高糖对脂多糖诱导的大鼠肺微血管内皮细胞自噬的影响

目的:探究高糖(HG)环境对脂多糖(LPS)处理的大鼠肺微血管内皮细胞(RPMECs)自噬的影响.方法:LPS联合HG处理RPMECs 24 h后;相应商品化试剂盒检测细胞活力、乳酸脱氢酶(LDH)含量、超氧化物歧化酶(SOD)活性及丙二醛(MDA)含量.免疫印迹法检测Beclin-1、微管相关蛋白1轻链3Ⅱ(LC-3...     

不同麻醉方法对白细胞介素-6和白细胞介素-10的影响

目的:本研究拟观察不同麻醉方法时对病人围术期促炎/抗炎性细胞因子及平衡的影响。方法:选择择期40例胆囊切除手术病人,ASA评分Ⅰ-Ⅱ级,随机分为2组:全凭静脉麻醉组(R组,n=20)和静吸复合麻醉组(F组,n=20)。R组以咪唑安定、异丙酚、维库溴铵和瑞芬太尼诱导气管插管,用微量泵以异丙酚和瑞芬太尼持续静脉输注维持麻醉,术中根据需要调节输注速度。F组麻醉诱导咪唑安定、异丙酚、芬太尼和维库溴铵诱导气管插管。术中静脉给予芬太尼及吸入异氟烷。手术结束时停止给药。两组均间断追加维库溴铵来维持肌松。在全麻诱导前,诱导后麻醉前,切皮后90 min,4 h,每次采血3 ml,采用酶联免疫吸附测量法(ELISA)测定细胞因子IL-6,IL-10。结果:两组病人的一般资料、麻醉期间MAP,HR,SpO2,呼出气PaCO2浓度及手术持续时间均无显著性差异(均为P>0.05)。在切皮后,4,12 h两组IL-6和IL-10浓度较麻醉前均有显著增加,两组组间比较有统计学差异。结论:控制术中炎症反应程度全凭静脉麻醉组优于静吸复合麻醉组,帮助减少手术的损伤,有利于患者的预后。     

缺血后处理对心肌缺血/再灌注大鼠血红素加氧酶-1表达的影响

目的:探讨缺血后处理对心肌缺血/再灌注大鼠血红素加氧酶-1(HO-1)表达的影响。方法:56只雄性SD大鼠随机分为4组:假手术组(Sham组)(n=8)、缺血再灌注组(I/R组)(n=16)、缺血后处理组(IPo组)(n=16)和血红素加氧酶抑制剂锌原卟啉组(ZnPP组)(n=16)。采用结扎心脏左冠状动脉前降支30 min,再灌注2 h制备心肌缺血再灌注损伤模型。IPo组在结扎心脏左冠状动脉前降支30 min,再灌注10 s,缺血10 s,重复3次后,完全恢复心肌血流。再灌注2 h后开胸,每组8只取心尖部缺血心肌,测定超氧化物歧化酶(SOD)活性、心肌组织中丙二醛(MDA)含量和心肌中HO-1蛋白表达。I/R组I、Po组和ZnPP组另取8只大鼠测定心梗面积。结果:与S组比较,I/R组缺血心肌中MDA含量增加,SOD活性降低(P<0.01),I/R组HO-1表达无统计学差异(P>0.05)。与I/R组比较,IPo组缺血心肌中MDA降低,SOD活性升高且心梗面积明显减小(P<0.01),HO-1蛋白表达显著增强(P<0.01)。与IPo组比较,ZnPP组MDA含量升高,SOD活性降低(P<0.01),HO-1表达明显减少(P<0.01)。结论:缺血后处理能减轻大鼠心肌缺血再灌注损伤,其机制与增强心肌抗氧化能力和增加血红素加氧酶(HO-1)的表达有关。     

内质网应激在大鼠心肌缺血再灌注损伤中的作用：与细胞自噬的关系

目的:评价内质网应激在大鼠心肌缺血再灌注损伤中的作用及其与细胞自噬的关系。方法:清洁级健康成年雄性SD大鼠36只,体重250~300 g,采用随机数字表法分为3组( n＝12)：假手术组(Sham组)、心肌缺血再灌注组(IR组)和内质网应激抑制剂4-PBA组(PBA组)。采用阻断冠状动脉左前降支(LAD)缺...     

