止血带拓展使用的研究进展

综述止血带的分类、使用方法,其拓展用途包括:固定心电监护导线、作为胸腹腔置管引流的中间连接带、连接吸痰管、固定胃管、用于气管切开患者颈部皮肤护理、替换听诊器的老化胶管、预防化疗性脱发等。     

AT2受体对自发性高血压大鼠肾脏近曲小管上皮细胞AT1受体表达与功能的影响

目的 研究AT2受体激动剂CGP42112对自发性高血压大鼠(SHR)肾脏近曲小管上皮(RPT)细胞AT1受体的表达及功能的影响.方法 以RPT细胞株作为研究对象,采用不同浓度AT2受体激动剂CGP42t12(10-9～10-7mol/L)作用24h或同一浓度CGP42112(10-7mol/L)作用不同时间(8、16...     

星状神经节阻滞治疗更年期女性失眠症疗效观察

目的观察星状神经节阻滞(SGB)治疗更年期女性失眠症的临床疗效。方法将76例更年期女性失眠症患者随机分为两组,研究组和对照组各38例。研究组给予星状神经节阻滞(生理盐水6mL+质量浓度为0.02g/mL利多卡因4mL,1次/d,左右两侧交替阻滞)治疗,对照组给予复方酸枣仁胶囊(每晚睡前1粒口服)治疗。整个治疗过程均不给予合并其他镇静催眠的药物及治疗方法,治疗时间为2周,采用睡眠障碍评定量表(SDRS)在治疗前及治疗后1、2周末各评定1次,对两组患者治疗后的疗效进行评价。结果两组患者治疗前后SDRS总分间差异均有统计学意义(P均<0.05);研究组治疗2周后的有效率(临床痊愈与显著有效之和)为28.9%,对照组治疗2周后的有效率为10.5%,两组有效率比较差异有统计学意义(P<0.05)。结论星状神经节阻滞治疗更年期女性失眠症有效率明显高于复方酸枣仁胶囊,是一种行之安全、有效的改善更年期女性失眠的治疗方法,不仅能明显改善患者的睡眠质量,还可改善更年期女性由于体内激素变化引起的自主神经功能紊乱而出现的一系列症状,提高更年期女性失眠患者的生活质量。     

Inhalation of nebulized nitroglycerin, a nitric oxide donor, for the treatment of pulmonary hypertension induced by high pulmonary blood flow

This study explores the effect and mechanisms of inhalation of nebulized nitroglycerin (Neb-NTG) on pulmonary hypertension induced by high pulmonary blood flow. An aortocaval shunt was produced in rats. Twelve weeks after the operation, rats started to inhale Neb-NTG. After 15 weeks, pulmonary and systemic hemodynamics as well as pathological changes were measured in all animals. Inhalation of Neb-NTG was able not only to markedly attenuate pulmonary artery pressure without impacting systolic pressure but also to ameliorate muscularization of small pulmonary arteries. The relaxation response of pulmonary artery ring to acetylcholine in shunt rats and Neb-NTG-treated rats was decreased. However, Neb-NTG did not impact the relaxation response of pulmonary artery ring to both nitroprusside and nitroglycerin (NTG). Neb-NTG successfully inhibited the increased expression of pulmonary artery smooth muscle cell (PASMC) proliferative cell nuclear antigen, collagen I, and collagen III, as well as pulmonary artery urotensin-II in shunt rats with high pulmonary blood flow. Neb-NTG selectively ameliorated pulmonary hypertension as well as pulmonary vascular structural remodeling induced by high pulmonary blood flow.     

Activation of D3 dopamine receptor decreases angiotensin II type 1 receptor expression in rat renal proximal tubule cells

The dopaminergic and renin angiotensin systems interact to regulate blood pressure. Disruption of the D(3) dopamine receptor gene in mice produces renin-dependent hypertension. In rats, D(2)-like receptors reduce angiotensin II binding sites in renal proximal tubules (RPTs). Because the major D(2)-like receptor in RPTs is the D(3) receptor, we examined whether D(3) receptors regulate angiotensin II type 1 (AT(1)) receptors in rat RPT cells. The effect of D(3) receptors on AT(1) receptors was studied in vitro and in vivo. The D(3) receptor agonist PD128907 decreased AT(1) receptor protein and mRNA in WKY RPT cells and increased it in SHR cells. PD128907 increased D(3) receptors in WKY cells but had no effect in SHR cells. D(3)/AT(1) receptors colocalized in RPT cells; D(3) receptor stimulation decreased the percent amount of D(3) receptors that coimmunoprecipitated with AT(1) receptors to a greater extent in WKY than in SHR cells. However, D(3) receptor stimulation did not change the percent amount of AT(1) receptors that coimmunoprecipitated with D(3) receptors in WKY cells and markedly decreased the coimmunoprecipitation in SHR cells. The D(3) receptor also regulated the AT(1) receptor in vivo because AT(1) receptor expression was increased in kidneys of D(3) receptor-null mice compared with wild type littermates. D(3) receptors may regulate AT(1) receptor function by direct interaction with and regulation of AT(1) receptor expression. One mechanism of hypertension may be related to increased renal expression of AT(1) receptors due decreased D(3) receptor regulation.     

