The bronchial tree,lobular division,and blood vessels of the lung of the silvered lutong (Presbytis cristata)

The lungs of three silvered lutongs (Presbytis cristata) were examined. The right and left lungs have the dorsal, lateral, ventral, and medial bronchiole systems, which arise from the corresponding sides of both bronchi, respectively. Bronchioles in the dorsal and lateral bronchiole systems are well developed, whereas those in the ventral and medial bronchiole systems are poorly developed and lack some portions. According to the fundamental structure of bronchial ramifications of the mammalian lung (Nakakuki, 1975, 1980), the right lung consists of the upper, middle, lower, and accessory lobes, whereas the left lung consists of a bilobed middle lobe and a lower lobe, in which the right upper lobe is extremely well developed. The right pulmonary artery runs across the ventral side of the right upper lobe bronchiole, and then across the dorsal side of the right middle lobe bronchiole. Initially it runs along the lateral side of the right bronchus and then gradually comes to run along the dorsal side. During its course, it gives off branches which run mainly along the dorsal or lateral side of the bronchiole. The left pulmonary artery runs across the dorsal side of the left middle lobe bronchiole, and then follows the same course as that in the right lower lobe. The pulmonary veins run medially or ventrally to the bronchioles, and finally enter the left atrium as four or five large veins.     

Properties of the ATP-sensitive K+ current activated by levcromakalim in isolated pulmonary arterial myocytes

Tension and patch clamp recording techniques were used to investigate the relaxation of rabbit pulmonary artery and the properties of the K⁺ current activated by levcromakalim in isolated myocytes. Under whole-cell voltage clamp, holding at –60 mV in symmetrical 139 mm K⁺, levcromakalim (10 m) induced a noisy inward current of –116 ± 19 pA (n = 13) which developed over 1 to 2 min. This current could be blocked by either glibenclamide (10 m) or phencyclidine (5–50 M) and was unaffected when extracellular Ca²⁺ was removed. Both these drugs inhibited the levcromakalim-induced relaxation of muscle strips precontracted with 20 mm [K⁺] _o . Application of voltage ramps in symmetrical 139 mm K⁺ confirmed that the levcromakalim-induced current was carried by K⁺ ions and was weakly voltage dependent over the potential range from –100 to +40 mV.The unitary current amplitude and density of the channels underlying the levcromakalim-activated whole-cell K⁺ current was estimated from the noise in the current record. We estimate that levcromakalim caused activation of around 300 channels per cell, with a single channel current of 1.1 pA, corresponding to a slope conductance of about 19 pS. Furthermore, cells dialyzed with an ATP-free pipette solution developed a large noisy inward current at –60 mV, which could subsequently be blocked by flash photolysis of caged ATP. Analysis of the noise associated with this current indicated that the single channel amplitude underlying the ATP-blocked current was 1.4 pA, a value similar to that estimated for the levcromakalim-induced current. We conclude that the conductance of this ATP-sensitive channel is likely to be small under physiological conditions and that it is present at low density.We thank SmithKline & Beecham for the gift of levcromakalim, ICI Pharmaceuticals for the gift of charybdotoxin and Prof. D. Colquhoun for the noise analysis programs. We also thank Mr. R. Davey for technical assistance with tension experiments. This work was supported by the British Heart Foundation and the Wellcome Trust. L.H.C. is a Wellcome Research Fellow and P.L. is an intermediate fellow of the BHF.     

