Remote postconditioning induced by brief pulmonary ischemia and reperfusion attenuates myocardial reperfusion injury in rabbits

Background The lung is one of the most important organs that are sensitive to ischemia. We hypothesized that remote postconditioning (RPostC) induced by brief occlusion and reperfusion of the pulmonary artery could attenuate myocardial reperfusion injury.Methods Thirty rabbits were randomized into three groups. Group ischemia-reperfusion (IR) (n=10) were anesthetized rabbits subjected to 30-minute occlusion of the left anterior descending coronary artery followed by 180-minute reperfusion. Group RPostC (n=10) had the left pulmonary artery blocked for five minutes followed by a 5-minute reperfusion, and the left anterior descending coronary artery (LAD) occluded for 30 minutes with a 180-minute reperfusion. Group L-Nw-nitro-L-arginine methylester (L-NAME) + RPostC (n=10) had the left pulmonary artery blocked for five minutes followed by a 5-minute reperfusion and intravenous infusion of L-NAME (10 mg/kg), and the LAD occluded for 30 minutes with a 180-minute reperfusion. Blood samples were taken for levels of creatine kinase (CK),superoxide dismutase (SOD) and malondialdehyde (MDA) at three different time points. At the end of the experiment,tissue samples of the infarcted region were harvested to calculate the cardiomyocyte apoptosis index (Al) by TUNEL. A piece of left and right lung tissue was harvested to evaluate the damage to the lung.Results After reperfusion for 180 minutes, the concentration of CK was lower in group RPostC, (4.79±0.27) U/ml, than that in group IR, (6.23±0.55) U/ml (P ＜0.01), and group L-NAME + RPsotC, (5.86±0.42) U/ml (P ＜0.01). The concentration of MDA was lower in group RPostC, (6.06±0.36) nmol/ml, than that in group IR, (11.41±0.91) nmol/ml (P ＜0.01), and group L-NAME + RPostC, (11.06±0.62) nmol/ml (P＜0.01). The activity of SOD was higher in group RPostC,(242.34±25.02) U/ml, than that in group IR, (148.05±18.24) U/ml (P＜0.01), and group L-NAME + RPostC, (160.66±9.55) U/ml (P＜0.01). The apoptosis index was lower in group RPostC, (14.25±5.20)%, than that in group IR, (35.77±10.09)% (P ＜0.01), and group L-NAME + RPostC, (30.37±7.76)% (P ＜0.01). No significant difference caused by pulmonary ischemia was found in the lung tissue among the three groups.Conclusions RPostC may attenuate myocardial ischemia-reperfusion injury connected to the activity of endothelial nitric oxide synthase. Brief pulmonary ischemia may not be harmful to lungs.     

PROTECTIVE EFFECT OF INSULIN ON ISOLATED RAT HEARTS

The protective effect of preoperative intravenous infusion of high doses of insulin (2U/100gm) was studied in isolated rat heart models, using modified Langendorff apparatus. Fifteen rat hearts were equally divided into three groups: Group Ⅰ(control group) received glucose and potassium within 60 min. prior to the onset of operation. Group Ⅱ (insulin group) was administered with glucose, insulin and potassium(GIK)within 60 min. before operation, whereas Group Ⅲ(insulin cardioplegia group)was treated with the same amount of GIK Preoperatively as well as an addition of insulin (100U/L) to the cardioplegia. All the rat hearts were subjected to a 30-min. period of ischemia. Coronary effluent, lactic dehydrogenase (LDH) of coronary effluent, myocardial water content, histochemistry and ultrastructure of myocardium were studied. After reperfusion, the amount of coronary effluent was 2.84±0.79 ml/min/100gm in Group Ⅱ, 1.32±0.45 ml/min/100gm in Group Ⅰ and 1.72±1.03 ml/min/100gm in Group Ⅲ, respectively, (Group Ⅱ vs Group Ⅰ or Ⅲ p<0.05), LDH was significantly lower in Group Ⅱ (4.48±1.24 U/L) than in Group Ⅰ (25.16±8.96 U/L) (P<0.01) and in Group Ⅲ (17.8±12.2 U/L) (P<0.05), but no significant difference could be seen between Group Ⅰ and Group Ⅲ. Myocardial water content was 71.5±1.21% in Group Ⅱ and 78.57±3.14% in Group Ⅰ (p<0. 01), whereas it was 75.42±3.28% in Group Ⅲ(vs Group Ⅰ and Ⅱ p>0.05).Histochemical succinodehydrogenase (SDH) reaction was graded 0 to 1 in Group Ⅱ and 2 to 3 in Group Ⅰ and Ⅲ (p<0.01). Group Ⅱ showed nearly normal myocardial ultrastructure with increased glycogen stores, while Groups Ⅰ and Ⅲ revealed local myofibrillary disorganization. disrupted mitochondria and Pronounced depletion of glycogen storages. These results prove that the Protective effect of preoperative application of high doses of insulin together with glucose and potassium on isolated rat hearts is definitely superior to the use of glucose and potassium alone. These findings also suggest that addition of insulin to cardioplegia is ineffective and even harmful to the ischemic myocardium.     

