充血性心衰患者血浆内皮素和一氧化氮变化的临床意义及培哚普利的干预作用

为了解充血性心衰（ＣＨＦ）时心钠素（ＡＮＦ），内皮素（ＥＴ）和一氧化氮（ＮＯ）变化的临床意义及培哚普利的于预作用，我们选择４０例临床确诊为ＣＨＦ的患者，并随机分为培哚普利治疗组和常规治疗组，放免法测定血浆ＡＮＦ，ＥＴ含量，比色法测定血浆ＮＯ含量，与正常对照组比较，并观察治疗前后上述指标的变化情况。结果ＣＨＦ患者的血浆ＡＮＦ，ＥＴ水平均显著高于对照组（Ｐ＜０．０１），ＮＯ明显低于对照组（Ｐ＜０．０５）。常规治疗组治疗前后上述指标无明显改变（Ｐ＞０．０５），培哚普利平均治疗８周后ＡＮＦ，ＥＴ显著下降（Ｐ＜０．００１）而ＮＯ显著上升（Ｐ＜０．０５），提示ＡＮＦ，ＥＴ和ＮＯ参与了ＣＨＦ的病理生理过程。培哚普利可以降低ＣＨＦ的治疗有益。     

一氧化氮在充血性心力衰竭患者血浆中含量变化及意义的探讨

为了探讨一氧化氮（ＮＯ）在充血性心力衰竭（ＣＨＦ）患者血浆中含量变化及其意义，应用比色法测定７０例ＣＨＦ患者治疗前后血浆ＮＯ水平，结果显示：ＣＨＦ患者治疗前、后血浆ＮＯ均显著高于对照组（均Ｐ＜０．０１），不同心功能分级组间ＮＯ有显著性差异（均Ｐ＜０．０１）。治疗后较治疗前心功能平均改善１．３级，且血浆ＮＯ下降有统计学意义（Ｐ＜０．０５）。提示：①ＮＯ可作为判定ＣＨＦ程度的指标；②ＮＯ在ＣＨＦ病理生理改变中起重要作用。     

肝硬化患者血清一氧化氮与肿瘤坏死因子—α的相关研究

目的　了解肝硬化患者血清一氧化氮（ＮＯ） 与肿瘤坏死因子－ α（ＴＮＦ－ α） 的变化,并探讨二者之间的关系。方法　用Ｇｒｉｅｓｓ 方法及放免法分别检测５０ 例肝硬化及３０ 例正常人血清ＮＯ 与ＴＮＦ－ α水平。结果　肝硬化患者与正常人比较,其血清ＮＯ 水平升高（ Ｐ＜ ０ ．００１） ,有腹水患者较无腹水者为高（ Ｐ＜ ０ ．０５） ,且ＮＯ 水平随Ｃｈｉｌｄ － Ｐｕｇｈ Ａ、Ｂ、Ｃ 分级的次序而增加。同时肝硬化患者血ＴＮＦ－ α亦明显增加（ Ｐ＜ ０ ．００１） ,并与ＮＯ 呈正相关（ｒ ＝ ｏ ．６２ ,Ｐ＜ ０ ．００１） 。结论　肝硬化患者血ＮＯ 升高,有腹水者更高,且ＮＯ 水平随Ｃｈｉｌｄ － Ｐｕｇｈ Ａ、Ｂ、Ｃ 分级的次序而增加,提示ＮＯ 可能参与了肝硬化高动力循环与腹水的形成,并能反映患者的预后。同时ＴＮＦ－ α亦升高,且与ＮＯ 呈正相关,为ＴＮＦ－ α诱导ＮＯ 生成提供了依据     

