促红细胞生成素预处理在脑缺血性损伤中神经保护作用的体外研究

目的在体外研究重组人促红细胞生成素(rh EPO)预处理在脑缺血性损伤中的神经保护作用及其合适的剂量范围、时间窗。方法取处于生长稳定期的高纯度原代皮质神经元,分为正常对照组、糖氧夺获(OGD)损伤组、rh EPO预处理组。rh EPO预处理组是在不同时间(OGD损伤前24 h、48 h、72 h)给予不同浓度(0.01 U/ml、0.1 U/ml、1 U/ml、10 U/ml、100 U/ml)的rh EPO,最后以MTT比色法检测存活率,光镜下观察细胞形态变化。结果rh EPO(0.01 U/ml、0.1 U/ml、1 U/ml、10 U/ml)预处理可明显增加OGD损伤的原代皮质神经元的存活率(P0.05),其中当浓度为1 U/ml时保护作用最强(P0.05);rh EPO(1 U/ml)预处理24 h、48 h可明显增加OGD损伤的原代皮质神经元的存活率(P0.05),其中rh EPO预处理48 h的保护作用强于24 h。在光学显微镜下,观察到的细胞形态和数量的变化与以上结果相符。结论 rh EPO预处理对OGD损伤的皮质神经元具有神经保护作用,其有效浓度为0.01~10 U/ml,其中最佳剂量为1 U/ml,其有效时间窗为OGD前48 h或24 h,最佳干预时间窗为OGD前48 h。     

面制食品中铝的可见分光光度测定法中样品前处理方法的探讨

目的建立可见分光光度法测定面制食品中铝的一种简单可行的前处理方法。方法样品分别经干法灰化、2种湿法消化和微波消解前处理后,用可见分光光度法测定馒头、油条和粉丝3类面制食品中的铝含量。结果①干法灰化前处理时,相对标准偏差为0．2％～0．9％,方法回收率为91．0％～98．6％;适合3类面制食品前处理;②硝酸／高氯酸（国标）法前处理时,相对标准偏差为0．1％～1．0％,方法回收率为91．0％～96．8％;适合馒头和粉丝样品前处理。③硝酸回流消化时,相对标准差为0．1％～0．9％,方法回收率为98．0％～99．5％;适合馒头和粉丝样品前处理。④微波消解前处理时,相对标准偏差为0．1％～0．9％,方法回收率为98．5％～99．2％;适合3类面制食品前处理。结论干法灰化法是一种简单、快速、安全及结果准确的前处理方法,同时适合各种样品的批量处理。     

烟碱对全身炎症反应综合征大鼠肝肾肺影响初探

目的 探讨烟碱预处理对“两次打击”SIRS大鼠模型重要脏器的影响.方法 选择雄性健康SD大鼠40只,随机分为A、B、C、D4组,每组10只,对照组(A组)未予处理,在诱导SIRS模型前7d,单侧迷走神经切断组(B组),行右侧颈部迷走神经切断,烟碱预处理组(C组)每天予烟碱液5 mg/kg腹腔内注射,联合组(D组)予联合迷走神经切断+烟碱预处理;造模前晚禁食、不禁水,术日采用戊巴比妥钠腹腔注射麻醉,无菌条件采用腹颈正中切口显露右侧颈部迷走神经主干,比较4组大鼠血生化及病理学变化.结果 4组大鼠血生化测定结果表现为B组高于A组、C组及D组均低于A组,差异有统计学意义(P＜0.05);另外,4组大鼠组织病理学表现差异情况同血液生化检查情况相一致.结论 迷走神经切断后能加重大鼠重要脏器的损伤,烟碱预处理后对重要脏器有保护作用,联合二者处理后组织损伤介于两者之间;烟碱预处理对SIRS大鼠重要脏器可能有一定保护作用.     

