【摘要】 目的 观察长期大量酒精摄入对大鼠心肌结构及心肌组织中丙二醛(MDA)、超氧化物歧化酶(SOD)和金属硫蛋白(MT)含量的影响,探讨氧化应激在酒精性心肌病大鼠中的作用。 方法 雄性健康SD大鼠45只,随机分为2组,即对照组20只和模型组25只。模型组酒精浓度从5%、10%、20%和30%依次各自由饮1周,然后递增至36%后以该浓度维持饲喂。对照组每日饮用与模型组酒精同等热量的葡萄糖水。6个月后,观察大鼠心肌组织的形态学改变及超微结构的变化,测定心肌组织中MDA、SOD及MT的含量。结果 模型组大鼠心肌细胞排列紊乱、间质充血、炎细胞浸润、线粒体肿胀、空泡形成、肌丝溶解、核膜不规则和核仁裂解。心肌组织中MDA含量明显升高(Plt;0.01),SOD活力含量明显降低(Plt;0.01),MT含量明显降低(Plt;0.01)。 结论 长期摄入大量酒精可使氧自由基代谢失衡,导致心肌损伤。氧化应激在酒精性心肌病发病机制中发挥着重要的作用。【Abstract】 Objective To observe the effect of longterm and large quantities of alcohol intake on myocardial structure of rats and the content of malondialdehyde (MDA), superoxide dismutase (SOD) and metallothionein (MT) in myocardium tissue. To study the effect of oxidative stress on the rats with alcoholic cardiomyopathy. Methods Fortyfive male and healthy SD rats were randomly divided into the control group (20 rats) and model group (25 rats).The alcoholic concentrate in model group was increased from 5%,10%,20% to 30% every week, and maintain free drinking mass concentration of 36% alcohol. The control group drink the same calories of glucose water. Six months later, the myocardial tissues were observed both in light microscope and electron microscope .The level of MDA、SOD and MT were tested in myocardium tissue. Results In the model rats, the cells of myocardial disarray, interstitial congestion, inflammatory cell infiltration, mitochondrial swelling, vacuole formation, melt filaments, irregular nuclear membrane and nucleolus cracking. The content of MDA incresed(Plt;0.01)and the activities of SOD decreased(Plt;001),levels of MT decreased (Plt;0.01) in the cardiac muscular tissues in the model group compared with the control group. Conclusion Longterm intake of large amounts of alcohol can break the balance of oxygen free radicals, which leading to the damage of myocardial. Oxidative stress plays an important role in the etiopathogenesis of alcoholic cardiomyopathy.
Objectives To compare umbilical cord daily care protocol in the current clinical setting in which 75% alcohol sterile is used daily for the umbilical and surrounding skins with the WHO-recommended method (dry and clean). Methods A total of 283 full-term newborns were randomly divided into two groups: the trial group (n=181) receiving WHO “dry and clean” protocol that the umbilical cord was open to air (with losing clothes), cleaned by clear water instead of alcohol. The control group (n=102) used the traditional method that after the newborns’ bathing, the umbilical cord and surrounding skins were sterilized with 75% alcohol. The basic condition of the newborns, umbilical departure time and complications around the navel were assessed. And bacterial culture from the newborns’ skins was observed. Results There were no significant differences in departure time of the umbilical cord (7.64±3.29 day vs. 8.50±3.45 days t=1.82, Pgt;0.05), complications (6 patients with slight omphalitis in the trial group and 2 patients with slight omphalitis in the control group), and the skin flora culture between the two groups. The umbilical cord of the newborns dropped off safely. And no fever was found. Conclusion This study does not support that 75% alcohol can prevent the umbilical cord from being infected. Keeping the umbilical cord and surrounding skins dry is important for infection control.
Objective To evaluate the disinfection efficacy of alcohol-based hand disinfectants for medical glove surface in continuous operation, and explore approaches of improving hand hygiene compliance. Methods Between March and July 2015, and between March and July 2016, all the nurses (n=5) in Blood Collection Room of Outpatient Department with many patients and frequent sterile operation needed were included in this study. Nurses wearing gloves for hand hygiene and disinfection between March and July 2016 were regarded as the observation group, and those who used alcohol-based disinfectants for routine hand hygiene without gloves between March and July 2015 were designated into the control group. The hand hygiene compliance was compared between the two groups. From March to July 2016, alcohol-based hand disinfectants were used for disinfection on the glove surface during continuous blood sampling by nurses with gloves on their hands. Fifty samples were collected respectively after the gloves were used for 1, 2, 5, 10, and 15 continuous times for blood sampling. Then, the samples were sent to the bacteriology room for culture. Results All of the 250 samples were qualified, and the bacterial colonies on the surface of gloves were equal to 10 cfu/mL2 or lower. NoStaphylococcus aureus,Escherichiacoli or other pathogens were detected on the glove surface. However, after the gloves were continuously used for 15 times, the gloves of two nurses could not meet the research criteria again because of significant sweating. Conclusions In the process of continuous blood sampling, it is effective to use alcohol-based hand disinfectants to disinfect the surface of medical gloves, which can promote hand hygiene compliance to a certain extent. However, there is a certain limit on the times of usage for medical gloves.
