l and 6.9±1.0 mmol/l in livers, 115±22 mmol/l and 6.3±0.9 mmol/l in kidneys and 87±17 mmol/l and 6.4±0.6 mmol/l in lungs. After preservation of organs in intracellular-type solutions, [Na⁺]_int was significantly lower for each organ (range from 69±8 mmol/l to 73±20 mmol/l) and [K⁺]_int was significantly higher (range from 8.0±1.7 mmol/l to 9.8±1.0 mmol/l). In no instance did the interstitial electrolyte concentration equilibrate with the intracellular electrolyte concentration. When the diffusion gradient from the vascular space to the interstitial space was calculated for Na⁺ and K⁺, a significantly higher barrier was found for K⁺ than for Na⁺ (P<0.001 and P<0.01 for hearts). Conclusions: These studies indicate that during cold storage of rat hearts, lungs, livers and kidneys, intra- and extracellular electrolytes do not equilibrate. Ion exchange stabilises at extracellular Na⁺ concentrations between 87 mmol/l and 115 mmol/l and K⁺ concentrations between 6.3 mmol/l and 6.9 mmol/l. Storage of organs in solutions with extracellular-type ion compositions might improve graft function and survival not only after lung and liver but also after heart and renal preservation. Received: 4 August 1999 In revised form: 23 February 2000 Accepted: 24 February 2000     

Variation du calcium ionisé plasmatique et injection de produit de contraste radiologique

Ionized serum calcium was determined, using a selective electrode, after administration of 80 ml of radiological contrast medium. The ionized calcium concentration was significantly diminished during five minutes after injection (control : 0,98 ± 0,02 mmol/l; 3 min : 0,94 ± 0,02 mmol/l, p <0,01; 5 min : 0,94 ± 0,01 mmol/l, p <0,05).Determinations were also performed in vitro on whole blood and separated plasma after addition of contrast medium. These determinations revealed a direct interaction between ionized calcium and contrast medium and the importance of the delay after mixing. Clinical consequences under the conditions of the study are probably null but this secondary effect of the contrast medium can explain incidents or accidents observed during the first local circulation of contrast medium especially during coronarography.     

加波沙朵对神经病理性痛大鼠的镇痛作用及对脊髓胶质细胞活化的影响

目的 探讨皮下注射γ-氨基丁酸(γ aminobutyric acid,GABA)A型受体激动剂加波沙朵对神经病理性痛(neuropathic pain,NP)大鼠痛阈和脊髓星形胶质细胞活化的影响. 方法 用坐骨神经慢性压迫损伤(chronic constriction injury of sciatic nerve,CCI)法建立NP模型.雄性SD大鼠36只,采用随机数字表法分为3组(每组12只):假手术组(S组)、CCI组(C组)和CCI+加沙波朵组(G组).术后10～14 d,S组和C组分别皮下注射生理盐水,G组皮下注射加波沙朵10 mg/kg,1次/d.每组随机选取8只大鼠,分别于术前,术后3d,术后10 d给药前,术后14 d给药后0.5、1、2、4、8、12 h,测定大鼠机械缩足反射阈值(paw withdrawal mechanical threshold,PWMT).每组取4只大鼠,于术后14 d给药后2h处死,采用免疫荧光技术观察脊髓星形胶质细胞的染色情况. 结果 与S组比较,C组大鼠术后3 d PWMT[(13.46±1.67)g比(4.65±0.46)g]开始降低,持续到术后14 d给药后12 h(P＜0.05),术后14d给药后2h脊髓背角星形胶质细胞数明显增加[(103±7)个比(402 ±20)个](P＜0.05);与C组比较,G组大鼠术后14 d给药后0.5 h PWMT[(2.73±0.57)g比(7.31±0.55)g]明显升高,持续到给药后8 h(P＜0.05),术后14 d给药后2h脊髓背角星形胶质细胞数明显减少[(251±20)个](P＜0.05). 结论 皮下注射GABAA受体激动剂加波沙朵可减轻大鼠NP,其机制与抑制脊髓星形胶质细胞活化有关.     

Synovial Fluid Analysis and Bacterial Findings in Arthritic Joints of Juvenile Male Camel (Camelus dromedarius) Calves

Eighteen synovial fluid samples from 11 male dromedarian calves, 9–12 month old, were analysed cytologically and bacteriologically. Calves were lame and all joints were grossly swollen. The mean ± SD of total nucleated cell count was 7970 ± 5000 cells/μl (range 2800–20 000 cells/μl). Polymorphonuclear (PMN) leucocytes were the predominant cell type. The mean ± SD of absolute and percentages of each cell type were as follows: PMN leucocytes 5518 ± 3600 cells/μl and 68 ± 19%, monocytes/macrophages 1600 ± 1120 cells/μl and 26 ± 17%, lymphocytes 830 ± 140 cells/μl and 8 ± 7%, and red blood cell 350 ± 130 cells/μl. The mean ± SD of total protein concentration was 3.5 ± 1 g/dl (range 2.5–5 g/dl). The most commonly isolated bacteria were non‐haemolytic streptococci spp., followed by Arcanobacterium pyogenes and Staphylococcus aureus. No bacterial growth was obtained in eight samples and non‐revealed Mycoplasma spp.