樟柳碱、东莨菪碱、山莨菪碱对急性肾功能衰竭大鼠的治疗作用

本文采用直接从左肾动脉注射油酸的方法制备大鼠急性肾功能衰竭(ARF)模型,从改善微循环的角度寻求ARF的防治措施。结果表明,樟柳碱、东莨菪碱、山莨菪碱均可不同程度减轻肾内微血管损伤及肾组织水肿,改善肾内脉动血管的功能,提高肾组织血液灌流量,提高血液中前列环素(PGI_2)的浓度,减轻肾组织缺血及肾小管损伤。樟柳碱的效果优于东莨菪碱及山莨菪碱。这些结果证明,莨菪类药对油酸致大鼠ARF有治疗作用。     

樟柳碱、东莨菪碱、山莨菪碱对急性肾衰大鼠肾微血管损伤的保护作用

目的 :研究急性肾衰时肾微血管的损伤及樟柳碱、东莨菪碱、山菪莨碱对这些损伤的影响。方法 :采用左肾动脉注射油酸的方法建立大鼠急性肾衰模型 ,采用电镜、光镜及TTC显色观察大鼠急性肾衰不同时期肾微血管超微结构、肾组织结构及TTC显色的改变。结果 :左肾动脉注射油酸后 1 0min ,肾小球毛细血管内皮细胞坏死 ;肾小球毛细血管不同程度充血肿胀 ,在皮质与髓质交界区 ,可见小血管内充满大量红细胞 ;TTC显色呈鲜红色。注射油酸后 6h和 2 4h上述损伤加重 ,TTC显然出现典型的不显色苍白区。三种莨菪药物不同程度减轻了急性肾衰时肾微血管损伤 ,改善了肾组织缺血 ,减少了肾小管上皮细胞坏死数。结论 :急性肾衰时很早即出现肾微血管的损伤 ,三种莨菪药对急性肾衰时肾微血管和组织结构的损伤均有保护作用。     

三种莨菪药对急性肾衰大鼠血流变性改变的影响

本文研究了油酸致大鼠急性肾衰时血液流变性的改变。观察了樟柳碱，东莨菪碱及山莨菪碱对这些改变的影响。结果表明，急性肾衰时，低切至高切变率时的全血粘度均明显增高，红细胞比积，血浆粘度及红细胞聚集指数也明显高于对照组。樟柳碱及东莨菪碱能降低血浆粘度、红细胞聚集指数及全血粘度；山莨菪碱能降低血浆粘度及红细胞聚集指数。结果说明，急性肾衰时血液的流变性有明显障碍，三种莨菪药均能改善急性肾衰时血液的流变性。     

急性肾衰大鼠肾组织水含量变化及三种莨菪药的治疗作用

采用比重梯度法定量研究了油酸致急性肾衰大鼠肾组织水含量的改变及樟柳碱、东莨菪碱、山莨菪碱对这些改变的影响。结果表明，左肾动脉注射油酸后１０ｍｉｎ，左肾皮质比重轻度降低，６ｈ及２４ｈ后左肾皮质及髓质比重均降低；低剂量油酸首先引起皮质比重降低，继而髓质的比重也降低；樟柳碱和山莨菪碱可提高左肾组织比重。上述结果说明，急性肾衰初期仅肾皮质水含量增加，维持期肾髓质水含量也增加，肾组织水含量随油酸剂量的加大而增加，樟柳碱和山莨菪碱可减轻急性肾衰大鼠肾组织水肿。     

樟柳碱、东莨菪碱、山莨菪碱对急性肾衰竭时血栓素和前列环素代谢的影响

本文从左肾动脉注射油酸建立了大鼠急性肾衰(ARF)模型,观察了樟柳碱、东莨菪碱、山莨菪碱对ARF时肾组织及血液中TXB_2和6-Keto—PGF_(1α)含量改变的影响。实验分四组,模型组左肾动脉注射油酸0.15ml/     

三种莨菪药对急性肾衰大鼠血栓素及前列环素代谢的影响

本文研究了急性肾衰时血栓素及前列环素代谢的改变，观察了樟柳碱，东莨菪碱及山莨菪碱对这些改变的影响。结果表明，肾衰后24小时，左肾皮质及髓质血栓素B2（TXB2）及6－酮－前列腺素F1α（6KF）均明显增高，6KF与TXB2比值无明显改变；肾衰后48小时，左肾皮质及髓质TXB2明显增高，6KF增高不明显，6KF与TXB2比值明显降低。三种药物对肾组织TXB2及6KF无明显影响．但均可提高血液中6KF含量，使6KF与TXB2比例增加。其作用以东莨菪碱最明显，其次是樟柳碱及山莨菪碱。结果说明，肾组织TXB2和6KF比例的变化可能是急性肾衰维持期肾组织血流量持续降低，肾功能恶化的重要因素。东莨菪碱及樟柳碱可提高血液中前列环素含量，这可能有助于肾组织血流量的恢复。     

