盐酸氟桂利嗪对再灌注损伤时鼠肝细胞线粒体的作用

目的 盐酸氟桂利嗪对大鼠肝脏缺血／再灌注香肝细胞线粒体的影响。方法：将Ｗｉｓｔａｒ大鼠随机分为三组,每组１２只。Ａ组为对照组,Ｂ组缺血／再灌注组组,Ｃ组为盐酸氟桂利嗪组。其中Ｂ,Ｃ两组均阻断肝门造成肝脏完全缺血３０分钟后再灌注９０分钟。测定各组动物血清中ＡＬＴ,ＬＤＨ含量,肝细胞线粒体脂质过氧化物（ＬＰＯ）含量、行超微结构的观察。结果 与Ａ组比较,Ｂ组血清ＡＬＴ,ＬＤＨ活性显著加（Ａ,Ｂ二组,ＡＬ     

不同时间的缺血预处理对肝脏缺血再灌注损伤的影响

我们通过观察不同时间的缺血预处理对肝脏缺血再灌注损伤的影响,旨在探讨ＰＣ对肝脏缺血再灌注损伤的保护作用所需要的适合的预处理时间。一、材料与方法１．动物模型：雄性ＳＤ大鼠６０只,体重１８０～２２０ｇ,参照Ｊａｅｓｃｈｋｅ和Ｍｅｔｚｇｅｒ法制备成右肝全部缺血、左肝部分缺血后再灌注大鼠模型［１］。２．预处理方案：本实验共设５组,每组１２只大鼠;假手术组（Ｓ组）：仅行假手术;缺血再灌注组（ＩＲ组）：肝脏持续缺血６０分钟,再灌注３０分钟;预处理组分为３组,在肝脏持续缺血之前分别进行５分钟缺血及５分钟的再灌…     

一氧化氮在急性缺血性肾衰中作用的实验研究

采用左肾动脉夹闭６０分钟再灌注致缺血性肾衰模型，观察再灌注后肾脏皮质、外髓、内髓中ＮＯ（ＮＯ稳定代谢产物）的动态变化；再灌注后加用ＮＯ底物（Ｌ－精氨酸）或ＮＯ生成抑制剂（Ｌ－ＮＮＡ）对肾脏ＮＯ生成及肾功能的影响。结果表明：再灌注后肾组织ＮＯ含量显著下降，再灌注２４小时无明显恢复。使用Ｌ－ＮＮＡ可进一步减少ＮＯ２生成，加重肾功能损害；Ｌ－精氨酸对肾脏ＮＯ２生成和肾功能均无显著改善。结果提示：再灌注后ＮＯ的生成减少，ＮＯ的生成抑制源于肾脏ＮＯ生成能力的损害，ＮＯ的减少可加重肾功能损害。     

肝脏手术中肝门阻断对肺脏影响的实验研究

目的 探讨肝脏手术时肝门阻断对肺脏的影响及其可能机制。方法 选用３０只实验家兔,雌雄均衡,随机分成４组,假手术对照组（Ｓ组：１０史兔）;全肝门阻断无再灌组（Ｎ组：５只兔）;部分肝门阻断再灌组（Ｌ组：５只兔）;全肝门阻断再灌组（Ｄ组：１０只兔）。分别检测各组血及肺组织中丙二醛（ＭＤＡ）血栓素Ｂ２（ＴｘＢ２）含量,并通过光学显微镜和电子显微镜观察组织学改变和ＰＭＮ计数。结果 （１）Ｎ组血ＭＤＡ、ＴｘＢ     

入肝血流阻断对阻塞性黄疸大鼠肝脏能量代谢的影响

目的 探讨阻塞性黄疸大鼠肝脏缺血后能量代谢变化的病理特征及其与动物耐受性的关系。方法 大鼠胆管结扎后１周,在门静脉转流入阻断入肝血流不同时程后观察动物存活率、肝细胞线粒体呼吸活性、肝组织ＡＴＰ含量及动脉血酮体比值。结果 阻断入肝血流３０、６０及９０分钟后１０天动物存活率分别为１００％、１００％及４０％;缺血后肝脏能量代谢功能明显受损,在再灌注后２４小时,阻断入肝血流３０及６０分钟两组动物肝脏能量代谢功能已有明显恢复,而阻断入肝血流９０分钟组肝脏能量代谢功能仍维持在显著低水平。结论 胆道梗阻后１周,大鼠门静脉转流下入肝血流阻断６０分钟以内肝脏能量代谢功能损害可逆,动物安全耐受;而阻断入肝血流９０分钟引起肝脏能量代谢功能不可逆性损害,动物难以安全耐受。     

