“消癃通闭”对犬大脑皮层α1-肾上腺素受体的拮抗作用

不同浓度的“消癃通闭”浸出液与犬大脑皮层粗制膜及IBE~(125)作用,测定“消癃通闭”对IBE~(125)与犬大脑皮层α_1-AR结合的抑制作用。结果显示“消癃通闭”对IBE~(125)犬大脑皮层的结合呈竞争性拮抗作用,IC_(50)为34.0±6.0g/L,Hill系数为0.70±0.06。佐证本方剂具有α_1-AR拮抗作用。     

中药消癃通闭对犬前列腺组织中T、E_2、DHT、AR和5α-还原酶的影响

取前列腺增生老龄犬,经口喂给消癃通闭药粉32天后,用RIA技术测定前列腺组织中睾酮(T)、雌二醇(E_2)、双氢睾酮(DHT),并与血清中浓度对照;用Scatchard Plots方法及双复管单点法测定雄激素受体(AR);用酶学法测定5α—还原酶Ⅰ、Ⅱ型。结果发现:正常犬微粒体中5α—还原酶Ⅰ型的活性为97.145±45.729,Ⅱ型的活性为15.745±15.093(单位均为DHT Pmol/mg Pro—tein·30min~(-1),下同)。予消癃通闭lg/kg·d~(-1)组犬的测定值分别为92.454±57.703和11.328±10.060;给予消癃通闭2g/kg·d~(-1)组犬的测定值分别为42.837±31.909和9.288±11.209。各组的前列腺组织中AR的测定值无明显差异。提示消癃通闭治疗前列腺增生的机理为抑制前列腺组织中5α—还原酶的活性。     

中药"消癃通闭"对前列腺平滑肌中NOS神经的影响

目的　 探讨一氧化氮 (NOS)与前列腺增生 (BPH)发病的关系以及中药消癃通闭对前列腺平滑肌中NOS神经的影响。 方法　 去势雄性大鼠 ,皮下注射丙酸睾酮 5mg/ (kg·d) ,分别给予消癃通闭、保列治灌胃 ,2 1d后断髓处死 ,应用NADPH组化染色结合形态学定量分析方法 ,检测各组前列腺中NOS神经含量。 结果　NOS神经纤维主要分布在前列腺平滑肌细胞周围 ,消癃通闭高剂量组在治疗 3周后 ,前列腺组织中NOS神经的长度密度 (Lv)相对值为 (113.4 9± 2 3.30 )× 10 -3 ,与其它 3组相比均有显著性差异 (P <0 .0 1)。 结论　 中药消癃通闭可增加模型BPH大鼠前列腺中NOS神经含量 ,为该药治疗前列腺增生改善临床症状提供了科学依据     

消癃通闭对前列腺平滑肌中NOS神经的影响

目的 探讨一氧化氮合酶(NOS)与良性前列腺增生(BPH)发病的关系以及中药消癃通闭对前列腺平滑肌中NOS神经的影响。方法 去势雄性大鼠,皮下注射丙酸睾酮5mg·kg~(-1)·d~(-1),分别给予消癃通闭、保列治灌胃,21天后断髓处死,应用NADPH组化染色结合形态学定量分析方法,检测各组前列腺中NOS神经含量。结果 NOS神经纤维主要分布在前列腺平滑肌细胞周围,泪癃通闭高剂量组在治疗3周后,前列腺组织中NOS神经的长度密度(L_v)为0.11349±0.023296,与其它三组相比均有显著性差异(p<0.001)。结论 中药消癃通闭可增加实验性BPH大鼠前列腺中NOS神经含量,为该药治疗前列腺增生,改善临床症状提供了科学依据。     

消癃通闭对犬大脑皮层α1受体的结合作用

以中药复方消癃通闭与犬大脑皮层粗制膜进行放射配体结合试验，发现当消癃通闭浓度为６２．５ｇ／Ｌ时，对犬脑α_１受体抑制率为３２．７６±７．０９％，２５０．０ｇ／Ｌ时抑制率达８８．５０±５．７６％，５００．０ｇ／Ｌ时，抑制率达１００％。表明消癃通闭对α_１受体具有阻滞作用。为消癃通闭治疗良性前列腺增生症药理作用提供了分子生物学作用实验依据。     

