异丙酚和1,6-二磷酸果糖在幼猪辅助性肝移植术中对肝脏的保护作用

目的:探讨异丙酚和1,6-二磷酸果糖(FDP)在幼猪辅助性肝移植术中对肝脏的保护作用。方法:健康幼猪24头,体重20~35 kg。按同窝别配对分别作为供体和受体,随机分为3组:对照组(C组,n=4)、异丙酚组(Y组,n=4)和实验组(R组,n=4)。肌肉注射氯胺酮10~15 mg/kg后麻醉诱导:氯胺酮1 mg/kg,芬太尼4μg/kg,维库溴铵0.2mg/kg,气管插管后行机械通气,维持呼气末二氧化碳分压35~45 mm Hg。术中安氟醚、维库溴铵、芬太尼维持麻醉。Y组、R组和C组在供体猪肝脏暴露时和受体猪接受供肝植入前即刻分别静脉输注生理盐水(2 ml/kg),10%FDP 2 ml/kg和生理盐水(2 ml/kg),1 h内输完。Y组和R组术中泵注异丙酚5~8 mg/(kg.h),C组以生理盐水代替。分别于手术开始(T1)、切肝时(T2)、切肝期30 min(T3)、再灌注后5 min(T4)、60 min(T5)、手术结束(T6)各抽取右侧颈内静脉血3 ml,测定血清丙二醛(MDA)浓度及超氧化物歧化酶(SOD)、谷胱甘肽过氧化酶(GSH-PX)活性、总抗氧化能力(T-AOC)和ALT、AST浓度,术后2 h(T7)、24 h(T8)各抽取右侧颈内静脉血2 ml,测定血清ALT、AST浓度。结果:与T1相比,C组T3时、R组和Y组T3~6时SOD活性升高,C组T4~6时、R组和Y组T4时MDA浓度升高,3组T5~8时ALT浓度均升高(P<0.05)。C组T4~8、R组和Y组T5~8时AST浓度升高(P<0.05);与C组相比,R组和Y组T4~6时SOD活性升高,T5,6时MDA下降,T6~8时ALT下降,T5~8时AST下降(P<0.05);与Y组相比,R组T6时SOD活性升高,MDA浓度下降,T7、T8时ALT、AST浓度下降(P<0.05)。结论:异丙酚和FDP联合应用在幼猪辅助性肝移植术中对肝脏具有一定的保护作用。     

FDP联合参麦注射液治疗新生儿缺氧性心肌损害的效果观察

目的 观察FDP(1,6-二磷酸果糖)联合参麦注射液治疗新生儿窒息合并缺氧性心肌损害的疗效.方法 将80例患儿随机分成两组,对照组40例,治疗组40例,两组均采用保温、氧疗、维持水电解质及酸碱平衡、对症、支持等综合治疗,治疗组在综合治疗的基础上,加用FDP和参麦注射液.结果 治疗组总有效率92.5%,对照组总有效率70%,两组间疗效比较有显著性差异(p<0.05).结论 FDP联合参麦注射液治疗新生儿缺氧性心肌损害有显著疗效.     

Umbrella handle technique for fixation of FDP avulsion fracture

We present the treatment course of a 29-year-old male patient with for a Type 3 FDP avulsion (Jersey's finger) of a fifth finger treated with umbrella handle technique. The patient had a volar base fracture of distal phalanx with dorsal subluxation of DIP joint after a fall. Following open reduction of the FDP avulsion fracture and fixation was achieved with a 0.9 mm one edge hooked Kirschner wire under fluoroscopy control. The straight edge of the wire was driven out in a central position in sterile nail matrix just distal to lunula. The wire was removed at the fifth week when the complete union of the fracture was observed. The patient achieved full flexion in DIP joint without an extension lag.     

Electrophysiologic features of ulnar neuropathy in childhood and adolescence

Objective

To analyze patterns of nerve injury in pediatric ulnar neuropathy (PUN).

