膳食黑米皮抑制高脂诱导的家兔动脉粥样硬化形成及其机制的初步探讨

目的 探讨膳食黑米皮对高脂诱导的家兔动脉粥样硬化形成的影响及其作用机制。方法 24只雄性新西兰大耳白家兔,按体重随机分为3组,分别饲以正常基础饲料、高脂饲料(含96％基础饲料、0.5％胆固醇、3.5％猪油)、黑米皮饲料(含 91％基础饲料、0.5％胆固醇、3.5％猪油、5％黑米皮),实验期为 60d。用图像分析法测定各组家兔主动脉脂质斑块面积,并分析家兔氧化与抗氧化状态。结果 黑米皮实验家兔的主动脉壁斑块面积较高脂组低66%(P<0.001);黑米皮组实验家兔的主动脉壁8-ohdG含量和血清及主动脉壁中MDA水平也低于高脂组(P<0.05 );而红细胞及主动脉壁中SOD水平和血清α-生育酚含量在两个处理组之间差异无显著性。结论 膳食黑米皮可以抑制高脂诱导的家兔动脉粥样硬化形成,其机制可能与之降低机体氧化应激水平及过氧化脂质生成有关。     

Angiotensin I conversion and coronary constriction by angiotensin II in ischemic and hypoxic isolated rat hearts.

Dose-response curves of angiotensin I (AI, 1.0-1000.0 pmol) and angiotensin II (AII, 1.25-1250.00 pmol) were obtained in isolated rat hearts subjected to control conditions, mild hypoxia (PO2 = 145 mm Hg), reoxygenation, ischemic (perfusion pressure = 35 mm Hg) and reperfusion. Both AI and AII caused dose-dependent coronary flow (CF) of 26 +/- 3 and 27 +/- 2%, respectively. The effects of both AI and AII were substantially attenuated during hypoxia, but were fully restored upon reoxygenation. During ischemia, the effect of AII was unaltered while the effect of AI was enhanced compared to the control (P less than 0.05). This enhancement was reversible on reperfusion. Cardiac conversion of AI, calculated from ED50 values for AI and AII, was significantly increased during ischemia (P less than 0.05). Infusion of saralasin (0.5-5.0 micrograms/min) did not increase CF in any of the groups. We conclude that (1) the coronary vasoconstrictive effect of AII is preserved in ischemia but attenuated in hypoxia and (2) cardiac conversion of AI to AII is enhanced in hearts injured by ischemia.     

335例术后全身炎症反应综合征的临床分析

【目的】了解手术创伤对术后全身炎症反应综合征 (SIRS)的影响。【方法】搜集外科重症监护室 (SICU) 335例患者的术后资料 ,分析不同手术组SIRS发病率 ;手术时间、失血量与SIRS持续时间的关系 ;SIRS持续时间与术后并发症的关系。【结果】术后SIRS发病率为 75 8% ,大手术高达 92 4 % ;无并发症患者失血量与SIRS持续时间呈正相关 (r1=0 783,P<0 0 1) ,手术时间与SIRS持续时间呈正相关 (r2 =0 398,P <0 0 1) ;随着SIRS持续时间延长 ,并发症发病率显著增高 (P<0 0 5 )。【结论】术后SIRS发生、发展与手术创伤密切相关 ;监测SIRS进程有助于及早发现并发症     