前列腺素E1对肺心病心衰疗效的观察

探讨前列腺素Ｅ１静脉滴注对肺心病心衰的疗效。方法对３０例肺心病心衰患者，应用前列腺素Ｅ１（ＰＧＥ１）２００μｇ／ｄ静脉滴注，疗程５天。于治疗前后同步检测内源性洋地黄因子（ＥＤＦ）、过氧化脂质（ＬＰＯ）、超氧化物歧化酶（ＳＯＤ）及动脉血氧分压（ＰａＯ２）、动脉血二氧化碳分压（ＰａＣＯ２）和观察症状体征变化，并与对照组（不用ＰＧＥ１）的３０例肺心病心衰患者及２０例健康者进行比较。结果两组肺心病心衰患者的ＥＤＦ、ＬＰＯ显著高于健康组（Ｐ＜０．００１），ＳＯＤ含量则显著降低（Ｐ＜０．００１）。治疗组病例治疗后ＥＤＦ、ＬＰＯ较治疗前显著降低（Ｐ＜０．００１），ＳＯＤ含量则显著升高（Ｐ＜０．００１），症状体征及血气参数显著改善（Ｐ＜０．０１～０．００１）。对照组（不用ＰＧＥ１）病例的ＥＤＦ、ＬＰＯ、ＳＯＤ、血气参数及症状体征，于治疗前、后无显著变化（Ｐ＞０．０５）。结论ＰＧＥ１对肺心病心衰患者确有较好的疗效。     

扩张型心肌病TNF和IL－1的检测及意义

应用双抗体夹心法及ＣｏｎＡ小鼠胸腺细胞增殖法分别检测３０例扩张型心肌病（ＤＣＭ）及２０例正常人（ＮＣ）的血清肿瘤坏死因子（ＴＮＦ）和白细胞介素１（ＩＬ－１）的水平，结果发现ＤＣＭ病人ＴＮＦ及ＩＬ－１均明显高于ＮＣ组（Ｐ＜０．００１，Ｐ＜０．０１），提示ＴＮＦ与ＩＬ－１可能在ＤＣＭ的发病机理中起重要作用。     

甘草对慢性阻塞性肺疾病患者糖皮质激素受体的影响

目的　研究甘草和甲泼尼龙对慢性阻塞性肺疾病（ＣＯＰＤ） 患者外周血白细胞糖皮质激素受体（ＧＣＲ）的影响。方法　将４５ 例ＣＯＰＤ患者根据用药情况分为甘草组、激素组和甘草、激素联合组各１５ 例。另选１０ 名健康体检者为正常组。应用放射配基结合试验检测患者治疗前后ＧＣＲ,放免法检测血浆皮质醇（Ｆ） 、促肾上腺皮质激素（ＡＣＴＨ） 水平,并同时检测肺功能。结果　ＣＯＰＤ 急性加重期患者Ｆ、ＡＣＴＨ 比正常组高,差异有显著性（ Ｐ＜ ０－００１） ,ＧＣＲ低于正常组（ Ｐ＜ ０－００１） ,甘草、激素、甘草激素联合组治疗后一秒种用力呼气容积占预计值百分比（ＦＥＶ１ 占预计值％ ） 均升高,尤以甘草激素联合组明显（ Ｐ＜０－００１） ,同时甘草上调ＧＣＲ,激素下调ＧＣＲ,二药联合应用ＧＣＲ 无显著变化。结论　甘草能够逆转激素对自身受体的下调作用,显著增强和延长激素疗效。     

阻塞性睡眠呼吸暂停患者持续正压通气治疗前后自主神经系统功能的研究

目的研究阻塞性睡眠呼吸暂停（ＯＳＡ）患者夜间睡眠时自主神经功能的状态，以及有效的持续正压通气治疗对自主神经张力的影响。方法对５６例重度ＯＳＡ患者持续正压通气（ＣＰＡＰ）治疗前和治疗中进行夜间７小时多导睡眠图（ＰＳＧ）及动态心电图监测，另择３０名正常受试者作为对照。采用心率功率谱分析法（ＨＲＰＳＡ）定量分析ＯＳＡ患者治疗前后夜间自主神经功能的变化。结果ＯＳＡ组夜间睡眠时伴随着反复的呼吸暂停和低氧血症，低频（ＬＦ）及高频（ＨＦ）值逐渐增高，与对照组比较差异有显著性（ＬＦ为１３８３±３０５∶１２５±６４，Ｐ＜０．００１；ＨＦ为６６２±１９０∶１６３±７８，Ｐ＜０．００１），表明交感神经和副交感神经张力均明显增高。夜间平均ＬＦ／ＨＦ比率在较高水平（２１１±１０１），与对照组（０８７±０６４）比较差异有显著性（Ｐ＜０．０５），说明以交感神经张力增加更为显著。经过有效的ＣＰＡＰ治疗，ＯＳＡ患者ＬＦ（２２１±８１）、ＨＦ（２２１±１０８）明显降低（Ｐ＜０．００１）。结论ＯＳＡ患者夜间有自主神经功能紊乱。针对ＯＳＡ的有效治疗可以改善自主神经的异常活动     

