目的 探讨地震应激对胃泌素、生长抑素、血清超氧化物歧化酶（SOD）活性和丙二醛（MDA）水平的影响，为震后灾区人群应激性溃疡的防治提供理论依据。 方法 随机抽取四川省人民医院2008年5月15日－31日间收治的60名5.12汶川地震灾民为研究组，58名健康体检者作为对照组。分别对两组人群进行心理调查，采用酶联免疫吸附法测定血清胃泌素和生长抑素水平，利用生化法检测血清SOD活性和MDA含量，并对上述各指标在两组间的分布进行比较。 结果 研究组症状自评量表得分高于对照组（P＜0.05）；两组血清胃泌素分别为（1.04 ± 0.67）、（0.74 ± 0.58） ng/mL，研究组高于对照组（P＜0.01）；两组MDA水平分别为（7.16 ± 5.58）、（4.83 ± 4.48） nmol/mL，研究组高于对照组（P＜0.05）；而两组生长抑素分别为（0.74 ± 0.94）、（1.92 ± 3.05） ng/mL，研究组低于对照组（P＜0.01）；两组SOD分别为（6.06 ± 2.20）、（7.79 ± 1.58）U/mL，研究组低于对照组（P＜0.01）。 结论 地震可引起生理应激状态，导致机体在免疫、抗氧化能力、胃肠激素等方面出现一系列变化，胃泌素、生长抑素等均参与应激性疾病的形成，这些变化可能导致地震灾区消化性溃疡高发。
【摘要】 目的 观察右星状神经节阻滞（R-SGB）对全身麻醉气管内插管期心血管反应的影响。 方法 2009年10-12月选取60例美国麻醉医师协会（ASA）Ⅰ、Ⅱ级择期全麻手术患者，随机分为3组。研究组于全麻诱导前15 min用1%利多卡因10 mL经颈6入路行R-SGB，对照组1诱导前同法注射10 mL生理盐水，对照组2诱导前肌注2%利多卡因5 mL。观察气管插管前后收缩压（SBP）、舒张压（DBP）、平均动脉压（MBP）、心率（HR）、心电图（ECG）、氧饱和度（SpO2）和心率收缩压乘积（RPP）的变化。 结果 研究组各时点与进入手术室时的基础值比较，仅诱导后SBP、DBP、MBP显著降低，窥喉时HR和RPP显著升高（Plt;0.01）；在插管3 min后已恢复至基础值。对照组1和对照组2诱导后SBP、DBP、MBP显著降低（Plt;0.01）；窥喉时SBP、DBP、MBP、HR、RPP均显著升高（Plt;0.01），并持续至插管后5 min。两对照组升高的程度均显著高于研究组（Plt;0.05或Plt;0.01）。 结论 R-SGB对全麻气管插管期的心血管反应有一定抑制作用，可用于调控全麻插管期心血管不良反应。【Abstract】 Objective To explore the effect of right stellate ganglion block (R-SGB) on cardiovascular response during endotracheal intubation under the general anesthesia. Methods Sixty ASAⅠ-Ⅱpatients who underwent general anaesthesia between October to December 2009 were randomly divided into three groups. The patients in the trial group accepted R-SGB by C6 route with 1% lidocaine (10 mL) 15 minutes before induction of general anesthesia; the patients in control group 1 were injected with 10 mL physiological saline in the same way before the induction; the patients in control group 2 underwent the intramuscular injection of 2% lidocaine (5 mL) before the induction. The changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), hear rate (HR), electrocardiogram (ECG), oxygen saturation (SpO2) and heart rate-systolic blood pressure product (RPP) before and after endotracheal intubation were observed and recorded. Results In the trial group, SBP, MAP, and DBP decreased significantly after the induction; HR and RPP increased evidently at the laryngeal exposure compared with the baseline values (Plt;0.01) and recovered three minutes after the intubation. In the control group 1 and 2, SBP, MAP, and DBP decreased significantly after induction (Plt;0.01); SBP, MAP, DBP, HR and RPP increased apparently at the laryngeal exposure compared with the baseline values (Plt;0.01), and the raise continued until five minutes after endotracheal intubation. The difference in the raise between the control groups and the trial group was significant (Plt;0.05 or Plt;0.01). Conclusion R-SGB may effectively inhibit the cardiovascular response during endotracheal intubation under the general anesthesia and can be used to control the negative reaction during the induction.
