表达谱基因芯片筛选体外循环前后心肌细胞因子的变化

Objestive Systemic inflarmmation may be triggered by injury, hypothermia, ischemia-reperfusion and the contact of the blood with foreign body during cardiopulmonary bypass (CPB). To determine the application values of gene chip technique in the clinical practice and the study of cardiovascular stagery, as well as to provide clues to the study of inflammatory responess during CPB, microarry for gene expression profiles was used to identify the differences in the gene expression of myocardium between pre-and post- CPB. Methods Six adult patients who underwent CPB from March to May in 2003 were involved. Samples of right atrium were col- lected before and at immediate end of CPB. BD AtlasTM cDNA Expression Arrays was used to identify the differences in the gene ex- pression of cytokines. The results were compared with that of semi-quantative RT-PCR. Resellts The mean age of 6 patients (5 males and 1 female) was (32.67± 11.72) years. The baseline heart function was gradeⅡin 3 cases and grade Ⅲ in 3 other cases. The baseline left ventricular ejection fraction(LVEF)was (58.17±7.91)%. The mere duration was (91.67±43.88) minutes for CPB and was (58.67±43.46) minutes for aorta blocking. The minimum nasopharynx/rectal temperture was (29.37±1.90)℃/ (32.15±1.52)℃. Gene expression profiles of cytokines in the myocardium pre- and post-CPB were analysed successfully. The ex- pression of IL-6, IFN-γ,Wnt5a, TNFRSF1B, a member of tumor necrosis factor receptor superfamily, PIGF and MFNG in the myo- cardium were unpregulated after CPB. Conclusion Microarray technique is applicable in the study of cytokines changes dying CPB. cDNA microarray identified pleliminarily the differences in the gene expression between pre- and post-CPB. These genes may be in- valved in inflammation and other psthophysiological responses incuced by CPB. The myocardiym is probably one of the major sources of cytokines during CPB. Further study may be helpful in understanding the llngthe development of inflammation during CPB, and eventually, reducing the post-operative complications.     

保留冠状动脉的猪心螺旋形心室肌带的解剖

Objective Based on the Helical Ventricular Myocardial Band (HVMB) theory proposed by Torrent-Guasp,the ventricular myocardial hand extends from the root of the pulmonary artery to the root of the aorta with two helical coils.This new theory is considered as a revolutionary concept for further understanding the global, three-dimensional and functional architecture of the ven- tricular myocardium. No repot had described techniques for disecting HVMB while keepin～ the integrity of the coronmy artery sys- tern. We explored techniques for dissecting HVMB in swine.Methads 33 fresh swine hearts were randomly divided intoll groups, 3 bearts in each. 160% barium sulfate (type I)suspmmion was injected into the coronary artery system. The coronary arteries were li- gated. The strial tissue was removed following puuing the hearts in boiling water then cooling for several hours. The superficial coro- nary vessels and fat tissue around the atrio-ventricular taxi inter-ventricular sulcus we～'e preserved. Some branches of the left anterior descending artery, distal segment, of posterior descending branch, and middle and distal segment of obtuse marginal branches were mu- tilated appropriately. HVMB dissection was completed with fingers in accordnce with Torrent Guasp' s technique. Results A contin- ued bundle of muscle, originated at the root of pulmonary artery and ended at the root of aorta, was unwrapped along the major dire- tion of the cardiac muscle fiber in all of the 33 hearts with spating of the coronary artery. The swine hearts' ventricular myocandium was cumosed of two loops, with basal loop firm the root of the pulmonart artery to the anterior papillary muscle and apical from the beginning of the anterior papillary muscle to the root tithe aorta. Each loop consisted of two segments: the right segment-coincid- ing with the right ventricular free wall and the left segment-coinciding with the basal d the left ventricular free wall. Posterior papillary muscle, which belongs to the descendant segment, denmrcated the border between the descendent and the ascendant of the HVMB's apical loop. Conclusion Although controversies about the theory of the HVMB remain, we have dissected the HVMB in the swine hearts' ventricular myocardium successfully with sparing of the coronary artery systems. This dissection procedure provides technical information for the studies of associated diseases based on the theory of HVMB.     

