瑞舒伐他汀对自发性高血压大鼠心肌组织SOD、MDA、NO、ET的影响

目的：观察氧自由基损害和血管内皮功能失调与高血压发生的关系及瑞舒伐他汀干预的影响。方法将8只Wistar －Kyoto 大鼠（WKY）作为正常对照组;32只自发性高血压（SHR）大鼠,随机分为瑞舒伐他汀低剂量组3．125 mg／（kg· d）、瑞舒伐他汀中剂量组6．25 mg／（kg· d）、瑞舒伐他汀高剂量组12．5 mg／（kg· d）和SHR 对照组,每组8只。给药大鼠分别每日给予不同剂量瑞舒伐他汀＋1 mL蒸馏水灌胃;SHR 对照组给予相同容积的蒸馏水灌胃,测量血压。4周停药,3天后麻醉状态下提取心肌组织,用比色法检测SOD、MDA、NO 的水平,免疫组化法测定ET 的表达,PCR 法测定SODmRNA 的水平。结果自发性高血压大鼠SOD 活力、SODmRNA 表达、NO 含量下降,MDA 含量、ET －1的表达增强,与正常对照组比较,P ＜0．05。瑞舒伐他汀干预后上述指标均有改善（P ＜0．05）,且呈剂量相关性。瑞舒伐他汀干预后SHR 大鼠血压下降,但无剂量相关性。结论 SHR 大鼠存在氧化应激反应的增强,瑞舒伐他汀可通过降低氧化应激反应,改善血管内皮功能、降低血压。     

阿立哌唑口崩片治疗精神分裂症的有效性Meta分析

目的：评价阿立哌唑口崩片的有效性,为其有效使用提供借鉴。方法检索CBM、CKNI数据库,时间不限。纳入随机、半随机及临床对照试验。按Cochrane 5．0版质量评价标准评价研究质量和提取数据进行Meta分析。结果共纳入7个研究。 Meta分析显示：阿立哌唑口崩片与其他非经典抗精神病药物间疗效的差异无显著性意义[RR＝1．01,95％CI（0．93,1．10）,P＝0．77];阿立哌唑口崩片与经典抗精神病药物间疗效的差异无显著性意义[RR＝1．02,95％CI（0．95,1．09）,P＝0．68]。结论阿立哌唑口崩片对精神分裂症的阳性、阴性症状均有明显疗效,且副作用低,值得推广。     

骨髓间充质干细胞移植治疗老年性痴呆模型大鼠的行为学检测

BACKGROUND:More recently, studies have demonstrated that bone marrow mesenchymal stem cells can be induced in vitro to differentiate into neuron-like cells that are used for in vivo transplantation to repair nerve damage. OBJECTIVE:To study the effect of bone marrow mesenchymal stem cell transplantation on learning and memory ability of senile dementia rats. METHODS:Thirty male Sprague-Dawley rats were randomly divided into three groups: normal control group, stem cell therapy group and model control group. Rats in the latter two groups were used to establish animal models of senile dementia by intracranial injection of β-amyloid 1-40. Three weeks after modeling, rats were given bilateral hippocampal injection of induced bone marrow mesenchymal stem cell suspension in the stem cell therapy group, whereas no treatment was given in the normal control and model control groups. Morris water maze test was used to detect learning and memory ability of rats, and rat’s brain tissues were detected pathologically using hematoxylin-eosin staining. RESULTS AND CONCLUSION:After modeling, the escape latency was higher and the cross-platform frequency was lower in the model control group compared with the normal control group. After cell transplantation, the escape latency and cross-platform frequency were gradually shortened and increased with time, respectively. Compared with the model control group, the learning and memory abilities of rats were improved in the stem cell therapy group. The brain tissues were relatively intact in structure and exhibited less cell degeneration and necrosis in the stem cell therapy group compared with the model control group. To conclude, bone marrow mesenchymal stem cell transplantation exerts certain therapeutic effects on senile dementia by effectively improving the learning and memory ability.     

