Rho激酶抑制剂对异丙肾上腺素诱导大鼠心肌肥厚的影响

目的 研究Rho激酶抑制剂对异丙肾上腺素(isoproterenol,Iso)诱导大鼠心肌肥厚的影响及其机制.方法 40只雄性Wistar大鼠随机分为5组:空白对照组、Iso模型组、法舒地尔(fasudil,Fas)低剂量组、高剂量组及卡托普利(captopril,Cap)组,每组8只.除空白对照组外,各组皮下注射Iso建立大鼠心肌肥厚模型.给药结束后分别测定各组大鼠体重(BW)、心脏重量(HW),计算心脏重量指数(HW/BW);测定左室收缩压(LVSP)、左室舒张末压(LVEDP)、左心室压力上升及下降最大速率(±dp/dtmax)等指标;取心肌组织作病理学检测;RT-PCR测定心肌组织RhoA、Rho激酶mRNA表达.结果 Iso模型组大鼠HW/BW增大;LVEDP增加,而LVSP、±dp/dtmax下降;心肌细胞直径增大、胶原纤维增生;左心室组织RhoA、Rho激酶mRNA表达上调.使用Fas和Cap干预,上述指标均出现不同程度的改善.结论 肾上腺素β受体兴奋所诱导的心肌肥厚伴有Rho激酶信号通路的激活,Rho激酶抑制剂可改善Iso所致心肌肥厚动物模型的心功能和病理学变化.     

天麻舒心方对SHR左心室舒张功能损伤的保护研究

目的探讨天麻舒心方对自发性高血压大鼠(SHR)降压及左心室舒张功能损伤的保护作用。方法 50只SHR大鼠随机分为天麻舒心方高、中、低剂量组及阳性药对照组、模型组,并以10只Wistar大鼠作为正常对照。分别给予不同剂量天麻舒心浸膏、氯沙坦片混悬液、蒸馏水。每2周测量血压心率;18周后应用心导管术观测左室舒张末压(LVEDP)、左室压力最大下降速度(-dp/dtmax)。结果给药后,各治疗组血压均显著低于模型组(P0.01),心率无统计学意义。模型组LVEDP显著上升(P0.01),-dp/dtmax绝对值显著下降(P0.01),与之相比,西药组与中药各剂量组的LVEDP下降,-dp/dtmax绝对值上升,具有统计学意义(P0.05或P0.01)。结论 SHR左心室舒张功能损伤以LVEDP上升,-dp/dtmax绝对值下降为特点,天麻舒心方有效降压,同时对SHR左室舒张功能损伤具有保护作用。     

福辛普利对SHR左室肥厚和心肌纤维化的影响

目的探讨福辛普利对自发性高血压大鼠(SHR)左心室肥厚(LVH)和心肌纤维化的影响。方法18只16周龄SHR大鼠,随机分为福辛普利治疗组(SHR-F)和SHR空白对照组(SHR-C);另设同源的WKY大鼠8只为正常对照组。治疗组口服福辛普利20mg·kg-1·d-1,给药8周后处死动物,取左心室心肌称重,计算左心室/体重比(LVW/BW),Masson三色法染色观察左心室心肌胶原变化,计算机图像分析测量心肌切片的胶原容积分数(CVF)和血管周围胶原面积(PVCA)。结果SHR空白对照组的SBP、LVW/BW、CVF、PVCA均显著高于WKY对照组(P<0.01),与SHR空白对照组相比,福新普利治疗组能有效降低SHR的SBP,改善SHR左心室肥厚(P<0.01〉并使左心室内膜及心肌小动脉周围的胶原减少(P<0.01〉。结论福辛普利可有效降低SHR血压,部分逆转心肌纤维化和左室肥厚。     

