松果腺切除对长期游泳老龄小鼠MDA影响的对比研究

为研究长期游泳运动老龄小鼠脂质过氧化水平的降低是否与刺激了松果腺释放褪黑素有关 ,将松果腺切除 1 2月龄昆明种小鼠分为手术组 (n =3 6)、非手术组 (n =3 6)和假手术组 (n =1 2 ) ,前 2组又各分为对照组、60min组和 60min 3 %体质量负荷组 ,对其血清中的MDA浓度进行对比研究。结果 :雄性小鼠非手术组中MDA浓度 60min组及 60min 3 %负荷组均显著低于手术同负荷组 (P <0 .0 5 ,P <0 .0 1 )。雌性小鼠 ,非手术组 60min组MDA浓度显著低于手术组 (P <0 .0 5 )。而在 60min 3 %负荷组 ,手术组要显著低于非手术组 (P <0 .0 5 )。提示 :长期运动训练降低血清脂质过氧化水平 ,可能与交感神经兴奋性升高刺激松果腺内褪黑素的合成和释放有关 ;如果选择负荷不当 ,会对松果腺机能产生抑制 ,而对机体抗氧化能力的提高产生负面影响     

慢性肾炎患者水钠潴留与PET相关性研究

为研究慢性肾炎患者水钠潴留与血浆内皮素(PET)的相关性,检测了伴或不伴水钠潴留慢性肾炎患者PET和24h尿蛋白排泄量。发现伴水钠潴留组PET显着高于对照组(P<0.01),无水钠潴留组与对照组无显着差异(P>0.05).还发现水钠潴留组尿蛋白排泄量亦显着高于无水钠潴留组(P<0.01),但PET和尿蛋白排泄量无直接相关性(r=0.35,t=1.23),推测PET可能在慢性肾炎的病理过程中起着重要作用,但与尿蛋白排泄量无直接关系。     

Risk factors and risk index of cardiac events in pregnant women with heart disease

Background  Pregnant women with heart disease are at high risk. Studies of risk factors of these patients are of great significance to improve maternal and fetal outcomes. In this paper, we try to discuss the main risk factors of cardiac events in pregnant women with heart disease and to establish a risk assessment system.

Methods  A retrospective analysis was carried out for pregnancies in 1741 women with heart disease who delivered in Shanghai Obstetrical Cardiology Intensive Care Center between January 1993 and September 2010. A Logistic regression model was used to identify independent risk factors of cardiac events and calculate the risk index in pregnant women with heart disease.

Results  The composition of heart disease in pregnant women was arrhythmia (n=662, 38.00%), congenital heart disease (CHD; n=529, 30.40%), cardiomyopathy (n=327, 18.80%), rheumatic heart disease (RHD; n=151, 8.70%), and cardiopathy induced by pre-eclampsia (n=53, 3.00%). Main cardiac events were heart failure (n=110, 6.32%), symptomatic arrhythmia needing medication (n=43, 2.47%), cardiac arrest (n=2, 0.11%), syncope (n=3, 0.17%), and maternal death (n=10, 0.57%). Six independent risk factors to predict cardiac events in pregnant women with heart disease were cardiac events before pregnancy (heart failure, severe arrhythmia, cardiac shock, etc., P=0.000), New York Heart Association (NYHA) class >II (P=0.000), oxygen saturation <90% (P=0.018), pulmonary artery hypertention (PAH) >50 mmHg (P=0.025), cyanotic heart disease without surgical correction (P=0.015), and reduced left ventricular systolic function (ejection fraction <40%, P=0.003). Every risk factor was calculated as 1 score. The incidence of cardiac events in patients with scores 0, 1, 2, 3, and ≥4 was 2.10%, 31.61%, 61.25%, 68.97%, and 100.00% respectively.

Conclusions  Pregnancy with heart disease could lead to undesirable pregnancy outcomes. The risk of cardiac events in pregnant women with heart disease could be assessed by risk index.

