缺血预处理程序中心肌环磷酸腺苷含量及环磷酸腺苷依赖蛋白激酶活性的变化

目的:制备大鼠在体缺血再灌注模型,观察缺血预处理程序中心肌环磷酸腺苷含量及环磷酸腺苷依赖蛋白激酶活性的变化。方法:实验于2005-03/2006-10在解放军沈阳军区总医院医学实验动物中心和全军心血管研究所实验室完成。实验分组:选用健康雌性SD大鼠36只,根据预适应程序分为第1,2,3次缺血,第1,2,3次再灌注,每一时间点6只大鼠。实验过程:用手术套管法造成左冠状动脉主干缺血及再灌注。所有实验动物在实验程序结束后,取出心脏迅速置液氮保存备用。实验评估:用放射免疫法测环磷酸腺苷水平,生化法测环磷酸腺苷依赖蛋白激酶活性变化。结果:36只大鼠均进入结果分析。①环磷酸腺苷含量:第1次再灌注组低于第1次缺血组[(0.325±0.015),(0.395±0.024)pmol/g,t=6.06,P<0.001],第2次再灌注组低于第2次缺血组[(0.523±0.017),(0.708±0.067)pmol/g,t=6.56,P<0.001],第3次再灌注组低于第3次缺血组[(0.567±0.031),(0.712±0.038)pmol/g,t=7.24,P<0.001]。②环磷酸腺苷依赖蛋白激酶活性:第1次再灌注组低于第1次缺血组[(10.115±1.000),(16.351±0.849)pkat/g,t=11.12,P<0.001],第2次再灌注组低于第2次缺血组[(11.877±2.213),(14.869±0.619)pkat/g,t=3.31,P<0.01],第3次再灌注组低于第3次缺血组[(11.745±0.987),(14.766±0.329)pkat/g,t=7.09,P<0.001]。③缺血预处理程序中心肌环磷酸腺苷含量及环磷酸腺苷依赖蛋白激酶活性随缺血及再灌注呈周期性波动。在5min缺血预处理时表现为明显增高,而在间隔的再灌注程序中恰呈相反改变,有明显下降的趋势。结论:环磷酸腺苷及环磷酸腺苷依赖蛋白激酶的周期性波动变化可能是激发心肌缺血预处理的机制之一,环磷酸腺苷可能在预处理保护作用中起一些作用。     

Comparison of transferrin receptor-mediated endocytosis and drug- induced endocytosis in human neonatal and adult RBCs

Neonatal RBCs can undergo receptor-mediated endocytosis; normal adult RBCs cannot. Previously, we showed that drug-induced endocytosis, which can occur in adult RBCs exposed to amphipathic cations like primaquine, is greatly enhanced in all density-defined fractions of neonatal RBCs. To investigate the similarities and differences between receptor- mediated endocytosis and drug-induced endocytosis, we characterized transferrin receptor-mediated endocytosis in neonatal RBCs and compared it with drug-induced endocytosis. Primaquine drug-induced endocytosis is dependent on RBC ATP levels, is invariably preceded by stomatocytosis, and is inhibited by vanadate. In contrast, receptor- mediated endocytosis of transferrin is not preceded by stomatocytosis, is not nearly so dependent on ATP levels as is drug-induced endocytosis, and is not inhibited by vanadate. Furthermore, receptor- mediated endocytosis is quantitatively blocked by preincubation of neonatal RBCs with sodium cyanide, whereas cyanide does not inhibit drug-induced endocytosis in either adult or neonatal RBCs. Morphologic observation of the neonatal RBCs established the fact that only puckered RBCs that exhibited brilliant cresyl blue staining reticulum were capable of undergoing receptor-mediated endocytosis of transferrin. These characteristics identify them as motile R-1 reticulocytes. Reticulocytes in normal adult RBCs were incapable of exhibiting this phenomenon. Thus, receptor-mediated endocytosis, a property of motile reticulocytes in neonatal RBCs, differs from drug- induced endocytosis in its energy requirements, response to inhibitors, and morphologic concomitants.     

Profile of thoracic trauma–An analysis of 350 cases

The incidence of chest trauma is rising rapidly and opinion continues to differ on its management. Our experience with 350 consecutive patients of chest injuries between January, 1983 and June, 1986 was reviewed. There were 300 males and 50 females. The average age was 29 years. Two-hundred and seventy-five (80%) were under forty years of age. The commonest presenting features were pain (100%), and dyspnoea (58.57%). Features of peripheral circulatory failure were found in 20 per cent. Ninety (25.71%) had other associated injuries. Three hundred (85.71%) were treated conservatively with 20 (6.66%) deaths. Forty-eight (13.7%) patients underwent surgical exploration (thoracotomy in 34 and laparotomy in 14 patients) with 8 deaths. Remaining 2 patients died in the casualty soon after arrival. The overall mortality was 8.57 per cent. The average period of hospitalisation was 9.5 days.     

The thoracic aorta studied by MR imaging

Thirty-three patients with a variety of disorders of the thoracic aorta (aneurysm, dissection, Marfan syndrome, coarctation/pseudocoarctation, L-transposition, and Takayasu disease) were evaluated with magnetic resonance (MR) imaging. MR imaging delineated the presence and extent of thoracic aortic aneurysms and showed the relationship of the aneurysm to arch vessels; it also demonstrated intimal flaps and individual lumina in types A and B aortic dissection. Dilation of the ascending aorta in Marfan syndrome and focal narrowing of the aorta in coarctation were well visualized. The anteroposterior and side-to-side relationships of the aorta and pulmonary artery in L-transposition were demonstrated, as were aortic wall thickening and branch vessel narrowing in Takayasu arteritis. Initial experience suggests that MR imaging may provide a noninvasive method for evaluating thoracic aortic disease. Limitations include inferior spatial resolution, occasional difficulty in imaging the entire region of interest in one section, lack of signal from calcifications, and inability to monitor critically ill patients.     

Who wants to be a surgeon? A study of 300 first year medical students

Background  

While medicine in general is becoming more female-dominated, women are still under-represented in surgery. Opinion is divided as to whether this is due to lifestyle considerations, disinterest or perceived discrimination. It is not clear at what stage these careers decisions are made.     

Spontaneous resolution of cholelithiasis in infants

Follow-up sonographic studies of five infants whose initial sonograms had displayed evidence for the diagnosis of cholelithiasis demonstrated spontaneous resolution of the gallbladder defects. These defects may have been caused by tumefactive sludge with acoustic shadowing. Whether sludge or gallstones are being imaged, in the absence of other clinical or imaging evidence of biliary tract disease, conservative (i.e., nonsurgical) management and serial sonograms are recommended.