布托啡诺预先给药对大鼠心肌缺血再灌注损伤的影响

Objective To investigate the effects of butorphanol pretreatment on myocardial ischemia-reperfusion (IR) injury in rats. Methods Forty healthy male SD rats weighing 200-250 g were randomly divided into 5 groups (n = 8 each) : sham operation group (group S); IR group; butorphanol pretreatment group (group B); Nor-BNI group (group N) and glibenclamide group (group G) . In group IR, B, N and G, myocardial IR was produced by occlusion of left anterior descending artery (LAD) for 30 min followed by 120 min reperfusion. In group S and IR, normal saline S ml/kg was injected via femoral vein 10 min before ischemia and then continuously infused at a rate of 5 ml· kg -1· h-1 iv. In group B, butorphanol 25 μg/kg was injected via femoral vein 10 min before ischemia and the rest method was the same as that described in group IR. In group N, Nor-BNI 2 mg/kg (a selective κ-opioid receptor antagonist) was injected via femoral vein 20 min before ischemia and the rest method was the same as that described in group B. In group G, glibenclamide 1 mg/kg (a KATP channel blocker) was injected via femoral vein 10 min before ischemia and the rest method was the same as that described in group B. Blood samples were taken from femoral artery at 120 min of reperfusion for determination of the concentrations of serum TNF-α, IL-6 and IL-10 by ELISA. Myocardial infarct area and ischemic area were measured by TTC staining and myocardial infarct size was calculated. Results The concentrations of serum TNF-a, IL-6 and IL-10 were significantly higher in the other four groups than in group S (P < 0.05) . The concentrations of serum TNF-α andIL-6 were significantly decreased while IL-10 increased, and the myocardial infarct size was significantly decreased in group B, N and G as compared with group IR ( P < 0.05) . The concentrations of serum TNF-α and IL-6 were significantly increased while the concentration of IL-10 decreased) and the myocardial infarct size was significantly increased in group N and G as compared with group B ( P < 0.05). Conclusion Butorphanol pretreatment can protect the myocardium against IR injury in rate via activating κ receptor and KATP channel.     

不同胶体溶液输注对急性胆囊炎手术患者免疫功能的影响

目的 观察6％羟乙基淀粉、聚明胶肽液输注对手术患者免疫功能的影响。方法 28例急性胆囊炎手术切除患者分为两组，分别于术前静注6％羟乙基淀粉和聚明胶肽。用夹心法ELISA检测患者术前术后血浆中白介素-10(IL-10)、白介素6(IL-6)、白介素-8(IL-8)、可溶性白介素-2受体(sIL-2R)、肿瘤坏死因子-α(TNF-α)的浓度。结果 6％羟乙基淀粉、聚明胶肽可降低TNF-α的浓度，聚明胶肽还可以提高抑炎性因子sIL-2R的浓度，而6％羟乙基淀粉还可降低炎性趋化因子IL-8的浓度。结论 术前输注6％羟乙基淀粉、聚明胶肽能预防或减轻手术和麻醉导致的免疫功能失调。     

使用充气升温毯预暖预防患者围手术期低体温的临床观察

目的:观察麻醉诱导之前使用充气升温毯预暖对围手术期患者体温的影响。方法:ASAⅠ-Ⅱ级在全身麻醉下行择期常规腹部手术的患者60例,随机分为A、B、C两组,每组20例。A组患者入室后采用棉被覆盖法进行保温处理,B和C组患者入室后采用充气升温毯进行预热处理,到达预热时间后再行麻醉诱导,B组预热时间15min,C组预热时间45min,入室后监测鼻咽温度,记录入室时麻醉诱导时、切皮时,开腹时及开腹后60,90及120min的鼻咽温度。术后第1天使用视觉模拟评分法对患者进行温度舒适度的评估并记录。结果:B组和C组患者在麻醉诱导时及以后的各时间点鼻咽温度显著高于A组(P<0.05),C组患者在开腹后120min时的鼻咽温度显著高于A组和B组,B组和C组患者温度舒适度评分显著高于A组(P<0.05),C组患者显著高于B组(P<0.05)。结论:在麻醉实施前期使用充气升温毯预暖是维持正常体温的有效保暖方法;充气升温毯预暖的时间越长越有利于患者的体温的维持和提高舒适感。     