放射线联合p53基因及内皮抑素治疗小鼠前列腺癌皮下移植瘤

Objective To test the hypothesis that p53 gene therapy combined with endostatin can enhance tumor response to radiation therapy of RM-1 mouse xenograft prostate cancer and to investigate its mechanism. Methods A mouse prostate cancer model was established. Then mice with xenograft tumor were randomly divided into group A (control), B (radiation), C (radiation and rAdp53), D (radiation and rh-endostatin) and E (radiation and rAdp53 and rh-endostatin). On day 1, rAdp53 was injected intra-tumorously with 1 × 1010 vp per animal to group C and E. From day 1 to 14, rh-endostatin was given 15 mg/kg intraperitoneally daily to group D and E. On day 4 single fraction of 15 Gy was given to tumors in groups B, C, D and E. Normal saline was injected intra-tumorously or intraperitoneaUy accordingly as control. No treatment was done to group A. Tumor volume was measured daily. Samples were collected on Days 5, 10 and 15. Ki67, CD31, p53 and VEGF were detected by means of immunohistochemistry. Results (1) Radiation alone, radiation combined with intra-tumorous injection of Adp53 and/or intraperitoneal injection of rh-endostatin resulted in tumor growth arrest of RM-1 cells in vivo (P = 0.000). Radiation combined with both rAdp53 and rh-endostatin was the most effective treatment (P < 0.05). (2) All the four treatment groups had a decreased expression of mutant type P53 (P = 0.000). The expression of Ki67 in groups B and C were equal (P 0.05) and increasing (P = 0.000), respectively. Group D had a up-down-up curve (P < 0.05), but group E had a up-down one. On day 5 the expresion of VEGF in group E was the lowest (P < 0.05). An increased expression of MVD compared with the control was shown, and MVD in groups C, D and E were always higher than that in the control (P < 0.05). Conclusions The limitation of radiotherapy could be overcome by combination with beth p53 gene therapy and endostatin on the growth of mouse prostate cancer cell. Radiation, rAdp53 and endostatin have their own role but they can be interacted with each other.     

超声电丛刺治疗后急性脑梗死患者神经功能缺损及实验室相关指标的变化

目的:观察超声电丛刺头穴丛刺法治疗急性脑梗死的效果,以及治疗前后体感诱发电位指标及血液生化指标变化。方法:①选择2003-01/2005-06在沈阳脑科医院神经内科住院的急性脑梗死患者261例,男160例,女101例。均为首次患病,且对治疗方案知情同意。将上述患者随机分为2组:丛刺治疗组131例,对照组130例。②丛刺治疗组:采用超声电丛刺治疗仪于头部电丛刺顶区(运动区),以100～200Hz疏密波电针通过6～8h,1次/d,1个疗程30次。对照组:均予以常规脑血管病药物同等治疗。丛刺治疗组和对照组均干预30d。两组疗效判定标准:治疗后神经功能缺损评分减少91%～100%为基本恢复,减少46%～90%为显著进步,减少18%～45%为进步。③采用酶联免疫法测定血浆α-颗粒膜蛋白水平;应用放射免疫法测定血浆血栓素A2水平;采用酶联免疫吸附法双抗体夹心法测定血浆D-二聚体水平;采用免疫透射比浊方法测定脂蛋白(a)水平。应用神经电生理检测仪检测体感诱发电位。④计数和计量资料差异比较采用χ2检验和t检验。结果:急性脑梗死患者261例均进入结果分析。①丛刺治疗组131例中:基本恢复31例,显著进步80例,进步15例,总有效率为96%(126/131);对照组130例:基本恢复14例,显著进步68例,进步12例,总有效率为72%(96/130);丛刺治疗组总有效率明显高于对照组(P<0.01)。②丛刺治疗组治疗后血浆α-颗粒膜蛋白、血栓素A2、D-二聚体和脂蛋白(a)含量较治疗前明显降低(P<0.01)。③丛刺治疗组治疗后体感诱发电位的波潜伏期与传导时间较治疗前明显缩短(P<0.01)。结论:超声电丛刺治疗急性脑梗死效果显著,可显著改善急性脑梗死患者体感诱发电位指标及血液生化指标。     

