门静脉部分结扎大鼠门脉血中一氧化氮水平与高动力循环综合征的关系

目的：了解一氧化氮（NO）在高动力循环综合征（HCS）形成中的作用以及NO水平升高或降低时对HCS的影响。方法：结扎大鼠部分门静脉使之形成稳定的HCS模型后，应用一氧化氮合成酶（NOS）抑制剂NG-甲基-L-精氨酸（L-NMMA）处理前、后检测其门静脉血中NO含量及肝组织NOS活性，同时检测左心室功能及血流动力学指标。结果：门静脉部分结扎后大鼠门静脉血中NO含量及肝组织中NOS活性二者呈平行变化，与HCS的形成关系密切；在注射L-NMMA后门静脉血中NO含量及肝组织中NOS活性均明显降低并接近对照水平，HCS明显缓解。结论：NO在HCS形成中起关键作用。降低或消除NO的作用则能明显缓解或阻断HCS，使门静脉压力明显降低直至恢复到正常范围。     

阻塞性黄疸时L-精氨酸对肾功能的保护作用

目的：研究阻塞性黄疸（OJ）时，L－精氨酸（L－Arg)对肾功能的保护作用。方法：胆总管结扎大鼠30只，随机分成生理盐水对照（NS）组、L－精氨酸（L－Arg)组和L－硝基精氨酸（L－NNA）组，每组10只。胆总管结扎后第2天起分别腹腔注射1ml NS、1ml L-Arg(500mg/kg)、1ml L-NNA(10mg/kg)，连用9d；假手术（SO）组用1ml NS腹腔注射。观察各组肾功能的变化，同时测定血和肾组织内皮素（ET）、一氧化氮（NO）水平、一氧化氮合酶（NOS）活性和丙二醛（MDA）的含量。并用图像分析检测ET1 mRNA和NOS mRNA表达的部位及量的变化。结果：用L－Arg后，血和肾组织NOS活性增加，肾组织ET1 mRNA表达减少，血和肾组织ET下降，NO升高；同时伴有内生肌酐清除率（Ccr)、肾皮质平均血流（RCBF）的升高，肾组织MDA含量降低。结论：L－Arg通过增强血和肾组织NOS活性来增加体内NO水平、抑制ET1 mRNA表达、降低体内ET水平，从而提高Ccr与RCBF，减轻阻塞性黄疸时的肾功能损伤。     

抗生素治疗原发性腹膜炎患者对血浆一氧化氮、内毒素及门脉血流动力学的影响

目的研究抗生素治疗肝硬化原发性腹膜炎病人对血浆一氧化氮、内毒素及门脉血流的影响。方法用抗生素治疗肝硬化原发性腹膜炎病人47例，检测治疗前、后病人血浆一氧化氮（NO）、内毒素水平（LPS）；用彩色多普勒检测治疗前、后门脉主干内径、门脉主干及门脉左支矢状部血流速度。结果治疗后血浆NO、内毒素水平明显低于治疗前（P〈0．035、0．044）；门脉主干及门脉左支矢状部血流速度较治疗前明显增加（P〈0．025、0．05）；但门脉内径无明显变化（P〈0．07）。结论抗生素治疗肝硬化原发性腹膜炎可降低血浆NO、内毒素水平，增加门静脉血流。     

血吸虫病门静脉高压兔肺组织病变的实验研究

目的探讨血吸虫病肝硬化门静脉高压症时肺组织的病理变化和内皮素1(ET1)、NO在肺血管病变机制中的作用。方法运用腹部敷贴法感染血吸虫尾蚴制作大耳白兔肝硬化门静脉高压症动物模型(n=10),采用免疫组化技术和HE染色、Masson三色染色及透射电镜方法研究血吸虫病肝硬化门脉高压症兔肺组织病理改变和ET1、NO合酶(NOS)的表达、分布。结果门脉高压症兔肺组织中ET1、NOS阳性或强阳性表达伴病理学改变,正常兔为阴性或弱阳性,图像定量分析两组灰度值和吸光度值差异具有统计学意义(P<0.01)。结论血吸虫病肝硬化门脉高压症时兔肺组织发生明显的病理改变,ET1、NO可能在血吸虫病门脉高压症肺血管病变发病机制中具有重要意义。     

