危重患儿如何选择脂肪乳剂

作为肠外营养的重要组成部分,脂肪乳剂具有避免必需脂肪酸缺乏和作为高密度能量来源的作用。选择脂肪乳剂非常复杂,主要是因为不同的脂肪乳剂由不同的脂肪酸构成,可通过不同途径改变机体的免疫反应。同时其生物化学特性不同,对炎症反应有明显影响。应依据患者的代谢状态选择脂肪酸的类型和脂肪乳剂的供给量。越来越多的证据提示,对处于高代谢状态的危重患者,应避免使用以大豆油为原料的标准脂肪乳剂,而选择含中链甘油三酯、橄榄油或鱼油的脂肪乳剂,以减少具有促进炎症反应和免疫抑制作用的ω-6多不饱和脂肪酸的比例。尽管目前证据尚不足以作出对某种脂肪乳剂的特殊推荐意见,但作为二十碳五烯酸和二十二碳六烯酸的来源,含鱼油的脂肪乳剂能更好地调节免疫反应,对减少危重患者住ICU时间有重要作用。     

芪蛭胶囊对大鼠脂质代谢紊乱的预干扰作用

目的观察芪蛭胶囊对实验性高脂血症大鼠模型生化指标、血液流变学指标的影响以证实其疗效,并初步探讨其作用机制。方法用高脂乳剂灌胃法建立高脂血症大鼠模型,并设立空白组,模型组,阳性药组,芪蛭胶囊大、中、小剂量组,观察各组生化指标、血液流变学指标的变化。结果芪蛭胶囊能降低大鼠血清TC、TG、LDL-C、APOB的含量(P<0.01,P<0.05),升高HDL-C、APOAI的含量(P<0.01,P<0.05),降低全血比粘度、血浆粘度、红细胞压积、纤维蛋白原含量(P<0.01,P<0.05),升高大鼠血清SOD(P<0.01),降低血清MDA(P<0.05);对血清ALT、BUN、Cr无明显影响。大剂量组效果优于中、小剂量组。结论芪蛭胶囊对灌服高脂乳剂引起的大鼠脂质代谢紊乱有一定的预防和调节作用,有改善血液流变学和抗脂质过氧化反应的作用。     

枣花佳的营养成分和营养作用实验研究

以酸枣果肉为原料的枣花佳中含有多种微量元素和维生素。它能明显降低小鼠血浆中ＬＰＯ含量，增加ＳＯＤ含量；能明显缩短大鼠尾腱胶原纤维断裂时间；对小鼠耐缺氧能力无明显影响，但使小鼠冰水游泳时间明显缩短。     

卡维地洛对老年慢性心衰患者神经内分泌激素激活、血管内皮功能及糖脂代谢的影响

目的:评价卡维地洛对老年慢性心衰(CHF)患者神经内分泌激素激活、血管内皮功能及糖脂代谢的影响.方法:选择2013年2月～2014年7月期间就诊于我院并经临床确诊的86例CHF老年患者进行研究,根据收治顺序单双号分成两组,各43例,对照组患者为常规抗心衰治疗,而观察组患者同时给予卡维地洛治疗,对比两组神经内分泌激素、血管内皮功能及糖脂代谢各项指标变化.结果:观察组患者治疗后血浆肾素(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)和内皮素(ET)检测结果均较治疗前及对照组患者治疗后有显著降低,而一氧化氮(NO)水平较治疗前和对照组患者治疗后有显著升高,差异有统计学意义(P＜0.05);观察组患者治疗后糖代谢各指标空腹血糖(FBG)、糖化血红蛋白(HbAlc)、胰岛素(INS)和胰岛素敏感指数(ISI)及脂代谢各指标三酰甘油(TG)、总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)水平均较治疗前及对照组患者治疗后有显著改善,差异有统计学意义(P＜0.05).结论:卡维地洛治疗老年慢性心衰可抑制神经内分泌激素的过度激活,保护血管内皮功能,调节糖脂代谢,尤其适合于合并血糖或血脂功能紊乱的患者.     

Nose to brain delivery of melatonin lipidic nanocapsules as a promising post-ischemic neuroprotective therapeutic modality

Ischemic stroke accounts for about 87% of all strokes, causing long-term disability in adults, and is the second leading cause of death worldwide. In search of new therapeutic modalities, the use of neuroprotective agents loaded in nanocarriers to be delivered by noninvasive means (i.e. via intranasal route) became a popular approach. In the current study, melatonin (MEL) was loaded in lipidic nanocapsules (LNCs) prepared using the phase inversion method, and characterized in terms of size, polydispersity, zeta potential, in vitro drug release, viscosity, storage stability, and ex vivo permeation across sheep nasal mucosa. Moreover, MEL-LNCs were tested for efficacy in cerebral ischemia/reperfusion (I/R/) injury model through histopathological assessment, and analysis of oxidative stress markers, pro-inflammatory cytokines, and apoptotic markers. Results showed that LNCs exhibited particle size ranging from 18.26 to 109.8 nm, negative zeta potential, good storage stability, spherical morphology, and a burst release followed by a sustained release pattern. LNCs exhibited 10.35 folds higher permeation of MEL than the drug solution across sheep nasal mucosa. Post-ischemic intranasal administration of MEL-LNCs revealed lowering of oxidative stress manifested by a decrease in malondialdehyde levels, and elevation of glutathione and superoxide dismutase levels, lowering of the inflammatory markers tumor necrosis factor-α, NO, myeloperoxidase, and significant inhibition of Caspase-3 activity as an apoptotic marker. Western blot analysis delineated a recovery of protein expression Nrf-2 and HO-1 with downregulation in the parent inflammatory markers nuclear factor kappa B p65, inducible nitric oxide synthase, Bax, and Cytochrome C expressions, and upregulation of B-cell lymphoma-2 Bcl-2, hence promoting neuronal survival. This was supported by histological evidence, revealing significant restoration of hippocampal neurons. In light of the above, it can be concluded that MEL-LNCs could be a promising delivery system for nose to brain delivery for treatment of cerebral ischemia.     