一氧化氮等自由基与脑出血关系的研究

目的探讨一氧化氮等自由基与脑出血的关系。方法检测１３３例脑出血患者和１００例健康对照者血浆一氧化氮（Ｐ－ＮＯ）、维生素Ｃ（Ｐ－ＶＣ）、维生素Ｅ（Ｐ－ＶＥ）、β－胡萝卜素（Ｐ－β－ＣＡＲ）和过氧化脂质（Ｐ－ＬＰＯ）含量及红细胞超氧化物歧化酶（Ｅ－ＳＯＤ）、过氧化氢酶（Ｅ－ＣＡＴ）、谷胱甘肽过氧化物酶（Ｅ－ＧＳＨ－Ｐｘ）活性和过氧化脂质（Ｅ－ＬＰＯ）含量。结果与对照组比较,患者组Ｐ－ＮＯ、Ｐ－ＬＰＯ、Ｅ－ＬＰＯ均值显著升高（Ｐ＜０．００１）,Ｐ－ＶＣ、Ｐ－ＶＥ、Ｐ－β－ＣＡＲ、Ｅ－ＳＯＤ、Ｅ－ＣＡＴ、Ｅ－ＧＳＨ－Ｐｘ均值显著降低（Ｐ＜０．００１）;逐步回归发现,患者病情（ＮＤＳ）与Ｐ－ＮＯ、Ｐ－ＶＣ、Ｅ－ＬＰＯ值相关最为密切,颅内血肿量与Ｐ－ＮＯ、Ｐ－ＶＥ、Ｅ－ＬＰＯ值相关最为密切。结论脑出血患者体内自由基反应病理性加剧,氧化抗氧化平衡严重失     

冠心病患者红细胞变形能力与红细胞膜脂质成分和PAF－AH活性关系的研究

本文检测了１１２例冠心病（ＣＨＤ）患者红细胞变形能力（ＥＤ）和膜脂质成分及血小板激活因子乙酰水解酶（ＰＡＦ－ＡＨ）活性变化。结果显示，ＣＨＤ病人红细胞滤过指数（ＩＦ）较对照组明显增高（Ｐ＜０．００１）；膜胆固醇（Ｃｈ）、脂质过氧化物（ＭＤＡ）和Ｃｈ／磷脂（Ｃｈ／ＰＬ）明显增高，而膜ＰＬ和ＰＡＦ－ＡＨ活性明显降低，与对照组相比差异有显著性意义（Ｐ＜０．００１）。ＣＨＤ患者ＩＦ与膜Ｃｈ、ＭＤＡ和ＣＵＰＬ呈正相关，与膜ＰＬ和ＰＡＦ－ＡＨ呈负相关。提示ＣＨＤ患者ＥＤ降低与红细胞膜脂质成分异常和ＰＡＦ－ＡＨ活性降低有关。     

乙肝后肝硬化患者血清IL—1β,TNF—α变化对骨代谢影响的临？…

为探讨细胞因子对乙肝后肝硬化骨代谢的影响，采用ＲＩＡ及ＥＬＩＳＡ分别测定３６例乙肝后肝硬化患者血清ＩＬ－１β、ＴＮＦ－α水平及骨密度测量，并与１５例健康者对照。结果表明，肝硬化患者血清ＩＬ－１β、ＴＮＦ－α水平较对照组显著升高（Ｐ〈０．００１，Ｐ〈０．００１），其中骨质疏松（ＯＰ）组较非骨质疏松（ＮＯＰ）组均升高明显（Ｐ〈０．００１，Ｐ〈０．０１），且两组间Ｃｈｉｌｄ－ＰｕｇｈＡ、Ｃ级同级分别比较     