目的：研究银杏达莫对糖尿病大鼠肾功能的影响，并从抗氧化应激反应的角度探讨其可能的作用机制。方法：50只Wistar大鼠随机分为正常组（10只），糖尿病模型组（20只）及糖尿病模型加银杏达莫组（20只）。采用单次腹腔注射链脲佐菌素（55 mg/kg）诱导糖尿病肾病（DN）大鼠模型，腹腔注射银杏达莫水溶液。生化法测定血糖，血、尿肌酐及尿白蛋白；尾静脉取血ELISA法检测血清血管内皮先长因子（VEGF）水平；肾脏匀浆后测肾脏丙二醛（MDA）、一氧化氮（NO）的含量。结果：糖尿病模型组和银杏达莫组生化指标均高于正常组（Plt;0.05），银杏达莫组MDA、NO及VEGF的表达减少与模型组比较差异有显著性（Plt;0.05）。结论：银杏达莫具有减轻糖尿病大鼠蛋白尿，提高尿肌酐排泄，减轻肾脏损害的作用，其机制可能与提高肾脏抗氧化系统功能有关。
Objective To explore repair role of allogeneic bone marrow mesenchymal stem cells （BM-MSCs） transplantation on treating hepatic ischemia reperfusion injury （HIRI） in rats. Methods Ten rats were executed to get BM-MSCs， then BM-MSCs were cultured in vitro and dyed by 4，6-diamidino-2-phenylindole （DAPI）. Models of 70% hepatic ischemia reperfusion injury were eatablished. Thirty two rats were randomly divided into sham operation group （Sham group）， ischemia reperfusion group （I/R group）， Vitamin C group （VC group）， and BM-MSCs group. Serum samples were analyzed for ALT and AST， and hepatic tissue were for superoxide dismutase （SOD） and malondialdehyde （MDA）. Liver sections were stain with hematoxylin and eosin （HE） for histological analysis， TUNEL staining was applied to detect hepatic apoptosis. Serum and tissues were both collected at 24 h after reperfusion. Results The isolated BM-MSCs maintained vigorous growth in vitro. Specific markers for MSCs antigens CD29 and CD44 were detected by flow cytometry， but antigens CD34 and CD45 were not be detected. Models of HIRI were stable， and BM-MSCs were detected around the periportal area by DAPI staining. Compared with I/R group， levels of ALT， AST， MDA， and AI in the VC group and BM-MSCs group decreased at 24 h after reperfusion （P＜0.05）， meanwhile SOD level increased （P＜0.05）. Compared with VC group， levels of ALT， AST， MDA， and AI in the BM-MSC group decreased at 24 h after reperfusion （P＜0.05）， meanwhile SOD level increased （P＜0.05）. Conclusion BM-MSCs could protect HIRI by alleviating oxidative stress and inhibiting cellular apoptosis.
Objective To investigate the effects of hand assistant laporoscopic splenectomy plus pericardial devascularization on systemic stress responses. Methods Forty patients with cirrhotic portal hypertension were selected， 20 cases of which were underwent hand assistant laparoscopic splenectomy plus pericardial devascularization (LAP group)， and the other 20 were underwent open splenectomy plus pericardial devascularization (OP group). The levels of blood glucose （BG）, insulin (Ins), triiodothyronine （T3）, tetraiodothyronine （T4）, corticosteroid （CS） and other related clinical data were measured before operation and on day 1-3 after operation, which were compared between two groups. Results There was no statistical significance between two groups on those levels before operation. On day 1 after operation， BG and CS level in both two groups were higher than those before operation (P＜0.05), but they were recovered on day 2 after operation in LAP group (Pgt;0.05), and on day 3 after operation in OP group (Pgt;0.05). BG and CS level in OP group were markedly higher than those in LAP group on day 2 after operation (P＜0.05). On day 1 after operation， Ins, T3 and T4 level of two groups were lower than those before operation (P＜0.05), but they were recovered on day 2 after operation in LAP group (Pgt;0.05) and on day 3 after operation in OP group (Pgt;0.05). Ins, T3 and T4 level in OP group were lower than those in LAP group on day 2 after operation (P＜0.05). There was no significant difference in operation time between two groups (Pgt;0.05). But laparoscopic surgery had more advantages than conventional open surgery such as reducing bleeding quantity in operation, shortening recovery time of bowel and urinary bladder function and the length of stay. Conclusion Compared with laparotomy, the laparoscope not only imposes less impact on physical stress system, but also makes recovery after operation more quickly.
【Abstract】ObjectiveTo explore the mechanisms of anabolism intensified by recombination human growth hormone (GH) on the basis of total parenteral nutrition (TPN) during postoperative in gastrointestinal carcinoma patients. MethodsNinety-four gastrointestinal carcinoma patients undergone operation were randomly divided into TPN group and TPN+GH group. The levels of TNF-α, IL-1, IL-6 and CRP were detected in the first, third, seventh postoperative day. ResultsThe levels of TNF-α, IL-1, IL-6 and CRP were significantly lower in TPN+GH group than those in the TPN group at the first, third, seventh postoperative day （P＜0.01）. The levels of TNF-α, IL-1, IL-6 and CRP were significantly higher at the indicated time of postoperative days than the pre-operative days in the two groups (P＜0.01）. ConclusionBy inhibiting TNF-α, IL-1, IL-6 and CRP production in gastrointestinal carcinoma patients undergone operation and blocking high catabolism induced by inflammatory cytokines, GH promotes the synthesis of anabolism.