冠状动脉旁路术围术期肺动脉血浆一氧化氮合成酶活性与一氧化氮浓度的变化

目的 研究冠状动脉旁路术围术期肺动脉血浆一氧化氮合成酶（NOS）活性和一氧化氮（NO）浓度的变化。方法 选择30例冠状动脉旁路手术（CABG）病人,在围术期抽取肺动脉血测定NOS和NO值。结果 肺动脉血浆中NOS和NO水平虽有明显变化（P＜0．05）,但NO浓度与NOS活性的增减并不一致：当NOS活性降低时,NO浓度增高;反之当NOS活性显著增高时,NO浓度降低。结论 在行CABG围术期中,肺动脉血浆中内源性NO分泌无法满足应激时自身保护对其的需要。     

内毒素对脐静脉内皮细胞分泌功能的影响

目的 探讨内毒素对脐静脉内皮细胞分泌功能的影响。方法 选择体外培养的人脐静脉血管内皮细胞（HUVEC）为研究对象，分别用内毒素，L－左旋精氨酸和硝基左旋精氨酸进行处理，并检测上清液中内皮素－1（ET－1）和一氧化氮（NO）含量。结果 内毒素使ET－1和NO含量增加；NO则使ET－1的含量降低。结论 内毒素能导致人脐静脉内皮细胞损伤，使ET－1和NO的合成和释放增加；NO则抑制ET－1的合成和释放。     

一氧化氮合酶与门脉高压高动力循环

门脉高压症高动力循环的主要特征是全身血管扩张、低血压、心率增加、全身血管阻力降低和组织血流量增加。这种改变常在内脏循环特别是门静脉循环改变的基础上发生。虽然高动力循环可在一定程度上保证组织灌注，但长期高心输出量易致心肌功能受损，而低血压状态最终导致脏器灌流不足，从而产生各种病理生理效应。这可能是肝硬化门脉高压症时多器官损害的原因【门。近年的临床和实验研究均发现一氧化氮（NO）产量增加在门脉高压高动力循环的血管扩张中起作用卜］。NO过多产生是原生型一氧化氮合酶卜NOS）或诱导型一氧化氮合酶（iNOS）增…     

葛根素对肝硬化大鼠肝脏缺血再灌注损伤保护作用及其保护机制的研究

目的观察葛根素（Pue）对肝硬化大鼠肝脏缺血再灌注损伤是否具有保护作用，及其保护机制。方法首先建立大鼠肝硬化动物模型，在此模型基础上建立大鼠全肝缺血再灌注模型，比较用Pue预处理对缺血再灌注后，肝组织光镜下的形态学改变；血清中丙氨酸氨基转移酶（ALT）、天冬氮酸氨基转移酶（AST）和氧化亚氮（NO）、丙二醛（MDA）含量、超氧化物歧化酶（SOD）活性，及肝组织中NO、肿瘤坏死因子α（TNF-α）、MDA含量、SOD活性变化。结果Pue预处理可使大鼠血清NO含量、肝组织NO含量及SOD活性明显增高；而血清ALT、AST、MDA含量及肝组织TNF—α、MDA含量明显降低；肝组织形态损伤也有所减轻。结论葛根素对肝硬化大鼠肝缺血再灌注损伤有显著的保护作用，其主要机制是减少NO的降低、扩张血管、改善微循环；清除氧自由基、减轻脂质过氧化。     

内皮素、一氧化氮与阻塞性黄疸肾功能障碍关系的实验研究

目的 研究内皮素(Endothelin ET)、一氧化氮(Nitric Oxide NO)与阻塞性黄疸(Obstructive Jaundice OJ)肾功能障碍的关系。方法 雄性SD大鼠胆总管结扎后随机分成5天、10天、15天三组，同时建立对应的假手术对照组。观察肾功能的变化，同时测定血和肾组织ET、NO水平及一氧化氮合酶(Nitric Oxide Synthetase NOS)活性，并用图像分析检测ET—1mRNA和NOS—mRNA表达的部位和量的变化。结果 随胆总管梗阻时间的延长，血和肾组织ET升高，NO下降，ET／NO比值与内生肌酐清除率(Creatinine clearance rate Ccr)、肾皮质血流(Renal cortex blood flow RCBF)呈负相关。肾组织ET—1mRNA和iNOS mRNA表达增加，血和肾组织NOS活性降低。结论 血和肾组织ET升高，NO下降，ET／NO比值升高是导致OJ时肾功能损伤的原因之一。     

