糖尿病烫伤大鼠胰岛素强化治疗对生长激素轴的影响

本实验将30只糖尿病烫伤大鼠随机分为胰岛素强化治疗组和常规治疗组，测定各组血清生长激素（GH）和胰岛素样生长因子Ⅰ（IGF-Ⅰ）浓度，并观察死亡率。结果表明，胰岛素强化治疗使血糖控制在3．9～5．6mmol／L，能明显改善糖尿病烫伤大鼠GH—IGF-I轴紊乱，并显著降低死亡率。     

人参皂苷素Rb1通过减轻氧化应激改善大鼠机械创伤诱发的迟发性心脏功能下降

目的 探讨人参皂苷素Rb1（GRb1）对大鼠机械创伤（MT）所致的迟发性心脏功能下降的保护作用。 方法 利用Nobel-Collip创伤仪制备大鼠MT模型,将大鼠随机分为假手术组（Sham）、创伤模型（MT+Vehicle,MT+V）组、创伤GRb1治疗（MT+GRb1）组,检测各组心脏功能、超氧化物歧化酶（SOD）以及丙二醛（MDA）含量的变化;分离培养大鼠乳鼠心肌细胞,将心肌细胞与各组大鼠血清孵育24 h并给予GRb1或超氧阴离子清除剂（TEMPOL）处理,分为对照（SS）组、创伤血清（TS）组、创伤血清+GRb1处理（TS+GRb1）组、创伤血清+TEMPOL处理（TS+TEMPOL）组,检测细胞存活率以及活性氧（ROS）、乳酸脱氢酶（LDH）和MDA含量的变化。 结果 与Sham组相比,MT后2 h大鼠心肌组织中SOD活性显著下降（P<0.01）、MDA水平升高（P<0.01）;MT后24 h心脏功能明显受损,表现为LVDP、±dP/dt_max均显著下降（P<0.01）。给予GRb1治疗可增强心肌组织中SOD活性（P<0.01）、降低MDA水平（P<0.01）,进而改善心脏功能（P<0.05）。对于离体分离培养的大鼠心肌细胞,创伤大鼠血清处理24 h显著增加细胞内ROS和MDA的含量（P<0.01）;利用TEMPOL或者GRb1处理均可减轻（P<0.05）创伤大鼠血清诱导的氧化应激并促进心肌细胞存活。 结论 GRb1通过减轻MT早期诱发的心肌细胞氧化应激保护心肌细胞,进而改善MT导致的迟发性心脏功能下降。     

低声压级水平次声对心肌梗死大鼠心功能的影响及机制

目的: 观察次声对心肌梗死大鼠心功能的影响及相关的机制。方法: 将30只SD大鼠随机分为3组,即假手术组（对照组）、心肌梗死组及次声治疗组,每组10只。采用次声治疗仪对心肌梗死大鼠进行治疗1周（2次/d,0.5 h/次）, 观察心肌细胞超微结构的改变,血浆NO和内皮素-1（ET-1）水平的变化以及大鼠心功能的变化。结果: 与心肌梗死组大鼠比较,次声治疗组大鼠心肌超微结构损伤减轻,血浆NO含量增加（P<0.01）,血浆ENT-1含量减少（P<0.01）,心功能明显改善（P<0.01）。结论: 低声压级水平次声治疗能够显著改善心肌梗死后大鼠心脏功能。     