Advances in Retinal Tissue Engineering

Retinal degenerations cause permanent visual loss and affect millions world-wide. Current treatment strategies, such as gene therapy and anti-angiogenic drugs, merely delay disease progression. Research is underway which aims to regenerate the diseased retina by transplanting a variety of cell types, including embryonic stem cells, fetal cells, progenitor cells and induced pluripotent stem cells. Initial retinal transplantation studies injected stem and progenitor cells into the vitreous or subretinal space with the hope that these donor cells would migrate to the site of retinal degeneration, integrate within the host retina and restore functional vision. Despite promising outcomes, these studies showed that the bolus injection technique gave rise to poorly localized tissue grafts. Subsequently, retinal tissue engineers have drawn upon the success of bone, cartilage and vasculature tissue engineering by employing a polymeric tissue engineering approach. This review will describe the evolution of retinal tissue engineering to date, with particular emphasis on the types of polymers that have routinely been used in recent investigations. Further, this review will show that the field of retinal tissue engineering will require new types of materials and fabrication techniques that optimize the survival, differentiation and delivery of retinal transplant cells.     

Ⅱ型糖尿病患者机体脂质过氧化及抗氧化能力研究

测定了Ⅱ型糖尿病患者及健康对照者红细胞超氧化物歧化酶、血中谷胱甘肽过氧化物酶、过氧化氢酶活力及丙二醛（ＭＤＡ）含量。结果：糖尿病患者病程从～１０年组ＳＯＤ活力开始下降，与对照组比较差异有高度显著性（Ｐ＜０．０１），与病程呈高度负相关。ＧＳＨ－Ｐｘ、ＭＤＡ与对照组比较差异均有高度显著性（Ｐ＜０．０１），并与病程呈高度正相关，ＣＡＴ仅１５年以上组与对照组比较差异有显著性（Ｐ＜０．０１），与病程相关不显著（Ｐ＞０．０５）。结果说明，Ⅱ型糖尿病患者脂质过氧化作用增强及抗氧化能力下降，对心血管系统造成氧化性损伤是心血管并发症的重要原因之一。     

膈肌功能测定及其在慢性阻塞性肺疾病中的应用

目的　比较最大跨膈压 (Pdimax)、最大口腔吸气压 (MIP)、最大吸鼻跨膈压 (Pdisniff)和颤搐性跨膈压(Pdi(t)ele)在评价膈肌功能中的差异及其在慢性阻塞性肺疾病 (COPD)中的应用。方法　对 13例正常者和 7例轻度与 7例重度COPD病人分别测定Pdimax、MIP、Pdisniff和Pdi(t)ele。结果　 (1)正常对照组的Pdimax、MIP、Pdisniff与轻度COPD组比较差异无显著性 ,与重度COPD组比较差异有显著性 (P 分别为 :<0 0 1、0 0 5和 0 0 5 ) ;而正常对照组Pdi(t)ele均比轻度和重度COPD组的高 (P均 <0 0 1)差异显著。 (2 )Pdi(t)ele的个体内变异性在正常对照组中均比Pdimax、MIP、Pdisniff小 (P分别为 :<0 0 1、0 0 1和 0 0 5 ) ;在COPD组中 ,明显比Pdimax小 (P <0 0 1) ,而与MIP和Pdisniff比较差异没有显著性。 (3)Pdi(t)ele与FEV1具有显著相关性 (P <0 0 5 )。结论　Pdi(t)ele能更客观、更敏感地反映膈肌功能。     

Chemical dissolution of gallstones in Taiwan: An in vitro study

Abstract To evaluate the potential for the chemical dissolution of gallstones, 480 stones from 214 patients were studied. The stones were obtained via surgery or endoscopically. They were classified into cholesterol-rich mixed stones, brown pigment stones and black stones. The composition of bilirubin and cholesterol was determined by Fourier transformed infrared spectroscopy. Two per cent tetrasodium ethylenediamine acetate (EDTA), dimethylsulfoxide (DMSO) or methyl-tert-butyl-ethylene (MTBE) were used to dissolve the stones. To enhance solubility, surfactant polysorbate-20 was used to mix two of the individual three solvents. Methyl-tert-butyl-ethylene was found to have the best dissolution ability (by dry weight) 94, 13.4 and 20% for mixed, brown and black stones, respectively. Dimethylsulfoxide resulted in 13, 14 and 25% dissolution and EDTA 9.5, 13 and 16.5%. In contrast, pure water dissolved 4, 6 and 10.4% of the stones, respectively. A combination of the dissolution agents did not enhance the dissolution rate. In fact, the combination of solvents unexpectedly reduced the solubility of the stones: EDTA/MTBE was 17.5, 6.7 and 16.0%; DMSO/MTBE 43.2, 21.9 and 18.0%; DMSO/EDTA 9.1, 7.0 and 9.6%. In conclusion, cholesterol-rich mixed stones were able to be dissolved using MTBE but results of contact dissolution for gallstones are still far from satisfactory.     

