瑞舒伐他汀结合比索洛尔对冠心病慢性心力衰竭患者心功能及血清TIMP-4、FFA水平的影响

目的 探究冠心病慢性心力衰竭患者采用瑞舒伐他汀结合比索洛尔治疗对其心功能及血清金属蛋白酶组织抑制因子4(TIMP-4)、游离脂肪酸(FFA)水平的影响.方法 选取2017年7月至2019年5月本院收治的102例冠心病慢性心力衰竭患者,根据盲抽法分为两组,每组51例.对照组采用瑞舒伐他汀治疗,观察组在对照组基础上给予比索...     

Diagnóstico y seguimiento de los pacientes con hipotiroidismo congénito diagnosticados por cribado neonatal

The screening program of congenital hypothyroidism (CH) is probably one of the best achievements in paediatrics. Thyroid hormones are essential for brain development and brain maturation that continue through the neonatal period. Hypothyroidism that begins in the first months of life causes irreversible damage to the central nervous system, and is one of the most frequent and preventable causes of mental retardation. As children with congenital hypothyroidism are born with a normal appearance, analytical studies are required to immediately start the appropriate therapy.This article analyses the aims, diagnostic procedures, tests required, aetiology, and differential diagnosis in this disorder. Especially relevant is to perform frequent monitoring to ensure dose adjustments of L-Thyroxine therapy, avoiding infra- or supra-dosing that negatively affects neurosensory functions. Re-evaluation of the aetiology permanent vs transient hypothyroidism is always recommended after 3 years of chronological age.The relevance of this screening program should be widely discussed in paediatrics. The main objective is to avoid cerebral damage in these patients, and has been highly successful and economically beneficial.Other aspects are required to optimise patient outcomes, to perform all the controls according to the recommendations and to include, in the near future, the diagnosis of central hypothyroidism. Implementation of this program is necessary to progress in accordance with current scientific knowledge.     

氧自由基在高氧所致离体血管内皮细胞损伤中的作用

本实验研究了离体兔主动脉血管内皮细胞在常压高氧(100%O_2)条件下(0～72h)细胞形态、三磷酸腺苷(ATP)、黄嘌呤氧化酶(XO)活性、丙二醛(MDA)含量及谷胱甘肽过氧化物酶(GSH-px)活性的改变。我们的实验发现内皮细胞形态改变(细胞肿胀、畸形、脱落)呈时间依赖性;ATP含量经短暂的升高后(24h)持续降低(48～72h);高氧作用24～48h内皮细胞XO活性、MDA含量持续升高,72h XO活性、MDA含量开始降低,但仍高于对照组;GSH-px活性在48h内无明显改变,72h其活性升高。上述结果表明高氧确能引起内皮细胞损伤,氧自由基在其损伤过程中有重要作用。     

血红蛋白氧化生成的自由基对自身红细胞老化作用的初步研究

本文报道用小鼠和家兔做实验,在红细胞悬液(1×10~8细胞/ml)中加入Hb(125×10~(-5)gHb/ml),并在4℃放置4天,溶血百分数为47.8±4.6(%),如果Hb是加入含有甘露醇或SOD的红细胞悬液,则溶血百分数为7.3±6.9和8.0±8.6(两者的P<0.01),红细胞膜脂质过氧化的程度(荧光单位/gHb)也由4.21±0.26分别降至3.61±0.26和3.43±0.17(两者的P<0.01)。家兔溶血前血浆自由基浓度为4.1±1.2,溶血后5分钟和1小时的值分别为14.3±3.6和12.8±1.9(两者的P<0.01)。结果表明,血红蛋白在自动氧化过程中产生自由基,它对自身红细胞产生脂质过氧化和老化作用,并认为在某些溶血性贫血患者体内也存在这种损伤作用。     

异丙肾上腺素性心肌缺血大鼠全身重要脏器自由基系统的改变及其意义

本文以异丙肾上腺素性心肌梗塞为模型系统地观察了全身重要脏器及血清脂质过氧化产物丙二醛(MDA)含量及抗氧化酶如超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)活力的改变。结果表明,心肌缺血大鼠全身重要脏器MDA含量增加,且缺血心肌SOD及GSH-Px活力增强。由此说明,心肌缺血大鼠全身重要脏器均存在着严重的自由基损伤效应,同时抗氧化酶活力亦随之代偿性增强。     

Transmural distribution of antioxidant defences and lipid peroxidation in the rabbit left ventricular myocardium

