The endothelin antagonist BQ123 reduces pulmonary vascular resistance after surgical intervention for congenital heart disease

OBJECTIVE: Postoperative pulmonary hypertension in children after surgical intervention for congenital heart disease has been attributed to failure of the pulmonary endothelium to provide adequate vasodilation. Although we have shown that the impaired vasodilatory component attributable to the l-arginine-nitric oxide pathway is almost completely reversible, a nonrestorable component persists, implying an additional vasoconstrictive mechanism in postoperative pulmonary endothelial dysfunction. In this study of children after surgical intervention for congenital heart disease, we measured endothelin-1 levels and used BQ123, a selective endothelin-A receptor antagonist, together with inhaled nitric oxide to discriminate dysfunctional pulmonary endothelial vasodilation from endothelin-mediated pulmonary vasoconstriction. METHODS: All children were examined early after surgical intervention in the intensive care unit. Pulmonary vascular resistance (with respiratory mass spectrometry), as well as arterial and venous endothelin-1 levels (measured by means of a quantitative enzyme-linked immunosorbent assay), were determined in 7 children (age range, 3.3-13.7 months; median age, 6.3 months) with intracardiac shunting defects at baseline and during ventilation with a fraction of inspired oxygen of 0.65, with additional BQ123 (0.1 mg/kg infused over 20 minutes), and with inhaled nitric oxide (20 ppm). RESULTS: Pulmonary vascular resistance decreased from 7.7 +/- 3.4 at baseline to 6.1 +/- 2.8 Woods units. m(-2) (P =.022) at a fraction of inspired oxygen of 0.65 and to 4.7 +/- 2.7 Woods units. m(-2) (P =.013) during BQ123 infusion. Inhaled nitric oxide had no further effect on pulmonary vascular resistance. Left atrial endothelin-1 levels (1.35-5.12 pg/mL; mean, 2.4 pg/mL) correlated significantly with the decrease in pulmonary vascular resistance in response to BQ123 infusion (r(2) = 0.89, P =.003). CONCLUSION: Postoperative elevation of pulmonary vascular resistance in children after surgical intervention for congenital heart disease is responsive to endothelin-A blockade with BQ123. Increased levels of endothelin-1 predict the response to this therapy, which might become an important addition to the clinical armamentarium in postoperative pulmonary hypertensive disease.     

营养鲜味剂的研制

通过酶法水解将小梅鱼制备成营养型高档调味剂 .用酶对小梅鱼进行水解 ,结果表明温度、pH、酶的种类、酶的组合、酶添加的顺序对产物的分布有影响 .在初始pH值为 8,温度为 5 0℃时 ,胰酶水解产物中小分子产物含量较高 .胰酶的水解产物用微生物风味复合酶进一步酶解 ,可脱除苦味 .对产物进行氨基酸分布检测 ,结果显示 ,产物中含 18种氨基酸 ,总氮质量分数为 12 6 .4mg/ g(以N计 ) ,α 氨基氮质量分数为 6 0 .8mg/ g .     

耐热β-半乳糖苷酶基因在大肠杆菌中的表达

将来自嗜热脂肪芽孢杆菌IAM 110 0 1的高温乳糖酶基因bgaB亚克隆到具强启动子的大肠杆菌载体 pKK 2 2 3 3中 ,经IPTG诱导后 ,表达出的重组蛋白质仍具有耐高温活性 ,其相对分子质量与天然蛋白质相似 ,表达量为 1.5U/mg ,比出发菌株高 10倍     

好氧颗粒污泥的形成及其性质

综述了好氧颗粒污泥的研究进展 ,包括好氧颗粒污泥的基本特征和微生物相、好氧颗粒污泥形成的主要条件及其颗粒化过程、好氧颗粒污泥反应器等 .好氧颗粒污泥是近几年发现的在好氧条件下自发形成的细胞自身固定化颗粒 ,具有良好的沉淀性能、较高的生物量和在高容积负荷条件下降解高浓度有机废水的良好生物活性 .颗粒化过程是一个多阶段的过程 ,取决于废水组成、操作条件和适当的选择压等因素 .SBR反应器 (SequencingBatchReactor)有利于好氧颗粒污泥的形成     