依达拉奉预处理对大鼠全脑缺血/再灌注损伤的保护作用

目的研究依达拉奉预处理对大鼠全脑缺血/再灌注损伤(I/R)大脑的保护作用,探讨其脑保护作用的可能机制。方法采用改良Pulsinelli法制作大鼠全脑I/R模型。依达拉奉(3mg·kg-1)腹腔内注射法进行预处理。35只健康雄性SD大鼠随机分为7组,每组5只:对照组(C)、缺血再灌注损伤组(I)、依达拉奉预处理组(E),根据再灌注时间(1d、3d、5d)I、E组依次分3个亚组。TUNEL法检测大鼠脑组织海马CA1区神经细胞凋亡数、免疫组织化学pv6001染色法检测Bcl-2、Bax及CytC(cytochromec)蛋白表达的变化。结果与相应I各亚组比较,E各亚组海马CA1区神经细胞凋亡数目显著减少;Bax、CytC蛋白的表达显著减少;Bcl-2蛋白的表达显著增加(P<0.05)。结论依达拉奉预处理可能通过调节凋亡相关调控基因Bcl-2、Bax、CytC的表达,明显减轻大鼠I/R的神经细胞凋亡,从而产生脑保护作用。     

Effects of clinical and laboratory variables and of pretreatment with cardiovascular drugs in acute ischaemic stroke: A retrospective chart review from the GIFA study

Background

Few studies have examined the role of cardiovascular drugs on acute ischaemic stroke prognosis.

Aims

To evaluate the relationship between a favourable outcome in patients with acute ischaemic stroke and specific demographic, clinical and laboratory variables and cardiovascular drug pretreatment.

Methods

The 1096 patients enrolled in the GIFA study (who had a main discharge diagnosis of ischaemic stroke) represent the final patient sample used in this analysis. Drugs considered in the analysis included angiotensin converting enzyme (ACE)-inhibitors, angiotensin II receptor blockers, statins, calcium channel blockers, anti-platelet drugs, vitamin K antagonists and heparins. The outcomes analyzed included in-hospital mortality, cognitive function evaluated by the Hodkinson Abbreviated Mental Test (HAMT), and functional status evaluated by activities of daily living (ADL). The definition of a good outcome was no in-hospital mortality, a HAMT score of ≥ 6 and no ADL impairment.

Results

Patients with no in-hospital mortality, a HAMT score of > 6 and no ADL impairment were more likely to be younger at baseline and have a lower blood glucose level and a systolic blood pressure (SBP) between 120 and180 mmHg, a higher plasma total cholesterol level, a lower white blood cell count, and a lower Charlson Index (CI) score, a higher rate of pretreatment with ACE-inhibitors, calcium channel blockers and a lower rate of pretreatment with heparin.

Conclusions

Predictors of good outcome, in terms of in-hospital mortality and cognitive and functional performance at discharge, included higher SBP at admission between 120 and180 mmHg, a SBP plasma total cholesterol levels, a lower CI score, and pretreatment with ACE-inhibitors, calcium channel blockers and anti-platelets.     

全氟化碳汽化吸入预处理对急性肺损伤实验兔早期炎症因子的影响

目的：探讨全氟化碳（PFC）汽化吸入预处理对油酸型兔急性肺损伤（ALI）早期炎症因子的干预作用。方法：实验兔12只随机分为对照组和PFC预处理组,每组6只。动物麻醉后气管插管行机械通气,对照组注油酸造ALI模型后行机械通气120min,预处理组在造模前先于经气管内汽化吸入PFC60min,再注油酸造AU模型后行机械通气120min。两组分别于麻醉通气30min（基础值）、ALI造模成功时、ALI后30、60、90、120min各时点检测氧合指数、PaO2、PaCO2。实验结束后留取静脉血离心取上清液,对左肺进行肺灌洗留取肺灌洗液,应用ELISA法检测血清及肺灌洗液中TNF-α、IL-1β的含量。结果：与对照组比较,PFC预处理组在各时点的氧合指数和PaO2均明显升高、PaO2明显下降（P均〈0．05）。PFC预处理组血清和肺灌洗液中TNF-α的含量分别为（211±1）ng／L、（326±9）ng／L,明显低于对照组（226±2）ng／L、（368±11）ng／L（P均〈0．05）;PFC预处理组血清和肺灌洗液中IL-1β的含量分别为（77±2）ng／L、（93±2）ng／L,也明显低于对照组（99±3）ng／L和（116±2）ng／L（P均〈0．05）。结论：经气道汽化吸入PFC预处理60min,可改善油酸型AU实验兔的氧合状况,减少早期炎症因子TNF-α、IL-1β的释放。     

