MAPK信号途径在一氧化氮抑制大鼠心肌肥大中的作用

实验观察了一氧化氮（NO）前体L－精氨酸对肾性高血压大鼠心肌组织eNOS蛋白表达及亚硝酸盐／硝酸盐含量、MKP－1蛋白表达及MAPK活性的影响,以及与心肌肥厚的关系,采用两肾一夹Goldblatt肾性高血压模型,随机分为5组：L－精氨酸高、中、低剂量组,分别于术后第5周给予L－精氨酸50、150及450mg/kg;L－NAME组,腹腔注射L－NAME 10mg/kg,同时给予L－精氨酸150mg/kg;高血压对照组,正常饮水,以及另设的一假手术对照组。用药8周后,用插管法测量大鼠动脉血压、左心室重与体重比值,用胶内原位磷酸化法测MFAPK活性、免疫印迹法检测心肌组织eNOS及MKP－1蛋白表达、酶还原法测定心肌组织亚硝酸盐／硝酸盐－硝酸盐含量。结果表明：（1）L－精氨酸可明显抑制肾动脉狭窄术后的血压升高、左心室重与体重比增加,增加心肌组织eNOS、MKP-1蛋白表达及亚硝酸盐－硝酸盐含量,降低心肌组织MAPK活性,其中以150mg/kg组作用最为明显;（2）NOS抑制剂L－NAME可明显抑制－精氨酸的以上作用,肾性高血压大鼠心肌组织eNOS蛋白表达下降。NO生成减少及MKP－1蛋白表达下降以及MAPK活性增强可能与高血压及心肌厚形成有关,L－精氨酸通过促进心肌组织eNOS蛋白表达、增加NO产生和MKP－1表达、减弱MAPK活性而发挥抗高血压及心肌肥厚的作用。     

CO2气腹对老年急性阑尾炎患者术后炎症反应及免疫应激反应的影响

目的:研究CO_2气腹对老年急性阑尾炎患者术后炎症反应及免疫应激反应的影响,为临床治疗提供依据。方法:选取2015年1月到2016年3月我院收治的老年急性阑尾炎患者130例,按照随机数字表法将患者分为研究组和对照组,每组65例,对照组给予常规开腹阑尾炎切除术,研究组应用CO_2气腹下腹腔镜下阑尾炎切除术,比较两组术前、术后1天、3天和5天白细胞计数、中性粒细胞计数、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平。结果:术后1天两组白细胞计数、中性粒细胞计数、IL-10和TNF-α水平均明显升高,比较差异具有统计学意义(P0.05),研究组术后1天白细胞计数和中性粒细胞计数与对照组比较,差异无统计学意义(P0.05),研究组术后1天TNF-α和IL-10水平显著低于对照组,比较差异具有统计学意义(P0.05);术后3天、5天与术后1天相比,两组白细胞计数、中性粒细胞计数、IL-10和TNF-α水平均明显降低,术后3天与术前比较差异无统计学意义(P0.05),术后5天与术前比较差异具有统计学意义(P0.05),术后3天和5天研究组白细胞计数、中性粒细胞计数、IL-10和TNF-α均显著低于对照组,比较差异具有统计学意义(P0.05)。结论:CO_2气腹能有效降低急性阑尾炎患者术后炎症反应和免疫应激反应,改善患者预后。     

