人骨髓间充质干细胞对放射损伤小鼠造血恢复的影响

本研究旨在探讨人骨髓间充质干细胞(hBMMSC)对受γ射线照射小鼠造血恢复的影响。亚致死剂量(6Gy)60Co-γ射线全身照射雌性BALb/c小鼠,静脉输注不同剂量(1×105,1×106和5×106)的hBMMSC,观察注射后小鼠血常规指标、骨髓造血祖细胞集落量以及血清人TPO,SCF和G-CSF水平等动态变化。结果表明:hBMMSC输注对亚致死量照射小鼠早期死亡率无影响;与对照组比较,接受细胞治疗小鼠早期血象水平无显著增高,但在第28天外周血白细胞、红细胞、血小板计数和血红蛋白水平高于对照组,尤以大剂量组明显(P值均小于0.05);在中剂量和大剂量hBMMSC组小鼠骨髓中,单个核细胞集落形成单位总数和粒单系集落形成单位数均高于对照组(P<0.05);hBMMSC输注后第2天,ELISA法检测可在细胞治疗组小鼠血清中检测到人G-CSF和SCF,以hBMMSC高剂量组G-CSF含量为最高(P<0.01)。所有各组未检测到人TPO,治疗后第9和16天所有各组血清中均未检测到人G-CSF和SCF。结论:hBMMSC输注可加速放射损伤小鼠造血功能的恢复,其机制可能与细胞短暂分泌相关造血细胞调控因子有关。     

再次开胸手术治疗先天性心脏病患者200例效果分析

目的 分析和总结再次开胸治疗先天性心脏病的外科技术和和临床结果。方法 回顾分析2012年1月~2014年1月阜外医院小儿中心再次开胸手术治疗先天性心脏病患儿200例的临床资料。结果 本组患儿手术均顺利完成,手术死亡2例,与同期首次正中开胸手术死亡率比较无显著差异。年龄0.6~16.8（5±3）岁,体质量5~112（18±10）kg,体外循环时间37~442（143±64）min,主动脉阻断时间21~222（89±41）min。发生重大损伤7例,本亚组无手术死亡。结论 再次开胸手术治疗先天性心脏病相对安全。开胸过程中发生的重大损伤不增加患儿的手术死亡率。     

成人再次开胸心脏手术疗效及其相关因素分析

目的 分析成人再次开胸心脏手术发生重大损伤的的相关因素及其对围手术期死亡率的影响。方法 实施再次开胸心脏手术患者242例,回顾性分析再次手术间隔时间、前次手术方式及前次手术心包缝合情况对再次开胸心脏手术重大损伤发生率的影响及其对围手术期死亡率的影响。结果 重大损伤发生率为2.1%（5/242）,发生重大损伤组再次手术间隔时间与未发生重大损伤组差异无统计学意义〔(8±5)年 vs.(2±9)年〕,前次手术为冠状动脉旁路移植术的患者重大损伤的发生率与其他手术的患者差异无统计学意义（6.3% vs. 1.8%）,前次手术缝合心包的患者重大损伤的发生率与前次手术未缝合者差异无统计学意义（0% vs. 7.4%）,但二者开胸至体外循环开始时间差异有统计学意义〔(57±20)min vs.(74±20)min,P<0.01〕;围手术期死亡率为1.7%（4/242）,发生重大损伤的围手术期死亡率与未发生者差异无统计学意义（0% vs. 1.7%）。结论 成人再次开胸心脏手术较安全,发生重大损伤可能不增加围手术期死亡率。     

Pan3基因第2-5外显子的环状RNA对脂多糖诱导的血管内皮细胞损伤的影响及机制

目的 探讨Pan3基因第2-5外显子的环状RNA(circPAN3)对脂多糖诱导的血管内皮细胞损伤的影响及机制.方法 体外培养人脐静脉内皮细胞(HUVEC)随机分为对照组、脂多糖组、空载体组、circPAN3组、抑制剂阴性组、抑制剂组、circPAN3+过表达阴性组和circPAN3+过表达组(n=9),检测各组细胞中...     