高脂高糖饮食诱导胰岛素抵抗大鼠心脏功能和心肌Ⅰ型胶原改变及替米沙坦干预的影响

目的 探讨高脂高糖饮食诱导胰岛素抵抗大鼠心脏功能和心肌Ⅰ型胶原改变及替米沙坦干预后对其影响。方法 27只Wistar大鼠随机分为正常对照组(n=9只)、高脂高糖饮食组（n=18只）,高脂高糖饮食干预12周后确定胰岛素抵抗模型建立,将高脂高糖饮食组随机分为高脂高糖组（n=9只）和替米沙坦组（n=9只）。饮食干预34周后颈动脉插管测左室舒张末内压（LVEDP）、左室收缩压（LVSP）和左室内压最大下降速率（-dP/dtmax）。ELISA方法检测血浆中心肌Ⅰ型胶原代谢标志物Ⅰ型前胶原末端的前肽序列(PICP)和Ⅰ型胶原吡啶交联终肽(ICTP)的含量。心肌组织Masson染色进行心肌间质胶原定量分析。结果 与正常对照组比较,高脂高糖组大鼠LVEDP上升,-dP/dtmax下降(P<0.01),血浆PICP含量及PICP/ICTP升高(P<0.01),左室心肌胶原容积分数增高(P<0.01)。与高脂高糖组大鼠比较,替米沙坦组大鼠LVSP、LVEDP均显著下降(P<0.01),-dP/dtmax升高(P<0.05);血浆PICP含量、PICP/ICTP降低(P<0.05)。左室心肌胶原容积分数含量显著下降(P<0.01)。左室心肌组织胶原含量与胰岛素抵抗指数呈显著正相关(R=0.634,P<0.01),与-dp/dtmax呈显著负相关(P<0.01)。结论 胰岛素抵抗大鼠心肌Ⅰ型胶原合成增加,心肌间质胶原沉积增加,心脏舒张功能下降;替米沙坦可改善胰岛素抵抗,减少胰岛素抵抗大鼠心肌Ⅰ型胶原的合成,减少心肌间质胶原沉积,改善心脏舒张功能。     

褪黑素对2型糖尿病患者血管内皮功能的影响

目的:探讨褪黑素对2型糖尿病患者血管内皮功能的影响。方法:选择早期无大血管并发症的2型糖尿病患者60例,随机分为试药组和对照组各30例,对照组采用饮食、运动、胰岛素治疗,试药组加用褪黑素（MLT）胶囊6 mg,每晚口服,共治疗6个月。同期选择28例健康个体为正常对照组。治疗前后检测血压、空腹血糖（FPG）、餐后2 h血糖（2hPG）、糖化血红蛋白（HbA1c）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）,计算体质量指数（BMI）。用高分辨率超声检测、计算肱动脉血流介导的内皮依赖性血管舒张功能(FMD)和硝酸甘油介导的内皮非依赖性血管舒张功能(NMD)。结果:①与正常对照组比较,糖尿病组治疗前FPG、2hPG、HbA1c、TG、LDL-C明显增高(均P<0.01),HDL-C明显降低(P<0.05)。 治疗半年后糖尿病组TG、LDL-C略下降,BMI、HDL C略升高但均无统计学差异,FBG、2hPG、HbA1c无明显变化。②与正常对照组比较, 糖尿病组治疗前肱动脉基础内径、NMD无显著差异,FMD明显降低（均P<0.01）。治疗半年后糖尿病各组肱动脉基础内径、NMD无明显变化;FMD明显升高（P<0.05或P<0.01）,试药组FMD明显高于对照组（P<0.05）。结论:2型糖尿病患者早期出现血管内皮舒张功能降低,褪黑素明显改善2型糖尿病早期患者受损血管内皮功能。     

糖尿病血管成形术鼠模型的构建

目的 探讨用大鼠作为糖尿病血管成形术模型的可行性及小剂量胰岛素对其成功率的影响。方法 大鼠被链脲佐菌素腹腔内注射形成糖尿病模型后随机分成三组:A组（血管成形术组）、AI组（血管成形术+胰岛素组）,C组（对照组）,每组10只。观察各组血糖、体重、死亡率变化。术后14 d处死大鼠并取其胸主动脉测定内膜面积、内膜/中膜面积。结果 三组间血糖及体重差异无显著性（P>0.05）;A组死亡率显著高于AI组（P<0.01）;AI组内膜面积、内膜/中膜面积与A组相比无显著性差异（P>0.05）。结论 大鼠适宜作为糖尿病血管成形术模型,但小剂量胰岛素的应用是此模型成功的保证。     