西宁地区冠心病患者血浆铁蛋白血脂水平测定的意义

目的 :探讨血浆铁蛋白及血脂水平在西宁地区冠心病诊治中的价值。方法 :西宁地区经临床确诊的冠心病患者 6 5例 ,其中冠心病合并高血压 30例 ,采清晨空腹静脉血 5ml,应用日立7170s全自动生化仪测定血浆铁蛋白、血脂 (TCh、TG、HDL -c、LDL -c)。 30例健康查体者为对照组。结果 :本地区冠心病患者血浆铁蛋白水平较对照组明显降低 (P <0 .0 1) ,LDL -C水平较对照组增高 (P <0 .0 5 )。结论 :高海拔地区冠心病患者血浆铁蛋白浓度显著低于正常对照组。较低的铁蛋白水平提示存在着较高的血清游离铁水平 ,促进了LDL的脂质氧化 ,加快了动脉粥样硬化斑块的形成     

不同铁摄取量对大鼠血脂和脂质过氧化影响的实验研究

经饮水给予健康雌性Ｗｉｓｔａｒ大鼠不同剂量的铁，形成体内铁储存量增加的动物模型，观察铁对大鼠血脂水平、脂质过氧化物（ＬＰＯ）和超氧化物歧化酶（ＳＯＤ）活性的影响。结果表明，长期摄取一定量的铁可致大鼠血清低密度脂蛋白（ＬＤＬ）含量增高，ＳＯＤ活力下降和脂质过氧化物的降解产物丙二醛（ＭＤＡ）含量增加。提示体内铁储存量增加可影响血脂的代谢。为预防动脉粥样硬化，长期补铁时，应有适当的剂量范围。     

胆汁胰液混合液溶解颈动脉粥样硬化斑块的体外实验研究

目的观察并评价胆汁胰液混合液在体外对颈动脉粥样硬化斑块的溶解效果。方法把手术取出的颈动脉粥样硬化斑块分为不稳定斑块与稳定斑块,在37℃下分别加入新鲜胆汁胰液混合液,观察并记录二者在胆汁胰液混合液中的溶解情况。结果不稳定斑块和稳定斑块内层的脂质核心均可迅速被胆汁胰液混合液软化溶解,而外层的纤维帽则均不被溶解。不稳定斑块因脂质核心占比大而溶解效果显著,而稳定斑块因其脂质核心小,溶解效果相对较差。结论本研究发现胆汁胰液混合液中的某种或某几种成分对颈动脉粥样硬化斑块有一定的溶解作用,本研究尝试提出可能的溶解机制,并在下一步探究胆汁胰液混合液中溶解颈动脉粥样硬化斑块的有效成分。     

Yoga Training Improves Metabolic Parameters in Obese Boys

Yoga has been known to have stimulatory or inhibitory effects on the metabolic parameters and to be uncomplicated therapy for obesity. The purpose of the present study was to test the effect of an 8-week of yoga-asana training on body composition, lipid profile, and insulin resistance (IR) in obese adolescent boys. Twenty volunteers with body mass index (BMI) greater than the 95th percentile were randomly assigned to yoga (age 14.7±0.5 years, n=10) and control groups (age 14.6±1.0 years, n=10). The yoga group performed exercises three times per week at 40~60% of heart-rate reserve (HRR) for 8 weeks. IR was determined with the homeostasis model assessment of insulin resistance (HOMA-IR). After yoga training, body weight, BMI, fat mass (FM), and body fat % (BF %) were significantly decreased, and fat-free mass and basal metabolic rate were significantly increased than baseline values. FM and BF % were significantly improved in the yoga group compared with the control group (p<0.05). Total cholesterol (TC) was significantly decreased in the yoga group (p<0.01). HDL-cholesterol was decreased in both groups (p<0.05). No significant changes were observed between or within groups for triglycerides, LDL-cholesterol, glucose, insulin, and HOMA-IR. Our findings show that an 8-week of yoga training improves body composition and TC levels in obese adolescent boys, suggesting that yoga training may be effective in controlling some metabolic syndrome factors in obese adolescent boys.     

Local anesthetic systemic toxicity (LAST) – Should we not be concerned?

Local anesthetics are one of the most commonly used drugs in the field of medicine. Yet little is known about the systemic toxicity that can occur with their overdose. In the last few years, a lot of research has taken place understanding the etiology of the Local anesthetics systemic toxicity (LAST) and the role of lipid emulsion in treating it. There is a need to increase the awareness about LAST and establish a protocol to treat any serious neuro or cardiotoxicity.