     

急性重复性缺氧小鼠脑组织中儿茶酚胺类神经递质含量变化的研究

用高效液相-电化学检测器测定急性重复性缺氧小鼠脑组织中DOPA、DA、NE和Ep等儿茶酚胺类物质的含量。结果发现:与空白对照组(A组)比较,缺氧1次的实验对照组(B组)及急性重复缺氧4次实验组(C组),随缺氧次数增加,小鼠脑组织中的DA含量显着上升(P<0.01),NE、DOPA含量明显降低(P<0.05或<0.01);A组与急性重复4次缺氧后饲养2d的实验对照组(D组)小鼠脑组织中儿茶酚胺类含量接近,没有统计学意义(P=23.77).结果提示脑组织中儿茶酚胺类物质可能参与急性重复缺氧小鼠的耐缺氧能力的形成,而且是一个可逆的快反应。     

对不同麻醉方法胃次全切除术中血糖、乳酸、总蛋白、血球压积的观察

对比观察硬膜外麻醉与七氟醚为主的静吸复合全麻胃次全切除术中血糖、乳酸、总蛋白、血球压积等指标的变化.结果表明:血糖在硬膜外麻醉后90min较麻醉前非常显着升高(P<0.01),在静吸复合全麻45、90min较麻醉前均显着升高,尤以90min为着(P<0.01).乳酸在硬膜外麻醉后45、90min较麻醉前显着升高(P<0.05),静吸复合全麻后45、90min较麻醉前均有非常显着升高(P<0.001).总蛋白、血球压积在硬膜外麻醉与静吸复合全麻前、后45、90min均无明显变化.     

星状神经节阻滞稳定全麻气管内插管及切皮时应激反应的初步研究

为观察应用星状神经节阻滞(SGB)后全麻诱导气管内插管及手术切皮时内分泌的变化,将神经外科择期手术病人按麻醉方法的不同,分为阻滞组(S组,n=14,于麻醉诱导前5min行左SGB)与对照组(N组,n=14)进行对比观察。测量入室(t₀)、气管插管后1min(t₁)、手术开始切皮(t₂)3个时间的血浆皮质醇(COR)、催乳素(PRL)和胰岛素(INS)浓度以及收缩压(SBP)、舒张压(DBP)和心率(HR).结果：S组3个时间的COR及PRL呈下降趋势、INS呈上升趋势;N组3个时间的COR及PRL呈上升趋势、INS呈下降趋势;且SBP、HR、COR和PRL组内差比较均为N组>S组(P<0.05和P<0.01).显示SGB后诱导气管内插管及切皮时的SBP、HR及COR、PRL和INS变化相对较小。提示全麻诱导前行SGB具有抑制气管内插管及手术切皮时应激反应和稳定血流动力学的作用。     

Characteristics of pulmonary inflammation in combined pulmonary fibrosis and emphysema

Background  The condition of concomitant upper lobe emphysema and lower lobe fibrosis as identified by computer tomography is known as combined pulmonary fibrosis and emphysema (CPFE). CPFE has distinct clinical characteristics compared with emphysema alone (EA) and idiopathic pulmonary fibrosis (IPF) without emphysema. However, the pulmonary inflammation characteristics of CPFE are not well known, and the differences between CPFE and the other two diseases with regards to pulmonary inflammation need to be explored. The pulmonary inflammatory characteristics were investigated in CPFE patients and compared with EA and IPF.

Methods  Fraction exhaled nitric oxide (Fe,NO) and differential cell counts, the concentrations of monokine induced by interferon gamma (MIG/CXCL9), interferon-inducible protein 10 (IP-10/CXCL10), and interferon-inducible T cell alpha chemoattractant (I-TAC/CXCL11) were measured in induced sputum obtained from subjects with CPFE (n=22), EA (n=22), IPF (n=14), and healthy volunteers (HV, n=12). In addition, immunohistochemistry was used to quantify the expression of nitric oxide synthases in alveolar macrophages in 23 lung tissues from patients and control subjects.