大肠埃希菌感染小鼠外周血中性粒细胞与 淋巴细胞比值的动态变化

目的通过观察大肠埃希菌感染小鼠模型不同时间段外周血中,中性粒细胞与淋巴细胞比值的动态变化,分析外周血中中性粒细胞/淋巴细胞比值与大肠埃希菌感染炎症程度的关系,以及中性粒细胞与淋巴细胞在大肠埃希菌感染时的可能作用机制。方法将麦氏浊度为2.73约为1×109CFU/m L大肠埃希菌通过尾静脉注射建立ICR小鼠感染模型44只、空白对照4只及阴性对照4只。实验组按1、3、6、12、24、48、72、96、120、144和168 h,共11个时间段,每次取4只小鼠,抽取外周血800μL,利用SYSMEX2100检查白细胞总数、中性粒细胞计数、淋巴细胞计数、中性粒细胞/淋巴细胞比值变化情况。结果大肠埃希菌ICR小鼠感染组1~24 h白细胞总数比对照组降低(0.01P0.05),第2天时与对照组比较差异无统计学意义,第3天至第7天白细胞总数比对照组高且差异有统计学意义(P0.01),并在第7天时略有回落;感染组中性粒细胞计数值在感染12 h到第7天比对照组高,差异有统计学意义;中性粒细胞/淋巴细胞比值对照组为0.06±0.03,感染1 h为0.07±0.04,与对照组比较差异无统计学意义(P0.05),3 h、6 h两组与对照组比较差异有统计学意义(0.01P0.05),12 h开始到第7天感染组与对照组比较差异有统计学意义,且第7天时为最高值(1.52±0.38)。结论中性粒细胞/淋巴细胞比值,比白细胞总数计数、中性粒细胞计数在大肠埃希ICR小鼠感染模型组中判断小鼠感染状况敏感,中性粒细胞/淋巴细胞比值结合白细胞总数计数、中性粒细胞计数能为临床大肠埃希菌感染的状况提供更灵敏的诊断参考数据,且易在临床推广。     

NO前体对高肺血流时肺动脉胱硫醚-γ-裂解酶基因表达的调节作用

目的：研究一氧化氮（NO）前体L-精氨酸（L—Arg）对高肺血流时肺动脉胱硫醚-γ-裂解酶（内源性硫化氢生成酶）的调节作用,以探讨NO体系对高肺血流肺动脉高压及肺血管结构重建调节作用的机制。方法：30只雄性SD大鼠随机分为对照组,分流组和分流＋L—Arg组。对后两组大鼠行腹主动脉-下腔静脉分流术。观察术后11周大鼠肺动脉平均压（mPAP）、右心室肥厚和肺动脉相对中膜面积的改变,用竞争逆转录聚合酶链反应（RT-PCR）对肺组织CSEmRNA表达进行定量分析,同时用化学法测定肺组织硫化氢产出率。结果：分流组大鼠mPAP及肺动脉相对中膜面积明显高于对照组（P〈0．01）,而分流＋L—Arg组大鼠mPAP及肺动脉相对中膜面积明显低于分流组（P〈0．01）。分流组CSEmRNA表达与对照组相比明显降低（P〈0．01）,而分流组＋L—Arg组CSEmRNA表达又明显高于分流组（P〈0．05）：分流组大鼠肺组织硫化氢产出率明显低于对照组（P〈0．01）,而分流组＋L—Arg组大鼠肺组织硫化氢产出率及血浆硫化氢含量明显高于分流组（P〈0．01）。结论：高肺血流可致肺动脉CSEmRNA下调,外源性NO能够缓解CSEmRNA的改变,从而对高肺血流所致肺血管结构重建和肺动脉高压起调节作用。     

内、外源性硫化氢在脂多糖所致大鼠急性肺损伤中的作用

目的：探讨内、外源性硫化氢（H2S）在脂多糖（LPS）所致大鼠急性肺损伤（ALI）中的作用并初探其机制。方法：将120只SD大鼠随机分为对照组、IPS组（经气管内滴注LPS复制ALI模型）、NaHS＋LPS组和炔丙基甘氨酸（PPG）＋LPS组。给药后4h或8h处死动物,测定肺系数;光镜观察肺组织形态学改变;化学法检测血浆H2S、NO和CO含量、肺组织丙二醛（MDA）含量、胱硫醚-γ-裂解酶（CSE）、诱导型一氧化氮合酶（iNOS）和血红素加氧酶（HO）活性以及支气管肺泡灌洗液（BALF）中中性粒细胞（PMN）数目和蛋白含量的变化;用免疫组织化学法检测肺组织iNOS、HO-1蛋白表达。再将血浆H2S含量与上述指标进行相关性分析。结果：气管内滴注LPS可引起肺组织明显的形态学改变;肺系数和肺组织MDA含量增加;BALF中PMN数目和蛋白含量增加;血浆H2S含量和肺组织CSE活性下降;肺组织iNOS活性、HO活性和iNOS蛋白表达、HO-1蛋白表达增强,血浆NO含量、CO含量增加。预先给予NaHS可显著减轻LPS所致上述指标的改变;而预先给予PIG可加重LPS所致肺损伤,使BALF中PMN数目和蛋白含量、血浆NO含量、肺组织iNOS活性和iNOS蛋白表达进一步增加,但对血浆CO含量、肺组织HO活性和HO-1蛋白表达无明显影响。HS含量与CSE活性、血浆CO含量、肺组织HO-1活性呈正相关（r值=0．945—0．987,P均〈0．01）;与其他指标呈负相关（r值=-0．994～-0．943,P均〈0．01）。结论：H2S／CSE体系的下调在LPS所致大鼠Ⅲ的发病学中有一定作用,内、外源性H2S具有抗LPS所致Au的作用,该作用可能与其抗氧化效应、减轻PMN所致肺过度的炎症反应以及下调NO／iNOS体系、上调CO／HO—1体系有一定关系。     