一氧化氮吸入治疗急性肺损伤的作用机制

目的：探讨一氧化氮（NO）对内毒素致伤大鼠急性肺损伤（ALI）肺组织核因子－KB（NF-kB)活性及肿瘤坏死因子－α（TNF－α）水平的影响和防治ALI的作用机理。方法：观察内毒素（LPS）和LPS／NO对大鼠血氧分析和肺组织损伤的影响,并采用凝胶电泳迁移率改变（EMSA）法检测肺组织核蛋白提取物中NF－kB活性和检测的特异性及酶联免疫检测（ELISA）测定肺组织匀浆TNF－α含量改变。结果：NO吸入后,显著抑制LPS静注致大鼠急性肺损伤,肺组织核蛋白NF－kB活性的增强以及肺组织匀浆TNF－α含量的升高。结论：NO通过抑制NF－kB活性,下调TNF－α等炎症分子表达而发挥抗炎的防治ALI的作用。     

2015年乳腺癌辅助化疗进展

【摘要】〓乳腺癌是危害我国女性健康的头号杀手,尽管近年来辅助化疗的研究进展突飞猛进,但临床中仍有不少问题未能明确,如辅助化疗的合适人群、化疗的开始时间、蒽环及紫杉类的地位和用法、强化维持治疗的作用、疗效及预后的生物标志物等。本文结合乳腺癌辅助化疗在临床上的常见问题和2015年各大乳腺癌会议阐述乳腺癌辅助化疗的最新进展。     

Alterations in T-Cell Subset Frequency in Peripheral Blood in Obesity

Background: Obesity affects the regulation of immune and inflammatory responses. This study characterizes differences in peripheral blood lymphocyte phenotype in obese humans. Methods: Frequencies of lymphocyte subsets among peripheral blood mononuclear cells were compared between 10 obese (BMI ≥35) and 10 lean subjects, as determined by antibodies directed against cluster differentiation (CD) markers. Results: Obese patients demonstrated an increased frequency of CD3+CD4+ T-cells (mean difference 12%, P=0.004), a decreased frequency of CD3+CD8+ T-cells (mean difference 9.4%, P=0.016) and an increased frequency of CD3+CD8+CD95+ T-cells (mean difference 13.3%, P=0.032). No other differences among T-cell or monocyte subsets were noted. Conclusions: Obesity is associated with alterations in frequencies of peripheral CD4+ and CD8+ T-cells and aberrations in the expression of CD95 among CD8+ T-cells. These data suggest both CD4+ and CD8+ T-cell compartments, as well as the regulation of CD95 expression on CD8+ T-cells, as targets for further study into obesity's effects on the immune system.     

西宁地区烧伤病人动脉血气分析观察

对高海拔地区的27例烧伤病人动脉血气变化进行了分析和观察。结果证明:无论是存活病人还是死亡病人伤后均存在有低氧血症问题。并且在死亡病人和烧伤合并吸入性损伤病人其低氧血症的发生早于单纯烧伤病人。提示:吸入性损伤病人应立即行气管切开术以保障氧气供给,单纯烧伤病人可常规吸氧以维持正常血 PaO_2,ARDS 均发生在合并吸入性损伤的病人,高频喷射通气技术对纠正低氧血症有一定效果。     

Controversies in Fistula in Ano

Managing a complex fistula in ano can be a daunting task for most surgeons; largely due to the two major dreaded complications—recurrence & fecal incontinence. It is important to understand the anatomy of the anal sphincters & the aetiopathological process of the disease to provide better patient care. There are quite a few controversies associated with fistula in ano & its management, which compound the difficulty in treating fistula in ano. This article attempts to clear some of those major controversies.     