Clinical outcomes of lumen-apposing metal stent in the management of benign gastrointestinal strictures: a systematic review and meta-analysis

Background and aims: Lumen-apposing metal stent (LAMS) have been considered as a viable alternative to treat benign gastrointestinal (GI) strictures. We aimed to determine the efficacy and safety of LAMS for benign GI strictures.

Methods: Medline, Embase, Cochrane, and PubMed databases were searched using the keywords ‘benign stricture’, ‘gastrointestinal stricture’, ‘lumen-apposing metal stent’ and related terms on December 2018. Articles were selected for review by two authors independently according to predefined inclusion criteria and exclusion criteria. A meta-analysis using a random effects model was performed.

Results: Six studies with a total of 144 patients were included in the final analysis (60 males, 41.7%). Overall, the pooled technical success rate was 98.3% [95% confidence interval (CI): 0.962–1.004], clinical success rate was 73.8% (95% CI: 0.563–0.912) and adverse events rate was 30.6% (95% CI: 0.187–0.425). The most common complication associated with LAMS for benign GI strictures was migration, and the pooled events rate was 10.9% (95% CI: 0.058–0.160). According to locations of stricture, subgroup analysis was performed in terms of clinical success [Esophagogastric: 63.9% (95% CI: 0.365–0.914); Gastroduodenal: 67.4% (95% CI: 0.421–0.927); Gastrojejunal: 78% (95% CI: 0.638–0.922); Pylorus: 77.6% (95% CI: 0.551–1.002); Colonic: 85.3% (95% CI: 0.515–1.191)].

Conclusions: Although the safety of LAMS placement in benign GI strictures is not very satisfactory, it is associated with a low migration rate. LAMS can achieve clinical symptom improvement or resolution in most patients with benign GI strictures, and it might be an alluring prospect for treating patients with this difficult condition.     

卵巢癌组织中CREB结合蛋白和P53蛋白的表达及其临床意义

目的检测CREB结合蛋白(CBP)和P53蛋白在卵巢癌中的表达,明确CBP突变的位置在氨基端还是羧基端,并分析CBP和P53蛋白的表达与临床病理特征之间的关系以及他们之间的相关程度,探讨他们在卵巢癌的发生、发展中的作用。方法采用免疫组化法检测67例上皮性卵巢癌,18例正常卵巢组织中,CBP(C-20)、CBP(N-22)和P53蛋白表达情况。结果 (1)CBP(N-22)和P53在卵巢癌中(阳性表达分别为48/67,37/67)表达明显高于正常卵巢组织(阳性表达例数分别为0/18,2/18)(P=0.000,P=0.000),CBP(C-20)在卵巢癌中阳性表达数为0,提示CBP的突变位点在CBP(C-20)。(2)CBP和P53的阳性表达与肿瘤的分期及淋巴转移有关,随着分期的增加,两者的表达明显增高,淋巴结转移者阳性表达明显高于无转移者,而与年龄、肿瘤的组织学类型、组织的分化程度无明显的相关性。(3)CBP和P53二者的表达呈正相关(r=0.432,P=0.000)。结论在卵巢癌中,CBP的突变位点在CBP(C-20),与卵巢正常组织相比,在卵巢癌中CBP和P53的表达明显增高,与分期及淋巴转移有关,而与年龄、肿瘤的组织学类型、组织的分化程度无显著的相关性,且两种蛋白的表达呈显著正相关性,提示CBP和P53可能协同参与了卵巢癌的发生、发展过程。     

Clinical Observation of Transepithelial Corneal Collagen Cross-linking by Iontophoresis of Riboflavin in Treatment of Keratoconus

Purpose： To evaluate the efficacy and safety of transepithelial collagen cross-linking by iontophoretic delivery of riboflavin in treatment of progressive keratoconus. Methods： Eleven patients （15 eyes） with progressive kerato- conus were enrolled. After 0.1% riboflavin-distilled water so- lution was deliveried via transepithelial iontophpresis for 5 min with 1 mA current, and ultraviolet radiation （370 nm, 3 mW/ cm2） was performed at a 1.5 cm distance for 30 min. The fol- low up were 6 months in all eyes. The uncorrected visual acu- ity, corrected visual acuity,endothelial cell counting, corneal thickness, intraocular pressure, corneal curvature, corneal to- pography, OCT and corneal opacity before and 6-month after surgery were analyzed. Results： At 6 month postoperatively, mean uncorrected visual acuity and corrected visual acuity changed from 0.36 to 0.30 and from 0.42 to 0.57 without statistical significance. The mean value of each index of corneal curvature declined with- out statistical significance.Kmax value dereased from 60.91 to 59.91, and the astigmatism declined from 3.86 to 3.19. Cen- tral corneal thickness decreased from 460.93 μm to 455.40 μm, and thinnest corneal thickness declined from 450.87 μm to 440.60 μm with no statistical significance. Intraocular pres- sure was significantly elevated from 10.85 mmHg to 12.62 mmHg. Endothelial cell count did not change significantly. No corneal haze occurred. Mean depth of corneal demarcation line was 288.46 μm at 1 month postoperatively.