Melatonin reduces oxidative stress and improves vascular function in pulmonary hypertensive newborn sheep

Pulmonary hypertension of the newborn (PHN) constitutes a critical condition with severe cardiovascular and neurological consequences. One of its main causes is hypoxia during gestation, and thus, it is a public health concern in populations living above 2500 m. Although some mechanisms are recognized, the pathophysiological facts that lead to PHN are not fully understood, which explains the lack of an effective treatment. Oxidative stress is one of the proposed mechanisms inducing pulmonary vascular dysfunction and PHN. Therefore, we assessed whether melatonin, a potent antioxidant, improves pulmonary vascular function. Twelve newborn sheep were gestated, born, and raised at 3600 meters. At 3 days old, lambs were catheterized and daily cardiovascular measurements were recorded. Lambs were divided into two groups, one received daily vehicle as control and another received daily melatonin (1 mg/kg/d), for 8 days. At 11 days old, lung tissue and small pulmonary arteries (SPA) were collected. Melatonin decreased pulmonary pressure and resistance for the first 3 days of treatment. Further, melatonin significantly improved the vasodilator function of SPA, enhancing the endothelial‐ and muscular‐dependent pathways. This was associated with an enhanced nitric oxide‐dependent and nitric oxide independent vasodilator components and with increased nitric oxide bioavailability in lung tissue. Further, melatonin reduced the pulmonary oxidative stress markers and increased enzymatic and nonenzymatic antioxidant capacity. Finally, these effects were associated with an increase of lumen diameter and a mild decrease in the wall of the pulmonary arteries. These outcomes support the use of melatonin as an adjuvant in the treatment for PHN.     

灯盏乙素介入IP3R-Ca2+途径抑制β淀粉样蛋白诱导的神经细胞凋亡

目的：观察灯盏乙素（Scu）对β淀粉样蛋白（Aβ）诱导的细胞模型中1，4，5-三磷酸肌醇受体（IP₃R）-Ca²⁺途径的影响，探讨其在阿尔茨海默病（AD）病程中可能发挥的积极作用。方法：选用神经母细胞瘤细胞分为对照组、Scu处理组、Aβ处理组、Aβ+Scu （高、中、低）处理组及Aβ+IP₃R拮抗剂组，用CCK-8法筛选药物浓度并检测各组细胞生存率；用酶联免疫吸附法检测各组细胞中1，4，5-三磷酸肌醇（IP₃）的含量；用蛋白印迹和实时荧光定量聚合酶链反应方法检测各组细胞IP₃R和凋亡相关因子Caspase-3、Bcl-2、Bax的蛋白及mRNA的表达水平；用激光共聚焦显微镜观察各组细胞内Ca²⁺浓度的变化；用AnnexinV/PI双染法测定各组细胞的凋亡率。结果：与对照组和Scu处理组相比，Aβ处理组细胞存活率下降，IP₃含量升高，IP₃R、Bax和Caspase-3的蛋白及mRNA表达上调，Bcl-2蛋白及mRNA的表达下调，细胞胞浆内Ca²⁺浓度及细胞凋亡率升高；Aβ+Scu处理组细胞中各检测指标的变化与Aβ处理组的结果正好相反，IP₃R通道下游指标的变化与Aβ+IP₃R拮抗剂组基本一致。结论：Scu能够下调通路蛋白IP₃、IP₃R的表达，抑制Aβ介导的Ca²⁺内流所致的细胞凋亡，可能通过对IP₃R-Ca²⁺途径的调控来影响AD病程。     

外周动脉闭塞患者的交感神经皮肤反应

目的：描述胚胎种植前遗传诊断在1例携带Ⅰ型白细胞黏附缺陷病（LAD-1）携带者并完成健康妊娠夫妇中的应用。设计：病例报道。机构：大学医院生殖中心。患者：1例男女双方都是LAD-1携带者的夫妇，女方CD18基因的外显子4携带有G400A置换，男方的外显子5携带有C562T置换。干预：标准体外受精（IVF）后第3天行卵裂期活检和分裂球遗传分析以检测2处突变以及21号染色体标记物。主要观察指标：1个未罹患LAD-1婴儿的出生。结果：得到15个卵母细胞，其中10个受精。8个胚胎适宜胚胎活组织检查。     