外源性硫化氢对大鼠内毒素性肺损伤的影响及机制研究

目的：应用H2S供体硫氢化钠（NaHS）,观察外源性H2S对中性粒细胞（PMN）在脂多糖（LPS）刺激大鼠肺内聚集的影响及其机制。方法：采用尾静脉注射致Sprague-Dawley（SD）大鼠内毒素急性肺损伤（ALI）模型,将大鼠随机分为4组（n=8～12）。对照组：由尾静脉注射无菌生理盐水（0.5ml/kg）;LPS组：由尾静脉注射LPS（1mg/kg）;LPS＋NaHS组：注射LPS前10min腹腔注射NaHS（28μmol/kg）;NaHS组：腹腔注射NaHS（28μmol/kg）。6h后光镜下观察各组大鼠肺组织学变化并计数肺泡间隔中PMN数目（number/HP）;脱氧核苷酸末端转移酶介导的原位末端标记技术（TUNEL）测定支气管肺泡灌洗液（BALF）中PMN凋亡百分率及应用Western blot检测肺组织细胞间黏附分子（ICAM）-1和核转录因子（NF）-κB表达的变化。结果：注射LPS后动物肺组织出现出血、水肿及PMN聚集等病理征象。LPS组大鼠肺组织中PMN数目较对照组显著增加,PMN凋亡百分率下降,ICAM-1、NF-κB表达显著增高;应用NaHS后每高倍镜PMN数目显著减少,PMN凋亡百分率明显增高,ICAM-1、NF-κB表达显著降低,肺组织损伤减轻。单独应用NaHS组大鼠上述各项指标与对照组大鼠相比无显著差异。结论：NaHS可减少PMN在肺内聚集,其机制与其抑制NF-κB通路,从而下调ICAM-1表达、促进PMN凋亡有关。     

体外循环患儿中性粒细胞自噬水平的变化及其对细胞存活的影响

为研究室间隔缺损修补术患儿体外循环(cardiopulmonary bypass, CPB)前后中性粒细胞自噬水平的变化,及其对细胞存活率的的影响,该研究以择期行CPB下室间隔缺损修补术的患儿12例为CPB组,超声引导下室间隔缺损外科微创封堵术患儿12例为对照(N-CPB组)。分别采集T0(麻醉诱导后)、T1(CPB后/封堵器置入成功后)血液标本5 mL,分离中性粒细胞,用Western blot检测自噬相关蛋白Beclin-1、LC3-II的表达。结果显示,与T0相比, CPB组T1时中性粒细胞Beclin-1、LC3-II表达明显升高(P0.05),而N-CPB组无明显变化;另以择期行CPB下室间隔缺损修补术的患儿6例为对象,于T0、T1时采集血液标本5 mL,分离中性粒细胞,分为对照组和3-MA(自噬抑制剂)组,分别于0、1、2、4、8 h经锥虫蓝染色检测存活率。结果显示,与T0比较,来自T1的中性粒细胞存活率在0、1 h时显著升高(P0.05);加入抑制剂三甲基腺嘌呤(3-methyladenine, 3-MA)后, T0和T1来源的中性粒细胞存活率均迅速降低(P0.05);与对照组比较, 3-MA组2、4、8 h时存活率显著降低(P0.05)。该研究表明, CPB使室间隔缺损修补术患儿中性粒细胞自噬水平升高,细胞存活时间延长,抑制自噬能缩短细胞存活时间。     

