甘木通提取物对家兔心肌缺血的保护作用

目的:探讨甘木通提取物对家兔急性心肌缺血的影响。方法:结扎家兔冠状动脉左前降支建立急性心肌缺血模型,40只健康家兔平均分为假手术组、模型组、丹参对照组与甘木通不同剂量组。甘木通组分别给予浓度为100%的甘木通提取液灌胃(剂量分别为1ml/kg和2ml/kg),连续5d,丹参对照组于缺血前从耳缘静脉注射给药(0.2mg/kg)。记录心肌缺血前后标准肢体导联心电图,测定血清乳酸脱氢酶(LDH)、肌酸激酶(CK)、超氧化物歧化酶(SOD)活性与脂质过氧化物丙二醛(MDA)的含量。结果:与模型组相比,甘木通提取物可明显对抗结扎家兔冠状动脉左前降支引起的急性心肌缺血时心电图S-T段的异常偏移及T波抬高,减慢心率;显著降低血清LDH、CK水平及MDA含量和升高SOD水平(P<0.05或P<0.01)。结论:甘木通提取物对家兔急性心肌缺血有明显的保护作用。     

非转流经典原位肝移植病人术中血糖和乳酸的变化

目的 探讨非转流经典原位肝移植病人术中血糖和乳酸的变化。方法 静吸复合全麻下行非转流经典原位肝移植病人80例,男66例,女14例,年龄12～67岁,体重40～130kg,于麻醉前、无肝前期、无肝期30和60min、门静脉开放后5和30min以及手术结束时采集动脉血,测定血糖及乳酸浓度。其中70例采集门静脉开放后的肝静脉血测定。结果 术中无一例出现低血糖,门静脉阻断前血糖轻度上升,无肝期血糖有所回降,但仍高于术前。静脉开放5min时,血糖由开放前6.34mmol/L升高到12.14mmol/L(P<0.01)。术中血乳酸呈进行性上升,术前1.87mmol/L,静脉开放5min时达5.23mmol/L(P<0.01),随后继续维持在高水平。开放门静脉后的肝静脉血血糖达16.0～90.5mmol/L,乳酸9.6～80mmol/L。结论 非转流原位肝移植术中常出现高血糖和高乳酸血症,尤其是移植肝开放循环后,需随时监测并纠正。     

Antemortem diagnosis of Leigh’s disease: Role of magnetic resonance studies

A two-and-a-half-year-old male child presented with recurrent attacks of intractable vomiting, psychomotor retardation since 14 months of age. He had also lower cranial nerve palsy and corticospinal involvement. Magnetic resonance imaging had shown multiple well circumscribed areas of hypointusity in T, weighted image which were brightly hyperintense in heavily T₂-weighted image. The lesions were seen in basal ganglia, thalamii and brainstenvand spared mamillary bodies. Magnetic resonance spectroscopy demonstrated lactate peak in the affected areas confirming the diagnosis of Leigh’s disease. The child responded well to large dose of vitamin ‘B’, therapy.     

白血病患者血清酶活性初探

探讨不同类型白血病和不同病期白血病的血清酶活性变化，以及酶活性与外周血白细胞总数、白血病细胞数的关系。方法：采用酶联法测定75例白血病患者血清乳酸脱氢酶（LDH）、谷丙转氨酶（GPT）、碱性磷酸酶（AKP）活性，并与正常人组38例比较。结果：白血病组LDH、AKP活性明显高于正常人组，且急性淋巴细胞白血病（ALL）者的LDH活性与外周血白血病细胞数呈正相关（P＜0．01）；白血病完全缓解期（CR）患者LDH活性明显低于初发患者（P＜0．01），血清GPT活性与正常人无显著性差异（P＞0．05）。结论：动态观察血清LDH活性有助于白血病疗效的判断。     

Limiting factors to oxygen transport on Mount Everest 30 years after: a critique of Paolo Cerretelli’s contribution to the study of altitude physiology

In 1976, Paolo Cerretelli published an article entitled Limiting factors to oxygen transport on Mount Everest in the Journal of Applied Physiology . The paper demonstrated the role of cardiovascular oxygen transport in limiting maximal oxygen consumption (O_2max). In agreement with the predominant view of O_2max limitation at that time, however, its results were taken to mean that cardiovascular oxygen transport does not limit O_2max at altitude. So it was argued that the limiting factor could be in the periphery, and muscle blood flow was proposed as a possible candidate. Despite this suggestion, the conclusion generated a series of papers on muscle structural characteristics. These experiments demonstrated a loss of muscle oxidative capacity in chronic hypoxia, and thus provided an unambiguous refutation of the then widespread hypothesis that an increased muscle oxidative capacity is needed at altitude to compensate for the lack of oxygen. This analysis is followed by a short account of Cerretellis more recent work, with a special attention to the subject of the so-called lactate paradox.     

豚鼠耳蜗毛细胞暴露非聚焦超声后的酶组织化学观察

目的　探讨非聚焦超声 (non focusedultrasound ,NFU)对耳蜗毛细胞的影响。方法　以A型超声波诊断仪为超声发射器 ,分别以 2 5MHz、8MHz照射各 15耳豚鼠耳蜗 6h后 30min和 8h行耳蜗基底膜毛细胞铺片及冰冻切片观察琥珀酸脱氢酶 (succinatedehydrogenase ,SDH)组织化学变化。结果　 2 5MHz、8MHzNFU照射豚鼠耳蜗 6h后 8h能引起不同节段基底膜毛细胞SDH酶活性降低 ,其中外毛细胞较内毛细胞SDH酶活性降低更甚。照射后 8h组较照射后 30min组SDH酶活性有明显恢复。结论不同频率NFU超声照射耳蜗达一定剂量可以引起不同部位基底膜毛细胞的病理性缺氧改变 ,而这种缺氧病理改变在一定暴露剂量下是可逆或部分可逆的。提示耳蜗毛细胞可能与超声感受有关 ,其中外毛细胞可能起更为重要的作用 ,且不同部位毛细胞与超声感受的频率选择性可能有一定关系     

血乳酸清除率在小儿脓毒性休克中的应用

血乳酸是反映全身组织灌注情况和细胞内是否缺氧的敏感标志物.近年来研究发现,脓毒性休克时血乳酸明显增高,当休克得到改善,血乳酸可很快下降.因此,测定体内乳酸的清除率可准确提示脓毒性休克的血流动力学改变情况并对其预后作出有效评估.该文就血乳酸清除率在小儿脓毒性休克中的研究进展作一概述.     