血清GDF-15、hs-cTnT对冠状动脉旁路移植术后新发房颤及近期主要心血管事件的预测效能研究

摘要 目的：分析血清生长分化因子15（GDF-15）、高敏心肌肌钙蛋白T（hs-cTnT）对冠状动脉旁路移植术后新发心房颤动（房颤）及近期主要心血管事件的预测效能。方法：选择自2020年1月至2022年1月在我院行冠状动脉旁路移植术的140例冠心病患者作为研究对象,根据术后是否新发房颤,分为房颤组（46例）和非房颤组（94例）。检测两组术前血清GDF-15、hs-cTnT水平,使用多因素Logistic回归分析血清GDF-15、hs-cTnT与术后新发房颤的关系;随访6个月,观察主要心血管事件发生情况,通过受试者工作特征曲线下面积（AUC）评价血清GDF-15、hs-cTnT对术后新发房颤及近期主要心血管事件的预测效能。结果：两组患者年龄、性别、体重指数等一般资料比较无差异（P＞0.05）;房颤组SYNTAX积分高于非房颤组,差异有统计学意义(P＜0.05);房颤组血清GDF-15、hs-cTnT水平均高于非房颤组（P＜0.05）;经多因素Logistic回归分析,SYNTAX积分、血清GDF-15、hs-cTnT均是冠状动脉旁路移植术后新发房颤的独立预测因素（P＜0.05）;经ROC曲线分析,血清GDF-15联合hs-cTnT预测冠状动脉旁路移植术后新发房颤的AUC为0.933,大于SYNTAX积分的0.790,预测近期主要心血管事件的AUC为0.925,大于SYNTAX积分的0.750（P＜0.05）。结论：血清GDF-15联合hs-cTnT对冠状动脉旁路移植术后新发房颤及近期主要心血管事件均具有良好的预测效能,值得临床予以重视。     

高血压前期患者颈动脉血管弹性超声参数与左室舒张功能的关系研究

摘要 目的：研究高血压前期患者颈动脉血管弹性超声参数与左室舒张功能的关系。方法：选取2019年12月-2020年12月因血压异常于河北北方学院附属第一医院接受诊断与治疗的161例患者,根据血压水平分为高血压前期组（82例）与高血压组（79例）;另选取同期于我院体检的80例健康志愿者作为对照组。收集三组临床资料,检测生化指标与血压;通过超声诊断仪中超声射频信号血管内中膜定量分析（QIMT）与动脉僵硬度定量分析（QAS）软件测量颈动脉血管弹性超声参数[颈动脉内中膜厚度（IMT）、顺应性系数（CC）、扩张性系数（DC）、血管弹性指数（α、β）、脉搏波传导速度（PWV）];超声心动图检查左室功能指标[左室射血分数（LVEF）、左室质量指数（LVMI）、舒张早期血流速度峰值（E）/舒张晚期血流速度峰值（A）、等容舒张时间（IVRT）、舒张期减速时间（DT）];采用Pearson相关性法分析颈动脉血管弹性超声参数与心室指标的相关性。结果：三组收缩压与舒张压水平存在统计学意义（P＜0.05）。高血压前期组与高血压组IMT、α、β、PWV高于对照组,DC、CC低于对照组（P＜0.05）,且高血压前期组IMT、α、β、PWV低于高血压组,DC、CC高于高血压组（P＜0.05）。高血压前期与高血压组E/A低于对照组,IVRT、DT高于对照组（P＜0.05）,且高血压前期组E/A高于高血压组,IVRT、DT低于高血压组（P＜0.05）。经Peason相关性分析显示,IMT、α、β、PWV与E/A呈负相关,与IVRT、DT呈正相关（P＜0.05）;DC、CC与E/A呈正相关,与IVRT、DT呈负相关（P＜0.05）。结论：高血压前期患者颈动脉血管弹性功能下降,且伴有左室舒张功能受损,颈动脉血管弹性超声参数与左室舒张功能密切相关。     