Objective To explore the relationship between alcohol induced osteonecrosis of the femoral head (ONFH) and the single nucleotide polymorphisms (SNP) of methylene tetrahydrofolate reductase (MTHFR) 677 C/T. Methods From July 2005 to May 2008, eighty-nine male patients with alcohol induced ONFH were selected as the patient group, aged from 24 to58 years old (mean 44.3 years old). The time of drinking was about 17 years, 375 mL/day. The imaging evidence showed ONFH with no other history associated to ONFH. Seventy-seven male healthy adults were selected as the control group, aged from 23 to 52 years old (mean 42.7 years old). The time of drinking was about 14 years, 335 mL/day. The imaging evidence showed no ONFH. The 2 mL blood sample was acquired from every subject. DNA was purified from leucocyte at first, then was ampl icated by PCR, the product of PCR was sequenced at last. The SNP of MTHFR 677 C/T was analyzed with SPSS 12.0 software package. Results The TT genotype and T allele frequencies of MTHFR 677 C/T were 27.2% and 52.0% (P gt; 0.05) in the control group, and the distribution of genotype was consistent with Hardy-Weinberg equil ibrium. The genotype frequencies of CC, CT and TT were 23.4% (18 cases), 49.4% (38 cases) and 27.2% (21 cases) in the control group, were 14.6% (13 cases), 36.0% (32 cases) and 49.4% (44 cases) in the patient group; showing statistically significant differences (P lt; 0.05). The allele frequencies of C and T were 48.0% (74) and 52.0% (80) in the control group, and were 32.6% (58) and 67.4% (120) in the patient group; showing statistically significant differences (P lt; 0.05). The frequencies of C, T alleles and TT genotype were higher in the patient group than in the control group, showing statistically significant differences (P lt; 0.05). The odds ratios were 0.523, 1.914 and 2.607, respectively; the 95% confidence interval were 0.335-0.816, 1.226-2.987, 1.359-5.001, respectively. Conclusion The relationship may exist between the SNP of MTHFR 677 C/T and alcohol induced ONFH.
Objective To compare the effectiveness of integrated traditional Chinese medicine (TCM) with Western medicine and Western medicine alone for acute episodes of withdrawal in alcoholism. Methods According to the criteria of alcohol dependence and acute alcochol withdrawal syndrome of Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-Ⅳ) , 62 consecutive patients were divided into two groups: 31 patients with odd numbers were allocated to the treatment group (4 patients were excluded because they left hospital early), 31 patients with even numbers were allocated to the control group. According to the four diagnostic methods of TCM, all patients in the treatment group were further divided into 4 types. The treatment group received valium, tiopronin, transfusion therapy and herbs (potion per day). The control group received the same therapy as the treatment group did but without oral herbs. Results Liver function, especially the difference between before and after treatment of GOT and γ-GT,the treatment group showed more improvement than the control group (P=0.046 and 0.001). The scores of anxiety and depression test, especially the HAMD, the treatment group showed more improvement than the control group (t=3.165, P=0.003). The treatment group used significantly less time than the control group (P=0.01), but no statistically significant difference was seen in the dosage of valium between the two groups (P=0.434). Conclusions The efficacy of integrated TCM with Western medicine is better than Western medicine alone for acute episodes of withdrawal in alcoholism.
Objective To optimize the in vitro culture system of C57/BL6 marrow mesenchymal stem cells (MSCs) and to investigate the effect of alcohol and acetaldehyde on MSCs. Methods The MSCs were isolated from the femur marrow of C57/BL6 mice and were cultured in the optimized system, so that highlypurified MSCs were harvested and identified by immunohistochemistry. Then, MSCs were cultured in the medium containing alcohol or its metabolic product acetaldehyde, with the following concentration groups: alcohol 5.7，17.0，50.0，100.0 and 150.0 mmol/L; acetaldehyde 4.5, 0.9, 0.18, 0.036, 0.007 2, 0.001 44 , 0.000 28 mmol/L. MSCs were cultured with α-MEM as the control group. After 3 days, their proliferation activity was measured by the MTT method. Results MSCs within 6 passages had a good stability and a high proliferation activity. They were identified to express CD90 but no CD34. The MTT assay showed that alcohol at the concentration greater than 100.0 mmol/L and acetaldehyde at the concentration greater than 4.5 mmol/L could inhibit proliferation of MSCs(P＜0.05) . But the proliferation activity might rise with an increase in the acetaldehyde concentration smaller than 0.18 mmol/L(P＜0.05) . Conclusion Theoptimized culture system can effectively isolate and culture MSCs. Both alcoholand acetaldehyde can inhibit proliferation of MSCs but toxicity of acetaldehydeis more serious.