Results  The CPFE group had higher alveolar NO than subjects in the EA and HV groups (P=0.009, P=0.001, respectively) but not than the IPF group (P >0.05). Numbers of sputum eosinophils were significantly elevated in CPFE and IPF groups compared with the HV group (P=0.001, P=0.008). In contrast, eosinophil counts in EA group did not differ from those in the HV group. Compared with the EA and HV groups, the CPFE group had a lower concentration of I-TAC/CXCL11 in sputum supernatants (P=0.003, P=0.004). Immunoreactivity for inducible nitric oxide synthase (iNOS) was higher in the CPFE group than in the EA group (P=0.018).

Conclusions  The pulmonary inflammation of CPFE group is more similar to IPF group, while the distal airway inflammation is more significant in CPFE and IPF groups than in EA group. Lung eosinophil cell infiltration and high NOS expression in alveolar macrophage might participate in this pathogenesis.

     

Predictors to assess non-sentinel lymph node status in breast cancer patients with only one sentinel lymph node metastasis

Background  The purpose of this study was to investigate the feasibility of avoiding axillary lymph node dissection (ALND) for patients with only one sentinel lymph node (SLN) metastasis. The characteristics and predictive factors for non-sentinel lymph node (NSLN) metastasis of patients with single positive SLN were also analyzed.

Methods  Patients with no and only one SLN metastasis (0/n and 1/n group, n ³2) were selected from 1228 cases of invasive breast carcinoma, who underwent axillary dissection in Shandong Cancer Hospital between November 1999 and December 2011, to compare the characteristics of NSLN metastasis between them. For the 1/n group, the factors that influenced the NSLN metastasis were analyzed by univariate and multivariate analysis.

Results  Differences of the NSLN metastasis between the 0/n and the 1/n groups were significant (P <0.001). There was no significant difference between the axillary lymph node metastasis on level III in 1/n group and 0/n group (P=0.570). When the total SLN number was ≥4 and with one positive case, the NSLN metastasis was not significantly different from that in the 0/n group (P=0.118). In the 1/n group, clinical tumor size (P = 0.012), over-expression of Her-2 (P=0.003), tumor grade (P=0.018) and the total number of SLN (P=0.047) significantly correlated with non-SLN metastasis. Clinical tumor size (P=0.015) and the expression of Her-2 (P=0.01) were independent predictive factors for non-SLN metastasis by the Logistic regression model.

Conclusion  Under certain conditions, breast cancer patients with single SLN metastasis could avoid ALND.

     

Prognostic factors of retroperitoneal soft tissue sarcomas: analysis of 132 cases

Background  Retroperitoneal sarcoma is a rare disease with poor prognosis. The aim of this study was to investigate the prognostic factors of the disease.
Methods  Between January 1988 and December 2003, 132 patients with retroperitoneal sarcoma were surgically treated in our hospital, 79 of them were followed up for 1−122 months (median: 19 months). Their clinicopathological data including tumor size, histological subtype, grade and resection margin status, were studied. The Kaplan-Meier method and log-rank test were used to analyze the disease-specific survival rates after the resection.
Results  Among the 132 patients, 98 (74.2%) received macroscopic complete resection, 29 (22.0%) incomplete resection, and 5 (3.8%) surgical biopsy. In the 79 patients who were followed up, macroscopic clear resection of retroperitoneal sarcoma (n=49) was associated with a significantly higher survival rate compared with unclear resection (n=30, P< 0.001). The median survival period was 31 months (95%CI, 20.09−41.91; actuarial 1-year survival, 85.7%) in the patients with the tumor completely resected and 11 months (95%CI, 6.71−15.29; actuarial 1-year survival, 46.7%) in those with incomplete resection. Patients with high-grade sarcomas had a significantly shorter survival time (n=39; median: 24, 95%CI: 5.71−42.29) than those with low-grade sarcomas (n=40; median: 15; 95%CI: 8.80−21.20; P<0.01). Moreover, compared with the patients with the tumor sized <15 cm in diameter (n=53), the survival rate was lower in those with a sarcoma sized >15 cm (n=26). (Median: 12, 95%CI: 8.26−15.74 vs median: 24, 95%CI: 17.25−30.75; P< 0.05). Furthermore, the survival of the patients with liposarcomas (n=29, median: 29, 95%CI: 12.84−45.16), leiomyosarcomas (n=14, median: 11, 95%CI: 6.11−15.89), and others (n=36, median: 22, 95%CI: 14.95−29.05) varied significantly (P<0.05).
Conclusion  Completeness of resection, tumor volume, grade, and subtype are prognostic factors of retroperitoneal soft tissue sarcomas.