瑞格列奈与二甲双胍联合治疗对2型糖尿病胰岛素早期分泌时相的影响

目的　观察瑞格列奈与二甲双胍联合治疗对 2型糖尿病 (T2 DM)早期胰岛素分泌相的影响。方法　 71例初诊 T2 DM病人 ,分为单纯口服瑞格列奈治疗组 38例 ;瑞格列奈和盐酸二甲双胍联合治疗强化组 33例。比较治疗前后两组各自空腹血糖、餐后 2 h血糖变化及餐后 1 h、2 h血浆胰岛素的变化。结果　治疗组餐后 2 h血糖治疗前后有明显下降 (P<0 .0 5) ,餐后 1 h血浆胰岛素明显升高 (P<0 .0 5)。强化组空腹血糖、餐后 2h血糖明显下降 (P<0 .0 5,P<0 .0 1 ) ;餐后 1 h血浆胰岛素显著升高 (P<0 .0 1 ) ,餐后 2 h血浆胰岛素降低 ,餐后 2 h血浆胰岛素显著低于餐后 1 h血浆胰岛素 (P<0 .0 5)。结论　瑞格列奈可改善胰岛素早期分泌时相 ,但恢复时相峰值困难。瑞格列奈与二甲双胍联合治疗可使 T2 DM胰岛素早期分泌相恢复 ,餐后血糖控制良好     

胰岛素治疗对心肌梗死大鼠胶原重构的影响

目的:研究观察胰岛素治疗对心肌梗死大鼠（myocardial infarction,MI）胶原重构的影响。方法:成年雄性SD大鼠34只,随机分为3组,即假手术(Sham)组（n=6）、生理盐水(NS)对照组（n=14）及胰岛素(ISL)治疗组［n=14,缺血20 min后,通过尾静脉以4 ml/(kg·h)的速率输入50 U/L ISL 2 h,并在缺血后1周内,每日皮下注射0.5 U/ml胰岛素1 ml/kg体质量］。分别于术后1周和4周,行心脏超声心动图(UCG)监测左室射血分数（LVEF）,用氯胺T法检测心肌组织中羟脯氨酸（Hyp）的含量,用Western blot检测Ⅰ型胶原和Ⅲ型胶原蛋白的表达。结果:术后1周和4周时,对照组的LVEF值较Sham相比明显降低（P<0.01）,而ISL治疗组与对照组相比,LVEF显著升高（P<0.05,P<0.01）。与Sham组相比,对照组心肌胶原的含量升高,ISL治疗组可使胶原的含量显著降低（P<0.05）。1周时,对照组的心肌Ⅰ/Ⅲ型胶原的比值增加,经ISL治疗后,Ⅰ/Ⅲ型胶原的比值明显下降（P<0.05）;4周时,对照组Ⅰ/Ⅲ型胶原的比值增加,而给予ISL治疗后Ⅰ/Ⅲ型胶原的比值无明显差异。结论:MI后大鼠心肌非梗死区组织出现胶原重构,ISL可影响该过程中心肌Ⅰ/Ⅲ型胶原的比值,从而起到改善心脏功能的作用。     