靶控输注舒芬太尼与瑞芬太尼复合吸入麻醉对手术患者血流动力学及术后恢复情况的比较

目的 比较靶控输注舒芬太尼与瑞芬太尼复合吸入麻醉对手术患者血流动力学及术后恢复情况的影响.方法 北京大学第一医院2008年1-7月40例择期全麻手术患者,美国麻醉医师协会分级Ⅰ～Ⅱ级,年龄18～65岁,体质指数(BMI)＜30.经医院伦理委员会审核,选用数字随机法随机分为瑞芬太尼组(R组)和舒芬太尼组(S组),每组20例,R组靶控输注瑞芬太尼(血浆靶浓度为3 ng/ml)复合0.9最低肺泡有效浓度(MAC)的吸入麻醉药;S组靶控输注舒芬太尼(血浆靶浓度为0.3 ng/ml)复合0.9最低肺泡有效浓度(MAC)的吸入麻醉药.瑞芬太尼在手术结束时停药,舒芬太尼在手术结束前40～60 min停止输注.记录麻醉中血压、心率及术后呼吸恢复时间、拔管时间,观察术后疼痛情况及呼吸抑制情况.结果 麻醉后两组患者的血压、心率均显著低于术前基础值(P＜0.05),但是都还在基础值±30%范围内;两组间血压差异无统计学意义,R组全麻诱导后,气管插管后,切皮时,手术结束以及气管拔管时的心率低于S组(P＜0.05).R组呼吸恢复时间及拔管时间均显著短于S组[(1.8±1.4)min比(2.9±1.5)min,P＜0.05;(6.8±3.9)min比(9.1±2.8)min,P＜0.05].R组有7例患者术后视觉模拟评分(VAS)≥4,需要吗啡补救镇痛治疗.结论 靶控输注舒芬太尼或瑞芬太尼复合吸入麻醉,对血流动力学的影响是相似的;瑞芬太尼麻醉的患者术后呼吸恢复更快,拔管更早,但应及早给予镇痛治疗.

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Objective To compare the effect of remifentanil versus sufentanil with target-controlled infusion in combination with inhalation anesthesia for surgical patients on the parameters of hemodynamics and postoperative recovery.Methods Forty ASA Ⅰ - Ⅱ patients aged 18 -65 years old with BMI (body mass index) ＜ 30,undergoing colectomy or pedical screw interfix were enrolled.Upon the approval of institutional Ethics Committee,they were randomized to receive remifentanil or sufentanil at a target plasma concentration of 3 ng/ml and 0.3 ng/ml respectively in combination of inhalated anesthesia at 0.9 MAC (minimal alveolar concentration).The infusion of remifentanil was discontinued at the end of surgery while the infusion of sufentanil at 40 -60 minutes before the end of surgery.The arterial blood pressure( ABP),heart rate (HR),electrocardiogram (ECG)and pulse blood oxygen saturation during anesthesia were monitored.The time between the termination of anesthetic use and recovery of spontaneous breathing and extubation were observed.And the incidence of postoperative pain and respiratory depression were recorded.Results As compared with the baseline values,BP and HR decreased significantly in both groups.BP was similar in both groups whereas HR was lower in Group R than that in Group S at post-induction,postintubation,incision,the end of surgery and extubation ( P ＜ 0.05 ).The time from termination of anesthesia to recovery of spontaneous breathing was 1.8 ± 1.4 min in Group R.And it was significantly shorter than that in Group S(2.9 ± 1.5 min) (P ＜0.05).The time from termination of anesthetic use to extubation was 6.8 ±3.9 min in Group R.And it was also significantly shorter than that in Group S(9.1 ±2.8 min) (P＜0.05).Seven patients experienced postoperative pain with visual analogue scale (VAS) ＞4.And morphine was used for rescue analgesia in recovery room.Conclusion When combined with inhalation anesthesia,the effects on hemodynamics are similar between the patients receiving the target-controlled infusions of remifentanil and sufentanil.Remifentanil offers a shorter time to recovery of spontaneous breathing and tracheal extubation.     

不同时间窗经皮冠状动脉介入治疗对急性心肌梗死患者预后的影响

目的 比较急性心肌梗死(AMI)患者,不同时间窗行直接经皮冠状动脉介入治疗(PCI)后,对患者预后的影响.方法 我院2007年1月至2008年9月连续入院行直接PCI的AMI患者95例.按行直接PCI时间分为:AMI后A组(＜6 h)45例,B组(6～12 h)15例和C组(12～24 h)35例.分别比较A、B、C 3组的术后心衰发生率、总死亡率.于PCI后6个月行超声心动图检查,测定左室射血分数(LVEF)、左室舒张末期内径.结果 住院期间和随访期间,术后A组的心衰发生率(8.9%)、总死亡率(2.2%),均明显低于B组(13.3%与6.7%)、C组(34.3%与14.2%),B组明显低于C组,差异有统计学意义(P＜0.05).3组在术后6个月行超声心动图检查,A组LVEF(57.51±6.9)%明显高于B组(52.25±4.27)%、C组(47.75±6.86)%,差异有统计学意义(P＜0.05).A组左室舒张末期内径(45.9±4.2)mm明显低于B组(49.0±3.1)mm、C组(52.5±4.9)mm,差异有统计学意义(P＜0.05).结论 急性心肌梗死后行PCI术时间越早则患者心功能恢复越好,心衰发生率越低,左室重构越低,死亡率越低,改善左心功能和预后.

Abstract：

Objective To compare the prognostic effects of different time windows on initiating PCI (percutaneous coronary intervention)in AMI(acute myocardial infarction)patients.Methods Ninety-five AMI patients undergoing PCI were enrolled continuously from January 2007 to September 2008.According to the timing of direct PCI,the patients were divided into 3 groups:after AMI,＜ 6 h(Group A,n=45),6-12 h(Group B,n=45)and 12-24 h(Group C,n=35).Comparisons were made among these 3 groups in terms of the post-PCI incidence of heart failure and mortality.The left ventricular ejection fraction(LVEF)and left ventricular end-diastolic inside diameter(LVEDV)were measured by echocardiogram at Month 6.Results During the hospitalization and follow-up,Group A had a lower incidence of heart failure and mortality than Groups B and C.And Group B had a lower rate than Group C.The difference was significant (P＜0.05).Compared with LVEF(%)(52.25 ± 4.27)in Group B and LVEF(%)(47.75 ± 6.86)in Group C,LVEF(%)(57.51 ±6.9)in Group A were significantly improved on ECG at Month 6 months.LVEDV(mm)(45.89 ±4.23)in Group A were significantly lower than LVEDV(mm)(49.0 ±3.1)in Group B and LVEDV(mm)(52.46 ±4.9)in Group C.The differences were both statistically significant (P＜0.05).Conclusion An early time windows of initiating PCI in AMI patients can significantly improve the left ventricular functions and reduce the incidence of heart failure,left ventricular remodeling and the mortality rate.All these measures could improve left ventricular functions and prognosis.     