左旋氨氯地平对自发性高血压大鼠左室肥厚及内皮素-1表达的影响

目的 观察左旋氨氯地平对自发性高血压大鼠(SHR)左室肥厚的影响,并探讨其对内皮素(ET-1)的作用.方法 20只SHR随机分为左旋氨氯地平治疗组和高血压对照组,同周龄的WKY大鼠作为正常对照组.给药12周,测量左室肥厚指标的变化,采用心室导管法检测心功能的变化,放免法测定左心室心肌ET-1含量,实时定量PCR法测定左心室心肌中前内皮素原(preproET-1) mRNA 的表达.结果 与高血压对照组相比左旋氨氯地平干预能够改善SHR左室收缩和舒张功能参数(+dp/dtmax/LVSP、-dp/dtmax/LVSP)(P<0.05),降低左室质量指数(P<0.01);左旋氨氯地平干预能够降低SHR心肌 ET-1含量(P<0.05),使心肌preproET-1 mRNA的表达降低约20%(P<0.05).结论 左旋氨氯地平能够抑制SHR的左室肥厚,并改善左室收缩和舒张功能,其作用机制可能与调节心肌ET-1的水平有关.     

依贝沙坦对自发性高血压大鼠左心室肥厚和心肌纤维化的影响

目的探讨依贝沙坦对自发性高血压大鼠(SHR)左心室肥厚(LVH)和心肌纤维化的影响。方法18只16周龄SHR,随机分为依贝沙坦治疗组(SHR-I)和SHR空白对照组(SHR-C);另设同源的WKY大鼠8只为正常对照组。治疗组口服依贝沙坦50mg.kg-1.d-1给药8周后处死动物,取左心室心肌称重,计算左心室/体重比(LVW/BW),Masson三色法染色观察左心室心肌胶原变化,计算机图象分析测量心肌切片的胶原容积分数(CVF)和血管周围胶原面积(PVCA)。结果SHR空白对照组的收缩压(SBP),LVW/BW,CVF,PVCA均显著高于WKY对照组(P<0.01),与SHR空白对照组相比,依贝沙坦治疗组能有效降低SHR的SBP,改善左心室肥厚(P<0.01)并使左心室内膜及心肌小动脉周围的胶原减少(P<0.01)。结论依贝沙坦可有效降低SHR血压,部分逆转心肌纤维化和左心室肥厚。     

法舒地尔对压力超负荷诱导大鼠心肌肥厚的影响

目的 研究Rho激酶抑制剂法舒地尔(fasudil)对大鼠腹主动脉缩窄压力超负荷诱导的心肌肥厚的影响及机制.方法 50只雄性Wistar大鼠随机分为5组:假手术组、压力超负荷模型组、法舒地尔低剂量组、法舒地尔高剂量组及阳性对照(卡托普利)组,每组10只.除假手术组外,其他4组大鼠结扎肾上方腹主动脉制备压力超负荷模型,4周后建立心肌肥厚模型并开始给药,疗程4周.给药结束后,检测各组血流动力学指标,心脏重量指数(HW/BW)及左心室重量指数(LVW/BW);取心肌组织,经不同染色方法,观察心肌病理改变并检测心肌细胞直径(MD)和心肌胶原百分比(CVF);RT-PCR法检测心肌组织中RhoA、Rho激酶mRNA的表达.结果 与假手术组比较,模型组的LVEDP明显增加,LVSP明显下降;HW/BW、LVW/BW明显增加;MD增大(P＜0.01),CVF明显增加(P＜0.05);RhoA、Rho激酶mRNA的表达明显上调(均P＜0.01).与模型组比较,经法舒地尔及阳性药物治疗后,上述指标均有不同程度的改善(均P＜0.05,P＜0.01).结论 Rho激酶抑制剂法舒地尔可以改善心功能,抑制心肌胶原的合成及心肌纤维化,改善压力超负荷所引起的心肌肥厚.     

