晕可宁颗粒对急、慢性梅尼埃病模型的影响

目的　探讨晕可宁颗粒的主要药效学 ,为临床提供药效学资料及治疗学基础。方法　采用三氯甲烷破坏豚鼠一侧膜迷路感受器模型 ,探讨受试药对眼震颤、摆头及旋转的影响 ;采用内淋巴囊和内淋巴管阻塞手术复制豚鼠膜迷路实验性膜迷路积水模型 ,研究内耳组织平均中阶面积 (SMA)增加率及形态学的变化。结果　抑眩宁阳性对照组、晕可宁颗粒 (8、16g/kg)模型给药组豚鼠眼球震颤次数减少 ,差异有显著意义 (P <0 .0 5 )。成功复制了不同程度膜迷路积水豚鼠模型 ,表现为前庭膜重度膨出 ,前庭阶缩小 ,膜蜗管增大 ,SMA增加率变大 ,差异有显著意义 (P <0 .0 1) ;晕可宁颗粒灌胃后可减轻豚鼠实验性膜迷路积水的程度 ,差异有显著意义 (P <0 .0 1) ;但与空白对照组比较SMA增加率差异无显著意义 (P >0 .0 5 )。结论　晕可宁颗粒可以减轻内淋巴囊积水程度 ,对梅尼埃病症状有对抗治疗作用。     

Développement du tissu adipeux : importance des lipides alimentaires

A well-balanced development of white adipose tissue (WAT) is physiologically important. Longitudinal studies indicate that excess of adipose tissue at early age is predictive of subsequent overweight and obesity, emphasizing infancy as a critical period for WAT development. In this respect, in response to a positive energy balance, its expansion takes place from adipocyte precursor cells which remain present throughout life. Moreover, lipoatrophy and lipodystrophy on one hand, overweight and obesity on the other hand, lead to the metabolic syndrome. In obese patients, the earlier is the obesity onset, the higher is adipocyte size and even more so adipocyte number. As adipocytes do not divide, this observation indicates that excessive proliferation of adipocyte precursor cells is a critical issue, hampered by the lack of specific markers of these cells which represent the true potential of WAT development.In animals and humans, both cross-sectional and longitudinal studies have shown that a caloric excess, i.e. fat-enriched foods in most cases, is associated to enhanced fat mass. The role of dietary fat as a major player in adult human obesity remains controversial because the prevalence of overweight and obesity has increased dramatically over the last decades despite no recent major change in the amount of ingested fats. However the importance of qualitative changes in the fatty acid composition of fats has been largely disregarded despite a dramatic alteration over decades of the balance of essential polyunsaturated fatty acids (PUFAs). There is evidence from animal and human studies that changes in the balance of ω6 and ω3 PUFAs may alter the early stages of adipose tissue development. Under isonenergetic conditions, pups from wild-type mother mice fed a linoleic acid (LA)-enriched diet were 40% heavier 1 week after weaning than those from mothers fed a LA/α-linolinenic acid (LA/LNA) diet, and the weight difference is maintained at the adult age. The LA-induced enhancement of fat mass is abolished in mice invalidated for the cell surface prostacyclin receptor (ip ^-/- mice), demonstrating the critical role of arachidonic acid and prostacyclin in excessive adipose tissue development. Changes observed in the past decades in the fatty acid composition of dietary fats observed in breast milk and formula milk, i.e. an increase in LA with slight or no change in LNA content, acting in concert with a positive energy balance, may be responsible at least in part for the dramatic rise in the prevalence of childhood overweight and obesity. The significant change in the composition of PUFAs in most consumed foods can be traced to changes in human food habits but, quite importantly, also in the feeding pattern of breeding stock. Since prevention of obesity appears critical to avoid difficult if not insurmountable health problems in the future, and in addition to a better control of energy balance, the composition of dietary lipids should be reconsidered from the very beginning of the food chain.     

Une cause de cardiomyopathie dilatée chez l’enfant : le déficit primaire en carnitine

Aim

The aim of this case report was to show the importance to research metabolic etiology, especially a carnitine deficiency in dilated cardiomyopathy of children.

Case report

A three years old Togolese child presented muscular hypotonia, dyspnea. Examination showed left galop murmur and systolic murmur 2/6. Chest X-ray showed cardiomegaly (CTI: 0.66), electrocardiogram, a sinusal rythm, left ventricle hypertrophy and T wave abnormalities. Echocardiogram showed a markedly dilated left ventricle with reduced systolic function (EF: 0.43; reference range 0.55–0.80) and moderate mitral regurgitation. The inflammatory signs where negatives. Magnetic resonance imaging don’t show signs of ischemic or myocarditis. The levels of free and total plasmatic carnitine decreased: 3 μmol/L (N: 18–48 μmol/L) and 5 μmol/l (N: 29–70 μmol/L) respectively. Mutation analysis of the gene SLC22A5 confirms the diagnosis of primary systemic carnitine deficiency. Treatment with oral carnitine was started at 200 mg/kg per day. Within three weeks of treatment, we observed the decrease of all symptoms and the left ventricular size and function normalized (EF: 0.62). He has now been on oral carnitine for live.

