缺血预处理-后处理对大鼠肠缺血再灌注损伤的影响

Objective To evaluate the effects of ischemic preconditioning-postconditioning on the intestinal ischemia-reperfusion (IR) injury in rats. Methods Forty healthy male SD weighing 225-275 g were randomly assigned into 5 groups ( n = 8 each): group I sham operation (group S) ; group II intestinal IR (group IIR); group Ⅲ ischemic preconditioning (group Ipr); group IV ischemic postconditioning (group Ipo); group V Ipr+ Ipo. The rats were anesthetized with intraperitonel 20% urethane 5 ml/kg. Superior mesenteric artery (SMA) was occluded for 60 min followed by 60 min reperfusion. In group S, SMA was isolated but not occluded. In group Ipr, SMA was occluded for 10 min followed by 10 min reperfusion, and the rest procedures were performed using the method described in group IIR. In group Ipo, 60 min ischemia was followed by three 30 s episodes of ischemia at 30 s intervals for reperfusion. In group Ipr+ Ipo, Ipr was performed followed by Ipo and the procedures were performed using the methods described in group Ipr and Ipo. The animals were killed at 60 min of reperfusion. The intestinal tissues were immediately removed for determination of MDA content, SOD and MPO activities and the degree of damage to intestinal mucous membrane was scored according to Chiu score. Arterial blood samples were taken for determination of plasma concentrations of TNF-α and 1L-6. Results Compared with group S, Chiu score, MDA content, MPO activity, and plasma concentrations of TNF-α and IL-6 were significantly increased, whereas SOD activity decreased in the other 4 groups ( P < 0.05). Chiu score, MDA content, MPO activity, and plasma concentrations of TNF-α and IL-6 were significantly decreased, whereas SOD activity increased in group Ipr, Ipo and Ipr + Ipo as compared with group IIR ( P < 0.05). Chiu score and MDA content were significantly lower, whereas SOD activity higher in group Ipr + Ipo than in group Ipr and Ipo ( P < 0.05). No significant differences were detected in the indices between group Ipr and group Ipo ( P > 0.05). Conclusion Ischemic preconditioning-postconditioning can attenuate the intestinal IR injury in rats, and the efficacy is better than that of either Ipr or Ipo alone.     

麻醉前应用抗胆碱能药物的广东省专家共识(2021版)

抗胆碱能药物在临床应用历史悠久,最初被应用于呼吸系统疾病的治疗。目前,抗胆碱能药物作为重要的术前用药,其术前应用是保证临床麻醉安全实施的重要措施,在促进患者术后快速康复中扮演重要角色。目前抗胆碱能药物种类较多,作用机制不同,术前规范并合理使用抗胆碱能药物可防范麻醉及手术因素所致的风险,保证患者围手术期安全,提高围手术期麻醉管理质量。为进一步规范术前抗胆碱能药物使用,受广东省医学会麻醉学分会的委托,本专家共识邀请省内相关领域麻醉专家,根据国内外最新研究进展和专家共识及指南,结合各中心术前应用抗胆碱能药物的临床实践经验,从抗胆碱能药物在临床麻醉中的应用及在围手术期的应用、麻醉前应用抗胆碱能药物的选择与考虑、抗胆碱能药物的用法用量及注意事项等方面,对术前应用抗胆碱能药物的要点进行阐述。     

腹腔镜下输卵管切开术中垂体后叶素不同使用方法的比较

【目的】探讨垂体后叶素两点注射法在腹腔镜下输卵管妊娠切开术中的应用价值。【方法】将2006年6月-2007年12月我院妇科未破裂输卵管妊娠患者200例,均行腹腔镜下输卵管切开术,分成3组,其中术中两点注射垂体后叶素组（观察1组）72例、单点注射垂体后叶素组（观察2组）62例和未使用垂体后叶素组（对照组）66例。比较3组的手术时间、术中出血量、术后最高体温、手术并发症等。【结果】观察1组和观察2组的手术时间、术中出血量均明显少于对照组（P〈0．05）,观察1组少于观察2组（P〈0．05）。观察1组的持续性宫外孕发生率低于对照组（P〈0．01）,观察2组的持续性宫外孕发生率与观察1组和对照组比较无显著性差异（P〉0．05）。3组术后最高体温无明显差异（P〉0．05）。使用垂体后叶素的患者无1例不良反应发生。【结论】在腹腔镜下输卵管切开术中应用垂体后叶素注射,能减少术中出血,缩短手术时间并减少持续性宫外孕等并发症的发生,在患侧宫角及输卵管系膜两点注射法优于输卵管系膜单点注射法,两种方法都安全可靠。     