氧化应激和植物凝集素样氧化型低密度脂蛋白受体1在氧化低密度脂蛋白上调内皮细胞自噬水平中的作用

目的 探讨氧化应激和植物凝集素样氧化型低密度脂蛋白受体1(LOX-1)在氧化低密度脂蛋白(ox-LDL)上调人脐静脉内皮细胞(HUVEC)自噬水平中的作用.方法 用LOX-1 mAb及抗氧化剂维生素C(vitC)、vitE预处理ox-LDL作用的HUVEC;酶联免疫技术观察培养上清中丙二醛(MDA)、超氧化物歧化物(SOD)含量;免疫印迹技术检测自噬标记物LC3-Ⅱ/LC3-Ⅰ、beclin1及溶酶体膜蛋白2a(Lamp2a)蛋白含量.结果 ox-LDL作用在0.5 h和6 h能显著减少细胞培养上清中TSOD活力[0.5 h(32.73±1.09比40.16±1.28)U/ml;6 h(29.32±1.56比40.16±1.28)U/ml,均P＜0.01];增加其MDA含量[0.5 h(1.11±0.04比0.57±0.05)nmol/ml,P＜0.01;6 h(0.69±0.03比0.57±0.05)nmol/ml,P＜0.05],与上调自噬水平的高峰时间点相吻合,该作用能部分性被抗氧化剂vitC、vitE拮抗.ox-LDL诱导的LC3-Ⅱ/LC3-Ⅰ表达上调能被viC、vitE(0.5 h,vitC:3.11±0.02比4.31±0.50;vitE:3.46±0.19比4.31±0.50,均P＜0.05;6 h,vitC:1.44±0.05比2.31±0.16,P＜0.05)而非LOX-1 mAb抑制;LOX-1mAb能抑制ox-LDL诱导的Lamp2a表达上调(0.5 h,0.75±0.02比1.12±0.02,P＜0.01;6 h,0.88±0.02比1.06±0.04,P＜0.05),而vitC和ritE仅能抑制Lamp2a 6 h的表达上调(vitC,0.73±0.01比1.06±0.04,P＜0.01;vitE,0.84±0.02比1.06±0.04,P＜0.05).结论 100μg/ml ox-LDL上调HUVEC的自噬水平作用不依赖LOX-1受体途径,而是与氧化应激有关.自噬溶酶体形成的增加可能与LOX-1受体介导的ox-LDL入胞有关,氧化应激仪参与了晚期人胞后ox-LDL对自噬溶酶体形成增加的调节.

Abstract：

Objective Our previous studies found that 100 μg/ml oxidized low-density lipoprotein (ox-LDL) could up-regulate the autophagic level in human umbilical vein endothelial cells (HUVEC). The present study was conducted to observe the roles of oxidative stress and lectin-like oxidized low density lipoprotein-1 ( LOX-1 ) in the ox-LDL-induced up-regulation of autophagy. Methods Prior to the ox-LDL exposure, LOX-1mAb, vitamin C and vitamin E were used to study the roles of LOX-1 and oxidative stress in the activation of autophagy. The contents of total-superoxide dismutase (T-SOD) and MDA (malondialdehyde) in the culture medium were detected with enzyme linked immunosorbent assay. Western blot was employed to detect the levels of autophagic marker microtubule-associated protein light chain 3 ( MAP1-LC3 ) - Ⅱ/LC3- Ⅰ , beclinl and lysosome associated membrane protein 2a (lamp2a). Results After the ox-LDL exposure, the down-regulated level of T-SOD [0. 5 h (32. 73 ± 1.09 vs 40. 16 ± 1.28) U/ml,P ＜0. 01; 6 h ( 29. 32 ± 1.56 vs 40. 16 ± 1.28 ) U/ml, P ＜ 0. 01]and the up-regulated level of MDA [0.5 h(1.11 ±0.04 vs 0.57 ±0.05) nmol/ml, P＜0. 01; 6 h (0.69 ±0.03 vs 0.57 ±0.05) nmol/ml,P ＜0. 05]in culture medium were also significant at 0. 5 h and 6 h. The ox-LDL-induced increased ratio of LC3- Ⅱ/LC3- Ⅰ was reversed by the pretreatments of vitamin C and vitamin E (0. 5 h, vitC:3. 11 ±0. 02 vs 4.31 ±0.50, P＜0. 05; vitE: 3.46 ±0. 19 vs 4.31 ±0.50, P ＜0.05;6 h,vitC: 1.44 ±0.05 vs 2.31 ±0. 16,P ＜0. 05 ), but not LOX-1mAb. LOX-1 mAb decreased the ox-LDL-induced elevated level of lamp2a protein while vitamin C and vitamin E only inhibited the elevation of lamp2a at the timepoint of 6 h, but not 0. 5 h. Conclusion Oxidative stress, rather than LOX-1, plays an important role in the ox-LDL-induced upregulation of autophagy in HUVEC. The formation of autolysosomes is associated with the LOX-1-mediated endocytosis of ox-LDL. Oxidative stress only plays a minor role in the formation of autolysosomes induced by the engulfed ox-LDL.     

Clinical Study on Suspension Pancreatic-Duct-Jejunum End-to-Side Continuous Suture Anastomosis in Pancreaticoduodenectomy