NLRP3炎症小体在大鼠严重烫伤早期心肌内的表达及意义

目的 探讨严重烫伤大鼠早期心肌组织内NLRP3炎症小体信号通路的表达及意义。方法 采用大鼠95℃热水浴18 s,制成40%总体表面积Ⅲ度烫伤模型,将24只健康雄性SD大鼠按随机数表法分为对照组、烫伤组、干预组。烫伤组大鼠立即腹腔注射10 ml生理盐水补液;干预组大鼠注射10 ml生理盐水+(BAY11-7082) 10 μl(0.2 mg/ml,10 mg/kg);对照组动物背部置于25℃温水浴18 s模拟烫伤过程。伤后8 h分别取各组大鼠心肌组织及血清,采用蛋白免疫印迹法和实时荧光定量RT-PCR法检测心肌组织中NLRP3、半胱氨酸天冬氨酸蛋白酶（caspase）-1蛋白表达水平和NLRP3、caspase-1、IL-1β、TNF-α mRNA表达水平,同时观察HE染色组织大体形态,酶联免疫吸附试验法检测血清肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）含量。结果 ①烫伤组大鼠心肌组织内NLRP3、caspase-1蛋白表达量显著高于对照组（P<0.01）;与烫伤组比较,干预组大鼠心肌组织内NLRP3、caspase-1明显降低（P<0.01）;②烫伤组大鼠心肌组织中NLRP3、caspase-1、IL-1β和TNF-α的mRNA表达量分别为3.15±0.46,2.47±0.24,3.26±0.22和2.17±0.32,显著高于对照组的1.00±0.09,1.00±0.06,1.00±0.08和1.00±0.07（均P<0.01）;干预组大鼠心肌组织中NLRP3、caspase-1、IL-1β和TNF-α的mRNA表达量分别为1.68±0.37,1.55±0.17,1.21±0.15和1.38±0.23,显著低于烫伤组（均P<0.01）;③对照组大鼠心肌组织呈不规则圆柱形、排列整齐、横纹清晰,结构完整。烫伤组大鼠部分心肌纤维排列紊乱,细胞和间质可见水肿,见点片状溶解灶及炎性细胞浸润。BAY11-7082干预组部分心肌纤维排列紊乱,心肌细胞和间质水肿、心肌纤维溶解及炎细胞浸润程度均较烫伤组减轻;④烫伤组大鼠血清CK-MB、LDH含量分别为(2753±825)U/L,(2618±238)U/L,显著高于对照组的(247±76)U/L,(721±59)U/L（均P<0.01）;干预组大鼠血清CK-MB、LDH含量分别为(1267±248)U/L,(1982±183)U/L,显著低于单纯烫伤组（均P<0.01）。结论 NLRP3炎症小体在严重烫伤大鼠早期心肌组织内活性增高,使用BAY11-7082干预后,可抑制NLRP3炎症小体的活化,减轻心肌组织损伤,降低心肌炎症反应。     

体外反搏对代谢综合征患者血管内皮功能的影响

目的探讨体外反搏对代谢综合征(MS)患者血管内皮功能及胰岛素抵抗的影响及其作用机制。方法MS患者50例随机分为两组,增强型体外反搏(EECP)组20例,对照组30例。两组均进行健康教育,血压不低于150/95mmHg的患者给予贝那普利治疗,在此基础上,EECP组给予1h/d,共36h的体外反搏治疗。两组治疗前后测定血压、空腹血糖、血脂、胰岛素、胰岛素敏感指数(ISI)及肱动脉血管内皮依赖性舒张功能。结果两组治疗后内皮依赖性舒张功能均有改善(P<0.01),但EECP组改善更明显(Z=-3.743,P<0.01);EECP组患者治疗后空腹血糖、血清胰岛素水平明显下降(P<0.01),ISI明显升高(P<0.01),血脂代谢紊乱改善,甘油三酯降低(P<0.01),高密度脂蛋白胆固醇升高(P<0.05)。结论体外反搏通过提高血流切应力,可明显改善MS患者血管内皮依赖性舒张功能,改善胰岛素抵抗,为体外反搏的临床应用提供进一步的理论依据。     

GLP-1 Improves Diastolic Function and Survival in Heart Failure with Preserved Ejection Fraction

Heart failure with preserved ejection fraction (HFpEF) has emerged as a public health burden with currently no effective medication. We assessed the treatment effects of the incretin hormone glucagon-like peptide-1 (GLP-1) on cardiac metabolism and function in a model of HFpEF. Following aortic banding, rats developed HFpEF characterized by diastolic dysfunction, pulmonary congestion, and poor survival (38%). A 4-week GLP-1 treatment via osmotic pumps significantly improved survival (70%) and reduced left ventricular stiffness, diastolic dysfunction, and pulmonary congestion. Isolated heart perfusion revealed preserved cardiac glucose oxidation (GO) and a shift in cardiac substrate utilization towards GO. While GLP-1 may boost insulin secretion and responsiveness, the protective effects were not related to cardiac insulin action. GLP-1 improves diastolic function and survival in rats with HFpEF, which was associated with a cardiac substrate switch towards GO. The therapeutic role of GLP-1 in HFpEF is new and warrants further investigation.     