血清ApoB/ApoA1比值、TG/HDL-C比值、LDH及ALP水平与冠心病患者冠状动脉病变严重程度的关系及其预测价值分析

摘要 目的：探讨血清载脂蛋白B（ApoB）/载脂蛋白A1（ApoA1）比值、三酰甘油（TG）/高密度脂蛋白胆固醇（HDL-C）比值、乳酸脱氢酶（LDH）及碱性磷酸酶（ALP）水平与冠心病（CHD）患者冠状动脉病变严重程度的关系及其预测价值。方法：选取2019年1月-2021年12月因胸痛来我院检查并收治的185例患者,根据检查结果是否为CHD分为CHD组（120例）和对照组（65例）,根据Gensini评分将CHD组分为轻度狭窄亚组36例、中度狭窄亚组55例、重度狭窄亚组29例。入院后检测血清ApoB/ApoA1比值、TG/HDL-C比值、LDH及ALP水平。采用Spearman相关系数分析CHD患者血清ApoB/ApoA1比值、TG/HDL-C比值、LDH、ALP水平与Gensini评分的相关性,采用多因素Logistic回归分析CHD的影响因素;受试者工作特征（ROC）曲线分析血清ApoB/ApoA1比值、TG/HDL-C比值、LDH及ALP水平对CHD的预测价值。结果：与对照组比较,CHD组吸烟、饮酒、高血压、糖尿病比例和血清总胆固醇（TC）、TG、低密度脂蛋白胆固醇（LDL-C）、ApoB、ApoB/ApoA1比值、TG/HDL-C比值、LDH、ALP水平升高,HDL-C、ApoA1水平降低（P＜0.05）。轻度、中度、重度狭窄亚组血清ApoB/ApoA1比值、TG/HDL-C比值、LDH及ALP水平依次升高（P＜0.05）。CHD患者血清ApoB/ApoA1比值、TG/HDL-C比值、LDH、ALP水平与Gensini评分呈正相关（P均＜0.001）。多因素Logistic回归分析显示,高血压、血清ApoB/ApoA1比值、TG/HDL-C比值、LDH、ALP水平升高为CHD的独立危险因素（P＜0.05）。ROC曲线分析显示,血清ApoB/ApoA1比值、TG/HDL-C比值、LDH及ALP水平联合预测CHD的曲线下面积大于单独预测（P＜0.05）。结论：血清ApoB/ApoA1比值、TG/HDL-C比值、LDH、ALP水平与CHD患者冠状动脉病变严重程度有关,且联合预测CHD的价值较高。     

基于老年综合评估结果指导治疗对老年冠心病患者心功能、脂代谢和生活质量的影响

摘要 目的：探讨基于老年综合评估结果指导（CGA）治疗对老年冠心病患者心功能、脂代谢和生活质量的影响。方法：本次研究将2020年6月-2022年1月在江苏省人民医院心血管内科接受治疗的106例老年冠心病患者,采用随机数字法将其随机分为对照组（常规药物治疗,53例）与研究组（对照组的基础上结合CGA治疗,53例）。对比两组疗效、心功能、脂代谢和生活质量相关情况。结果：研究组的临床总有效率为94.34%,明显高于对照组的79.25%（P<0.05）。研究组治疗3个月后左心室舒张期末内径（LVEDD）、左心室收缩期末内径（LVESD）低于对照组,左心室射血分数（LVEF）高于对照组（P<0.05）。研究组治疗3个月后高密度脂蛋白胆固醇（HDL-C）高于对照组,甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）低于对照组（P<0.05）。研究组治疗3个月后病情、体力、医疗状况、一般生活、社会心理状况、工作状况各维度评分高于对照组（P<0.05）。研究组的住院期间心脏不良事件总发生率低于对照组（P<0.05）。结论：基于CGA治疗老年冠心病,可有效改善心功能、脂代谢,降低住院期间不良事件发生率,提高患者的生活质量。     

大鼠基底动脉和尾动脉平滑肌G蛋白的异质性

用离体血管收缩功能实验法分析了大鼠基底动脉（ＢＡ）和尾动脉（ＣＡ）平滑肌细胞Ｇ蛋白的异质性。结果显示,当ＢＡ和ＣＡ平滑肌被精氨酸血管加压素（ＡＶＰ）激动后,该两种血管对Ｇ蛋白非选择性激活剂ＧＴＰγＳ的收缩反应发生了相反的变化：ＢＡ对ＧＴＰγＳ的收缩增强,并且这种收缩增强不受百日咳毒素（ＰＴ,Ｇｉ和Ｇｏ抑制剂）的影响。而霍乱毒素（ＣＴ,Ｇｓ激活剂）则完全抑制这种收缩,呈单相反应。与ＢＡ相反,ＣＡ对ＧＴＰγＳ的收缩减弱,后者可被ＰＴ预温育反转为收缩增强,而且ＣＴ对这种收缩的抑制作用短暂,呈双相反应。结果提示,ＢＡ和ＣＡ平滑肌细胞介导激动剂收缩反应的Ｇ蚕白存在异质性。     