消癃通闭对大鼠前列腺上皮细胞DNA合成的影响

为了进一步了解中药消癃通闭对前列腺上皮细胞增生的影响,用去势wistar大鼠,每天皮下注射丙酸睾酮5mg/kg,以维持其副性腺的发育。消癃通闭2g/kg灌胃20天时断头处死,取前列腺相同部位腹叶,匀浆,PI染色,采用流式细胞技术对大鼠前列腺上皮细胞DNA合成进行定量检测,结果显示:消癃通闭可抑制G2+M期DNA的合成(P<0.005),即该药可能抑制了前列腺上皮细胞的有丝分裂。     

中药"消癃通闭"对大鼠前列腺上皮细胞凋亡的影响

目的：研究中药“消癃通闭”对前列腺上皮细胞凋亡的影响。方法：将大鼠分为消癃通闭组，保列治组，去势组、空白组，采用免疫组化原位末端标记染色法，因实验后第7d,14d,21d时，检测各组大前列腺上皮细胞的凋亡百分率。结果：消癃通闭组及保列治组在实验第7d时，凋亡百分率达到高峰，分别为9．27％、5．65％，第14d时稍减少，第21d锂有所恢复，去势组在第7d时凋亡即出现，到第14d时凋亡百分率达到高峰，与其它组相比差异显著。结论：中药消癃通闭可在较短时间促进大鼠前列腺上皮细胞凋亡，为该药治疗前列腺增生提供了理论依据。     

癃畅颗粒对睾酮诱导的大鼠前列腺增生组织bax表达影响的研究

目的:通过癃畅颗粒对大鼠前列腺增生组织中bax表达影响的研究,探讨癃畅颗粒治疗前列腺增生的作用机制。方法:采用大鼠去势后注射丙酸睾酮致前列腺增生法造模,灌胃给药后30d处死。摘取前列腺组织并测量湿重,采用免疫组化对癃畅颗粒和癃闭舒干预的大鼠前列腺增生组织进行bax检测。结果:前列腺湿重:空白组(0.61±0.03)g,模型组(0.95±0.04)g,癃闭舒组(0.73±0.02)g,癃畅颗粒低剂量组(0.80±0.05)g,癃畅颗粒中剂量组(0.78±0.07)g,癃畅颗粒高剂量组(0.68±0.03)g,与模型组比较差异有显著性(P<0.05)。前列腺指数:空白组0.143±0.006,模型组0.226±0.008,癃闭舒组0.172±0.004,癃畅颗粒低剂量组0.199±0.012,癃畅颗粒中剂量组0.181±0.010,癃畅颗粒高剂量组0.168±0.003,与模型组比较,差异有显著性(P<0.05)。癃畅颗粒对BPH大鼠前列腺上皮细胞bax表达影响(平均光密度):空白组0.226±0.010,模型组0.184±0.005,癃闭舒组0.206±0.015,癃畅颗粒低剂量组0.199±0.001,癃畅颗粒中剂量组0.202±0.003,癃畅颗粒高剂量组0.211±0.003,与模型组比较,差异有显著性(P<0.05)。结论:癃畅颗粒能够有效缩小模型大鼠前列腺湿重,减轻病理变化。其作用机制可能为上调大鼠前列腺bax基因表达促进前列腺细胞凋亡。     

消癃通闭对大鼠前列腺上皮细胞分裂周期的影响

目的：进一步了解中药消癃通闭对前列腺上皮细胞增殖的影响。方法：用去势Ｗｉｓｔａｒ大鼠，每天皮下注射丙酸睾酮，消癃通闭每天灌胃，于２０ｄ时断头处死，取前列腺各叶称重及测体积，取相同部位腹叶，采用流式细胞技术对大鼠前列腺上皮细胞分裂周期进行定量检测。结果：消癃通闭高剂量组的前列腺体积、腺重量及腺重与体重的比值均明显小于睾酮组，Ｐ＜００１；前列腺上皮细胞分裂Ｇ２＋Ｍ期所占比例亦明显长于睾酮组，Ｐ＜０００５。结论：消癃通闭可抑制前列腺上皮细胞的有丝分裂，从而抑制了前列腺细胞的生长     