地氟醚预处理对肝脏缺血再灌注损伤的保护作用及其机制

目的：观察地氟醚预处理在肝脏缺血再灌注损伤中的保护作用,研究其对多种炎症因子,肝脏氧自由基（reacive oxygen species,ROS）产生和组织炎症细胞浸润的影响,并探讨其产生肝脏保护作用的机制。方法：选择择期在硬膜外阻滞复合全麻下行肝部分切除术的患者60例,随机分为地氟醚预处理组（干预组）和无地氟醚预处理组（对照组）,每组30例。干预组予静脉顺序诱导后气管插管,外科切皮前开始吸入地氟醚1．0MAC,持续30min后予洗脱10min,其后予异丙酚静脉维持麻醉。对照组予静脉顺序诱导后气管插管,整个手术过程仅由异丙酚静脉维持麻醉。2组患者均在进行肝部分切除时阻断肝门血流15～20min,然后再恢复肝血流。肝脏再灌注后1h获取对侧肝脏组织,观察肝组织形态学变化并检测肝组织丙二醛水平。分别在诱导后切皮前、阻断肝门血流10min、恢复肝血流后20min、恢复肝血流后1h及术后第1、第3、第5天抽取患者静脉血检测丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TB）、结合胆红素（CB）、谷氨酰转肽酶（-／一GT）水平。结果：2组患者术后第1、第3、第5天ALT、AsT、TB、cB及rGT水平均较术前呈上升趋势;经地氟醚干预后,干预组ALT、AST、TB、CB及rGT水平上升均显著低于对照组（P〈0．05）。干预组肝组织MDA水平显著低于对照组（P〈0．01）。结论：地氟醚预处理可以减轻肝切除手术患者的肝功能损害及炎症细胞对肝组织的浸润,并能减少肝ROS的生成,对肝脏的缺血再灌注具有一定的保护作用。     

Prevalence of Sclerotic Pterygoid Plate in Pretreatment Nasopharyngeal Carcinoma

Objectives: The objective of our study was to determine the prevalence of sclerotic pterygoid plate in pretreatment CT of nasopharyngeal carcinoma compared with the control group. Materials and Methods: A total of 51 nasopharyngeal carcinoma patients (37 men, 14 women) with a mean age of 51.94±13 years, and 51 controls (30 men, 21 women) with a mean age, 49.31±15 years were included in this study in a retrospective fashion. All computed tomographic (CT) images were evaluated by two neuroradiologists. Sclerosis of pterygoid plate and other findings included pterygoid plate erosion, adjacent tumor enhancement, and parapharyngeal extension which were assessed. MRI findings were also recorded. The prevalence of pterygoid plate sclerosis was compared using Chi-square statistical tests. Imaging findings were analyzed by binary logistic regression analyses. Results: The prevalence of pterygoid plate sclerosis in nasopharyngeal carcinoma was 53.9% compared to the control group (16.7%) and the difference was statistically significant (P-value< 0.001). In nasopharyngeal carcinoma, the prevalence of tumor adjacent to the pterygoid plate, parapharyngeal extension and pterygoid plate erosion were 69.6%, 81.4%, 38.2%, respectively. No erosion of pterygoid plate was detected in the control group. The odds of adjacent tumor enhancement and pterygoid plate erosion was 7.29 and 20.56 times higher in the sclerotic pterygoid plate (p-values of 0.019 and 0.000, respectively). MRI was available for four nasopharyngeal carcinoma cases with five sclerotic pterygoid plates, where two showed enhancements. All non-sclerotic pterygoid plates showed no enhancement on MRI. Conclusion: The prevalence of sclerotic pterygoid plate is significantly higher in patients with nasopharyngeal carcinoma with a considerably higher chance of adjacent tumor enhancement and pterygoid plate erosion.     

针灸与缺血预适应“第二保护窗”

缺血预适应作为诱发细胞自身保护反应的重要机制,对包括心肌细胞在内的各种组织器官均有明显的保护作用,尤其是缺血预适应"第二窗口"保护或延迟性保护的作用较强,时间窗较宽,并有可能通过针灸预处理等手段模拟诱导其保护作用。文章从缺血预适应的信号转导途径的"触发物质-中介物质-效应子"3个环节,总结了针灸与缺血预适应触发物质、针灸与缺血预适应中介物质以及针灸与缺血预适应延迟保护效应的研究进展。