Ultrastructural localization of nitric oxide synthase and endothelin in coronary and pulmonary arteries of newborn rats

This is the first report on the ultrastructural distribution of nitric oxide synthase and endothelin immunoreactivities in the coronary and pulmonary arteries of newborn Wistar rats. The distribution of nitric oxide synthase and endothelin was investigated using pre-embedding peroxidase-antiperoxidase immunocytochemistry. In both arteries examined, positive labelling for nitric oxide synthase was localized both in the endothelium and smooth muscle, whereas positive labelling for endothelin was localized in the endothelium exclusively. In the coronary artery, approximately 80% and 55% of the endothelial cells examined were positive for nitric oxide synthase and endothelin, respectively, whereas in the pulmonary artery, 77% and 60% of the endothelial cells were positive for nitric oxide synthase and endothelin, respectively. These findings indicate that nitric oxide synthase and endothelin are colocalized in some of the endothelial cells of the newborn rat. In the endothelium, nitric oxide synthase and endothelin immunoreactivities were distributed throughout the cell cytoplasm and in association with the membranes of intracellular organelles. In smooth muscle, a relationship of nitric oxide synthase immunoreactivity to endoplasmic reticulum was observed in the pulmonary artery. In summary, in the newborn rat, endothelial cells of the coronary and pulmonary artery are rich in nitric oxide synthase (neuronal isoform) and endothelin, and it is suggested therefore that they may be substantially involved in vasomotor control of the cardiac and pulmonary circulation during early stages of postnatal development.     

缺氧促进热休克蛋白70在肺动脉平滑肌细胞中的表达

缺氧性肺动脉高压中肺动脉结构重组,中膜平滑肌细胞增殖并迁移,但机制不明。本研究观察缺氧对肺动脉平滑肌细胞（ＰＡＳＭＣ）细胞周期、ＤＮＡ合成及细胞增殖的影响,并通过观察缺氧对ＰＡＳＭＣ热休克蛋白７０（ＨＳＰ７０）表达的影响,初步探讨缺氧的作用是如何介导的。结果表明缺氧可直接或协同内皮质－１促进ＰＡＳＭＣ ＤＮＡ合成及细胞增殖,并可增加ＨＳＰ７０在ＰＡＳＭＣ中的表达。     

内皮素－1对缺氧肺动脉平滑肌细胞的增殖作用

内皮素（ＥＴ）是至今所发现的最强的内源性血管收缩肽,近年来发现ＥＴ－１能促进血管平滑肌细胞增殖。本研究表明ＥＴ－１对缺氧培养的肺动脉平滑肌细胞（ＰＡＳＭＣ）有剂量依赖的增殖作用,缺氧可促进ＰＡＳＭＣ的ＤＮＡ合成且增加ＥＴ－１的丝裂原作用。ＥＴ－１的丝裂原作用主要由其Ａ型受体（ＥＴＲ＿Ａ）所介导,ＥＴＲ＿Ａ的特异拮抗剂ＢＱ１２３可显著抑制缺氧以及缺氧与ＥＴ－１协同所产生的增殖作用,而且发现ＥＴＲ＿Ａ在缺氧培养的ＰＡＳＭＣ中的表达显著高于常氧对照组ＰＡＳＭＣ。本研究表明ＥＴ－１参与了缺氧性肺动脉结构重组,而缺氧可增强ＰＡＳＭＣ对ＥＴ－１的增殖反应性。