深低温停循环时不同脑保护方法对海马区神经元凋亡的影响

目的 通过观察海马区神经元的损伤情况，探讨深低温停循环(DHCA)时中枢神经系统损伤的机制及其保护方法。方法 北京农业大学实验用小型猪16头，体重22～25kg。鼻咽温降至18℃时分别给予如下处理90min：DHCA(I组)，顺行脑灌注(ACP，Ⅱ组)，逆行脑灌注(RCP，Ⅲ组)，RCP 尼莫地平(Ⅳ组)。复温120min至鼻咽温36℃。取左侧海马头部制备细胞悬液，AnnexinV—FITC染色，应用流式细胞仪分析细胞凋亡情况。电镜观察细胞超微结构的变化。结果 正常细胞百分比I组明显低于其他3组，Ⅱ组明显高于Ⅲ组，Ⅱ组、Ⅲ组与IV组之间差异无显著性；早期凋亡细胞百分比I组明显高于其他3组，Ⅱ组明显低于Ⅲ组，Ⅱ组、Ⅲ组与Ⅳ组之间差异无显著性；坏死细胞百分比I组明显高于其他3组，而其他3组之间差异无显著性；死亡细胞百分比I组明显高于其他3组，而其他3组之间差异无显著性(显著性界值P=0．05)。结论 DHCA后神经元发生凋亡、坏死和死亡，是术后神经功能障碍的主要原因；ACP使细胞凋亡和死亡减少，神经元保护作用最佳；RCP亦能使细胞凋亡和死亡减少，但神经元保护作用次于ACP；尼莫地平部分抑制了Ca^2 内流，脑保护效果一般。     

基因芯片在心血管外科实验研究中的应用

生物芯片技术自20世纪90年代出现以来,已在基因测序、基因突变及多态性分析、基因表达及功能分析、文库筛选、新药开发以及病原体检测等方面进行了应用和探讨。1999年基因芯片技术应用于心血管系统的研究,在心血管外科及其相关领域,基因芯片技术的应用还不是很普遍。综述近几年基因芯片技术在心血管外科实验研究中应用的文献,观察其应用价值,介绍基因芯片在心血管外科的研究进展,对其主要内容简要总结、分析。基因芯片在心血管外科相关领域的成功应用,短时间、大范围地揭示了许多未知领域。基因芯片技术可更多地应用于心血管外科领域,可能为此领域的科研提供线索。     

还原型谷胱甘肽临床研究及应用进展

谷胱甘肽(glutat hione)广泛分布于人体肝、肾细胞和红细胞。由还原型谷胱甘肽(GSH)和氧化型谷胱甘肽(GSSG)组成,两种形式,可以互变,两者的正常比例约为100∶1。还原型谷胱甘肽、氧化型谷胱甘肽、谷胱甘肽氧化酶(GSH2Px)和谷胱甘肽还原酶(GSH2R)共同组成了谷胱甘肽氧化还原系统。     

深低温停循环时猪脑不同部位组织含水率的比较

目的通过观察猪脑不同部位组织的含水率,揭示深低温停循环(DHCA)对不同部位脑组织含水率的影响。方法采用北京农业大学实验用小型猪6头,体质量22～25kg,通过体外循环使鼻咽温降至18℃时给予DHCA处理90min。取左侧海马、额叶大脑皮质、小脑和延髓组织测湿质量,于110℃烘箱内干燥24h,测干质量,计算组织含水率。结果脑组织不同部位含水率不同,大脑皮质(81.81%±1.03%)和海马区(83.91%±1.80%)差异无统计学意义(P=0.078),二者明显高于延髓(74.67%±1.73%,P<0.01)和小脑(77.98%±0.66%,P<0.01);延髓含水率最低,与其他位置相比,差异有统计学意义(与小脑相比P=0.004)。结论由于组织结构的不同,DHCA时脑组织不同部位含水率不同,可能和术后神经精神并发症的发生及其类型有关。     

142名瓣膜置换病人用血状况初步总结

我国<献血法>的颁布与实施,对血液来源及应用有了新的要求.为此笔者总结了本院近几年瓣膜置换病人用血的初步经验,认为综合血液保护措施是解决此问题的一个好办法,现报道如下.     

表达谱基因芯片筛选体外循环前后心肌细胞因子的变化

Objestive Systemic inflarmmation may be triggered by injury, hypothermia, ischemia-reperfusion and the contact of the blood with foreign body during cardiopulmonary bypass (CPB). To determine the application values of gene chip technique in the clinical practice and the study of cardiovascular stagery, as well as to provide clues to the study of inflammatory responess during CPB, microarry for gene expression profiles was used to identify the differences in the gene expression of myocardium between pre-and post- CPB. Methods Six adult patients who underwent CPB from March to May in 2003 were involved. Samples of right atrium were col- lected before and at immediate end of CPB. BD AtlasTM cDNA Expression Arrays was used to identify the differences in the gene ex- pression of cytokines. The results were compared with that of semi-quantative RT-PCR. Resellts The mean age of 6 patients (5 males and 1 female) was (32.67± 11.72) years. The baseline heart function was gradeⅡin 3 cases and grade Ⅲ in 3 other cases. The baseline left ventricular ejection fraction(LVEF)was (58.17±7.91)%. The mere duration was (91.67±43.88) minutes for CPB and was (58.67±43.46) minutes for aorta blocking. The minimum nasopharynx/rectal temperture was (29.37±1.90)℃/ (32.15±1.52)℃. Gene expression profiles of cytokines in the myocardium pre- and post-CPB were analysed successfully. The ex- pression of IL-6, IFN-γ,Wnt5a, TNFRSF1B, a member of tumor necrosis factor receptor superfamily, PIGF and MFNG in the myo- cardium were unpregulated after CPB. Conclusion Microarray technique is applicable in the study of cytokines changes dying CPB. cDNA microarray identified pleliminarily the differences in the gene expression between pre- and post-CPB. These genes may be in- valved in inflammation and other psthophysiological responses incuced by CPB. The myocardiym is probably one of the major sources of cytokines during CPB. Further study may be helpful in understanding the llngthe development of inflammation during CPB, and eventually, reducing the post-operative complications.     

