参附注射液对糖尿病大鼠心肌缺血再灌注时PTEN和P13 K表达的影响

目的 探讨参附注射液(SFI)对糖尿病大鼠心肌缺血再灌注时第10染色体同源丢失性磷酸酶-张力蛋白酶基因(PTEN)和磷脂酰肌醇-3激酶(PI3K)表达的影响.方法 健康成年雄性SD大鼠,体重220-280 g,单次腹腔注射1%链脲佐菌素.柠檬酸盐缓冲液60 m~Ckg制备糖尿病模型,取糖尿病模型制备成功的大鼠30只,随机分为3组(n=10):假手术组(S组)、缺血再灌注组(IR组)和SH组.IR组和SFI组采用结扎冠状动脉左前降支30 min,再灌注120 min的方法建立心肌缺血再灌注模型,S组只穿线不结扎;SFI组开胸前以10ml·kg-1·h-1 的速率静脉输注SFI,开胸后以3 ml·kg-1·h-1的速率静脉输注至术毕,S组和IR组均静脉输注等容量乳酸钠林格氏液和羟乙基淀粉.于再灌注120 min时处死大鼠,取左心室心肌组织,计算心肌梗死面积.采用TUNEL法检测心肌细胞凋亡情况,计算细胞凋亡指数.采用免疫组织化学法测定心肌组织PTEN和PI3K的表达水平,并计算其比值(PTEN/PI3K).观察心肌组织病理学结果.细胞凋亡指数与PTEN/PI3K行直线相关分析.结果 与S组比较,IR组和SFI组心肌梗死面积增加,细胞凋亡指数升高,PTEN和PI3K的表达上调(P<0.05或0.01),SFI组PTEN/PI3K降低(P<0.05);与IR组比较,SFI组心肌梗死面积减小,细胞凋亡指数降低,FTEN表达下调,PI3K表达上调,PTEN/PI3K降低(P<0.05);SFI组心肌损伤程度比IR组减轻.细胞凋亡指数与PTEN/PI3K呈正相关(r=0.452,P<0.05).结论 SFI减轻糖尿病大鼠心肌缺血再灌注损伤的机制与下调心肌组织FTEN表达,上调PI3K表达,从而激活PI3K/Akt信号通路有关.     

医源性肛管狭窄24例治疗体会

回顾分析2007年我院收治的24例医源性肛管狭窄患者资料，总结报道如下。     

参附对大鼠肠缺血再灌注时肠上皮细胞Caspase-3,Bcl-2基因表达的影响

目的研究参附注射液(简称参附)对大鼠肠缺血再灌注期间黏膜上皮细胞凋亡的影响,并探讨其可能机制.方法采用大鼠肠缺血再灌注模型.24只大鼠随机分为对照组(C组)、缺血再灌注组(I/R组)和参附治疗组(SF组),SF组于阻断前30 min静注SF液2 mL/100g.再灌注2 h检测回肠黏膜上皮细胞Cas-pase-3,Bcl-2蛋白的表达及细胞凋亡;同时观察小肠黏膜病理形态学改变.结果凋亡细胞检测显示I/R组凋亡细胞显著增多,SF组凋亡细胞数较I/R组显著减少而多于C组(均P＜0.05);Caspase-3,Bcl-2蛋白的表达Caspase-3表达I/R组显著多于SF组和C组(P＜0.01),SF组与C组无明显差异;Bcl-2表达SF组显著高于I/R组(P＜0.05),后者显著低于C组(P＜0.05);SF组小肠黏膜病理损伤程度明显减轻I/R组(P＜0.01).结论参附注射液通过抑制Caspase-3表达和促进Bcl-2基因表达减少缺血再灌注期间肠黏膜上皮细胞的凋亡,从而减轻肠黏膜缺血再灌注损伤.     

会阴伤口皮内缝合临床应用观察

我院自2001年2月以来采用可吸收性合成线行会阴伤口皮内连续缝合，具有无须拆线。减少疼痛，伤口愈合好。住院时间短等优点。现总结如下。一般资料：随机选取阴道分娩会阴侧切产妇123例作为观察组随机选取同期阴道分娩会阴侧切产妇112例为对照组。两组产妇年龄分布在21～36岁。孕周分布在37～41周．产次分布在0～3次，会阴条件均无明显差异。具有可比性。     

包头市补磺地区7—14岁儿童少年T3、T4、TSH及尿碘的测定

目的：了解包头市九原区缺碘地区碘盐防治十年后对7～14岁儿童少年碘代谢和垂体—甲状腺功能的影响。方法：采用放射免疫分析测定T3、T4、TSH含量,采用衍生气相色谱法测定尿碘。结果：观察组T3为(1.09±0.49)μg/L,T4为(107.32±23.13)μg/L,TSH为(3.62±2.73)mIU/L,尿碘为(111.3±104.0)μg/L。对照组T3为(1.37±0.78)μg/L,T4为(114.99±41.65)μg/L,TSH为(6.23±7.98)mIU/L,尿碘为(286.0±120.6)μg/L。结论：缺碘地区7～14岁儿童少年的缺碘状态已得到基本纠正,补碘有效,但部分人群还处在摄碘相对不足的状态。     