Objective To study the influence of Suspension Pancreatic-Duct-Jejunum End-to-Side Continuous Suture Anastomosis(SPDJCS) on the incidence of pancreatic fistula after pancreaticoduodenectomy,and to analyze its applicability,safety,and efficacies.Methods A prospective controlled trial was conducted with 165 cases receiving pancreaticoduodenectomy in the Department of Hepatopancreatobiliary Surgery from January 2010 to May 2012.The patients were divided into Group A(end-to-end/end-to-side invaginated anastomosis,n=52),Group B(end-to-side mucosal anastomosis,n=48),and Group C(SPDJCS,n=65).The preoperative data,intraoperative data,and operative outcomes(incidence of pancreatic fistula,operation time,intraoperative blood loss,peritoneal drainage,peritoneal hemorrhage,peritoneal abscess,delayed gastric emptying,pulmonary infection,postoperative infection,blood transfusion,and perioperative mortality) were compared among the 3 groups.Results The total incidence of pancreatic fistula was 13.9%(23/165) in all the 165 patients.The incidence in Group A and Group B was 23.1%(12/52) and 18.8%(9/48),both higher than that in Group C [3.1%(2/65),both P<0.05].Group C showed significantly better outcomes than group A and B in terms of the operation time(5.5±1.2 hours vs.6.1±1.1 hours,5.5±1.2 hours vs.6.3±1.5 hours),volume of blood loss(412.0±205.0 mL vs.525.0±217.0 mL,412.0±205.0 mL vs.514.0±217.0 mL),and postoperative drainage amount of plasma tubes(175.0±65.0 mL vs.275.0±80.0 mL,175.0±65.0 mL vs.255.0±75.0 mL)(all P<0.05),while Group A and Group B displayed no difference in these aspects(P>0.05).As complications other than pancreatic fistula were concerned,the three groups were not different from each other(P>0.05).Conclusions SPDJCS may have the effect of reducing the incidence of pancreatic fistula after pancreaticoduodenectomy.It could be safe,practical and convenient technique of anastomosis for pancreaticojejunostomy.     

术中放疗在局部晚期胰腺癌治疗中的作用

目的 评价术中放疗(IORT)在局部晚期胰腺癌综合治疗中的价值.方法 2007年1月至2009年12月中国医学科学院肿瘤医院收治的、经组织细胞学证实、不可切除的局部晚期胰腺癌65例,随机分为IORT组及对照组(IORT组31例,对照组34例)、进行前瞻性研究.IORT组采用术中放疗加内引流/剖腹探查手术治疗;对照组仅行内引流/剖腹探查治疗.评价两组的术中和术后的不良事件、近期毒副反应、疼痛缓解情况、肿瘤标志物下降情况和远期生存期情况.结果 两组手术时间(205.2、173.32 min),术中出血(178.61、162.38 ml,P=0.081)等指标及术后恢复情况差异无统计学意义;术后血液毒性、疼痛缓解、CA19-9 IORT组下降明显(术后2周两组分别为(388.9±31.2)U/ml和(508.0±29.8)U/ml,术后1个月分别为(356.7±41.3)U/ml和(566.0±32.1)U/ml、生存期差异均有统计学意义(P=0.029).结论 IORT可有效抑制肿瘤的生长、延长患者的生存;止痛效果明显,改善生活质量;毒副作用小、对术后恢复无显著影响、安全可靠;简便、易于掌握.

Abstract：

Objective To assess the value of intraoperative radiotherapy (IORT) in the combined treatment of locally advanced pancreatic cancer. Methods All patients with locally advanced pancreatic cancer at our hospital from January 2007 to December 2009, judged as unresectable and confirmed by histology or cytology, were recruited into this prospective study. They were randomly assigned into the IORT group (n=31) and control group (n =34). The IORT group received IORT plus internal drainage or laparotomy. The control group had internal drainage or laparotomy only. The evaluation of adverse results of two groups included: intraoperative and postoperative adverse events, recent post-operative side effects,analgesic effect, the level of tumor marker such as CA19-9 and the long-term survival. Results There was no difference in operation duration, intraoperative hemorrhage and postoperative recovery. Significant differences were found in hematotoxicology, analgesic effect, tumor marker decreasing and long-term survival. Conclusion IORT is a safe, reliable and easy-to-master technique without any obvious side effect. Its analgesic effect is better than the control group. Also IORT can retard the tumor growth and improve the patient survival.     

淋巴引流及ω-3多不饱和脂肪酸干预对大鼠肠道缺血再灌注的影响

目的 观察大鼠肠道缺血再灌注(Ⅰ/R)损伤时肠淋巴液引流对高迁移率族蛋白1(HMGB1)、炎症因子和内毒素的影响以及ω-3多不饱和脂肪酸(ω-3 PUFA)干预的效果.方法 72只SD大鼠随机区组法随机分为单纯引流组、Ⅰ/R组、Ⅰ/R+引流组(每组8只)和胃造口组[正常饮食(N)组、普通肠内营养(EN)组、普通肠内营养加ω-3 PUFA(PUFA)3大组,每大组再根据是否行Ⅰ/R 和引流分为2组,每组8只].单纯引流组只引流180 mⅠn淋巴液不行Ⅰ/R损伤;Ⅰ/R、VR+引流组行肠系膜上动脉夹闭60 mⅠn再灌注120 mⅠn;Ⅰ/R+引流组同时行肠淋巴液引流180 mⅠn.胃造口组大鼠均先行胃造口手术,分别给予不同营养5 d后造模,各引流组同前进行肠淋巴液引流180 mⅠn.手术完毕后分别取血清和淋巴液,定量检测内毒素,酶联免疫吸附试验(ELⅠSA)定量检测炎症因子以及HMGB1.结果 Ⅰ/R+引流组淋巴液中内毒素、炎症因子以及HMGBl均高于单纯引流组[均P＜0.05,白细胞介素(ⅠL)-6(30±8)pg/ml比(20±6)pg/ml,内毒素(0 029±0.011)U/ml比(0 008±0 005)U/ml];Ⅰ/R+引流组血清中内毒素、炎症因子均低于Ⅰ/R组(均P＜0 05).在胃造口组中,N 组和EN组的淋巴液中肿瘤坏死因子(TNF)-α与HMGBl均高于PUFA组[(46±17)pg/ml、(54±16)pg/ml比(28±9)pg/ml,(4.8±1.6)ng/ml、(5.3±1.8)ns/ml比(3.0±1.0)ng/ml,均P＜0.05].PUFA(Ⅰ/R)组血清中内毒素、炎症因子以及HMGBl均低于N(Ⅰ/R)组(均P＜0.05),PUFA(Ⅰ/R+引流)组血清中TNF-α与HMGBl均低于N(Ⅰ/R+引流)组(均P＜0 05).结论 引流肠淋巴液能够降低肠道Ⅰ/R损伤时内毒素、炎症因子和HMGB1的水平,减轻大鼠肠道Ⅰ/R引起的损伤.ω-3PUFA的干预对于肠道Ⅰ/R引起的损伤有一定的保护作用,对于减轻炎症反应有积极作用.

