不同氧合器对体外循环心脏手术患儿中性粒细胞凋亡的影响

Objective To evaluate the effect of two kind oxygenators on polymorphonuclear neutrophil (PMN) apoptosis, and to give a method of inhibting the systemic inflammatory response syndrome(SIRS) to cardiopulmonary bypass(CPB). Methods Sixty VSD patients undergoing open heart surgery with CPB were randomly divided into two groups(n = 30): group B(bubble oxygenator), group M(membrane oxygenator). Blood samples were drawn from the central venous line before starting CPB, at the end of CPB, 4, 8 and 24 h after CPB. The PMN counts were performed by blood cell counter. PMN apoptosis and the expression of CD11b were evaluated by flow eytometry. The plasma concentration of elastase was determined by enzyme linked immunosorbent assays. Results The rates of PMN apoptosis were significantly reduced (P<0.05) and the PMN counts, the expression of CD11b and the plasma con-centration of elastase were remarkably increased after CPB(P<0.05), but at the end of CPB, 4 h and 8 h after CPB the rate of PMN apoptosis was higher in group M than that in group B. PMN counts, the expression of CDI lb and the plasma concentration of elastase were higher in group B than in group M (P<0.05). The PMN counts were higher in group B than in group M 24 h after CPB (P< 0.05). Conclusion XiJian-Ⅱ membrane oxygenator can increase PMN apoptosis and depress systemic inflammatory response better than XIJing-90 bubble oxygenator.     

肿瘤坏死因子-α预处理与缺血预处理在减轻肝脏缺血再灌注损伤的作用

目的研究采用肿效瘤坏死因子-α(TNF-α)预处理与采用缺血预处理两种方法对减轻大鼠肝脏缺血再灌注损伤(IRI)的作用效果,并探讨采用TNF-α预处理减轻大鼠肝脏IRI的机制。方法将40只Wistar大鼠随机分为4组:假手术组(SO组)仅行开腹及游离肝十二指肠韧带;缺血再灌注组(IR组)采用Pringle’s法阻断肝门30 min,再灌注6 h;缺血预处理组(IPC组)采用Pringle’s法阻断肝门10 min,开放血流10 min,此后操作同IR组;TNF-α预处理组(TPC组),术前30 min给予TNF-α1μg/kg腹腔注射,此后操作同IR组。检测血清谷丙转氨酶(ALT)和谷草转氨酶(AST),采用免疫组织化学检测Bcl-2蛋白和NF-κB p65蛋白表达情况,以及肝细胞凋亡指数(AI)。结果 IPC组血清ALT、AST水平为(316.4±90.6)U/L、(316.4±90.6)U/L,TPC组为(336.8±79.4)U/L、(392.7±109.3)U/L,与IR组(642.8±149.3)U/L、(730.6±103.0)U/L比较明显降低,P0.05差异有统计学意义;肝细胞凋亡评分AI在IPC组(4.36+0.88)和TPC组(4.94+2.04)明显降低,与IR组(9.48+2.42)比较,P0.05差异有统计学意义;肝组织内Bcl-2蛋白阳性表达在IPC组(62.30+9.20)和TPC组(60.99+6.30)升高,与IR组(11.45+11.97)比较,有显著性差异(P0.05);NF-κB p65阳性表达在IPC组(31.56+4.85)和TPC组(32.80+5.30)明显降低,与IR组(68.33+6.07)比较,有显著性差异(P0.05)。上述各项指标在IPC组与TPC组间,差异无统计学意义(P0.05)。结论采用TNF-α预处理与缺血预处理对减轻大鼠肝脏IRI的效果一致,TNF-α预处理通过抑制NF-κB p65蛋白表达、激活凋亡抑制基因Bcl-2蛋白表达,减轻了大鼠肝脏IRI。     

不同氧合器对体外循环心脏手术患儿中性粒细胞凋亡的影响

Objective To evaluate the effect of two kind oxygenators on polymorphonuclear neutrophil (PMN) apoptosis, and to give a method of inhibting the systemic inflammatory response syndrome(SIRS) to cardiopulmonary bypass(CPB). Methods Sixty VSD patients undergoing open heart surgery with CPB were randomly divided into two groups(n = 30): group B(bubble oxygenator), group M(membrane oxygenator). Blood samples were drawn from the central venous line before starting CPB, at the end of CPB, 4, 8 and 24 h after CPB. The PMN counts were performed by blood cell counter. PMN apoptosis and the expression of CD11b were evaluated by flow eytometry. The plasma concentration of elastase was determined by enzyme linked immunosorbent assays. Results The rates of PMN apoptosis were significantly reduced (P<0.05) and the PMN counts, the expression of CD11b and the plasma con-centration of elastase were remarkably increased after CPB(P<0.05), but at the end of CPB, 4 h and 8 h after CPB the rate of PMN apoptosis was higher in group M than that in group B. PMN counts, the expression of CDI lb and the plasma concentration of elastase were higher in group B than in group M (P<0.05). The PMN counts were higher in group B than in group M 24 h after CPB (P< 0.05). Conclusion XiJian-Ⅱ membrane oxygenator can increase PMN apoptosis and depress systemic inflammatory response better than XIJing-90 bubble oxygenator.     

