胃十二指肠溃疡出血胃切除术后大出血的外科治疗

目的 总结胃十二指肠溃疡出血行胃大部切除术后大出血再手术治疗的经验。方法 对我院1980年至2002年间收治的26例胃切除术后大出血再手术患者的临床资料进行回顾分析。结果 本组有6例术前行急诊胃镜检查，11例行术中胃镜检查，2例采用超选择性动脉造影。11例球部旷置溃疡出血或球后溃疡出血者，采取旷置溃疡切除或十二指肠球部及降部纵行切开、直视下缝合出血点，同时阻断十二指肠周围血管手术；13例吻合口出血者，局部缝扎止血、切除原吻合口，再作毕Ⅱ式重建或行空肠胃Roux-en-Y吻合；还有2例行再次胃切除手术。治愈24例(92．3％)；死亡2例(7．7%)，均为术后再出血者。结论 术前采用超选择性血管造影及术中胃镜检查，有利于明确出血部位及原因；选择恰当的手术方式对防止术后再出血非常重要。     

Right coronary artery fistula to left ventricle complicated with huge coronary artery aneurysm

Congenital coronary artery fistula (CAF) with huge coronary artery aneurysm is a very rare condition. In this paper, we describe a 26-year-old asymptomatic male patient with right coronary artery (RCA) to the left ventricle fistula with a huge coronary artery aneurysm which was diagnosed by multidetector computed tomography and coronary angiography. The patient received surgical treatment for coronary artery after diagnosis. Both RCA and a giant aneurysm were excised; surgical closure of CAF and coronary artery bypass grafting were performed on this patient. Two months after surgery, the enlarged left ventricle returned to normal as evaluated by echocardiography.     

New insights into the competition between antioxidant activities and pro-oxidant risks of rosmarinic acid

Direct and indirect antioxidant activities of rosmarinic acid (RA) based on HOO˙/CH₃OO˙ radical scavenging and Fe(iii)/Fe(ii) ion chelation were theoretically studied using density functional theory at the M05-2X/6-311++G(2df,2p) level of theory. First, four antioxidant mechanisms including hydrogen atom transfer (HAT), radical adduct formation (RAF), proton loss (PL) and single electron transfer (SET) were investigated in water and pentyl ethanoate (PEA) phases. Regarding the free radical scavenging mechanism, HAT plays a decisive role with overall rate coefficients of 1.84 × 10³ M⁻¹ s⁻¹ (HOO˙) and 4.49 × 10³ M⁻¹ s⁻¹ (CH₃OO˙) in water. In contrast to PL, RAF and especially SET processes, the HAT reaction in PEA is slightly more favorable than that in water. Second, the [Fe(iii)(H₂O)₆]³⁺ and [Fe(ii)(H₂O)₆]²⁺ ion chelating processes in an aqueous phase are both favorable and spontaneous especially at the O5, site-1, and site-2 positions with large negative Δ_rG⁰ values and great formation constant K_f. Finally, the pro-oxidant risk of RA⁻ was also considered via the Fe(iii)-to-Fe(ii) complex reduction process, which may initiate Fenton-like reactions forming reactive HO˙ radicals. As a result, RA⁻ does not enhance the reduction process when ascorbate anions are present as reducing agents, whereas the pro-oxidant risk becomes remarkable when superoxide anions are found. The results encourage further attempts to verify the speculation using more powerful research implementations of the antioxidant activities of rosmarinic acid in relationship with its possible pro-oxidant risks.

Direct and indirect antioxidant activities of rosmarinic acid (RA) based on HOO˙/CH₃OO˙ radical scavenging and Fe(iii)/Fe(ii) ion chelation were theoretically studied using density functional theory at the M05-2X/6-311++G(2df,2p) level of theory.     

银杏叶提取物对豚鼠肠系膜下神经节细胞生物电的影响

目的：通过观察银杏叶提取物(EGb)对交感神经节细胞生物电的影响,为进一步探讨EGb调节肠系膜下神经节(IMG)支配的包括远端结肠在内的内脏功能活动的作用机制提供依据。方法：采用细胞内生物电记录技术记录体外IMG电位。结果：在敏感细胞,EGb761(35～350mg／L)可使71．0％的肠系膜下神经节细胞产生膜去极化反应,且在一定范围内呈现剂量效应关系;19．4％的细胞超极化;9．7％的细胞出现先超极化后去极化的双相反应。去极化反应的细胞其膜电阻有降低、增大和不变等多种表现。此去极化反应可被低钙．高镁克氏液部分阻断,但不为胆碱和肾上腺素受体阻断剂所阻断。还发现EGb761可抑制外源性5-HT引起的去极化电位。结论：EGb761对IMG细胞可能通过非胆碱能、非肾上腺素能通路产生易化作用;其机制可能与影响其他递质的释放有关。     

Arginase Inhibition by Ethylacetate Extract of Caesalpinia sappan Lignum Contributes to Activation of Endothelial Nitric Oxide Synthase

Caesalpinia sappan (C. sappan) is a medicinal plant used for promoting blood circulation and removing stasis. During a screening procedure on medicinal plants, the ethylacetate extract of the lignum of C. sappan (CLE) showed inhibitory activity on arginase which has recently been reported as a novel therapeutic target for the treatment of cardiovascular diseases such as atherosclerosis. CLE inhibited arginase II activity prepared from kidney lysate in a dose-dependent manner. In HUVECs, inhibition of arginase activity by CLE reciprocally increased NOx production through enhancement of eNOS dimer stability without any significant changes in the protein levels of eNOS and arginase II expression. Furthermore, CLE-dependent arginase inhibition resulted in increase of NO generation and decrease of superoxide production on endothelium of isolated mice aorta. These results indicate that CLE augments NO production on endothelium through inhibition of arginase activity, and may imply their usefulness for the treatment of cardiovascular diseases associated with endothelial dysfunction.