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。     

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     

Pregnancy and uncomplicated vaginal delivery only 13 months after cardiac transplantation (case report)

Summary Background Pregnancy is prossible in female patients who underwent cardiac transplantation but is associated with unpredictable risks. Methods A 23-year old female patient underwent cardiac transplantation because of dilatative cardiomyopathy. Results Against our advice, she became pregnant 4 months after transplantation. Following an uneventful pregnancy, spontaneous vaginal delivery occurred 13 months after transplantation. The patient gave birth to a healthy new-born in good physical condition. Thereafter, the patient refused to attend any further routine follow-up control. 9 months after delivery, the patient was admitted to hospital in severe cardiac shock. Biopsy showed a serious, acute rejection which was treated with a course of methylprednisolone. Clinically, the patient recovered within 1 week, but died from acute myocardial infarction 1 day after discharge from hospital. Conclusions Only women without a history of rejection episodes, with good kidney function, good graft function, and high compliance should be counselled to become pregnant.      

Inhibition of Expression of Hypoxia-inducible Factor-1α mRNA by Nitric Oxide in Hypoxic Pulmonary Hypertension Rats

Hypoxiaisadirectfactorcausinghypoxicpul monaryhypertension (HPH) .hypoxiainduciblefac tor 1α (HIF 1α)isfoundtobethemostcrucialfactorsofarwhichmediatesthecellularresponsetohypoxi a[1] .OurpreviousstudyrevealedthatoverexpressionofHIF 1andendothelin 1(ET 1…     

Variability of the Schirmer tear test values in a normal Arab population

Background: As in many parts of the world, the Schirmer tear test is the main test used by optometrists in Saudi Arabia for assessing adequacy of tear production. Variability of the test has been reported in different ethnic groups but not in Arabs. This paper looks at the mean and repeatability of the values obtained by the Schirmer test in a normal Arab population Method: The test was performed on the right eyes of 23 young adult Saudi male subjects at five visits over two weeks. Result: Results showed that for each subject the test values were not repeatable, varying widely over the period of evaluation. The mean value was estimated at 10.6 mm and the 95 per cent confidence limits were 7.9 and 13.3 mm. It was also established that the greater the amount of tears, the greater the variability. Conclusion: This study supports the claim that the Schirmer test is not repeatable and hence is unreliable. Therefore, caution should be exercised in employing it for clinical diagnosis. (Clin Exp Optom 1995; 78: 5: 190–193)     

Post-transplant survival after lowering fixed pulmonary hypertension using left ventricular assist devices.

OBJECTIVE: We have previously shown that fixed pulmonary hypertension in cardiac transplant candidates can be lowered using left ventricular assist devices (LVADs). The post-transplant survival of these patients is uncertain as pulmonary hypertension may reappear, possibly affecting post-transplant survival. MATERIALS AND METHODS: Between 01/2000 and 01/2005 a total of 26 cardiac transplant candidates (92% male; mean age 56.2 years) in whom fixed pulmonary hypertension was lowered by LVAD implantation (pulmonary vascular resistance (PVR) before implantation: 5.1+/-2.8wood units (WU); PVR before cardiac transplantation: 2.0+/-.9WU) underwent cardiac transplantation at our institution. These patients were age and sex matched with 52 cardiac transplant candidates without pulmonary hypertension undergoing cardiac transplantation during the same time period. Study endpoints were peri-transplant complications and long-term survival. Mean follow-up was 36+/-14 months. RESULTS: Peri-transplant mortality was 5% in patients after LVAD therapy and 7% in patients without prior LVAD therapy (p=.089). We observed 2 cases (4%) of acute right heart failure requiring mechanical support in patients without prior LVAD therapy. None of the patients with LVAD therapy developed peri-transplant right heart failure requiring mechanical support. Incidence of other peri-transplant complications was comparable between the two groups. Log-rank (p=.124) revealed comparable long-term survival between patients with (1 year: 85%, 2 year: 85%, 3 year: 85%) and without (1 year: 90%, 2 year 82%, 3 year prior 79%) prior LVAD therapy. CONCLUSION: LVAD therapy lowers fixed pulmonary hypertension in cardiac transplant candidates with fixed pulmonary hypertension. Thereafter, long-term post-transplant survival is comparable to cardiac transplant recipients without pulmonary hypertension.     

生理盐水用于会阴切开缝合术后擦洗效果观察

目的观察生理盐水用于会阴切开缝合术后伤口擦洗的效果。方法按时间顺序将790例会阴切开缝合术后产妇分为对照组371例，观察组419例。分别采用5％活力碘与生理盐水擦洗外阴及伤口，比较两组伤口愈合情况。结果两组伤口愈合情况比较，差异无显著性意义（P〉0．05）。结论采用生理盐水擦洗会阴及伤口对伤口愈合亦可起到与活力碘同样的作用，且成本低，对皮肤无刺激。     

咪唑立宾在肾移植术后的应用

目的 探讨咪唑立宾（MZR）在肾移植术后的临床应用效果。方法 选取2003年8月至2004年4月间肾移植术后采用环孢素A（CsA）或他克莫司（FK506）＋MZR＋激素三联免疫抑制方案的患者112例，定期检查患者用药后的血常规、肝肾功能、尿酸、血糖、血脂等生化指标；对乙型肝炎病毒、丙型肝炎病毒、艾滋病病毒、巨细胞病毒、EB病毒、腺病毒及带状疱疹病毒进行抗原学或者抗体监测；疑有排斥反应时，行移植肾穿刺病理检查。统计病毒感染发生情况，评价该治疗方案的安全性。结果 肾移植术后随访12～20个月，患者的人／肾存活率均为96％；急性排斥发生率为11．6％，经冲击治疗后全部逆转；患者主要不良反应是高尿酸血症，但可以控制而不需要停药；巨细胞病毒感染率为11．6％，未发生巨细胞病毒病；有1例感染腺病毒。结论 MZR是一种安全有效的免疫抑制剂，病毒感染的发生率相对较低。由于肾移植术后应用MZR患者主要不良反应是高尿酸血症，因此要注意对患者的尿酸进行控制。