2型糖尿病运用早期胰岛素强化治疗的疗效及对患者血糖水平的影响分析

目的探究早期胰岛素强化治疗方案在2型糖尿病(T2DM)患者中的应用价值。方法选取2018年4月—2020年4月收治的108例T2DM患者进行回顾性分析,依据治疗方案的不同分为对照组(n=54)与观察组(n=54),对照组均采用阶梯式治疗,观察组则实施早期胰岛素强化治疗,对比两组患者治疗前后的血糖水平、胰岛功能、脂质代谢以及不良反应。结果观察组病例在治疗后的血糖水平[空腹血糖(FPG)、餐后2 h血糖(2 hPG)]明显低于对照组,差异有统计学意义(P<0.05);且观察组病例在治疗后的胰岛素分泌指数(HOMA-β)明显高于对照组,差异有统计学意义(P<0.05),而胰岛素抵抗指数(HOMA-IR)则明显低于对照组,差异有统计学意义(P<0.05);此外,观察组病例在治疗后的总胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)、高脂血症(TG)水平均明显低于对照组,差异有统计学意义(P<0.05);但两组病例在治疗过程中的不良反应发生率对比差异无统计学意义(P>0.05)。结论早期胰岛素强化治疗方案在T2DM患者的治疗中具有较高的可行性及安全性。     

胰岛素抵抗与2型糖尿病患者左室舒张功能的关系

目的:探讨胰岛素抵抗(IR)与2型糖尿病(DM)患者左室舒张功能的关系。方法:经彩色多普勒超声心动图及心电图或活动平板运动试验检查排除合并冠心病的65例2型DM患者,据彩色多普勒超声心动图检查结果将患者分成左室舒张功能减退组(A组,共30例)及左室舒张功能正常组(B组,共35例)。于空腹及75g葡萄糖粉负荷2小时分别检测血糖(BG)、血胰岛素(Ins)、C肽,计算胰岛素作用指数(IAI)。结果:显示两组在BG、Ins、Ins/C肽、IAI有统计学上显著差异(P<0.05～<0.01)。结论:左室舒张功能减退的2型DM患者存在IR。提示高BG、高Ins血症、IR可能参与2型DM患者心脏左室舒张功能减退的机制。     

Cardioprotective effects of metformin and vildagliptin in adult rats with insulin resistance induced by a high-fat diet

Insulin resistance has been shown to be associated with cardiac sympathovagal imbalance, myocardial dysfunction, and cardiac mitochondrial dysfunction. Whereas metformin is a widely used antidiabetic drug to improve insulin resistance, vildagliptin is a novel oral antidiabetic drug in a group of dipeptidyl peptidase-4 inhibitors in which its cardiac effect is unclear. This study aimed to determine the cardiovascular effects of metformin and vildagliptin in rats with insulin resistance induced by high-fat diet. Male Wistar rats were fed with either a normal diet or high-fat diet (n =24 each) for 12 wk. Rats in each group were divided into three subgroups to receive the vehicle, metformin (30 mg/kg, twice daily), or vildagliptin (3 mg/kg, once daily) for another 21 d. Heart rate variability (HRV), cardiac function, and cardiac mitochondrial function were determined and compared among these treatment groups. Rats exposed to a high-fat diet developed increased body weight, visceral fat, plasma insulin, cholesterol, oxidative stress, depressed HRV, and cardiac mitochondrial dysfunction. Metformin and vildagliptin did not alter body weight and plasma glucose levels but decreased the plasma insulin, total cholesterol, and oxidative stress levels. Although both metformin and vildagliptin attenuated the depressed HRV, cardiac dysfunction, and cardiac mitochondrial dysfunction, vildagliptin was more effective in this prevention. Furthermore, only vildagliptin prevented cardiac mitochondrial membrane depolarization caused by consumption of a high-fat diet. We concluded that vildagliptin is more effective in preventing cardiac sympathovagal imbalance and cardiac dysfunction, as well as cardiac mitochondrial dysfunction, than metformin in rats with insulin resistance induced by high-fat diet.     