Abstract：

Objective To investigate the effects of lymphatic drainage and ω-3 polyunsaturated fatty acid (ω-3PUFA) on high mobility group box 1 (HMGB1) , inflammatory cytokines and endotoxin in rats with intestinal ischemia-reperfusion (Ⅰ/R) injury. Methods A total of 72 SD rats were randomly divided into drainage-alone group, Ⅰ/R group, ischemia-reperfusion plus drainage (Ⅰ/R+D) group (n=8 each)and 3 groups with 16 rats undergoing gastrostomy in each group: normal diet (N) group, enteral nutrition (EN) group and enteral nutrition & ω-3PUFA (PUFA) group. And they were further divided into 2 subgroups (n=8). The rats in Ⅰ/R and Ⅰ/R+D groups were subjected to a 60-min ischemia follow by 120-min reperfusion injury of superior mesenteric artery. When the rats suffered Ⅰ/R injury, intestinal lymph was drained for 180 min in the Ⅰ/R+D group. The rats in the drainage-alone group received 180-min lymph drainage without Ⅰ/R injury. After 5 days with different nutrition regimes, the models were established similarly. The rats in the Ⅰ/R+D sub-groups were treated with intestinal lymph drainage for 180 min. The serum and lymph samples were collected post-operatively. Endotoxin was detected by a Limulus kit. The inflammatory cytokines and high mobility group box 1 (HMGB1) were analyzed by enzyme-linked immunosorbent assay (ELISA).Results Endotoxin, inflammatory cytokines and lymphatic HMGB1 of lymphatic in the Ⅰ/R+D group were higher than those in the drainage-alone group [all P＜0.05 , IL-6 :(30±8) pg/ml vs (20±6) pg/ml, endotoxin: (0.029±0.011) U/ml vs (0.008+0.005) U/ml].The serum levels of endotoxin and inflammatory cytokines in the Ⅰ/R+ D group were lower than those in the Ⅰ/R group (P＜0.05).The lymphatic levels of TNF-a (tumor necrosis factor-alpha) and HMGB1 in the N and EN groups were higher than those in the PUFA group[TNF-α: (46±17)pg/ml, (54±16)pg/ml vs(28±9) pg/ml, HMGB1: (4.8±1.6) ng/ml, (5.3±1.8) ng/ml, (3.0±1.0) ng/ml, all P＜0.05) ].The serum levels of endotoxin, inflammatory cytokines and HMGB1 in the PUFA(l/R) group were lower than those in the N(Ⅰ/R) group (F＜0.05).The levels of TNF-a and HMGB1 were lower in the PUFA (Ⅰ/R+D) group than those in the N(Ⅰ/R+ D) group (both P＜0.05).Conclusion Lymphatic drainage may reduce the levels of endotoxin, inflammatory cytokines and HMGB1 so as to alleviate the intestinal Ⅰ/R injury. The intervention of ω-3PUFA has some protective effect through relieving inflammation.     

牛奶和辅酶Q10对丙烯腈致血管内皮功能紊乱的影响

目的 探讨牛奶或辅酶Q10预处理对丙烯腈致大鼠血管内皮功能紊乱的影响.方法 将80只大鼠分为4组:对照组、单纯丙烯腈组、牛奶组、辅酶Q10组.采用灌胃染毒法,对照组仅予玉米油(丙烯腈的溶剂,1 ml/100 g),其他3组予丙烯腈25 mg/kg染毒.牛奶组和辅酶Q10组在染毒前30 min分别给予牛奶、辅酶Q10预处理.染毒12周后检测血清及主动脉组织中诱导型一氧化氮合酶(iNOS)和内皮型一氧化氮合酶(eNOS)的活力.结果 单纯丙烯腈组、牛奶组、辅酶Q10组血清iNOS水平[(42.9±2.5)U/ml、(26.5±4.4)U/ml、(26.7±3.3)U/ml]比对照组[(21.9±1.6)U/ml,P＜0.05]升高.主动脉组织中iNOS在单纯丙烯腈组、牛奶组、辅酶Q10组[(0.812±0.008)、(0.773±0.019)、(0.622±0.013)U/mg蛋白]比对照组[(0.540±0.028)U/mg蛋白,P＜0.05]高;而辅酶Q10组的主动脉eNOS活力[(0.471±0.011)U/mg蛋白]高于对照组、单纯丙烯腈组和牛奶组[(0.371±0.029)、(0.380±0.016)、(0.425±0.020)U/mg蛋白,P＜0.05].结论 牛奶和辅酶Ql0可以缓解丙烯腈致血管内皮功能紊乱作用.

Abstract：

Objective To explore the influences of milk or coenzyme Q10 pretreatment to acrylonitrile on vascular endothelial functions in rats.Methods A total of 80 rats were randomly divided into 4 groups:control group(Con),acrylonitrile exposure group(ACN),milk pretreatment group (M + ACN)and coenzyme Q10 pretreatment group(Q10 + ACN).The experiment was conducted by the method of gavage exposure in rats.Control group was exposed to corn oil;acrylonitrile was administered to other three groups at the doses of 25 mg/kg.The M + ACN and Q10 + ACN groups were pretreated by milk or coenzyme Q10 at 30 minutes before acrylonitrile exposureAfter a 12-week exposure,the activities of inducible nitric oxide synthase(iNOS)and endothelial nitric oxide synthase(eNOS)were measured in serum and aortal tissues.Results As compared with Con group[(21.9 ± 1.6)U/ml],the activity of blood serum iNOS was higher in ACN,M + ACN and Q10 + ACN groups[(42.9 ± 2.5)U/ml,(26.5 ± 4.4)U/ml,(26.7 ±3.3)U/ml,P＜0.05].As compared with Con group[(0.540 ± 0.028)U/mgprot],the activity of aortal iNOS was higher in ACN,M + ACN and Q10 + ACN groups[(0.812 ± 0.008),(0.773 ± 0.019),(0.622 ±0.013)U/mgprot,(P ＜0.05)].Furthermore the activity of aortal eNOS in Q10 + ACN group[(0.471 ±0.011)U/mgprot]was higher than Con,ACN or M +ACN group[(0.371 ±0.029),(0.380 ±0.016),(0.425 ±0.020)U/mgprot,P ＜0.05].Conclusion Chronic administration of ACN by gavages results in vascular endothelial dysfunctions.Milk and coenzyme Q1o pretreatment reduce this effect in rats.     