黄芪对失血性休克再灌注大鼠小肠粘膜iNOS和ET蛋白表达的影响

目的观察大鼠失血性休克再灌注后诱导型一氧化氮合酶(iNOS)和内皮素(ET)在小肠粘膜的表达及黄芪对它们的影响。方法雄性SD大鼠24只,随机分成对照组、模型组和黄芪组。复制重度失血性休克及复苏动物模型,黄芪于再灌注前静脉注入,造模完成后观察各组动物小肠粘膜病理学变化,用免疫组化法检测肠粘膜组织诱导型iNOS和ET表达。结果模型组肠粘膜损伤最重,黄芪具有保护缺血-再灌注肠粘膜的作用,对照组肠粘膜无损伤;Chiu’s评分模型组最大,黄芪组次之,对照组最低(P<0·01)。各组肠粘膜均可见到iNOS和ET表达。模型组iNOS表达明显增强,表达的灰度值明显高于其它两组(P<0·05);黄芪组比对照组有增高趋势,但两组间表达的灰度值无显著性差异。模型组和黄芪组ET表达灰度评分值高于对照组(P<0·05),与模型组相比,黄芪组肠粘膜ET表达灰度值虽有所降低,但无显著性差异。结论黄芪能减少失血性休克再灌注小肠粘膜组织iNOS表达,这可能与其抗失血性休克再灌注肠粘膜的损伤机制有关。     

人β防御素2在子宫内膜异位症患者在位和异位内膜组织中的表达及其意义

子宫内膜异位症(内异症)是一种育龄妇女常见的妇科良性疾病[1],其发病机制仍未完全明确,目前研究表明,内异症与免疫炎性反应有着密切的关系[2].     

人β防御素2在子宫内膜异位症患者在位和异位内膜组织中的表达及其意义

子宫内膜异位症(内异症)是一种育龄妇女常见的妇科良性疾病[1],其发病机制仍未完全明确,目前研究表明,内异症与免疫炎性反应有着密切的关系[2].     

缺血后处理抗大鼠肠缺血-再灌注损伤的蛋白质组学研究

目的 研究缺血后处理(ischemic postconditioning,IPo)抗大鼠肠缺血-再灌注(intestinal ischemic/reperfusion injury,IL/R)损伤后肠黏膜的蛋白质变化,探讨其可能的肠保护机制.方法 16只雄性SD大鼠,随机分为IL/R组和IPo组.IL/R组阻断肠系膜上动脉60 min后再开放60min,IPo组在阻断肠系膜上动脉60 min后行三个循环灌注30 s/,阻断30 s,余同IL/R组.再灌注结束即刻在距回肠末端5 cm处取20 cm小肠刮取肠黏膜,利用高分辨双向电泳对肠黏膜组织进行蛋白质分离,Image Master 2D Elite 5.0图像软件进行分析,应用基质辅助电离解析飞行时间质谱获取肽质量指纹图谱,检索数据库鉴定差异表达的蛋白质,明确其生物学功能.结果 研究发现10个差异表达的蛋白质点,其中6个在IPo组中表达上调,4个表达下调.9个通过鉴定及功能分析,其中醛糖还原酶、醛脱氢酶与抗氧化应激和抑制凋亡相关.结论 建立了重复性较好的IPo与IL/R损伤后肠黏膜组织的双向电泳图谱.IPo的肠保护机制可能与其上调醛糖还原酶和醛脱氢酶的表达,从而抑制氧化损伤及细胞凋亡有关.     

超声联合神经刺激仪引导腋路臂丛神经阻滞应用不同浓度罗哌卡因的效果分析

目的 观察不同浓度罗哌卡因对超声联合神经刺激仪引导腋路臂丛神经阻滞的影响.方法 选取2018年1—10月在我院行超声联合神经刺激仪引导腋路臂丛神经阻滞麻醉的手部手术患者共160例,所有患者均行超声联合神经刺激仪引导腋路臂丛神经阻滞,按不同浓度罗哌卡因将所选患者分为A组、B组、C组、D组,每组各40例,A组给予0.25％...