高血压大鼠心脏肥厚过程中心肌细胞凋亡心肌纤维化动态观察

目的探讨SHR心脏肥厚进展阶段心肌细胞凋亡、心肌纤维化及左室重构特点及其相互关系.方法分别采用末端脱氧核糖核苷酸转移酶介导dUTP缺口末端标记(TUNEL)、放射免疫测定及病理检查方法对16周龄、24周龄、32周龄SHR心肌细胞凋亡指数(APOI)、心肌胶原容积分数(CVF)和心肌血管周围胶原面积(PVCA)、血浆和组织血管紧张素Ⅱ检测,并以同龄Wister大鼠作对照.结果与同龄正常血压Wistar大鼠比较,SHR各周龄组收缩压明显增高、心脏肥厚指标心脏重量(HW)、左室重量(LVW)、左室重量指数(LVW/BW)均显著增加;各周龄组SHR心肌细胞APOI显著增加,各周龄组间无显著性差异;各周龄组SHR大鼠血浆、心肌组织AngⅡ明显增高;24、32周龄SHR的CVF和PVCA显著增加;SHR心肌组织AngⅡ分别与APOI、CVF呈显著正相关,APOI与CVF呈显著正相关.结论心肌细胞凋亡与心肌纤维化参与SHR代偿性心脏肥厚阶段心脏重构病理过程,组织AngⅡ是导致SHR代偿性心脏肥厚阶段心肌细胞凋亡与心肌纤维化的重要机制之一.     

自发性高血压大鼠心肌增殖细胞核抗原(PCNA)的表达以及厄贝沙坦和咪哒普利的影响

目的探讨自发性高血压大鼠(SHR)左心室肌增殖细胞核抗原(PCNA)的表达以及咪哒普利、厄贝沙坦的影响. 方法选用13周龄的SHR30只,雌性9只,雄性21只,体重228.5±39 g,随机分为三组,使得每组雌性3只,雄性7只,分别设为SHR组,厄贝沙坦组,咪哒普利组;另选同源同系Wistar-Kyoto 大鼠(WKY大鼠)10只,雌性5只,雄性5只,体重206.1 g±49.1 g,作为正常对照组(WKY组).实验期14周.观察指标血压、左室重量/体重(LVW/BW)、左室厚度/体重、心肌PCNA蛋白水平.结果 SHR组血压、LVW/BW、左室厚度/体重均增高,心肌PCNA蛋白的表达明显增加; 咪哒普利组、厄贝沙坦组血压、LVW/BW、左室厚度/体重、心肌增殖核抗原(PCNA)蛋白的表达均比SHR组低.结论 26周龄SHR左心室肌PCNA蛋白的表达明显升高,咪哒普利、厄贝沙坦不仅可以良好地控制血压,而且可以抑制自发性高血压大鼠左心室重塑,并可以降低SHR左心室肌PCNA蛋白的表达,二者对SHR左室肥厚的抑制效应可能与降低PCNA蛋白的表达有关系.     

地尔硫(艹卓)对自发性高血压大鼠左心室舒张功能的影响及其可能机制

目的:观察地尔硫(艹卓)对自发性高血压大鼠(SHR)左心室舒张功能的影响,并探讨这种影响是否与肌浆网钙ATP酶(SERCA2)蛋白的表达、活性及心肌纤维化相关. 方法:将22只12周龄SHR随机分为地尔硫(艹卓)组(25 mg·kg-1·d-1,SHR-D),苯那普利组(10 mg·kg-1·d-1,SHR-B)和SHR空白对照组(蒸馏水灌胃,SHR-C);另设WKY大鼠7只为正常对照组(WKY).灌胃法给药18周后测定左心室心功能,计算左心室/体重比(LVW/BW),Western印迹杂交测定左心室心肌SERCA2的表达,无机磷比色法检测心肌肌浆网Ca2 ATPase活性.饱和苦味酸天狼星红染色分析胶原容积分数(CVF)和血管周围胶原面积(PVCA),估计心肌纤维化程度. 结果:SHR-D组和SHR-B组的LVEDP显著低于SHR-C组,SHR-D组和SHR-B组之间差异无统计学意义(P＞0.05).与SHR-C组相比,SHR-D组与SHR-B组的-dp/dtmax/MAP增加.地尔硫(艹卓)和苯那普利治疗明显增加SERCA2蛋白的表达(SHR-D:0.38±0.07,SHR-B:0.42±0.06,SHR-C:0.47±0.07)与活性(SHR-D:8.2±0.07,SHR-B:10.5±1.95,SHR-C:6.3±0.75).SHR-D组左心室内膜及心肌小动脉周围的胶原减少,其作用类似于SHR-B组. 结论:地尔硫(艹卓)可改善SHR左心室舒张功能,其机制可能与增加SERCA2蛋白的表达及活性,抑制心肌纤维化有关.     