慢性特发性血小板减少性紫癜患者PAIgG、ACAIgG的测定及意义

应用ELISA法对 41例慢性特发性血小板减少性紫癜 (ITP)患者和 2 5例健康对照者进行血浆和 (或 )血清血小板相关抗体 (PAIgG)、抗心磷脂抗体 (ACAIgG)测定 ,并常规血小板计数。发现ITP患者治疗有效组治疗后血小板计数明显升高、PAIgG含量显著降低 ,治疗前较治疗后及对照组均有显著性差异 (P <0 .0 1 ) ,且血小板计数与PAIgG之间呈显著性负相关 (r =- 0 .738,P <0 .0 0 1 )。而治疗无效组血小板计数、PAIgG均无明显变化。ACAIgG治疗前后无明显变化 ,且未发现与血小板及PAIgG相关。PAIgG、ACAIgG含量增高提示ITP患者针对血小板磷脂及其他糖类蛋白等不同抗原产生了自身免疫反应 ,为免疫抑制剂的应用提供了理论依据     

Commonalities in vasoactive intestinal peptide and peptide N-terminal histidine C-terminal isoleucine stimulation of N-acetyltransferase activity in the rat pineal

Abstract: Exposure of adult rat pineal glands in organ culture to the polypeptides vasoactive intestinal polypeptide (VIP), and peptide N-terminal histidine C-terminal isoleucine (PHI) increases pineal serotonin N-acetyltransferase (NAT) activity and melatonin synthesis. The following research results are taken to indicate that VIP and PHI share common components of the NAT induction system: (1) The effects of the two peptides are additive at concentrations of 10 nM VIP and 100 nM PHI but not at higher peptide concentrations. (2) Pineals from newborns also respond to PHI with a dose dependent increase in NAT activity. NAT responses are additive at the same concentrations as seen with the adult pineals. (3) Light exposure affects the sensitivity of pineals to VIP and PHI stimulation in a similar manner; pineals taken after 3 hr of light are much less sensitive to PHI or VIP than those taken after 13 hr of light. (4) Pineals exposed for 48 hr to either PHI or VIP have a reduced NAT response to either agonist, which is reversible by culture in agonist-free media. (5) Neither VIP nor PHI stimulation of NAT activity is affected by concentrations of the VIP antagonists (N-Ac-Tyr¹, D-Phe²)-GRF(l-29)-NH2 (NAcTDGRF), L-8-K, VIP-Neurotensin Hybrid (VIPNET), or (4Cl-D-Phe⁶, Leu¹⁷)-VIP (4C1PLVIP), which affect VIP binding or function in other tissues.     

同型半胱氨酸对血管内皮细胞合成蛋白聚糖的影响

为探讨同型半胱氨酸对血管内皮细胞合成蛋白聚糖的影响，采用400umol／L同型半胱氨酸作用于培养的人脐静脉内皮细胞，以^35S-Na2SO4为示踪物标记细胞合成的蛋白聚糖，通过离子交换层析，凝胶过滤层析分离蛋白聚糖。结果发现，实验组培养液中总蛋白聚糖降低，硫酸乙酰肝素蛋白聚糖及硫酸软骨素-硫酸皮肤素蛋白聚糖含量也降低，但其百分含量未见改变。细胞层中蛋白聚糖未见明显变化。     

Flow-mediated dilation and gender in patients with coronary artery disease: arterial size influences gender differences in flow-mediated dilation