实验性急性肾功能衰竭家兔肾组织学损伤与血液流变学的关系

目的 探讨实验性急性肾功能衰竭（ARF）兔肾组织形态学改变与血液流变学的关系。方法 用50%的甘油10ml/kg行兔后肢肌肉加压注射，建立ARF动物模型，观察不同时相血液流变学，肾组织形态学以及肾功能改变，结果 ARF组肾组织出现严重损害，主要为：肾小球轻度出血；肾小管广泛颗粒变性，部分肾小管上皮细胞坏死，管腔闭塞；大量管型形成；肾小管轻度出血；肾间质水肿，炎性细胞浸润；肾血管瘀血，肾功能明显下降，血液流变学指标明显异常。结论 1、甘油所致ARF兔血液流变特性明显异常；肾组织出现严重损害，2、ARF时血液流变特性恶化可能是造成肾组织形态学损害的直接原因之一。     

黄芪和多巴胺对实验性急性肾衰大鼠的NO和ET影响

目的 :探讨静脉或肾脂肪囊内注射黄芪和多巴胺对实验性急性肾衰大鼠的血清NO及肾组织NO和ET的影响。方法 :SD大鼠腹腔注射LPS建立大鼠内毒素休克模型后 ,分别在静脉或肾脂肪囊应用黄芪和多巴胺 ,在 4、8、12、16h测定血清内NO及肾组织内NO和ET的浓度。结果 :肾脂肪囊内联合应用黄芪与多巴胺组血清内NO及肾脏内NO和ET浓度增加较内毒素组明显为少 (P <0 0 5 ) ,在 12h至实验结束 ,肾脂肪囊组肾脏内NO和ET浓度较静脉组明显降低 (P均 <0 0 5 )。结论 :肾脂肪囊内联合应用黄芪与多巴胺 ,可以降低急性肾衰大鼠肾脏内NO与ET的浓度 ,且较静脉给药组明显。     

当归对急性肾小管坏死的防治作用及其机制

用甘油皮下注射复制兔急性肾小管坏死（ＡＴＮ）模型，观察当归（ＲＡＳ）对初发期ＡＴＮ的防治效果，并初步探讨其作机理，结果表明，注射甘油后２４ｈ，ＡＴＮ组动物出现典型急性肾衰性肾功能改变和肾小管坏死，ＡＴＮ＋ＲＡＳ组与ＡＴＮ组比较，动物死亡率，滤过钠排泄分数和尿总氨基酸含量下降，血清肌酐，尿素氮和丙二醛的上升幅度减弱，肾组织钙和丙二醛含量降低，而超氧化物岐化酶，谷胱甘肽过氧化物酶，ＡＴＰ酶活性升高，肾     

血瘀证患者微循环容积波与舌诊比较研究

YHG型微循环容积波仪采用现代光电检测技术，结合微电脑快速、准确、简便的特点，对人体各部位微循环容积波（OPG）与心电信号进行无损伤的动态观察，记录该部位组织的微循环状态。所获得30余项参数，可从不同侧面反映血管弹性、管周阻力、静脉回流阻力、微血管供血量等生理病理状况。应用YHG型微循环容积波仪我们研究血瘀证患者微循环状态与舌象关系，并参照舌诊观察。结果表明：3O例血瘀证患者OPG图47个参数中，室缩波高度、降中峡高度、重搏波高度明显低于正常对照组；收缩期充血指数、重搏波指数、流入、流出容积速度、平均灌注速度与相对供血量显著降低。另外，血瘀证患者OPG参数与舌质的关系表明：30例血瘀证患者舌质判断，包括暗红舌4例，紫红舌12例，紫暗舌14例。血瘀证患者舌质与OPG图间有密切关系，随表示血瘀程度的增加舌质变化，OPG参数呈现进行性降低，表明OPG图参数可作为血瘀证诊断新的量化诊断依据。     

家兔心肌缺血及再灌流对红细胞变形能力的损伤及其防治的实验研究

本文以家兔为对象,利用激光衍射法研究了在结扎冠状动脉左室枝后及放开结扎重新供血造成再灌流时红细胞变形能力的改变情况。结果表明:再灌流对红细胞变形能力的损伤程度比单纯缺血严重得多,这些改变可以引起并加重心肌微循环障碍,导致心肌细胞的进一步损伤,再灌流前给予山莨菪碱和樟柳碱均可以有效地改善红细胞的变形能力。结果提示对心肌梗塞患者及时给予山茛菪碱或樟柳碱可能有助于防止再灌流对红细胞变形能力的损伤。     

Renal polyamine metabolism in rats with renovascular hypertension

A standardized stenosis was induced by applying a silver clip around the left renal artery in male rats. This resulted in arterial hypertension within 10 days (as determined by increase in heart weight). Ornithine decarboxylase (ODC) activity was determined in the right (untouched) kidney, the left kidney, and the adrenal glands 1 day, 10 days, and 3 months after the operation. There was no difference in ODC activity in the right kidney of the operated animals when compared with matched controls. In the left kidney (with artery stenosis), ODC activity decreased to 40% after 1 day. A partial recovery was seen after 10 days (ODC activity 70% of normal), and after 3 months ODC activity had normalized. Removal of the clip 1 day prior to killing induced in the 3-month group a more than two-fold increase in ODC activity in the previously clipped kidney; ODC activity in the contralateral kidney was not affected. Only minor changes in ODC activity occurred in the adrenal glands following the operation. Contents of putrescine and spermidine were increased in the left (stenotic) kidney, and after clip removal, also in the right (untouched) kidney. Our observations thus indicate that alterations in renal blood flow are rapidly followed by changes in ODC activity. Contents of putrescine, spermidine and spermine seemed to a great extent to be independent of the ODC activity.     