糖尿病树鼩血栓性脑缺血时心脏血流动力学及心肌超微结构的变化

目的观察实验性糖尿病树鼩在血栓性局部脑缺血时心脏血流动力学及心肌超微结构的变化。方法链脲佐菌素(STZ)55mg/kg空腹腹腔注射制备糖尿病树鼩模型,一周后通过光化学反应诱导局部血栓性脑缺血。将树鼩随机分为糖尿病组,脑缺血组,糖尿病加脑缺血组,并设假手术对照组,每组8只,用多导生理仪观察左心室内压(LVSP)、左心室舒张末压(LVEDP),左心室收缩与舒张瞬间变化最大速率(±dp/dtmax),收缩动脉压(SAP),舒张动脉压(DAP)及心率(HR)。并取左心室心肌组织,行透射电镜观察心肌超微结构变化。结果 与假手术对照组相比,脑缺血组LVSP、+dp/dtmax下降(P<0.05),-dp/dtmax明显下降(P<0.01),LVEDP升高(P<0.05);糖尿病组-dp/dtmax下降(P<0.05),LVEDP明显升高(P<0.01)。与脑缺血组相比,糖尿病加脑缺血组LVSP、+dp/dtmax降(P<0.05),-dp/dtmax明显下降(P<0.01),LVEDP升高(P<0.05)。脑缺血组和糖尿病组心肌超微结构观察显示:心肌肌原纤维间水肿,一些肌原纤维可见收缩小带形成,部份线粒体固缩,部份线粒体肿胀。糖尿病加脑缺血组树鼩可见:大部分线粒体固缩,部分线粒体肿胀、嵴溶解,心肌纤维较多收缩带形成,间质充血水肿,毛细血管内皮细胞见较多空泡。结论树鼩血栓性脑缺血时伴有心脏血流动力学及心肌超微结构的异常,糖尿病急     

表观扩散系数值与肝细胞癌分级的相关性以及相关性与肿瘤大小关系的分析

[摘要]　目的　探讨表观扩散系数（apparent diffusion coefficient, ADC）值与肝细胞癌（hepatocellular carcinoma, HCC）组织学分级的相关性以及不同直径肿瘤的ADC值与HCC的相关性。方法?回顾性分析2017年—2020年180例病理证实为HCC的病例资料,按肿瘤直径大小分为＜2 cm、≥2 cm且＜3 cm、≥3 cm且＜5 cm、≥5 cm 4组,标为I、II、III、IV组。分析ADC值与HCC组织学分级的相关性,并分析在不同直径肿瘤ADC值与HCC的相关性。结果?高、中和低分化HCC的ADC值分别为（1.159±0.302）×10-3、（0.951±0.213）×10-3和（0.811±0.239）×10-3 mm2/s,逐级降低（P＜0.05）。ADC值与总体HCC的组织学分级呈负相关（r=-0.474）,与I～III组HCC的组织学分级均呈负相关（r值分别为-0.663、-0.527、-0.364）,而与IV组HCC的组织学分级无相关性。结论?ADC值可以作为非侵入性预测HCC组织学分级的指标,预测结果受肿瘤大小影响,更适用于小肝细胞癌。     

Research and Evaluation of the Influence of the Construction of the Gate and the Influence of the Piston Velocity on the Distribution of Gases into the Volume of the Casting

Distribution of gasses to the cast volume and volume of pores can be maintained within the acceptable limits by means of correct setting of technological parameters of casting and by selection of suitable structure and gating system arrangement. The main idea of this paper solves the issue of suitability of die casting adjustment—i.e., change of technological parameters or change of structural solution of the gating system—with regards to inner soundness of casts produced in die casting process. Parameters which were compared included height of a gate and velocity of a piston. The melt velocity in the gate was used as a correlating factor between the gate height and piston velocity. The evaluated parameter was gas entrapment in the cast at the end of the filling phase of die casting cycle and at the same time percentage of porosity in the samples taken from the main runner. On the basis of the performed experiments it was proved that the change of technological parameters, particularly of pressing velocity of the piston, directly influences distribution of gasses to the cast volume.     