脉络宁治疗脑梗死的60例疗效观察

最新研究认为脉络宁具有防治脑缺血再灌注损伤的作用 〔1〕。鉴于此 ,我们应用脉络宁治疗脑梗死 60例 ,获得满意疗效。1　临床资料1.1　 病例选择　纳入研究的脑梗死病人 12 0例 ,均为住院病人 ,全部经头部 CT检查证实 ,随机分为治疗组和对照组各 60例。全部病例发病均在 7d之内 ,且多为首次发病。1.1.1　治疗组　男 44例 ,女 16例 ,年龄 49～ 81岁 ,平均 62 .9岁。其中高血压 15例 ,动脉粥样硬化 2 5例。轻型 40例 ,中型 18例 ,重型 2例。其中基底节区梗死左、右、双侧分别为 12例、10例、12例 ,额顶叶梗死左、右分别为 6例、4例 ,枕叶梗…     

急性冠状动脉综合征患者介入术前后血小板活化及血管内皮功能的变化

目的观察急性冠状动脉综合征患者介入治疗后血小板活化指标CD62p、CD63及糖蛋白Ⅱb/Ⅲa受体复合物及内皮功能的改变。方法60例急性冠状动脉综合征患者在冠状动脉介入术前和术后即刻以及次日采用流式细胞仪检测血小板活化指标CD62p、CD63及糖蛋白Ⅱb/Ⅲa受体复合物;双抗体夹心固相酶联免疫吸附试验测定血浆假血友病因子的表达水平;放射免疫测定法测定血浆内皮素1表达水平;酶法测定血浆一氧化氮的含量;彩色多谱勒超声诊断仪测量内皮依赖性血管舒张功能。选择健康体检者和稳定型心绞痛患者各30例作对照,观察急性冠状动脉综合征患者冠状动脉介入前后指标的变化并与对照组比较。结果与健康对照组和稳定型心绞痛组比,急性冠状动脉综合征组CD62p、CD63及糖蛋白Ⅱb/Ⅲa受体复合物明显增高(P<0.05或0.01);急性冠状动脉综合征患者介入术后即刻CD62p、CD63和糖蛋白Ⅱb/Ⅲa受体复合物与术前相比明显增高(P<0.01),但术后24h较术前无明显变化(P>0.05)。与健康对照组和稳定型心绞痛组比,急性冠状动脉综合征组假血友病因子、内皮素1的表达水平明显增高(P<0.01),内皮依赖性血管舒张功能和一氧化氮降低(P<0.05或<0.01);急性冠状动脉综合征患者介入术后即刻血浆假血友病因子和内皮素1水平升高(P<0.05或P<0.01),内皮依赖性血管舒张功能和一氧化氮水平降低(P<0.05),且介入术后24h假血友病因子水平也较术前升高(P<0.05),内皮依赖性血管舒张功能降低(P<0.05),但内皮素1和一氧化氮水平与术前差异无显著性(P>0.05)。结论血小板活化和内皮功能的损伤在急性冠状动脉综合征发生和发展过程中起重要的作用,冠状动脉介入术后血管内皮受到一定损伤,血小板有一定程度的激活。     

细粒棘球蚴致过敏性休克绵羊肺水肿及对血气影响的观察

为观察细粒棘球蚴致过敏性休克绵羊肺水肿及对血气的影响，探讨其发病机制，选用感染细粒棘球蚴的12只绵羊，随机分为两组，Ⅰ组用细粒棘球蚴粗制囊液抗原10mL攻击发敏，Ⅱ组用生理盐水作对照，确定休克的发生，记录血气pH,PaO2,PaCO2的变化，观察60min后处死绵羊，测定绵羊肺湿/干重量比值，观察绵羊肺部形态结构的变化，结果显示，攻击发敏后，和Ⅱ组比较，Ⅰ组的pH值、PaO2持续降低；PaCO2在休克初期增加，30min升至最高点后，逐渐恢复；肺湿/干重量比值明显升高；肺部形态结构观察，Ⅰ组均有明显的病理变化。说明：（1）休克早期形成广泛的弥漫性蛋白通透性肺水肿；（2）休克时血气变化剧烈，表现为明显的PaO2的持续降低以及PaCO2的增高，且反应迅速，消退较快。     