Conclusion

Primary carnitine deficiency is a cause of dilated cardiomyopathy in child. It must systematically be suspected when a child presents a primitive cardiomyopathy. The treatment with oral carnitine for live is simple, with excellent prognosis.     

Correlation between income and non-alcoholic fatty liver disease in a Chinese population

ObjectiveThe aim of the study was to analyze the correlation between income and non-alcoholic fatty liver disease (NAFLD) in a Chinese population.Methodsubjects were divided into three groups according to liver fat content (LFC). (1) normal: LFC < 9.15%, 197 cases; (2) low LFC: LFC 9.15–20%, 532 cases; and (3) high LFC: LFC > 20%, 201 cases. Participants’ clinical and social background were collected, including a routine fasting test to assess the relevant indices. Intergroup differences were compared on 1-way ANOVA, to analyze the relation between income and each index on Pearson correlation, and independent factors for LFC were identified on binary logistic regression.Results(1) In retired persons, prevalence of NAFLD was greater in females (81.2%) than males (75%), but fell with age: the highest prevalence was between 40 and 49 years of age (87.5%), and the lowest above 70 years (68%). (2) Income correlated positively with triglyceride and serum uric acid levels and LFC (P < 0.05) and negatively with alanine aminotransferase (P = 0.01). (3) As income increased from level I to V, prevalence of NAFLD increased progressively (P < 0.05). In the study, LFC was taken as the dependent variable, and the traditional NAFLD risk factors and income level (I–V) were taken as independent variables. Income emerged as an independent risk factor for NAFLD. Risk in group V was 1.964-fold higher than in group I.ConclusionPrevalence of NAFLD was closely related to socio-economic level. Demographic risk factors include female gender, age 40–49 years, and monthly income > 5,000 RMB. Thus, if income is increased without improving educational level and health awareness, NAFLD prevalence will rise.     

艾灸神阙穴对不同程度力竭运动大鼠海马区单胺类神经递质的影响

目的:探讨艾灸神阙穴对不同程度力竭运动大鼠海马区单胺类神经递质的影响。方法:将72只SD雄性大鼠按随机数字表法分为正常组8只、模型组和艾灸组各32只,根据造模或治疗时间将模型组和艾灸组随机分为1、4、7、10次亚组,每亚组8只,采用游泳实验建立力竭模型。艾灸各亚组大鼠造模后即刻温和灸神阙穴15min,隔日1次,各亚组大鼠完成相应力竭运动后24 h检测海马组织5-HT、DA、NE的含量。结果:与正常组比较,模型各亚组5-HT含量均明显升高,模型1、4、7次亚组NE含量均明显升高,模型1次亚组DA含量明显升高,模型10次亚组却明显降低。与相应模型亚组比较,艾灸4次亚组NE含量明显升高,艾灸7、10次亚组5-HT含量显著降低,DA、NE含量明显升高。结论:艾灸神阙穴可以通过调节反复力竭运动大鼠海马区神经递质,促进神经细胞的功能恢复,改善机体疲劳状态,为今后临床应用提供一定的实验基础。     

卡介菌多糖核酸治疗小儿咳嗽变异性哮喘

目的：观察卡介菌多糖核酸注射液在小儿咳嗽变异性哮喘治疗应用的疗效。方法：将本科40例咳嗽变异性哮喘患儿，随机分为治疗组和对照组（各20例）。治疗组给予BCG—PSN＋必可酮气雾剂，对照组：给予单用必可酮气雾剂吸入，连续吸入6周，观察疗效，并进行统计学处理。结果：治疗组总有效率为95％，对照组总有效率为70％，统计学处理总有效率有显著差异（P〈O．01）。结论：卡介菌多糖核酸（polysaccharide nucleic acidfraction of BCG，BCG—PSN）能有效地控制咳嗽变异性哮喘（CVA）的呼吸道的反复感染，提高免疫功能；与必可酮配合，能有效地控制CVA的复发。     