缺锌对孕鼠生长发育及其肝脏、胎盘中谷胱甘肽过氧化物酶及过氧化氢酶活性的影响

为观察喂养缺锌饲料对孕鼠生长发育及其肝脏、胎盘中谷胱甘肽过氧化物酶(GSH-PX)及过氧化氢酶(CAT)活性的影响。将16只受孕Wistar鼠随机分为缺锌组(ZD组)、加锌组(ZS组)和正常对照组(ZC组),分别喂饲缺锌饲料、加锌饲料和基础饲料,记录每只孕鼠每日体重变化。于妊娠21日将孕鼠处死,取其肝脏、胎盘作GSH-PX和CAT活性测定。结果为ZD组孕鼠体重未见增加,SC组和ZS组孕鼠体重增加明显;与ZC组和ZS组相比,ZD组孕鼠肝脏和胎盘中GSH-PX活性显著降低(P<0.05),孕鼠肝脏和胎盘中CAT活性显著升高(P<0.05)。故认为缺锌可影响孕鼠肝脏、胎盘中谷胱甘肽过氧化物酶及过氧化氢酶活性,并影响其生长发育。     

Ligaments of the larynx and the adjacent pharynx and esophagus

Two ligament systems of the larynx are demonstrated by dissection. The suspensory ligament of the esophagus is attached to the posterior aspect of the cricoid cartilage and is also a part of the fascial sheath which is common to the hyoid, thyroid, and cricoid. The ligaments at the inner margins of the vocal, ventricular, and aryepiglottic folds are distinctive in site and, inferentially, in function. The aryepiglottic ligaments join at the incisura between the arytenoid cartilages and are continued as the corniculopharyngeal ligament which splays into the flexible tissues in the anterior wall of the hypopharynx, posterior to the suspensory ligament of the esophagus. These ligament systems are involved in two different actions in swallow. The gross superior and anterior motions of the larynx are transmitted to the esophagus by the suspensory ligament, so that the esophagus is elevated in relation to the bolus and is also opened. These esophageal displacements resemble, in effect, the swallow displacements of the pharyngoesophageal segment and of the constrictor wall of the hypopharynx. The marginal ligaments of the laryngeal folds help to implement the constriction and closure of the larynx during swallow. By anatomical inference, the corniculopharyngeal ligament effects vertical traction within the flexible tissues of the anterior wall of the hypopharynx.     

Humanism and the suffering of the people

Abstract
Humanism includes, among its many contexts, the ideal of the universal perfection of health. Procedures for alleviation of disease existed through all epochs of human history, but efficacy was mostly lacking. The prototypic humanism of the Renaissance ( ad  1300−1600) scarcely involved the medical ­sciences other than human anatomy. The Enlightenment of the seventeenth century included discovery of the circulation of the blood, and applications of microscopy. Discoveries relevant to medical practice began in the nineteenth century, ushered in by vaccination and the germ theory of disease. This 200-year period saw a transformation of human health according to the surrogate marker of increased life-­expectancy. This has been variously attributed to: (i) increased prosperity following the industrial revolution, (ii) efforts of humanistic social and public health reformers and, more recently, (iii) advances in medical science. Yet the beneficiaries remain a minority of the world's population. The nexus between poverty, illness and low life-expectancy between and within nations is the major challenge for the future. Contemporary science is providing ever-expanding knowledge on means to achieve the goal of perfection of human health, but the need for humanism is as great as at any previous age. Fortunately, however, the targets are more clearly visible than during the periods of poverty, plagues and pestilence of the past. (Intern Med J 2003; 33: 195−202)