丹参酮ⅡA对心力衰竭大鼠心室重构和PI3K/Akt信号通路的影响

目的观察丹参酮ⅡA对心力衰竭大鼠心室重构和磷脂酰肌醇3-激酶/蛋白激酶B(PI3K/Akt)信号通路的影响,阐明丹参酮ⅡA对心力衰竭的可能作用机制。方法将48只Wistar大鼠采用随机数字表法分为正常对照组(A组)、模型组(B组)和丹参酮ⅡA治疗组(C组),各16只大鼠。采用皮下注射异丙肾上腺素建立心力衰竭大鼠模型。建模后C组大鼠腹腔注射丹参酮ⅡA干预28 d。采用酶联免疫吸附试验(ELISA)法测定血清血管紧张素Ⅱ(AngⅡ)、脑钠肽(BNP)水平。测量左心室质量(LVM),计算左室质量指数(LVMI)、球型指数(SI)。苏木精-伊红(HE)染色和Masson染色观察心脏组织形态学变化和纤维化情况。蛋白免疫印迹法测定心肌组织Ⅰ型胶原(ColⅠ)、Ⅲ型胶原(ColⅢ)、PI3K、磷酸化PI3K(p-PI3K)、Akt、磷酸化Akt(p-Akt)蛋白水平。结果与A组比较,B组大鼠血清AngⅡ、BNP水平、LVMI、LVM、心肌组织ColⅠ、ColⅢ、p-PI3K、p-Akt蛋白含量升高(P<0.05),心肌胶原容积比增加(P<0.05),SI降低(P<0.05);与B组比较,C组大鼠血清AngⅡ、BNP水平、LVMI、LVM、心肌组织ColⅠ、ColⅢ、p-PI3K、p-Akt蛋白含量、心肌胶原容积比降低(P<0.05),SI升高(P<0.05)。HE染色和Masson染色显示:A组心肌组织形态结构正常,B组心肌纤维化和心室重构明显,C组心肌纤维化和心室重构较B组减轻。结论丹参酮ⅡA对心力衰竭大鼠心室重构具有保护作用,可抑制PI3K/Akt信号通路激活。     

瑞舒伐他汀与阿托伐他汀对原发性高血压患者血管内皮功能影响的比较

目的比较瑞舒伐他汀与阿托伐他汀对高血压患者血管内皮功能的影响。方法纳入血脂正常的高血压1-2级患者180例,随机分为对照组(A组)、阿托伐他汀组(B组)和瑞舒伐他汀组(C组),每组60例,均给予降压治疗及生活方式干预,A组口服安慰剂1片/d,B组口服阿托伐他汀10mg/d,C组口服瑞舒伐他汀10mg/d,随访6个月。分别于治疗前后测定血压、血脂、一氧化氮(NO)、内皮素(ET)、颈动脉内中膜厚度(IMT)、肱动脉内皮依赖性舒张功能(FMD),观察上述指标的变化。结果对照组治疗前后各指标无明显变化,B、C组经治疗后NO、FMD水平较前上升,ET、IMT水平较前下降,C组较B组上述指标改善更加明显,差异均有统计学意义(P0.05)。结论瑞舒伐他汀与阿托伐他汀均有改善内皮功能的作用,相对于相同剂量的阿托伐他汀,瑞舒伐他汀对内皮功能的改善更显著。     

氯吡格雷抵抗CYP2C19基因多态性研究现状

氯吡格雷是一种新型噻吩吡啶类抗血小板药,它是一种药物前体,经小肠内吸收和肝脏代谢转化为有活性的代谢物后通过阻断血小板膜P2Y2受体与ADP结合而发挥抗血小板作用.但并不是所有的服用患者都同等受益,近年研究表明部分患者存在氯吡格雷抵抗,多数学者认为参与氯吡格雷代谢的CYP2C19等基因多态性与氯吡格雷抵抗密切相关.本文系统综述了氯吡格雷的药物代谢、吸收、转化特点以及近几年国内外在不良心脑血管事件中CYP2C19*2,CYP2C19*3,CYP2C19*17基因多态性与氯吡格雷的疗效关系.     

木犀草素对心力衰竭大鼠心肌炎症反应和TLR4/MyD88/NF-κB信号通路的影响

目的观察木犀草素对心力衰竭大鼠心肌炎症反应和Toll样受体4/髓样分化因子88/核转录因子-κB(TLR4/MyD88/NF-κB)信号通路的影响,阐明木犀草素对心力衰竭的可能作用机制。方法将51只雄性SD大鼠采用随机数字表法分为假手术组(S组)、心力衰竭组(H组)和木犀草素治疗组(L组),各17只大鼠。采用开胸手术建立心力衰竭动物模型,L组大鼠给予50 mg/(kg·d)木犀草素(体积3 mL)灌胃。心脏超声测定左室射血分数(LVEF)、短轴缩短率(FS)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)。苏木精-伊红(HE)染色观察心脏组织形态学变化;Masson染色观察心肌组织胶原形成情况。采用双抗夹心酶联免疫吸附试验(ELISA)测定血清脑钠肽(BNP)、白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)水平。采用蛋白免疫印迹法测定心肌组织IL-1β、IL-6、TNF-α、TLR4、MyD88、NF-κB p65蛋白表达水平。结果与S组比较,H组LVEF、FS降低(P<0.05),LVEDD、LVESD、LVEDV、LVESV增加(P<0.05);与H组比较,L组LVEF、FS升高(P<0.05),LVEDD、LVESD、LVEDV、LVESV降低(P<0.05)。HE染色:S组大鼠心肌组织正常;H组大鼠心肌坏死和炎症浸润严重;L组大鼠心肌坏死和炎症浸润明显减轻。Masson染色:与S组比较,H组胶原面积比增加(P<0.05);与H组比较,L组胶原面积比降低(P<0.05)。与S组比较,H组血清BNP、IL-1β、IL-6、TNF-α水平及心肌组织IL-1β、IL-6、TNF-α、TLR4、MyD88、NF-κB p65蛋白水平升高(P<0.05);与H组比较,L组血清BNP、IL-1β、IL-6、TNF-α水平及心肌组织IL-1β、IL-6、TNF-α、TLR4、MyD88、NF-κB p65蛋白水平降低(P<0.05)。结论木犀草素可抑制心力衰竭大鼠心肌炎症反应和TLR4/MyD88/NF-κB信号通路,发挥对心力衰竭的保护作用。     