The left ventricular subendocardial and subepicardial layers of six perfused rabbit hearts were tested for enzymatic and non-enzymatic antioxidant defences and for lipid peroxidation. The subendocardium showed significantly lower catalase activity and contents of non-protein thiol compounds and vitamin E associated with a higher degree of lipid peroxidation. The activities of Cu,Zn- and Mn-superoxide dismutases, glutathione reductase, -glutamylcysteine synthetase and -glutamyl transpeptidase showed no significant transmural differences, and Se-independent glutathione peroxidase activity was not detectable in either layer. Comparable results were observed in another group of six unperfused rabbit hearts. In five H₂O₂-perfused rabbit hearts, lipid peroxidation was higher, and myocardial creatine phosphokinase activity lower, in the subendocarium than in the subepicardium. In this group, only the subendocardium had significantly higher lipid peroxidation levels than the control hearts. Thus, a lower antioxidant capacity and a greater oxidative stress are present in the rabbit subendocardium. These findings could provide insight into the problem of subendocardial vulnerability to free radical-mediated processes, such as occurs in ischaemia-reperfusion injury.     

小鼠内毒素休克某些血液变化和细胞超微结构损伤的发生

小鼠内毒素休克有血液的乳酸、ＮＰＮ、ＡＫＰ、ＬＤＨ水平升高和ｐＨ值降低并可用６５４－２或ＡＬ所预防，只是预防ＮＰＮ升高的效应须在早期的肾血管挛缩消失后才能显示出来；心、肝、肠和肺的ＭＤＡ含量升高并可被６５４－２预防，除肺外还可被ＡＬ预防；将高肺ＭＤＡ只能用６５４－２预防结合注射内毒素后１０ｍｉｎ有ＷＢＣ入肺扣押来看，损伤肺的自由萁坷能主要来自被激活的中性粒细胞；血中ＡＫＰ和ＬＤＨ升高分别反映溶酶体     

OSAHS患者CPAP治疗前后MMP-9和FFA水平变化

目的探讨OSAHS治疗前后MMP-9、FFA的变化及呼吸紊乱指数、最低血氧饱和度及血脂的相关性,为研究OSAHS病情程度及与心血管疾病、内分泌疾病的关联提供相关依据。方法对50例符合纳入条件的重度OSAHS患者在进行CPAP治疗前及治疗后6个月PSG监测并抽取清晨空腹血清测定MMP-9、FFA及临床常规血脂四项(TG、TCH、HDL、LDL),并做相关比较。结果①OSAHS患者治疗后呼吸紊乱指数(AHI)下降,与术前比较有统计学意义(P<0.01),最低血氧饱和度(SO2)上升,与术前比较有统计学意义(P<0.05)。②OSAHS患者治疗后MMP-9水平较治疗前有统计学意义(P<0.01)。FFA水平较治疗前有统计学意义(P<0.01)。③OSAHS患者治疗后TG、TCH、LDL值下降,HDL值上升,较术前均有统计学意义(P<0.01)。结论应用持续正压通气(continuous positive airway pressure,CPAP)治疗OSAHS可以降低MMP-9与FFA的水平,有效降低OSAHS所致炎症反应及心血管疾病的发生。     

免费龋齿充填干预对上海嘉定区学龄前儿童乳牙龋病的影响

目的:为上海市嘉定区儿童口腔预防工作提供基线资料,明确嘉定区儿童中浅度龋齿免费充填活动的效果.方法:使用整体抽样方法,对2所经济条件、生活环境相似的幼儿园中的918名儿童连续观察3 a.一所幼儿园连续3年免费充填中、浅度龋齿,一所幼儿园作为对照.采用SPSS20.0软件包对数据进行r检验.结果:基线时2所幼儿园患龋率、龋均(dft)、龋蚀严重度指数(CSI)均无显著差异.经过3年干预,2组幼儿园儿童患龋率、dft、CSI均有显著差异.经过3年干预,干预组幼儿患龋率(43.90％)、dft(2.86)、CSI(7.34)均显著低于对照组(64.08％、3.51、10.17).结论:免费充填干预提高了儿童龋病充填率,降低了患龋率、龋均、CSI,早期抑制了龋病的发展.     

Factors involved in free flap thrombosis after reconstructive surgery for head and neck cancer

Objective

Reconstructive surgery in which a free flap is used following extended resection for head and neck cancer has been popular for more than a quarter of a century. However, postoperative total flap necrosis has not been completely resolved, and few studies have analyzed the specific risk factors for this complication.

Methods

Over a three-year period from 2005 to 2007, 388 flaps were used for reconstructive surgery on 384 patients at Department of Head and Neck of the Cancer Institute Hospital of Japanese Foundation for Cancer Research, and the results for 22 flaps with thrombosis were analyzed.

Results

The only statistically significant risk factor for free flap thrombosis was the history of radical concurrent chemoradiotherapy.

Conclusions

It will be necessary to keep this observation in mind when performing salvage surgery following chemoradiotherapy, which is expected to be performed more often in the future.