     

Early and long-term results of combined cardiac surgery and neoplastic resection in patients with concomitant severe heart disease and neoplasms

Background  It is a surgical dilemma when patients present with both severe heart disease and neoplasms. The best surgical treatment remains controversial. This study aimed to analyze the early and long-term results of simultaneous surgical treatment of severe heart disease and neoplasms.

Methods  We reviewed the clinical records of 15 patients who underwent simultaneous neoplastic resection and cardiac surgery between September 2006 and January 2011. There were 5 male and 10 female patients. The mean age was (59.2±12.5) years and the mean left ventricular ejection fraction was (57.4±11.0)%. All patients were followed up completely for a period of 12 to 51 months (mean, (33.1±11.2) months).

Results  Fifteen patients underwent simultaneous cardiac surgery and neoplastic resection. Cardiac procedures consisted of off pump coronary artery bypass grafting (n=7), aortic valve replacement (n=3), mitral valve replacement (n=3), mitral valve replacement with coronary artery bypass grafting (n=1) and left atrial myxoma resection (n=1). Neoplastic resection consisted of lung cancer resection (n=5), colonic cancer resection (n=3), gallbladder resection (n=1), colonic cancer resection with gallbladder resection (n=1), hysterectomy (n=2), hysterectomy with bilateral salpingo-oophorectomy (n=2) and left ovariectomy (n=1). Pathological examination confirmed malignant disease in 10 patients and benign disease in 5 patients. There were no perioperative myocardial infarctions, stroke, pericardial tamponade, renal failure or hospital deaths. The most frequent complications were atrial fibrillation (33.3%), pneumonia (26.7%), low cardiac output syndrome (6.7%) and delayed healing of surgical wounds (6.7%). There was 1 late death 42 months after surgery for recurrent malignant disease. At 1 and 3 years, survival rates were 100% (Kaplan-Meier method).

Conclusions  Simultaneous cardiac surgery and neoplastic resection was not associated with increased early or late morbidity or mortality. Cardiopulmonary bypass does not appear to adversely affect survival in patients with malignant disease. The long-term survival was determined by tumor stage.

     

“花鼓操”对老年2型糖尿病的疗效研究

目的:研究规律“花鼓操”有氧运动对老年2型糖尿病的疗效。方法:随机将40例受试者分为干预组和对照组, 2组均维持药物治疗和饮食控制不变, 干预组受试者采用有氧运动处方“花鼓操”训练12周(每周运动3次, 有氧运动强度为50%~70%最大心率, 每次50~60 min)进行运动干预, 对照组则不进行任何形式的体育锻炼。结果:干预组干预后空腹血糖、胆固醇、低密度脂蛋白与上臂、腹部、肩胛、皮脂厚度及腰围、臀围和体质量指数降低程度均明显高于对照组(P<0.01)。结论:采用“花鼓操”运动干预是一种简便易行、安全有效防治2型糖尿病的临床辅助疗法, 应在城乡社区大力提倡和推广“花鼓操”有氧运动疗法, 以提高2型糖尿病老年患者的生命质量。     