Effects of Tongguan Capsule(通冠胶囊)on Post-myocardial Infarction Ventricular Remodeling and Cardiac Function in Rats

<正>Objective:To observe the effects of Tongguan Capsule(通冠胶囊,TGC) on post-myocardial infarction ventricular remodeling and heart function in rats.Methods:A rat model of acute myocardial infarction (AMI) was established by coronary ligation.Experimental rats were randomized to 4 groups including three model groups(Group A:captopril 5 mg/kg·day,n=7;Group B:TGC 10 g/kg·day,n=7;and Group C:placebo, n=8),and a sham-control group(Group D:blank control,n=6).Animals were treated for 4 weeks.The cardiac function of rats was assessed at the end of the experiment based on left ventricular ejection fraction(LVEF) and left ventricular short axis fractional shortening(LVFS) detected by colored echocardiography;meanwhile, the condition of ventricular remodeling was observed through the levels of left ventricular mass(LVM),plasma aldosterone(ALD),myocardial angiotensinⅡ(AngⅡ) and myocardial collagen measurements.Results:At the end of the experiment,LVEF and LVFS in Group A and B were improved significantly,while those in Group C were unchanged,the LVEF in Group A,B,C,and D was 0.57±0.46,0.61±0.08,0.36±0.55 and 0.76±0.02,respectively;and their LVFS was 0.31±0.52,0.34±0.04,0.23±0.57 and 0.45±0.03,respectively.The difference was statistically significant when comparing the two indexes in Group A and B with those in Group C and D(P0.05).LVM,levels of plasma ALD and myocardial AngⅡwere lower in Group A and B than in Group C,but a comparison between Group A and B showed an insignificant difference in lowering LVM and ALD,while the lowering of AngⅡwas more significant in Group B than in Group A(754.7±18.7 pg/mL vs 952.6±17.6 pg/ mL,P0.05).Morphological examination showed that in Group A and B the swollen myocardial cells had shrunk, with regularly arranged myocardial fibers and decreased collagen proliferation,but the improvements in Group B were more significant.Conclusion:TGC could markedly improve the post-infarction ventricular remodeling and cardiac function in rats,showing that the efficacy was better than or equal to that of captopril.     

Remote postconditioning induced by brief pulmonary ischemia and reperfusion attenuates myocardial reperfusion injury in rabbits

Background  The lung is one of the most important organs that are sensitive to ischemia. We hypothesized that remote postconditioning (RPostC) induced by brief occlusion and reperfusion of the pulmonary artery could attenuate myocardial reperfusion injury.

Methods  Thirty rabbits were randomized into three groups. Group ischemia-reperfusion (IR) (n=10) were anesthetized rabbits subjected to 30-minute occlusion of the left anterior descending coronary artery followed by 180-minute reperfusion. Group RPostC (n=10) had the left pulmonary artery blocked for five minutes followed by a 5-minute reperfusion, and the left anterior descending coronary artery (LAD) occluded for 30 minutes with a 180-minute reperfusion. Group L-N_w-nitro-L-arginine methylester (L-NAME) + RPostC (n=10) had the left pulmonary artery blocked for five minutes followed by a 5-minute reperfusion and intravenous infusion of L-NAME (10 mg/kg), and the LAD occluded for 30 minutes with a 180-minute reperfusion. Blood samples were taken for levels of creatine kinase (CK), superoxide dismutase (SOD) and malondialdehyde (MDA) at three different time points. At the end of the experiment, tissue samples of the infarcted region were harvested to calculate the cardiomyocyte apoptosis index (AI) by TUNEL. A piece of left and right lung tissue was harvested to evaluate the damage to the lung.

Results  After reperfusion for 180 minutes, the concentration of CK was lower in group RPostC, (4.79±0.27) U/ml, than that in group IR, (6.23±0.55) U/ml (P <0.01), and group L-NAME + RPsotC, (5.86±0.42) U/ml (P <0.01). The concentration of MDA was lower in group RPostC, (6.06±0.36) nmol/ml, than that in group IR, (11.41±0.91) nmol/ml (P <0.01), and group L-NAME + RPostC, (11.06±0.62) nmol/ml (P <0.01). The activity of SOD was higher in group RPostC, (242.34±25.02) U/ml, than that in group IR, (148.05±18.24) U/ml (P <0.01), and group L-NAME + RPostC, (160.66±9.55) U/ml (P <0.01). The apoptosis index was lower in group RPostC, (14.25±5.20)%, than that in group IR, (35.77±10.09)% (P <0.01), and group L-NAME + RPostC, (30.37±7.76)% (P <0.01). No significant difference caused by pulmonary ischemia was found in the lung tissue among the three groups.

Conclusions  RPostC may attenuate myocardial ischemia-reperfusion injury connected to the activity of endothelial nitric oxide synthase. Brief pulmonary ischemia may not be harmful to lungs.

     

白首乌提取物对血管性痴呆模型小鼠学习记忆功能的影响

目的 研究自首乌提取物对血管性痴呆模型小鼠学习记忆功能和抗氧化水平的影响.方法 小鼠反复脑缺血再灌注合并尾部放血降压建立痴呆模型;Morris水迷宫观察各组小鼠的学习记忆功能;快速断头处死,观测张口喘气时间;测定海马区及大脑皮质组织匀浆中超氧化物歧化酶(SOD)、丙二醛(MDA)水平.结果 与模型组相比,药物高剂量组逃避潜伏期缩短,差异具有显著性(P<0.01),正确探索时间延长(P<0.01);张口喘气时间延长[(19.3±1.6)s vs(15.7±0.7)s,P<0.01];SOD活性升高[(121.0±14.2)U·mgprot-1 vs(101.5±9.4)U·mgprot-1,P<0.05];MDA含量降低[(5.12±1.09)nmol·mgprot-1和(6.77±0.96)nmol·mgprot-1,P<0.01].结论 白首乌提取物对小鼠脑缺血再灌注损伤有保护作用,其机制可能与抗自由基损伤有关.     