P2X3受体介导急性痛反应大鼠脊髓背角星形胶质细胞P物质受体和谷氨酸受体表达的变化

P2X3受体在背根感觉神经节特异表达,参与疼痛的信号传递.大鼠足底注射ATP等P2X3受体激动剂可诱发急性伤害性反应[1].研究表明,疼痛的发生和维持不仅与神经元有关,脊髓胶质细胞在某些因素诱导下,也参与了疼痛产生的过程[2],而其是否参与了由P2X3受体介导的急性疼痛信号传导,目前尚不清楚.本研究拟评价P2X3受体介导急性痛反应大鼠脊髓背角星形胶质细胞内P物质受体NK-1和谷氨酸受体NMDA1表达的变化,以探讨脊髓背角星形胶质细胞在急性痛信号传导中的作用.     

TAT-血红素氧合酶-1融合蛋白对大鼠供肝冷保存期炎性反应及肝功能的影响

目的 探讨HIV-1反式激活蛋白-血红素氧合酶-1(TAT-HO-1)融合蛋白对大鼠供肝冷保存期炎性反应及肝功能的影响.方法 成年健康雄性SD大鼠48只,体重250～300 g,开腹游离腹主动脉并结扎,于左右髂总动脉分叉处向心端穿刺腹主动脉,切断肝上下腔静脉,随机灌注4℃HTK液(C组,U=24)或4℃含TAT-HO-1融合蛋白50 μg/ml的HTK液(P组,n=24),至流出灌洗液清亮后停止灌注,取肝脏,置于相应保存液中冷保存.分别于冷保存即刻、6、12和18 h时取保存液并切取肝组织.采用全自动生化分析仪测定保存液谷草转氨酶(AST)、谷丙转氨酶(ALT)及乳酸脱氢酶(LDH)活性,免疫组化法检测肿瘤坏死因子α(TNF-α)的表达,光镜下观察肝组织形态学.结果 随冷保存时间延长,两组保存液AST、ALT及LDH活性升高,TNF-α表达上调(P<0.05);与C组比较,冷保存6、12、18 h时P组保存液AST、ALT及LDH活性降低,TNF-α表达下调(P<0.05).结论 TAT-HO-1融合蛋白可抑制大鼠供肝冷保存期的炎性反应,对肝功能具有一定保护作用.     

手术治疗间歇性外斜视的临床观察

目的讨论间歇性外斜视手术治疗的效果。方法对72例间歇性外斜视进行手术治疗,并观察手术时机,手术过矫等对手术效果的影响。结果手术年龄越小,术后双眼单视功能恢复越好。结论大于20^△的间歇性外斜视早期手术治疗有利于双眼单视功能的重建。     

血红素加氧酶-1对器官移植保护作用的研究进展

血红素加氧酶-1(heme oxygenase,HO-1)是机体血红素降解过程的限速酶,它可将血红素分解为一氧化碳(CO)、游离铁和胆绿素.目前HO-1及其降解血红素的代谢产物体系在抗氧化、抗凋亡、抗炎症、舒张血管及细胞保护等方面的作用受到了普遍关注.HO-1在器官移植中的作用已成为研究热点,现就HO-1在器官移植中细胞保护作用的研究进展作如下综述.     

体外循环全身炎性反应的影响因素

体外循环（extracorporeal circulation，ECC）是心血管外科手术主要的辅助手段，从1953年John Gibbon成功完成第1例ECC下房间隔缺损修补术至今已有半个多世纪，随着其理论和设备技术的不断发展，使心血管外科手术缘于ECC非生理性灌注干扰的危险性大为降低，从而推动了心脏外科的飞速发展。近年来，ECC引起的全身炎性反应受到普遍关注。ECC导致机体炎性反应的程度与术后并发症有着密切关系，严重者将引起多器官功能障碍和衰竭，造成死亡。为此，学者们对围ECC期机体炎性反应的机理，以及其发生的病理生理基本过程进行了大量的临床观察和实验室研究，随着本领域研究的不断深入，很多极具意义的新进展相继报道。本文主要对ECC期间可能影响全身炎性反应的因素进行综述。     

TAT-血红素氧合酶-1融合蛋白对大鼠供肝冷保存期核因子-κB表达及氧化反应的影响

肝移植是目前治疗终末期肝病的重要手段,但器官冷保存期的冷缺血损伤是导致移植肝脏功能衰竭或早期无功能的重要原因[1].炎症和氧化反应在肝脏冷缺血/再灌注损伤中起重要作用.     

不同氧合器对体外循环心脏手术患儿中性粒细胞凋亡的影响

Objective To evaluate the effect of two kind oxygenators on polymorphonuclear neutrophil (PMN) apoptosis, and to give a method of inhibting the systemic inflammatory response syndrome(SIRS) to cardiopulmonary bypass(CPB). Methods Sixty VSD patients undergoing open heart surgery with CPB were randomly divided into two groups(n = 30): group B(bubble oxygenator), group M(membrane oxygenator). Blood samples were drawn from the central venous line before starting CPB, at the end of CPB, 4, 8 and 24 h after CPB. The PMN counts were performed by blood cell counter. PMN apoptosis and the expression of CD11b were evaluated by flow eytometry. The plasma concentration of elastase was determined by enzyme linked immunosorbent assays. Results The rates of PMN apoptosis were significantly reduced (P<0.05) and the PMN counts, the expression of CD11b and the plasma con-centration of elastase were remarkably increased after CPB(P<0.05), but at the end of CPB, 4 h and 8 h after CPB the rate of PMN apoptosis was higher in group M than that in group B. PMN counts, the expression of CDI lb and the plasma concentration of elastase were higher in group B than in group M (P<0.05). The PMN counts were higher in group B than in group M 24 h after CPB (P< 0.05). Conclusion XiJian-Ⅱ membrane oxygenator can increase PMN apoptosis and depress systemic inflammatory response better than XIJing-90 bubble oxygenator.