目的总结外科手术后应激性溃疡大出血的临床特点和治疗经验。方法回顾分析1997~2003年期间我院治疗的32例应激性溃疡大出血患者的临床资料。结果28例患者采用非手术治疗，其中12例患者接受急诊胃镜检查; 手术治疗4例。本组患者总的治愈率为87.50%，死亡率为15.62%。结论急诊胃镜检查有助于明确诊断及止血治疗，应激性溃疡大出血首选非手术治疗，无效者可选择手术治疗。
ObjectiveTo investigate the systemic stress responses after laparoscopic resection in colorectal cancer patients.MethodsSixty patients were randomized into the laparoscopic resection group (30 cases) and open resection group (30 cases) from October 2001 to September 2002 in our hospital.Analgesic dosages, recovery time of intestinal peristalsis, postoperative temperatures, C reactive protein(CRP), IL6 and white blood cell (WBC) counts were recorded after operation. ResultsThe changes of postoperative temperatures and WBC counts showed no significant difference between two groups.But in the laparoscopic resection group, the recovery time of intestinal peristalsis, postoperative analgesic dosages, CRP and IL6 significantly decreased (P＜0.01,P＜0.05).ConclusionCompared with traditional open resection, laparoscopic resection of colorectal cancer can diminish the systemic stress responses and decrease the injury to patients.
Objective To invesitgate the relationship between 8-isoprostane ( 8-iso-PG) level in exhaled breath condensates ( EBCs) and severity of asthma and explore the role of 8-iso-PG in asthma evaluation and monitoring. Methods Fifty-nine patients with asthma were enrolled. In which 15 cases were acute exacerbation, 13 cases were mild intermittent, 15 cases were mild persistent, and 16 cases were moderate-to-severe persistent. Thirteen healthy volunteers were recruited as control. EBCs were collected using EcoScreen system. The 8-iso-PG levels in EBCs were measured by a specific enzyme immunoassay.The patients with mild intermittent asthma were treated with inhaled corticosteroid ( ICS) for one month and their EBCs were recollected for 8-iso-PG measurement. Results Exhaled 8-iso-PG levels were obviously increased in the patients with acute asthma compared with those chronic asthmatics [ ( 47. 2 ±6. 8) pg/mL vs ( 24. 5 ±12. 0) pg/mL, P lt; 0. 01] . In the chronic persistent asthma, the levels were significantly higher in patients with mild persistent and moderate-to-severe asthma [ ( 17. 9 ±1. 2) pg/mL and ( 39. 7 ±4. 0) pg/mL,P lt; 0. 01] . While 8-iso-PG level did not differ significantly in intermittent asthma [ ( 13. 5 ±1. 1) pg/mL]compared with the control subjects ( P gt; 0. 05 ) . After one-month ICS treatment the 8-iso-PG level in the patients with mild intermittent asthma did not change significantly although the ACT score improved. Conclusions 8-iso-PG levels in EBC are associated with the severity of asthma, implicating 8-iso-PG may be useful in monitoring airway oxidative stress in asthma. ICS treatment is incapable of decreasing the 8-iso-PG, suggesting the ICS has minor impact on oxidative stress.
Objective To observe the effects of cigarette smoke extract ( CSE) on the proliferation and secretion of hydrogen peroxide ( H2O2 ) in human lung fibroblasts ( HLFs) induced by transforming growth factor-β1 ( TGF-β1 ) . Methods Cultured HLFs were divided into a normal group and a model group induced by TGF-β1 ( 5 ng/mL) , then intervened with CSE at different concentrations ( 0% , 2. 5% , 5% ,10% , respectively) . Brdu ELISA assay was used to detect cell proliferation. H2O2 release from cultured cells was assayed using a fluorimetric method. Cellular localization of H2O2 and expression of α-SMA were performed using a fluorescent-labeling strategy. Results TGF-β1 stimulated group showed positive expression of α-SMA, implying TGF-β1 had induced fibroblasts to differentiate into myofibroblasts. In TGF-β1 stimulated group, 2. 5% and 5% CSE promoted cell proliferation ( P lt; 0. 01 or 0. 05) , while 10% CSE inhibited cell proliferation ( P lt; 0. 01) . In the normal group, both low and high concentration of CSE inhibited cell proliferation ( P lt; 0. 01 or P lt; 0. 05) , and the inhibition effect was dose-dependent. HLF induced by TGF-β1 generated low constitutive levels of extracellular H2O2 that was markedly enhanced by CSE treatment ( P lt; 0. 01) . Pretreatment with DPI, an inhibitor of NADPH oxidase, abolished secretion of H2O2 . Cellular localization of H2O2 by a fluorescent-labeling strategy demonstrated that extracellular secretion of H2O2 is specific to the myofibroblast. Conclusions Low concentration of CSE can promote myofibroblast proliferation, and markedly increase extracellular secretion of H2O2 . CSE possibly take part in the development and progress of idiopathic pulmonary fibrosis by increasing oxidative stress.