消癃通闭对小鼠前列腺上皮细胞DNA合成的影响

去势昆明雄性小鼠24只,皮下注的丙酸睾丸素5mg/kg·d~(-1),同时将其分为4组,分别给予高剂量消癃通闭、低剂量消癃通闭、雌二醇及睾丸素。于15天、30天时分别腹腔注射~3H TdR(20uci/g),24小时后处死,取前列腺右头叶和腹叶称重,制成石腊切片进行放射自显影,观察前列腺上皮细胞核上标记银盐颗粒。结果结示~3H TdR标记呈不均一性,腺管末梢标记明显。单纯给予丙酸睾丸素组被标记的腺上皮明显高于其它组。用消癃通闭15天后标记细胞减少,但30天后4组间无明显差异。提示消癃通闭对小鼠前列腺的生长、DNA合成有抑制作用。前列腺内DNA合成局限于腺管末梢,前列腺发育到一定程度,其合成也相对停止。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Is the recovery profile of mivacurium independent of the rate of decay of its plasma concentration in patients with normal plasma cholinesterase activity?

Background: The duration of action of muscle relaxants is poorly correlated to the rate of decay of their plasma concentration. The plasma concentration of mivacurium may rapidly decrease below its active concentration because of the extensive hydrolysis of mivacurium. By inflating a tourniquet on one upper limb for 3 min after the administration of atracurium, mivacurium or vecuronium, we studied the influence of the initial decline of their plasma concentration on their effect. Methods: In 50 patients anaesthetised with thiopental, isoflurane and fentanyl, the effect of bolus doses of 0.15 or 0.25 mg . kg^?1 mivacurium (MIV 15, MIV 25), 0.3 or 0.5 mg . kg^?1 atracurium (ATR 30, ATR 50) and 0.06 or 0.1 mg . kg^?1 vecuronium (VEC 06, VEC 10) were measured on both arms (evoked response of the adductor pollicis to train-of-four stimulation every 12 s), a tourniquet being applied on one arm just before and during 3 min after the muscle relaxant bolus. Results: Tourniquet inflation of 3 min almost abolished the neuromuscular effect of mivacurium. In the vecuronium groups and in the ATR 50 group, tourniquet inflation did not modify the maximum degree of depression of the twitch response. Also, the duration of action of vecuronium was unaffected by the tourniquet. In the ATR 30 group, times to return of the twitch response to 25% (duration 25%) and 75% (duration 75%) of control response were significantly shorter in the cuffed arm, 23 min vs 27 min, and 41 min vs 45 min, respectively. In the ATR 50 group, only duration 25% was significantly shorter in the cuffed arm (41 min vs 45 min). Conclusion: The results suggest that the rate of decline of the plasma concentration of mivacurium is so rapid, that a very low and almost clinically ineffective concentration is present as soon as 3 min after its administration. The results also indicate that the recovery from a mivacurium-induced neuromuscular blockade is not influenced by the rate of decay of its plasma concentration in patients with genotypically normal plasma cholinesterase.     

Membranes in Artificial Organs

Abstract: Membrane processes play a pivotal and enabling role in modern replacement therapy for acute and chronic organ failure and in the management of immunologic diseases. In fact, virtually all contemporary extracorporeal blood purification methods employ membrane devices, and the next generation of artificial organs and tissue engineering therapies are almost certain to be similarly grounded in membrane technology. In this short essay, we comment on the similarities and differences among synthetic membranes and their natural counterparts and also provide a critical overview of the demographics and technology of hemodialysis, hemofiltration, apheresis, oxygenation, and emerging membrane technologies and applications.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Dilemma of Membrane Biocompatibility and Reuse

Abstract: Numerous articles have been published on the multiple use of dialyzers and on the effect of different reprocessing chemicals and techniques on the dialyzer biocompatibility and performance. The results often appear contradictory, especially those comparing standard biocompatibility parameters. Despite this confusion, a discerning review of the published works allows certain limited conclusions to be drawn. Reprocessing of used hemodialyzers changes the biocompatibility profile of a dialyzer as defined by the parameters complement activation. leukopenia, and cytokine release. The effect of reprocessing depends on the chemicals and reprocessing technique applied and also on the type of membrane polymer being subjected to the reprocessing procedure. Reports of pyrogenic reactions indicate that the flux of the membrane also influences how suitable it is for safe reuse. An increased risk of allergic and pyrogenic reactions appears to be associated with dialyzer reuse. Furthermore, there has been a lack of investigations into the immunologic effect of the layer of adsorbed and chemically altered proteins that remains on the inner surface of reprocessed dialyzers. We conclude that the clinical benefit of dialyzer reuse cannot be generally accepted from a biocompatibility point of view.