ObjectiveTo explore the potential safety problems of acute alcohol intoxication. MethodsBetweenDecember 2009 and December 2012, 508 patients with acute alcohol intoxication were admitted to the Department ofEmergency of our hospital. We analyzed the potential safety problems of acute alcohol intoxication and made relative countermeasures. ResultsThe 508 cases of acute alcohol intoxication were treated with comprehensive measures, such as physical examination, health condition evaluation, airway patency maintaining, vein channel establishing, accelerating in vivo alcohol exclusion, maintaining consciousness, taking safety protective measures, and strengthening the communication between doctors and patients. There was no accident injury or death occurred. ConclusionWe should pay more attention to the potential safety problems of patients with acute alcohol intoxication, and take measures to ensure their safety.
Objective To integrate and analyze the disease burden of esophageal cancer caused by alcohol consumption in China from 1990 to 2019, along with the differences between genders, and predict the trends in disease burden changes from 2020 to 2029 to improve prevention and treatment strategies. Methods The disease burden of esophageal cancer caused by alcohol consumption in China from 1990 to 2019 was extracted and integrated from the 2019 Global Burden of Disease (GBD) database, and the corresponding trend was analyzed using the Joinpoint regression model with Joinpoint 4.9.1.0 software. The gray prediction model [GM (1, 1) ] was used to forecast the disease burden of alcohol-related esophageal cancer in China from 2020 to 2029. Results In 2019, the leading causes of esophageal cancer in China were tobacco, alcohol, high body mass index, and insufficient fruit and vegetable intake, accounting for the first to fifth positions in esophageal cancer deaths. From a gender perspective, in 2019, the death number and standardized mortality rate for males were 18.97 times and 20.00 times higher than for females, respectively. The disability-adjusted life years (DALYs) and standardized DALYs rate for males were 33.08 times and 24.78 times higher than those for females, respectively, indicating a heavier disease burden of alcohol-related esophageal cancer among Chinese males. From 1990 to 2019, the average annual percentage change (AAPC) in deaths and DALYs due to alcohol-related esophageal cancer in China was 2.08% and 1.63%, respectively, showing a continuous upward trend with statistical significance (P<0.05). The AAPC values for standardized mortality rate and standardized DALYs rate from 1990 to 2019 were –0.92% and –1.23%, respectively, showing a continuous downward trend with statistical significance (P<0.05). The population aged ≥55 years was the main group bearing the disease burden among all age groups from 1990 to 2019. The gray prediction model predicted that by 2029, the overall standardized mortality rate and standardized DALYs rate would decrease to 2.94/100 000and 67.94/100 000, with a greater decline in females than in males. Conclusion Over the past 30 years, the disease burden of alcohol-related esophageal cancer in China has slightly decreased. However, the reduction in disease burden is still lower compared to the overall decline in esophageal cancer burden, and the disease burden for males is significantly higher than for females. Focusing on prevention and treatment for males and the elderly population remains a major issue in addressing alcohol-related esophageal cancer in China.
Objective To explore the characteristics of cognitive impairment in patients with alcohol dependence, and analyze the related influencing factors. Methods The Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the cognitive function of 65 alcohol dependent patients hospitalized between January 1st and December 31st, 2014. The features of cognitive impairment and related influencing factors were analyzed. Results The differences of MoCA attention and delayed recall between different drinking year groups had statistical significance (P<0.05). The correlations of drinking year with MoCA attention (r=–0.250,P=0.044), and with delayed recall (r=–0.326,P=0.008) were both negative. MoCA scores, naming, attention and delayed recall were different statistically among different age groups (P<0.05). The correlations of ages with MoCA scores (r=–0.429,P<0.001), naming (r=–0.261,P=0.035), attention (r=–0.391,P=0.001) and delayed recall (r=–0.461,P<0.001) were all negative. MoCA scores, the visuoconstructional skills, language, abstraction and delayed recall were significantly different among different education level groups (P<0.05). The correlations of education level with MoCA scores (rs=0.650,P<0.001), the visuoconstructional skills (rs=0.540,P<0.001), language (rs=0.486,P<0.001), abstraction (r=0.602,P<0.001) and delayed recall (rs=0.593,P<0.001) were all positive. Ages had an effect on MoCA scores by multiple linear regression analysis (P<0.01). Conclusions For alcohol dependent patients with cognitive impairment, cognitive function is correlated with drinking year, age and education level. The cognitive function is much serious in patients with older age and longer drinking years. This kind of patients should be focused on and intervened early.
Objective To review the research progress of alcohol-induced osteonecrosis of the femoral head (ONFH). Methods Recent literature concerning alcohol-induced ONFH was reviewed and summarized. Results Alcohol-induced ONFH accounte for approximately 1/3 of total ONFH. Alcohol intake and the incidence of ONFH has a significant dose-effect relationship. There are some correlations between alcohol-induced ONFH and lipid metabolism, secretion of corticosteroid, and some gene of alcohol or lipid metabolism. Conclusion The relationships between alcohol and lipid metabolism, and between alcohol and steroid are still the main direction of the research of ONFH. Gene level researches can not demonstrate the pathogenesis, therefore further research should be carried on.