褪黑素对大鼠重症急性胰腺炎肾脏损伤的保护作用及机制研究

目的:探讨褪黑素(melatonin,MT)在大鼠重症急性胰腺炎相关肾脏损伤发病机制中的作用。方法:90只雌性SD大鼠随机分为正常对照组、胰腺炎组、褪黑素组,各组按12、24、48h随机分配10只。采用5%牛磺胆酸钠逆行胰胆管注射的方法,复制大鼠重症急性胰腺炎相关肾脏损伤模型。用全自动生化分析仪测定大鼠血清淀粉酶,肌酐(Cr);用硫代巴比妥法测定MDA含量,黄嘌呤氧化酶法测定SOD活力;原位末端标记法(TUNEL)检测肾脏细胞凋亡率。结果:造模后各组大鼠血清淀粉酶,肌酐,MDA含量和肾脏细胞凋亡率逐渐升高,SOD活力降低;褪黑素干预后各组大鼠血清淀粉酶,肌酐,MDA含量和肾脏细胞凋亡率逐渐降低,SOD活力增加。结论:大鼠重症急性胰腺炎相关肾损伤发病过程可能与脂质过氧化引起肾脏细胞凋亡有关,褪黑素可能通过抗氧化作用对肾脏损伤起保护作用。     

有氧运动对衰老大鼠血清中抗氧化酶和过氧化脂质的影响

目的:研究有氧运动对衰老大鼠血清中抗氧化酶和过氧化脂质的影响.方法:建立衰老大鼠模型,随机分为对照组和三组运动组,运动组分别给予每天0.5 ,1,2 h游泳训练,12周后检测血清中超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-px)、过氧化氢酶(CAT)、丙二醛(MDA)、过氧化氢(H2O2)含量.结果:三组运动组的GSH-px含量明显大于对照组(P＜0.01),各运动组间均有明显差异性,1 h运动组高于其他两组;0.5 h运动组的CAT含量明显大于对照组(P＜0.05);三组运动组的MDA含量明显小于对照组(P＜0.01);SOD,H2O2含量四组间没有明显差异性.结论:长期有氧运动训练可以增强抗氧化酶系统对氧自由基清除能力,减少对机体的氧化损害,以中低强度运动较为适宜.     

有氧运动对老年男性单纯性肥胖患者血流动力学和运动能力的改善作用

目的：观察12周低强度有氧运动对老年男性单纯性肥胖患者身体成分、血流动力学参数和运动能力的作用,为特异性运动康复方案的制定提供依据。方法：将46例老年男性单纯性肥胖患者按主观意愿分为对照组（n=19）和运动组（n=27）,对照组患者维持生活习惯不变,运动组则进行12周低强度有氧运动。实验前后分别测定各组患者安静时的心率和血压,体成分仪测定身体成分,利用症状限制性递增负荷运动实验测定最大摄氧量（VO_2max）、最大功率（MP）和力竭时间（ET）,并描绘运动过程中的心率曲线和血压曲线。结果：与实验前比较,实验后运动组患者脂肪质量、体脂百分比、安静心率和血压下降（P < 0.05）,VO_2max、MP和ET增加（P < 0.05）,递增负荷运动实验中心率曲线和血压曲线发生右移;对照组各指标均无明显改变（P > 0.05）。实验后,与对照组比较,运动组安静心率和血压、脂肪质量和体脂百分比均明显降低（P < 0.05）,VO_2max、MP和ET升高（P < 0.05）。结论：12周低强度有氧运动能够改善老年男性单纯性肥胖患者血液动力学异常,下调脂肪含量,增强运动能力。     

运动疗法改善慢性阻塞性肺疾病患者的生活质量和肺功能

目的:探讨运动疗法对中重度慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者生活质量和肺功能的影响.方法:选取中重度COPD稳定期住院患者122例,随机分为试验组62人和对照组60人,2组在进行常规治疗基础上,试验组进行呼吸肌运动疗法和有氧运动疗法1年,对照组未...     