好氧同时硝化-反硝化脱氮微生物的混合培养

筛选和分离得到的多株脱氮微生物 ,能在完全好氧条件下将氨氮转化为NO2 - ,随即在好氧反硝化菌的作用下还原为N2 排放 ,整个生物脱氮过程历时较短 ,30h内对 2 0 0mg/L的氨氮去除率达 99% ,而且无中间产物NO2 - 的积累 .混合脱氮微生物菌群生长的适宜 pH范围为 7～ 10 ,探索实现混合脱氮微生物菌群高密度培养的 pH :发酵前期补酸控制 pH≤ 8,发酵中后期不控制 pH值 ,可缩短菌体的生长周期 ,提高菌体的氨氮降解速率 ,细胞质量浓度达 3.9g/L ,比自然 pH条件下提高了 6 2 .5 % .     

肝细胞癌综合治疗

肝细胞癌（hepatocellular carcinoma，HCC）是第5位常见的恶性肿瘤，各种方法治疗后的总体5年生存率仅为7％左右．全世界每年由于肝细胞癌所致的死亡人数可达60万。既往肝癌疗效极差很大程度上是由于早期诊断困难，随着对肝癌高危人群的筛选，CT、MRI及PET等影像技术的提高，目前已能精确诊断并定位0．5cm左右的早期肝癌。而肿瘤生物学研究的不断深入，对肝癌的发生、发展、转移和复发的分子机制有了新的理解。因此，近年肝癌的诊断及治疗有了很大提高，对传统的治疗手段不断也有新的认识．基于生物学研究的进步而发展的生物治疗也越来越受到关注。     

Osteopontin inhibits macrophage nitric oxide synthesis to enhance tumor proliferation

BACKGROUND: Interactions between tumor cells and their host environment can play a major role in regulating survival programs required for tumor progression. Osteopontin (OPN) is a glycophosphoprotein overexpressed by tumors, and is a key molecule for tumor progression and metastasis. OPN also inhibits expression of autocrine and paracrine inducible nitric oxide synthase (iNOS). Given the cytotoxic effects of macrophage NO expression, we hypothesized that tumor-derived OPN inhibits expression of local macrophage iNOS to potentiate tumor survival. METHODS: We used a coculture system of murine CT26 colorectal cancer cells with RAW264.7 murine macrophage cells. CT26 expresses OPN at high levels. RNA interference was utilized to produce long-term specific silencing of OPN in CT26. RESULTS: Inhibition of constitutive OPN synthesis in CT26 upregulates local NO production with inhibition of CT26 proliferation and promotion of CT26 apoptosis. Macrophage iNOS expression is accompanied by increased binding activity of nuclear factor-kappaB DNA. When the CT26 culture media were examined for a panel of proinflammatory cytokines, elevated concentrations of granulocyte colony-stimulating factor (G-CSF) were found. Subsequently, in CT26 cells treated with antisense-G-CSF, NO levels in CT26-RAW cocultures were significantly decreased. CONCLUSION: In our system of CT26-RAW264.7 coculture, we conclude that inhibition of OPN synthesis in CT26 results in G-CSF-mediated induction of macrophage iNOS expression with resultant inhibition of CT26 proliferation via increased apoptosis. Our results suggest that tumor-derived OPN may enhance tumor survival by down regulating expression of NO in the local microenvironment. This is one mechanism by which OPN may potentiate cancer survival and progression.     

