Effects of decreased insulin-like growth factor-1 stimulation on hypoxia inducible factor 1-α protein synthesis and function during cutaneous repair in diabetic mice

Insulin-like growth factor-1 (Igf-1), a critical mediator of tissue repair, is significantly decreased in diabetic wounds. Furthermore, decreased levels of hypoxia-inducible factor 1-alpha (Hif-1alpha) and its target genes are also associated with impaired wound healing in diabetic mice. The aim of our study was to examine whether the reduced levels of Igf-1 are responsible for the reduction in Hif-1alpha protein synthesis and activity in diabetic wounds. We provide evidence that Igf-1 regulates Hif-1alpha protein synthesis and activity during wound repair. In addition, Igf-1 stimulated phosphytidylinositol 3-kinase activity in diabetic fibroblasts, which, in turn, increased activation of the translational regulatory protein, p70 S6 kinase. Moreover, improved healing of diabetic wounds by addition of recombinant IGF-1 protein was associated with an increase in Hif-1alpha protein synthesis and function in vivo.     

Myocardial Depressant Effects of Desflurane: Mechanical and Electrophysiologic Actions In Vitro

Background: The authors determined whether desflurane altered myocardial excitation-contraction coupling and electrophysiologic behavior in the same manner as isoflurane and sevoflurane.

Methods: The effects of desflurane on isometric force in guinea pig ventricular papillary muscles were studied in modified standard and in 26 mm K+ Tyrode solution with 0.1 [mu]m isoproterenol. Desflurane effects on sarcoplasmic reticulum Ca2+ release were also determined by examining its actions on rat papillary muscles, guinea pig papillary muscles in low-Na+ Tyrode solution, and rapid cooling contractures. Normal and slow action potentials were recorded using a conventional microelectrode technique. Ca2+ and K+ currents of guinea pig ventricular myocytes were examined.

Results: Desflurane (5.3% and 11.6%) decreased peak force to approximately 70% and 40% of the baseline, respectively, similar to the effects of equianesthetic isoflurane concentrations. With isoproterenol in 26 mm K+ Tyrode solution, desflurane markedly depressed late peaking force and modestly depressed early peak force. The rested state contractions of rat myocardium or guinea pig myocardium in low-Na+ Tyrode solution were modestly depressed, whereas rapid cooling contractures were virtually abolished after desflurane administration. Desflurane significantly prolonged the action potential duration. Desflurane reduced L-type Ca2+ current and the delayed outward K+ current but did not alter the inward rectifier K+ current.     

云南白药对全髋关节置换术出血量的影响

目的研究云南白药在围术期对全髋关节置换术术中出血量及术后引流量的影响。方法2006至2008年我科收治的股骨颈骨折行全髋关节置换术60例,随机分成两组,分别服用云南白药胶囊和空胶囊;术前术后测定凝血酶原时间(PT),记录全部病人术中出血量及术后24 h引流量。结果实验组和对照组病人的凝血酶原时间(PT)差异有统计学意义(P<0.01);试验组的术中出血量、术后24 h引流量分别为(380±78)ml(、336±77)ml,较对照组(481±77)ml(、418±68)ml明显减少,差异具有统计学意义(P<0.01)。结论云南白药胶囊能够明显减少全髋关节置换术围术期出血量。     

炎琥宁与阿奇霉素联合治疗小儿支原体肺炎

目的:探讨炎琥宁辅助治疗小儿支原体肺炎的疗效.方法:将141例临床确诊的支原体肺炎患儿随机分为两组,治疗组71例,应用阿奇霉素加炎琥宁静点.对照组70例,单纯使用阿奇霉素治疗.结果:治疗组有效率96%,对照组有效率87%,两组统计学差异显著(P＜0.05),治疗组疗效优于对照组.结论:炎琥宁辅助治疗小儿支原体肺炎,临床症状消失快,疗效显著,无明显不良反应,值得推广.     

Reversal of vascular 18F-FDG uptake with plasma high-density lipoprotein elevation by atherogenic risk reduction