大鼠心肌线粒体L-Arg/ NO系统对线粒体Ca2+转运功能的影响

目的和方法采用大鼠心肌线粒体体外孵育的方法,观察线粒体L-精氨酸/一氧化氮系统对线粒体Ca2+转运功能的影响.结果NO生成的底物L-Arg (10-4 mol/L)、外源性NO供体硝普纳(5×10-7 mol/L)孵育的线粒体NO-2的生成量分别高于对照组66%、89% (P<0.01);钙含量较对照组分别低40%、54% (P<0.01); 线粒体Ca2+的摄入量较对照组分别减少67%、85%(P<0.01), 线粒体Ca2+释放率(11%、8%)降低与对照组(14%)相比差异显著(P<0.05、P<0.01).NO合酶抑制剂左旋硝基精氨酸甲酯(L-NAME, 10-4 mol/L)与相同浓度的L-Arg共同孵育的线粒体,明显抑制了L-Arg对线粒体的效应,与单纯L-Arg组比较,NO2生成减少,线粒体钙含量和反映线粒体45 Ca2+的摄入与释放能力都接近对照组水平.结论心肌线粒体L-精氨酸/一氧化氮系统参与了线粒体对心肌细胞Ca2+浓度的调节,其生理和病理生理意义值得进一步探讨.     

中性粒细胞mGluRI的激活促进其与内皮细胞相互黏附

本文旨在探讨I组代谢型谷氨酸受体(group I metabotropic glutamate receptor,mGluRI)在中性粒细胞上的表达,以及该受体的激活对中性粒细胞与内皮细胞相互黏附的影响。取健康人新鲜静脉血,Ficoll-Hypaque密度梯度离心法分离中性粒细胞,免疫细胞化学法和real-time PCR法检测中性粒细胞mGluRI(包括mGluR1和mGluR5)的表达,分别应用不同浓度的mGluRI特异性激动剂S-3,5-二羟基苯甘氨酸(S-3,5-dihydroxy-phenylglycine,S-DHPG)处理中性粒细胞不同时间,通过比色法检测中性粒细胞和人正常脐静脉内皮细胞(human normal umbilical vein endothelial cells,HUVE-12)黏附率,采用流式细胞术测定中性粒细胞黏附分子CD11a表达的变化。结果证实中性粒细胞表达mGluRI(mGluR1/5);S-DHPG在1×10-8~1×10-6mol/L浓度范围内呈剂量依赖性地提高中性粒细胞与内皮细胞之间的黏附率(P0.05或P0.01);1×10-6mol/L S-DHPG单独作用于中性粒细胞0.5h,即可促进中性粒细胞黏附于内皮细胞(P0.01),但没有时间依赖性;1×10-6mol/L S-DHPG单独作用于中性粒细胞可促进CD11a表达(P0.01);mGluRI拮抗剂(RS)-α-甲基-4-羧基苯甘氨酸[(RS)-α-methyl-4-carboxyphenylglycine,(±)-MCPG](0.5mmol/L)可以显著阻断激动剂S-DHPG(1×10-6mol/L,1h)的促黏附效应(P0.01)。上述结果证实了中性粒细胞膜上mGluRI的激活可增强中性粒细胞表面黏附分子CD11a的表达,促进中性粒细胞与内皮细胞的黏附。     

细胞粘附分子在中性粒细胞介导的缺氧／复氧心肌细胞损伤中的作用

目的观察缺氧/复氧对心肌细胞与中性粒细胞粘附效应的影响及细胞间粘附分子-1(intercellularadhensionmolecule-1,ICAM-1)和淋巴细胞功能相关抗原-1(lymphocytefunctionassociatedantigen-1,LFA-1)在中性粒细胞介导的心肌细胞损伤的作用。方法计数不同实验条件下与心肌细胞粘附的中性粒细胞;以及抗ICAM-1单抗和抗LFA-1单抗阻断后中性粒细胞粘附数的改变,检测心肌细胞乳酸脱氢酶释放量。结果中性粒细胞与缺氧/复氧心肌细胞粘附数较缺氧组和正常对照组显著增加(P＜0.01);心肌细胞释放LDH明显增高(P＜0．01),单纯缺氧组与正常对照组相比无显著差异(P＞0．05)。加入抗ICAM-1单抗和抗LFA-1单抗后,缺氧/复氧组与心肌细胞粘附的中性粒细胞数较正常对照组显著降低(P<0．01),心肌细胞释放LDH也明显下降(P＜0．01)。缺氧组与正常对照组相比则无显著差异(P＞0.05)。结论缺氧/复氧使心肌细胞与中性粒细胞粘附效应增加,心肌细胞损伤加重,ICAM-1和LFA-1参与这一过程。抗ICAM-1和抗LFA-1单抗可减轻中性粒细胞对缺氧/复氧心肌细胞的损伤。     