穴位埋线治疗进行性肌营养不良的疗效观察

目的观察穴位埋线联合糖皮质激素及神经营养药物治疗进行性肌营养不良的临床疗效。方法 50例进行性假肥大性肌营养不良患者,随机分为治疗组和对照组,每组25例。对照组采用糖皮质激素及神经营养药物治疗,治疗组在对照组基础上采用穴位埋线治疗。观察两组治疗前后10米步行时间和登梯时间及血清肌酸磷酸激酶(CPK)、乳酸脱氢酶(LDH)水平的变化,并比较两组临床疗效。结果两组治疗后及随访10米步行时间和登梯时间与同组治疗前比较,差异有统计学意义(P<0.05);两组治疗后及随访10米步行时间和登梯时间比较,差异有统计学意义(P<0.05)。两组治疗后及随访血清CPK、LDH水平较同组治疗前明显下降,差异有统计学意义(P<0.01);治疗组治疗后及随访血清CPK和LDH水平低于对照组(P<0.01)。治疗组总有效率为96.0%,对照组总有效率为72.0%,治疗组总有效率高于对照组(P<0.05)。结论穴位埋线联合糖皮质激素治疗进行性肌营养不良的临床疗效显著,可作为临床治疗进行性肌营养不良方案的优选方法。     

依沙吖啶联合米非司酮和米索前列醇治疗中期妊娠引产的疗效观察

目的探讨乳酸依沙吖啶注射液联合米非司酮片和米索前列醇片治疗中期妊娠引产的临床疗效。方法选取2013年9月—2017年3月安阳市人民医院妇产科收治的中期妊娠引产患者132例为研究对象,将所有患者分为依沙吖啶组(A组,44例)、米非司酮联合米索前列醇组(B组,41例)和依沙吖啶联合米非司酮和米索前列醇组(C组,47例)。A组腹部注射位点采用腰穿针行羊膜腔穿刺,注入乳酸依沙吖啶注射液100 mg。B组口服米非司酮片,50 mg/次,2次/d,连续3 d,第4天阴道后穹窿放置米索前列醇片0.4 mg。C组口服米非司酮片100 mg/次,1 h后采用腰穿针行羊膜腔穿刺,注入乳酸依沙吖啶注射液100 mg,12 h后阴道后穹窿放置米索前列醇片0.4 mg。观察各组患者的引产效果,比较术中及术后情况。结果3组引产成功率比较差异无统计学意义。A、B、C组清宫率分别为36.36%、29.27%、12.77%,C组清宫率明显低于A、B组,3组比较差异具有统计学意义(P0.05)。C组用药至宫缩时间、引产时间、产后2 h出血量、产后出血天数、胎盘残留率显著低于A、B组,3组比较差异具有统计学意义(P0.05)。C组1级疼痛程度明显高于A、B组,3、4级疼痛程度明显低于A、B组,3组比较差异具有统计学意义(P0.05)。3组患者复潮时间、经期持续时间相当,没有统计学差异。结论乳酸依沙吖啶注射液联合米非司酮片和米索前列醇片治疗中期妊娠引产具有较好的临床效果,可降低清宫率和胎盘残留率,缩短用药至宫缩时间、引产时间,减少出现量和出血天数,具有一定临床推广应用价值。     

DNA Sequence Polymorphism of the Lactate Dehydrogenase Genefrom Iranian Plasmodium vivax and Plasmodium falciparum Isolates

Background:

Parasite lactate dehydrogenase (pLDH) is extensively employed as malaria rapid diagnostic tests (RDTs). Moreover, it is a well-known drug target candidate. However, the genetic diversity of this gene might influence performance of RDT kits and its drug target candidacy. This study aimed to determine polymorphism of pLDH gene from Iranian isolates of P. vivax and P. falciparum.

Methods:

Genomic DNA was extracted from whole blood of microscopically confirmed P. vivax and P. falciparum infected patients. pLDH gene of P. falciparum and P. vivax was amplified using conventional PCR from 43 symptomatic malaria patients from Sistan and Baluchistan Province, Southeast Iran from 2012 to 2013.

Results:

Sequence analysis of 15 P. vivax LDH showed fourteen had 100% identity with P. vivax Sal-1 and Belem strains. Two nucleotide substitutions were detected with only one resulted in amino acid change. Analysis of P. falciparum LDH sequences showed six of the seven sequences had 100% homology with P. falciparum 3D7 and Mzr-1. Moreover, PfLDH displayed three nucleotide changes that resulted in changing only one amino acid. PvLDH and PfLDH showed 75%–76% nucleotide and 90.4%–90.76% amino acid homology.

Conclusion:

pLDH gene from Iranian P. falciparum and P. vivax isolates displayed 98.8–100% homology with 1–3 nucleotide substitutions. This indicated this gene was relatively conserved. Additional studies can be done weather this genetic variation can influence the performance of pLDH based RDTs or not.