β-半乳糖苷酶在体内外成骨细胞中的表达

目的 研究β—半乳糖苷酶(β—gal)在成骨细胞中的表达状况，为阐明MorquioB综合征的发病机制提供依据。方法 裸鼠各器官和骨组织标本行X-gal染色检测。抽取羊和人骨髓行骨髓基质细胞(BMSCs)培养，分为4组：I：Adv-hBMP-2转染组；Ⅱ：Adv—β—gal转染组；Ⅲ：未转染组；Ⅳ：地塞米松诱导组。分别行X-gal染色和RT-PCR检测β—gal的表达。结果 裸鼠骺板两侧、骨膜内面及松质骨的成骨细胞和破骨细胞可见多量β—gal的表达。未转染BMSCs组有少量β—gal的表达，其他3组细胞的β—gal表达增高。结论成骨细胞和破骨细胞可表达多量β—gal，该两种细胞的β—gal缺乏可能是MorquioB综合征骨骼异常的直接原因。     

Smoking-Attributable mortality in Spain in 2016

IntroductionSmoking-attributable mortality (SAM) is a valuable indicator that can be used to characterize the course and health burden of the smoking epidemic. The aim of this paper was to estimate SAM in Spain in 2016 in the population aged 35 and over, using the best available evidence.MethodsA smoking prevalence-dependent analysis based on the estimation of population-attributable fractions was performed. Smoking prevalence (never, former, and current smokers) was calculated from a combination of the Spanish Health Survey (2016) and the European Health Survey (2014); the relative risk of death among current and former smokers was taken from the follow-up of various cohorts; and mortality rates were obtained from National Center for Statistics data. SAM estimates are presented globally, and by sex, age groups, and major disease categories: cancer, cardiometabolic diseases and respiratory diseases.ResultsIn 2016, 56,124 deaths were attributed to tobacco consumption, 84% in men (47,000), and 50% in the population aged over 74 (27,795). Overall, 50% of SAM was due to cancer (28,281), 65% of which was lung cancer. One in 4 attributable deaths (13,849) occurred before the age of 65.ConclusionsOne in 7 deaths in Spain in 2016 were attributable to smoking. This estimation of SAM clearly highlights the great impact of smoking on mortality in Spain, mainly due to lung cancer and chronic obstructive pulmonary disease.     

MicroRNAs in hepatic pathophysiology in diabetes

MicroRNAs(miRNAs or miRs) are small approximately 22 nucleotide RNA species that are believed to regulate diverse metabolic and physiological processes.In the recent past,several reports have surfaced that demonstrate the role of miRNAs in various biological processes and numerous disease states.For a disease as complex as diabetes,the emergence of miRNAs as key regulators leading to the disease phenotype has added a novel dimension to the area of diabetes research.On the other hand,the liver,a metabolic hub,contributes in a major way towards maintaining normal glucose levels in the body as it can both stimulate and inhibit hepatic glucose output.This equilibrium is frequently disturbed in diabetes and hence,the liver assumes special significance considering the correlation between altered hepatic physiology and diabetes.While the understanding of the mechanisms behind this altered hepatic behavior is not yet completely understood,recent reports on the status and role of miRNAs in the diabetic liver have further added to the complexities of the knowledge of hepatic pathophysiology in diabetes.Here,we bring together the various miRNAs that play a role in the altered hepatic behavior during diabetes.     

Fluid-phase transcytosis in the primate epididymis in vitro and in vivo

Ligated tubules from the corpus epididymidis of men and monkeys were incubated in medium containing horseradish peroxidase (HRP) as a marker for fluid-phase endocytosis. HRP was localized by light and electron microscopy after 0, 15, 30 and 60 min of incubation. Movement between the cells was prevented by tight junctions, but bypass of this barrier was apparently achieved by an intracellular vesicular mechanism leading to a time-dependent appearance of HRP in the lumen. Uptake of HRP into basal cells and capture by the lysosomal apparatus of principal cells were also observed. HRP-filled vesicles also appeared in the basal, mid and apical cytoplasm of epithelial cells in the caput 1 h after injection of the tracer into the epididymal circulation of the monkey, suggesting that this pathway also operates in vivo.