芪苈强心胶囊对阿霉素所致心力衰竭大鼠氧化损伤的影响

目的观察芪苈强心胶囊对慢性心力衰竭(CHF)模型大鼠血清超氧化物歧化酶(SOD)、丙二醛(MDA)水平的影响。方法 Wistar大鼠40只,随机抽取8只作为健康对照组,其余大鼠用多次间断腹腔注射阿霉素(ADR)的方法来建立大鼠CHF模型。造模成功后,随机分为模型组和芪苈强心胶囊组(0.6 g·kg^(-1)·d(-1)·d^(-1)),每组15只,健康对照组和模型组灌胃等容积的蒸馏水。4周后,各组大鼠称质量,取心脏称质量,计算心脏指数,腹主动脉取血测MDA、SOD水平及血清脑钠肽(BNP)水平。结果与健康对照组比较,模型组大鼠心脏指数[(3.76±0.22)g/kg vs.(2.69±0.25)g/kg]、BNP[(657±59)pg/ml vs.(203±31)pg/ml]水平均明显升高(P<0.05),而芪苈强心胶囊组分别为(3.18±0.15)g/kg和(554±43)pg/ml,均明显低于模型组,差异有统计学意义(P相似文献   

三级战备状态对官兵心理和部分生化指标的影响及干预效果

目的 探讨三级战备状态对官兵心理、部分生化指标的影响及心理行为干预的效果.方法 以进入三级战备状态的某摩步营189名官兵为研究对象,以班为单位随机分为研究组和对照组.战备期间2组进行统一的军事训练和思想政治教育,研究组增加心理行为干预.在进入三级战备状态当天(战备前)和结束次日(战备后),2组分别进行抑郁自评量表(SDS)、焦虑自评量表(SAS)、简易应对方式问卷(SCSQ)评定,超氧化物歧化酶(SOD)、丙二醛(MDA)、皮质醇(COR)和醛固酮(ALD)含量测定.结果 研究组战备后SDS总分(42.1±9.3)分、SAS总分(43.8±7.2)分、MDA(2.6±0.51)μmol/L、COR(252.5±52.4)ng/ml、ALD(97.5±24.4)pg/ml低于对照组,积极应对(21.2±6.4)分和SOD(1551±354)U/gHb高于对照组(均P＜0.01或0.05).对照组战备后SDS总分(49.2±10.3)分、SAS总分(50.6±10.2)分、MDA(2.9±0.35)μmol/L、COR(333.8±62.6)ng/ml、ALD(123.8±29.6)pg/ml高于战备前,积极应对(18.2±5.4)分和SOD(1302±352)U/gHb低于战备前(均P＜0.01).SDS、SAS总分与SOD显著负相关(r=-0.142、-0.119,P＜0.01或0.05),与COR、ALD显著正相关(r=0.156,0.151,0.159,0.156,P＜0.01或0.05);SCSQ的积极应对分与SOD显著正相关(r=0.141,P＜0.01),与COR和ALD显著负相关(r=-0.152,-0.155,P＜0.01).结论 三级战备状态下官兵产生了明显的心身应激反应,心理行为干预可有效改善应激反应水平.     

氧化损伤与糖尿病发病的相关性

目的测定糖尿病病人和非糖尿病人群血清中超氧化物歧化酶（SOD）和脂质过氧化产物丙二醛（MDA）的含量,并观察氧化损伤与糖尿病发病有无相关性。方法采用黄嘌呤氧化酶法和硫代巴比妥酸比色法分别测定糖尿病和非糖尿病病人血清中SOD和MDA的含量。结果糖尿病组病人的血清SOD的平均浓度测量值为（87.33±1.40）U/ml,非糖尿病组的测量值为（92.91±1.62）U/ml,前者明显低于后者,二者差异有统计学意义（P〈0.05）;糖尿病组血清MDA的测量值平均浓度为（9.40±0.34）n mol/ml,非糖尿病组的测量值为（8.50±0.34）n mol/ml,前者明显高于后者,二者差异有统计学意义（P〈0.05）。结论糖尿病患者血清抗氧化酶活性下降,血清MDA含量升高,提示糖尿病的发生可能与机体内抗氧化酶活性下降、脂质过氧化产物增多存在相关性。     

利多卡因对非体外循环冠状动脉旁路移植术病人血清活性氧的影响

目的研究利多卡因对非体外循环冠状动脉旁路移植术（OPCAB）病人活性氧的影响。方法30例择期行OPCAB的病人随机分为对照组（C组）和利多卡因组（L组）,每组15例,两组麻醉方法相同。L组于麻醉诱导后静脉注射利多卡因2mg/kg,继以2mg/（kg.h）持续泵入至术毕;C组给予等量0.9%氯化钠注射液。分别在麻醉诱导后手术前（T1）、乳内动脉游离结束肝素化后即刻（T2）、手术结束（T3）、术后24h（T4）采集中心静脉血,用分光光度法检测超氧化物歧化酶（SOD）及丙二醛（MDA）。同时记录血流动力学指标及术后早期临床资料、ICU滞留时间、住院时间等。结果SOD两组组内各时点间和组间变化都不明显（P〉0.05）;MDA在L组各时点间变化无明显差异（P〉0.05）,C组MDA在T4比T1显著升高,分别为（7.4±2.3）nmol/ml vs（3.7±1.1）nmol/ml,（P〈0.01）,MDA在T4时点两组间比较差异显著,数值为（7.4±2.3）nmol/ml vs（4.7±1.3）nmol/ml（,P〈0.05）;L组病人术后ICU滞留时间、住院时间较C组显著缩短（P〈0.05）。结论利多卡因可以抑制OPCAB病人活性氧浓度的升高,具有一定的心肌保护作用。     