瑞芬太尼联合硝酸甘油控制性降压在鼻内镜手术中的应用

目的比较瑞芬太尼和瑞芬太尼联合硝酸甘油在全麻下鼻内镜手术中控制性降压效果。方法鼻内镜下鼻息肉、鼻窦炎手术病人共40例,ASAⅠ或Ⅱ级,用随机数字表分为瑞芬组和瑞硝组,每组20例,咪达唑仑、丙泊酚、瑞芬太尼和维库溴铵静脉复合全麻气管插管,2组术中均以瑞芬太尼0.1～0.2μg·kg~(-1)·min~(-1)、丙泊酚2～5 mg·kg~(-1)·h~(-1)持续泵输,维库溴铵4 mg·h~(-1),静脉注射。瑞硝组加用硝酸甘油静脉滴注,开始剂量5μg·min~(-1),调节滴速使收缩压维持在12 kPa(90 mmHg)左右。观察降压前(T_0)、降压后5 min(T_1)、30 min(T_2)、60 min(T_3)和停止降压后5 min(T_4)的收缩压和心率,计算心肌氧耗指数,瑞芬太尼、丙泊酚用量,手术时间和病人苏醒时间。结果2组病人年龄、性别和体重间差别无统计学意义(P>0.05)。T_1时2组血压明显下降,与T_0比较,均P<0.01,且瑞硝组降压程度明显大于瑞芬组(P<0.01),降压后的T_1,T_2瑞硝组心率加快,与瑞芬组相比有非常显著意义(P<0.01);降压期的氧耗指数,瑞硝组低于瑞芬组(P<0.05,P<0.01);停止降压后,瑞芬组血压和心率变化与T_3比,无统计学意义(P>0.05),但瑞硝组血压和心率均明显增加(P<0.01);瑞芬组的瑞芬太尼、丙泊酚用量和手术时间明显大于瑞硝组(P<0.01),2组病人的苏醒时间差异无统计学意义(P>0.05)。结论鼻内镜手术瑞芬太尼在常用剂量范围内作控制性降压虽比较平稳,但难以达到目标血压,联合硝酸甘油后效果明显,并可减少麻醉药用量和手术时间,减少病人医疗费用。     

Acides gras trans : nature, origine et impact sur la santé

Trans fatty acids include mono- and poly-unsaturated fatty acids having methylene interrupted double bonds. Trans monounsaturated fatty acids are formed during hydrogenation of oils to produce margarine and shortening but are also present in ruminant meat and milk as a result of biohydrogenation in the rumen. The linoleic and a-linolenic acid trans isomers may also be present in non-hydrogenated fats as the result of exposure of these polyunsaturated fatty acids to heat treatment, such as steam deodorization, or deep fat frying in food.Trans monounsaturated isomers are the major trans isomers consumed by humans. Data on trans fatty acids were obtained from nutritional interventions but also from epidemiological studies. For example, a meta analysis of 60 controlled trials published between 1970 to 1998 which included over 1,600 volunteers showed that replacing carbohydrates isoenergetically (1% of total energy) by 18: 1 trans would increase LDL cholesterol while the effect on HDL would be similar. The calculated impact on the ratio of total cholesterol/HDL would be of +0.022nmoles/L (p=0.015). A recent meta analysis of the four larger epidemiological studies showed that increasing the total energy intake with 2% trans fatty acids would result in a 23% increase in cardiovascular disease risk.However, it is essential now to answer the following question: Are trans fatty acids from natural origin have the same effects as those demonstrated for the “industrial ones”. Some studies which are being carried out should give some new information on this important still pending question despite the number of studies so far carried out.     

Influence des acides gras polyinsaturés n-3 et des antioxydants alimentaires sur les acides gras de la viande et la lipoperoxydation chez le bovin en finition

This study aimed at analysing the impact, on beef lipids and fatty acids and on beef colour, of dietary lipid supplements provided by extruded linseeds (rich in n-3 polyunsaturated fatty acids, n-3 PUFA) alone or with extruded rapeseed (rich in n-6 and n-3 PUFA and in 18:1n-9) in association or not with dietary antioxidants in cull dairy cows in finition. Dietary linseeds increased significantly proportions of 18:3n-3 (+56% and +36% respectively), of total trans 18:1 (+66% and +105%); and of 9cis,11trans 18:2 (CLA) (+50% and +41%) in Longissimus thoracis and Semitendinosus muscles, 18:3n-3 and CLA being known to be beneficial for the human health. Antioxidant supplements (association of vitamin E with plant extracts rich in polyphenols, PERP) reinforced the stimulating effect of lipid supplements on proportions of 18:3 n-3, 18:1trans, and 9cis,11trans 18:2 in lipids of the two muscles. Dietary n-3 PUFA reduced the capacity of plasma to resist against lipoperoxidation (−11%) favouring the formation of peroxides such as conjugated dienes (× 1.75) and malonedialdehyde (MDA, ×2). Intensity of lipoperoxidation tended to increase in beef packaged under modified atmosphere rich in oxygen (O₂/CO₂: 70/30) of the linseed group (2.96 μg/g fresh tissue) when compared to that in the control group (2.19 μg/g, p = 0.1). Combined supply of vitamin E and PERP efficiently protected beef against lipoperoxidation, even in beef packaged under modified atmosphere rich in oxygen. Beef samples packaged under air from cows of the linseed group exhibited a more intense red colour than that of cows of the control group. In cows of the linseed group submitted to an emotional stress 2 hours before slaughtering, beef samples packaged under the air or the O₂-rich atmosphere had a red colour with a lower intensity that beef samples from cows of the linseed plus antioxidants group. In conclusion, feeding strategy for finishing cull cows combining lipid (from linseed rich in n-3 PUFA) and antioxidant (vitamin E + PERP) supplements improve the health value of beef fatty acids avoiding the major risks of beef lipoperoxidation and of alteration of beef colour whatever (i) the conditions of beef ageing and packaging (especially with O₂), (ii) the level of emotional stress of animals just before slaughtering.