The effects of the nitric oxide donor SIN-1 on ischemia-reperfused cutaneous and myocutaneous flaps

Ischemia-reperfusion injury causes tissue damage that leads to a decrease in bioavailability of nitric oxide. The authors hypothesized that an exogenous supply of nitric oxide will have beneficial effects on survival of skin and skeletal muscle subjected to ischemia-reperfusion injury. By using the nitric oxide donor SIN-1 (3-morpholino-sydnonimine) the effects of direct intraarterial infusion of an exogenous source of nitric oxide in reperfused flaps was studied. Bilateral island buttock skin flaps and latissimus dorsi myocutaneous flaps were elevated in eight pigs, for a total of 32 flaps. Flaps were subjected to 6 hours of ischemia followed by 18 hours of reperfusion. Flaps on one side of each animal were randomized to be treated with the nitric oxide donor (treatment group). The contralateral side was treated with an equivalent volume of saline vehicle (infusion control) SIN-1, or saline was administered as a continuous direct intraarterial infusion at the onset of reperfusion and continued during the observation period. Outcomes measured were tissue neutrophil accumulation by using myeloperoxidase assay and tissue survival (intravenous fluorescein and nitroblue tetrazolium for skin and muscle, respectively). In both skin and myocutaneous flaps, SIN-1 treatment caused a significant improvement in survival and a decrease in neutrophil accumulation. Nitric oxide may play an important role in the pathophysiologic process of ischemia-induced reperfusion injury in skin and skeletal muscle. Nitric oxide donors may be a promising family of therapeutic agents for the prevention of ischemia-induced reperfusion injury in cutaneous and myocutaneous flaps.     

The impact of L-NAME and L-arginine chronic toxicity induced lesions on ascites--pulmonary hypertension syndrome development in broiler chickens

The impact of L-arginine (LA), a precursor for synthesis of nitric oxide (NO), and N-omega-nitro-L-arginine methyl ester (L-NAME, LN), a non-selective inhibitor of the enzyme producing nitric oxide (nitric oxide synthase; NOS) chronic toxicity induced lesions on Ascites - Pulmonary hypertension syndrome (PHS) development was investigated in 140 one-day-old male broiler chickens (ROSS) during the first 5 weeks of life. Every second day the animals were treated intraperitoneally (ip) with L-NAME (10 mg/kg of body weight; BW), L-arginine (100 mg/kg BW), L-arginine and L-NAME in combination (100 mg/kg BW and 10 mg/kg BW respectively), and with physiological saline (0.90% w/v of NaCl; 0.5 mL/kg BW). Seven birds from each group were euthanized every week. The histopathological examination of the heart, the liver, the lungs, the blood vessels and the lymphoid organs, was performed. Also the organ index values were determined. At the end of the experiment the pre-ascitic condition or ascites - PHS was confirmed in five dead animals in the L-NAME-treated group. In the same group the edema was the most prominent histopathological change confirmed in the heart and in the lungs of the sacrificed chickens. In L-arginine-treated group the congestion and the haemorrhages were the striking changes in the same organs with the highest degree in the last two weeks of trial. While the focal disruption of myocardiofibriole and hepatocytes were predominant lesions in L-NAME-treated chickens (5th and 4th weeks, respectively), in L-NAME/L-arginine-treated group only the mild focal myocardial degeneration was seen. According to the most of the results of present investigation, it was concluded that the consecutive treatment with L-NAME provoked ascites - PHS, while L-arginine has protective effect in this animal model of disease.     

Presence and activity of nitric oxide synthase isoforms in ischemia-reperfusion-injured flaps