后十字韧带重建后移植物组织学与胶原表型的变化

目的探讨采用半腱肌腱重建后十字韧带（posterior cruciate ligament,PCL）后移植物的组织学与胶原表型的变化.方法取20只成年新西兰大白兔,实验组18只切除右膝PCL后即刻用双股自体半腱肌腱重建,实验组于术后3、6、52周各处死动物2只,12、26周各处死动物6只,切取半腱肌腱移植物;对照组2只直接切取半腱肌腱和PCL.标本采用HE、甲苯胺蓝以及Ⅰ、Ⅲ型胶原免疫组化染色观察移植物的组织学与胶原表型变化,并与正常半腱肌腱和PCL进行比较.结果常规组织化学染色显示正常半腱肌腱和PCL在细胞构成上有明显的差别,PCL内可见软骨样细胞;重建后的移植物经过坏死、细胞重新长入、胶原形成和重塑阶段,52周时形成的结构类似于正常PCL,但在纤维排列上与正常PCL仍有差异.免疫组织化学染色结果显示正常PCL纤维内部仅有Ⅰ型胶原表达,重建韧带Ⅰ型胶原染色随时间延长从少到多,Ⅲ型胶原染色从多到少,52周时移植物内局部仍有表达.结论采用半腱肌腱重建PCL 52周时移植物和正常PCL结构相似,但仍有差异.     

颈丛阻滞、硬膜外阻滞下甲状腺手术应激反应的比较

目的 :比较颈丛阻滞、硬膜外阻滞下甲状腺手术应激反应的大小。方法 :选择ASAⅠ～Ⅱ级 ,女性 ,甲状腺手术患者 30例 ,年龄 2 2～ 5 5岁 ,术前无呼吸、循环和内分泌疾病 ,随机分为颈丛阻滞组 (颈丛组 ) 15例 ,硬膜外阻滞组(硬膜外组 ) 15例 ;颈丛阻滞选用 0 .8%利多卡因和 0 .2 5 %布比卡因混合液 ,以C4一点法行双侧深浅丛阻滞 ;硬膜外阻滞选用 1.3%利多卡因和 0 .15 %丁卡因混合液 ,穿刺点选择C4～ 5或C5～ 6间隙 ,采用侧卧位直入法 ,并向头置管 3cm ;分别测定并记录麻醉前、麻醉后 2 0min、切皮、分上极、切腺体和术毕共六个时点的血糖、血压和心率的变化。结果 :两组病例各时点血糖均逐步上升 ,于分上极、切腺体和术毕血糖值与麻醉前比较有显著性差异 (P <0 .0 1) ;硬膜外组只在分上极时SBP与麻醉前比较有差异外 (P <0 .0 5 ) ,而颈丛组在分上极、切腺体时DBP与麻醉前比较有差异 (P <0 .0 5 ) ,SBP、MAP与麻醉前比较有显著性差异 (P <0 .0 1)。结论 :本研究表明颈丛阻滞、硬膜外阻滞均不能完全抑制甲状腺手术的应激反应 ,在稳定甲状腺手术循环功能方面硬膜外阻滞优于颈丛阻滞     

Primary tubal choriocarcinoma

Choriocarcinoma is one of the most serious forms of gestational trophoblastic tumor. It is a malignant tumor from the epithelium of the chorionic villi. The most frequent location site is the uterus. Associated with ectopic pregnancy, it is extremely rare and in general, very aggressive. In 75% of the cases, it items from distant metastasis; therefore, a histological examination of the tubes must be performed in all ectopic pregnancies. Our patient was a 33-year-old woman who was admitted to emergency room (ER) with an intense pain in the right, iliac cavity, and limited genital bleeding. During the exploration, there was abdominal pain, with doubtful signs of peritoneal irritation. The vaginal ultrasound offered an image that was compatible with an extra uterine pregnancy in the left appendages. At emergency, right salpingectomy was performed via laparotomy. The patient was treated with polychemotherapy and contraceptives for a year, with no recurrence of the disease. Control follow-up was performed using beta-human chorionic gonadotropin (HCG) testing on a weekly basis during the first month and then bi-monthly during the first year of follow-up.     