空气流动床在我国西部高原地区大面积烧伤治疗中的应用观察

目的:观察在我国西部高原地区使用空气流动床治疗大面积烧伤的临床效果.方法:我院于2013年5月引进使用空气流动床,以此时间为分组标准,2010年4月30日-2013年4月30日收治的使用烧伤翻身床治疗的35例患者为翻身床组,创面予切削痂手术及植皮处理.2013年5月31日-2016年5月31日收治的使用空气流动床治疗的42例患者为空气流动床组,创面行保痂治疗及植皮处理.全部患者的烧伤面积＞47％TBSA,Ⅲ度烧伤面积＞30％TBSA.两组患者均行补液抗休克、抗感染、远红外烧伤治疗仪照射等治疗.观察两组患者创面干痂时间、创面感染情况、创面愈合时间、手术例数、休克期补液量、血制品用量、血钠值、住院时间及住院费用的差异.结果:空气流动床组创面干痂时间、创面愈合时间、住院时间均较翻身床组明显缩短(P＜0.01),手术例数、血制品用量、住院费用均明显减少(P＜0.01),创面感染率也明显下降(P＜0.05),休克期补液量则增加(P＜0.01),血钠值明显增加(P＜0.05).结论:空气流动床在大面积烧伤治疗中具有保护创面、减少创面感染和加速创面愈合的作用;但是会引起液体丢失增多、高渗性脱水,因此应当适当增加补液量.空气流动床总体上能减少手术次数、降低血制品消耗、缩短住院时间,尤其明显节省治疗费用,值得推广.     

MHD患者营养不良-炎症综合征与营养风险及生存质量的相关分析

目的 探讨维持性血液透析(maintenance hemodialysis,MHD)患者营养不良-炎症综合征(malnutrition inflammation complex syndrome,MICS)与营养风险及生存质量的相关性.方法 选择在昆明医科大学第一附属医院和云南肾脏病医院接受血液透析治疗≥3个月的61例透析患者为研究对象,用NRS2002进行营养风险筛查,用营养不良-炎症评分(MIS)来判断其MICS,用SF-36量表进行生存质量调查.并根据MIS评分将存在MICS的患者分为轻度(MIS≤4)、中度(5≤MIS≤8)、重度(MIS≥9)三组.结果 ①MIS评分在有、无营养风险两组患者之间差异有统计学意义(P＜0.01),与NRS2002评分正相关(r=0.612,P＜0.01);②不同MICS组间握力差异有统计学意义(P＜0.05);③三组MICS组间比较体力所致工作和生活受限得分差异有统计学意义(P＜0.05),MIS评分与SF-36总分、生理和心理领域、体能、体力所致工作和生活受限、社会功能呈负相关,差异有统计学意义(P＜0.05);④有、无营养风险的两组MHD患者生存质量无差异(P＞0.05).结论 MHD患者营养风险越高其营养不良-炎症综合征越严重,营养不良-炎症综合征越严重其生存质量越差.     

脂肪囊内解剖途径在后腹腔镜肾上腺肿瘤切除术中的应用

目的 探讨脂肪囊内解剖途径在后腹腔镜肾上腺手术的临床应用价值.方法 2013年5月至2015年12月,采用后腹腔镜技术经脂肪囊内解剖途径血管区,行肾上腺及腺瘤切除术65例.男性35例,女性30例,年龄25～ 70岁.原发性醛固酮增多症15例,库兴综合征14例,嗜铬细胞瘤5例,副神经节瘤10例,髓脂瘤12例,其他单纯无功能皮质腺瘤9例;瘤体直径范围1.5 ～8.0 cm.这些病例手术均通过后腹腔镜经脂肪囊内途径完成.结果 本组65例手术均顺利完成.单侧手术时间25 ～ 150 min,术中估计出血量15 ～ 300 mL,术后住院时间3～8d.术后随访至今,未发现肿瘤复发.结论 依据脂肪囊内途径的解剖步骤,术中出血少,解剖层次清楚,较好避免术中腹膜损伤.脂肪囊内途径后腹腔镜手术是治疗肾上腺外科一个有益尝试.