曲马多对正常人离体外周血白介素-6和肿瘤坏死因子-α的影响

临床上许多麻醉性镇痛药物能影响机体免疫功能，曲马多是一种可激活阿片μ受体、抑制中枢神经系统去甲肾上腺素和5-羟色胺再摄取的非阿片类中枢性镇痛药，其对白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的影响尚无定论，本实验拟用脂多糖(LPS)诱导正常人离体外周血的炎性反应，探讨曲马多对离体外周血IL-6和TNF-α的影响。     

布托啡诺预先给药对大鼠心肌缺血再灌注损伤的影响

Objective To investigate the effects of butorphanol pretreatment on myocardial ischemia-reperfusion (IR) injury in rats. Methods Forty healthy male SD rats weighing 200-250 g were randomly divided into 5 groups (n = 8 each) : sham operation group (group S); IR group; butorphanol pretreatment group (group B); Nor-BNI group (group N) and glibenclamide group (group G) . In group IR, B, N and G, myocardial IR was produced by occlusion of left anterior descending artery (LAD) for 30 min followed by 120 min reperfusion. In group S and IR, normal saline S ml/kg was injected via femoral vein 10 min before ischemia and then continuously infused at a rate of 5 ml· kg -1· h-1 iv. In group B, butorphanol 25 μg/kg was injected via femoral vein 10 min before ischemia and the rest method was the same as that described in group IR. In group N, Nor-BNI 2 mg/kg (a selective κ-opioid receptor antagonist) was injected via femoral vein 20 min before ischemia and the rest method was the same as that described in group B. In group G, glibenclamide 1 mg/kg (a KATP channel blocker) was injected via femoral vein 10 min before ischemia and the rest method was the same as that described in group B. Blood samples were taken from femoral artery at 120 min of reperfusion for determination of the concentrations of serum TNF-α, IL-6 and IL-10 by ELISA. Myocardial infarct area and ischemic area were measured by TTC staining and myocardial infarct size was calculated. Results The concentrations of serum TNF-a, IL-6 and IL-10 were significantly higher in the other four groups than in group S (P < 0.05) . The concentrations of serum TNF-α andIL-6 were significantly decreased while IL-10 increased, and the myocardial infarct size was significantly decreased in group B, N and G as compared with group IR ( P < 0.05) . The concentrations of serum TNF-α and IL-6 were significantly increased while the concentration of IL-10 decreased) and the myocardial infarct size was significantly increased in group N and G as compared with group B ( P < 0.05). Conclusion Butorphanol pretreatment can protect the myocardium against IR injury in rate via activating κ receptor and KATP channel.     

不同液体输注对手术病人血浆细胞因子的影响

目的:观察6%羟乙基淀粉、聚明胶肽和乳酸林格氏液输注对手术病人细胞因子的影响。方法:42例急性胆囊炎手术切除病人分为三组,分别于术前静注6%羟乙基淀粉、聚明胶肽(国产)和乳酸林格氏液500 ml,用夹心法ELISA检测病人术前术后血浆中IL-10、sIL-2RI、L-6I、L-8、TNF-α的浓度。结果:6%羟乙基淀粉、聚明胶肽可降低TNF-α的浓度,还可以提高sIL-2R的浓度,6%羟乙基淀粉可降低IL-8的浓度,而林格液使TNF-α浓度升高。结论:术前输注6%羟乙基淀粉、聚明胶肽有预防或减轻手术和麻醉导致的细胞因子失调的作用,而输注林格氏液则不能减轻手术和麻醉导致的细胞因子失调。