神经干细胞移植治疗老年痴呆

BACKGROUND:Neural stem cell transplantation has been used to treat a series of brain injury diseases, such as cerebral palsy, but its effect on Alzheimer’s disease is rarely reported. OBJECTIVE:To observe the effect of neural stem cell transplantation on the behavior and immune regulating system of Alzheimer’s disease rats.  METHODS:Thirty-five Sprague-Dawley rats were enrolled to make a postcerebral incision and given hippocampal injection of amanita phalloides acid to establish rat models of Alzheimer’s disease. Another 10 rats were only given hippocampal injection of normal saline after preparation of postcerebral skin incision as sham operation group. Then 32 successful rat models were randomly divided into two groups (n=16 per group): rats in experimental group were administrated hippocamal injection of 5×109/L allogeneic neural stem cell suspension; those in model group were given no injection. Five-day Morris water maze test was conducted at 4 weeks after transplantation. At 1 week after Morris water maze test, levels of interleukin-1 and interleukin-10 in the cerebral homogenate were detected, as well as pathological changes of brain tissues were observed in the three groups. RESULTS AND CONCLUSION:Compared with the model group, the abilities of cognition and memory were significantly higher in the sham operation group (P < 0.01), and the abilities of spatial learning and memory were significantly higher in the experimental group (P < 0.05, P < 0.01). Levels of interleukin-1 and interleukin-10 in the model group were significantly higher than those in the sham operation group (P < 0.01) but significantly lower than those in the experimental group (P < 0.01). Besides, the number of neurons in the model group was obviously less than that in the experimental and sham operation group. These results indicate that neural stem cell transplantation supplements and protects neurons against Alzheimer's disease in rats, thereby significantly improving the learning and memory ability.     

丁苯酞注射液联合依达拉奉治疗老年急性脑梗死的临床疗效

目的观察丁苯酞注射液联合依达拉奉对老年急性脑梗死的临床效果。方法将75例老年急性脑梗死患者随机分为3组,每组25例,观察组、对照组1、对照组2,常规治疗包括控制血糖、血压,抗血小板、稳定斑块、改善循环、营养脑细胞等,观察组为常规治疗加用丁苯酞注射液、依达拉奉注射液,对照组1为常规治疗加用依达拉奉注射液,对照组2仅常规治疗,疗程均14d,治疗前后采用神经功能缺损程度(NIHSS)评分、日常生活活动能力量评分,评价治疗效果。结果观察组治疗后NIHSS评分及ADL评分较对照组改善明显,且临床总有效率高于对照组,差异均有统计学意义(P0.05)。结论丁苯酞注射液联合依达拉奉治疗老年急性脑梗死疗效显著,值得临床推广。     

瑞舒伐他汀对高血压合并颈动脉硬化患者颈动脉斑块及脑缺血事件影响的前瞻性研究

目的 通过应用瑞舒伐他汀对高血压合并颈动脉斑块的患者进行干预,观察其对血脂、斑块及缺血性卒中发生率的影响。 方法 选取2013年5月—2015年5月就诊于邯郸市第一医院存在颈动脉斑块的高血压患者255例,随机分为对照组、瑞舒伐他汀低规剂量组(观察1组)和常规剂量组(观察2组),每组85例,均给予降压治疗及生活方式干预,对照组口服与瑞舒伐他汀相同外观的安慰剂1片,观察1组口服瑞舒伐他汀5 mg/d,观察2组口服瑞舒伐他汀10 mg/d,随访6个月。治疗前及治疗后检测血脂、血压,颈部血管超声检测颈动脉内膜-中膜厚度(iatima-media thickness,IMT)、斑块面积和Crouse斑块积分。比较治疗6个月后的脑缺血事件发生率。 结果 对照组治疗前、后各指标水平比较差异无统计学意义(P>0.05);治疗后观察1组、观察2组收缩压、舒张压均较治疗前下降,但差异无统计学意义(P>0.05);观察1组、观察2组治疗后TC水平较治疗前明显下降,IMT、斑块面积、Crouse积分、易损斑块率较治疗前降低,差异均有统计学意义(P<0.05),且观察2组各指标改善较观察1组明显(P<0.05)。 结论 瑞舒伐他汀除具有降脂作用外,还能逆转和稳定斑块,减少缺血性卒中事件的发生,且与剂量呈正相关。