参芪通脉汤加减治疗心肌炎44例

[目的]对应用参芪通脉汤治疗心肌炎的临床效果进行研究分析。[方法]抽取88例心肌炎患者病例,将其分为两组。对照组患者采用常规西药进行治疗;治疗组患者在对照组基础上采用参芪通脉汤进行治疗。[结果]治疗组患者心肌炎症状改善效果明显优于对照组;治疗前后心肌功能指标改善幅度明显高于对照组。[结论]应用参芪通脉汤对患有心肌炎的患者进行治疗的临床效果非常明显。     

Increased heparanase level and procoagulant activity in orthopedic surgery patients receiving prophylactic dose of enoxaparin

Background

Orthopedic hip and knee surgeries are followed by a hypercoagulable state. Heparanase is implicated in inflammation, coagulation activation and angiogenesis. Recently, heparanase was shown to directly interact with tissue factor (TF) and to enhance the generation of factor Xa (Nadir et al., Haematologica, 2010). In addition, an assay assessing heparanase procoagulant activity has been lately developed (Nadir et al., Thromb Res, 2011). In the present study heparanase level and procoagulant activity in patients undergoing orthopedic surgery were assessed.

Methods

The study group included 50 orthopedic patients. 31 patients underwent hip surgery and 19 had knee operation. 15 individuals suffered from traumatic hip fractures and 35 had osteoarthrosis of hip or knee joints. All patients received prophylactic dose of enoxaparin starting 6-8 hours post operation and lasting for 5 weeks. Plasma samples were drawn preoperatively and at 1 hour, 1 week and 1 month post operation. Samples were tested for heparanase levels by ELISA and TF/heparanase complex activity, TF activity, heparanase procoagulant activity, factor Xa and thrombin levels using chromogenic substrates.

Results

Heparanase levels were significantly higher 1 hour and 1 week post operatively compared to preoperative levels (p < 0.05, p < 0.005, respectively). The most dramatic changes were observed in heparanase procoagulant activity reaching a 2 fold increase 1 week postoperatively and 1.7 fold increase 1 month after surgery (p < 0.0001, p < 0.0001, respectively). Levels of factor Xa and thrombin did not significantly change.

Conclusions

Heparanase is involved in coagulation activation of orthopedic surgery patients. Heparanase procoagulant activity is highest 1 week postoperatively and remains high 1 month after operation. Considering extending prophylactic anticoagulant therapy or evaluating heparanase procoagulant activity may potentially prevent late thrombotic events.     

口服FDP对小鼠急性肝损伤的保护作用

目的 研究二磷酸果糖钠（FDP）对D-氨基半乳糖引起的小鼠急性肝损伤的保护作用，并分析其对小鼠肝生化指标的影响。方法 对小鼠连续灌胃FDP3天后，采用腹腔注射D-氨基半乳糖造成小鼠急性肝损害，研究各组小鼠间肝损害的差异，衡量FDP的肝保护作用。同时检测FDP对小鼠生化指标（ALT、T-BIL、Asr）的影响。结果 FDP对肝损伤模型小鼠有一定的保护作用，并可降低血液中ALT、AST和T-BIL的水平。结论 FDP能防止化学物质造成的肝损伤，保护肝功能。     

血液采集量对凝血功能检测影响的研究

目的：探讨采血量对于凝血功能检测中各项指标的影响情况。方法：收集2012年3月～2012年10月长沙市中医医院（市八医院）心胸外科病人标本32例、血液科病人30例及正常健康者标本30例,以血液采集量不足（1.4～1.5mL）为实验组,重抽采血量合格标本（1.8mL）为对照组,运用 sysmex CA1500全自动凝血分析仪检测各组样本凝血七项（血浆凝血酶原时间（PT）、纤维蛋白原（Fbg）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原降解产物（FDP）、D 二聚体（D-D）、抗凝血酶Ⅲ（AT-Ⅲ））。运用统计学分析血液采集量对于健康者、心胸外科病人与血液内科病人凝血功能检测的影响。结果：与对照组相比,各实验组 APTT、FDP、D-D 测定值均明显增加,AT-Ⅲ明显减小,具有统计学差异。心胸外科病人则凝血七项检测值均有统计学差异。血液科病人的 PT、Fbg、TT 则无显著性差异。正常健康组 PT 无差异。结论：血液采集量影响凝血功能的检测。特别是对心胸外科的影响较血液内科病人和正常健康人更甚。     

固定化酵母细胞生产1，6－二磷酸果糖的动力学研究

筛选获得一株１,６－二磷酸果糖（ＦＤＰ）的高产酵母菌株,改变通透性后的酵母细胞,在发酵及固定化生产ＦＤＰ过程中发现Ｆｅ２＋和甘油能大量提高ＦＤＰ的积累。将戊二醛交联后的酵母细胞,用卡拉胶固定化后,装入酶反应柱,连续生产ＦＰＤ,柱反应可稳定在１０天以上,转化率维持在２０％以上。