利多卡因对非体外循环冠状动脉旁路移植术患者血清炎性介质及氧自由基的影响

目的:研究利多卡因对非体外循环冠状动脉旁路移植术(OPCAB)患者血清炎性介质及氧自由基的影响。方法:30例择期行OPCAB的患者随机分为对照组(C组)和利多卡因组(L组),每组15例,两组麻醉方法相同。L组于麻醉诱导后静脉注射利多卡因2mg.kg-1,继以2mg.kg-1.h-1持续泵入至术毕;C组给予等量生理盐水。分别在麻醉诱导后手术前(T1)、乳内动脉游离结束肝素化后即刻(T2)、手术结束(T3)、术后24h(T4)采集中心静脉血,用ELISA法检测肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8);分光光度法检测超氧化物歧化酶(SOD)及丙二醛(MDA)。同时记录血流动力学指标及术后早期临床资料I、CU滞留时间、住院时间等。结果:①TNF-α、IL-8:与术前比较,两组TNF-α、IL-8术中及术后均明显升高(P<0.01),但L组升高幅度显著低于C组(P<0.01或0.05);②SOD、MDA:SOD两组组内各时点间和组间变化都不明显(P>0.05);MDA在L组各时点间变化无明显差异(P>0.05),C组MDA术后24h显著升高(P<0.01),组间比较差异显著(P<0.05);③L组患者...     

Expression and regulation of osteoprotegerin in adipose tissue

PURPOSE: Osteoprotegerin (OPG), a potent inhibitor of osteoclastic bone resorption, has a variety of biological functions that include anti-inflammatory effects. Adipocytes and osteoblasts share a common origin, and the formation of new blood vessels often precedes adipogenesis in developing adipose tissue microvasculature. We examined whether OPG is secreted from adipocytes, therefore contributing to the prevention of neovascularization and protecting the vessels from intimal inflammation and medial calcification. MATERIALS AND METHODS: The mRNA expression of OPG and receptor activator of NF-kappaB ligand (RANKL) was measured in differentiated 3T3L1 adipocytes and adipose tissues. RESULTS: OPG mRNA expression increased with the differentiation of 3T3L1 adipocytes, while RANKL expression was not significantly altered. OPG mRNA was expressed at higher levels in white adipose tissue than in brown adipose tissue and was most abundant in the epididymal portion. In differentiated 3T3L1 adipocytes, Rosiglitazone and insulin reduced the OPG/RANKL expression ratio in a dose- and time- dependent manner. In contrast, tumor necrosis factor-alpha (TNF-alpha) increased the expression of both OPG and RANKL in a time-dependent manner. The OPG/RANKL ratio was at a maximum two hours after TNF-alpha treatment and then returned to control levels. Furthermore, OPG was abundantly secreted into the media after transfection of OPG cDNA with Phi C31 integrase into 3T3L1 cells. CONCLUSION: Our results indicate that OPG mRNA is expressed and regulated in the adipose tissue. Considering the role of OPG in obesity-associated inflammatory changes in adipose tissue and vessels, we speculate that OPG may have both a protective function against inflammation and anti-angiogenic effects on adipose tissue.     

糖尿病足危险因素筛查对糖尿病足预防的影响

目的:探讨健康教育联合糖尿病足危险因素筛查对糖尿病足预防的影响.方法:将160例糖尿病患者随机分为观察组和对照组各80例.对照组患者在住院期间接受糖尿病常规知识教育.观察组在此基础上进行糖尿病足部危险因素筛查,根据筛查结果有针对性地对患者进行足部指导护理.在两组患者接受健康教育24个月后,采用自制问卷对患者的糖尿病足护理知识掌握情况进行调查,内容包括正确修剪指甲、赤脚习惯、鞋袜合适、每日检查足部、合适水温泡脚、自行处理伤口、生活方式(吸烟、饮酒)6个方面.同时评估两组患者的下肢、足部状况.结果:两组患者接受健康教育24个月后对糖尿病足护理知识掌握情况比较差异均有统计学意义(P<0.01);在下肢、足部状况方面,除胼胝/水泡一项两组比较差异无统计学其他项目两组比较差异均有统计学意义(P<0.01).结论:通过进行健康教育,并开展糖尿病足危险因素筛查,提高了糖尿病患者的对足部的自我管理能力,养成良好的生活习惯,提高了遵医行为,对糖尿病足的发生起到了预防作用.