Preservation of heart function in diabetic rats by the combined effects of muscle cell implantation and insulin therapy

BACKGROUND: Diabetic cardiomyopathy is a common cause of heart failure in diabetic patients, but current treatments do not directly improve ventricular function. Cell transplantation can prevent cardiac dilatation after injury, and may also prevent congestive heart failure in diabetic cardiomyopathy. AIM: This study evaluated the functional effects of smooth muscle cells (SMCs) implanted into the myocardium of insulin- and non insulin-treated diabetic rats. METHODS: Four weeks after streptozotocin infusion, adult Wistar rats were implanted with BrdU-labelled SMCs or culture media (N=12/group). Six rats in each group were also treated with insulin. Echocardiograms were performed at 0, 4 and 8 weeks after streptozotocin injection, and histology and heart function were evaluated at 4 weeks after implantation. RESULTS: Blood glucose levels decreased after insulin treatment. Among cell-injected rats, histology indicated that those that did not receive insulin retained fewer surviving BrdU+ SMCs, and a smaller volume of myocardial tissue positive for alpha-smooth muscle actin. Cardiac function was preserved in the insulin-treated groups relative to those that did not receive insulin. Among insulin-treated rats, the cell-injected group functioned better than the media-injected group. CONCLUSIONS: Diabetic cardiomyopathy is partially treatable with insulin; however, a combination of SMC transplantation and insulin treatment produced the best functional result. Cell transplantation may prevent the progression of diabetic cardiomyopathy in patients whose glucose levels are controlled with insulin.     

Effects of a 7-day infusion of glucose on insulin secretion in vivo and in vitro in ventromedial hypothalamic-lesioned obese rats

Excessive stimulation of insulin secretion may be one cause of the beta-cell dysfunction induced by hyperglycemia. We investigated a possible link between the prior endogenous hypersecretion of insulin and this dysfunction by performing a 7-day glucose infusion (50% wt/vol, 1.2 ml/h) on ventromedial hypothalamic VMH-lesioned hyperinsulinemic rats. Intravenous glucose tolerance tests (IVGTT 1.0 g/kg) revealed that a 3-day glucose infusion enhanced the insulin responses in both the sham- and VMH-lesioned rats compared with saline infusions. A similar 7-day glucose infusion enhanced the insulin response to glucose in sham-lesioned rats but not in VMH-lesioned rats. Batch-incubation of islets isolated from sham-lesioned rats showed an enhanced insulin response to glucose after 7 days of glucose treatment compared with the saline infusions. Conversely, the glucose infusion in VMH-lesioned rats markedly suppressed the in vitro insulin response. In sham- and VMH-lesioned rats, similar islet insulin contents were produced by saline and glucose treatments. Electron microscopy revealed that glucose infusions impaired the granule-releasing function of the beta-cells in VMH-lesioned rats, while insulin synthesis was accelerated in either group. These findings support the notion that excessive secretion is partly responsible for the beta-cell dysfunction induced by hyperglycemia without signs of exhaustion. Received: 13 June 1997 / Accepted in revised form: 14 November 1997     

White matter lesions are associated with the results of I-metaiodobenzylguanidine myocardial scintigraphy in type 2 diabetes mellitus patients