肝血流阻断后一氧化氮供体对胰腺ATP酶活性的影响

观察家兔肝血流阻断后ＮＯ供体对胰腺组织Ｎａ＾＋－Ｋ＾＋－ＡＴＰ酶和Ｃａ＾２＋－ＡＴＰ酶活性的影响。方法：门静脉高压模型的家兔２４只（部分门静脉结扎法）,体重２．０－２．５ｋｇ,随机分为三组,对照组、硝普钠组（ＳＮＰ组）、左旋硝基精氨酸甲酯组（Ｌ－ＮＡＭＥ组）每组８只,戊巴比妥钠静脉麻醉下行气管切开后,股动脉切开插管监测血压。然后行肝门阻断（包括门静脉、肝固有动脉和胆总管）６０分钟,然后恢复肝血流,     

丹参对肢体缺血再灌注脂质过氧化反应影响的临床观察

目的：临床观察丹参对肢体缺血再灌注脂质过氧化反应的效果。方法：选择１６例肢体手术需充气带加压肢体止血的患者，随机分为对照组（ｎ＝８）和治疗组（ｎ＝８）。治疗组病人术前１０分钟静脉滴入复方丹参注射液（４００ｍｇ／ｋｇ），对照组病人给等量平衡液。肢体缺血前、再灌注后３０分钟、９０分钟、１８０分钟分别检测血ＭＤＡ、ＣＰＫ和ＳＯＤ。结果：肢体缺血再灌注３０分钟、９０分钟、１８０分钟与缺血前比较，血ＭＤＡ和ＣＰＫ含量升高，ＳＯＤ含量下降。治疗组缺血再灌注同时间，血ＭＤＡ含量明显低于对照组（Ｐ值＜０．０１）；ＣＰＫ值低于对照组（Ｐ值＜０．０５）；ＳＯＤ活性逐渐上升，１８０分钟高于对照组（Ｐ值＜０．０５）。结论：丹参有抗脂质过氧化作用，降低ＣＰＫ值，提高ＳＯＤ活性，能有效防治肢体缺血再灌注损伤。     

肝门阻断对远隔脏器的影响

为研究肝门阻断对远隔脏器的影响，我们将３０只实验家兔随机分成４组：假手术对照组；全肝门阻断加再灌组；全肝门阻断无再灌且；部分肝门阻断加再灌组。分别检测血缲ＭＤＡ和ＴｘＢ２含量，并通过光镜和电镜进行组织学分析，结果表明：（１）Ｎ组血ＭＤＡ和ＴｘＢ２含量明显高于Ｓ、Ｎ组；Ｄ、Ｌ两组间ＭＤＡ和ＴｘＢ２增高程度基本一致；（２）Ｄ、Ｌ组肺、肾ＰＭＮ计数明显高于Ｓ、Ｎ组，Ｓ、Ｎ间ＰＮＭ无差别；心肌组织中各组Ｐ     

纳洛酮对缺血再灌注心肌c-fos基因表达的影响

目的：研究纳洛酮对心肌缺血再灌注损伤的影响,从分子水平探讨心肌缺血再灌注损伤的保护机制。方法：３０只大白兔分为三组：（１）对照组;（２）心肌缺血３０分钟再灌３０分钟组;（３）静注纳洛酮１０分钟后缺血３０分钟再灌３０分钟组。提取心肌总ＰＮＡ与经同位素标记的ｃ－ｆｏｓ ｃＤＮＡ探针进行分子杂交并自显影,测定ｃ－ｆｏｓ基因ｍＲ－ＮＡ水平。结果：纳洛酮能显著抑制心肌缺血再灌注时ｃ－ｆｏｓ基因的表达。结论：     