包头市补碘地区7～14岁儿童少年T3、T4、TSH及尿碘的测定

目的：了解包头市九原区缺碘地区碘盐防治十年后对7～14岁儿童少年碘代谢和垂体—甲状腺功能的影响。方法：采用放射免疫分析测定T3、T4、TSH含量,采用衍生气相色谱法测定尿碘。结果：观察组T3为(1.09±0.49)μg/L,T4为(107.32±23.13)μg/L,TSH为(3.62±2.73)mIU/L,尿碘为(111.3±104.0)μg/L。对照组T3为(1.37±0.78)μg/L,T4为(114.99±41.65)μg/L,TSH为(6.23±7.98)mIU/L,尿碘为(286.0±120.6)μg/L。结论：缺碘地区7～14岁儿童少年的缺碘状态已得到基本纠正,补碘有效,但部分人群还处在摄碘相对不足的状态。     

参附注射液对糖尿病大鼠心肌缺血再灌注时PTEN和P13 K表达的影响

Objective To investigate the effect of Shenfu injectio (SFI) on the expression of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and phosphatidylinositol 3-kinase (PI3K) during myocardial ischemia-reperfusion (IR) in diabetic rats.Methods Thirty adult male diabetic SD rats weighing 220-280 g were used in this study. Diabetes mellitus was induced with intraperitoneal streptozotocin 60 mg/kg and confirmed by fasting blood glucose > 16.7 mmol/L. The animals were randomly divided into 3 groups ( n = 10 each): group I sham operation (group S); group II IR and group Ⅲ SFI. Myocardial IR was produced by occlusion of left anterior descending branch (LAD) of coronary artery for 30 min followed by 120 min reperfusion in group IR and SFI. LAD was exposed but not occluded in group S.SFI was infused iv at 10 ml·kg-1 ·h-1 before opening the thoracic cavity and at 3ml·kg-1·h-1 after opening the thoracic cavity in group SFI until the end of operation. Equal volume of Lactated Ringer's solution and hydroxyethyl starch was infused instead of SFI in group S and IR. The rats were killed and hearts removed at 120 min of reperfusion for microscopic examination and determination of cardiomyocyte apoptosis (by TUNEL)and expression of PTEN and PDK (by immunohistochemical method). PTEN/PI3K ratio, myocardial infarct size of left ventricle and apoptosis index were calculated.Correlation between apoptosis index and PTEN/PI3K ratio was analyzed. Results Myocardial infarct size and apoptosis index were significantly increased, while expression of PTEN and PI3K was up-regulated in group IR and SFI as compared with group S ( P < 0.05 or 0.01) . PTEN/PI3K ratio was significantly decreased in group SFI as compared with group S (P< 0.05). Myocardial infarct size and apoptosis index were significantly decreased, PTEN expression was down-regulated, PI3K expression was up-regulated and PTEN/PI3K ratio was significantly decreased in group SFI as compared with group IR( P < 0.05) . Myocardial pathological damage was attenuated in group SFI as compared with group IR. Apoptosis index was positively correlated to PTEN/PI3K ratio (r =0.452,P <0.05) .Conclusion SFI can attenuate myocardial IR injury via down-regulating the expression of PTEN,up-regulating the expression of PBK and activating PI3K/Akt signal pathway in diabetic rats.     

瑞芬太尼持续泵注用于肾移植手术麻醉14例

目的 探讨瑞芬太尼持续微量泵输注用于肾移植手术麻醉的可行性。方法 肾移植手术24例，按麻醉维持用药不同分为A组14例，B组10例，两组麻醉诱导药物相同。A组持续泵注瑞芬太尼（0.1～0.2 μg·kg^-1·min^-1），持续吸入异氟醚（1%）并根据手术需要调节瑞芬太尼用量，手术结束前15 min停吸入麻醉药、5 min停止瑞芬太尼输入。B组持续吸入异氟醚（1%～3%）。记录两组各时段血流动力学变化、术中生命体征、麻醉恢复情况（睁眼时间、呼吸满意、拔管时间）。结果 术中两组生命体征维持稳定，应激指标无明显差异；A组麻醉苏醒时间及拔管时间明显短于B组（P＜0.05），且A组苏醒平稳和耐受气管导管情况良好，无呼吸遗忘及呼吸抑制。结论 瑞芬太尼持续微量泵输注复合异氟醚用于肾移植手术麻醉安全、有效，是较理想的麻醉方法。     

HB-ESWL-VG型体外碎石机维修二例

介绍了HB-ESWL-VG型体外碎石机2例故障分析与排除的过程。     

外固定支架结合髂骨治疗胫腌骨远端粉碎性骨折

目的：观察单臂外固定支架结合髂骨柱植骨治疗胫腌骨远端粉碎性骨折的疗效。方法：对25例闭合性骨折,3例开发性骨折应用髂骨柱植入,使骨折端相对稳定,然后行“T”形外固定支架固定,结果：经12－24个月随访,均骨性愈合,患肢功能恢复良好,结论：应用外固定结合髂骨柱植骨治疗胫腌骨远端粉碎性骨折,疗效满意。