White matter lesions (WMLs) and cardiovascular autonomic dysfunction are associated with high mortality in type 2 diabetes mellitus patients. This preliminary study was therefore designed to test the hypothesis that WML is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetes mellitus patients without insulin treatment. Based on brain magnetic resonance imaging findings, 55 type 2 diabetes mellitus patients were divided into 2 groups: a WML-positive group (59 ± 5 years [mean ± SD], n = 21) and a WML-negative group (58 ± 6 years, n = 34). Cardiovascular autonomic function was assessed by baroreflex sensitivity, heart rate variability, plasma norepinephrine concentrations, and cardiac ¹²³I-metaiodobenzylguanidine (MIBG) scintigraphy. Baroreflex sensitivity was lower in the WML-positive group than in the WML-negative group (P < .01). Early and delayed ¹²³I-MIBG myocardial uptake values were lower (P < .005 and P < .001, respectively) and the percentage washout rate (WR) of ¹²³I-MIBG was higher (P < .0001) in the WML-positive group than in the WML-negative group. The fasting plasma glucose (P < .005) and insulin concentrations (P < .0001) and the homeostasis model assessment (HOMA) index values (P < .0001) were higher in the WML-positive group than in the WML-negative group. Multiple logistic regression analysis revealed that HOMA index and percentage WR of ¹²³I-MIBG were associated with WML patients. Our results suggested that WML was associated with depressed cardiovascular autonomic function and insulin resistance and that HOMA index and the percentage WR of ¹²³I-MIBG were independent associations for WML in Japanese patients with type 2 diabetes mellitus.     

肝移植大鼠肝窦内皮细胞细胞凋亡与移植肝肝细胞损害的关系

目的探讨冷保存肝移植大鼠肝窦内皮细胞（SEC）细胞凋亡与移植肝肝细胞损害的关系。方法雄性SD大鼠随机分为假手术组（n=6）、UW1h肝移植组（11=48）、UW12h肝移植组（n=48）。参照Kamada的方法行原位肝移植（OLT）。观察大鼠I68h存活率。分别于术后不同时相点采取血液及组织标本，检测血清丙氨酸氨基转移酶（ALT）及透明质酸（HA）水平；TUNEL法检测SEC凋亡，透射电镜观察细胞凋亡的形态学改变。结果UW12h组168h存活率为50％，显著低于UW1h组（F=6．39，P〈0．05）。UW12h组肝移植后血清ALT、HA水平明显高于UW1h组（F=3．99，P〈0．05；F=12．43，P〈0．05），两组大鼠ALT水平均于术后6h达高峰。UW12h组SEC凋亡指数（AI）明显高于UW1h组和假手术组（F值分别为63．58和86．58，P值均〈0．01），两组大鼠SEC的AI也于术后6h达高峰，与血中丙氨酸氨基转移酶（ALT）的高峰时相点一致。且两组大鼠SEC的AI均与ALT水平呈显著正相关（，值分别为1．0和0．962，P〈0．05）。结论SEC凋亡程度与移植肝肝细胞损害呈显著正相关，SEC凋亡是冷保存再灌注损伤的关锋环节。     

血糖及胰岛素水平对老年高血压患者左室舒张功能的影响

目的探讨血糖、胰岛素水平和肥胖对老年高血压患者左心舒张功能的影响。方法检测３６例健康老年人、２８例单纯肥胖者、３８例高血压及４２例高血压合并肥胖者的血糖、胰岛素及糖化血红蛋白浓度，４组中各有２０例做口服葡萄糖耐量及胰岛素释放试验；均行多普勒超声心动图检查。结果各组射血分数和心脏指数均正常。高血压组二尖瓣舒张早、晚期峰值比（Ｅ／Ａ）明显下降，等容舒张时间明显延长，以合并肥胖者尤为明显（均为Ｐ＜０００５）。Ｅ／Ａ值与空腹血糖相关（ｒ＝０６７，Ｐ＜０００５），与血清胰岛素及左室重量无关。结论肥胖及糖耐量异常可加重老年高血压患者左室舒张功能障碍