川芎嗪对三氯化铝致阿尔茨海默病模型小鼠学习记忆能力的影响

目的 观察川芎嗪(TMP)对阿尔茨海默病(AD)模型小鼠学习记忆能力的改善作用及其机制.方法 采用AlCl3灌胃方法建立AD模型小鼠,灌胃给予TMP(200 mg·kg-1)观察疗效,榆测各组小鼠的逃避潜伏期、腩组织AChE、SOD活性、MDA含量及大脑皮层AB、NF-κB表达的变化.结果 1)TMP可使A1C13诱导的AD模型鼠的逃避潜伏期显著缩短(P＜0.05);2)TMP可使AlCl3诱导的AD模型鼠脑组织中AChE活性降低19%[(1.37±0.13)U·mgpro-1,(1.69 4-0.27)U·mgpro-1,P=0.016];使SOD活性提高39%[(55.81±10.25)U·mgprot-1,(40.04±13.06)U·mgprot-1,P=0.026];使MDA含量降低34%[(43.63±13.27)nmol·mgprot-1,(28.59±8.52)nmol·mgprot-1,P=0.023];3)TMP可明显降低AD模型鼠腩组织中AB、NF-κB的表达(P＜0.05).结论 TMP可改善化学诱导的AD模型小鼠学习记忆能力障碍,可能机制与提高SOD活件、降低MDA含量、降低AChE活性、降低脑绀织中AB、NF-κB的表达等相关.     

抗血小板治疗对非体外循环冠状动脉旁路移植术患者围手术期出血的影响

目的探讨抗血小板药物治疗对非体外循环冠状动脉旁路移植术（offpumpcoronaryarterybypassgrafting,OPCABG）围手术期出血的影响。方法回顾性总结分析611例择期OPCABG患者临床资料,分为服药组（Y组）466例和未服药组（N组）145例。服药组又分为：阿司匹林组（A组）94例和阿司匹林＋氯吡格雷组（AC组）372例。记录各组临床资料;分析比较各组术中失血量,术后胸腔引流量、血液制品使用率和使用量。多元线性回归模型分析与手术失血相关的因素。结果术中血浆用量Y组比N组少[（584．65±322．81）mlVS（681．47±359．38）ml,P：0．006],两组在其他方面差异无统计学意义。服药组中,与AC组相比,A组手术时间短[（257．02±41．84）minVS（273．49±60．48）min,P=0．002],近段吻合口数多（1．76±0．48VS1．58±0．60,P=0．002）,红细胞使用率低（90．4％VS96．5％,P=0．013）,血小板使用率低（4．3％VS15．6％,P=0．004）,输血浆量多[（706．96±422．16）mlvs（551．56±303．37）ml,P=0．000],术后A纽血浆总使用率低（89．4％VS96．0％,P=0．011）。多元线性回归模型分析,术前是否抗血小板治疗因素（r=-13．770,P=0．618）与术中失血量无显著相关性。手术时间因素（r=1．16,P=0．000）是影响术中失血量的相关因素。结论术前抗血小板治疗不增加择期OPCABG术中失血量,术前双联与单联抗血小板治疗相比不增加手术失血量。     

褪黑素对噪声应激大鼠学习记忆的保护作用

目的 探讨噪声应激对大鼠记忆功能的影响及可能机制.方法 将50只大鼠用随机数字法分为空白组和2个实验组、2个对照组.空白组不给任何处理,实验组及对照组暴露于120dB噪声应激1d或3d,8h/d,并于每次噪声应激前分别腹腔注射褪黑素(MT,15mg/kg)或等量生理盐水.应激结束后,用旷场反应箱测试大鼠的行为,用Morris水迷宫法测试大鼠学习记忆,用试剂盒检测大鼠大脑皮层和海马中一氧化氮(NO)、超氧化物歧化酶(SOD)和丙二醛(MDA)含量.结果 无论噪声应激1d或3d,旷场反应测试大鼠兴奋性和探索性行为实验组[运动总距离(TMD)(1322.50±504.32)cm,(1819.55±458.37)cm,较快运动时间(FMT)(68.49±23.90)s,(87.34±16.01)s,距中心距离(DTC)(63.56±2.75)cm,(60.13±1.87)cm,内环内时间(ITT)(7.87±2.06)s,(9.60±2.89)]均明显小于对照组[TMD(2042.03±449.19)cm,(2325.73±384.90)cm,FMT(109.32±21.84)s,(124.65±16.74)s,DTC(58.00±1.53)cm,(55.05±5.13)cm,ITT(12.84±3.62)s,(14.92±2.75)s,(P＜0.05,P＜0.01)];水迷宫中的逃避潜伏期实验组大鼠[(10.69±3.37)s,(18.87±4.74)s]均明显小于对照组[(23.86±7.66)s,(33.55±7.20)s,(P＜0.01)];大鼠大脑皮层和海马组织中NO和MDA含量实验组[皮层NO(3.35±0.40)μmol/gprot,(4.50±0.41)μmol/gprot,海马NO(2.24±0.18)μmol/gprot,(3.15±0.21)μmol/gprot,皮层MDA(1.34±0.44)nmol/mgprot,(2.39±0.18)nmol/mgprot,海马MDA(0.13±0.07)nmol/mgprot,(0.53±0.10)nmol/mgprot]明显低于对照组[皮层NO(3.35±0.40)μmol/gprot,(5.03±0.44)μmol/gprot,海马NO(2.93±0.31)μmol/gprot,(3.38±0.24)μmol/gprot,皮层MDA(2.24±0.26)nmol/mgprot,(4.21±0.21)nmol/mgprot,海马MDA(0.47e0.29)nmol/mgprot,(1.33±0.187)nmol/mgprot,(P＜0.05,P＜0.01)],SOD含量实验组[皮层(763.95±214.36)U/mgprot,(491.33±35.85)U/mgprot,海马(817.02±232.39)U/mgprot,(644.85±28.02)U/mgprot]明显高于对照组[皮层(556.50±101.51)U/mgprot,(327.35±30.54)U/mgprot,海马(279.74±117.02)U/mgprot,(108.75±15.52)U/mgprot,(P＜0.05,P＜0.01)].结论 褪黑素对噪声应激大鼠记忆障碍有改善作用,这种作用可能与抑制噪声应激大鼠大脑皮层和海马中NO及MDA的升高,并提高SOD活性作用有关.