8周有氧运动对肥胖青少年动态血压和运动能力的影响

目的观察8周有氧运动对肥胖青少年动态血压（ABP）和运动能力的影响,为制定特异性的运动处方提供依据。方法 52例肥胖青少年（BMI≥25）随机分为运动组和对照组。运动组进行每周5次,每次持续50~60 min,共8周的有氧运动,对照组保持日常生活习惯。分别于治疗前后测定2组受试者的身体形态学指标包括身高、体质量、身体质量指数（BMI）和身体成分,诊室血压包括诊室收缩压（SBP）和诊室舒张压（DBP）,动态血压指标包括日间ABP（dSBP和dDBP）、夜间ABP（nSBP和nDBP）和24h ABP（24 h SBP和24 h DBP）,利用递增负荷功率车实验测定运动能力指标包括最大摄氧量（VO2max）、最大功率和力竭时间。结果实验后,组内比较,运动组脂肪重量（FM）、体脂百分比（BF%）、24 h SBP、24 h DBP、dSBP和dDBP下降（P〈0.01）,诊室SBP、诊室DBP、nSBP和nDBP无统计学意义（P〉0.05）,VO2max、最大功率和力竭时间增加（P〈0.01）,对照组所有参数与治疗前比较均无统计学意义（P〉0.05）。实验后,组间比较,运动组FM、BF%、24 h SBP、24 h DBP、dSBP和dDBP均低于对照组（P〈0.01）,VO2max、最大功率和力竭时间均高于对照组（P〈0.01）。结论8周有氧运动可有效降低肥胖青少年ABP水平并提高其运动能力。     

地黄饮子对运动性疲劳小鼠运动能力的影响

目的 探讨地黄饮子对运动性疲劳小鼠运动能力的影响.方法 将昆明小鼠30只随机分为安静对照组(安静组)、疲劳模型组(模型组)和地黄饮子组,每组10只.采用游泳训练方式建立小鼠疲劳模型.常规饲料喂养外,地黄饮子组给予地黄饮子水煎液灌胃,安静组和模型组给予蒸馏水灌胃,连续给药28 d.ELISA法检测血尿素氮、睾酮、皮质醇含...     

8周有氧耐力运动对正常和肥胖大鼠摄食量、身体成分和血脂的影响

目的 探讨8周有氧耐力运动对体质量正常和肥胖大鼠摄食量、身体成分和血脂影响的差异性.方法 采用高脂饮食建立营养性肥胖大鼠模型,然后将肥胖模型大鼠随机分为肥胖安静组（OC组）和肥胖运动组（OE组）,另设普通饲料安静组（NC组）和普通饲料运动组（NE组）,运动组进行8周有氧耐力运动.整个实验过程中每日计算摄食量,运动干预结束后,应用双能X线骨密度仪测量大鼠身体成分,全自动生化分析仪检测血脂.结果 1）NE组第1、4、7周的摄食量均显著低于NC组（P＜0.05）;OE组第1、2、3、4、6、8周的摄食量均显著低于OC组（P＜0.05）.2）与OC组比较,OE组全身脂肪组织量和全身脂肪百分比均显著下降（P＜0.05）,但NE和NC组间均无显著差异（P＞0.05）.3）OE组全身肌肉组织量和全身肌肉百分比均显著高于OC组（P＜0.05）,但NE和NC组间均无显著差异（P＞0.05）.4）NE组全身骨密度显著高于NC组（P＜0.05）,但OE和OC组间无显著差异（P＞0.05）.5）OE组血清TG水平显著低于OC组（P＜0.05）,但NE和NC组间无显著差异（P＞0.05）.结论 相同强度的有氧耐力运动对体质量正常和肥胖大鼠的摄食量、脂肪组织量、肌肉组织量、全身骨密度以及血清TG水平的影响存在差异性.     

热量限制对C57小鼠糖脂代谢的影响

目的探讨热量限制(caloric restriction,CR)对小鼠体质量、血糖和血清胆固醇的影响。方法雄性C57小鼠30只,随机分为3组:正常对照组、高能量组、低能量组,每组10只,每2周测体质量和血糖,喂养6个月后用ELISA方法检测小鼠血清总胆固醇。结果高能量组小鼠体质量较正常对照组明显上升(P<0.01),低能量组小鼠体质量较正常对照组明显下降(P<0.01);高能量组小鼠血糖较正常对照组明显上升(P<0.01),低能量组小鼠血糖较正常对照组明显下降(P<0.01);高能量组血清总胆固醇较正常对照组明显增高(P<0.01)。结论热量限制能明显降低小鼠体质量和血糖,高能量饮食明显增高小鼠体质量、血糖和血清总胆固醇水平,热量限制能够改善C57小鼠的糖脂代谢。