Nitric oxide is produced from the amino acid L-arginine by nitric oxide synthase, which has three known isoforms: (1) endothelial nitric oxide synthase and (2) brain nitric oxide synthase, both of which are constitutive nitric oxide synthase; and (3) inducible nitric oxide synthase. The authors' hypothesis is that after reperfusion injury, endothelial cell dysfunction leads to disruption of nitric oxide synthase-mediated nitric oxide production and that this may in part explain the deleterious effects of ischemia-reperfusion injury on tissue survival and blood reflow in flaps. An experiment was designed to study the effects of ischemia-reperfusion injury on the bioactivity of all three isoforms of nitric oxide synthase. Buttock skin flaps and latissimus dorsi myocutaneous flaps were elevated in eight pigs. Flaps on one side of the animal were randomized to receive 6 hours of arterial ischemia, whereas flaps on the other side served as controls. At 6 hours of ischemia and at 1, 4, and 18 hours after reflow, tissue biopsy specimens were obtained and were processed for both constitutive nitric oxide synthase and inducible nitric oxide synthase enzyme activity on the basis of the L-citrulline assay. In addition, specimens were processed for Western blot analysis of the three isoforms. The authors' results revealed three key findings: first, there was a statistically significant (p < 0.001) decrease in constitutive nitric oxide synthase activity of ischemia-reperfusion-injured flaps as compared with controls in both skin and muscle for all time intervals measured. Second, Western blot analyses of endothelial nitric oxide synthase and brain nitric oxide synthase showed a significant decrease in the signal intensity in ischemic and reperfused tissue as compared with controls. Third, the inducible nitric oxide synthase isoform's activity and protein remained undetectable in both tissue types for all time points measured. The authors' data demonstrated that following ischemia-reperfusion injury in the pig flap model there was a disruption of constitutive nitric oxide synthase expression and activity, which may lead to decreased nitric oxide production. The significant decrease in nitric oxide synthase activity found in the current study may partly explain the mechanism of tissue damage in flaps subjected to ischemia-reperfusion injury. Knowledge of the kinetics of nitric oxide synthase activity under conditions of ischemia-reperfusion injury has important implications for the choice and timing of delivery of therapeutic agents whose goal is to increase the bioavailability of nitric oxide in reperfused tissue.     

The role of nitric oxide in remodeling of capillary network in rat interscapular brown adipose tissue after long-term cold acclimation

Cold exposure has been shown to increase blood flow in interscapular brown adipose tissue (IBAT). The aim of the present study was to evaluate the role of the L-arginine-nitric oxide (*NO) pathway on IBAT capillary network remodeling and its possible correlation with superoxide anion radical (O2(*-)). In the rats that received L-arginine (2.25%) or NG-nitro-L-arginine methyl ester (L-NAME, 0.01%) as a drinking liquid and maintained at room (22+/-1 degrees C) or low (4+/-1 degrees C) temperature for 45 days, IBAT capillaries were analyzed by stereology and observed by light and electron microscopy. Additionally, endothelial *NO synthase (eNOS) expression, nitrotyrosine immunoreactivity and both copper zinc superoxide dismutase (CuZnSOD) enzyme activity and immunohistochemical localization were examined. Stereological analyses of IBAT show that the capillary volume density, as well as capillary-to-brown adipocytes ratio, are increased in cold. L-arginine treatment increases, while L-NAME decreases both parameters, compared to respective controls. Those changes were accompanied by capillary dilatation observed by light and electron microscopy. The activity of CuZnSOD is lower in control cold-acclimated rats, as well as in both L-arginine-treated groups, when compared to control animals acclimated to room temperature. L-NAME treatment attenuates the effects both of cold and L-arginine on CuZnSOD and increases immunopositivity for CuZnSOD in room temperature-acclimated rats. Our results show that *NO induces remodeling of the IBAT capillary network by angiogenesis, and presumably that interaction with O2(*-) has a role in that modulation. The increased eNOS expression accompanied by an increased nitrotyrosine immunoreaction observed in both L-arginine-treated groups compared to corresponding controls strengthens this hypothesis.     

The Effect of Local Application of Natural Hirudin on Random Pattern Skin Flap Microcirculation in a Porcine Model

The aim of this study was to investigate the effect of local administration of hirudin in improving random pattern skin flap microcirculation in a porcine model. Five Chinese minipigs were used and six dorsal random pattern skin flaps were elevated in each animal (4 × 14 cm). All flaps (n = 30) were assigned to experimental (n = 10), control (n = 10), and sham (n = 10) groups. Flap edema measurement showed that edema in experimental flaps was more severe (P < 0.05) than either control or sham flaps. Local blood flow detection showed an increased image signal of blood flow in experimental flaps instead of an obvious avascular area in control and sham flaps. The survival area was significantly greater in experimental group (67.6 ± 2.1 %) as compared to control (45.2 ± 1.4 %) or sham (48.3 ± 1.1 %) group (P < 0.05). Our data showed that local administration of hirudin can significantly improve random pattern skin flap microcirculation in over dimensioned random pattern skin flaps in a porcine model.     