Vascular 18F-FDG uptake marker represents inflammation in atherosclerotic lesions, but whether inflammation can be reversed by risk-modifying interventions has not, to our knowledge, been demonstrated. In this study, we evaluated the change of vascular 18F-FDG uptake in response to lifestyle intervention on serial PET/CT scans and further assessed how the findings relate to atherogenic risk reduction. METHODS: A total of 60 healthy adults underwent 18F-FDG PET/CT scans and atherogenic risk-factor assessment at baseline and again after 17.1 +/- 8.3 mo of practicing lifestyle modification. The PET/CT images were evaluated for the presence of vascular 18F-FDG lesions, and vessel-to-blood-pool 18F-FDG ratios were measured. Indices from summed ratios of positive lesions were compared and correlated to atherogenic risk factors. RESULTS: At follow-up, significant reductions in diastolic blood pressure (P < 0.05), total cholesterol (P < 0.05), and low-density lipoprotein level (P < 0.05) and an increase in high-density lipoprotein (HDL) level (P < 0.0001) were demonstrated. On the initial PET/CT scan, 50 of 60 subjects showed 1 or more 18F-FDG-positive lesions (5.9 +/- 5.0/subject), leading to a total of 352 vascular sites. On follow-up, 18F-FDG-positive lesions were significantly reduced to 2.1 +/- 2.2 sites per subject (P < 0.0001) and a total of 124 sites (64.8% reduction). Follow-up 18F-FDG-positive rates were significantly reduced for the aorta and iliac arteries. In addition, significant reductions in the whole-body 18F-FDG index from 1.39 +/- 1.23 to 0.53 +/- 0.59 (P < 0.0001) and carotid 18F-FDG index from 0.08 +/- 0.16 to 0.03 +/- 0.06 (P = 0.01) were shown. The whole-body 18F-FDG index correlated with total cholesterol (P < 0.05) and HDL level (P < 0.05), and the magnitude of reduction in the 18F-FDG index closely correlated to the amount of increase in plasma HDL level (P = 0.005). CONCLUSION: Our study demonstrated that vascular 18F-FDG uptake is reversed in response to atherogenic risk reduction by lifestyle intervention and that the magnitude of improvement correlates to increases in plasma HDL levels. Thus, serial 18F-FDG PET/CT may be useful for monitoring improvements in the inflammatory component of atherosclerotic lesions in response to risk modification.     

Uncooked rice of relatively low gelatinization degree resulted in lower metabolic glucose and insulin responses compared with cooked rice in female college students

Cooking processes that gelatinize granules or disrupt structure might increase the glucose and insulin responses because a disruption of the structure of starch by gelatinization increases its availability for digestion and absorption in the small intestine. We hypothesized that the uncooked form of rice, which has a relatively low degree of gelatinization even though in powder form, would result in lower metabolic glucose and insulin responses compared with cooked rice (CR). To assess the effects of the gelatinization of rice on metabolic response of glucose and insulin, we investigated the glucose and insulin responses to 3 rice meals of different gelatinization degree in female college students (n = 12): CR (76.9% gelatinized), uncooked rice powder (UP; 3.5% gelatinized), and uncooked freeze-dried rice powder (UFP; 5.4% gelatinized). Uncooked rice powders (UP and UFP) induced lower glucose and insulin responses compared with CR. The relatively low gelatinization degree of UPs resulted in low metabolic responses in terms of the glycemic index (CR: 72.4% vs UP: 49.7%, UFP: 59.8%) and insulin index (CR: 94.8% vs UP: 74.4%, UFP: 68.0%). In summary, UPs that were less gelatinized than CR induced low postprandial glucose and insulin responses.     

扩髓交锁髓内钉治疗股骨、胫骨干骨折

目的探讨交锁髓内钉治疗股骨、胫骨干骨折的临床效果.方法应用交锁髓内钉治疗不同类型的股骨干骨折18例,胫骨干骨折15例.结果33例患者随访8～24个月,平均15.2个月,33例均骨性愈合.未出观畸性愈合、再骨折、断钉及膝、踝关节僵硬等并发症.结论交锁髓内钉治疗股骨、胫骨干骨折治愈率高,并发症少,效果满意.     

胰岛素抑制突变亨廷顿蛋白的聚积和毒性

目的:探讨胰岛素对细胞内突变亨廷顿蛋白(Huntingtin,htt)聚集物形成及其细胞毒性的影响.方法:利用脂质体转染法在培养的Hela细胞和HEK293细胞瞬时或稳定转染编码正常或突变htt的氨基末端片段的cDNA,检测不同浓度胰岛素刺激对细胞内突变htt聚集物形成以及细胞活力的影响.结果:在瞬时转染的Hela细胞和稳定转染的HEK293细胞中,含20个谷氨酰胺重复序列(20Q)的正常htt氨基末端片段弥散分布在胞浆内,而含150个谷氨酰胺重复序列(150Q)的突变htt氨基末端片段在多数细胞胞浆或核内形成聚集物.150Q的Hela和HEK293细胞经一定浓度的胰岛素刺激后聚集物的形成显著减少,细胞活力也明显提高.而胰岛素的刺激对20Q的细胞内正常htt的表达以及细胞活力无明显影响.结论:胰岛素能有效抑制细胞内突变htt聚集物的形成及其细胞毒性.     

地震伤中小腿开放性骨折的特点及治疗经验

四川汶川发生里氏8.0级地震后,第二军医大学第七医疗队于5月15日凌晨抵达重灾区江油市,至7月7日离开54d中,共处理开放性胫腓骨骨折43例.山于地震伤在不同时期、不同震级、不同地理环境及建筑物条件下都有其不同的特点,加上胫腓骨开放性骨折的高致残率(截肢、感染、肢体短缩)在地震伤中的高发生率[1],故将这43例的病例特点及我们的救治体会总结如下.