腭裂修复术腭咽肌肉重建与否的鼻咽内窥镜的比较观察

目的通过是否进行腭咽肌肉重建的两组腭裂修复术后患者鼻咽内窥镜的比较观察,了解腭咽部肌肉重建术后腭咽闭合状况的改变。方法将41例腭裂术后患者,按照在腭裂修复时是否进行腭咽肌肉重建分为重建组(22例)和非重建组(19例),以鼻咽纤维内窥镜记录静态和发音时腭咽闭合运动状况,对两组患者腭咽闭合运动类型和状况进行比较。结果重建组静态腭咽腔形态较非重建组明显缩小,各壁光滑丰满,未见软腭鼻腔面V型缺损畸形;动态时以环状闭合为主。非重建组静态腭咽腔形态较大,可见软腭鼻腔面V型缺损畸形;动态时以冠状闭合为主。经比较重建组腭咽闭合良好率(90.91%)明显优于非重建组(37.31%)。结论鼻咽内窥镜观察证实腭咽肌肉重建腭裂修复术后腭咽闭合功能恢复明显优于非重建组。腭裂修复术时重建腭咽肌肉有助于缩小腭咽腔和更易于达到良好的腭咽闭合状态。     

介入治疗下肢深静脉血栓的临床应用

目的 探讨介入治疗下肢深静脉血栓(deep venous thrombosis,DVT)的效果. 方法 38例DVT均行深静脉置管接触性溶栓,12例联合血管球囊扩张及血管内支架置入术.按我院疗效观察标准:治愈,造影检查示血栓完全溶解,静脉壁光滑;显效,静脉回流通畅,静脉内有附壁血栓,管腔内径≥2/3;有效,静脉内仍有血栓残留,管腔内径＜2/3;无效,造影检查示静脉回流不通畅. 结果 治愈22例,显效14例,有效2例.治疗中无严重并发症发生.34例随访3～24个月,其中3～6个月7例,7～12个月12例,13～24个月15例,血栓复发2例,经再次深静脉置管接触性溶栓治疗后部分再通. 结论 介入治疗DVT操作简便,安全有效.     

血管内栓塞结合显微手术治疗颅内动脉瘤临床研究

目的应用显微手术夹闭、血管内栓塞和栓塞后手术夹闭3种治疗方法，探讨治疗颅内破裂动脉瘤的安全有效方案。方法显微手术瘤颈夹闭30个动脉瘤，栓塞34个动脉瘤，栓塞后夹闭15个动脉瘤。结果夹闭组30个完全夹闭，无复发，死亡率6％（2／30）。栓塞组完全闭塞率70．6％（24／34），复发率17．6％（6／34），死亡率11．8％（4／34）。栓塞后手术组15个完全夹闭，无复发，死亡率6．7％（1／15）。治疗结束用GOS评价，1个月后3组良好率分别为80．0％、79．4％和80．0％；半年后良好率分别为90．0％、88．2％和86．7％。结论显微手术瘤颈夹闭术仍然是治疗破裂动脉瘤的有效方法，具有1次治疗彻底和复发率低的优势，并可作为栓塞失败的补救手段。     

抽动障碍中医证型与血清单胺类物质的相关性研究

目的 观察抽动障碍不同中医证型患者血清多巴胺、去甲肾上腺素等单胺类神经递质的水平,并探讨各证型之间血清神经递质的水平是否存在差别.方法 采用化学荧光法测定46例抽动障碍患者(病例组)血清多巴胺、去甲肾上腺素水平,并与40例正常儿童(对照组)进行比较.结果 病例组血清多巴胺为0.449μg/ml,对照组为0.210μg/ml;病例组血清去甲肾上腺素为0.227μg/ml,对照组为0.127μg/ml,两组各均值比较,病例组血清多巴胺和去甲肾上腺素均显著高于对照组.病例组外风侵袭、肝风内动型,或兼气郁化火型,或兼脾虚痰聚型,或兼阴虚风动型血清多巴胺水平分别为0.316、0.400、0.235、0.247μg/ml,四者比较有显著性差异;病例组符证型血清去甲.肾上腺素水平分别为0.203、0.224、0.144、0.154μg/ml,四者比较差异有显著性.结论 抽动障碍患者存在多巴胺和去甲肾上腺素水平异常,且各证型血清多巴胺、去甲肾上腺素水平有明显差异,而尤其以外风侵袭、肝风内动兼气郁化火型水平最高.