保留冠状动脉的猪心螺旋形心室肌带的解剖

Objective Based on the Helical Ventricular Myocardial Band (HVMB) theory proposed by Torrent-Guasp,the ventricular myocardial hand extends from the root of the pulmonary artery to the root of the aorta with two helical coils.This new theory is considered as a revolutionary concept for further understanding the global, three-dimensional and functional architecture of the ven- tricular myocardium. No repot had described techniques for disecting HVMB while keepin～ the integrity of the coronmy artery sys- tern. We explored techniques for dissecting HVMB in swine.Methads 33 fresh swine hearts were randomly divided intoll groups, 3 bearts in each. 160% barium sulfate (type I)suspmmion was injected into the coronary artery system. The coronary arteries were li- gated. The strial tissue was removed following puuing the hearts in boiling water then cooling for several hours. The superficial coro- nary vessels and fat tissue around the atrio-ventricular taxi inter-ventricular sulcus we～'e preserved. Some branches of the left anterior descending artery, distal segment, of posterior descending branch, and middle and distal segment of obtuse marginal branches were mu- tilated appropriately. HVMB dissection was completed with fingers in accordnce with Torrent Guasp' s technique. Results A contin- ued bundle of muscle, originated at the root of pulmonary artery and ended at the root of aorta, was unwrapped along the major dire- tion of the cardiac muscle fiber in all of the 33 hearts with spating of the coronary artery. The swine hearts' ventricular myocandium was cumosed of two loops, with basal loop firm the root of the pulmonart artery to the anterior papillary muscle and apical from the beginning of the anterior papillary muscle to the root tithe aorta. Each loop consisted of two segments: the right segment-coincid- ing with the right ventricular free wall and the left segment-coinciding with the basal d the left ventricular free wall. Posterior papillary muscle, which belongs to the descendant segment, denmrcated the border between the descendent and the ascendant of the HVMB's apical loop. Conclusion Although controversies about the theory of the HVMB remain, we have dissected the HVMB in the swine hearts' ventricular myocardium successfully with sparing of the coronary artery systems. This dissection procedure provides technical information for the studies of associated diseases based on the theory of HVMB.     

深低温停循环时不同脑保护方法对猪大脑组织含水率的影响

目的:观察试验用小型猪脑海马头部组织含水率,揭示深低温停循环时不同脑保护方法对脑水肿的影响。方法:①实验于1998-10/2000-02在解放军总医院动物实验中心完成。选用北京农业大学实验用小型猪16头。随机将猪分为4组:深低温停循环组,顺行脑灌注组,逆行脑灌注组,逆行脑灌注+尼莫地平组,每组4头。②鼻咽温降至18℃时分别给予如下处理90min:深低温停循环组通过上、下腔静脉放血至氧合器的静脉储血罐,冰袋敷头;顺行脑灌注组阻断降主动脉,通过主动脉弓灌注头臂三支血管,维持灌注压在50mmHg(1mmHg=0.133kPa)左右;逆行脑灌注组阻断降主动脉,结扎奇静脉,通过上腔静脉逆行灌注,维持灌注压在25mmHg左右;逆行脑灌注+尼莫地平组在体外循环开始10min内经氧合器的标本口加入尼莫地平注射液,其他操作同顺行脑灌注组。③复温120min至鼻咽温36℃。取左侧海马头部组织称湿质量,于110℃烘箱内干燥24h,测干质量,计算组织含水率。④多组比较采用单因素完全随机设计方差分析。结果:小型猪16只均进入结果分析。大脑组织含水率:逆行脑灌注组明显高于深低温停循环组、顺行脑灌注组和逆行脑灌注+尼莫地平组[(83.60±0.68)%,(81.52±1.16)%,(81.04±0.59)%,(80.92±0.74)%,F=9.22,P=0.0019],而深低温停循环组、顺行脑灌注组、逆行脑灌注+尼莫地平组间差异不明显(P>0.05)。结论:①逆行脑灌注加重深低温停循环后的脑水肿,脑水肿可能是深低温停循环后神经功能障碍的一原因。②尼莫地平在深低温停循环时有降低逆行脑灌注引起的脑水肿的作用。