BACKGROUND: The risk of atherosclerosis and its complications differs between male and female subjects. This is probably associated with gender differences in endothelial function as reflected by endothelium-dependent vasodilation. The aim of the study was to compare flow-mediated dilatation (FMD) in males and females with coronary artery disease (CAD), and to determine factors that might potentially influence FMD. METHODS: Ninety-six patients with stable CAD (CCS II-III): 76 males (mean age: 57.7 +/- 10 years) and 20 postmenopausal females (mean age: 60.1 +/- 10 years) were included into the study. Clinical data, pharmacotherapy, concomitant diseases, and FMD were all assessed. FMD was measured with high-resolution ultrasound as the percent change of brachial artery diameter (BAd) after a 3-minute occlusion (%FMD), and following the administration of 0.4 mg sublingual nitroglycerin (%NTG-MD). RESULTS: The percentage of FMD was significantly decreased (P < 0.05), and BAd was significantly larger (P < 0.001) in males as compared to females. Clinical data, pharmacotherapy, and concomitant diseases were comparable in the study groups.In all subjects examined, %FMD was related to BAd (r =-0.415, P < 0.001) and the percentage of ejection fraction (EF%) (r = 0.325, P < 0.01) in the univariate analysis, and to BAd only (r =-0.343, P < 0.01) in the multivariate analysis. The percentage of nitroglycerine-mediated vasodilatation (NTG-MD) correlated negatively with BAd (r =-0.430, P < 0.001), and positively with EF% (r = 0.334, P < 0.01) in the univariate analysis, and with BAd (r =-0.288, P < 0.05) in the multivariate analysis. Index %FMD x BAd was comparable for male and female subjects. CONCLUSIONS: Males and postmenopausal females with CAD show differences in endothelium-dependent vasodilatation that seem to secondarily result from differences in the BAd. Objective comparison of %FMD is only possible between patients with the same brachial artery size.     

Regulation of Intracellular pH in Periportal and Perivenular Hepatocytes Isolated from Ethanol-Treated Rats

The aim of this study was to gain information on intracellular pH (pH_i) regulation in periportal (PP) and perivenular (PV) hepatocytes isolated from rats pair-fed liquid diets with either ethanol (T rats) or isocaloric carbohydrates (C rats). pH_i was analyzed by the pH-sensitive dye BCECF in perfused sub-confluent hepatocyte monolayers. Cells were acid-loaded by pulse exposure to NH₄Cl and were alkali-loaded by suddenly reducing external C0₂ and HC0₃^-(from 10% and 50 mm , respectively, to 5% and 25 mm ) at constant pH_out. In cells from C rats: (a) steady-state pH_i was higher in PP than in PV hepatocytes in the presence, but not in the absence, of bicarbonate; (b) pH_i recovery from an acid load was 35% higher in PP than in PV cells in the presence of HC0₃^-, whereas it was similar in HC0₃^--free experiments; and, on the contrary, (c) pH_i recovery from an alkaline load was 30% higher in PV than in PP cells. In cells from T rats: (a) steady-state pH_i was always lower than in cells isolated from pair-fed animals; (b) steady-state pH_i was similar in PP and PV hepatocytes either in the presence or absence of bicarbonate in the perfusate; (c) pH_i recovery from an acid load was not significantly different in PP and PV cells either in the presence of HC0₃^- or in HC0₃^--free experiments; and (d) pH_i recovery from an alkaline load was similar in PP and PV cells. Our data suggest that chronic ethanol treatment selectively modifies pH, by affecting the activity of ion transport mechanisms regulating pH_i in PP and PV hepatocytes isolated from rat liver.     

纤溶酶原对星形胶质细胞纤溶酶原激活因子及其抑制的调节作用

目的 探讨纤溶酶原（PGn)对大鼠脑星菜胶质细胞纤溶酶原激活因子（PAI）及其抑制剂(PA)的调节作用。方法 利用大鼠血纤溶酶原对体外培养的星形胶质细胞进行诱导刺激,采用酶谱分析法、反射酶谱分析法、免疫印迹法对所产生的PAs和PAIs进行分析测定。结果 实验所用PGn调uPA和PAI－1,下调tPA活性,并且诱导产生一个28kDa的低分子量的uPA活性分子。结论 在体外,纤溶酶原有调节星形胶质细胞的功能。