左旋精氨酸对低氧性肺动脉高压治疗作用的实验研究

目的：探讨结构型一氧化氮合酶（ｃＮＯＳ）,内皮素－１（ＥＴ－１）在低氧性肺动脉高压（ＨＰＨ）发病中的机制及左旋精氢酸（Ｌ－Ａｒｇ）对ＨＰＨ的治疗作用。方法：３０只健康雄性ＳＤ大鼠平均分为三组：正常对照组（ＮＣ组）、低氧组（ＨＰ组）、低氧左旋精氨酸治疗组（ＬＴ组）。后组每日低氧前给予２００ｍｇ／ｋｇ Ｌ－Ａｒｇ。于低氧２１ｄ检测运动血流动力学,肺组织ＮＯ、ＥＴ－１含量,肺动脉内皮ｃＮＯＳ含量的改变,     

Evaluation of the mechanism of vascular endothelial growth factor improvement of ischemic flap survival in rats

This study evaluated the effects of exogenous vascular endothelial growth factor (VEGF) on the regulation of cytokines in a rat dorsal ischemic skin flap model. Exogenous VEGF (1 microg/ml) was injected subdermally into the flaps of 12 rats before the flaps were sutured back in place. Another 12 rats with flaps received saline injections, as a control group. Biopsy specimens were obtained from the flaps treated with VEGF or saline solution, at positions 2.5, 5.5, and 8.5 cm from the distal edge of the flaps, at 12 hours (n = 6 for each group) and 24 hours (n = 6 for each group) after suturing of the flaps. Expression of cytokine, growth factor, and inducible nitric oxide synthase was measured. The results demonstrated that expression of tumor necrosis factor-alpha and nitric oxide synthase in the distal part of the VEGF-treated flaps was significantly decreased, compared with the control values, at 12 and 24 hours postoperatively. It was concluded that administration of exogenous VEGF could protect flaps from ischemia-reperfusion injury through the regulation of proinflammatory cytokines and the inhibition of cytotoxic nitric oxide production.     

Effects of L-NAME and L-arginine on ischemia-reperfusion injury in rat skeletal muscle

The involvement of nitric oxide in ischemia-reperfusion injury remains controversial and has been reported to be both beneficial and deleterious, depending on the tissue and model used. This study evaluated the effects of the nitric oxide synthase inhibitor N(G)-nitro-L-arginine-methyl ester (L-NAME) and the substrate for nitric oxide synthase, L-arginine on skeletal muscle necrosis in a rat model of ischemia-reperfusion injury. The rectus femoris muscle in male Wistar rats (250 to 500 g) was isolated on its vascular pedicle and subjected to 4 hours of complete arteriovenous occlusion. The animals were divided into five groups: (1) sham-raised control, no ischemia, no treatment (n = 6); (2) 4 hours of ischemia (n = 6); (3) vehicle control, 4 hours of ischemia + saline (n = 6); (4) 4 hours of ischemia + L-arginine infusion (n = 6); and (5) 4 hours of ischemia + L-NAME infusion (n = 6). The infusions (10 mg/kg) were administered into the contralateral femoral vein beginning 5 minutes before reperfusion and during the following 30 to 45 minutes. Upon reperfusion, the muscle was sutured in its anatomic position and all wounds were closed. The percentage of muscle necrosis was assessed after 24 hours of reperfusion by serial transections, nitroblue tetrazolium staining, digital photography, and computerized planimetry. Sham (group 1) animals sustained baseline necrosis of 11.9 +/- 3.0 (percentage necrosis +/- SEM). Four hours of ischemia (group 2) significantly increased necrosis to 79.2 +/- 1.4 (p < 0.01). Vehicle control (group 3) had no significant difference in necrosis (81.17 +/- 5.0) versus untreated animals subjected to 4 hours of ischemia (group 2). Animals treated with L-arginine (group 4) had significantly reduced necrosis to 34.6 +/- 7.5 versus untreated (group 2) animals (p < 0.01). Animals infused with L-NAME (group 5) had no significant difference in necrosis (68.2 +/- 6.7) versus untreated (group 2) animals. L-Arginine (nitric oxide donor) significantly decreased the severity of muscle necrosis in this rat model of ischemia-reperfusion injury. L-arginine is known to increase the amount of nitric oxide through the action of nitric oxide synthase, whereas L-NAME, known to inhibit nitric oxide synthase and decrease nitric oxide production, had comparable results to the untreated 4-hour ischemia group. These results suggest that L-arginine, presumably through nitric oxide mediation, appears beneficial to rat skeletal muscle subjected to ischemia-reperfusion injury.     