参麦注射液抗肝缺血再灌注损伤的研究

目的：研究参麦注射液对肝缺血再灌注损伤的保护作用。方法：将３７只成年雄性ＳＤ大鼠随机分成假手术对照组（ＳＯＣ）、缺血再灌注组（Ｉ／Ｒ）、缺血再灌注加参麦组（Ｉ／Ｒ＋ｓｈｅｎｍａｉ）。通过阻断大鼠肝门３０ｍｉｎ后再开放建立肝缺血再灌注损伤模型,在肝脏再灌注９０ｍｉｎ时测肝组织丙二醛（ＭＤＡ）、超氧化物歧化酶（ＳＯＤ）和测血ＡＬＴ、ＡＳＴ、ＬＤＨ,并取肝组织作光镜及电镜观察。结果：再灌注９０ｍｉｎ时Ｉ／Ｒ＋Ｓｈｅｎｍａｉ组的肝组织ＭＤＡ生成,ＳＯＤ消耗,血清ＡＬＴ、ＡＳＴ、ＬＤＨ升高值均少于Ｉ／Ｒ组（Ｐ＜０．０１）,且Ｉ／Ｒ＋Ｓｈｅｎｍａｉ组的肝细胞显微、超微结构损害的改变较Ｉ／Ｒ组轻。结论：参麦注射液能清除肝缺血再灌注过程中产生的氧自由基,对鼠肝缺血再灌注所致肝细胞的结构和功能损伤有保护作用     

Ischemic nephropathy

Ischemic nephropathy is a major cause of chronic renal failure in people over 50 years of age. In addition, renal artery stenosis is associated with increased mortality, particularly if renal or cardiac function is compromised. The diagnosis is made both by clinical characteristics and imaging studies. At present, duplex Doppler ultrasound and magnetic resonance angiography appear to be the most promising non-invasive screening tests. Although data from controlled trials are lacking, revascularization is the mainstay of therapy for ischemic nephropathy. Advances in percutaneous interventions now allow revascularization to be offered to many patients, including those who are poor surgical candidates. The role of medical therapies (statins, angiotensin-converting enzyme inhibitors, intensive control of blood pressure) and how to best utilize revascularization (which patients and when) remain to be defined.     

Ischemic nephropathy

Ischemic nephropathy is an independent pathway towards end-stage renal disease. Its prevalence is estimated to be significant and increasing among populations with vascular disease, hypertension, and chronic renal failure. Angiography remains the gold standard for evaluation of ischemic nephropathy; however, selection by clinical criteria and noninvasive screening with ultrasound are recommended for most patients. Surgical revascularization of ischemic kidneys can halt or reverse deterioration of renal function and is preferable to medical treatment. Direct comparison of angioplasty and stent placement with surgery is needed.     

Ischemic Colitis

Ischemic diseases of the gastrointestinal tract are some of the commonly encountered gastrointestinal diseases which are difficult to diagnose and still more difficult to treat. Presentation of colon ischemia is even more subtle, and this review article details about the various presentation patterns of ischemic colitis and their management.     

Ischemic colitis

BACKGROUND: Ischemic colitis almost always occurs in older patients. Because life expectancy is increasing, more and more often physicians will face this problem. The aim of this study was to identify factors leading to surgery in the acute phase of the disease, and to evaluate mortality and long-term follow-up evaluation. METHODS: We performed a retrospective study of 73 patients (mean age, 73 y) in the Department of General and Digestive Surgery. Diagnosis was obtained by endoscopic and pathologic procedures. The median follow-up period was 4.5 years (range, 2-9 y). RESULTS: Thirty-six patients had 1 or more co-existing medical diseases. All the patients had either lower intestinal bleeding (45 patients) or diarrhea (28 patients). Thirty-three patients had undergone surgery (45%). In the surgical group, 13 patients underwent immediate surgery for abdominal tenderness and/or shock. Eight of these patients died (62%). Out of 60 patients undergoing nonsurgical immediate management, 1 patient died (septic shock). Delayed surgery was indicated in 20 out of the 59 remaining patients for clinical or endoscopic aggravation. Six of these patients died (30%). Multivariate analysis selected 4 factors of severity: age younger than 80 years, male sex, absence of bleeding, and abdominal tenderness. In the follow-up period 13 patients died from a cardiovascular disease. The 2- and 5-year actuarial survival rates of patients who survived the initial hospitalization were 88% and 68%, respectively. CONCLUSIONS: Multivariate analysis selected the risk factors of severity. In severely ill patients serial endoscopic evaluations are the best indicator for surgery before appearance of tenderness, septic shock, full-thickness gangrene, and perforation. At discharge, anticoagulant or anti-arrhythmic therapy should be considered for patients who have cardiovascular disease.