Aneurisma de aorta abdominal infrarrenal en asociación con riñón en herradura: aportación de un caso

We review the association between surgically resolvable aortic disease and horseshoe kidney with a discussion of diagnostic problems and therapeutic options.Male patient 81 years of age with horseshoe kidney and an abdominal aortic aneurysm that was discovered by chance in an abdominal ultrasound during a check-up for his prostate condition.A retroperitoneal approach was used in order to resect the aneurysm and perform an aorto-aortic bypass with no complications occurring. Two years after the diagnosis, the patient is still asymptomatic from a vascular point of view.The co-presence of horseshoe kidney and aortic disease needing surgical correction is infrequent, but it significantly increases the technical complexity of aortic reconstruction. A literature review is included.     

关节镜下胭绳肌腱部分重建、单束重建和双束重建前交叉韧带的疗效比较

目的 研究使用腘绳肌腱进行关节镜下前交叉韧带（ACL）损伤后部分重建、单束重建和双束重建的疗效差异。方法 本研究共包括56例ACL重建病例，其中部分重建11例，单束重建25例，双束重建20例。所有患者术前及随访时均进行IKDC2000、Tegner和Lysholm评分以及常规KT-2000和后推KT-2000测量，并对结果进行统计学分析。结果 平均随访19．84±5．03个月（13～22个月）。对三组的IKDC、Lysholm和Tegner评分的配对t检验显示，术后的IKDC、Lysholm和Tegner评分比术前均有显著改善。后推法KT-2000测量显示，ACL双束重建可以比单束重建获得更好的膝关节稳定性，ACL部分重建组膝关节的稳定性优于单束重建和双束重建组。但常规KT-2000测量无法辨别三种术式之间膝关节稳定性的差异。结论 ACL双束重建可以比单束重建更好地重建膝关节的稳定性，ACL部分重建的临床效果优于单束重建和双束重建；后推KT-2000测量在ACL双束重建和部分重建的术后稳定性评估上可能具有重要的应用价值。     

磁共振尿路成像诊断肾移植输尿管坏死

目的:探讨磁共振尿路成像(MRU)诊断肾移植输尿管坏死的价值。材料和方法:12例肾移植术后怀疑输尿管坏死患者,临床表现为移植肾区肿痛、少尿或无尿,B超提示移植肾盂积水,输尿管扩张,移植肾周积液,用重T2WI快速自旋回波序列和脂肪抑制技术行MRU检查。结果:MRU均显示移植肾盂及肾盏扩张,输尿管上段扩张,重T2WI表现为高信号。输尿管连续性消失,其下方为局限性包裹液性区。在渗出的包裹性尿液邻近或下方可见高信号的膀胱影。12例患者均接受手术探查,术中均发现输尿管有坏死,坏死部位与MRU显示输尿管连续性消失部位一致,输尿管坏死下方可见渗出的尿液,与MRU所见局限性包裹液性区相吻合。结论:MRU诊断肾移植后输尿管坏死具有极高诊断价值。     

医学遗传学教学中计算机辅助教学的应用

目的:探讨计算机辅助教学在医学遗传学教学中的作用.方法:将180名护理中专生按学年分为对照组和观察组,分别采用传统的教学方法和计算机辅助教学进行医学遗传学教学,并在学期末对两组学生进行理论与综合考试,并调查两组学生对各组教学方法的作用及满意度.结果:两组学生考试成绩比较,观察组明显好于对照组(P＜0.05);两组学生对各自所在组教学方法的作用及满意度比较,观察组好于对照组(P＜0.05),差异有显著性意义.结论:计算机辅助教学有利于增强学生的学习兴趣,提高学生的学习效果,是一种较好的医学遗传学教学方法.