Effects of L-arginine and NG-nitro L-arginine methyl ester (L-NAME) on ischemia/reperfusion injury of skeletal muscle, small and large intestines

This study analyzed the effects of L-arginine and non-specific nitric oxide (NO) synthase blocker (L-NAME) on structural and metabolic changes in experimental ischemia/reperfusion injury in the rat. Histopathological evaluation of rat tissues after reperfusion was also performed. The animals were divided into four groups: [1] nonischemic control, [2] ischemia 4 hrs/repefusion 30, 60, 120 min, [3] ischemia/reperfusion after L-arginine administration, [4] ischemia/reperfusion, after L-arginine, and L-NAME. L-arginine (500 mg/kg) and L-NAME (75 micromol/rat/day) were administrated orally for 5 days before experiment. Concentrations of free radicals, CD-62P, CD-54 and malonyl dialdehyde (MDA) in tissues, and MDA and NO levels in sera were determined. Free radical levels significantly increased in reperfused skeletal muscle, small and large intestines. In large bowel, reperfusion increased MDA levels and evoked a rise of endotoxin level while NO levels decreased. Histological studies showed an increase in the number of lymphocytes in both intestines. Administration of L-arginine reduced leukocyte adherence associated with ischemia-repefusion injury, decreased the levels of free radicals and MDA in the examined tissues, and inhibited the release of endotoxins into blood. L-arginine-treated animals showed higher serum NO levels and reduced leukocyte bowel infiltration. Concomitant L-NAME administration reduced serum NO and tissue free radical [corrected] levels, but did not affect intestinal leukocyte infiltration. L-arginine could ameliorate intestinal ischemia/reperfusion injury and constitute a possible protective mechanism by decreasing neutrophil-endothelial interactions, stimulating free radical scavenging and reducing lipid peroxidation.     

What Happened if Various Kinds of Postconditioning Working on the Preconditioned Ischemic Skin Flaps

Objective: Ischemic pre-conditioning and post-conditioning are useful manipulations to reduce the undesirable effects of ischemia-reperfusion skin flap each. But the impact of post-conditioning on the pre-conditioning skin flap is not manifested. Here we investigated the influence of ischemic post-conditioning in a preconditioned axial pattern skin flap model.Method: We used the skin flap in 40 rabbits and divided them into 5 groups randomly. At first we induced the ischemic pre-conditioning of the flap which was applied by 2 periods of 15 minutes of ischemia/15 minutes of reperfusion cycle. Next post-conditioning was performed by 6 cycles of 10 seconds of repeated ischemia/reperfusion periods at different times of just after the reperfusion,5 minutes after the reperfusion,10 minutes after the reperfusion. The animals were allocated into 5 groups: group 1 (Ischemia Group); group 2: (Pre-conditioning Group); group 3: (Pre-conditioning+ Post-conditioning Group); group 4 (Pre-conditioning+ Post-conditioning 5 minutes later Group); group5 (Pre-conditioning+ Post-conditioning 10 minutes later). The neutrophil count was assessed with histologic analysis before the dissection of the skin flap. Flap viability was assessed 1 week after the operation, and surviving flap area was recorded as a percentage of the whole flap area. LSD test was used for statistical analysis among different groups to evaluate the effects of ischemic pre-conditioning against ischemia.Result: Among the varying groups, the neutrophil count varied: Group 1 was50.12±5.91; Group 2, 30.00±2.00, and Group 3, 18.87±3; Group 4, 22.50±1.92; Group 5, 30.12±1.88.The mean± SD surviving areas of the flaps for groups 1, 2, 3, 4 and 5 were 31.76±4.59, 51.26±3.24,82.18±5.28,66.85±3.87 and 51.13±2.90 respectively. Spearman correlation analysis shows an increase relation between neutrophil count and flap survival rate in the different groups (P <0.05).Conclusion: Ischemic post-conditioning has protective effect on ischemic preconditioned skin flaps, but the post-conditioning should be performed within 5 minutes after the end of ischemia.