Renovascular Hypertension Treated by Renal Artery Embolization

Renovascular hypertension is caused by narrowing of the arteries supplying the kidneys. There are several methods to treat renal artery stenosis, such as medications, percutaneous transluminal renal angioplasty, and atherosclerosis. A boy presented to our hospital with severe hypertension. Computed tomography angiogram revealed severe narrowing of the left renal artery and hypoplastic left kidney. Total renal artery embolizaton was performed to make a complete occlusion of the left renal artery. Follow-up renin and aldosterone levels were gradually decreased. The main advantage of renal artery embolization is that it is minimally invasive compared with extensive surgical procedures. Therefore, renal artery embolization should be considered as an alternative to surgical nephrectomy in pediatric patients with renovascular hypertension.     

Renal blood flow in twins

The aim of this preliminary study was the estimation of renal blood flow in 16 premature newborns from twin pregnancies with mean body weight 1270 g and mean gestational age 29 weeks. In control group we have 16 singleton newborns with mean gestational age 29 weeks and mean birth weight 1240 g. In both intervention and control group we have the similar clinical symptoms. The renal blood flow was carried out in the first day of life with the Acuson 128 XP Colour Doppler using the 6 and 7 MHz linear transducer. The renal blood flow parameters-PI, RI, Vmax, Vmin Vmean were measured in right and left renal arteries in theirs courses from the aorta to the renal hilus, by color sinal. In the investigation group the mean value of RI in right and left renal artery was 0.88. Mean PI in right vessel was 1.67 and in left 1.56. Mean V min in right and in left artery was 0.03 and mean V max in right artery was 0.34 and in left 0.33. Mean value of mean velocity in right vessels was 0.18 and in left 0.19. In control group we observed in right artery mean value of PI 1.74 and in left 1.6. Mean RI was 0.86 and 0.86 in right vessel in left vessel. Mean V min was 0.05 in right and 0.04 in left artery. Mean V max was 0.37 in right and 0.34 in left artery. Mean value of V mean was 0.19 in right artery and 0.18 in left artery. Using the student, Mann-Whitney and Shapiro-Wilk tests we have not observed statistically significant difference of Doppler parameters between control and investigation group and between the left and right artery. Although in newborns with broad PDA we noted significant higher value of RI (0.97, 0.98) than in newborns without PDA (0.78, 0.81).     

胎儿肾移植的解剖学要点

在以胎肾为供体的肾移植应用解剖学研究的基础上,我们先后为11例患者进行了大月龄胎儿肾整块移植术,成功9例.对于手术至关重要的低温灌洗途径的选择、供体血管的解剖及与受体血管的吻合方式和部位等解剖学技术逐步进行了改进和完善,介绍了供肾体外血循环的建立和观察方法,提出了保护肾上极动脉的初步意见。     

Renal cortical perfusion-Preliminary experience with the Dynamic Spatial Reconstructor (DSR)

The three-dimensional image data generated by the Dynamic Spatial Reconstructor (DSR) enables measurement of the three-dimensional distribution of blood supply in organs. We have applied this imaging technique to evaluate renal cortical blood flow distribution and compare it with distribution of radiolabeled microspheres. The DSR, a high temporal resolution volumetric roentgenographic computed tomographic scanner, was used to scan the volume containing a kidney in 0.13–0.26 s and repeating this scan 8–4 times per s for six s during a renal arteriogram. Five anesthetized dogs were studied in the prone position with the left kidney exteriorized through a flank incision. An electromagnetic flowmeter was placed around the renal artery and a needle placed retrograde into the artery for injection of a 2 cc bolus of contrast agent. During the scan the contrast agent was injected over a four s period during which radioactively labelled microspheres were injected into the left atrium. The tomographic images of approximately 10 parallel, 5 mm thick sagittal slices corresponding to the slices of the kidney used for counting microspheres in the cortical layers were displayed and analyzed. The time point chosen for analysis was the one in which peak brightness (i.e., concentration of contrast agent) was detected in the cortex. The spatial distribution of peak brightness values was compared to the number of microspheres at the same sampling locations. The microsphere-based value of regional cortical blood flow fell below the regression line for the juxtamedullary cortex and above for the outer cortex. This result is consistent with the preferential distribution of microspheres to the outer cortex whereas the contrast agent distributed more uniformly throughout the cortex.