家兔动脉粥样硬化与血小板源内皮型氧化氮合酶表达的相关性

Objective To explore the correlation of atheroselerosis progression and the expression of platelet derived endothelial nitric oxide synthase (eNOS) in rabbits. Methods A total of 24 male New Zealand white rabbits were used in this study. Six of the animals were fed with normal food (control group). Eighteen rabbits were fed with cholesterol-rich food (1 g/d) for 12 weeks to establish the atherosclerosis model. Among 18 models, 6 rabbits were executed immediately and their aorta and platelet samples were collected for further analysis (model group), 6 rabbits were orally administered with pravastatin (10 rag/d) for additional 12 weeks (treated group), and the remaining 6 rabbits were left untreated until the end of the study (untreated group). The control, treated and untreated animals were then killed, and the aorta and platelet samples were collected for eNOS expression analysis (RT-PCR). Results The aorta samples in model and untreated group exhibited rough intima and a lot of longitudinal fatty streaks, which indicated that atherosclerosis models were established successfully. While in treated group, the degree of atherosclerosis was decreased. The average percent of thickness of fatty streaks or atheroselerotic plaques relative to the whole thickness of vessel walls was 0. 04±0. 02, 0. 82±0. 16, 0. 33±0. 18,0. 77±0. 14 in control, model, treated and untreated group, respectively. The thickness of fatty streaks or atherosclerotic plaques was significantly increased in the model and untreated groups and decreased in treated group compared with the control group (both P<0. 05). The expressions of platelet derived eNOS/mRNA were 1. 02± 0. 28, 0. 41± 0. 27, 1.00 ± 0. 77, 0. 40±0. 29 in control, model, treated and untreated group, respectively. The expression of eNOS/mRNA was markedly decreased in model group and untreated group compared with the control group, but was increased in treated group compared with untreated and model groups (F=3. 544, P = 0. 024). Conclusions There is a negative correlation between eNOS expression and atherosclerosis development, which suggests that the reversal effect of pravastatin on atheroselerosis progression and plaque formation may relate to the expression of platelet derived eNOS.     

A Study on Changes of the Plasma Endothelin Level in Patients with Dilated Cardiomyopathy

Objectives To evaluate the changes of the plasma endothelin level in patients with dilated cardiomyopathy, and to investigate the relationship between the plasma endothelin level and the severity of heart failure, heart size, left ventricular function and with or not with pulmonary arterial hypertension; the changes of the plasma endothelin level before and after treatment. Methods The plasma endothelin level of 30 patients with DCM, 30 healthy control subjects, and their LVEF, PAP, heart size, plasma endothelin level before and after treatment were determined. Results The plasma endothelin level in DCM group was significantly higher than that in control group ( 135.93 ± 70. 65pg/mL) vs(43.65 ± 12.07pg/mL), P < 0.05 ; there was a correlation between ET level and heart size ( r = O. 4580, P = 0. 0109 ) ; there was a significant negative correlation between LVEF of DCM and ET level( r = -0. 6922 ,P =0. 0021 ) ;and it was a significant positive correlation between ET level and pulmonary arterial hyperten     

右室心尖部与右室流出道间隔部起搏对心室间电机械同步性的比较

选择行射频消融术患者30例,术后分别将标测电极置于左室后侧壁(LVPLW)及右室前侧壁(RVALW),大头消融电极依次放置于右室心尖部(RVA)和右室流出道间隔部(RVS)。结果:RVA起搏时,至LVPLW及至RVALW的传导时间差,主动脉射血前间期(APEI)与肺动脉射血前间期(PPE I)差值,绝对值均显著大于RVS起搏(P0.01)。心室起搏后,LVPLW-RVALW差值变化与APE I-PPEI绝对值增加呈正相关(r=0.993,P0.001)。结论:与RVA起搏相比,RVS起搏心室间电激动与机械收缩更同步。